Financial strain and food insecurity drive accelerated cardiac aging

A novel analysis investigating the contribution of social determinants of health (SDoH) to cardiac aging has found that financial strain and food insecurity are the strongest drivers of accelerated biological aging and increased mortality risk. The study in Mayo Clinic Proceedings, published by Elsevier, underscores the complexity and interplay of novel social risk factors that may contribute to cardiovascular events and emphasizes the need for targeted preventive interventions and patient-centered care.

The number of US residents aged 65 years and older is estimated to nearly double to 82 million people by the end of 2050, representing 23% of the total population.

He adds, "Our current research was motivated by the observation that traditional risk factors do not explain and contribute equally to cardiovascular disease. There are social factors that we do not identify or inquire about from our patients that may potentially reverse biological aging."

The cross-sectional study, investigating SDoH status with interaction to comorbidities and demographic risk factors in cardiac aging and mortality, included over 280,000 adult patients who sought care at Mayo Clinic between 2018 and 2023. Researchers assessed SDoH using a questionnaire that collects information across nine domains (stress, physical activity, social connection, housing instability, financial strain, food insecurity, transportation needs, nutrition, and education). They estimated cardiac age using an AI-enabled electrocardiogram (AI-ECG) algorithm and used structural equation modeling to map the connections between SDoH, conventional risk factors, and cardiac age gap.

Cardiac age gap

• The interplay of SDoH was the most influential determinant of cardiac aging when compared with traditional clinical risk factors.
• Among all SDoH, financial strain and food insecurity were the most impactful in the overall population and sex-stratified analysis.
• SDoH such as financial strain, housing, and physical inactivity are robust predictors of increased mortality risk, matching or even surpassing certain conventional mortality risk factors.

Dr. Lerman concludes, "Our study highlights the critical role of SDoH in cardiac aging and mortality. Identifying the most important risk factors for cardiac aging allows for targeted preventive intervention in the community and empowers physicians to engage in patient-centered care, addressing the social context that contributes to heart disease."

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