Abstract Body: Background: Health-related quality of life (HRQoL) measures quantify the impact of heart problems on HRQoL changes over time. Previous research has shown Black individuals are more likely to have negative HRQoL changes over time, compared to their White counterparts. However, little research has clarified how sex differences within Black populations, and perceived heart problems play a role in HRQoL changes using the minimal clinically important difference (MCID).
Hypothesis: Black women reporting perceived heart problems will have a higher odds of clinically meaningful HRQoL decline over a 15-year period, compared to Black men with perceived heart problems.
Methods: We used data from the longitudinal, multicentered study of 853 Black participants attending the years 15, 20, 25, and 30 Coronary Artery Risk Development in Young Adults Study (CARDIA) examinations. Perceived heart problems were self-reported; HRQoL was measured through the 12-Item Short Form Survey consisting of mental (MCS) and physical (PCS) component surveys. For the MCID, we used 0.5 standard deviation of the change score between Year 15 and 30, and then created a binary clinically meaningful decline variable. Mixed effects logistic regression models assessed the impact of race and perceived heart problems on HRQoL changes.
Results: At year 30, 66% of women and 34% of men had a clinically meaningful decline in MCS. In PCS, 64% of women and 36% of men had a meaningful decline at year 30. After adjusting for heart problems and sociodemographic factors, Black men have a higher odds of a clinically meaningful decline between years 20 and 25 compared to years 15 and 20 (OR: 1.81, 95% CI: 1.10, 2.99), but this significance was not found in women (OR: 1.00, 95% CI: 0.68, 1.46). We found no significance after adjustment for either men or women in PCS model.
Discussion: Previous studies found Black women report lower HRQoL compared to Black men, but few adjust for the impact of heart problems, which are known to impact Black men more frequently. Finding perceived heart problems impact HRQoL changes overtime in Black men, could signify greater issues including lack of care for their heart conditions, and other psychosocial factors. More research may be necessary to understand this association.