Abstract P118: Association Between Shift-and-Persist and Cardiovascular Health Among Young Adults in Puerto Rico

Abstract

Background: Shift-and-persist (SP), defined as the ability to adapt the self to stressors while preserving focus in the future, is associated with favorable cardiometabolic outcomes. SP may be of great importance to individuals in Puerto Rico (PR) given their disproportionate exposure to social and environmental stressors. However, there is a scarcity of data on SP and cardiovascular health (CVH), and none in PR. This study examined the association between SP and CVH, as measured by the Life’s Essential 8 metric, among young adults in PR. Hypothesis: We hypothesize that greater SP will be associated with higher CVH scores. Methods: Baseline data from the PR-OUTLOOK study were used for this cross-sectional analysis. Young adults (18-29y, 64% women) completed baseline and clinic assessments between September 2020 and September 2022. Those with complete data on CVH were included (n=962). SP was measured with the Chen & Miller scale, with higher scores indicative of greater SP, and categorized in quartiles (SP Q1-Q4). Because dietary data are not yet available, we used questionnaires, anthropometric measurements, and fasting blood samples to calculate an adapted Life’s Essential 8 metric including physical activity, nicotine exposure, sleep health, BMI, blood lipids, blood glucose, and blood pressure; thus, actual CVH scores may be lower due to potentially low diet quality scores. Relationships between CVH and SP scores were assessed with multivariable linear regression models. Results: SP was significantly associated with CVH and its components. After adjustment for confounders, individuals in SP Q2-Q4, vs. Q1, had significantly higher total CVH (b=2.81, 95%CI=0.60, 5.03; b=4.68, 95%CI=2.54, 6.82; and b=7.34, 95%CI=4.85, 9.83, respectively) and physical activity CVH-score (b=-11.5, 95%CI=3.96, 19.1; b=11.6, 95%CI=4.27, 18.9; and b=18.6, 95%CI=10.1, 27.1, respectively). Individuals in SP Q3-Q4 also had higher BMI CVH-score (b=8.89, 95%CI=3.10, 14.7; and b=10.4, 95%CI=3.61, 17.1, respectively) than those in Q1. Additionally, those in the SP Q4, vs. Q1, had higher blood lipids (b=7.10, 95%CI=2.24, 12.0), blood glucose (B=3.91, 95%CI=0.41, 7.41), and blood pressure (b=6.23, 95%CI=1.93, 10.5) CVH-scores. Estimates were similar by sex and socioeconomic status. Conclusion: Higher SP scores were associated with higher CVH among young adults in PR. Longitudinal analyses are needed to confirm our results. We need to further understand the potential benefits of SP for CVH and identify strategies to improve SP and promote CVH in underserved populations.