Abstract 20038: Maternal Pre-Pregnancy Overweight is Associated with Increased Cardiovascular Disease Mortality in the Framingham Heart Study

Introduction: In the U.S., obesity among women of childbearing age is highly prevalent. Maternal obesity is associated with offspring obesity and cardiovascular disease (CVD) risk factors, potentially through epigenetic and early developmental mechanisms. There is limited evidence on the association of maternal overweight with offspring CVD events and mortality. Methods: We analyzed prospectively collected data from 1971 to 2012 on 879 Framingham Heart Study Offspring cohort participants with either directly measured pre-pregnancy maternal body mass index (BMI) (n=361) or offspring-reported maternal pre-pregnancy overweight status (n=518). Our outcomes included a composite measure of any CVD event or mortality, CVD mortality and all-cause mortality. Cox proportional hazard models were conducted, initially age and sex adjusted, and then additionally adjusted for potential mediators including traditional CVD risk factors. Pharmacologic treatments for diabetes, hypertension, and/or dyslipidemia were included as time-varying covariates. Results: Maternal pre-pregnancy overweight (BMI >= 85th percentile or self-report) was available for 879 Framingham Offspring Study participants (mean age [SD] at baseline 30 [5] years; 49% female; mean follow-up [SD] 32 [8] years). There were 193 CVD events, 28 CVD deaths, and 138 total deaths among the offspring. Maternal overweight was associated with an increased hazard ratio (HR) with CVD mortality (HR 10.5 [2.6-43]; p=0.001), all-cause mortality (HR 3.1 [1.5-6.4]; p=0.002), and marginally associated with the composite endpoint of CVD events and mortality (HR 1.7 [95% CI 0.99-2.8]; p=0.05). Adjustment for offspring BMI, diabetes, hypertension, and dyslipidemia attenuated the associations. In sensitivity analyses restricted to only those with directly measured maternal pre-pregnancy BMI, effect estimates remained robust (similar hazard ratios but larger confidence intervals). Conclusions: Maternal pre-pregnancy overweight is associated with offspring CVD mortality. The association is likely mediated in part through classical CVD risk factors such as offspring obesity, hypertension, diabetes, and dyslipidemia.

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Association of γ’ Fibrinogen with Risk Factors and Prevalent Cardiovascular Disease in the Framingham Heart Study.

Blood ◽

10.1182/blood.v110.11.131.131 ◽

2007 ◽

Vol 110 (11) ◽

pp. 131-131

Author(s):

Rehana S. Lovely ◽

Joseph F. Massaro ◽

Ralph B. D’Agostino ◽

Emelia J. Benjamin ◽

Steven C. Kazmierczak ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Framingham Heart Study ◽

Odds Ratio ◽

Inverse Association ◽

Cvd Risk Factors ◽

Case Control Studies ◽

Cvd Risk ◽

Heart Study

Abstract Background: γ’ fibrinogen is a newly-emerging cardiovascular disease (CVD) biomarker that has shown significant associations with coronary artery disease in small case/control studies. γ’ fibrinogen is an isoform with an altered γ chain, and constitutes ∼10% of total fibrinogen. Both elevated γ’ and total fibrinogen cause fibrinolytic resistance in vitro. However, data are lacking from community based studies on the association of γ’ fibrinogen with CVD risk factors or with clinical CVD. Methods: γ’ fibrinogen levels were measured using an ELISA assay in 3284 men and women in the Framingham Heart Study Offspring Cohort 7th examination cycle (2002–05). Associations of γ’ fibrinogen were examined using linear regression for continuous CVD risk factors and logistic regression for prevalent CVD and other dichotomous measures. Results: The ELISA CV was 9.3% at mean γ’ fibrinogen levels. Participants (mean age 60 years, 53.4% women) with prevalent CVD (0.297 ± 0.007 mg/ml; mean ± SE) had significantly higher mean concentrations than those without CVD (0.255 ± 0.002 mg/ml). There were significant (all p<0.05) associations between γ’ fibrinogen levels with several cardiovascular risk factors, including age, BMI, systolic blood pressure, diabetes mellitus, cigarette smoking, and total cholesterol, and an inverse association with HDL cholesterol. γ’ fibrinogen was associated with prevalent CVD with an odds ratio of 1.76 (95% CI 1.06–2.92) for the highest compared to the lowest tertile, after adjustment for all of the above risk factors. As expected, since γ’ fibrinogen constitutes a subset of total fibrinogen, γ’ fibrinogen was correlated with total fibrinogen. However, if we included both γ’ and total fibrinogen in further analyses of association with CVD, the odds ratio was 3.08 (95% CI 1.41–6.72) for the combined tertile of both the highest γ’ fibrinogen and highest total fibrinogen, an odds ratio that was substantially higher than that for either marker alone. Conclusions: γ’ fibrinogen is associated with multiple CVD risk factors and with prevalent CVD, accounting for CVD risk factors, over and above total fibrinogen alone. Prospective studies are warranted to examine the ability of γ’ fibrinogen to predict CVD.

