Abstract P011: Serum Magnesium and the Incidence of Coronary Heart Disease Over 20 Years of Follow-up: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Jeffrey R Misialek ◽  
Alvaro Alonso ◽  
Aaron R Folsom ◽  
Erin D Michos ◽  
Casey M Rebholz ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Serum Magnesium ◽  
Peripheral Blood Flow ◽  
Atherosclerosis Risk In Communities ◽  
Chd Risk ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Low Serum

Background: Low serum magnesium (Mg) may be linked to higher cardiovascular risk through impaired glucose levels, elevated blood pressure, chronic inflammation, impaired vasomotor tone or peripheral blood flow, and electrocardiogram abnormalities. Relatively few studies have examined the association of serum Mg and coronary heart disease (CHD). Hypothesis: Individuals with low serum Mg levels will have an increased risk for CHD. Methods: We studied 13,349 participants (75% white, 57% women, mean age 54) free of CHD at baseline from the Atherosclerosis Risk in Communities study. Serum Mg, assessed at baseline (1987-89) and a second visit (1990-92), was averaged. Incident CHD cases through 2012 were ascertained from hospital discharge codes and death certificates and adjudicated by physician review. Multivariate Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. Interactions by age, race, and sex were tested. Results: Over a median follow-up time of 23.4 years, 1,606 incident CHD cases were identified. Low serum Mg was associated with higher CHD risk after adjustment for demographics and behaviors (Table, Model 2). Although the test for trend was significant, most of the excess risk was for the lowest Mg category. The association persisted after adjustment for potential mediators (Table, Mediation Model). There was no evidence of significant interactions between serum Mg and age, race, or sex. Conclusion: Low serum Mg was associated with higher CHD risk, which is consistent with the proposed mechanisms and prior studies that have suggested a relationship. Interventional primary prevention studies could be considered to evaluate whether raising low serum Mg levels might lower CHD risk.

Abstract P041: Serum Magnesium and the Incidence of Coronary Heart Disease Over 20 Years of Follow-up: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Mary R Rooney ◽  
Jeffrey R Misialek ◽  
Alvaro Alonso ◽  
Aaron R Folsom ◽  
Erin D Michos ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Proportional Hazards ◽  
Serum Magnesium ◽  
A Priori ◽  
Cox Proportional Hazards ◽  
Chd Risk ◽  
Chd Risk Factors ◽  
Aric Study

Introduction: Low serum magnesium (Mg) levels have been associated with increased coronary heart disease (CHD) risk, likely acting through pathways such as hypertension, hyperglycemia or inflammation. An early (1998) ARIC paper evaluated this association, based on 319 events, and identified a sex-interaction whereby the inverse Mg-CHD association was stronger among women than men. Nearly 2,000 events have occurred since the prior publication. Hence, we sought to update the analysis. Hypothesis: We hypothesized serum Mg would be inversely and independently associated with long-term risk of CHD. Methods: A total of 14,465 ARIC study participants without CHD at visit 1 (baseline) were included. Serum Mg was measured at visit 1 (1987-89) and visit 2 (1990-92). Incident CHD events were identified through 2014 using annual telephone calls, hospital discharge lists and death certificates, and were adjudicated by physician review. Multivariable Cox proportional hazards regression models were used. Serum Mg was categorized into quintiles based on mean visit 1 and 2 concentrations. Based on prior findings in ARIC suggesting an interaction, we decided a priori to provide sex-stratified results. Results: Participants at baseline were mean±SD age 54±6y, 57% were women and 27% black. Serum Mg was 1.62±0.14 mEq/L overall, 1.62±0.14 mEq/L among women and 1.63±0.14 mEq/L among men. Over a median follow-up of 25 years, 1,939 CHD cases were identified. Overall, serum Mg was inversely and monotonically associated with CHD risk after adjustment for demographics, lifestyle factors and other CHD risk factors (Table, p-trend<0.001). The association was stronger among women (HR Q5 vs Q1=0.63) than men (HR=0.83), but the sex-interaction was not statistically significant (p>0.05). Conclusions: In this large community-based cohort, serum Mg was inversely associated with CHD risk. This association was slightly stronger among women than men. Further research is needed to understand if increasing Mg levels is a useful target for CHD prevention.

