Cardiovascular Risk Linked with Changes in Income

Negative changes in income were associated with increased risk for incident cardiovascular disease, according a recent study in JAMA Cardiology.

Noting in their abstracting that “higher income is associated with lower incident cardiovascular disease,” the authors noted that there remains “limited research on the association between changes in incomes and incident cardiovascular disease. Drawing from the Atherosclerosis Risk in Communities (ARIC), an ongoing prospective cohort of more than 15,000 community-dwelling men and women from four U.S. centers, beginning in 1987. For the present study, the researchers followed-up through December 2016. The researchers categorized individuals based whether on household income dropped by more than 50% (income drop), remained unchanged/changed <50% (income unchanged), or increased by >50% (income rise) over a mean period of approximately six years. The primary study outcome of interest was the incidence of cardiovascular disease after ARIC visit 3, which includes myocardial infarction (MI), fatal coronary heart disease, heart failure, or stroke, over a mean of 17 years. The authors adjusted for sociodemographic variables, health behaviors, and cardiovascular disease biomarkers.

According to the study results, 8,989 participants were included in the analysis (1,820 black, 3,835 men). A total of 900 participants (10%) experienced an income drop, 6,284 (70%) saw no change in income, and 1,805 (20%) saw an income increase. After adjustment, the researchers reported that those who experienced an income drop had a significantly higher rate of incident cardiovascular disease compared with those with unchanged income (HR=1.17; 95% CI, 1.03 to 1.22). Those who saw an income increase saw their risk for incident cardiovascular disease decline compared with unchanged (HR=0.86; 95% CI, 0.77 to 0.96).

“Income drop over six years was associated with higher risk of subsequent incident cardiovascular disease over 17 years, while income rise over six years was associated with lower risk of subsequent incident cardiovascular disease over 17 years,” the authors wrote in their conclusion. “Health professionals should have greater awareness of the influence of income change on the health of their patients.”