Wang, X;
Dalmeijer, GW;
den Ruijter, HM;
Anderson, TJ;
Britton, AR;
Dekker, J;
Engstrom, G;
... Bots, ML; + view all
(2017)
Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study.
PLOS ONE
, 12
(3)
10.1371/journal.pone.0173393.
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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.
| Type: | Article |
|---|---|
| Title: | Clustering of cardiovascular risk factors and carotid intima-media thickness: The USE-IMT study |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1371/journal.pone.0173393 |
| Publisher version: | http://dx.doi.org/10.1371/journal.pone.0173393 |
| Language: | English |
| Additional information: | © 2017 Wang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
| Keywords: | Subclinical atherosclerosis, general-population, clinical-practice, malmo diet, progression, artery, prediction, rotterdam, disease, events |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1557193 |
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