Abstract WP180: The Association between Neighborhood Socioeconomic Disadvantage, Fish Consumption, and Stroke Risk Factors: the Cardiovascular Health Study

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Li-Jung Liang ◽  
Stefanie D Vassar ◽  
W. T Longstreth ◽  
Sharon S Merkin ◽  
Jose J Escarce ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Score ◽  
Low Income ◽  
Fish Consumption ◽  
Cardiovascular Health ◽  
Stroke Risk ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Stroke Risk Factors ◽  
Disadvantaged Neighborhoods

Background: Fish consumption has been associated with reduced risk of stroke, and residence in low income neighborhoods has been associated with higher risk of stroke, either directly or through biologic risk factors for stroke, such as hypertension, diabetes, and subclinical disease. No studies, however, have examined the relationship between neighborhood characteristics, fish consumption, and stroke risk factors. Methods: We analyzed data from 3907 adults from the Cardiovascular Health Study (CHS), a population-based, longitudinal study of adults ages ≥65 years from 4 US counties. The outcomes were fish consumption (non-fried fish: ≥5 times/wk, 1-4 times/wk, 1-3 times/mo, <1 time/mo; fried fish: ≥1 times/wk, 1-3 times/mo, <1 time/mo) and stroke risk factors (Framingham stroke risk score [FSRS], diabetes, subclinical CVD [sCVD], hypertension). Neighborhood socioeconomic status (NSES) was measured using a composite of 6 census variables. Hierarchical generalized mixed-effects regression models with census-level random-effects were fit to continuous, binary, and ordinal outcomes adjusted for sociodemographic characteristics. Results: In adjusted analyses, residents of the most disadvantaged neighborhoods had lower consumption of non-fried fish (OR=0.55, 95% CI: 0.41-0.74) and higher consumption of fried fish (OR=1.61, 1.28-2.03). Eating non-fried fish was independently associated with a lower stroke risk score, but not with diabetes, hypertension, or sCVD. However, these relationships differed by neighborhood. Among those who consumed non-fried fish 1-4 times/wk, residents of the most disadvantaged neighborhoods had higher odds of diabetes (OR=1.78; p=0.03) and sCVD (OR=1.59; p=0.003), a trend towards higher odds of hypertension (OR=1.33; p=.054), and a higher FSRS (OR=1.09; p=.03). Eating fried fish was not associated with differences in stroke risk factors or FSRS. Conclusions: Residents of disadvantaged neighborhoods consumed less non-fried fish and more fried fish. Even with the same level of non-fried fish consumption, residents of more disadvantaged neighborhoods did not get the same benefit in stroke risk reduction as residents of higher SES neighborhoods.

Abstract 2568: Cerebral Infarcts in Blacks vs Whites: the Southall and Brent REvisited (SABRE) Multi-ethnic Cohort Study

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Dean Shibata ◽  
Therese Tillin ◽  
Norman Beauchamp ◽  
John Heasman ◽  
Wadyslaw Gedroyc ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Health ◽  
African Descent ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Stroke Mortality ◽  
Black African ◽  
Cerebral Mri ◽  
Mri Scans

