Why should population attributable fractions be periodically recalculated?

Grau, María; Subirana, Isaac; Elosúa, Roberto; Fitó, Montserrat; Covas, Marı́a-Isabel; Sala, Joan; Masiá, Rafael; Ramos, Rafel; Solanas, Pascual; Cordón, Ferrán; Nieto, F. Javier; Marrugat, Jaume

doi:10.1016/j.ypmed.2010.03.012

Cited by 24 publications

(16 citation statements)

References 48 publications

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“…As shown in Figure 2, younger men aged 30-45 had strikingly high PARs for all-cause mortality. This finding is consistent with studies suggesting that young smokers have higher PARs for coronary heart disease [4,31]. In the Framingham Heart Study, it was found that the competing risk of death from other smoking-related causes shortened median survival by 5 years [32].…”

Section: Discussionsupporting

confidence: 88%

“…From a preventive perspective, PARs are a helpful measurement for planning public health interventions and creating new public policy. As such, it should be recalculated periodically [4,16], especially for individual risk factors in different subgroups. The aim of this study was to assess the age and gender effects of MetS and metabolic disorders, including high waist circumference (WC), AH, DM, high TG, and low high-density lipoprotein cholesterol (HDL-C) on all-cause and CVD-related mortality within an 8-year follow-up period.…”

Section: Introductionmentioning

confidence: 99%

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Age- and gender-specific population attributable risks of metabolic disorders on all-cause and cardiovascular mortality in Taiwan

et al. 2012

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BackgroundThe extent of attributable risks of metabolic syndrome (MetS) and its components on mortality remains unclear, especially with respect to age and gender. We aimed to assess the age- and gender-specific population attributable risks (PARs) for cardiovascular disease (CVD)-related mortality and all-cause mortality for public health planning.MethodsA total of 2,092 men and 2,197 women 30 years of age and older, who were included in the 2002 Taiwan Survey of Hypertension, Hyperglycemia, and Hyperlipidemia (TwSHHH), were linked to national death certificates acquired through December 31, 2009. Cox proportional hazard models were used to calculate adjusted hazard ratios and PARs for mortality, with a median follow-up of 7.7 years.ResultsThe respective PAR percentages of MetS for all-cause and CVD-related mortality were 11.6 and 39.2 in men, respectively, and 18.6 and 44.4 in women, respectively. Central obesity had the highest PAR for CVD mortality in women (57.5%), whereas arterial hypertension had the highest PAR in men (57.5%). For all-cause mortality, younger men and post-menopausal women had higher PARs related to Mets and its components; for CVD mortality, post-menopausal women had higher overall PARs than their pre-menopausal counterparts.ConclusionsMetS has a limited application to the PAR for all-cause mortality, especially in men; its PAR for CVD mortality is more evident. For CVD mortality, MetS components have higher PARs than MetS itself, especially hypertension in men and waist circumference in post-menopausal women. In addition, PARs for diabetes mellitus and low HDL-cholesterol may exceed 20%. We suggest differential control of risk factors in different subpopulation as a strategy to prevent CVD-related mortality.

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Section: Discussionsupporting

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Age- and gender-specific population attributable risks of metabolic disorders on all-cause and cardiovascular mortality in Taiwan

et al. 2012

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“…Fatal events were identified from regional and national mortality registers. After reviewing all medical records and physician notes, suspected CHD events were classified in committee according to standardized criteria [18]. …”

Section: Methodsmentioning

confidence: 99%

Assessment of the value of a genetic risk score in improving the estimation of coronary risk

Lluís-Ganella¹,

Subirana

Lucas³

et al. 2012

Atherosclerosis

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Background The American Heart Association has established criteria for the evaluation of novel markers of cardiovascular risk. In accordance with these criteria, we assessed the association between a multi-locus genetic risk score (GRS) and incident coronary heart disease (CHD), and evaluated whether this GRS improves the predictive capacity of the Framingham risk function. Methods and results Using eight genetic variants associated with CHD but not with classical cardiovascular risk factors (CVRFs), we generated a multi-locus GRS, and found it to be linearly associated with CHD in two population based cohorts: The REGICOR Study (n=2,351) and The Framingham Heart Study (n=3,537) (meta-analyzed HR [95%CI]: ~1.13 [1.01–1.27], per unit). Inclusion of the GRS in the Framingham risk function improved its discriminative capacity in the Framingham sample (c-statistic: 72.81 vs.72.37, p=0.042) but not in the REGICOR sample. According to both the net reclassification improvement (NRI) index and the integrated discrimination index (IDI), the GRS improved re-classification among individuals with intermediate coronary risk (meta-analysis NRI [95%CI]: 17.44 [8.04; 26.83]), but not overall. Conclusions A multi-locus GRS based on genetic variants unrelated to CVRFs was associated with a linear increase in risk of CHD events in two distinct populations. This GRS improves risk reclassification particularly in the population at intermediate coronary risk. These results indicate the potential value of the inclusion of genetic information in classical functions for risk assessment in the intermediate risk population group.

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“…(Chuang et al, 2012;Elliott et al, 2008;Nilsson et al, 1997) Dyslipidemia is a well-known risk factor for vascular disease. (Grau et al, 2010;Karthikeyan et al, 2009) Furthermore, it appears that the use of certain, not all, AEDs can put patients at a higher risk of developing dyslipidemia. (Mantel-Teeuwisse et al, 2001) There is also evidence to suggest that, in paediatric patients, some AEDs affect liver enzymes involved in lipid metabolism and therefore directly increasing the risk of dyslipidemia.…”

Section: Introductionmentioning

confidence: 99%

Antiepileptic drug use for treatment of epilepsy and dyslipidemia: Systematic review

et al. 2015

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Why should population attributable fractions be periodically recalculated?

Cited by 24 publications

References 48 publications

Age- and gender-specific population attributable risks of metabolic disorders on all-cause and cardiovascular mortality in Taiwan

Age- and gender-specific population attributable risks of metabolic disorders on all-cause and cardiovascular mortality in Taiwan

Assessment of the value of a genetic risk score in improving the estimation of coronary risk

Antiepileptic drug use for treatment of epilepsy and dyslipidemia: Systematic review

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