Abstract P108: Association of Forced Expiratory Volume (1 Second) with Incidence of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jingjing Li ◽  
Sunil K Agarwal ◽  
Alvaro Alonso ◽  
Saul Blecker ◽  
Alanna M Chamberlain ◽  
...  
Keyword(s):  
Risk Factors ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Population Based ◽  
Forced Expiratory Volume ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Objective: To investigate the association between low forced expiratory volume in 1 second (FEV 1 ) and incident atrial fibrillation (AF) in a population-based cohort. Background: Impaired FEV 1 , a complex measure indicating genetic, developmental, obstructive and restrictive airway disease, musculoskeletal function, and motivation, has been inconsistently associated with an increased risk of cardiovascular disease mortality. Also, extant reports do not provide separate estimates for African Americans, who surprisingly have lower AF incidence than Caucasians. Methods: We examined 15,282 middle-aged African Americans (26%) and Caucasians, men (45%) and women from four U.S. communities enrolled in the Atherosclerosis Risk in Communities (ARIC) cohort study. Lung volumes by standardized spirometry and information on covariates were collected on these participants at the baseline visit (1987-1989). Prevalent AF cases were excluded by 12-lead ECG at baseline. Incident AF was defined as the first event identified from the following: ICD codes for AF from hospital discharge records or death certificates, or ECGs performed during three triennial follow-up visits. Results: Over an average follow-up of 17.5 years, a total of 1,733 (11%) participants developed new-onset AF. The rate of incident AF increased monotonically and inversely by tertiles of FEV 1 in each of the 4 gender-race strata. The unadjusted average incidence rates of AF per 100 person years of follow up by tertiles of FEV 1 (from lowest to highest tertile) were 13.6, 8.3, and 5.7 for white men; 8.7, 4.5, and 3.4 for white women; 8.2, 5.5, and 3.8 for black men; 6.9, 4.1, and 2.4 for black women. After multivariable adjustment for traditional cardiovascular disease risk factors and height, hazard ratios (95% CI) of AF comparing the lowest with the highest tertile of FEV 1 were 1.44 (1.16,1.78) among white men, 1.45 (1.12, 1.87) among white women, 1.81 (1.09, 3.02) among black men, and 1.84(1.20, 2.82) among black women. The trend estimate for per 1 Standard-Deviation lower FEV 1 for the corresponding race and gender groups were 1.21 (1.12, 1.32), 1.38 (1.25, 1.54), 1.45 (1.18, 1.76), and 1.35 (1.12, 1.63), respectively. The above associations were observed across all smoking status categories (current, former, and never). The association between low lung function and incidence of AF was similarly unchanged after exclusion of participants with heart failure (n = 689) or CHD (n = 558) at baseline. The hazard of AF was about 50% higher among those with FEV1/FVC ratio below 0.7. Conclusions: In this large population-based cohort study with a long term follow-up, reduced FEV 1 is strongly associated with a higher AF risk, independent of race, gender, smoking, and several other CVD risk factors. These findings suggest the need for research on mechanisms underlying the observed association to seek broader opportunities for prevention of AF.

Abstract P001: Retirement Age And 20-year Cognitive Decline: The Atherosclerosis Risk In Communities Neurocognitive Study

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Albert Liu ◽  
Mehul D Patel ◽  
Alden L Gross ◽  
Thomas Mosley ◽  
Andreea Rawlings ◽  
...  
Keyword(s):  
Black Women ◽  
Cognitive Decline ◽  
Black Men ◽  
Occupational Status ◽  
White Men ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Status Score ◽  
Lower Baseline ◽  
Atherosclerosis Risk

Background: The effect of retirement on cognitive functioning is not clear. We examined the association between age at retirement, midlife occupation, and cognitive decline in the large Atherosclerosis Risk in Communities (ARIC) biracial community-based cohort. Methods: Retirement status after ARIC visit 4 (1996-98) was reported in annual follow-up questionnaires administered in 1999-2007 (n= 8,426), and classified as occurring before or after age 70. Current or most recent occupation at visit 1 (1987-89) was categorized based on 1980 US census major occupation groups and tertiles of Nam-Powers-Boyd occupational status score (a measure of socioeconomic status of occupations, hereby used as a proxy for occupational complexity). Generalized estimating equation models were used to examine the associations of retirement with trajectories of a global cognitive factor score, assessed in 1990-92 (visit 2), 1996-98 (visit 4) and 2011-2013 (visit 5). Models were a priori stratified by race and sex and adjusted for demographics and comorbidities. To account for attrition, we also performed multiple imputation by chained equations. Results: Retirement before age 70 is associated with higher educational level and higher occupational status score in white men and women, and in black men. We observed associations between retirement before age 70 and lower baseline cognitive scores, as well as slower cognitive decline in white men and women, and in black men (Figure). The results did not change substantially after adjusting for the occupational status score or accounting for attrition. Conclusion: Retirement before age 70 was significantly associated with lower baseline cognitive scores and slower cognitive decline in whites and in black men. The lack of similar associations in black women and the investigation of reasons for the observed associations warrant further research.

