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Tremblay JO, Nahodyl L, Mesa RA, Vilchez L, Elfassy T. Low income and education are associated with greater ASCVD risk scores among adults in the US. Prev Med Rep 2024; 41:102720. [PMID: 38623580 PMCID: PMC11017042 DOI: 10.1016/j.pmedr.2024.102720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Revised: 04/03/2024] [Accepted: 04/06/2024] [Indexed: 04/17/2024] Open
Abstract
Introduction Social determinants of health (SDOH) are fundamental causes of poor cardiovascular health, yet cardiovascular disease (CVD) risk assessment tools exclude SDOH. Our objective was to determine whether SDOH are independently associated with CVD risk in US adults. Methods Utilizing the National Health and Nutrition Examination Survey (NHANES), we combined years 1999-2018 and included participants aged 40-79 without history of CVD and with information to calculate CVD risk (n = 21,694). Ten-year risk of atherosclerotic CVD (ASCVD) was calculated using the American Heart Association/American College of Cardiology (AHA/ACC) pooled cohort equations. We used linear regression models to estimate the association between SDOH and ASCVD risk, after adjusting for demographic factors. All analyses accounted for the complex survey design. Results Mean age was 54.7 years, with 52.7 % female, 73.8 % non-Hispanic White, 9.4 % non-Hispanic Black, and 10.7 % Hispanic. From adjusted models, compared with an income of ≥ $75 K, ASCVD risk was greater by 3.06 (95 % CI: 2.65, 3.47) among those with income < $25 K, by 1.55 (95 % CI: 1.21, 1.89) among those with income $25 K-<$55 K, and by 1.20 (95 % CI: 0.84, 1.56) among those with income $55 K-<$75 K. Compared to college graduates, ASCVD risk was greater by 3.09 (95 % CI: 2.56, 3.62) among those with less than a high school education, by 1.65 (95 % CI: 1.31, 200) among those who were high school graduates, and by 1.41 (95 % CI: 1.11, 1.72) among those with some college education. Conclusion We found strong graded associations between lower income and lower educational attainment with greater CVD risk.
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Affiliation(s)
- Julien O. Tremblay
- Department of Medicine, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lauren Nahodyl
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Robert A. Mesa
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lilliana Vilchez
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Tali Elfassy
- Department of Medicine, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, United States
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Park J, Park S. Association of Handgrip Strength and Cardiovascular Disease Risk Among Middle-Aged Postmenopausal Women: An Analysis of the Korea National Health and Nutrition Examination Survey 2014-2019. Vasc Health Risk Manag 2024; 20:183-194. [PMID: 38628618 PMCID: PMC11020303 DOI: 10.2147/vhrm.s442277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
Purpose Handgrip strength is an indicator of overall muscle strength and has been associated with an increased risk of cardiovascular disease. Evidence suggests that menopause is a risk factor for cardiovascular disease in women, and muscle strength decreases progressively after menopause. Despite the prognostic importance of the decline in muscle strength and increased cardiovascular disease risk among postmenopausal women, evidence of their association is limited. This study aimed to investigate the relationship between handgrip strength and cardiovascular disease risk among postmenopausal, middle-aged Korean women. Patients and Methods Using pooled cohort equations, we calculated the 10-year risk of atherosclerotic cardiovascular disease (ASCVD) among postmenopausal women (N = 2019) aged 50-64 years without cardiovascular disease history from the 2014-2019 Korea National Health and Nutrition Examination Survey. Relative grip strength was defined as measured grip strength divided by body mass index. Logistic regression analysis of a complex sampling design was performed to evaluate the association between relative grip strength and a predicted 10-year ASCVD risk ≥7.5%. Results The average handgrip strength was 24.8 kg, and 5.2% of women were considered for sarcopenia (<18 kg). The quartile-stratified relative grip strength was negatively associated with 10-year ASCVD risk (p < 0.001). In the multiple logistic regression analysis, the adjusted odds ratio for the highest relative grip strength quartile was 0.53 (95% confidence interval [CI]: 0.36-0.78), and that of the group who breastfed for more than 12 months was 1.75 (95% CI: 1.36-2.25) for 10-year ASCVD risk. Conclusion Increased handgrip strength may be associated with lower cardiovascular disease risk among middle-aged postmenopausal women in Korea. Our findings provide critical evidence regarding the importance of increasing handgrip strength among postmenopausal, middle-aged women to reduce cardiovascular disease risk. Handgrip strength measurement might be a valuable screening tool for cardiovascular disease prevention.
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Affiliation(s)
- Jinkyung Park
- College of Nursing, Chonnam National University, Gwangju, 61469, Republic of Korea
| | - Sooyeon Park
- College of Nursing, Konyang University, Daejeon, 35365, Republic of Korea
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Shapiro I, Youssim I, Paltiel O, Calderon-Margalit R, Manor O, Friedlander Y, Hochner H. Perinatal exposures and adolescence overweight: The role of shared maternal-offspring pathways. Atherosclerosis 2024; 389:117438. [PMID: 38241794 PMCID: PMC10872218 DOI: 10.1016/j.atherosclerosis.2023.117438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 12/11/2023] [Accepted: 12/21/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND AND AIMS Early life exposures affect offspring health across the life-course. We aimed to examine whether prevalent perinatal exposures and obstetric complications are independently associated with offspring overweight in adolescence. We then assessed whether shared maternal-offspring pathways drive the association of perinatal exposures with offspring overweight. METHODS Using data from the Jerusalem Perinatal Study birth cohort, two perinatal scores were constructed: obstetric complications (OC) and prevalent perinatal exposures (PPE) scores. PPE score, generated by principal component analysis, included three primary components. Logistic regressions were used to assess associations of scores with offspring overweight, with and without adjustment for maternal life-course survival. RESULTS OC and PPE scores were independently associated with offspring overweight (OROC = 1.15, 95%CI:1.07,1.25; ORPPE1- SEP and lifestyle = 0.85, 95%CI:0.79,0.91; ORPPE2- Maternal body size = 1.20, 95%CI: 1.13,1.28; ORPPE3-Fetal growth = 1.18, 95%CI:1.11,1.26). Maternal survival was associated with offspring overweight (OR = 1.38, 95%CI:1.08,1.76), yet introducing PPE score to the same model attenuated this association (OR = 1.16, 95%CI:0.90, 1.49). When OC score and maternal survival were included in the same model, their associations with offspring overweight remained unchanged. CONCLUSIONS Mother-offspring shared factors, captured by maternal life-course survival, underlie the effect of prevalent perinatal exposures on offspring overweight. However, the effect of obstetric complications was independent, highlighting the contribution of additional pathways.
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Affiliation(s)
- Ilona Shapiro
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel.
| | - Iaroslav Youssim
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Ora Paltiel
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | | | - Orly Manor
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Yechiel Friedlander
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
| | - Hagit Hochner
- Braun School of Public Health, Hebrew University of Jerusalem, Jerusalem, 99112102, Israel
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Morris MC, Moradi H, Aslani M, Sims M, Schlundt D, Kouros CD, Goodin B, Lim C, Kinney K. Predicting incident cardiovascular disease among African-American adults: A deep learning approach to evaluate social determinants of health in the Jackson heart study. PLoS One 2023; 18:e0294050. [PMID: 37948388 PMCID: PMC10637695 DOI: 10.1371/journal.pone.0294050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023] Open
Abstract
The present study sought to leverage machine learning approaches to determine whether social determinants of health improve prediction of incident cardiovascular disease (CVD). Participants in the Jackson Heart study with no history of CVD at baseline were followed over a 10-year period to determine first CVD events (i.e., coronary heart disease, stroke, heart failure). Three modeling algorithms (i.e., Deep Neural Network, Random Survival Forest, Penalized Cox Proportional Hazards) were used to evaluate three feature sets (i.e., demographics and standard/biobehavioral CVD risk factors [FS1], FS1 combined with psychosocial and socioeconomic CVD risk factors [FS2], and FS2 combined with environmental features [FS3]) as predictors of 10-year CVD risk. Contrary to hypothesis, overall predictive accuracy did not improve when adding social determinants of health. However, social determinants of health comprised eight of the top 15 predictors of first CVD events. The social determinates of health indicators included four socioeconomic factors (insurance status and types), one psychosocial factor (discrimination burden), and three environmental factors (density of outdoor physical activity resources, including instructional and water activities; modified retail food environment index excluding alcohol; and favorable food stores). Findings suggest that whereas understanding biological determinants may identify who is currently at risk for developing CVD and in need of secondary prevention, understanding upstream social determinants of CVD risk could guide primary prevention efforts by identifying where and how policy and community-level interventions could be targeted to facilitate changes in individual health behaviors.
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Affiliation(s)
- Matthew C. Morris
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee, United States of America
- Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
| | - Hamidreza Moradi
- Department of Data Science, University of Mississippi Medical Center, Jackson, Mississippi, United States of America
- Department of Computer Science, University of North Carolina Agricultural and Technical State University, Greensboro, North Carolina, United States of America
| | - Maryam Aslani
- Department of Data Analytics, University of North Texas, Denton, Texas, United States of America
| | - Mario Sims
- Department of Social Medicine, Population, and Public Health, University of California, Riverside, California, United States of America
| | - David Schlundt
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
| | - Chrystyna D. Kouros
- Department of Psychology, Southern Methodist University, Dallas, Texas, United States of America
| | - Burel Goodin
- Department of Psychology, University of Alabama at Birmingham, Birmingham, Alabama, Texas, United States of America
- Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri, United States of America
| | - Crystal Lim
- Department of Health Psychology, University of Missouri, Columbia, Missouri, Texas, United States of America
| | - Kerry Kinney
- Department of Psychology, Vanderbilt University, Nashville, Tennessee, United States of America
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Vogel B, Tycinska A, Sambola A. Cardiogenic shock in women - A review and call to action. Int J Cardiol 2023; 386:98-103. [PMID: 37211458 DOI: 10.1016/j.ijcard.2023.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/13/2023] [Accepted: 05/05/2023] [Indexed: 05/23/2023]
Affiliation(s)
- Birgit Vogel
- The Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | | | - Antonia Sambola
- Acute Cardiac Care Unit, Department of Cardiology, University Hospital Vall d'Hebron, Barcelona, Spain
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Korenhof SA, Rouwet EV, Elstgeest LEM, Fierloos IN, Tan SS, Pisano-Gonzalez MM, Boone ALD, Pers YM, Pilotto A, López-Ventoso M, Diez Valcarce I, Zhang X, Raat H. The effect of a community-based group intervention on chronic disease self-management in a vulnerable population. Front Public Health 2023; 11:1221675. [PMID: 37670825 PMCID: PMC10475542 DOI: 10.3389/fpubh.2023.1221675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 07/24/2023] [Indexed: 09/07/2023] Open
Abstract
Introduction Chronic non-communicable diseases (NCDs) are predominantly related to modifiable health behaviors and account for 74% of global deaths at present. Behavior modification through self-management is a strategy to prevent NCDs. Chronic Disease Self-Management Programs (CDSMPs) have demonstrated improvements in health behaviors, health status, and use of healthcare. Objective We evaluated the effects of a 6-week CDSMP on self-efficacy, health behaviors, mental health, health-related quality of life (HR-QoL), and health responsibilities among vulnerable populations with chronic disease in Europe. Methods A prospective cohort study with a 6-month pre-post single-group design was conducted in five European countries. The intervention targeted adults with chronic conditions and low socioeconomic status, as well as their caregivers. The intervention was a 6-week community-based CDSMP in a group setting. Outcomes were measured per self-report questionnaire at baseline and 6-month follow-up: self-efficacy, health behaviors, mental health, HR-QoL, and health responsibilities. Results Of 1,844 participants, 1,248 (67.7%) completed follow-up and attended ≥4 sessions. For the chronic condition group, the following outcome measures at follow-up significantly improved compared with baseline (all P < 0.002): self-efficacy (SEMCD-6 6.7 vs. 6.4), mental health (PHQ-8 6.3 vs. 7.0), HR-QoL (SF-12 PCS 42.3 vs. 40.2, SF-12 MCS 42.8 vs. 41.4), health utility (EQ-5D-5L 0.88 vs. 0.86), self-rated health (EQ-5D-5L 67.2 vs. 63.9), communication with healthcare providers (2.28 vs. 2.11), understanding information (3.10 vs. 3.02), number of doctor visits (3.61 vs. 4.97), accident and emergency department visits (0.25 vs. 0.48), total nights in a hospital (0.65 vs. 1.13), and perceived medical errors (19.6 vs. 28.7%). No significant changes were detected in dietary habits, physical activity, substance use, and sleep and fatigue. For caregivers without a chronic condition, only doctor visits significantly decreased (1.54 vs. 2.25, P < 0.001). Discussion This CDSMP was associated with improvement in self-efficacy, depression, HR-QoL, and health responsibilities over 6 months in a diverse European population with a chronic condition. However, additional interventions targeting lifestyle risk factors are needed to improve health outcomes.
