Role of Family Income in Predicting All-cause Deaths and Coronary Heart Disease Events Among Turkish Adults

The issue, whether the economic status at baseline in 1990 affected the development of coronary events, was investigated prospectively among participants of the Turkish Adult Risk Factor Study. Five ineome brackets had been delineated at baseline. However, since the number of paricipants in the highest bracket constituted no more than 5% of the sample, brackets 4 and S were combined, and analysis was canied out in 4 brackets. Information on the mode of death was obtained from first-degree relatives and/or the health personnel of the local health office; definite or suspect coronary heart disease (CHD) was diagnosed in survivors based on history, physical examination of the cardiovascular system and Minnesota coding of resting ECGs. Definition of CHD comprised fatal and nonfatal myocardial infa rction, stable angina and/or myocardial ischemia which had developed since the baseline survey. After having exclu ded participants with a CHD diagnosis at onset, a total of 237 deaths and 274 fatal and nonfatal CHD occurred in a mean 9.3 years' follow-up of 2648 men and women aged 20 years or over (mean age 41.6 [±5]). All-cause mortality was not found to be significantly associated with ineome brackets in a logistic regression analysis when controlled for age and gender or when three major risk factors were added to the model. Fatal and nonfatal CHD, adjusted for gender and age, exhibted a s ignificant excess in bracket 3 (p<0.047), and a significant reduction (p<0.044) in the highest bracket. Relative risk in these two ineome brackets were 1.27 and 0.77. Adding 3 major factors into the model, disclosed family ineome to be signifi cantly associated with coronary events (p<0.047) as a trend. The excess risk in bracket 3 was attenuated to nonsignificant levels and conversely RR in the highest bracket was further reduced to 0.7 (pKeywords: Coronary heart disease, family income, risk fac tors, Turkish adults