Association of Net Worth and common carotid artery (CCA) cross-sectional compliance as a risk factor for cardiovascular disease (CVD) in Early Middle-Aged African American Women with and without systemic lupus erythematosus (SLE) Open Access

Abstract

Importance: African-American women with lupus are at a disproportionate risk for CVD, this is not explained by traditional risk factors. Stressors such as debt have been linked to CVD in other diseases; however, associations have not been studied in African-American women with SLE. NetWorth is a measure of the overall assets that are shaped by race-related historical policies. NetWorth captures longer-term financial stability and economic reserve, therefore; it can analyze debt among African-Americans. We hypothesized that: 1) African American women with SLE would report greater amounts of debt than African-American women without SLE and 2) that the association between debt and CCA compliance will be stronger for African-American women with SLE compared to African-American women without SLE.

Objective: Determine the association of Net Worth and CCA cross-sectional compliance (CSC1_cca) as a risk factor for CVD in young-middle aged African American Women with and without SLE.

Design: Cohort study

Setting: Community-based, southeastern United States. 

Participants: African-American women with and without SLE, ages 22-50, without clinical CVD.

Exposures: Self-reported NetWorth (total financial assets minus debt)

Main Outcomes and Measures: Carotid intima media thickness (IMT) variable: CSC1_cca. IMT progression was assessed over a two-year period.

Results: Included 401 African-American women from a range of SES backgrounds and on average were 36.5 years of age (SD=6.9). Women with SLE (N=68) did not report greater amounts of debt than women without SLE (N=68) ( P =0.22). The association between NetWorth and CSC1_cca was not stronger in African-American women with SLE (β = 0.016, 95% CI: 0.0018, 0.030; P = 0.028) than African-American women without SLE (β = -0.015, 95% CI: -0.030, -0.00052; P = 0.042).

Conclusion and Relevance: In our cohort study having a negative (“in debt”) NetWorth was not associated with a higher risk for CVD or higher carotid media thickness in the form of cross-sectional compliance. Additional research on the type of debt assessed and looking into the differences in education, income and employment across the two groups will be beneficial toward CVD outcomes in this high-risk group of African-American women with SLE.

Table of Contents

Abstract......p.4

Introduction......p.6-8

Methods........p.8-12

Results......p.12-15

Discussion....p.15-17

Tables......p.17-21

References.......p.22-23

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Psychosocial Epidemiology Lupus African American women Cardiovascular disease Systemic lupus erythematosus (SLE) Epidemiology
Committee Chair / Thesis Advisor	Lewis, Tené T., Emory University

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