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  • 1
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 139, No. 7 ( 2019-02-12), p. 850-859
    Abstract: Income volatility is on the rise and presents a growing public health problem. Because in many epidemiological studies income is measured at a single point in time, the association of long-term income volatility with incident cardiovascular disease (CVD) and mortality has not been adequately explored. The goal of this study was to examine associations of income volatility from 1990 to 2005 with incident CVD and all-cause mortality in the subsequent 10 years. Methods: The Coronary Artery Risk Development in Young Adults Study is an ongoing prospective cohort study conducted within urban field centers in Birmingham, AL; Chicago, IL; Minneapolis, MN; and Oakland, CA. We studied 3937 black and white participants 23 to 35 years of age in 1990 (our study baseline). Income volatility was defined as the intraindividual SD of the percent change in income across 5 assessments from 1990 to 2005. An income drop was defined as a decrease of ≥25% from the previous visit and less than the participant’s average income from 1990 to 2005. CVD events (fatal and nonfatal) and all-cause mortality between 2005 and 2015 were adjudicated with the use of medical records and death certificates. CVD included primarily acute events related to heart disease and stroke. Results: A total of 106 CVD events and 164 deaths occurred between 2005 and 2015 (incident rate, 2.76 and 3.66 per 1000 person-years, respectively). From Cox models adjusted for sociodemographic, behavioral, and CVD risk factors, higher income volatility and more income drops were associated with greater CVD risk (high versus low volatility: hazard ratio, 2.07; 95% CI, 1.10–3.90; ≥2 versus 0 income drops: hazard ratio, 2.54; 95% CI, 1.24–5.19) and all-cause mortality (high versus low volatility: hazard ratio, 1.78; 95% CI,1.03–3.09; ≥2 versus 0 income drops: hazard ratio, 1.92; 95% CI, 1.07–3.44). Conclusions: In a cohort of relatively young adults, income volatility and drops during a 15-year period of formative earning years were independently associated with a nearly 2-fold risk of CVD and all-cause mortality.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1466401-X
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  • 2
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 79, No. 8 ( 2022-08), p. 1656-1667
    Abstract: The availability of whole-genome sequencing data in large studies has enabled the assessment of coding and noncoding variants across the allele frequency spectrum for their associations with blood pressure. Methods: We conducted a multiancestry whole-genome sequencing analysis of blood pressure among 51 456 Trans-Omics for Precision Medicine and Centers for Common Disease Genomics program participants (stage-1). Stage-2 analyses leveraged array data from UK Biobank (N=383 145), Million Veteran Program (N=318 891), and Reasons for Geographic and Racial Differences in Stroke (N=10 643) participants, along with whole-exome sequencing data from UK Biobank (N=199 631) participants. Results: Two blood pressure signals achieved genome-wide significance in meta-analyses of stage-1 and stage-2 single variant findings ( P 〈 5×10 -8 ). Among them, a rare intergenic variant at novel locus, LOC100506274 , was associated with lower systolic blood pressure in stage-1 (beta [SE]=−32.6 [6.0] ; P =4.99×10 -8 ) but not stage-2 analysis ( P =0.11). Furthermore, a novel common variant at the known INSR locus was suggestively associated with diastolic blood pressure in stage-1 (beta [SE]=−0.36 [0.07] ; P =4.18×10 -7 ) and attained genome-wide significance in stage-2 (beta [SE]=−0.29 [0.03] ; P =7.28×10 -23 ). Nineteen additional signals suggestively associated with blood pressure in meta-analysis of single and aggregate rare variant findings ( P 〈 1×10 -6 and P 〈 1×10 -4 , respectively). Discussion: We report one promising but unconfirmed rare variant for blood pressure and, more importantly, contribute insights for future blood pressure sequencing studies. Our findings suggest promise of aggregate analyses to complement single variant analysis strategies and the need for larger, diverse samples, and family studies to enable robust rare variant identification.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 2094210-2
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  • 3
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 129, No. 7 ( 2023-04-14), p. 1202-1212
