{"doi":"10.1016/j.atherosclerosis.2022.01.006","title":"Sociodemographic determinants of change in cardiovascular health in middle adulthood in a bi-racial cohort","abstract":"BACKGROUND AND AIMS: Cardiovascular health (CVH), as many other aspects of health, is socially patterned. However, little is known about the socioeconomic determinants of following a more or less favourable pattern of CVH change at midlife. METHODS: We used data on 11,049 participants in the Atherosclerosis Risk in Communities (ARIC) study, a prospective, population-based, bi-racial cohort that included participants aged 44-66 years in 1987-1989, who attended a second visit 6 years later. At both visits, CVH was assessed with the American Heart Association's Life's Simple 7 (LS7) score ranging 0-14, based on 7 metrics: cholesterol, blood glucose, blood pressure, smoking, body mass index, physical activity, and diet. An LS7 score ≥8 was considered ideal, <8 was considered poor. Multivariable logistic regression models were used. In a first sample (N = 4416) of participants who started with a poor CVH, we modelled odds of improvement (Poor-Ideal vs. Poor-Poor). In a second sample (N = 6633) with baseline ideal CVH, we modelled odds of deterioration (Ideal-Poor vs. Ideal-Ideal). The determinants considered were baseline age, sex, race, educational level, income and working status. RESULTS: = 1.41; 95% CI:1.17, 1.69), whereas Black race (vs White, OR = 0.68; 0.57, 0.80), low education (vs high, OR = 0.65; 0.53, 0.79) and low income (vs high, OR = 0.71; 0.57, 0.87)) were associated with lower odds of improvement. Compared to ideal-ideal CVH, Black participants (OR = 1.59; 1.33, 1.89), with low education (OR = 1.98; 1.64, 2.39), low income (OR = 1.57; 1.30, 1.88), and non-working (vs currently working, OR = 1.27; 1.06, 1.51) had greater odds of deterioration to poor CVH. CONCLUSIONS: We identified vulnerable groups at higher risk of worsening their CVH over time: Black people, with low income, low education, and who are unemployed. Efforts to reduce income and educational gaps and address structural racism, which shapes the distribution of health-promoting and health-harming resources, are paramount to reduce inequities in CVH.","journal":"Atherosclerosis","year":2022,"id":254052,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":21,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.6021,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":411566,"name":"Crystal W. Cené","orcid":"0000-0001-8512-9441","position":1,"is_corresponding":false},{"id":900581,"name":"Anouk Asselin","orcid":"0000-0002-8235-5475","position":2,"is_corresponding":false},{"id":251225,"name":"Mario Sims","orcid":"0000-0002-2554-8932","position":3,"is_corresponding":false},{"id":33934,"name":"Xavier Jouven","orcid":null,"position":4,"is_corresponding":false},{"id":900582,"name":"Bamba Gaye","orcid":"0000-0002-5516-4665","position":5,"is_corresponding":false},{"id":330878,"name":"Camille Lassale","orcid":"0000-0002-9340-2708","position":0,"is_corresponding":true}],"reference_count":43,"raw_metadata":null,"created_at":"2026-07-19T00:25:03.918844Z","pmid":"35115158","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}