Modifiable high-risk behaviors for cardiovascular disease among family physicians in the United States. A national Survey

The American media often disseminates antivaccination messages. Cinema in particular reaches many individuals and influences attitudes regarding high-risk behaviors such as smoking and alcohol use. We hypothesized that negative cinematic portrayals of immunization have increased over the last 3 decades. Films released in the United States featuring immunization through 2016 were identified on IMDb and viewed in their entirety by 2 reviewers. Themes were recorded, and the portrayal of immunization (positive, negative, or mixed) across each decade was assessed in a logistic regression model. Cultural references attributed to films (eg, television references) were recorded from the “connection” feature on IMDb. Fifty relevant films were identified (1925-2016). Negative/mixed portrayals of immunization were more frequent after 1990 (odds ratio = 4.0, 95% confidence interval = 1.2-13.5), and films with positive immunization portrayals garnered significantly fewer cultural references than films with negative/mixed portrayals (mean = 9.2 vs 56.2, P = .048). American cinema features increasingly negative portrayals of immunization.

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Abstract 264: Utilizing Risk Scoring for Prescribing Statins to Hospitalized Patients to Primarily Prevent Coronary Artery Disease

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.264 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Muhammed Atere ◽

William Lim ◽

Vishnuveni Leelaruban ◽

Bhavya Narala ◽

Stephanie Herrera ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Coronary Artery Disease ◽

Coronary Artery ◽

High Risk ◽

Disease Risk ◽

The United States ◽

Intermediate Risk ◽

Peripheral Artery ◽

Artery Disease

Background: Cardiovascular disease is the leading cause of mortality in the United States. Approximately 25% of total deaths in the United States are attributed to cardiovascular diseases. Modification of risk factors has been shown to reduce mortality and morbidity in people with coronary artery disease. Medications such as statins are well known for reducing risks and recent data has shown that statins are beneficial in the primary prevention of coronary artery disease. The purpose of this study is to assess whether statins are being prescribed on discharge to patients who are identified as intermediate to high risk using the ACC/AHA Pooled Cohort Equations. Methodology: We reviewed and analyzed the charts of hospitalized patient’s ages 40 to 79 years who were discharged under the service of Internal Medicine at Richmond University Medical Center from September 2018 to August 2019. Exclusion criteria included: patients that expired before discharge or were admitted to the intensive or coronary care units, pregnancy, previous diagnosis of coronary/peripheral artery disease or stroke, already on statins or lipid-lowering medications, allergic to statins, discharged on statins for coronary/peripheral artery disease or stroke, and patients with liver disease or elevated liver enzymes. We used the ACC/AHA Pooled Cohort Equations risk to calculate the 10-year coronary artery disease risk for each patient. Results: The 10-year risk is grouped as low risk (<5%), borderline risk (5% to 7.4%), intermediate risk (7.5% to 19.9%) and high risk (≥20%). Among 898 patients, 10% had intermediate and high risk that were not discharged with statins. Among the 10%, about 6.6% were intermediate risk and 3.4% were high risk. Conclusions: A significant number of intermediate and high-risk patients were discharged without statins, although a CT coronary calcium may be helpful in further classifying the risk in some of them. We believe that a lipid profile should be checked in all hospitalized patients 40 years and older in order to calculate their atherosclerosis cardiovascular disease risk score and to possibly initiate statins after discussing the benefits and side effects, particularly in the intermediate risk group. The continuation of statins would be followed up by their primary care physicians. We plan to liaise with the information technology department in our facility to provide a link to the risk calculator in the electronic medical record so that the risk can be calculated and statins initiated as necessary. We will conduct a follow up review to assess for effectiveness.

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1310. The Impact of Recent Incarceration on Post-Release HIV Linkage to Care and Risk-Taking Behaviors in the Setting of Enhanced Linkage to Care Policies in Florida

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.1173 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S472-S473

Author(s):

Greg Matthew E Teo ◽

Suraj Nagaraj ◽

Nisha Sunku ◽

Sadaf Aslam ◽

Rahul Mhaskar ◽

...

Keyword(s):

