01835nas a2200229 4500008004100000022001400041245009100055210006900146260001700215300001200232490000700244520114300251100002101394700002001415700002301435700002201458700002001480700002001500700002501520700002401545856003601569 2020 eng d a1546-415600aBrachial Flow-mediated Dilation and Risk of Dementia: The Cardiovascular Health Study.0 aBrachial Flowmediated Dilation and Risk of Dementia The Cardiova c2020 Jul-Sep a272-2740 v343 a

INTRODUCTION: Brachial flow-mediated dilation (FMD) is a physiologic measure of endothelial function. We determined the prospective association of brachial FMD with incident dementia among older adults.

METHODS: We included 2777 Cardiovascular Health Study participants who underwent brachial FMD measurement. Incident dementia was ascertained by medication use, International Classification of Diseases-9 codes, requirement for a proxy, and death certificates and calibrated to gold-standard assessments performed in a subset of the cohort.

RESULTS: Mean participant age at time of brachial FMD measurement was 77.9 years. We identified 1650 incident dementia cases (median follow-up=10.5 y). After adjusting for age, race, sex, education, clinic site, and baseline arterial diameter, risk of dementia for participants in the highest quartile of percent brachial FMD did not differ from those in lowest quartile (hazard ratio=0.89, 95% confidence interval: 0.77, 1.03).

CONCLUSIONS: Brachial FMD, measured late in life, is not associated with an increased risk of incident dementia.

1 aGarg, Parveen, K1 aTan, Annabel, X1 aOdden, Michelle, C1 aGardin, Julius, M1 aLopez, Oscar, L1 aNewman, Anne, B1 aRawlings, Andreea, M1 aMukamal, Kenneth, J uhttps://chs-nhlbi.org/node/839202635nas a2200241 4500008004100000022001400041245006200055210006100117260001300178300001200191490000700203520196100210100002002171700002002191700002202211700002002233700001602253700002202269700002302291700002002314700002302334856003602357 2021 eng d a1942-008000aAssociation Between Myocardial Strain and Frailty in CHS.0 aAssociation Between Myocardial Strain and Frailty in CHS c2021 May ae0121160 v143 a

BACKGROUND: Myocardial strain, measured by speckle-tracking echocardiography, is a novel measure of subclinical cardiovascular disease and may reflect myocardial aging. We evaluated the association between myocardial strain and frailty-a clinical syndrome of lack of physiological reserve.

METHODS: Frailty was defined in participants of the CHS (Cardiovascular Health Study) as having ≥3 of the following clinical criteria: weakness, slowness, weight loss, exhaustion, and inactivity. Using speckle-tracking echocardiography data, we examined the cross-sectional (n=3206) and longitudinal (n=1431) associations with frailty among participants who had at least 1 measure of myocardial strain, left ventricular longitudinal strain (LVLS), left ventricular early diastolic strain rate and left atrial reservoir strain, and no history of cardiovascular disease or heart failure at the time of echocardiography.

RESULTS: In cross-sectional analyses, lower (worse) LVLS was associated with prevalent frailty; this association was robust to adjustment for left ventricular ejection fraction (adjusted odds ratio, 1.32 [95% CI, 1.07-1.61] per 1-SD lower strain; =0.007) and left ventricular stroke volume (adjusted OR, 1.32 [95% CI, 1.08-1.61] per 1-SD lower strain; =0.007). In longitudinal analyses, adjusted associations of LVLS and left ventricular early diastolic strain with incident frailty were 1.35 ([95% CI, 0.96-1.89] =0.086) and 1.58 ([95% CI, 1.11-2.27] =0.013, respectively). Participants who were frail and had the worst LVLS had a 2.2-fold increased risk of death (hazard ratio, 2.20 [95% CI, 1.81-2.66]; <0.0001).

CONCLUSIONS: In community-dwelling older adults without prevalent cardiovascular disease, worse LVLS by speckle-tracking echocardiography, reflective of subclinical myocardial dysfunction, was associated with frailty. Frailty and LVLS have an additive effect on mortality risk.

1 aTan, Annabel, X1 aShah, Sanjiv, J1 aSanders, Jason, L1 aPsaty, Bruce, M1 aWu, Chenkai1 aGardin, Julius, M1 aPeralta, Carmen, A1 aNewman, Anne, B1 aOdden, Michelle, C uhttps://chs-nhlbi.org/node/879002505nas a2200229 4500008004100000022001400041245009300055210006900148260001600217520179200233100002502025700001802050700002002068700002102088700002002109700002202129700002202151700002202173700002102195700002302216856003602239 2025 eng d a1470-273800aAssociation between spatial social polarisation and high blood pressure in older adults.0 aAssociation between spatial social polarisation and high blood p c2025 Mar 243 a

BACKGROUND: Using data from the Cardiovascular Health Study (CHS) and the REasons for Geographic And Racial Differences in Stroke (REGARDS) study, we investigate the association between socioeconomic polarisation and blood pressure outcomes in black and white adults. We also validate previous findings that joint racial/ethnic and income measures of spatial social polarisation (SSP) outperform single domain measures.

METHODS: We conducted a cross-sectional analysis using a retrospective cohort combining CHS (recruited 1989-1990 and 1992-1993) and REGARDS (recruited 2003-2007). The study included 5888 CHS participants aged ≥65 years and 30 183 REGARDS participants aged ≥45 years. SSP was measured using the Index of Concentration at the Extremes for education, race/ethnicity, income, home ownership, and joint race/ethnicity and income at ZIP code, census tract and county levels. The SSP measures were modelled against the presence of high blood pressure and systolic blood pressure.

RESULTS: The sample had a mean age of 66 (SD: 9), was majority female (56%), white/other (63%), and at least high school graduates (85%). A total of 26% had high blood pressure, with a mean systolic blood pressure of 129 mm Hg (SD: 18). Census tract-level models showed low-income black areas had 25% (95% CI 11%-40%) higher odds of high blood pressure and 1.8 mm Hg (95% CI 1.0-2.5) higher mean systolic blood pressure than high-income White areas.

CONCLUSION: Greater SSP is associated with a higher risk of high blood pressure and higher systolic blood pressure. Further investigating and reducing polarisation could help mitigate cardiovascular health disparities, improving outcomes for socioeconomically deprived communities.

1 aMagid, Hoda, S Abdel1 aJaros, Samuel1 aLovasi, Gina, S1 aRosso, Andrea, L1 aTan, Annabel, X1 aRehkopf, David, H1 aNelson, Lorene, M1 aCarlson, Michelle1 aJudd, Suzanne, E1 aOdden, Michelle, C uhttps://chs-nhlbi.org/node/9904