Gender differences in the accuracy of time-dependent blood pressure indices for predicting coronary heart disease: A random-effects modeling approach

Brant, Larry J.; Ferrucci, Luigi; Shan, Sheng; Concin, Hans; Zonderman, Alan B.; Kelleher, Cecily; Longo, Dan L.; Ulmer, Hanno; Strasak, Alexander

doi:10.1016/j.genm.2010.11.005

Cited by 10 publications

(10 citation statements)

References 30 publications

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“…The results from this study showed that individuals with MAP ≥103 mm Hg were 1.19-fold chance to develop CHD than those with MAP <84 mm Hg, after adjusting for confounding factors. Our finding of a significantly positive relationship of high MAP with the risk of CHD was consistent with a previous studies 26 27. Besides, this relationship was confirmed in cohort studies from the USA and Swedish 5 7.…”

Section: Discussionsupporting

confidence: 93%

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

Xia

Wang

et al. 2019

BMJ Open

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ObjectivesThe aim of this study was to evaluate the relationship between mean arterial pressure (MAP) and coronary heart disease (CHD) in Chinese rural population. In addition, we hypothesised that this relationship might be mediated by some degree of serum lipids.DesignThis is a cross-sectional study.SettingThe participants were from the Henan Rural Cohort Study, initiated in five rural areas (Tongxu county of Kaifeng city, Yima county of Sanmenxia city, Suiping county of Zhumadian city, Xinxiang county of Xinxiang city and Yuzhou county of Xuchang city) in Henan Province, China, during July 2015 and September 2017.ParticipantsThe study included 39 020 subjects aged 18–79 years as current research population.Outcome measuresSystolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured using an electronic sphygmomanometer. MAP was calculated by one-third SBP plus two-thirds DBP. The study used restricted cubic splines and logistic regression models to evaluate the ORs and 95% CIs. Mediation analysis using bootstrap was performed to examine the contribution of serum lipids to MAP-related CHD.ResultsThe adjusted OR (95% CI) for the highest MAP quartile with the risk of CHD was 1.45 (1.24 to 1.69) compared with the lowest quartile. Simultaneously, each 1-SD increment in MAP was significantly associated with a 12% increased risk of CHD. A linear dose–response relationship between MAP and CHD was found (p value for non-linear=0.1169) in the fully adjusted model. We further reported that 36.07% of proportion explained risk of CHD was mediated through serum lipids.ConclusionsIncreased MAP was a significant marker of CHD in Chinese rural population. Meanwhile, the relationship was mediated by some degree of serum lipids, and triglyceride was the strongest mediator.Trial registration numberHenan Rural Cohort study has been registered at Chinese Clinical Trial Register (ChiCTR-OOC-15006699) and the stage it relates to is Post-results.

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Section: Discussionsupporting

confidence: 93%

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

Xia

Wang

et al. 2019

BMJ Open

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“…Increasing attention has been focused on sex differences in the biology and hemodynamics of the human arterial system . However, there have been limited data specifically on sex differences in the association between arterial stiffness and CAD.…”

Section: Discussionmentioning

confidence: 99%

Sex Difference in the Association Between Brachial Pulse Pressure and Coronary Artery Disease: The Korean Women's Chest Pain Registry (KoROSE)

Kim

Shim

et al. 2016

J of Clinical Hypertension

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This study was performed to investigate the association between brachial pulse pressure (PP) and the presence/ extent of obstructive coronary artery disease (CAD) in men and women. Study data were obtained from a nation-wide registry composed of 632 patients (173 men and 459 women, 58.1AE10.5 years) with suspected CAD who underwent invasive coronary angiography. PP was higher in patients with obstructive CAD (≥50% stenosis) than those without CAD in both sexes (P=.032 in men; P<.001 in women). However, PP increased proportionally with the increasing number of obstructed coronary arteries in women (P<.001) but not in men (P=.070). Multiple logistic-regression analyses demonstrated that higher PP (≥50.5 mm Hg) was an independent factor for determining obstructive CAD even after controlling for potential confounders in women (odds ratio, 2.83; 95% confidence interval, 1.40-5.73; P=.004). These results were consistent in 173 selected women matched with 173 men based on age and CAD severity. In conclusion, the association between brachial PP and obstructive CAD was more pronounced in women than in men. Brachial PP can be a simple and useful indicator of CAD especially in women.

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“…While a variety of approaches, including imaging, mechanical and bio-electrical techniques have been used [ 8 – 10 ], developing blood based methods has its advantages because of the 1) proof-of-principal provided by prior work with triglycerides and cholesterol, 2) clear involvement of blood components such as platelets and white blood cells in CHD pathogenesis and 3) the ease of integrating blood based approaches into current medical diagnostics.…”

Section: Introductionmentioning

confidence: 99%

Integrated genetic and epigenetic prediction of coronary heart disease in the Framingham Heart Study

et al. 2018

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An improved method for detecting coronary heart disease (CHD) could have substantial clinical impact. Building on the idea that systemic effects of CHD risk factors are a conglomeration of genetic and environmental factors, we use machine learning techniques and integrate genetic, epigenetic and phenotype data from the Framingham Heart Study to build and test a Random Forest classification model for symptomatic CHD. Our classifier was trained on n = 1,545 individuals and consisted of four DNA methylation sites, two SNPs, age and gender. The methylation sites and SNPs were selected during the training phase. The final trained model was then tested on n = 142 individuals. The test data comprised of individuals removed based on relatedness to those in the training dataset. This integrated classifier was capable of classifying symptomatic CHD status of those in the test set with an accuracy, sensitivity and specificity of 78%, 0.75 and 0.80, respectively. In contrast, a model using only conventional CHD risk factors as predictors had an accuracy and sensitivity of only 65% and 0.42, respectively, but with a specificity of 0.89 in the test set. Regression analyses of the methylation signatures illustrate our ability to map these signatures to known risk factors in CHD pathogenesis. These results demonstrate the capability of an integrated approach to effectively model symptomatic CHD status. These results also suggest that future studies of biomaterial collected from longitudinally informative cohorts that are specifically characterized for cardiac disease at follow-up could lead to the introduction of sensitive, readily employable integrated genetic-epigenetic algorithms for predicting onset of future symptomatic CHD.

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Gender differences in the accuracy of time-dependent blood pressure indices for predicting coronary heart disease: A random-effects modeling approach

Cited by 10 publications

References 30 publications

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

Contribution of serum lipids as effect modifiers to a relationship between mean arterial pressure and coronary heart disease in Chinese rural population: the Henan Rural Cohort Study

Sex Difference in the Association Between Brachial Pulse Pressure and Coronary Artery Disease: The Korean Women's Chest Pain Registry (KoROSE)

Integrated genetic and epigenetic prediction of coronary heart disease in the Framingham Heart Study

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