Neighborhood Environments and Cardiovascular Disease
Summary
To investigate the contributions of neighborhood environments to the distribution of cardiovascular disease (CVD) risk across different age ranges and racial/ethnic groups, using data from three ongoing cohort studies of cardiovascular disease: the Coronary Artery Disease Risk Development in Young Adults (CARDIA) Study, the Atherosclerosis Risk in Communities (ARIC) Study, and the Cardiovascular Health Study (CHS).
Description
BACKGROUND:
There is abundant evidence of persistent differences in cardiovascular disease morbidity and mortality by socioeconomic status (SES). The determinants of SES-related differences in CVD outcomes and risk factors have not been fully established. Previous work in this area has focused predominantly on individual-level SES indicators, but recently attention has shifted to the role of neighborhood or community-level variables in shaping health outcomes, independently of individual-level SES. Several epidemiologic studies have suggested that neighborhood characteristics may influence the distribution of disease risk, but the role of both neighborhood-level and individual level SES variables in shaping individual-level outcomes and risk factors has been rarely addressed in epidemiologic studies of CVD.
DESIGN NARRATIVE:
Associations of neighborhood socioenvironmental characteristics with CVD prevalence and incidence in middle-aged and elderly populations were investigated using data from the ARIC Study and CHS. Associations of neighborhood socioenvironmental characteristics with CVD risk factors and risk factor trends in young and middle-aged adults were investigated using data from the CARDIA and ARIC studies. CARDIA and ARIC data were also used to explore the contributions of neighborhood characteristics to racial differences in CVD risk factors. Census defined areas were used as proxies for neighborhoods. Participants were linked to their census-tract and block-group of residence using their home address, and neighborhood characteristics were obtained from the 1990 U.S. Census. The three data sets were analyzed separately. After exploratory and descriptive analyses, regression models were used to investigate associations of neighborhood characteristics with the outcomes before and after controlling for individual-level SES and other relevant covariates. Appropriate statistical methods (mixed effects models) were used to account for the multilevel structure of the data (individuals nested within neighborhoods and repeated measures nested within individuals), and the potential violations of the assumption of independence of observations that might arise from it.
Study Design
Observational Model: Natural History
Conditions
Cardiovascular Diseases
Status
Completed
Source
National Heart, Lung, and Blood Institute (NHLBI)
Results (where available)
Links
- Source: http://clinicaltrials.gov/show/NCT00005505
- Information obtained from ClinicalTrials.gov on July 15, 2010
Medical and Biotech [MESH] Definitions
Cardiovascular Diseases
Pathological conditions involving the CARDIOVASCULAR SYSTEM including the HEART; the BLOOD VESSELS; or the PERICARDIUM.
Diagnostic Techniques, Cardiovascular
Methods and procedures for the diagnosis of diseases or dysfunction of the cardiovascular system or its organs or demonstration of their physiological processes.
Death, Sudden, Cardiac
Unexpected rapid natural death due to cardiovascular collapse within one hour of initial symptoms. It is usually caused by the worsening of existing heart diseases. The sudden onset of symptoms, such as CHEST PAIN and CARDIAC ARRHYTHMIAS, particularly VENTRICULAR TACHYCARDIA, can lead to the loss of consciousness and cardiac arrest followed by biological death. (from Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine, 7th ed., 2005)
Cardiovascular Physiological Phenomena
Processes and properties of the CARDIOVASCULAR SYSTEM as a whole or of any of its parts.
Dental Care For Chronically Ill
Dental care for patients with chronic diseases. These diseases include chronic cardiovascular, endocrinologic, hematologic, immunologic, neoplastic, and renal diseases. The concept does not include dental care for the mentally or physically disabled which is DENTAL CARE FOR DISABLED.
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