Burden Of Cardiovascular Disease Risk Research Articles

Physical activity moderates the relationship between cardiovascular disease risk burden and cognition in older adults.

Introduction Older individuals with higher cardiovascular disease (CVD) burden have a higher risk for accelerated cognitive decline and dementia. Physical activity (PA) is an inexpensive and accessible preventive measure to CVD, cognitive impairment, and dementia. The current study examined (1) whether PA moderates the relationship between CVD burden and cognition and (2) whether the moderating effect of PA differs by race/ethnicity groups and by APOE-ɛ4 status. Methods Our cross-sectional study included participants from the Washington Heights-Inwood Columbia Aging Project (WHICAP), a multi-ethnic, community-based, longitudinal study on aging and dementia among individuals aged 65 years and older who reside in northern Manhattan. All participants underwent an interview and a neuropsychological assessment for global cognition, memory, language, visuospatial, and speed functioning. Results In 2122 older individuals without dementia, having higher CVD burden was associated with worse cognitive scores for global, language, speed, and visuospatial cognitive functions. PA mitigated the relationship between CVD burden and visuospatial function. Furthermore, PA mitigated the association of CVD burden with global cognition, language, and visuospatial functions in APOE-ɛ4 carriers, but not in non-carriers. Discussion/Conclusion Our study suggests that PA may mitigate the negative association between CVD and cognition, especially in APOE-ɛ4 carriers. The moderating effect of PA did not differ by race/ethnicity.

Abstract P373: Psychosocial Risk and Resilience Profile in Rural Alabama: A Preliminary Analysis of Risk Underlying Rural Areas Longitudinal (RURAL) Study

Background: Given the disproportionate burden of cardiovascular disease risk and outcomes, there is an urgent need to understand the psychosocial drivers of these inequities. We characterized the psychosocial risk and resilience profiles of a cohort of rural-dwelling adults in the southeast U.S. Methods: This preliminary analysis includes 765 participants with complete covariate data (mean age 47.9 (SD=10.9), 70.7% self-reporting as women, 77.9% Black individuals, 41.4% with annual household income below $15,000; 43.7% possessing a high school diploma/GED or lower) residing in two rural counties in Alabama, part of the larger RURAL study. We evaluated participants across six crucial psychosocial domains: financial strain (continuous), financial adjustments (categorized as 0, 1-3, 4+), housing stability (tertiles), childhood adversity (including general, physical, and emotional trauma experienced before 18 years, categorized into tertiles), depression (measured using CES-D 16; yes/no), and resilience (measured using CD-RISC, categorized into tertiles). We examined the distribution of study outcomes and conducted race and sex-based comparisons. Results: Resilience was high overall and did not vary significantly by race or sex. Significant racial disparities were observed, with Black participants experiencing higher financial strain (mean: 2.84 Black vs. 2.34 White), housing instability (30.1% Black vs. 11.9% White), and elevated depressive symptoms (35.2% Black vs. 25.3% White). Conversely, White participants reported greater general trauma and depression (highest tertile: 17.8% Black, 23.8 % White for general trauma; 64.3% Black vs. 73.8% White for depression). Sex-based differences were statistically insignificant across most psychosocial factors, except for financial adjustments (highest tertile: 27.7% men vs. 36.0% women) and physical trauma (38.0% men vs. 22.0% women). When considering the intersection of race and sex, Black men had the highest prevalence of housing instability (highest tertile: 35.2% Black men, 27.8% Black women, 6.8% White men, 15.8% White women), and elevated depressive symptoms (35.8% Black men, 35% Black women, 15.3 % White men, 31.6% White women). White men had the highest prevalence of physical trauma (highest tertile: 35.8% Black men, 21.3% Black women, 44.1% White men, 25.3% White women), and White women had the highest prevalence of financial adjustments (highest tertile: 30.3% Black men, 33.9% Black women, 20.3% White men, 46.3% White women). Conclusion: Our preliminary analysis of the RURAL study underscores substantial psychosocial adversity in these Southern rural communities. Future investigations should explore the relationship between these psychosocial factors and CVD risk to help identify potential intervention targets to improve cardiovascular health in rural communities.

