Higher neighborhood disadvantage is associated with weaker interactions among cardiometabolic drivers

Adiposity, dysglycemia, and hypertension are metabolic drivers that have causal interactions with each other. However, the effect of neighborhood-level disadvantage on the intensity of interactions among these metabolic drivers has not been studied. The objective of this study is to determine whether the strength of the interplay between these drivers is affected by neighborhood-level disadvantage. This cross-sectional study analyzed patients presenting to a multidisciplinary preventive cardiology center in New York City, from March 2017 to February 2021. Patients’ home addresses were mapped to the Area Deprivation Index to determine neighborhood disadvantage. The outcomes of interest were correlation coefficients (range from −1 to +1) among the various stages (0 - normal, 1 - risk, 2 - predisease, 3 - disease, and 4 - complications) of abnormal adiposity, dysglycemia, and hypertension at presentation, stratified by neighborhood disadvantage. The cohort consisted of 963 patients (age, median [IQR] 63.8 [49.7–72.5] years; 624 [65.1 %] female). The correlation among the various stages of adiposity, dysglycemia, and hypertension was weaker with increasing neighborhood disadvantage (P for trend