Abstract MP02: Association Between Acculturation and Ideal Cardiovascular Health Among Adults From the Multi-Ethnic Study of Atherosclerosis

Background: Greater acculturation is associated with increased risk of cardiovascular disease (CVD). However, little is known about the association between acculturation and ideal cardiovascular health (CVH) as measured by the American Heart Association’s Life’s Simple 7 (LS7) metric. We investigated the association between acculturation and ideal CVH among a multi-ethnic cohort of United States (US) adults free of clinical CVD at baseline. Methods: This is a cross-sectional analysis of 6,506 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis. The independent variables were measures of acculturation [birthplace, language spoken at home and years lived in the US (foreign-born participants)]. The primary dependent variable was the CVH score derived from the LS7 metrics and the total CVH score ranged from 0-14 points. Scores of 0-8 indicate inadequate, 9-10 average and 11-14 optimal CVH. We used multivariable logistic and multiple linear regression models to examine the association between acculturation and CVH, adjusting for age, sex, race/ethnicity, education, income and health insurance. Results: The mean age (SD) was 62 (10) years and 53% were women. US-born participants had lower odds of having optimal CVH scores [prevalence odds ratio (POR) 0.63 (0.50-0.79), Table ] compared to foreign-born participants. Participants who spoke Chinese and other foreign languages at home had higher odds of having optimal CVH compared to those who spoke English [POR 1.91 (1.08-3.36) & 1.65 (1.04-2.63), respectively]. Among foreign-born participants, years lived in the US was associated with a decrease in CVH score [β coefficient -0.01 (-0.02, -0.01)]. Conclusion: Greater US acculturation was associated with poorer CVH. This finding suggests that promotion of ideal CVH should be encouraged among immigrant populations since more years lived in the US is associated with a decline in CVH score.

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Greater Acculturation is Associated With Poorer Cardiovascular Health in the Multi‐Ethnic Study of Atherosclerosis

Journal of the American Heart Association ◽

10.1161/jaha.120.019828 ◽

2021 ◽

Author(s):

Olatokunbo Osibogun ◽

Oluseye Ogunmoroti ◽

Lena Mathews ◽

Victor Okunrintemi ◽

Martin Tibuakuu ◽

...

Keyword(s):

United States ◽

Cardiovascular Disease ◽

Cardiovascular Health ◽

Hispanic Americans ◽

The United States ◽

Foreign Born ◽

Cross Sectional ◽

Lower Odds ◽

Increased Risk ◽

At Home

Background Greater acculturation is associated with increased risk of cardiovascular disease. However, little is known about the association between acculturation and ideal cardiovascular health (CVH) as measured by the American Heart Association's 7 CVH metrics. We investigated the association between acculturation and ideal CVH among a multi‐ethnic cohort of US adults free of clinical cardiovascular disease at baseline. Methods and Results This was a cross‐sectional analysis of 6506 men and women aged 45 to 84 years of 4 races/ethnicities. We examined measures of acculturation(birthplace, language spoken at home, and years lived in the United States [foreign‐born participants]) by CVH score. Scores of 0 to 8 indicate inadequate, 9 to 10 average and 11 to 14 optimal CVH. We used multivariable regression to examine associations between acculturation and CVH, adjusting for age, sex, race/ethnicity, education, income and health insurance. The mean (SD) age was 62 (10) years, 53% were women, 39% non‐Hispanic White‐, 26% non‐Hispanic Black‐, 12% Chinese‐ and 22% Hispanic‐Americans. US‐born participants had lower odds of optimal CVH (odds ratio [OR]: 0.63 [0.50–0.79], P <0.001) compared with foreign‐born participants. Participants who spoke Chinese and other foreign languages at home had greater odds of optimal CVH compared with those who spoke English (1.91 [1.08–3.36], P =0.03; and 1.65 [1.04–2.63], P =0.03, respectively). Foreign‐born participants who lived the longest in the United States had lower odds of optimal CVH (0.62 [0.43–0.91], P =0.02). Conclusions Greater US acculturation was associated with poorer CVH. This finding suggests that the promotion of ideal CVH should be encouraged among immigrant populations since more years lived in the United States was associated with poorer CVH.

