Abstract 08: Heterogeneity in Cardiovascular Disease Risk Factor Prevalence Among Whites, African Americans, African Immigrants and Afro-Caribbeans: Insights From the 2010-2018 National Health Interview Survey

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Diana Baptiste ◽  
Ruth-Alma N Turkson-Ocran ◽  
Oluwabunmi Ogungbe ◽  
Binu Koirala ◽  
Lucine Francis ◽  
...  

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the U.S. Blacks are disproportionately affected by CVD risk factors, compared to whites. However, Blacks are not monolithic and include the following ethnic groups; African Americans (AAs), African Immigrants (AIs), and Afro-Caribbeans (ACs). It is unclear how AIs and ACs compare to their AA counterparts and Whites with respect to CVD risk factors. Objective: To examine trends in CVD risk factors among three Black ethnic groups in comparison to whites between 2010-2018. Methods: A comparative analysis of the National Health Interview Survey was conducted among N=452,997 participants, examining sociodemographic data and trends in self-reported CVD risk factors (hypertension, diabetes, overweight/obesity, and smoking). Generalized linear models with a Poisson distribution were used to obtain the respective predictive probabilities of CVD risk factors. Results: The sample included 82,835 Blacks (89% AAs, 5% AIs and 6% ACs) and 370,362 whites. AIs were the youngest with mean age of 40.8 years and were less likely to be insured (76%) compared to whites (91%) and AAs (83%) ( p =<0.001). ACs (23%) were more likely be college-educated than AAs (17%) but not AIs (36%) or whites (32%), (p=<0.001). AIs had the lowest age- and sex-adjusted prevalence of all four CVD risk factors. There were disparities (among AAs) and advantages (among AIs and ACs) in CVD risk factors. ( Figure) . Overweight/obesity and diabetes prevalence was increasing in AAs and whites ( p -values for trend<0.001). Smoking prevalence was highest in whites and AAs compared to AIs and ACs but the prevalence decreased significantly between 2010-2018 ( p -values for trend<0.001). Conclusion: Our results have shown significant heterogeneity in CVD risk factors among three Black ethnic groups compared to whites. These findings suggest that race alone does not account for health disparities in CVD risk factors. Environmental, psychological, and social factors may play a larger role in CVD risk.

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Sabrina Elias ◽  
Ruth-alma N Turkson-ocran ◽  
Binu Koirala ◽  
Samuel Byiringiro ◽  
Hailey Miller ◽  
...  

Introduction: Persons of Hispanic origin are a growing share of the U.S. population but include diverse ethnic groups with unique cultures, lifestyles, exposures, and countries of origin. Hispanics are disproportionately affected by cardiovascular disease (CVD) risk factors in comparison to non-Hispanics. However, few studies have examined the heterogeneity in their burden of CVD risk. Hypothesis: We hypothesized that there would be significant heterogeneity in the prevalence of CVD risk factors among ethnic subgroups of Hispanic adults. Methods: We used a cross-sectional design to examine the prevalence of CVD risk factors, defined per national guidelines, among Hispanic adults in the 2010-2018 National Health Interview Surveys. Generalized linear models using Poisson distribution were fitted to obtain adjusted predicted probabilities and risk of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking by Hispanic ethnic subgroup. Results: We included 185,511 participants with mean(±sd) age 31(0.2) years and 50% male. Most were Mexican (65.1%) whereas, few were Dominican (3.0%). Prevalence of hypertension (28.4%), diabetes (12.9%), high cholesterol (25.0%), and current smoking (6.1%) was highest among Puerto Ricans. Prevalence of overweight/obesity was highest among Mexicans (74.5%) and physical inactivity was highest among Dominicans (62.3%). Compared to Mexicans, Central Americans were less likely to smoke and have hypertension, overweight/obesity, and diabetes (ps<0.05). ( Table ) Conclusion: We observed striking heterogeneity in the prevalence of CVD risk factors across Hispanic ethnic subgroups, especially for diabetes, physical inactivity, and smoking. These results suggest that aggregating data on Hispanics may mask differences in CVD risk and hinder efforts to reduce health disparities in this population. Our findings provide actionable information on CVD risk factors for specific Hispanic ethnic subgroups.


