According to a recent UC Davis study published online in BMC Cardiovascular Disorders, people with lower socioeconomic status are at greater risk of developing heart disease compared to those who are wealthier or better educated. The likelihood of heart disease persists, even with long-term progress in addressing traditional risk factors, such as smoking, high blood pressure and elevated cholesterol. Peter Franks, a UC Davis professor of family and community medicine and lead author of the study said:

“Being poor or having less than a high school education can be regarded as an extra risk when assessing a patient’s chances of developing cardiovascular disease.” He continued saying that, “People with low socioeconomic status need to have their heart-disease indicators managed more aggressively.”

The authors used data from the Atherosclerosis Risk in Communities Study, including more than 12,000 people between the ages of 45 to 64 years living in North Carolina, Mississippi, Minnesota and Maryland, in which participants reported their education and income levels in 1987. The participants were periodically evaluated for heart-disease diagnoses and changes in their risk factors, including cholesterol, blood pressure and smoking over the course of 10 years.

According to the results, people with lower socioeconomic status had a 50% increased risk of developing heart disease compared to other study participants.

Although it is common knowledge for people with low socioeconomic status to have a greater risk for developing heart disease and other health problems, the reason is often attributed to reduced health-care access or poor adherence to treatments, such as smoking cessation or medication.

For the first time this study revealed that the increased risk continued even though long-term improvements in other risk factors have been made, showing that access and adherence could not account for the differences. According to Franks, low socio-economic status is therefore a heart-disease risk factor on its own and needs to be regarded as such by the medical community.

He said that previous studies could help explain the association between low socioeconomic status and increased heart-disease risk. Social disadvantages and adversity in childhood could mean lasting adaptations to stress which result in more stress on the heart. Cumulative effects of social disadvantage throughout a person’s life could also cause more “wear and tear” on the cardiovascular system.

Franks recommends including socio-economic status in the Framingham risk assessment, a tool based on outcomes from the Framingham Heart Study, commonly used to determine treatments for heart-disease prevention. He commented that UK health-care providers are already considering socio-economic status for the determination of care plans. Franks, who’s research focuses on addressing health-care disparities said:

“Doctors could, for instance, moderately increase the dosage of cholesterol-lowering drugs to reflect the higher risk imposed by socioeconomic status. Changes like this would be easy to implement, and the benefits could be significant.”

Written by Petra Rattue