Abstract P283: Disparities in Long-term Risk of Cardiovascular Disease by Sexual Orientation and Race/Ethnicity: the National Longitudinal Study of Adolescent Health

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Cari J Clark ◽  
Iris W Borowsky ◽  
Alvaro Alonso ◽  
Rachael A Spencer ◽  
Susan A Everson-Rose
Keyword(s):  
Cardiovascular Disease ◽  
Sexual Orientation ◽  
Longitudinal Study ◽  
Adolescent Health ◽  
Sexual Minorities ◽  
P Value ◽  
Cvd Risk ◽  
National Longitudinal Study ◽  
Increased Risk ◽  
Race Ethnicity

Background: Risk of cardiovascular disease (CVD) may be higher in sexual minorities, but epidemiologic evidence is sparse. We used a nationally representative sample of young adults to examine sex-specific disparities in global CVD risk by sexual orientation and race/ethnicity. Methods: Data were from National Longitudinal Study of Adolescent Health subjects who participated in wave 4 (2008-09) and who had valid weights and non-missing data (7087 women; 6340 men). Age, race/ethnicity, sexual orientation, education, financial stress, and CVD risk factors (body mass index, smoking, diabetes, systolic blood pressure, and use of antihypertensive medication) were collected via an in-home interview. We calculated the 30-Year risk for total CVD using a Framingham-based prediction model. Sex-specific differences in 30-year risk of CVD by sexual orientation were calculated with weighted linear models adjusted for age, race/ethnicity, education, and financial distress. Sex-specific interactions between race/ethnicity and sexual orientation were tested. Results: Mean age was 28.9 ± .2 years; 93% (n=5912) of male participants were heterosexual, 4% (n=258) were bisexual, and 2% (n=170) were gay. 80% (n=5713) of female participants were heterosexual, 18% (n=1243) were bisexual, and 2% (n=131) were lesbian. Average 30-year risk of CVD was 17.2 ± .5% in men and 9.0 ± .3% in women. Differences in CVD risk by sexual orientation were not detectable for men (p=.59). Compared to heterosexual women, bisexual and lesbian women had a .9% (95% CI: .3, 1.4) and 2.0% (95% CI: .7, 3.2) higher risk of CVD, respectively. In race/ethnicity stratified models (interaction p-value=.01), an increased risk among sexual minorities, especially lesbians, was detectable except among Hispanic women (Figure). Conclusion: Disparities in global CVD risk were observed by sexual orientation for women and persisted across most racial/ethnic groups. Sexual orientation may be a marker of increased risk of CVD but more research on contributing factors is needed.

scholarly journals Sexual orientation and sex differences in socioeconomic status: a population-based investigation in the National Longitudinal Study of Adolescent to Adult Health

2018 ◽  
Vol 72 (11) ◽  
pp. 1016-1026 ◽  
Author(s):  
Kerith J Conron ◽  
Shoshana K Goldberg ◽  
Carolyn T Halpern
Keyword(s):  
Socioeconomic Status ◽  
Sexual Orientation ◽  
Longitudinal Study ◽  
Sexual Minorities ◽  
Population Based ◽  
Racial Minority ◽  
Adult Health ◽  
Poverty Level ◽  
National Longitudinal Study ◽  
Race Ethnicity

BackgroundSocioeconomic status (SES) is a fundamental contributor to health; however, limited research has examined sexual orientation differences in SES.Methods2008–2009 data from 14 051 participants (ages 24–32 years) in the US-based, representative, National Longitudinal Study of Adolescent to Adult Health were analysed using multivariable regressions that adjusted for age, race-ethnicity, childhood SES, urbanicity and Census region, separately for females and males. Modification by racial minority status (black or Latino vs white, non-Hispanic) was also explored.ResultsAmong females, sexual minorities (SM) (10.5% of females) were less likely to graduate college, and were more likely to be unemployed, poor/near poor, to receive public assistance and to report economic hardship and lower social status than heterosexuals. Adjusting for education attenuated many of these differences. Among males, SM (4.2% of males) were more likely than heterosexuals to be college graduates; however, they also had lower personal incomes. Lower rates of homeownership were observed among SM, particularly racial minority SM females. For males, household poverty patterns differed by race-ethnicity: among racial minority males, SM were more likely than heterosexuals to be living at >400% federal poverty level), whereas the pattern was reversed among whites.ConclusionsSexual minorities, especially females, are of lower SES than their heterosexual counterparts. SES should be considered a potential mediator of SM stigma on health. Studies of public policies that may produce, as well as mitigate, observed SES inequities, are warranted.

