A high burden of unfavorable social determinants of health was associated with an increased risk of major adverse cardiovascular events compared to a low burden (HR 1.18; 95% CI 1.08-1.30).
Cohort (n=38,571)
Yes
Does a high burden of unfavorable social determinants of health and poor cardiovascular health increase the risk of MACE and mortality in community-dwelling adults without cardiovascular disease?
A high burden of unfavorable social determinants of health and poor cardiovascular health are independently and jointly associated with increased risks of MACE and mortality in Chinese adults without baseline cardiovascular disease.
Effect estimate: HR 1.18 (95% CI 1.08-1.30)
Background: Limited data exist regarding the prognostic implications of social determinants of health (SDOH) and cardiovascular health (CVH) in Chinese community populations. Objectives: The aim of this study was to evaluate the associations of SDOH and CVH with major adverse cardiovascular events (MACE) and all-cause death. Methods: Individuals without cardiovascular disease were obtained from the China Patient-Centered Evaluative Assessment of Cardiac Events Million Persons Project. SDOH (educational attainment, economic stability, health care access, social support, and neighborhood) and CVH components were extracted. Participants were divided into groups with low and high burden of unfavorable SDOH and groups with poor, intermediate, and ideal CVH. MACE (a composite of coronary heart disease or myocardial infarction, stroke, heart failure, and cardiovascular death) and all-cause death were identified by linking hospital records with resident identity card number. Results: Among the cohort (n = 38,571, median age 54 years, 60.5% women), the proportion of individuals with a high burden of unfavorable SDOH was 68.9%, and that with poor CVH was 30.7%. In reference to the group with a low burden of unfavorable SDOH, the adjusted HRs for MACE and all-cause death in the high burden group were 1.18 (95% CI: 1.08-1.30) and 1.35 (95% CI: 1.09-1.68), respectively. In reference to the group with ideal CVH, poor CVH was associated with higher risks for MACE and all-cause death. A high burden of unfavorable SDOH and poor CVH exerted joint effects on all-cause death (HR: 2.20; 95% CI: 1.08-4.48). Conclusions: A high burden of unfavorable SDOH and poor CVH were associated with increased risks for MACE and mortality. Dedicated efforts are needed to address these health disparities.
Cai et al. (Tue,) conducted a cohort in Without cardiovascular disease (n=38,571). High burden of unfavorable social determinants of health vs. Low burden of unfavorable social determinants of health was evaluated on Major adverse cardiovascular events (composite of coronary heart disease or myocardial infarction, stroke, heart failure, and cardiovascular death) (HR 1.18, 95% CI 1.08-1.30). A high burden of unfavorable social determinants of health was associated with an increased risk of major adverse cardiovascular events compared to a low burden (HR 1.18; 95% CI 1.08-1.30).