By Lisa Rapaport
(Reuters Health) – African-American adults who often struggle to pay bills may be more than twice as likely to develop heart disease than their counterparts who don’t have much financial stress, a U.S. study suggests.
Heart disease is the leading cause of death in the U.S., and African-Americans are more likely to develop the condition than people from other racial and ethnic groups. Some previous research has linked financial stress to an increased risk of chronic health problems, but whether money troubles are a factor contributing to heart disease in the African-American population isn’t as well understood, the study team writes in American Journal of Preventive Medicine.
For the current study, researchers examined data on 2,256 African-American men and women participating in the long-term Jackson Heart Study in Mississippi from 2000 to 2012. None of the participants had evidence of heart disease at the start of the study.
After an average follow-up period of 9.6 years, 98 people, or about 4 percent of the participants, experienced a heart attack, cardiac hospitalization or another event related to heart disease.
“We found that psychological feelings of stress due to finances were related to the onset of heart disease, such as heart attacks and procedures used to treat heart attacks – even when other issues like access to care, or difficulty affording medications were considered,” said senior study author Dr. Cheryl Clark of Brigham and Women’s Hospital and Harvard Medical School in Boston.
“While it may be difficult to turn around finances quickly, there are treatments and strategies to reduce stress and stress-related diseases,” Clark said by email. “Patients should always discuss concerns about heart health with a physician, and make sure that issues such as depression, or other heart disease risks are treated to lower their risk of heart disease.”
In the study, participants were asked regularly to rate the stress they experienced in several areas, including financial hardship, such as having problems paying bills or running out of pocket money.
Researchers also looked at other patient characteristics and behaviors that can impact the risk of heart disease including whether people smoked or exercised, if they had chronic health problems like diabetes or high blood pressure, whether they had depression, if they had insurance, and how much income and education they had.
Some of the connection between financial hardship and heart problems was explained by smoking, diabetes and depression.
The study wasn’t designed to prove whether or how financial stress might directly cause heart disease. Researchers also were unable to determine whether the impact of financial stress on the heart differed based on how long people lived with money troubles.
Still, stress of any kind, including financial stress, can trigger changes in the body that contribute to inflammation and lead to increases in heart rate and blood pressure as well as metabolic problems, said Dr. Erica Spatz, a researcher at Yale School of Medicine in New Haven, Connecticut.
“Financial hardships also make it more difficult for people to engage in healthy behaviors or to obtain needed healthcare and medications – both of which incur high out-of-pocket costs,” Spatz, who wasn’t involved in the study, said by email.
“Financial hardship is a powerful stressor,” Spatz added. “While monetary support may be helpful, we shouldn’t underestimate the importance of social support and connection and potentially mental-health care to mitigate the psychological and physiological effects of financial hardship.”
SOURCE: https://bit.ly/2N6rp1m American Journal of Preventive Medicine, online January 17, 2019.