From screen time and alcohol choices to vaccination and blood pressure trends, new research being presented at ACC.26 highlights how everyday behaviors and preventive care can significantly shape cardiovascular risk – especially for younger adults and women. The studies point to emerging risk factors, stark disparities and practical steps that could help reduce heart disease, dementia and premature death.

More Screen Time, More CV Risk: Young adults who reported spending six or more hours a day on screens outside of school or work had higher levels of systolic blood pressure (+18 mm Hg), LDL-C (+28 mg/dL) and BMI than those with more limited screen time – suggesting screen time as an emerging risk factor for cardiovascular disease. The finding was independent of physical activity and remained after adjusting for age, sex and baseline clinical characteristics. Additionally, high screen time plus low physical activity had an even greater adverse impact. Based on questionnaires completed by 382 adults about 35 years old living in Pakistan, researchers found higher screen time was also associated with a higher rate of smoking and vaping.

Alcohol and CV Risk: A study of some 340,000 British adults found that high alcohol intake increased the risk of death from any cause and cardiovascular disease, by 24% and 14%, compared to never or occasional drinkers. But, at low and moderate levels of intake, differences in risk emerged by type of alcohol, with a 9% higher risk of cardiovascular death with spirits, beer and cider while the same level of wine consumption was associated with a 21% lower risk of death. Researchers said the study provides a more comprehensive and nuanced picture of the health impacts of alcohol intake.

Shingles Vaccine Reduces Cardiac Events: Adults over age 50 with ASCVD who had a shingles vaccine, vs. no vaccine, were 46% less likely to suffer any major adverse cardiac event and 66% less likely to die from any cause. Their risk of a heart attack was 32% lower and risk of a stroke or heart failure was 25% lower. Noting the study of 246,822 U.S. adults focused on the first year after vaccination, researchers said the lifetime impacts may differ, with a previous study suggesting cardioprotective effects may last up to eight years.

Sharp Rise in HBP-Related Deaths in Women: Cardiovascular disease related to high blood pressure accounted for a growing proportion of deaths among women age 25-44 years, rising from 1.1 to 4.8 per 100,000 deaths among women in this age group between 1999 and 2023. More than 29,000 women died from hypertensive cardiovascular disease-related death during the study period. The study also revealed striking differences based on factors like race and geography. Non-Hispanic Black women had the highest hypertension-related mortality rate over the study period at 8.6 per 100,000, compared to 2.3 per 100,000 in non-Hispanic White Americans. Across U.S. regions, women in the South had the highest hypertension-related mortality rate. No differences were found among women living in urban vs. rural areas.

Vascular Aging and Dementia: Measures of vascular health derived from routine blood pressure readings may help identify adults at increased risk for dementia. Two analyses from SPRINT showed that pulse pressure-heart rate index independently predicted risk of dementia among adults >50 years, with each unit increase associated with a 76% higher risk, and that persistently elevated or rapidly increasing estimated pulse wave velocity was associated with a greater likelihood of developing dementia.

Exercise Timing and Cardiometabolic Disease: People who regularly exercised early in the morning were significantly less likely to have coronary artery disease, high blood pressure, type 2 diabetes or obesity compared with people who exercised later in the day. The research is based on health records and Fitbit-derived heart rate data from over 14,000 people. Although it is unclear whether the relationship between exercise timing and cardiometabolic health is causal or mediated by other factors, researchers said the findings could inform approaches for counseling patients on physical activity based on a more granular look at exercise behaviors than has been possible before.

Transportation Noise and CV Health: Living in areas with consistently higher levels of noise from transportation was associated with a significantly higher risk of major adverse cardiac events compared with living in quieter areas. Based on health data from more than 1.2 million adults living in Houston, TX, those in areas with loud transportation noise were 17% more likely than those living in quiet areas to die from any cause, suffer a heart attack or stroke, or require coronary revascularization. Examined by source, loud road noise was associated with a 17% higher risk, a combination of loud road and aviation noise was associated with a 16% higher risk and loud rail noise was associated with a 10% higher risk. Researchers suggest that implementing strategies to reduce exposure to traffic noise from roads, railways and aviation corridors may be a new target for urban planning and improving the cardiovascular health of communities.

When Temperatures Drop, CV Deaths Rise: Months with lower temperatures see significantly greater rates of death from heart attacks, strokes and coronary artery disease than milder months. Researchers analyzed monthly temperatures and total cardiovascular deaths in 819 U.S. locations that collectively include about 80% of the U.S. population over 25 years of age. During the period from 2000-2020, they found that the temperature associated with the lowest rate of cardiovascular death was 23°C (about 74°F), and rates gradually increased as temperatures deviated both below and above that level. Hotter temperatures were also associated with increases in cardiovascular deaths, but at a more modest rate.

Clinical Topics: Cardiovascular Care Team, Diabetes and Cardiometabolic Disease, Prevention, Exercise, Sleep Apnea

Keywords: ACC Annual Scientific Session, ACC26, Screen Time, Blood Pressure, Dementia, Exercise, Alcohol Drinking, Herpes Zoster, Environmental Indicators