Abstract P439: Risk Factor Profile and Prevalence of Subclinical Disease in African Americans with Diabetes and Metabolic Syndrome: The Jackson Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Kamel A Gharaibeh ◽  
Vanessa Xanthakis ◽  
Jung Hye Sung ◽  
Tandaw S Samdarshi ◽  
Herman A Taylor ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
African Americans ◽  
Left Ventricular ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Metabolic Derangement ◽  
Risk Factor Profile ◽  
Subclinical Disease ◽  
Heart Study

Background . Metabolic derangements such as diabetes (DM) and metabolic syndrome (MetS) are common in African Americans (AA) and contribute to the higher cardiovascular disease (CVD) mortality in this group. A greater prevalence of subclinical disease (ScD) among those with DM and MetS in the AA community may be an explanatory factor. Objective . We assessed the CVD risk factor profile and distribution of ScD among AA with DM and MetS in the Jackson Heart Study (JHS). Methods . We evaluated 4,365 AA participants [mean age (SD) of 53.8 (12.3) years, 64.5% women] free of overt CVD who attended JHS Exam 1 (between 2000- 2004), when ScD assessment was routinely performed(with the exception of CT for coronary calcium that occurred in Exam2). SCD measures included 1) peripheral artery disease (PAD, defined as ankle-brachial index<0.9), 2) high coronary artery calcium (CAC, defined as score>100), 3) left ventricular (LV) hypertrophy (LVH defined as left ventricular mass index>51 g/m 2.7 , 4) low LV ejection fraction (low EF, defined as an EF<50%), and 5) microalbuminuria (MA, defined as an albumin-to-creatinine ratio>25 μg/mg in men and >35 μg/mg in women). We compared the distribution of standard CVD risk factors and ScD prevalence in 1) those without DM or MetS (referent), 2) those with MetS but no DM and 3) those with DM. Results . In our study sample, 1,089 (24.9%) had MetS with no DM and 752 (17.2%) had DM. Compared to the referent group, groups with metabolic derangement tended to be older, female, hypertensive, obese, and had lower HDL, higher fasting glucose, and higher triglycerides levels. Table 1 compares the distribution of ScD for the three groups, and demonstrates the greater odds of. CAC, LVH and microalbuminuria in participants with MetS or DM. Conclusion . In our large community-based sample of AAs, we observed a significantly high prevalence of ScD overall, especially so in participants with MetS and DM. These findings likely contribute to the high CVD rates in AA with MetS and DM. -->

scholarly journals Life Course Socioeconomic Position and Subclinical Disease: The Jackson Heart Study

2016 ◽  
Vol 26 (3) ◽  
pp. 355 ◽  
Author(s):  
Bradley Deere ◽  
Michael Griswold ◽  
Seth Lirette ◽  
Ervin Fox ◽  
Mario Sims
Keyword(s):  
African Americans ◽  
Health Behaviors ◽  
Socioeconomic Position ◽  
College Education ◽  
Left Ventricular ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Material Resources ◽  
Subclinical Disease ◽  
Heart Study

<p><strong>Objectives: </strong>African Americans experience higher rates of cardiovascular disease (CVD) and lower childhood and adult socioeconomic position (SEP). Research that examines the associations of multiple measures of SEP with subclinical CVD markers among African Americans is limited. </p><p><strong>Methods: </strong>Data from the Jackson Heart Study (JHS) were used to examine cross-sectional associations of childhood SEP and adult SEP with subclinical markers among 4,756 African American participants (mean age 54, 64% female), adjusting for age, health behaviors and CVD risk factors. Subclinical markers included prevalent left ventricular hypertrophy (LVH), peripheral artery disease (PAD), coronary artery calcification (CAC), and carotid intima-media thickness (CIMT). </p><p><strong>Results: </strong>The prevalence of LVH, PAD and CAC was 7%, 6% and 45%, respectively. The mean CIMT was .72 ± .17 mm. In fully-adjusted models, having a college education was inversely associated with PAD (OR, .27; 95% CI .13,.56) and CIMT (β=-29.7, P&lt;.01). Income was inversely associated with LVH after adjustment for health behaviors (OR, .49 95% CI .25,.96), though associations attenuated in the fully-adjusted model. Measures of childhood SEP (material resources and mother’s education) were not consistently associated with subclinical disease measures other than a positive association between material resources and CIMT. </p><p><strong>Conclusions: </strong>Subclinical disease markers were patterned by adult SEP measures among African Americans. <em>Ethn Dis. </em>2016;26(3);355-362; doi:10.18865/ed.26.3.355 </p>

