January 24, 2019
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Financial stress may lead to CHD risk in black adults

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Among black adults, financial stress may be a risk factor in CHD, according to findings published in the American Journal of Preventive Medicine.

Cheryl Clark, MD, ScD, a hospitalist and researcher in the division of general medicine and primary care, and director of health equity research and intervention in the Center for Community Health and Health Equity at Brigham and Women's Hospital, and colleagues sought to determine whether financial hardship was associated with CHD in black adults.

“Stress is known to contribute to disease risk, but the data from our study suggest a possible relationship between financial stress and heart disease that clinicians should be aware of as we research and develop interventions to address social determinants of health disparities,” Clark said in a press release.

The researchers analyzed data from the Jackson Heart Study cohort and identified 2,256 participants who had no prior CHD history and submitted all required data through a weekly stress inventory survey. The survey stratified participants by levels of stress: did not experience financial stress, no stress, mild stress and moderate to high stress.

Clark and colleagues identified that participants with moderate to high financial stress had a higher probability of incident CHD (HR = 2.42; 95% CI, 1.13-5.17) compared with participants with no stress once controlled for demographics, access to care, socioeconomic status and traditional clinical risk factors.

When the researchers adjusted for the risk factors of depression, smoking status and diabetes, the association between financial stress and CHD was no longer significant (HR = 1.99; 95% CI, 0.91-4.39).

Additional research should examine the association in intervention studies that address perceived stress, in addition to other CHD risk factors, in experiencing financial stress, Clark and colleagues wrote.

“The results suggest the potential importance of identifying and addressing financial stress as a strategy for reducing differential risks for CHD,” the researchers wrote. “Future research should determine whether interventions that directly influence financial stressors, or that influence the psychological, behavioral and clinical correlates of financial stress are effective in reducing the CHD burden that disproportionately affects some African-Americans.” – by Earl Holland Jr.

Disclosures: The authors report no relevant financial disclosures.