Quantitative study of correlates of physical activity in women from diverse racial/ethnic groupsThe Women's Cardiovascular Health Network Project summary and conclusions

Background: Significant racial/ethnic disparities exist in the cardiovascular health of the nation. Prior studies have identified differences between groups, but have not summarized trends in these disparities across multiple race/ethnic subgroups, which could allow us to assess the extent to which we are achieving disparity-related goals. Methods: We used NHANES Surveys from cycles 1999–2000, 2001–2002, 2003–2004, and 2005–2006 to examine the age-adjusted prevalence of ideal levels of CV health factors by race/ethnicity. Ideal levels of BMI, cholesterol, glucose, blood pressure, diet, physical activity and smoking were defined according to the AHA 2020 strategic goals. Racial/ethnic groups were categorized as Hispanic, Non-Hispanic White, Non-Hispanic Black and other. Both absolute (Between Group Variance- BGV) and relative measures (Theil Index -T) of disparities were calculated, calculations were weighted by population share. The percentage change in disparities relative to 1999–2000 was examined. Results: Age-adjusted rates of ideal CV health components and the percentage change from 1999–2006 varied by race/ethnicity (see Table). Disparities in the prevalence rates of ideal levels of blood pressure, cholesterol and physical activity have increased dramatically between race/ethnic groups in both men and women (see Table). Disparities in smoking and diet have increased in men but decreased in women. Disparities in BMI have changed little in men (BGV= 0.5%, T=−37.8%), but increased dramatically in women (BGV= 894%, T=280%). Findings were generally similar for both absolute and relative measures of disparities. Conclusions: Representative national data on these summary measures of disparities suggest that disparities between race/ethnic groups have increased for many cardiovascular health factors over the past decade. Understanding the issues underlying these increasing disparities and addressing them will be critical to improving the cardiovascular health of all Americans by 2020 and beyond.

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Abstract P306: Racial/Ethnic Differences In Self-reported Sedentary Time Are Related To Differential Risk For Prevalent Hypertension: NHANES 2011-2016

Circulation ◽

10.1161/circ.141.suppl_1.p306 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Jennifer L Mattingly ◽

Megan E Petrov

Keyword(s):

Physical Activity ◽

Ethnic Groups ◽

Ethnic Differences ◽

Cardiovascular Health ◽

Sedentary Time ◽

Lower Odds ◽

Increased Risk ◽

History Of ◽

Race Ethnicity ◽

Racial Ethnic

Introduction: Evidence suggests there are racial/ethnic differences in lifestyle behaviors that may affect cardiovascular health outcomes such as physical activity engagement, diet, and sleep duration. However, the literature on racial/ethnic differences in sedentary time (ST) and whether these differences may be related differentially to cardiovascular health is limited. The goals of this study are to investigate racial/ethnic differences in self-reported ST, and examine if the modifying effect of ST with race/ethnicity will be associated with hypertension (HTN) prevalence. Methods: Adults (N=15903, age ≥20 yrs) from the National Health and Nutrition Examination Survey (NHANES) 2011-2016 reported their race/ethnicity (Mexican American [MA], Other Hispanic [OH], non-Hispanic White [NHW], non-Hispanic Black [NHB], non-Hispanic Asian, Other or mixed race [OM]), ST on a typical day (median split at 6 hrs: Low vs. High ST), and history of physician diagnosed HTN (yes/no). Weighted logistic regression models were conducted to examine the association between race/ethnic groups and ST, and combined racial/ethnic-ST groups (reference group: NHW with Low ST) on HTN prevalence while controlling for age, sex, education, body mass index, smoking status, moderate-vigorous physical activity min/wk, and history of diabetes, cardiovascular (i.e., heart failure, myocardial infarction, stroke, coronary heart disease) and kidney conditions. Results: There was a significant association between race/ethnic groups and ST (Wald F [5,43]=23.4, p <0.001) such that compared to NHW, MA (OR=.43, 95%CI:.36,.51) OH (OR=.51, 95%CI:.42,.62), and OM (OR=.71, 95%CI:.55,.91) had lower odds for High ST. Weighted percent of the sample with HTN was 32.6%. There was a significant effect of combined race by ST groups on HTN (Wald F [11,37] = 9.8, p <0.001). Compared to NHW with Low ST, MA (OR=.70, 95%CI: .54,.90) and OH (OR=.79, 95%CI: .64,.97) with Low ST had lower odds for HTN, whereas NHB with Low ST (OR=1.58, 95%CI: 1.34,1.87) and High ST (OR=1.76, 95%CI: 1.50,2.07) had increased odds of HTN. Conclusion: In a large national cohort, daily ST differed by race/ethnicity, and ST modified the association between race/ethnicity and odds for HTN such that compared to more active NHW, more active Hispanic groups had decreased odds for HTN, but NHB regardless of ST had increased risk for HTN. ST may be a key modifiable risk factor in addressing race/ethnic disparities in cardiovascular health.