High Risk ◽

Risk Behaviors ◽

Barriers To Care ◽

Linkage To Care ◽

The United States ◽

Self Report ◽

Hiv Care ◽

High Risk Behaviors ◽

Persons Living With Hiv ◽

The Impact

Abstract Background The United States has the largest incarcerated population in the world with 6.61 million adults in 2016.1 While incarceration is a known risk factor for difficulties in linkage to care2–3 and adverse health outcomes4–6, little is published on post-release incarcerated persons living with HIV (PLWH) in Florida. Methods Data were acquired from the Florida Cohort, an ongoing, longitudinal, cross-sectional study of PLWH recruited across HIV clinics in the state of Florida, from 2014 to 2018. Chi-square and multiple regression analyses correlated recent incarceration (within last 12 months) with demographics, HIV care adherence, perceived barriers to care, and self-reported high-risk behaviors. Results Of 936 participants, 6.4% (n = 60) reported recent incarceration within the last 12 months. Those recently incarcerated were more likely to report missing at least one appointment in the last 6 months (46.7% vs. 22.2%; P < 0.0001), to have an excessively long travel time ( >60 minutes) to a HIV provider (34.5% vs. 16.6%, P = 0.002; OR 2.66 [95% CI: 1.20–5.92]), and to lack reliable transportation (70% vs. 47.5%, P = 0.0007; OR 1.70 [95% CI: 0.82–3.52]) Those not recently incarcerated reported having completed a high school education (OR: 0.69 [95% CI: 0.5–0.97]) and stated they “never missed an appointment” (OR: 0.42 [95% CI: 0.22–0.81]). Recently incarcerated PLWH also had higher occurrence of high-risk behaviors such as receiving (40.4% vs. 8.7%; P = 0.001) or providing (30.4% vs. 10.4%; P = 0.000) money or drugs for sex, having used IV drugs (15% vs. 4%; P = 0.001), and not using condoms during exchange of drugs for sex (OR: 9.43 [95% CI: 3.78–23.52]). Conclusion Recently incarcerated PLWH continue to have significant geographical and logistical barriers to care and self-report more high-risk behaviors than nonincarcerated peers. Enhanced case management and telehealth services may be useful in linkage to care when PLWH transition from correctional to community healthcare systems in the Florida setting. Disclosures All authors: No reported disclosures.

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P340 Trends in high-risk sexual risk behaviors in the united states, 2002–2015

10.1136/sextrans-2019-sti.448 ◽

2019 ◽

Author(s):

Jami Leichliter ◽

Patricia Dittus ◽

Sevgi Aral

Keyword(s):

United States ◽

High Risk ◽

Sexual Risk ◽

Risk Behaviors ◽

Sexual Risk Behaviors ◽

The United States

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Abstract 181: Application of the 2018 Cholesterol Guideline for Secondary Prevention in Very High-risk Patients with Atherosclerotic Cardiovascular Disease in the United States

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.12.suppl_1.181 ◽

2019 ◽

Vol 12 (Suppl_1) ◽

Author(s):

Doosup Shin ◽

Chandrashekar Bohra ◽

Kullatham Kongpakpaisarn

Keyword(s):

United States ◽

Cardiovascular Disease ◽

High Risk ◽

Secondary Prevention ◽

The United States ◽

Atherosclerotic Cardiovascular Disease ◽

High Risk Patients ◽

Risk Patients ◽

Very High

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Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States

Journal of the American Heart Association ◽

10.1161/jaha.120.020028 ◽

2021 ◽

Author(s):

Shiwani Mahajan ◽

Gowtham R. Grandhi ◽

Javier Valero‐Elizondo ◽

Reed Mszar ◽

Rohan Khera ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Food Security ◽

High Risk ◽

Food Insecurity ◽

Family Income ◽

The United States ◽

Atherosclerotic Cardiovascular Disease ◽

Risk Characteristics ◽

Sociodemographic Determinants

Background Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown. Methods and Results Using 2013 to 2018 National Health Interview Survey data, we evaluated the prevalence and sociodemographic determinants of food insecurity among adults with ASCVD in the United States. ASCVD was defined as self‐reported diagnosis of coronary heart disease or stroke. Food security was measured using the 10‐item US Adult Food Security Survey Module. Of the 190 113 study participants aged 18 years or older, 18 442 (adjusted prevalence 8.2%) had ASCVD, representing ≈20 million US adults annually. Among adults with ASCVD, 2968 or 14.6% (weighted ≈2.9 million US adults annually) reported food insecurity compared with 9.1% among those without ASCVD ( P <0.001). Individuals with ASCVD who were younger (odds ratio [OR], 4.0 [95% CI, 2.8–5.8]), women (OR, 1.2 [1.0–1.3]), non‐Hispanic Black (OR, 2.3 [1.9–2.8]), or Hispanic (OR, 1.6 [1.2–2.0]), had private (OR, 1.8 [1.4–2.3]) or no insurance (OR, 2.3 [1.7–3.1]), were divorced/widowed/separated (OR, 1.2 [1.0–1.4]), and had low family income (OR, 4.7 [4.0–5.6]) were more likely to be food insecure. Among those with ASCVD and 6 of these high‐risk characteristics, 53.7% reported food insecurity and they had 36‐times (OR, 36.2 [22.6–57.9]) higher odds of being food insecure compared with those with ≤1 high‐risk characteristic. Conclusion About 1 in 7 US adults with ASCVD experience food insecurity, with more than 1 in 2 adults reporting food insecurity among the most vulnerable sociodemographic subgroups. There is an urgent need to address the barriers related to food security in this population.

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