Cardiovascular Health of Middle-Aged U.S. Adults by Income Level, 1999 to March 2020 : A Serial Cross-Sectional Study
Authors' conclusion
Over 2 decades in the United States, hypertension increased in low-income middle-aged adults, whereas diabetes and obesity increased in their higher-income counterparts. Income-based disparities in hypertension, diabetes, and smoking persisted even after adjustment for other social determinants of health.
Study context
- Population
- US adults aged 40 to 64 years, NHANES, 1999 to March 2020
- Participants
- 20,761 adults
- Exposure
- Low-income vs higher-income middle-aged adults
- Outcome
- Age-standardised prevalence of hypertension, diabetes, hyperlipidemia, obesity and cigarette use; treatment rates for hypertension, diabetes and hyperlipidemia; BP, glycemic and cholesterol control rates
- Follow-up
- 1999 to March 2020
Methodological detailsSample size limitations could preclude detection of small changes in treatment and control rates
- Sample size limitations could preclude detection of small changes in treatment and control rates
Main finding
As reported in the abstract
Trends in CV risk factors by income, 1999 to March 2020
| Group | Hypertension | Cigarette use | Diabetes | Obesity |
|---|---|---|---|---|
| Low-income | 37.2% (95% CI 33.5% to 40.9%) to 44.7% (CI 39.8% to 49.5%) | 33.2% (CI 28.4% to 38.0%) to 33.9% (CI 29.6% to 38.3%) | ||
| Higher-income | 18.6% (CI 13.5% to 23.7%) to 11.5% (CI 8.7% to 14.3%) | 7.8% (CI 5.0% to 10.6%) to 14.9% (CI 12.4% to 17.3%) | 33.0% (CI 26.7% to 39.4%) to 44.0% (CI 40.2% to 47.7%) |
Hypertension
Low-income37.2% (95% CI 33.5% to 40.9%) to 44.7% (CI 39.8% to 49.5%)
Higher-income— not stated in the abstract
Cigarette use
Low-income33.2% (CI 28.4% to 38.0%) to 33.9% (CI 29.6% to 38.3%)
Higher-income18.6% (CI 13.5% to 23.7%) to 11.5% (CI 8.7% to 14.3%)
Diabetes
Low-income— not stated in the abstract
Higher-income7.8% (CI 5.0% to 10.6%) to 14.9% (CI 12.4% to 17.3%)
Obesity
Low-income— not stated in the abstract
Higher-income33.0% (CI 26.7% to 39.4%) to 44.0% (CI 40.2% to 47.7%)
Observational data: associations, not effects.
Further findings
| Outcome | Higher-income |
|---|---|
| Diabetes treatment rates | |
| Diabetes treatment | 58.4% (CI 44.4% to 72.5%) to 77.4% (CI 67.6% to 87.1%) |
Hypertension treatment and control
- Unchanged in both groups
- >80%
Diabetes treatment rates
- Improved only among the higher-income group
Income-based disparities after adjustment for insurance, health care access and food insecurity · more recent years
- Disparities in hypertension, diabetes and cigarette use persisted
Original publication
Cardiovascular Health of Middle-Aged U.S. Adults by Income Level, 1999 to March 2020 : A Serial Cross-Sectional Study. Ann Intern Med. Published 21 November 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →