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Background and aims Socioeconomic status (SES) has been linked to worse cardiovascular risk factor (CRF) profiles and higher rates of cardiovascular disease (CVD), with an especially high burden of disease for low-income groups. We aimed to describe the trends in prevalence of CRFs among US adults by SES from 2002 to 2013. Methods Data from the Medical Expenditure Panel Survey was analyzed. CRFs (obesity, diabetes, hypertension, physical inactivity, smoking and hypercholesterolemia), were ascertained by ICD-9-CM and/or self-report. Results The proportion of individuals with obesity, diabetes and hypertension increased overall, with low-income groups representing a higher prevalence for each CRF. Of note, physical inactivity had the highest prevalence increase, with the “lowest-income” group observing a relative percent increase of 71.1%. Conclusions Disparities in CRF burden continue to increase, across SES groups. Strategies to potentially eliminate the persistent health disparities gap may include a shift to greater coverage for prevention, and efforts to engage in healthy lifestyle behaviors. [ABSTRACT FROM AUTHOR]

Background and aims We examined the association between the American Heart Association's Life's Simple 7 (LS7) metrics and the risk of atrial fibrillation (AF) in the Multi-Ethnic Study of Atherosclerosis (MESA), a prospective cohort study of adults free of cardiovascular disease (CVD) at baseline. Methods We analyzed data from 6506 participants. The LS7 metrics (smoking, physical activity, body mass index, diet, blood pressure, total cholesterol and blood glucose) were each categorized into ideal (assigned 2 points), intermediate (1 point) or poor (0 points). Scores were summed for a maximum of 14. A score of 0–8 was considered inadequate; 9-10, average and 11-14, optimal for cardiovascular health. Atrial fibrillation was ascertained using ICD-9 codes from hospital discharge records and Medicare claims data. Cox proportional hazard ratios (HR) and incidence rates of AF per 1000 person-years were calculated. Results During a median follow-up of 11.2 years (interquartile range: 10.6–11.7 years), 709 (11%) participants were hospitalized with a first AF episode. In the overall cohort, optimal scores at baseline were associated with a 27% lower risk for AF compared with inadequate scores (0.73 [0.59–0.91]). A similar finding was observed when the results were stratified by race/ethnicity (White, Chinese American, African American and Hispanic), though many of the associations were not statistically significant. There was no interaction by race/ethnicity ( p  = 0.15). Conclusions In the overall cohort, optimal LS7 status was associated with a lower risk of AF. These findings suggest that promoting ideal cardiovascular health may reduce the incidence and burden of AF. [ABSTRACT FROM AUTHOR]

Background and aims Given the prevalence and economic burden of diabetes mellitus (DM), we studied the impact of a favorable cardiovascular risk factor (CRF) profile on healthcare expenditures and resource utilization among individuals without cardiovascular disease (CVD), by DM status. Methods 25,317 participants were categorized into 3 mutually-exclusive strata: “Poor”, “Average” and “Optimal” CRF profiles (≥4, 2–3, 0–1 CRF, respectively). Two-part econometric models were utilized to study cost data. Results Mean age was 45 (48% male), with 54% having optimal, 39% average, and 7% poor CRF profiles. Individuals with DM were more likely to have poor CRF profile vs. those without DM (OR 7.7, 95% CI 6.4, 9.2). Individuals with DM/poor CRF profile had a mean annual expenditure of $9,006, compared to $6,461 among those with DM/optimal CRF profile ( p < 0.001). Conclusions A favorable CRF profile is associated with significantly lower healthcare expenditures and utilization in CVD-free individuals across DM status, suggesting that these individuals require aggressive individualized prescriptions targeting lifestyle modifications and therapeutic treatments. [ABSTRACT FROM AUTHOR]