Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: results from the Asia Pacific Cohort Studies Collaboration. Issue 3 (6th March 2018)

• Record Type: Journal Article
• Authors: Peters, Sanne A E; Wang, Xin; Lam, Tai-Hing; Kim, Hyeon Chang; Ho, Suzanne; Ninomiya, Toshiharu; Knuiman, Matthew; Vaartjes, Ilonca; Bots, Michael L; Woodward, Mark
• Other Names: author non-byline.; Fang X author non-byline.; Gu D F author non-byline.; Huxley R author non-byline.; Imai Y author non-byline.; Kim H C author non-byline.; Lam T H author non-byline.; Pan W H author non-byline.; Rodgers A author non-byline.; Suh I author non-byline.; Ueshima H author non-byline.; Okayama H author non-byline.; Ueshima H author non-byline.; Maegawa H author non-byline.; Aoki N author non-byline.; Wu Z S author non-byline.; Yao C H author non-byline.; Wu Z S author non-byline.; Luszcz Mary author non-byline.; Welborn T A author non-byline.; Tang Z author non-byline.; Liu L S author non-byline.; Xie J X author non-byline.; Norton R author non-byline.; Ameratunga S author non-byline.; Macmahon S author non-byline.; Whitlock G author non-byline.; Knuiman M W author non-byline.; Christensen H author non-byline.; Wu X G author non-byline.; Zhou J author non-byline.; Yu X H author non-byline.; Tamakoshi A author non-byline.; H Pan W author non-byline.; Wu Z L author non-byline.; Chen L Q author non-byline.; Shan G L author non-byline.; Sritara P author non-byline.; Gu D F author non-byline.; Duan X F author non-byline.; Macmahon S author non-byline.; Norton R author non-byline.; Whitlock G author non-byline.; Jackson R author non-byline.; Li Y H author non-byline.; Lam T H author non-byline.; Jiang C Q author non-byline.; Ninomiya T author non-byline.; Hata J author non-byline.; Hirakawa Y author non-byline.; Woo J author non-byline.; Ho S C author non-byline.; Hong Z author non-byline.; Huang M S author non-byline.; Zhou B author non-byline.; Fuh J L author non-byline.; Ueshima H author non-byline.; Kita Y author non-byline.; R Choudhury S author non-byline.; Suh I author non-byline.; Jee S H author non-byline.; Kim I S author non-byline.; Giles G G author non-byline.; Hashimoto T author non-byline.; Sakata K author non-byline.; Imai A Dobson;y author non-byline.; Ohkubo T author non-byline.; Hozawa A author non-byline.; Jamrozik K author non-byline.; Knuiman M W author non-byline.; Hobbs M author non-byline.; Broadhurst R author non-byline.; Nakachi K author non-byline.; H Fang X author non-byline.; Li S C author non-byline.; Yang Q D author non-byline.; Chen Z M author non-byline.; Tanaka H author non-byline.; Kita Y author non-byline.; Nozaki A author non-byline.; Ueshima H author non-byline.; Horibe H author non-byline.; Matsutani Y author non-byline.; Kagaya M author non-byline.; Hughes K author non-byline.; Lee J author non-byline.; Heng D author non-byline.; Chew S K author non-byline.; Zhou B F author non-byline.; Zhang H Y author non-byline.; Shimamoto K author non-byline.; Saitoh S author non-byline.; Li Z Z author non-byline.; Zhang H Y author non-byline.; Norman P author non-byline.; Jamrozik K author non-byline.; He Y author non-byline.; Lam T H author non-byline.; Yao S X author non-byline.;
• Is Part Of: BMJ open. Volume 8:Issue 3(2018)
• Publication Date: 2018-03-06
• Subjects: epidemiology -- preventive medicine -- myocardial infarction -- stroke; Medicine -- Research -- Periodicals; 610.72
• DOI: 10.1136/bmjopen-2017-019335
• Languages: English
• ISSNs: 2044-6055

Abstract

Abstract : Objective: To assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster. Setting: Asia Pacific Cohort Studies Collaboration. Participants: Individual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline. Outcome measures: Clusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95% CIs for CVD associated with individual risk factors and risk factor clusters. Population-attributable fractions (PAFs) were calculated. Results: During a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP–smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24% and 11%, respectively. For individuals with three risk factors, the BP–smoking–cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13% and 10%. Conclusions: Risk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.