Inflammatory Bowel Disease and Atherosclerotic Cardiovascular Disease in U.S. Adults—A Population-Level Analysis in the National Health Interview Survey

BACKGROUND Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of morbidity and mortality worldwide. Health-Information Technologies (HIT) have recently emerged as a viable intervention to mitigate the burden of ASCVD. At least 60% of United States (US) adults report searching the internet for health information; however, previous research has not examined the prevalence of general technology or HIT use between adults with and without ASCVD. In addition, social determinants in HIT use among adults with ASCVD are not well understood. OBJECTIVE To evaluate the prevalence and social determinants of HIT use among U.S. adults with vs without self-reported ASCVD. METHODS We pooled cross-sectional data from the 2011-2018 National Health Interview Survey (NHIS) to examine general technology and HIT use between adults aged ≥18 years with and without self-reported ASCVD (coronary heart disease and/or stroke). General technology use was defined as mobile phone ownership, Internet use, and computer use. HIT use was defined as looking up health information on the Internet, filling a prescription online, scheduling a medical appointment on the Internet, communicating with a healthcare provider by email, or using online group chats to learn about health topics. We evaluated sociodemographic differences in HIT use among respondents using Poisson regression. Analyses were weighted according to NHIS standards. RESULTS A total sample of N=256,534 individuals were included, 2,194 (0.9%) reported prior ASCVD. Among adults with prior ASCVD, the mean (±SD) age was 70.6 (11.5) years, and 47% were female. General technology use differed between participants with and without prior ASCVD, with 36% (657/1,826) and 76% (162,500/213,816) indicating internet usage and 25% (394/1,575) and 61% (112,580/184,557) indicating using a computer every day, respectively. Similarly, adults with ASCVD were less likely to use HIT use than those without ASCVD (25% vs. 51%, p<0.001). Among adults with prior ASCVD, social determinants that were associated with HIT use included younger age, higher education, higher income, being employed, and being married. CONCLUSIONS HIT use was low among adults with a history of ASCVD, which may represent a barrier to delivering care via emerging HIT. Given the associations with social determinants such as income, education and employment, targeted strategies and policies are needed to eliminate barriers to impact HIT usage. CLINICALTRIAL N/A

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Abstract P197: Health Information Technology Use Among Patients With Diagnosed Atherosclerotic Cardiovascular Disease: Evidence From The 2010-2018 National Health Interview Survey

Circulation ◽

10.1161/circ.141.suppl_1.p197 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Uchenna Nwokeji ◽

Erin Spaulding ◽

Rongzi Shan ◽

Ruth-Alma N Turkson-Ocran ◽

Diana Baptiste ◽

...

Keyword(s):

Cardiovascular Disease ◽

Health Information ◽

National Health ◽

National Health Interview Survey ◽

Atherosclerotic Cardiovascular Disease ◽

Health Interview Survey ◽

Sociodemographic Differences ◽

Health Interview ◽

History Of ◽

Interview Survey

Introduction: Atherosclerotic Cardiovascular Disease (ASCVD) is the leading cause of morbidity and mortality worldwide. Health Information Technologies (HIT) have recently emerged as a viable intervention to mitigate the burden of ASCVD. At least 60% of US adults report searching the internet for health information; however, previous research has not examined prevalence and sociodemographic differences in HIT use among adults with ASCVD. Objective: To evaluate the prevalence and sociodemographic differences in HIT use among U.S. adults with a history of diagnosed ASCVD. Methods: We pooled cross-sectional data from the 2010-2018 National Health Interview Survey (NHIS) to examine HIT use among adults aged ≥18 years (N=2,410) who self-reported being diagnosed with ASCVD (coronary heart disease (CHD) and/or stroke). We evaluated sociodemographic differences in HIT use among respondents with generalized linear models using Poisson distribution. Analyses were weighted according to NHIS standards. Results: The mean (±sd) age was 70 (±0.2) years, and 47.7% were female. Among US adults with a history of ASCVD, 22.6% of respondents utilized some form of HIT. HIT users with a history of ASCVD were more likely to be younger in age, have at least some college education, be employed, and be married ( Table 1 ). Conclusion: HIT use was low among adults with a history of ASCVD, which may represent a barrier to delivering care via emerging HIT. Given the association with sociodemographic factors such as education and employment, there is a need to develop targeted strategies to address sociodemographic barriers that impact HIT usage.

