Family income and cardiovascular disease risk in American adults
Abstract Socioeconomic status is an overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend greater CVD risk. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American...
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| Format: | Article |
| Language: | English |
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Nature Portfolio
2023-01-01
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| Series: | Scientific Reports |
| Online Access: | https://doi.org/10.1038/s41598-023-27474-x |
| _version_ | 1797958697506308096 |
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| author | Abdul Mannan Khan Minhas Vardhmaan Jain Monica Li Robert W. Ariss Marat Fudim Erin D. Michos Salim S. Virani Laurence Sperling Anurag Mehta |
| author_facet | Abdul Mannan Khan Minhas Vardhmaan Jain Monica Li Robert W. Ariss Marat Fudim Erin D. Michos Salim S. Virani Laurence Sperling Anurag Mehta |
| author_sort | Abdul Mannan Khan Minhas |
| collection | DOAJ |
| description | Abstract Socioeconomic status is an overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend greater CVD risk. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American adults. This retrospective analysis included data from participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Family income to poverty ratio (PIR) was calculated by dividing family (or individual) income by poverty guidelines specific to the survey year and used as a measure of socioeconomic status. The association of PIR with the presence of cardiovascular risk factors and CVD as well as cardiac mortality and all-cause mortality was examined. We included 35,932 unweighted participants corresponding to 207,073,472 weighted, nationally representative participants. Participants with lower PIR were often female and more likely to belong to race/ethnic minorities (non-Hispanic Black, Mexican American, other Hispanic). In addition, they were less likely to be married/living with a partner, to attain college graduation or higher, or to have health insurance. In adjusted analyses, the prevalence odds of diabetes mellitus, hypertension, coronary artery disease (CAD), congestive heart failure (CHF), and stroke largely decreased in a step-wise manner from highest (≥ 5) to lowest PIR (< 1). In adjusted analysis, we also noted a mostly dose-dependent association of PIR with the risk of all-cause and cardiac mortality during a mean 5.7 and 5.8 years of follow up, respectively. Our study demonstrates a largely dose-dependent association of PIR with hypertension, diabetes mellitus, CHF, CAD and stroke prevalence as well as incident all-cause mortality and cardiac mortality in a nationally representative sample of American adults. Public policy efforts should be directed to alleviate these disparities to help improve cardiovascular outcomes in vulnerable groups with low family income. |
| first_indexed | 2024-04-11T00:22:40Z |
| format | Article |
| id | doaj.art-2d8e6cde9ac44e6f9e6064a6dc142b73 |
| institution | Directory Open Access Journal |
| issn | 2045-2322 |
| language | English |
| last_indexed | 2024-04-11T00:22:40Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | Scientific Reports |
| spelling | doaj.art-2d8e6cde9ac44e6f9e6064a6dc142b732023-01-08T12:10:57ZengNature PortfolioScientific Reports2045-23222023-01-0113111010.1038/s41598-023-27474-xFamily income and cardiovascular disease risk in American adultsAbdul Mannan Khan Minhas0Vardhmaan Jain1Monica Li2Robert W. Ariss3Marat Fudim4Erin D. Michos5Salim S. Virani6Laurence Sperling7Anurag Mehta8Department of Medicine, Forrest General HospitalEmory Clinical Cardiovascular Research Institute, Emory University School of MedicineDepartment of Medicine, Emory University School of MedicineDepartment of Medicine, Brigham and Women’s HospitalDivision of Cardiology, Duke University Medical CenterDivision of Cardiology, Johns Hopkins University School of MedicineMichael E. DeBakey Veterans Affair Medical Center and Section of Cardiovascular Research, Department of Medicine, Baylor College of MedicineEmory Clinical Cardiovascular Research Institute, Emory University School of MedicineVCU Health Pauley Heart Center, Virginia Commonwealth University School of MedicineAbstract Socioeconomic status is an overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend greater CVD risk. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American adults. This retrospective analysis included data from participants aged ≥ 20 years from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Family income to poverty ratio (PIR) was calculated by dividing family (or individual) income by poverty guidelines specific to the survey year and used as a measure of socioeconomic status. The association of PIR with the presence of cardiovascular risk factors and CVD as well as cardiac mortality and all-cause mortality was examined. We included 35,932 unweighted participants corresponding to 207,073,472 weighted, nationally representative participants. Participants with lower PIR were often female and more likely to belong to race/ethnic minorities (non-Hispanic Black, Mexican American, other Hispanic). In addition, they were less likely to be married/living with a partner, to attain college graduation or higher, or to have health insurance. In adjusted analyses, the prevalence odds of diabetes mellitus, hypertension, coronary artery disease (CAD), congestive heart failure (CHF), and stroke largely decreased in a step-wise manner from highest (≥ 5) to lowest PIR (< 1). In adjusted analysis, we also noted a mostly dose-dependent association of PIR with the risk of all-cause and cardiac mortality during a mean 5.7 and 5.8 years of follow up, respectively. Our study demonstrates a largely dose-dependent association of PIR with hypertension, diabetes mellitus, CHF, CAD and stroke prevalence as well as incident all-cause mortality and cardiac mortality in a nationally representative sample of American adults. Public policy efforts should be directed to alleviate these disparities to help improve cardiovascular outcomes in vulnerable groups with low family income.https://doi.org/10.1038/s41598-023-27474-x |
| spellingShingle | Abdul Mannan Khan Minhas Vardhmaan Jain Monica Li Robert W. Ariss Marat Fudim Erin D. Michos Salim S. Virani Laurence Sperling Anurag Mehta Family income and cardiovascular disease risk in American adults Scientific Reports |
| title | Family income and cardiovascular disease risk in American adults |
| title_full | Family income and cardiovascular disease risk in American adults |
| title_fullStr | Family income and cardiovascular disease risk in American adults |
| title_full_unstemmed | Family income and cardiovascular disease risk in American adults |
| title_short | Family income and cardiovascular disease risk in American adults |
| title_sort | family income and cardiovascular disease risk in american adults |
| url | https://doi.org/10.1038/s41598-023-27474-x |
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