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Abstract 3746: Association of Gamma ′ Fibrinogen with Risk Factors and Prevalent Cardiovascular Disease in the Framingham Heart Study

Circulation ◽

10.1161/circ.116.suppl_16.ii_852 ◽

2007 ◽

Vol 116 (suppl_16) ◽

Author(s):

Rehana S Lovely ◽

Joseph F Massaro ◽

Ralph B D’Agostino ◽

Emelia J Benjamin ◽

Steven C Kazmierczak ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Framingham Heart Study ◽

Odds Ratio ◽

Inverse Association ◽

Cvd Risk Factors ◽

Case Control Studies ◽

Cvd Risk ◽

Heart Study

Background: γ′ fibrinogen is a newly-emerging cardiovascular disease (CVD) biomarker that has shown significant associations with coronary artery disease in small case/control studies. γ ′ fibrinogen is an isoform with an altered γ chain, and constitutes ∼10% of total fibrinogen. Both elevatedγ ′ and total fibrinogen cause fibrinolytic resistance in vitro . However, data are lacking from community based studies on the association ofγ ′ fibrinogen with CVD risk factors or with clinical CVD. Methods: γ ′ fibrinogen levels were measured using an ELISA assay in 3284 men and women in the Framingham Heart Study Offspring Cohort 7th examination cycle (2002– 05). Associations ofγ ′ fibrinogen were examined using linear regression for continuous CVD risk factors and logistic regression for prevalent CVD and other dichotomous measures. Results: The ELISA CV was 9.3% at meanγ ′ fibrinogen levels. Participants (mean age 60 years, 53.4% women) with prevalent CVD (0.297 ± 0.007 mg/ml; mean ± SE) had significantly higher mean concentrations than those without CVD (0.255 ± 0.002 mg/ml). There were significant (all p<0.05) associations betweenγ ′ fibrinogen levels with several cardiovascular risk factors, including age, BMI, systolic blood pressure, diabetes mellitus, cigarette smoking, and total cholesterol, and an inverse association with HDL cholesterol. γ ′ fibrinogen was associated with prevalent CVD with an odds ratio of 1.76 (95% CI 1.06–2.92) for the highest compared to the lowest tertile, after adjustment for all of the above risk factors. As expected, sinceγ ′ fibrinogen constitutes a subset of total fibrinogen, γ ′ fibrinogen was correlated with total fibrinogen. However, if we included bothγ ′ and total fibrinogen in further analyses of association with CVD, the odds ratio was 3.08 (95% CI 1.41–6.72) for the combined tertile of both the highestγ ′ fibrinogen and highest total fibrinogen, an odds ratio that was substantially higher than that for either marker alone. Conclusions: γ ′ fibrinogen is associated with multiple CVD risk factors and with prevalent CVD, accounting for CVD risk factors, over and above total fibrinogen alone. Prospective studies are warranted to examine the ability ofγ ′ fibrinogen to predict CVD.

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Black–White Differences in Cardiovascular Disease Mortality: A Prospective US Study, 2003–2017

American Journal of Public Health ◽

10.2105/ajph.2019.305543 ◽

2020 ◽

Vol 110 (5) ◽

pp. 696-703

Author(s):

Gabriel S. Tajeu ◽

Monika M. Safford ◽

George Howard ◽

Virginia J. Howard ◽

Ligong Chen ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Socioeconomic Status ◽

Racial Differences ◽

Mortality Risk ◽

Risk Difference ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Mortality Difference ◽

