Abstract 17878: Hospital Admission Rates for Myocardial Infarction and Stroke in New York City Before and After the Ban on Trans Fatty Acids

Abstract

Introduction: Numerous bans on the use of trans fatty acids (TF)s in eateries are in effect across the United States. No studies have examined cardiovascular event rates after the bans were enacted. Hypothesis: The July 1, 2007 ban on TFs in restaurants and food trucks in New York City (NYC) was associated with an accelerated decline in MI and stroke. Methods: We used the 2002-2013 New York Department of Health Statewide Planning and Research Cooperative System (SPARCS) data to calculate hospital admission rates for incident of MI and stroke in NYC residents (using county of residence). Diagnosis was established using primary discharge ICD-9-CM codes 410.00-410.99 for MI and 430.00-438.99 for stroke. Rates were calculated using Census 2000 and 2010 data and intercensal estimates. Incidence rates of MI and stroke declined between 2002 and 2007. To analyze whether there was additional decline from these prior trends after implementation of the NYC TF ban, we used negative binomial regression to model event trends and compare this to actual trends. We also used publicly available data from the 2004 NYC Health and Nutrition Examination Survey (NYC HANES) to investigate restaurant usage per week among NYC residents. This was reported as never, less than weekly (we estimated as 0.5 uses per week), or 1 to 25 uses per week. All analyses were stratified by decade of age. Results: After 2007, younger age groups (25-34 and 35-44) experienced an additional decline in stroke (see table), but not MI, that was greater than would have been expected based on temporal trends. Younger age groups also reported higher mean restaurant use in NYC HANES. Conclusions: Stroke rates in NYC among younger adults declined faster than would have been expected after the 2007 TF ban. Additionally, younger age groups were also those that had highest restaurant usage. Further study to compare event trends in NYC counties to other New York counties is warranted to investigate if this trend is related to other secular trends.