Moderation of weight misperception on the associations between obesity indices and cardiovascular disease risk

Accurate Estimation ◽

Cvd Risk ◽

Weight Category ◽

Weight Misperception ◽

Ascvd Risk ◽

Obesity Indices

Abstract PurposeTo evaluate whether weight misperception is associated with estimated cardiovascular disease (CVD) risk and whether gender moderates the association between obesity indices and CVD risk.MethodsIn 7836 men and 10299 women aged 40-79 years without CVD history from the 2014–2018 Korea National Health and Nutrition Examination Survey, the risk of 10-year atherosclerotic cardiovascular disease (ASCVD) was calculated using Pooled Cohort Equations. Weight misperception was defined as accurate estimation, overestimation, or underestimation by comparing perceived body shape to actual weight category. Obesity indices were BMI and waist circumference (WC).ResultsIn fully-adjusted models, odds of 10-year ASCVD risk of ≥ 7.5% were lower in men with overestimating weight (odd ratio [95% confidence interval], 0.85 [0.73, 0.99] after adjusting for BMI; 0.79 [0.68, 0.92] after adjusting for WC), but higher in women with underestimating weight (1.44 [1.27, 1.63] after adjusting for BMI; 1.42 [1.26, 1.61] after adjusting for WC) compared to those with accurate weight estimates. Compared to women with accurate weight estimates, the ASCVD risk associated with obesity indices was higher in those who underestimated weight (ß [95% CI], 0.33 [0.23, 0.43] for BMI; 0.16 [0.13, 0.20] for WC), whereas it was lower in those who overestimated weight (-0.15 [-0.28, -0.02] for BMI; -0.07 [-0.11, -0.03] for WC). In men, weight misperception did not moderate the association between obesity indices and the ASCVD risk.ConclusionWeight misperception was associated with CVD risk independently across gender and moderates the association between obesity indices and CVD risk in women.

Abstract 024: Effects Of Diet On 10-year Atherosclerotic Cardiovascular Disease Risk Using The Pooled Cohort Equations Risk Calculator: Results From The Dash Trial

Circulation ◽

10.1161/circ.143.suppl_1.024 ◽

2021 ◽

Vol 143 (Suppl_1) ◽

Author(s):

Sun Young Jeong ◽

Lara Kovell ◽

Timothy B Plante ◽

Christina C Wee ◽

Edgar R Miller ◽

...

Keyword(s):

Cardiovascular Disease ◽

Disease Risk ◽

Control Diet ◽

Hdl Cholesterol ◽

Risk Scores ◽

Cvd Risk ◽

Dash Diet ◽

Background: The Dietary Approaches to Stop Hypertension (DASH) diet is known to reduce cardiovascular disease (CVD) risk factors, but its effects on 10-year CVD risk based on the pooled cohort estimating equation has not been reported. Objective: To determine the effects of adopting the DASH diet on 10-year atherosclerotic cardiovascular disease (ASCVD) risk compared to a typical American (control) diet or a diet rich fruit and vegetables (F/V), but otherwise similar to control. Methods: The DASH trial was a 3-arm, parallel-group, randomized controlled feeding trial of 459 adults aged 22 to 75 years without CVD and not taking anti-hypertensive or diabetes medications. These participants were randomized to a control diet, a F/V diet, or the DASH diet for 8 weeks. Weight was kept constant. Blood pressure (BP) and lipids were measured at baseline and at 8-weeks to compare 10-year ASCVD risk scores across dietary assignments. Comparisons were performed via linear regression adjusted for baseline ASCVD risk score. Results: The mean age of participants was 45 years; 49% were women, 60% were black, and 10% were current smokers. Mean systolic BP was 131.3±10.8 mm Hg, mean LDL cholesterol was 121±32 mg/dL, and mean HDL cholesterol was 48±14 mg/dL. Both DASH and F/V diets shifted the distribution of ASCVD risk scores downward compared to the control diet ( Figure, Panel A ). Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk by 10.0% (95% CI: -17.7, -1.5; P = 0.02) and 11.7% (95% CI: -19.3, -3.3; P = 0.007) respectively ( Figure, Panel B ). There was no difference between the DASH and F/V diets (-1.9%; 95% CI: -10.3, 7.4; P = 0.68). Conclusions: Compared to the control diet, the DASH and F/V diets reduced 10-year ASCVD risk, while the DASH and F/V had similar effects.

