Association of socioeconomic status with arterial stiffness in older African American and White adults: The ARIC study cohort

Am J Prev Cardiol. 2023 Jan 26:13:100469. doi: 10.1016/j.ajpc.2023.100469. eCollection 2023 Mar.

Abstract

Objective: To examine the cross-sectional associations of individual measures of SES-educational attainment and household income-and the joint effects of SES with PWV, as well as the SES-race interaction, in a cohort of older African American and White adults.

Methods: Data from the Atherosclerosis Risk in Communities (ARIC) Study were used to evaluate the cross-sectional associations of individual and joint SES [education and income] and carotid femoral pulse wave velocity (cfPWV), a subclinical marker of arterial stiffness, and the interaction of SES and race using adjusted multivariable linear regression models in a cohort of 3342 men and women aged 67-89 years free of CVD in 2011-2013.

Results: Participants were 64% female, 23% African American, mean cfPWV (12.3±3.5-African American and 11.6±3.9-White participants). Post-graduate education compared to less than high school was significantly associated with lower cfPWV (less stiffness) in African American (β = -1.28 m/s; 95% CI, -1.97, -0.59) but not in White (β = -0.69 m/s; 95% CI, -1.39, 0.01) participants. Income ≥$50K as compared to <$25K, was associated with lower cfPWV both in African American (β = -0.82 m/s; 95% CI, -1.42, -0.22) and White (β = -0.76 m/s; 95% CI, -1.19, -0.32) participants. The interaction of race and individual measures of SES on cfPWV in African American and White adults were not statistically significant (p-value >0.10).

Conclusions: Higher SES was cross-sectionally associated with lower arterial stiffness in this cohort; the data did not support differences by race. Prospective studies of SES and cfPWV are needed to efficiently compare larger racially and regionally diverse populations with a wider range of socioeconomic profiles to better identify subgroup CVD risk.

Keywords: CVD risk; Disparities; SES; Social determinants of health.