scholarly journals Prevalences and Risk Factors of Electrocardiographic Abnormalities in Chinese Adults: a cross-sectional study

2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang
Keyword(s):  
Risk Factors ◽  
Large Population ◽  
Cerebrovascular Diseases ◽  
Cvd Risk Factors ◽  
Chinese Adults ◽  
Cvd Risk ◽  
Bundle Branch Block ◽  
St Depression ◽  
History Of ◽  
Ecg Abnormalities

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and risk factors of ECG abnormalities in the general population of Chinese adults.Methods: ECG data were obtained from 34965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test.Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, the older age significantly increased the risk of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds ratios of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left.Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases had important impact on ECG abnormalities.# Liping Yu and Xiaojun Ye contributed equally to this work.

scholarly journals Prevalences and Associated Factors of Electrocardiographic Abnormalities in Chinese Adults: A Cross-sectional Study

2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang
Keyword(s):  
Risk Factors ◽  
Large Population ◽  
Cerebrovascular Diseases ◽  
Cvd Risk Factors ◽  
Chinese Adults ◽  
Cvd Risk ◽  
Bundle Branch Block ◽  
St Depression ◽  
History Of ◽  
Ecg Abnormalities

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults. Methods: ECG data were obtained from 34,965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test. Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left. Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.

scholarly journals Prevalences and associated factors of electrocardiographic abnormalities in Chinese adults: a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Liping Yu ◽  
◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
...  
Keyword(s):  
Risk Factors ◽  
Large Population ◽  
Cerebrovascular Diseases ◽  
Cvd Risk Factors ◽  
Chinese Adults ◽  
Cvd Risk ◽  
Bundle Branch Block ◽  
St Depression ◽  
History Of ◽  
Ecg Abnormalities

Abstract Background Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults. Methods ECG data were obtained from 34,965 participants in the 2007–2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test. Results The prevalences of major arrhythmias were 1.70, 2.37 and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96, 7.54 and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left. Conclusions This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.

scholarly journals Prevalences and Associated Factors of Electrocardiographic Abnormalities in Chinese Adults: A Cross-sectional Study

2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang
Keyword(s):  
Risk Factors ◽  
Large Population ◽  
Cerebrovascular Diseases ◽  
Cvd Risk Factors ◽  
Chinese Adults ◽  
Cvd Risk ◽  
Bundle Branch Block ◽  
St Depression ◽  
History Of ◽  
Ecg Abnormalities

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults. Methods: ECG data were obtained from 34,965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test. Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left. Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.

scholarly journals Prevalences and Associated Factors of Electrocardiographic Abnormalities in Chinese Adults: A Cross-sectional Study

2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang
Keyword(s):  
Risk Factors ◽  
Large Population ◽  
Cerebrovascular Diseases ◽  
Cvd Risk Factors ◽  
Chinese Adults ◽  
Cvd Risk ◽  
Bundle Branch Block ◽  
St Depression ◽  
History Of ◽  
Ecg Abnormalities

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults.Methods: ECG data were obtained from 34,965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test. Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left.Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.

Abstract P292: Cardiovascular Risk Factors in U.S. Men With and Without History of Prostate Cancer: NHANES 1999-2014

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Ahmed A Hassoon ◽  
Lawrence Appel ◽  
Hsin-Chieh Yeh
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Cancer Survivors ◽  
Odds Ratio ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Prevalence Odds Ratio ◽  
Cancer History ◽  
Prostate Cancer Survivors ◽  
History Of

In 2017 161,000 new cases of prostate cancer diagnosed in the U.S. With improved survival from prostate cancer, cardiovascular disease has emerged as competing cause of morbidity and mortality. However, few studies have assessed CVD risk factors among prostate cancer survivors. We analyzed National Health and Nutrition Examination Survey (NHANES) from 1999-2014 to assess CVD risk factors, as defined by AHA/ACC, in adult men with and without a history of prostate cancer. A total of 602 men, age 50 years and older, with prostate cancer history and 8,226 men without cancer history were included in the analysis. Among men with prostate cancer history, the mean (SE) age at survey was 72.3(0.4); 41% of the survivors had their diagnoses less than 5 years ago, while 31% survived more than 10 years after diagnosis. Compared to men without cancer, prostate cancer survivors were older (mean age 72 (0.4) vs 62y (0.1)), but with similar education level ( p =0.41). For CVD risk factors, prostate cancer survivors were less likely to be current smokers (6.5% vs 20.3%), but more likely to have hypertension and on anti-hypertensive medication (95.6% vs 88.9%) with age-adjusted prevalence odds ratio of 1.53 ([95% CI, 1.2 - 1.9]; p =0.001) and 1.78 ([95% CI, 1.1 - 2.9]; p =0.024), respectively. There were no differences in lipids profiles between men with and without prostate cancer. In stratified analysis, non-Hispanic blacks’ survivors have almost two times the prevalence of hypertension compared to non-Hispanic blacks free of cancer, with age-adjusted prevalence odds ratio of 1.9 ([95% CI, 1.2 - 2.96]; p=0.005). In conclusion, CVD risk factors were prevalent in prostate cancer survivors. Improving cardiovascular health through lifestyle change and preventive strategies is a public health priority, particularly among non-Hispanic Blacks.

