Serum Urate Trajectory in Young Adulthood and Incident Cardiovascular Disease Events by Middle Age: CARDIA Study

Hypertension ◽  
2021 ◽  
Author(s):  
Nagisa Morikawa ◽  
Michael P. Bancks ◽  
Yuichiro Yano ◽  
Masanari Kuwabara ◽  
Angelo L. Gaffo ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Young Adulthood ◽  
Middle Age ◽  
Exposure Period ◽  
Serum Urate ◽  
Hazard Ratios ◽  
Trajectory Group ◽  
Incident Cardiovascular Disease

Serum urate levels have been shown to be correlated with risk for incident cardiovascular disease (CVD) events among middle-aged or older adults. However, serum urate trajectory during young adulthood and its association with CVD events has been understudied. Using serum urate measurements collected at baseline and 10, 15, 20 years after baseline from 3563 CARDIA (Coronary Artery Risk Development in Young Adults) participants (mean age 25.1±3.6 [18–30] years at baseline [year 0, 1985–1986]; 46.3% Black; 56.1% female), we determined sex-specific serum urate trajectories using SAS PROC TRAJ. We estimated hazard ratios for incident CVD events (coronary heart disease, heart failure, and stroke) occurring after the year 20 exam through 2017. We identified 3 serum urate trajectories by sex, including low-stable (n=1251), moderate-stable (n=1761), and high-increasing (n=551). Over a median 10.6 years of follow-up, 157 incident CVD events occurred. Participants among the high-increasing trajectory group had 2.89 (95% CI, 1.88–4.43) times greater risk for CVD compared with the low-stable trajectory group. The association was attenuated after adjustment for blood pressure levels during young adulthood. In conclusion, high-increasing serum urate trajectory during young adulthood was associated with incident CVD by middle age, and the association may be explained by blood pressure levels during the exposure period.

Abstract P107: Serum Urate Trajectories in Young Adulthood and Incident Cardiovascular Disease Events By Middle Age; The Coronary Artery Risk Development in Young Adults (cardia) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nagisa Morikawa ◽  
Michael P. Bancks ◽  
Yuichiro Yano ◽  
Masanori Kuwabara ◽  
Angelo L. Gaffo ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Young Adulthood ◽  
Clinical Characteristics ◽  
Middle Age ◽  
Serum Urate ◽  
Hazard Ratios ◽  
Study Participants ◽  
Incident Cardiovascular Disease

Introduction: Higher levels of serum urate (UA) obtained on a single occasion have been shown to be associated with a higher risk of cardiovascular disease (CVD) events among middle-aged or older adults. However, little is known regarding UA trajectory patterns during young adulthood and their associations with CVD outcomes by middle age. Hypothesis: We hypothesize that higher UA trajectory is associated with a higher risk for CVD events compared to lower UA trajectories. Methods: We included data from 4845 CARDIA Study participants (mean age at the Year 20 exam 44.8±3.7 (37-55) years; 50.8% African American; 55.6% female). Sex-specific UA trajectories were assessed using group-based trajectory modeling (PROC TRAJ in SAS version 9.4) based on UA levels obtained at baseline (Year 0) and 10, 15, 20 years later. Covariates included age, sex, race, and clinical characteristics at Year 20 (body mass index, diabetes and creatinine). We estimated hazard ratios (HR) for CVD events (coronary heart disease, heart failure, and stroke) from Year 20 (2005-06) through 2017. Results: We identified 3 UA trajectories in men and 3 similar but lower UA trajectories in women, characterized by low-increasing (men: 30%; n=652, mean UA 5.1; women 43%, n=1191, mean UA 3.9), moderate-increasing (men: 52%; n=1290, mean UA 6.4; women 45%, n=1284, mean UA 5.0), and high-increasing UA (men: 17%; n=377, mean UA 8.0; women 12%, n=305, mean UA 6.4) (Figure 1). Sex-specific trajectories were pooled. Over a median follow-up of 10.9 years, 203 incident CVD events occurred. The adjusted HRs for CVD events were 0.98 (95%CI, 0.66-1.45) for the pooled moderate-increasing group and 1.77 (95%CI, 1.10-2.84) for the pooled high-increasing group compared to the pooled low-increasing group. Conclusions: High-increasing UA trajectory during young adulthood was associated with an greater risk of CVD events by middle age. Modeling UA trajectories may help identify young adults at higher risk for CVD events.

