Abstract P073: Cardiometabolic Conditions And Their Risk Factors Among Adults In Puerto Rico Before And After Hurricane María, 2015-2019
Authors: Josiemer Mattei, Martha Tamez, June O'Neill, Sebastien Haneuse, Sigrid Mendoza, Jonathan Orozco, Carlos Rios-Bedoya, Luis Falcon, Katherine L Tucker, Jose F Rodriguez-Orengo
Journal: Circulation (2021)

Adults living in Puerto Rico (PR) have high prevalence of multiple cardiometabolic conditions and their risk factors. It remains unknown if the destructive events of Hurricane María in 2017 influenced disease burden. We aimed to contrast estimated prevalence of chronic diseases and lifestyle and psychosocial risk factors among adults living in PR before and after the Hurricane. Data from adults aged 30-75y was obtained from PRADLAD, a pilot cross-sectional study of 380 adults conducted in 2015, and from PROSPECT, a longitudinal study that started in 2019 and had 534 participants recruited by March 2020. A subset of 87 PRADLAD participants returned to PROSPECT. Data collection protocols were similar between studies and included validated questions on sociodemographic factors, lifestyle behaviors, psychosocial factors, self-reported medically-diagnosed diseases, and measured anthropometrics. We estimated crude and age-standardized characteristics contrasting the two study populations at different time points (PRADLAD 2015 vs. PROSPECT 2019). Analysis was also conducted solely for the 87 returning participants. Sociodemographic characteristics were similar between studies. Contrasting all participants from both studies showed significantly (p&lt;0.05) higher crude abdominal obesity (73.2 vs. 61.3%), sedentarism (44.4 vs. 35.8%), binge drinking (17.9 vs. 12.1%), and social support (26.9 vs. 24.7 mean score) in 2019 vs. 2015, but lower depressive symptoms (31.7 vs. 52.6%) and perceived stress (19.3 vs. 21.7 mean score). In 2019 (vs. 2015), there was significantly higher crude self-reported hypertension (47.3 vs. 39.2%), arthritis (32.3 vs. 25.6%), high cholesterol (36.4 vs. 23.8%), pre-diabetes (20.3 vs. 15.2%), high triglycerides (23.1 vs. 14.7%), eye disease (17.6 vs. 12.7%), fatty liver disease (12.8 vs. 7.5%), and osteoporosis (13.9 vs. 5.2%). Trends remained, albeit slightly attenuated, after age-standardization. Similar differences in depressive symptoms, perceived stress, social support, high cholesterol, and fatty liver disease were noted for the 87 returning participants, who also reported higher gastrointestinal disease (30.6 vs. 15.1%) and heart disease or stroke (9.5 vs. 2.3%) in 2019 vs. 2015. In conclusion, adults in PR have higher prevalence of unhealthy behaviors and chronic diseases, including multiple cardiometabolic conditions, after Hurricane María, suggesting that natural disasters may amplify cardiovascular-related disparities. Despite this, depressive symptoms and stress were lower and social support was higher post-Hurricane. Larger longitudinal studies and trend data should confirm these observations. Leveraging positive psychosocial factors may bolster population-wide behavioral and clinical preventive measures to improve cardiometabolic health and close inequities among adults in PR, who often face natural disasters.