Wealth and Income Provide Buffer against Stroke

By Charles Bankhead, Staff Writer, MedPage Today
Published: April 24, 2008
Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco
ROTTERDAM, The Netherlands, April 24 -- Money might not buy love, but it can protect some people against stroke, investigators found.

Action Points

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• Explain to patients that lower levels of wealth and income appear to be associated with an increased risk of stroke in people ages 50 to 64.
  
  
• Point out that the findings came from an analysis of a database, not a randomized, controlled clinical trial.

In a study of more than 1,500 stroke patients, wealth and income independently predicted stroke risk in people ages 50 to 64 but not in older individuals, Mauricio Avendano, Ph.D., of Erasmus University Medical Center here, reported in the May issue of Stroke.

Dr. Avendano and co-author M. Maria Glymour, Ph.D., of Harvard, suggested that the association they found between affluence and stroke probably understate the impact of social disparities on stroke risk.

Several studies have suggested that lower socioeconomic status is associated with higher stroke risk in developing countries. In the United States, however, the association goes in the opposite direction, as stroke disparities across education and income appear to reverse at age 74, the authors said.

Almost 90% of strokes occur after 65, but the influence of socioeconomic status on stroke risk in that older age group had not been examined, they continued.

So Drs. Avendano and Glymour analyzed data from the Health and Retirement Study, a longitudinal survey of a national sample of U.S. adults 50 and older. They included 19,965 participants who were stroke-free at baseline.

Baseline assessments of wealth, income, and education were included in a Cox proportional hazards model to predict time to stroke.

Separate models were developed for the age groups 50 to 64, 65 to 74, and 75 and older, incorporating known stroke risk factors.

During a mean follow-up of 8.5 years, 1,542 participants had strokes.

Higher education predicted a reduced stroke risk in the age group of 50 to 64, but not after adjustment for wealth and income.

In contrast, wealth and income were independent predictors of stroke in that age group.