Circulating Proangiogenic Cell Activity Is Associated with Cardiovascular Disease Risk

CrossRef Listing of Deleted DOIs ◽

10.1177/1087057112454919 ◽

2012 ◽

Vol 17 (9) ◽

pp. 1163-1170 ◽

Cited By ~ 8

Author(s):

Kreton Mavromatis ◽

Konstantinos Aznaouridis ◽

Ibhar Al Mheid ◽

Emir Veledar ◽

Saurabh Dhawan ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Bone Marrow ◽

Disease Risk ◽

Cell Activity ◽

Cvd Risk ◽

The Relationship

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.

Cohort study on the effects of depression on atherosclerotic cardiovascular disease risk in Korea

BMJ Open ◽

10.1136/bmjopen-2018-026913 ◽

2019 ◽

Vol 9 (6) ◽

pp. e026913 ◽

Cited By ~ 2

Author(s):

Yon Ho Jee ◽

Hyoungyoon Chang ◽

Keum Ji Jung ◽

Sun Ha Jee

Keyword(s):

Cardiovascular Disease ◽

Cohort Study ◽

Disease Risk ◽

Population Based ◽

Western World ◽

Cvd Risk ◽

National Health Insurance System ◽

Increased Risk

ObjectivesDepression has been reported to be a risk factor of cardiovascular disease in the western world, but the association has not yet been studied among Asian populations. The aim of this study was to investigate whether depression increases the risk of developing atherosclerotic cardiovascular disease (ASCVD) in a large Korean cohort study.DesignPopulation based cohort study.SettingDatabase of National Health Insurance System, Republic of Korea.Participants481 355 Koreans (260 695 men and 220 660 women) aged 40–80 years who had a biennial health check-up between 2002 and 2005.Main outcome measureThe main outcome in this study was the first ASCVD event (hospital admission or death).ResultsDepression increased the risk of developing ASCVD by 41% for men and 48% for women. In men, 3–4 outpatient visits for depression increased the risk of angina pectoris by 2.12 times (95% CI 1.55 to 2.90) and acute myocardial infarction by 2.29 times (95% CI 1.33 to 3.95). Depression was also associated with stroke in men (HR 1.29, 95% CI 1.19 to 1.39) and in women (HR 1.37, 95% CI 1.29 to 1.46). However, no increased risk of ASCVD was found for men who received 10 or more depressive treatments, compared with those without any outpatient visit for depression.ConclusionsIn this cohort, depressed people were at increased risk of ASCVD incidence. Therefore, individuals with depression may need routine monitoring of heart health that may prevent their future CVD risk.

Abstract MP53: The Impact of the Obesity Epidemic on Atherosclerotic Cardiovascular Disease Risk Scores: The CARDIA Study

Circulation ◽

10.1161/circ.131.suppl_1.mp53 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Duke Appiah ◽

Pamela J Schreiner ◽

Raegan W Durant ◽

Sharina D Person ◽

Catarina I Kiefe ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Young Adults ◽

Disease Risk ◽

Risk Scores ◽

Cvd Risk ◽

Obesity Epidemic ◽

Ascvd Risk ◽

The Impact

Introduction: Cardiovascular disease (CVD) mortality has decreased over recent decades, in part, due to changes in the prevalence of risk factors. However, few studies have explored the impact of the obesity epidemic on CVD risk prediction in young adults. Hypothesis: We assessed the hypothesis that BMI trends are positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores from young adulthood to middle age beyond the effect of other CVD risk factors included in the scores (age, sex, race, lipids, blood pressure, hypertension medication, diabetes, smoking). METHODS: Data were obtained from 2437 black and white men and women aged 18-30 years at baseline (1985-1986) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study with follow-up exams at year 0, 5, 10, 15, 20 and 25 (ages 43-55 years). Repeated-measures regression was used to model the association between ASCVD risk scores and time-varying BMI measures. RESULTS: The average 10-year ASCVD risk increased from 0.6% at baseline (mean age: 25.3) to 3.9% at year 25 (mean age: 50.3) with the change higher for men (blacks: 1.0 to 8.2%, whites: 0.3 to 4.6%) than women (blacks: 0.5 to 3.6%, whites: 1.2 to 1.4%). The overall prevalence of obesity at baseline and year 25 was 10% and 42% respectively. BMI trends were positively associated with 10-year change in ASCVD risk scores (0.12% per 1 kg/m2 increase, p<0.001). BMI adjustment minimally reduced risk scores trends with the greatest change between unadjusted and adjusted risk scores observed among black women (0.1 to 3.0%) (Figures A and B). CONCLUSION: In young adults, BMI trends are associated positively with 10-year changes in ASCVD risk independent of other risk factors. This adds to the evidence that weight control in early adulthood is an important predictor of lower future CVD risk.

