Dataset Information

Racial Differences in the Association Between Apolipoprotein E Risk Alleles and Overall and Total Cardiovascular Mortality Over 18 Years.

ABSTRACT: OBJECTIVES:To examine the difference in the association between apolipoprotein (APO)E allele and overall and cardiovascular mortality between African Americans (AAs) and European Americans (EAs). DESIGN:Longitudinal, cohort study of 18 years. SETTING:Biracial urban US population sample. PARTICIPANTS:4,917, 68% AA and 32% EA. MEASUREMENTS:APOE genotype and mortality based on National Death Index. RESULTS:A higher proportion of AAs than of EAs had an APOE ?2 allele (?2?2/?2?3/?2?4; 22% vs 13%) and an APOE ?4 allele (?3?4/?4?4; 33% vs 24%). After adjusting for known risk factors, the risk of mortality was 19% less with the APOE ?2 allele (hazard ratio (HR) = 0.81, 95% confidence interval (CI) = 0.76-0.87), and the risk of cardiovascular mortality was 35% less (HR = 0.65, 95% CI = 0.58-0.76) than with the ?3?3 allele. The risk of mortality was 10% greater with the APOE ?4 allele (HR = 1.10, 95% CI = 1.04-1.16), and the risk of cardiovascular mortality was 20% greater (HR = 1.20, 95% CI = 1.07-1.29) than with the ?3?3 allele. No difference in the association between APOE allele and mortality was observed between AAs and EAs. CONCLUSION:The APOE ?4 allele increased the risk of overall and cardiovascular mortality, whereas the APOE ?2 allele decreased the risk of overall and cardiovascular mortality. There was no racial difference in the association between these alleles and mortality.

SUBMITTER: Rajan KB

PROVIDER: S-EPMC6201232 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Racial Differences in the Association Between Apolipoprotein E Risk Alleles and Overall and Total Cardiovascular Mortality Over 18 Years.

Rajan Kumar B KB Barnes Lisa L LL Wilson Robert S RS McAninch Elizabeth A EA Weuve Jennifer J Sighoko Dominique D Evans Denis A DA

Journal of the American Geriatrics Society 20170912 11

<h4>Objectives</h4>To examine the difference in the association between apolipoprotein (APO)E allele and overall and cardiovascular mortality between African Americans (AAs) and European Americans (EAs).<h4>Design</h4>Longitudinal, cohort study of 18 years.<h4>Setting</h4>Biracial urban US population sample.<h4>Participants</h4>4,917, 68% AA and 32% EA.<h4>Measurements</h4>APOE genotype and mortality based on National Death Index.<h4>Results</h4>A higher proportion of AAs than of EAs had an APOE ...[more]

PMID: 28898389

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Project description:Background The incidence and clinical manifestations of cardiovascular disease (CVD) differ between blacks and whites. Biomarkers that reflect important pathophysiological pathways may provide a window to allow deeper understanding of racial differences in CVD. Methods and Results The study included 2635 white and black participants from the Dallas Heart Study who were free from existing CVD. Cross-sectional associations between race and 32 biomarkers were evaluated using multivariable linear regression adjusting for age, traditional CVD risk factors, imaging measures of body composition, renal function, insulin resistance, left ventricular mass, and socioeconomic factors. In fully adjusted models, black women had higher lipoprotein(a), leptin, d-dimer, osteoprotegerin, antinuclear antibody, homoarginine, suppression of tumorigenicity-2, and urinary microalbumin, and lower adiponectin, soluble receptor for advanced glycation end products and N-terminal pro-B-type natriuretic peptide versus white women. Black men had higher lipoprotein(a), leptin, d-dimer, high-sensitivity C-reactive protein, antinuclear antibody, symmetrical dimethylarginine, homoarginine, high-sensitivity cardiac troponin T, suppression of tumorigenicity-2, and lower adiponectin, soluble receptor for advanced glycation end products, and N-terminal pro-B-type natriuretic peptide versus white men. Adjustment for biomarkers that were associated with higher CVD risk, and that differed between blacks and whites, attenuated the risk for CVD events in black women (unadjusted hazard ratio 2.05, 95% CI 1.32, 3.17 and adjusted hazard ratio 1.15, 95% CI 0.69, 1.92) and black men (unadjusted hazard ratio 2.39, 95% CI 1.64, 3.46, and adjusted hazard ratio 1.21, 95% CI 0.76, 1.95). Conclusions Significant racial differences were seen in biomarkers reflecting lipids, adipokines, and biomarkers of endothelial function, inflammation, myocyte injury, and neurohormonal stress, which may contribute to racial differences in the development and complications of CVD.

Project description:BackgroundFor adults in general population community settings, data regarding long-term course and outcomes of illicit drug use are sparse, limiting the formulation of evidence-based recommendations for drug use screening of adults in primary care.ObjectiveTo describe trajectories of three illicit drugs (cocaine, opioids, amphetamines) among adults in community settings, and to assess their relation to all-cause mortality.DesignLongitudinal cohort, 1987/88-2005/06.SettingCommunity-based recruitment from four cities (Birmingham, Chicago, Oakland, Minneapolis).ParticipantsHealthy adults, balanced for race (black and white) and gender were assessed for drug use from 1987/88-2005/06, and for mortality through 12/31/2008 (n = 4301)MeasurementsUse of cocaine, amphetamines, and opioids (last 30 days) was queried in the following years: 1987/88, 1990/91, 1992/93, 1995/96, 2000/01, 2005/06. Survey-based assessment of demographics and psychosocial characteristics. Mortality over 18 years.ResultsTrajectory analysis identified four groups: Nonusers (n = 3691, 85.8%), Early Occasional Users (n = 340, 7.9%), Persistent Occasional Users (n = 160, 3.7%), and Early Frequent/Later Occasional Users (n = 110, 2.6%). Trajectories conformed to expected patterns regarding demographics, other substance use, family background and education. Adjusting for demographics, baseline health status, health behaviors (alcohol, tobacco), and psychosocial characteristics, Early Frequent/Later Occasional Users had greater all-cause mortality (Hazard Ratio, HR = 4.94, 95% CI = 1.58-15.51, p = 0.006).LimitationsStudy is restricted to three common drugs, and trajectory analyses represent statistical approximations rather than identifiable "types". Causal inferences are tentative.ConclusionsFour trajectories describe illicit drug use from young adulthood to middle age. Two trajectories, representing over one third of adult users, continued use into middle age. These persons were more likely to continue harmful risk behaviors such as smoking, and more likely to die.

Dataset Information

Racial Differences in the Association Between Apolipoprotein E Risk Alleles and Overall and Total Cardiovascular Mortality Over 18 Years.

Publications

Racial Differences in the Association Between Apolipoprotein E Risk Alleles and Overall and Total Cardiovascular Mortality Over 18 Years.

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