smoothHR: An R Package for Pointwise Nonparametric Estimation of Hazard Ratio Curves of Continuous Predictors

Meira‐Machado, Luís; Cadarso‐Suárez, Carmen; Gudé, Francisco; Araújo, Artur

doi:10.1155/2013/745742

Cited by 133 publications

(103 citation statements)

References 29 publications

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“…The proportional hazards assumption was assessed graphically and found to be met. Estimated HR curves of RHR relative to the hazard of RHR with best mortality were performed using a smoothing method based on splines to introduce flexibility into the Cox model18 (see online supplementary data). …”

Section: Methodsmentioning

confidence: 99%

Heritability of resting heart rate and association with mortality in middle-aged and elderly twins

Jensen

Wod

Galatius

et al. 2017

Heart

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Objective Resting heart rate (RHR) possibly has a hereditary component and is associated with longevity. We used the classical biometric twin study design to investigate the heritability of RHR in a population of middle-aged and elderly twins and, furthermore, studied the association between RHR and mortality. Methods In total, 4282 twins without cardiovascular disease were included from the Danish Twin Registry, hereof 1233 twin pairs and 1816 ’single twins’ (twins with a non-participating co-twin); mean age 61.7 (SD 11.1) years; 1334 (31.2%) twins died during median 16.3 (IQR 13.8–16.5) years of follow-up assessed through Danish national registers. RHR was assessed by palpating radial pulse. Results Within pair correlations for RHR adjusted for sex and age were 0.23 (95% CI 0.14 to 0.32) and 0.10 (0.03 to 0.17) for RHR in monozygotic (MZ) and dizygotic (DZ) twin pairs, respectively. Overall, heritability estimates were 0.23 (95% CI 0.15 to 0.30); 0.27 (0.15 to 0.38) for males and 0.17 (0.06 to 0.28) for females. In multivariable models adjusting for age, gender, body mass index, diabetes, hypertension, pulmonary function, smoking, physical activity and zygosity, RHR was significantly associated with mortality (eg, RHR >90 vs 61–70 beats per min: all-cause HR 1.56 (95% CI 1.21 to 2.03); cardiovascular 2.19 (1.30 to 3.67). Intrapair twin comparison revealed that the twin with the higher RHR was significantly more likely to die first and the probability increased with increase in intrapair difference in RHR. Conclusions RHR is a trait with a genetic influence in middle-aged and elderly twins free of cardiovascular disease. RHR is independently associated with longevity even when familial factors are controlled for in a twin design.

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Section: Methodsmentioning

confidence: 99%

Heritability of resting heart rate and association with mortality in middle-aged and elderly twins

Jensen

Wod

Galatius

et al. 2017

Heart

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“…Penalized splines were used as the smoothing technique, and the degrees of freedom of splines were selected on the basis of the lowest Akaike Information Criteria. 33 The age-, sex-, muscle mass-, and history of diabetes and hypertension medication-adjusted residuals of eGFR were divided into semidecile groups (five percentile intervals) according to percentile rank. Then, the association between percentile rank groups and allcause mortality was analyzed with the Cox proportional hazards model.…”

