Empty wallet, broken heart? Midlife money troubles linked to heart problems

DALLAS, Texas — Is your bank account the best tool for measuring your heart health? A new study certainly suggests as much, at least for middle-aged adults. Researchers from UT Southwestern Medical Center report a decline in wealth and personal finances during midlife may increase the odds of a cardiac event or heart disease later on. Interestingly, this effect appears to work both ways, with having more money between ages 50 and 64 showing a connection to better heart health.

While prior studies support the general notion that socioeconomic status and cardiovascular health influence each other, this is the first project to investigate if changes in wealth directly affect cardiovascular health. In other words, how much do wealth fluctuations and lifestyle changes matter from a heart health perspective as one grows older and older?

“We already know that wealth relates to health, but we show that wealth trajectories also matter. This means that the cardiovascular risk associated with wealth is not permanent and can be influenced,” says study author Andrew Sumarsono, M.D., an assistant professor of internal medicine at UT Southwestern, in a university release.

‘Upward mobility’ is the key to heart health?

In the United States, there is an estimated 10 to 15-year difference in life expectancies between the richest one percent of Americans and the poorest one percent.

For this project, researchers examined a collection of over 5,500 adults without cardiovascular disease. That analysis led to the discovery that middle-aged adults who had enjoyed “upward wealth mobility” showed a lower cardiovascular risk after age 65 in comparison to their peers of a similar age. For reference, study authors define upward wealth mobility as “relative increases in the total value of assets excluding primary residence.”

Conversely, adults who dealt with “downward wealth mobility” in middle-to-late age experienced a higher cardiovascular risk later in life. Cardiovascular events reported by participants include myocardial infarction (a heart attack), heart failure, cardiac arrhythmia, cardiac-related death, and stroke.

All in all, study authors estimate a one-percent change in cardiovascular risk for every $100,000 gained or lost by a single individual. However, it’s worth mentioning that adults who started out in life within the top 20 percent of wealth but then saw financial losses actually showed roughly the same cardiac risk as those who started out rich and remained wealthy. But, adults who started out within the bottom fifth of wealth accumulation and then enjoyed upward wealth mobility displayed lower cardiovascular risk than their peers who remained within the poorer quintiles.

Does wealth spread heart health throughout a family?

Researchers speculate that this suggests a “legacy protection” among the wealthiest families and individuals. Unfortunately, the poorest do not share the same protection. These findings remained consistent across all considered racial or ethnic groups.

“We found that irrespective of one’s baseline wealth, upward wealth mobility relative to peers in late-middle age was associated with lower risk of a new cardiac event or death after age 65. This suggests that upward wealth mobility may offset some of the risk associated with past economic hardship,” Dr. Sumarsono says. “We also found the inverse was true – that people who experienced downward wealth mobility relative to one’s peers faced a higher risk of a new cardiac event or death after 65, potentially offsetting some of the benefit associated with prior economic thriving.”

“We live in a system where people can experience catastrophic losses in wealth from situations beyond their control and that opportunities to accrue wealth are not equally available across racial or socioeconomic groups,” Dr. Sumarsono adds. “Policies that build resilience against large wealth losses and that address these opportunity gaps should be prioritized and may be considered a public health measure to improve overall health while also potentially narrowing racial, socioeconomic, and cardiovascular health disparities.”

The study appears in the journal JAMA Cardiology.

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