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The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study

BACKGROUND: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated t...

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Autores principales: Kluwe, Bjorn, Pohlman, Neal, Kesireddy, Veena, Zhao, Songzhu, Tan, Yubo, Kline, David, Brock, Guy, Odei, James B., Effoe, Valery S., Tcheugui, Justin B. Echouffo, Kalyani, Rita R., Sims, Mario, Taylor, Herman A., Mongraw-Chaffin, Morgana, Akhabue, Ehimare, Joseph, Joshua J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126856/
https://www.ncbi.nlm.nih.gov/pubmed/37114212
http://dx.doi.org/10.1016/j.ajpc.2023.100494
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author Kluwe, Bjorn
Pohlman, Neal
Kesireddy, Veena
Zhao, Songzhu
Tan, Yubo
Kline, David
Brock, Guy
Odei, James B.
Effoe, Valery S.
Tcheugui, Justin B. Echouffo
Kalyani, Rita R.
Sims, Mario
Taylor, Herman A.
Mongraw-Chaffin, Morgana
Akhabue, Ehimare
Joseph, Joshua J.
author_facet Kluwe, Bjorn
Pohlman, Neal
Kesireddy, Veena
Zhao, Songzhu
Tan, Yubo
Kline, David
Brock, Guy
Odei, James B.
Effoe, Valery S.
Tcheugui, Justin B. Echouffo
Kalyani, Rita R.
Sims, Mario
Taylor, Herman A.
Mongraw-Chaffin, Morgana
Akhabue, Ehimare
Joseph, Joshua J.
author_sort Kluwe, Bjorn
collection PubMed
description BACKGROUND: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated the mediational role of aldosterone in the association of 5 components of ICH (cholesterol, body mass index (BMI), physical activity, diet and smoking) with incident CVD and the mediational role of blood pressure (BP) and glucose in the association of aldosterone with incident CVD in a cohort of African Americans (AA). METHODS: The Jackson Heart Study is a prospective cohort of AAs adults with data on CVD outcomes. Aldosterone, ICH metrics and baseline characteristics were collected at exam 1 (2000–2004). ICH score was developed by summing 5 ICH metrics (smoking, dietary intake, physical activity, BMI, and total cholesterol) and grouped into two categories (0–2 and ≥3 metrics). Incident CVD was defined as stroke, coronary heart disease, or heart failure. Cox proportional hazard regression models were used to model the association of categorical ICH score with incident CVD. The R Package Mediation was utilized to examine: 1) The mediational role of aldosterone in the association of ICH with incident CVD and 2) The mediational role of blood pressure and glucose in the association of aldosterone with incident CVD. RESULTS: Among 3,274 individuals (mean age: 54±12.4 years, 65% female), there were 368 cases of incident CVD over a median of 12.7 years. The risk of incident CVD was 46% lower (HR: 0.54; 95%CI 0.36, 0.80) in those with ≥3 ICH metrics at baseline compared to 0–2. Aldosterone mediated 5.4% (p = 0.006) of the effect of ICH on incident CVD. A 1-unit increase in log-aldosterone was associated with a 38% higher risk of incident CVD (HR 1.38, 95%CI: 1.19, 1.61) with BP and glucose mediating 25.6% (p<0.001) and 4.8% (p = 0.048), respectively. CONCLUSION: Aldosterone partially mediates the association of ICH with incident CVD and both blood pressure and glucose partially mediate the association of aldosterone with incident CVD, emphasizing the potential importance of aldosterone and ICH in risk of CVD among AAs.
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spelling pubmed-101268562023-04-26 The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study Kluwe, Bjorn Pohlman, Neal Kesireddy, Veena Zhao, Songzhu Tan, Yubo Kline, David Brock, Guy Odei, James B. Effoe, Valery S. Tcheugui, Justin B. Echouffo Kalyani, Rita R. Sims, Mario Taylor, Herman A. Mongraw-Chaffin, Morgana Akhabue, Ehimare Joseph, Joshua J. Am J Prev Cardiol Original Research BACKGROUND: Higher levels of ideal cardiovascular health (ICH) are associated with lower levels of aldosterone and incidence of cardiovascular disease (CVD). However, the degree to which aldosterone mediates the association between ICH and CVD incidence has not been explored. Thus, we investigated the mediational role of aldosterone in the association of 5 components of ICH (cholesterol, body mass index (BMI), physical activity, diet and smoking) with incident CVD and the mediational role of blood pressure (BP) and glucose in the association of aldosterone with incident CVD in a cohort of African Americans (AA). METHODS: The Jackson Heart Study is a prospective cohort of AAs adults with data on CVD outcomes. Aldosterone, ICH metrics and baseline characteristics were collected at exam 1 (2000–2004). ICH score was developed by summing 5 ICH metrics (smoking, dietary intake, physical activity, BMI, and total cholesterol) and grouped into two categories (0–2 and ≥3 metrics). Incident CVD was defined as stroke, coronary heart disease, or heart failure. Cox proportional hazard regression models were used to model the association of categorical ICH score with incident CVD. The R Package Mediation was utilized to examine: 1) The mediational role of aldosterone in the association of ICH with incident CVD and 2) The mediational role of blood pressure and glucose in the association of aldosterone with incident CVD. RESULTS: Among 3,274 individuals (mean age: 54±12.4 years, 65% female), there were 368 cases of incident CVD over a median of 12.7 years. The risk of incident CVD was 46% lower (HR: 0.54; 95%CI 0.36, 0.80) in those with ≥3 ICH metrics at baseline compared to 0–2. Aldosterone mediated 5.4% (p = 0.006) of the effect of ICH on incident CVD. A 1-unit increase in log-aldosterone was associated with a 38% higher risk of incident CVD (HR 1.38, 95%CI: 1.19, 1.61) with BP and glucose mediating 25.6% (p<0.001) and 4.8% (p = 0.048), respectively. CONCLUSION: Aldosterone partially mediates the association of ICH with incident CVD and both blood pressure and glucose partially mediate the association of aldosterone with incident CVD, emphasizing the potential importance of aldosterone and ICH in risk of CVD among AAs. Elsevier 2023-04-03 /pmc/articles/PMC10126856/ /pubmed/37114212 http://dx.doi.org/10.1016/j.ajpc.2023.100494 Text en © 2023 The Authors. Published by Elsevier B.V. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Original Research
Kluwe, Bjorn
Pohlman, Neal
Kesireddy, Veena
Zhao, Songzhu
Tan, Yubo
Kline, David
Brock, Guy
Odei, James B.
Effoe, Valery S.
Tcheugui, Justin B. Echouffo
Kalyani, Rita R.
Sims, Mario
Taylor, Herman A.
Mongraw-Chaffin, Morgana
Akhabue, Ehimare
Joseph, Joshua J.
The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title_full The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title_fullStr The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title_full_unstemmed The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title_short The role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: The Jackson heart study
title_sort role of aldosterone and ideal cardiovascular health in incident cardiovascular disease: the jackson heart study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10126856/
https://www.ncbi.nlm.nih.gov/pubmed/37114212
http://dx.doi.org/10.1016/j.ajpc.2023.100494
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