Relationship of Overall Cardiovascular Health and Hearing Loss in The Jackson Heart Study Population

Background: Optimism has been shown to be positively associated with better cardiovascular health (CVH). However, there is a dearth of prospective studies showing the benefits of optimism on CVH, especially in the presence of adversities, i.e., psychosocial risks. This study examines the prospective relationship between optimism and CVH outcomes based on the Life's Simple 7 (LS7) metrics and whether multilevel psychosocial risks modify the aforementioned relationship.Methods: We examined self-reported optimism and CVH using harmonized data from two U.S. cohorts: Multi-Ethnic Study of Atherosclerosis (MESA) and Jackson Heart Study (JHS). Modified Poisson regression models were used to estimate the relationship between optimism and CVH using LS7 among MESA participants (N = 3,520) and to examine the relationship of interest based on four biological LS7 metrics (body mass index, blood pressure, cholesterol, and blood glucose) among JHS and MESA participants (N = 5,541). For all CVH outcomes, we assessed for effect measure modification by psychosocial risk.Results: Among MESA participants, the adjusted risk ratio (aRR) for ideal or intermediate CVH using LS7 comparing participants who reported high or medium optimism to those with the lowest level of optimism was 1.10 [95% Confidence Interval (CI): 1.04–1.16] and 1.05 (95% CI: 0.99–1.11), respectively. Among MESA and JHS participants, the corresponding aRRs for having all ideal or intermediate (vs. no poor) metrics based on the four biological LS7 metrics were 1.05 (0.98–1.12) and 1.04 (0.97–1.11), respectively. The corresponding aRRs for having lower cardiovascular risk (0–1 poor metrics) based on the four biological LS7 metrics were 1.01 (0.98–1.03) and 1.01 (0.98–1.03), respectively. There was some evidence of effect modification by neighborhood deprivation for the LS7 outcome and by chronic stress for the ideal or intermediate (no poor) metrics outcome based on the four biological LS7 metrics.Conclusion: Our findings suggest that greater optimism is positively associated with better CVH based on certain LS7 outcomes among a racially/ethnically diverse study population. This relationship may be effect measure modified by specific psychosocial risks. Optimism shows further promise as a potential area for intervention on CVH. However, additional prospective and intervention studies are needed.

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Abstract MP58: Racial Residential Segregation is Associated With Worse Cardiovascular Health in African American Adults: The Jackson Heart Study

Circulation ◽

10.1161/circ.137.suppl_1.mp58 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Sharrelle Barber ◽

Kiarri Kershaw ◽

Xu Wang ◽

Mario Sims ◽

Julianne Nelson ◽

...

Keyword(s):

African American ◽

African Americans ◽

Residential Segregation ◽

Cardiovascular Health ◽

Jackson Heart Study ◽

Racial Residential Segregation ◽

African American Adults ◽

Heart Study ◽

Neighborhood Environments ◽

The Impact

Introduction: Racial residential segregation results in increased exposure to adverse neighborhood environments for African Americans; however, the impact of segregation on ideal cardiovascular health (CVH) has not been examined in large, socioeconomically diverse African American samples. Using a novel spatial measure of neighborhood-level racial residential segregation, we examined the association between segregation and ideal CVH in the Jackson Heart Study (JHS). Hypothesis: Racial residential segregation will be associated with worse cardiovascular health among African American adults. Methods: The sample included 4,354 men and women ages 21-93 from the baseline exam of the JHS (2000-2004). Racial residential segregation was assessed at the census-tract level. Data on racial composition (% African American) from the 2000 US Census was used to calculate the local G i * statistic- a spatially-weighted z-score that represents how much a neighborhood’s racial/ethnic composition deviates from the larger metropolitan area. Ideal CVH was assessed using the AHA Life’s Simple Seven (LS7) index which includes 3 behavioral (nutrition, physical activity, and smoking) and 4 biological (systolic BP, glucose, BMI, and cholesterol) metrics of CVH. Multivariable regression models were used to test associations between segregation and the LS7 index continuously (range: 0-14) and categorically (Inadequate: 0-4; Average: 5-9; and Optimal: 10-14). Covariates included age, sex, income, education, and insurance status. Results: The average LS7 summary score was 7.03 (±2.1) and was lowest in the most racially segregated neighborhood environments (High Segregation: 6.88 ±2.1 vs. Low Segregation: 7.55 ±2.1). The prevalence of inadequate CVH was higher in racially segregated neighborhoods (12.3%) compared to neighborhoods that were the least segregated (6.9%). After adjusting for key socio-demographic characteristics, racial residential segregation was inversely associated with ideal CVH (B=-0.041 ±0.02, p=0.0146). Moreover, a 1-SD unit increase in segregation was associated with a 6% increased odds of having inadequate CVH (OR: 1.06, 95% CI: 1.00-1.12, p=0.0461). Conclusion: In conclusion, African Americans in racially segregated neighborhoods are less likely to achieve ideal CVH even after accounting for individual-level factors. Policies aimed at restricting housing segregation/discrimination and/or structural interventions designed to improve neighborhood environments may be viable strategies to improving CVH in this at-risk population.