Abstract P236: Association Between Perceived Discrimination and Arterial Stiffness in Non-Hispanic Black Adults

Introduction: Racial discrimination is a chronic stressor that may contribute to cardiovascular disease (CVD) disparities in non-Hispanic Black (NHB) adults. Compared to non-Hispanic White adults, NHB adults experience greater perceived discrimination (PD), chronic perceived stress (PS), and burden of CVD risk. However, associations between PD, PS, and CVD risk, measured as arterial stiffness (AS), have not been tested in a population-based study of NHB adults in the US, limiting our understanding of whether and how CVD prevention initiatives should target PD and PS. Purpose: Determine the association between PD and AS, and whether this association is modified by biological sex and mediated by PS. Hypothesis: We hypothesized a direct association between PD and AS and that associations will be stronger in females and mediated by PS. Methods: Study sample included 594 NHB adults with complete data who participated in the Jackson Heart (JHS) and Atherosclerosis Risk in Communities (ARIC) studies’ shared cohort. PD (lifetime, everyday, and burden of lifetime discrimination) and PS were measured at JHS baseline (2000-2004). AS was measured at ARIC Visit 5 (2011-2013). PD and PS were coded as continuous variables. Effect modification was evaluated by including an interaction term between sex and PD in fully adjusted models. Mediation was assessed via the natural indirect effects from the CAUSALmed procedure. Models were adjusted for age, sex, body mass index (BMI), blood pressure medication, diabetes status, and mean arterial pressure (MAP). Results: Participants had a mean [95% confidence interval (95%CI)] age of 64.7 [64.3, 65.1] years, BMI of 30.1 [29.7, 30.6] kg/m 2 ; 69% (410 of 594) were female, 24% (143 of 594) had diabetes, and 70% (416 of 594) had hypertension. Mean [95%CI] total scores for everyday, lifetime, and burden of lifetime PD were 1.96 [1.89, 2.03], 2.97 [2.81, 3.14], and 2.28 [2.21, 2.34], respectively. Mean [95%CI] AS, measured as pulse wave velocity, was 12.42 [12.15, 12.70] m/s. A 1-unit increase in lifetime PD score was associated with a decrease in AS ( β =- 0.30 [-0.57, -0.02] m/s ). The association remained after adjusting for demographics and clinical characteristics ( β= -0.29 [-0.55, 0.02] m/s ), but was no longer statistically significant when including MAP ( β= -0.21 [-0.46, 0.05] m/s ). There were non-significant associations between everyday PD and burden of lifetime PD and AS. There was no evidence of effect modification by sex or mediation by PS. Conclusion: Higher lifetime PD, but not everyday PD or burden of lifetime PD, was associated with lower AS in crude models. However, the association was attenuated to non-significance when adjusted for MAP, suggesting the association between PD and AS may be pressure-dependent. Future studies characterizing PD’s role in CVD risk development in other geographical regions and NHB populations.

Cardiovascular risk burden, dementia risk and brain structural imaging markers: a study from UK Biobank

BackgroundCardiovascular risk burden is associated with dementia risk and neurodegeneration-related brain structure, while the role of genetics and incident cardiovascular disease (CVD) remains unclear.AimsTo examine the association of overall cardiovascular...

Cardiovascular Disease Risk Burden, Cognitive Impairments and Incident Dementia among Community-Dwelling Middle-Aged and Older Adults: An 8-Year Longitudinal Follow-up Study.

