Nov 21, 2023 - Health

How income disparities drive heart risks for middle-aged adults

Illustration of a heart rate monitor screen with the line forming a red cross.

Illustration: Brendan Lynch/Axios

Over roughly the past two decades, middle-aged adults with lower incomes were more likely to develop high blood pressure, while those with higher incomes were more likely to develop diabetes and obesity, according to a new study in the Annals of Internal Medicine.

Why it matters: Progress in preventing death from cardiovascular events like heart attack or stroke has stagnated over time, in large part because of a rise in such deaths among middle-aged Americans. The study helps illuminate how income disparities are contributing to differing risks for heart problems.

What they're saying: "We think of cardiovascular disease as a disease of older adults, and this younger, middle-aged population is overlooked," study co-author Rishi Wadhera, a cardiologist at Beth Israel Deaconess Medical Center in Boston, told Axios.

Details: The cross-sectional study of more than 20,000 middle-aged U.S. adults between 1999 and 2020 found that those earning below or just above the poverty level consistently fall within higher risk when it comes to blood pressure, diabetes, obesity and cigarette use compared to higher-income adults.

  • Rates of high blood pressure increased significantly among low-income adults, from 37.2% to 44.7%, while it remained roughly the same among higher-income adults.
  • Less green space for physical activity, worse access to medication, and stress can contribute to worse cardiovascular health for poorer adults, researchers say.
  • While the prevalence of diabetes didn't change among those with lower incomes, it nearly doubled — from 7.8 to 14.9% — among those with higher incomes.
  • Obesity rates also rose among high-income adults from 33% to 44% while remaining roughly the same among low-income adults.
  • The research suggests fast-food consumption is most prevalent among higher-income individuals, who are also more likely to work desk jobs where they're sitting for longer periods of time.

Between the lines: Previous studies found heart disease deaths rose early in the pandemic, and heart disease rates are among the top reasons men are dying earlier than women.

  • "This could eventually result in a tsunami of cardiovascular disease years down the road, which is really why we need to intensify our efforts to screen, to prevent and treat these risk factors early in life," Wadhera said.
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