The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
Background: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated t...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2023-06-01
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| Series: | American Journal of Preventive Cardiology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666667723000351 |
| _version_ | 1797798589002416128 |
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| author | Bjorn Kluwe Neal Pohlman Veena Kesireddy Songzhu Zhao Yubo Tan David Kline Guy Brock James B. Odei Valery S. Effoe Justin B. Echouffo Tcheugui Rita R. Kalyani Mario Sims Herman A. Taylor Morgana Mongraw-Chaffin Ehimare Akhabue Joshua J. Joseph |
| author_facet | Bjorn Kluwe Neal Pohlman Veena Kesireddy Songzhu Zhao Yubo Tan David Kline Guy Brock James B. Odei Valery S. Effoe Justin B. Echouffo Tcheugui Rita R. Kalyani Mario Sims Herman A. Taylor Morgana Mongraw-Chaffin Ehimare Akhabue Joshua J. Joseph |
| author_sort | Bjorn Kluwe |
| collection | DOAJ |
| description | Background: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated the mediational role of aldosterone in the association of 5 components of ICH (cholesterol, body mass index (BMI), physical activity, diet and smoking) with incident CVD and the mediational role of blood pressure (BP) and glucose in the association of aldosterone with incident CVD in a cohort of African Americans (AA). Methods: The Jackson Heart Study is a prospective cohort of AAs adults with data on CVD outcomes. Aldosterone, ICH metrics and baseline characteristics were collected at exam 1 (2000–2004). ICH score was developed by summing 5 ICH metrics (smoking, dietary intake, physical activity, BMI, and total cholesterol) and grouped into two categories (0–2 and ≥3 metrics). Incident CVD was defined as stroke, coronary heart disease, or heart failure. Cox proportional hazard regression models were used to model the association of categorical ICH score with incident CVD. The R Package Mediation was utilized to examine: 1) The mediational role of aldosterone in the association of ICH with incident CVD and 2) The mediational role of blood pressure and glucose in the association of aldosterone with incident CVD. Results: Among 3,274 individuals (mean age: 54±12.4 years, 65% female), there were 368 cases of incident CVD over a median of 12.7 years. The risk of incident CVD was 46% lower (HR: 0.54; 95%CI 0.36, 0.80) in those with ≥3 ICH metrics at baseline compared to 0–2. Aldosterone mediated 5.4% (p = 0.006) of the effect of ICH on incident CVD. A 1-unit increase in log-aldosterone was associated with a 38% higher risk of incident CVD (HR 1.38, 95%CI: 1.19, 1.61) with BP and glucose mediating 25.6% (p<0.001) and 4.8% (p = 0.048), respectively. Conclusion: Aldosterone partially mediates the association of ICH with incident CVD and both blood pressure and glucose partially mediate the association of aldosterone with incident CVD, emphasizing the potential importance of aldosterone and ICH in risk of CVD among AAs. |
| first_indexed | 2024-03-13T04:06:05Z |
| format | Article |
| id | doaj.art-3129b4b1d537409cbd8951577c28b2fc |
| institution | Directory Open Access Journal |
| issn | 2666-6677 |
| language | English |
| last_indexed | 2024-03-13T04:06:05Z |
| publishDate | 2023-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Preventive Cardiology |
| spelling | doaj.art-3129b4b1d537409cbd8951577c28b2fc2023-06-21T07:00:49ZengElsevierAmerican Journal of Preventive Cardiology2666-66772023-06-0114100494The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart studyBjorn Kluwe0Neal Pohlman1Veena Kesireddy2Songzhu Zhao3Yubo Tan4David Kline5Guy Brock6James B. Odei7Valery S. Effoe8Justin B. Echouffo Tcheugui9Rita R. Kalyani10Mario Sims11Herman A. Taylor12Morgana Mongraw-Chaffin13Ehimare Akhabue14Joshua J. Joseph15Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, United StatesDivision of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, United StatesDivision of Endocrinology, University Of Texas Medical Branch at Galveston, Galveston, Texas, United StatesCenter for Biostatistics, Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, United StatesCenter for Biostatistics, Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, United StatesDivision of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United StatesCenter for