Abstract MP08: Bundle Branch Blocks and Risk of Mortality in the Atherosclerosis Risk in Communities Study: Gender and Racial Differences

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Zhu-ming Zhang ◽  
Pentti M Rautaharju ◽  
Ronald J Prineas ◽  
Laura Loehr ◽  
Wayne Rosamond ◽  
...  
Keyword(s):  
Racial Differences ◽  
Preventive Intervention ◽  
Atherosclerosis Risk In Communities ◽  
Gender And Race ◽  
Risk Of Mortality ◽  
Atherosclerosis Risk ◽  
All Cause Mortality ◽  
Bundle Branch Blocks ◽  
Cox Proportional Hazard Models ◽  
Aric Study

Introduction: Gender and racial differences in the association between different patterns of bundle branch block (BBB) and mortality in the general population are not well established. Methods: We used Cox proportional hazard models to evaluate the risk of all-cause mortality associated with left BBB (LBBB) and right BBB (RBBB). The study group, 15,316 participants from the Atherosclerosis Risk in Communities (ARIC) study was stratified by gender and race. We excluded the participants with other BBBs or QRS duration ≥120 ms not classified as complete RBBB or LBBB. Results: At baseline in 1987-89, mean age was 54 years, 55.3% were women, and 26.8% blacks. There were 88 LBBB and 202 RBBB. During a mean follow up of 18 years, 3,347 deaths occurred. Compared to No-BBB, LBBB was strongly associated with increased mortality in all subgroups by gender and race (Table). However, RBBB was not significantly associated with all-cause mortality in any of the subgroups in the multivariable adjusted models. Conclusions: Prevalent LBBB, but not RBBB, is a predictor of all-cause mortality in women and men as well as in blacks and whites. These findings may help in selecting patients who could benefit from further diagnostic evaluation for possible therapeutic and preventive intervention.

Bundle branch blocks and the risk of mortality in the Atherosclerosis Risk in Communities study

2016 ◽  
Vol 17 (6) ◽  
pp. 411-417 ◽  
Author(s):  
Zhu-Ming Zhang ◽  
Pentti M. Rautaharju ◽  
Ronald J. Prineas ◽  
Laura Loehr ◽  
Wayne Rosamond ◽  
...  
Keyword(s):  
Atherosclerosis Risk In Communities ◽  
Risk Of Mortality ◽  
Atherosclerosis Risk ◽  
Bundle Branch Blocks

scholarly journals Endogenous Testosterone and its Relationship to Preclinical and Clinical Measures of Cardiovascular Disease in the Atherosclerosis Risk in Communities Study

2015 ◽  
Vol 100 (4) ◽  
pp. 1602-1608 ◽  
Author(s):  
Reshmi Srinath ◽  
Sherita Hill Golden ◽  
Kathryn A. Carson ◽  
Adrian Dobs
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiac Mortality ◽  
Cardiac Events ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
All Cause Mortality ◽  
Aric Study

Context: Epidemiologic studies suggest that endogenous testosterone (T) levels in males may be implicated in cardiovascular disease (CVD), however further clarification is needed. Objective: We assessed the cross-sectional relationship between endogenous plasma T and mean carotid intima media thickness (cIMT), and the longitudinal relationship with incident clinical CVD events, cardiac mortality, and all-cause mortality using male participants in the Atherosclerosis Risk in Communities (ARIC) study. Design: This study involved a subset of men from visit 4 of the ARIC study. Setting: The study was conducted in a community based cohort. Participants: Males who provided a morning blood sample excluding those taking androgen therapy, with prevalent coronary heart disease (CHD), stroke, or heart failure (HF) (n = 1558). Intervention: None. Main Outcome Measures: Plasma T by liquid chromatography mass spectrometry and carotid IMT using high resolution B-mode ultrasound were obtained at visit 4. Incident CHD, HF, cardiac mortality, and all-cause mortality were identified by surveillance through 2010 (median 12.8 years). Results: Lower T was significantly associated with higher body mass index, greater waist circumference, diabetes, hypertension, lower HDL, and never smoking (P = 0.01). T was not associated with mean cIMT in unadjusted or adjusted analyses. Following multivariable adjustment, there was no association of quartile (Q) of T with incident CHD [hazard ratio (HR) = 0.87 (95% CI = 0.60–1.26) for Q1; 0.97 (95% CI = 0.69–1.38) for Q2; 0.97 (95% CI = 0.69–1.36) for Q3 compared to reference of Q4] or for incident HF [HR = 0.77 (95% CI = 0.46–1.29) for Q1; 0.72 (95% CI = 0.43–1.21) for Q2; 0.87 (95% CI = 0.53–1.42) for Q3 compared to reference of Q4]. Similarly there was no association of Q of T with mortality or cardiac-associated mortality. Conclusions: Low male plasma T is cross-sectionally associated with key CVD risk factors, but after adjustment there was no association with mean cIMT, incident cardiac events, or mortality. Our results are reassuring that neither high nor low T levels directly predict atherosclerosis, but are a marker for other cardiovascular risk factors.

