Abstract P188: Anxiety Is Associated With Six-year Blood Pressure Change And Incident Hypertension: Findings From The Hispanic Community Health Study/ Study Of Latinos

Introduction: Prior research on the association of anxiety with hypertension has yielded mixed results. Despite the high burden of both conditions in Hispanics/Latinos, little is known about their association in this population. This study examined the longitudinal relationship of trait anxiety with changes in BP and incidence of hypertension. Hypothesis: Higher trait anxiety at Visit 1 (V1) will be associated with greater increases in BP and incident hypertension over 6 years. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multi-center prospective community-based study of 16,415 diverse Hispanics/Latinos ages 18-74 at V1 (2008-11). Data included 11,048 participants with complete information on BP, trait anxiety, and other variables at V1 and V2 (2014-17). Trait anxiety was measured at V1 using the 10-item Spielberger Trait Anxiety Scale, which was dichotomized into low and high using a cut-point of 20 points, the top quartile in the HCHS/SOL cohort. BP was measured using a standardized protocol and validated automated device. Hypertension was defined as systolic BP ≥ 140 or diastolic BP ≥ 90 mm Hg or self-reported antihypertensive medication use. Linear regressions were used to examine the association of anxiety with BP change; to account for medication use, 9 mmHg and 6 mmHg were added to systolic and diastolic BP of treated participants, respectively. The association of anxiety with incident hypertension at V2 was examined using Poisson regression among those without hypertension at V1 ( N = 7,878). Estimates were adjusted for complex survey design, sociodemographic factors, baseline BP, antidepressant/anxiolytic medication use, and health conditions. Results: Mean baseline age was 45.8 years and 60% were women. Mean change was 3.13 ( SE = 15.67) in systolic and 0.21 ( SE = 9.73) in diastolic BP. Individuals with high, compared to those with low, trait anxiety had greater increases in systolic ( B = 1.10, 95% CI = 0.28-1.93, p = 0.009) and diastolic BP ( B = 0.69, 95% CI = 0.11-1.27, p = 0.02) over 6 years, after adjusting for covariates. Individuals with high, relative to those with low, trait anxiety had an 18% higher risk of hypertension (RR = 1.18, 95% CI = 1.03-1.34, p = 0.012). Conclusions: Elevated trait anxiety is associated with small increases in BP over 6 years and an 18% higher risk of hypertension among diverse Hispanics/Latino adults. Research on the mechanisms underlying these relationships among Hispanics/Latinos is warranted to develop effective interventions to prevent and treat hypertension in this population.

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Abstract P123: Antihypertensive Medication Use and Hypertension Control Among Hispanic/Latino Adults With Hypertension: Findings From Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.139.suppl_1.p123 ◽

2019 ◽

Vol 139 (Suppl_1) ◽

Author(s):

Jenny S Guadamuz ◽

David Lee ◽

Martha L Daviglus ◽

Ramon A Durazo-Arvizu ◽

Sylvia Wassertheil-Smoller ◽

...

Keyword(s):

Community Health ◽

Antihypertensive Medication ◽

Medication Use ◽

Health Study ◽

Hypertension Control ◽

Hispanic Community ◽

Latino Adults

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Associations of Sleep Disordered Breathing and Insomnia with Incident Hypertension and Diabetes: The Hispanic Community Health Study/Study of Latinos

American Journal of Respiratory and Critical Care Medicine ◽

10.1164/rccm.201912-2330oc ◽

2020 ◽

Author(s):

Xiaoyu Li ◽

Daniela Sotres-Alvarez ◽

Linda C Gallo ◽

Alberto R Ramos ◽

Larissa Aviles-Santa ◽

...

Keyword(s):

Community Health ◽

Sleep Disordered Breathing ◽

Health Study ◽

Incident Hypertension ◽

Hispanic Community ◽

Disordered Breathing

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Associations of Sleep Disordered Breathing and Insomnia with Incident Hypertension and Diabetes: A Prospective Analysis of Data from the Hispanic Community Health Study/Study of Latinos

10.1164/ajrccm-conference.2019.199.1_meetingabstracts.a5605 ◽

2019 ◽

Cited By ~ 1

Author(s):

X. Li ◽

D. Sotres-Alvarez ◽

T. Sofer ◽

L.C. Gallo ◽

L. Aviles-Santa ◽

...

