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 ◽  
...  

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.

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Kamel A Gharaibeh ◽  
Vanessa Xanthakis ◽  
Jung Hye Sung ◽  
Tandaw S Samdarshi ◽  
Herman A Taylor ◽  
...  

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. -->


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Marwah Abdalla ◽  
John N Booth ◽  
Keith M Diaz ◽  
Mario Sims ◽  
Paul Muntner ◽  
...  

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.


2015 ◽  
Vol 2015 (1) ◽  
pp. 2758
Author(s):  
Anne M Weaver ◽  
Demarc A. Hickson ◽  
Masoor Kamalesh ◽  
Melissa Eliot ◽  
Wen-Chih Wu ◽  
...  

2016 ◽  
Vol 26 (3) ◽  
pp. 355 ◽  
Author(s):  
Bradley Deere ◽  
Michael Griswold ◽  
Seth Lirette ◽  
Ervin Fox ◽  
Mario Sims

<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>


2020 ◽  
Vol 9 (2) ◽  
pp. 49-55
Author(s):  
Steven R. Horbal ◽  
Michael E. Hall ◽  
Paul C. Dinh ◽  
Abbas Smiley ◽  
Solomon K. Musani ◽  
...  

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Anne M. Weaver ◽  
Gregory A. Wellenius ◽  
Wen-Chih Wu ◽  
DeMarc A. Hickson ◽  
Masoor Kamalesh ◽  
...  

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Harsha Nagarajarao ◽  
Solomon K Musani ◽  
Vasan S Ramachandran ◽  
Aurelian Bidulescu ◽  
Herman A Taylor ◽  
...  

Introduction: There is emerging evidence that brain natriuretic peptide (BNP) may play a role in human metabolism. Suppressed concentrations in BNP in obese individuals may contribute to clinical phenotypes of metabolic syndrome. There is limited data on the relation of BNP to metabolic syndrome in African Americans. Methods: To assess the association between plasma brain natriuretic peptide (BNP) concentration and metabolic syndrome (MetS) and MetS risk factors in blacks, we analyzed cross-sectional data from 3,729 Jackson Heart Study participants free of heart failure (mean age, 54 years; 64% women). We performed sex-specific Tobit regression analysis on log transformed BNP to account for the left censored BNP distribution and adjusted for clinical and echocardiographic variables. Prevalence of MetS was 44% and 35% in women and men, respectively. We estimated percent changes for the underlying variables by back-transformation. Results: Plasma BNP concentration was inversely associated with metabolic syndrome components (fasting glucose and waist circumference in both men and women; and triglycerides in women). Sex-specific multivariable adjusted BNP concentrations were significantly lower in subjects with MetS than those without. In men, BNP concentration was 35% lower (P < 0.0001); and in women it was 31% lower (P < 0.0001). Men and women with insulin resistance represented by elevated homeostasis assessment model (HOMA-IR) index had significantly (P < 0.0001) lower BNP concentration compared to those with low HOMA-IR index. Discussion and Conclusion: We found in a community based cohort of African Americans a significant relation of low BNP concentration to MetS and individual components of MetS. This data supports a growing body of evidence that BNP plays a potential crucial role in total body metabolism.


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