Abstract 17875: Association of Cumulative Social Risk With Mortality and Adverse Cardiovascular Disease Outcomes
Background: Quantification of the cumulative effect of social risk factors on cardiovascular disease (CVD) risk can provide insight into the effects of social disadvantage on and contributors to racial disparities in CVD incidence and mortality.
Methods: Data from the Heart Strategies Concentrating on Risk Evaluation (Heart SCORE) study were used to create an index of cumulative social risk (CSR) and quantify its association with incident CVD and all-cause mortality. CSR was defined by assigning a score of 1 for the presence of each of 4 social factors: i) racial minority status (Black race), ii) single living status, iii) low income, and iv) low educational level. The primary outcome was a composite of CVD events and all-cause mortality. Cox-regression models were fit to examine the associations of CSR with the incident primary outcome. We also analyzed the cross-sectional association of CSR with presence of significant subclinical atherosclerosis defined as carotid artery intima-media thickness (CIMT) >1 mm.
Results: Over a median follow-up period of 8.3 years, 127 incident events were observed. Individuals with CSR score of one had an age- and sex adjusted hazard ratio (HR) of 1.94 (95% CI 1.21, 3.11) for incident primary outcomes, compared to those with a CSR score of 0. The HR was 1.85 (1.15-2.97) after further adjustment for CVD risk factors. The corresponding age- and sex-, and fully adjusted HRs for individuals with CSR score of 2 or more were 3.35 (2.12-5.29) and 2.58 (1.60-4.17), respectively. There was a similar graded association between CSR and CIMT.
Conclusion: An accumulation of social risk factors increased the likelihood of CVD events and deaths and subclinical atherosclerosis in a cohort of White and Black individuals.
Author Disclosures: S. Erqou: None. J.B. Echouffo-Tcheugui: None. K.E. Kip: None. A. Aiyer: None. S.E. Reis: None.
- © 2016 by American Heart Association, Inc.