scholarly journals Ideal Cardiovascular Health in Urban Jamaica: Prevalence Estimates and Relationship to Community Property Value, Household Assets and Educational Attainment

Author(s):  
Joette A. McKenzie ◽  
Novie O. Younger-Coleman ◽  
Marshall K. Tulloch-Reid ◽  
Ishtar Govia ◽  
Nadia R. Bennett ◽  
...  

ABSTRACTBACKGROUNDIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We estimated the prevalence of ICH in urban Jamaica and evaluated associations between ICH and community, household and individual socioeconomic status (SES).METHODSCross-sectional study using data from 360 men and 665 women, age ≥20 years in urban Jamaica. ICH was defined as having seven characteristics: current non-smoking, healthy diet, moderate physical activity, and normal body mass index, blood pressure, glucose, and cholesterol. Logistic regression, weighted for survey design, quantified association between the outcome (≥5 ICH characteristics [ICH-5]), and exposure variables (tertiles of community median land value [MLV], tertiles of household assets and educational attainment).RESULTSPrevalence of ICH (7 characteristics) was 0.51%, while prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared to men in the upper tertile (lowest tertile: OR 0.33, 95%CI 0.12-0.91, p=0.032; middle tertile: OR 0.46 (0.20-1.04) p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women. No significant association was seen for household assets.CONCLUSIONPrevalence of ICH is low in urban Jamaica. Living in poorer communities was associated with lower odds of ICH-5 among men. Higher education was associated with higher odds of ICH-5 among women but lowers odds among men.

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040664
Author(s):  
Joette A McKenzie ◽  
Novie O Younger ◽  
Marshall Kerr Tulloch-Reid ◽  
Ishtar Govia ◽  
Nadia R Bennett ◽  
...  

ObjectiveIdeal cardiovascular health (ICH) is associated with greater longevity and reduced morbidity, but no research on ICH has been conducted in Jamaica. We aimed to estimate the prevalence of ICH in urban Jamaica and to evaluate associations between ICH and community, household, and individual socioeconomic status (SES).DesignCross-sectional study.SettingUrban communities in Jamaica.Participants360 men and 665 women who were urban residents aged ≥20 years from a national survey, the Jamaica Health and Lifestyle Survey 2016–2017.ExposuresCommunity SES, using median land values (MLV); household SES, using number of household assets; and individual SES, using education level.Primary outcomeThe main outcome variable was ICH, defined as having five or more of seven ICH characteristics (ICH-5): current non-smoking, healthy diet, moderate physical activity, normal body mass index, normal blood pressure, normal glucose and normal cholesterol. Prevalence was estimated using weighted survey design and logistic regression models were used to evaluate associations.ResultsThe prevalence of overall ICH (seven characteristics) was 0.51%, while the prevalence of ICH-5 was 22.9% (male 24.5%, female 21.5%, p=0.447). In sex-specific multivariable models adjusted for age, education, and household assets, men in the lower tertiles of community MLV had lower odds of ICH-5 compared with men in the upper tertile (lowest tertile: OR 0.33, 95% CI 0.12 to 0.91, p=0.032; middle tertile: OR 0.46, 95% CI 0.20 to 1.04, p=0.062). Women from communities in the lower and middle tertiles of MLV also had lower odds of ICH-5, but the association was not statistically significant. Educational attainment was inversely associated with ICH-5 among men and positively associated among women.ConclusionLiving in poorer communities was associated with lower odds of ICH-5 among men in Jamaica. The association between education level and ICH-5 differed in men and women.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Oluseye Ogunmoroti ◽  
Olatokunbo Osibogun ◽  
Robyn L McClelland ◽  
Mariana Lazo ◽  
Lena Mathews ◽  
...  

Background: Light to moderate alcohol consumption is associated with lower incidence of cardiovascular disease (CVD) and favorable cardiovascular health (CVH). However, the association between alcohol type and ideal CVH is yet to be established. This study examined the relationship between alcohol type and ideal CVH as measured by the American Heart Association Life’s Simple 7 (LS7) metrics. Methods: We analyzed data from 6,389 men and women aged 45-84 years from a multi-ethnic cohort free of CVD at baseline. Alcohol type (wine, beer and liquor), assessed from a food frequency questionnaire, was categorized as never, >0 but <1 drink/day, 1-2 drinks/day and >2 drinks/day. Each LS7 metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) was scored 0-2 points, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. The maximum CVH score attainable ranged from 0-14 points (inadequate score, 0-8; average, 9-10; optimal, 11-14). We used multinomial logistic regression to examine the association between alcohol type and CVH adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of study participants was 62 (10) years and 53% were women. Participants who consumed 1-2 drinks/day of wine had higher odds of having optimal CVH scores compared to those who never drank wine [prevalence odds ratio (POR) 1.50 (1.02-2.20), Table ]. In comparison to participants who never drank beer, those who consumed 1-2 and >2 drinks/day of beer had lower odds of having optimal scores [POR 0.49 (0.27-0.86) & 0.27 (0.12-0.58), respectively]. Additionally, those who consumed 1-2 and >2 drinks/day of liquor had lower odds of having optimal scores compared to those who never drank liquor [POR 0.52 (0.30-0.89) & 0.28 (0.14-0.55), respectively]. Conclusion: In this cross sectional analysis, moderate consumption of wine was associated with favorable CVH. However, consumption of beer or liquor was associated with poorer CVH.


