The association of periodontal disease and cardiovascular disease risk: Results from the Hispanic Community Health Study/Study of Latinos

AbstractObjective:Hispanics/Latinos in the United States are less aware of their cholesterol levels and have a higher burden of associated adverse cardiovascular and cerebrovascular outcomes than non-Latino whites. Investigations of the associations between cholesterol levels and cognition in this population have often occurred within the context of metabolic syndrome and are limited to select lipids despite the fact that triglycerides (TGs) may be more relevant to the health of Hispanics/Latinos.Methods:Baseline data from the Hispanic Community Health Study/Study of Latinos, collected from 2008 to 2011, was used to investigate the associations of lipid levels (i.e., TG, total cholesterol, TC; low-density and high-density lipoprotein cholesterol, LDL-C and HDL-C) with cognition (i.e., learning, memory, verbal fluency, and digit symbol substitution, DSS), adjusting for relevant confounders.Results:In 7413 participants ages 45 to 74 years from Central American, Cuban, Dominican, Mexican, Puerto Rican, and South American backgrounds, separate, fully adjusted linear regression models revealed that TG levels were inversely associated with DSS performance; however, this relationship was no longer significant once additional cardiovascular disease risk factors were added to the model (p = .06). TC and LDL-C levels (separately) were positively associated with learning and verbal fluency regardless of adjustments (p-values < .05). Separate analyses investigating the effect modification by background and sex revealed a particularly robust association between TC levels and DSS performance for Puerto Ricans and Central Americans (albeit in opposite directions) and an inverse relationship between TG levels and DSS performance for women (p-values < .02).Conclusions:It is important to consider individual lipid levels and demographic characteristics when investigating associations between cholesterol levels and cognition in Hispanics/Latinos.

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Abstract 16591: The Impact of African Ancestry on the Pooled Cohort Equation Atherosclerotic Cardiovascular Disease Risk Estimation: Insights From the Hispanic Community Health Study/study of Latinos

Circulation ◽

10.1161/circ.142.suppl_3.16591 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Karen P Flores ◽

Amit Khera ◽

Daniela Sotres-Alvarez ◽

Anurag Mehta ◽

Amber Pirzada ◽

...

Keyword(s):

Cardiovascular Disease ◽

Community Health ◽

Disease Risk ◽

African Ancestry ◽

Health Study ◽

Atherosclerotic Cardiovascular Disease ◽

Risk Estimates ◽

Hispanic Community ◽

Ascvd Risk ◽

The Impact

ACC/AHA 2018 guidelines recommend using Non-Hispanic (NH)-White pooled cohort equations (PCE) to estimate 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among Hispanics. If African ancestry is present, the PCE for Blacks is recommended. African ancestry estimates among Hispanic Community Health Study/Study of Latinos (HCHS/SOL) background groups have been reported. 1 We applied the PCE based on fractional African ancestry to HCHS/SOL participants and compared risk estimates from NH-White and NH-Black PCE in these groups. HCHS/SOL participants aged 40-75 years were divided into two groups based on median fractional African ancestry of ~10%: groups with >=10% or higher African Ancestry (Puerto Rican, Central Americans, and Dominicans) and those with <10% or lower African ancestry (Mexicans, South Americans, Cubans). Mean predicted ASCVD incidence using both PCE's was assessed. ASCVD risk frequencies are weighted using survey methods. Differences were determined by Rao-Scott Chi-square test. The PCE was applied to 9091 HCHS/SOL participants. (mean age 53.5, 48% F) Applying the NH-White PCE to lower African ancestry groups led to 38% of participants being classified as intermediate/high (>7.5%) ASCVD risk compared to 45% using the NH-Black PCE. Using the NH-White PCE in groups with higher African ancestry led to 36% of participants being classified as intermediate/high risk compared to 46% using the NH-Black PCE. ASCVD risk estimates per Hispanic background groups are shown. (Figure 1C ). Our study is the first to apply both NH-Black and NH-White PCE to Hispanics and assess differences based on fractional African ancestry. The NH-Black PCE provided consistently greater estimates in both groups with slightly greater differential of estimates relative to NH-White PCE in those with higher African Ancestry. Further studies with outcomes data are needed to determine optimal application of PCE in Hispanics based upon fractional African Ancestry.

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