S-EPMC11312363 - Multidimensional Poverty and Risk of Atherosclerotic Cardiovascular Disease: A U.S. National Study. - OmicsDI

Unknown

Dataset Information

Multidimensional Poverty and Risk of Atherosclerotic Cardiovascular Disease: A U.S. National Study.

ABSTRACT:

Background

Poverty is associated with atherosclerotic cardiovascular disease (ASCVD). While poverty can be evaluated using income, a unidimensional poverty metric inadequately captures socioeconomic adversity.

Objectives

The aim of the study was to examine the association between a multidimensional poverty measure and ASCVD.

Methods

Survey data from the National Health Interview Survey was analyzed. Four poverty dimensions were used: income, education, self-reported health, and health insurance status. A weighted deprivation score (c _i ) was calculated for each person. The multidimensional poverty index was computed for various cutoffs, k, for total population, and by ASCVD status. The association between multidimensional poverty and ASCVD was examined using Poisson regression. Area under receiver operator characteristics curve analysis was performed to compare the multidimensional poverty measure with the income poverty measure as a classification tool for ASCVD.

Results

Among the 328,164 participants, 55.0% were females, the mean age was 46.3 years, 63.1% were non-Hispanic Whites, and 14.1% were non-Hispanic Blacks. Participants with ASCVD (7.95%) experienced greater deprivation at each multidimensional poverty cutoff, k, compared to those without ASCVD. In adjusted models, higher burden of multidimensional poverty was associated with up to 2.4-fold increased prevalence of ASCVD (c _i = 0.25, adjusted prevalence ratio [aPR] = 1.66, P < 0.001; c _i = 0.50, aPR = 1.99; c _i = 0.75, aPR = 2.29; P < 0.001; c _i = 1.00, aPR = 2.38, P < 0.001). Multidimensional poverty exhibited modestly higher discriminant validity, compared to income poverty (area under receiver operator characteristics = 0.62 vs 0.58).

Conclusions

There is an association between the multidimensional poverty and ASCVD. Multidimensional poverty index demonstrates slightly better discriminatory power than income alone. Future validation studies are warranted to redefine poverty's role in health outcomes.

SUBMITTER: Butt SA

PROVIDER: S-EPMC11312363 | biostudies-literature | 2024 Jul

REPOSITORIES: biostudies-literature

altmetric image

Publications

Multidimensional Poverty and Risk of Atherosclerotic Cardiovascular Disease: A U.S. National Study.

Butt Sara Ayaz SA Retamales Mauricio Tano MT Javed Zulqarnain Z Hagan Kobina K Arshad Hassaan Bin HB Khan Safi S Acquah Isaac I Nikoloski Zlatko Z Mossialos Elias E Cainzos-Achirica Miguel M Nasir Khurram K

JACC. Advances 20240515 7

<h4>Background</h4>Poverty is associated with atherosclerotic cardiovascular disease (ASCVD). While poverty can be evaluated using income, a unidimensional poverty metric inadequately captures socioeconomic adversity.<h4>Objectives</h4>The aim of the study was to examine the association between a multidimensional poverty measure and ASCVD.<h4>Methods</h4>Survey data from the National Health Interview Survey was analyzed. Four poverty dimensions were used: income, education, self-reported health, ...[more]

Similar Datasets

Project description:BackgroundThis study aimed to investigate the relationship between the dietary intake of total flavonoids and their six subclasses and the risk of atherosclerotic cardiovascular disease (ASCVD) in adults, and to evaluate the potential mediating effect of inflammation in this association.MethodsCross-sectional data from 3841 individuals participating in the National Health and Nutrition Examination Survey 2017-2018 were included in the analysis. Flavonoid intake was assessed using a 2-day dietary recall method, and ASCVD status was determined by extracting relevant information from the medical condition questionnaire. To determine the relationship between flavonoid intake and ASCVD risk, we employed logistic regression, subgroup, mediation, and restricted cubic spline analyses.ResultsIntake of flavan-3-ols, flavones, flavonols, and total flavonoids was negatively correlated with ASCVD risk. Subgroup analysis revealed that the association between flavonoid intake and ASCVD risk exhibits sex-specific differences, with the relationship being more pronounced among women. The significant associations between increased flavonoid intake and reduced ASCVD risk were observed in smokers, non-alcohol consumers, physically inactive individuals, those with hypertension. A nonlinear relationship was observed between the intake of total flavonoids, flavan-3-ols and flavonols and ASCVD risk. Additionally, high-sensitivity C-reactive protein (hs-CRP) and the neutrophil-to-lymphocyte ratio (NLR), inflammatory markers relevant to ASCVD, were found to mediate the association between flavonoid intake and ASCVD risk. Flavonoids demonstrated a dose‒response relationship with reductions in the levels of hs-CRP and the NLR.ConclusionsThis study indicates the inverse association between flavonoid intake, particularly flavan-3-ols, flavones, and flavonols, and the risk of ASCVD. It highlights the mediating role of CRP and NLR in this relationship. Furthermore, the study emphasizes the importance of considering lifestyle factors and sex when evaluating the cardiovascular benefits of flavonoids.