scholarly journals Adherence to a Healthy Lifestyle and the Risk of All-Cause Mortality and Cardiovascular Events in Individuals With Diabetes: The ARIC Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Dongze Li ◽  
Yu Jia ◽  
Jing Yu ◽  
Yi Liu ◽  
Fanghui Li ◽  
...  
Keyword(s):  
Lower Risk ◽  
Cox Regression ◽  
Healthy Lifestyle ◽  
The United States ◽  
Normal Weight ◽  
Clinical Trial Registration ◽  
Atherosclerosis Risk In Communities ◽  
Risk Of Mortality ◽  
All Cause Mortality ◽  
Aric Study

Objective: The relationship between combined healthy lifestyle and cardiovascular (CV) events in diabetes is unclear. We aim to investigate the association between a healthy lifestyle score (HLS) and the risk of mortality and CV events in diabetes.Methods: We examined the associations of six lifestyle factors scores (including healthy diet, moderate alcohol and regular coffee intakes, never smoking, physical activity, and normal weight) with diabetes in the Atherosclerosis Risk in Communities (ARIC) study of 3,804 participants with diabetes from the United States at baseline. Primary outcomes included all-cause mortality, CV mortality, and composite CV events (heart failure hospitalizations, myocardial infarction, fatal coronary heart disease, and stroke).Results: Among these diabetic participants, 1,881 (49.4%), 683 (18.0%), and 1,600 (42.0%) cases of all-cause mortality, CV mortality, and CV events were documented, respectively, during the 26 years of follow-up. Further, the prevalence of these adverse events became lower with the increase of HLS (all P < 0.001). In the risk-factors adjusted Cox regression model, compared to participants with HLS of 0, participants with HLS of 2 had significant lower risk of all-cause mortality (HR = 0.811, 95% CI: 0.687–0.957, P = 0.013), CV mortality (HR = 0.744, 95% CI: 0.576–0.962, P = 0.024), and CV events (HR = 0.789, 95% CI: 0.661–0.943, P = 0.009). The association of HLS with CV events was stronger for women than men (P for interaction <0.05).Conclusion: Adherence to a healthy lifestyle was associated with a lower risk of CV events and mortality in diabetics. Our findings suggest that the promotion of a healthy lifestyle would help reduce the increasing healthcare burden of diabetes.Clinical Trial Registration:https://clinicaltrials.gov, Identifier: NCT00005131.

scholarly journals Associations of 1,5-Anhydroglucitol and 2-Hour Glucose with Major Clinical Outcomes in the Atherosclerosis Risk in Communities (ARIC) Study

2020 ◽  
Vol 5 (6) ◽  
pp. 1296-1306
Author(s):  
Bethany Warren ◽  
Alexandra K Lee ◽  
Christie M Ballantyne ◽  
Ron C Hoogeveen ◽  
James S Pankow ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Clinical Outcomes ◽  
Atherosclerosis Risk In Communities ◽  
C Statistic ◽  
Atherosclerosis Risk ◽  
All Cause Mortality ◽  
Diagnosed Diabetes ◽  
Aric Study

Abstract Background 1,5-Anhydroglucitol (1,5-AG) is a novel biomarker of glycemic control proposed to monitor recent hyperglycemic excursions in persons with diabetes. The clinical utility of 1,5-AG outside of diagnosed diabetes is unclear, but it may identify people at high risk for diabetes and its complications. We compared associations of 1,5-AG with 2-h glucose for risk of major clinical complications. Research Design and Methods We prospectively followed 6644 Atherosclerosis Risk in Communities (ARIC) Study participants without diagnosed diabetes for incident diagnosed diabetes, chronic kidney disease, cardiovascular disease, and all-cause mortality for ∼20 years. We assessed associations of 1,5-AG and 2-h glucose (modeled categorically and continuously with restricted cubic splines) with adverse outcomes using Cox models and evaluated improvement in risk discrimination using Harrell’s c-statistic. Results 1,5-AG <10 µg/mL was statistically significantly associated with incident diabetes (HR: 2.70, 95% CI 2.31, 3.15), and showed suggestion of association with the other outcomes compared to 1,5-AG ≥10 µg/mL. Continuous associations of 1,5-AG with outcomes displayed a clear threshold effect, with risk associations generally observed only <10 µg/mL. Comparing associations of 1,5-AG and 2-h glucose with outcomes resulted in larger c-statistics for 2-h glucose than 1,5-AG for all outcomes (difference in c-statistic [2-h glucose -1,5-AG] for diagnosed diabetes: 0.17 [95%CI, 0.15, 0.19]; chronic kidney disease 0.02 [95%CI 0.00, 0.05]; cardiovascular disease 0.03 [95%CI, 0.00, 0.06]; and all-cause mortality 0.04 [95%CI, 0.02, 0.06]). Conclusions In this community-based population without diagnosed diabetes, low 1,5-AG was modestly associated with major clinical outcomes and did not outperform 2-h glucose.

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