Journal article
Persistence of cardiovascular risk factor changes after the great recession: fixed effects analysis of prospective cohort data from the multi-ethnic study of atherosclerosis
BMJ open, v 16(10), e123802
07 Oct 2026
PMID: 42843884
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Abstract
Multiple prospective cohort studies, including the multi-ethnic study of atherosclerosis (MESA), have documented elevations in cardiovascular risk factors after the Great Recession (GR) of 2008, despite other studies that report mortality declines after the GR. It is possible that the deleterious effects of the GR on cardiovascular risk profiles are short-lived and reversed. We examine whether risk factor elevations seen in MESA in the 2010-2011 wave persist into the 2016-2018 wave of data collection.
Individual fixed effects (IFE) analysis of prospective cohort data from MESA, with rate of change in the risk factor (from wave 2 to later waves) as the dependent variable, effectively controlling for individual-specific linear trends in ageing and all time-invariant characteristics. Models included controls for time-varying characteristics.
Communities centred around Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York City, New York; and St. Paul, Minnesota.
All MESA participants who participated in at least two pre-GR waves and both post-GR waves; n=3101 (47% men, 25% African American, 21% Hispanic, 13% Asian).
Primary: Systolic blood pressure (SBP), pulse pressure (PP), fasting blood glucose, serum C-reactive protein (CRP). Secondary: Serum low density lipoprotein cholesterol (LDL-C) and Body Mass Index (BMI) RESULTS: Mean SBP and PP in 2016-2018 were greater by 8.6 (95% CI 5.9 to 11.4) and 8.0 (95% CI 6.0 to 9.9) mm Hg, respectively, than predicted by individual-specific pre-GR linear ageing trends, and fasting blood glucose was 6.3% higher (95% CI 4.6 to 8.1). In comparison, corresponding increases in 2010-2011 were 2.5 and 3.0 mm Hg and 3.3%. CRP increased by 29.7% (95% CI 21.8 to 38.2) in 2010-2011 and 45.1% (95% CI 28.3 to 64.2) in 2016-2018. Mean BMI did not change in 2010-2011 but decreased by 0.5 kg/m
(95% CI -0.7 to -0.2) in 2016-2018. LDL-C decreased by 4.4 (95% CI -6.5 to -2.2) and 5.2 (95% CI -9.5 to -0.9) mg/dL in the two post-GR waves.
Post-GR increases in blood pressure, blood glucose and CRP in the USA not only persisted for 8-10 years after the GR but also grew in magnitude. In contrast, mean BMI and mean LDL-C reduced post-GR. Further studies are needed to uncover mechanisms (behavioural or otherwise) underlying the BMI and LDL-C reductions seen here, and the mortality consequences of these risk factor changes.
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Details
- Title
- Persistence of cardiovascular risk factor changes after the great recession: fixed effects analysis of prospective cohort data from the multi-ethnic study of atherosclerosis
- Creators
- Arun S Karlamangla (Corresponding Author) - University of California, Los AngelesDuncan Thomas - Duke UniversitySharon Stein Merkin - University of California, Los AngelesKari A Moore - Drexel UniversityKarol E Watson - University of California, Los AngelesTeresa E Seeman - University of California, Los Angeles
- Publication Details
- BMJ open, v 16(10), e123802
- Publisher
- Bmj Publishing Group
- Number of pages
- 10
- Grant note
- N01 HC095164 / NHLBI NIH HHS N01 HC095160 / NHLBI NIH HHS N01 HC095168 / NHLBI NIH HHS N01 HC095169 / NHLBI NIH HHS N01 HC095165 / NHLBI NIH HHS HHSN268201500003C / NHLBI NIH HHS N01 HC095162 / NHLBI NIH HHS N01 HC095159 / NHLBI NIH HHS N01 HC095166 / NHLBI NIH HHS N01 HC095163 / NHLBI NIH HHS
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Urban Health Collaborative
- Web of Science ID
- WOS:001897003000001
- Other Identifier
- 991022237878204721