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

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Oluseye Ogunmoroti ◽  
Olatokunbo Osibogun ◽  
Robyn L McClelland ◽  
Mariana Lazo ◽  
Lena Mathews ◽  
...  

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.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Olatokunbo I Osibogun ◽  
Oluseye Ogunmoroti ◽  
Erica S Spatz ◽  
Gregory L Burke ◽  
Erin D Michos

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.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Cameron Hicks ◽  
Jonathan Butler ◽  
Natalie B Slopen ◽  
David Williams ◽  
Dayna A Johnson ◽  
...  

Introduction: While insomnia is associated with an increased risk of incident cardiovascular disease (CVD), its relationship with ideal cardiovascular health (ICH) is less certain. Given that sleep disturbances increase with age, we examined the relationship between insomnia symptoms and ICH in older women. Methods: Among women participating in the ongoing Women’s Health Study stress cohort with no apparent history of CVD [N= 2588; Mean age= 72.5 ± 6.3], insomnia symptoms were characterized as self-reported difficulty falling asleep or waking up multiple times a night, three or more times per week. Ideal cardiovascular health, as defined by the American Heart Association’s 2020 Impact goals, included standard optimal targets for blood pressure, total cholesterol, glucose, body mass index, physical activity, diet, and smoking. We examined the relationship between insomnia symptoms and ICH using logistic regression, adjusting for clinical and demographic variables. Results: Of the 26588 participants, 52% reported insomnia symptoms, and 38% had ICH. Women with insomnia symptoms had significantly lower odds of ICH after full adjustment for age, race/ethnicity, education, income, depression/anxiety, marital status, and sleep duration (OR [95% CI]: 0.73 [0.64-0.83]). Moreover, compared to women without insomnia symptoms, those with insomnia symptoms were significantly more likely to have hypertension, diabetes, hypercholesterolemia, depression, anxiety, currently smoke, drink one or more alcoholic beverages per day, have a BMI >30, or exercise less frequently. Conclusion: In older women, insomnia symptoms were significantly associated with lower odds of ideal cardiovascular health even after adjusting for socioeconomic status, psychosocial factors, and sleep duration. These results suggest insomnia screening may be an important component of cardiovascular health promotion in this patient population. Further research is needed to evaluate the effects of sleep behavioral interventions on improving ICH.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Christy L Avery ◽  
Donglin Zeng ◽  
Sujatro Chakladar ◽  
Katelyn M Holliday ◽  
Dan Yu Lin ◽  
...  

Ideal cardiovascular health is a novel concept adopted by the American Heart Association (AHA) that is operationalized through measurement and classification (ideal; intermediate; poor) of seven health metrics, including fasting glucose. Declines in the prevalence of ideal fasting glucose levels have been consistently associated with higher rates of cardiovascular disease, yet few studies have examined the ages at which such declines begin. We used cross-sectional data from NHANES (2007-2010, n=5,961) and the HCHS/SOL (n=14,357) to estimate the age-specific prevalence of ideal (<100 mg/dl without medication), intermediate (100-125 mg/dl or treated to <100 mg/dl) and poor (≥126 mg/dl) fasting glucose levels defined per AHA criteria among European American (EA), African American (AA), and Hispanic/Latino (H/L) participants ≥16 years of age. Race/ethnicity-stratified age-specific net probabilities of transitioning between ideal, intermediate and poor glucose levels were then calculated from cross-sectional estimates using state-of-the-art Markov models that accommodated complex sampling under the assumption that transitions remained stable across time. In all race/ethnic groups, approximately 80% of participants ≤20 years of age had ideal glucose levels. However, the estimated probability of maintaining ideal glucose levels after age 20 varied by race/ethnicity. For example, by the age of 40, the estimated probability of maintaining ideal levels of glucose over the next five years was approximately 90% for EAs and AAs and slightly higher for H/Ls (five-year probability: 92.1%, 95% CI: 91.1%, 93.1%). Among individuals with intermediate glucose levels at age 40, the estimated five-year probability of transitioning to poor levels of glucose was twice as high for AAs (five-year probability: 8.1%, 95% CI: 4.3%, 11.9%) and H/Ls (five-year probability: 9.8%, 95% CI: 8.0%, 11.6%) compared to EAs (five-year probability = 3.9%, 95% CI: 2.7%, 5.3%). Unfortunately, among participants with poor glucose levels, the estimated probability of transitioning to ideal glucose levels remained 0% for all race/ethnic groups and across all ages. Our results suggest that efforts to maintain ideal glucose levels should target young adults and extend through 40 years of age, given the sizeable prevalence of intermediate and poor levels of glucose observed by age 20, the estimated acceleration in the transition to intermediate and poor glucose levels that occurs between the second and fourth decade of life, and the negligible estimated probability of successfully re-attaining ideal glucose levels among those with intermediate or poor glucose levels. Enhanced efforts to identify and treat populations with poor glucose levels also are needed, since these populations would include persons with undiagnosed and therefore untreated type 2 diabetes.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Oluseye Ogunmoroti ◽  
Olatokunbo Osibogun ◽  
Robyn L McClelland ◽  
Erin D Michos ◽  
Gregory L Burke ◽  
...  

