TY - JOUR
T1 - Sex differences in the association between ideal cardiovascular health and biomarkers of cardiovascular disease among adults in the United States
T2 - A cross-sectional analysis from the multiethnic study of atherosclerosis
AU - Osibogun, Olatokunbo
AU - Ogunmoroti, Oluseye
AU - Tibuakuu, Martin
AU - Benson, Eve Marie
AU - Michos, Erin D.
N1 - Funding Information:
We found that more favourable CVH scores were associated with lower concentrations of CVD-related biomarkers in both women and men, except for NT-proBNP which showed a direct relationship. These favourable associations of CVH with biomarkers of risk may be an intermediary step in the prevention of clinical CVD events. Overall, our findings were qualitatively similar between the sexes and suggest that promotion of ideal CVH would have similarly favourable impact on the reduction of biomarkers of risk among women and men. However, long-term outcome studies are needed to improve our understanding of the underlying sex-specific mechanisms and the clinical implications of these findings. The authors thank the other investigators, the staff, and the participants of the Multi-Ethnic Study of Atherosclerosis for their valuable contributions. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org . Twitter @ErinMichos Contributors Author contributions, study conception and design: O Osibogun, O Ogunmoroti and EDM. Acquisition of data and analysis: O Osibogun and O Ogunmoroti. Interpretation of data: O Osibogun, O Ogunmoroti, MT, EB and EDM. Drafting of manuscript: O Osibogun, O Ogunmoroti and EDM. Critical revision and approval of final version submitted: O Osibogun, O Ogunmoroti, MT, EB and EDM. Funding The Multi-Ethnic Study of Atherosclerosis is supported by contracts N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168, N01-HC-95169 and HHSN268201500003I from the National Heart, Lung, and Blood Institute (NHLBI) and by grants UL1-RR-024156 and UL1-RR-025005 from the National Center for Research Resources (NCRR). Dr Michos is supported by the (unrestricted) Blumenthal Scholars Fund in Preventive Cardiology at Johns Hopkins University. Competing interests None declared. Patient consent for publication Not required. Ethics approval The MESA protocol was approved by the institutional review boards of all the recruitment centers. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data may be obtained from a third party and are not publicly available.
Publisher Copyright:
© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives This study investigated the sex differences in the associations between ideal cardiovascular health (CVH), measured by the American Heart Association's Life's Simple 7 metrics, and cardiovascular disease (CVD)-related biomarkers among an ethnically diverse cohort of women and men free of clinical CVD at baseline. Setting We analysed data from the Multi-Ethnic Study of Atherosclerosis conducted in six centres across the USA (Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York, New York; and St Paul, Minnesota). Participants This is a cross-sectional study of 5379 women and men, aged 45-84 years old. Mean age (SD) was 62 (10), 52% were women, 38% White, 11% Chinese American, 28% Black and 23% Hispanic. Primary measures The seven metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose) were each scored as 0 points (poor), 1 point (intermediate) or 2 points (ideal). The total CVH score ranged from 0 to 14. The CVD-related biomarkers studied were high-sensitivity C-reactive protein, D-dimer, fibrinogen, homocysteine, high-sensitivity cardiac troponin T, N-terminal pro B-type natriuretic peptide (NT-proBNP) and interleukin 6. We examined the association between the CVH score and each biomarker using multivariable linear regression, adjusting for age, race/ethnicity, education, income and health insurance status. Results Higher CVH scores were associated with lower concentrations of all biomarkers, except for NT-proBNP where we found a direct association. There were statistically significant interactions by sex for all biomarkers (p<0.001), but results were qualitatively similar between women and men. Conclusion A more favourable CVH score was associated with lower levels of multiple CVD-related biomarkers for women and men, except for NT-proBNP. These data suggest that promotion of ideal CVH would have similarly favourable impact on the reduction of biomarkers of CVD risk for both women and men.
AB - Objectives This study investigated the sex differences in the associations between ideal cardiovascular health (CVH), measured by the American Heart Association's Life's Simple 7 metrics, and cardiovascular disease (CVD)-related biomarkers among an ethnically diverse cohort of women and men free of clinical CVD at baseline. Setting We analysed data from the Multi-Ethnic Study of Atherosclerosis conducted in six centres across the USA (Baltimore, Maryland; Chicago, Illinois; Forsyth County, North Carolina; Los Angeles, California; New York, New York; and St Paul, Minnesota). Participants This is a cross-sectional study of 5379 women and men, aged 45-84 years old. Mean age (SD) was 62 (10), 52% were women, 38% White, 11% Chinese American, 28% Black and 23% Hispanic. Primary measures The seven metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood pressure and blood glucose) were each scored as 0 points (poor), 1 point (intermediate) or 2 points (ideal). The total CVH score ranged from 0 to 14. The CVD-related biomarkers studied were high-sensitivity C-reactive protein, D-dimer, fibrinogen, homocysteine, high-sensitivity cardiac troponin T, N-terminal pro B-type natriuretic peptide (NT-proBNP) and interleukin 6. We examined the association between the CVH score and each biomarker using multivariable linear regression, adjusting for age, race/ethnicity, education, income and health insurance status. Results Higher CVH scores were associated with lower concentrations of all biomarkers, except for NT-proBNP where we found a direct association. There were statistically significant interactions by sex for all biomarkers (p<0.001), but results were qualitatively similar between women and men. Conclusion A more favourable CVH score was associated with lower levels of multiple CVD-related biomarkers for women and men, except for NT-proBNP. These data suggest that promotion of ideal CVH would have similarly favourable impact on the reduction of biomarkers of CVD risk for both women and men.
KW - biomarkers
KW - cardiovascular disease
KW - gender
KW - ideal cardiovascular health metrics
KW - life's simple 7
KW - sex
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U2 - 10.1136/bmjopen-2019-031414
DO - 10.1136/bmjopen-2019-031414
M3 - Article
C2 - 31772093
AN - SCOPUS:85075670402
SN - 2044-6055
VL - 9
JO - BMJ Open
JF - BMJ Open
IS - 11
M1 - e031414
ER -