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declines after the GR. It is possible that the deleterious effects of the GR on cardiovascular risk profiles are short-lived and reversed. We examine whether risk factor elevations seen in MESA in the 2010\u20132011\u2009wave persist into the 2016\u20132018\u2009wave of data collection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Individual fixed effects (IFE) analysis of prospective cohort data from MESA, with rate of change in the risk factor (from wave 2 to later waves) as the dependent variable, effectively controlling for individual-specific linear trends in ageing and all time-invariant characteristics. Models included controls for time-varying characteristics.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Communities centred around Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York City, New York; and St. Paul, Minnesota.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>All MESA participants who participated in at least two pre-GR waves and both post-GR waves; n=3101 (47% men, 25% African American, 21% Hispanic, 13% Asian).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Outcomes<\/jats:title>\n                    <jats:p>Primary: Systolic blood pressure (SBP), pulse pressure (PP), fasting blood glucose, serum C-reactive protein (CRP). Secondary: Serum low density lipoprotein cholesterol (LDL-C) and Body Mass Index (BMI)<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean SBP and PP in 2016\u20132018 were greater by 8.6 (95% CI 5.9 to 11.4) and 8.0 (95% CI 6.0 to 9.9) mm Hg, respectively, than predicted by individual-specific pre-GR linear ageing trends, and fasting blood glucose was 6.3% higher (95%\u2009CI 4.6 to 8.1). In comparison, corresponding increases in 2010\u20132011 were 2.5 and 3.0\u2009mm Hg and 3.3%. CRP increased by 29.7% (95% CI 21.8 to 38.2) in 2010\u20132011\u2009and 45.1% (95% CI 28.3 to 64.2) in 2016\u20132018. Mean BMI did not change in 2010\u20132011\u2009but decreased by 0.5\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (95%\u2009CI \u22120.7 to \u22120.2) in 2016\u20132018. LDL-C decreased by 4.4 (95% CI \u22126.5 to \u22122.2) and 5.2 (95% CI \u22129.5 to \u22120.9) mg\/dL in the two post-GR waves.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and relevance<\/jats:title>\n                    <jats:p>Post-GR increases in blood pressure, blood glucose and CRP in the USA not only persisted for 8\u201310 years after the GR but also grew in magnitude. In contrast, mean BMI and mean LDL-C reduced post-GR. Further studies are needed to uncover mechanisms (behavioural or otherwise) underlying the BMI and LDL-C reductions seen here, and the mortality consequences of these risk factor changes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2026-123802","type":"journal-article","created":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T13:25:42Z","timestamp":1791379542000},"page":"e123802","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Persistence of cardiovascular risk factor changes after the great recession: fixed effects analysis of prospective cohort data from the multi-ethnic study of atherosclerosis"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2293-6064","authenticated-orcid":false,"given":"Arun S","family":"Karlamangla","sequence":"first","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9471-1345","authenticated-orcid":false,"given":"Duncan","family":"Thomas","sequence":"additional","affiliation":[{"name":"Economics, Duke University, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharon Stein","family":"Merkin","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kari A","family":"Moore","sequence":"additional","affiliation":[{"name":"Urban Health Collaborative, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karol E","family":"Watson","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa E","family":"Seeman","sequence":"additional","affiliation":[{"name":"University of California Los Angeles, Los Angeles, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,10,7]]},"reference":[{"key":"2026100706252085000_16.10.e123802.1","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1016\/j.socscimed.2015.12.029","article-title":"The physiological impacts of wealth shocks in late life: Evidence from the Great Recession","volume":"150","author":"Boen","year":"2016","journal-title":"Soc Sci Med"},{"key":"2026100706252085000_16.10.e123802.2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1710502115"},{"key":"2026100706252085000_16.10.e123802.3","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.socscimed.2017.12.010","article-title":"The impact of the Great Recession on health-related risk factors, behaviour and outcomes in England","volume":"197","author":"Jofre-Bonet","year":"2018","journal-title":"Soc Sci Med"},{"key":"2026100706252085000_16.10.e123802.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0056674","article-title":"Health and the 2008 economic recession: evidence from the United Kingdom","volume":"8","author":"Astell-Burt","year":"2013","journal-title":"PLoS ONE"},{"key":"2026100706252085000_16.10.e123802.5","doi-asserted-by":"publisher","DOI":"10.1097\/JOM.0b013e3182677dad"},{"key":"2026100706252085000_16.10.e123802.6","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1097\/PSY.0000000000001233","article-title":"Racial and Educational Disparities in Cumulative Exposure to Hardships of the 2008 Great Recession and Inflammation","volume":"85","author":"Kirsch","year":"2023","journal-title":"Psychosom Med"},{"key":"2026100706252085000_16.10.e123802.7","doi-asserted-by":"publisher","DOI":"10.1136\/jech-2017-209105"},{"key":"2026100706252085000_16.10.e123802.8","unstructured":"an VX . 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