scholarly journals COPD in a Population-Based Sample of Never-Smokers: Interactions among Sex, Gender, and Race

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Esme Fuller-Thomson ◽  
Rachel S. Chisholm ◽  
Sarah Brennenstuhl
Keyword(s):  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
Insurance Coverage ◽  
White Men ◽  
Population Based ◽  
Behavioral Risk ◽  
Gender And Race ◽  
Never Smokers

This observational epidemiological study investigates sex/gender and racial differences in prevalence of COPD among never-smokers. Data were derived from the 2012 Center for Disease Control’s Behavioral Risk Factor Surveillance System. The sample consisted of 129,535 non-Hispanic whites and blacks 50 years of age and older who had never smoked. Descriptive and multivariable analyses were conducted, with the latter using a series of logistic regression models predicting COPD status by sex/gender and race, adjusting for age, height, socioeconomic position (SEP), number of household members, marital status, and health insurance coverage. Black women have the highest prevalence of COPD (7.0%), followed by white women (5.2%), white men (2.9%), and black men (2.4%). Women have significantly higher odds of COPD than men. When adjusting for SEP, black and white women have comparably higher odds of COPD than white men (black women OR = 1.66; 99% CI = 1.46, 1.88; white women OR = 1.49; 99% CI = 1.37, 1.63), while black men have significantly lower odds (OR = 0.62; 99% CI = 0.49, 0.79). This research provides evidence that racial inequalities in COPD (or lack thereof) may be related to SEP.

Abstract P003: Trajectories of Cardiovascular Risk Factors / Outcomes and Atrial Fibrillation in a 25 Year Follow-up: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Faye L Lopez ◽  
Sunil K Agarwal ◽  
Elsayed Z Soliman ◽  
Lin Y Chen ◽  
Lindsay G Smith ◽  
...  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Index Date ◽  
Reference Group ◽  
Large Population ◽  
Population Based ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Little attention has been devoted to the timing of risk factor development in relation to atrial fibrillation (AF) diagnosis. We assessed the long term trajectories of risk factors and cardiovascular (CV) outcomes in the Atherosclerosis Risk in Communities (ARIC) study, a US community-based cohort. Methods: Our analysis included 2134 individuals with incident AF and 5674 controls matched with cases 1:3 on age, sex, race and center, participating in the ARIC study. Information on incident AF and risk factors / CV outcomes (obesity, hypertension, smoking, diabetes, heart failure (HF), myocardial infarction (MI), and stroke) was obtained during 5 study exams between 1987 and 2013, and surveillance of CV events through 2010. The prevalence of risk factors / CV outcomes in the period before and after the diagnosis of AF (and the corresponding index date for controls) was modeled using general estimating equations models. Adjusted odds ratios (OR) of risk factors / CV outcomes were calculated, using the index date ±2.5 years as the reference group. The interaction of time with AF was used to compare differences in trajectories. Results: During a median follow-up of 24 years, we observed diverse trajectories in the prevalence of risk factors and CV outcomes among AF patients, with steep increases in the prevalence of stroke, MI and HF during the period close to AF diagnosis, while trajectories for hypertension and diabetes showed monotonic increases, and those for smoking and obesity suggested decreases in prevalence after AF diagnosis (Figure A). The trajectories over time for hypertension, obesity, HF, stroke and MI were significantly different based on AF status, with lower increments among those without AF (Figure A and B). Conclusion: In this large population-based study, trajectories in the odds of risk factors and CV outcomes were diverse, suggesting they could have different roles in the pathogenesis of AF. The prevalence of CV outcomes increased after AF diagnosis, and trajectories differed by AF status.

