Clinical Edge

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Income Volatility & Elevated Risk of CVD

Circulation; ePub 2019 Jan 7; Elfassy, et al

Among a cohort of relatively young adults, income volatility was independently associated with a nearly 2-fold risk of cardiovascular disease (CVD) and all-cause mortality, a new study found. Researchers examined associations of income volatility from 1990 to 2005 with incident CVD and all-cause mortality in the subsequent 10 years. They studied 3,937 black and white participants aged 23-35 years in 1990 (baseline) from the Coronary Artery Risk Development in Young Adults Study. Income volatility was defined as the intraindividual SD of the percent change in income across 5 assessments from 1990 to 2005. Among the findings:

  • 106 CVD events and 164 deaths occurred between 2005 and 2015 (incident rate, 2.76 and 3.66 per 1,000 person-years, respectively).
  • Higher income volatility and more income drops were associated with greater CVD risk and all-cause mortality.
  • It is likely that there are specific psychosocial and biological pathways through which income volatility is associated with CVD and premature mortality.


Elfassy T, Swift SL, Glymour MM, et al. Associations of income volatility with incident cardiovascular disease and all-cause mortality in a US cohort. [Published online ahead of print January 7, 2019]. Circulation. doi:10.1161/CIRCULATIONAHA.118.035521.