Difference in cardiovascular disease incidence by sociodemographic factors in adolescent and young adult (AYA) cancer survivors.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 6565-6565
Author(s):  
Theresa Keegan ◽  
Lawrence H. Kushi ◽  
Qian Li ◽  
Ann Brunson ◽  
Marcio H. Malogolowkin ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cancer Survivors ◽  
Sociodemographic Factors ◽  
Cancer Type ◽  
Cvd Risk ◽  
Risk Of Death ◽  
Increased Risk ◽  
Race Ethnicity ◽  
The Impact

6565 Background: AYA cancer survivors are at increased risk of developing cardiovascular disease (CVD) compared to AYAs without a history of cancer. In AYA cancer survivors, few population-based studies have focused on CVD risk and none have considered whether the occurrence of CVD differs by sociodemographic factors. Methods: Analyses focused on 64,918 patients aged 15-39 y at diagnosis for one of 14 first primary cancers during 1996-2010 and surviving > 2 years after diagnosis, with follow-up through 2013. Data were obtained from the California Cancer Registry and State hospital discharge data. CVD included coronary artery disease, heart failure, and stroke. We estimated the cumulative incidence of developing CVD, accounting for death as a competing risk, stratified by race/ethnicity, neighborhood socioeconomic status (SES) at diagnosis, health insurance status at diagnosis/initial treatment and cancer type. We examined the impact of CVD on mortality using multivariable Cox proportional hazards regression with CVD as a time-dependent covariate. Results: Overall, 2374 (3.7%) patients developed CVD, and 7690 (11.9%) died over the follow-up period. Survivors of acute myeloid leukemia (12.6%), acute lymphoid leukemia (11.1%), central nervous system cancer (9.0%) and non-Hodgkin lymphoma (6.0%) had the highest incidence of CVD at 10-years. Incidence was significantly higher among Blacks (6.7%) at 10-years than non-Hispanic Whites (3.0%), Hispanics (3.7%) and Asian/Pacific Islanders (3.7%) (p < 0.001). AYA survivors with public or no insurance (vs private) had a higher 10-year incidence of CVD (5.8% vs 2.9%; p < 0.001), as did survivors residing in low (vs high) SES neighborhoods (4.1% vs 2.7%; p < 0.001). These sociodemographic differences in CVD incidence were apparent across most cancer sites. The risk of death was increased by five-fold or higher among AYAs who developed CVD. Conclusions: AYA cancer survivors who were uninsured or publicly insured, of Black race/ethnicity, or who resided in lower SES neighborhoods are at increased risk for developing CVD and experiencing higher mortality. The proactive management of CVD risk factors in these subgroups may improve patient outcomes.

Abortion and subsequent depressive symptoms: an analysis of the National Longitudinal Study of Adolescent Health

2017 ◽  
Vol 48 (2) ◽  
pp. 294-304 ◽  
Author(s):  
A. M. Gomez
Keyword(s):  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Adolescent Health ◽  
Young Women ◽  
Depression Scale ◽  
Epidemiologic Studies ◽  
Traumatic Experiences ◽  
Linear Regression Models ◽  
National Longitudinal Study ◽  
Increased Risk

BackgroundTwenty states currently require that women seeking abortion be counseled on possible psychological responses, with six states stressing negative responses. The majority of research finds that women whose unwanted pregnancies end in abortion do not subsequently have adverse mental health outcomes; scant research examines this relationship for young women.MethodsFour waves of data from the National Longitudinal Study of Adolescent Health were analyzed. Population-averaged lagged logistic and linear regression models were employed to test the relationship between pregnancy resolution outcome and subsequent depressive symptoms, adjusting for prior depressive symptoms, history of traumatic experiences, and sociodemographic covariates. Depressive symptoms were measured using a nine-item version of the Center for Epidemiologic Studies Depression scale. Analyses were conducted among two subsamples of women whose unwanted first pregnancies were resolved in either abortion or live birth: (1) 856 women with an unwanted first pregnancy between Waves 2 and 3; and (2) 438 women with an unwanted first pregnancy between Waves 3 and 4 (unweighted n’s).ResultsIn unadjusted and adjusted linear and logistic regression analyses for both subsamples, there was no association between having an abortion after an unwanted first pregnancy and subsequent depressive symptoms. In fully adjusted models, the most recent measure of prior depressive symptoms was consistently associated with subsequent depressive symptoms.ConclusionsIn a nationally representative, longitudinal dataset, there was no evidence that young women who had abortions were at increased risk of subsequent depressive symptoms compared with those who give birth after an unwanted first pregnancy.

