GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Abstract 12598: Impact of Obesity, Metabolic Syndrome, and Nonalcoholic Fatty Liver Disease on Systemic Inflammation and Subclinical Atherosclerosis: The Multi-Ethnic Study of Atherosclerosis (MESA)
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Introduction: We sought to characterize the association of three adiposity-related risk factors - obesity, metabolic syndrome, and nonalcoholic fatty liver disease (NAFLD) - with the outcomes of increased inflammation and subclinical atherosclerosis. Methods: We conducted a cross-sectional analysis of 3976 participants from the Multi-Ethnic Study of Atherosclerosis (MESA) with adequate CT imaging to diagnose NAFLD. For the study exposures, obesity was defined as BMI ≥30 kg/m 2 , metabolic syndrome by ATP III criteria, and NAFLD using non-contrast cardiac CT and a liver/spleen attenuation ratio (L/S) 0. In order to assess for a possible gradient-response, adjusted logistic regression was used to examine the association of a stepwise increase in the number of three adiposity-related risk factors with increased inflammation and subclinical atherosclerosis. Additional models were conducted stratifying by gender or ethnicity. Results: Mean age of participants was 63 years, 45% were male, 37% were white, 10% Chinese, 30% African American, and 23% Hispanic. NAFLD was associated with an odds ratio for high hs-CRP and CAC 〉 0 of 1.54 (1.27-1.87) and 1.41 (1.15-1.73), respectively, adjusting for obesity, metabolic syndrome and traditional risk factors. There was a positive interaction between female gender and NAFLD in the association with high hs-CRP (p=0.01). There was no interaction by race. Importantly, with increasing number of adiposity-related risk factors, the odds ratios of high hs-CRP and CAC 〉 0 increased in a graded fashion, suggesting a collective association (Figure). Conclusion: There is an association between three adiposity-related risk factors - obesity, metabolic syndrome, and NAFLD - with both increased inflammation and subclinical coronary atherosclerosis.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.12598
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Abstract 11601: Association Between Remnant Cholesterol and Coronary Plaque Features: The Miami Heart Study at Baptist Health South Florida
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: Remnant particles, the product of partial metabolism of triglyceride-rich lipoproteins, have been associated with atherosclerotic cardiovascular diseases (ASCVD), independent of low-density lipoprotein cholesterol (LDL-C). This study aims to further examine the role of remnant cholesterol (RC) in atherogenesis by assessing its association with plaque characteristics. Methods: After excluding individuals on statin therapy (n=527), we included 1,832 statin-naïve participants from the Miami Heart Study, a prospective cohort of clinical ASCVD-free individuals in Miami (2015-2018) evaluated using coronary computed tomography angiography (CTA). RC was estimated as non-high density lipoprotein cholesterol minus LDL-C. Multivariable logistic regression models were used to estimate the association between low/high RC/LDL-C groups (defined by 〈 or ≥ medians) and plaque features. Results: Mean age of participants was 52.5±6.7 years, 54% women, 49.5% Hispanic. Median LDL-C and RC were 129.1 and 21.6 mg/dL, respectively. For each SD increase in RC levels, the odds of having non-calcified coronary plaque increased (OR 1.19 [95% CI 1.07-1.33]) and so did the segmental involvement score (OR 1.05 [95% CI 1.01-1.09] ) independent of traditional risk factors including LDL-C. The prevalence of coronary plaque features per RC/LDL-C group are shown in Table. Among those with low LDL-C, having high RC conferred a significantly higher risk of non-calcified plaque (OR 1.61 [95% CI 1.11-2.32]) compared to having low RC, although associations were not statistically significant with other plaque features (Table). Conclusions: In asymptomatic individuals with low LDL-C, elevated RC was independently associated with non-calcified plaque.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.11601
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Abstract 13639: The Impact of Income Level on All-Cause and Cardiovascular Mortality Across the Spectrum of Cardiovascular Health & Disease Among Adults in the United States
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 144, No. Suppl_1 ( 2021-11-16)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 144, No. Suppl_1 ( 2021-11-16)