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Racial, Ethnic, and Geographic Disparities in Cardiovascular Health Among Women of Childbearing Age in the United States

Journal of the American Heart Association ◽

10.1161/jaha.120.020138 ◽

2021 ◽

Author(s):

Yi Zheng ◽

Xiaoxiao Wen ◽

Jiang Bian ◽

Jinying Zhao ◽

Heather S. Lipkind ◽

...

Keyword(s):

Physical Activity ◽

United States ◽

Blood Pressure ◽

Cardiovascular Health ◽

The United States ◽

Women Of Childbearing Age ◽

Childbearing Age ◽

Geographic Disparities ◽

Racial Ethnic ◽

Hispanic White

Background In the United States, large disparities in cardiovascular health (CVH) exist in the general population, but little is known about the CVH status and its disparities among women of childbearing age (ie, 18–49 years). Methods and Results In this cross‐sectional study, we examined racial, ethnic, and geographic disparities in CVH among all women of childbearing age in the United States, using the 2011 to 2019 Behavioral Risk Factor Surveillance System. Life's Simple 7 (ie, blood pressure, glucose, total cholesterol, smoking, body mass index, physical activity, and diet) was used to examine CVH. Women with 7 ideal CVH metrics were determined to have ideal CVH. Among the 269 564 women of childbearing age, 13 800 (4.84%) had ideal CVH. After adjusting for potential confounders, non‐Hispanic Black women were less likely to have ideal CVH (odds ratio, 0.54; 95% CI, 0.46–0.63) compared with non‐Hispanic White women, and with significantly lower odds of having ideal metrics of blood pressure, blood glucose, body mass index, and physical activity. No significant difference in CVH was found between non‐Hispanic White and Hispanic women. Large geographic disparities with temporal variations were observed, with the age‐ and race‐adjusted ideal CVH prevalence ranging from 4.05% in the District of Columbia (2011) to 5.55% in Maine and Montana (2019). States with low ideal CVH prevalence and average CVH score were mostly clustered in the southern United States. Conclusions Large racial, ethnic, and geographic disparities in CVH exist among women of childbearing age. More efforts are warranted to understand and address these disparities.

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Abstract P170: Ideal Levels of Cardiovascular Health Metrics across Racial and Ethnic Groups in California

Circulation ◽

10.1161/circ.129.suppl_1.p170 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Mohammed Umer A Waris ◽

Nathan D Wong

Keyword(s):

