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CALCULATING CARDIOMETABOLIC RISK: A DISEASE SIMULATION MODEL TO ESTIMATE THE LIFETIME RISK OF COMPLICATIONS OF CARDIOVASCULAR DISEASE AND DIABETES
Abstracts
the Shoppers Drug Mart/Pharmaprix website (during five non-contiguous months between June 2103 and March 2014), participants were also queried regarding their medication adherence, current lifestyle habits, and health goals. RESULTS: Among 10,120 individuals treated for dyslipidemia, the average age was 63 years, 55% were female, 58% were overweight (body mass index> 27), 25% were sedentary (weekly METS<720), 64% were taking medication for hypertension, 12% smoked, 24% had diagnosed diabetes, and 27% had diagnosed cardiovascular disease (CVD). Optimal (100%) adherence with daily lipid medication during the previous month was reported by 7,261 (72%), while 2,502 (25%) had missed taking medication on at least one day, and 357 (3%) had discontinued their medication. The most common reasons for not taking their lipid medications were: forgetting (70%), not having medication available (19%), feeling OK (14%), and perceived side effects (13%). Using multiple logistic regression analysis, we identified independent factors significantly associated (p <0.05) with missing or discontinuing medication including: younger age, female, overweight, sedentary, smoking, not taking anti-hypertensive medication, and lower satisfaction with the quality of their sleep. When asked to identify their current action plan to reduce their cardiovascular risk, the most frequently mentioned goals were increasing physical activity (72%) and losing weight (71%) while the least frequent were speaking with their physician (20%) or pharmacist (4%). CONCLUSION: Self-reported non-adherence with lipid medication and lifestyle risk factors for CVD are common among Canadian adults. Healthy lifestyle habits including not smoking, exercising regularly, and maintaining a healthy body weight were associated with better medication adherence. Accordingly, engaging patients to adopt and maintain these healthy lifestyle habits could prove highly effective in managing blood lipid levels and other modifiable CVD risk factors.
S303
Heart Study, and the ARIC Study. After validating the model projections, we estimated the YLL that would be associated with an increased body mass index (BMI) of 25 to <30 (overweight), 30 to <35 (obese) or >35 (very obese) compared to an ideal BMI of 18.5 to <25. CMage was calculated as an individual’s chronologic age + YLL due to their BMI and associated risk factors for diabetes and CVD. SUBJECTS: Data from the National Nutrition and Examination Survey (2003-2010) provided the cardio-metabolic risk factors representative of individuals 20-30, 40-59, and 60-70 years of age. RESULTS: During validation exercises, the model estimates of life expectancy closely matched the results reported in National Life Tables for adult Americans; and years of life lost to obesity as reported by the Framingham Heart Study investigators. Using NHANES data, excess body weight was positively associated with elevated risk factors for cardiovascular disease and diabetes including: blood pressure, the total cholesterol/HDL cholesterol ratio, fasting blood glucose, and a family history of diabetes. The YLL associated with excess weight ranged from. 0.7-20.8 years for men and 3.3-18.1 years for women. Older individuals with excess body weight were estimated to lose fewer years than younger individuals. Smokers lost fewer years compared to non-smokers. The calculated CMage of these individuals would increase accordingly so that a 50 year old very obese man whose YLL ¼ 11.9 years would have a CMage of 61.9 years while a 60 year old overweight woman whose YLL ¼ 3.3 years would have a CMage of 63.3 years. CONCLUSION: Calculating CMage captures the clinical impact of excess body weight associated with the increased risk of developing complications from CVD and diabetes. This may provide a useful metric for clinical practice.
