What question did this study set out to answer?

To assess temporal trends in 10-year predicted absolute cardiovascular risk and major cardiovascular risk factors across different socioeconomic strata among US adults.

June 7, 2017JAMA CardiologyOpen Access

Income Disparities in Absolute Cardiovascular Risk and Cardiovascular Risk Factors in the United States, 1999-2014

Q: What are the key findings of this study?

High-income adults had significant decreases in predicted cardiovascular risk ≥20% from 1999 to 2014 (12.0% to 9.5%), whereas those at or below the poverty level saw no change (14.9% to 16.5%).

Q: What is the clinical evidence from this study?

Study design: Cross-Sectional. Population: Cardiovascular risk (n=17199). Intervention: High income (family income to poverty ratio ≥4) vs. At or below federal poverty level (≤1). Primary outcome: Predicted absolute cardiovascular risk ≥20% in 2011-2014 (p=≤0.02 for interaction).

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Key result

High income linked to a ~21% drop in high CV risk, while poverty shows no change.

P≤0.02 for interaction
n=17,199

Why the study?

Do temporal trends in 10-year predicted absolute cardiovascular risk and cardiovascular risk factors vary by socioeconomic status among US adults?

Population

17,199 adults aged 40 to 79 years without established cardiovascular disease from the 1999-2014 National…

Comparison

High income (family income to poverty ratio ≥4) vs Middle income or at or below the federal poverty…

Design

Cross-sectional

Authors

AOAyodele OdutayoPreventive Cardiology PGPeter GillUniversity of Toronto SSShaun ShepherdUniversity Health Network

Discussion

Member takes

Implication

Disparities in CV risk trends by income warrant targeted screening; leaves open whether interventions can close gaps in low-income adults.

Key Points

To assess temporal trends in 10-year predicted absolute cardiovascular risk and major cardiovascular risk factors across different socioeconomic strata among US adults.
Cross-sectional analysis of 17,199 adults aged 40 to 79 years without established cardiovascular disease from the 1999 to 2014 National Health and Nutrition Examination Survey.
Categorized socioeconomic status by family income-to-poverty ratio (high [≥4], middle [>1 and <4], or at/below federal poverty level [≤1]) and evaluated 10-year absolute cardiovascular risk using the pooled cohort equation alongside blood pressure, smoking status, diabetes, and total cholesterol.
Trends from 1999 to 2014 in high absolute cardiovascular risk (≥20%), mean systolic blood pressure, and current smoking varied significantly across income strata (P ≤ .02 for interaction).
High-income adults experienced significant reductions from 1999-2004 to 2011-2014 in high cardiovascular risk (12.0% [95% CI, 10.7%-13.3%] to 9.5% [95% CI, 8.2%-10.7%]; P = .003), systolic blood pressure (126.0 [95% CI, 125.0-126.9] to 122.3 [95% CI, 121.3-123.3] mm Hg; P < .001), and smoking (14.1% [95% CI, 12.0%-16.2%] to 8.8% [95% CI, 6.6%-11.0%]; P = .001).
Adults at or below the poverty level showed no significant changes from 1999-2004 to 2011-2014 in high cardiovascular risk (14.9% to 16.5%; P = .41), systolic blood pressure (127.6 to 126.8 mm Hg; P = .44), or smoking (36.5% to 36.0%; P = .87), while diabetes and total cholesterol trends did not vary by income.

Study Design

Type

Cross-Sectional (n=17,199)

Structured PICO

Do temporal trends in 10-year predicted absolute cardiovascular risk and cardiovascular risk factors vary by socioeconomic status among US adults?

Population

17,199 adults aged 40 to 79 years without established cardiovascular disease (8,828 women and 8,371 men; mean age 54.4 years) from the 1999-2014 National Health and Nutrition Examination Survey.

Intervention

High income (family income to poverty ratio ≥4)

Comparator

Middle income (>1 and <4) or at or below the federal poverty level (≤1)

Outcome

Temporal trends in 10-year predicted absolute cardiovascular risk (using pooled cohort equation) and 4 risk factors (systolic blood pressure, smoking status, diabetes, and total cholesterol)surrogate

Main Result

Absolute Event Rate: 9.5% vs 16.5%

p-value: p=≤0.02 for interaction

Improvements in cardiovascular risk and risk factors in the US between 1999 and 2014 have been concentrated among high-income adults, with no significant improvements seen among those at or below the poverty level.

Cite This Study

Odutayo et al. (2017) conducted a cross-sectional in Cardiovascular risk (n=17,199). High income (family income to poverty ratio ≥4) vs. At or below federal poverty level (≤1) was evaluated on Predicted absolute cardiovascular risk ≥20% in 2011-2014 (p=≤0.02 for interaction). High-income adults had significant decreases in predicted cardiovascular risk ≥20% from 1999 to 2014 (12.0% to 9.5%), whereas those at or below the poverty level saw no change (14.9% to 16.5%).

synapsesocial.com/papers/6a0e4eca55003e511e78d414 https://doi.org/10.1001/jamacardio.2017.1658

Topics

Women and heart disease Hypertension management

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Implication

Disparities in CV risk trends by income warrant targeted screening; leaves open whether interventions can close gaps in low-income adults.

Income Disparities in Absolute Cardiovascular Risk and Cardiovascular Risk Factors in the United States, 1999-2014

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

Income Disparities in Absolute Cardiovascular Risk and Cardiovascular Risk Factors in the United States, 1999-2014

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Also Consider

Topics

Also Consider