Abstract 014: Comparative Cost-Effectiveness of 10-Year Atherosclerotic Cardiovascular Disease Risk Equations Over 10 Years of Follow-up: The Multi-Ethnic Study of Atherosclerosis

Circulation ◽

10.1161/circ.137.suppl_1.014 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Gabriel S Tajeu ◽

Ciaran Kohli-Lynch ◽

Yiyi Zhang ◽

Paul Muntner ◽

Steven Shea ◽

...

Keyword(s):

Cardiovascular Disease ◽

Cost Effectiveness ◽

Disease Risk ◽

Statin Treatment ◽

Moderate Intensity ◽

Ethnic Study ◽

Policy Model ◽

Introduction: Uncertainty remains regarding the most efficient and cost-effective 10-year atherosclerotic cardiovascular disease (ASCVD) risk prediction tool for identifying moderate to high-risk patients for primary prevention statin treatment. Methods: We utilized the CVD Policy Model, a computer microsimulation model of ASCVD incidence, prevalence, mortality, and costs, to compare cost-effectiveness of statin treatment at varying 10-year predicted ASCVD risk thresholds for Framingham CVD (FRS-CVD), Reynolds Risk Score (RRS), and Pooled Cohorts Risk Equations over a 10-year time horizon in the Multi-Ethnic Study of Atherosclerosis (MESA) cohort. Cost effectiveness was assessed at predicted 10-year risk ≥ 20.0%, 15.0%, 10.0%, 7.5%, 5.0%, and 2.5%. We restricted the simulation cohort to participants aged 50 to 74 years who were not taking statins at baseline (n = 2,871). Moderate intensity statin treatment effectiveness was parameterized in the model as a 29% low-density lipoprotein cholesterol reduction. Total cost comprised statins ($100/year), side effect costs, and ASCVD event costs. Disability from treatment side effects and ASCVD events were included. Results: Average FRS-CVD, RRS, and Pooled Cohorts 10-year predicted ASCVD risks were 18.8%, 11.3%, 12.2%, for men and 8.9%, 4.3%, 6.6%, for women, respectively. At the same predicted risk, FRS-CVD consistently selected the most patients for treatment, and RRS the fewest ( Figure ). Compared with no treatment, treating patients with RRS ≥ 20% was cost saving in men. Subsequent risk threshold strategies with incremental cost effectiveness <$75,000/quality-adjusted life-year (QALY) for men were: FRS-CVD ≥ 20% ($13,046), RRS ≥ 7.5% ($17,774), and RRS ≥ 5.0% ($19,891). For women, the non-dominated thresholds were: Pooled Cohorts ≥ 15% ($27,908) and Pooled Cohorts ≥ 7.5% ($72,377). Conclusions: At cost-effectiveness thresholds less than $75,000/QALY, RRS was the highest value tool for men while the Pooled Cohorts Risk Equations performed best for women.

Real Men Don’t Cry: Skill Expressing Discrete Emotions Differentially Predicts Cardiovascular Disease Risk in Men and Women

Annals of Behavioral Medicine ◽

10.1093/abm/kaz024 ◽

2019 ◽

Vol 54 (1) ◽

pp. 49-60 ◽

Cited By ~ 1

Author(s):

Laura M Thompson ◽

Natalie L Tuck ◽

Sarah D Pressman ◽

Nathan S Consedine

Keyword(s):

Cardiovascular Disease ◽

New Zealand ◽

Lower Risk ◽

Disease Risk ◽

Community Sample ◽

Cvd Risk ◽

Men And Women ◽

Ascvd Risk ◽

And Performance

Abstract Background Expressing emotions effectively is central to social functioning and has links to health and cardiovascular disease (CVD) risk. Previous work has linked the ability to smile to lower CVD risk in men but has not studied other expressions or considered the context of these skills. Purpose To test whether the ability to express fear, anger, sadness, happiness, and disgust cross-sectionally predict CVD risk in both genders and whether links are moderated by the ability to decode others’ emotional signals. Methods A community sample of 125 men and women (30–75 years) provided trait emotion data before a laboratory visit where blood was drawn and performance-based assessments of the ability to signal and decode emotions were administered. Expressive accuracy was scored using FaceReader software. Projected CVD risk was calculated using Framingham, a New Zealand (NZ) specific, and Atherosclerosis CVD (ASCVD) risk algorithms. Results Accuracy expressing happiness predicted lower projected risk, whereas greater accuracy expressing fear and sadness predicted higher risk. Gender frequently moderated these links; greater accuracy expressing happiness predicted lower risk in men but not women. Conversely, greater accuracy expressing fear predicted higher risk in men, whereas greater accuracy expressing sadness predicted lower risk in women but, again, higher risk in men. The ability to accurately decode others’ emotions moderated some links. Conclusions The ability to signal emotion has complex links to health parameters. The ability to flexibly regulate expressions in accordance with gender norms may be one useful way of thinking about adaptive expressive regulation.

