Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study
Abstract Background Understanding long-term patterns (trajectories) of cardiovascular diseases (CVD) risk and identifying different sub-groups with the same underlying risk patterns could help facilitate targeted cardiovascular prevention programs. Methods A total of 3699 participants of the Tehran...
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| Format: | Article |
| Language: | English |
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BMC
2021-07-01
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| Series: | Journal of Translational Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12967-021-02984-2 |
| _version_ | 1818649694403821568 |
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| author | Fatemeh Koohi Nooshin Ahmadi Farzad Hadaegh Siavash Safiee Fereidoun Azizi Davood Khalili |
| author_facet | Fatemeh Koohi Nooshin Ahmadi Farzad Hadaegh Siavash Safiee Fereidoun Azizi Davood Khalili |
| author_sort | Fatemeh Koohi |
| collection | DOAJ |
| description | Abstract Background Understanding long-term patterns (trajectories) of cardiovascular diseases (CVD) risk and identifying different sub-groups with the same underlying risk patterns could help facilitate targeted cardiovascular prevention programs. Methods A total of 3699 participants of the Tehran Lipid and Glucose Study (TLGS) (43% men, mean age = 53.2 years), free of CVD at baseline in 1999–2001 and attending at least one re-examination cycle between the second (2002–2005) and fourth cycles (2009–2011) were included. We examined trajectories of CVD risk, based on the ACC/AHA pooled cohort equation, over ten years and subsequent risks of incident CVD during eight years later. We estimated trajectories of CVD risk using group-based trajectory modeling. The prospective association of identified trajectories with CVD was examined using Cox proportional hazard model. Results Three distinct trajectories were identified (low-low, medium-medium, and high-high risk). The high-high and medium-medium CVD risk trajectories had an increasing trend of risk during the time; still, this rising trend was disappeared after removing the effect of increasing age. Upon a median 8.4 years follow-up, 146 CVD events occurred. After adjusting for age, the medium-medium and high-high trajectories had a 2.4-fold (95% CI 1.46–3.97) and 3.46-fold (95% CI 1.56–7.70) risk of CVD compared with the low-low group, respectively. In all trajectory groups, unfavorable increasing in fasting glucose, but favorable raising in HDL and decreasing smoking and total cholesterol happened over time. Conclusions Although the risk trajectories were stable during the time, different risk factors varied differently in each trajectory. These findings emphasize the importance of attention to each risk factor separately and implementing preventive strategies that optimize CVD risk factors besides the CVD risk. |
| first_indexed | 2024-12-17T01:38:24Z |
| format | Article |
| id | doaj.art-4c2b614057d547bf809bf6e95dda6550 |
| institution | Directory Open Access Journal |
| issn | 1479-5876 |
| language | English |
| last_indexed | 2024-12-17T01:38:24Z |
| publishDate | 2021-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Translational Medicine |
| spelling | doaj.art-4c2b614057d547bf809bf6e95dda65502022-12-21T22:08:23ZengBMCJournal of Translational Medicine1479-58762021-07-011911910.1186/s12967-021-02984-2Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose studyFatemeh Koohi0Nooshin Ahmadi1Farzad Hadaegh2Siavash Safiee3Fereidoun Azizi4Davood Khalili5Department of Epidemiology, School of Public Health and Safety, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesPrevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesFaculty of Medicin, Tehran Medical Branch, Islamic Azad UniversityEndocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesDepartment of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesAbstract Background Understanding long-term patterns (trajectories) of cardiovascular diseases (CVD) risk and identifying different sub-groups with the same underlying risk patterns could help facilitate targeted cardiovascular prevention programs. Methods A total of 3699 participants of the Tehran Lipid and Glucose Study (TLGS) (43% men, mean age = 53.2 years), free of CVD at baseline in 1999–2001 and attending at least one re-examination cycle between the second (2002–2005) and fourth cycles (2009–2011) were included. We examined trajectories of CVD risk, based on the ACC/AHA pooled cohort equation, over ten years and subsequent risks of incident CVD during eight years later. We estimated trajectories of CVD risk using group-based trajectory modeling. The prospective association of identified trajectories with CVD was examined using Cox proportional hazard model. Results Three distinct trajectories were identified (low-low, medium-medium, and high-high risk). The high-high and medium-medium CVD risk trajectories had an increasing trend of risk during the time; still, this rising trend was disappeared after removing the effect of increasing age. Upon a median 8.4 years follow-up, 146 CVD events occurred. After adjusting for age, the medium-medium and high-high trajectories had a 2.4-fold (95% CI 1.46–3.97) and 3.46-fold (95% CI 1.56–7.70) risk of CVD compared with the low-low group, respectively. In all trajectory groups, unfavorable increasing in fasting glucose, but favorable raising in HDL and decreasing smoking and total cholesterol happened over time. Conclusions Although the risk trajectories were stable during the time, different risk factors varied differently in each trajectory. These findings emphasize the importance of attention to each risk factor separately and implementing preventive strategies that optimize CVD risk factors besides the CVD risk.https://doi.org/10.1186/s12967-021-02984-2Cardiovascular risk scoreRisk predictionTrajectory analysisCohort study |
| spellingShingle | Fatemeh Koohi Nooshin Ahmadi Farzad Hadaegh Siavash Safiee Fereidoun Azizi Davood Khalili Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study Journal of Translational Medicine Cardiovascular risk score Risk prediction Trajectory analysis Cohort study |
| title | Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study |
| title_full | Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study |
| title_fullStr | Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study |
| title_full_unstemmed | Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study |
| title_short | Trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow-up: The Tehran Lipid and Glucose study |
| title_sort | trajectories of cardiovascular disease risk and their association with the incidence of cardiovascular events over 18 years of follow up the tehran lipid and glucose study |
| topic | Cardiovascular risk score Risk prediction Trajectory analysis Cohort study |
| url | https://doi.org/10.1186/s12967-021-02984-2 |
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