RT Journal Article SR Electronic T1 The educational gradient in coronary heart disease: the association with cognition in a cohort of 57 279 male conscripts JF Journal of Epidemiology and Community Health JO J Epidemiol Community Health FD BMJ Publishing Group Ltd SP 322 OP 329 DO 10.1136/jech-2014-204597 VO 69 IS 4 A1 Ariansen, Inger A1 Mortensen, Laust A1 Igland, Jannicke A1 Tell, Grethe S A1 Tambs, Kristian A1 Graff-Iversen, Sidsel A1 Strand, Bjørn Heine A1 Næss, Øyvind YR 2015 UL http://jech.bmj.com/content/69/4/322.abstract AB Background Independently of cardiovascular disease (CVD) risk factors, cognitive ability may account for some of the excess risk of coronary heart disease (CHD) associated with lower education. We aimed to assess how late adolescence cognitive ability and midlife CVD risk factors are associated with the educational gradient in CHD in Norway. Methods In a cohort of 57 279 men born during 1949–1959, health survey information was linked to military conscription records of cognitive ability, to national educational data, to hospitalisation records from the Cardiovascular Disease in Norway (CVDNOR) project and to the Norwegian Cause of Death Registry. Results Age and period adjusted HR for incident CHD events was 3.62 (95% CI 2.50 to 5.24) for basic relative to tertiary education, and was attenuated after adjustment; to 2.86 (1.87 to 4.38) for cognitive ability, to 1.90 (1.30 to 2.78) for CVD risk factors, and to 1.84 (1.20 to 2.83) when adjusting for both. Age and period adjusted absolute rate difference was 51 (33 to 70) incident CHD events per 100 000 person years between basic and tertiary educated, and was attenuated after adjustment; to 42 (22 to 61) for cognitive ability, to 25 (7 to 42) for CVD risk factors, and to 24 (5 to 43) when adjusting for both. Conclusions Late adolescence cognitive ability attenuated the educational gradient in incident CHD events. CVD risk factors further attenuated the gradient, and to the same extent regardless of whether cognitive ability was included or not. Cognitive ability might be linked to the educational gradient through CVD risk factors.