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Affiliation(s)
- Sophie A. Korenhof
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ellen V. Rouwet
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Liset E. M. Elstgeest
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Reinier Academy, Reinier de Graaf Hospital, Delft, Netherlands
| | - Irene N. Fierloos
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Siok Swan Tan
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Research Group City Dynamics, InHolland University of Applied Sciences, Rotterdam, Netherlands
| | - Marta M. Pisano-Gonzalez
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - An L. D. Boone
- Public Health General Directorate, Ministry of Health of the Principality of Asturias, Oviedo, Spain
| | - Yves-Marie Pers
- IRMB, University of Montpellier, INSERM, CHU Montpellier, Montpellier, France
- Clinical Immunology and Osteoarticular Diseases Therapeutic Unit, Department of Rheumatology, Lapeyronie University Hospital, Montpellier, France
| | - Alberto Pilotto
- Department of Geriatric Care, Orthogeriatrics and Rehabilitation, Galliera Hospital, Genoa, Italy
- Department of Interdisciplinary Medicine, University of Bari, Bari, Italy
| | - Mónica López-Ventoso
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - Isabel Diez Valcarce
- Research Group “Community Health and Active Aging” of the Research Institute of Asturias (IPSA), General Directorate of Care, Ministry of Health, Oviedo, Spain
| | - Xuxi Zhang
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Social Medicine and Health Education, School of Public Health, Peking University, Beijing, China
| | | | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
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Nguyen TA, Mai TD, Vu LD, Dao CX, Ngo HM, Hoang HB, Tran TA, Pham TQ, Pham DT, Nguyen MH, Nguyen LQ, Dao PV, Nguyen DN, Vuong HTT, Vu HD, Nguyen DD, Vu TD, Nguyen DT, Do ALN, Pham QT, Khuat NH, Duong NV, Ngo CC, Do SN, Nguyen HT, Nguyen CV, Nguyen AD, Luong CQ. Factors related to intracerebral haematoma in patients with aneurysmal subarachnoid haemorrhage in Vietnam: a multicentre prospective cohort study. BMJ Open 2023; 13:e066186. [PMID: 37085308 PMCID: PMC10124281 DOI: 10.1136/bmjopen-2022-066186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
OBJECTIVES To investigate the impact of intracerebral haematoma (ICH) on the outcomes and the factors related to an ICH in patients with aneurysmal subarachnoid haemorrhage (aSAH) in a low- and middle-income country. DESIGN A multicentre prospective cohort study. SETTING Three central hospitals in Hanoi, Vietnam. PARTICIPANTS This study included all patients (≥18 years) presenting with aSAH to the three central hospitals within 4 days of ictus, from August 2019 to June 2021, and excluded patients for whom the admission Glasgow Coma Scale was unable to be scored or patients who became lost at 90 days of follow-up during the study. OUTCOME MEASURES The primary outcome was ICH after aneurysm rupture, defined as ICH detected on an admission head CT scan. The secondary outcomes were 90-day poor outcomes and 90-day death. RESULTS Of 415 patients, 217 (52.3%) were females, and the median age was 57.0 years (IQR: 48.0-67.0). ICH was present in 20.5% (85/415) of patients with aSAH. There was a significant difference in the 90-day poor outcomes (43.5% (37/85) and 29.1% (96/330); p=0.011) and 90-day mortality (36.5% (31/85) and 20.0% (66/330); p=0.001) between patients who had ICH and patients who did not have ICH. The multivariable regression analysis showed that systolic blood pressure (SBP) ≥140 mm Hg (adjusted odds ratio (AOR): 2.674; 95% CI: 1.372 to 5.214; p=0.004), World Federation of Neurosurgical Societies (WFNS) grades II (AOR: 3.683; 95% CI: 1.250 to 10.858; p=0.018) to V (AOR: 6.912; 95% CI: 2.553 to 18.709; p<0.001) and a ruptured middle cerebral artery (MCA) aneurysm (AOR: 3.717; 95% CI: 1.848 to 7.477; p<0.001) were independently associated with ICH on admission. CONCLUSIONS In this study, ICH was present in a substantial proportion of patients with aSAH and contributed significantly to a high rate of poor outcomes and death. Higher SBP, worse WFNS grades and ruptured MCA aneurysms were independently associated with ICH on admission.
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Affiliation(s)
- Tuan Anh Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Ton Duy Mai
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
| | - Luu Dang Vu
- Department of Radiology, Hanoi Medical University, Hanoi, Viet Nam
- Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam
| | - Co Xuan Dao
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
- Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam
| | - Hung Manh Ngo
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
- Department of Neurosurgery II, Neurosurgery Center, Vietnam-Germany Friendship Hospital, Hanoi, Viet Nam
- Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
| | - Hai Bui Hoang
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam
| | - Tuan Anh Tran
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
- Department of Radiology, Hanoi Medical University, Hanoi, Viet Nam
- Radiology Centre, Bach Mai Hospital, Hanoi, Viet Nam
| | - Trang Quynh Pham
- Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
- Department of Neurosurgery, Bach Mai Hospital, Hanoi, Viet Nam
| | - Dung Thi Pham
- Department of Nutrition and Food Safety, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - My Ha Nguyen
- Department of Health Organization and Management, Faculty of Public Health, Thai Binh University of Medicine and Pharmacy, Thai Binh, Viet Nam
| | - Linh Quoc Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Phuong Viet Dao
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Stroke Center, Bach Mai Hospital, Hanoi, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
| | | | - Hien Thi Thu Vuong
- Department of Emergency, Vietnam-Czechoslovakia Friendship Hospital, Hai Phong, Viet Nam
| | - Hung Dinh Vu
- Emergency and Critical Care Department, Hanoi Medical University Hospital, Hanoi Medical University, Hanoi, Viet Nam
| | - Dong Duc Nguyen
- Department of Neurosurgery II, Neurosurgery Center, Vietnam-Germany Friendship Hospital, Hanoi, Viet Nam
| | - Thanh Dang Vu
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Department of Emergency, Agriculture General Hospital, Hanoi, Viet Nam
| | | | - Anh Le Ngoc Do
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Quynh Thi Pham
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Nhung Hong Khuat
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Department of Intensive Care and Poison Control, Duc Giang General Hospital, Hanoi, Viet Nam
| | - Ninh Van Duong
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Department of Intensive Care and Poison Control, Dien Bien Provincial General Hospital, Dien Bien Phu, Viet Nam
| | - Cong Chi Ngo
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Department of Emergency, Military Central Hospital 108, Hanoi, Viet Nam
| | - Son Ngoc Do
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
- Center for Critical Care Medicine, Bach Mai Hospital, Hanoi, Viet Nam
| | - Hao The Nguyen
- Department of Surgery, Hanoi Medical University, Hanoi, Viet Nam
- Department of Neurosurgery, Bach Mai Hospital, Hanoi, Viet Nam
| | - Chi Van Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Anh Dat Nguyen
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
| | - Chinh Quoc Luong
- Center for Emergency Medicine, Bach Mai Hospital, Hanoi, Viet Nam
- Department of Emergency and Critical Care Medicine, Hanoi Medical University, Hanoi, Viet Nam
- Faculty of Medicine, University of Medicine and Pharmacy, Vietnam National University, Hanoi, Viet Nam
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Cornelissen A, Guo L, Neally SJ, Kleinberg L, Forster A, Nair R, Gadhoke N, Ghosh SKB, Sakamoto A, Sato Y, Kawakami R, Mori M, Kawai K, Fernandez R, Dikongue A, Abebe B, Kutys R, Romero ME, Kolodgie FD, Baumer Y, Powell-Wiley TM, Virmani R, Finn AV. Relationships between neighborhood disadvantage and cardiovascular findings at autopsy in subjects with sudden death. Am Heart J 2023; 256:37-50. [PMID: 36372247 DOI: 10.1016/j.ahj.2022.10.086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 07/19/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Neighborhood disadvantage is associated with a higher risk of sudden cardiac death. However, autopsy findings have never been investigated in this context. Here, we sought to explore associations between neighborhood disadvantage and cardiovascular findings at autopsy in cases of sudden death in the State of Maryland. METHODS State of Maryland investigation reports from 2,278 subjects within the CVPath Sudden Death Registry were screened for street addresses and 9-digit zip codes. Area deprivation index (ADI), used as metric for neighborhood disadvantage, was available for 1,464 subjects; 650 of whom self-identified as Black and 814 as White. The primary study outcome measurements were causes of death and gross and histopathologic findings of the heart. RESULTS Subjects from most disadvantaged neighborhoods (i.e., ADI ≥ 8; n = 607) died at younger age compared with subjects from less disadvantaged neighborhoods (i.e., ADI ≤ 7; n = 857; 46.07 ± 14.10 vs 47.78 ± 13.86 years; P = 0.02) and were more likely Black or women. They were less likely to die from cardiac causes of death (61.8% vs 67.7%; P = 0.02) and had less severe atherosclerotic plaque features, including plaque burden, calcification, intraplaque hemorrhage, and thin-cap fibroatheromas. In addition, subjects from most disadvantaged neighborhoods had lower frequencies of plaque rupture (18.8% vs 25.1%, P = 0.004). However, these associations were omitted after adjustment for traditional risk factors and race. CONCLUSION Neighborhood disadvantage did not associate with cause of death or coronary histopathology after adjustment for cardiovascular risk factors and race, implying that social determinants of health other than neighborhood disadvantage play a more prominent role in sudden cardiac death.
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Affiliation(s)
| | - Liang Guo
- CVPath Institute, Gaithersburg, MD, US
| | - Sam J Neally
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Institutes of Health, Bethesda, MD, US
| | | | | | | | | | | | | | - Yu Sato
- CVPath Institute, Gaithersburg, MD, US
| | | | | | | | | | | | | | | | | | | | - Yvonne Baumer
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Institutes of Health, Bethesda, MD, US
| | - Tiffany M Powell-Wiley
- Social Determinants of Obesity and Cardiovascular Risk Laboratory, Cardiovascular Branch, National Institutes of Health, Bethesda, MD, US
| | | | - Aloke V Finn
- CVPath Institute, Gaithersburg, MD, US; School of Medicine, University of Maryland School of Medicine, Baltimore, MD, US.
