Association of change in cardiovascular risk factors with incident cardiovascular events

I got absolutely nothing out of this. Lots of mumbo jumbo statistics.

Association of change in cardiovascular risk factors with incident cardiovascular events

JAMA — van Sloten TT, et al. | November 08, 2018

Researchers investigated the association of changes in cardiovascular health with incident cardiovascular events in this prospective cohort study that included 9256 participants without cardiovascular disease (CVD) who received follow-up over a median 18.9 years. Finding revealed the direction of change in category of a composite metric of cardiovascular health was not consistently associated with the risk of CVD.

Methods

• Researchers performed a prospective cohort study in a UK general community (Whitehall II); examinations of cardiovascular health from 1985/1988 (baseline) and every 5 years thereafter until 2015/2016 and follow-up for incident CVD until March 2017 were performed.
• They used the 7 metrics of the American Heart Association (nonsmoking; and ideal levels of body mass index, physical activity, diet, blood pressure, fasting blood glucose, and total cholesterol) to categorized participants with 0 to 2, 3 to 4, and 5 to 7 ideal metrics as having low, moderate, and high cardiovascular health.
• Consideration was given to cardiovascular health change over 10 years between 1985/1988 and 1997/1999.
• Incident CVD (coronary heart disease and stroke) was mainly assessed.

Results

• The study population comprised 9256 participants without prior CVD (mean [SD] age at baseline, 44.8 [6.0] years; 2941 [32%] women); data about cardiovascular health change was available for 6326 of these patients.
• They recognized 1114 incident CVD events over a median follow-up of 18.9 years after 1997/1999.
• In multivariable analysis and compared with individuals with persistently low cardiovascular health (consistently low group, 13.5% of participants; CVD incident rate per 1000 person-years, 9.6 [95% CI, 8.4-10.9]), CVD risk was not observed to be significantly correlated with the low to moderate group (6.8% of participants; absolute rate difference per 1000 person-years, −1.9 [95% CI, −3.9 to 0.1]; HR, 0.84 [95% CI, 0.66-1.08]), the low to high group, (0.3% of participants; absolute rate difference per 1000 person-years, −7.7 [95% CI, −11.5 to −3.9]; HR, 0.19 [95% CI, 0.03-1.35]), and the moderate to low group (18.0% of participants; absolute rate difference per 1000 person-years, −1.3 [95% CI, −3.0 to 0.3]; HR, 0.96 [95% CI, 0.80-1.15]).
• They identified a lower CVD risk in the consistently moderate group (38.9% of participants; absolute rate difference per 1000 person-years, −4.2 [95% CI, −5.5 to −2.8]; HR, 0.62 [95% CI, 0.53-0.74]), the moderate to high group (5.8% of participants; absolute rate difference per 1000 person-years, −6.4 [95% CI, −8.0 to −4.7]; HR, 0.39 [95% CI, 0.27-0.56]), the high to low group (1.9% of participants; absolute rate difference per 1000 person-years, −5.3 [95% CI, −7.8 to −2.8]; HR, 0.49 [95% CI, 0.29-0.83]), the high to moderate group (9.3% of participants; absolute rate difference per 1000 person-years, −4.5 [95% CI, −6.2 to −2.9]; HR, 0.66 [95% CI, 0.51-0.85]), and the consistently high group (5.5% of participants; absolute rate difference per 1000 person-years, −5.6 [95% CI, −7.4 to −3.9]; HR, 0.57 [95% CI, 0.40-0.80]).

Read the full article on JAMA