Life’s Simple 7’s Cardiovascular Health Metrics are Associated with Hispanic/Latino Neurocognitive Function: HCHS/SOL Results

Hispanics/Latinos are purportedly at increased risk for neurocognitive decline and dementias. Without dementia cures, low-cost, well-tolerated public health means for mitigating neurocognitive decline are needed

Macronutrient Intake, Diagnosis Status, and Glycemic Control Among US Hispanics/Latinos With Diabetes

CONTEXT: Diet modification is a mainstay of diabetes management. US Hispanics/Latinos are disproportionately affected by diabetes, but few studies have examined dietary intake among US Hispanics/Latinos with diabetes, and little is known regarding the influence of diabetes awareness on dietary intake. OBJECTIVE: We evaluated macronutrient intake and its associations with diabetes awareness and glycemic control among US Hispanics/Latinos with diabetes. PARTICIPANTS: This analysis included 3310 diabetic adults aged 18–74 years from the Hispanic Community Health Study/Study of Latinos (2008–2011). MAIN OUTCOME MEASURES: Diabetes was defined as diagnosed (based on medical history or antihyperglycemic medication use) or undiagnosed diabetes (based on fasting glucose ≥ 126 mg/dL, glycated hemoglobin [HbA1c] ≥ 6.5%, or 2 h glucose ≥ 200 mg/dL in the absence of a physician diagnosis). Dietary intake was assessed using two 24-hour recalls. RESULTS: Among Hispanic/Latino adults with diabetes, 21.2%, 55.7%, and 71.2% met the American Diabetes Association recommendations for fiber (≥14 g per 1000 kcal), saturated fat (<10% of total energy), and cholesterol intake (<300 mg), respectively. Compared with those with undiagnosed diabetes, people with diagnosed diabetes consumed less carbohydrate (50.3 vs 52.4% of total energy; P = .017), total sugar (19.1 vs 21.5% of total energy; P = .002), added sugar (9.8 vs 12.1% of total energy; P < .001), and more total fat (30.7 vs 29.3% of total energy; P = .048) and monounsaturated fat (11.5 vs 10.7% of total energy; P = .021). Association between diabetes awareness and low total and added sugar intake was observed in individuals of Mexican and Puerto Rican background but not in other groups (P for interaction < .05). Among people with diagnosed diabetes, those with HbA1c of 7% or greater consumed more total fat, saturated fat, and cholesterol than those with HbA1c less than 7% (all P < .05). CONCLUSIONS: Among US Hispanics/Latinos with diabetes, fiber intake is low, and diabetes awareness is associated with reduced carbohydrate and sugar intake and increased monounsaturated fat intake. Sugar intake may require special attention in certain Hispanic/Latino background groups

Prevalence of Low Cardiovascular Risk Profile Among Diverse Hispanic/Latino Adults in the United States by Age, Sex, and Level of Acculturation: The Hispanic Community Health Study/Study of Latinos

BACKGROUND: Favorable levels of all readily measurable major cardiovascular disease risk factors (ie, low risk [LR]) are associated with lower risks of cardiovascular disease morbidity and mortality. Data are not available on LR prevalence among Hispanic/Latino adults of diverse ethnic backgrounds. This study aimed to describe the prevalence of a low cardiovascular disease risk profile among Hispanic/Latino adults in the United States and to examine cross-sectional associations of LR with measures of acculturation. METHODS AND RESULTS: The multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos examined 16 415 men and women aged 18 to 74 years at baseline (2008-2011) with diverse Hispanic/Latino backgrounds. Analyses involved 14 757 adults (mean age 41.3 years; 60.6% women). LR was defined using national guidelines for favorable levels of serum cholesterol, blood pressure, and body mass index and by not having diabetes mellitus and not currently smoking. Age-adjusted LR prevalence was low (8.4% overall; 5.1% for men, 11.2% for women) and varied by background (4.2% in men of Mexican heritage versus 15.0% in women of Cuban heritage). Lower acculturation (assessed using proxy measures) was significantly associated with higher odds of a LR profile among women only: Age-adjusted odds ratios of having LR were 1.64 (95% CI 1.24-2.17) for foreign-born versus US-born women and 1.96 (95% CI 1.49-2.58) for women residing in the United States <10 versus ≥10 years. CONCLUSIONS: Among diverse US Hispanic/Latino adults, the prevalence of a LR profile is low. Lower acculturation is associated with higher odds of a LR profile among women but not men. Comprehensive public health strategies are needed to improve the cardiovascular health of US Hispanic/Latino adults

Comparing measures of overall and central obesity in relation to cardiometabolic risk factors among US Hispanic/Latino adults: Obesity and Cardiometabolic Risk in Hispanics

US Hispanics/Latinos have high prevalence of obesity and related comorbidities. We compared overall and central obesity measures in associations with cardiometabolic outcomes among US Hispanics/Latinos

Prevalence of Suspected Nonalcoholic Fatty Liver Disease in Hispanic/Latino Individuals Differs by Heritage

