Abstract P266: Prevalence and Age-related Trends of Subclinical Cardiovascular Disease Burden in Adult Afro-Caribbean Men From Tobago
Introduction: Cardiovascular disease (CVD) is the leading cause of death throughout the world and age-adjusted rates of CVD mortality in Trinidad and Tobago are estimated to be ~2x those of the US. Given the drastic differences in culture and urbanization between Tobago and the US, we started the Tobago Heart Health Study to evaluate several aspects of subclinical CVD within a sample of men from an existing longitudinal study on the island.
Hypothesis: We assessed the hypothesis that subclinical CVD burden in adult Afro-Caribbean men would be low overall, but that the burden would be substantially greater in the oldest men.
Methods: We have preliminary data on subclinical CVD measures from 140 men, including carotid plaque from B-mode ultrasound, coronary artery calcification (CAC) and pericardial fat from computed tomography, and ankle-brachial index (ABI) and brachial-ankle pulse-wave velocity (baPWV) from automated waveform analysis. To assess the burden of multiple adverse measures, we calculated a subclinical CVD score (range 0-5) by summing the prevalence of the following: any carotid plaque, any CAC, highest quintile of pericardial fat, lowest quintile of ABI, or highest quintile of baPWV. For all subclinical variables of interest, we calculated means(SD) or frequencies, as appropriate, and identified age trends by testing for linear trends with age grouped as <60 years (n=56), 60-69 years (n=59) or ≥70 years (n=30).
Results: The men were aged 53-88 years (mean(SD): 64(9) years) and the prevalence of hypertension, diabetes, smoking, moderate alcohol intake, and sedentary behavior were 64%, 26%, 5%, 18% and 52%, respectively. Sixteen percent of men had any carotid plaque and 25% had any CAC. Mean ABI was 1.1(0.1), mean baPWV was 1696(388)cm/s and mean pericardial fat was 41.4(27.6)cm3. Only 56% had ≥1 adverse subclinical CVD measure (23% with 1, 21% with 2, 10% with 3, 2% with 4, 0 with 5). Men in the oldest age group had significantly more carotid plaque, more CAC, lower ABI, higher baPWV and more pericardial fat compared to the younger age groups (all p<0.05). Mean(SD) subclinical CVD score was 0.6(0.8) in men <60 years, 0.8(0.9) in men aged 60-69 years, and 2.2(1.0) in men aged ≥70 years (p<0.001). Greater age remained a significant predictor of subclinical CVD score after adjustment for hypertension, diabetes, smoking, alcohol intake and physical activity (p<0.001).
Conclusions: Subclinical CVD burden was low in this sample of 140 Afro-Caribbean men from Tobago. However, prevalence of adverse subclinical CVD measures greatly increased over the age of 70. It will be important to assess the impact of this aging-related subclinical burden on clinical CVD and cardiovascular mortality risks in adult Afro-Caribbean men in future studies.
Author Disclosures: A.L. Kuipers: None. I. Miljkovic: None. J.J. Carr: None. J.G. Terry: None. S. Nair: None. Y. Ge: None. R. Cvejkus: None. C.H. Bunker: None. A.L. Patrick: None. C.L. Wassel: None. J.M. Zmuda: None.
- © 2016 by American Heart Association, Inc.