This study aimed to examine the association between cardiovascular/cerebrovascular disease history and financial distress among U.S. adults using nationally representative data, and to identify associated factors of financial distress in this high-risk population.

A cross-sectional analysis using pooled data from the 2021, 2022, and 2023 National Health Interview Survey (NHIS) was conducted. Financial distress was assessed using self-reported measures related to medical affordability and medication adherence. Multivariable logistic regression models were utilized to evaluate associations between disease history and financial distress and to identify factors associated with financial distress measures among those with cardiovascular/cerebrovascular disease history.

After propensity score matching, 20,993 respondents with cardiovascular/cerebrovascular disease history and 20,993 without were identified. The overall prevalence of any financial distress did not significantly differ between the two cohorts (47.3% vs. 46.5%, p=0.40). However, individuals with disease history had greater odds of having problems paying medical bills (OR=1.35, 95%CI 1.27-1.44), inability to afford prescription medications (OR=1.31, 95%CI: 1.21-1.42), and delaying care due to cost (OR=1.12, 95%CI 1.03-1.21). Within the disease cohort, factors associated with greater odds of financial distress included female sex, Hispanic ethnicity, lower educational attainment, lack of insurance, and hospitalization history, while older age and Medicaid coverage were associated with lower odds.

Cardiovascular/cerebrovascular disease is associated with a higher burden of specific financial distress measures, highlighting the need for targeted financial and policy interventions to alleviate cost-related healthcare barriers among individuals with cardiovascular/cerebrovascular conditions.