Abstract P196: Cardiovascular Health Across the Lifespan: The Development and Validation of a Synthetic Cardiovascular Cohort

Abstract

Introduction: The burden of cardiovascular (CV) risk factors accumulates over the lifespan: however, little information on CV risk across the full lifespan is available. Synthetic cohorts offer the opportunity to understand CV health across the lifespan. In this study we developed and validated a synthetic cohort approach to examine CV risk factors from age 18-90 years of age. Methods: This study included African American and Caucasian participants from 7 cohorts in the Lifetime Risk Pooling Project. Individuals’ demographics (age, birth year, sex, race, SES), CV risk factors (smoking, total cholesterol, SBP, DBP, glucose, diabetes, lipid-lowering and antihypertensive meds) and outcomes (incident CVD and death) at each exam were included. To generate a complete set of values from age 18 to 90 for each participant, we multiply imputed the participant’s CV risk profile and outcome using the available exam records based on a joint multi-level imputation model. To validate our imputed values, we removed the observed CARDIA data with exam ages 18-30, MESA data with exam ages 50-59 and CHS data with exam ages 80-90. We then imputed the CV risk profile of these deleted values and compared imputed and observed values. Results: We included 41,387 participants (55% female, 30% African American, mean age 51 at baseline, avg follow-up time 20 yrs). In our validation sample, imputed CV risk factor levels were consistent with observed values at both younger and older ages (table) for BMI, SBP, DBP, glucose and total cholesterol. The prevalence of antihypertensive meds was 14.6% in the observed and 14.9% in the imputed data. Similar findings were shown for the prevalence of diabetes, current smoking, CVD events and death. Imputed prevalence of lipid-lowering meds was lower than observed rates (5% vs 12%). Conclusions: This synthetic cohort approach provides valid and unbiased estimates of CV risk factors across the lifespan. Future studies using this synthetic cohort can provide novel insights into the origins and accumulation of CVD.