Introduction: Alcohol intake is associated with cardiovascular disease (CVD), with moderate drinkers having a decreased CVD risk compared to non- and heavy drinkers. However, this association is yet to be examined using the AHA Life’s Simple 7 (LS7) metrics as a proxy for cardiovascular health (CVH). We explored associations between alcohol intake and CVH in a multi-ethnic population. Methods: Our cross-sectional analyses included 6,506 MESA participants, free of CVD, aged 45 to 84 years. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each scored 0-2, with 2 indicating “ideal”, 1 “intermediate” and 0 “poor”. Total LS7 score ranged from 0-14. Alcohol data was obtained from personal history and food frequency questionnaires. Participants were classified as never, former or current drinkers. Current drinkers were categorized as <1 (light), 1-2 (moderate) and >2 (heavy) drinks/day. Multinomial logistic regression models assessed associations between alcohol intake and CVH, adjusted for age, sex, race/ethnicity, education, income and health insurance. Results: Mean (SD) age was 62 (10) years, 53% were women; 20% were never, 24% former and 56% current drinkers. Among current drinkers, 44% had <1, 9% 1-2 and 3% >2 drinks/day. Additionally, 47% had inadequate LS7 scores, 33% average and 20% optimal. Compared to never drinkers, those who drank <1 drink/day were more likely to have average and optimal scores, although most of the associations were not significant. Women with 1-2 drinks/day were more likely than men to have optimal scores. Overall and in men, those who drank >2 drinks/day were less likely to have average or optimal scores. Whites and Hispanics with >2 drinks/day were less likely to have optimal and average scores, respectively (Table). Conclusion: Light alcohol intake tended to show favorable CVH, whereas heavy alcohol intake was unfavorable. For moderate alcohol intake, the associations with CVH varied by sex and race/ethnicity.


PLoS ONE ◽  
2021 ◽  
Vol 16 (8) ◽  
pp. e0255959
Author(s):  
Janko Janković ◽  
Stefan Mandić-Rajčević ◽  
Maša Davidović ◽  
Slavenka Janković

Background In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. Methods A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. Results This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. Conclusions To the best of our knowledge, this is the first systematic review on the relationship between participants’ socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.


2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
E M Raevschi ◽  
B C Martin