scholarly journals Role of BMI in the Association of theTCF7L2rs7903146 Variant with Coronary Heart Disease: The Atherosclerosis Risk in Communities (ARIC) Study

2010 ◽  
Vol 2010 ◽  
pp. 1-5 ◽  
Author(s):  
Anna M. Kucharska-Newton ◽  
Keri L. Monda ◽  
Suzette J. Bielinski ◽  
Eric Boerwinkle ◽  
Thomas D. Rea ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Hazard Ratio ◽  
Study Cohort ◽  
Atherosclerosis Risk In Communities ◽  
Cox Proportional Hazard ◽  
Chd Risk ◽  
Atherosclerosis Risk ◽  
Cox Proportional Hazard Regression ◽  
Aric Study

We examined the association of variation in the type 2 diabetes risk-conferringTCF7L2gene with the risk of incident coronary heart disease (CHD) among the lean, overweight, and obese members of the Atherosclerosis Risk in Communities (ARIC) Study cohort. Cox proportional hazard regression analyses were performed using a general model, with the major homozygote as the reference category. For 9,865 whites, a significant increase in the risk of CHD was seen only among lean (BMI<25 kg/m2) individuals homozygous for theTallele of theTCF7L2rs7903146 gene risk variant (hazard ratio 1.42; 95% CI 1.03,1.97;P=.01). No association was found among 3,631 blacks, regardless of BMI status. An attenuated hazard ratio was observed among the nondiabetic ARIC cohort members. This study suggests that body mass modifies the association of theTCF7L2rs7903146 T allele with CHD risk.

Abstract P064: Dietary Glycemic Index and Glycemic Load and Risk of Coronary Heart Disease in a Prospective Study Among US Male Health Professionals

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Shanshan Li ◽  
Frank B Hu ◽  
John P Forman ◽  
Eric B Rimm
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Glycemic Index ◽  
Glycemic Load ◽  
Effect Modification ◽  
Fiber Intake ◽  
Chd Risk ◽  
Increased Risk ◽  
Dietary Glycemic Index

Introduction: The associations between dietary glycemic index (GI) and glycemic load (GL) with subsequent risk of coronary heart disease (CHD) are inconclusive among men. The association is further complicated by the potential biological interactions between the carbohydrate quality of the diet and factors that may influence underlying insulin resistance. Hypothesis: We hypothesized that long-term exposure to a diet with high GI and GL would be associated with increased CHD risk in a cohort of US men, and the association would be further modified by fiber intake, alcohol consumption and BMI. Methods: We included 37,736 men aged 40–75 years from the Health Professional Follow-up Study, with no previous diagnosis of CHD, cancer, or type 2 diabetes. We confirmed 3,121 total incident CHD cases during 22 years of follow-up. Cox proportional hazard models were used to adjust for covariates. Results: After adjusting for lifestyle and dietary covariates, the hazard ratio (RR) and 95% confidence intervals comparing men in the highest vs. the lowest quintile was 1.16 (1.04, 1.31; p for trend=0.03) for dietary GI, and 1.09 (0.94, 1.27; p for trend =0.16) for GL. We found a significant effect modification by fiber intake (p=0.02); The associations between GL and CHD risk were strongest among participants in the lowest tertile of fiber intake (RR= 1.00, 1.00, 0.93, 1.11 and 1.16 with increasing quintiles of GL; RR=1.00, 0.68, 0.79, 0.73 and 0.76 for participants in the highest tertile of fiber intake). The association between GL and CHD was stronger among men with body mass index (BMI) greater than 25 kg/m2 than normal weight men, even though the test for interaction was only marginally significant (RR=1.00, 1.03, 1.05, 1.10, and 1.16 for increasing quintles of GL among men with BMI≥25 kg/m2 and RR= 1.00, 0.92, 0.96, 1.09 and 1.04 for men with BMI<25 kg/m2, p for interaction=0.09). Alcohol intake did not modify the association of GL with CHD (p for interaction=0.44). Conclusion: We observed a significantly increased risk of CHD with high GI diet and a modestly elevated association between GL and CHD among men with low fiber intakes or who were overweight or obese. No effect modification by alcohol was observed, but we did find that the association between GL and CHD was more pronounced among those with lower fiber intake or higher BMI.

