Debt: A burden to the heart, too?

A young adult’s feeling of indebtedness may compromise his or her cardiovascular health. A longitudinal study that included 8,400 adults between 24 and 32 years old found higher subjective relative debt was associated with a clinically significant increase in diastolic blood pressure.

The results were published in the October issue of Social Science & Medicine.

Overall household debt in the U.S. tripled since the 1980s, with student loan debt alone accounting for more than $1 trillion, wrote Elizabeth S. Sweet, PhD, of Northwestern University Feinberg School of Medicine in Chicago, and colleagues. “[F]inancial debt has become a fixture of the American household economy.”

Hypothesizing that debt may be a predictor of health outcomes, Sweet et al turned to the National Longitudinal Study of Adolescent Health (Add Health), which followed participants for more than 15 years. The study data included several indices of self-reported debt and assets as well as measures of health. Relevant to this study, those measures included self-reported general health and systolic and diastolic blood pressure.

Blood pressure was measured during data collection in 2007 and 2008, when participants had reached young adulthood. Field interviewers took three consecutive readings, using the average of the second and third readings for the blood pressure variables.

The sample had an average age of 28, with 47 percent men and 70 percent non-Hispanic white. They reported a mean household income of $62,000; mean assets of $85,500; mean non-mortgage debt of $30,000 and a mean calculated ratio of debt to assets of 2.5. About one in five said they would remain in debt if they liquidated all assets.

“[H]igher subjective relative debt was significantly associated with higher diastolic blood pressure in both unadjusted and adjusted models (a 1.3 percent increase in DBP [diastolic blood pressure] relative to the mean in fully adjusted models),” they wrote. “While this effect is relatively small, it is clinically significant; a 2 mmHg increase in DBP, for instance, is associated with 17 percent higher risk of hypertension and 15 percent higher risk of stroke.”

They acknowledged that respondents’ view of their financial picture was subjective and may not accurately reflect their financial situation. As young adults, they may not have accumulated enough debt burden to fully display adverse health outcomes.

Sweet et al recommended more research that focuses on potential debt-induced mechanisms that might influence health outcomes.

“In testing multiple indices of debt, we found high household debts relative to assets to be the most consistent and robust predictor of health outcomes,” they summarized. “We also found that a high subjective assessment of indebtedness was the strongest predictor of blood pressure, suggesting that psychological dimensions of debt may be particularly salient when it comes to cardiovascular health.”