Lifelong poverty increases heart disease risks

NEW YORK (Reuters Health) - The longer a person remains in poverty, the more likely he or she is to develop heart disease, a new study suggests.

Studies in developed countries have consistently shown that people with low incomes and less education generally have higher rates of heart disease than their more-educated, higher-income counterparts.

In this latest study, published in the American Journal of Epidemiology, researchers found that lifelong disadvantage may translate into an “accumulation of risk” for heart disease.

They found that among more than 1,800 U.S. adults in a long-term heart- health study, greater lifetime exposure to poverty was related to increasing heart disease risks. Those who were disadvantaged as children and adults were 82 percent more likely to develop heart disease than those who were comparatively well off in childhood and adulthood.

Much of the disparity seemed to be explained by higher rates of “classic” heart disease risk factors, said lead researcher Dr. Eric B. Loucks, who was at McGill University in Montreal, Canada, at the time of the study.

People who were disadvantaged throughout life were, for example, more likely to smoke or be obese, explained Loucks, who is now an assistant professor at Brown University in Providence, Rhode Island.

The study included 1,835 men and women who were followed between 1971 and 2003. During that time, 144 developed heart-artery blockages, suffered a heart attack or died from heart disease.

The researchers gave each participant a “score” for lifelong socioeconomic status -- using fathers’ education as an indicator of childhood status, and participants’ own education and job as a measure of adulthood status.

Overall, the researchers found, men and women with the greatest lifelong exposure to poverty faced the greatest heart risks.

The findings, according to Loucks and his colleagues, underscore the potential importance of heart-disease prevention and treatment in people who have faced lifelong disadvantage.

That could take two types of approaches, Loucks told Reuters Health. Improving educational and economic opportunities for Americans, he said, could eventually improve their heart health -- not only for adults today, but for future generations if parents’ education does in fact influence their children’s long-term heart risks.

In addition, Loucks noted, health professionals could do more as far as lifestyle advice and treatment of heart disease risk factors in lower-income patients.

SOURCE: American Journal of Epidemiology, April 1, 2009.