Project description:Introduction: Age is a major risk factor that affects the likelihood of developing atherosclerotic cardiovascular disease (ASCVD). The anticipated 10-year ASCVD risk for nearly all individuals aged 70 years and older surpasses conventional risk thresholds. When considering treatment for risk factors, it is important to take into account ASCVD risk modifiers, such as malnutrition, polypharmacy, and comorbidities. Objectives: The aim of this study was to estimate ASCVD risk in apparently healthy (without established ASCVD) elderly persons. We also evaluated several biochemical and clinical indicators to better characterize the studied population. Patients and methods: A total of 253 elderly individuals aged 70 years and older, who were apparently healthy and did not have established atherosclerotic cardiovascular disease (ASCVD), were enrolled in the study. The Systemic Coronary Risk Estimation 2-Older Persons (SCORE2-OP) model was utilized to assess their 10-year risk of developing ASCVD. Results: Among the 253 participants, 41 (16.2%) were classified as high risk, while 212 (83.8%) were categorized as very high risk. No individuals had a low ASCVD risk (defined as less than 7.5%). The median 10-year risk of developing ASCVD for the study group was 23% (ranging from 17% to 32%). The number of individuals identified as very high risk increased significantly with age, with nearly all participants aged 75 years and older being considered very high risk. An age of 75 years or older is associated with a very high risk for ASCVD, supported by a C-statistic of 0.92, which reflects a positive predictive value (PPV) of 99% and a negative predictive value (NPV) of 52% (p < 0.001). Conclusions: Elderly individuals without established ASCVD constitute a varied group. The majority were identified as being at very high risk for ASCVD. Age and hypertension were the primary factors contributing to this risk. Furthermore, modifiers of ASCVD risk, including malnutrition, polypharmacy, and multimorbidity, were commonly observed.

Project description:BackgroundClonal hematopoiesis of indeterminate potential (CHIP), which is defined as the presence of an expanded somatic blood-cell clone in persons without other hematologic abnormalities, is common among older persons and is associated with an increased risk of hematologic cancer. We previously found preliminary evidence for an association between CHIP and atherosclerotic cardiovascular disease, but the nature of this association was unclear.MethodsWe used whole-exome sequencing to detect the presence of CHIP in peripheral-blood cells and associated such presence with coronary heart disease using samples from four case-control studies that together enrolled 4726 participants with coronary heart disease and 3529 controls. To assess causality, we perturbed the function of Tet2, the second most commonly mutated gene linked to clonal hematopoiesis, in the hematopoietic cells of atherosclerosis-prone mice.ResultsIn nested case-control analyses from two prospective cohorts, carriers of CHIP had a risk of coronary heart disease that was 1.9 times as great as in noncarriers (95% confidence interval [CI], 1.4 to 2.7). In two retrospective case-control cohorts for the evaluation of early-onset myocardial infarction, participants with CHIP had a risk of myocardial infarction that was 4.0 times as great as in noncarriers (95% CI, 2.4 to 6.7). Mutations in DNMT3A, TET2, ASXL1, and JAK2 were each individually associated with coronary heart disease. CHIP carriers with these mutations also had increased coronary-artery calcification, a marker of coronary atherosclerosis burden. Hypercholesterolemia-prone mice that were engrafted with bone marrow obtained from homozygous or heterozygous Tet2 knockout mice had larger atherosclerotic lesions in the aortic root and aorta than did mice that had received control bone marrow. Analyses of macrophages from Tet2 knockout mice showed elevated expression of several chemokine and cytokine genes that contribute to atherosclerosis.ConclusionsThe presence of CHIP in peripheral-blood cells was associated with nearly a doubling in the risk of coronary heart disease in humans and with accelerated atherosclerosis in mice. (Funded by the National Institutes of Health and others.).