2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Camila X. Romero ◽  
Tomas E. Romero ◽  
Judith C. Shlay ◽  
Lorraine G. Ogden ◽  
Dana Dabelea

Objectives. To examine trends in the prevalence and disparities of traditional cardiovascular disease (CVD) risk factors among the major race/ethnic groups in the USA: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexican Americans (MAs).Methods. We used cross-sectional trend analysis in women and men aged 25–84 years participating in the NHANES surveys, years 1988–1994 (n=14,341) and 1999–2004 (n=12,360).Results. The prevalence of obesity and hypertension increased significantly in NHW and NHB, both in men and women; NHB had the highest prevalence of obesity and hypertension in each time period. Diabetes prevalence showed a nonsignificant increasing trend in all groups and was higher in MA in both periods. Smoking significantly decreased in NHW men and NHB, the latter with the largest decline although the highest prevalence in each period; no changes were noted in MA, who had the lowest prevalence in both periods. Race/ethnic CVD risk factors disparities widened for obesity and hypercholesterolemia, remained unchanged for diabetes and hypertension, and narrowed for smoking.Conclusions. The increasing prevalence of obesity and hypertension underscores the need for better preventive measures, particularly in the NHB group that exhibits the worst trends. The decline in smoking rates may offset some of these unfavorable trends.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Farah Ammous ◽  
Wei Zhao ◽  
Scott M. Ratliff ◽  
Thomas H. Mosley ◽  
Lawrence F. Bielak ◽  
...  

Abstract Background Cardiovascular disease (CVD) is the leading cause of mortality among US adults. African Americans have higher burden of CVD morbidity and mortality compared to any other racial group. Identifying biomarkers for clinical risk prediction of CVD offers an opportunity for precision prevention and earlier intervention. Results Using linear mixed models, we investigated the cross-sectional association between four measures of epigenetic age acceleration (intrinsic (IEAA), extrinsic (EEAA), PhenoAge (PhenoAA), and GrimAge (GrimAA)) and ten cardiometabolic markers of hypertension, insulin resistance, and dyslipidemia in 1,100 primarily hypertensive African Americans from sibships in the Genetic Epidemiology Network of Arteriopathy (GENOA). We then assessed the association between epigenetic age acceleration and time to self-reported incident CVD using frailty hazard models and investigated CVD risk prediction improvement compared to models with clinical risk scores (Framingham risk score (FRS) and the atherosclerotic cardiovascular disease (ASCVD) risk equation). After adjusting for sex and chronological age, increased epigenetic age acceleration was associated with higher systolic blood pressure (IEAA), higher pulse pressure (EEAA and GrimAA), higher fasting glucose (PhenoAA and GrimAA), higher fasting insulin (EEAA), lower low density cholesterol (GrimAA), and higher triglycerides (GrimAA). A five-year increase in GrimAA was associated with CVD incidence with a hazard ratio of 1.54 (95% CI 1.22–2.01) and remained significant after adjusting for CVD risk factors. The addition of GrimAA to risk score models improved model fit using likelihood ratio tests (P = 0.013 for FRS and P = 0.008 for ASCVD), but did not improve C statistics (P > 0.05). Net reclassification index (NRI) showed small but significant improvement in reassignment of risk categories with the addition of GrimAA to FRS (NRI: 0.055, 95% CI 0.040–0.071) and the ASCVD equation (NRI: 0.029, 95% CI 0.006–0.064). Conclusions Epigenetic age acceleration measures are associated with traditional CVD risk factors in an African-American cohort with a high prevalence of hypertension. GrimAA was associated with CVD incidence and slightly improved prediction of CVD events over clinical risk scores.


Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Binu Koirala ◽  
Yvonne Commodore-mensah ◽  
Ruth Alma Turkson Ocran ◽  
Diana Baptiste ◽  
Patricia Davidson ◽  
...  