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9
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Familial aggregation of the aging process: biological age measured in young adult offspring as a predictor of parental mortality. GeroScience 2022; 45:901-913. [PMID: 36401109 PMCID: PMC9886744 DOI: 10.1007/s11357-022-00687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/06/2022] [Indexed: 11/20/2022] Open
Abstract
Measures of biological age (BA) integrate information across organ systems to quantify "biological aging," i.e., inter-individual differences in aging-related health decline. While longevity and lifespan aggregate in families, reflecting transmission of genes and environments across generations, little is known about intergenerational continuity of biological aging or the extent to which this continuity may be modified by environmental factors. Using data from the Jerusalem Perinatal Study (JPS), we tested if differences in offspring BA were related to mortality in their parents. We measured BA using biomarker data collected from 1473 offspring during clinical exams in 2007-2009, at age 32 ± 1.1. Parental mortality was obtained from population registry data for the years 2004-2016. We fitted parametric survival models to investigate the associations between offspring BA and parental all-cause and cause-specific mortality. We explored potential differences in these relationships by socioeconomic position (SEP) and offspring sex. Participants' BAs widely varied (SD = 6.95). Among those measured to be biologically older, parents had increased all-cause mortality (HR = 1.10, 95% CI: 1.08, 1.13), diabetes mortality (HR = 1.19, 95% CI: 1.08, 1.30), and cancer mortality (HR = 1.07, 95% CI: 1.02, 1.13). The association with all-cause mortality was stronger for families with low compared with high SEP (Pinteraction = 0.04) and for daughters as compared to sons (Pinteraction < 0.001). Using a clinical-biomarker-based BA estimate, observable by young adulthood prior to the onset of aging-related diseases, we demonstrate intergenerational continuity of the aging process. Furthermore, variation in this familial aggregation according to household socioeconomic position (SEP) at offspring birth and between families of sons and daughters proposes that the environment alters individuals' aging trajectory set by their parents.
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Zhao L, Zierath R, John JE, Claggett BL, Hall ME, Clark D, Butler KR, Correa A, Shah AM. Subclinical Risk Factors for Heart Failure With Preserved and Reduced Ejection Fraction Among Black Adults. JAMA Netw Open 2022; 5:e2231878. [PMID: 36107422 PMCID: PMC9478780 DOI: 10.1001/jamanetworkopen.2022.31878] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Accepted: 07/30/2022] [Indexed: 11/14/2022] Open
Abstract
Importance Sparse data exist regarding the contributions of subclinical impairments in cardiovascular and noncardiovascular function to incident heart failure (HF) with reduced ejection fraction (HFrEF) and preserved ejection fraction (HFpEF) among Black US residents, limiting understanding of the etiology of HF subtypes. Objectives To identify subclinical cardiovascular and noncardiovascular risk factors associated with HFrEF and HFpEF in Black US residents. Design, Setting, and Participants This cohort study used cross-sectional and time-to-event analysis with data from the community-based Jackson Heart Study (JHS), a longitudinal cohort study with baseline data collected from 2000 to 2004 (visit 1) and 10-year follow-up for incident HF. Black US residents from the Jackson, Mississippi, metropolitan area enrolled in JHS; those with prevalent HF, with moderate or greater aortic or mitral valve diseases on visit 1, who died before 2005, and who had missing HF status on follow-up were excluded. The analysis included 4361 participants and was performed between June 2020 to August 2021. Exposures Quantitative measures of cardiovascular (left ventricular mass index [LVMI], left ventricular ejection fraction [LVEF], left atrial [LA] diameter, and pulse pressure) and noncardiovascular (percent predicted forced expiration volume in 1 second [FEV1 (percent predicted)], estimated glomerular filtration rate (eGFR), waist circumference, and hemoglobin A1c [HbA1c] level) organ function. Main Outcomes and Measures Incident HF, HFrEF, and HFpEF over 10-year follow-up. Results The 4361 participants had a mean (SD) age of 54 (13); 2776 (64%) were women; and there were 163 HFpEF and 146 HFrEF events. In multivariable models incorporating measures reflecting each organ system, factors associated with incident HFpEF included greater LA diameter (hazard ratio [HR], 1.23; 95% CI, 1.03-1.47; P = .02), higher pulse pressure (HR, 1.23; 95% CI, 1.05-1.44; P = .009), lower FEV1 (percent predicted) (HR, 1.22; 95% CI, 1.04-1.43; P = .02), lower eGFR (HR, 1.43; 95% CI, 1.19-1.72; P < .001), higher HbA1c level (HR, 1.25; 95% CI, 1.07-1.45; P = .005), and higher waist circumference (HR, 1.41; 95% CI, 1.18-1.69; P < .001). Factors associated with incident HFrEF included greater LVMI (HR, 1.25; 1.07-1.46; P = .005), lower LVEF (HR, 1.65; 95% CI, 1.42-1.91; P < .001), lower FEV1 (percent predicted) (HR, 1.19; 95% CI, 1.00-1.42; P = .047), and lower eGFR (HR, 1.27; 95% CI, 1.04-1.55; P = .02). Conclusions and Relevance In this community-based cohort study of Black US residents, subclinical impairments in cardiovascular and noncardiovascular organ function were differentially associated with risk of incident HFpEF and HFrEF.
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Affiliation(s)
- Li Zhao
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Division of Cardiovascular Medicine, the Sixth Medical Center, Chinese People’s Liberation Army General Hospital, Beijing, China
| | - Rani Zierath
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Jenine E. John
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Brian Lee Claggett
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | | | - Donald Clark
- University of Mississippi Medical Center, Jackson
| | | | | | - Amil M. Shah
- Division of Cardiovascular Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
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Lumsden RH, Goldstein KM, Shephard-Banigan M, Kroll-Desrosiers A, Bean-Mayberry B, Farmer MM, Mattocks KM. Racial Differences in Nontraditional Risk Factors Associated with Cardiovascular Conditions in Pregnancy Among U.S. Women Veterans. J Womens Health (Larchmt) 2022; 31:706-714. [PMID: 35072546 DOI: 10.1089/jwh.2021.0078] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background: Pregnancy-related cardiovascular (CV) conditions are important predictors of future cardiovascular disease (CVD). Nontraditional factors, such as depression and chronic stress, have been associated with CVD, but their role in pregnancy-related CVD conditions (pCVD) remains unknown. To determine the association between nontraditional factors and CV conditions in pregnancy, and to explore if this risk varies by race. Methods: Using data from a prospective study of pregnant women within the veterans affairs health system (COMFORT study), we described the prevalence of nontraditional factors (e.g., depression, post-traumatic stress disorder [PTSD], chronic stress) and used logistic regression to determine the association between nontraditional factors and pregnancy-related CV conditions (pre-eclampsia/eclampsia, gestational hypertension, gestation diabetes, or preterm delivery). Analyses were then stratified by race. Results: Among 706 enrollees, 26% had pregnancy-related CV conditions. These women had significantly higher rates of depression (62% vs. 45%, p < 0.01), anxiety (50% vs. 37%, p = 0.01), PTSD (44% vs. 29%, p < 0.01), and high stress levels before pregnancy (22% vs. 16%, p = 0.05) compared with women with normal pregnancies. Overall, these factors were not associated with increased adjusted odds of pCVD. Overall, Black women had disproportionately higher rates of prepregnancy hypertension compared with White women (22% vs. 6%, p < 0.01). Conclusions: Women Veterans with pCVD are a high-risk group for future CVD, with disproportionately high rates of depression, anxiety, PTSD, and chronic stress. Racial disparities exist in pregnancy-related CV risk factors, which may further compound existing racial disparities in CVD among women Veterans.
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Affiliation(s)
- Rebecca H Lumsden
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
| | - Karen M Goldstein
- Department of Medicine, Duke University School of Medicine, Durham, North Carolina, USA
- Durham VA Health Care System, Durham, North Carolina, USA
- Durham Center of Innovation to Accelerate Discovery and Practice Transformation, Durham VA healthcare system, Durham, North Carolina, USA
| | - Megan Shephard-Banigan
- Durham VA Health Care System, Durham, North Carolina, USA
- Department of Population Health Sciences, Duke University, Durham, North Carolina, USA
- Duke-Margolis Center for Health Policy, Duke University Durham, North Carolina, USA
| | - Aimee Kroll-Desrosiers
- VA Central Western Massachusetts Healthcare System, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Bevanne Bean-Mayberry
- VA Greater Los Angeles Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Los Angeles, California, USA
- Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California, USA
| | - Melissa M Farmer
- VA Greater Los Angeles Center for the Study of Healthcare Innovation, Implementation and Policy (CSHIIP), Los Angeles, California, USA
| | - Kristin M Mattocks
- VA Central Western Massachusetts Healthcare System, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
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12
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Aguayo L, Chirinos DA, Heard-Garris N, Wong M, Davis MM, Merkin SS, Seeman T, Kershaw KN. Association of Exposure to Abuse, Nurture, and Household Organization in Childhood With 4 Cardiovascular Disease Risks Factors Among Participants in the CARDIA Study. J Am Heart Assoc 2022; 11:e023244. [PMID: 35475340 PMCID: PMC9238582 DOI: 10.1161/jaha.121.023244] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background We investigated associations of childhood abuse with 4 cardiovascular disease risk factors in adulthood, and whether exposure to nurturing and household organization in childhood mitigated these associations. Methods and Results The CARDIA (Coronary Artery Risk Development in Young Adults) study (baseline examination, 1985–1986) was used to examine associations of childhood exposures (measured retrospectively at the year 15 examination) with incident obesity, type 2 diabetes, hypertension, and hyperlipidemia (assessed from baseline to year 30). Race‐ and sex‐stratified Cox proportional hazards models were used to examine associations of exposure to childhood abuse with incident cardiovascular disease risk factors. Interaction terms between exposure to abuse and exposure to nurturing relationship and household organization were included to test for effect modifications. Exposure to occasional/frequent abuse (versus no abuse) was associated with incident type 2 diabetes among White men (hazard ratio [HR], 1.81; 95% CI, 1.06–3.08). Exposure to low versus no abuse was associated with incident hyperlipidemia among White men (HR, 1.35; 95% CI, 1.09–1.67) and White women (HR, 1.26; 95% CI, 1.01–1.56). Risks of incident hyperlipidemia were higher for White women who experienced abuse and lived in dysfunctional households (HR, 3.61; 95% CI, 1.62–8.05) or households with low levels of organization (HR, 2.05; 95% CI, 1.25–3.36) compared with White women who experienced abuse but lived in well‐organized households (HR, 0.66; 95% CI, 0.41–1.06). Similar patterns were seen for Black men who lived in dysfunctional households (HR, 3.62; 95% CI, 1.29–10.12) or households with low organization (HR, 2.01; 95% CI, 1.08–3.72). Conclusions We identified race‐ and sex‐specific associations of childhood exposures with incident cardiovascular disease risk factors. The associations of household organization and dysfunction with cardiovascular disease risks merits further investigation.
