Abstract P387: Race and Sex Differences Exist in the Volumes of Visceral Adipose Tissue Associated With Prevalent Hypertension in Middle Age Adults

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christina M Shay ◽  
Prasenjeet N Motghare ◽  
David R Jacobs ◽  
Cora E Lewis ◽  
J. Greg Terry ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Adipose Tissue ◽  
Black Women ◽  
White Women ◽  
Middle Age ◽  
White Men ◽  
True Positive ◽  
True Negative ◽  
Cut Points ◽  
Visceral Adipose

Background: Higher visceral adipose tissue (VAT) volume is associated with greater risk for hypertension (HTN). Although VAT volume and prevalence of HTN vary by sex and race, the differences in VAT volumes associated with identification of individuals with prevalent HTN across these groups is unclear. Objective: To determine VAT volume cut points that maximize true positive, true negative and optimal identification of prevalent HTN and to compare the cut points across sex and race groups. Methods: Data were examined from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center longitudinal study of the development of cardiovascular risk in black and white men and women ages 18-30 years at baseline. In 2010-11, the Year 25 exam was performed (43-55 years) and VAT volume (cm3) was quantified by computed tomography based on two 5 mm contiguous slices at the level of the 4th-5th lumbar vertebra (n=3,153). HTN was defined as systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg and/or anti-hypertension medication use. Receiver operating characteristic (ROC) curve analysis was used to identify VAT volume cut points associated with true positive, true negative and optimal identification of prevalent HTN. Results: Year 25 prevalence of HTN ranged from 18.2% (white women) to 49.4% (black women); mean VAT volume ranged from 113.5 cm3 (white women) to 172.1 cm3 (white men). White males exhibited the highest VAT volumes (22-36% higher) and black women exhibited the lowest VAT volumes (3-50% lower) associated with true positive, true negative and optimal identification of HTN compared to other race/sex groups (Table 1). VAT volumes associated with HTN among black participants were generally lower than those exhibited for whites. Conclusions: Although the utility of VAT alone to identify HTN cases is modest - likely a result of unaccounted HTN confounders - these findings display the distinct race- and sex-specific differences in VAT volumes associated with prevalent HTN in middle age adults.

Abstract P152: Clinical Utility Of Visceral Adipose Tissue Volume In Identification Of Middle Age Adults With Type 2 Diabetes

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Prasenjeet N Motghare ◽  
Christina Shay ◽  
Mercedes R Carnethon ◽  
David R R Jacobs ◽  
Cora E. E Lewis ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Adipose Tissue ◽  
Visceral Adipose Tissue ◽  
White Women ◽  
White Men ◽  
True Positive ◽  
True Negative ◽  
Cut Points ◽  
Visceral Adipose

Background: Higher visceral adipose tissue (VAT) volume is associated with greater risk for the development of type 2 diabetes (T2D). Although VAT volume and prevalence of T2D vary by sex and race, differences in VAT volumes that are associated with the identification of individuals with prevalent T2D across these groups has not been fully examined. Objective: Our goal was to determine VAT volume cut points that maximize true positive, true negative, and optimal identification of individuals with T2D according to sex and race. Methods: Data were examined from the Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center longitudinal study of the development of cardiovascular risk in black and white men and women ages 18-30 years at baseline. In 2010-2011, the Year 25 exam was performed (43-55 years). VAT (cm 3 ) was quantified by computed tomography based on two 5 mm contiguous slices at the level of the 4 th -5 th lumbar vertebra (n=3,161). T2D was defined based on the presence of fasting plasma glucose ≥126 mg/dL, 2-hour post load blood glucose ≥200 mg/dL, HbA1c ≥6.5% and/or diabetes medication use. Receiver operating characteristic (ROC) curve analysis was used to identify VAT cut points associated with identification of T2D. Results: Prevalence of T2D at the year 25 exam ranged from 8.8% in white women to 17.7% in black men; mean (SD) VAT volume ranged from 113.5 (79.9) cm 3 in white women to 170.2 (80.2) in white men. White men exhibited the highest cut points of VAT volume needed to identify cases of T2D (26-35% higher) and black women exhibited the lowest cut points (4-36% lower) for true positive, true negative, and optimal identification of T2D compared to other race and sex groups (Table 1). Conclusions: Although the utility of VAT volume to identify individuals with T2D is modest [[Unable to Display Character: –]] likely a result of other unaccounted metabolic risk factors [[Unable to Display Character: –]] these cross-sectional findings display race and sex differences in the VAT volume cut points associated with prevalent T2D.