Non-alcoholic fatty liver disease (NAFLD) was shown to disproportionally affect Hispanic persons. We examined the prevalence of suspected NAFLD in Hispanic/Latino persons with diverse backgrounds

Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Hispanic/Latino Individuals of Diverse Backgrounds in the United States

Major cardiovascular diseases (CVDs) are leading causes of mortality among US Hispanic and Latino individuals. Comprehensive data are limited regarding the prevalence of CVD risk factors in this population and relations of these traits to socioeconomic status (SES) and acculturation

Abstract P393: AHA Life's Essential 8 and Incident Hypertension Among US Hispanics/Latinos: Results From the Hispanic Community Health Study/Study of Latinos

Byline: Julien Tremblay, Univ of Miami, Miami, FL; Natalie A Bello, Cedars-Sinai Med Cntr, Los Angeles, CA; Robert A Mesa, Univ of Miami, Miami, FL; Neil Schneiderman, Univ of Miami, Coral Gables, FL; Tatjana Rundek, Univ of Miami, Miami, FL; Fernando Testai, Univ of Illinois at Chicago, Chicago, IL; Amber Pirzada, Univ of Illinois at Chicago, Chicago, IL; Martha L Daviglus, Univ of Illinois at Chicago, Chicago, IL; Krista Perreira, Univ of North Carolina at Chapel Hill, Chapel Hill, NC; Linda Gallo, San Diego State Univ, Chula Vista, CA; Frank Penedo, Univ of Miami, Miami, FL; Daniela Sotres-Alvarez, Univ of North Carolina at Chapel Hill, Chapel Hill, NC; Sylvia Wassertheil-Smoller, Albert Einstein College of Medicine, Bronx, NY; Tali Elfassy, Univ of Miami, Miami, FL Background: The American Heart Association's Life Essential 8 (LE8) are a set of eight simple health metrics used to define cardiovascular (CV) health and promote healthy behaviors. Our objectives are to: 1) describe for the first time, LE8 among Hispanics/Latinos of diverse backgrounds and 2) determine the association between LE8 and incident hypertension, a leading risk factor for CV disease. Methods: The Hispanic Community Health Study/Study of Latinos is a population-based study of diverse Hispanics/Latinos aged 18-74 years from four US communities. Participants were examined in 2008-2011 (visit 1) and 2014-2017 (visit 2). At visit 1, information on behavioral factors (diet, smoking status, physical activity, sleep duration) and clinical factors (BMI, blood pressure, cholesterol, fasting glucose, and medication use) were measured and used to estimate a LE8 score (range: 0 to 100%) for 14,772 participants with complete information. Ideal cardiovascular health (ICH) was defined by LE8 [greater than or equal] 80%. Hypertension was defined as systolic BP [greater than or equal] 130 mmHg or diastolic BP [greater than or equal] 80 mmHg, or self-reported use of antihypertensive medications. We estimated ICH and described LE8 score according to Hispanic/Latino background group. Among the 5,667 participants free from hypertension at visit 1, we used Poisson regression models to determine the association between LE8 and incident hypertension at visit 2 including time between visits as an offset. Models were adjusted for age, sex, Hispanic/Latino background, income, education, nativity, health insurance, and marital status. All analyses accounted for the complex survey design of the study. Results: Among diverse US Hispanics/Latinos with a mean age of 41, 21.6% (SE: 0.7) had ICH. Mean LE8 score (68.2, SE: 0.3) varied by Hispanic/Latino background (p<0.05). Compared with Mexican background, (mean: 72.6, SE: 0.3), LE8 was significantly lower (less favorable) in all other Hispanic/Latino background groups: mean score of 62.2 (SE: 0.4) among Puerto Ricans; 62.3 (SE: 0.5) among Cubans; 69.3 (SE: 0.4) among Central Americans, 70.2 (SE: 0.5) among Dominicans; and 70.2 (SE: 0.7) among South Americans. Among Hispanics/Latinos without hypertension at Visit 1, each 10% decrement in LE8 score was associated with 23% increased risk of hypertension over approximately six years (incident density ratio: 1.23, 95% CI: 1.16, 1.30). Conclusion: Only one in five Hispanics/Latinos had ICH and LE8 varied substantially across Hispanic/Latino background group. Improvements in other components of CV health may result in lower risk of developing hypertension.Professiona

Favorable levels of all major cardiovascular risk factors at younger ages and high-sensitivity C-reactive protein 39 years later — The Chicago Healthy Aging Study