    Abstract: Introduction: There is increasing interest in the role of income level as a social determinant of health for cardiovascular disease (CVD). In this study we examine the interplay of household income, all-cause mortality, and CVD mortality in a representative US adult population. Methods: We used National Health Interview Survey data from 2006-2014 including adults ≥18 years. Mortality data with follow-up till December 2015 was derived from the National Death Index. We evaluated age-adjusted all-cause, CVD and non-CVD mortality rates across income levels (lowest, low, middle, and high; defined based on based on the percentage of family income relative to the federal poverty level), among people with and without ASCVD at baseline. We further classified participants without ASCVD as having optimal (0-1 risk factors), average (2-3), and poor ( 〉 3) cardiovascular risk factor (CRF) profile. Cox regression models were used to evaluate the association between income and mortality. Results: The analysis included 256,991 adults, representing ~230 million adults annually. Mean age was 46.3 (SD=17.7), 52% were women, 13% NHB, and 8% had ASCVD. Overall, 18% were in the lowest income category compared to 39% in highest group. During the 10 years of follow up, participants with highest income and optimal CVH had the lowest all-cause and cause-specific mortality rates, whereas those with lowest income and poor CVH had the highest rates (Figure). Additionally, multivariate adjustment for demographics and CRF, lower income was associated with increased all-cause mortality (lowest/low vs middle/high income, HR: 1.22; 95% CI: 1.11-1.35 CVD vs non-CVD HR: 1.24, 95% CI: 1.16-1.33) and CVD mortality (lowest/low vs middle/high income: HR: 1.29, 95% CI: 1.07-1.56 CVD vs non-CVD HR: 1.44, 95% CI: 1.23-1.67). Conclusions: In a US representative population, lower income adults were consistently associated with increased risk of all-cause and CVD mortality irrespective of baseline CVD status.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.144.suppl_1.13639
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Abstract 25: Favorable Modifiable Cardiovascular Risk Profile is Associated with Lower Healthcare Costs: The 2012 Medical Expenditure Panel Survey
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 133, No. suppl_1 ( 2016-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. suppl_1 ( 2016-03)
    Abstract: Background: The AHA’s 2020 Strategic Goals emphasize the value of favorable modifiable risk factor (MRF) profile to reduce the burden of CVD morbidity and mortality. In this study we aimed to quantify the overall and incremental impact of MRF on health care expenditure in the U.S among those with and without CVD. Methods: The study population was derived from the 2012 Medical Expenditure Panel Survey (MEPS), a nationally representative adult sample (≥ 40 years). Direct costs were calculated for all-cause health care resource utilization. Variables of interest included CVD diagnoses (coronary artery disease, stroke, peripheral artery disease, dysrhythmias or heart failure), ascertained by ICD-9-CM codes, and MRF (hypertension, diabetes mellitus, hypercholesterolemia, smoking, physical activity and/or obesity). Two-part econometric models were utilized to study cost data; a generalized linear model with gamma distribution and link log was used to assess expenditures, taking into consideration the survey’s complex design. Results: The final study sample consisted of 15,651 MEPS participants (57 ± 12 years, 52% female). Overall, 6,231 (39%) had 0-1, 7,429 (49%) had 2-3, and 1,991 (12%) had ≥ 4 MRF, translating to 55.5, 69.9 and 17.9 million adults ≥ 40 years in U.S, respectively. Generally, there was a direct decrease in health expenditures with favorable MRF across CVD status (Table). These differences persisted after taking into account demographics, insurance status and comorbid conditions. Among those without established CVD, the average medical expenditure was $4,013 (95% CI 5,117, 2,910) and $2,696 (95% CI 4,416, 977) lower for those with 0-1 & 2-3 MRF, as compared to those with ≥ 4 MRF. Conclusion: Favorable MRF profile is associated with significantly lower medical expenditure among individuals with and without established CVD. Our study provides robust estimates for potential healthcare savings with nationwide policies focusing on preventing and managing modifiable CV risk factors.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.133.suppl_1.25
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Abstract 12049: The Association of Subclinical Vascular Disease and Erectile Dysfunction at 9-Year Assessment: The Multi-Ethnic Study of Atherosclerosis (MESA)
