Abstract MP024: Increase in Adverse Cardiovascular Risk Profile among Hispanics/Latinos of Diverse Backgrounds Living in the United States: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Martha L Daviglus ◽  
Jianwen Cai ◽  
Amber Pirzada ◽  
Nicole M Butera ◽  
Ramon A Durazo-Arvizu ◽  
...  
Keyword(s):  
Sex Education ◽  
Multinomial Logistic Regression ◽  
The United States ◽  
Central American ◽  
Health Study ◽  
Sociocultural Factors ◽  
South American ◽  
Cvd Risk ◽  
Hispanic Community ◽  
Latino Adults

Background: HCHS/SOL showed that a sizeable proportion of Hispanics/Latinos (80% of men, 71% of women) had at least 1 major CVD risk factor (RF), with marked variations by ethnic background. Little is known about changes in CVD RF profiles over time in this population. Objective: To describe ~6-year changes in CVD RF profiles and examine associations with demographic and socioeconomic/ sociocultural factors. Methods: HCHS/SOL is a multi-center prospective community-based study of 16,415 Hispanic/Latino adults of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American backgrounds, aged 18-74 at Visit 1 (2008-11). Visit 2 (2014-17) is ongoing and 8,413 persons (~60% of the cohort to be studied) attended as of Sept. 2016. Analyses included 7,789 men and women with complete data. CVD RF profiles were defined as having 0 (0RF) or any 1 or more (1+RF) of the following: hypercholesterolemia, hypertension, obesity, diabetes, and smoking (see definitions in Table). Adjusted percent increases in number of RFs were computed. Multinomial logistic regression was used to examine associations of Visit 1 characteristics with change in RFs, adjusted for sociodemographic, sociocultural, and lifestyle factors. Results: After 5.8 years, 29% of men and 27% of women had increases in number of RFs; changes occurred more frequently in persons with 1+ RF at Visit 1 than in those with 0RF and varied by background ( Table ). Significantly higher odds of increase in number of RFs (vs. 0RF at both visits) were seen with older age (OR=1.07, 95% CI=1.06-1.08 per 1 yr) and male sex (1.74, 1.37-2.21); lower odds with higher education (0.60; 0.44-0.83 for > vs. < high school) and income (0.56, 0.38-0.81 for >$50,000 vs. <$20,000); acculturation did not relate to RF changes. Conclusions: In just a few years, a large percent of US Hispanic/Latino adults had an increase in number of adverse RFs, which varied by background; age, sex, education, and income were associated with RF increases. Greater efforts are needed to prevent CVD RFs in this population.

scholarly journals Association of birthplace and occupational exposures with chronic bronchitis in US Hispanics/Latinos, 2008–2011

2020 ◽  
Vol 77 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Victor Kim ◽  
Wei Wang ◽  
David Mannino ◽  
Alejandro Diaz
Keyword(s):  
Risk Factors ◽  
Chronic Bronchitis ◽  
Occupational Exposures ◽  
Population Based ◽  
Central American ◽  
Health Study ◽  
Mortality Data ◽  
South American ◽  
Hispanic Community ◽  
American Heritage

ObjectivesIn the US, chronic bronchitis (CB) is common and is associated with substantial morbidity and mortality. Data on CB in the Hispanic/Latino population—a large, diverse US minority—are scarce. We aimed to test whether the prevalence of CB varies across Hispanic/Latino heritages and to identify CB risk factors, including occupational exposures, in this population.MethodsWe analysed data from the Hispanic Community Health Study/Study of Latinos, a US population-based probability sample of participants aged 18–74 years (n=16 415) including those with Mexican, Puerto Rican, Dominican, Cuban, Central American and South American heritages. Participants who had a completed respiratory questionnaire and valid spirometric data were included in the analysis (n=13 259). CB, place of birth, heritage, occupational exposures and other risk factors were based on standardised questionnaires. The prevalence of CB was estimated using survey logistic regression-conditional marginal analysis.ResultsThe estimated (mean (95% CI)) overall adjusted prevalence of CB was 12.1% (9.3 to 15.6), with a large variation across heritages. Dominican heritage had a fivefold higher prevalence than South American heritage. US-born participants had a higher adjusted prevalence than their non-US-born counterparts (16.8% (12.5 to 22.1) vs 11.0% (8.5 to 14.10); p=0.022). Compared with non-exposed participants, those exposed to cleaning or disinfecting solutions had a higher adjusted prevalence of CB (12.6% (9.1 to 17.1) vs 11.8% (9.2 to 15.1); p=0.024).ConclusionsThe prevalence of CB was higher among Dominicans than other Hispanic/Latino heritages. CB was more prevalent among US-born participants and those exposed to cleaning and disinfecting solutions.