Introduction: Stroke mortality is doubled in people of Black African descent compared with Whites, but factors responsible for this excess are unclear. We wished to compare infarct like lesions (ILL) on MRI by ethnicity and the role of risk factors. Methods: SABRE is a UK community based multi-ethnic cohort of men and women aged 40-69 years at baseline (1988-1990), and 58-86 years at follow up (2008-2011). At follow up, a questionnaire was completed and investigations performed including resting and ambulatory BP, anthropometry, and bloods for glucose and lipids. Cerebral MRI scans were scored for infarcts independently by two readers according to the Cardiovascular Health Study protocol. Results: Of 2346 Whites, 684 attended follow up, and 590 completed cerebral MRI. Of 801 Blacks (first generation migrants of Black African descent to the UK), 232 attended clinic and 207 completed MRI. Mortality loss was greater in Whites (605, 25%) than Blacks (121, 15%)(p<0.0001), although stroke was more likely the underlying cause in Blacks (23, 19%), than Whites (43, 7%)(p<0.0001) . Baseline systolic/diastolic BP was similarly higher in Blacks than Whites in attendees (8/5 mmHg), non-responders (7/6 mm Hg), and those who died (8/5 mmHg). At follow up stroke risk factors were adverse in Blacks, apart from smoking ( table ). Prevalence of ILL was similar by ethnicity, not differing when those <65 years were analysed separately, or when those with stroke/TIA history were excluded. Associations between ILL and risk factors did not differ by ethnicity. But prescribed treatment in those with elevated clinic BP (≥140 mmHg systolic, or ≥90 mmHg diastolic) was 83% in Blacks, 63% in Whites (p<0.0001). Further, in those with an ILL, 95% of Blacks, and 69% (p<0.0001) of Whites were on treatment. Conclusion: Equivalence of ILL rates in Blacks and Whites was unanticipated, given the greater stroke mortality in Blacks. Mitigating against selective mortality as the explanation of our findings is the similar ethnic differential in baseline BP in survivors and non-survivors, the lower overall mortality in Blacks, and overall small numbers of stroke deaths. A more likely explanation is that better targeted more aggressive treatment is now occurring in Blacks than Whites, reducing their potential burden of ILL.

scholarly journals Risk factors for cardiovascular disease across the spectrum of older age: The Cardiovascular Health Study

2014 ◽  
Vol 237 (1) ◽  
pp. 336-342 ◽  
Author(s):  
Michelle C. Odden ◽  
Michael G. Shlipak ◽  
Heather E. Whitson ◽  
Ronit Katz ◽  
Patricia M. Kearney ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
Older Age ◽  
Health Study ◽  
Cardiovascular Health Study

Determinants, circumstances and consequences of injurious falls among older women living in the community

2020 ◽  
pp. injuryprev-2019-043499
Author(s):  
Elizabeth A Phelan ◽  
Eileen Rillamas-Sun ◽  
Lisa Johnson ◽  
Michael J LaMonte ◽  
David M Buchner ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
Older Women ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Logistic Regression Models ◽  
The Past ◽  
Injurious Falls ◽  
Injurious Fall

ObjectiveTo identify the risk factors of women who fell with injury relative to women who did not fall or fell without injury and to describe the circumstances and consequences of injurious and non-injurious falls.MethodsWe analysed 5074 older women from the Objective Physical Activity and Cardiovascular Health Study who prospectively tracked their falls using a 13-month calendar. Women with a reported fall were phone interviewed about fall-related details, including injuries. Risk factors were identified from surveys and clinical home visits. Logistic regression models were used to calculate adjusted ORs and 95% CIs for injurious falls relative to not falling or falling without injury. Circumstances of injurious and non-injurious falls were compared.ResultsAt least one fall was experienced by 1481 (29%) participants. Of these, 1043 were phone interviewed, of whom 430 (41%) reported at least one injurious fall. Relative to not falling, the risk factor most strongly associated with experiencing an injurious fall was having fallen ≥2 times (OR 4.0, CI 2.7 to 5.8) in the past year. Being black was protective for fall-related injury (OR 0.6, CI 0.4 to 0.9). No strong associations in risk factors were observed for injurious relative to non-injurious falls. Injurious falls were more likely to occur away from and outside of the home (p<0.05). Over half of those who injured self-managed their injury.ConclusionFalling repeatedly is a powerful risk factor for injurious falls. Those who have fallen more than once should be prioritised for interventions to mitigate the risk of an injurious fall.