scholarly journals Association of Resting Heart Rate With Blood Pressure and Incident Hypertension Over 30 Years in Black and White Adults

Hypertension ◽  
2020 ◽  
Vol 76 (3) ◽  
pp. 692-698 ◽  
Author(s):  
Laura A. Colangelo ◽  
Yuichiro Yano ◽  
David R. Jacobs ◽  
Donald M. Lloyd-Jones
Keyword(s):  
Black Women ◽  
Black Men ◽  
Young Adulthood ◽  
White Women ◽  
Middle Age ◽  
White Men ◽  
Resting Heart Rate ◽  
Incident Hypertension ◽  
Black And White ◽  
Hazard Ratios

Few studies have assessed the association of resting heart rate (RHR) through young adulthood with incident hypertension by middle age. We investigated the association between RHR measured over 30 years with incident hypertension in a cohort of young Black and White men and women. A joint longitudinal time-to-event model consisting of a mixed random effects submodel, quadratic in follow-up time, and a survival submodel adjusted for confounders, was used to determine hazard ratios for a 10 bpm higher RHR. Race-sex specific effects were examined in a single joint model that included interactions of race-sex groups with longitudinal RHR. Out of 5115 participants enrolled in year 0 (1985–1986), after excluding prevalent cases of hypertension at baseline, 1615 men and 2273 women were included in the analytic cohort. Hypertension event rates per 1000 person-years were 42.5 and 25.7 in Black and White men, respectively, and 36.2 and 15.3 in Black and White women, respectively. The hazard ratios for a 10 bpm higher RHR were 1.47 (95% CI, 1.23–1.75), 1.51 (95% CI, 1.28–1.78), 1.48 (95% CI, 1.26–1.73), and 1.02, (95% CI, 0.89–1.17) for Black men, White men, White women, and Black women, respectively. Higher RHR during young adulthood is associated with a greater risk of incident hypertension by middle age. The association is similarly strong in Black men, White men, and White women, but absent in Black women, which may suggest racial differences in the effect of sympathetic nervous activity on hypertension among women.

Abstract 131: Racial Differences in Nocturnal Hypertension and Non-dipping Blood Pressure: The Coronary Artery Risk Development in Young Adults (CARDIA) Study

Hypertension ◽  
2017 ◽  
Vol 70 (suppl_1) ◽  
Author(s):  
Paul Muntner ◽  
John N Booth ◽  
Stephen J Thomas ◽  
Luqin Deng ◽  
Joseph E Schwartz ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Young Adults ◽  
Coronary Artery ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
White Men ◽  
Self Report ◽  
Nocturnal Hypertension ◽  
Multivariable Adjustment

Risk factors for nocturnal hypertension are more common among blacks compared with whites. We hypothesized nocturnal hypertension and nocturnal non-dipping BP are more common among blacks compared with whites. We analyzed data for 781 participants of the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study who completed ambulatory blood pressure (BP) monitoring (ABPM) in 2015-2016. Awake and sleep periods were defined using actigraphy and self-report. Nocturnal hypertension was defined as mean sleep systolic BP (SBP)/diastolic BP (DBP) ≥ 120/70 mm Hg. Non-dipping SBP and DBP, separately, were defined as a decline in mean sleep BP, relative to mean awake BP < 10%. The mean age of participants was 54.7 years, 21.1% were white women, 38.5% were black women, 16.8% were white men and 23.6% were black men. The prevalence of nocturnal hypertension was 18.2% and 44.5% among white and black women, respectively, and 35.9% and 59.8% among white and black men, respectively. After multivariable adjustment, the prevalence of nocturnal hypertension was higher among black women, white men and black men, each compared with white women (Table). The prevalence of non-dipping SBP was 21.2% and 40.9% among white and black women, respectively, and 19.8% and 37.5% among white and black men, respectively. After multivariable adjustment, non-dipping SBP was more common among black women and black men compared with white women. There were no statistically significant differences in non-dipping DBP across race-gender after multivariable adjustment. Nocturnal hypertension and non-dipping SBP are more common among blacks compared with whites even after adjustment for mean BP.