Antibiotic Use in Urban Whites and Blacks: The Minnesota Heart Survey

1992 ◽  
Vol 26 (10) ◽  
pp. 1292-1295 ◽  
Author(s):  
Sandra L. Melnick ◽  
J. Michael Sprafka ◽  
David L. Laitinen ◽  
Roberd M. Bostick ◽  
John M. Flack ◽  
...  
Keyword(s):  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
Response Rate ◽  
White Men ◽  
Female Gender ◽  
Antibiotic Use ◽  
Population Based ◽  
Drug Classes

OBJECTIVE: To assess racial differences in the use of antibiotics, including penicillins, erythromycins, tetracyclines, sulfas, and cephalosporins. DESIGN: Population-based surveys, conducted from 1985 to 1987. SETTING: The seven-county metropolitan area of Minneapolis-St. Paul, MN. PARTICIPANTS: 3127 whites (response rate 68 percent) and 1047 blacks (response rate 65 percent), aged 35–74 years. RESULTS: White women (26 percent of 1625) were more likely to report having taken an antibiotic in the past year than were white men (18 percent of 1502), black women (18 percent of 590), or black men (15 percent of 457). Reported antibiotic usage decreased with increasing age. Black men were more likely than white men to report the use of tetracyclines or sulfas; otherwise, white men reported higher usage prevalences. White women reported higher usage prevalences of all drug classes than black women. CONCLUSIONS: Significant independent predictors of antibiotic use were younger age, white race, and female gender. Potential explanations for these differences include differences in patient access, physician-prescribing behaviors, or both.

Abstract 10: Metabolically Healthy Obesity Over 25 Years in the Coronary Artery Risk Development in Young Adults (CARDIA) Study: Race and Sex Differences

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah M Camhi ◽  
Aviva Must ◽  
Philimon N Gona ◽  
Arlene Hankinson ◽  
Andrew Odegaard ◽  
...  
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Time Points ◽  
Metabolically Healthy ◽  
Baseline Bmi

Background: Obesity is heterogeneous condition with phenotypic variation. Metabolically healthy obese (MHO) may represent an unstable phenotype which changes over time. MHO duration, or the length of time in MHO, is not well characterized. The purpose is to quantify MHO duration over 25 years and explore possible race/sex differences. Methods: Young adults (baseline ages 18-30 yrs) from CARDIA were included if they were non-obese at baseline, developed obesity (BMI ≥30kg/m 2 ) at any follow-up exam (yrs 7, 10, 15, 20 and 25), and had complete data for metabolic status, age, race and sex (n=702). MHO was defined as obese (BMI ≥30 kg/m 2 ) and having either 0 or 1 risk factor of the following: ≥SBP/DBP 130/85 mmHg; glucose ≥100 mg/dL; triglycerides (≥150 mg/dL); and HDL-C (men <40, women <50 mg/dL). Obese individuals with ≥2 risk factors were classified as metabolically unhealthy obese (MUO). MHO duration (yrs) and obesity duration (yrs) were estimated for subsequent time-points; and a duration sum was calculated for the follow-up period. For two time-points in which a person remained MHO and obese, a duration for that period was assigned. If they transitioned to MUO or non-obese, then the midpoint of the time period was estimated as MHO duration (yrs). MHO duration was also expressed as the percentage (%) of the total obesity duration. Multivariable adjusted ANCOVA was used to compare MHO duration (%) between race and sex groups (black men, white men, black women and white women), adjusting for baseline age, baseline BMI status (normal weight or overweight). Results: The eligible CARDIA sample was 55% black, 71% women and had a mean (± SD) baseline age of 25.0 ± 3.7 yrs. Duration of obesity was 12.3 ± 6.8 yrs, MHO duration (yrs) was 6.2 ± 5.4 yrs (range: 0 years to 19 yrs), and MHO duration (%) was 51.9 ± 34.8%. After adjusting for age and baseline BMI, MHO duration (%, mean ± SE) was significantly higher in women compared to men within race (black women n=292: 56.3 ± 2.0% vs. black men n=91: 43.3 ± 3.6%, p=0.001; white women n=206: 56.1 ± 2.4% vs. white men n=113: 39.7 ± 3.2%, p <0.0001). No significant differences were found between race groups within gender (black men vs. white men or black women vs. white women). Conclusion: MHO status is a transient phenotype accounting for only approximately half of obesity duration. Women have longer MHO duration compared to men, but differences by race were not apparent. Future research is needed to explore possible modifiable predictors and/or determinants of longer MHO duration in order to maintain a healthy cardiometabolic phenotype, even in the presence of obesity.

scholarly journals Epidemiology of Heart Failure Stages in Middle‐Aged Black People in the Community: Prevalence and Prognosis in the Atherosclerosis Risk in Communities Study

