Abstract 16591: The Impact of African Ancestry on the Pooled Cohort Equation Atherosclerotic Cardiovascular Disease Risk Estimation: Insights From the Hispanic Community Health Study/study of Latinos

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Karen P Flores ◽  
Amit Khera ◽  
Daniela Sotres-Alvarez ◽  
Anurag Mehta ◽  
Amber Pirzada ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Community Health ◽  
Disease Risk ◽  
African Ancestry ◽  
Health Study ◽  
Atherosclerotic Cardiovascular Disease ◽  
Risk Estimates ◽  
Hispanic Community ◽  
Ascvd Risk ◽  
The Impact

ACC/AHA 2018 guidelines recommend using Non-Hispanic (NH)-White pooled cohort equations (PCE) to estimate 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among Hispanics. If African ancestry is present, the PCE for Blacks is recommended. African ancestry estimates among Hispanic Community Health Study/Study of Latinos (HCHS/SOL) background groups have been reported. 1 We applied the PCE based on fractional African ancestry to HCHS/SOL participants and compared risk estimates from NH-White and NH-Black PCE in these groups. HCHS/SOL participants aged 40-75 years were divided into two groups based on median fractional African ancestry of ~10%: groups with >=10% or higher African Ancestry (Puerto Rican, Central Americans, and Dominicans) and those with <10% or lower African ancestry (Mexicans, South Americans, Cubans). Mean predicted ASCVD incidence using both PCE's was assessed. ASCVD risk frequencies are weighted using survey methods. Differences were determined by Rao-Scott Chi-square test. The PCE was applied to 9091 HCHS/SOL participants. (mean age 53.5, 48% F) Applying the NH-White PCE to lower African ancestry groups led to 38% of participants being classified as intermediate/high (>7.5%) ASCVD risk compared to 45% using the NH-Black PCE. Using the NH-White PCE in groups with higher African ancestry led to 36% of participants being classified as intermediate/high risk compared to 46% using the NH-Black PCE. ASCVD risk estimates per Hispanic background groups are shown. (Figure 1C ). Our study is the first to apply both NH-Black and NH-White PCE to Hispanics and assess differences based on fractional African ancestry. The NH-Black PCE provided consistently greater estimates in both groups with slightly greater differential of estimates relative to NH-White PCE in those with higher African Ancestry. Further studies with outcomes data are needed to determine optimal application of PCE in Hispanics based upon fractional African Ancestry.

Abstract MP53: The Impact of the Obesity Epidemic on Atherosclerotic Cardiovascular Disease Risk Scores: The CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Duke Appiah ◽  
Pamela J Schreiner ◽  
Raegan W Durant ◽  
Sharina D Person ◽  
Catarina I Kiefe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Disease Risk ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Obesity Epidemic ◽  
Ascvd Risk ◽  
The Impact

Introduction: Cardiovascular disease (CVD) mortality has decreased over recent decades, in part, due to changes in the prevalence of risk factors. However, few studies have explored the impact of the obesity epidemic on CVD risk prediction in young adults. Hypothesis: We assessed the hypothesis that BMI trends are positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores from young adulthood to middle age beyond the effect of other CVD risk factors included in the scores (age, sex, race, lipids, blood pressure, hypertension medication, diabetes, smoking). METHODS: Data were obtained from 2437 black and white men and women aged 18-30 years at baseline (1985-1986) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study with follow-up exams at year 0, 5, 10, 15, 20 and 25 (ages 43-55 years). Repeated-measures regression was used to model the association between ASCVD risk scores and time-varying BMI measures. RESULTS: The average 10-year ASCVD risk increased from 0.6% at baseline (mean age: 25.3) to 3.9% at year 25 (mean age: 50.3) with the change higher for men (blacks: 1.0 to 8.2%, whites: 0.3 to 4.6%) than women (blacks: 0.5 to 3.6%, whites: 1.2 to 1.4%). The overall prevalence of obesity at baseline and year 25 was 10% and 42% respectively. BMI trends were positively associated with 10-year change in ASCVD risk scores (0.12% per 1 kg/m2 increase, p<0.001). BMI adjustment minimally reduced risk scores trends with the greatest change between unadjusted and adjusted risk scores observed among black women (0.1 to 3.0%) (Figures A and B). CONCLUSION: In young adults, BMI trends are associated positively with 10-year changes in ASCVD risk independent of other risk factors. This adds to the evidence that weight control in early adulthood is an important predictor of lower future CVD risk.

scholarly journals The association of periodontal disease and cardiovascular disease risk: Results from the Hispanic Community Health Study/Study of Latinos

2018 ◽  
Vol 89 (7) ◽  
pp. 840-857 ◽  
Author(s):  
Richard H. Singer ◽  
Mark Stoutenberg ◽  
Daniel J. Feaster ◽  
Jianwen Cai ◽  
WayWay M. Hlaing ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Periodontal Disease ◽  
Community Health ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health Study ◽  
Hispanic Community

Estimating the performance of three cardiovascular disease risk scores: the Estonian Biobank cohort study

2019 ◽  
Vol 73 (3) ◽  
pp. 272-277 ◽  
Author(s):  
Aet Saar ◽  
Kristi Läll ◽  
Maris Alver ◽  
Toomas Marandi ◽  
Tiia Ainla ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Disease Risk ◽  
Risk Estimation ◽  
Cardiovascular Disease Risk ◽  
Scoring Systems ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Risk Estimates ◽  
C Statistic ◽  
Ascvd Risk