Author(s):  
Rosevine A. Azap ◽  
Timiya S. Nolan ◽  
Darrell M. Gray ◽  
Kiwan Lawson ◽  
John Gregory ◽  
...  

Background Black men are burdened by high cardiovascular risk and the highest all‐cause mortality rate in the United States. Socioeconomic status (SES) is associated with improved cardiovascular risk factors in majority populations, but there is a paucity of data in Black men. Methods and Results We examined the association of SES measures including educational attainment, annual income, employment status, and health insurance status with an ideal cardiovascular health (ICH) score, which included blood pressure, glucose, cholesterol, body mass index, physical activity, and smoking in African American Male Wellness Walks. Six metrics of ICH were categorized into a 3‐tiered ICH score 0 to 2, 3 to 4, and 5 to 6. Multinomial logistic regression modeling was performed to examine the association of SES measures with ICH scores adjusted for age. Among 1444 men, 7% attained 5 to 6 ICH metrics. Annual income <$20 000 was associated with a 56% lower odds of attaining 3 to 4 versus 0 to 2 ICH components compared with ≥$75 000 ( P =0.016). Medicare and no insurance were associated with a 39% and 35% lower odds of 3 to 4 versus 0 to 2 ICH components, respectively, compared with private insurance (all P <0.05). Education and employment status were not associated with higher attainment of ICH in Black men. Conclusions Among community‐dwelling Black men, higher attainment of measures of SES showed mixed associations with greater attainment of ICH. The lack of association of higher levels of educational attainment and employment status with ICH suggests that in order to address the long–standing health inequities that affect Black men, strategies to increase attainment of cardiovascular health may need to address additional components beyond SES.


2021 ◽  
Vol 4 ◽  
pp. 100071
Author(s):  
Mónica Acevedo ◽  
Paola Varleta ◽  
Carolina Casas-Cordero ◽  
Amalia Berríos ◽  
Carlos Navarrete ◽  
...  

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Anshul Saxena ◽  
Muni Rubens ◽  
Sankalp Das ◽  
Tanuja Rajan ◽  
Gowtham Grandhi ◽  
...  

Objectives: Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults. Methods: This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics. Results: 95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age. Conclusions: The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations. Figure


Author(s):  
Fernanda Penido Matozinhos ◽  
Mariana Santos Felisbino-Mendes ◽  
Crizian Saar Gomes ◽  
Ann Kristine Jansen ◽  
Ísis Eloah Machado ◽  
...  

Resume Objective: to estimate the prevalence of ideal cardiovascular health indicators in the Brazilian population, according to gender, age, education and region of residence. Method: cross-sectional study that used data from 41,134 participants of the Surveillance System of Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel). The ideal cardiovascular health assessment considers four behavioral factors: not smoking; body mass index less than 25 kg/m2; practicing physical activity, eating fruits and vegetables five or more times per day; and two clinical factors (no diagnosis of diabetes or hypertension). The sum of factors at ideal levels results in a score ranging from zero (worse cardiovascular health) to six (ideal cardiovascular health). Results: considering the six factors, only 3.4% of the studied population presented ideal levels of cardiovascular health, with the majority of participants (57.6%) presenting three or four ideal factors. Women had higher prevalence of ideal cardiovascular health (3.8% versus 2.9% for men) (p < 0.0001). Conclusion: the findings of this study are consistent with the elevated risk of mortality from cardiovascular disease, observed in the Brazilian population. This may contribute to a better understanding of the scenario of cardiovascular health in the urban population of the country.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Cameron Hicks ◽  
Jonathan Butler ◽  
Natalie B Slopen ◽  
David Williams ◽  
Dayna A Johnson ◽  
...  

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christy L Avery ◽  
Donglin Zeng ◽  
Sujatro Chakladar ◽  
Katelyn M Holliday ◽  
Dan Yu Lin ◽  
...  

