scholarly journals TROPONIN T IDENTIFIES INDIVIDUALS AT HIGHER RISK FOR HEART FAILURE AMONG ALL BLOOD PRESSURE CATEGORIES IN THE ATHEROSCLEROSIS RISK IN COMMUNITIES (ARIC) STUDY

2014 ◽  
Vol 63 (12) ◽  
pp. A1408 ◽  
Author(s):  
Yashashwi Pokharel ◽  
Wensheng Sun ◽  
George Taffet ◽  
Salim Virani ◽  
James Lemos ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Troponin T ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Abstract MP77: Projected Impact of Shifting Population Distributions of Blood Pressure on Rates of Coronary Heart Disease, Heart Failure and Stroke: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Shakia T Hardy ◽  
Laura R Loehr ◽  
Kenneth R Butler ◽  
Patricia P Chang ◽  
Aaron R Folsom ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Population Distribution ◽  
The United States ◽  
Incidence Rates ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

Introduction: Rates of cerebrovascular disease, heart failure (HF), and coronary heart disease (CHD), increase progressively as blood pressure rises. Several authors have estimated the theoretical effects of shifting the population distribution of blood pressure; however few studies have examined the degree to which modest decrements in blood pressure affect HF incidence, or included a racially diverse population. Methods: Incident HF was identified by a first hospitalization with discharge diagnosis code of 428.X. Incident hospitalized (definite or probable) CHD and stroke were classified according to protocol. We used multivariable regression to estimate incidence rate differences (IRD) for HF, CHD, and stroke that could be associated with a two mm Hg reduction in systolic blood pressure (SBP) in 15,744 participants from the Atherosclerosis Risk in Communities Study. Results: Over a mean of 18.3 years of follow up, age-adjusted incidence rates for HF, CHD, and stroke were higher among African American than Caucasians (Table 1). After adjusting for antihypertensive use, gender, and age, a two mm Hg decrement in SBP across the total population was associated with an estimated 24/100,000 person-years (PY) and 39/100,000 PY fewer incident HF events in Caucasians and African Americans, respectively. The projected disease reductions were of smaller absolute magnitude for incident CHD and incident stroke. Extrapolation to the African American and Caucasian U.S. populations age greater than 45 years suggests that a two mmHg decrement in SBP could result in approximately 22,000 fewer incident HF events, 15,000 fewer incident CHD events, and 5,000 fewer incident stroke events annually. Conclusion: Our results suggest that modest shifts in SBP, consistent with what could theoretically be achieved through population level lifestyle interventions, could substantially decrease the incidence of HF, stroke, and CHD in the United States, especially among African American populations.

Abstract 79: Troponin T, NT-proBNP, and Incidence of Stroke: The Atherosclerosis Risk in Communities (ARIC) Study

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Aaron R Folsom ◽  
Vijay Nambi ◽  
Elizabeth J Bell ◽  
Oludamilola W Oluleye ◽  
Rebecca F Gottesman ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
General Population ◽  
Troponin T ◽  
High Sensitivity ◽  
Hazard Ratio ◽  
Cardioembolic Stroke ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

Increased levels of plasma troponins and natriuretic peptides in the general population are associated with increased future risk of cardiovascular disease, but only limited information exists on these biomarkers and stroke occurrence. In a prospective epidemiological study, the Atherosclerosis Risk in Communities (ARIC) Study, we tested the hypothesis that high-sensitivity troponin T (TnT) and N-terminal pro B-type natriuretic peptide (NT-proBNP) are associated positively with incidence of stroke. We measured plasma high-sensitivity TnT and NT-proBNP in 10,902 men or women initially free of stroke and followed them for a mean of 11.3 years for stroke occurrence (n=507). Analyses were performed using proportional hazards modeling. Both biomarkers were associated positively with total stroke, nonlacunar ischemic, and especially, cardioembolic stroke, but not with lacunar or hemorrhagic stroke. After adjustment for other stroke risk factors, the hazard ratio (95% CI) per one SD greater increment of natural log-transformed TnT was 1.23 (1.13, 1.35) for total stroke, 1.27 (1.15, 1.40) for total ischemic stroke, and 1.36 (1.14, 1.62) for cardioembolic stroke. Likewise, the hazard ratio per one SD greater natural log-transformed NT-proBNP, was 1.37 (1.26, 1.49) for total stroke, 1.39 (1.27, 1.53) for total ischemic stroke, and 1.95 (1.67, 2.28) for cardioembolic stroke. The hazard ratios for jointly high values of TnT (≥0.013 ug/L) and NT-proBNP (≥155.2 pg/mL), versus neither biomarker high, were 2.70 (1.92, 3.79) for total stroke and 6.26 (3.40, 11.5) for cardioembolic stroke, and somewhat stronger for NT-proBNP than TnT. Strikingly, approximately 58% of cardioembolic strokes occurred in the highest quintile of pre-stroke NT-proBNP (versus 3% occurring in the lowest quintile), and 32% of cardioembolic strokes occurred in participants who had both NT-proBNP in the highest quintile and were known by ARIC to have atrial fibrillation sometime before their cardioembolic stroke occurrence. In conclusion, in the general population, elevated plasma TnT and NT-proBNP concentrations are associated with increased risk of cardioembolic and other nonlacunar ischemic strokes.

scholarly journals Hemodynamic Correlates of Blood Pressure in Older Adults: The Atherosclerosis Risk in Communities (ARIC) Study