Cvd Mortality

Objectives. To determine factors that explain the higher Black:White cardiovascular disease (CVD) mortality rates among US adults. Methods. We analyzed data from the Reasons for Geographic and Racial Differences in Stroke study from 2003 to 2017 to estimate Black:White hazard ratios (HRs) for CVD mortality within subgroups younger than 65 years and aged 65 years or older. Results. Among 29 054 participants, 41.0% who were Black and 54.9% who were women, 1549 CVD deaths occurred. Among participants younger than 65 years, the demographic-adjusted Black:White CVD mortality HR was 2.23 (95% confidence interval [CI] = 1.87, 2.65) and 1.21 (95% CI = 1.00, 1.47) after full adjustment. Among participants aged 65 years or older, the demographic-adjusted Black:White CVD mortality HR was 1.58 (95% CI = 1.39, 1.79) and 1.12 (95% CI = 0.97, 1.29) after full adjustment. When we used mediation analysis, socioeconomic status explained 21.2% (95% CI = 13.6%, 31.4%) and 38.0% (95% CI = 20.9%, 61.7%) of the Black:White CVD mortality risk difference among participants younger than 65 years and aged 65 years or older, respectively. CVD risk factors explained 56.6% (95% CI = 42.0%, 77.2%) and 41.3% (95% CI = 22.9%, 65.3%) of the Black:White CVD mortality difference for participants younger than 65 years and aged 65 years or older, respectively. Conclusions. The higher Black:White CVD mortality risk is primarily explained by racial differences in socioeconomic status and CVD risk factors.

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Abstract P337: Lifetime Burden of Traditional Cardiovascular Disease Risk Factors and Incidence of Cancer: The Bogalusa Heart Study

Circulation ◽

10.1161/circ.141.suppl_1.p337 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Alexander C Razavi ◽

Tanika N Kelly ◽

Jiang He ◽

Camilo Fernandez ◽

Tekada Ferguson ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Cancer Risk ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Bogalusa Heart Study ◽

Incidence Of Cancer ◽

Incident Cancer ◽

Heart Study

Introduction: Cardiovascular disease (CVD) and cancer remain the leading causes of death globally. While these diseases have traditionally been regarded as separate entities, recent evidence points towards shared biological pathways, underlying a need to study CVD and cancer conjointly. We examined the association between CVD risk factors and the incidence of cancer over the life course in a biracial community-based cohort. Methods: The analysis included 1,368 participants of the Bogalusa Heart Study who had at least 3 measurements of CVD risk factors throughout life (57.6% women, 32.8% black, baseline age=10.5 + 3.6 years, median follow-up=38.2 years). CVD risk factors assessed included systolic and diastolic blood pressure, LDL-C, HDL-C, plasma glucose, serum triglycerides, and body mass index (BMI). Cancer cases were ascertained via the Louisiana Tumor Registry. Cox proportional hazards regression assessed the association between CVD risk factors and cancer incidence, adjusting for race, sex, smoking, and blood pressure-, lipid-, and glucose-lowering medications. Results: There were 88 incident cases of cancer, with breast (22.7%), cervical (11.4%), and prostate (9.1%) being the most highly represented cancers. BMI (kg/m 2 ) had the most robust association with incident cancer (HR=5.83, 95% CI: 2.24, 15.19; p=3.0x10 -4 ). We observed a strong association between annualized change in blood pressure per mmHg and hazard of all cancers (for systolic, HR=2.24, 95% CI: 1.50, 3.35; p<0.0001 and diastolic, HR=4.86, 95% CI: 2.86, 8.27; p<0.0001). Race and sex significantly modified the relationship of incident cancer with lipids and blood pressure, respectively ( Figure ). Conclusion: Subclinical increases in adiposity and blood pressure associate with an increased cancer risk, while HDL-C inversely associates with cancer risk, more consistently in women versus men and in blacks versus whites. Control of CVD risk factors beginning in childhood may lead to improved overall cancer prevention in the general population.