To evaluate the associations between cardiovascular disease (CVD) risk burden (estimated by the World Health Organization (WHO) algorithm) and cognitive impairments (e.g., incident dementia, global and domain-specific impairments) among CVD-, dementia- and disability-free, community-dwelling middle-aged and older adults during an 8-year follow-up. A community-based longitudinal cohort study. Yuanshan township in Yi-Lan County, Taiwan. A total of 889 community-dwelling residents aged 50 years or older. Age, sex, educational level, employment status, alcohol status, body mass index, physical activity, gait speed, depressive symptoms, WHO region-specific CVD risk scores (10-year CV risk, low: <10% vs. moderate-to-high: ≥ 10%), Chinese version of the Mini-Mental State Examination (MMSE), verbal memory by the delay-free recall in the Chinese Version Verbal Learning Test (CVVLT), language function by the Boston Naming Test and the category (animal) Verbal Fluency Test, visuospatial function by the Taylor Complex Figure Test, executive function by the digit backward and the Clock Drawing Test. Compared to those with low CVD risk, middle-aged and older adults with moderate-to-high CVD risk were at greater risk for cognitive impairments with respect to the MMSE (adjusted odds ratio (aOR) 1.60 [95% confidence interval (CI) 1.19-2.15], P=0.002), verbal memory (aOR 1.97 [1.43-2.70], P< 0.001) and language (aOR 1.99 [1.46-2.70], P< 0.001), as well as incident dementia (aOR 2.40 [1.33-4.33], P=0.004). After adjusting for all covariates, CVD risk was not associated with other domains of cognitive impairment. Among healthy, community-dwelling, middle-aged and older adults, those with moderate-to-high cardiovascular risk burden were significantly associated with incident dementia and global and domain-specific cognitive impairments (verbal memory and language), which suggests the existence of a relationship between early cognitive deficits and CVD risk burden. Further studies are needed to elucidate the pathophysiological mechanism of the link between CVD risk burden and cognitive impairment.

Religious Attendance, Religious Coping, and Systemic Inflammation among Older African American Adults

Older African Americans bear a disproportionate burden of cardiovascular disease risk. One factor underlying these effects may be lifetime stressors exposure. Prior research has shown that religious attendance and positive religious coping, exhibiting a trusting relationship with God, are positively related to health outcomes. Mixed results emerged for negative religious coping. We examined whether these factors interacted with stress in predicting systemic inflammation, a key mechanism in stress-related chronic disease risk. Data was collected from the Health among Older Adults Living in Detroit study (N= 211, M= 67.6 yrs., 73.3% female). Measures included the number and severity of life stressors (measured via the Adult Stress and Adversity Inventory), religious attendance, positive/negative religious coping, and C-Reactive Protein (CRP). Number of participants (N= 114-119) varied in different analyses because of listwise deletion. Religious attendance and negative religious coping did not interact with any lifetime stressor indicators in predicting CRP. However, a significant interaction was found between stress severity and positive religious coping. A significant negative association emerged between positive religious coping and CRP for participants at -1.5 SD (but not +1.5 SD) from average stress severity. At very high levels of stress severity (~+2 SD), a positive link was found between positive religious coping and CRP. Positive religious coping may help to buffer against inflammation for older African American adults reporting low levels of lifetime stress severity. For participants reporting very high levels of stress, religious coping might have deleterious effects on inflammation.

Introduction to the Compendium on Early Cardiovascular Disease.

Introduction to the Compendium on Early Cardiovascular Disease.

Regional Disparities of Cardiovascular Risk Factors and Major Cardiovascular Events in Non-electively Hospitalized Young Adults.

Cardiovascular diseases contribute to considerable morbidity and mortality in the USA. We sought to establish regional disparities across the nation contributing to cardiovascular disease (CVD) among non-elective young adult hospitalizations. The National Inpatient Sample (2019) was utilized to identify the incidence of non-elective hospitalizations among young adults (18-44 yrs) and analyze the burden of CVD risk factors and outcomes (MACCE; all-cause mortality, AMI, cardiac arrest and stroke) in different US regions. A total of 5,833,930 (median age 32 [26-37] years) non-elective admissions were recorded; plurality from the south (39.6%). Most admissions were white (51.4%) and female (65.5%) amid all regions. The burden of CVD risk factors was significantly higher in the South followed by the Mid-west regions. The South had the highest and the Northeast had the lowest rates of MACE (2.9% vs 2.3%) and stroke (1.0% vs 0.8%). The risk of AMI was high for the south and Midwest regions (1.1%). All-cause mortality was highest in South and West regions (0.7%). Multivariate adjusted odds for these cardiovascular events were higher in the West (aOR 1.22; 95%CI 1.12-1.33) followed by South (aOR 1.16; 95%CI 1.07-1.26) regions. This population-based study assessing non-elective admissions in the young revealed a higher burden of CVD risk factors and rate of MACCE in the South compared to other areas of the USA. Regional policies should be tailored to the local CVD risk burden.

