Navegando por Autor "Santos, Itamar de Souza"
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Item Associations of life course socioeconomic position and job stress with carotid intima - media thickness. The brazilian longitudinal study of adult health (ELSA - Brasil).(2015) Camelo, Lidyane do Valle; Gonçalves, Luana Giatti; Chor, Dóra; Griep, Rosane Härter; Benseñor, Isabela Judith Martins; Santos, Itamar de Souza; Kawachi, Ichiro; Barreto, Sandhi MariaRationale: The association between life course socioeconomic position (SEP) and subclinical atherosclerosis is not consistent across studies. Socioeconomic adversities early in life are related to an increased probability of a low occupational grade and more stressful jobs in adulthood. However, the role of job stress in explaining the life course social gradient in subclinical atherosclerosis is unknown. Objectives: To examine whether life course SEP is associated with carotid intima-media thickness (IMT) and to investigate whether this association is partially mediated by job stress. Methods: This study used baseline data (2008e2010) for 8806 current workers from ELSAeBrasil. Maternal education, social class of first occupation and social class of current occupation were used to evaluate childhood, youth and adulthood SEP, respectively. Accumulation of risk across the life course was also evaluated. Job stress was assessed by the Swedish Demande Controle Support Questionnaire. Directed acyclic graph and linear regression models were used. Results: Low childhood SEP was associated with increased IMT only in women, but low youth and adulthood SEP were associated with higher IMT in both genders. The simultaneous adjustment for all SEP indicators showed that only adulthood SEP continued to be associated with IMT. However, higher IMT values were observed among men and women sequentially exposed to low SEP in more than one period of life. High-strain jobs and low job control were not associated with IMT independent of SEP. Conclusion: Our results support a model of the cumulative effects of exposures to SEP across the life span because the highest IMT values were observed in individuals sequentially exposed to low SEP in more than one period of life. We did not find that job stress explained the association between life course SEP and IMT, suggesting that strategies to address socioeconomic inequalities in CVD should target additional steps beyond reducing job stress.Item Life course socioeconomic adversities and 10-year risk of cardiovascular disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health.(2016) Andrade, Dayse Rodrigues de Sousa; Camelo, Lidyane do Valle; Reis, Rodrigo Citton Padilha dos; Santos, Itamar de Souza; Ribeiro, Antônio Luiz Pinho; Gonçalves, Luana Giatti; Barreto, Sandhi MariaObjectives To investigate whether life course exposure to adverse socioeconomic positions (SEP) as well as maintaining a low SEP or decreasing the SEP intra- and intergeneration was associated with an increased 10-year cardiovascular disease (CVD) risk predicted by the Framingham Risk Score. Methods This is a cross-sectional analysis of baseline data (2008–2010) of 13,544 active workers from ELSA-Brasil cohort. Maternal education, leg length, social class of first occupation and education were used to evaluate childhood, youth and adulthood SEP. Results After considering adulthood SEP, exposure to early-life low SEP remained associated with an increased 10-year CVD risk. The 10-year CVD risk also rose as the number of exposures to low SEP throughout life increased. Compared to individuals in high-stable intragenerational trajectory, those in upward, downward, or stable low trajectory presented higher 10-year CVD risk. Increasing individuals’ SEP over generation showed no increased risk of 10-year CVD risk compared to individuals in highstable trajectory. Conclusions Childhood may be a critical period for exposures to social adversities. Life course low SEP may also affect the 10-year CVD risk via accumulation of risk and social mobility.