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The association between obesity and cardiovascular disease mortality in different strata of socioeconomic position: evidence from pooled Norwegian health surveys

European Journal of Public Health ◽

10.1093/eurpub/ckz141 ◽

2019 ◽

Vol 29 (6) ◽

pp. 1160-1166

Author(s):

Marte Kjøllesdal ◽

Eirik Degerud ◽

Øyvind Næss

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Socioeconomic Position ◽

Health Surveys ◽

Census Data ◽

Socioeconomic Indicators ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Men And Women ◽

Cvd Mortality

Abstract Background Socioeconomic position (SEP) is related to both obesity and cardiovascular disease (CVD). There is little evidence on whether SEP modifies the relation between obesity and CVD. The aim of the study was to investigate whether the association between obesity and CVD mortality is stronger among people with disadvantaged than among people with advantaged life course SEP. Methods Data from Norwegian population-based cardiovascular health surveys (1985–2003), including body mass index and CVD risk factors (cholesterol, blood pressure, smoking, current treatment for hypertension) were linked to socioeconomic indicators from register and census data (1960–90), and to the Cause of Death Registry (up until 2014). The total number of participants was 398 297. Results In comparison with normal weight, the age-adjusted hazard ratios and 95% confidence intervals of CVD mortality among obese participants were 2.39 (2.07–2.75) and 2.08 (1.70–2.53) among men and women with high SEP, respectively and 1.88 (1.60–2.21) and 1.75 (1.43–2.14) among men and women with low SEP. Adjustment for CVD risk factors attenuated the results in a similar manner in all SEP groups, and among both women and men. Conclusion Obesity was consistently associated with a higher risk of CVD mortality, with only minor variation according to SEP. This means that preventing or treating obesity is, for the purpose of reducing CVD risk, equally important for an individual with high or low SEP.

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Autoantibodies to Apolipoprotein A-1 as Independent Predictors of Cardiovascular Mortality in Renal Transplant Recipients

Journal of Clinical Medicine ◽

10.3390/jcm8070948 ◽

2019 ◽

Vol 8 (7) ◽

pp. 948 ◽

Cited By ~ 4

Author(s):

Josephine L.C. Anderson ◽

Sabrina Pagano ◽

Julien Virzi ◽

Robin P.F. Dullaart ◽

Wijtske Annema ◽

...

Keyword(s):

Risk Factors ◽

Renal Transplant ◽

Graft Failure ◽

Renal Transplant Recipients ◽

Transplant Recipients ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Hdl Functionality ◽

All Cause Mortality ◽

Cvd Mortality

Renal transplant recipients (RTRs) are known to have a high cardio-vascular disease (CVD) burden only partly explained by traditional CVD risk factors. The aim of this paper was therefore to determine: i) the prognostic value of autoantibodies against apoA-1 (anti-apoA-1 IgG) for incidence of CVD mortality, all-cause mortality and graft failure in RTR. Four hundred and sixty two (462) prospectively included RTRs were followed for 7.0 years. Baseline anti-apoA-1 IgG were determined and associations with incidence of CVD mortality (n = 48), all-cause mortality (n = 92) and graft failure (n = 39) were tested. Kaplan–Meier analyses demonstrated significant associations between tertiles of anti-apoA-1 IgG and CVD mortality (log rank test: p = 0.048). Adjusted Cox regression analysis showed a 54% increase in risk for CVD mortality for each anti-apoA-1 IgG levels standard deviation increase (hazard ratio [HR]: 1.54, 95% Confidence Interval [95%CI]: 1.14–2.05, p = 0.005), and a 33% increase for all-cause mortality (HR: 1.33; 95%CI: 1.06–1.67, p = 0.01), independent of CVD risk factors, renal function and HDL function. The association with all-cause mortality disappeared after excluding cases of CVD specific mortality. The sensitivity, specificity, positive predictive value, and negative predictive value of anti-apoA-1 positivity for CVD mortality were 18.0%, 89.3%, 17.0%, and 90.0%, respectively. HDL functionality was not associated with anti-apoA-1 IgG levels. This prospective study demonstrates that in RTR, anti-apoA-1 IgG are independent predictors of CVD mortality and are not associated with HDL functionality.

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Higher Serum Sex Hormone–Binding Globulin Levels Are Associated With Incident Cardiovascular Disease in Men

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2019-01317 ◽

2019 ◽

Vol 104 (12) ◽

pp. 6301-6315 ◽

Cited By ~ 4

Author(s):

Prabin Gyawali ◽

Sean A Martin ◽

Leonie K Heilbronn ◽

Andrew D Vincent ◽

Alicia J Jenkins ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Community Dwelling ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Total Testosterone ◽

Hormone Binding ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cvd Mortality

