---
type: source
title: "Food Insecurity and Cardiovascular Disease Risk Factors Among U.S. Adults"
author: "BMC Public Health"
url: https://link.springer.com/article/10.1186/s12889-025-22031-9
date: 2025-01-01
domain: health
secondary_domains: []
format: article
status: processed
processed_by: vida
processed_date: 2026-04-04
priority: medium
tags: [food-insecurity, cardiovascular, hypertension, SDOH, diet, ultra-processed-food, CVD-risk]
extraction_model: "anthropic/claude-sonnet-4.5"
---

## Content

Published 2025 in *BMC Public Health*. Analysis of food insecurity and CVD risk factors among US adults.

**Key findings:**

1. **40% higher hypertension prevalence** among food-insecure adults compared to food-secure adults. Food insecure adults showed higher systolic blood pressure overall.

2. **Scale of food insecurity:** As of the period studied, 42+ million people in the US lived in food-insecure households. Roughly **40% of individuals with cardiovascular disease** experience food insecurity — twice the rate among those without CVD.

3. **Bidirectional relationship:** CVD → food insecurity (medical costs drain food budget) AND food insecurity → CVD (diet quality → CVD risk factors). The direction is bidirectional, creating a reinforcing loop.

4. **Dietary mechanism:**
   - Food insecurity → lower fruits and vegetables intake
   - Food insecurity → higher consumption of energy-dense ultra-processed foods during scarcity
   - High sodium + low potassium content of available processed foods → BP elevation
   - Poor-quality diet → diabetes, hypertension, obesity, dyslipidemia (cardiovascular risk intermediaries)

5. **Neighborhood compounding:** In impoverished neighborhoods, food insecurity is compounded by unfavorable trade policies making fresh produce unaffordable — distinguishing between income insufficiency and food environment barriers.

6. **Hispanic-specific finding** (companion paper, ScienceDirect 2024): Food insecurity associated with **mortality risk among Hispanics with hypertension** — the CVD risk from food insecurity is not equally distributed across racial/ethnic groups.

## Agent Notes

**Why this matters:** Provides the population-scale epidemiology for the food insecurity → hypertension chain. The 40% higher prevalence figure is a strong claim anchor. Combined with the REGARDS cohort (UPF → 23% higher incident HTN in 9 years), the SDOH-hypertension mechanism has both population evidence (this paper) and cohort evidence (REGARDS).

**What surprised me:** 40% of CVD patients experience food insecurity — meaning the population already suffering from CVD is simultaneously experiencing the dietary driver that makes their condition worse and their treatment less effective. This is the positive feedback loop at clinical scale.

**What I expected but didn't find:** Longitudinal data showing whether food assistance programs (SNAP, WIC) reduce hypertension incidence or improve BP control in the food-insecure population. This would test the SDOH intervention hypothesis directly. Not available from this paper — would require a separate search.

**KB connections:**
- `Big Food companies engineer addictive products...` — food environment claim; this paper shows food insecurity forces reliance on these engineered products
- `hypertension-related-cvd-mortality-doubled-2000-2023-despite-available-treatment...` — food insecurity-driven UPF consumption is part of the mechanism
- `SDOH interventions show strong ROI but adoption stalls because Z-code documentation remains below 3 percent...` — food insecurity screening is one of the Z-codes; this paper shows why it matters for CVD
- `food-as-medicine` (from Session 3) — food assistance programs are the SDOH intervention for this mechanism; VBID termination (from Session 14) removed the payment mechanism

**Extraction hints:**
- Data point for existing claims: enriches `hypertension-related-cvd-mortality-doubled` with the food insecurity → HTN mechanism
- 40% of CVD patients experiencing food insecurity is a strong claim anchor that could justify a standalone claim: "Food insecurity affects 40% of US adults with cardiovascular disease and is associated with 40% higher hypertension prevalence, creating a reinforcing loop where disease drives dietary insufficiency and dietary insufficiency drives disease"

**Context:** BMC Public Health is a solid peer-reviewed venue. This is a 2025 publication so it represents recent synthesis. The companion Hispanic-specific mortality paper (ScienceDirect 2024) suggests racial/ethnic disparities in the food insecurity → CVD mechanism, consistent with the AHA SDOH systematic review finding that race predicts hypertension beyond standard SDOH measures.

## Curator Notes

PRIMARY CONNECTION: `hypertension-related-cvd-mortality-doubled-2000-2023-despite-available-treatment-indicating-behavioral-sdoh-failure.md`

WHY ARCHIVED: Provides the epidemiological anchor (40% higher HTN prevalence, 40% of CVD patients food-insecure) for the SDOH mechanism claims. Paired with REGARDS UPF cohort and AHA SDOH systematic review, this triples the evidence base for the food environment → hypertension treatment failure chain.

EXTRACTION HINT: Use as supporting evidence for SDOH mechanism claims rather than a standalone. The 40%/40% epidemiological facts are the useful extractables. The bidirectional loop (CVD → food insecurity → CVD) is a claim worth extracting separately.
