Does living in a low-income or high-crime neighborhood have a measurable effect on your heart health? Here are five things to know about a recent Massachusetts General Hospital research study led by Ahmed Tawakol, MD, and Katrina Armstrong, MD, that explored connections between the two:

Individuals of lower socioeconomic status have an increased risk of increased risk of cardiovascular diseases such as heart attack, stroke and angina. While some of this risk can be linked to lifestyle factors, including greater rates of smoking and obesity and limited access to care, the risk persists even after adjusting for these factors—suggesting there may be additional biological factors in play.

In 2017, Tawakol was part of a Mass General research team that  identified a pathway in which stress-related activity in the brain leads to an increased risk of stroke by increasing immune cell production and inflammation of the arteries. The pathway was identified by analyzing PET scans that looked at inflammation levels in the brain and arteries. This in turn increases the risk for stroke, heart attack and other cardiovascular disorders.

The team’s latest study took a closer look at a subset of patients from the 2017 study for whom socioeconomic data was available. The team found that individuals from neighborhoods with lower household incomes or higher crime rates had higher rates of activity in the amygdala, increased immune cell production and more arterial inflammation, which significantly increased their risk of a heart attack, unstable angina, cardiac failure or death in the four years after the study.

It may be possible to reduce these risks through lifestyle-based interventions such as sufficient sleep, exercise and meditation, using statins to reduce inflammation in the arteries and developing new drugs that target the pathway between the amygdala and the arteries.

The researchers will continue studying this pathway with the hopes of identifying new drugs that could help reduce the risk of adverse cardiac events. They will also look at small number of study participants who live in low-income or high-crime communities but don’t show elevated levels of inflammation to see if these individuals hold clues to regulating this pathway in others.

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