Dataset Information

Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all-cause mortality.

ABSTRACT:

Background

Both hypertension and atherosclerotic plaques are risk factors for cardiovascular disease (CVD).

Hypothesis

This study aimed to investigate whether the combined effects of carotid plaques and hypertension increase the risks of CVD and all-cause mortality.

Methods

Patients from the stroke and elderly cohorts of the Kailuan study in China who completed a carotid sonography examination were included in the study. Participants in both cohorts underwent physical examinations between 2010 and 2011 and were divided into four groups: no carotid plaques with normal blood pressure (n = 2227), hypertension only (n = 1290), carotid plaques only (n = 1128), and hypertension with carotid plaques (n = 1862). The outcomes included the first occurrence of CVD and all-cause mortality.

Results

Among the 6507 participants (mean age, 58.1 ± 11.8 years, 61% males), 157 cardiovascular events, and 210 deaths occurred after average follow-ups of 4.5 and 4.9 years, respectively. After adjusting for covariates, carotid plaques only and hypertension with carotid plaques were associated with excess risk (hazard ratio [HR]; confidence interval [CI]) for the first occurrence of CVD (HR = 1.85; 95% CI, 1.01-3.44; and HR = 2.97; 95% CI, 1.66-5.29, respectively), cerebral infarction (HR = 2.66; 95% CI, 1.16-6.15; and HR = 4.15; 95% CI, 1.87-9.19, respectively), and all-cause mortality (HR = 1.96; 95% CI, 1.16-3.31; and HR = 1.85; 95% CI, 1.09-3.13, respectively).

Conclusions

The combination of hypertension and atherosclerotic plaques may increase the risk of CVD events and all-cause mortality, especially cerebral infarction, compared with participants without those factors.

SUBMITTER: Li W

PROVIDER: S-EPMC7368304 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Publications

Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all-cause mortality.

Li Wen W Zhao Jianqiu J Song Lu L Chen Shuohua S Liu Xuemei X Wu Shouling S

Clinical cardiology 20200512 7

<h4>Background</h4>Both hypertension and atherosclerotic plaques are risk factors for cardiovascular disease (CVD).<h4>Hypothesis</h4>This study aimed to investigate whether the combined effects of carotid plaques and hypertension increase the risks of CVD and all-cause mortality.<h4>Methods</h4>Patients from the stroke and elderly cohorts of the Kailuan study in China who completed a carotid sonography examination were included in the study. Participants in both cohorts underwent physical exami ...[more]

PMID: 32400055

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Project description:Objective It is unknown whether renal impairment and atherosclerosis increase the risk of cardiovascular disease (CVD) and death. Atherosclerosis already raises the risk of CVD and all-cause death. This study investigated the joint effects of carotid plaques and renal impairment on CVD and all-cause death in community-based populations. Methods The study cohort consisted of 20,416 participants from the Kailuan Study who completed a carotid plaque ultrasound in 2012. A glomerular filtration rate (GFR) of < 60 ml/min or trace semiquantitative proteinuria or higher were both considered signs of renal insufficiency. We divided them into four groups according to the presence of carotid plaque and renal impairment. These groups were categorized as no carotid plaque, estimated glomerular filtration rate (eGFR) ≥ 60 ml/min, and proteinuria < trace; no carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace; carotid plaque, eGFR ≥ 60 ml/min and proteinuria < trace; and carotid plaque, eGFR < 60 ml/min, and proteinuria ≥ trace, respectively. We investigated the combined effect of renal impairment and carotid plaque on cardiovascular events and all-cause death in the Kailuan community-based population. Result Participants with carotid plaque, eGFR < 60 ml/min and proteinuria had a 2.88-fold higher risk of all-cause death (95% CI, 2.18–3.80), which was significantly higher than those with lone factors (HR, 1.57; 95% CI, 1.04–2.36; and HR, 1.91; 95% CI, 1.56–2.32), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group. Participants with carotid plaque, eGFR < 60 ml/min, and proteinuria had a 1.05-fold higher risk of CVD (95% CI, 0.82–1.35), which was not higher than those with alone factors (HR, 1.35; 95% CI, 1.02–1.80; and HR, 1.12; 95% CI, 0.96–1.30), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group. Stratified analysis by age, participants with the carotid plaque, eGFR < 60 ml/min and proteinuria had a 2.98-fold higher risk of all-cause death (95% CI: 2.24–3.96), which was significantly higher than participants with lone factors (HR, 1.68; 95% CI, 1.10–2.59; and HR, 1.95; 95% CI, 1.59–2.40), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group in the age of ≥ 50 years. Participants with carotid plaque, eGFR < 60 ml/min and proteinuria had a 1.66-fold higher risk of CVD (95% CI: 1.29–2.25), which was significantly higher than participants with lone factors (HR, 1.63; 95% CI, 1.20–2.22, and HR, 1.28; 95% CI, 1.11–1.49), compared to participants with no carotid plaque, eGFR ≥ 60 ml/min and proteinuria <trace group, in the age of ≥ 50 years. Conclusion The joint of carotid plaques and renal impairment may further increase the risk of CVD and all-cause death compared with participants with alone factors in the age of ≥ 50 years, but not in the age of < 50 years, from a community-based study.

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Project description:BackgroundDiabetes is prevalent worldwide and is associated with cardiovascular disease (CVD). Furthermore, due to the insulin resistance, diabetic populations are vulnerable to liver fibrosis, which increases the risk of CVD. Fibrosis-4 index (FIB-4)-a non-invasive biomarker for liver fibrosis-is crucial in predicting CVD among patients with liver diseases. However, the association between FIB-4, death, and CVD in the US diabetic population has not yet been investigated.MethodWe conducted a cross-sectional study using the data from the National Health and Nutrition Examination Survey (NHANES) 1999-2008. The mortality status was obtained from the National Death Index through December 31, 2015. Participants were divided into survivor and mortality group to compare the basic characteristics. The association between FIB-4, death, and CVD was analyzed using the restricted cubic spline method and Cox proportional hazards models. In stratified analysis, Participants were stratified based on age, sex, BMI, hypertension, or eGFR respectively.ResultsThe participants (N = 3,471) were divided into survivor (N = 1,785) and mortality groups (N = 1,632), with the mortality group exhibiting significantly higher FIB-4 values. Moreover, the risk of all-cause mortality (HR 1.24; 95% CI, 1.17-1.32) and CVD mortality (HR 1.17; 95% CI, 1.04-1.31) increased with each FIB-4 SD increase after adjusting for all covariates. However, except for myocardial infarction, FIB-4 had no significant effect on the incidence of the other three CVD subtypes (congestive heart failure, coronary heart disease, and angina pectoris). In stratified analysis, we found that the effect of FIB-4 on CVD mortality was influenced by age, and FIB-4 is a risk factor for people older than 60 years (HR 1.14; 95% CI, 1.01-1.29).ConclusionUsing data from NHANES 1999-2008, FIB-4 was found to be associated with all-cause and CVD mortality in the diabetic population, and this association was significantly affected by age. However, FIB-4 only affected the incidence of myocardial infarction. Future work should investigate the association between FIB-4 and CVD in the diabetic population.

Dataset Information

Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all-cause mortality.

Background

Hypothesis

Methods

Results

Conclusions

Publications

Combined effects of carotid plaques and hypertension on the risk of cardiovascular disease and all-cause mortality.

Similar Datasets

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