부산대학교 도서관

Background: Socioeconomic status is an often-overlooked risk factor for cardiovascular disease (CVD). Low family income is a measure of socioeconomic status and may portend worse CVD burden. Therefore, we assessed the association of family income with cardiovascular risk factor and disease burden in American adults.Methods: This retrospective analysis included data from participants aged ≥20 years from the National Health and Nutrition Examination Survey (NHANES) cycles between 2005 and 2018. Family income to poverty ratio (PIR) was calculated by dividing family (or individual) income by the poverty guidelines specific to the survey year and used as a measure of socioeconomic status. The association of PIR with the presence of cardiovascular risk factors and CVD as well as cardiac mortality and all-cause mortality was examined.Results: We included 35,932 unweighted participants corresponding to 207,073,472 weighted, nationally representative participants. Participants with lower PIR were often female and more likely to belong to race/ethnic minorities (non-Hispanic Black, Mexican American, other Hispanic). In addition, they were less likely to be married/living with a partner, to attain college graduation or higher, or to have health insurance. In the adjusted analysis, the prevalence odds of diabetes mellitus, hypertension, coronary artery disease (CAD), congestive heart failure (CHF), and stroke largely decreased in a step-wise manner from highest (≥5) to lowest PIR (<1) (Table 1). In the adjusted analysis, we also noted a mostly dose-dependent association of PIR with the risk of all-cause and cardiac mortality during a mean 5.7 and 5.8 years of follow up, respectively.Conclusions: Public policy efforts should be directed to alleviate these disparities to help improve cardiovascular outcomes in this vulnerable subgroup.