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Abstract: TH-PO714

Geographic Variations in Congestive Heart Failure and Ischemic Heart Disease in Dialysis Patients and Associations with Neighborhood Walkability

Session Information

Category: Hypertension and CVD

  • 1401 Hypertension and CVD: Epidemiology, Risk Factors, and Prevention

Authors

  • Reviriego-Mendoza, Marta, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Rondeau, Diane M., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Han, Hao, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Ash, Brian Scott, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Lindsay, Janice D., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Chaudhuri, Sheetal, Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Larkin, John W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Usvyat, Len A., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Hymes, Jeffrey L., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Kossmann, Robert J., Fresenius Medical Care North America, Waltham, Massachusetts, United States
  • Maddux, Franklin W., Fresenius Medical Care North America, Waltham, Massachusetts, United States
Background

Higher neighborhood walkability associates with better cardiovascular health in the general population (Gaglioti et al., 2018) and positively associates to objective physical activity levels in hemodialysis (HD) patients (Han M et al. 2018). We assessed if neighborhood walkability is related with the prevalence of congestive heart failure (CHF) and ischemic heart disease (IHD) in HD patients throughout the United States (US).

Methods

We used data from HD patients treated at a large dialysis organization in 2018. We calculated the average percent of HD patients with CHF and IHD per state within the US. We obtained data on the Walk Score (www.walkscore.com) in the US. The Walk Score measures neighborhood walkability on a scale of 0 (poorest walkability) to 100 (greatest walkability) based on access to key destinations (e.g. grocery stores, restaurants, retail stores). We calculated the correlation coefficients between the average walkability score for each state versus CHF and IHD prevalence.

Results

Data from 254,322 HD patients was analyzed on a state level in the US. Overall, we found small positive relationships between higher Walk Score and a higher CHF (correlation coefficient (R)=0.12) and higher IHD (R=0.16) prevalence in the US. However, this was not a consistent finding in many geographies and individual states. There appears to be distinct dichotomy between Western States and Eastern States, as well as less significant differences between the Northeast and the Southeast regions of the US (Figure 1).

Conclusion

Findings suggest HD patients tend to have a higher prevalence of CHF and IHD in areas with higher walkability. Despite this, this observation is not universally observed at state level, and county level analysis is needed. Further analyses are needed to understand the relationships between walkability and heart diseases.

Funding

  • Commercial Support