Sex-specific incidence rates and risk factors of premature cardiovascular disease. A long term follow up of the Tehran Lipid and Glucose Study

Eslami, Akbar; Mozaffary, Amirhossein; Derakhshan, Arash; Azizi, Fereidoun; Khalili, Davood; Hadaegh, Farzad

doi:10.1016/j.ijcard.2016.10.037

Cited by 32 publications

(32 citation statements)

References 39 publications

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“…Our finding suggests that the threshold considered for definition of high risk age in women (55 yr) might be even lower among Iranian women, for incidence of CVD. This is consistent with finding from our recent study that showed women had high incidence rate of premature CVDs after the age of 45 years 44 .…”

Section: Discussionsupporting

confidence: 94%

A new look at risk patterns related to coronary heart disease incidence using survival tree analysis: 12 Years Longitudinal Study

Ramezankhani

Bagherzadeh‐Khiabani

Khalili

et al. 2017

Sci Rep

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We identified risk patterns associated with incident coronary heart disease (CHD) using survival tree, and compared performance of survival tree versus Cox proportional hazards (Cox PH) in a cohort of Iranian adults. Data on 8,279 participants (3,741 men) aged ≥30 yr were used to analysis. Survival trees identified seven subgroups with different risk patterns using four [(age, non-HDL-C, fasting plasma glucose (FPG) and family history of diabetes] and five [(age, systolic blood pressure (SBP), non-HDL-C, FPG and family history of CVD] predictors in women and men, respectively. Additional risk factors were identified by Cox models which included: family history of CVD and waist circumference (in both genders); hip circumference, former smoking and using aspirin among men; diastolic blood pressure and lipid lowering drug among women. Survival trees and multivariate Cox models yielded comparable performance, as measured by integrated Brier score (IBS) and Harrell’s C-index on validation datasets; however, survival trees produced more parsimonious models with a minimum number of well recognized risk factors of CHD incidence, and identified important interactions between these factors which have important implications for intervention programs and improve clinical decision making.

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Section: Discussionsupporting

confidence: 94%

A new look at risk patterns related to coronary heart disease incidence using survival tree analysis: 12 Years Longitudinal Study

Ramezankhani

Bagherzadeh‐Khiabani

Khalili

et al. 2017

Sci Rep

Self Cite

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“…As for the strengths of our study, it is the first to be conducted among a non-US population with a high CVD burden. 28 Other strengths are the large sample size, direct measurement of different variables and outcomes other than self-reported data, repeated assessments of BMI and WC as well as potential confounding and intermediate factors, and verification and adjudication of CHD, stroke and CHF events. Nevertheless, there are some important limitations.…”

Section: Discussionmentioning

confidence: 99%

Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study

Kabootari

Asgari

Mansournia

et al. 2018

JAHA

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BackgroundThis study aimed to determine the association between different weight histories, including cumulative excess weight, cumulative excess waist circumference (WC), duration of general and central adiposity, current and maximum body mass index, and current and maximum WC, and incident coronary heart disease (CHD) and stroke.Methods and ResultsThe study population consisted of 4398 adults aged ≥40 years without CHD or stroke at baseline. Associations between different weight histories and CHD and stroke were determined by multivariable time‐varying Cox regression models after adjustment for age, sex, and time‐varying confounders. Further adjustment was also done for mediators (eg, diabetes mellitus, hypercholesterolemia, and hypertension). During median follow‐up of 13.9 years, 718 incident CHD and 158 stroke events were documented. Multivariable adjusted hazard ratios (HRs) were calculated in the sex and confounder adjusted model for CHD per 1‐SD increase in cumulative excess weight (HR: 1.02; 95% confidence interval [CI], 0.96–1.07), cumulative excess WC (HR: 1.14; 95% CI, 1.04–1.24), duration of general adiposity (HR: 1.00; 95% CI, 0.92–1.08), duration of central adiposity (HR: 1.01; 95% CI, 0.93–1.09), current body mass index (HR: 1.03; 95% CI, 0.99–1.07), current WC (HR: 1.21; 95% CI, 1.11–1.32), maximum body mass index (HR: 1.01; 95% CI, 0.95–1.07), and maximum WC (HR: 1.17; 95% CI, 1.07–1.28). After further adjustment for mediators, current and maximum WC still showed a significant risk (HR: 1.13 [95% CI, 1.03–1.23] and 1.09 [95% CI, 1.00–1.20], respectively). Moreover, in the sex and confounder adjusted model, cumulative excess WC and maximum WC were associated with higher risk of stroke (hazard ratio: 1.21 [95% CI, 0.99–1.48] and 1.25 [95% CI, 1.02–1.55], respectively).ConclusionsExposure to cumulative excess weight and cumulative excess WC confers little additional risk beyond their current and maximum values. Even current and maximum WC were associated with incident CHD in the presence of obesity mediators, and the latter was a significant predictor of stroke in the presence of confounders.

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“…4 Middle-aged men are at least twice as likely to develop premature CVD than same-aged female counterparts. [5][6][7][8][9][10][11][12][13] This was consistently observed in the United Kingdom, 14 Australia, 15 United Sates, Canada, 16 and Norway, 17 even upon adjusting for conventional CVD risk factors. 17 It is unclear how sex differences in the risk of premature CVD vary by whether a woman had preeclampsia or not.…”

mentioning

confidence: 86%

“…The primary study outcome was a CVD composite of any hospitalization or revascularization for coronary artery disease, cerebrovascular disease, peripheral artery disease, heart failure, or dysrhythmia, using validated hospitalization codes and algorithms [5][6][7] (Supplemental Table S1). The CVD outcome was ascertained starting at 90 days after the index delivery date of the group of women with preeclampsia and their matched female counterparts without preeclampsia, or at 90 days after the index primary care visit index date among the matched male counterparts, thereby creating a common "time zero" for all 3 cohorts.…”

Section: Exposures and Outcomesmentioning

confidence: 99%

Preeclampsia Brings the Risk of Premature Cardiovascular Disease in Women Closer to That of Men

Langlois

Park

Lentz

et al. 2020

Canadian Journal of Cardiology

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Sex-specific incidence rates and risk factors of premature cardiovascular disease. A long term follow up of the Tehran Lipid and Glucose Study

Cited by 32 publications

References 39 publications

A new look at risk patterns related to coronary heart disease incidence using survival tree analysis: 12 Years Longitudinal Study

A new look at risk patterns related to coronary heart disease incidence using survival tree analysis: 12 Years Longitudinal Study

Different Weight Histories and Risk of Incident Coronary Heart Disease and Stroke: Tehran Lipid and Glucose Study

Preeclampsia Brings the Risk of Premature Cardiovascular Disease in Women Closer to That of Men

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