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: In cross sectional studies, erectile dysfunction (ED) and overt clinical cardiovascular disease commonly coexist. However, the temporal relationship between subclinical vascular disease and subsequent identification of ED remains unclear. Methods: After excluding participants taking ED medications at baseline, we studied 1,862 asymptomatic men from the Multi-Ethnic Study of Atherosclerosis (MESA) with complete baseline multi-modality subclinical disease phenotyping who underwent ED assessment at MESA visit 5 (9.4 years after baseline). ED was defined by self-report per the single question self-assessment in the Massachusetts Male Aging Study. Using multivariable logistic regression (see figure legend for adjustments), we assessed the relationship between three different categories of baseline subclinical vascular disease with subsequent self-identification of ED. Subclinical vascular disease measures tested were: atherosclerosis: coronary artery calcium [CAC], carotid intima-media thickness [CIMT] ; vascular stiffness: aortic distensibility, distensibility coefficient; vascular dysfunction: ankle-brachial index [ABI], flow-mediated dilation [FMD] . Results: A total of 839 men (45%) self-reported ED 9.4 ± 0.5 years after baseline. The mean age for the study population was 63.9 ± 8.9. There was a graded association between number and severity of subclinical disease abnormalities and ED. Measures of atherosclerosis were most closely associated with ED (see figure). Of the specific subclinical disease measurements, only presence of CAC and CAC 〉 100 retained significance in a fully adjusted model (OR 1.5, 1.2 - 1.9; OR 1.4, 1.1 - 1.9). Conclusions: Multiple vascular disease abnormalities tend to cluster in men who later self-report ED. Of the tested subclinical vascular disease domains, markers of subclinical atherosclerosis, in particular CAC, are most closely associated with subsequent ED nearly 10 years after baseline.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.12049
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Abstract 6199: Relationship of Carotid Arterial Compliance and Thoracic Aorta Calcification: Multi-Ethnic Study of Atherosclerosis (MESA)
    Ovid Technologies (Wolters Kluwer Health) ; 2008
    In:  Circulation Vol. 118, No. suppl_18 ( 2008-10-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 118, No. suppl_18 ( 2008-10-28)
    Abstract: Decreased arterial compliance is one of the earliest manifestations of adverse structural and functional changes within the vessel wall. Prior studies have shown that indirect measures of arterial stiffness predict severity of atherosclerosis as well as subsequent cardiovascular events. Ultrasonography of the common carotid artery however enables a direct measurement of compliance and stiffness and may be a more sensitive marker of subclinical vascular disease. MESA is a longitudinal, population-based study of 6,814 men and women aged 45–84 without clinical cardiovascular disease at enrollment. Of these, 3,540 (62± 10 years, 47% males) individuals underwent arterial compliance assessment via calculation of the distensibility coefficient (DC, in 1/mmHg ×10 3 ), which uses carotid ultrasonographic measurements of cardiac cycle-dependent vessel size and upper arm measurements of blood pressure. All patients had their thoracic artery calcium (TAC) calculated using non-contrast cardiac CT. The cross-sectional association between decreasing quartiles of DC (4 th quartile as reference group) and TAC was assessed by multivariable relative risk regression using a generalized linear model and binomial error distribution. The mean DC in the study population was 2.51± 1.11. Overall, 1,828 (28%) individuals had detectable TAC. A lower DC was observed among those with vs. without TAC (2.06± 0.90 vs. 2.69± 1.13, p 〈 0.0001). The prevalence of TAC increased significantly across decreasing quartiles of DC (4 th : 11%, 3 rd : 21%, 2 nd : 32%, 1 st : 11%, p 〈 0.0001). The table below demonstrates the adjusted relative risk for presence of TAC with decreasing quartiles of DC. Decreased arterial compliance measured by carotid ultrasonography is independently correlated with thoracic aortic atherosclerosis. Further studies are in progress to assess the prognostic value of this marker of subclinical atherosclerosis.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.118.suppl_18.S_1156-a
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2008
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 7
    Online Resource
    Online Resource