Keyword(s):

Community Health ◽

Sleep Disordered Breathing ◽

Health Study ◽

Prospective Analysis ◽

Incident Hypertension ◽

Hispanic Community ◽

Disordered Breathing

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

Circulation ◽

10.1161/circ.137.suppl_1.009 ◽

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.

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Abstract P182: Diet Quality and Longitudinal Change in Kidney Function: Findings From the Hispanic Community Health Study/Study of Latinos (hchs/sol)

Circulation ◽

10.1161/circ.141.suppl_1.p182 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Celestin Missikpode ◽

Ana Ricardo ◽

Ramon Durazo-Arvizu ◽

Josiemer Mattei ◽

Carmen R Isasi ◽

...

Keyword(s):

Community Health ◽

Kidney Function ◽

Diet Quality ◽

Complete Information ◽

Estimating Equation ◽

Potential Effect ◽

Healthy Eating Index ◽

Longitudinal Change ◽

Health Study ◽

Hispanic Community

Introduction: Recent studies suggest an association between healthy diet and incident chronic kidney disease (CKD), but these included few Hispanics/Latinos. We examined the relationship of diet quality with change in kidney function in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Given the bidirectional relationship between CKD and cardiovascular disease (CVD), we assessed prevalent CVD as a potential effect modifier. Methods: Data from HCHS/SOL Visits 1 (2008-2011) and 2 (2014-2017) were used. The Alternative Healthy Eating Index (AHEI-2010), a measure of diet quality, was calculated from two 24-hour dietary recalls administered at Visit 1 and analyzed as quintiles (lowest to highest quality). Kidney function was assessed using CKD-EPI creat glomerular filtration rate estimating equation (eGFR), and urine albumin-to-creatinine ratio (UACR). Annualized change was computed as the difference in eGFR or UACR between visits divided by follow-up time in years. CVD was defined at Visit 1 as self-reported coronary heart disease, cerebrovascular events, peripheral artery disease or heart failure. Of 16415 HCHS/SOL participants, data from 9336 and 9209 persons with complete information on dietary intake, and change in eGFR and UACR, respectively, were analyzed using linear regression. Interaction between AHEI-2010 and CVD was explored. Analyses accounted for complex sampling design. Results: Average age was 41 years, 52% were women, and 22% had prevalent CVD. On average, eGFR declined by 0.67 mL/min/1.73 m 2 / year, and UACR increased by 2.0 mg/g/year. A significant interaction between diet quality and CVD was seen (p < 0.01). Lower AHEI-2010 quintiles were associated with greater decline in eGFR in a dose-response manner in persons without CVD (P-trend <0.01, Table). The association between diet quality and eGFR was stronger in those with CVD. AHEI-2010 was not associated with change in UACR. Conclusion: These findings have important implications for CKD prevention, especially for those with CVD.

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Abstract P223: Changes In Cardiometabolic Risk Factors Following Complications Of Pregnancy Among Hispanic/latina Women Of The Hispanic Community Health Study/study Of Latinos, 2008-2017.

Hypertension ◽

10.1161/hyp.76.suppl_1.p223 ◽

2020 ◽

Vol 76 (Suppl_1) ◽

Author(s):

Tali Elfassy ◽

Natalie Bello ◽

Marissa DeFreitas ◽

Christina Cordero ◽

Maria Argos ◽

...

Keyword(s):