scholarly journals Racial Differences in Associations of Blood Pressure Components in Young Adulthood With Incident Cardiovascular Disease by Middle Age

2017 ◽  
Vol 2 (4) ◽  
pp. 381 ◽  
Author(s):  
Yuichiro Yano ◽  
Jared P. Reis ◽  
Yacob G. Tedla ◽  
David C. Goff ◽  
David R. Jacobs ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Racial Differences ◽  
Young Adulthood ◽  
Middle Age ◽  
Incident Cardiovascular Disease

scholarly journals Association of Blood Pressure Patterns in Young Adulthood With Cardiovascular Disease and Mortality in Middle Age

2020 ◽  
Vol 5 (4) ◽  
pp. 382 ◽  
Author(s):  
Yuichiro Yano ◽  
Jared P. Reis ◽  
Cora E. Lewis ◽  
Stephen Sidney ◽  
Mark J. Pletcher ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Young Adulthood ◽  
Middle Age ◽  
Blood Pressure Patterns

scholarly journals Optimal Target Blood Pressure and Risk of Cardiovascular Disease in Low-Risk Younger Hypertensive Patients

2019 ◽  
Vol 32 (9) ◽  
pp. 833-841
Author(s):  
Chang Hee Kwon ◽  
Jeonggyu Kang ◽  
Ara Cho ◽  
Yoosoo Chang ◽  
Seungho Ryu ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Multivariable Analysis ◽  
Health Examination ◽  
Hypertensive Patients ◽  
Comprehensive Health ◽  
Optimal Target ◽  
Ischemic Attack ◽  
Incident Cardiovascular Disease

Abstract BACKGROUND This study aimed to examine longitudinal associations between blood pressure (BP) categories and incident cardiovascular disease (CVD) in treated hypertensive patients without CVD. METHODS A cohort study was performed in Korean adults who underwent a comprehensive health examination from 1 January 2011 to 31 December 2016 and was followed for incident CVD via linkage to the Health Insurance and Review Agency database until the end of 2016, with a median follow-up of 4.3 years. RESULTS Among 263,532 participants, 8,418 treated hypertensive patients free of CVD at baseline were included. The incident CVD end point was defined as new hospitalization for CVD, including ischemic heart disease, stroke, and transient ischemic attack. During 32,975.6 person-years of follow-up, 200 participants developed new-onset CVD (incidence rate of 60.6 per 104 person-years). The multivariable-adjusted hazard ratio (HR; 95% confidence intervals [CI]) for CVD according to systolic blood pressure (SBP) levels (comparing SBP < 110, SBP = 120–129, SBP = 130–139, SBP = 140–149, SBP = 150–159, and SBP ≥160 to SBP 110–119 mm Hg [reference]) were 0.83 (0.53–1.30), 1.31 (0.91–1.89), 1.18 (0.74–1.87), 1.46 (0.79–2.72), 3.19 (1.25–8.12), and 5.60 (2.00–15.70), respectively. In multivariable analysis for CVD according to diastolic blood pressure (DBP) levels, HR (95% CI) of DBP < 60, DBP = 70–79, DBP = 80–89, DBP = 90–99, and DBP ≥100 compared to DBP = 60–69 mm Hg [reference]) were 0.51 (0.12–2.14), 1.13 (0.76–1.67), 1.26 (0.83–1.92), 1.62 (0.89–2.97), and 1.68 (0.51–5.55), respectively. CONCLUSIONS In this large cohort of middle-aged treated hypertensive patients, SBP < 120 mm Hg and/or DBP < 70 mm Hg were acceptable and showed a trend of protection of incident CVD.