Abstract P012: Hypertension and Alterations in Left Ventricular Geometry in African Americans: The Jackson Heart Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Marwah Abdalla ◽  
John N Booth ◽  
Keith M Diaz ◽  
Mario Sims ◽  
Paul Muntner ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
African Americans ◽  
Left Ventricular ◽  
Left Ventricular Geometry ◽  
Jackson Heart Study ◽  
Antihypertensive Medications ◽  
Geometric Patterns ◽  
Ventricular Geometry ◽  
Disease Outcomes ◽  
Heart Study

Introduction: Compared with whites, African Americans (AAs) have a higher risk for hypertension-related cardiovascular disease outcomes, which may be related to alterations in left ventricular geometry. Scarce data exist on how the left ventricle remodels in response to hypertension among AAs. Hypothesis: We hypothesized that among AAs, hypertension will be associated with abnormal echocardiographic–derived left ventricular geometric patterns defined as concentric remodeling (CR), concentric hypertrophy (CH), and eccentric hypertrophy (EH). Methods: We analyzed data from the Jackson Heart Study, a community-based AA cohort who completed a baseline exam that included clinic blood pressure (CBP) and 2D echocardiography (n=5,301). CR, CH, EH, and normal patterns were defined according to left ventricular mass index and relative wall thickness defined using standard American Society of Echocardiography recommendations. The analysis was restricted to 4,572 participants with complete CBP, information on antihypertensive medication, and echocardiographic data. Results: Mean ± SD age was 55.5 ± 12.7 years; 64% were female. Mean ± SD systolic and diastolic CBP was 127 ± 18 and 79 ± 11 mmHg, respectively; 2,785 (61%) of participants had hypertension (CBP ≥140/90 mmHg and/or taking antihypertensive medications). The prevalence of CR, CH, and EH were 10.1%, 5.2%, and 8.2%, respectively. In a multivariable-adjusted model with a normal pattern as the referent group, hypertension was associated with a greater risk of CR, CH, and EH: odds ratio 1.85 (95% confidence interval (CI) 1.43-2.38), 4.16 (95% CI 2.53-6.86), and 1.67 (95% CI: 1.26-2.23) respectively. Among hypertensive participants, older age was significantly associated with CR, CH, and EH after multivariable adjustment. Higher systolic CBP, current smoking and a higher number of classes of antihypertensive medications were additionally significantly associated with CH and EH. Male sex, and heavy and moderate alcohol consumption versus none were also significantly associated with CR. Conclusions: In conclusion, abnormal left ventricular geometry was present in almost 25% of AAs. Hypertension was associated with each abnormal geometric pattern, with approximately a four-fold greater odds for CH. Future studies should examine whether abnormal left ventricular geometric patterns, particularly CH, explains the increased risk of cardiovascular disease outcomes associated with hypertension in AAs.

scholarly journals Association of psychosocial stressors with metabolic syndrome severity among African Americans in the Jackson Heart Study

2018 ◽  
Vol 90 ◽  
pp. 141-147 ◽  
Author(s):  
Michelle I. Cardel ◽  
Yuan-I Min ◽  
Mario Sims ◽  
Solomon K. Musani ◽  
Akilah Dulin-Keita ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
African Americans ◽  
Psychosocial Stressors ◽  
Jackson Heart Study ◽  
Heart Study

Abstract MP65: Masked Hypertension is Associated with Cardiovascular Disease Events in African Americans: The Jackson Heart Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
John N Booth ◽  
Keith M Diaz ◽  
Samantha Seals ◽  
Mario Sims ◽  
Joseph Ravenell ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
African Americans ◽  
Blood Pressure Monitoring ◽  
Masked Hypertension ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Nocturnal Hypertension ◽  
Heart Study ◽  
All Cause Mortality