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Affiliation(s)
- Liliana Aguayo
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Hubert Department of Global Health Rollins School of Public Health Emory University Atlanta GA
| | - Diana A Chirinos
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Nia Heard-Garris
- Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Division of Advanced General Pediatrics and Primary Care Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL.,Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago IL
| | - Mandy Wong
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
| | - Matthew M Davis
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Mary Ann & J. Milburn Smith Child Health Outreach, Research, and Evaluation CenterStanley Manne Children's Research InstituteAnn & Robert H. Lurie Children's Hospital Chicago IL.,Division of Advanced General Pediatrics and Primary Care Department of Pediatrics Ann & Robert H. Lurie Children's Hospital of Chicago Chicago IL.,Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago IL.,Department of Medicine Northwestern University Feinberg School of Medicine Chicago IL.,Department of Medical Social Sciences Northwestern University Feinberg School of Medicine Chicago IL
| | - Sharon Stein Merkin
- Division of Geriatrics Los Angeles Geffen School of MedicineUniversity of California Los Angeles CA
| | - Teresa Seeman
- Division of Geriatrics Los Angeles Geffen School of MedicineUniversity of California Los Angeles CA
| | - Kiarri N Kershaw
- Department of Preventive Medicine Northwestern University Feinberg School of Medicine Chicago IL
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13
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Torabi AJ, Mshelbwala FS, Hugenberg D, Kovacs RJ, Kreutz RP. Social deprivation index and ischemic events after percutaneous coronary intervention in patients with diabetes mellitus. Catheter Cardiovasc Interv 2022; 99:1015-1021. [DOI: 10.1002/ccd.30108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/17/2022] [Indexed: 11/06/2022]
Affiliation(s)
- Asad J. Torabi
- Division of Cardiology, Krannert Institute of Cardiology Indiana University School of Medicine Indianapolis Indiana USA
| | | | - Daniel Hugenberg
- Division of Cardiology Parkview Physicians Group Fort Wayne Indiana USA
| | - Richard J. Kovacs
- Division of Cardiology, Krannert Institute of Cardiology Indiana University School of Medicine Indianapolis Indiana USA
| | - Rolf P. Kreutz
- Division of Cardiology, Krannert Institute of Cardiology Indiana University School of Medicine Indianapolis Indiana USA
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14
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Leak-Johnson T, Yan F, Daniels P. What the Jackson Heart Study Has Taught Us About Diabetes and Cardiovascular Disease in the African American Community: a 20-year Appreciation. Curr Diab Rep 2021; 21:39. [PMID: 34495422 DOI: 10.1007/s11892-021-01413-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/25/2021] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW The burden of cardiometabolic diseases such as cardiovascular disease (CVD) and type 2 diabetes (T2D) is pronounced among African Americans. Research has shown that behavioral, social, metabolic, psychosocial, and genetic risk factors of CVD and T2D are closely interwoven. Approximately 20 years ago, the Jackson Heart Study (JHS) was established to investigate this constellation of risk factors. RECENT FINDINGS Findings from neighborhood studies emphasize the importance of social cohesion and physical environment in the context CVD and T2D risk. Socioeconomic status factors such as income and education were significant predictors for CVD and T2D. Behavioral studies indicate that modifiable risk factors such as smoking, physical inactivity, lack of sleep, and poor nutrition are associated with CVD risk and all-cause mortality. Mental health also was found to be associated with CVD and T2D. Genetic influences are associated with disease etiology. This review summarizes the joint contributions of CVD and cardiometabolic risk factors in an African American population.
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Affiliation(s)
- Tennille Leak-Johnson
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA, 30310, USA.
- Department of Physiology, Morehouse School of Medicine, Atlanta, GA, USA.
| | - Fengxia Yan
- The Research Design and Biostatistics Core, Morehouse School of Medicine, Atlanta, GA, USA
- Community Health & Preventive Medicine, Morehouse School of Medicine, Atlanta, GA, USA
| | - Pamela Daniels
- The Research Design and Biostatistics Core, Morehouse School of Medicine, Atlanta, GA, USA
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15
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Vogel B, Acevedo M, Appelman Y, Bairey Merz CN, Chieffo A, Figtree GA, Guerrero M, Kunadian V, Lam CSP, Maas AHEM, Mihailidou AS, Olszanecka A, Poole JE, Saldarriaga C, Saw J, Zühlke L, Mehran R. The Lancet women and cardiovascular disease Commission: reducing the global burden by 2030. Lancet 2021; 397:2385-2438. [PMID: 34010613 DOI: 10.1016/s0140-6736(21)00684-x] [Citation(s) in RCA: 509] [Impact Index Per Article: 169.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 03/08/2021] [Accepted: 03/12/2021] [Indexed: 02/07/2023]
Abstract
Cardiovascular disease is the leading cause of death in women. Decades of grassroots campaigns have helped to raise awareness about the impact of cardiovascular disease in women, and positive changes affecting women and their health have gained momentum. Despite these efforts, there has been stagnation in the overall reduction of cardiovascular disease burden for women in the past decade. Cardiovascular disease in women remains understudied, under-recognised, underdiagnosed, and undertreated. This Commission summarises existing evidence and identifies knowledge gaps in research, prevention, treatment, and access to care for women. Recommendations from an international team of experts and leaders in the field have been generated with a clear focus to reduce the global burden of cardiovascular disease in women by 2030. This Commission represents the first effort of its kind to connect stakeholders, to ignite global awareness of sex-related and gender-related disparities in cardiovascular disease, and to provide a springboard for future research.
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Affiliation(s)
- Birgit Vogel
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Acevedo
- Divisón de Enfermedades Cardiovasculares, Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Yolande Appelman
- Amsterdam UMC, VU University Medical Center, Amsterdam, Netherlands
| | - C Noel Bairey Merz
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Alaide Chieffo
- Interventional Cardiology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Gemma A Figtree
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Mayra Guerrero
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK; Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundations Trust, Newcastle Upon Tyne, UK
| | - Carolyn S P Lam
- National Heart Centre Singapore, Singapore; Cardiovascular Sciences Academic Clinical Programme, Duke-National University of Singapore, Singapore
| | - Angela H E M Maas
- Department of Women's Cardiac Health, Radboud University Medical Center, Nijmegen, Netherlands
| | - Anastasia S Mihailidou
- Royal North Shore Hospital, Northern Sydney Local Health District, Sydney, NSW, Australia; Cardiovascular and Hormonal Research Laboratory, Kolling Institute, Sydney, NSW, Australia; Faculty of Medicine and Health Sciences, Macquarie University, Sydney, NSW, Australia
| | - Agnieszka Olszanecka
- 1st Department of Cardiology, Interventional Electrocardiology and Hypertension, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
| | - Jeanne E Poole
- Division of Cardiology, University of Washington Medical Center, Seattle, WA, USA
| | - Clara Saldarriaga
- Department of Cardiology and Heart Failure Clinic, Clinica CardioVID, University of Antioquia, Medellín, Colombia
| | - Jacqueline Saw
- Division of Cardiology, Vancouver General Hospital, Vancouver, BC, Canada
| | - Liesl Zühlke
- Departments of Paediatrics and Medicine, Divisions of Paediatric and Adult Cardiology, Red Cross Children's and Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa
| | - Roxana Mehran
- Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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17
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Zuma BZ, Parizo JT, Valencia A, Spencer-Bonilla G, Blum MR, Scheinker D, Rodriguez F. County-Level Factors Associated With Cardiovascular Mortality by Race/Ethnicity. J Am Heart Assoc 2021; 10:e018835. [PMID: 33653083 PMCID: PMC8174200 DOI: 10.1161/jaha.120.018835] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background Persistent racial/ethnic disparities in cardiovascular disease (CVD) mortality are partially explained by healthcare access and socioeconomic, demographic, and behavioral factors. Little is known about the association between race/ethnicity‐specific CVD mortality and county‐level factors. Methods and Results Using 2017 county‐level data, we studied the association between race/ethnicity‐specific CVD age‐adjusted mortality rate (AAMR) and county‐level factors (demographics, census region, socioeconomics, CVD risk factors, and healthcare access). Univariate and multivariable linear regressions were used to estimate the association between these factors; R2 values were used to assess the factors that accounted for the greatest variation in CVD AAMR by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic/Latinx individuals). There were 659 740 CVD deaths among non‐Hispanic White individuals in 2698 counties; 100 475 deaths among non‐Hispanic Black individuals in 717 counties; and 49 493 deaths among Hispanic/Latinx individuals across 267 counties. Non‐Hispanic Black individuals had the highest mean CVD AAMR (320.04 deaths per 100 000 individuals), whereas Hispanic/Latinx individuals had the lowest (168.42 deaths per 100 000 individuals). The highest CVD AAMRs across all racial/ethnic groups were observed in the South. In unadjusted analyses, the greatest variation (R2) in CVD AAMR was explained by physical inactivity for non‐Hispanic White individuals (32.3%), median household income for non‐Hispanic Black individuals (24.7%), and population size for Hispanic/Latinx individuals (28.4%). In multivariable regressions using county‐level factor categories, the greatest variation in CVD AAMR was explained by CVD risk factors for non‐Hispanic White individuals (35.3%), socioeconomic factors for non‐Hispanic Black (25.8%), and demographic factors for Hispanic/Latinx individuals (34.9%). Conclusions The associations between race/ethnicity‐specific age‐adjusted CVD mortality and county‐level factors differ significantly. Interventions to reduce disparities may benefit from being designed accordingly.
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Affiliation(s)
| | - Justin T Parizo
- Division of Cardiovascular Medicine and the Cardiovascular Institute Stanford University School of Medicine Stanford CA
| | | | | | - Manuel R Blum
- Department of General Internal Medicine Bern University HospitalUniversity of Bern Switzerland
| | - David Scheinker
- Department of Pediatrics Stanford University School of Medicine Stanford CA.,Department of Management Science and Engineering Stanford University School of Engineering Stanford CA
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and the Cardiovascular Institute Stanford University School of Medicine Stanford CA
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18
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Sims M, Glover LM, Gebreab SY. Response to "Socioeconomic Status and Hypertension in African Americans From the Jackson Heart Study". Am J Hypertens 2020; 33:964-965. [PMID: 32434217 PMCID: PMC7577642 DOI: 10.1093/ajh/hpaa082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Revised: 04/29/2020] [Accepted: 05/14/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - LáShauntá M Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Samson Y Gebreab
- National Human Genome Research Institute (NHGRI), National Institutes of Health, Bethesda, Maryland, USA
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Sidhu GS, Ward C, Ferdinand KC. Racial disparity in atherosclerotic cardiovascular disease in hospitalized patients with diabetes 2005-2015: Potential warning signs for future U.S. public health. Am J Prev Cardiol 2020; 4:100095. [PMID: 34327471 PMCID: PMC8315432 DOI: 10.1016/j.ajpc.2020.100095] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/22/2020] [Accepted: 10/09/2020] [Indexed: 11/03/2022] Open
Abstract
Introduction The pattern of atherosclerotic cardiovascular disease (ASCVD) and diabetes driven hospitalizations in the United States (U.S.) is unclear. We attempted to identify the disparate outcome in race related ASCVD hospitalizations with comorbid diabetes. Methods Adults aged ≥40 years old with ASCVD (acute coronary syndrome (ACS), coronary artery disease (CAD), stroke, or peripheral arterial disease (PAD)) as the first-listed diagnosis with comorbid diabetes as a secondary diagnosis were determined using the U.S. 2005-2015 National (Nationwide) Inpatient Sample (NIS) data. The incidence of other modifiable cardiovascular risk factors (hypertension, dyslipidemia, smoking/substance abuse, obesity, and renal failure), in hospital procedures and outcomes was estimated. Complex samples multivariate regression was used to determine the odds ratio (OR) with 95% confidence Interval (CI) of risk associations and to determine patient comorbidity adjusted ASCVD related in-hospital mortality rate. Results The rate of total ASCVD hospitalizations with comorbid diabetes adjusted to the U.S. census population increased by 5.7% for black men compared to 4% for black women. There was a higher odd of an ASCVD hospitalization if there was comorbid hypertension (Odds Ratio (OR 1.29; 95% CI 95% 1.28-1.31), dyslipidemia (OR 2.03; 95% CI 2.01-2.05), renal failure (OR 1.84; 95% CI 1.82-1.86), and smoking/substance use disorder (OR 1.31; 95% CI 1.29-1.33). White Women had the highest risk-adjusted incidence of ASCVD related in-hospital mortality (4.2%) relative to black women (3.9%), compared to white men (3.6%) and black men (3.5%) respectively. Conclusions Despite improving treatment options for ASCVD in the diabetic population, blacks with diabetes continue to have a higher hospitalization burden with a concomitant disparity in comorbid presentation and outcome. Further evaluation is the need to understand these associations.
