Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: Results from the Asia Pacific Cohort Studies Collaboration

Sanne A.E. Peters, Xin Wang, Tai Hing Lam, HyeonChang Kim, Suzanne Ho, Toshiharu Ninomiya, Matthew Knuiman, Ilonca Vaartjes, Michael L. Bots, Mark Woodward

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective To assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster. Setting Asia Pacific Cohort Studies Collaboration. Participants Individual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline. Outcome measures Clusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95% CIs for CVD associated with individual risk factors and risk factor clusters. Population-Attributable fractions (PAFs) were calculated. Results During a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP-smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24% and 11%, respectively. For individuals with three risk factors, the BP-smoking-cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13% and 10%. Conclusions Risk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.

Original languageEnglish
Article numbere019335
JournalBMJ open
Volume8
Issue number3
DOIs
Publication statusPublished - 2018 Mar 1

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Cluster Analysis
Cohort Studies
Cardiovascular Diseases
Population
Blood Pressure
New Zealand
Smoking
Cholesterol
Proportional Hazards Models
Outcome Assessment (Health Care)
Incidence

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Peters, Sanne A.E. ; Wang, Xin ; Lam, Tai Hing ; Kim, HyeonChang ; Ho, Suzanne ; Ninomiya, Toshiharu ; Knuiman, Matthew ; Vaartjes, Ilonca ; Bots, Michael L. ; Woodward, Mark. / Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations : Results from the Asia Pacific Cohort Studies Collaboration. In: BMJ open. 2018 ; Vol. 8, No. 3.
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title = "Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations: Results from the Asia Pacific Cohort Studies Collaboration",
abstract = "Objective To assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster. Setting Asia Pacific Cohort Studies Collaboration. Participants Individual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline. Outcome measures Clusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95{\%} CIs for CVD associated with individual risk factors and risk factor clusters. Population-Attributable fractions (PAFs) were calculated. Results During a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP-smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24{\%} and 11{\%}, respectively. For individuals with three risk factors, the BP-smoking-cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13{\%} and 10{\%}. Conclusions Risk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.",
author = "Peters, {Sanne A.E.} and Xin Wang and Lam, {Tai Hing} and HyeonChang Kim and Suzanne Ho and Toshiharu Ninomiya and Matthew Knuiman and Ilonca Vaartjes and Bots, {Michael L.} and Mark Woodward",
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Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations : Results from the Asia Pacific Cohort Studies Collaboration. / Peters, Sanne A.E.; Wang, Xin; Lam, Tai Hing; Kim, HyeonChang; Ho, Suzanne; Ninomiya, Toshiharu; Knuiman, Matthew; Vaartjes, Ilonca; Bots, Michael L.; Woodward, Mark.

In: BMJ open, Vol. 8, No. 3, e019335, 01.03.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Clustering of risk factors and the risk of incident cardiovascular disease in Asian and Caucasian populations

T2 - Results from the Asia Pacific Cohort Studies Collaboration

AU - Peters, Sanne A.E.

AU - Wang, Xin

AU - Lam, Tai Hing

AU - Kim, HyeonChang

AU - Ho, Suzanne

AU - Ninomiya, Toshiharu

AU - Knuiman, Matthew

AU - Vaartjes, Ilonca

AU - Bots, Michael L.

AU - Woodward, Mark

PY - 2018/3/1

Y1 - 2018/3/1

N2 - Objective To assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster. Setting Asia Pacific Cohort Studies Collaboration. Participants Individual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline. Outcome measures Clusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95% CIs for CVD associated with individual risk factors and risk factor clusters. Population-Attributable fractions (PAFs) were calculated. Results During a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP-smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24% and 11%, respectively. For individuals with three risk factors, the BP-smoking-cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13% and 10%. Conclusions Risk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.

AB - Objective To assess the relationship between risk factor clusters and cardiovascular disease (CVD) incidence in Asian and Caucasian populations and to estimate the burden of CVD attributable to each cluster. Setting Asia Pacific Cohort Studies Collaboration. Participants Individual participant data from 34 population-based cohorts, involving 314 024 participants without a history of CVD at baseline. Outcome measures Clusters were 11 possible combinations of four individual risk factors (current smoking, overweight, blood pressure (BP) and total cholesterol). Cox regression models were used to obtain adjusted HRs and 95% CIs for CVD associated with individual risk factors and risk factor clusters. Population-Attributable fractions (PAFs) were calculated. Results During a mean follow-up of 7 years, 6203 CVD events were recorded. The ranking of HRs and PAFs was similar for Australia and New Zealand (ANZ) and Asia; clusters including BP consistently showed the highest HRs and PAFs. The BP-smoking cluster had the highest HR for people with two risk factors: 4.13 (3.56 to 4.80) for Asia and 3.07 (2.23 to 4.23) for ANZ. Corresponding PAFs were 24% and 11%, respectively. For individuals with three risk factors, the BP-smoking-cholesterol cluster had the highest HR (4.67 (3.92 to 5.57) for Asia and 3.49 (2.69 to 4.53) for ANZ). Corresponding PAFs were 13% and 10%. Conclusions Risk factor clusters act similarly on CVD risk in Asian and Caucasian populations. Clusters including elevated BP were associated with the highest excess risk of CVD.

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U2 - 10.1136/bmjopen-2017-019335

DO - 10.1136/bmjopen-2017-019335

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VL - 8

JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

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