scholarly journals Sex differences in the association of abdominal adipose tissue measurements by using quantitative computed tomography (QCT) with untreated hypertension in a Chinese population

2020 ◽  
Author(s):  
Youzhou Chen ◽  
Zhuoli Zhang ◽  
Jihong Wang ◽  
Huayi Sun ◽  
Xingshan Zhao ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Blood Pressure ◽  
Adipose Tissue ◽  
Chinese Population ◽  
Quantitative Computed Tomography ◽  
Hip Circumference ◽  
Hypertension Status ◽  
Increased Risk ◽  
Visceral Adipose ◽  
Subcutaneous Adipose

Abstract Background: There are inconsistent results regarding the relationships of adiposity anthropometric indices and blood pressure (BP) and hypertension, and whether these relationships differ by sex is unclear. We aimed to elucidate the associations of adiposity indices measured using quantitative computed tomography (QCT) with BP and hypertension and to determine the effect of sex on the relationships in a Chinese population. Methods: Abdominal adipose fat, including visceral adipose tissue (VAT) area and subcutaneous adipose tissue (SAT) area, was measured by QCT in 1488 participants. Body mass index (BMI), waist circumference (WC), hip circumference (HC) and systolic (SBP) and diastolic BP (DBP) were measured. Results: Compared to women, men had significantly greater VAT but less SAT regardless of hypertension status. VAT, SAT and WC correlated more with SBP in men than in women. After controlling for body weight, height and age, VAT area and WC in women and VAT area in men were positively associated with SBP and DBP level. VAT area correlated more with the increased risk of hypertension in men than in women [men: odds ratio (OR) = 1.013, women: OR = 1.011]. WC had a significant correlation with an increased risk of hypertension in women but a borderline association in men (P = 0.059) when adjusted for VAT area and SAT area. Conclusions: The association of abdominal adiposity with blood pressure components and hypertension differs qualitatively by sex. WC may be an important determinant of hypertension and may be used for risk stratification for hypertension among Chinese individuals.

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 047: Trajectories of Maintaining Recommended Amounts of Physical Activity in Young Adulthood and Associations with Abdominal Adiposity in Middle Age: The Cardia Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Christina M Shay ◽  
Laura Colangelo ◽  
Mercedes R Carnethon ◽  
Kiang Liu ◽  
Norrina B Allen ◽  
...  
Keyword(s):  
Physical Activity ◽  
Adipose Tissue ◽  
Young Adulthood ◽  
Middle Age ◽  
White Men ◽  
Abdominal Adiposity ◽  
Men And Women ◽  
Highly Active ◽  
Active Adults ◽  
Modest Activity

Background: Greater abdominal adiposity is associated with insulin resistance and obesity-related vascular disease. Physical activity (PA) is inversely associated with abdominal adiposity yet associations between trends in adherence to PA recommendations through young adulthood and abdominal adiposity in middle age is unclear. Objective: To identify common trajectories of maintaining recommended levels of PA through young adulthood and to examine associations between trajectories and abdominal adiposity at middle age. Methods: The Coronary Artery Risk Development in Young Adults (CARDIA) study is a population-based, prospective, observational study of black and white men and women. PA was assessed at 8 exams across 25 years of follow-up. PA trajectories were identified by group-based modeling (PROC TRAJ) based on likelihood of maintaining recommended PA levels across exams. Visceral, subcutaneous, and abdominal intermuscular adipose tissue volumes (cm3) were assessed by computed tomography at the year 25 exam (43-55 yrs, n=3180). Results: Four major PA trajectories were identified: highly active (27.3%), declining activity (18.2%), modestly active (20.7%) and always sedentary (33.8%). Abdominal adipose tissue volumes by PA trajectory, race, and sex are displayed in Figure 1. Among white men and women, abdominal adiposity was lowest in always active adults and highest in those always sedentary; higher abdominal adiposity was observed with declining activity compared to modest activity. In black women, highest levels of abdominal adiposity were observed with declining activity. Black men exhibited no differences in abdominal adiposity across PA trajectory groups. Conclusions: Maintaining recommended physical activity levels through young adulthood is associated with lower abdominal adiposity at middle age. Highly active adults who exhibit declining physical activity towards middle age exhibit higher abdominal adiposity compared to adults with consistent modest activity throughout adulthood.