Abstract Context Sex hormone–binding globulin (SHBG) levels are associated with cardiovascular disease (CVD) risk factors. However, prospective data on the association between SHBG levels and CVD events are sparse, with conflicting results. Objectives To examine associations between serum SHBG, total testosterone (TT), and incident CVD and CVD-related mortality in middle-aged to elderly men. Design and Methods Data on 2563 community-dwelling men (35 to 80 years) were obtained from participants in the Men Androgen Inflammation Lifestyle Environment and Stress cohort. The analytic sample included 1492 men without baseline (2002 to 2007) CVD and with fasted morning serum SHBG and TT available at both baseline and follow-up (2007 to 2010) and without medications affecting TT or SHBG. Associations of baseline SHBG and TT, with incident CVD and CVD mortality, were analyzed using logistic regression for incident CVD and Cox proportional hazard regression for CVD mortality, adjusting for established CVD risk factors. Results In multivariable models, elevated baseline SHBG and lower baseline TT were independently associated with incident CVD (SHBG: OR, 1.54; 95% CI, 1.15 to 2.06 per SD increase in SHBG, P = 0.003; TT: OR, 0.71; 95% CI, 0.52 to 0.97 per SD decrease in TT; P = 0.03). A decrease in TT between time points was associated with incident CVD (OR, 0.72; 95% CI, 0.56 to 0.92; P = 0.01). Neither SHBG nor TT was significantly associated with all-age CVD mortality [hazard ratio (HR), 0.69; 95% CI, 0.29 to 1.63; P = 0.40; and HR, 0.60; 95% CI, 0.28 to 1.26; P = 0.18, respectively]. Conclusions Among all men and men >65 years, elevated SHBG and lower TT were independently associated with both a greater risk of CVD and an increased CVD mortality risk.

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Abstract P245: Impact of Depressive and Anxiety Symptoms on All Cause Mortality Among Andean Hispanics: Result From the PREVENCION Study

Circulation ◽

10.1161/circ.141.suppl_1.p245 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Diana Chirinos ◽

Liliana Aguayo ◽

Emily Vargas ◽

Mercedes R Carnethon ◽

Josefina Medina Lezama

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Depressive Symptoms ◽

Depression Scale ◽

Anxiety Symptoms ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Community Based ◽

Hispanic Adults ◽

All Cause Mortality

Introduction: Depressive/anxiety symptoms are associated with mortality among patients with established cardiovascular disease (CVD). These symptoms are also associated with higher burden of CVD risk factors. Few studies have examined whether the association between psychological symptoms and mortality is independent of CVD risk factors in community-based samples, and no study to date has focused on Andean Hispanic adults. In this study, we examined the association between depressive/anxiety symptoms and 10-year all-cause mortality among community-based Andean Hispanic adults, after adjusting for demographic and CVD risk factors. Hypothesis: Depressive/anxiety symptoms are independently associated with 10-year all-cause mortality among Andean Hispanic adults. Methods: Participants included 551 adults (57.7% female, mean baseline age=50.9 years [SD=16.8]) enrolled in the Peruvian Study of Cardiovascular Disease (PREVENCION). Depressive/anxiety symptoms were assessed with the Hospital Anxiety and Depression Scale. Cox proportional-hazards models were used to examine associations between depressive/anxiety symptoms and all-cause mortality. Results: Mean depressive and anxiety symptom scores were 5.7 (SD=3.5) and 7.6 (3.6), respectively. There were 42 events (7.6%) reported at the 10-year follow-up. In unadjusted models, depressive symptoms were significantly associated with all-cause mortality (HR=1.25, 95% Confidence Intervals [CI]=1.14-1.37). After controlling for demographic factors and CVD risk factors (Figure 1), depressive symptoms remained significantly associated with all-cause mortality (HR=1.18, 95% CI=1.06-1.31). No associations were found between anxiety symptoms and all-cause mortality in unadjusted or adjusted models. Conclusion: Depressive symptoms were associated with 10-year all-cause mortality among Andean Hispanic adults even after adjusting for demographic and CVD risk factors. Future studies should examine associations with cause-specific mortality.

