Photo Credit: Rasi Bhadramani
The following is a summary of “Associations of Self-Reported Race, Social Determinants of Health, and Polygenic Risk With Coronary Heart Disease,” published in the November 2024 issue of Cardiology by Norland et al.
Social determinants of health (SDOH) affect the risk of common diseases like coronary heart disease (CHD).
Researchers conducted a retrospective study to assess the impact of race, SDOH, and polygenic risk score (PRS) on CHD.
They analyzed data from 67,256 participants from All of Us (AoU), including self-reported race/ethnicity, 22 SDOH measures across 5 domains, and a PRS for CHD (PRSCHD, PGS004696). Associations between SDOH, PRSCHD, and CHD were tested using regression models adjusting for clinical risk factors.
The results showed that SDOH across 5 domains (food insecurity, income, educational attainment, health literacy, neighborhood disorder, and loneliness) were associated with CHD. The SDOHCHD was highest in self-reported Black and Hispanic individuals. The study found that self-reporting as Black was associated with higher odds of CHD compared to White individuals, but this association was no longer significant after adjusting for SDOHCHD while SDOHCHD and PRSCHD were weakly correlated. In the test set (n = 33,628), a 1-SD increase in SDOHCHD (OR: 1.32; 95% CI: 1.23-1.41) and PRSCHD (OR: 1.36; 95% CI: 1.28-1.44) were associated with CHD, after adjusting for clinical risk factors. Both SDOHCHD and PRSCHD were linked to incident CHD events (n = 52) during a median follow-up of 214 days (Q1-Q3: 88 days).
They concluded that Black individuals have the increased risk of CHD may be largely attributed to a higher burden of SDOH, and that including both SDOH and PRS in CHD risk models could improve the accuracy.
Source: jacc.org/doi/10.1016/j.jacc.2024.06.052