Personality, Cardiovascular Disease, and Cancer:

2004 ◽  
Vol 12 (3) ◽  
pp. 102-115 ◽  
Author(s):  
Manfred Amelang ◽  
Petra Hasselbach ◽  
Til Stürmer
Keyword(s):  
Cardiovascular Disease ◽  
Behavioral Control ◽  
Smoking Behavior ◽  
Type A Behavior ◽  
Incremental Validity ◽  
Personality Factors ◽  
Emotional Lability ◽  
Prevalent Disease ◽  
Incident Cardiovascular Disease

Abstract. Ten years ago a sample of N = 5.133 male and female subjects (age 28-74) responded to questionnaires including scales for personality, life style, work stress as well as questions on prevalent disease. We now report on the follow-up regarding self-reported incidence of cardiovascular disease and cancer. During a mean follow-up of 10 years, 257 participants had died. Of those alive, N = 4.010 (82%) participated in the follow-up. Of these, 120 and 180 persons reported incident cardiovascular disease and cancer, respectively. The incidence of cardiovascular disease could be significantly predicted by the personality factors “Emotional Lability”, “Behavioral Control” and “Type-A-Behavior” as well as by the “Rationality/Antemotionality”-scale according to Grossarth-Maticek. After controlling for age, gender and smoking behavior only the significant effect of “Emotional Lability” remained and the predictors according to Grossarth-Maticek had no incremental validity. Cancer could not be predicted by any personality factors.

scholarly journals Skin autofluorescence predicts new cardiovascular disease and mortality in people with type 2 diabetes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Henderikus E. Boersma ◽  
Robert P. van Waateringe ◽  
Melanie M. van der Klauw ◽  
Reindert Graaff ◽  
Andrew D. Paterson ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Fasting Blood Glucose ◽  
Multivariable Analysis ◽  
Oral Glucose ◽  
Skin Autofluorescence ◽  
Z Score

Abstract Background Skin autofluorescence (SAF) is a non-invasive marker of tissue accumulation of advanced glycation endproducts (AGE). Recently, we demonstrated in the general population that elevated SAF levels predict the development of type 2 diabetes (T2D), cardiovascular disease (CVD) and mortality. We evaluated whether elevated SAF may predict the development of CVD and mortality in individuals with T2D. Methods We included 2349 people with T2D, available baseline SAF measurements (measured with the AGE reader) and follow-up data from the Lifelines Cohort Study. Of them, 2071 had no clinical CVD at baseline. 60% were already diagnosed with diabetes (median duration 5, IQR 2–9 years), while 40% were detected during the baseline examination by elevated fasting blood glucose ≥7.0 mmol/l) and/or HbA1c ≥6.5% (48 mmol/mol). Results Mean (±SD) age was 57 ± 12 yrs., BMI 30.2 ± 5.4 kg/m2. 11% of participants with known T2D were treated with diet, the others used oral glucose-lowering medication, with or without insulin; 6% was using insulin alone. Participants with known T2D had higher SAF than those with newly-detected T2D (SAF Z-score 0.56 ± 0.99 vs 0.34 ± 0.89 AU, p < 0.001), which reflects a longer duration of hyperglycaemia in the former group. Participants with existing CVD and T2D had the highest SAF Z-score: 0.78 ± 1.25 AU. During a median follow-up of 3.7 yrs., 195 (7.6%) developed an atherosclerotic CVD event, while 137 (5.4%) died. SAF was strongly associated with the combined outcome of a new CVD event or mortality (OR 2.59, 95% CI 2.10–3.20, p < 0.001), as well as incidence of CVD (OR 2.05, 95% CI 1.61–2.61, p < 0.001) and death (OR 2.98, 2.25–3.94, p < 0.001) as a single outcome. In multivariable analysis for the combined endpoint, SAF retained its significance when sex, systolic blood pressure, HbA1c, total cholesterol, eGFR, as well as antihypertensive and statin medication were included. In a similar multivariable model, SAF was independently associated with mortality as a single outcome, but not with incident CVD. Conclusions Measuring SAF can assist in prediction of incident cardiovascular disease and mortality in individuals with T2D. SAF showed a stronger association with future CVD events and mortality than cholesterol or blood pressure levels.

scholarly journals Sex-Specific Associations between Blood Pressure and Risk of Atrial Fibrillation Subtypes in the Tromsø Study

2021 ◽  
Vol 10 (7) ◽  
pp. 1514
Author(s):  
Hilde Espnes ◽  
Jocasta Ball ◽  
Maja-Lisa Løchen ◽  
Tom Wilsgaard ◽  
Inger Njølstad ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Pressure Management ◽  
Reference Models ◽  
Proportional Hazards Regression ◽  
Hazard Ratios ◽  
Increased Risk

