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May 6, 2026Circulation

Abstract TH902: Joint Impact of Social Determinants of Health Burden and Coronary Artery Disease on All-Cause and Cardiovascular Mortality: 18-Year Follow-up From National Health And Nutrition Examination Survey 2000–2018

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Key result

High SDoH burden combined with CHD is linked to a ~14-fold higher all-cause mortality risk.

  • HR 13.6
  • P<0.001
  • n=49,300,000

Why the study?

Does high social determinants of health burden increase all-cause and cardiovascular mortality in adults with and without coronary heart disease?

Population

49.3 million U.S. adults ≥20 years from the National Health and Nutrition Examination Survey 2000–2018, mean…

Comparison

High cumulative social determinants of health… vs Low SDoH burden (0-2 domains) and no CHD

Design

Cohort

Follow-up

18 years

Authors

MNMuhammad NizamTrinity HealthOKOmar KamelSouth Valley UniversityAGAnika GoelKakatiya University

Discussion

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Implication

High cumulative social determinants of health burden synergistically amplifies all-cause and cardiovascular mortality risk in adults with coronary heart disease.

Key Points

  • This research examines how social determinants of health impact mortality among adults with coronary artery disease.
  • Analyzed NHANES data from 2000-2018 for adults over 20 years old
  • Measured cumulative SDoH burden through eight domains
  • Utilized weighted Cox proportional hazards models for mortality risk estimation
  • Adjusted for demographic and cardiometabolic factors
  • Higher cumulative SDoH burden is linked to increased all-cause and cardiovascular mortality
  • Those with high SDoH burden had a 3-fold increased risk of all-cause mortality
  • Individuals with both high SDoH burden and coronary artery disease faced a nearly 14-fold increased all-cause mortality risk

Study Design

Type

Observational (n=49,300,000)

Structured PICO

Does high social determinants of health burden increase all-cause and cardiovascular mortality in adults with and without coronary heart disease?

P
Population
49.3 million U.S. adults aged ≥20 years from NHANES 2000-2018, followed for up to 18 years to evaluate the joint impact of social determinants of health and coronary heart disease on mortality.
E
Exposure
High cumulative social determinants of health (SDoH) burden (6-8 domains) and presence of coronary heart disease (CHD)
C
Comparator
Low SDoH burden (0-2 domains) and no CHD
O
Outcome
All-cause and cardiovascular mortalityhard clinical

Main Result

Hazard Ratio: 13.6

p-value: p=<0.001

High cumulative social determinants of health burden synergistically amplifies all-cause and cardiovascular mortality risk in adults with coronary heart disease.

Cite This Study

Nizam et al. (2026) conducted an observational in Coronary artery disease and Social Determinants of Health burden (n=49,300,000). High SDoH burden and CHD vs. Low SDoH burden and no CHD was evaluated on All-cause mortality (HR 13.6, p=<0.001). Compared with low social determinants of health burden and no coronary heart disease, adults with both conditions had a nearly 14-fold higher risk of all-cause mortality (HR 13.6, p<0.001).

synapsesocial.com/papers/69fa983604f884e66b531ffchttps://doi.org/10.1161/cir.153.suppl_1.th902
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