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.

Parsing out the “Hispanic Effect” in Disaggregated Homicide Trends at the Intersection of Race, Ethnicity, and Gender from 1990 to 2016

2020 ◽  
pp. 108876792093931
Author(s):  
Shytierra Gaston ◽  
CheyOnna Sewell
Keyword(s):  
Black Women ◽  
White Women ◽  
White Men ◽  
Policy Implications ◽  
Mortality Data ◽  
Homicide Victimization ◽  
Hispanic Men ◽  
Race Ethnicity ◽  
And Gender ◽  
Ethnicity And Gender

This study contributes to homicide research by parsing out the Hispanic Effect and applying an intersectional approach to examining U.S. homicide victimization trends by race, ethnicity, and gender, jointly. Drawing on mortality data, we document and describe total, firearm, and non-firearm homicide victimization rates from 1990 to 2016 for six subgroups: Black women, Black men, Hispanic women, Hispanic men, White women, and White men. The analysis of within- and between-group homicide trends reveals important subgroup-specific patterns that prior studies using aggregate or confounded data have masked. The findings have important research, theory, and policy implications and advocate for an intersectional approach to studying homicide.

scholarly journals The discriminatory power of visceral adipose tissue area vs anthropometric measures as a diagnostic marker for metabolic syndrome in South African women

2019 ◽  
Vol 11 (1) ◽  
Author(s):  
Florence E. Davidson ◽  
Tandi E. Matsha ◽  
Rajiv T. Erasmus ◽  
Andre Pascal Kengne ◽  
Julia H. Goedecke
Keyword(s):  
Metabolic Syndrome ◽  
Adipose Tissue ◽  
High Risk ◽  
South African ◽  
Visceral Adipose Tissue ◽  
African Women ◽  
Anthropometric Measures ◽  
Cut Points ◽  
South African Women ◽  
Visceral Adipose

Abstract Background A number of studies have shown central adiposity, in particular visceral adipose tissue (VAT) accumulation to be a hallmark of metabolic syndrome (MetS). In clinical practice, waist circumference (WC) is used as a proxy for VAT. Aim To compare the ability of dual energy x-ray absorptiometry (DXA)-derived VAT area and anthropometric measures of adiposity for diagnosing MetS in a sample of high risk South African women. Methods MetS was quantified using the Joint Interim Statement (JIS) criteria. Fasting glucose, insulin and lipid profile were measured in 204 post-menopausal women. Anthropometry measures included body mass index (BMI), WC, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR) and a body shape index (ABSI). The area under the curve (AUC) was used to assess their performance in detecting any two components of MetS (excluding WC). Optimal WC and VAT area cut-points were derived to compare their performance for diagnosing MetS and to compare to internationally recognised cut-points. Results The highest AUC for the prediction of MetS was recorded for VAT, followed by WHtR and WC (AUC, 0.767, 0.747 and 0.738 respectively), but these did not differ significantly (all p ≥ 0.192). In contrast, VAT was significantly better than BMI (p = 0.028), hip (p = 0.0004) and ABSI (p < 0.0001). The optimal WC (94.4 cm) and VAT area (174 cm2 based on the Youden’s index method and 175.50 cm2 based on the CTL approach) cut-points performed similarly in detecting MetS. Conclusion DXA-derived VAT and WC had the same overall performance in discriminating the presence of any 2 MetS components in high risk South African women. These findings support the current recommendations of using WC rather than VAT for MetS risk screening, as it is cheap, accessible and easy to measure.

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