    Abstract 13711: Coronary Artery Calcium, Ankle-brachial Index, High Sensitivity C-reactive Protein, and a Family History of Coronary Artery Disease as Predictors of Incident Cardiovascular Events at Different Stages of Hypertension: The Multi-ethnic Study of Atherosclerosis
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Background: Coronary artery calcium (CAC), ankle-brachial index (ABI), high-sensitivity CRP (hsCRP), and family history (FHx) of coronary artery disease (CAD) are used as complementary aids in cardiac risk stratification. The 2017 ACC/AHA hypertension guideline’s new Stage I hypertension group has created uncertainty regarding intensity of blood pressure (BP) treatment in this group. We evaluated the comparative utility of CAC, ABI, hsCRP and FHx CAD as risk predictors of cardiovascular (CVD) events within different BP strata. Methods: The MESA cohort was followed for a median of 13 years with regards to incident coronary heart disease (CHD) and CVD events. BP was categorized per ACC/AHA guideline: normal- 〈 120/ 〈 80, elevated 120-129/ 〈 80, stage I 130-139/80-89, and stage II ≥140/≥90. Participants on BP medications were assigned stage II. Cox regression was used to compare prediction of CHD and CVD events by CAC 〉 300, CAC 〉 75 t h %, ABI 〈 0.9, hsCRP 〉 2 mg/L and FHx CAD, stratifying by BP groups after adjusting for demographics, CVD risk factors and use of BP and cholesterol medications. Results: Of 6268 persons, 539 incident CHD events and 572 incident CVD events were noted. CAC 〉 300 and CAC 〉 75 th % predicted an increased CHD event risk throughout all BP groups. ABI 〈 0.9 was predictive of CHD events in stage I and II, while hsCRP was not predictive in any group. CAC 〉 300 predicted a 2-fold increased CVD risk in all BP groups after adjustment. In the Stage I group, CAC 〉 300, CAC 〉 75 th % and ABI 〈 0.9 showed additive predictive value in incident CHD and CVD events. Using the adjusted model to predict CHD survival, CAC 〉 300 had a consistently higher C-statistic throughout all BP categories compared to other risk markers. Conclusion: CAC 〉 300 was associated with increased CHD and CVD risk in all BP groups and demonstrated superior prognostic utility compared to other risk markers. CAC 〉 300, CAC 〉 75 th % and ABI 〈 0.9 showed potential as risk modifiers in the new Stage I hypertension group.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.13711
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 8
    Online Resource
    Online Resource
    Abstract 14240: Thoracic Aortic Calcium for the Prediction of Stroke Mortality: The Coronary Artery Calcium Consortium
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Thoracic aortic calcium(TAC) is an important marker of extra-coronary atherosclerosis with known predictive value for all-cause mortality. We sought to explore the predictive value of TAC for stroke mortality, independent of the more established coronary artery calcium score. Methods: The Coronary Artery Calcium(CAC) Consortium is a retrospectively assembled database of 66,636 patients aged ≥18 years with no prior history of cardiovascular disease, who had CAC scans done for risk stratification and were followed-up for an average of 12±4years. CAC scans capture a view of the adjacent thoracic aorta, enabling us to assess TAC at no extra cost. TAC was analyzed as present or not present and we restricted analysis to those with this information available. To account for competing risks for death from other causes, we utilized multivariable-adjusted competing risk regression models adjusted for traditional cardiovascular risk factors (age, sex, hypertension, hyperlipidemia, cigarette smoking, diabetes, family history of CHD) and CAC score. We report the relationship between TAC and stroke mortality using sub-distribution hazard ratios(SHR) with 95% CI. Results: There were 41,066 patients with information on TAC, 110 of whom had stroke mortality. The mean age of participants was 53.8±10.3 years, with 34.4% female. The unadjusted SHR for stroke mortality among those who had TAC compared to those who did not was 8.80(95%CI:5.97,12.98). After adjusting for traditional risk factors and CAC score, the SHR was 2.21(95%CI:1.39,3.49). The fully adjusted SHR for females was 3.42(95%CI:1.74,6.73) while for males it was 1.55(95%CI:0.83,2.90). Conclusion: TAC was predictive of stroke mortality independent of traditional risk factors and CAC, more so in females. The presence of TAC appears to be an independent marker of stroke mortality risk though further research is needed to study its incremental value over existing cardiovascular risk prediction models.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.14240
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 9
    Online Resource
    Online Resource
