Dataset Information

Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium.

ABSTRACT:

Aims

Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear.

Methods and results

An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration (n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events.

Conclusion

Averaged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints.

SUBMITTER: Bahls M

PROVIDER: S-EPMC7008553 | biostudies-literature | 2020 Feb

REPOSITORIES: biostudies-literature

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Publications

Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium.

Bahls Martin M Lorenz Matthias W MW Dörr Marcus M Gao Lu L Kitagawa Kazuo K Tuomainen Tomi-Pekka TP Agewall Stefan S Berenson Gerald G Catapano Alberico L AL Norata Giuseppe D GD Bots Michiel L ML van Gilst Wiek W Asselbergs Folkert W FW Brouwers Frank P FP Uthoff Heiko H Sander Dirk D Poppert Holger H Hecht Olsen Michael M Empana Jean Philippe JP Schminke Ulf U Baldassarre Damiano D Veglia Fabrizio F Franco Oscar H OH Kavousi Maryam M de Groot Eric E Mathiesen Ellisiv B EB Grigore Liliana L Polak Joseph F JF Rundek Tatjana T Stehouwer Coen DA CD Skilton Michael R MR Hatzitolios Apostolos I AI Savopoulos Christos C Ntaios George G Plichart Matthieu M McLachlan Stela S Lind Lars L Willeit Peter P Steinmetz Helmuth H Desvarieux Moise M Ikram M Arfan MA Johnsen Stein Harald SH Schmidt Caroline C Willeit Johann J Ducimetiere Pierre P Price Jackie F JF Bergström Göran G Kauhanen Jussi J Kiechl Stefan S Sitzer Matthias M Bickel Horst H Sacco Ralph L RL Hofman Albert A Völzke Henry H Thompson Simon G SG

European journal of preventive cardiology 20191016 3

<h4>Aims</h4>Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear.<h4>Methods and results</h4>An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholest ...[more]

PMID: 31619084

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Project description:BackgroundCarotid intima-media thickness (cIMT) is related to the risk of cardiovascular events in the general population. An association between changes in cIMT and cardiovascular risk is frequently assumed but has rarely been reported. Our aim was to test this association.MethodsWe identified general population studies that assessed cIMT at least twice and followed up participants for myocardial infarction, stroke, or death. The study teams collaborated in an individual participant data meta-analysis. Excluding individuals with previous myocardial infarction or stroke, we assessed the association between cIMT progression and the risk of cardiovascular events (myocardial infarction, stroke, vascular death, or a combination of these) for each study with Cox regression. The log hazard ratios (HRs) per SD difference were pooled by random effects meta-analysis.FindingsOf 21 eligible studies, 16 with 36,984 participants were included. During a mean follow-up of 7·0 years, 1519 myocardial infarctions, 1339 strokes, and 2028 combined endpoints (myocardial infarction, stroke, vascular death) occurred. Yearly cIMT progression was derived from two ultrasound visits 2-7 years (median 4 years) apart. For mean common carotid artery intima-media thickness progression, the overall HR of the combined endpoint was 0·97 (95% CI 0·94-1·00) when adjusted for age, sex, and mean common carotid artery intima-media thickness, and 0·98 (0·95-1·01) when also adjusted for vascular risk factors. Although we detected no associations with cIMT progression in sensitivity analyses, the mean cIMT of the two ultrasound scans was positively and robustly associated with cardiovascular risk (HR for the combined endpoint 1·16, 95% CI 1·10-1·22, adjusted for age, sex, mean common carotid artery intima-media thickness progression, and vascular risk factors). In three studies including 3439 participants who had four ultrasound scans, cIMT progression did not correlate between occassions (reproducibility correlations between r=-0·06 and r=-0·02).InterpretationThe association between cIMT progression assessed from two ultrasound scans and cardiovascular risk in the general population remains unproven. No conclusion can be derived for the use of cIMT progression as a surrogate in clinical trials.FundingDeutsche Forschungsgemeinschaft.

Dataset Information

Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium.

Aims

Methods and results

Conclusion

Publications

Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium.

Similar Datasets

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