Age-Dependent Association Between Modifiable Risk Factors and Incident Cardiovascular Disease.

Autor: Kaneko H; Department of Cardiovascular Medicine The University of Tokyo Japan.; Department of Advanced Cardiology The University of Tokyo Japan., Yano Y; YCU Center for Novel and Exploratory Clinical Trials Yokohama City University Hospital Yokohama Japan.; Department of Family Medicine and Community Health Duke University Durham NC., Okada A; Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine The University of Tokyo Japan., Itoh H; Department of Cardiovascular Medicine The University of Tokyo Japan., Suzuki Y; Department of Cardiovascular Medicine The University of Tokyo Japan., Yokota I; Department of Biostatistics, Faculty of Medicine Hokkaido University Sapporo Japan., Morita K; Global Nursing Research Center, Graduate School of Medicine The University of Tokyo Japan., Fujiu K; Department of Cardiovascular Medicine The University of Tokyo Japan.; Department of Advanced Cardiology The University of Tokyo Japan., Michihata N; Department of Health Services Research The University of Tokyo Japan., Jo T; Department of Health Services Research The University of Tokyo Japan., Yamaguchi S; Department of Prevention of Diabetes and Lifestyle-Related Diseases, Graduate School of Medicine The University of Tokyo Japan., Takeda N; Department of Cardiovascular Medicine The University of Tokyo Japan., Morita H; Department of Cardiovascular Medicine The University of Tokyo Japan., Node K; Department of Cardiovascular Medicine Saga University Saga Japan., Yamauchi T; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine The University of Tokyo Japan., Nangaku M; Division of Nephrology and Endocrinology The University of Tokyo Graduate School of Medicine Tokyo Japan., Kadowaki T; Department of Diabetes and Metabolic Diseases, Graduate School of Medicine The University of Tokyo Japan.; Toranomon Hospital Tokyo Japan., McEvoy JW; National Institute for Prevention and Cardiovascular Health National University of Ireland Galway Ireland.; Johns Hopkins Ciccarone Center for Cardiovascular Disease Prevention Johns Hopkins University School of Medicine Baltimore MD., Lam CSP; National Heart Centre Singapore Singapore.; Duke-NUS Medical School Singapore.; Department of Cardiology University of Groningen, University Medical Centre Groningen Groningen The Netherlands., Yasunaga H; Department of Clinical Epidemiology and Health Economics, School of Public Health The University of Tokyo Japan., Komuro I; Department of Cardiovascular Medicine The University of Tokyo Japan.
Jazyk: angličtina
Zdroj: Journal of the American Heart Association [J Am Heart Assoc] 2023 Jan 17; Vol. 12 (2), pp. e027684. Date of Electronic Publication: 2023 Jan 11.
DOI: 10.1161/JAHA.122.027684
Abstrakt: Background There have been limited data examining the age-dependent relationship of wide-range risk factors with the incidence of each subtype of cardiovascular disease (CVD) event. We assessed age-related associations between modifiable risk factors and the incidence of CVD. Methods and Results We analyzed 3 027 839 participants without a CVD history enrolled in the JMDC Claims Database (mean age, 44.8±11.0 years; 57.6% men). Each participant was categorized as aged 20 to 49 years (n=2 008 559), 50 to 59 years (n=712 273), and 60 to 75 years (n=307 007). Using Cox proportional hazards models and the relative risk reduction, we identified associations between risk factors and incident CVD, consisting of myocardial infarction, angina pectoris, stroke, and heart failure (HF). We assessed whether the association of risk factors for developing CVD would be modified by age category. Over a mean follow-up of 1133 days, 6315 myocardial infarction, 56 447 angina pectoris, 28 079 stroke, and 56 369 HF events were recorded. The incidence of myocardial infarction, angina pectoris, stroke, and HF increased with age category. Hazard ratios of obesity, hypertension, and diabetes in the multivariable Cox regression analyses for myocardial infarction, angina pectoris, stroke, and HF decreased with age category. The relative risk reduction of obesity, hypertension, and diabetes for CVD events decreased with age category. For example, the relative risk reduction of hypertension for HF decreased from 59.2% in participants aged 20 to 49 years to 38.1% in those aged 60 to 75 years. Conclusions The contribution of modifiable risk factor to the development of CVD is greater in younger compared with older individuals. Preventive efforts for risk factor modification may be more effective in younger people.
Databáze: MEDLINE
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