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Abstract P315: Is Self-rated Health Associated With Ideal Cardiovascular Health? The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.137.suppl_1.p315 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Olatokunbo I Osibogun ◽

Oluseye Ogunmoroti ◽

Erica S Spatz ◽

Gregory L Burke ◽

Erin D Michos

Keyword(s):

Cardiovascular Health ◽

Reference Group ◽

Multinomial Logistic Regression ◽

Heart Association ◽

Cross Sectional ◽

Ethnic Study ◽

Ideal Cardiovascular Health ◽

Health Insurance Status ◽

Self Rated Health ◽

Race Ethnicity

Introduction: Self-rated health (SRH) is a commonly used indicator of health status. It has been identified as a determinant of health-promoting behaviors and a predictor of morbidity and mortality. However, little is known about the association between SRH and ideal cardiovascular health (CVH) as measured by the American Heart Association Life’s Simple 7 (LS7) criteria. We examined whether SRH was associated with ideal CVH, for the overall cohort and by sex and race/ethnicity. Methods: We conducted a cross-sectional analysis of 6457 men and women of 4 race/ethnicities, aged 45 to 84 years, who participated in the Multi-Ethnic Study of Atherosclerosis. SRH was measured on a 5-point Likert scale (excellent, very good, good, fair and poor). CVH was determined using the LS7 score with each of the 7 metrics scored from 0-2, and a total score ranging from 0-14. Scores of 0-8 indicate an inadequate score, 9-10, average and 11-14, optimal. Odds ratios (OR) and 95% confidence intervals were calculated for the associations between SRH and LS7 score categories using multinomial logistic regression, adjusted for age, sex, race/ethnicity, education, income, marital status, health insurance status and chronic diseases Results: The mean age (SD) of participants was 62 (10) years; 53% were women. Approximately, 16% of participants rated their health as excellent, 33% very good, 41% good and 9% poor-fair. In this population, 47% had inadequate LS7 scores, 33%, average and 20% optimal. The odds of having a higher LS7 score increased as SRH improved. Using participants who rated their health as poor-fair as the reference group, the adjusted OR for having an optimal LS7 score in the overall cohort was: excellent 3.0 (2.1-4.3); very good 1.6 (1.1-2.1); good 1.2 (0.9-1.7). A similar trend was observed in the stratified analyses by sex and race/ethnicity ( Table ) Conclusion: A more favorable SRH was associated with better CVH irrespective of sex or race/ethnicity. Further research could explore whether optimization of SRH predicts cardiovascular outcomes.

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Abstract P513: Alcohol Type and Ideal Cardiovascular Health in The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.141.suppl_1.p513 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Oluseye Ogunmoroti ◽

Olatokunbo Osibogun ◽

Robyn L McClelland ◽

Mariana Lazo ◽

Lena Mathews ◽

...

Keyword(s):

Cardiovascular Health ◽

Multinomial Logistic Regression ◽

Heart Association ◽

Prevalence Odds Ratio ◽

Cross Sectional ◽

Lower Odds ◽

Ideal Cardiovascular Health ◽

Study Participants ◽

Sectional Analysis ◽

The Relationship

Background: Light to moderate alcohol consumption is associated with lower incidence of cardiovascular disease (CVD) and favorable cardiovascular health (CVH). However, the association between alcohol type and ideal CVH is yet to be established. This study examined the relationship between alcohol type and ideal CVH as measured by the American Heart Association Life’s Simple 7 (LS7) metrics. Methods: We analyzed data from 6,389 men and women aged 45-84 years from a multi-ethnic cohort free of CVD at baseline. Alcohol type (wine, beer and liquor), assessed from a food frequency questionnaire, was categorized as never, >0 but <1 drink/day, 1-2 drinks/day and >2 drinks/day. Each LS7 metric (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) was scored 0-2 points, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. The maximum CVH score attainable ranged from 0-14 points (inadequate score, 0-8; average, 9-10; optimal, 11-14). We used multinomial logistic regression to examine the association between alcohol type and CVH adjusted for age, sex, race/ethnicity, education, income, health insurance and study site. Results: The mean (SD) age of study participants was 62 (10) years and 53% were women. Participants who consumed 1-2 drinks/day of wine had higher odds of having optimal CVH scores compared to those who never drank wine [prevalence odds ratio (POR) 1.50 (1.02-2.20), Table ]. In comparison to participants who never drank beer, those who consumed 1-2 and >2 drinks/day of beer had lower odds of having optimal scores [POR 0.49 (0.27-0.86) & 0.27 (0.12-0.58), respectively]. Additionally, those who consumed 1-2 and >2 drinks/day of liquor had lower odds of having optimal scores compared to those who never drank liquor [POR 0.52 (0.30-0.89) & 0.28 (0.14-0.55), respectively]. Conclusion: In this cross sectional analysis, moderate consumption of wine was associated with favorable CVH. However, consumption of beer or liquor was associated with poorer CVH.

