DALLAS – June 30, 2021 – Relative decline in wealth in midlife increases likelihood of a heart event or heart disease after 65, while increase in wealth between 50 and 64 is associated at a lower cardiovascular risk, according to a new study in JAMA Cardiology.
Andrew Sumarsono, MD
Although the association between socioeconomic status and cardiovascular outcomes is well established, little research has been done to determine whether longitudinal changes in wealth are associated with cardiovascular health. In the study, Andrew Sumarsono, MD, an assistant professor of internal medicine at UT Southwestern, along with colleagues from the Brigham and Women’s Hospital Heart & Vascular Center affiliated with Harvard and the London School of Economics, studied the cardiovascular toll that changes in monetary health can have on patients. United States, where there is a difference in life expectancy of 10 to 15 years between the richest 1 percent of the population and the poorest 1 percent.
Examining a cohort of over 5,500 adults without cardiovascular disease, they found that middle-aged participants who experienced upward mobility of wealth – defined as relative increases in total asset value excluding primary residence – had a lower cardiovascular risk after 65 years compared to their peers of similar age. Conversely, participants who experienced downward mobility of wealth in the later parts of their careers had higher cardiovascular risk later in life. Cardiovascular events cited as outcomes include acute myocardial infarction, heart failure, cardiac arrhythmia and stroke, or cardiac death.
“We already know that wealth is linked to health, but we show that wealth trajectories also matter. This means that the cardiovascular risk associated with wealth is not permanent and can be influenced, ”says Sumarsono, a faculty member in the Division of Hospital Medicine.
Researchers estimate a 1% change in cardiovascular risk for every $ 100,000 people gain or lose. Notably, participants who started in the top 20% and experienced downward mobility of wealth still had the same cardiovascular risk as those who stayed fixed in the top quintile. However, those who started in the bottom fifth of wealth accumulation and experienced upward mobility of wealth had lower cardiovascular risk than those set in the bottom quintile. Investigators suggest this may indicate potential inheritance protection present among the richest, but not the poorest. These findings linking wealth change and downstream cardiovascular events were similar across racial or ethnic subgroups.
“We found that, regardless of a person’s baseline wealth, upward mobility of wealth relative to peers in late middle age was associated with a lower risk of a new cardiac event or death after 65 years. This suggests that upward mobility of wealth may offset some of the risk associated with past economic hardships, ”Sumarsono says. “We also found that the reverse was true: People who experienced downward mobility of wealth relative to their peers faced a higher risk of a new cardiac event or death after age 65, potentially making up for some benefits associated with past economic prosperity.
“We live in a system where people can experience catastrophic wealth losses due to situations beyond their control and where opportunities to accumulate wealth are not equally available between racial or socio-economic groups,” adds Sumarsono. “Policies that build resilience against large losses of wealth and that fill these gaps in opportunity should be prioritized and can be viewed as a public health measure to improve overall health while potentially reducing racial, socioeconomic disparities. and cardiovascular. “
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s leading academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty has been awarded six Nobel Prizes and includes 24 members of the National Academy of Sciences, 16 members of the National Academy of Medicine and 13 researchers of the Howard Hughes Medical Institute. The full-time faculty of more than 2,800 is responsible for revolutionary medical advancements and is committed to rapidly translating science-driven research into new clinical treatments. Doctors at UT Southwestern provide care in approximately 80 specialties to more than 117,000 inpatients, more than 360,000 emergency room cases and supervise nearly 3 million outpatient visits per year.