scholarly journals Early Menopause and Cardiovascular Disease Risk in Women With or Without Type 2 Diabetes: A Pooled Analysis of 9,374 Postmenopausal Women

2021 ◽  
Author(s):  
Yilin Yoshida ◽  
Zhipeng Chen ◽  
Robin L. Baudier ◽  
Marie Krousel-Wood ◽  
Amanda H. Anderson ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Postmenopausal Women ◽  
Lipid Lowering ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Early Menopause ◽  
Increased Risk ◽  
Race Ethnicity

OBJECTIVE <p>Early menopause may be associated with higher cardiovascular disease (CVD) risk. Type 2 diabetes (T2DM), coupled with early menopause, may result in even greater CVD risk in women. We examined CVD risk in women with early compared to normal-age menopause, with and without T2DM overall and by race/ethnicity.</p> <p>RESEARCH DESIGN AND METHODS</p> <p>We pooled data from the Atherosclerosis Risk in Communities Study, the Multi-Ethnic Study of Atherosclerosis, and the Jackson Heart Study. We included women with data on menopausal status, menopausal age, and T2DM, excluding pre- or peri-menopausal women, and those with prevalent CVD. Outcomes included incident coronary heart disease (CHD), stroke, heart failure (HF), and atherosclerotic cardiovascular disease (ASCVD; CHD or stroke). We estimated the risk associated with early (<45 years) compared to normal-age menopause using Cox proportional hazards models. Covariates included age, race/ethnicity, education, body mass index, blood pressure, cholesterol, smoking, alcohol consumption, antihypertensive medication, lipid-lowering medication, hormone therapy use, and pregnancy history. </p> <p>RESULTS </p> <p>We included 9,374 postmenopausal women for a median follow-up of 15 years. We observed 1,068 CHD, 659 stroke, 1,412 HF and 1,567 ASCVD events. <a>T2DM significantly modified the effect of early menopause on CVD ris</a>k. Adjusted HRs for early menopause and the outcomes were greater in women with T2DM versus without (CHD 1.15, 1.00-1.33 vs 1.09, 1.03-1.15; stroke 1.21, 1.04-1.40 vs 1.10, 1.04-1.16; ASCVD 1.29, 1.09-1.51 vs 1.10, 1.04-1.17; HF 1.18, 1.00-1.39 vs 1.09, 1.03-1.16)). <a>The modifying effect of T2DM on the association between early menopause and ASCVD was only statistically significant in black compared to white women.</a></p> <p>CONCLUSION</p> <p>Early menopause was associated with increased risk for CVD in postmenopausal women. T2DM may further augment the risk, particularly in black women. </p>

Abstract 19911: Markers of Survival in Septuagenarians and Octogenarians With Heterozygous or Homozygous Familial Hypercholesterolemia

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Étienne Khoury ◽  
Diane Brisson ◽  
Gérald Tremblay ◽  
Karine Tremblay ◽  
Daniel Gaudet
Keyword(s):  
Cardiovascular Disease ◽  
Familial Hypercholesterolemia ◽  
Density Lipoprotein ◽  
Lipoprotein Cholesterol ◽  
P Value ◽  
Atherosclerotic Cardiovascular Disease ◽  
French Canadian ◽  
Ldlr Gene ◽  
Cvd Risk ◽  
Increased Risk

