Social, Financial Factors Critical to Assessing Cardiovascular Risk

Certain markers of a person’s financial and social status may offer valuable information about their potential risk of developing heart disease, according the findings of two studies

presented at the American College of Cardiology’s Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Researchers assessed data from 2017 on over 400,000 U.S. adults in the Behavioral Risk Factor Surveillance System. At baseline, one in 10 of the survey respondents reported having at least one form of heart disease. The researchers evaluated how respondents’ perceptions of their levels of food, housing and financial security related to their likelihood of having various forms of heart disease, including heart attack, stroke, coronary artery disease and congestive heart disease.

The findings revealed that food and housing insecurity increased the odds of heart disease by more than 50%, while health care access hardship augmented the odds by 47%. Researchers observed that people with a high degree of financial insecurity were more than twice as likely to have heart disease than those who considered themselves financially secure. “We are very focused on addressing certain cardiovascular risk factors, but we forget about factors such as food, housing and financial security that often play a major role in the development of cardiovascular disease,” said Tarang Parekh, MBBS, an assistant researcher in the Department of Health Administration and Policy at George Mason University and lead author of one of the studies in a press release. “We are not investing enough to address these issues. We [must] start addressing patients’ problems from a broader perspective in order to better reduce the toll of cardiovascular diseases.”

In a separate study, researchers evaluated the modeling tools physicians commonly use to assess cardiovascular risk. They uncovered that current prediction models fail to account for financial and social status, and likely underestimate the cardiovascular risk patients in minority groups and low-income tiers face.

“If we systematically underpredict risk, we will systematically undertreat,” said Gmerice Hammond, MD, cardiology fellow at Washington University School of Medicine and the study’s lead author. “Our study is the first to show that if you bring a robust panel of social determinant factors into the risk models, you may actually be able to improve clinical risk prediction.”


Parekh T. Impact of Social Determinants of Health and Cardiovascular Diseases. Presented at the ACC.20 World Congress of Cardiology; March 28-30, Chicago, IL.