Abstract
Despite improvements in cardiovascular disease (CVD) outcomes, it remains a leading cause of mortality among adult men and women, across racial and ethnic groups in the United States. There are several established biobehavioral risk factors for CVD. For example, the American Heart Association (AHA) has outlined seven risk factors that contribute to incident CVD. These risk factors include blood pressure, smoking, body mass index (BMI), physical activity, diet, total cholesterol, and fasting blood glucose (Life’s Simple Seven (LS7)). However, both the AHA and National Institutes of Health (NIH) have recently expanded focus beyond LS7 to include social determinants of health, such that the disparities in the overall burden of CVD may continue to decrease. The primary aim of this project was to identify latent subpopulations based on traditional risk factors for CVD (high blood pressure, high cholesterol, diabetes mellitus, physical activity, diet, obesity, and tobacco use) and social determinants of health (age, race and ethnicity, sex, socioeconomic factors, chronic stress, experiences of discrimination, and negative emotional states, i.e., depression and anxiety). The second aim was to assess the association between the identified subpopulations and CVD incidence based on hard criteria. Exploratory analyses evaluated the relationship between identified subpopulations and CVD incidence based on all criteria and whether identified subpopulations captured information beyond what the atherosclerotic cardiovascular disease risk estimator based on the pooled cohort equation (ASCVD PCE) predicts.