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Affiliation(s)
| | - Charisse Ward
- Cardiovascular Institute of the South, New Orleans, LA, USA
| | - Keith C Ferdinand
- Division of Cardiology, Department of Medicine, Tulane University, New Orleans, LA, USA
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20
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Lago-Peñas S, Rivera B, Cantarero D, Casal B, Pascual M, Blázquez-Fernández C, Reyes F. The impact of socioeconomic position on non-communicable diseases: what do we know about it? Perspect Public Health 2020; 141:158-176. [PMID: 32449467 DOI: 10.1177/1757913920914952] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
AIMS Non-communicable diseases (NCDs) have become a primary health concern for most countries around the world. The aim of this research is to analyze the relevant evidence that determines the effect of socioeconomic position (SEP) on the incidence and prevalence of NCDs. METHODS A systematic literature search was performed using PubMed, Cochrane Library, and Web of Science to identify evidence regarding the relationship between income inequalities and NCDs, between 2005 and 2015. The final selection of papers was based on applied studies focusing on Organisation for Economic Co-operation and Development (OECD) countries and articles referring to three main groups of chronic diseases: cardiovascular and heart diseases, cancer, and diabetes. RESULTS A final set of 47 selected studies were fully taken into account in this review. Despite significant heterogeneity in exposure and outcomes measures, overall the evidence suggests that having low SEP increases the risk of developing cardiovascular diseases (CVDs), lung and breast cancer, and type 2 diabetes. SEP is also associated with multiple NCD risk factors such as smoking and physical inactivity. CONCLUSION Low socioeconomic status appears to have a significant consistent impact on mortality and morbidity caused by NCDs in OECD countries. Social and economic disadvantages are associated with health inequalities in terms of access to care, increased incident risk of NCDs, and early death. These findings point to the need for public health strategies and research to address socioeconomic status disparity among individuals.
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Affiliation(s)
- S Lago-Peñas
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Applied Economics, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
| | - B Rivera
- Department of Economics, Faculty of Economics and Business, University of A Coruña, Campus de Elviña, A Coruña 15071, Spain.,GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
| | - D Cantarero
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - B Casal
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Economics and Business, University of A Coruña, A Coruña, Spain
| | - M Pascual
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - C Blázquez-Fernández
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Economics, Faculty of Business and Economics, University of Cantabria, Santander, Spain
| | - F Reyes
- GEN Governance and Economics Network-Spain, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain.,Department of Applied Economics, Faculty of Business Sciences and Tourism, University of Vigo, Ourense, Spain
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21
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Juarez PD, Tabatabai M, Burciaga Valdez R, Hood DB, Im W, Mouton C, Colen C, Al-Hamdan MZ, Matthews-Juarez P, Lichtveld MY, Sarpong D, Ramesh A, Langston MA, Rogers GL, Phillips CA, Reichard JF, Donneyong MM, Blot W. The Effects of Social, Personal, and Behavioral Risk Factors and PM 2.5 on Cardio-Metabolic Disparities in a Cohort of Community Health Center Patients. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E3561. [PMID: 32438697 PMCID: PMC7277630 DOI: 10.3390/ijerph17103561] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/30/2020] [Accepted: 05/15/2020] [Indexed: 12/26/2022]
Abstract
(1) Background: Cardio-metabolic diseases (CMD), including cardiovascular disease, stroke, and diabetes, have numerous common individual and environmental risk factors. Yet, few studies to date have considered how these multiple risk factors together affect CMD disparities between Blacks and Whites. (2) Methods: We linked daily fine particulate matter (PM2.5) measures with survey responses of participants in the Southern Community Cohort Study (SCCS). Generalized linear mixed modeling (GLMM) was used to estimate the relationship between CMD risk and social-demographic characteristics, behavioral and personal risk factors, and exposure levels of PM2.5. (3) Results: The study resulted in four key findings: (1) PM2.5 concentration level was significantly associated with reported CMD, with risk rising by 2.6% for each µg/m3 increase in PM2.5; (2) race did not predict CMD risk when clinical, lifestyle, and environmental risk factors were accounted for; (3) a significant variation of CMD risk was found among participants across states; and (4) multiple personal, clinical, and social-demographic and environmental risk factors played a role in predicting CMD occurrence. (4) Conclusions: Disparities in CMD risk among low social status populations reflect the complex interactions of exposures and cumulative risks for CMD contributed by different personal and environmental factors from natural, built, and social environments.
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Affiliation(s)
- Paul D. Juarez
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA; (W.I.); (P.M.-J.)
| | - Mohammad Tabatabai
- School of Graduate Studies and Research, Meharry Medical College, Nashville, TN 37208, USA;
| | - Robert Burciaga Valdez
- RWJF Professor, Department of Family & Community Medicine AND Economics, University of New Mexico, Albuquerque, NM 87131, USA;
| | - Darryl B. Hood
- Department of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, OH 43210, USA;
| | - Wansoo Im
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA; (W.I.); (P.M.-J.)
| | - Charles Mouton
- Department of Family Medicine, University of Texas Medical Branch, Galveston, TX 77555, USA;
| | - Cynthia Colen
- Department of Sociology, Ohio State University, Columbus, OH 43210, USA;
| | - Mohammad Z. Al-Hamdan
- Universities Space Research Association, NASA Marshall Space Flight Center, Huntsville, AL 35805, USA;
| | - Patricia Matthews-Juarez
- Department of Family and Community Medicine, Meharry Medical College, Nashville, TN 37208, USA; (W.I.); (P.M.-J.)
| | - Maureen Y. Lichtveld
- Department of Environmental Health Sciences, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA 70112, USA;
| | - Daniel Sarpong
- Department of Biostatistics, Xavier University, Cincinnati, OH 45207, USA;
| | - Aramandla Ramesh
- Department of Biochemistry, Cancer Biology, Neuroscience & Pharmacology, Meharry Medical College, Nashville, TN 37208, USA;
| | - Michael A. Langston
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA; (M.A.L.); (C.A.P.)
| | - Gary L. Rogers
- National Institute for Computational Sciences, University of Tennessee, Knoxville, TN 37996, USA;
| | - Charles A. Phillips
- Department of Electrical Engineering and Computer Science, University of Tennessee, Knoxville, TN 37996, USA; (M.A.L.); (C.A.P.)
| | - John F. Reichard
- Department of Environmental Health, Risk Science Center, University of Cincinnati, Cincinnati, OH 45221, USA;
| | - Macarius M. Donneyong
- Division of Outcomes and Translational Sciences, College of Pharmacy, Ohio State University, Columbus, OH 43210, USA;
| | - William Blot
- Center for Population-based Research, Vanderbilt University, Nashville, TN 37235, USA;
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22
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Lunyera J, Stanifer JW, Davenport CA, Mohottige D, Bhavsar NA, Scialla JJ, Pendergast J, Boulware LE, Diamantidis CJ. Life Course Socioeconomic Status, Allostatic Load, and Kidney Health in Black Americans. Clin J Am Soc Nephrol 2020; 15:341-348. [PMID: 32075808 PMCID: PMC7057315 DOI: 10.2215/cjn.08430719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Accepted: 01/07/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Low socioeconomic status confers unfavorable health, but the degree and mechanisms by which life course socioeconomic status affects kidney health is unclear. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We examined the association between cumulative lifetime socioeconomic status and CKD in black Americans in the Jackson Heart Study. We used conditional process analysis to evaluate allostatic load as a potential mediator of this relation. Cumulative lifetime socioeconomic status was an age-standardized z-score, which has 1-SD units by definition, and derived from self-reported childhood socioeconomic status, education, and income at baseline. Allostatic load encompassed 11 baseline biomarkers subsuming neuroendocrine, metabolic, autonomic, and immune physiologic systems. CKD outcomes included prevalent CKD at baseline and eGFR decline and incident CKD over follow-up. RESULTS Among 3421 participants at baseline (mean age 55 years [SD 13]; 63% female), cumulative lifetime socioeconomic status ranged from -3.3 to 2.3, and 673 (20%) had prevalent CKD. After multivariable adjustment, lower cumulative lifetime socioeconomic status was associated with greater prevalence of CKD both directly (odds ratio [OR], 1.18; 95% confidence interval [95% CI], 1.04 to 1.33 per 1 SD and OR, 1.45; 95% CI, 1.15 to 1.83 in lowest versus highest tertile) and via higher allostatic load (OR, 1.09; 95% CI, 1.06 to 1.12 per 1 SD and OR, 1.17; 95% CI, 1.11 to 1.24 in lowest versus highest tertile). After a median follow-up of 8 years (interquartile range, 7-8 years), mean annual eGFR decline was 1 ml/min per 1.73 m2 (SD 2), and 254 out of 2043 (12%) participants developed incident CKD. Lower cumulative lifetime socioeconomic status was only indirectly associated with greater CKD incidence (OR, 1.04; 95% CI, 1.01 to 1.07 per 1 SD and OR, 1.08; 95% CI, 1.02 to 1.14 in lowest versus highest tertile) and modestly faster annual eGFR decline, in milliliters per minute (OR, 0.01; 95% CI, 0.00 to 0.02 per 1 SD and OR, 0.02; 95% CI, 0.00 to 0.04 in lowest versus highest tertile), via higher baseline allostatic load. CONCLUSIONS Lower cumulative lifetime socioeconomic status was substantially associated with CKD prevalence but modestly with CKD incidence and eGFR decline via baseline allostatic load.
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Affiliation(s)
- Joseph Lunyera
- Division of General Internal Medicine, Department of Medicine,
| | | | | | | | | | - Julia J Scialla
- Division of Nephrology, Department of Medicine.,Duke Clinical Research Institute, and
| | - Jane Pendergast
- Division of General Internal Medicine, Department of Medicine.,Department of Biostatistics and Bioinformatics
| | | | - Clarissa Jonas Diamantidis
- Division of General Internal Medicine, Department of Medicine.,Division of Nephrology, Department of Medicine.,Department of Population Health Sciences, Duke University School of Medicine, Durham, North Carolina
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23
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Mitchell S, Malanda B, Damasceno A, Eckel RH, Gaita D, Kotseva K, Januzzi JL, Mensah G, Plutzky J, Prystupiuk M, Ryden L, Thierer J, Virani SS, Sperling L. A Roadmap on the Prevention of Cardiovascular Disease Among People Living With Diabetes. Glob Heart 2020; 14:215-240. [PMID: 31451236 DOI: 10.1016/j.gheart.2019.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 12/19/2022] Open
Affiliation(s)
| | - Belma Malanda
- International Diabetes Federation, Brussels, Belgium
| | | | - Robert H Eckel
- Division of Endocrinology, Metabolism and Diabetes, and Cardiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dan Gaita
- Universitatea de Medicina si Farmacie Victor Babes, Institutul de Boli Cardiovasculare, Clinica de Recuperare Cardiovasculara, Timisoara, Romania
| | - Kornelia Kotseva
- Imperial College Healthcare NHS Trust, London, United Kingdom; National Institute for Prevention and Cardiovascular Health, National University of Ireland, Galway, Ireland
| | - James L Januzzi
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - George Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Jorge Plutzky
- Preventive Cardiology, Cardiovascular Medicine, Brigham and Women's Hospital, Shapiro Cardiovascular Centre, Boston, MA, USA
| | - Maksym Prystupiuk
- Department of Surgery №2, Bogomolets National Medical University, Kyiv, Ukraine
| | - Lars Ryden
- Department of Medicine K2, Karolinska Institute, Stockholm, Sweden
| | - Jorge Thierer
- Unidad de Insuficiencia Cardíaca, Centro de Educación Médica e Investigación Clínica CEMIC, Buenos Aires, Argentina
| | - Salim S Virani
- Cardiology and Cardiovascular Research Sections, Baylor College of Medicine, Houston, TX, USA; Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX
| | - Laurence Sperling
- Emory Heart Disease Prevention Center, Department of Global Health Rollins School of Public Health at Emory University, Atlanta, GA, USA.
