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 Between 1999 and 2014, high-income people had decreases in rates of
high blood pressure, smoking and high risk for heart disease. The
same wasn't true for low-income people, however.
An earlier study of risk factors for heart disease in the U.S. in
1971-2002 also found more of them among low-income people - but
"that was 10 years ago," lead author Dr. Ayodele Odutayo of the
University of Oxford in the UK and St. Michael's Hospital in Toronto
told Reuters Health. "So, it was quite dated and we didn’t have more
modern information on this."
Odutayo and colleagues write in JAMA Cardiology that great strides
have been made over the past two decades in reducing the number of
people at risk for heart disease due to smoking, high blood
pressure, high cholesterol and diabetes. It's unclear if everyone
benefited equally from those improvements, though.
For the new study, the researchers used data collected from 17,199
participants, ages 40 to 79, in the U.S. National Health and
Nutrition Examination Survey.
Overall, there were no significant changes in risk factors for heart
disease among people living below the federal poverty line.
For example, the proportion of low-income people with a 20 percent
or greater risk of heart disease was about 15 percent between 1999
and 2004, and 16.5 percent between 2011 and 2014.
Also, the average systolic blood pressure (the top number) among
low-income people was about 128 millimeters of mercury (mm/Hg)
during the earlier part of the study, and that only fell to about
127 mm/Hg at the end. A healthy reading is less than 120 mm/Hg,
according to the American Heart Association.
There was also no significant change in the proportion of low-income
people who smoked over the study period.
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High-income people did experience declines in all those measures, on
the other hand. The proportion at high risk for heart disease
decreased from 12 percent to 9.5 percent during the study period,
for example. The average blood pressure dropped by nearly 4 mm/Hg,
and the proportion of smokers fell by more than five percentage
points.
Rates of diabetes and cholesterol did not vary by income.
Odutayo told Reuters Health that it will be important to look at
data after 2014 to account for the increasing number of people
gaining health insurance under the Affordable Care Act.
"It would be interesting to see if there are any changes," he said.
The data shows that primary care and prevention is important for
people with low incomes, he added.
"It’s important that the insurance that people with lower income can
obtain puts an emphasis on primary care medicine and preventive
medicine," said Odutayo.
SOURCE: http://bit.ly/2rNaztW JAMA Cardiology, online June 7, 2017.
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