Abstract P161: Peripheral Arterial Disease in Hispanic Communities: Results from the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Matthew A Allison ◽  
Franklyn Gonzales ◽  
Leopoldo Raij ◽  
Robert Kaplan ◽  
Robert Ostfeld ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Puerto Rican ◽  
Mexican Americans ◽  
Arterial Disease ◽  
Central American ◽  
Health Study ◽  
South American ◽  
Hispanic Community ◽  
Peripheral Arterial ◽  
Cuban Americans

Background: Compared to non-Hispanic Whites, Hispanic Americans have a significantly lower prevalence of peripheral arterial disease (PAD). Since Hispanic ethnicity in the United States is heterogeneous, the purpose of this study was to determine the differential odds for PAD by Hispanic/Latino subgroup. Methods: Subjects were 9,648 men and women over the age of 45 years enrolled in the Hispanic Community Health Study - Study of Latinos (HCHS-SOL) who were evaluated by extensive survey information, relevant physical measurements and fasting blood assays. The ankle brachial index (ABI) was computed as the higher of the posterior tibial and dorsalis pedis systolic blood pressures (SBP) for each leg divided by the higher brachial artery SBP. The index ABI was the lower of the two. An ABI ≤ 0.90 was criterion for the presence of PAD. Results: The mean age was 56 years and 62% were female. Thirty percent were Mexican American, while 27% were Cuban American, 19% Puerto Rican American, 9% Dominican American, 7% Central American, 5% South American and 3% Mixed or Other Hispanic ethnicities. Overall, the prevalence of an ABI ≤ 0.90 (PAD), 0.90 to 0.99 (borderline), 1.0 to 1.39 (normal) and ≥ 1.40 (high) was 5.7, 19.3, 72.5 and 2.6%, respectively. Cuban Americans had the highest prevalence of PAD (9.1%), followed by Puerto Rican (5.9%), Central American (5.3%), Mixed/Other (5.0%), Dominican (4.7%), South American (4.6%) and Mexican Americans (3.2%). The prevalence of an ABI ≥ 1.40 ranged from 3.1% (South Americans) to 0.6% (Mixed/Other). After multivariable adjustment, and compared to Mexican Americans, Cuban Americans had nearly a 3-fold higher odds for PAD (OR = 2.85). The odds of PAD for the other Hispanic/Latino groups ranged from 1.23 to 1.82. Although males had over a 3-fold higher odds of an ABI ≥ 1.40 (OR = 3.55), the odds did not differ significantly by Hispanic/Latino ethnicity. Conclusions: Compared to Mexican Americans, all other Hispanic/Latino ethnic groups have a significantly higher odds of having PAD, with the odds being nearly 3-fold higher among Cuban Americans.

Abstract 009: Incidence of Hypertension among Diverse US Hispanics/Latinos: Findings from the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Tali Elfassy ◽  
Jianwen Cai ◽  
Pedro Baldoni ◽  
Maria M Llabre ◽  
Adina Zeki Al Hazzouri ◽  
...  
Keyword(s):  
Community Health ◽  
Puerto Rican ◽  
Survey Design ◽  
Incidence Rates ◽  
Central American ◽  
Health Study ◽  
South American ◽  
Sampling Weights ◽  
Hispanic Community ◽  
The Us

