Abstract 107: Longitudinal Associations Of Dietary Fructose And Psychological Stress With Vascular Aging Index And Incident Cardiovascular Disease Among Us Black And White Adults In The CARDIA Study

Abstract

Background: Cardiovascular diseases (CVD) is the leading cause of death and disability worldwide. CVD risk increases exponentially with age, largely due to pathophysiological changes within the vasculature. As per AHA’s Life’s Essential 8, modifiable lifestyle factors such as diet and psychological stress are important predictors of CVD. We designed this study to assess how dietary behaviors, specifically sucrose, fructose and sodium, and endured psychological stress in young adult men and women impact the vascular aging index (VAI) and CVD risk by mid-life. Methods: All data were obtained from the Coronary Artery Risk Development in Young Adults (CARDIA) Study. We used the data from black and white men and women (n=2656) who had undergone carotid artery ultrasound Doppler scans at visit 7 (year 20 of follow-up) and used these measures to calculate the VAI, as shown previously. Baseline demographics, dietary data and stress/depression measures (CES-D scores) were obtained from visits 1 (at enrollment, year 0) and 7 and compared (men vs. women) with Kruskal-Wallis and Pearson’s chi-square tests. Regression analyses were used to assess the predictive value of these variables on VAI. Cox regression analyses were conducted to assess the risk of fatal and non-fatal CVD, hypertensive CVD, and stroke. Results: Significant associations were found for fructose intake (expressed as percent total calories, P=0.042) and BP >30/80 mmHg (P=0.025) at baseline with VAI in men but not women. Conversely, CES-D scores at baseline were significantly associated with VAI in women (P=0.014) but not men. On Cox regression analyses, baseline BMI was significantly associated with the incidence of any CVD (HR=1.065, P <0.001), hypertensive CVD (HR=1.083, P<0.001) and stroke (HR=1.068, P=0.002) 30 years later. Dietary fructose intake recorded in mid-life was significantly associated with the incidence of any CVD (HR=1.041, P=0.044), and having BP >130/80 mmHg at baseline was associated with stroke (HR=1.996, P=0.029). No sex differences were noted in the Cox regression analyses. Conclusion: Our results suggest that in young adult black and white men but not women BMI and fructose consumption, but not sodium are associated with increased VAI and incidence of CVD by mid-life.