    Abstract: Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56·2 years and proportion female 55·2 %). The National Cancer Institute method was used to estimate dietary intake from two 24-h recalls. We derived DFA patterns using principal component analysis with twenty-six fatty acid and total plant and animal MUFA input variables. Global cognitive function was calculated as the average z -score of four neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake and CVD. DFA patterns were characterised by the consumption of long-chain SFA, animal-based MUFA and trans -fatty acids (factor 1); short to medium-chain SFA (factor 2); very-long-chain n -3 PUFA (factor 3); very-long-chain SFA and plant-based MUFA and PUFA (factor 4). Factor 2 was associated with greater scores for global cognitive function ( β = 0·037 ( sd 0·012)) and the Digit Symbol Substitution (DSS) ( β = 0·56 ( sd 0·17)), Brief Spanish English Verbal Learning-Sum (B-SEVLT) ( β = 0·23 ( sd 0·11)) and B-SEVLT-Recall ( β = 0·11 ( sd 0·05)) tests ( P 〈 0·05 for all). Factors 1 ( β = 0·04 ( sd 0·01)) and 4 ( β = 0·70 ( sd 0·18)) were associated with the DSS test ( P 〈 0·05 for all). The consumption of short to medium-chain SFA may be associated with higher cognitive function among US-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 4
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Background: Hispanics/Latinos of Dominican heritage living in the United States (US) have the highest prevalence of hypertension (HTN) compared with other Hispanic/Latino groups. To better understand cardiovascular health among Dominicans, a primarily immigrant population, it is crucial to examine the unique social contexts that influence their health outcomes. Our objective was to evaluate HTN prevalence and risk factors among individuals of Dominican descent from two social contexts - the US and the Dominican Republic (DR). Methods: HTN among DR Dominicans (DRD) was assessed using data from ENPREFAR-HAS 17, a representative sample of DRD (N=2,016; mean age 40±0.37 years, 60% females, unweighted); while HTN among US Dominicans (USD) was assessed from the HCHS/SOL, a population-based cohort study of Hispanics/Latinos in the US (Dominican subset, N=1,473; mean age 41±.25 years, 50% females, weighted). HTN was defined as blood pressure recording ≥140/90 mm Hg, self-reported HTN, or HTN treatment. Exposures included sociodemographic, lifestyle, and clinical characteristics. Poisson regression analyses were used to estimate associations between study characteristics and the prevalence of HTN (PR = prevalence ratio), adjusting for age and gender. Results: HTN was more prevalent among DRD (31%) than USD (27%). Younger adults (18-39) and females were more likely to have HTN in the DR, while older adults (40-60+) and males had a higher prevalence of HTN in the US. In those with HTN, awareness was common (74% USD, 68% DRD); most were receiving treatment (62% USD, 61% DRD), but overall, HTN control was low (35% USD, 36% DRD). Alcohol use was inversely associated with HTN prevalence for DRD (PR=0.8) with no association among USD. In both settings, diabetes (PR DRD = 1.4; PR USD = 1.4) and increased BMI (PR DRD = 1.8; PR USD = 2.0) were associated with a greater prevalence of HTN. Conversely, physical activity was protective against prevalent HTN among USD (PR=0.80) but associated with increased prevalence of HTN among DRD (PR=1.16); all p 〈 0.05. Conclusions: Variations in social, lifestyle, and clinical characteristics associated with HTN among Dominicans in the US and DR were identified, suggesting that context and cultural issues matters among immigrant populations.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 5
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Hypertension Vol. 80, No. 7 ( 2023-07), p. 1452-1462
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 80, No. 7 ( 2023-07), p. 1452-1462
    Abstract: Most research examining the association between blood pressure (BP) and cardiovascular disease (CVD) is sex-agnostic. Our goal was to assess sex-specific associations between BP and CVD mortality. Methods: We combined ten cycles of the National Health and Nutrition Examination Survey (1999–2018), N=53 289. Blood pressure was measured 3× and averaged. Data were linked to National Death Index data, and CVD mortality through December 31, 2019, was defined from International Classification of Diseases, Tenth Revision codes. We estimated sex-stratified, multivariable-adjusted incidence rate ratios (IRRs) for CVD mortality. Results: Over a median follow-up of 9.5 years, there were 2405 CVD deaths. Associations between categories of systolic blood pressure (SBP) and diastolic blood pressure (DBP) with CVD mortality differed by sex ( P 〈 0.01). Among men, compared with SBP of 100 to 〈 110 mm Hg, CVD mortality was 76% higher with SBP ≥160 mm Hg (IRR, 1.76 [95% CI, 1.27–2.44]). Among women, compared with SBP 100 to 〈 110 mm Hg, CVD mortality was 61% higher with SBP 130 to 139 mm Hg (IRR, 1.61 [95% CI, 1.02–2.55]), 75% higher with SBP 140 to 159 mm Hg (IRR, 1.75 [95% CI, 1.09–2.80] ), and 113% higher with SBP≥160 mm Hg (IRR, 2.13 [95% CI, 1.35–3.36]). Compared with DBP 70 to 〈 80 mm Hg, CVD mortality was higher with DBP 〈 70 mm Hg and DBP≥80 mm Hg among men, and higher with DBP 〈 50 mm Hg and DBP≥80 mm Hg among women. Conclusions: The association between BP and CVD mortality differed by sex, with increased CVD mortality risk present at lower levels of systolic blood pressure among women compared with men.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2094210-2