Introduction: Hypertension (HTN) is a major contributor to cardiovascular disease, the leading cause of death in the US. Yet, among diverse US Hispanics/Latinos, one of the fastest growing ethnic minority populations in the US, incident rates of HTN are currently unknown. Objectives: To determine rates of incident HTN over six years among diverse US Hispanics/Latinos and evaluate whether rates differed by Hispanic/Latino background. Methods: The Hispanic Community Health Study/Study of Latinos is an ongoing prospective population-based study of 16,415 diverse Hispanics/Latinos, ages 18-74 years, from four US communities sampled through a stratified multi-stage area probability design. Baseline examination was conducted in 2008-2011. Systolic and diastolic blood pressure (BP), as the average of three seated measurements, was measured at baseline and at an ongoing second visit (2014-2017). At each visit, HTN was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or use of anti HTN medication. This analysis includes 7,258 adults who were free of HTN at baseline and attended the second study visit by August, 2 nd , 2017. Age adjusted, sex stratified, HTN incidence rates (IR) were calculated in person-years (PY) by Hispanic/Latino background. All analyses were weighted by nonresponse adjusted, trimmed, and calibrated sampling weights and took into account the complex survey design. Results: At baseline, age distributions were similar for men and women with: 40% age 18-34, 38% age 35-49, and 22% age 50 - 74; mean follow-up time was 5.7 years. Among 2,694 men, a total of 539 developed HTN for an overall age-adjusted IR of 25.7/1,000PY (95% CI: 22.8, 28.9). Among men, compared with Mexican background (IR: 20.5, 95% CI: 16.6, 25.2), the age adjusted IR of HTN per 1,000 PY was higher among Hispanics/Latinos of Dominican (IR: 39.2, 95% CI: 28.4, 54.0; p<0.01) and Cuban (IR: 30.6, 95% CI: 25.2, 37.2; p<0.01) background, but comparable among Central American (IR: 19.7, 95% CI: 14.1, 27.6; p=0.86), Puerto Rican (IR: 28.3, 95% CI: 20.5, 39.0; p=0.09), and South American (IR: 18.8, 95% CI: 11.5, 30.7; p=0.75) background. Among 4,564 women, a total of 855 developed HTN for an overall age-adjusted IR of 25.6/1,000PY (95% CI: 23.1, 28.3). Among women, compared with Mexican background (IR: 20.1, 95% CI: 17.0, 23.8), the age adjusted IR of HTN per 1,000 PY was higher among Hispanic/Latinos of Dominican (IR: 32.7, 95% CI: 24.3, 44.1; p<0.01), Cuban (IR: 26.8, 95% CI: 21.3, 33.6; p<0.05), and Puerto Rican (IR: 35.1, 95% CI: 27.4, 45.1; p<0.01) background, and comparable among Central American (IR: 23.2, 95% CI: 18.4, 29.3; p=0.31) and South American (IR: 24.3, 95% CI: 18.5, 31.8; p=0.24) background. Conclusions: Among a large sample of US Hispanics/Latinos free of HTN, age adjusted IRs of hypertension differed substantially by Hispanic/Latino background, being highest among those of Caribbean background.

Social capital and periodontal disease in Hispanic/Latino adults in the United States: Results from the Hispanic Community Health Study/Study of Latinos

2020 ◽  
Vol 47 (5) ◽  
pp. 542-551
Author(s):  
Nadia Laniado ◽  
Victor M. Badner ◽  
Anne E. Sanders ◽  
Richard H. Singer ◽  
Tracy L. Finlayson ◽  
...  
Keyword(s):  
United States ◽  
Social Capital ◽  
Periodontal Disease ◽  
Community Health ◽  
The United States ◽  
Health Study ◽  
Hispanic Community ◽  
Latino Adults

scholarly journals The Role of Stress in Understanding Differences in Sedentary Behavior in Hispanic/Latino Adults: Results From the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study

2016 ◽  
Vol 13 (3) ◽  
pp. 310-317 ◽  
Author(s):  
Elizabeth Vásquez ◽  
Garrett Strizich ◽  
Linda Gallo ◽  
Simon J. Marshall ◽  
Gina C. Merchant ◽  
...  
Keyword(s):  
Community Health ◽  
Sedentary Behavior ◽  
Stress Reduction ◽  
Self Report ◽  
Health Study ◽  
Sedentary Behaviors ◽  
Ancillary Study ◽  
Hispanic Community ◽  
Latino Adults ◽  
Sedentary Activities

