Relative Deprivation, Income Inequality, and Cardiovascular Health: Observational and Mendelian Randomization Studies
Man Ki Kwok1, Ichiro Kawachi2, David Rehkopf3
1School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China.
Frontiers in Public Health
|February 7, 2022
Summary
Relative income deprivation showed weak associations with cardiovascular disease risk factors in Hong Kong Chinese. Cortisol did not mediate this link, and genetic analysis found no association between cortisol and cardiovascular disease risk.
Area of Science:
- Public Health
- Epidemiology
- Social Determinants of Health
Background:
- The relationship between income (absolute and relative) and cardiovascular disease (CVD) risk is understudied in China.
- The potential mediating role of stress biomarkers like cortisol in this association is unclear.
Purpose of the Study:
- To examine associations of absolute and relative income with CVD risk factors in Hong Kong Chinese.
- To investigate the mediating role of cortisol in the income-CVD risk pathway.
- To validate cortisol's role using Mendelian Randomization (MR).
Main Methods:
- Observational analysis of 17,607 participants using multilevel models for income and CVD risk factors (BMI, blood pressure, self-reported CVD/diabetes).
- Mediation analysis (n=1,562) to assess cortisol's role.
- Mendelian Randomization (n=1,562) to validate cortisol-CVD risk associations.
Main Results:
- Relative household income deprivation was associated with higher systolic blood pressure but lower BMI, independent of absolute income.
- Neighborhood income inequality and absolute income (household/neighborhood) were generally unrelated to CVD risk factors.
- Cortisol did not significantly mediate the association between relative income and blood pressure.
- MR analysis found no association between genetically predicted cortisol and CVD risk.
Conclusions:
- Relative household income deprivation showed inconsistent associations with cardiovascular health in Hong Kong Chinese.
- Neighborhood income inequality and absolute income were not consistently linked to CVD risk.
- Findings highlight context-specific relationships between income and CVD risk.
Related Concept Videos
01:30Coronary Artery Disease I: Introduction
234
Coronary Artery Disease (CAD): An Overview with Scientific InsightsCoronary Artery Disease (CAD), often referred to as C-A-D, is a prevalent blood vessel disorder classified under the broader category of atherosclerosis. Atherosclerosis is a pathological process characterized by the hardening and narrowing of arteries due to the accumulation of atherosclerotic plaques. These plaques are composed of cholesterol, fatty substances, inflammatory cells, calcium, and fibrin, reducing blood flow to...
234
01:26Longitudinal Studies
277
Longitudinal studies are also widely used in other medical and social science fields. For instance, in cardiovascular research, they can monitor patients' health over decades to identify risk factors for heart disease, such as high cholesterol or smoking, and evaluate the long-term effectiveness of preventive measures. Similarly, in mental health studies, researchers might follow individuals from adolescence into adulthood to understand the development and progression of conditions like...
277
01:29Bias in Epidemiological Studies
761
Biases can arise at various stages of research, from study design and data collection to analysis and interpretation. Recognizing and addressing these biases is essential to ensure the validity and reliability of epidemiological findings.Broadly speaking, biases in epidemiology fall into three main categories: selection bias, information bias, and confounding. A more detailed description of possible biases is:
761
01:27Psychoneuroimmunology: Cardiovascular Disease
97
Psychoneuroimmunology (PNI) is a multidisciplinary field that examines how psychological factors, particularly stress, interact with the immune system and impact physical health. Research in PNI has shown that chronic or traumatic stress can disrupt both the hypothalamic-pituitary-adrenal axis and the sympathetic nervous system. These disruptions contribute to serious health conditions, including cardiovascular diseases.
A key area of focus in PNI is the relationship between stress and coronary...
A key area of focus in PNI is the relationship between stress and coronary...
97
01:27Confounding in Epidemiological Studies
294
Confounding in statistical epidemiology represents a pivotal challenge, referring to the distortion in the perceived relationship between an exposure and an outcome due to the presence of a third variable, known as a confounder. This variable is associated with both the exposure and the outcome but is not a direct link in their causal chain. Its presence can lead to erroneous interpretations of the exposure's effect, either exaggerating or underestimating the true association. This...
294
01:26Coronary Artery Disease IV: Preventive Measures
172
Effective preventive measures for coronary artery disease (CAD) focus on controlling modifiable risk factors, including cholesterol abnormalities and lifestyle changes.Cholesterol ManagementFirst, the Mediterranean diet and the American Heart Association advocate for maintaining low-density lipoprotein (LDL) cholesterol levels below 100 mg/dL, with a more stringent recommendation of below 70 mg/dL for individuals at high risk. LDL cholesterol, often termed "bad cholesterol," can lead to the...
172