Hemoglobin Decline and Health Outcomes in the Elderly: the Cardiovascular Health Study

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 3448-3448
Author(s):  
Neil A Zakai ◽  
Benjamin French ◽  
Alice Arnold ◽  
Anne Newman ◽  
Linda F. Fried ◽  
...  
Keyword(s):  
Risk Factors ◽  
Kidney Disease ◽  
Cardiovascular Health ◽  
The Elderly ◽  
Baseline Risk ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Logistic Regression Models ◽  
Concurrent Development ◽  
Adjusted Logistic Regression

Abstract Introduction: Anemia is associated with increased morbidity and mortality in the elderly, though the risk factors for and the consequences of hemoglobin (HGB) decline are poorly characterized. Methods: We studied 5201 men and women ≥65 participating in the Cardiovascular Health Study. The cohort was followed biannually and had baseline and repeat hemograms 3 years later. HGB decline was defined as >1g/dL HGB drop, or incident anemia at 3 years by WHO criteria. Results: 4006 participants survived to 3 years and had two HGB measures. The median HGB change was −0.2g/dL (IQR-0.8, 0.1). 961 (24%) participants had a >1g/dL HGB drop and 335 (8%) developed incident anemia. The left side of the table presents adjusted logistic regression models of baseline risk factors for HGB decline. Those with baseline cardiovascular disease (CVD), diabetes and kidney disease were more likely to develop >1g/dL HGB drop while only baseline kidney disease was associated with incident anemia. The table also shows the adjusted risk of HGB decline with concurrent development of co-morbid conditions. A >1g/dL drop in HGB was more likely in those who concurrently developed incident CVD, hypertension or inflammation. Incident anemia was more likely in participants with concurrent development of kidney disease or inflammation. Both incident anemia and a HGB drop >1g/dL were associated with subsequent 9-year mortality adjusting for age, race, gender, year 3 HGB, hypertension, CVD, diabetes, and renal disease; HRs (95% CI) 1.4 (1.2, 1.6) and 1.2 (1.1, 1.4) respectively. Discussion: Among studied factors, baseline CVD, diabetes and kidney disease were risk factors for >1g/dL HGB drop while only baseline kidney disease was a risk factor for incident anemia. Incident CVD and hypertension were associated concurrently with >1g/dL HGB drop while kidney disease was associated with concurrent incident anemia. Inflammation development was the strongest risk factor accompanying HGB decline. HGB decline, especially a 1g/dL drop, was associated with subsequent mortality irrespective of HGB concentration. These data suggest that small HGB changes not captured by the WHO anemia criteria are associated with poor health outcomes and that inflammation is a major correlate of HGB decline in the elderly. Table: Risk Factors for HGB Decline in Age-, Race-, Gender, and Baseline HGB-Adjusted Logistic Regression Models Baseline Risk Factors for HGB Decline Risk of HGB Decline with Concurrent Conditions HGB Drop >1g/dL Incident Anemia HGB Drop >1g/dL Incident Anemia CVD 1.2 (1.1, 1.4) 1.0 (0.8, 1.3) 1.3 (1.1, 1.6) 1.0 (0.7, 1.3) Hypertension 1.1 (0.99, 1.3) 1.1 (0.8, 1.2) 1.4 (1.1, 1.7) 1.1 (0.8, 1.5) Diabetes 1.3 (1.1, 1.5) 1.1 (0.8, 1.4) 0.9 (0.6, 1.4) 0.8 (0.4, 1.7) Kidney Disease (GFR <60ml/min/1.73m2) 1.2 (1.0, 1.3) 1.3 (1.1, 1.7) 1.1 (0.8, 1.4) 1.5 (1.0, 2.1) Inflammation CRP ≥10mg/dL or WBC≥15×109/mm3 1.0 (0.8, 1.3) 1.3 (0.99 1.8) 2.3 (1.8, 2.8) 2.3 (1.8, 3.0)

scholarly journals Cardiovascular Risk Factors and Incident Acute Renal Failure in Older Adults: The Cardiovascular Health Study

2008 ◽  
Vol 3 (2) ◽  
pp. 450-456 ◽  
Author(s):  
Anuja Mittalhenkle ◽  
Catherine O. Stehman-Breen ◽  
Michael G. Shlipak ◽  
Linda F. Fried ◽  
Ronit Katz ◽  
...  
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Renal Failure ◽  
Acute Renal Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study
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