BackgroundWe aim to investigate the predictive ability of PCE (Pooled Cohort Equations), QRISK2 and SCORE (Systematic COronary Risk Estimation) scoring systems for atherosclerotic cardiovascular disease (ASCVD) risk prediction in Estonia, a country with one of the highest ASCVD event rates in Europe.MethodsSeven-year risk estimates were calculated in risk score–specific subsets of the Estonian Biobank cohort. Calibration was assessed by standardised incidence ratios (SIRs) and discrimination by Harrell’s C-statistics. In addition, a head-to-head comparison of the scores was performed in the intersection of the three score-specific subcohorts.ResultsPCE, QRISK2 and SCORE risk estimates were calculated for 4356, 7191 and 3987 eligible individuals, respectively. During the 7-year follow-up, 220 hard ASCVD events (PCE outcome), 671 ASCVD events (QRISK2 outcome) and 94 ASCVD deaths (SCORE outcome) occurred among the score-specific subsets of the cohort. While PCE (SIR 1.03, 95% CI 0.90 to 1.18) and SCORE (SIR 0.99, 95% CI 0.81 to 1.21) were calibrated well for the cohort, QRISK2 underestimated the risk by 48% (SIR 0.52, 95% CI 0.48 to 0.56). In terms of discrimination, PCE (C-statistic 0.778) was inferior to QRISK2 (C-statistic 0.812) and SCORE (C-statistic 0.865). All three risk scores performed at similar level in the head-to-head comparison.ConclusionOf three widely used ASCVD risk scores, PCE and SCORE performed at acceptable level, while QRISK2 underestimated ASCVD risk markedly. These results highlight the need for evaluating the accuracy of ASCVD risk scores prior to use in high-risk populations.

Abstract P022: Self-reported Polycystic Ovary Syndrome Is Associated With Higher Odds Of Metabolic Syndrome In Women Aged 18-76 Years From The Hispanic Community Health Study/Study Of Latinos

Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Hridya C Rao ◽  
Lindsay Fernandez-Rhodes ◽  
Michelle Meyer ◽  
Michelle Kominiarek ◽  
Linda Gallo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Polycystic Ovary Syndrome ◽  
Disease Risk ◽  
Polycystic Ovary ◽  
Health Study ◽  
Latina Women ◽  
Ovary Syndrome ◽  
Hispanic Community ◽  
Hs Crp

Introduction: Polycystic Ovary Syndrome (PCOS) is associated with increased Metabolic Syndrome (MetS), however, these findings have not been characterized in Hispanic/Latina women who are disproportionately burdened by obesity and cardiovascular disease risk compared to non-Hispanic whites. It is also unclear if this association is moderated by elevated high-sensitivity C-Reactive Protein (hs-CRP) levels, a marker for inflammation and a predictor of cardiovascular disease. Hypothesis: In Hispanic/Latina women, we hypothesized that 1) PCOS (self-reported diagnosis and signs) is associated with a higher prevalence of MetS compared to those not reporting PCOS 2) elevated hs-CRP is associated with MetS, and 3) the PCOS-MetS association is moderated by elevated hs-CRP. Methods: We used information from reproductive and economic questionnaires and venous blood measurements collected in Hispanic Community Health Study/Study of Latinos (2008-2017), a U.S. community-based cohort study of Hispanic/Latino adults. PCOS was operationalized as either 1) signs of PCOS (e.g., menstrual cycles >35 days, irregular cycles (at age 20 to 40 years old when not using birth control pills or other hormone medications and not pregnant or breastfeeding) or 2) having answered “yes” to a self-reported question on PCOS. MetS was operationalized as ≥3 elevated subcomponents of MetS (i.e., waist circumference, hypertension, insulin resistance, lipid profile, and triglycerides). A hs-CRP value ≥3.0 mg/L was considered elevated. We adjusted for the complex survey study design, age, study center, Hispanic/Latina background, and age at immigration in all models. Results: The overall (unweighted N=9582) age ranged from 18 to 76 years (mean=41.74, SD=14.18). The prevalence of PCOS (self-reported diagnosis and signs) was 12% (1008/7366), prevalence of MetS was 40% (2380/3495), prevalence of elevated-hsCRP was 44% (3704/4667). PCOS was associated with a significantly higher odds of MetS before (OR 1.35, 95% CI: 1.06-1.71) and after adjusting for elevated-hsCRP (OR 1.29, 95%CI: 1.02-1.65). Elevated hs-CRP is significantly associated with MetS (OR 2.31, 95%CI: 1.95-2.76). There was no significant interaction effect of hs-CRP in the PCOS-MetS association. Conclusions: Prevalence of PCOS (self-reported and signs) was 12% in our sample of Hispanic/Latina women, which is consistent with the previous findings in non-Hispanic whites. Both PCOS (self-reported diagnosis and signs) and elevated hs-CRP were significantly associated with higher prevalence of MetS and could indicate women at metabolic disease risk.

Abstract P083: Relationship Between Prevalent Cardiovascular Disease and 6-Year Incidence of Diabetes: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽  
2019 ◽  
Vol 139 (Suppl_1) ◽  
Author(s):  
Celestin Missikpode ◽  
Ramon A Durazo-Arvizu ◽  
Richard S Cooper ◽  
Sheila F Castaneda ◽  
Gregory A Talavera ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Community Health ◽  
Health Study ◽  
Hispanic Community
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