Social, Economic Disadvantages During Childhood May Influence Heart Disease Risk

Children who grow up in socially and economically disadvantaged families and neighborhoods may be at a higher risk of developing heart disease. This population was found to have thicker carotid artery walls, which could lead to a higher risk of heart attack and stroke later in life, according to a new study published by the Journal of the American Heart Association.

The carotid arteries transport blood to the brain. An ultrasound test of the arteries’ inner layers—intima and media—is used to determine the early development of atherosclerosis, which is a precursor to cardiovascular disease.

“We know that socioeconomically disadvantaged people are at greater risk of health problems, including more cardiovascular disease earlier in life, and we also know that atherosclerosis is a life-long process that starts in childhood,” said senior study author David P. Burgner, PhD. “For this study, we wanted to determine if there is an association between socioeconomic position and the thickness of the carotid artery wall in mid-childhood.”

The authors explored data regarding the socioeconomic position of 1477 and their neighborhoods. Socioeconomic factors, such as income, education, and occupations were examined, in addition to the socioeconomic status of the neighborhood.

The investigators imaged the carotid artery and measured the carotid artery intima-media thickness in children aged 11 to 12 years.

They found that both family and socioeconomic position were linked to intima-media thickness; however, the link between family was observed to be stronger, according to the study.

Children whose families were the most socioeconomically disadvantaged were 46% more likely to have thicker carotid arteries. Interestingly, socioeconomic position at age 2 or 3 was observed to result in carotid artery thickness at age 11 or 12.

These findings remained true, even when cardiovascular risk factors were considered.

“It is surprising to see that these traditional risk factors do not appear responsible for our findings,” said lead author Richard S. Liu, MBBS. “There’s a suggestion that there may be additional factors driving this association.”

The authors hypothesize that infection and inflammation may drive this link. Infection, which leads to inflammation, is more common among socioeconomically disadvantaged patients, according to the study.

“This doesn’t mean that body weight and blood pressure aren’t important — they are — but there appear to be additional factors that contribute to cardiovascular disease risk beyond the traditional factors,” Dr Burgner said. “So, there may be multiple opportunities for early intervention to prevent cardiovascular disease.”

The link between socioeconomic position during early childhood and carotid artery thickness during mid-childhood may indicate that cardiovascular disease starts prior to birth, according to the study.

The authors report that reducing disadvantages and poverty before birth and early childhood may result in a lower risk of heart disease later in life.

“Every child needs and deserves the opportunity to grow up healthy,” said Clyde Yancy, MD, past president of the American Heart Association and chief of cardiology at Northwestern University in Chicago. “Fortunately, we have the tools to improve heart health across the lifespan by ensuring every child has healthy foods to eat and safe places to be active. Community leaders need to focus on giving kids a healthy start from birth, healthy schools as they grow up, and healthy communities for families to thrive.”