Arrhythmias & electrophysiologyCohort study

Association Between Life-Course Social and Racial Inequities and the Incidence of Major ECG Abnormalities in the ELSA-Brasil Cohort

Circ Popul Health OutcomesPublished

  • prospective cohort study

Authors' conclusion

Life-course social and racial inequalities are associated with MEA incidence, particularly among women, underscoring the importance of social determinants in cardiovascular health.

Study context

Population
Participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) free of major ECG abnormalities (MEA) and cardiovascular disease at baseline (2008–2010)mean age 51 years (SD±8), 55.5% women
Participants
11,761 participants
Exposure
Life-course socioeconomic position, intergenerational social mobility, race and racial discrimination and incidence of MEA, stratified by gender

Main finding

As reported in the abstract

Cumulative incidence of MEA · 8 years follow-up

Cumulative incidence of MEA

15.8%

Observational data: associations, not effects.

Further findings

OutcomeEstimate
Incidence of MEA by childhood socioeconomic position (women) · only among women48% higher (95% CI 1.17–1.87)
Incidence of MEA by race (women)35% higher (95% CI 1.13–1.61)

Incidence of MEA by adulthood socioeconomic position

Low income and educational level associated with a higher incidence of MEA in both genders
Occupational variables associated only among women

Incidence of MEA with social immobility at the base of the educational and socio-occupational hierarchy (women)

Educational hierarchy: increase in MEA incidence
25% (95% CI, 1.04-1.49)
Socio-occupational hierarchy: increase in MEA incidence
31% (95% CI, 1.08-1.61)
  • only among women

Incidence of MEA with lifetime exposure to racial discrimination

Black women, hazard ratio
1.37 [95% CI, 1.04-1.82]
Brown women, hazard ratio
1.70 [95% CI, 1.07-2.70]
These associations were not observed among men

Original publication

Association Between Life-Course Social and Racial Inequities and the Incidence of Major ECG Abnormalities in the ELSA-Brasil Cohort. Circ Popul Health Outcomes. Published 16 February 2026. doi:10.1161/circoutcomes.125.012216

Summarised from the published abstract; every number is checked against it