480 CALCULATING CARDIOMETABOLIC RISK: A DISEASE SIMULATION MODEL TO ESTIMATE THE LIFETIME RISK OF COMPLICATIONS OF CARDIOVASCULAR DISEASE AND DIABETES S Grover, L Joseph, M Kaouache, P Remple, I Lowensteyn Montréal, Québec BACKGROUND:
Excess body weight increases the risk of cardiovascular disease (CVD) and diabetes but effectively communicating this information to health professionals and patients remains challenging. We hypothesized that calculating one’s “CardioMetabolic Age (CMage)” to capture the healthy years of life lost (YLL) free of cardiovascular disease or diabetes could prove useful. OBJECTIVE: To estimate the YLL and increased CMage associated with excess body weight. STUDY DESIGN: A disease simulation model was built to estimate the annual risk of developing diabetes, CVD, and the associated complications. The annual risks of developing specific CVD and diabetes outcomes were derived from data provided by the LRC Follow-Up Cohort, the Framingham
CIHR
the Shoppers Drug Mart/Pharmaprix website (during five non-contiguous months between June 2103 and March 2014), participants were also queried regarding their medication adherence, current lifestyle habits, and health goals. RESULTS: Among 10,120 individuals treated for dyslipidemia, the average age was 63 years, 55% were female, 58% were overweight (body mass index> 27), 25% were sedentary (weekly METS<720), 64% were taking medication for hypertension, 12% smoked, 24% had diagnosed diabetes, and 27% had diagnosed cardiovascular disease (CVD). Optimal (100%) adherence with daily lipid medication during the previous month was reported by 7,261 (72%), while 2,502 (25%) had missed taking medication on at least one day, and 357 (3%) had discontinued their medication. The most common reasons for not taking their lipid medications were: forgetting (70%), not having medication available (19%), feeling OK (14%), and perceived side effects (13%). Using multiple logistic regression analysis, we identified independent factors significantly associated (p <0.05) with missing or discontinuing medication including: younger age, female, overweight, sedentary, smoking, not taking anti-hypertensive medication, and lower satisfaction with the quality of their sleep. When asked to identify their current action plan to reduce their cardiovascular risk, the most frequently mentioned goals were increasing physical activity (72%) and losing weight (71%) while the least frequent were speaking with their physician (20%) or pharmacist (4%). CONCLUSION: Self-reported non-adherence with lipid medication and lifestyle risk factors for CVD are common among Canadian adults. Healthy lifestyle habits including not smoking, exercising regularly, and maintaining a healthy body weight were associated with better medication adherence. Accordingly, engaging patients to adopt and maintain these healthy lifestyle habits could prove highly effective in managing blood lipid levels and other modifiable CVD risk factors.
S303
Heart Study, and the ARIC Study. After validating the model projections, we estimated the YLL that would be associated with an increased body mass index (BMI) of 25 to <30 (overweight), 30 to <35 (obese) or >35 (very obese) compared to an ideal BMI of 18.5 to <25. CMage was calculated as an individual’s chronologic age + YLL due to their BMI and associated risk factors for diabetes and CVD. SUBJECTS: Data from the National Nutrition and Examination Survey (2003-2010) provided the cardio-metabolic risk factors representative of individuals 20-30, 40-59, and 60-70 years of age. RESULTS: During validation exercises, the model estimates of life expectancy closely matched the results reported in National Life Tables for adult Americans; and years of life lost to obesity as reported by the Framingham Heart Study investigators. Using NHANES data, excess body weight was positively associated with elevated risk factors for cardiovascular disease and diabetes including: blood pressure, the total cholesterol/HDL cholesterol ratio, fasting blood glucose, and a family history of diabetes. The YLL associated with excess weight ranged from. 0.7-20.8 years for men and 3.3-18.1 years for women. Older individuals with excess body weight were estimated to lose fewer years than younger individuals. Smokers lost fewer years compared to non-smokers. The calculated CMage of these individuals would increase accordingly so that a 50 year old very obese man whose YLL ¼ 11.9 years would have a CMage of 61.9 years while a 60 year old overweight woman whose YLL ¼ 3.3 years would have a CMage of 63.3 years. CONCLUSION: Calculating CMage captures the clinical impact of excess body weight associated with the increased risk of developing complications from CVD and diabetes. This may provide a useful metric for clinical practice.
480 CALCULATING CARDIOMETABOLIC RISK: A DISEASE SIMULATION MODEL TO ESTIMATE THE LIFETIME RISK OF COMPLICATIONS OF CARDIOVASCULAR DISEASE AND DIABETES S Grover, L Joseph, M Kaouache, P Remple, I Lowensteyn Montréal, Québec BACKGROUND:
Excess body weight increases the risk of cardiovascular disease (CVD) and diabetes but effectively communicating this information to health professionals and patients remains challenging. We hypothesized that calculating one’s “CardioMetabolic Age (CMage)” to capture the healthy years of life lost (YLL) free of cardiovascular disease or diabetes could prove useful. OBJECTIVE: To estimate the YLL and increased CMage associated with excess body weight. STUDY DESIGN: A disease simulation model was built to estimate the annual risk of developing diabetes, CVD, and the associated complications. The annual risks of developing specific CVD and diabetes outcomes were derived from data provided by the LRC Follow-Up Cohort, the Framingham
CIHR