scholarly journals Prevalence of major cardiovascular disease risk factors among a group of sub-Saharan African young adults: a population-based cross-sectional study in Yaoundé, Cameroon

BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029858 ◽  
Author(s):  
Jobert Richie Nansseu ◽  
Bibiane Siaheu Kameni ◽  
Felix Kembe Assah ◽  
Jean Joel Bigna ◽  
Saint-Just Petnga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Family History ◽  
Cross Sectional Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Prevalence Estimates ◽  
Hazardous Alcohol ◽  
History Of ◽  
Hazardous Alcohol Consumption

ObjectiveTo determine the prevalence estimates of some major risk factors for cardiovascular disease (CVD) in a young adult-aged population living in Yaoundé, Cameroon.DesignA cross-sectional study held from May to July 2017.SettingParticipantsStudents aged 18–35 years, with no known history of CVD, found at the campus during recruitment and who voluntarily agreed to be included in the study.Primary and secondary outcome measuresData were collected on personal and family history as well as lifestyle and nutritional habits; anthropometric parameters and blood pressure were also measured. Prevalence rates were calculated with their respective 95% CI.ResultsOverall, 931 participants (53.8% males) were included, with a median age of 23 years (IQR 21–25). The prevalence estimates for some major CVD risk factors were: 3.1% (95% CI 2.0 to 4.2) for family history of heart attack, 6.3% (95% CI 4.7 to 7.9) for family history of stroke, 26.7% (95% CI 23.9 to 29.5) for hazardous alcohol consumption, 0.9% (95% 0.3 to 1.5) for current tobacco smoking, 27.6% (95% CI 24.7 to 30.5) for secondhand smoking, 88.9% (95% CI 86.9 to 90.9) for physical inactivity, 99.0% (95% CI 98.4 to 99.6) for inadequate fruits and/or vegetables consumption, 39.8% (95% CI 36.7 to 42.9) for self-reported anxiety, 49.2% (95% CI 46.0 to 52.4) for self-reported depression, 22.1% (95% CI 19.4 to 24.8) for overweight, 3.9% (95% CI 2.7 to 5.1) for obesity, 14.4% (95% CI 12.1 to 16.7) for abdominal obesity, 14.5% (95% CI 12.2 to 16.8) for excess body fat mass, 30.0% (95% CI 27.1 to 32.9) for suspected prehypertension and 2.8% (95% CI 1.7 to 3.9) for suspected hypertension.ConclusionThe prevalence of some major CVD risk factors is high among young adults living in Yaoundé, Cameroon. Therefore, specific actions should be undertaken in this population to mitigate the upcoming burden of CVD. Accordingly, younger-aged adult populations should be encouraged and accompanied to practice physical activity, eat healthily, and stop or avoid smoking and/or hazardous alcohol consumption.

scholarly journals Prevalence of cardiovascular disease risk factors and long-term outcomes in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)

2020 ◽  
Author(s):  
Khalid Alhabib ◽  
Mohammed A Batais ◽  
Turky H Almigbal ◽  
Mostafa Q Alshamiri ◽  
Hani Altaradi ◽  
...  
Keyword(s):  
Risk Factors ◽  
Urban Areas ◽  
Saudi Population ◽  
Cvd Risk Factors ◽  
Long Term Outcomes ◽  
Cvd Risk ◽  
Urban Rural ◽  
History Of ◽  
Unhealthy Diet

