Studying the ‘cause of causes’ affecting cardiovascular health
CU 鶹ӰԺ researchers find that socioeconomic status is a key indicator of heart health
Cardiovascular disease, the in the United States, significantly affects those of lower socioeconomic status. In addition, members of historically marginalized groups—including Black, Indigenous and Asian populations—suffer disproportionately. Therefore, public health advocates and policy makers need to make extra efforts to reach these populations and find ways to reduce their risk of cardiovascular disease.
These are the findings of researchers Sanna Darvish and Sophia Mahoney, PhD candidates in the 鶹ӰԺ Department of Integrative Physiology. Their on socioeconomic status and arterial aging—written with CU 鶹ӰԺ co-authors Ravinandan Venkatasubramanian, Matthew J. Rossman, Zachary S. Clayton and Kevin O. Murray—was published in the Journal of Applied Physiology.
Researchers Sanna Darvish (left) and Sophia Mahoney (right), PhD candidates in the CU 鶹ӰԺ Department of Integrative Physiology advocate for making extra efforts to reach historically marginalized populations and find ways to reduce their risk of cardiovascular disease.
Darvish and Mahoney conducted a literature review of cardiovascular disease, looking specifically at how it affects various demographics. Their focus was on two physiological features that are predictors of cardiovascular issues: endothelial dysfunction—a failure of the lining of blood vessels that can cause a narrowing of the arteries—and stiffening of arteries.
“It’s pretty well established that individuals of lower socioeconomic status have increased risk for many chronic diseases, but our lab focuses on the physiological and cellular mechanisms contributing to that increased risk,” Darvish explains. “We’re looking at what studies have been conducted, looking at blood vessel dysfunction, arterial dysfunction in these marginalized groups that then will predict their risk for cardiovascular disease.”
Exercise as therapy
Beyond the clinical findings, Darvish and Mahoney cite four social determinants of health regarding cardiovascular disease across ethnic and racial groups: environmental factors, like proximity to pollution or access to green spaces; psychological and social factors, such as stress or structural racism; health care access; and socioeconomic status.
While each of the four has different facets that contribute to overall cardiovascular health, the authors found that socioeconomic status was the “cause of causes,” and thus the most important indicator to examine in their goal of recommending effective therapies.
“It became clear to us that socioeconomic status really played a role in every single aspect of social determinants of health,” says Mahoney. “So, our paper naturally centered around socioeconomic status as we realized that it was the most integrated and affected the rest of the determinants of health.”
To help overcome the barriers to better cardiovascular health among those in lower socioeconomic groups, Darvish and Mahoney recommend exercise.
“Exercise is well established as first line of defense, especially aerobic exercise,” says Mahoney. “It’s easy for us to say that in Colorado, but there are plenty of barriers to people everywhere who do not have access to resources.”
“Exercise is well established as first line of defense, especially aerobic exercise,” says CU 鶹ӰԺ researcher Sophia Mahoney. “It’s easy for us to say that in Colorado, but there are plenty of barriers to people everywhere who do not have access to resources.”
One option the researchers propose is high-intensity interval training (HIIT), which packs a robust aerobic effort into workouts as brief as five or 10 minutes. The authors also recommend inspiratory muscle strength training (IMST), during which users breathe into a simple handheld device that inhibits air flow and get a simulated aerobic workout that also strengthens the diaphragm. that just a few minutes of IMST therapy a day can reduce blood pressure and the risk of cardiovascular disease.
Reducing research barriers
One thing Darvish and Mahoney hope their study will do is galvanize researchers to include more diverse populations in their research. While investigating the existing literature for their review, the two were dismayed to find few studies that included or focused on populations from the lower socioeconomic echelons.
There are structural reasons for that, Darvish explains. Time is an issue, as those lower on the socioeconomic ladder often work more hours and have more demands on their non-work time. In addition, transportation can be an obstacle, as research facilities may not be near neighborhoods with more diverse populations. “We pay our participants an appropriate amount for their participation, but not all clinical trials do,” Darvish says.
“Another thing we are doing is instituting a lift service through our lab, to drive people in from their homes in Denver to our lab in 鶹ӰԺ, and we hope this will help improve access for more people to participate.”
Language barriers can be another impediment, as all release forms and study literature would need to be translated for those who don’t speak English. Darvish and Mahoney say it is important that researchers work to overcome these structural barriers. “Our lab is working to do all we can to reduce biases, and include these diverse populations,” says Mahoney. “We need to practice what we preach and start with ourselves.”
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