Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events.

Pubmed ID: 26134404

Pubmed Central ID: PMC4489855

Journal: PloS one

Publication Date: July 2, 2015

MeSH Terms: Humans, Male, Adult, Female, Aged, Risk Factors, Middle Aged, Smoking, Prevalence, Hypertension, Proportional Hazards Models, Follow-Up Studies, Comorbidity, Incidence, Stroke, Myocardial Infarction, Carotid Artery Diseases, Cholesterol, HDL, Diabetes Mellitus, Linear Models, Carotid Intima-Media Thickness, Age Distribution, Cholesterol, LDL, Dyslipidemias, Global Health, Ethnicity, Racial Groups

Grants: N01-HC-95159, HHSN268200800007C, HHSN268201200036C, N01HC55222, N01HC85079, N01HC85080, N01HC85081, N01HC85082, N01HC85083, N01HC85086, N01-HC-95167, MR/M006638/1, N01HC95167, N01HC95159

Authors: Lorenz MW, Polak JF, Mathiesen EB, Rundek T, Bots ML, Sitzer M, Evans GW, Grobbee DE, Rosvall M, Dekker JM, Nijpels G, Stehouwer CD, Kitamura A, den Ruijter HM, Peters SA, Groenewegen KA, Anderson TJ, Britton AR, Engström G, Eijkemans MJ, de Graaf J, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Lonn EM, Okazaki S, O'Leary DH, Price JF, Robertson C, Rembold CM, Salonen JT, Gijsberts CM, Hoefer IE, Asselbergs FW, de Kleijn DP, Pasterkamp G

Cite As: Gijsberts CM, Groenewegen KA, Hoefer IE, Eijkemans MJ, Asselbergs FW, Anderson TJ, Britton AR, Dekker JM, Engström G, Evans GW, de Graaf J, Grobbee DE, Hedblad B, Holewijn S, Ikeda A, Kitagawa K, Kitamura A, de Kleijn DP, Lonn EM, Lorenz MW, Mathiesen EB, Nijpels G, Okazaki S, O'Leary DH, Pasterkamp G, Peters SA, Polak JF, Price JF, Robertson C, Rembold CM, Rosvall M, Rundek T, Salonen JT, Sitzer M, Stehouwer CD, Bots ML, den Ruijter HM. Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events. PLoS One 2015 Jul 2;10(7):e0132321. doi: 10.1371/journal.pone.0132321. eCollection 2015.

Studies:

Abstract

BACKGROUND: Clinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events. METHODS: We used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity. RESULTS: Ethnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites. CONCLUSION: The magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.