2021 ◽  
Author(s):  
Ramachandran S. Vasan ◽  
Solomon K. Musani ◽  
Kunihiro Matsushita ◽  
Walter Beard ◽  
Olushola B. Obafemi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Left Ventricular ◽  
Study Cohort ◽  
Atherosclerosis Risk In Communities ◽  
Cardiovascular Morbidity And Mortality ◽  
Atherosclerosis Risk

Background Black individuals have a higher burden of risk factors for heart failure (HF) and subclinical left ventricular remodeling. Methods and Results We evaluated 1871 Black participants in the Atherosclerosis Risk in Communities Study cohort who attended a routine examination (1993–1996, median age 58 years) when they underwent echocardiography. We estimated the prevalences of 4 HF stages: (1) Stage 0 : no risk factors; (2) Stage A : presence of HF risk factors (hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, coronary artery disease without clinical myocardial infarction), no cardiac structural/functional abnormality; (3) Stage B : presence of prior myocardial infarction, systolic dysfunction, left ventricular hypertrophy, regional wall motion abnormality, or left ventricular enlargement; and (4) Stage C/D : prevalent HF. We assessed the incidence of clinical HF, atherosclerotic cardiovascular disease events, and all‐cause mortality on follow‐up according to HF stage. The prevalence of HF Stages 0, A, B, and C/D were 3.8%, 20.6%, 67.0%, and 8.6%, respectively, at baseline. On follow‐up (median 19.0 years), 309 participants developed overt HF, 390 incurred new‐onset cardiovascular disease events, and 651 individuals died. Incidence rates per 1000 person‐years for overt HF, cardiovascular disease events, and death, respectively, were Stage 0, 2.4, 0.8, and 7.6; Stage A, 7.4, 9.7, and 13.5; Stage B 13.6, 15.9, and 22.0. Stage B HF was associated with a 1.5‐ to 2‐fold increased adjusted risk of HF, cardiovascular disease events and death compared with Stages 0/A. Conclusions In our large community‐based sample of Black individuals, we observed a strikingly high prevalence of Stage B HF in middle age that was a marker of high cardiovascular morbidity and mortality.

Abstract MP050: Race and Gender Group Specific Trends in Length of Stay for Acute Myocardial Infarction: The Atherosclerosis Risk in Communities (ARIC) study, 1987–2008

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Laura R Loehr ◽  
Xiaoxi Liu ◽  
C. Baggett ◽  
Cameron Guild ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Black Women ◽  
Length Of Stay ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Quadratic Term ◽  
Race And Gender ◽  
Insurance Type ◽  
And Gender ◽  
Aric Study

Introduction: Since the 1980’s, length of stay (LOS) for acute MI (AMI) has declined in the US. However, little is known about trends in LOS for non-white racial groups and whether change in LOS is related to insurance type or hospital complications. Methods: We determined 22 year trends in LOS for nonfatal (definite or probable) AMI among black and white residents age 35–74 in 4 US communities (N=396,514 in 2008 population) under surveillance in the ARIC Study. Events were randomly sampled and independently validated using a standardized algorithm. All analyses accounted for sampling scheme. We excluded MI events which started after admission (n=1,677), events within 28 days for the same person (n=3,817), hospital transfers (n=571), and those with LOS=0 or LOS >66 (top 0.5% of distribution, N= 144) leaving 22,258 weighted events for analysis. The average annual change in log LOS was modeled using weighted linear regression with year as a quadratic term. All models adjusted for age and secondary models adjusted for insurance type (Medicare, Medicaid, private, or other), and complications during admission (cardiac arrest, cardiogenic shock, or heart failure). Results: The average age-adjusted LOS from 1987 to 2008 was reduced by 5 days in black men (9.5 to 4.5 days); 4.6 days in white women (9.4 to 4.8 days); 4 days in white men (8.3 to 4.3 days) and 3.6 days in black women (9.0 to 5.4 days). Between 1987 and 2008, the age-adjusted average annual percent change (with 95% CI) in LOS was largest for white men at −4.40 percent per year (−4.91, −3.89) followed by −3.89 percent (−4.52, −3.26) for white women, −3.72 percent (−4.46, −2.89) for black men, and −2.94 percent (−3.92, −1.96) for black women (see Figure). Adjustment for insurance type, and complications did not change the pattern by race and gender. Conclusions: Between 1987 and 2008, LOS for AMI declined significantly and similarly in men and women, blacks and whites. These changes appear independent of differences in insurance type and hospital complications among race-gender groups.

