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Cumulative Effects of Multiple Modifiable Risk Factors on Cardiovascular Disease Mortality.

Jonathan Yunzhou Xiong1, Kai Goldenstein Vonkiel1, Lance Ridpath1

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|February 27, 2026
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Summary
This summary is machine-generated.

The cumulative impact of multiple risk factors significantly increases cardiovascular disease mortality in West Virginia counties. Addressing combined socioeconomic and healthcare access issues is crucial for reducing deaths.

Keywords:
cardiovascular diseasedeath rate

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Area of Science:

  • Public Health
  • Epidemiology
  • Health Services Research

Background:

  • Cardiovascular disease (CVD) remains a leading cause of mortality.
  • Understanding the impact of cumulative risk factors on CVD mortality is essential for targeted interventions.
  • West Virginia presents a unique setting to study the interplay of socioeconomic and healthcare access factors on CVD outcomes.

Purpose of the Study:

  • To evaluate the association between the cumulative burden of modifiable risk factors and cardiovascular disease mortality in West Virginia counties.
  • To determine if combined risk factors have a synergistic effect on CVD mortality beyond their individual contributions.

Main Methods:

  • Retrospective observational study analyzing CVD mortality rates and modifiable risk factors (income, PCP ratio, Food Desert Status) in West Virginia counties (2011-2020).
  • Data sourced from Census Bureau, AMA, USDA, and WV HHS.
  • Multiple linear regression and ANOVA were employed to analyze the relationships between risk factors and CVD mortality.

Main Results:

  • Combined risk factors showed a stronger association with CVD mortality than individual factors.
  • Each individual risk factor (Income, PCP Ratio, FDS) was significantly associated with CVD mortality.
  • Significant two-way interactions were found between PCP Ratio and Income, and FDS and Income, indicating synergistic effects.

Conclusions:

  • Counties with multiple cumulative risk factors experienced disproportionately higher CVD mortality.
  • The combined effect of risk factors on CVD mortality exceeds the sum of their individual impacts.
  • Addressing cumulative socioeconomic and healthcare access factors at the county level is critical for mitigating CVD mortality.