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Abstract 17930: Indices of Adiposity and Subclinical Cardiovascular Disease: the Jackson Heart Study(JHS)

Circulation ◽

10.1161/circ.130.suppl_2.17930 ◽

2014 ◽

Vol 130 (suppl_2) ◽

Author(s):

Adedotun A Ogunsua ◽

Akintunde O Akinkuolie ◽

Olulade A Ayodele ◽

Jiankang Liu ◽

DeMarc Hickson ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Adipose Tissue ◽

Characteristic Curve ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Logistic Regression Models ◽

C Statistic ◽

Heart Study ◽

Subclinical Cvd

Background: Evidence that indices of adiposity, which better account for central obesity, outperform body mass index (BMI) in discriminating presence versus absence of cardiovascular disease (CVD) are largely derived from Caucasian populations with limited and inconsistent findings in African Americans (AA). Characterization of the optimal measure of adiposity for improving CVD risk prediction and stratification in AAs is needed. Aim: We cross-sectionally evaluated the performance of BMI, waist circumference (WC), % body fat (%BF), waist to height ratio (WHtR), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) in predicting the presence of subclinical CVD as defined by coronary artery calcification (CAC) and abdominal aorta calcification (AAC) in the JHS, a cohort of AAs. Methods: 2,253 participants (66% female, mean age: 55 years) with no prior CVD were studied. VAT, SAT, CAC and AAC were determined using CT scan, %BF was assessed with bioelectric impedance and other adiposity indices were measured using standard protocols. Logistic regression models were constructed and c statistic from receiver operating characteristic curve was used to assess the utility of each adiposity index in predicting CAC and AAC. Results: Prevalence of CAC and AAC were 43% and 63% respectively. In univariate analyses with CAC as outcome, c statistic for VAT, WHtR, WC, %BF, SAT and BMI ranged from 0.60-0.51 in decreasing order, and were statistically significantly higher when compared with BMI, except SAT and %BF. Similar results were noted for AAC. However, none of the indices improved risk discrimination beyond traditional CVD risk factors (Table). Conclusion: VAT had the highest discrimination capacity for subclinical CVD followed by WHtR and WC. These results suggest that though other adiposity measures performed slightly better than BMI, none of the measures contributed significantly to discriminating subclinical CVD beyond the traditional CVD risk factors.

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Abstract P107: Leucocyte Telomere Length and Cardiovascular Disease in the Jackson Heart Study

Circulation ◽

10.1161/circ.135.suppl_1.p107 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Stanford Mwasongwe ◽

Laura Raffield ◽

Yan Gao ◽

James G Wilson ◽

Abraham Aviv ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Telomere Length ◽

Left Ventricular ◽

Jackson Heart Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Heart Study ◽

Increased Risk ◽

Age And Sex

Background: In European descent populations, shorter leucocyte telomere length (LTL) has been associated with clinical and subclinical atherosclerosis, while longer LTL has been associated with greater left ventricular hypertrophy (LVH). We evaluated the relationship of LTL with subclinical indices of cardiovascular disease (CVD) (coronary artery calcification [CAC], abdominal aorta calcification [AAC], carotid intima media thickness [CIMT], left ventricular mass [LVM], and ankle-brachial index [ABI]) in African Americans (AAs). We also examined whether LTL is associated with CVD events and mortality. Methods: Analyses included participants of the Jackson Heart Study (JHS), a prospective cohort study of AAs, with LTL data (n=2,573) measured by Southern blot analysis in DNA from the baseline exam (2000-2004). Adjudicated CVD events (coronary heart disease [CHD], heart failure [HF] and stroke) and mortality were identified through December 2012. Relationships were assessed using linear, logistic regression models, or Tobit model (CAC and AAC due to left censoring) in STATA 14. Results: In an age and sex adjusted model, longer LTL was significantly associated with lower CAC ( P =0.049, β=-0.535; 95% confidence interval [CI], -1.066,-0.003); this association was no longer significant after adjusting for body mass index, current smoking and other CVD risk factors. There were no significant associations between LTL and AAC, CIMT, or LVM. LTL was associated with higher ABI ( P =0.017, β=0.023; 95% CI, 0.004, 0.042) when the highest was compared to the lowest LTL quartile in models adjusted for CVD risk factors. After a median follow-up of 9 years, longer LTL was associated with lower risk of incident ischemic stroke and total mortality in age and sex adjusted models, but these associations were no longer significant in models fully adjusted for CVD risk factors. Conclusions: In conclusion, among a community-based cohort of AAs, LTL was associated with increased ABI, indicative of increased risk of peripheral arterial disease, but there were no significant associations with other CVD indices and mortality after adjustment for established risk factors.

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