U.S. adults of low socioeconomic status experienced double the incidence of heart attacks and coronary heart disease-related deaths compared to individuals of higher status. But less than half of the excess events were attributable to traditional risk factors such as cigarette smoking, high blood pressure and high cholesterol.
The computer simulation study of adults ages 35 to 64 years, published in JAMA Cardiology, defined low socioeconomic status as income below 150% of the federal poverty level or educational level of less than a high school diploma. Compared with individuals of higher status, men and women of low socioeconomic status had twice the excess risk for heart attack and twice the risk for the prevalence of coronary heart disease death. After accounting for traditional risk factors, the simulation calculated that 60% of the excess risk for heart attack and coronary heart disease death was tied to socioeconomic status.
The findings, researchers said, have important implications on doctors who should not only address traditional risk factors, but who should make themselves aware of the greater social needs of their poor patients. Similarly in a commentary about the study, George Mensah, M.D., director of NHLBI’s Center for Translation Research and Implementation Science, noted “that the time has come to also tackle the social, environmental, and socioeconomic determinants of health and associated cardiovascular health disparities.” The study was funded by NHLBI.