U.S. Prevalence of Adverse CVD Outcomes Varies With Income, Education

FRIDAY, March 14, 2025 (HealthDay News) — Top 20 percent income earners with college degrees have the lowest prevalence of adverse cardiovascular disease (CVD) outcomes, according to a study published online March 6 in The Lancet Regional Health: Americas.

Salma M. Abdalla, Dr.P.H., M.B.B.S., M.P.H., from the Boston University School of Public Health, and colleagues describe population patterns in CVD by income and education during a 20-year period from 1999 to 2018. Participants were stratified into four groups by income and education: top 20 percent income earners, college graduates; top 20 percent income earners, non-college graduates; bottom 80 percent income earners, college graduates; and bottom 80 percent income earners, non-college graduates.

Data for both income and education were reported for 49,704 participants. The researchers observed variation in the age-standardized prevalence of CVD outcomes across the groups. The variation was most significant when comparing prevalence among the top 20 percent income, college graduate group to the bottom 80 percent income, non-college graduate group for congestive heart failure (CHF; 0.5 versus 3.0 percent), angina (1.4 versus 2.8 percent), heart attack (1.7 versus 3.9 percent), and stroke (1.1 versus 3.4 percent). The odds of all CVD conditions were significantly higher in the bottom 80 percent income groups compared with the top 20 percent income, college group (odds ratios, 1.48 to 3.67 for college graduates; 2.36 to 6.52 for non-college graduates), as well as for CHF and heart attack in the top 20 percent, non-college graduate group (odds ratios, 3.11 and 1.92, respectively).

“Despite efforts to narrow health gaps, these observations highlight the challenge of improving the well-being of the majority,” the authors write.

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