Prevalence Of Cardiovascular Health Research Articles

Abstract 11389: Prevalence and Trends of Ideal Cardiovascular Health in 18 Countries: A Pooled Analysis of 68 Nationally Representative Surveys

Introduction: Increasing the prevalence of the ideal cardiovascular health (CVH) phenotype over the coming decades would likely result in dramatic improvements in healthy longevity and reductions in healthcare costs. Therefore, it is of paramount importance to understand the global prevalence and trends of the ideal CVH behaviors and factors for monitoring progress and providing evidence to support policy efforts. Hypothesis: We aim to describe the prevalence of CVH for the AHA defined metrics of tobacco use, body mass index, total cholesterol, blood pressure and glucose levels, and estimate its trends worldwide. Methods: We used data from people aged > 20 years who participated in 68 national health examination surveys from 1983 to 2017 in 18 countries: Australia, Czech Republic, Denmark, Germany, Greece, Ireland, Italy, Malaysia, Mexico, Poland, Seychelles, Slovakia, South Korea, Spain, Sweden, Turkey, the UK, and the USA. We calculated age-standardized prevalence of ideal CVH (no current smoking, BMI < 25 kg/m2, untreated TC < 200 mg/dL, untreated BP < 120 / < 80 mmHg, and absence of diabetes mellitus). Additionally, we examined the trends of the ideal CVH for countries that had at least two individual-level national surveys in two different decades (2000-2009 vs 2010-2019). Results: With the exception of Australia and South Korea, age-standardized prevalence of idea CVH was lower than 10% in women and lower than 5% in men across all countries. Older individuals had a lower prevalence of Ideal CVH than younger ones. Those over 65 years of age had a prevalence almost equal to zero. In ages 35-64 years, ideal CVH prevalence ranged from 3.6% to 25.4% among women, and from 0.6% to 7.1% among men. For the 10 countries where trends were estimated by age-sex groups, ideal CVH prevalence did not change or declined in the selected middle-income countries and increased in the selected high-income countries except for South Korea, where it plateaued for men and declined for women. Conclusions: Prevalence of ideal CVH worldwide is low and is declining for adults in middle-income countries in recent decades.

Educational Attainment and Prevalence of Cardiovascular Health (Life's Simple 7) in Asian Americans.

Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.

Abstract 17284: Geographic Variation in Cardiovascular Health Among American Adults

Background: There are longstanding and pervasive geographic disparities in cardiovascular (CV) health in the US. We sought to evaluate the contemporary trends in CV risk factors by census regions from 2011-2017. The region-specific CV mortality for 2017 was evaluated to assess the geographic overlap between risk factors, CV mortality, and COVID-19 mortality. Methods: The age-adjusted prevalence (per 2010 US census proportions) of CV health index (CVHI) metrics (sum of ideal blood pressure, blood glucose, lipid levels, body mass index, smoking status, physical activity, and diet) (0-7 points), were estimated as both continuous and categorical (ideal, intermediate and poor CVHI) measures in the 2011-2017 BRFSS. Regional trends were evaluated with multivariable-adjusted logistic regression models. Age-adjusted CV mortality for 2017 was derived from the CDC WONDER database. COVID-19 crude mortality rates were ascertained from respective state public health departments. Results: Among 1,362,529 American adults, the CVHI score increased from 3.89±0.004 in 2011 to 3.96±0.01 in 2017 (P&lt;0.001), modestly improvements in all regions (P&lt;0.05 for all). Ideal CV health prevalence improved only in the northeastern (P=0.03) and southern regions (P=0.002). The CVHI score (3.81±0.01) and prevalence of ideal CV health [2017: 12.2% (95% CI: 11.7-12.7%)] was lowest in southern US. This corresponded with the distribution of CV mortality (per 100,000 persons), which was highest in southern region (233.0 [95% CI: 232.2-233.8]) and lowest in western region (197.5 [95% CI: 19.6-198.5]) ( Figure 1 ). State-level distribution of poor CV health did not track with COVID-19 mortality. Conclusion: Despite a modest improvement in CVHI, only one-in-six Americans have ideal CV health with significant regional and state-level differences that correlate with the geographical distribution of CV mortality but not COVID-19 mortality. These disparities may worsen after the COVID-19 pandemic.

Abstract P126: The Cardiovascular Health of Afro-Caribbean Immigrants in New York City: a Cross Sectional Study

Introduction: Afro-Caribbean (AC) immigrants are the largest black immigrant group in the U.S. and generally display better physical health than United States (U.S.) born blacks. Cardiovascular health (CVH) disparities among AC immigrant sub-groups are poorly understood. We examined the prevalence of CVH factors among AC immigrants (Guyanese, Haitian and Jamaican) relative to U.S. born blacks residing in New York City. We hypothesized that some AC immigrant sub-groups will have higher rates of CVH factors than U.S. born blacks. Methods: We performed a cross-sectional analysis of pooled data from the 2010-2014 New York City Community Health Survey administrations to estimate the prevalence of CVH and differences among AC immigrant sub-groups. We included 7678 non-Hispanic black participants from Haiti (n=291), Jamaica (n=1031), Guyana (n=369) and U.S. born blacks (5987). Logistic regression was used to examine the association between country of birth and CVH factors. The CVH factors were determined from the AHA’s CVH metrics. We adjusted the models for significant covariates using backward sequential selection. Results: In final adjusted models, in comparison to U.S. born blacks, Jamaican immigrants were more likely to self-report diabetes but were less likely to be overweight/obese. Guyanese immigrants were also less likely to be overweight/obese than U.S. born blacks. There were no significant differences between Haitian immigrants and U.S. born blacks for CVH factors. Conclusions: Although AC immigrants depict superior health status compared to U.S. born blacks, ethnic differences exist in CVH among AC immigrant sub-groups. Efforts to address cardiovascular health factors among black populations in the U.S. should consider ethnic differences that may provide information about the most at-risk populations for disease-specific programmatic or policy interventions.

