Longitudinal Associations Between Income Changes and Incident Cardiovascular Disease
Key result
A household income drop of >50% over 6 years was associated with a higher risk of incident CVD (HR 1.17; 95% CI 1.03-1.32), whereas an income rise of >50% was associated with a lower risk (HR 0.86).
Why the study?
Higher income is linked to lower incident cardiovascular disease, but research examining the association between changes in income and subsequent CVD risk was limited.
Does a change in household income affect the risk of incident cardiovascular disease in community-dwelling adults?
Population
8989 community-dwelling men and women from 4 US centers
Comparison
Household income drop >50% vs income unchanged vs income rise >50%
Design
Prospective cohort study
Follow-up
Mean 17 years
Authors
Discussion
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Member takes
Implication
Income changes should not yet guide clinical decisions; leaves open whether socioeconomic interventions modify CVD risk.
Study Design
Type
Cohort (n=8,989)
Multicenter
Yes
Structured PICO
Does a change in household income affect the risk of incident cardiovascular disease in community-dwelling adults?
P
Population
8,989 community-dwelling men and women from 4 centers in the United States, mean age 53 years, 20% black, 43% men.
I
Intervention
Income drop (>50% decrease) or income rise (>50% increase) over a mean period of approximately 6 years.
C
Comparator
Income remained unchanged/changed less than 50% over the same period.
O
Outcome
Incidence of cardiovascular disease (composite of myocardial infarction, fatal coronary heart disease, heart failure, or stroke) during a mean of 17 years.composite
Main Result
Effect estimate: HR 1.17 (drop), HR 0.86 (rise) (95% CI 1.03-1.32 (drop), 0.77-0.96 (rise))
Significant changes in household income over a 6-year period are independently associated with the long-term risk of incident cardiovascular disease, highlighting the impact of social determinants on cardiovascular health.
Cite This Study
Wang et al. (2019) conducted a cohort in Incident cardiovascular disease (n=8,989). Income change (drop or rise >50%) vs. Income unchanged (<50% change) was evaluated on Incidence of CVD, including myocardial infarction, fatal coronary heart disease, heart failure, or stroke (HR 1.17 (drop), HR 0.86 (rise), 95% CI 1.03-1.32 (drop), 0.77-0.96 (rise)). A household income drop of >50% over 6 years was associated with a higher risk of incident CVD (HR 1.17; 95% CI 1.03-1.32), whereas an income rise of >50% was associated with a lower risk (HR 0.86).