Introduction: Masked hypertension has been associated with increased cardiovascular disease (CVD) risk in Europeans and Asians. Hypothesis: Determine the association of masked hypertension with CVD events and all-cause mortality in African Americans (AA). Methods: The Jackson Heart Study, an exclusively AA population-based, prospective cohort study, was restricted to participants with clinic systolic/diastolic blood pressure (SBP/DBP) < 140/90 mmHg and valid ambulatory blood pressure monitoring (ABPM) at the baseline exam in 2000-2004 (n=738). Masked daytime hypertension was defined as mean ambulatory daytime (10am-8pm) SBP ≥ 135 mmHg or DBP ≥ 85 mmHg. Masked nocturnal hypertension was defined as mean ambulatory nighttime (12am-6am) SBP ≥ 120 mmHg or DBP ≥ 70 mmHg. Using all ABPM measurements, masked 24-hour hypertension was defined as mean SBP ≥ 130 mmHg or DBP ≥ 80 mmHg. CVD events (nonfatal/fatal stroke, nonfatal myocardial infarction or fatal coronary heart disease) and all-cause mortality were identified and adjudicated through December 31, 2011. Results: Any masked hypertension (masked daytime, nocturnal or 24-hour hypertension) was present in 52.2% of participants; 28.2% had masked daytime hypertension, 48.2% had masked nocturnal hypertension and 31.7% had masked 24-hour hypertension. There were 51 CVD events and 44 deaths over a median follow up of 8.2 and 8.5 years, respectively. The CVD rate (95% CI) per 1,000 person years in participants with and without any masked hypertension were 13.5 (9.9-18.4) and 3.9 (2.2-7.1), respectively (Table). The multivariable adjusted hazard ratio (95% CI) between any masked hypertension and CVD was 2.49 (1.26-4.93). CVD rates for those with and without masked daytime, nocturnal and 24-hour hypertension, and the hazard ratios for CVD associated with masked daytime, nocturnal and 24-hour hypertension, were similar. Masked hypertension was not associated with all-cause mortality. Conclusion: Masked hypertension is common and associated with increased CVD risk in AAs.

Abstract P345: Prediction of Cardiovascular Disease Events and Death using Multiple Biomarkers in African Americans: the Jackson Heart Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Solomon K Musani ◽  
Ramachandran Vasan ◽  
Aurelian Bidulescu ◽  
Jung Lee ◽  
Gregory Wilson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African Americans ◽  
High Sensitivity ◽  
Serum Cortisol ◽  
Jackson Heart Study ◽  
Cvd Risk ◽  
Risk Reclassification ◽  
Heart Study ◽  
Traditional Risk Factors

Background: The usefulness of biomarkers from different biologic pathways for predicting cardiovascular disease (CVD) events among African Americans is not well understood. Methods: We evaluated prospectively 3,102 Jackson Heart Study participants (mean age 54 years; 64% women) with data on a panel of 9 biomarkers representing inflammation (high sensitivity C - reactive protein), adiposity (adiponectin, leptin), neurohormonal activation (B-type natriuretic peptide [BNP], aldosterone, and cortisol); insulin resistance (HOMA-IR); and endothelial function (endothelin and homocysteine). We used Cox proportional hazard regression to relate the biomarker panel to the incidence of CVD (stroke, coronary heart disease, angina, heart failure and intermittent claudication) adjusting for standard CVD risk factors. Results: On follow-up (median 8.2 years), 224 participants (141 women) experienced a first CVD event, and 238 (140 women) died. Circulating concentrations of aldosterone, BNP and HOMA-IR were associated with CVD (multivariable-adjusted hazard ratios [HR] and 95% confidence interval [CI] per standard deviation (SD) increase in log-biomarker) were, respectively 1.15, (95% CI 1.01-1.30, p=0.016), 1.97, (95% CI 1.22-2.41, p<0.0001), and 1.30, (95% CI 1.10-1.52, p=0.0064). Blood cortisol and homocysteine were associated with death (HR per SD increment log-biomarker, respectively, 1.17, (95% CI 1.01-1.35, p=0.042), and 1.24, (95% CI 1.10-1.40, pvalue=0.0005). Biomarkers improved risk reclassification by 0.135; 0.120 of which was gained in classification of participants that experienced CVD events and 0.015 from participants that did not. Also, biomarkers marginally increased the model c-statistic beyond traditional risk factors. Conclusions: In our community-based sample of African Americans, circulating aldosterone, BNP and HOMA-IR predicted CVD risk, whereas serum cortisol and homocysteine predicted death. However, the incremental yield of biomarkers over traditional risk factors for risk prediction was minimal.

scholarly journals Prevalence, associated factors and heritabilities of metabolic syndrome and its individual components in African Americans: the Jackson Heart Study

BMJ Open ◽  
2015 ◽  
Vol 5 (10) ◽  
pp. e008675 ◽  
Author(s):  
Rumana J Khan ◽  
Samson Y Gebreab ◽  
Mario Sims ◽  
Pia Riestra ◽  
Ruihua Xu ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
African Americans ◽  
Associated Factors ◽  
Jackson Heart Study ◽  
Heart Study

scholarly journals The contribution of stress to the social patterning of clinical and subclinical CVD risk factors in African Americans: The Jackson Heart Study