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  • 6
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: Ultra-processed food (UPF) consumption is linked to adverse health outcomes, including cardiovascular disease and all-cause mortality. Asian Americans (AAs) are the fastest growing ethnic group in the United States (US), yet their dietary patterns have seldom been described. Objectives: To characterize UPF consumption among AAs and determine whether acculturation is associated with increased UPF consumption. Methods: The National Health and Nutrition Examination Survey (NHANES) is an annual, cross-sectional survey representative of the US population. We examined NHANES dietary data, combining years in which AAs were over-sampled (2011-2018). We included 2,404 AAs ≥ 18 years old with valid 24-hour dietary recall data. Using day 1 dietary recalls, we characterized UPF consumption as the percentage of caloric intake from UPFs, using the NOVA classification system. This framework classifies foods from any culture based on degree of industrial processing. Acculturation was characterized by nativity, nativity/years in the US, home language, and an acculturation index (based on a sum of levels related to nativity/years in the US and home language). We assessed the relationship between each acculturation measure and UPF consumption using linear regression analyses adjusted for age, sex, marital status, education, income, self-reported health, and self-reported diet quality. All analyses accounted for the complex survey design. Results: Among all AAs, the percentage of caloric intake attributable to UPFs was 39.3% (95% CI: 38.1-40.5). In adjusted regression analyses, UPF consumption was 14% (95% CI: 9.5-17.5; p 〈 0.05) greater among those with the highest vs. lowest acculturation index score, 12% (95% CI: 8.5-14.7: p 〈 0.05) greater among those who speak English only vs. non-English only in the home, 12% (95% CI: 8.6-14.7: p 〈 0.05) greater among US-born vs. foreign-born AAs, and 15% (95% CI: 10.7-18.3: p 〈 0.05) greater among US-born vs. foreign-born AAs with less than ten years in the US. Conclusions: Among AAs, UPF consumption was common, and acculturation was strongly associated with greater proportional UPF intake. As the US-born AA population continues to grow, UPF consumption in this group is likely to increase. Further research is necessary to characterize trends in dietary patterns across disaggregated AA subgroups to better inform culturally tailored dietary interventions.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 7
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 137, No. suppl_1 ( 2018-03-20)
    Abstract: Introduction: Hypertension (HTN) is a major contributor to cardiovascular disease, the leading cause of death in the US. Yet, among diverse US Hispanics/Latinos, one of the fastest growing ethnic minority populations in the US, incident rates of HTN are currently unknown. Objectives: To determine rates of incident HTN over six years among diverse US Hispanics/Latinos and evaluate whether rates differed by Hispanic/Latino background. Methods: The Hispanic Community Health Study/Study of Latinos is an ongoing prospective population-based study of 16,415 diverse Hispanics/Latinos, ages 18-74 years, from four US communities sampled through a stratified multi-stage area probability design. Baseline examination was conducted in 2008-2011. Systolic and diastolic blood pressure (BP), as the average of three seated measurements, was measured at baseline and at an ongoing second visit (2014-2017). At each visit, HTN was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or use of anti HTN medication. This analysis includes 7,258 adults who were free of HTN at baseline and attended the second study visit by August, 2 nd , 2017. Age adjusted, sex stratified, HTN incidence rates (IR) were calculated in person-years (PY) by Hispanic/Latino background. All analyses were weighted by nonresponse adjusted, trimmed, and calibrated sampling weights and took into account the complex survey design. Results: At baseline, age distributions were similar for men and women with: 40% age 18-34, 38% age 35-49, and 22% age 50 - 74; mean follow-up time was 5.7 years. Among 2,694 men, a total of 539 developed HTN for an overall age-adjusted IR of 25.7/1,000PY (95% CI: 22.8, 28.9). Among men, compared with Mexican background (IR: 20.5, 95% CI: 16.6, 25.2), the age adjusted IR of HTN per 1,000 PY was higher among Hispanics/Latinos of Dominican (IR: 39.2, 95% CI: 28.4, 54.0; p 〈 0.01) and Cuban (IR: 30.6, 95% CI: 25.2, 37.2; p 〈 0.01) background, but comparable among Central American (IR: 19.7, 95% CI: 14.1, 27.6; p=0.86), Puerto Rican (IR: 28.3, 95% CI: 20.5, 39.0; p=0.09), and South American (IR: 18.8, 95% CI: 11.5, 30.7; p=0.75) background. Among 4,564 women, a total of 855 developed HTN for an overall age-adjusted IR of 25.6/1,000PY (95% CI: 23.1, 28.3). Among women, compared with Mexican background (IR: 20.1, 95% CI: 17.0, 23.8), the age adjusted IR of HTN per 1,000 PY was higher among Hispanic/Latinos of Dominican (IR: 32.7, 95% CI: 24.3, 44.1; p 〈 0.01), Cuban (IR: 26.8, 95% CI: 21.3, 33.6; p 〈 0.05), and Puerto Rican (IR: 35.1, 95% CI: 27.4, 45.1; p 〈 0.01) background, and comparable among Central American (IR: 23.2, 95% CI: 18.4, 29.3; p=0.31) and South American (IR: 24.3, 95% CI: 18.5, 31.8; p=0.24) background. Conclusions: Among a large sample of US Hispanics/Latinos free of HTN, age adjusted IRs of hypertension differed substantially by Hispanic/Latino background, being highest among those of Caribbean background.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1466401-X
