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There is a high prevalence of cardiovascular disease risk factors across low- and middle-income groups compared to high-income groups, reflecting cardiovascular health inequality in the young working-age population based on income levels.

The income of an individual is an important social determinant of his or her cardiovascular health; however, there is limited evidence to support the trends of risk factors of cardiovascular health based on income levels of working-age adults. A four-year longitudinal cohort study published in the journal Endocrine Practice identified an increase in the gap of risk factors related to cardiovascular health by income levels of adults.

Dyslipidemia: A Sporadic Find in Low- and Middle-Income Men

This longitudinal cohort study demonstrated that low income was related to a higher prevalence of diabetes, hypertension, and obesity among young men and women.

While the study discovered a higher prevalence of dyslipidemia among men from the low- and middle-income groups compared to that for the high-income group in 2019, this pattern was not consistently present during other years.

Increase in Other Risk Factors Across High-Income and Low-Income Groups

In addition to the prevalence differences in cardiovascular disease risk factors, including hypertension, the study also observed an increase in the prevalence differences in other risk factors across high-income and low-income groups. These included higher waist circumference, systolic blood pressure (SBP), diastolic blood pressure (DBP), body mass index (BMI), and levels of HbA1c among individuals belonging to the low-income or middle-income groups in contrast to individuals belonging to the high-income group. The study found no supporting evidence regarding low-density lipoprotein cholesterol (LDL-C) levels across the high- and low-income groups. This is indicative of greater social inequality regarding cardiovascular health among young men and women.

Gender-Based Prevalence of Cardiovascular Disease Risk Factors

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Compared with women in the high-income group, there was a greater prevalence of  hypertension among women in the middle-income and low-income groups.

The study found a higher prevalence of risk factors related to cardiovascular disease among young working-age men and women across low- and middle-income groups compared to those for high-income groups during the last four years.


Inoue, K., Kondo, N., Sato, K., & Fukuma, S. (2023). Trends in Cardiovascular Risk Factors by Income Among Japanese Adults Aged 30-49 Years From 2017 to 2020: A Nationwide Longitudinal Cohort Study. Endocrine Practice, 29(3), 185-192. https://doi.org/10.1016/j.eprac.2022.12.018