2012 ◽  
Vol 75 (9) ◽  
pp. 1697-1707 ◽  
Author(s):  
Samson Y. Gebreab ◽  
Ana V. Diez-Roux ◽  
DeMarc A. Hickson ◽  
Shawn Boykin ◽  
Mario Sims ◽  
...  
Keyword(s):  
Risk Factors ◽  
African Americans ◽  
Jackson Heart Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Heart Study ◽  
The Social ◽  
Subclinical Cvd

Abstract P024: A Multimarker Approach to Evaluate Cardiac Structure in African Americans: The Jackson Heart Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
James D Pollard ◽  
Faren White ◽  
Ramachandran S Vasan ◽  
Aurelian Bidulescu ◽  
Ervin R Fox ◽  
...  
Keyword(s):  
Logistic Regression ◽  
African Americans ◽  
Natriuretic Peptide ◽  
Multinomial Logistic Regression ◽  
Left Ventricular ◽  
Biological Pathways ◽  
Cardiac Structure ◽  
Jackson Heart Study ◽  
Positive Relation ◽  
Heart Study

Background: Cardiac structure is an independent predictor of cardiovascular outcomes including stroke, heart attack and death. Using a multimarker approach we investigated the potential association of a group of biological pathways with cardiac mass and geometry that would suggest a role in the pathophysiology of cardiac remodeling in African Americans, a high risk group. Objective: We examined the association of a panel of nine circulation biomarkers with cardiac structure in a community of African Americans. Methods and Results: The study sample included participants in the Jackson Heart Study who underwent an echocardiogram and phlebotomy for a panel of biomarkers that included pathways of inflammation (C-reactive protein, CRP); neurohormonal activation (B-type natriuretic peptide, BNP); renin-angiotensin system (aldosterone and renin modeled as a ratio ARR); endothelial (homocysteine, endothelin); adiposity (adiponectin and leptin); and insulin resistance (HOMAIR) with cardiac structure. The main outcomes were left ventricular mass (LVM) and LV geometry (normal geometry [reference] vs. concentric remodeling [CR], concentric hypertrophy [CH] or eccentric hypertrophy [EH]). We used multiple linear and multinomial logistic regression models to relate the biomarker panel to LVM and LV geometry, respectively. We selected the best multiple linear regression model for LVM using Akaike Information Content and backwards elimination in a multinomial logistic regression to evaluate biomarkers associated with LV geometry. Circulating concentrations of ARR, BNP and adiponectin were associated with LVM, multiple adjusted regression coefficients [beta] and standard error [±SE] per standard deviation (SD) increase in log-biomarker were, respectively; 0.056±0.009, p=0.0067; 0.020±0.005, p<0.0001; and -0.011±0.005, p=0.0432. In terms of LV geometry, BNP concentrations was significantly associated with EH (1.38 [1.11-1.72], p=0.0045) and CH (1.34 [1.03-1.75], p=0.0314). ARR was significantly associated with EH (1.34, 95% CI [1.04-1.73] odds ratio [OR], p=0.0434) per SD increment and HOMAIR was significantly associated with CR (1.26, 95% CI [1.05-1.52], p=0.0212) and EH (1.22, 95% CI [1.00-1.48], p=0.0290). Conclusions: In a community-based sample of African Americans there were significant and positive relation of ARR and natriuretic peptide pathway to LVM and LV geometry, a significant and positive relation of HOMAIR to LV geometry and a significant and inverse relation of adiponectin to LVM. These observations support the notion of differential influences of biological pathways on cardiac structure.

Abstract MP007: Epicardial Fat Thickness: Distribution of and Associations With Cardiovascular Risk Factors in the Framingham Heart Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Michael L Chuang ◽  
Philimon Gona ◽  
Noriko Oyama-Manabe ◽  
Carol J Salton ◽  
Udo Hoffmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Cvd Risk Factors ◽  
Odds Ratios ◽  
Cvd Risk ◽  
Epicardial Fat Thickness ◽  
Heart Study ◽  
Fat Thickness ◽  
Fat Volume