Community Health ◽

Cardiometabolic Risk ◽

Gestational Hypertension ◽

Survey Design ◽

Glycosylated Hemoglobin ◽

Health Study ◽

Close Monitoring ◽

Linear Regression Models ◽

Latina Women ◽

Hispanic Community

Background: Pregnancy-related complications (PC), such as preeclampsia (PE), gestational hypertension (GH) and gestational diabetes (GD), are associated with an elevation of cardiometabolic risk and subsequent cardiovascular disease (CVD) following pregnancy among European Caucasian mothers. Our study goal was to determine whether PC is associated with greater change in blood pressure (BP), fasting glucose (FPG), and/or glycosylated hemoglobin (HbA1c) among US Hispanic/Latina women. Methods: The Hispanic Community Health Study/Study of Latinos is a population-based study of 16,415 Hispanics/Latinos aged 18-74 years (at visit one: 2008-11) from four US sites. At visit two (2014-17), PC information was collected in 550 women who reported a live birth between visits. PC was defined as: no PC (PE, eclampsia, GH, or GD), PC without (w/o) pre-existing conditions (hypertension or diabetes), or PC with pre-existing conditions. At both visits (before and after birth), BP was measured (average of three seated readings) along with FPG and HbA1c (from blood). The association of PC with visit-to-visit change in BP, FPG, and HbA1c was estimated using linear regression models accounting for the complex survey design and adjusted for follow-up time, and visit one sociodemographic, clinical, and behavioral characteristics. Results: Baseline age was 26.2 years (SE: 0.3), with 77.4% without PC, 17.2% with PC w/o pre-existing conditions, and 5.4% with PC with pre-existing conditions. From fully adjusted models, PC w/o pre-existing conditions compared to no PC, was associated with a greater increase in systolic BP (+4.58mmHg; 95% CI: 1.08, 8.08), diastolic BP (+4.20mmHg; 95% CI: 1.19, 7.20), and FPG (+3.03mg/dL; 95% CI: 0.37, 5.69). PC with pre-existing conditions compared to no PC, was associated with a greater increase in systolic BP (+19.17mmHg; 95% CI: 7.10, 31.23), diastolic BP (+10.10mmHg; 95% CI: 2.67, 17.53), HbA1c (+0.82; 95% CI: 0.19, 1.45), and FPG (+27.12mg/dL; 95% CI: 7.70, 46.55). Conclusions: BP and blood glucose levels increased among US Hispanic/Latina women following PC with the greatest increase among women with pre-existing conditions. These findings suggest close monitoring of US Hispanic/Latina women with PC is warranted to prevent future CVD.

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Gut microbiome composition in the Hispanic Community Health Study/Study of Latinos is shaped by geographic relocation, environmental factors, and obesity

Genome Biology ◽

10.1186/s13059-019-1831-z ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 14

Author(s):

Robert C. Kaplan ◽

Zheng Wang ◽

Mykhaylo Usyk ◽

Daniela Sotres-Alvarez ◽

Martha L. Daviglus ◽

...

Keyword(s):

Community Health ◽

Gut Microbiome ◽

Alpha Diversity ◽

Amplicon Sequencing ◽

Shannon Index ◽

Health Study ◽

Rrna Gene ◽

Cross Sectional ◽

Hispanic Community ◽

The Usa

Abstract Background Hispanics living in the USA may have unrecognized potential birthplace and lifestyle influences on the gut microbiome. We report a cross-sectional analysis of 1674 participants from four centers of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), aged 18 to 74 years old at recruitment. Results Amplicon sequencing of 16S rRNA gene V4 and fungal ITS1 fragments from self-collected stool samples indicate that the host microbiome is determined by sociodemographic and migration-related variables. Those who relocate from Latin America to the USA at an early age have reductions in Prevotella to Bacteroides ratios that persist across the life course. Shannon index of alpha diversity in fungi and bacteria is low in those who relocate to the USA in early life. In contrast, those who relocate to the USA during adulthood, over 45 years old, have high bacterial and fungal diversity and high Prevotella to Bacteroides ratios, compared to USA-born and childhood arrivals. Low bacterial diversity is associated in turn with obesity. Contrasting with prior studies, our study of the Latino population shows increasing Prevotella to Bacteroides ratio with greater obesity. Taxa within Acidaminococcus, Megasphaera, Ruminococcaceae, Coriobacteriaceae, Clostridiales, Christensenellaceae, YS2 (Cyanobacteria), and Victivallaceae are significantly associated with both obesity and earlier exposure to the USA, while Oscillospira and Anaerotruncus show paradoxical associations with both obesity and late-life introduction to the USA. Conclusions Our analysis of the gut microbiome of Latinos demonstrates unique features that might be responsible for health disparities affecting Hispanics living in the USA.

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