Abstract 12064: Low Income, Regardless of Education Level, is a Significant Independent Predictor of Incident Heart Failure in Community-Dwelling, Medicare-Eligible Older Adults
Background: Prior studies (PMID: 21147865 and 10378616) have reported variable associations between low education and incident heart failure (HF). Further, to what extent this association is mediated by income remains unclear. In the current analysis, we used a public-use copy of the Cardiovascular Health Study data obtained from the National Heart, Lung and Blood Institute to examine the associations of education and income with incident HF.
Methods: Of the 5411 community-dwelling, Medicare-eligible adults age ≥65 years with data on self-reported education and income, 5153 were free of HF at baseline. Participants were categorized into 4 groups based on education (low, <college) and income (low, <$25K annual household): high education-high income, low education-high income, high education-low income, and low education-low income.
Results: Patients had a mean (±SD) age of 72 (±6) years; 57% were women; and 15% were African American. Unadjusted, age-sex-race-adjusted and multivariable-adjusted associations of the 3 lower education-income categories (reference, high education-high income) with centrally-adjudicated incident HF during over 13 years of follow-up are displayed in the Table.
Conclusions: Despite Medicare coverage, community-dwelling older adults with low income have a significant and independent increased risk of incident HF, which apparently persisted among older adults with high education levels. Future studies need to examine the mechanisms through which income disparity influences HF risk in older Medicare beneficiaries and effective ways to mitigate them.
- © 2011 by American Heart Association, Inc.