Section: Setting and Participantsmentioning

confidence: 99%

Renal Hyperfiltration as a Novel Marker of All-Cause Mortality

Park

Yoon

Lim

et al. 2015

Journal of the American Society of Nephrology

119

136

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Although renal hyperfiltration (RHF) or an abnormal increase in GFR has been associated with many lifestyles and clinical conditions, including diabetes, its clinical consequence is not clear. RHF is frequently considered to be the result of overestimating true GFR in subjects with muscle wasting. To evaluate the association between RHF and mortality, 43,503 adult Koreans who underwent voluntary health screening at Seoul National University Hospital between March of 1995 and May of 2006 with baseline GFR$60 ml/min per 1.73 m 2 were followed up for mortality until December 31, 2012. GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration creatinine equation, and RHF was defined as GFR.95th percentile after adjustment for age, sex, muscle mass, and history of diabetes and/or hypertension medication.Muscle mass was measured with bioimpedance analysis at baseline. During the median follow-up of 12.4 years, 1743 deaths occurred. The odds ratio of RHF in participants with the highest quartile of muscle mass was 1.31 (95% confidence interval [95% CI], 1.11 to 1.54) compared with the lowest quartile after adjusting for confounding factors, including body mass index. The hazard ratio of all-cause mortality for RHF was 1.37 (95% CI, 1.11 to 1.70) by Cox proportional hazards model with adjustment for known risk factors, including smoking. These data suggest RHF may be associated with increased all-cause mortality in an apparently healthy population. The possibility of RHF as a novel marker of all-cause mortality should be confirmed. Although CKD is a well known risk factor for all-cause or cardiovascular mortality, 1 the clinical consequences of an abnormally high GFR or renal hyperfiltration (RHF) have not been adequately evaluated. On the basis of several cross-sectional studies, RHF is known to be associated with various medical conditions, such as diabetes, 2,3 hypertension, 4 obesity, 5 prehypertension, and prediabetes, 6 as well as lifestyle factors, such as smoking, 7 lack of physical activity, 8 and low aerobic fitness. 9 Although these conditions are well known risk factors for early mortality, 10 the clinical implications of RHF remain unclear.Several cohort studies and meta-analyses have reported a J-shaped association between GFR and all-cause and cardiovascular mortality. However, the increased mortality associated with a higher GFR was commonly regarded as an overestimation of GFR because of muscle wasting in a high-risk group. [11][12][13][14][15][16][17] The disappearance of the J-shaped association between GFR and mortality within a younger age group in the higher GFR range is considered as supporting evidence for the overestimation of the true GFR

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“…18 All P values reported are nominal. For sensitivity analyses, we repeated the growth mixture modeling and the analyses of baseline characteristic association and Cox proportional HRs for participants without any missing follow-up SBP measurements within the first 6 months (complete case).…”

Section: Statistical Analysesmentioning

confidence: 99%

Heterogeneity in Early Responses in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

et al. 2017

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Abstract-Randomized trials of hypertension have seldom examined heterogeneity in response to treatments over time and the implications for cardiovascular outcomes. Understanding this heterogeneity, however, is a necessary step toward personalizing antihypertensive therapy. We applied trajectory-based modeling to data on 39 763 study participants of the ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial) to identify distinct patterns of systolic blood pressure (SBP) response to randomized medications during the first 6 months of the trial. Two trajectory patterns were identified: immediate responders (85.5%), on average, had a decreasing SBP, whereas nonimmediate responders (14.5%), on average, had an initially increasing SBP followed by a decrease. Compared with those randomized to chlorthalidone, participants randomized to amlodipine (odds ratio, 1.20; 95% confidence interval [CI], 1.10-1.31), lisinopril (odds ratio, 1.88; 95% CI, 1.73-2.03), and doxazosin (odds ratio, 1.65; 95% CI, 1.52-1.78) had higher adjusted odds ratios associated with being a nonimmediate responder (versus immediate responder). After multivariable adjustment, nonimmediate responders had a higher hazard ratio of stroke (hazard ratio, 1.49; 95% CI, 1.21-1.84), combined cardiovascular disease (hazard ratio, 1.21; 95% CI, 1.11-1.31), and heart failure (hazard ratio, 1.48; 95% CI, 1.24-1.78) during follow-up between 6 months and 2 years. The SBP response trajectories provided superior discrimination for predicting downstream adverse cardiovascular events than classification based on difference in SBP between the first 2 measurements, SBP at 6 months, and average SBP during the first 6 months. Our findings demonstrate heterogeneity in response to antihypertensive therapies and show that chlorthalidone is associated with more favorable initial response than the other medications. (Hypertension. 2017;70:94-102.

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smoothHR: An R Package for Pointwise Nonparametric Estimation of Hazard Ratio Curves of Continuous Predictors

Cited by 133 publications

References 29 publications

Heritability of resting heart rate and association with mortality in middle-aged and elderly twins

Heritability of resting heart rate and association with mortality in middle-aged and elderly twins

Renal Hyperfiltration as a Novel Marker of All-Cause Mortality

Heterogeneity in Early Responses in ALLHAT (Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial)

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