Background:Chronic stress and/or lifetime traumatic stress can create a self-reinforcing cycle of unhealthy behaviors, such as overeating and sedentary behavior, that can lead to further increases in stress. This study examined the relationship between stress and sedentary behavior in a sample of Hispanic/Latino adults (N = 4244) from the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.Methods:Stress was measured as the number of ongoing difficulties lasting 6 months or more and as lifetime exposure to traumatic events. Sedentary behavior was measured by self-report and with accelerometer. Multivariable regression models examined associations of stress measures with time spent in sedentary behaviors adjusting by potential confounders.Results:Those who reported more than one chronic stressor spent, on average, 8 to 10 additional minutes per day in objectively measured sedentary activities (P < .05), whereas those with more than one lifetime traumatic stressor spent (after we adjusted for confounders) 10 to 14 additional minutes in sedentary activities (P < .01) compared with those who did not report any stressors. Statistical interactions between the 2 stress measures and age or sex were not significant.Conclusion:Interventions aimed at reducing sedentary behaviors might consider incorporating stress reduction into their approaches.

Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rachael R Baiduc ◽  
Brittany Bogle ◽  
Franklyn Gonzalez ◽  
Elizabeth Dinces ◽  
David J Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Hearing Loss ◽  
Total Cholesterol ◽  
Young Women ◽  
Young Men ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

scholarly journals Associations of Helicobacter pylori and hepatitis A seropositivity with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL): addressing the hygiene hypothesis

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Christian S. Alvarez ◽  
M. Larissa Avilés-Santa ◽  
Neal D. Freedman ◽  
Krista M. Perreira ◽  
Olga Garcia-Bedoya ◽  
...  
Keyword(s):  
Helicobacter Pylori ◽  
Community Health ◽  
Sex Education ◽  
Hepatitis A ◽  
Hepatitis A Virus ◽  
Hygiene Hypothesis ◽  
Health Study ◽  
Chronic Obstructive ◽  
Hispanic Community ◽  
H Pylori

Abstract Background The hygiene hypothesis posits that microbial exposure reduces risk of asthma and other respiratory-related diseases. Helicobacter pylori and hepatitis A virus (HAV) are common fecal–oral infections. Our study aimed to examine associations of seropositivity to these agents with asthma in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods A total of 12,471 HCHS/SOL participants with baseline data on self-reported physician-diagnosed asthma, and antibodies anti-H. pylori and anti-HAV were included in this cross-sectional analysis. Multivariable logistic regression models were used to estimate the odds ratios and 95% confidence intervals for the overall associations of seropositivity to each agent with asthma. Analyses were also stratified by Hispanic/Latino background. Effect modification by smoking status and nativity were tested. An analysis restricted to individuals with spirometry-defined chronic obstructive pulmonary disease (COPD) was also considered. Results The weighted overall prevalence of asthma was 16.6%. The weighted seroprevalence of H. pylori was 56.6% and of HAV was 76.6%, and they significantly differed by Hispanic/Latino background. After accounting for age, sex, education and other key confounders, we found no associations between H. pylori or HAV seropositivity with asthma (with and without COPD), either for all individuals combined or for any of the six specific backgrounds. There were no significant interactions by smoking and nativity. Conclusion Our findings did not provide support for the role of H. pylori or HAV, as evidence of the hygiene hypothesis in asthma among the large and diverse Hispanic/Latino populations of the HCHS/SOL. Trial registration NCT02060344

scholarly journals Smoking cessation among U.S. Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

2015 ◽  
Vol 81 ◽  
pp. 412-419 ◽  
Author(s):  
Cheryl R. Merzel ◽  
Carmen R. Isasi ◽  
Garrett Strizich ◽  
Sheila F. Castañeda ◽  
Marc Gellman ◽  
...  
Keyword(s):  
Smoking Cessation ◽  
Community Health ◽  
Health Study ◽  
Hispanic Community ◽  
Latino Adults

Abstract P071: Association of Baseline Depressive Symptoms With 6-Year Incidence of Diabetes in the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Matthew J O'Brien ◽  
Mercedes R Carnethon ◽  
Frank J Penedo ◽  
Karen M Tabb ◽  
Sylvia Wassertheil-Smoller ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Community Health ◽  
Self Report ◽  
Incident Diabetes ◽  
Health Study ◽  
Incidence Density ◽  
Diabetes Incidence ◽  
Central Americans ◽  
Hispanic Community ◽  
Latino Adults

