Where you live during early adulthood could have implications for your heart health years later, new research suggests.

A study led by researchers at Northwestern Medicine found that people exposed to more adverse neighbourhood social conditions during early adulthood had a higher risk of developing coronary artery calcification (CAC) by middle age.

CAC refers to calcium deposits that build up in the walls of the coronary arteries and is considered an early marker of atherosclerosis and cardiovascular disease.

The findings, published in Nature Communications, suggest that factors beyond individual lifestyle choices may contribute to long-term heart health.

How Can a Neighbourhood Affect Heart Health?

The researchers developed an index combining several neighbourhood-level factors rather than looking at a single measure of deprivation.

These included socioeconomic conditions, access to food, availability of places for physical activity, and local crime rates. The researchers then used data from the Coronary Artery Risk Development in Young Adults (CARDIA) study to examine how these conditions were associated with cardiovascular health over time.

The CARDIA study began in 1985–86 and included 5,115 Black and White adults aged 18 to 30 from Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; and Oakland, California.

For the current analysis, 3,499 participants who had coronary calcium measurements at the 25-year follow-up were included. Their average age was around 50.

What Did the Study Find?

The researchers found that each one-standard-deviation increase in the neighbourhood social determinants index was associated with a 15% to 17% higher odds of coronary artery calcification, depending on when neighbourhood conditions were measured.

The odds ratios ranged from 1.15 at year 15 to 1.17 at years seven and 20. The association remained after researchers accounted for factors including age, sex, race, body mass index, smoking, alcohol consumption, and physical activity. Additional adjustments for blood pressure, diabetes, cholesterol, and diet produced similar results.

The association was also stronger among Black participants at later follow-up points compared with White participants. The researchers said differences in neighbourhood conditions, including poverty, access to healthy food, physical activity facilities, and exposure to crime, may contribute to disparities in cardiovascular health.

What Is Coronary Artery Calcification?

Coronary artery calcification occurs when calcium accumulates in plaques inside the arteries supplying the heart.

It does not necessarily mean a person will have a heart attack, but a higher calcium burden can indicate a greater level of underlying coronary atherosclerosis and cardiovascular risk.

In this study, CAC was detected using computed tomography (CT) scans. Researchers defined incident CAC as a calcium score greater than zero.

Does Living in a Poorer Neighbourhood Cause Heart Disease?

Not necessarily. The study was observational and did not establish a direct cause-and-effect relationship between neighbourhood conditions and coronary artery calcification. The researchers acknowledged that factors such as environmental pollution, access to healthcare, and other unmeasured health conditions could also influence the findings.

Instead, the findings suggest that the environments people experience in early adulthood may form part of the wider circumstances influencing cardiovascular health over the life course.

Neighbourhoods with fewer opportunities for physical activity, limited access to affordable healthy food, or higher levels of crime may make it harder for residents to maintain healthy behaviours. Chronic exposure to stressful conditions may also play a role, although the study did not directly establish these mechanisms.

What Can You Do to Protect Your Heart?

Your postcode is not your destiny. Many established cardiovascular risk factors can be modified, including smoking, physical inactivity, unhealthy diet, high blood pressure, high cholesterol, and excess body weight.

Regular physical activity, a balanced diet, avoiding tobacco, and keeping blood pressure and cholesterol under control can all contribute to better cardiovascular health.

The researchers say future studies will investigate whether the same neighbourhood factors are associated with outcomes such as heart attacks and heart failure, and whether improving neighbourhood conditions could reduce cardiovascular risk.

For now, the findings add to the evidence that heart health is shaped by more than individual choices, and that the environment people live in may matter too.

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Frequently Asked Questions

  • How can neighbourhood conditions affect heart health?
    Neighbourhood conditions such as socioeconomic status, access to food, physical activity opportunities, and crime rates can influence long-term heart health.
  • What is coronary artery calcification?
    Coronary artery calcification refers to calcium deposits in the coronary arteries, indicating atherosclerosis and cardiovascular risk.
  • Does living in a poorer neighbourhood cause heart disease?
    The study did not establish a direct cause-and-effect relationship but suggests that neighbourhood conditions may influence cardiovascular health.
  • What can you do to protect your heart?
    Modifying risk factors such as smoking, diet, physical inactivity, high blood pressure, and cholesterol can help protect heart health.