Self-reported fraud victimization and objectively measured blood pressure: Sex differences in post-fraud cardiovascular health

Abstract

Background: Over 5 million older Americans are victims of financial exploitation, schemes, and/or scams per year. Such victimization is associated with increased hospitalizations, admittance to skilled nursing facilities, and lower 5-year all-cause mortality survival rates. Despite this, associations with medical comorbidities like elevated blood pressure (BP) have not been examined.

Methods: We investigated the association of self-reported fraud victimization (presence/absence) with objectively measured BP metrics leveraging cross-sectional and longitudinal data from over 1200 non-demented adults (75% female; age ~81 years) from the Rush Memory and Aging Project. We first examined cross-sectional associations between baseline fraud victimization and BP, then used longitudinal data to test the hypothesis that fraud victimization is associated with increases in BP after incident fraud. During up to 11 years of annual observation, participants were queried for fraud victimization and underwent serial BP measurements to calculate per visit averages of systolic and diastolic BP, mean arterial pressure (MAP), and pulse pressure.

Results: Cross-sectional analyses established that fraud victimization at baseline was associated with higher BP values. Next, using longitudinal changepoint analyses, we showed that fraud victimization was associated with elevations in BP among men but not women. Specifically, men who reported incident fraud exhibited increases in all BP metrics post-fraud.

Conclusion: Results suggest an important link between fraud victimization and BP, particularly among men. Older men showed significant elevations in BP after incident fraud that, compounded over time, may portend other adverse health outcomes.

Keywords: aging; blood pressure; fraud victimization.

Figure 1.

Rate of change in blood pressure in male participants pre- and post-fraud victimization (solid orange line with inflection point to signify rates of change before and after incident fraud in those reproting fraud; dotted blue line signifies the projected continual decline in blood pressure seen in men who did not report incident fraud). Lines based on relevant estimates for men taken from the fully-adjusted changepoint model including terms for age, sex, education, anti-hypertension medication use, diabetes status, cumulative vascular diease burden, global cognitive functioning, body mass index, and smoking. Panels reflect (from left to right) systolic blood pressure, mean arterial pressure, and pulse pressure; diastolic blood pressure is not shown given it was not significant.