    Abstract 14073: Omega-3 Fatty Acid Levels and Risk for Incident Bleeding and Atrial Fibrillation: Multi-Ethnic Study of Atherosclerosis (MESA)
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: The association between plasma OM3 FA levels and key safety endpoints identified in the REDUCE-IT trial such as bleeding and atrial fibrillation (AF) remains uncertain. Hypothesis: Consistent with REDUCE-IT, we hypothesized that higher baseline OM3 FA levels, particularly EPA, would be associated with incident bleeding and AF in a population free of clinical ASCVD or AF. Methods: We examined the association between baseline plasma OM3 FA levels (expressed as percent mass of total FA) with incident bleeding and AF in MESA. Bleeding events were identified from review of hospitalization ICD-9/10 codes, and AF from participant report, discharge diagnoses, Medicare claims data, and study ECGs performed at MESA visit 5. Multivariable Cox proportional hazard modeling was used to estimate HRs of the association of continuous OM3 FA (log EPA, log DHA, log (EPA+DHA)) and our outcomes. Results: Among the 6546 participants, mean age was 62.1(±10.2) and 3468(53%) were female. For incident bleeding, consistent statistically significant reductions were seen with increasing levels of EPA and EPA+DHA in unadjusted and adjusted models including medications that modulate bleeding risk, such as aspirin, NSAIDS, corticosteroids and proton pump inhibitors (Table). For incident AF, a significant reduction was seen with increasing levels of DHA in univariate analyses that did not persist following adjustment for AF risk factors. No significant associations were seen with either EPA or EPA+DHA. Conclusions: In MESA, a population free of clinical ASCVD or AF at baseline, higher plasma levels of OM3 FA (EPA and EPA+DHA, but not DHA) were associated with significantly lower risk of hospitalized bleeding events, but there was no significant association with AF. These findings from observational studies will need to be reconciled with clinical trial data of high-dose pharmacologic OM3 FA therapy.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.14073
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 10
    Online Resource
    Online Resource
    Abstract 16752: Cumulative Social Determinant of Health Risk Score and Prevalent Atherosclerotic CVD Among National Representative Adult Population in US
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 142, No. Suppl_3 ( 2020-11-17)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 142, No. Suppl_3 ( 2020-11-17)
    Abstract: Introduction: Social determinants of health (SDOH) are contextual factors and shared experiences that impact an individual’s life and health. Unfavorable SDOH are recognized as a major source of excess cardiovascular disease (CVD) risk; however, prior studies have focused on restricted sets of SDOH domains. We aimed to assess the burden of multiple unfavorable SDOH at the population level, and the association between increasing cumulative burden of unfavorable SDOH features and atherosclerotic CVD (ASCVD) prevalence. Methods: Using a nationally-representative sample of 164,696 adults from the National Health Interview Survey (2013-17) we identified 39 parameters (classified as favorable or unfavorable) from the Healthy People 2020SDOH domains: Economic stability, Education, Food access, Neighborhood conditions, Social context, Health systems. An aggregate score of these features ranging 0-36 was then divided into quartiles-- the most unfavorable scores in the highest quartile. ASCVD was ascertained via self-report. Results: 15,758 individuals (8%), representing ~19.6 million Americans, had ASCVD and were more likely to experience economic instability, adverse neighborhood and social cohesion, psychologic distress, food scarcity, and significant cost and non-cost-related healthcare barriers than those without ASCVD. The age adjusted mean (SD) SDOH risk score among ASCVD vs non-ASCVD participants was 12.5 (0.13) vs 0.9 (0.03) respectively. We observed a graded increase in ASCVD prevalence with higher SDOH quartiles (Figure). In multivariate analyses, adults with highest SDOH scores had 2-fold higher odds of having ASCVD compared to those with lowest scores (Figure). Conclusions: In the US, aggregate SDOH risk significantly discriminate risk of prevalent ASCVD among US adults. Standardized SDOH risk scores have the potential to inform risk stratification models at the individual level for addressing avoidable social inequities in health status.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.142.suppl_3.16752
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...