Abstract WP180: The Association between Neighborhood Socioeconomic Disadvantage, Fish Consumption, and Stroke Risk Factors: the Cardiovascular Health Study

Abstract

Background: Fish consumption has been associated with reduced risk of stroke, and residence in low income neighborhoods has been associated with higher risk of stroke, either directly or through biologic risk factors for stroke, such as hypertension, diabetes, and subclinical disease. No studies, however, have examined the relationship between neighborhood characteristics, fish consumption, and stroke risk factors. Methods: We analyzed data from 3907 adults from the Cardiovascular Health Study (CHS), a population-based, longitudinal study of adults ages ≥65 years from 4 US counties. The outcomes were fish consumption (non-fried fish: ≥5 times/wk, 1-4 times/wk, 1-3 times/mo, <1 time/mo; fried fish: ≥1 times/wk, 1-3 times/mo, <1 time/mo) and stroke risk factors (Framingham stroke risk score [FSRS], diabetes, subclinical CVD [sCVD], hypertension). Neighborhood socioeconomic status (NSES) was measured using a composite of 6 census variables. Hierarchical generalized mixed-effects regression models with census-level random-effects were fit to continuous, binary, and ordinal outcomes adjusted for sociodemographic characteristics. Results: In adjusted analyses, residents of the most disadvantaged neighborhoods had lower consumption of non-fried fish (OR=0.55, 95% CI: 0.41-0.74) and higher consumption of fried fish (OR=1.61, 1.28-2.03). Eating non-fried fish was independently associated with a lower stroke risk score, but not with diabetes, hypertension, or sCVD. However, these relationships differed by neighborhood. Among those who consumed non-fried fish 1-4 times/wk, residents of the most disadvantaged neighborhoods had higher odds of diabetes (OR=1.78; p=0.03) and sCVD (OR=1.59; p=0.003), a trend towards higher odds of hypertension (OR=1.33; p=.054), and a higher FSRS (OR=1.09; p=.03). Eating fried fish was not associated with differences in stroke risk factors or FSRS. Conclusions: Residents of disadvantaged neighborhoods consumed less non-fried fish and more fried fish. Even with the same level of non-fried fish consumption, residents of more disadvantaged neighborhoods did not get the same benefit in stroke risk reduction as residents of higher SES neighborhoods.