Sociodemographic determinants of change in cardiovascular health in middle adulthood in a bi-racial cohort

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• dc.contributor.author Lassale, Camille
• dc.contributor.author Cené, Crystal W.
• dc.contributor.author Asselin, Anouk
• dc.contributor.author Sims, Mario
• dc.contributor.author Jouven, Xavier
• dc.contributor.author Gaye, Bamba
• dc.date.accessioned 2022-07-27T14:02:05Z
• dc.date.available 2022-07-27T14:02:05Z
• dc.date.issued 2022
• dc.description.abstract Background and aims: Cardiovascular health (CVH), as many other aspects of health, is socially patterned. However, little is known about the socioeconomic determinants of following a more or less favourable pattern of CVH change at midlife. Methods: We used data on 11,049 participants in the Atherosclerosis Risk in Communities (ARIC) study, a prospective, population-based, bi-racial cohort that included participants aged 44-66 years in 1987-1989, who attended a second visit 6 years later. At both visits, CVH was assessed with the American Heart Association's Life's Simple 7 (LS7) score ranging 0-14, based on 7 metrics: cholesterol, blood glucose, blood pressure, smoking, body mass index, physical activity, and diet. An LS7 score ≥8 was considered ideal, <8 was considered poor. Multivariable logistic regression models were used. In a first sample (N = 4416) of participants who started with a poor CVH, we modelled odds of improvement (Poor-Ideal vs. Poor-Poor). In a second sample (N = 6633) with baseline ideal CVH, we modelled odds of deterioration (Ideal-Poor vs. Ideal-Ideal). The determinants considered were baseline age, sex, race, educational level, income and working status. Results: The majority (8,347, 75.5%) of participants remained in the same CVH category at both waves: 28.7% poor-poor, and 46.8% ideal-ideal. The remaining 24.5% were evenly split between improving (11.2%) and deteriorating (13.2%). Compared to poor-poor CVH, older participants displayed higher odds of improving to ideal CVH (OR>58yvs < 50y = 1.41; 95% CI:1.17, 1.69), whereas Black race (vs White, OR = 0.68; 0.57, 0.80), low education (vs high, OR = 0.65; 0.53, 0.79) and low income (vs high, OR = 0.71; 0.57, 0.87)) were associated with lower odds of improvement. Compared to ideal-ideal CVH, Black participants (OR = 1.59; 1.33, 1.89), with low education (OR = 1.98; 1.64, 2.39), low income (OR = 1.57; 1.30, 1.88), and non-working (vs currently working, OR = 1.27; 1.06, 1.51) had greater odds of deterioration to poor CVH. Conclusions: We identified vulnerable groups at higher risk of worsening their CVH over time: Black people, with low income, low education, and who are unemployed. Efforts to reduce income and educational gaps and address structural racism, which shapes the distribution of health-promoting and health-harming resources, are paramount to reduce inequities in CVH.
• dc.description.sponsorship Camille Lassale is supported by a fellowship from “La Caixa” Foundation (ID 100010434) and from the European Union's Horizon 2020 research and innovation programme under the Marie Sklodowska-Curie grant agreement No 847648. The fellowship code is LCF/BQ/PR21/11840003. Bamba Gaye is supported by a FRM (Fondation pour la Recherche Médicale) grant and a Fondation Bettencourt Schueller Price. The ARIC study has been funded in whole or in part with Federal funds from the National Heart, Lung, and Blood Institute, National Institute of Health, Department of Health and Human Services, under contract numbers (HHSN268201700001I, HHSN268201700002I, HHSN268201700003I, HHSN268201700004I, and HHSN268201700005I).
• dc.format.mimetype application/pdf
• dc.identifier.citation Lassale C, Cené CW, Asselin A, Sims M, Jouven X, Gaye B. Sociodemographic determinants of change in cardiovascular health in middle adulthood in a bi-racial cohort. Atherosclerosis. 2022 Apr;346:98-108. DOI: 10.1016/j.atherosclerosis.2022.01.006
• dc.identifier.doi http://dx.doi.org/10.1016/j.atherosclerosis.2022.01.006
• dc.identifier.issn 0021-9150
• dc.identifier.uri http://hdl.handle.net/10230/53862
• dc.language.iso eng
• dc.publisher Elsevier
• dc.relation.ispartof Atherosclerosis. 2022 Apr;346:98-108
• dc.relation.projectID info:eu-repo/grantAgreement/EC/H2020/847648
• dc.rights © 2022 The Author(s). Published by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
• dc.rights.accessRights info:eu-repo/semantics/openAccess
• dc.rights.uri http://creativecommons.org/licenses/by-nc-nd/4.0/
• dc.subject.keyword Change in cardiovascular health
• dc.subject.keyword Determinants
• dc.subject.keyword Ethnicity
• dc.subject.keyword Socioeconomic
• dc.title Sociodemographic determinants of change in cardiovascular health in middle adulthood in a bi-racial cohort
• dc.type info:eu-repo/semantics/article
• dc.type.version info:eu-repo/semantics/publishedVersion