Abstract
Background: Psychosocial stress is associated with an increased risk of cardiovascular disease (CVD). The relationship between financial strain, a toxic form of psychosocial stress, and ideal cardiovascular health (CVH) is not well established. This study examined whether financial strain was associated with poorer CVH in a multi-ethnic cohort free of CVD at baseline. Methods: This is a cross-sectional analysis of 6,468 men and women aged 45-84 years. Two measures of financial strain were assessed: ongoing financial strain and ongoing financial strain for >6 months. Responses to both measures were categorized as yes or no. CVH was measured from 7 metrics (smoking, physical activity, body mass index, diet, total cholesterol, blood pressure, and blood glucose). A CVH score was calculated from points assigned to the categories of each metric (poor = 0 points; intermediate = 1 point; ideal = 2 points) for a total of 14 points. Multinomial logistic regression was used to examine the association of financial strain with the CVH score (inadequate 0-8, average 9-10, and optimal 11-14 points) and number of ideal metrics, adjusting for sociodemographic factors. Results: The mean age (SD) was 62 (10) and 53% were women. Ongoing financial strain was reported by 25% of participants while 23% reported ongoing financial strain for > 6 months. Participants who reported ongoing financial strain had lower odds of having average (0.82 [0.71, 0.94]) and optimal (0.73 [0.62, 0.87]) CVH scores ( Table ). Likewise, ongoing financial strain for >6 months was associated with lower odds of having average (0.81 [0.70, 0.93]) and optimal (0.70 [0.58, 0.83]) CVH scores. Similar results were observed for the association of financial strain with the number of ideal metrics. Conclusions: Financial strain was associated with poorer CVH. More research is needed to understand this relationship so the burden of CVD can be decreased, particularly among people experiencing financial hardship.
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