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Abstract P210: The Social Distribution Of Ideal Cardiovascular Health: A Global Systematic Review

Circulation ◽

10.1161/circ.143.suppl_1.p210 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Farah Qureshi ◽

Kelb Bousquet-Santos ◽

Sakurako Shiba ◽

Scott Delaney ◽

Anne-Josee Guimond ◽

...

Keyword(s):

Social Status ◽

Social Determinants ◽

Cardiovascular Health ◽

Risk Of Bias ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

The Social ◽

The Us ◽

Race Ethnicity ◽

Social Distribution

Introduction: Numerous studies have examined the social determinants of ideal cardiovascular health (ICVH) around the world, but no work has summarized evidence to date. This study aimed to systematically review findings on the social distribution of ICVH globally, and to compare trends in high-income countries (HICs) vs. low/middle-income countries (LMICs). Methods: In November 2019, we systematically searched PubMed, Embase, and LILACS for observational studies published after the American Heart Association (AHA) defined ICVH as a combination of health factors and behaviors in 2010. Search terms included ICVH/Life’s Simple 7 and a pre-defined set of social determinants of health (i.e., education, income/wealth, socioeconomic status (SES), employment, occupation, and race/ethnicity). Each abstract was reviewed by two independent researchers. Studies were included if associations between a composite measure of ICVH and a social determinant of health was quantified using statistical methods. We evaluated risk of bias using an adapted version of the Newcastle-Ottawa Quality Assessment Scale. Overall findings and comparisons between HICs and LMICs (defined by World Bank guidelines) were summarized narratively. Results: A total of 33 studies met inclusion criteria. Only 8 studies were from LMICs (n=4 from China), while 25 were from HICs (n=19 from the US). The most commonly assessed social determinants were education (n=18) and income/wealth (n=17). In both HICs and LMICs, few studies examined occupation or area-level measures, like rurality/urbanicity. Most studies were cross-sectional (n=27). Two thirds of studies and had a moderate (n=14, 43%) or high (n=8, 24%) risk of bias, but no systematic differences were noted by country setting. Nearly half of studies used composite ICVH measures that were of moderate or poor quality (i.e., based on only self-reported data and/or unvalidated instruments), and only 15% of studies (n=5) assessed each ICVH component using the exact criteria defined by the AHA. Despite substantial heterogeneity in how ICVH measures were derived and analyzed (e.g., as a binary, categorical, or count variable), fairly consistent associations were observed between higher levels of ICVH and higher social status (higher education, income/wealth, racial/ethnic majority status) across both HICs and LMICs. Studies of occupation (n=6, all from HICs) and area-level measures (n=4, 3 from LMICs) were less conclusive. Conclusion: Associations between higher social status and ICVH were noted in both HICs and LMICs, but most evidence was based on correlational data from cross-sectional studies in the US, primarily in relation to education and income. Important gaps in the literature include studies from LMICs, longitudinal designs to improve causal inference, and investigations of occupation, rurality/urbanicity, and race/ethnicity in non-US settings.

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Left ventricular mechanical dispersion in a general population: Data from the Akershus Cardiac Examination 1950 study

European Heart Journal - Cardiovascular Imaging ◽

10.1093/ehjci/jez210 ◽

2019 ◽

Author(s):

Erika N Aagaard ◽

Brede Kvisvik ◽

Mohammad O Pervez ◽

Magnus N Lyngbakken ◽

Trygve Berge ◽

...

Keyword(s):

General Population ◽

Global Longitudinal Strain ◽

Population Data ◽

Left Ventricular ◽

Linear Regression Models ◽

Cross Sectional ◽

Clinical Model ◽

Mechanical Dispersion ◽

Obesity And Diabetes ◽

Increased Risk

Abstract Aims Increased left ventricular mechanical dispersion by 2D speckle tracking echocardiography predicts ventricular arrhythmias in ischaemic heart disease and heart failure. However, little is known about mechanical dispersion in the general population. We aimed to study mechanical dispersion in the general population and in diseases associated with increased risk of cardiovascular disease. Methods and results The present cross-sectional study consists of 2529 subjects born in 1950 included in the Akershus Cardiac Examination (ACE) 1950 study. Global longitudinal strain (GLS) was assessed from 17 strain segments, and mechanical dispersion calculated as the standard deviation of contraction duration of all segments. The cohort was divided according to the median value of mechanical dispersion, and multivariable linear regression models were performed with mechanical dispersion as the dependent variable. The prevalence of coronary artery disease (CAD), hypertension, obesity, and diabetes (P < 0.01 for all) was significantly higher in subjects with supra-median mechanical dispersion. In a multivariable clinical model, CAD (B = 7.05), hypertension (B = 4.15; both P < 0.001), diabetes (B = 3.39), and obesity (B = 1.89; both P < 0.05) were independently associated with increasing mechanical dispersion. When echocardiographic indices were added to the multivariable model, CAD (B = 4.38; P < 0.01) and hypertension (B = 2.86; P < 0.001) remained significant in addition to peak early diastolic tissue velocity e’ (B = −2.00), GLS (B = 1.68), and ejection fraction (B = 0.22; P < 0.001 for all). Conclusion In a general middle-aged population, prevalent CAD and hypertension were associated with increasing mechanical dispersion, possibly indicating elevated risk of fatal arrhythmias and sudden cardiac death. Albeit weaker, systolic and diastolic dysfunction, were also associated with increasing mechanical dispersion.

