The BMJ's video: Education and coronary heart disease: mendelian randomisation study

Read the full open access research: http://www.bmj.com/content/358/bmj.j3542 Staying in education is associated with a lower risk of developing heart disease, finds a study published by The BMJ today. The findings provide the strongest evidence to date that increasing the number of years that people spend in the education system may lower their risk of developing coronary heart disease by a substantial amount, say the authors. Many studies have found that people who spend more time in education have a lower risk of developing coronary heart disease. However, this association may be due to confounding from other factors, such as diet or physical activity. To date, it has been unclear if spending more time in education has any causal impact on heart disease--in other words, whether increasing education might prevent it. To better understand the nature of this association, and help inform public policy, a team of international researchers from University College London, the University of Lausanne, and the University of Oxford set out to test whether education is a risk factor for the development of coronary heart disease. They analysed 162 genetic variants already shown to be linked with years of schooling from 543,733 men and women, predominantly of European origin, using a technique called mendelian randomisation. This technique uses genetic information to avoid some of the problems that afflict observational studies, making the results less prone to confounding from other factors, and therefore more likely to be reliable in understanding cause and effect. The authors found that genetic predisposition towards more time spent in education was associated with a lower risk of coronary heart disease. More specifically, 3.6 years of additional education, which is similar to an undergraduate university degree, would be predicted to translate into about a one third reduction in the risk of coronary heart disease. Genetic predisposition towards longer time spent in education was also associated with less likelihood of smoking, lower body mass index (BMI), and a more favourable blood fat profile. And the authors suggest that these factors could account for part of the association found between education and coronary heart disease. The results remained largely unchanged after further sensitivity analyses and are in line with findings from other studies, and the effect of raising the minimum school leaving age. The authors outline some study limitations. For example, it is not fully understood how genetic variants cause changes to the length of time spent in education, and this could have introduced bias.