Abstract P656: Household Food Insecurity is Adversely Associated With Ideal Cardiovascular Health in US Adults: An Updated Analysis Using the American Heart Association’s New Life’s Essential 8 Measure

Introduction: Food insecurity, a condition of limited household food availability due to insufficient resources, is a critical social determinant of health. Food insecurity increases the risks for poor physical, behavioral, and mental health outcomes. Cardiovascular disease remains the leading cause of mortality in the US, and adults with food insecurity may face a high burden of cardiovascular disease risk. This study aimed to examine the associations between household food security status and ideal cardiovascular health (CVH), defined using the American Heart Association (AHA)’s new Life’s Essential 8 measure. We hypothesized that greater severity of food insecurity will be associated with lower overall cardiovascular health. Methods: Data came from 14,619 adults ≥20 years from the 2013-2018 National Health and Nutrition Examination Surveys. Food security was measured using the 18-item Household Food Security Survey Module, and categorized into households with high, marginal, low, and very low food security. Per AHA criteria, ideal CVH was calculated as scores (0-100) indicating the attainment of standards for diet, physical activity, smoking, sleep, body mass index, blood lipids, blood glucose, and blood pressure. Overall CVH was calculated as the unweighted average score across the eight metrics and overall average CVH score ≥80 was considered high CVH. We used linear and logistic regression models to examine the associations between household food security and ideal CVH outcomes, adjusting for sociodemographic characteristics. Complex survey weights were applied to all analyses. Results: In the sample, 72.7% of adults had high food security, 10.0% had marginal food security, 10.4% had low food security, and 6.8% had very low food security. The mean overall CVH score was 68.8 (SE 0.3), ranging from 70.2 (SE 0.3) for high food security to 62.7 (SE 1.8) for very low food security. After multivariate adjustment, marginal food security (β= -1.5, 95% CI -2.9, -0.1), low food security (β= -3.0, 95% CI -4.4, -1.7), and very low food security (β= -4.7, 95% CI -6.4, -3.0) were each associated with lower overall CVH scores when compared to high food security ( P-trend&lt;0.0001 ). These associations were driven by lower mean scores for diet, tobacco, sleep, BMI, and blood glucose with greater severity of food insecurity ( P-trends&lt;0.05 ). Furthermore, low food security (OR 0.57, 95% CI 0.45, 0.74) and very low food security (OR 0.52, 95% CI 0.37, 0.73) were both associated with lower odds of high CVH. Results remained significant in sensitivity analyses restricting the sample to adults with family incomes ≤300% of the federal poverty level. Discussion: Household food insecurity was adversely associated with cardiovascular health metrics in a dose-response fashion. Public health interventions and policies should consider a holistic approach to health promotion among populations with food insecurity.

Abstract P317: Heterogeneity in Prevalence of Hypertension and Overweight/Obesity Among US-Born and Foreign-Born Latino Subgroups: Evidence From the 2010-2018 National Health Interview Survey

Introduction: Latino individuals account for almost 20% of the U.S. population and are disproportionately affected by cardiovascular disease (CVD) risk factors, such as hypertension and overweight/obesity. They are not monolithic, but diverse in culture, lifestyle, and health exposures that impact their cardiovascular health. Further examination of heterogeneity in CVD risk factors among US-born and foreign-born Latino subgroups is needed to deepen our understanding of the burden of CVD risk in this population. Hypothesis: We hypothesized that there would be significant heterogeneity in the prevalence of hypertension and overweight/obesity among foreign-born Latino individuals as compared to their US-born counterparts. Methods: We examined the prevalence of CVD risk factors using a cross-sectional design, among Latino adults in the 2010-2018 National Health Interview Surveys. Generalized linear models using Poisson distribution were fitted to obtain adjusted odds ratio and risk of self-reported hypertension and overweight/obesity among US-born and foreign-born Latino subgroups. Results: We included 175,761 participants with mean(±sd) age 41 (0.2) years, 50.1% female, 32.4% with less than high school education, 84.5% with ≥10 years of length of US residence, and 72% with health insurance. We observed a statistically significant lower prevalence of hypertension among foreign-born Mexicans (adjusted odds ratio [AOR]: 0.98, 95% confidence interval or [CI]: 0.80 - 0.99) and Puerto Ricans (AOR: 0.75; 95% CI: 0.65 - 0.86) compared to their US-born counterparts. ( Table ) Conclusion: We observed heterogeneity in the prevalence of hypertension when foreign-born and US-born Mexicans and Puerto Ricans are compared. No differences were found for overweight/obesity. Our results highlight the need to evaluate CVD risk differences by nativity status.