scholarly journals Marital Status, Hypertension, Coronary Heart Disease, Diabetes, and Death Among African American Women and Men: Incidence and Prevalence in the Atherosclerosis Risk in Communities (ARIC) Study Participants

2010 ◽  
Vol 31 (9) ◽  
pp. 1211-1229 ◽  
Author(s):  
Hilary M. Schwandt ◽  
Josef Coresh ◽  
Michelle J. Hindin
Keyword(s):  
Coronary Heart Disease ◽  
African American ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
African Americans ◽  
Marital Status ◽  
The United States ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk

Heart disease is the leading cause of death in the United States, and African Americans disproportionately experience more cardiovascular disease, including coronary heart disease (CHD), hypertension, and diabetes. The literature documents a complex relationship between marital status and health, which varies by gender. We prospectively examine the relationship between African American men’s and women’s marital status and their risk of developing cardiovascular diseases and dying using the Atherosclerosis Risk in Communities (ARIC) data. After multivariable adjustment for individual characteristics and health status, we found that marital status was not associated with hypertension or new cases of CHD, but remaining single throughout the study period was associated with an increased risk of developing diabetes for women and an increased likelihood of death for men. Culturally appropriate interventions for African Americans are needed to decrease racial disparities in cardiovascular diseases and mortality.

scholarly journals Serum magnesium and the incidence of coronary artery disease over a median 27 years of follow-up in the Atherosclerosis Risk in Communities (ARIC) Study and a meta-analysis

2019 ◽  
Vol 111 (1) ◽  
pp. 52-60 ◽  
Author(s):  
Mary R Rooney ◽  
Alvaro Alonso ◽  
Aaron R Folsom ◽  
Erin D Michos ◽  
Casey M Rebholz ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Meta Analysis ◽  
Serum Magnesium ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Artery Disease ◽  
Aric Study ◽  
Cad Risk ◽  
Low Serum

ABSTRACT Background Low serum magnesium (Mg) concentrations have been associated with higher coronary artery disease (CAD) risk. A previous Atherosclerosis Risk in Communities (ARIC) Study article that evaluated the Mg–CAD association, based on 319 events occurring over 4–7 y, identified a sex-interaction whereby the inverse Mg–CAD association was much stronger among women than men. More than 1700 additional ARIC CAD events have since accrued. Objective We aimed to test our hypothesis that serum Mg is inversely and independently associated with long-term CAD risk in ARIC and in a meta-analysis with other prospective studies. Methods A total of 14,446 ARIC study participants (baseline mean ± SD age: 54 ± 6 y, 57% women, 27% African American) were followed for incident CAD through 2017. CAD events were defined by myocardial infarction or CAD mortality. Serum Mg was modeled as quintiles based on mean visit 1 (1987–1989) and visit 2 (1990–1992) concentrations. Cox regression models were used. We also conducted a random-effects meta-analysis incorporating these contemporary ARIC findings. Results Over a median follow-up of 27 y, 2131 incident CAD cases accrued. Overall, low serum Mg was associated with higher CAD risk after adjustment for demographics, lifestyle factors, and other CAD risk factors than was higher serum Mg (HR Q1 compared with Q5: 1.28; 95% CI: 1.11, 1.47; P-linear trend &lt;0.001). The association was stronger among women (HR Q1 compared with Q5: 1.53; 95% CI: 1.22, 1.92) than men (HR: 1.11; 95% CI: 0.92, 1.34) (P-interaction = 0.05). In the meta-analysis including 5 studies, the pooled RR (95% CI) for CAD in the lowest compared with the highest circulating Mg category was 1.18 (1.06, 1.31) (I2 = 22%, P-heterogeneity = 0.27). Conclusions In this large community-based cohort and updated meta-analysis, low circulating Mg was associated with higher CAD risk than was higher Mg. Whether increasing Mg concentrations within healthy limits is a useful strategy for CAD prevention remains to be seen.

