Number Of Ideal Factors Research Articles

Abstract MP61: Comparing the Influence of Individual vs. Community Socioeconomic Factors on Cardiovascular Health

BACKGROUND: Despite advances in treatment and decreases in risk factors, cardiovascular disease remains the cause of 1/3 deaths. Both prevalence and cost of cardiovascular disease are expected to increase over the coming decades. In supporting health efforts to reduce cardiovascular disease burden, the AHA developed a comprehensive cardiovascular health index (CVHI) incorporating behavioral and biological factors. A thorough understanding of health determinants requires inclusion of factors at multiple levels of proximity to individuals and communities. The objective of this study was to identify the demographic characteristics of individuals and areas in which they live that promote cardiovascular health. METHODS: Data from 2011 BRFSS were used to calculate CVHI. Participants were ineligible if missing information necessary to calculate CVHI (n = 156,973), if pregnant or pregnancy status was unknown (n = 3,693), or if missing county code (n = 37,163). Poisson model was used to determine change in the expected number of ideal factors an individual had due to various individual and county demographic characteristics. County demographic variables were abstracted from the Area Health Resource File. RESULTS: The effect of a 10 year increase in an individual’s age decreased the expected number of ideal CVHI factors by 6.31% (6.14, 6.47). Females had a 12.09% (11.48, 12.70) increase in expected number of ideal CVHI factors over males. Non-Hispanic blacks had a 7.42% (6.39, 8.44) decrease in expected number of ideal CVHI factors compared to other race/ethnicities. An individual’s education and income level had a dose response association with CVHI. Compared to having less than a high school education, those with a high school education had a 5.15% increase in the expected number of ideal CVHI factors and an 11.64% increase for those with a 4 year degree. As an individual’s income category increased there was a 7.89%, 10.79%, and 16.34% increase respectively in the expected number of ideal CVHI factors. For county demographics increases in the expected number of ideal factors was seen with increases in Hispanic population (0.93% per 10% increase) and increasing socioeconomic index (0.14% per 10 unit increase). A 10% increase in the population with no health insurance decreased the expected number of factors 1.49% (0.75, 2.22). There was a significant interaction (p <0.01) between an individual’s income level and the socioeconomic status of the county lived in, with those in lower income categories benefiting more from living in higher socioeconomic areas than those with higher incomes. In conclusion, both individual and county demographic characteristics were associated with changes in an individual’s CVHI. CONCLUSION: This information can assist public health and government agencies in developing priorities and evaluating the potential effectiveness of policies and programs.

Cardiovascular Risk Factors in CKD Associate with Both ESRD and Mortality

The American Heart Association's Life's Simple 7 initiative allows individuals to assess health factors (BP, cholesterol, and glucose) and health behaviors (cigarette smoking, physical activity, diet, and body mass index) to promote improved cardiovascular health. Because several cardiovascular risk factors also associate with progressive kidney disease, Life's Simple 7 may also inform an individual's risk for ESRD. Here, we investigated the association of Life's Simple 7 components with both ESRD incidence and all-cause mortality among 3093 participants with an estimated GFR (eGFR) <60 ml/min per 1.73 m(2) from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. During a median 4 years of follow-up, 160 participants developed ESRD, and 610 participants died. Compared with individuals who had zero or one of the Life's Simple 7 components in the ideal range, those individuals with two, three, and four ideal factors had progressively lower risks for ESRD; furthermore, no participant with five to seven ideal factors developed ESRD. The risk for all-cause mortality exhibited a similar trend. Adjusting for eGFR and albuminuria, however, completely attenuated the associations between the number of ideal factors and the risks for both ESRD and all-cause mortality. In conclusion, a favorable cardiovascular risk profile among individuals with CKD associates with a reduced risk for ESRD and mortality, but whether the severity of kidney disease confounds or mediates this association requires additional investigation.