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Inflammatory Bowel Disease and Atherosclerotic Cardiovascular Disease

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2020.10.027 ◽

2020 ◽

Vol 76 (24) ◽

pp. 2895-2905

Author(s):

Miguel Cainzos-Achirica ◽

Kerri Glassner ◽

Hassan Syed Zawahir ◽

Amit K. Dey ◽

Tanushree Agrawal ◽

...

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Bowel Disease ◽

Atherosclerotic Cardiovascular Disease ◽

Inflammatory Bowel

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Atherosclerotic cardiovascular disease in inflammatory bowel disease: The role of chronic inflammation

World Journal of Gastrointestinal Pathophysiology ◽

10.4291/wjgp.v11.i5.104 ◽

2020 ◽

Vol 11 (5) ◽

pp. 104-113

Author(s):

Simcha Weissman ◽

Preetika Sinh ◽

Tej I Mehta ◽

Rishi K Thaker ◽

Abraham Derman ◽

...

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Chronic Inflammation ◽

Bowel Disease ◽

Atherosclerotic Cardiovascular Disease ◽

Inflammatory Bowel

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Abstract 16424: Cardiovascular Risk Factors Among a Nationally Representative Adult Population With Inflammatory Bowel Disease and Without Clinical Atherosclerotic Cardiovascular Disease

Circulation ◽

10.1161/circ.142.suppl_3.16424 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Tanushree Agrawal ◽

Isaac Acquah ◽

Amit Dey ◽

Syed Z Hassan ◽

Kerri Glassner ◽

...

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Bowel Disease ◽

Cardiovascular Risk ◽

Bowel Disease ◽

Adult Population ◽

Chronic Inflammatory Disease ◽

Atherosclerotic Cardiovascular Disease ◽

Systemic Involvement ◽

Inflammatory Bowel ◽

Nationally Representative

Introduction: Inflammatory Bowel Disease (IBD), comprised of Ulcerative Colitis (UC) and Crohn’s Disease (CD) is a chronic inflammatory disease with systemic involvement. Inflammation predisposes to atherosclerosis and studies suggest that IBD is associated with premature atherosclerotic cardiovascular disease (ASCVD). There is, however, limited population-based data on cardiovascular risk factor (CRF) burden in IBD among those who have not yet developed clinical ASCVD. We sought to study the association between IBD and CRFs among a nationally representative population with IBD and without established ASCVD. Methods: The study population was derived from the 2015-2016 National Health Interview Survey database. ASCVD was defined as myocardial infarction, angina or stroke; those with ASCVD were excluded. IBD was defined as either CD or UC. We computed weighted prevalence estimates of various traditional CRFs for the US population by IBD status. Univariate and multivariate logistic regression models were used to evaluate associations between CRFs and IBD. Average and poor cardiovascular risk profiles were defined as 2-3 and ≥4 CRFs, respectively. Results: Overall 786 (1.2%) representing 2.6 million ASCVD-free adults reported IBD. Individuals with IBD had higher prevalence of multiple CRFs (Figure, top). In adjusted models those with IBD had significantly higher odds of having prevalent hypertension, diabetes mellitus and hypercholesterolemia (Figure, bottom). These associations were similar among elderly and young participants. Those with IBD were almost 2-fold more likely to have a poor cardiovascular risk profile. Conclusion: Our findings from a nationally representative US population suggest an increased burden and clustering of CRFs among IBD patients without clinical ASCVD. Future efforts are needed to understand the underlying mechanisms, and enhance the detection and treatment of these CRFs to reduce ASCVD risk in IBD patients.

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