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Abstract P114: Low Prevalence of Ideal Cardiovascular Health Metrics among African Americans: The Jackson Heart Study

Circulation ◽

10.1161/circ.129.suppl_1.p114 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Luc Djousse ◽

Andrew Petrone ◽

Chad Blackshear ◽

Michael Griswold ◽

Jane Harman ◽

...

Keyword(s):

Physical Activity ◽

Blood Pressure ◽

Cardiovascular Disease ◽

African Americans ◽

Cardiovascular Health ◽

Smoking Status ◽

Jackson Heart Study ◽

Men And Women ◽

Ideal Cardiovascular Health ◽

Heart Study

Background: While the prevalence of cardiovascular health metrics or Life’s Simple Seven (LSS) has been shown to be far from optimal in the US, such information has been predominantly reported in Caucasians. The burden of cardiovascular disease among African Americans underscores the need to evaluate the prevalence and secular trends of LSS in other ethnic groups. Objective: To test the hypothesis that the prevalence of the LSS is far from ideal among participants of the Jackson Heart Study. Methods: We analyzed LSS with 3,500 African Americans from the Jackson Heart Study, using data from their first clinic visit (2000-2004). Standard methods were used to measure blood pressure, glucose, body mass index (BMI), and cholesterol. Information on physical activity, smoking, and diet was collected with interviewer-administered questionnaires. Each of the LSS metrics (smoking status, diet, physical activity, BMI, fasting blood glucose, total cholesterol, and blood pressure) was categorized as poor, intermediate, or ideal, as defined by the AHA guidelines. Results: The mean age at baseline was 56.9 ± 12.2 years and 2,350 participants (67%) were women. Among men, the prevalence of having 0, 1, 2, 3, 4, 5, 6, and 7 ideal cardiovascular health metrics was 6.6%, 25.8%, 32.7%, 21.6%, 10.6%, 2.3%, 0.4%, and 0%, respectively. Corresponding values for women were 3.2%, 28.1%, 32.9%, 22.3%, 10.1%, 2.9%, 0.38%, and 0%. While about two-thirds of men and women reported ideal smoking status, almost none reported ideal diet quality, and few met recommendations for BMI and blood pressure ( Figure) . Conclusions: Our data are consistent with less than optimal prevalence of cardiovascular health metrics in both men and women from the Jackson Heart Study. The lower prevalence of meeting ideal recommendations for diet, physical activity, BMI, and blood pressure underscores the need for targeted interventions to improve these modifiable lifestyle factors in order to reduce the burden of cardiovascular disease among African-Americans.

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Abstract P408: Cardiovascular Health And Recovery From Mobility Limitation in Middle Aged African Americans: The Jackson Heart Study

Circulation ◽

10.1161/circ.141.suppl_1.p408 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Michelle C Odden ◽

Kendra D Sims ◽

Roland Thorpe ◽

Nancy Min ◽

Mandip S Dhamoon ◽

...

Keyword(s):

African Americans ◽

Cardiovascular Health ◽

Mobility Limitation ◽

Jackson Heart Study ◽

Mobility Limitations ◽

Middle Aged ◽

Factors Associated ◽

Phone Calls ◽

Heart Study ◽

One Year

Despite a well-established literature demonstrating that African Americans shoulder a high burden of mobility limitation, little is known about factors associated with recovery. Although poor cardiovascular health is a risk factor for mobility limitation, its role in recovery is less clear. The present study investigated demographic and cardiovascular factors associated with recovery from incident mobility limitation within one year in the Jackson Heart Study, a cohort study of African Americans in Jackson, MS. Participants underwent three in-person interviews and exams from 2000-2013, and mobility limitations were assessed by self-reported limitations in walking half a mile or climbing stairs during annual phone calls. The outcome of interest, recovery from mobility limitation, was defined as no mobility limitation the following year. Candidate predictor variables were assessed in logistic regression models and included sociodemographic factors, behaviors, cardiovascular health measures, and chronic conditions. Multiple imputation using chained equations was used to address missing data. Among 5,276 participants [mean (SD) age = 55.4 (12.9) years], 1,759 (33%) had an incident mobility limitation over 12 years of follow-up, and 953 (54%) reported recovery from mobility limitation by one year later. Young women were more likely to recover from mobility limitation than young men. However, with increasing age, women were less likely to recovery from mobility limitation compared with men (p-value for age and gender interaction = 0.03). In adjusted models, being married was associated with a greater likelihood of recovering (OR: 1.26; 95% CI: 1.02, 1.55), whereas a history of heart failure and current statin use were associated with a lower likelihood of recovering (OR = 0.57; 95% CI: 0.34, 0.98 and 0.77; 95% CI: 0.61, 0.98, respectively). In conclusion, the majority of incident mobility limitations in this population of middle-aged African Americans was transient. Being married may support recovery from limitations by providing a form of structural social support. Cardiovascular health status appears to be an important factor in recovery.

