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- Title
Association of cumulative social risk with mortality and adverse cardiovascular disease outcomes.
- Authors
Erqou, Sebhat; Echouffo-Tcheugui, Justin B.; Kip, Kevin E.; Aiyer, Aryan; Reis, Steven E.
- Abstract
<bold>Background: </bold>Quantifying the cumulative effect of social risk factors on cardiovascular disease (CVD) risk can help to better understand the sources of disparities in health outcomes.<bold>Method and Results: </bold>Data from the Heart Strategies Concentrating on Risk Evaluation (HeartSCORE) study were used to create an index of cumulative social risk (CSR) and quantify its association with incident CVD and all-cause mortality. CSR was defined by assigning a score of 1 for the presence of each of 4 social factors: i) racial minority status (Black race), ii) single living status, iii) low income, and iv) low educational level. Hazard ratios (HRs) were computed using Cox-regression models, adjusted for CVD risk factors. Over a median follow-up period of 8.3 years, 127 incident events were observed. The incidence of the primary outcome for subgroups of participants with 0, 1, and ≥2 CSR scores was 5.31 (95% CI, 3.40-7.22), 10.32 (7.16-13.49) and 17.80 (12.94-22.67) per 1000 person-years, respectively. Individuals with CSR score of 1 had an adjusted HR of 1.85 (1.15-2.97) for incident primary outcomes, compared to those with score of 0. The corresponding HR for individuals with CSR score of 2 or more was 2.58 (1.60-4.17).<bold>Conclusion: </bold>An accumulation of social risk factors independently increased the likelihood of CVD events and deaths in a cohort of White and Black individuals.
- Subjects
UNITED States; CARDIOVASCULAR diseases risk factors; MORTALITY; RACIAL minorities; SOCIAL factors; COHORT analysis; CARDIOVASCULAR disease related mortality; BLACK people; CARDIOVASCULAR diseases; INCOME; PROGNOSIS; RISK assessment; SINGLE people; TIME; WHITE people; LOGISTIC regression analysis; SOCIOECONOMIC factors; EDUCATIONAL attainment; HEALTH equity; DISEASE incidence; CROSS-sectional method; PROPORTIONAL hazards models; KAPLAN-Meier estimator; CAROTID intima-media thickness
- Publication
BMC Cardiovascular Disorders, 2017, Vol 17, p1
- ISSN
1471-2261
- Publication type
journal article
- DOI
10.1186/s12872-017-0539-9