Abstract ObjectiveWe report the prevalence of unhealthy lifestyle behaviors, cardiovascular disease (CVD) risk factors, and long-term outcomes within the Saudi population, stratified by age, sex, and place of residence.MethodsThe Prospective Urban Rural Epidemiology (PURE) study is a global cohort study including adults of 35–70 years old in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Clinical follow-up of major CVD events and mortality is ongoing.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, 25.1% diabetes, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had history of stress (several periods), 6.8% had permanent stress, 0.98% had history of stroke, 0.64% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers (21% vs. 0.45%, p<0.001), have diabetes (28.2% vs. 21.3%, p<0.001), and have history of CHD (3.2% vs. 1.6%, p=0.02); while women were more likely to be obese (58.6% vs. 42.8%, p<0.001), have central obesity (70.7% vs. 32.7%, p<0.001), self-report sadness (22.7%, vs. 9.9% p<0.001), experience stress (several periods), feel permanent stress (9.9% vs. 4.5%, p<0.001), and have low education (46.6% vs. 20.2%, p<0.001). Compared to participants in urban areas, those in rural areas had higher rates of diabetes (31.1% vs. 23.3%, p<0.001), obesity (56.6% vs. 47.3%, p<0.001), and hypertension (35.5% vs. 28.6%, p=0.004); and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle- and old-age individuals, younger participants more commonly reported unhealthy diet, permanent stress, and self-reporting of being sad. ConclusionPURE-Saudi, the first population cohort study in Saudi Arabia, revealed a high prevalence of CVD risk factors in the adult Saudi population, with higher rates in rural than urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.

TO THE QUESTION ABOUT SPECIFIC FEATURES OF THE CARDIOVASCULAR RISK FACTORS STRUCTURE IN MEN UNDER 60 YEARS OLD WITH ACUTE KIDNEY INJURY DURING MYOCARDIAL INFARCTION

2021 ◽  
pp. 23-28
Author(s):  
Gordienko A.V. ◽  
Balabanov A.S. ◽  
Tassybayev B.B.
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Coronary Artery Bypass Surgery ◽  
Bypass Surgery ◽  
Artery Bypass ◽  
Kidney Injury ◽  
Study Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
History Of

Relevance. Acute kidney injury (AKI) worsens the prognosis of myocardial infarction (MI). Aim. To study the characteristics of cardiovascular (CVD) risk factors in men under 60 years of age with AKI in myocardial infarction (MI) to improve prevention. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with ACI - 25 patients; II - control, without it - 168 patients. A comparative analysis of the frequency of observation of the main and additional CVD risk factors in groups was performed. Results. In the patients of the study group, more often than in the control group, the following was observed: MI in winter (68.0 and 36.3%, respectively; p = 0.01), with repeated cases - the interval between infarction of more than one year (48.0 and 29.8%; p = 0.04); psychoemotional stress (64.0 and 46.1%; p = 0.04) or hypertensive crisis as a situation provoking MI (28.0 and 19.2%; p = 0.04); a history of: overweight less than 10 years (72.0 and 35.7%; p = 0.002) with moderate obesity (48.0 and 22.6%; p = 0.03), chronic heart failure (36.0 and 14.0%; p = 0.006), peptic ulcer (32.0 and 13.7%; p = 0.01), unstable angina (64.0 and 42.6%; p = 0.003), peripheral angiopathies (80.0 and 56.5%; p = 0.02), coronary angiography (45.5 and 25.5%; p = 0.04) and coronary artery bypass surgery (24.0 and 8.6%; p = 0.009). Conclusions. The structure of CVD risk factors in men under 60 years old with MI and AKI is characterized by the prevalence of moderate obesity, gastroduodenal ulcers, chronic heart failure, stress and crisis course of hypertension, coronary angiography and a history of coronary artery bypass surgery, as well as MI in winter. It is advisable to use the listed combinations of factors in predictive modeling and planning of preventive measures in such patients.

Abstract 13525: The Association Between Multiparity and Adipokine Levels: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Carla P Rodriguez ◽  
Oluseye Ogunmoroti ◽  
Renato Quispe ◽  
Olatokunbo I Osibogun ◽  
Chiadi E Ndumele ◽  
...  
Keyword(s):  
Risk Factors ◽  
Covariate Adjustment ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Live Births ◽  
Grand Multiparity ◽  
Adjustment Model ◽  
Multiparous Women ◽  
History Of ◽  
The Relationship

