Abstract 16274: Race-Ethnic Disparities in Cardiovascular Health Behavior and Health Factor Changes: Results From the Northern Manhattan Study
Background and Objective: To target a 20% improvement in cardiovascular health (CVH) of all Americans by 2020, the AHA developed seven CVH metrics using smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), plasma glucose and cholesterol. This study aims to evaluate race/ethnic differences in changes across six of the CVH metrics (except for diet) in a prospective elderly urban cohort.
Methods: In the Northern Manhattan Study, there were 938 stroke-free participants that had assessments of the six CVH metrics at both baseline and follow-up (mean age at baseline 64±8 years, mean follow-up time 7±2 years, 60% female, 66% Hispanic, 19% non-Hispanic black and 15% non-Hispanic white). We classified participants into two groups (improving to or staying ideal vs. other) based on the CVH status at baseline and at follow-up for each metric. We used logistic regression models to investigate the race/ethnic differences in improving to or staying ideal for each of the six CVH metrics while controlling for age, sex and follow-up time.
Results: At baseline, 81% of participants were ideal for smoking, 68% for glucose, and 42% for cholesterol, but only 28% were ideal for BMI, 31% for PA, and 7% for BP. Among those who were ideal at baseline for the metric, 99% stayed ideal at follow-up for smoking, 69% stayed ideal for BMI, 50% stayed ideal for PA, 40% stayed ideal for BP, 80% stayed ideal for glucose, and 67% stayed ideal for cholesterol. Compared with non-Hispanic whites, non-Hispanic blacks had lower odds of quitting smoking or staying nonsmoking (OR: 0.43, 95% CI: 0.22-0.84); Hispanics had lower odds of improving to or staying ideal for BMI (0.53, 0.35-0.79) and glucose (0.57, 0.37-0.85); both non-Hispanic blacks and Hispanics had lower odds of improving to or staying ideal for PA (0.62, 0.39-0.98 for blacks; 0.50, 0.34-0.74 for Hispanics) and BP (0.31, 0.14-0.67 for blacks; 0.24, 0.14-0.43 for Hispanics), but had greater odds of improving to or staying ideal for cholesterol (1.79, 1.10-2.90 for blacks; 1.66, 1.10-2.50 for Hispanics).
Conclusion: Our findings demonstrate substantial race/ethnic disparities in improving to, or staying, ideal for CVH behaviors and factors, and provide insights for setting health promotion priorities in diverse populations.
- © 2013 by American Heart Association, Inc.