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the US. Asians are the fastest-growing immigrant group in the US and are disproportionately affected by CVD risk factors, compared to Whites. Studies on CVD risk aggregate Asians into a homogenous group. It is unclear how Asian immigrants (Indian subcontinent, Southeast Asia, Asia) differ with respect to CVD risks and in comparison, to Whites. Hypothesis: We hypothesize that there will be significant heterogeneity in CVD risk factors among Asian immigrant subgroups as compared to Non-Hispanics Whites. Methods: A cross-sectional comparative analysis of the 2010 to 2018 National Health Interview Survey was conducted among 508,941 participants. A generalized linear model using Poisson distribution was fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and smoking among Asian immigrants to Whites, adjusting for known confounders. Results: In this sample, 33,973 were Asian immigrants (26% Indian subcontinent; 45% Southeast Asia; 29% Asia) and 474,968 Whites; Indian subcontinent were the youngest (39 years; SE: 0.36). Compared to Whites, the Indian subcontinent had the highest prevalence of overweight/obesity (PR:1.22; 95% CI:1.19-1.25) and Southeast Asian had highest in high cholesterol (PR:1.16; 95% CI:1.10-1.23). Both, the Indian subcontinent (PR:1.69; 95% CI:1.49 - 1.93) and Southeast Asian (PR:1.38; 95%:1.26-1.52), reported a higher prevalence of diabetes. All Asian subgroups were more likely to be physically inactive and less likely to smoke than Whites (Table). Conclusion: Significant heterogeneity in CVD risk factors among Asian immigrants was observed compared to Whites. Providers caring for Asians should consider health behaviors and cultural beliefs influencing health outcomes and provide tailored and culturally informed care to improve the cardiovascular health of diverse populations.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Yvonne Y Commodore-Mensah ◽  
Charles O Agyemang ◽  
Jonathan K Aboagye ◽  
Nancy Abu-Bonsrah ◽  
Cheryl R Himmelfarb

Introduction: There are research gaps on cardiovascular disease (CVD) risk of the burgeoning West-African immigrants (WAI) in the United States (US) because they are lumped into the racial category of “Black/African-American”. The epidemiological transition in Africa suggests that WAI may be at high risk for CVD prior to migration, which may worsen with increased years of US residence. We sought to examine the global CVD risk using the 10-year Framingham CVD score (FRS10), CVD risk factors and identify independent predictors of increased CVD risk, among WAI. Methods: The “AFRO-CardiAC” study is a community-based cross-sectional study among first generation WAI aged 35-74 years, born in Ghana/Nigeria and residing in the Washington, D.C metropolis. Cardiovascular disease risk factors (total cholesterol, HDL cholesterol, hypertension (HTN), diabetes, smoking and body mass index) and health behaviors were determined according to AHA guidelines. Descriptive statistics were performed on participant’s FRS10 and CVD risk factors with comparison by sex. Participants with FRS10 below 10% were deemed low risk and those at ≥ 10% were classified as high risk. A multivariate logistic regression was fitted to identify independent risk factors associated with high CVD risk. Results: A total of 145 participants have been recruited to date; aged 50±8.5years and 61% female. The majority (72%; 104/145) have resided in the US for more than 10 years. The overall prevalence of HTN was 53% with no significant difference between males (46%) and females (57%)[p=0.201]. The prevalence of overweight/obesity was 94% in females and 82% in males (p<0.0001). Only one participant reported smoking and 15% were diabetic, with no sex differences (males 20 % and females 12 %). Males had a significantly higher mean FRS10 (11.10±8.85) than females (6.66±6.48) [p=0.0016]. Also, 13%, 23%, 64% (n=56) of males were classified as having high, intermediate and low risk of CVD compared to 3%, 20%, and 77% of females (n=87)[p=0.082]. The predictors of high CVD risk using dichotomized FRS10 categories (<10% vs. ≥10%) as the outcome included increasing length of stay in the US, [Odds Ratio (OR):1.12, 95%CI: 1.04-1.20,p= 0.001], unemployment[OR:7.0, 95% CI: 1.69-29.79, p=0.008] and household income less than $25,000 (OR: 4.17, 95%CI:1.33-13.08,p=0.014) Conclusion: In conclusion, this preliminary analysis of an ongoing study shows a high prevalence of major CVD risk factors in relatively young WAI. Males had a significantly higher global CVD risk although females had a striking prevalence of overweight/obesity. Employment was protective against high CVD risk while lower income and longer stay in the US were associated with higher CVD risk. These data suggest a need for CVD prevention strategies that are tailored to the needs of the WAI with consideration of socioeconomic status and gender.


2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.


Author(s):  
Magdalena Mijas ◽  
Karolina Koziara ◽  
Andrzej Galbarczyk ◽  
Grazyna Jasienska

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.


2021 ◽  
Vol 12 ◽  
pp. 215013272098095
Author(s):  
Marwa S. Said ◽  
Inas T. El Sayed ◽  
Eman E. Ibrahim ◽  
Ghada M. Khafagy

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.


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