Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study.

Pubmed ID: 28323823

Pubmed Central ID: PMC5360240

Journal: PloS one

Publication Date: March 21, 2017

Affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht,Utrecht, the Netherlands.

MeSH Terms: Humans, Male, Female, Aged, Cardiovascular Diseases, Risk Factors, Cohort Studies, Age Factors, Middle Aged, Smoking, Hypertension, Sex Factors, Cross-Sectional Studies, Overweight, Cluster Analysis, Linear Models, Cholesterol, Carotid Intima-Media Thickness, Meta-Analysis as Topic

Grants: N01HC95167, N01HC95159

Authors: Lorenz MW, Polak JF, Mathiesen EB, Tuomainen TP, Rundek T, Bots ML, Sitzer M, Kauhanen J, Evans GW, Grobbee DE, Rosvall M, Nijpels G, Stehouwer CD, Kitamura A, Wang X, den Ruijter HM, Peters SA, Anderson TJ, Britton AR, Engström G, de Graaf J, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Lonn EM, Okazaki S, Price JF, Rembold CM, Salonen JT, Dalmeijer GW, Dekker J, Kurl S

Cite As: Wang X, Dalmeijer GW, den Ruijter HM, Anderson TJ, Britton AR, Dekker J, Engström G, Evans GW, de Graaf J, Grobbee DE, Hedblad B, Holewijn S, Ikeda A, Kauhanen J, Kitagawa K, Kitamura A, Kurl S, Lonn EM, Lorenz MW, Mathiesen EB, Nijpels G, Okazaki S, Polak JF, Price JF, Rembold CM, Rosvall M, Rundek T, Salonen JT, Sitzer M, Stehouwer CD, Tuomainen TP, Peters SA, Bots ML. Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study. PLoS One 2017 Mar 21;12(3):e0173393. doi: 10.1371/journal.pone.0173393. eCollection 2017.

Studies:

Abstract

BACKGROUND: The relation of a single risk factor with atherosclerosis is established. Clinically we know of risk factor clustering within individuals. Yet, studies into the magnitude of the relation of risk factor clusters with atherosclerosis are limited. Here, we assessed that relation. METHODS: Individual participant data from 14 cohorts, involving 59,025 individuals were used in this cross-sectional analysis. We made 15 clusters of four risk factors (current smoking, overweight, elevated blood pressure, elevated total cholesterol). Multilevel age and sex adjusted linear regression models were applied to estimate mean differences in common carotid intima-media thickness (CIMT) between clusters using those without any of the four risk factors as reference group. RESULTS: Compared to the reference, those with 1, 2, 3 or 4 risk factors had a significantly higher common CIMT: mean difference of 0.026 mm, 0.052 mm, 0.074 mm and 0.114 mm, respectively. These findings were the same in men and in women, and across ethnic groups. Within each risk factor cluster (1, 2, 3 risk factors), groups with elevated blood pressure had the largest CIMT and those with elevated cholesterol the lowest CIMT, a pattern similar for men and women. CONCLUSION: Clusters of risk factors relate to increased common CIMT in a graded manner, similar in men, women and across race-ethnic groups. Some clusters seemed more atherogenic than others. Our findings support the notion that cardiovascular prevention should focus on sets of risk factors rather than individual levels alone, but may prioritize within clusters.