DALLAS – June 30, 2021 – A relative wealth decline in midlife increases the likelihood of a cardiac event or heart disease after age 65 JAMA cardiology.
Although the relationship between socioeconomic status and cardiovascular outcomes is well established, little research has been done into whether longitudinal changes in wealth are associated with cardiovascular health. In the study, Andrew Sumarsono, MD, an assistant professor of internal medicine at UT Southwestern, along with colleagues from Harvard-affiliated Brigham and Women’s Hospital Heart & Vascular Center and the London School of Economics, looked at cardiovascular stresses affecting monetary health can have an impact in the United States, where life expectancy between the richest 1 percent of the population and the poorest 1 percent is 10 to 15 years.
When they examined a cohort of more than 5,500 adults without cardiovascular disease, they found that middle-aged participants who experienced wealth enhancement mobility – defined as the relative increase in the total value of wealth without a primary residence – experienced lower cardiovascular health after age 65 At risk as peers of similar age. Conversely, participants who experienced downward wealth mobility in the latter parts of their careers had higher cardiovascular risk later in life. Cardiovascular events listed as endpoints include acute myocardial infarction, heart failure, cardiac arrhythmias, and stroke or cardiovascular death.
“We already know that wealth has to do with health, but we are showing that wealth development also plays a role. This means that the cardiovascular risk associated with affluence is not permanent and can be manipulated, ”says Sumarsono, faculty member in the Department of Hospital Medicine.
The researchers estimate a 1 percent increase in cardiovascular risk for every $ 100,000 an individual gains or loses. Notably, participants who started in the top 20 percent of wealth and experienced downward wealth mobility still had similar cardiovascular risk as those who remained fixed in the top quintile. However, those who started in the lower fifth of wealth accumulation and experienced increased wealth mobility had a lower cardiovascular risk than those who were fixed in the lower quintile. The investigators suspect that this could be an indication of possible inheritance protection for the richest, but not for the poorest. These results, which linked wealth changes and cardiovascular downstream events, were similar for all racial or ethnic subgroups.
“We found that regardless of basic wealth, wealth advancement mobility was associated with a lower risk of a new cardiac event or death after age 65 compared to their late middle age peers. This suggests that wealth ascension mobility may offset some of the risk involved with the economic troubles of the past, ”says Sumarsono. “We also found that the opposite was true – that people who experienced downward wealth mobility compared to their peers were at greater risk of a new cardiac event or death after 65, which may be part of the benefits associated with an earlier economic boom.
“We live in a system where people can suffer catastrophic wealth losses from situations beyond their control and wealth-building opportunities are not equally available in all ethnic or socio-economic groups,” added Sumarsono. “Policies that build resilience to and close those opportunity gaps should be a priority and can be viewed as a public health measure to improve overall health while potentially reducing racial, socio-economic and cardiovascular health inequalities.”
Via the UT Southwestern Medical Center
UT Southwestern, one of the leading academic medical centers in the country, integrates groundbreaking biomedical research with exceptional clinical care and training. The institution’s faculty has won six Nobel Prizes and includes 24 members from the National Academy of Sciences, 16 members from the National Academy of Medicine, and 13 Howard Hughes Medical Institute Investigators. The full-time faculty, with more than 2,800 employees, is responsible for breakthrough medical advances and is committed to quickly translating science-based research into new clinical treatments. UT Southwestern doctors care for more than 117,000 hospital patients, more than 360,000 emergency rooms in approximately 80 specialties, and oversee nearly 3 million outpatient visits annually.