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24
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Glover LM, Cain-Shields LR, Wyatt SB, Gebreab SY, Diez-Roux AV, Sims M. Life Course Socioeconomic Status and Hypertension in African American Adults: The Jackson Heart Study. Am J Hypertens 2020; 33:84-91. [PMID: 31420642 PMCID: PMC6931894 DOI: 10.1093/ajh/hpz133] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 06/23/2019] [Accepted: 08/12/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Limited research has examined the association of life-course socioeconomic status (SES) with hypertension prevalence and incidence in a large cohort of African Americans. METHODS Among 4,761 participants from the Jackson Heart Study (JHS), we examined the association of SES indicators with prevalent and incident hypertension. We used multivariable Poisson regression to estimate prevalence ratios (PR, 95% confidence interval-CI) of baseline (2000-2004) hypertension by adult (education, income, occupation, wealth) and childhood (mother's education) SES. Cox proportional hazards regression was used to estimate hazard ratios (HR, 95% CI) of incident hypertension by adult and childhood SES (2005-2013; 7.21 median years of follow-up). We also examined the association of childhood-to-adult SES mobility (parent-to-adult education) with prevalent and incident hypertension. Model 1 adjusted for age and sex. Model 2 added waist circumference, behaviors (smoking, alcohol, physical activity, diet), and diabetes prevalence. RESULTS High (vs. low) adult SES measures were associated with a lower prevalence of hypertension, with the exception of having a college degree and upper-middle income (PR: 1.04, 95% CI: 1.01, 1.07; PR: 1.05, 95% CI: 1.01, 1.09, respectively). Higher childhood SES was associated with a lower prevalence and risk of hypertension (PR: 0.83, 95%: CI 0.75, 0.91; HR: 0.76, 95% CI: 0.65, 0.89, respectively). Upward mobility and consistent high SES (vs. consistent low SES) from childhood to adulthood was associated with a greater prevalence, but lower incidence of hypertension. CONCLUSION Efforts to prevent hypertension among African Americans should consider childhood and current SES status.
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Affiliation(s)
- Láshauntá M Glover
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill North Carolina, USA
| | - Loretta R Cain-Shields
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Sharon B Wyatt
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | | | - Ana V Diez-Roux
- Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania, USA
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
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25
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Boylan JM, Cundiff JM, Jakubowski KP, Pardini DA, Matthews KA. Pathways Linking Childhood SES and Adult Health Behaviors and Psychological Resources in Black and White Men. Ann Behav Med 2019; 52:1023-1035. [PMID: 29546291 DOI: 10.1093/abm/kay006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Background Exposure to low socioeconomic status (SES) in childhood predicts increased morbidity and mortality. However, little prospective evidence is available to test pathways linking low childhood SES to adult health. Purpose In the current study, indirect effects through positive parenting in adolescence and adult SES were tested in the association between childhood SES and adult health behaviors and psychological resources. Methods Men (n = 305; 53% Black) were followed longitudinally from ages 7 to 32. SES was measured annually in childhood (ages 7-9) and again in adulthood (age 32) using the Hollingshead index. Parenting was assessed annually (ages 13-16) using caregivers' and boys' self-report of supervision, communication, and expectations for their son's future. Health behaviors (cigarette and alcohol use, fruit and vegetable consumption, and physical activity) and psychological resources (optimism, purpose in life, self-mastery, and self-esteem) were assessed in adulthood (age 32). Results Structural equation modeling showed that higher childhood SES was associated with more positive parenting in adolescence and higher adult SES. Higher childhood SES was indirectly associated with healthier behaviors and higher psychological resources in adulthood through pathways involving positive parenting during adolescence and SES in adulthood. Findings were consistent in both racial groups. Conclusions Positive parenting in adolescence was an important pathway in understanding associations among childhood SES and health behaviors and psychological resources in adulthood. Low childhood SES was prospectively associated with healthier behaviors and greater psychological resources in part through more positive parenting in adolescence.
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Affiliation(s)
| | - Jenny M Cundiff
- Department of Psychological Sciences, Texas Tech University, Lubbock, TX
| | - Karen P Jakubowski
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
| | - Dustin A Pardini
- School of Criminology and Criminal Justice, Arizona State University, Phoenix, AZ
| | - Karen A Matthews
- Department of Psychiatry and Psychology, University of Pittsburgh, Pittsburgh, PA
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26
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Gao Y, Hickson DA, Talegawkar S, Norwood AF, Tucker KL, Sims M, Diez Roux AV, Griswold M. Influence of individual life course and neighbourhood socioeconomic position on dietary intake in African Americans: the Jackson Heart Study. BMJ Open 2019; 9:e025237. [PMID: 30862633 PMCID: PMC6429841 DOI: 10.1136/bmjopen-2018-025237] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE African Americans, especially those in the Southeastern USA, have different dietary behaviours from the general US population, and have the highest prevalence, incidence and mortality of diet-related disease outcomes, such as cardiovascular disease. However, there are scant data regarding factors such as socioeconomic position (SEP) across the life course that influence dietary behaviours in this high-risk population. Our aim was to examine the impact of life course and neighbourhood SEPs on dietary intake among African Americans. PARTICIPANTS AND SETTING Data for this cross-sectional analysis came from the community-based Jackson Heart Study (JHS). We analysed a total of 3948 JHS participants (mean age: 55.4±12.5; 63.9% women), who had complete dietary intake and covariate information. METHODS We examined the associations of childhood SEP (CSEP), adulthood SEP (ASEP) and neighbourhood SEP (NSEP) with 10 selected dietary intake measures, using multilevel log-gamma generalised linear regression models. OUTCOME MEASURES Dietary intake measures include daily saturated fat, sodium, protein, fibre, fruits and vegetables, whole grains, sugar-sweetened beverage, nuts, fish and processed meat. RESULTS In age, sex and total energy intake adjusted models, most dietary intakes were associated with these three SEP measures. After additional adjustment for other SEP measures, most of the significant associations with CSEP and NSEP were attenuated, except for the associations of fibre with CSEP (relative rate [RR] [95% CI] 1.05 [1.00-1.10]) and whole grains with NSEP (RR [95% CI] 1.28 [1.02-1.61]). The associations (shown as RR [95% CI]) between ASEP and sugar-sweetened beverage: 0.70 (0.59-0.83), processed meat: 0.75 (0.63-0.90), sodium: 0.99 (0.94-1.00), fibre: 1.10 (1.03-1.16), protein: 1.05 (1.01-1.09), fruits and vegetables: 1.21 (1.11-1.32), nuts: 2.13 (1.59-2.87), and fish: 1.57 (1.27-1.95) generally persisted after additional adjustment for both CSEP and NSEP. However, the association between ASEP and whole grains was attenuated. CONCLUSIONS High ASEP may have a more beneficial influence on dietary practices in African Americans than CSEP or NSEP.
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Affiliation(s)
- Yan Gao
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - DeMarc A Hickson
- My Brother’s Keeper, Inc., Ridgeland, Mississippi, USA
- Jackson State University, Jackson, Mississippi, USA
| | - Sameera Talegawkar
- Department of Exercise and Nutrition Sciences, The George Washington University, Washington, District of Columbia, USA
| | - Arnita Ford Norwood
- Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Katherine L Tucker
- Department of Clinical Laboratory and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Mario Sims
- Department of Internal Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Ana V Diez Roux
- Epidemiology & Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Michael Griswold
- Center for Biostatistics and Bioinformatics, University of Mississippi Medical Center, Jackson, Mississippi, USA
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27
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Whitley JC, Peralta CA, Haan M, Aiello AE, Lee A, Ward J, Zeki Al Hazzouri A, Neuhaus J, Moyce S, López L. The association of parental and offspring educational attainment with systolic blood pressure, fasting blood glucose and waist circumference in Latino adults. Obes Sci Pract 2018; 4:582-590. [PMID: 30574351 PMCID: PMC6298209 DOI: 10.1002/osp4.307] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2018] [Revised: 09/14/2018] [Accepted: 09/22/2018] [Indexed: 12/29/2022] Open
Abstract
Objective The objective of the study is to evaluate the association of intergenerational educational attainment with cardiovascular disease (CVD) risk factors among US Latinos. Methods We used cross‐sectional data from the Niños Lifestyle and Diabetes Study, an offspring cohort of middle‐aged Mexican‐Americans whose parents participated in the Sacramento Latino Study on Aging. We collected educational attainment, demographic and health behaviours and measured systolic blood pressure (SBP), fasting glucose and waist circumference. We evaluated the association of parental, offspring and a combined parent–offspring education variable with each CVD risk factor using multivariable regression. Results Higher parental education was associated only with smaller offspring waist circumference. In contrast, higher offspring education was associated with lower SBP, fasting glucose and smaller waist circumference. Adjustment for parental health behaviours modestly attenuated these offspring associations, whereas adjustment for offspring health behaviours and income attenuated the associations of offspring education with offspring SBP and fasting glucose but not smaller waist circumference, even among offspring with low parental education. Conclusions Higher offspring education is associated with lower levels of CVD risk factors in adulthood, despite intergenerational exposure to low parental education.
