Abstract TMP47: Risk Factors for Intracerebral Hemorrhage and the Racial Differences in the Impact of Age on Risk: The REasons for Geographic And Racial Differences in Stroke (REGARDS) Study

Introduction: Because of low incidence rates, risk factors for intracerebral hemorrhage (ICH) have largely been estimated in case/control studies, very selected population cohorts, or by pooling of multiple longitudinal cohorts. Methods: REGARDS is a longitudinal cohort study of 30,239 African American (AA) and white community-dwelling participants aged 45 and over, recruited from the 48 contiguous US states. Physician-adjudicated incident stroke events in the REGARDS study were used to assess risk factors for ICH among those stroke-free at baseline. Results: A total of 62 ICH events occurred over an average 5.6 year follow-up among 27,760 participants stroke-free at baseline. In multivariable models, there was a significant (p = 0.0066) interaction between race and age; ICH risk dramatically increases with age for whites (HR = 2.03 per 10 year difference; 95% CI: 1.14 - 2.86), but there was little evidence of increasing risk with age in AAs (HR = 1.01 per 10 year difference; 95%: 0.65 - 1.58). This differential impact of age underlies a substantial excess in AA-to-white risk at age 45 (HR = 5.30; 95% CI: 1.41 - 19.91), but a marginally lower risk at age 85 (HR = 0.33; 95% CI: 0.10 - 1.05) (see figure). Risk of ICH was also significantly higher for men than women (HR = 2.60; 95% CI: 1.50 - 4.48), in those with higher systolic blood pressure (HR = 1.19 per 10 mmHg difference; 95% CI: 1.05 - 1.36), and for warfarin use to non-use (HR = 2.24; 95% CI: 1.01 - 5.00). Diabetes, chronic kidney disease, cholesterol components, smoking, alcohol use, and aspirin use were not related to ICH risk. Discussion: Additional research is needed to understand the striking AA-to-white differences in ICH risk across the age spectrum. In addition, higher systolic blood pressure, male sex, and warfarin were confirmed as substantial ICH risk factors in the general population. Other factors found to be significant in other studies were not confirmed in this single cohort, population-based, longitudinal cohort study.

Download Full-text

Abstract P227: Depressive Symptoms and Incident CHD among African Americans and Whites: The Reasons for Geographical and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.127.suppl_12.ap227 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Mario Sims ◽

Nicole Redmond ◽

Yulia Khodneva ◽

Raegan Durant ◽

Jewell Halanych ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Depressive Symptoms ◽

African Americans ◽

Racial Disparities ◽

Racial Differences ◽

Community Dwelling ◽

Chd Risk ◽

Regards Study ◽

Chd Risk Factors

Objectives: African Americans (AA) have higher risk for coronary heart disease (CHD) outcomes than Whites. This racial disparity has been attributed to differences in risk factors such as hypertension, diabetes, smoking, and inactivity. Depression has been associated with CHD risk, both through behavioral factors and possibly through more direct mechanisms. Yet, the role of depressive symptoms in racial disparities in risk of CHD is not clear. Using the REGARDS Study, we examined the association between depressive symptoms and incident CHD. Hypothesis: Depressive symptoms are associated with incident CHD among AA, but not Whites. Methods: REGARDS is a national cohort of US community-dwelling adults aged >45 recruited from 2003 to 2007. Longitudinal associations of depressive symptoms with incident acute CHD (fatal CHD or nonfatal myocardial infarction or coronary revascularization) by race were examined among 24,261 participants (AA = 10,265; Whites =13,996) free of CHD at baseline, and observed through 12/31/09. Baseline depressive symptoms were defined by the 4-item Centers for Epidemiological Studies Depression Scale (CES-D), with continuous scores (0-12 range) dichotomized as normal (<4) or depressive symptoms (≥4). We estimated multivariable Cox proportional hazards models of incident CHD with depressive symptoms, adjusting for sociodemographics, CHD risk factors and health behaviors. Results: Overall mean follow-up was 4.2+1.5 years, CHD incidence was 8.3 events per 1000 person-years (n=366 events) among AA and 8.8 events per 1000 person-years (n=613 events) among Whites, p=0.0015. Depressive symptoms were more prevalent among AA (13.1%) than among Whites (8.5%), p<0.001. There was a significant interaction between race and depressive symptoms, thus models were stratified on race. After adjustment for age, sex, marital status and region, depressive symptoms were significantly associated with incident CHD among AA (HR 1.57 {95% CI 1.18-2.09}) but not among Whites (HR 1.11 {0.80-1.56}). After adding education, income, physical activity, smoking, alcohol consumption, diabetes, BMI, CRP, systolic blood pressure, cholesterol, albuminuria, use of blood pressure or statin medications, the relationship for AA was modestly attenuated but still significant (HR 1.35 {95% CI 1.01-1.81}). Conclusions: Depressive symptoms were associated with risk of incident CHD among AA but not Whites. Efforts to reduce racial disparities in CHD may need to address environmental and psychosocial factors that place AA at higher risk.

Download Full-text

Genetic and Environmental Risk Factors for Alcoholism: A 16-Year Longitudinal Cohort Study

SSRN Electronic Journal ◽

10.2139/ssrn.3335865 ◽

2019 ◽

Author(s):

I-Chao Liu ◽

Shu-Fen Liao ◽

Lawrence Shih-Hsin ◽

Susan Shur-Fen Gau ◽

Wen-Chung Lee ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Environmental Risk ◽

Environmental Risk Factors ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort

Download Full-text

Association between polymorphism at IGF-1 rs35767 gene locus and long-term decline in renal function: a Japanese retrospective longitudinal cohort study

BMC Nephrology ◽

10.1186/s12882-021-02408-9 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Kosuke Honda ◽

Satoru Kuriyama ◽

Kimiyoshi Ichida ◽

Tomoko Nakano ◽

Naoki Sugano ◽

...

Keyword(s):

Blood Pressure ◽

Metabolic Syndrome ◽

Renal Function ◽

Uric Acid ◽

Cohort Study ◽

Serum Uric Acid Level ◽

Human Growth ◽

Longitudinal Cohort Study ◽

Longitudinal Cohort

Abstract Background Insulin-like growth factor-1 (IGF-1) acts on glucose and protein metabolism and human growth and also influences blood pressure and renal function. This study investigated whether the single-nucleotide polymorphism of IGF-1, rs35767, plays a role in metabolic syndrome indicators, including blood pressure, glucose metabolism, uric acid levels, and renal function. Methods In this retrospective longitudinal cohort study, blood samples from 1506 Japanese individuals were collected and used for genotyping for variant rs35767: T > C in the IGF-1 upstream promoter. Data were analyzed to identify associations between IGF-1 genotypes and patient biochemical parameters, including the components of metabolic syndrome and the long-term change in renal function. Results The cohort rs35767 genotypes included 650 CC carriers (43.2%), 687 TC carriers (45.6%), and 169 TT carriers (11.2%). Multiple regression analysis revealed no association between IGF-1 genotype and blood pressure, glycated hemoglobin level, and serum uric acid level. However, in females, blood pressure was negatively correlated with the TT genotype. Longitudinal observation revealed that the decline in eGFR over 10 years was greater in TT (− 18.51 ± 1.04 mL/min/1.73m2) than in CC carriers (− 16.38 ± 0.52 mL/min/1.73m2; P < 0.05). Conclusion The present study suggests that renal function declines faster in individuals with the TT genotype at the IGF-1 rs35767 locus than in those with the CC genotype, suggesting that the TT genotype is associated with the long-term chronological decline in renal function.

Download Full-text