TY - JOUR
T1 - Modifiable risk factors versus age on developing high predicted cardiovascular disease risk in blacks
AU - Bress, Adam P.
AU - Colantonio, Lisandro D.
AU - Booth, John N.
AU - Spruill, Tanya M.
AU - Ravenell, Joseph
AU - Butler, Mark
AU - Shallcross, Amanda J.
AU - Seals, Samantha R.
AU - Reynolds, Kristi
AU - Ogedegbe, Gbenga
AU - Shimbo, Daichi
AU - Muntner, Paul
N1 - Funding Information:
The authors thank the participants and data collection staffof the Jackson Heart Study. The Jackson Heart Study is supported and conducted in collaboration with Jackson State University (N01-HC-95170); University of Mississippi Medical Center (N01-HC-95171); and Tougaloo College (N01-HC-95172). The Jackson Heart Study is supported by contracts HHSN268201300046C, HHSN 268201300047C, HHSN268201300048C, HHSN2682013 00049C, and HHSN268201300050C from the National Heart, Lung, and Blood Institute and the National Institute on Minority Health and Health Disparities. This work was also supported by the NIH (R01 HL117323, K24-HL125704) from the National Heart, Lung, and Blood Institute and the National Institute of Health, Bethesda, MD. Dr Bress was supported by the NIH 5KL2TR001065 (PI Byington/Dere) from the National Center for Advancing Translational Sciences, Bethesda, MD. Drs Bress, Colantonio, and Muntner had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. The views expressed in this manuscript are those of the authors and do not necessarily represent the views of the National Heart, Lung, and Blood Institute; the National Institutes of Health; or the US Department of Health and Human Services.
Publisher Copyright:
© 2017 The Authors.
PY - 2017
Y1 - 2017
N2 - Background-Clinical guidelines recommend using predicted atherosclerotic cardiovascular disease (ASCVD) risk to inform treatment decisions. The objective was to compare the contribution of changes in modifiable risk factors versus aging to the development of high 10-year predicted ASCVD risk. Methods and Results-A prospective follow-up was done of the Jackson Heart Study, an exclusively black cohort at visit 1 (2000-2004) and visit 3 (2009-2012). Analyses included 1115 black participants without high 10-year predicted ASCVD risk (<7.5%), hypertension, diabetes mellitus, or ASCVD at visit 1. We used the Pooled Cohort equations to calculate the incidence of high (≥7.5%) 10-year predicted ASCVD risk at visit 3. We recalculated the percentage with high 10-year predicted ASCVD risk at visit 3 assuming each risk factor (age, systolic blood pressure, antihypertensive medication use, diabetes mellitus, smoking, total and high-density lipoprotein cholesterol), one at a time, did not change from visit 1. The mean age at visit 1 was 45.2±9.5 years. Overall, 30.9% (95% CI 28.3-33.4%) of participants developed high 10-year predicted ASCVD risk. Aging accounted for 59.7% (95% CI 54.2-65.1%) of the development of high 10-year predicted ASCVD risk compared with 32.8% (95% CI 27.0-38.2%) for increases in systolic blood pressure or antihypertensive medication initiation and 12.8% (95% CI 9.6-16.5%) for incident diabetes mellitus. Among participants <50 years, the contribution of increases in systolic blood pressure or antihypertensive medication initiation was similar to aging. Conclusions-Increases in systolic blood pressure and antihypertensive medication initiation are major contributors to the development of high 10-year predicted ASCVD risk in blacks, particularly among younger adults.
AB - Background-Clinical guidelines recommend using predicted atherosclerotic cardiovascular disease (ASCVD) risk to inform treatment decisions. The objective was to compare the contribution of changes in modifiable risk factors versus aging to the development of high 10-year predicted ASCVD risk. Methods and Results-A prospective follow-up was done of the Jackson Heart Study, an exclusively black cohort at visit 1 (2000-2004) and visit 3 (2009-2012). Analyses included 1115 black participants without high 10-year predicted ASCVD risk (<7.5%), hypertension, diabetes mellitus, or ASCVD at visit 1. We used the Pooled Cohort equations to calculate the incidence of high (≥7.5%) 10-year predicted ASCVD risk at visit 3. We recalculated the percentage with high 10-year predicted ASCVD risk at visit 3 assuming each risk factor (age, systolic blood pressure, antihypertensive medication use, diabetes mellitus, smoking, total and high-density lipoprotein cholesterol), one at a time, did not change from visit 1. The mean age at visit 1 was 45.2±9.5 years. Overall, 30.9% (95% CI 28.3-33.4%) of participants developed high 10-year predicted ASCVD risk. Aging accounted for 59.7% (95% CI 54.2-65.1%) of the development of high 10-year predicted ASCVD risk compared with 32.8% (95% CI 27.0-38.2%) for increases in systolic blood pressure or antihypertensive medication initiation and 12.8% (95% CI 9.6-16.5%) for incident diabetes mellitus. Among participants <50 years, the contribution of increases in systolic blood pressure or antihypertensive medication initiation was similar to aging. Conclusions-Increases in systolic blood pressure and antihypertensive medication initiation are major contributors to the development of high 10-year predicted ASCVD risk in blacks, particularly among younger adults.
KW - Atherosclerotic cardiovascular disease risk
KW - Blacks
KW - Blood pressure
KW - Hypertension
KW - Population
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U2 - 10.1161/JAHA.116.005054
DO - 10.1161/JAHA.116.005054
M3 - Article
C2 - 28179220
AN - SCOPUS:85015979581
SN - 2047-9980
VL - 6
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
IS - 2
M1 - e005054
ER -