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Affiliation(s)
- J C Whitley
- University of California, San Francisco San Francisco CA USA
| | - C A Peralta
- University of California, San Francisco San Francisco CA USA
| | - M Haan
- University of California, San Francisco San Francisco CA USA
| | - A E Aiello
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | - A Lee
- University of California, San Francisco San Francisco CA USA
| | - J Ward
- Gillings School of Public Health University of North Carolina Chapel Hill NC USA
| | | | - J Neuhaus
- University of California, San Francisco San Francisco CA USA
| | - S Moyce
- College of Nursing Montana State University MT USA
| | - L López
- University of California, San Francisco San Francisco CA USA
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28
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Kelli HM, Hammadah M, Ahmed H, Ko YA, Topel M, Samman-Tahhan A, Awad M, Patel K, Mohammed K, Sperling LS, Pemu P, Vaccarino V, Lewis T, Taylor H, Martin G, Gibbons GH, Quyyumi AA. Association Between Living in Food Deserts and Cardiovascular Risk. Circ Cardiovasc Qual Outcomes 2018; 10:CIRCOUTCOMES.116.003532. [PMID: 28904075 DOI: 10.1161/circoutcomes.116.003532] [Citation(s) in RCA: 51] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Accepted: 07/06/2017] [Indexed: 01/01/2023]
Abstract
BACKGROUND Food deserts (FD), neighborhoods defined as low-income areas with low access to healthy food, are a public health concern. We evaluated the impact of living in FD on cardiovascular risk factors and subclinical cardiovascular disease (CVD) with the hypothesis that people living in FD will have an unfavorable CVD risk profile. We further assessed whether the impact of FD on these measures is driven by area income, individual household income, or area access to healthy food. METHODS AND RESULTS We studied 1421 subjects residing in the Atlanta metropolitan area who participated in the META-Health study (Morehouse and Emory Team up to Eliminate Health Disparities; n=712) and the Predictive Health study (n=709). Participants' zip codes were entered into the United States Food Access Research Atlas for FD status. Demographic data, metabolic profiles, hs-CRP (high-sensitivity C-reactive protein) levels, oxidative stress markers (glutathione and cystine), and arterial stiffness were evaluated. Mean age was 49.4 years, 38.5% male and 36.6% black. Compared with those not living in FD, subjects living in FD (n=187, 13.2%) had a higher prevalence of hypertension and smoking, higher body mass index, fasting glucose, and 10-year risk for CVD. They also had higher hs-CRP (P=0.014), higher central augmentation index (P=0.015), and lower glutathione level (P=0.003), indicative of increased oxidative stress. Area income and individual income, rather than food access, were associated with CVD risk measures. In a multivariate analysis that included food access, area income and individual income, both low-income area and low individual household income, were independent predictors of a higher 10-year risk for CVD. Only low individual income was an independent predictor of higher hs-CRP and augmentation index. CONCLUSIONS Although living in FD is associated with a higher burden of cardiovascular risk factors and preclinical indices of CVD, these associations are mainly driven by area income and individual income rather than access to healthy food.
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Affiliation(s)
- Heval M Kelli
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Muhammad Hammadah
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Hina Ahmed
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Yi-An Ko
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Matthew Topel
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Ayman Samman-Tahhan
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Mossab Awad
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Keyur Patel
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Kareem Mohammed
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Laurence S Sperling
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Priscilla Pemu
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Viola Vaccarino
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Tene Lewis
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Herman Taylor
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Greg Martin
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Gary H Gibbons
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.)
| | - Arshed A Quyyumi
- From the Emory Clinical Cardiovascular Research Institute (H.M.K., M.H., H.A., M.T., A.S.-T., M.A., K.P., K.M., L.S.S., V.V., A.A.Q.), Rollins School of Public Health, Emory University School of Medicine (Y.-A.K., V.V., T.L.), and Predictive Health Institute (G.M.), Emory University, Atlanta, GA; Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, GA (P.P., H.T.); and National Heart, Lung, and Blood Institute, Bethesda, MD (G.H.G.).
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Schultz WM, Kelli HM, Lisko JC, Varghese T, Shen J, Sandesara P, Quyyumi AA, Taylor HA, Gulati M, Harold JG, Mieres JH, Ferdinand KC, Mensah GA, Sperling LS. Socioeconomic Status and Cardiovascular Outcomes: Challenges and Interventions. Circulation 2018; 137:2166-2178. [PMID: 29760227 PMCID: PMC5958918 DOI: 10.1161/circulationaha.117.029652] [Citation(s) in RCA: 725] [Impact Index Per Article: 120.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Socioeconomic status (SES) has a measurable and significant effect on cardiovascular health. Biological, behavioral, and psychosocial risk factors prevalent in disadvantaged individuals accentuate the link between SES and cardiovascular disease (CVD). Four measures have been consistently associated with CVD in high-income countries: income level, educational attainment, employment status, and neighborhood socioeconomic factors. In addition, disparities based on sex have been shown in several studies. Interventions targeting patients with low SES have predominantly focused on modification of traditional CVD risk factors. Promising approaches are emerging that can be implemented on an individual, community, or population basis to reduce disparities in outcomes. Structured physical activity has demonstrated effectiveness in low-SES populations, and geomapping may be used to identify targets for large-scale programs. Task shifting, the redistribution of healthcare management from physician to nonphysician providers in an effort to improve access to health care, may have a role in select areas. Integration of SES into the traditional CVD risk prediction models may allow improved management of individuals with high risk, but cultural and regional differences in SES make generalized implementation challenging. Future research is required to better understand the underlying mechanisms of CVD risk that affect individuals of low SES and to determine effective interventions for patients with high risk. We review the current state of knowledge on the impact of SES on the incidence, treatment, and outcomes of CVD in high-income societies and suggest future research directions aimed at the elimination of these adverse factors, and the integration of measures of SES into the customization of cardiovascular treatment.
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Affiliation(s)
| | - Heval M Kelli
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | | | | | - Jia Shen
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | - Pratik Sandesara
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | - Arshed A Quyyumi
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | | | - Martha Gulati
- University of Arizona-Phoenix College of Medicine (M.G.)
| | - John G Harold
- Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (J.G.H.)
| | | | | | - George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.A.M.)
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
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30
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Nayor M, Stevenson MD, Musani SK, Xanthakis V, LaValley MP, Larson MG, Fox ER, Vasan RS. Incidence of cardiovascular disease in individuals affected by recent changes to US blood pressure treatment guidelines. J Hypertens 2018; 36:436-443. [PMID: 29084083 PMCID: PMC6062206 DOI: 10.1097/hjh.0000000000001570] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE We evaluated the incidence of cardiovascular disease (CVD) in individuals whose blood pressure (BP) management strategy would change with adoption of recent US hypertension guidelines in two large, community-based cohorts with different racial and geographic compositions: the Framingham and Jackson Heart Studies (FHS and JHS). METHODS We assigned 11 237 FHS (mean age 46, 53% women) and 2948 JHS (mean age 55, 69% women) participants free of CVD and chronic kidney disease to one of five categories representing different treatment recommendations between 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee and The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure guidelines. Absolute incidence rates (incidence rate; per 1000 person-years) and multivariable-adjusted hazard ratios were calculated for each group; cohort-specific results were combined using fixed effect meta-analysis. RESULTS CVD events occurred in 1047 FHS and 230 JHS participants during mean follow-up times of 11 and 8.9 years, respectively. Compared with individuals without hypertension, those with BP 140-149/<90 mmHg had increased risk for CVD regardless of treatment status [hazard ratio for untreated BP 140-149/<90 mmHg 1.96, 95% confidence interval (CI) 1.40-2.75; hazard ratio for treated BP 140-149/<90 mmHg 3.37, 95% CI 2.37-4.78]. The risk for those with treated BP 140-149/<90 mmHg was consistent in those aged at least 60 years (hazard ratio: 2.61, 95% CI 1.75-3.90). Statistical power was limited to evaluate the effect of diabetes. CONCLUSION Individuals with treated BP 140-149/<90 mmHg have increased risk of CVD compared with those without hypertension including in participants at least 60 years. The 2014 Evidence-Based Guidelines for the Management of High Blood Pressure in Adults: Report from the Panel Members Appointed to the Eighth Joint National Committee recommendations to treat BP levels less aggressively may be associated with substantial residual CVD risk.
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Affiliation(s)
- Matthew Nayor
- Framingham Heart Study, Framingham, MA
- Brigham and Women’s Hospital, Division of Cardiovascular Medicine, Boston, MA
| | - Meredith D. Stevenson
- Framingham Heart Study, Framingham, MA
- Department of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, TN
| | - Solomon K. Musani
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Vanessa Xanthakis
- Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Sections of Preventive Medicine & Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
| | - Michael P. LaValley
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
| | - Martin G. Larson
- Framingham Heart Study, Framingham, MA
- Department of Biostatistics, Boston University School of Public Health, Boston, MA
- Department of Mathematics and Statistics, Boston University, Boston, MA
| | - Ervin R. Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
| | - Ramachandran S. Vasan
- Framingham Heart Study, Framingham, MA
- Sections of Preventive Medicine & Epidemiology, and Cardiology, Department of Medicine, Boston University School of Medicine, Boston, MA
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31
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Characterizing Cardiovascular Health and Evaluating a Low-Intensity Intervention to Promote Smoking Cessation in a Food-Assistance Population. J Community Health 2018; 42:605-611. [PMID: 27837357 DOI: 10.1007/s10900-016-0295-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Food assistance recipients are at higher risk for poor cardiovascular health given their propensity to poor dietary intake and tobacco use. This study sought to evaluate the cardiovascular health status, and determine the impact of a low-intensity smoking cessation education intervention that connected mobile food pantry participants to state quit-smoking resources. A pre-post design with a 6-week follow-up was used to evaluate the impact of a 10-12 min smoking cessation education session implemented in five food pantries in Delaware. Baseline cardiovascular health, smoking behaviors and food security status were assessed. Smoking cessation knowledge, intention to quit and use of the state quit line were also assessed at follow-up. Of the 144 participants 72.3% reported having hypertension, 34.3% had diabetes, 13.9% had had a stroke. 50.0% were current smokers. The low-intensity intervention significantly increased smoking cessation knowledge but not intention to quit at follow-up. Seven percent of current smokers reported calling the quit line. Current tobacco use was five times more likely in food insecure versus food secure adults (OR 4.98; p = 0.006), even after adjustment for demographic factors. Systems based approaches to address tobacco use and cardiovascular health in low-income populations are needed. The extent to which smoking cessation could reduce food insecurity and risk for cardiovascular disease in this population warrants investigation.
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Yingling LR, Mitchell V, Ayers CR, Peters-Lawrence M, Wallen GR, Brooks AT, Troendle JF, Adu-Brimpong J, Thomas S, Henry J, Saygbe JN, Sampson DM, Johnson AA, Graham AP, Graham LA, Wiley KL, Powell-Wiley T. Adherence with physical activity monitoring wearable devices in a community-based population: observations from the Washington, D.C., Cardiovascular Health and Needs Assessment. Transl Behav Med 2017; 7:719-730. [PMID: 28097627 PMCID: PMC5684058 DOI: 10.1007/s13142-016-0454-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Wearable mobile health (mHealth) technologies offer approaches for targeting physical activity (PA) in resource-limited, community-based interventions. We sought to explore user characteristics of PA tracking, wearable technology among a community-based population within a health and needs assessment. In 2014-2015, we conducted the Washington, D.C., Cardiovascular Health and Needs Assessment in predominantly African-American churches among communities with higher obesity rates and lower household incomes. Participants received a mHealth PA monitor and wirelessly uploaded PA data weekly to church data collection hubs. Participants (n = 99) were 59 ± 12 years, 79% female, and 99% African-American, with a mean body mass index of 33 ± 7 kg/m2. Eighty-one percent of participants uploaded PA data to the hub and were termed "PA device users." Though PA device users were more likely to report lower household incomes, no differences existed between device users and non-users for device ownership or technology fluency. Findings suggest that mHealth systems with a wearable device and data collection hub may feasibly target PA in resource-limited communities.