Objective: Familial hypercholesterolemia (FH) is an autosomal dominant trait characterized by elevated low-density lipoprotein-cholesterol (LDL-C) concentrations appearing at birth and is associated with an increased risk of premature atherosclerotic cardiovascular disease (CAD). Some homozygous (Ho) FH subjects survive over 80 years of age and a proportion of heterozygous (He) FH subjects aged over 70 years have never experienced CAD symptoms. The objective of this study consists in identifying genetic, clinical and/or environmental factors associated with survival over 70 years in FH. Methods and Results: The familial analysis of 1,860 French-Canadian FH individuals carrying either the French-canadian Type 1 (15KB deletion) or the French-canadian Type 2, (W66G), which are both FH-causing mutations in the LDLR gene, was performed to identify HoFH and HeFH subjects over 70 years of age. Out of this number, we were able to list a total of 112 subjects (among which 2 HoFH aged 72 and 84 years with baseline cholesterol 18 and 21 mmol/L respectively). Multivariate regression analyses revealed that the gender, high-density lipoprotein-cholesterol (HDL-C) level, the proportion of LDL-C decrease under therapy and the type of mutation in the LDLR gene were significant contributory factors of survival over 80 years or of CAD-free survival over 70 years (p-value under 0.001). In these models, the contribution of HDL-C was independent from that of LDL-C reduction. Notably, HDL-C and gender were shown to be significant covariates of survival among HoFH relatives. Fine phenotyping and exome sequencing analyses are ongoing. Conclusion: Based on a monogenic model of high LDL-C and premature CAD, these results demonstrated that despite the reduction of LDL-C, several other covariates would probably constitute major targets for cardiovascular disease (CVD) risk management.

Depressive symptoms and cigarette smoking in twins from the National Longitudinal Study of Adolescent Health.

2008 ◽  
Vol 27 (3, Suppl) ◽  
pp. S207-S215 ◽  
Author(s):  
Jeanne M. McCaffery ◽  
George D. Papandonatos ◽  
Cassandra Stanton ◽  
Elizabeth E. Lloyd-Richardson ◽  
Raymond Niaura
Keyword(s):  
Depressive Symptoms ◽  
Longitudinal Study ◽  
Cigarette Smoking ◽  
Adolescent Health ◽  
National Longitudinal Study

scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies

2021 ◽  
Vol 14 ◽  
pp. 117954412110287
Author(s):  
Mir Sohail Fazeli ◽  
Vadim Khaychuk ◽  
Keith Wittstock ◽  
Boris Breznen ◽  
Grace Crocket ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Literature Review ◽  
Rheumatoid Factor ◽  
Qualitative Evidence Synthesis ◽  
Cvd Risk ◽  
Rheumatoid Arthritis Risk ◽  
Published Evidence ◽  
Increased Risk

Objective: To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents. Methods: Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out. Results: A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients. Conclusion: Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.

scholarly journals Vitamin D and Cardiovascular Disease: An Updated Narrative Review

2021 ◽  
Vol 22 (6) ◽  
pp. 2896
Author(s):  
Armin Zittermann ◽  
Christian Trummer ◽  
Verena Theiler-Schwetz ◽  
Elisabeth Lerchbaum ◽  
Winfried März ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Vitamin D ◽  
High Risk ◽  
General Population ◽  
Vitamin D Deficiency ◽  
Specific Gene ◽  
Vitamin D Status ◽  
Cvd Risk ◽  
Severe Vitamin ◽  
Increased Risk

During the last two decades, the potential impact of vitamin D on the risk of cardiovascular disease (CVD) has been rigorously studied. Data regarding the effect of vitamin D on CVD risk are puzzling: observational data indicate an inverse nonlinear association between vitamin D status and CVD events, with the highest CVD risk at severe vitamin D deficiency; however, preclinical data and randomized controlled trials (RCTs) show several beneficial effects of vitamin D on the surrogate parameters of vascular and cardiac function. By contrast, Mendelian randomization studies and large RCTs in the general population and in patients with chronic kidney disease, a high-risk group for CVD events, largely report no significant beneficial effect of vitamin D treatment on CVD events. In patients with rickets and osteomalacia, cardiovascular complications are infrequently reported, except for an increased risk of heart failure. In conclusion, there is no strong evidence for beneficial vitamin D effects on CVD risk, either in the general population or in high-risk groups. Whether some subgroups such as individuals with severe vitamin D deficiency or a combination of low vitamin D status with specific gene variants and/or certain nutrition/lifestyle factors would benefit from vitamin D (metabolite) administration, remains to be studied.

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