Dr. Virginia J. Howard, professor in the department of epidemiology and co-principal investigator in the population-based longitudinal study REasons for Geographic and Racial Differences in Stroke (REGARDS), collaborated with REGARDS co-investigator Dr. Suzanne E. Judd, associate professor in the department of biostatistics, both at the University of Alabama at Birmingham, and colleagues to investigate how prevalent ideal cardiovascular health is among 5,566 employed African American and white men and women aged 45 and up showing no evidence of coronary heart disease (CHD) or stroke at enrollment in REGARDS. Ideal cardiovascular health, or iCVH, is defined by the American Heart Association (AHA) as “the absence of disease and the presence of seven key health factors and behaviors,” known as “Life’s Simple 7.” These modifiable influences include three clinical factors (blood pressure [BP], total cholesterol, and fasting glucose) and four behavioral factors (physical activity, smoking status, diet quality, and body mass index [BMI]).
[Photo: Dr. Virginia J. Howard]
When each of the represented occupational groups was compared with data from a combination of all remaining groups — after adjusting for participants’ age, race, sex, and region — older workers were found to have low occurrence of iCVH, even though the majority were non-smokers and had ideal glucose; additionally, less than half scored ideal levels of other risk factors. Those participants in managerial positions scored higher for ideal BP and BMI, and were more likely to be physically active and abstain from smoking; most workers in the fields of business and finance, however, were more likely to eat a poor diet. Healthcare practitioners and participants who worked in entertainment, the arts, sports, and media had the highest incidence of ideal BP, although those in healthcare support also ranked highest in obesity along with food preparers and servers. Sales workers and those employed in protective services, such as policemen and policewomen as well as firefighters, exhibited high instances of uncontrolled BP, as did service workers, who also were more likely to have uncontrolled glucose and cholesterol, have a lower ideal BMI, and to smoke. Transportation and material-moving workers also had high rates of uncontrolled BP and the highest prevalence of smoking. Service workers and personal care workers also had the highest rates of dyslipidemia, which is high levels of LDL and low levels of HDL cholesterol; skilled laborers specializing in installation, maintenance, and repair had not only low incidences of dyslipidemia, but also the lowest levels of ideal BMI. Participants employed in sales and low-status office work were more likely to be smokers and not engage in physical activity.
[Photo: Dr. Suzanne E. Judd]
Since study results indicate that substantial differences in CVH exist by occupation, “targeted screening and health promotion is warranted to accommodate the information, resource, and schedule needs of older workers employed in diverse occupational settings with different clinical and behavioral risk factor profiles.”
Results from “Ideal Cardiovascular Health Is Low Among U.S. Workers 45 Years and Older: Results of a National Population-based Cohort Study” were presented at the AHA’s EPI/Lifestyle meeting in March.
Journal article: http://circ.ahajournals.org/content/133/Suppl_1/AMP01.short