Abstract
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.