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Relationship of Iron Deficiency and Serum Ferritin Levels with Pulmonary Hypertension: The Jackson Heart Study

PLoS ONE ◽

10.1371/journal.pone.0167987 ◽

2016 ◽

Vol 11 (12) ◽

pp. e0167987 ◽

Cited By ~ 3

Author(s):

Matthew Jankowich ◽

Beth Elston ◽

Samuel K. Evans ◽

Wen-Chih Wu ◽

Gaurav Choudhary

Keyword(s):

Pulmonary Hypertension ◽

Iron Deficiency ◽

Serum Ferritin ◽

Jackson Heart Study ◽

Heart Study ◽

Relationship Of

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Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study

Journal of the American Heart Association ◽

10.1161/jaha.118.008855 ◽

2018 ◽

Vol 7 (11) ◽

Cited By ~ 11

Author(s):

LaPrincess C. Brewer ◽

Nicole Redmond ◽

Joshua P. Slusser ◽

Christopher G. Scott ◽

Alanna M. Chamberlain ◽

...

Keyword(s):

American Heart Association ◽

Cardiovascular Health ◽

American Heart ◽

Heart Association ◽

Jackson Heart Study ◽

Heart Study ◽

Life’S Simple 7 ◽

Life's Simple 7

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Abstract 020: Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life’s Simple 7 TM in African-Americans of the Jackson Heart Study

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/circoutcomes.10.suppl_3.020 ◽

2017 ◽

Vol 10 (suppl_3) ◽

Author(s):

LaPrincess Brewer ◽

Nicole Redmond ◽

Joshua Slusser ◽

Christopher Scott ◽

Alanna Chamberlain ◽

...

Keyword(s):

Physical Activity ◽

High Risk ◽

Chronic Stress ◽

Cardiovascular Health ◽

American Heart ◽

Composite Score ◽

Jackson Heart Study ◽

Cumulative Stress ◽

Heart Study ◽

Minor Stressors

Background: Cardiovascular disease (CVD) remains the leading cause of death for African-American (AA) adults. There is a low prevalence of ideal cardiovascular health (CVH) (as defined by the American Heart Association’s Life’s Simple 7 TM (LS7)), especially diet, physical activity and obesity among AAs placing them at a disproportionately high risk for CVD. The identification of psychosocial stress that may influence ideal CVH could assist in the development of more effective behavior change interventions among AAs. Objectives: The aim of this study is to examine the associations of multidimensional stressors (chronic stress, minor stressors, and major life events - MLEs) with the LS7 components (classified as poor, intermediate and ideal) in AAs. We hypothesize that stress is negatively associated with the likelihood of achievement of intermediate/ideal levels of the LS7 components and LS7 composite score after adjusting for traditional socio-demographic factors. Methods: Using the Jackson Heart Study (JHS), a cohort of AAs based in Jackson, Mississippi (n=4383), we conducted a cross-sectional analysis of the association of stress measures with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol and glucose). This association was measured using logistic regression which assessed the odds ratios (OR, 95% confidence interval (CI)) of the achievement of intermediate/ideal levels of CVH with progressive adjustment for demographic, socioeconomic, behavioral and biomedical factors. A composite LS7 score was calculated [range 0-14; categorized as 0 to 6 (poor), 7 to 8 (intermediate) and 9 to 14 (ideal)]. We also constructed a cumulative stress score as a summation of tertiles of each stress measure (range 3-9). Results: Fewer participants achieved intermediate or ideal CVH for the LS7 components including diet (39%), physical activity (51%) and BMI (47%). Higher chronic stress and minor stressors scores were associated a decreased likelihood of achievement of ideal/intermediate levels for smoking [OR 0.80; 95% CI 0.73-0.88 and OR 0.84; 95% CI 0.75-0.94, respectively). Higher MLE scores were associated decreased likelihood of achievement of ideal/intermediate levels for smoking (OR 0.84; 95% CI 0.76-0.92) and glucose (OR 0.90; 95% CI 0.82-0.98). Those with higher minor stressors and MLE scores were less likely to achieve intermediate or ideal LS7 composite score categories (OR 0.89; 95% CI 0.81-0.97 and OR 0.91; 95% CI 0.84-0.98, respectively). There was no statistically significant association between LS7 composite scores and cumulative stress scores. Conclusions: Our results suggest that key stress measures may contribute adversely to CVH among AAs. These findings provide support for future lifestyle interventions which integrate a focus on alleviating stressors in this high risk population to improve CVH.

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