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Individuals with elevated C-reactive protein at 1.0 mg/dL and poverty had a greater risk for 15-year all-cause mortality

There is a potential synergistic effect for inflammation and living in poverty with increased mortality risk for adults, according to a study published online Jan. 16 in Frontiers in Medicine.

Arch G. Mainous III, Ph.D., from the University of Florida in Gainesville, and colleagues examined whether there is a synergistic effect of the presence of inflammation and poverty on the 15-year risk for all-cause, heart disease, and cancer mortality among U.S. adults. The authors evaluated data from the National Health and Nutrition Examination Survey (1999 to 2002) with linked records to the National Death Index through Dec. 31, 2019. The 15-year mortality risk was assessed among adults aged 40 years and older.

The researchers found that the risk for 15-year adjusted, all-cause mortality was increased for individuals with elevated C-reactive protein (CRP) at 1.0 mg/dL and poverty compared with those with low CRP and above poverty (hazard ratio, 2.45). The mortality risk was essentially the same for those with one at-risk characteristic (hazard ratios, 1.58 and 1.59 for low inflammation/poverty and inflammation/above poverty, respectively); these risks were substantially lower than those seen for adults with both inflammation and poverty. The 15-year heart disease mortality risk was elevated by 127 percent and 15-year cancer mortality was elevated by 196 percent for individuals with both elevated inflammation and living in poverty.

“Inflammation and poverty are well known risk factors for mortality, but when both exist simultaneously and CRP is >1.0 mg/dL, they have the potential to increase mortality more than one would expect from an additive effect,” the authors write. “This is particularly concerning in socially disadvantaged patients who are already a medically vulnerable population.”

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