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Social Determinants of Cardiovascular Aging

Aaron L Troy1, Anjali Bhatla2, Scott A Berkowitz2

  • 1Division of Cardiology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA; Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.

JACC. Advances
|November 20, 2025
PubMed

Insights

Social determinants of health significantly impact cardiovascular aging across the lifespan. Addressing factors like race, education, and social connection is crucial for improving heart health outcomes in aging populations.

Area of Science:

  • Cardiovascular Medicine
  • Public Health
  • Gerontology

Background:

  • Social determinants of health (SDOH) are critical drivers of cardiovascular disease (CVD) and aging.
  • Understanding the interplay between SDOH and cardiovascular aging is essential for mitigating adverse outcomes.

Purpose of the Study:

  • To review frameworks of SDOH and cardiovascular aging.
  • To examine the impact of SDOH on vascular, myocardial, valvular, and electrophysiologic aging.
  • To identify interventions for improving cardiovascular health across the life course.

Main Methods:

  • Literature review synthesizing frameworks and evidence on SDOH and cardiovascular aging.
  • Categorization of determinants by life stage (early life, adulthood, elderhood).
  • Identification of mediators (behavioral, biological, healthcare-related) and interventions.

Main Results:

  • Structural determinants (race/ethnicity, gender, education, geography) impact cardiovascular aging from early life.
  • Intermediary determinants (food/digital/financial security, social connection, transportation) require targeted interventions in adulthood and elderhood.
  • Specific cardiovascular conditions (atherosclerosis, heart failure, valvular disease, atrial fibrillation) are influenced by SDOH.

Conclusions:

  • SDOH profoundly shape cardiovascular aging trajectories.
  • Multi-level interventions (patient, population, policy) are needed to address SDOH and improve cardiovascular outcomes.
  • Further research and targeted interventions are priorities for promoting healthy cardiovascular aging.

Keywords:
atherosclerotic cardiovascular diseaseatrial fibrillationcardiovascular aginggeriatric cardiologyhealth policyheart failureimplementation sciencepopulation healthpreventive cardiologysocial determinants of healthvalvular heart disease

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