Introduction: High pericardial fat volume (fatVOL) is associated with excess cardiovascular disease (CVD), but analyses for true fat volume can be time-consuming and require specialized software. Linear epicardial fat thickness (fatTHK) can be measured quickly from cardiac magnetic resonance (MRI) images and may serve as a surrogate for fatVOL. We sought to determine the distribution and CVD risk factor correlates of high fatTHK and to compare fatTHK with fatVOL in a community-dwelling adult cohort. Methods: Participants were drawn from the Framingham Heart Study Offspring cohort (N=995, aged 65±9 years, 54% women) and underwent cardiac MRI (SSFP sequence) and multidetector CT during 2002-2005. Clinical and risk factor covariates were obtained at the preceding cycle 7 examination (1998-2001). FatVOL was determined from volumetric MDCT data. FatTHK was measured from the MRI 4-chamber view over the midlevel right ventricular free wall at end-diastole. A healthy referent subsample (N=328), free of major CVD risk factors, was used to determine sex-specific cut points for high fatTHK. Odds ratios for high (>90th percentile) fatVOL and fatTHK versus common CVD risk factors were determined. Results: FatTHK was greater in men than women and increased with age in both sexes. FatTHK correlated with fatVOL at r=0.45 (p less than 0.001) High fatTHK was >=16.0 mm in men and >=13.3 mm in women, with 20.1% prevalence in men and 18.1 % in women. In both sexes, high fatVOL was associated ( Table ) with obesity, metabolic syndrome, dysglycemia, hypertension, prevalent CVD and hypertriglyceridemia. Similar associations, with slightly lower odds ratios, were seen for fatTHK. Conclusions: Greater fatTHK is associated with an excess burden of multiple CVD risk factors. Although correlation between linear fatTHK and true fatVOL was relatively modest, both measures appear to have similar associations with common CVD risk factors. FatTHK may be advantageous in that it can be determined quickly using standard MRI sequences for ventricular function. Table. Odds Ratios for High Pericardial Fat vs. Common CVD Risk Factors fatVOL: Men fatVOL: Women fatTHK: Men fatTHK: Women Obesity, BMI >=30 kg/m2 4.34 (2.78–6.78) 3.13 (2.03–4.82) 2.52 (1.77–3.60) 2.62 (1.84–3.74) Metabolic Syndrome 3.72 (2.38–5.83) 2.60 (1.65–4.08) 2.59 (1.75–3.84) 2.21 (1.53–3.17) Dysglycemia, FPG >=100 mg/dL 2.64 (1.72–4.06) 3.05 (1.98–4.68) 1.75 (1.22–2.50) 1.56 (1.10–2.23) Hypertension, S>=140 or D>=90 mmHg 2.51 (1.66–3.78) 1.96 (1.30–2.97) 2.10 (1.48–2.98) 1.58 (1.13–2.22) Prevalent CVD 1.94 (1.17–3.21) 2.48 (1.41–4.38) 1.73 (1.17–2.55) 1.83 (1.19–2.81) Triglycerides >=150 mg/dL 1.89 (1.25–2.86) 2.21 (1.43–3.42) 1.64 (1.15–2.34) 1.98 (1.38–2.82) Low HDL: M<40, W<50 mg/dL 1.57 (1.03–2.38) 1.44 (0.91–2.28) 1.40 (0.98–1.99) 2.57 (1.80–3.67)

scholarly journals Experiences of Discrimination Are Associated With Worse Metabolic Syndrome Severity Among African Americans in the Jackson Heart Study

2020 ◽  
Author(s):  
Michelle I Cardel ◽  
Xiaofei Chi ◽  
Yuan-I Min ◽  
Mario Sims ◽  
Solomon K Musani ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Risk Factor ◽  
African Americans ◽  
Mixed Model ◽  
Perceived Discrimination ◽  
Psychosocial Risk Factor ◽  
Mixed Model Approach ◽  
Heart Study ◽  
Severity Scores ◽  
Measure Of Discrimination

Abstract Background Metabolic syndrome (MetS) is a risk factor for the development of cardiovascular disease and type 2 diabetes. Although the development of MetS is attributed to known lifestyle factors, perceived discrimination may also contribute to MetS development and severity. Purpose We examined the associations of perceived discrimination with MetS severity among African American adults at baseline and 8-year follow-up. Methods Three thousand eight hundred and seventy participants (mean age 53.8 ± 13.0; 63.1% female) without diabetes and no missing MetS severity scores at baseline were included. Each self-reported measure of discrimination at baseline (everyday, lifetime, and burden of lifetime) was classified into tertiles (low, medium, high). After adjustment for demographics and MetS risk factors, associations of discrimination were examined with a sex- and race/ethnicity-specific MetS severity Z-score. We employed a mixed model approach that allowed for the assessment of an overall association between reported discrimination at baseline and MetS severity, and for the possible change over time. Results Sex and age differences were observed in experiences with discrimination, such that men reported higher levels of all aspects of discrimination relative to women. Everyday discrimination decreased with age, whereas lifetime discrimination increased with age (p &lt; .05). Independent of lifestyle and demographic factors, everyday and lifetime discrimination were significantly associated with MetS severity (p = .003 and p = .017, respectively) and the associations remained constant over the 8 years (i.e., no interaction with time). Conclusions Our results suggest that, in a large community-based sample of African Americans, discrimination is a salient psychosocial risk factor for severity of MetS.

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