Relationship of cardiovascular disease risk and hearing loss in a clinical population

Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA0.5,1,2,4) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated.

Cohort profile: Research on Obesity and Diabetes among African Migrants in Europe and Africa Prospective (RODAM-Pros) cohort study

PurposeThe Research on Obesity and Diabetes among African Migrants (RODAM) prospective (RODAM-Pros) cohort study was established to identify key changes in environmental exposures and epigenetic modifications driving the high burden...

Unique Cardiovascular Disease Risk Factors in Hispanic Individuals.

Purpose of ReviewThis review summarizes contemporary data on unique cardiovascular disease (CVD) risk factors in Hispanic individuals in the USA, and how addressing these factors is important in addressing health equity.Recent FindingsRecent studies have shown high rates of traditional CVD risk factors in Hispanic individuals such as obesity, hypertension, diabetes, hyperlipidemia, and emerging CVD risk factors like hypertensive disorders of pregnancy, psychological stress, and occupational exposures. However, most studies fail to consider the significant heterogeneity in risk factor burden and outcomes in atherosclerotic CVD by Hispanic subgroup. Heart failure and rhythm disorders are less well studied in Hispanic adults, making risk assessment for these conditions difficult. High levels of CVD risk factors in Hispanic youth given an aging Hispanic population overall highlight the importance of risk mitigation among these individuals.SummaryIn brief, these data highlight the significant, unique burden of CVD risk among Hispanic individuals in the USA and predict a rising burden of disease among this growing and aging population. Future CVD research should focus on including robust, diverse Hispanic cohorts as well as specifically delineating results for disaggregated Hispanic groups across CVDs. This will allow for better risk assessment, prevention, and treatment decisions to promote health equity for Hispanic patients.

Impact of cardiovascular risk factors on the relationships of physical activity with mood and cognitive function in a diverse sample

ABSTRACT Physical activity has well-known benefits for older adults’ mood and cognitive functioning; however, it is not clear whether risk factors for cardiovascular disease (CVD) affect the relationships of physical activity with these health outcomes among diverse older adults. This study investigated the impact of CVD risk burden on the relationships among self-reported physical activity, mood, and cognitive functioning in a diverse sample of 62 adults age 45 and older. We found that higher physical activity was associated with better attention and verbal working memory at lower CVD risk, but with worse attention and verbal working memory at higher CVD risk levels. Thus, higher CVD risk might limit the effectiveness of exercise interventions for mood and cognitive functioning. Future studies are needed to further clarify individual differences that impact the relationships among physical activity, CVD risk, and cognitive outcomes.

Association of Prior Statin Therapy With Cardiovascular Outcomes in Patients With Initial Diagnosis of OCAD and LDL-C Below 1.8mmol/L.

This study investigated the effect of prior statin therapy on cardiovascular outcomes in patients with a diagnosis of obstructive coronary artery disease (OCAD) and low-density lipoprotein cholesterol (LDL-C) <1.8mmol/L. A total of 1330 patients with baseline LDL-C <1.8mmol/L were included; 548 had received prior statin therapy [prior statin (+)] and 782 had no prior statin [prior statin (-)]. Major adverse cardiac and cerebral event (MACCE) during hospitalization and a median follow-up of 25 months were analyzed. Compared with the prior statin (-) group, who displayed similar atherosclerotic cardiovascular disease risk burden including 71.6% with hypertension, 39.1% with diabetes, and 76.1% with ≥3 risk factors, the prior statin (+) group had significantly lower incidence of composite MACCE, all-cause death and cardiovascular death. After multivariable adjustment, non-prior statin therapy was independently associated with all-cause death [hazard ratio (HR) 2.09, 95% confidence interval (CI), 1.13-3.87, P = .019] and cardiovascular death (HR 2.28, 95% CI, 1.04-5.00, P = .040), particularly in the subgroups aged ≥65years and with hypertension. Overall, compared with "naturally" LDL-C <1.8mmol/L without statin, prior statin therapy to achieve an LDL-C <1.8mmol/L independently predicted a lower risk of all-cause and cardiovascular mortality in patients with a diagnosis of OCAD.