Abstract MP32: Race-sex differences in hyperlipidemia awareness, treatment and control in the Reasons for Geographic And Racial Differences in Stroke (REGARDS) study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monika M Safford ◽  
Paul Muntner ◽  
Raegan Durant ◽  
Stephen Glasser ◽  
Christopher Gamboa ◽  
...  
Keyword(s):  
Sex Differences ◽  
Black Women ◽  
Black Men ◽  
Racial Differences ◽  
White Women ◽  
White Men ◽  
Risk Category ◽  
Chd Risk ◽  
And Control ◽  
Risk Categories

Introduction: To identify potential targets for eliminating disparities in cardiovascular disease outcomes, we examined race-sex differences in awareness, treatment and control of hyperlipidemia in the REGARDS cohort. Methods: REGARDS recruited 30,239 blacks and whites aged ≥45 residing in the 48 continental US between 2003-7. Baseline data were collected via telephone interviews followed by in-home visits. We categorized participants into coronary heart disease (CHD) risk groups (CHD or risk equivalent [highest risk]; Framingham Coronary Risk Score [FRS] >20%; FRS 10-20%; FRS <10%) following the 3 rd Adult Treatment Panel. Prevalence, awareness, treatment and control of hyperlipidemia were described across risk categories and race-sex groups. Multivariable models examined associations for hyperlipidemia awareness, treatment and control between race-sex groups compared with white men, adjusting for predisposing, enabling and need factors. Results: There were 11,677 individuals at highest risk, 847 with FRS >20%, 5791 with FRS 10-20%, and 10,900 with FRS<10%; 43% of white men, 29% of white women, 49% of black men and 43% of black women were in the highest risk category. More high risk whites than blacks were aware of their hyperlipidemia but treatment was 10-17% less common and control was 5-49% less common among race-sex groups compared with white men across risk categories. After multivariable adjustment, all race-sex groups relative to white men were significantly less likely to be treated or controlled, with the greatest differences for black women vs. white men (Table). Results were similar when stratified on CHD risk and area-level poverty tertile. Conclusion: Compared to white men at similar CHD risk, fewer white women, black men and especially black women who were aware of their hyperlipidemia were treated and when treated, they were less likely to achieve control, even after adjusting for factors that influence health services utilization.

scholarly journals Differences in Cardiovascular Mortality Risk among African Americans in the Minnesota Heart Survey: 1985-2015 vs The Atherosclerosis Risk in Communities Study Cohort: 1987-2015

2019 ◽  
Vol 29 (1) ◽  
pp. 47-52 ◽  
Author(s):  
Kristen M. George ◽  
Aaron R. Folsom ◽  
Lyn M. Steffen ◽  
Lynne E. Wagenknecht ◽  
Thomas H. Mosley
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
African Americans ◽  
Population Based ◽  
Study Cohort ◽  
Cvd Risk ◽  
Atherosclerosis Risk In Communities ◽  
Hazard Ratios ◽  
Atherosclerosis Risk ◽  
Cvd Mortality

Geographic differences in cardiovascular disease (CVD) mortality among African Americans (AAs) are well-established, but not well-characterized. Using the Minnesota Heart Survey (MHS) and Atherosclerosis Risk in Communities (ARIC) Study, we aimed to assess whether CVD risk factors drive geographic disparities in CVD mortal­ity among AAs.ARIC risk factors were measured be­tween1987-1989 from a population-based sample of AAs, aged 45 to 64 years, living in Jackson, MS and Forsyth County, NC. Simi­lar measures were made at MHS baseline, 1985, in AAs from Minneapolis-St. Paul, MN. CVD mortality was identified using ICD codes for underlying cause of death. We compared MHS and ARIC on CVD death rates using Poisson regression, risk factor prevalences, and hazard ratios using Cox regression.After CVD risk factor adjustment, AA men in MHS had 3.4 (95% CI: 2.1, 4.7) CVD deaths per 1000 person-years vs 9.9 (95% CI: 8.7, 11.1) in ARIC. AA women in MHS had 2.7 (95% CI: 1.8, 3.6) CVD deaths per 1000 person-years vs 6.7 (95% CI: 6.0, 7.4) in ARIC. A 2-fold higher CVD mortality rate remained in ARIC vs MHS after additional adjustment for education and income. ARIC had higher total cholesterol, hypertension, diabetes, and BMI, as well as less education and income than MHS. Risk factor hazard ratios of CVD death did not differ.The CVD death rate was lower in AAs in Minnesota (MHS) than AAs in the South­east (ARIC). While our findings support maintaining low risk for CVD preven­tion, differences in CVD mortality reflect unidentified geographic variation.Ethn Dis. 2019;29(1):47-52; doi:10.18865/ ed.29.1.47

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