Abstract P260: The Association of Changes in Area Deprivation Index With Cardiometabolic Risk Factors: The Atherosclerosis Risk in Communities (ARIC) Study

Abstract

Introduction: Higher Area Deprivation Index (ADI) is associated with greater cardiometabolic risk. The impact of changes in ADI on the likelihood of cardiometabolic risk factors is currently unknown. Methods: Among 12,044 White and Black participants at ARIC Visit 1 (1987-89), we examined the association of cross-categories of ADI quartiles at Visit 1 and at the last visit attended up to Visit 4 (1996-98) with cardiometabolic risk factors at the time of the second ADI measurement. Cross-categories were grouped as stable low ADI (remaining in ADI quartile 1 or 2), increasing ADI (moving from ADI quartile 1 or 2 at Visit 1 to quartile 3 or 4 at follow-up), decreasing ADI (moving from ADI quartile 3 or 4 at Visit 1 to quartile 1 or 2 at follow-up) or stable high ADI (remaining in ADI quartile 3 or 4).We assessed the prevalence of hypertension, diabetes, and obesity in each group at the follow-up time point and used logistic regression to evaluate associations of changes in ADI over the 9-year period with the odds of cardiometabolic risk factors. Results: The study population had a mean age of 63 years, with 55% female and 22% Black adults. Persons with decreasing ADI had a lower prevalence of hypertension, diabetes and obesity at follow-up than those with stable high ADI, while those with increasing ADI had a higher prevalence of hypertension and obesity at follow-up than those with stable low ADI (Figure). In regression models adjusted for age and sex, decreasing ADI was linked to lower odds of hypertension, diabetes and obesity compared to stable high ADI (Table), with stronger associations for hypertension among Black adults (p interaction = 0.03). Increasing ADI was linked to modestly increased odds of obesity compared to stable low ADI. Associations were attenuated after adjustment for lifestyle measures, comorbidities and other social determinants. Conclusion: ADI changes are associated with the prevalence of cardiometabolic risk factors. Interventional studies should assess the cardiometabolic impact of targeting the built environment.