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  • 8
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 50, No. 4 ( 2019-04), p. 805-812
    Abstract: It is unclear whether disparities in mortality among stroke survivors exist long term. Therefore, the purpose of the current study is to describe rates of longer term mortality among stroke survivors (ie, beyond 30 days) and to determine whether socioeconomic disparities exist. Methods— This analysis included 1329 black and white participants, aged ≥45 years, enrolled between 2003 and 2007 in the REGARDS study (Reasons for Geographic and Racial Differences in Stroke) who suffered a first stroke and survived at least 30 days after the event. Long-term mortality among stroke survivors was defined in person-years as time from 30 days after a first stroke to date of death or censoring. Mortality rate ratios (MRRs) were used to compare rates of poststroke mortality by demographic and socioeconomic characteristics. Results— Among adults who survived ≥30 days poststroke, the age-adjusted rate of mortality was 82.3 per 1000 person-years (95% CI, 75.4–89.2). Long-term mortality among stroke survivors was higher in older individuals (MRR for 75+ versus 〈 65, 3.2; 95% CI, 2.6–4.1) and among men than women (MRR, 1.3; 95% CI, 1.1–1.6). It was also higher among those with less educational attainment (MRR for less than high-school versus college graduate, 1.5; 95% CI, 1.1–1.9), lower income (MRR for 〈 $20k versus 〉 50k, 1.4; 95% CI, 1.1–1.9), and lower neighborhood socioeconomic status (SES; MRR for low versus high neighborhood SES, 1.4; 95% CI, 1.1–1.7). There were no differences in age-adjusted rates of long-term poststroke mortality by race, rurality, or US region. Conclusions— Rates of long-term mortality among stroke survivors were higher among individuals with lower SES and among those residing in neighborhoods of lower SES. These results emphasize the need for improvements in long-term care poststroke, especially among individuals of lower SES.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1467823-8
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  • 9
    Online Resource
    Online Resource
    Springer Science and Business Media LLC ; 2020
    In:  Journal of Human Hypertension Vol. 34, No. 9 ( 2020-09), p. 624-632
    In: Journal of Human Hypertension, Springer Science and Business Media LLC, Vol. 34, No. 9 ( 2020-09), p. 624-632
    Type of Medium: Online Resource
    ISSN: 0950-9240 , 1476-5527
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2006792-6
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  • 10
    Online Resource
    Online Resource
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Neurology Vol. 93, No. 20 ( 2019-11-12), p. e1890-e1899
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 93, No. 20 ( 2019-11-12), p. e1890-e1899
    Abstract: Income volatility presents a growing public health threat. To our knowledge, no previous study examined the relationship among income volatility, cognitive function, and brain integrity. Methods We studied 3,287 participants aged 23–35 years in 1990 from the Coronary Artery Risk Development in Young Adults prospective cohort study. Income volatility data were created using income data collected from 1990 to 2010 and defined as SD of percent change in income and number of income drops ≥25% (categorized as 0, 1, or 2+). In 2010, cognitive tests (n = 3,287) and brain scans (n = 716) were obtained. Results After covariate adjustment, higher income volatility was associated with worse performance on processing speed (β = −1.09, 95% confidence interval [CI] −1.73 to −0.44) and executive functioning (β = 2.53, 95% CI 0.60–4.50) but not on verbal memory (β = −0.02, 95% CI −0.16 to 0.11). Similarly, additional income drops were associated with worse performance on processing speed and executive functioning. Higher income volatility and more income drops were also associated with worse microstructural integrity of total brain and total white matter. All findings were similar when restricted to those with high education, suggesting reverse causation may not explain these findings. Conclusion Income volatility over a 20-year period of formative earning years was associated with worse cognitive function and brain integrity in midlife.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    RVK:
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
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