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Prevalence and determinants of ideal cardiovascular health in a latin women cohort: a cross-sectional study

The Lancet Regional Health - Americas ◽

10.1016/j.lana.2021.100071 ◽

2021 ◽

Vol 4 ◽

pp. 100071

Author(s):

Mónica Acevedo ◽

Paola Varleta ◽

Carolina Casas-Cordero ◽

Amalia Berríos ◽

Carlos Navarrete ◽

...

Keyword(s):

Cardiovascular Health ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Ideal Cardiovascular Health

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Abstract P001: LGB Health Disparities: Examining the Status of Ideal Cardiovascular Health From the 2011-2012 NHANES Survey

Circulation ◽

10.1161/circ.137.suppl_1.p001 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Anshul Saxena ◽

Muni Rubens ◽

Sankalp Das ◽

Tanuja Rajan ◽

Gowtham Grandhi ◽

...

Keyword(s):

Sexual Orientation ◽

Cardiovascular Health ◽

Cross Sectional Study ◽

Minority Populations ◽

Sectional Study ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

The Status ◽

Nationally Representative ◽

And Bisexual

Objectives: Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults. Methods: This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics. Results: 95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age. Conclusions: The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations. Figure

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Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) for therapeutic drug monitoring in patients with inflammatory bowel disease

Journal of Crohn s and Colitis ◽

10.1093/ecco-jcc/jjab128 ◽

2021 ◽

Author(s):

Desmond Chee ◽

Rachel Nice ◽

Ben Hamilton ◽

Edward Jones ◽

Sarah Hawkins ◽

...

Keyword(s):

Therapeutic Drug Monitoring ◽

Drug Monitoring ◽

Blood Sampling ◽

Therapeutic Drug ◽

Linear Regression Models ◽

Cross Sectional ◽

Immune Mediated ◽

Low Volume ◽

Antibody Levels ◽

At Home

Abstract Background & Aims Because of COVID-19 public health restrictions, telemedicine has replaced conventional outpatient follow up for most patients with chronic immune-mediated inflammatory disorders treated with biologic drugs. Innovative solutions to facilitate remote therapeutic drug monitoring are therefore required. Low-volume intracapillary blood sampling can be undertaken by patients at home and samples returned by post to central laboratories. We sought to report the effect of the COVID-19 pandemic on requests for therapeutic drug monitoring and the equivalence, acceptability and effectiveness of low volume Patient-led Remote IntraCapillary pharmacoKinetic Sampling (fingerPRICKS) compared to conventional venepuncture. Methods We undertook a cross-sectional blood sampling methods comparison study and compared sample types using linear regression models. Drug and antidrug antibody levels were measured using standard ELISAs. Acceptability was assessed using a purpose-designed questionnaire. Results Therapeutic drug monitoring requests for adalimumab (96.5 [70.5 - 106] per week to 52 [33.5 - 57.0], p < 0.001) but not infliximab (184.5 [161.2 - 214.2] to 161 [135 – 197.5], p = 0.34) reduced during the first UK stay-at-home lockdown compared with the preceding six months. Fingerprick sampling was equivalent to conventional venepuncture for adalimumab, infliximab, vedolizumab, and ustekinumab drug, and anti-adalimumab and -infliximab antibody levels. The median (IQR) volume of serum obtained using intracapillary sampling was 195µL (130-210). More than 87% (90/103) patients agreed that intracapillary testing was easy and 69% (71/103) preferred it to conventional venepuncture. In routine care, 75.3% (58/77) patients returned two blood samples within 14 days to permit remote assessment of biologic therapeutic drug monitoring. Conclusions Therapeutic drug monitoring can be undertaken using patient-led remote intracapillary blood sampling and has the potential to be a key adjunct to telemedicine in patients with immune-mediated inflammatory diseases.

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