Abstract 17098: Liver Fibrosis and Associated Cardiovascular Disease Risk and Its Predictors Among US Adults With and Without Diabetes

Circulation ◽

10.1161/circ.142.suppl_3.17098 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Nathan D Wong ◽

Matthew Bang ◽

WENJUN FAN ◽

Aprille Espinueva

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Liver Fibrosis ◽

Disease Risk ◽

Advanced Fibrosis ◽

Alcoholic Fatty Liver ◽

Female Sex ◽

Background: Liver fibrosis is a complication of non-alcoholic fatty liver disease (NAFLD) and is associated with increased atherosclerotic cardiovascular disease (ASCVD) risk. Whether this risk may be enhanced in persons with pre-diabetes (pre-DM) or diabetes (DM), however, is not established. We examined the association of liver fibrosis with estimated ASCVD risk and its predictors according to DM status. Methods: We studied 30,895 adults (3,983 or 12.9% with DM) from the National Health and Nutrition Examination Surveys 1999-2014 with liver function measures to calculate FIB-4 scores; values of 1.3-2.67 and >2.67 indicated a moderate and high probability of advanced fibrosis, respectively. We studied the prevalence high FIB-4 scores in those with and without pre-DM and DM and the 10-year ASCVD risk based on the ACC/AHA Pooled Cohort Risk Calculator in persons without known ASCVD. In addition, multiple logistic regression examined predictors of high FIB-4 scores. Results: The prevalence of FIB-4 scores of 1.3-2.67 and >2.67 ranged from 17.8% and 1.5% in those without pre-DM/DM, 29.9% and 2.5% in those with pre-DM, and 35.3% and 3.5% in those with DM, respectively (p<0.0001). The figure shows the 10-year ASCVD risk by FIB-4 scores and presence of pre-DM and DM. Multivariable indicators of a FIB-4 score >2,67 were age (odds ratio [OR]=3.0 / 10 years), female sex (OR=0.53), non-Hispanic Black ethnicity (OR=2.0), waist circumference (OR=0.76/SD), alcohol use (OR=1.5), and NALFD (OR=3.3) in those without DM, and age (OR=2.2/10 years), female sex (OR=0.48), systolic blood pressure (1.4/SD), diastolic blood pressure (0.76/SD), and current smoking (OR=2.2) in those with DM (all p<0.05 to p<0.0001). Conclusions: Advanced fibrosis is more prevalent in those with vs. without DM. The presence of DM with higher FIB-4 scores is associated with especially high estimated ASCVD risks warranting increased efforts to address prevention and treatment of liver fibrosis.

External validation of three atherosclerotic cardiovascular disease risk equations in rural areas of Xinjiang, China

BMC Public Health ◽

10.1186/s12889-020-09579-4 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Yunxing Jiang ◽

