Key result
Great Recession linked to ~9 mm Hg higher persistent systolic blood pressure long-term.
Why the study?
Multiple cohort studies documented elevations in cardiovascular risk factors after the Great Recession, but it is unclear whether these changes persist or reverse over time.
Cohort (n=3,101)
Yes
Mean Difference: 8.6 (95% CI 5.9–11.4)
Post-Great Recession increases in cardiovascular risk factors, including blood pressure, blood glucose, and CRP, persisted and worsened 8-10 years later, highlighting the long-term deleterious health effects of macroeconomic shocks.
May indicate sustained post-recession cardiovascular risk; leaves open causal economic effects in longitudinal cohorts.
Objective Multiple prospective cohort studies, including the multi-ethnic study of atherosclerosis (MESA), have documented elevations in cardiovascular risk factors after the Great Recession (GR) of 2008, despite other studies that report mortality declines after the GR. It is possible that the deleterious effects of the GR on cardiovascular risk profiles are short-lived and reversed. We examine whether risk factor elevations seen in MESA in the 2010–2011 wave persist into the 2016–2018 wave of data collection. Design Individual fixed effects (IFE) analysis of prospective cohort data from MESA, with rate of change in the risk factor (from wave 2 to later waves) as the dependent variable, effectively controlling for individual-specific linear trends in ageing and all time-invariant characteristics. Models included controls for time-varying characteristics. Setting Communities centred around Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York City, New York; and St. Paul, Minnesota. Participants All MESA participants who participated in at least two pre-GR waves and both post-GR waves; n=3101 (47% men, 25% African American, 21% Hispanic, 13% Asian). Outcomes Primary: Systolic blood pressure (SBP), pulse pressure (PP), fasting blood glucose, serum C-reactive protein (CRP). Secondary: Serum low density lipoprotein cholesterol (LDL-C) and Body Mass Index (BMI) Results Mean SBP and PP in 2016–2018 were greater by 8.6 (95% CI 5.9 to 11.4) and 8.0 (95% CI 6.0 to 9.9) mm Hg, respectively, than predicted by individual-specific pre-GR linear ageing trends, and fasting blood glucose was 6.3% higher (95% CI 4.6 to 8.1). In comparison, corresponding increases in 2010–2011 were 2.5 and 3.0 mm Hg and 3.3%. CRP increased by 29.7% (95% CI 21.8 to 38.2) in 2010–2011 and 45.1% (95% CI 28.3 to 64.2) in 2016–2018. Mean BMI did not change in 2010–2011 but decreased by 0.5 kg/m 2 (95% CI −0.7 to −0.2) in 2016–2018. LDL-C decreased by 4.4 (95% CI −6.5 to −2.2) and 5.2 (95% CI −9.5 to −0.9) mg/dL in the two post-GR waves. Conclusions and relevance Post-GR increases in blood pressure, blood glucose and CRP in the USA not only persisted for 8–10 years after the GR but also grew in magnitude. In contrast, mean BMI and mean LDL-C reduced post-GR. Further studies are needed to uncover mechanisms (behavioural or otherwise) underlying the BMI and LDL-C reductions seen here, and the mortality consequences of these risk factor changes.
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Karlamangla et al. (2026) conducted a cohort in Cardiovascular risk factors (n=3,101). The Great Recession (2008) vs. Pre-recession individual-specific linear ageing trends was evaluated on Systolic blood pressure (MD 8.6 mm Hg, 95% CI 5.9 to 11.4). The Great Recession was associated with persistent increases in systolic blood pressure by 8.6 mm Hg (95% CI 5.9-11.4) and worsened blood glucose and CRP levels 8-10 years later.
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