The aim of this study was to explore sex-specific associations between systolic blood pressure (SBP), hypertension, and the risk of incident atrial fibrillation (AF) subtypes, including paroxysmal, persistent, and permanent AF, in a general population. A total of 13,137 women and 11,667 men who participated in the fourth survey of the Tromsø Study (1994–1995) were followed up for incident AF until the end of 2016. Cox proportional hazards regression analysis was conducted using fractional polynomials for SBP to provide sex- and AF-subtype-specific hazard ratios (HRs) for SBP. An SBP of 120 mmHg was used as the reference. Models were adjusted for other cardiovascular risk factors. Over a mean follow-up of 17.6 ± 6.6 years, incident AF occurred in 914 (7.0%) women (501 with paroxysmal/persistent AF and 413 with permanent AF) and 1104 (9.5%) men (606 with paroxysmal/persistent AF and 498 with permanent AF). In women, an SBP of 180 mmHg was associated with an HR of 2.10 (95% confidence interval [CI] 1.60–2.76) for paroxysmal/persistent AF and an HR of 1.80 (95% CI 1.33–2.44) for permanent AF. In men, an SBP of 180 mmHg was associated with an HR of 1.90 (95% CI 1.46–2.46) for paroxysmal/persistent AF, while there was no association with the risk of permanent AF. In conclusion, increasing SBP was associated with an increased risk of both paroxysmal/persistent AF and permanent AF in women, but only paroxysmal/persistent AF in men. Our findings highlight the importance of sex-specific risk stratification and optimizing blood pressure management for the prevention of AF subtypes in clinical practice.

Association with Longevity of Phosphatidylinositol 3-Kinase Regulatory Subunit 1 Gene Variants Stems from Protection against Mortality Risk in Men with Cardiovascular Disease

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Timothy A. Donlon ◽  
Randi Chen ◽  
Kamal H. Masaki ◽  
Bradley J. Willcox ◽  
Brian J. Morris
Keyword(s):  
Cardiovascular Disease ◽  
Life Span ◽  
Mortality Risk ◽  
Regulatory Subunit ◽  
Phosphatidylinositol 3 Kinase ◽  
Survival Curves ◽  
Genotypic Effect ◽  
Hazard Ratios ◽  
Phosphatidylinositol 3

<b><i>Introduction:</i></b> Genetic variation in the phosphatidylinositol 3-kinase reregulatory subunit 1 gene (<i>PIK3R1</i>) is associated with longevity. <b><i>Objective:</i></b> The aim of the study was to determine whether cardiovascular disease (CVD) affects this association. <b><i>Methods:</i></b> We performed a longitudinal study of longevity-associated <i>PIK3R1</i> single-nucleotide polymorphism <i>rs7709243</i> genotype by CVD status in 3,584 elderly American men of Japanese ancestry. <b><i>Results:</i></b> At baseline (1991–1993), 2,254 subjects had CVD and 1,314 did not. The follow-up until Dec 31, 2019 found that overall, men with a CVD had higher mortality than men without a CVD (<i>p</i> = 1.7 × 10<sup>−5</sup>). However, survival curves of CVD subjects differed according to <i>PIK3R1</i> genotype. Those with longevity-associated <i>PIK3R1 TT</i>/<i>CC</i> had survival curves similar to those of subjects without a CVD (<i>p</i> = 0.11 for <i>TT</i>/<i>CC</i>, and <i>p</i> = 0.054 for <i>TC</i>), whereas survival curves for CVD subjects with the <i>CT</i> genotype were significantly attenuated compared with survival curves of subjects without a CVD (<i>p</i> = 0.0000012 compared with <i>TT</i>/<i>CC</i>, and <i>p</i> = 0.0000028 compared with <i>TC</i>). Men without CVD showed no association of longevity-associated genotype with life span (<i>p</i> = 0.58). Compared to subjects without any CVD, hazard ratios for mortality risk were 1.26 (95% CI, 1.14–1.39; <i>p</i> = 0.0000043) for <i>CT</i> subject with CVD and 1.07 (95% CI 0.99–1.17; <i>p</i> = 0.097) for <i>CC</i>/<i>TT</i> subjects with CVD. There was no genotypic effect on life span for 1,007 subjects with diabetes and 486 with cancer. <b><i>Conclusion:</i></b> Our study provides novel insights into the basis for <i>PIK3R1</i> as a longevity gene. We suggest that the <i>PIK3R1</i> longevity genotype attenuates mortality risk in at-risk individuals by protection against cellular stress caused by CVD.

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