Abstract P228: Social Networks And Cardiovascular Disease Events Among Men And Women From The Jackson Heart Study

Abstract

Background: Cardiovascular disease (CVD) burden disproportionately affects African-American adults in the United States. Greater social networks, or social integration, may lower CVD risk among African-American adults. Objective: To determine the association of social networks and incident coronary heart disease (CHD), stroke, and heart failure (HF) and test whether there are differences by sex. Methods: Among participants of the Jackson Heart Study without CVD at baseline (mean age: 54.4 years, n=3,053 women, n=1684 men), we used the Social Networks Index at baseline (2000-2004) to develop a continuous social networks score in standard deviation units (range 0-5) and binary categories (high vs. low relative to the median). Surveillance of CHD, stroke, and HF events occurred after exam 1 (2005 for HF) until 2016. We utilized Cox proportional hazards regression to estimate hazard ratios (HR 95% confidence interval-CI) of each CVD event by levels of social networks, adjusting for demographics, education, behaviors, risk factors and depressive symptoms. Interaction terms by sex were used to evaluate sex differences. Results: There were 262 CHD events, 213 stroke events, and 331 HF events that occurred by 2016. P-values for interaction terms by sex were statistically significant for stroke and HF ( p <0.05). After full adjustment, a 1-SD unit increase in social networks was associated with a lower hazard of CHD and HF among women (HR 0.80, 95% CI 0.72, 0.90 and HR 0.81 95% CI 0.69, 0.98, respectively). Men had a lower hazard of CHD with every 1-SD unit increase in social networks (HR 0.88, 95% CI 0.79, 0.99) after full adjustment. High vs. low social networks was associated with a lower hazard of stroke (HR 0.58, 95% CI 0.35, 0.98) and HF (HR 0.61, 95% CI 0.39, 0.94) among women after full adjustment. Conclusion: Men and women who reported greater social networks were less likely to have a CHD event, but women with greater social networks were less likely to have stroke and HF.