Abstract 5090: Impact of Adding a Single Allele in the 9p21 Locus to Traditional Risk Factors on Risk Classification for Coronary Heart Disease and Implications for Lipid-Modifying Therapy in the White Population of the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Ariel Brautbar ◽  
Christie Ballantyne ◽  
Kim Lawson ◽  
Vijay Nambi ◽  
Lloyd Chambless ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Risk Prediction ◽  
White Population ◽  
Atherosclerosis Risk In Communities ◽  
Chd Risk ◽  
Atherosclerosis Risk ◽  
Traditional Risk Factors ◽  
Aric Study

Aim: A single nucleotide polymorphism on chromosome 9p21, rs10757274 (9p21 allele), has been shown to be a predictor of coronary heart disease (CHD) in whites. We evaluated if the addition of the 9p21 allele to traditional risk factors (TRF) improved CHD risk prediction in the white population of the Atherosclerosis Risk in Communities (ARIC) study, and whether changes in risk prediction will modify lipid therapy recommendation. Methods: Whites (n=10,004) in the ARIC study for whom the 9p21 genotype and TRF (age, gender, systolic blood pressure, total cholesterol, smoking, diabetes, HDL-C, and anti-hypertensive medication use) information was available were included. Using Cox proportional hazards models, the ARIC Cardiovascular Risk Score (ACRS) which is based on TRF was determined. The impact of adding the 9p21 allele to TRF with respect to the area under the curve (AUC) of a receiver operating characteristic (ROC) curve and then risk strata reclassification was determined. Results: The addition of 9p21 allele to TRF was associated with a hazard ratio (HR) of 1.25 (p<0.0001) and an increase in the AUC for incident CHD from 0.776 to 0.780 (Δ= 0.004, 95% CI=0.001, 0.008). The 9p21 allele’s greatest influence to the ACRS (Table ) was observed in the intermediate (5–10% 10-year CHD risk) and intermediate-high (10 –20% 10-year CHD risk) categories with 19.3% and 16.9% reclassified, respectively, which would impact therapy, as approximately 90% of these individuals had LDL-C >100 mg/dL. Table: Reclassification in the different ACRS categories after the addition of the 9p21 allele to the traditional risk factors

scholarly journals Joint association between education and polygenic risk score for incident coronary heart disease events: a longitudinal population-based study of 26 203 men and women

2021 ◽  
pp. jech-2020-214358
Author(s):  
Pekka Martikainen ◽  
Kaarina Korhonen ◽  
Aline Jelenkovic ◽  
Hannu Lahtinen ◽  
Aki Havulinna ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Risk Score ◽  
Density Lipoprotein ◽  
Population Based ◽  
Polygenic Risk Score ◽  
Genome Wide ◽  
Increased Risk ◽  
Region Of Residence

BackgroundGenetic vulnerability to coronary heart disease (CHD) is well established, but little is known whether these effects are mediated or modified by equally well-established social determinants of CHD. We estimate the joint associations of the polygenetic risk score (PRS) for CHD and education on CHD events.MethodsThe data are from the 1992, 1997, 2002, 2007 and 2012 surveys of the population-based FINRISK Study including measures of social, behavioural and metabolic factors and genome-wide genotypes (N=26 203). Follow-up of fatal and non-fatal incident CHD events (N=2063) was based on nationwide registers.ResultsAllowing for age, sex, study year, region of residence, study batch and principal components, those in the highest quartile of PRS for CHD had strongly increased risk of CHD events compared with the lowest quartile (HR=2.26; 95% CI: 1.97 to 2.59); associations were also observed for low education (HR=1.58; 95% CI: 1.32 to 1.89). These effects were largely independent of each other. Adjustment for baseline smoking, alcohol use, body mass index, igh-density lipoprotein (HDL) and total cholesterol, blood pressure and diabetes attenuated the PRS associations by 10% and the education associations by 50%. We do not find strong evidence of interactions between PRS and education.ConclusionsPRS and education predict CHD events, and these associations are independent of each other. Both can improve CHD prediction beyond behavioural risks. The results imply that observational studies that do not have information on genetic risk factors for CHD do not provide confounded estimates for the association between education and CHD.

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