Abstract Background Achieving and maintaining cardiovascular health of individuals has a significant impact on reducing cardiovascular disease (CVD) and mortality at the population level. Methods We performed a cross-sectional community survey of 2,612 adult respondents in the Republic of Moldova. The American Heart Association cardiovascular health metrics score was used in total and by its two components: (1) health factors (blood pressure, total cholesterol, glucose, body mass index); (2) health behaviors (nonsmoking, physical activity, healthy diet score). The prevalence of CVD was identified as the main outcome measure. Results The prevalence of CVD was lower in study participants having all 7 cardiovascular health metrics (14.7%; 95% CI, 2.8% to 26.6%) compared to those with 0 to 1 cardiovascular health metrics (78.2%; 95% CI, 67.3% to 89.1%). Among participants who met all health factor metrics, the prevalence of CVD was lower (15.1%; 95% CI, 5.5% to 24.7%) compared to those with 0 to 1 health factor metrics (72.5 %; 95% CI, 69.9% to 75.0%). Study respondents who engaged in all health behaviors and those who engaged in 0 to 1 health behaviors had a similarly high prevalence of CVD (60.1%; 95% CI, 57.4% to 62.8% and 60.4%; 95% CI, 55.3% to 65.4%, respectively). Conclusions Lower prevalence of CVD was related to a greater total score of cardiovascular health metrics and with health factor components. While those diagnosed CVD appear willing to improve their behaviors, the population at risk is not likely to engage in health behaviors to prevent the onset of CVD. Key messages Increasing individual’s responsibility in addressing their own health implies improvement of community health. Strategies for health promotion should focus more on an individual’s motivation to assume personal responsibility for behaviors affecting their health.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Lissette Piedra ◽  

Introduction: Evidence suggests that subjective social status (SSS)—perceived status in the social hierarchy—may be more strongly associated with health than objective markers of social status (OSS), income and education. Compared to persons with high SSS, those with low SSS report poorer self-rated physical health and have higher rates of medical comorbidities. Little is known about the relationship between SSS and ideal cardiovascular health (CVH) profiles defined by the American Heart Association (AHA), particularly among diverse Hispanic/Latino adults. Hypothesis: Higher SSS will be associated with more favorable CVH profiles. Methods: We analyzed baseline HCHS/SOL data † on adults ages 18-74 in 2008-11 (N=15,440). SSS was assessed using the McArthur Scale, a 10-rung “social ladder” to specify social rank (scores range from 1-10; higher scores indicate higher SSS). CVH was defined based on levels of 7 metrics: diet, body mass index (BMI), physical activity, cholesterol, blood pressure, fasting glucose, and smoking status; levels of each metric were categorized as ideal, intermediate and poor using AHA criteria. A composite CVH score was calculated by summing across metrics (scores range from 0-14; higher scores indicate better CVH). Linear and logistic regressions were used to examine cross-sectional associations of SSS with CVH (overall and single metrics), after adjusting for OSS, demographics, Hispanic/Latino group, study center, marital status, insurance, prevalent coronary heart disease, and depressive symptoms (CESD). Results: In multivariate-adjusted models, each one unit increase in SSS* was associated with a higher overall CVH score (β = 0.03, 95% CI 0.004, 0.057, p <0.05); higher SSS was also positively associated with ideal levels of BMI, physical activity, and fasting blood glucose levels (see Table 1). Conclusions: These findings suggest an association between SSS and CVH among diverse Hispanic/Latino adults. Future studies will explore the mechanisms through which SSS may influence CVH.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sarah Singh ◽  
Courtney Pilkerton ◽  
Stephanie Frisbee

Background/Objective: An abnormal ankle-brachial index (ABI) strongly correlates with higher mortality in patients with cardiovascular disease however, the inverse link has not been established for cardiovascular (CV) health. The American Heart Association (AHA) aims to improve CV health by 20% by 2020 and has thus proposed the use of CV health metrics (Life’s Simple 7 or LS7). This study examines the relationship of abnormally low ABI with CV health. Methods: We evaluated 5,308 men and women aged ≥40 years, without history of CVD or diabetes mellitus (DM), participating in NHANES from 1999-2004. Abnormally low ABI was defined as ABI< 1.00 which included borderline low [0.91-0.99] and low ABI [<=0.90]). LS7 was scored on a 0-14 point scale and calculated based on poor, intermediate and ideal categories of 7 health components: diet, BMI, smoking, physical activity, blood pressure, glucose and cholesterol. LS7 scores were categorized as inadequate (0-7points), average (8-11) and optimum (12-14) CV health. Ordinal logistic regression models identified associations between abnormal ABI and CV health, with adjustments for sex, age, race/ethnicity, socioeconomic status and hs-CRP. Results: The mean (95% CI) LS7 score was 7.4 (7.3-7.5), with the majority of the population (75.3%) clustered at the lower end of average CV health. Adjusted models demonstrated that, compared to those with inadequate CV health, those with average CV health experienced 28% lower odds of abnormal ABI (OR 0.72, 95% CI; 0.52-0.97). Further improving CV health from inadequate to optimum was associated with 78% lower odds of abnormal ABI (OR 0.22, 95% CI; 0.09-0.57). On examining individual components, only blood pressure was found to be significantly associated with lower odds of abnormal ABI. Those with intermediate, as compared to poor, blood pressure readings showed 32% lower odds of abnormal ABI (OR 0.68, 95% CI; 0.48-0.94) while those with ideal blood pressure showed a 61% lower odds of abnormal ABI (OR 0.39, 95% CI; 0.21-0.72). Discussion/Conclusion: Although those with average CV health experienced lower odds of abnormal ABI, improving CV health to optimum can significantly lower these odds. This suggests that optimizing cardiovascular health, particularly in those who have not yet been affected by CVD or DM, can significantly slow or prevent progression of systemic atherosclerosis.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Olatokunbo Osibogun ◽  
Oluseye Ogunmoroti ◽  
Lena Mathews ◽  
Victor Okunrintemi ◽  
Martin Tibuakuu ◽  
...  