"Healthy Heart, Healthy You": Ten-Year Cardiovascular Disease (CVD) Risk among Adults in Anekal Taluk Hospital, Bangalore Urban District, Karnataka.

Cardiovascular Disease (CVD) is the leading cause of mortality globally. Over 75% of CVD deaths occur in low- and middle-income countries. To assess the 10-year CVD risk among adults aged 30 years and above attending the outpatient department at a Taluk Hospital, Bangalore Urban District, Karnataka. A cross-sectional study was conducted among 217 subjects above 30 years of age attending the hospital. They were selected by consecutive sampling and administered a face-validated interview schedule. WHO/ISH CVD risk assessment tool was used to categorize them into four categories of CVD risk. Additional risk factors like alcohol use and smoking were also assessed. The mean age of the subjects was 55.7 ± 12.3 years. About 65% of the study population had low risk (<10%), 21.2% had mild risk (10%-20%), 9.7% had moderate risk (20%-30%) and 4.1% had high risk (>30%) according to the World Health Organization/International Society of Hypertension (WHO/ISH) CVD risk assessment tool. In the study population, 4.6% were abusing alcohol as per the CAGE questionnaire. The burden of CVD risk among the adults interviewed was high. The WHO/ISH chart is an inexpensive tool that can be used for screening in a regular OPD.

Historical redlining and cardiovascular health: The Multi-Ethnic Study of Atherosclerosis

We investigated historical redlining, a government-sanctioned discriminatory policy, in relation to cardiovascular health (CVH) and whether associations were modified by present-day neighborhood physical and social environments. Data included 4,779 participants (mean age 62 y; SD = 10) from the baseline sample of the Multi-Ethnic Study of Atherosclerosis (MESA; 2000 to 2002). Ideal CVH was a summary measure of ideal levels of seven CVH risk factors based on established criteria (blood pressure, fasting glucose, cholesterol, body mass index, diet, physical activity, and smoking). We assigned MESA participants' neighborhoods to one of four grades (A: best, B: still desirable, C: declining, and D: hazardous) using the 1930s federal Home Owners' Loan Corporation (HOLC) maps, which guided decisions regarding mortgage financing. Two-level hierarchical linear and logistic models, with a random intercept to account for participants nested within neighborhoods (i.e., census tracts) were used to assess associations within racial/ethnic subgroups (non-Hispanic White, non-Hispanic Black, Hispanic, and non-Hispanic Chinese). We found that Black adults who lived in historically redlined areas had a 0.82 (95% CI -1.54, -0.10) lower CVH score compared to those residing in grade A (best) neighborhoods, in a given neighborhood and adjusting for confounders. We also found that as the current neighborhood social environment improved the association between HOLC score and ideal CVH weakened (P < 0.10). There were no associations between HOLC grade and CVH measures or effect modification by current neighborhood conditions for any other racial/ethnic group. Results suggest that historical redlining has an enduring impact on cardiovascular risk among Black adults in the United States.

African Immigrant Health: The Health Promotion Beliefs of Zimbabwean Immigrants in the United States.

To examine the health beliefs that can influence engagement in cardiovascular disease (CVD) risk reduction health promotion activities among Zimbabwe-born immigrants in the US. Focus group interviews with 37 New England-based Zimbabwean immigrants in the US conducted between January and April 2019. Focus groups were led by study investigators who were members of the Zimbabwean community. Interviews were audio-recorded and transcribed. Data were analyzed using framework analysis. Five themes emerged: (1) negative attitudes toward ill health, (2) mistrust toward western medicine, (3) stigma and taboo toward ill health, (4) a negative change in eating habits and (5) negative attitudes toward physical exercise. The participants' attitudes and beliefs may interfere with their engagement in health promotion activities aimed at reducing the burden of CVD risk in this population. Understanding these beliefs paves the way for development of culturally congruent health promotion interventions in Zimbabwean and other African immigrant populations.

