Disparities in the Prevalence of Excess Heart Age Among Women with a Recent Live Birth

J Womens Health (Larchmt). 2020 May;29(5):703-712. doi: 10.1089/jwh.2018.7564. Epub 2019 Aug 8.

Abstract

Background: Understanding and addressing cardiovascular disease (CVD) risk has implications for maternal and child health outcomes. Heart age, the modeled age of an individual's cardiovascular system based on risk level, and excess heart age, the difference between a person's heart age and chronological age, are alternative simplified ways to communicate CVD risk. Among women with a recent live birth, we predicted heart age, calculated prevalence of excess heart age (≥5 years), and examined factors associated with excess heart age. Materials and Methods: Data were analyzed in 2017 from 2009 to 2014 Pregnancy Risk Assessment Monitoring System (PRAMS). To calculate heart age we used maternal age, prepregnancy body mass index, systolic blood pressure, smoking status, and diabetic status. Weighted prevalence and prevalence ratios compared the likelihood of excess heart age across racial/ethnic groups by selected factors. Results: Prevalence of excess heart age was higher in non-Hispanic black women (11.8%) than non-Hispanic white women (7.3%, prevalence ratio [PR], 95% confidence interval [CI]: 1.62, 1.49-1.76) and Hispanic women (4.9%, PR, 95% CI: 2.39, 2.10-2.72). Prevalence of excess heart age was highest among women who were without health insurance, obese or overweight, engaged in physical activity less than thrice per week, or were smokers in the prepregnancy period. Among women with less than high school education, non-Hispanic black women had a higher prevalence of excess heart age than Hispanic women (PR, 95% CI: 4.01, 3.15-5.10). Conclusions: Excess heart age may be an important tool for decreasing disparities and encouraging CVD risk reduction among certain groups of women.

Keywords: cardiovascular health; heart age; maternal and child health; reproductive health.

MeSH terms

  • Adult
  • Black People / statistics & numerical data*
  • Cardiovascular Diseases / epidemiology*
  • Female
  • Health Behavior
  • Health Status Disparities*
  • Heart / physiopathology*
  • Hispanic or Latino / statistics & numerical data*
  • Humans
  • Live Birth
  • Population Surveillance
  • Prevalence
  • Risk Assessment
  • Socioeconomic Factors
  • Surveys and Questionnaires
  • United States
  • White People / statistics & numerical data*
  • Young Adult