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.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Shabatun Islam ◽  
Jeong Hwan Kim ◽  
Syed Ahmad ◽  
Matthew L Topel ◽  
Peter Baltrus ◽  
...  

Introduction: Sleep is hypothesized to be a contributing factor towards disparities in cardiovascular disease (CVD). It has been demonstrated that Black Americans have worse sleep quality compared to other ethnic groups, but within group differences have not been studied. Whether overall sleep quality and patterns affect cardiovascular health (CVH) among Blacks has yet to be elucidated. Hypothesis: Black individuals reporting worse sleep quality and patterns will have poor CVH as measured by the American Heart Association’s Life’s Simple 7 (LS7) scores. Methods: We recruited 499 Black adults (age 53 ± 10, 38% male) without known CVD from the Atlanta, GA metropolitan area. Sleep quality and patterns were assessed by the Pittsburgh Sleep Quality Index (PSQI) which includes sleep quality, nighttime disturbance, efficiency (amount of time slept while in bed), daytime dysfunction, duration, need of medications and latency (time required to fall asleep). CVH was determined by LS7 scores calculated from measured blood pressure, glucose, cholesterol, body mass index (BMI), and self-reported exercise, diet, and smoking, and categorized into poor (0-8), intermediate (9-10), and ideal (11-14). Multinomial logistic regression was used to examine the relationship between sleep and the odds of intermediate (vs. poor) and ideal (vs. poor) CVH categories after adjusting for age, gender, household income, education, marital status, and employment status. Results: A total of 55 (11%), 107 (21%), and 337 (67%) participants had ideal, intermediate, and poor LS7 scores, respectively. Those reporting PSQI-assessed poor sleep quality (OR 0.50, 95% CI [0.33 - 0.78]), longer latency (OR 0.50, 95% CI [0.36 - 0.70]), disturbance (OR 0.45, 95% CI [0.26 - 0.77]) and daytime dysfunction (OR 0.52, 95% CI [0.31 - 0.89]) had significantly lower adjusted odds of having ideal CVH. Daytime dysfunction was significantly associated with lower adjusted odds of having ideal blood pressure (OR 0.57, 95% CI [0.38 - 0.87]), glucose (OR 0.71, 95% CI [0.51 - 0.98]), and physical activity (OR 0.58, 95% CI [0.36 - 0.93]). Similarly, longer latency was significantly associated with lower adjusted odds of having ideal BMI (OR 0.72, 95% CI [0.54 - 0.95]), blood pressure (OR 0.71, 95% CI [0.55 - 0.92]), and cholesterol (OR 0.73, 95% CI [0.55 - 0.98]). PSQI-assessed shorter sleep duration was not associated with poor overall CVH, but was associated with significantly lower adjusted odds of having ideal blood pressure (OR 0.77, 95% CI [0.61 - 0.99]). Conclusion: Among Black Americans, poor sleep in terms of quality, nighttime disturbance, daytime dysfunction and longer latency, was associated with worse overall CVH or its components. Whether addressing sleep quality in Blacks will improve CVH and outcomes needs to be studied.


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