Ideal cardiovascular health is a novel concept adopted by the American Heart Association (AHA) that is operationalized through measurement and classification (ideal; intermediate; poor) of seven health metrics, including fasting glucose. Declines in the prevalence of ideal fasting glucose levels have been consistently associated with higher rates of cardiovascular disease, yet few studies have examined the ages at which such declines begin. We used cross-sectional data from NHANES (2007-2010, n=5,961) and the HCHS/SOL (n=14,357) to estimate the age-specific prevalence of ideal (<100 mg/dl without medication), intermediate (100-125 mg/dl or treated to <100 mg/dl) and poor (≥126 mg/dl) fasting glucose levels defined per AHA criteria among European American (EA), African American (AA), and Hispanic/Latino (H/L) participants ≥16 years of age. Race/ethnicity-stratified age-specific net probabilities of transitioning between ideal, intermediate and poor glucose levels were then calculated from cross-sectional estimates using state-of-the-art Markov models that accommodated complex sampling under the assumption that transitions remained stable across time. In all race/ethnic groups, approximately 80% of participants ≤20 years of age had ideal glucose levels. However, the estimated probability of maintaining ideal glucose levels after age 20 varied by race/ethnicity. For example, by the age of 40, the estimated probability of maintaining ideal levels of glucose over the next five years was approximately 90% for EAs and AAs and slightly higher for H/Ls (five-year probability: 92.1%, 95% CI: 91.1%, 93.1%). Among individuals with intermediate glucose levels at age 40, the estimated five-year probability of transitioning to poor levels of glucose was twice as high for AAs (five-year probability: 8.1%, 95% CI: 4.3%, 11.9%) and H/Ls (five-year probability: 9.8%, 95% CI: 8.0%, 11.6%) compared to EAs (five-year probability = 3.9%, 95% CI: 2.7%, 5.3%). Unfortunately, among participants with poor glucose levels, the estimated probability of transitioning to ideal glucose levels remained 0% for all race/ethnic groups and across all ages. Our results suggest that efforts to maintain ideal glucose levels should target young adults and extend through 40 years of age, given the sizeable prevalence of intermediate and poor levels of glucose observed by age 20, the estimated acceleration in the transition to intermediate and poor glucose levels that occurs between the second and fourth decade of life, and the negligible estimated probability of successfully re-attaining ideal glucose levels among those with intermediate or poor glucose levels. Enhanced efforts to identify and treat populations with poor glucose levels also are needed, since these populations would include persons with undiagnosed and therefore untreated type 2 diabetes.


2019 ◽  
Vol 34 (03) ◽  
pp. 288-296 ◽  
Author(s):  
Rebecca E. Cash ◽  
Remle P. Crowe ◽  
Julie K. Bower ◽  
Randi E. Foraker ◽  
Ashish R. Panchal

AbstractBackground:Emergency Medical Services (EMS) professionals face high physical demands in high-stress settings; however, the prevalence of cardiovascular health (CVH) risk factors in this health care workforce has not been explored. The primary objective of this study was to compare the distribution of CVH and its individual components between a sample of emergency medical technicians (EMTs) and paramedics. The secondary objective was to identify associations between demographic and employment characteristics with ideal CVH in EMS professionals.Methods:A cross-sectional survey based on the American Heart Association’s (AHA; Dallas, Texas USA) Life’s Simple 7 (LS7) was administered to nationally-certified EMTs and paramedics. The LS7 components were scored according to previously described cut points (ideal = 2; intermediate = 1; poor = 0). A composite CVH score (0-10) was calculated from the component scores, excluding cholesterol and blood glucose due to missing data. Multivariable logistic regression was used to estimate odds ratios (OR; 95% CI) for demographic and employment characteristics associated with optimal CVH (≥7 points).Results:There were 24,708 respondents that were currently practicing and included. More EMTs achieved optimal CVH (n = 4,889; 48.8%) compared to paramedics (n = 4,338; 40.6%). Factors associated with higher odds of optimal CVH included: higher education level (eg, college graduate or more: OR = 2.26; 95% CI, 1.97-2.59); higher personal income (OR = 1.26; 95% CI, 1.17-1.37); and working in an urban versus rural area (OR = 1.31; 95% CI, 1.23-1.40). Paramedic certification level (OR = 0.84; 95% CI, 0.78-0.91), older age (eg, 50 years or older: OR = 0.65; 95% CI, 0.58-0.73), male sex (OR = 0.54; 95% CI, 0.50-0.56), working for a non-fire-based agency (eg, private service: OR = 0.68; 95% CI, 0.62-0.74), and providing medical transport service (OR = 0.81; 95% CI, 0.69-0.94) were associated with lower odds of optimal CVH.Conclusions:Several EMS-related characteristics were associated with lower odds of optimal CVH. Future studies should focus on better understanding the CVH and metabolic risk profiles for EMS professionals and their association with incident cardiovascular disease (CVD), major cardiac events, and occupational mortality.Cash RE, Crowe RP, Bower JK, Foraker RE, Panchal AR. Differences in cardiovascular health metrics in emergency medical technicians compared to paramedics: a crosssectional study of Emergency Medical Services professionals.Prehosp Disaster Med.2019;34(3):288–296.


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