2016 ◽  
Vol 18 (12) ◽  
pp. 1222-1227 ◽  
Author(s):  
Hirofumi Tanaka ◽  
Gerardo Heiss ◽  
Elizabeth L. McCabe ◽  
Michelle L. Meyer ◽  
Amil M. Shah ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Abstract 14482: Apparent Resistant Hypertension is a Marker of Risk: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Magnus O Wijkman ◽  
Marcus Malachias ◽  
Brian Claggett ◽  
Susan Cheng ◽  
Kunihiro Matsushita ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Antihypertensive Drug ◽  
Resistant Hypertension ◽  
Composite Endpoint ◽  
Atherosclerosis Risk In Communities ◽  
Drug Classes ◽  
Atherosclerosis Risk ◽  
Aric Study

Introduction: Apparent resistant hypertension (ARH) is a common marker of risk in patients with established cardiovascular disease. We ascertained the prevalence and prognostic significance of ARH in patients without prior cardiovascular disease. Methods: This prospective observational cohort study included 9669 community-based participants without a history of heart failure, myocardial infarction, or stroke, who completed the Atherosclerosis Risk in Communities (ARIC) study visit 4 between 1996-1998. The definition of ARH was blood pressure (BP) above goal (traditional goal <140/90mmHg, more stringent goal <130/80mmHg) despite use of ≥3 antihypertensive drug classes, or any BP with ≥4 antihypertensive drug classes. Participants with controlled hypertension (CH), defined as BP at goal with use of 1-3 antihypertensive drug classes, constituted the reference group. The outcome was a composite endpoint of heart failure, myocardial infarction, stroke, or death. Cox regression models were adjusted for age, sex, race, BMI, heart rate, smoking, eGFR, LDL, HDL, triglycerides, glucose, and diabetes. Results: Applying the traditional BP goal, 154/9669 participants (1.6%) had ARH, and there were 2311 participants with CH (23.9%). Using the more stringent BP goal, 218/9669 participants (2.3%) had ARH, and 1523 participants (15.8 %) had CH. The median follow-up time was 19 years. Apparent resistant hypertension was associated with an increased risk for the composite endpoint (adjusted hazard ratio 1.58 [95% CI 1.32-1.90] with the traditional BP goal, and adjusted hazard ratio 1.51 [95% CI 1.28-1.79] with the more stringent BP goal). Conclusions: Apparent resistant hypertension had a low prevalence but was independently associated with adverse outcome during long term follow-up, compared to controlled hypertension and even compared to uncontrolled hypertension. This was observed for both traditional and more stringent BP goals.

scholarly journals HbA1c as a risk factor for heart failure in persons with diabetes: the Atherosclerosis Risk in Communities (ARIC) study

Diabetologia ◽  
2008 ◽  
Vol 51 (12) ◽  
pp. 2197-2204 ◽  
Author(s):  
A. Pazin-Filho ◽  
A. Kottgen ◽  
A. G. Bertoni ◽  
S. D. Russell ◽  
E. Selvin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Risk Factor ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Abstract WP202: Cardiac and Brain Structure and Function Associations: The Atherosclerosis Risk in Communities (ARIC) Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Michelle C Johansen ◽  
Amil Shah ◽  
Michael Griswold ◽  
Seth Lirette ◽  
Thomas H Mosley ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Diastolic Function ◽  
Brain Mri ◽  
Volume Index ◽  
Atherosclerosis Risk In Communities ◽  
Lv Mass ◽  
Atherosclerosis Risk ◽  
Aric Study ◽  
The Brain

Background: Heart failure (HF) is a disease that impacts many organs, but the effect on the brain remains poorly understood. To explore associations with subclinical disease, in the Atherosclerosis Risk in Communities (ARIC) study, we evaluated the relationship between cardiac dysfunction on echocardiography and vascular lesions on brain MRI. Methods: A cross-sectional analysis between subclinical cardiac and brain markers was performed using echo and brain MRI data from the 5 th visit of the ARIC study (n=1974), a community-based biracial cohort study. LV structure was assessed using wall thickness (mm) and mass index (g/m 2 ), while diastolic function was assessed as LA volume index (g/m2). MRI was evaluated for presence/size/location/number of infarcts and white matter hyperintensities (WMH). Demographic and vascular risk factors (including hypertension) were considered as covariates in statistical models. Results: In adjusted models, worse LV structure was significantly associated with the presence of WMH as well as infarction. WMH was 0.66 cm 3 greater (95%CI [0.11, 1.21]) for every 1 mm increase in wall thickness, and 0.65 cm 3 greater (95%CI [0.27, 1.03]) for every 10g/m 2 increase in LV mass index. Odds of infarction increased (OR 1.11, 95%CI [1.02, 1.21]), per 1 mm thicker LV wall increase as well as with larger LV mass (per 10 g/m 2 ) (OR 1.08, 95%CI [1.02, 1.14]). The rate of accumulating additional cortical infarcts was increased by 2.4% (95%CI 1.01, 1.04) per ml/m 2 increase in LA volume index, a marker of LV diastolic function. The rate of accumulation of lacunar infarcts was increased by 1.5% per ml/m2 increase in LA volume index (95% CI [1.00, 1.03]). No significant interactions were detected by race. Conclusions: Among participants in a large cohort study, subclinical changes in markers of LV structure were associated with increased odds of infarction and volume of WMH even when controlling for hypertension. Our findings could suggest that the brain represents another end-organ at risk among patients with even early stages of heart failure.

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