[lifestyle] Poor socioeconomic status, unhealthy lifestyle confer higher mortality, CVD risk

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Patients with low socioeconomic status and unhealthy lifestyles had elevated risk for mortality and incident CVD, researchers reported.

“Studies found that individual lifestyle factors might mediate the associations between single socioeconomic factors and health; however, the results are not consistent, and to what extent lifestyle factors mediate the associations of overall socioeconomic status with mortality and incident CVD remains unclear,” Yan-Bo Zhang, PhD student in the department of epidemiology and biostatistics, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, and colleagues wrote.

 

The researchers analyzed 44,462 U.S. adults aged 20 years or older and 399,537 U.K. adults aged 37 to 73 years. Mean follow-up was 11 years.

Participants with low socioeconomic status (SES) had higher risks for mortality and CVD, whereas overall lifestyle accounted for 3% to 12.3% of the excess risks.

According to the researchers, among adults of low SES, the age-adjusted risk for death was 22.5 per 1,000 person-years (95% CI, 21.7-23.3) in the U.S. cohort and 7.4 per 1,000 person-years (95% CI, 7.3-7.6) in the U.K. cohort.

The researchers found that compared with adults of high SES, those of low SES had elevated risk for all-cause mortality (HR in U.S. cohort = 2.13; 95% CI, 1.9-2.38; HR in U.K. cohort = 1.96; 95% CI, 1.87-2.06), CVD mortality (HR in U.K. cohort = 2.25; 95% CI, 2-2.53) and incident CVD (HR in U.K. cohort = 1.65; 95% CI, 1.52-1.79).

According to the researchers, adults with low SES and no or one healthy lifestyle factors had elevated risk for poor outcomes compared with adults with high SES (HR for all-cause mortality in U.S. cohort = 3.53; 95% CI, 3.01-4.14; HR for all-cause mortality in U.K. cohort = 2.65; 95% CI, 2.39-2.94 ; HR for CVD mortality in U.K. cohort = 2.65; 95% CI, 2.09-3.38; HR for incident CVD in U.K. cohort = 2.09; 95% CI, 1.78-2.46).

The researchers also found that each additional healthy lifestyle factor was associated with 11% to 17% lower risks for mortality and incident CVD.

“Individuals with disadvantaged SES and unhealthy lifestyles had the highest risks of mortality and incident CVD, which highlights the importance of lifestyle modification in reducing disease burden for all people, especially those of low SES,” the researchers wrote.