Early life determinants of cardiovascular health in adulthood. The Australian Aboriginal Birth Cohort study

BackgroundIn 2010, The American Heart Association (AHA) set seven impact goals for ideal cardiovascular health (CVH): ideal blood pressure (BP), glucose, cholesterol levels and body mass index (BMI), physical activity on recommended levels, non-smoking and a healthy diet. We explored the prevalence of ideal CVH and the relationship between early life determinants and later CVH in an Aboriginal Birth Cohort in Australia. MethodsThe sample comprised 686 Aboriginal babies born in Darwin between 1987 and 1990. At birth, birthweight was measured and data was gathered about the families. A follow-up was conducted in adulthood. Prevalences of CVH metrics were assessed and each participant received an AHA score between 0 and 7. The relationship between socioeconomic factors at birth and later CVH was analysed. ResultsIdeal CVH was rare. Females had higher levels of ideal blood pressure (OR 5.87, P < 0.0001) and lower levels of ideal physical activity (OR 0.19, P < 0.0001). Low areal disadvantage was inversely associated with ideal levels of physical activity (OR 0.13, P = 0.04) and ideal BP (OR 0.06, P = 0.04). Participants living in urban environments had lower levels of ideal BP (OR 0.11, P = 0.03). Living in large households was inversely associated with non-smoking (OR 0.22, P = 0.02). High maternal BMI was inversely associated with ideal cholesterol (OR 0.13, P = 0.004) and ideal BP (OR 0.20, P = 0.04). ConclusionsSeveral early life factors affect later CVH in this cohort. These factors could be of significance in reducing the gap in cardiovascular mortality and morbidity between the Aboriginal and the non-Aboriginal populations in Australia.

Prevalence of Cardiovascular Health by Occupation: A Cross-Sectional Analysis Among U.S. Workers Aged ≥45 Years

Identification of groups with poor cardiovascular health (CVH) can inform where and how to target public health efforts. National prevalence estimates of CVH were derived for clinical (blood glucose, total cholesterol, blood pressure) and behavioral (BMI, diet quality, physical activity, smoking) factors among U.S. workers aged ≥45 years. This cross-sectional analysis included 6,282 employed black and white men and women aged ≥45 years enrolled in the national population-based REasons for Geographic And Racial Differences in Stroke study from 2003 to 2007. Each CVH factor was scored as ideal (2); intermediate (1); or poor (0) according to American Heart Association criteria, and summed to define optimal composite scores: CVH (sum, 10-14); clinical (sum, 5-6); and behavioral (sum, 6-8) health. Occupational data were collected 2011-2013. Analyses were conducted in 2016. Only 14% met ideal criteria for all three clinical health factors, and none met ideal criteria for all four behavioral health factors. Sales and low status office workers had a low prevalence of optimal CVH. Service workers in protective services and the food preparation and serving occupations had a low prevalence of optimal clinical health; computer and healthcare support workers had a low prevalence of optimal behavioral health. The prevalence of optimal CVH among middle-aged and older workers in the U.S. is low, but considerable differences exist by occupation. Targeted public health interventions may improve the CVH of at-risk older workers with different clinical and behavioral risk factor profiles employed in diverse occupational settings.

Prevalence of cardiovascular health and its relationship with job strain: a cross-sectional study in Taiwanese medical employees

ObjectivesTo explore the prevalence and associated factors of cardiovascular health as defined by the AHA among different job categories in health settings.MethodsThis is a cross-sectional and hospital-based survey. A total...

Sex inequalities in cardiovascular health: a cross-sectional study.

The aim of this study was to determine sex differences in the prevalence of cardiovascular health (CVH) metrics according to the CVH status. The cross-sectional, population-based study involved 2250 women and 1920 men aged ≥18 years that participated in the 2010 National Health Survey in the Republic of Srpska, Bosnia and Herzegovina. Prevalence of CVH behaviours (smoking, body mass index, physical activity, diet), CVH factors (cholesterol, fasting blood glucose and blood pressure, plus smoking) and ideal CVH were estimated according to the American Heart Association criteria for ideal, intermediate and poor levels. Association between sex and ideal CVH categories was analyzed with multivariable logistic regression analysis across three age stratums. A higher prevalence of ideal CVH metrics was seen in women for smoking status, body mass index, healthy diet score and blood pressure, and in men for physical activity and total cholesterol. Women from all age groups had better CVH behaviours (odds ratio [OR] = 1.40 for the youngest; OR = 2.05 for middle-aged; and OR = 2.03 for older-aged women), while only women from the youngest age group had better CVH factors (OR = 5.09). In line with this, ideal overall CVH prevailed in younger and middle-aged women in comparison to men of the same ages (OR = 3.01 and OR = 2.25, respectively), while disappeared in older ones. Significant differences in the prevalence of CVH metrics between men and women in the Republic of Srpska should be considered in cardiovascular disease prevention.