Background: Among Hispanics/Latinos, there is substantial heterogeneity in the prevalence of depressive symptoms and diabetes by background. This study aimed to examine the association between depressive symptoms and incident diabetes among Hispanic/Latino adults of diverse backgrounds. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective, community-based study of 16,415 self-identified Hispanic/Latino adults aged 18-74 years at Visit 1 (2008-2011) and 10,914 who have also completed the Visit 2 examination by August 2017. This analysis includes 8,804 participants who were free from diabetes at baseline and attended both Visits. Baseline depressive symptoms were assessed using the CES-D 10-item depression scale and divided into quartiles. Incident diabetes was defined by fasting glucose ≥126mg/dL, 2-hour postload glucose 140-199mg/dL, HbA1c ≥6.5%, or self-report. Accounting for HCHS/SOL complex survey design, we used Poisson regression models to estimate diabetes incidence density ratios (Table). Results: Baseline BMI was associated with both depressive symptoms and incident diabetes. Overall, 876 participants developed diabetes. In analyses stratified by Hispanic/Latino background, the association between baseline depressive symptoms and incident diabetes was significant for South Americans, Central Americans, and Mexicans. No significant associations between depressive symptoms and diabetes were seen among Hispanics/Latinos of Dominican, Cuban, or Puerto Rican backgrounds. Conclusions: These findings suggest that the association between depressive symptoms and incident diabetes in Hispanics/Latinos may differ by their background, with South and Central Americans at the highest risk. This difference may be partly explained by variation in participants’ understanding of CES-D questions by Hispanic/Latino background. Future research is needed to understand these novel findings fully and explore their implications for practice and policy.

Abstract P115: Relationship between Cardiovascular Risk Factors and Psychological Distress among Hispanic/Latinos: The Hispanic Community Health Study/ Study of Latinos

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sheila F Castaneda ◽  
Patricia Gonzalez ◽  
Linda C Gallo ◽  
Gregory A Talavera ◽  
Addie L Fortmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Depressive Symptomatology ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Sampling Weights ◽  
Hispanic Community ◽  
Unit Increase ◽  
Hispanic Latinos

Background: Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress. Minimal research has been conducted exploring the relationship between psychological distress and CVD risk among Hispanic/ Latinos (H/L) of different background groups. The aim of this study was to investigate which CVD risk factors were most strongly correlated with psychological distress. Methods: The multi-site prospective population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of H/L adults (n = 16,415) ages 18-74 in four US communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified two-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010 US Population Census. Analyses involve 15,464 participants with complete data. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale and 10 item Spielberger Trait Anxiety Scale), socio-demographics (i.e., age, education, health insurance, gender, and H/L background), acculturation (i.e., years in the U.S., country of birth, and language), and CVD risk factors [i.e., dyslipidemia (HDL cholesterol < 40, LDL cholesterol ≥ 160,or triglycerides ≥ 200), body mass index (BMI), current cigarette smoking, diabetes (i.e., fasting time > 8 hr AND fasting glucose ≥ 126, or fasting time ≤ 8 hr AND fasting glucose ≥ 200, or post-OGTT glucose ≥ 200, or A1C≥ 6.5 or on medication), and hypertension (blood pressure ≥140/90 or on mediations)] were measured during the HCHS/SOL baseline exam. Associations between CVD risk factors and psychological distress were assessed using multiple linear regression models with depression and anxiety as dependent variables, accounting for the complex survey design and sampling weights, and controlling for socio-demographic and acculturation covariates. Results: Current smoking, diabetes, and BMI were significantly associated with depression and anxiety symptoms, after adjusting for covariates. Mean depressive symptomatology was 1.66 higher among smokers, .58 higher among diabetics, and increased by .04 for every one unit increase in BMI; mean anxiety symptomatology was 1.31 higher among smokers, .58 higher among diabetics, and increased by .05 for every one unit increase in BMI, adjusting for other factors. Dyslipidemia and hypertension were not associated with depression or anxiety. Discussion: Results demonstrate that certain CVD risk factors (i.e., smoking, diabetes, and BMI) were associated with psychological distress. Among the multiple CVD risk factors, current smoking was the strongest correlate; indicating its importance in CVD risk reduction among patients with depressive symptomatology.

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