Abstract
INTRODUCTION: Socioeconomic inequities affect cardiovascular outcomes in adults, but their cumulative effect in adolescents remains unclear. The aim of this study is to evaluate the association between simultaneous exposure to different socioeconomic disadvantages and cardiovascular health (CVH) in Brazilian adolescents. METHODS: The sample consisted of 34,831 adolescents aged 12 to 17 years, participants of the Brazilian Cardiovascular Risk in Adolescents Study (ERICA), a national, school-based, cross-sectional, multicenter study. CVH was assessed using the Life's Essential 8 (LE8) score, which ranges from 0 to 100 points and is composed of eight metrics grouped into two domains: health behaviors (diet, physical activity, nicotine exposure, and sleep duration) and health factors (body mass index, non-HDL cholesterol, blood glucose, and blood pressure). Simultaneous exposure to socioeconomic disadvantages was assessed using five variables: parental education, family structure, possession of goods, type of school, and skin color. The total number of exposures ranged from 0 to 5. Linear regression models adjusted for sex and age were used to evaluate the association between simultaneous exposure to socioeconomic disadvantages and CVH. RESULTS: The simultaneous exposure to at least two socioeconomic disadvantages was 80.7 %, while the average LE8 score was 75.9 (95 % CI 75.5-76.4). The higher the number of simultaneous exposures to the investigated socioeconomic disadvantages, the worse the CVH of Brazilian adolescents. Those exposed to all the investigated disadvantages simultaneously had a reduction of 4.5 points in the LE8. Physical activity and smoking were the LE8 components most impacted by socioeconomic disadvantages. Belonging to a fragmented family structure appeared to have the greatest impact on CVH. CONCLUSION: Simultaneous exposure to multiple socioeconomic disadvantages was associated with poorer CVH in Brazilian adolescents.