Rulin Ma ◽

Heng Guo ◽

Xianghui Zhang ◽

Xinping Wang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Rural Areas ◽

Disease Risk ◽

External Validation ◽

Final Analysis ◽

Men And Women ◽

Risk Equation ◽

Abstract Background To externally validate the Prediction for ASCVD Risk in China (PAR) risk equation for predicting the 5-year atherosclerotic cardiovascular disease (ASCVD) risk in the Uyghur and Kazakh populations from rural areas in northwestern China and compare its performance with those of the pooled cohort equations (PCE) and Framingham risk score (FRS). Methods The final analysis included 3347 subjects aged 40–74 years without CVD at baseline. The 5-year ASCVD risk was calculated using the PAR, PCE, and FRS. Discrimination, calibration, and clinical usefulness of the three equations in predicting the 5-year ASCVD risk were assessed before and after recalibration. Results Of 3347 included subjects, 1839 were female. We observed 286 ASCVD events in within 5-year follow-up. All three risk equations had moderate discrimination in both men and women. C-indices of PAR, PCE, and FRS were 0.727 (95% CI, 0.725–0.729), 0.727 (95% CI, 0.725–0.729), and 0.740 (95% CI, 0.738–0.742), respectively, in men; the corresponding C-indices were 0.738 (95% CI, 0.737–0.739), 0.731 (95% CI, 0.730–0.732), and 0.761 (95% CI, 0.760–0.762), respectively, in women. PCE, PAR and FRS substantially underestimated the 5-year ASCVD risk in women by 70, 23 and 51%, respectively. However, PAR and FRS fairly predicted the risk in men and PAR was well calibrated. The calibrations of the three risk equations could be changed by recalibration. The decision curve analyses demonstrated that at the threshold risk of 5%, PCE was the most clinically useful in both men and women after recalibration. Conclusions All three risk equations underestimated the 5-year ASCVD risk in women, while PAR and FRS fairly predicted that in men. However, the results of predictive performances for three risk equations are inconsistent, more accurate risk equations are required in the primary prevention of ASCVD aiming to this Uyghur and Kazakh populations.

Cardiovascular disease risk prediction by the American College of Cardiology (ACC)/American Heart Association (AHA) Atherosclerotic Cardiovascular Disease (ASCVD) risk score among HIV-infected patients in sub-Saharan Africa

PLoS ONE ◽

10.1371/journal.pone.0172897 ◽

2017 ◽

Vol 12 (2) ◽

pp. e0172897 ◽

Cited By ~ 17

Author(s):

Mosepele Mosepele ◽

Linda C. Hemphill ◽

Tommy Palai ◽

Isaac Nkele ◽

Kara Bennett ◽

...

Keyword(s):

Cardiovascular Disease ◽

American Heart Association ◽

American Heart ◽

Disease Risk ◽

Heart Association ◽

Sub Saharan Africa ◽

Ascvd Risk ◽

Sub Saharan

941. Incarcerated patients living with HIV: Atherosclerotic cardiovascular disease risk and management

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa439.1127 ◽

2020 ◽

Vol 7 (Supplement_1) ◽

pp. S503-S504

Author(s):

Sarah M Michienzi ◽

Thomas D Chiampas ◽

Amy Valkovec ◽

Siria Arzuaga ◽

Mahesh C Patel ◽

...

Keyword(s):

Cardiovascular Disease ◽

Statin Therapy ◽

Disease Risk ◽

Heart Association ◽

Blood Cholesterol ◽

Lipid Panel ◽

Ascvd Risk ◽

Living With Hiv

Abstract Background The 2018 American Heart Association and American College of Cardiology (AHA/ACC) 2018 Guideline on the Management of Blood Cholesterol included human immunodeficiency virus (HIV) as an atherosclerotic cardiovascular disease (ASCVD) risk enhancer for the first time. Our study investigates if patients living with HIV in the Illinois Department of Corrections (IDOC) were prescribed appropriate HMG-CoA reductase inhibitor (statin) therapy following release of these guidelines based on risk. Methods This was a retrospective study of patients with > 1 visit in our multidisciplinary HIV IDOC Telemedicine Clinic from 1/1/19-6/1/19. Our prescriptive authority is limited to HIV and directly related conditions, and we provide recommendations to on-site providers for other comorbidities. Included patients were > 18 years of age, HIV positive, and incarcerated within IDOC. Excluded patients had existing ASCVD. Data from the first visit in the study period were extracted from the electronic medical record and analyzed utilizing descriptive statistics. Primary objectives were to quantify ASCVD risk and appropriate statin use in our population. Results Of the 158 patients included, average age was 42 years. The majority were male (89%), Black (73%), overweight/obese (117/148, 79%), on an integrase single-tablet regimen (78%), with CD4 >200 cells/µL (97%), and HIV RNA < 20 copies/mL (85%). Of the 18 females, 8 were transgender. Within the prior year, 65% had a lipid panel. For the 50 patients meeting criteria for 10-year ASCVD estimation, median (range) risk was 6.6% (0.8% - 31.9%). Only 12 patients were on statins. Of these, all were indicated per AHA/ACC guidelines with 10 prescribed appropriate intensity. An additional 45 patients had indications for statins but were untreated. In total, 47 patients (30%) were not receiving appropriate statin therapy. Conclusion Results of our study suggest ASCVD risk management is an area of improvement for inmates living with HIV, especially as we look towards caring for an aging HIV population. Future directions include comparing these data to data from a later time point to evaluate time for guideline uptake. Disclosures Thomas D. Chiampas, PharmD, BCPS, AAHIVP, Gilead (Employee)