Background: Multiparity is a risk factor for cardiovascular disease (CVD). However, the mechanism of this relationship is unknown. Adipokines may predispose multiparous women to certain cardiometabolic complications that can increase their risk of future CVD. Methods: We studied 975 female MESA participants (ages 45-84 yrs and initially free of CVD) who had complete data on parity assessed at baseline and adipokine levels measured at either Exam 2 or 3. Parity was categorized as nulliparity (reference), 1-2, 3-4 and ≥5 live births. Multivariable linear regression was used to evaluate the association of parity categories with log-transformed levels of leptin, resistin, and adiponectin. Results: The women (38% white, 23% black, 13% Chinese, and 26% Hispanic) had mean age at MESA visit 2/3 of 63±9 yrs. Median adipokine levels by parity group are shown in the Table . Compared to nulliparity, a history of 3-4 live births was associated with higher leptin levels, even after full covariate adjustment including body mass index (BMI) and CVD risk factors (model 4). Grand multiparity (≥5 births) was associated with greater leptin after adjustment for demographic and lifestyle factors (models 1 & 2), but these associations were no longer significant after BMI adjustment (model 3). Grand multiparity was also associated with lower adiponectin levels in demographic/lifestyle-adjusted models but not after adjustment for BMI. In contrast, grand multiparity remained associated with higher resistin levels after full covariate adjustment (model 4). Conclusions: In a multiethnic U.S. cohort of women, multiparity is associated with adipokine levels, specifically with higher leptin and resistin levels. Further studies are needed to determine whether adipokines mediate the relationship between multiparity and CVD.

Abstract MP63: Established Cardiovascular Disease Risk Factors Mediate The Relationship Between Hypertensive Disorders In First Pregnancy And Maternal Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Jennifer J Stuart ◽  
Lauren J Tanz ◽  
Eric B Rimm ◽  
Donna Spiegelman ◽  
Stacey A Missmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Chronic Hypertension ◽  
Cvd Risk Factors ◽  
First Birth ◽  
Cvd Risk ◽  
Hypertensive Disorders ◽  
Increased Risk ◽  
History Of ◽  
The Relationship

Introduction: Women with a history of hypertensive disorders in pregnancy (HDP; gestational hypertension [GHTN] or preeclampsia) have an increased risk of CVD risk factors and events compared to women with normotensive pregnancies. However, the extent to which the relationship between HDP and CVD events is mediated by established CVD risk factors is less clear. Hypothesis: We hypothesized that a large proportion of the HDP-CVD relationship would be mediated by subsequent CVD risk factors — chronic hypertension (CHTN), type 2 diabetes (T2D), hypercholesterolemia, and BMI. Methods: Parous women free of prior CVD events, CHTN, T2D, and hypercholesterolemia at first birth in the Nurses’ Health Study II comprised the analytic sample (n=57,974). Pregnancy history was retrospectively reported in 2009. Women were followed for confirmed CVD events (coronary heart disease [non-fatal or fatal MI, fatal CHD] or stroke [non-fatal or fatal]) from first birth through 2015. Potential mediators were self-reported on biennial questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals (CI) for the relationship between HDP in first pregnancy (preeclampsia or GHTN vs. normotension [ref]) and CVD, adjusting for age, race/ethnicity, parental education, family history of CVD before age 60, and pre-pregnancy risk factors (e.g., smoking, diet, and BMI). To evaluate the proportion of the HDP-CVD association that was jointly mediated by the CVD risk factors we used the difference method, comparing a model including these four factors to a model without them. Results: Nine percent of women (n=5,306) had a history of HDP in first pregnancy (preeclampsia: 6.3%; GHTN: 2.9%). CVD events occurred in 650 women with normotension in first pregnancy, 30 with GHTN, and 81 with preeclampsia. Adjusting for pre-pregnancy confounders, women with HDP in first pregnancy had a 63% higher rate of incident CVD (CI: 1.33-2.00) compared to women with normotension in first pregnancy; in particular, the strongest association was observed between preeclampsia and CHD (HR=2.18, CI: 1.62-2.93). The overall HDP-CVD association was largely mediated by the group of four CVD risk factors (HDP: proportion mediation [PM]=65%, CI: 35-87; preeclampsia: PM=57%, CI: 21-87; GHTN: PM=99%, CI: inestimable). All CVD risk factors contributed to mediation, but chronic hypertension accounted for the largest proportion. Conclusions: While approximately 40% of the association between preeclampsia and CVD remained unexplained, almost all the increased risk of CVD conferred by a history of GHTN was jointly accounted for by the development of established risk factors postpartum. Screening for CHTN, T2D, hypercholesterolemia, and overweight/obesity after pregnancy may be especially helpful in CVD prevention among women with a history of HDP.

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