Abstract 10467: Rising Burden of Cardiovascular Disease Risk and Major Adverse Cardiac Events in Young African American Patients: A National Analysis of Two Cohorts 10-Years Apart (2017 vs. 2007)

Background: Previous reports have suggested disparities in healthcare access in the US. We aim to compare the burden of CVD risk factors and major adverse cardiac events (MACE) and in-hospital outcomes among young hospitalized African Americans (18-44 years) selecting two nationally representative samples a decade apart. Methods: Hospitalizations among young (18-44 years) African Americans were identified using The National Inpatient Sample databases in 2007 and 2017. Then, we compared the sociodemographic, comorbidities, and inpatient outcomes including MACE (all-cause mortality, AMI, cardiogenic shock, cardiac arrest, ventricular fibrillation/flutter, pulmonary embolism, coronary intervention) between 2017 vs. 2007 cohort. Multivariable analyses were performed controlling potential covariates. Results: A total of 2,922,743 (mean age 31 years, 70.3% female) admissions among young African Americans were studied (1,341,068 in 2007 &amp; 1,581,675 in 2017). The 2017 cohort often had younger (mean 30 vs. 31 years), male (30.4% vs. 28.8%) patients with higher non-elective admissions (76.8% vs. 75%) (p&lt;0.001) and showed a rising burden of traditional cardiometabolic comorbidities, congestive heart failure, chronic pulmonary disease, coagulopathy, depression, along with notable reductions in alcohol abuse and drug abuse compared to the 2007 cohort. The adjusted multivariable analysis showed worsening in-hospital outcomes including MACE (aOR 1.21), AMI (aOR1.34), cardiogenic shock (aOR 3.12), Afib/flutter (aOR 1.34), Vfib/flutter (aOR 1.32), cardiac arrest (aOR 2.55), pulmonary embolism (aOR 1.89) and stroke (aOR 1.53). Of note, the 2017 cohort showed a decreased rate of PCI/CABG and all-cause mortality vs. 2007 (p&lt;0.001). Conclusion: Young African American patients have had an increasing burden of CVD risk factors and worsened in-hospital outcomes including MACE and stroke in the last decade, though with improved survival odds.

Abstract 13245: Cardiovascular Risk Burden in Relation to Dementia and Brain Structural Imaging Markers: A Study From UK Biobank

Introduction: Cardiovascular risk burden is associated with higher all-cause dementia risk. However, the roles of cardiovascular disease (CVD) and genetic background, and the associations of cardiovascular risk burden with dementia subtypes and brain structure, need to be examined. Hypothesis: We hypothesized that the Framingham General Cardiovascular Risk Score (FGCRS) would be associated with all-cause and subtypes of dementia and brain structure. Methods: We conducted a prospective study among 354,654 participants free of CVD and dementia at baseline (2006-2010, mean age 56.4 years) within UK Biobank. CVD risk burden was evaluated by baseline FGCRS. Dementia case was identified from hospital inpatient records and death register data. Brain MRI volume markers were available for 15,104 participants since 2014. Logistic and linear regression models were used for dementia risk and brain volumes, respectively. Results: During a median 12.0 years of follow-up, 3,996 all-cause dementia cases were identified. Higher FGCRS was associated with an increased all-cause dementia risk after adjusting for demographic, major lifestyle, clinical factors, and polygenic risk score (PRS) of Alzheimer’s disease (AD). Comparing the high vs. low tertile of FGCRS, the odds ratios (ORs) and 95% CIs were 1.26 (1.12, 1.42) for all-cause dementia, 1.67 (1.33, 2.09) for AD, and 1.53 (1.08, 2.17) for vascular dementia (all P trend &lt; 0.05). Incident stroke and coronary heart disease accounted for 13% (95% CI: 9%, 19%) of the association of FGCRS with all-cause dementia. Interaction was not detected for FGCRS and PRS on risk of all-cause or any subtype of dementia (all P for interaction &gt; 0.05). We observed an 83% (95% CI: 47%, 128%) higher all-cause dementia risk comparing the high-high vs. low-low for FGCRS-PRS category. For standardized brain volumes, higher FGCRS was associated with greater log-transformed white matter hyperintensities, smaller cortical volume, and smaller grey matter volume. Conclusions: Cardiovascular risk burden was associated with higher dementia risk and neurodegeneration-related brain volume markers. The association of cardiovascular risk burden with all-cause dementia was partly explained by CVD onset and independent of dementia genetic risk.