TY - JOUR
T1 - Aldosterone, Renin, Cardiovascular Events, and All-Cause Mortality Among African Americans
T2 - The Jackson Heart Study
AU - Joseph, Joshua J.
AU - Echouffo-Tcheugui, Justin B.
AU - Kalyani, Rita R.
AU - Yeh, Hsin Chieh
AU - Bertoni, Alain G.
AU - Effoe, Valery S.
AU - Casanova, Ramon
AU - Sims, Mario
AU - Wu, Wen Chih
AU - Wand, Gary S.
AU - Correa, Adolfo
AU - Golden, Sherita H.
N1 - Publisher Copyright:
© 2017 American College of Cardiology Foundation
PY - 2017/9
Y1 - 2017/9
N2 - Objectives This study examined the association of aldosterone and plasma renin activity (PRA) with incident cardiovascular disease (CVD), using a composite endpoint of coronary heart disease, stroke, and/or heart failure and mortality among African Americans in the Jackson Heart Study. Background There is a paucity of data for the association of aldosterone and PRA with incident CVD or all-cause mortality among community-dwelling African Americans. Methods A total of 4,985 African American adults, 21 to 94 years of age, were followed for 12 years. Aldosterone, PRA, and cardiovascular risk factors were collected at baseline (from 2000 to 2004). Incident events included coronary heart disease and stroke (assessed from 2000 to 2011) and heart failure (assessed from 2005 to 2011). Cox models were used to estimate hazard ratios (HRs) for incident CVD and mortality, adjusting for age, sex, education, occupation, current smoking, physical activity, dietary intake, and body mass index. Results Among 4,160 participants without prevalent CVD over a median follow-up of 7 years, there were 322 incident CVD cases. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HR of 1.26 (95% confidence intervals [CI]: 1.14 to 1.40) and 1.16 (95% CI: 1.02 to 1.33) for incident CVD, respectively. Over a median of 8 years, 513 deaths occurred among 4,985 participants. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HRs of 1.13 (95% CI: 1.04 to 1.23) and 1.12 (95% CI: 1.01 to 1.24) for mortality, respectively. Conclusions Elevated aldosterone and PRA may play a significant role in the development of CVD and all-cause mortality among African Americans.
AB - Objectives This study examined the association of aldosterone and plasma renin activity (PRA) with incident cardiovascular disease (CVD), using a composite endpoint of coronary heart disease, stroke, and/or heart failure and mortality among African Americans in the Jackson Heart Study. Background There is a paucity of data for the association of aldosterone and PRA with incident CVD or all-cause mortality among community-dwelling African Americans. Methods A total of 4,985 African American adults, 21 to 94 years of age, were followed for 12 years. Aldosterone, PRA, and cardiovascular risk factors were collected at baseline (from 2000 to 2004). Incident events included coronary heart disease and stroke (assessed from 2000 to 2011) and heart failure (assessed from 2005 to 2011). Cox models were used to estimate hazard ratios (HRs) for incident CVD and mortality, adjusting for age, sex, education, occupation, current smoking, physical activity, dietary intake, and body mass index. Results Among 4,160 participants without prevalent CVD over a median follow-up of 7 years, there were 322 incident CVD cases. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HR of 1.26 (95% confidence intervals [CI]: 1.14 to 1.40) and 1.16 (95% CI: 1.02 to 1.33) for incident CVD, respectively. Over a median of 8 years, 513 deaths occurred among 4,985 participants. In adjusted analyses, each 1-U SD increase in log-aldosterone and log-PRA were associated with HRs of 1.13 (95% CI: 1.04 to 1.23) and 1.12 (95% CI: 1.01 to 1.24) for mortality, respectively. Conclusions Elevated aldosterone and PRA may play a significant role in the development of CVD and all-cause mortality among African Americans.
KW - aldosterone
KW - all-cause mortality
KW - cardiovascular disease
KW - plasma renin activity
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U2 - 10.1016/j.jchf.2017.05.012
DO - 10.1016/j.jchf.2017.05.012
M3 - Article
C2 - 28822744
AN - SCOPUS:85027523762
SN - 2213-1779
VL - 5
SP - 642
EP - 651
JO - JACC: Heart Failure
JF - JACC: Heart Failure
IS - 9
ER -