Biostatistics, Department of Biomedical Informatics, The Ohio State University Wexner Medical Center, Columbus, Ohio, United StatesDivision of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United StatesDivision of Biostatistics, The Ohio State University College of Public Health, Columbus, Ohio, United StatesDivision of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, United StatesDivision of Endocrinology, Diabetes, and Metabolism, Johns Hopkins University School of Medicine, Baltimore, Maryland, United StatesDepartment of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, United StatesDivision of Cardiology, Morehouse School of Medicine, Atlanta, Georgia, United StatesDepartment of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, United StatesDivision of Cardiovascular Diseases and Hypertension, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, United StatesDivision of Endocrinology, Diabetes and Metabolism, The Ohio State University Wexner Medical Center, Columbus, Ohio, United States; Corresponding author at: 579 McCampbell Hall, 1581 Dodd Drive, Columbus, Ohio 43210Background: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated the mediational role of aldosterone in the association of 5 components of ICH (cholesterol, body mass index (BMI), physical activity, diet and smoking) with incident CVD and the mediational role of blood pressure (BP) and glucose in the association of aldosterone with incident CVD in a cohort of African Americans (AA). Methods: The Jackson Heart Study is a prospective cohort of AAs adults with data on CVD outcomes. Aldosterone, ICH metrics and baseline characteristics were collected at exam 1 (2000–2004). ICH score was developed by summing 5 ICH metrics (smoking, dietary intake, physical activity, BMI, and total cholesterol) and grouped into two categories (0–2 and ≥3 metrics). Incident CVD was defined as stroke, coronary heart disease, or heart failure. Cox proportional hazard regression models were used to model the association of categorical ICH score with incident CVD. The R Package Mediation was utilized to examine: 1) The mediational role of aldosterone in the association of ICH with incident CVD and 2) The mediational role of blood pressure and glucose in the association of aldosterone with incident CVD. Results: Among 3,274 individuals (mean age: 54±12.4 years, 65% female), there were 368 cases of incident CVD over a median of 12.7 years. The risk of incident CVD was 46% lower (HR: 0.54; 95%CI 0.36, 0.80) in those with ≥3 ICH metrics at baseline compared to 0–2. Aldosterone mediated 5.4% (p = 0.006) of the effect of ICH on incident CVD. A 1-unit increase in log-aldosterone was associated with a 38% higher risk of incident CVD (HR 1.38, 95%CI: 1.19, 1.61) with BP and glucose mediating 25.6% (p<0.001) and 4.8% (p = 0.048), respectively. Conclusion: Aldosterone partially mediates the association of ICH with incident CVD and both blood pressure and glucose partially mediate the association of aldosterone with incident CVD, emphasizing the potential importance of aldosterone and ICH in risk of CVD among AAs.http://www.sciencedirect.com/science/article/pii/S2666667723000351AldosteroneIdeal cardiovascular healthCardiovascular disease |
| spellingShingle | Bjorn Kluwe Neal Pohlman Veena Kesireddy Songzhu Zhao Yubo Tan David Kline Guy Brock James B. Odei Valery S. Effoe Justin B. Echouffo Tcheugui Rita R. Kalyani Mario Sims Herman A. Taylor Morgana Mongraw-Chaffin Ehimare Akhabue Joshua J. Joseph The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study American Journal of Preventive Cardiology Aldosterone Ideal cardiovascular health Cardiovascular disease |
| title | The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study |
| title_full | The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study |
| title_fullStr | The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study |
| title_full_unstemmed | The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study |
| title_short | The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study |
| title_sort | role of aldosterone and ideal cardiovascular health in incident cardiovascular disease the jackson heart study |
| topic | Aldosterone Ideal cardiovascular health Cardiovascular disease |
| url | http://www.sciencedirect.com/science/article/pii/S2666667723000351 |
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