Living in a Food Desert Is a Barrier to Optimal Care in Patients With PAD

Living in a food desert can increase risk for major adverse cardiac events in patients with peripheral artery disease.

Patients with peripheral artery disease (PAD) who live in a food desert have an increased risk for major adverse cardiac events (MACE), according to study results presented at the American Heart Association (AHA) Scientific Sessions 2022, held from November 5th through 7th, in Chicago, Illinois.

Researchers sought to determine whether the optimal medical therapy-adjusted rate of MACE events is affected by social determinants of health, including living in a food desert, which is characterized as a census tract with low income and poor food access defined by proximity to a grocery store.

Patients with PAD from 1 health care system were grouped as living in a food desert or not living in a food desert based on the US Department of Agriculture Food Access Research Atlas.

MACE was defined as a composite of all-cause death, acute myocardial infarction, or stroke, and optimal medical therapy was defined as being prescribed an antiplatelet, statin, or renin-angiotensin inhibitor, with tobacco abstention. The association of area characteristics such as food desert, poor access, and low income with MACE was assessed with use of Cox proportional hazards models. Multivariable logistic regression was used to evaluate the association of demographic, clinical, and area characteristics with optimal medical therapy. 

Health care providers should absolutely ask patients with PAD about their access to healthy foods and about their ability to afford and access medical care.

Of the 11,907 patients with PAD included in the study, 15.4% lived in a food desert from 2015 to 2021. The individuals in a food desert were more likely to be Black people or Hispanic people, reside in urban areas, have low vehicle access, and have an increased prevalence of hypertension, chronic kidney disease, and diabetes. The patients who lived in a food desert had a higher adjusted risk for MACE (hazard ratio [HR], 1.17; 1.04-1.31, P =.008), including all-cause death (HR, 1.19; 1.03-1.37, P =.018).

The factors that were significantly associated with lower odds of having optimal medical therapy were being a woman (19% lower odds), malnutrition (59% lower odds), chronic obstructive pulmonary disease (36% lower odds), chronic kidney disease (19% lower odds), and living in a low-income area (11% lower odds). 

“Health care providers should absolutely ask patients with PAD about their access to healthy foods and about their ability to afford and access medical care,” stated lead author Dr Rayan S. El-Zein in a press release. “This is essential to holistic and meaningful patient engagement in chronic disease.”

Disclosure: One of the study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

References:

El-Zein RS, Nguyen DD, Fu Z, et al. Patients with peripheral artery disease living in food deserts are associated with worse outcomes and suboptimal medical therapy. Presented at: The American Heart Association (AHA) Scientific Sessions 2022; November 5-7, 2022; Chicago, IL. Abstract # SU3070.

 

Food insecurity linked to increased heart risks for people with peripheral artery disease. Dallas, TX: American Heart Association Scientific Sessions 2022; October 31, 2022.