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Growing Up in a Low-Income Family Was Linked to More Artery Plaque Decades
Later A Swedish study of 15,640 adults aged 50 to 64 found those from the
lowest-income childhood households had higher odds of significant coronary
plaque on CT scans.




The Capital Brief October 12
Heart Health Edition
Growing Up in a Low-Income Family Was Linked to More Artery Plaque Decades
Later


Heart disease is usually discussed in terms of adult habits such as diet,
smoking and exercise. A Swedish study suggests the roots may reach back to
childhood circumstances. Researchers at Karolinska Institutet published the
study in the Journal of the American Heart Association on October 7. They
analyzed 15,640 adults aged 50 to 64 in the Swedish CArdioPulmonary bioImage
Study, known as SCAPIS, and linked them to their families' incomes when they
were 10 to 12 years old. Participants had CT scans of the arteries supplying
the heart, which can show plaque, the buildup that narrows arteries and can
lead to heart attacks. According to the researchers, people who grew up in the
lowest-income households had about 43% higher odds of moderate to severe
coronary plaque than those from the highest-income households. After accounting
for adult lifestyle, adult socioeconomic circumstances and established risk
factors, the odds were still about 31% higher. This was an observational study.
It shows an association between childhood income and plaque found on scans, not
that childhood poverty directly causes heart disease, and it measured plaque
rather than heart attacks. The useful idea is that cardiovascular risk may
accumulate across a lifetime, beginning well before adulthood. This edition
explores the evidence, not individual medical advice. Heart health questions
are best discussed with a clinician.

01 What coronary plaque is
Atherosclerosis is the buildup of fat, cholesterol and other material in
artery walls. In the coronary arteries, plaque can narrow the vessels that
supply the heart. Plaque can rupture and trigger a heart attack. It develops
slowly over decades, often without symptoms. CT scans of the coronary arteries
can detect and grade plaque. Plaque on a scan is a marker of risk, not a heart
attack itself. Many risk factors for plaque are well known, including high
cholesterol, high blood pressure, smoking and diabetes.

02 How the study was designed
SCAPIS is a large Swedish population study that has scanned the hearts and
lungs of middle-aged adults. Researchers linked participants to registry data
on their parents' income when they were 10 to 12 years old. They compared
people from the lowest- and highest-income childhood households. The main
outcome was moderate to severe coronary atherosclerosis on CT scans about 50
years later. The first analysis accounted for age, sex and other basic factors.
A second analysis also accounted for adult lifestyle, adult socioeconomic
circumstances and established risk factors. Full methods and confidence
intervals are in the published paper.

03 What was found
People from the lowest-income childhood households had about 43% higher odds
of moderate to severe coronary plaque in the first analysis. After accounting
for adult factors, the odds were still about 31% higher. That suggests adult
circumstances explain part, but not all, of the association. The findings refer
to odds of plaque on scans, not to heart attack or death rates. Lead researcher
Per Svensson said early-life socioeconomic circumstances have an impact on
cardiovascular health. He said the link likely reflects a lifelong accumulation
of risk factors not fully captured by adult data. Absolute rates of plaque by
income group are reported in the full paper.

04 Why childhood might matter
The researchers suggested several possible explanations, which need further
study. Children in low-income households may face more stress, which can affect
inflammation and the cardiovascular system. Childhood overweight and diet can
influence long-term metabolic health. Access to health care, healthy food and
safe places for activity may differ by income. Early exposures may set patterns
that persist into adulthood. The study could not identify which of these
factors matter most. Mechanisms remain plausible but unproven.

05 Context and generalizability
Sweden has universal health care and a strong social safety net. That such an
association appears there suggests childhood circumstances matter even with
broad access to care. Results may differ in countries with different health and
social systems. Childhood income was measured once, which may not capture
changes over time. Socioeconomic differences in heart disease are well
documented in many countries. This study adds evidence that some of the gap may
begin in childhood. Prevention efforts may need to start early.

06 Study limits
The study was observational and cannot prove that childhood income causes
plaque. Unmeasured factors may explain part of the association. Childhood
income was measured at one point in time. Results apply to Swedish adults aged
50 to 64. The outcome was plaque on scans, not heart attacks or deaths. These
figures come from the researchers' summary; confidence intervals and full
details are in the published paper. The study was funded in part by the Swedish
Heart-Lung Foundation.

07 What people can do
Adults can know their cholesterol, blood pressure and blood sugar numbers and
discuss heart risk with a clinician. Sharing family and early-life history with
a clinician can add context to risk assessment. Not smoking, regular physical
activity and a heart-healthy diet reduce cardiovascular risk at any age.
Parents and caregivers can support children's activity, nutrition and sleep
where possible. Community programs for healthy food and safe recreation can
help families with limited resources. Stress management and social support
benefit both children and adults. Heart health can improve at any age,
regardless of where life started.

08 The long view on heart health
Heart disease develops over a lifetime, and risk may begin long before the
first symptoms. This study suggests childhood economic circumstances are
associated with artery plaque decades later. For individuals, practical
questions include: What are my risk factors today? What do I know about my
early life? What changes can I make now? For clinicians, early-life
circumstances may add context to cardiovascular risk. For policymakers, the
findings add to the case for supporting children's health early. The long-view
idea is that the health of adults is shaped in childhood. Prevention is a
lifelong project.


The Takeaway

1 In 15,640 Swedish adults aged 50 to 64, growing up in the lowest-income
households was associated with about 43% higher odds of significant coronary
plaque.
2 After accounting for adult lifestyle, circumstances and risk factors, the
odds were still about 31% higher.
3 The outcome was plaque on CT scans, not heart attacks.
4 The study was observational, and mechanisms remain uncertain.
5 The findings support early-life prevention, not a prediction for any
individual.
Stay patient, stay curious,
T.C. Brown
Editor, True Capital Talk


Sources & Further Reading

• Low parental income during childhood is associated with coronary
atherosclerosis in midlife —Journal of the American Heart Association, October
7, 2026 <[link removed]>
• What is atherosclerosis? — National Heart, Lung, and Blood Institute
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• Atherosclerosis — American Heart Association
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• Cardiovascular diseases fact sheet — World Health Organization
<[link removed]-(cvds)>
For educational and informational purposes only. Nothing here is a diagnosis,
treatment plan, or individualized medical advice. Talk to a qualified clinician
about heart health and cardiovascular risk.  


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