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Grants
- HHSN268201400023C NHLBI NIH HHS
- ZIA HL006168 Intramural NIH HHS
- Division of Intramural Research, National Heart, Lung, and Blood Insitute, USA
- Division of Intramural Research, National Heart, Lung, and Blood Institute, USA
- Office of Intramural Training and Education, National Institutes of Health, USA
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Affiliation(s)
- Leah R Yingling
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Valerie Mitchell
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Colby R Ayers
- Donald W. Reynolds Cardiovascular Clinical Research Center, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Marlene Peters-Lawrence
- Office of the Clinical Director, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Gwenyth R Wallen
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - Alyssa T Brooks
- Clinical Center, National Institutes of Health, Bethesda, MD, USA
| | - James F Troendle
- Office of Biostatistics Research, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Joel Adu-Brimpong
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Samantha Thomas
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - JaWanna Henry
- Office of the National Coordinator for Health Information Technology, Washington, DC, USA
| | - Johnetta N Saygbe
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA
| | - Dana M Sampson
- Office of Minority Health, U.S. Department of Health and Human Services, Rockville, MD, USA
| | - Allan A Johnson
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Avis P Graham
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Lennox A Graham
- College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Kenneth L Wiley
- Division of Genomic Medicine, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Tiffany Powell-Wiley
- Cardiovascular and Pulmonary Branch, Division of Intramural Research, National Heart, Lung, and Blood Institute, National Institutes of Health, 10 Center Drive, Suite 5-3330, Bethesda, MD, 20892, USA.
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Abstract
PURPOSE OF REVIEW The aim of this paper is to summarize the recent and relevant evidence linking socioeconomic status (SES) to cardiovascular disease (CVD) and cardiovascular risk factors (CVRFs). RECENT FINDINGS In high-income countries (HICs), the evidence continues to expand, with meta-analyses of large longitudinal cohort studies consistently confirming the inverse association between SES and several CVD and CVRFs. The evidence remains limited in low-income and middle-income countries (LMICs), where most of the evidence originates from cross-sectional studies of varying quality and external validity; the available evidence indicates that the association between SES and CVD and CVRFs depends on the socioeconomic development context and the stage in the demographic, epidemiological, and nutrition transition of the population. The recent evidence confirms that SES is strongly inversely associated with CVD and CVRFs in HICs. However, there remains a need for more research to better understand the way socioeconomic circumstances become embodied in early life and throughout the life course to affect cardiovascular risk in adult and later life. In LMICs, the evidence remains scarce; thus, there is an urgent need for large longitudinal studies to disaggregate CVD and CVRFs by socioeconomic indicators, particularly as these countries already suffer the greatest burden of CVD.
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Affiliation(s)
- Carlos de Mestral
- Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Biopôle 2 - Route de la Corniche 10, 1010, Lausanne, Switzerland
| | - Silvia Stringhini
- Division of Chronic Diseases, Institute of Social and Preventive Medicine (IUMSP), Lausanne University Hospital (CHUV), Biopôle 2 - Route de la Corniche 10, 1010, Lausanne, Switzerland.
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Min YI, Anugu P, Butler KR, Hartley TA, Mwasongwe S, Norwood AF, Sims M, Wang W, Winters KP, Correa A. Cardiovascular Disease Burden and Socioeconomic Correlates: Findings From the Jackson Heart Study. J Am Heart Assoc 2017; 6:JAHA.116.004416. [PMID: 28778943 PMCID: PMC5586401 DOI: 10.1161/jaha.116.004416] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Black persons have an excess burden of cardiovascular disease (CVD) compared with white persons. This burden persists after adjustment for socioeconomic status and other known CVD risk factors. This study evaluated the CVD burden and the socioeconomic gradient of CVD among black participants in the JHS (Jackson Heart Study). METHODS AND RESULTS CVD burden was evaluated by comparing the observed prevalence of myocardial infarction, stroke, and hypertension in the JHS at baseline (2000-2004) with the expected prevalence according to US national surveys during a similar time period. The socioeconomic gradient of CVD was evaluated using logistic regression models. Compared with the national data, the JHS age- and sex-standardized prevalence ratios for myocardial infarction, stroke, and hypertension were 1.07 (95% CI, 0.90-1.27), 1.46 (95% CI, 1.18-1.78), and 1.51 (95% CI, 1.42-1.60), respectively, in men and 1.50 (95% CI, 1.27-1.76), 1.33 (95% CI, 1.12-1.57), and 1.43 (95% CI, 1.37-1.50), respectively, in women. A significant and inverse relationship was observed between socioeconomic status and CVD within the JHS cohort. The strongest and most consistent socioeconomic correlate after adjusting for age and sex was income for myocardial infarction (odds ratio: 3.53; 95% CI, 2.31-5.40) and stroke (odds ratio: 3.73; 95% CI, 2.32-5.97), comparing the poor and affluent income categories. CONCLUSIONS Except for myocardial infarction in men, CVD burden in the JHS cohort was higher than expected. A strong inverse socioeconomic gradient of CVD was also observed within the JHS cohort.
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Affiliation(s)
- Yuan-I Min
- University of Mississippi Medical Center, Jackson, MS
| | - Pramod Anugu
- University of Mississippi Medical Center, Jackson, MS
| | | | - Tara A Hartley
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV
| | | | | | - Mario Sims
- University of Mississippi Medical Center, Jackson, MS
| | - Wei Wang
- University of Mississippi Medical Center, Jackson, MS
| | | | - Adolfo Correa
- University of Mississippi Medical Center, Jackson, MS
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35
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Life course socioeconomic adversities and 10-year risk of cardiovascular disease: cross-sectional analysis of the Brazilian Longitudinal Study of Adult Health. Int J Public Health 2016; 62:283-292. [PMID: 27913814 DOI: 10.1007/s00038-016-0928-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Revised: 11/07/2016] [Accepted: 11/17/2016] [Indexed: 10/20/2022] Open
Abstract
OBJECTIVES To investigate whether life course exposure to adverse socioeconomic positions (SEP) as well as maintaining a low SEP or decreasing the SEP intra- and intergeneration was associated with an increased 10-year cardiovascular disease (CVD) risk predicted by the Framingham Risk Score. METHODS This is a cross-sectional analysis of baseline data (2008-2010) of 13,544 active workers from ELSA-Brasil cohort. Maternal education, leg length, social class of first occupation and education were used to evaluate childhood, youth and adulthood SEP. RESULTS After considering adulthood SEP, exposure to early-life low SEP remained associated with an increased 10-year CVD risk. The 10-year CVD risk also rose as the number of exposures to low SEP throughout life increased. Compared to individuals in high-stable intragenerational trajectory, those in upward, downward, or stable low trajectory presented higher 10-year CVD risk. Increasing individuals' SEP over generation showed no increased risk of 10-year CVD risk compared to individuals in high-stable trajectory. CONCLUSIONS Childhood may be a critical period for exposures to social adversities. Life course low SEP may also affect the 10-year CVD risk via accumulation of risk and social mobility.
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36
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Barber S, Hickson DA, Wang X, Sims M, Nelson C, Diez-Roux AV. Neighborhood Disadvantage, Poor Social Conditions, and Cardiovascular Disease Incidence Among African American Adults in the Jackson Heart Study. Am J Public Health 2016; 106:2219-2226. [PMID: 27736207 PMCID: PMC5105010 DOI: 10.2105/ajph.2016.303471] [Citation(s) in RCA: 86] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2016] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To examine the impact of neighborhood conditions resulting from racial residential segregation on cardiovascular disease (CVD) risk in a socioeconomically diverse African American sample. METHODS The study included 4096 African American women (n = 2652) and men (n = 1444) aged 21 to 93 years from the Jackson Heart Study (Jackson, Mississippi; 2000-2011). We assessed neighborhood disadvantage with a composite measure of 8 indicators from the 2000 US Census. We assessed neighborhood-level social conditions, including social cohesion, violence, and disorder, with self-reported, validated scales. RESULTS Among African American women, each standard deviation increase in neighborhood disadvantage was associated with a 25% increased risk of CVD after covariate adjustment (hazard ratio = 1.25; 95% confidence interval = 1.05, 1.49). Risk also increased as levels of neighborhood violence and physical disorder increased after covariate adjustment. We observed no statistically significant associations among African American men in adjusted models. CONCLUSIONS Worse neighborhood economic and social conditions may contribute to increased risk of CVD among African American women. Policies directly addressing these issues may alleviate the burden of CVD in this group.
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Affiliation(s)
- Sharrelle Barber
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - DeMarc A Hickson
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Xu Wang
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Mario Sims
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Cheryl Nelson
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Ana V Diez-Roux
- Sharrelle Barber, Xu Wang, and Ana V. Diez-Roux are with Drexel University School of Public Health, Department of Epidemiology and Biostatistics, and Center for Integrative Approaches to Health Disparities, Philadelphia, PA. DeMarc A. Hickson and Mario Sims are with University of Mississippi Medical Center, Jackson. Cheryl Nelson is with National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
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Lee JE, Sung JH, Barnett ME, Norris K. User-Friendly Data-Sharing Practices for Fostering Collaboration within a Research Network: Roles of a Vanguard Center for a Community-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2015; 13:ijerph13010034. [PMID: 26703645 PMCID: PMC4730425 DOI: 10.3390/ijerph13010034] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/15/2015] [Revised: 10/27/2015] [Accepted: 11/09/2015] [Indexed: 01/24/2023]
Abstract
Although various attempts have been made to build collaborative cultures for data sharing, their effectiveness is still questionable. The Jackson Heart Study (JHS) Vanguard Center (JHSVC) at the NIH-funded Research Centers in Minority Institutions (RCMI) Translational Research Network (RTRN) Data Coordinating Center (DCC) may be a new concept in that the data are being shared with a research network where a plethora of scientists/researchers are working together to achieve their common goal. This study describes the current practices to share the JHS data through the mechanism of JHSVC. The JHS is the largest single-site cohort study to prospectively investigate the determinants of cardiovascular disease among African-Americans. It has adopted a formal screened access method through a formalized JHSVC mechanism, in which only a qualified scientist(s) can access the data. The role of the DCC was to help RTRN researchers explore hypothesis-driven ideas to enhance the output and impact of JHS data through customized services, such as feasibility tests, data querying, manuscript proposal development and data analyses for publication. DCC has implemented these various programs to facilitate data utility. A total of 300 investigators attended workshops and/or received training booklets. DCC provided two online and five onsite workshops and developed/distributed more than 250 copies of the booklet to help potential data users understand the structure of and access to the data. Information on data use was also provided through the RTRN website. The DCC efforts led to the production of five active manuscript proposals, seven completed publications, 11 presentations and four NIH grant proposals. These outcomes resulted from activities during the first four years; over the last couple of years, there were few new requests. Our study suggested that DCC-customized services enhanced the accessibility of JHS data and their utility by RTRN researchers and helped to achieve the principal goal of JHSVC of scientific productivity. In order to achieve long-term success, the following, but not limited to these, should be addressed in the current data sharing practices: preparation of new promotional strategies in response to changes in technology and users’ needs, collaboration with the Network statisticians, harmonization of the JHS data with the other local-based heart datasets to meet the needs of the potential users from the broader geographical areas, adoption of the RTRN comprehensive data-sharing policy to broaden the variety of research topics and implementation of an ongoing monitoring program to evaluate its success.
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Affiliation(s)
- Jae Eun Lee
- Research Centers in Minority Institutions Translational Research Network Data Coordinating Center, Mississippi e-Center, Jackson State University, 1230 Raymond Rd., Jackson, MS 39204, USA.
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Drive Jackson Medical Mall, Jackson, MS 39213, USA.
| | - Jung Hye Sung
- Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, 350 W. Woodrow Wilson Drive Jackson Medical Mall, Jackson, MS 39213, USA.
| | - M Edwina Barnett
- Research Centers in Minority Institutions Translational Research Network Data Coordinating Center, Mississippi e-Center, Jackson State University, 1230 Raymond Rd., Jackson, MS 39204, USA.
| | - Keith Norris
- Department of Medicine, David Geffen School of Medicine, UCLA, 911 Broxton Ave, Los Angeles, CA 90024, USA.
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