Association of Income Level and Ischemic Heart Disease: Potential Role of Walkability

Association of Income Level and Ischemic Heart Disease: Potential Role of Walkability Association of ischemic heart disease (adjusted for traditional risk factors and socioeconomics variables) and income level (A), and walkability z-score (B), and association of walkability z-score and income level...

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Veröffentlicht in:Arquivos brasileiros de cardiologia Jg. 120; H. 11; S. e20220844
Hauptverfasser: Cerci, Rodrigo Julio, Fernandes-Silva, Miguel Morita, Vitola, João Vicente, Cerci, Juliano Julio, Pereira Neto, Carlos Cunha, Masukawa, Margaret, Gracia, Ana Paula Weller, Silvello, Lara Luiza, Prado, Pedro, Guedes, Murilo, Hino, Adriano Akira Ferreira, Baena, Cristina Pellegrino
Format: Journal Article
Sprache:Englisch
Veröffentlicht: Brazil 01.11.2023
Schlagworte:
Cross-Sectional Studies
Environment Design
Female
Humans
Male
Myocardial Ischemia - epidemiology
Residence Characteristics
Socioeconomic Factors
Walking
ISSN:1678-4170, 1678-4170
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Zusammenfassung:Association of Income Level and Ischemic Heart Disease: Potential Role of Walkability Association of ischemic heart disease (adjusted for traditional risk factors and socioeconomics variables) and income level (A), and walkability z-score (B), and association of walkability z-score and income level (C). Socioeconomic status has been linked to ischemic heart disease (IHD). High-income neighborhoods may expose individuals to a walking-promoting built environment for daily activities (walkability). Data from the association between income and IHD is lacking in middle-income countries. It is also uncertain whether walkability mediates this association. To investigate whether income is associated with IHD in a middle-income country and whether neighborhood walkability mediates the income-IHD association. This cross-sectional study evaluated 44,589 patients referred for myocardial perfusion imaging (SPECT-MPI). Income and walkability were derived from participants' residential census tract. Walkability quantitative score combined 4 variables: street connectivity, residential density, commercial density, and mixed land use. IHD was defined by abnormal myocardial perfusion during a SPECT-MPI study. We used adjusted mixed effects models to evaluate the association between income level and IHD, and we performed a mediation analysis to measure the percentage of the income-IHD association mediated by walkability. We considered p values below 0.01 as statistically significant. From 26,415 participants, those living in the lowest-income tertile census tract were more physically inactive (79.1% versus 75.8% versus 72.7%) when compared to higher-income tertile census tracts (p < 0.001). Income was associated with IHD (odds ratio: 0.91 [95% confidence interval: 0.87 to 0.96] for each 1,000.00 international dollars increase in income) for both men and women equally (p for interaction = 0.47). Census tracts with a higher income were associated with better walkability (p < 0.001); however, walkability did not mediate the income-IHD association (percent mediated = -0.3%). Income was independently associated with higher prevalence of IHD in a middle-income country irrespective of gender. Although walkability was associated with census tract income, it did not mediate the income-IHD association.
Bibliographie:ObjectType-Article-1
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content type line 23
ISSN:1678-4170
1678-4170
DOI:10.36660/abc.20220844