Abstract P378: Behavior Patterns over 20 Years and their Relationship to Subclinical Atherosclerosis

Abstract

Background: While individual health risk behaviors are independently associated with CVD and mortality, these behaviors frequently co-occur. Less is known about combinations of behaviors and their relationship to subclinical atherosclerosis. Objective: To identify patterns of behavior from young adulthood through middle age and whether these patterns are associated with developing coronary artery calcification (CAC) and carotid intima-media thickening (IMT) over 20 years Methods: Our sample consists of all participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort study who completed the Year 20 exam (n = 3538). We assessed five healthy lifestyle factors at Years 0, 7, and 20: BMI (<25 kg/m 2 ), alcohol intake (women: ≤ 15 g/day; men: ≤ 30 g/day), diet (best 40% of cohort by race and sex: high in potassium, calcium, & fiber; low in saturated fatty acids), physical activity (> 300 exercise units), not a cigarette smoker (Yes/No). We applied Latent class analysis (LCA) to these 15 binary variables in order to identify a discrete set of participant groups characterized by the presence or absence of behaviors. We then regressed CAC and IMT thickening on our identified groups to determine those behavioral patterns that are associated with subclinical atherosclerosis. Regression models controlled for age, race, and gender. Missing values were replaced prior to analyses using imputation. Results: We identified six distinct behavioral patterns primarily characterized by combinations of the presence or absence of being overweight, smoking, and/or healthy diet and physical activity (HDiet&PA; see table). Odds of CAC and IMT thickening were highest among the two smoking groups. Normal-weight non-smokers had the lowest odds of CAC and the least IMT thickening. Conclusions: We identified combinations of behaviors through young adulthood associated with varying burden of subclinical atherosclerosis in middle age. These data may suggest potential targets for primordial and primary prevention.