Physical Activity ◽

Ethnic Groups ◽

American Indians ◽

Mexican Americans ◽

Cardiovascular Health ◽

California Health Interview Survey ◽

Alaskan Natives ◽

Wide Variability ◽

Racial Ethnic ◽

Diet Score

Introduction: The American Heart Association (AHA) set a goal to improve the cardiovascular health of the nation by 20% by 2020 and identified cardiovascular disease (CVD) health metrics. We estimated the prevalence of adults at ideal levels for six key CVD health metrics among the racial and ethnic groups in California. Methods: Using data from the California Health Interview Survey (CHIS) 2009 study of adults aged 18 and over, and closely following AHA definitions, we identified prevalence of “poor”, “intermediate”, and “ideal” levels of 6 key CVD health metrics: 1) smoking status, 2) physical activity, 3) BMI, 4) diet score, 5) fasting plasma glucose, and 6) blood pressure among Chinese, Filipino, South Asians, Japanese, Koreans, Vietnamese, Caucasians, Mexican Americans, Other Hispanics, African Americans, and Native Americans/ Alaskan Natives living in California (n=46,693, projected = 26.6 mil). The seventh key AHA metric, cholesterol, was not available in our sample. Results: Among all racial/ ethnic groups, physical activity, BMI, and diet score were the metrics at poorest levels. Wide variability in ideal levels for the six key CVD health metrics is seen across all racial/ ethnic groups (table). The CVD health metrics were most consistently poor among American Indians/ Alaskan Natives but were also at low levels for specific Asian, Hispanic, and African American groups. Less than 1% of all California adults had ideal measures for all six CVD Health metrics. Conclusions: Our study shows wide variability between Asian and other racial/ ethnic groups in key CVD health metrics in California. Larger scale national surveys representing all key US racial and ethnic groups are needed to validate these findings and to document the gaps needed to be addressed for improving CVD health. These findings provide opportunities for targeted health outreach to those racial/ ethnic groups most at risk and addressing metrics at poorest attainment. Table. Proportion (%) at Ideal Levels of CVD Health Metrics, by Race and Ethnicity

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Abstract P082: Neighborhoods and Racial/Ethnic Differences in Ideal Cardiovascular Health: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽

10.1161/circ.131.suppl_1.p082 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Mahasin Mujahid ◽

Latetia Moore ◽

Lucia Petito ◽

Kiarri Kershaw ◽

Karol Watson ◽

...

Keyword(s):

Physical Activity ◽

Ethnic Differences ◽

Cardiovascular Health ◽

Neighborhood Context ◽

Neighborhood Factors ◽

Ideal Cardiovascular Health ◽

Neighborhood Environments ◽

Summary Measures ◽

The Impact ◽

Racial Ethnic

Introduction: Neighborhood environments have been investigated in relation to individual cardiovascular disease risk. However, few studies have examined the contribution of neighborhood environments to racial/ethnic differences in cardiovascular health (CVH). Hypothesis: We hypothesized that there would be significant racial/ethnic differences in ideal CVH and these differences would be reduced after adjustment for neighborhood factors. Methods: We used data from the MESA baseline examination (2000-2002; mean age=62, SD=10). Ideal cardiovascular health was defined using guidelines from the American Heart Association 2020 Strategic Impact Goals. We examined seven CVH indicators (blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking) and three summary measures (health factors, health behaviors, overall CVH). We compared racial/ethnic differences in ideal CVH before and after adjustment for neighborhood factors (socioeconomic, physical activity, healthy food, social environment) using logistic regression and hybrid fixed effects models. Neighborhood-level data were obtained from various administrative data sources including the Neighborhood Community Survey and linked to MESA study participants. Results: Among the 5,263 participants in our analytic sample, 215 (4.1%) had ideal CVH. This proportion varied across racial/ethnic groups (6.6% for whites, 2% for African Americans, and 2.1% for Hispanics). Significant racial/ethnic differences were present for all indicators (excluding physical activity and diet) and summary measures of ideal CVH, independent of confounders. Additional adjustments for neighborhood factors produced modest reductions in racial/ethnic differences. Conclusion: Neighborhood factors may play a role in shaping racial/ethnic health disparities in CVH. Future research is necessary to better understand the impact of neighborhood context on CVH disparities over the life course.

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Simple Lifestyle Changes Boost Physical Activity/Cardiovascular Health

PsycEXTRA Dataset ◽

10.1037/e602002007-001 ◽

1999 ◽

Keyword(s):

Physical Activity ◽

Cardiovascular Health ◽

Lifestyle Changes

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