Data suggest connection between financial strain, heart health measures
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Key takeaways:
- Adults reporting financial strain had poorer measures of CV health.
- More research is needed on the relationship between psychosocial stress and CVD.
Adults who report experiencing financial strain have lower odds of having average and optimal CV health measures, suggesting psychosocial stress can impact CVD risk, researchers reported.
The relationship between financial strain, a “toxic form of psychosocial stress,” and ideal CV health is not well established, Olatokunbo Osibogun, MBBS, MPH, PhD, assistant professor of epidemiology at the Robert Stempel College of Public Health and Social Work at Florida International University in Miami, and colleagues wrote in the American Journal of Preventive Cardiology. The researchers sought to assess whether financial strain was associated with poorer CV health among diverse adults without CVD at baseline.
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“One in three U.S. adults experiences financial strain, which is more commonly associated with low socioeconomic status,” the researchers wrote. “Moreover, low socioeconomic status is a known risk factor for poorer health outcomes, which is partly due to unhealthy lifestyles but also associated with reduced access to health care and preventive services.”
In a cross-sectional study, Osibogun and colleagues analyzed data from 6,453 adults aged 45 to 84 years who participated in the Multi-Ethnic Study of Atherosclerosis (MESA). The mean age of participants was 62 years and 53% were women. The researchers assessed financial strain via questionnaire with the questions, “Are you experiencing ongoing financial strain?” and “Has this been a problem for 6 months or more?” with responses categorized as “yes” or “no.” CV health was assessed via the American Heart Association’s Life’s Simple 7 tool, which measures smoking, BMI, physical activity, diet, total cholesterol, blood glucose and BP. An ideal Life’s Simple 7 score of 14 was calculated by assigning points to the categories of each metric (poor = 0 points; intermediate = 1 point; ideal = 2 points). Researchers estimated the association between financial strain and CV health score.
Within the cohort, 25% of respondents reported financial strain.
Those who reported financial strain had lower odds of an average CV health score (OR = 0.82; 95% CI, 0.71-0.94) and optimal CV health score (OR = 0.73; 95% CI, 0.62-0.87); however, in models adjusting for all variables, the association was only significant for optimal CV health scores, with an OR of 0.81 (95% CI, 0.68-0.97).
The researchers wrote that there are several potential mechanisms by which financial strain may worsen CV health.
“For example, financial strain is associated with psychosocial stress, which may lead to physiological dysregulation of the stress response systems,” the researchers wrote. “This dysregulation has been linked to elevated levels of serum inflammatory biomarkers such as interleukin-6, interleukin-1 beta and C-reactive protein. Furthermore, maladaptive coping strategies may mediate the association between financial strain and poor cardiovascular health through unhealthy dietary habits, lack of physical activity, and substance use disorders in addition to poor management of stress, anxiety and depression.”
The researchers noted that the data highlight the importance of promoting and preserving favorable CV health among people experiencing financial hardship.
“There is need for future longitudinal studies to examine the causal pathways between financial strain and unfavorable CV health so that effective policies and public health interventions that promote favorable CV health can be implemented,” the researchers wrote. “Additional studies could also examine how financial strain affects the updated construct of CV health that includes sleep health.”
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