Objectives: Examine associations of favorable levels of all cardiovascular disease (CVD) risk factors (RFs) [i.e., low risk (LR)] at younger ages with high sensitivity C-reactive protein (hs-CRP) at older ages. Methods: There were 1324 participants ages 65–84 years with hs-CRP ≤ 10 mg/L from the Chicago Healthy Aging Study (2007–2010), and CVD RFs assessed at baseline (1967–73) and 39 years later. LR was defined as untreated blood pressure (BP) ≤120/≤80 mm Hg, untreated serum total cholesterol <200 mg/dL, body mass index (BMI) <25 kg/m2, not smoking, and no diabetes. Hs-CRP was natural log-transformed or dichotomized as elevated (≥3 mg/L or ≥2 mg/L) vs. otherwise. Results: With multivariable adjustment, the odds ratios (95% confidence intervals) for follow-up hs-CRP ≥3 mg/in participants with baseline 0 RF, 1 RF and 2+ RFs compared to those with baseline LR were 1.35 (0.89–2.03), 1.61 (1.08–2.40) and 1.69 (1.04–2.75), respectively. There was also a graded, direct association across four categories of RF groups with follow-up hs-CRP levels (β coefficient/P-trend = 0.18/0.014). Associations were mainly due to baseline smoking and BMI, independent of 39-year change in BMI levels. Similar trends were observed in gender-specific analyses. Conclusions: Favorable levels of all CVD RFs in younger age are associated with lower hs-CRP level in older age

Correlates of and Body Composition Measures Associated with Metabolically Healthy Obesity Phenotype in Hispanic/Latino Women and Men: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Background. Individuals with “metabolically healthy obesity” (MHO) phenotype (i.e., obesity and absence of cardiometabolic abnormalities: favorable levels of blood pressure, lipids, and glucose) experience lower risk of cardiovascular disease compared with those with “metabolically at-risk obesity” (MAO) phenotype (i.e., obesity with concurrent cardiometabolic abnormalities). Among Hispanic/Latino women and men with obesity, limited data exist on the correlates of and body composition measures associated with obesity phenotypes. Methods. Data from the Hispanic Community Health Study/Study of Latinos (2008–2011) were used to estimate the age-adjusted distribution of obesity phenotypes among 5,426 women and men (aged 20–74 years) with obesity (BMI ≥ 30 kg/m2) and to compare characteristics between individuals with MHO and MAO phenotypes. Weighted Poisson regression models were used to examine cross-sectional associations between 1-standard deviation (SD) increase in body composition measures (i.e., body fat percentage, waist circumference, and body lean mass) and MHO phenotype prevalence. Results. The age-adjusted proportion of the MHO phenotype was low (i.e., 12.5% in women and 6.5% in men). In bivariate analyses, women and men with the MHO phenotype were more likely to be younger, have higher education and acculturation levels, report lower lifetime cigarette use, and have fasting insulin and waist circumference levels than MAO. Adjusting for sociodemographic and lifestyle factors, among women, each 1-SD increase in body fat percentage, waist circumference, and lean body mass was, respectively, associated with a 21%, 33%, and 31% lower prevalence of the MHO phenotype. Among men, each 1-SD increase in waist circumference and lean body mass was, respectively, associated with a 20% and 15% lower prevalence of the MHO phenotype. Conclusions. We demonstrated that higher waist circumference and higher lean body mass were independently associated with a lower proportion of the MHO phenotype in Hispanic/Latino women and men. Findings support the need for weight reduction interventions to manage cardiometabolic health among Hispanics/Latinos

Abstract 99: Association of Life Essential 8 Score With Major Vascular Outcomes. Results of the Hispanic Community Health Study/Study of Latinos

Abstract only Background: The “Life’s Essential 8” (LE8) score is a new tool to determine cardiovascular health (CVH). This includes diet, physical activity, nicotine exposure, sleep duration, body mass index, blood lipids, blood glucose, and blood pressure levels. Here we investigated the association of LE8 with incident major adverse cardiovascular events (MACE) among Hispanic/Latino adults living in the US. Design/Method: Baseline characteristics (n=13,956) of HCHS/SOL participants were determined between 2008 and 2011. Annual follow-up interviews were conducted from inception until 2016 to determine outcomes of interest. Hospital records were reviewed and incident MACE, defined as the composite of incident stroke, myocardial infarction, or heart failure, was adjudicated using standard criteria. LE8 scores (range 0 to 100, with higher scores denoting better CVH) were determined using published definitions. Incident rate ratios (IRR) of MACE across LE8 (modeled in 20-points increments) were determined using Poisson regression models and adjusting for baseline characteristics. Analyses were weighted for complex survey design and non-response. Results: The mean age (95% CI) at baseline was 40.7 (40.2-41.2) years and 60.6% were females. The mean LE8 score was 68.5 (68.0-69.1). Compared to females, males achieved higher scores in diet (44.9 vs. 36.1, P<0.001), physical activity (82.1 vs. 69.3; p<0.001), and body mass index (60.1 vs. 56.9; p<0.001) and lower scores in nicotine exposure (65.0 vs. 77.1; p<0.001), blood lipids (59.4 vs. 65.1; p<0.001), blood pressure (70.4 vs. 77.5; p<0.001). A total of 181 outcomes occurred during the mean follow-up of 6.8 (6.8-6.9) years. In the fully adjusted model, higher LE8 was associated with a lower incidence of MACE (IRR 0.47, 95% CI 0.30-0.74 for all; IRR 0.44, 95% CI 0.23 to 0.84 in males; IRR 0.49, 95% CI 0.28-0.85 in females). Conclusion: Among Hispanic/Latino adults, better CVH, quantified using LE8, is associated with a lower incidence of stroke, myocardial infarction, or heart failure