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Progression of conventional cardiovascular risk factors and vascular disease risk in individuals: insights from the PROG-IMT consortium

Journal article
Authors M. Bahls
M. W. Lorenz
M. Dörr
L. Gao
K. Kitagawa
T. P. Tuomainen
S. Agewall
G. Berenson
A. L. Catapano
G. D. Norata
M. L. Bots
W. van Gilst
F. W. Asselbergs
F. P. Brouwers
H. Uthoff
D. Sander
H. Poppert
M. Hecht Olsen
J. P. Empana
U. Schminke
D. Baldassarre
F. Veglia
O. H. Franco
M. Kavousi
E. de Groot
E. B. Mathiesen
L. Grigore
J. F. Polak
T. Rundek
C. D. A. Stehouwer
M. R. Skilton
A. I. Hatzitolios
C. Savopoulos
G. Ntaios
M. Plichart
S. McLachlan
L. Lind
P. Willeit
H. Steinmetz
M. Desvarieux
M. A. Ikram
S. H. Johnsen
Caroline Schmidt
J. Willeit
P. Ducimetiere
J. F. Price
G. Bergström
J. Kauhanen
S. Kiechl
M. Sitzer
H. Bickel
R. L. Sacco
A. Hofman
H. Völzke
S. G. Thompson
Published in European Journal of Preventive Cardiology
Volume 27
Issue 3
ISSN 2047-4873
Publication year 2020
Published at Institute of Medicine, Department of Molecular and Clinical Medicine
Language en
Keywords CVD biomarker, risk factor progression, Risk factors
Subject categories Cardiovascular medicine


Aims: Averaged measurements, but not the progression based on multiple assessments of carotid intima-media thickness, (cIMT) are predictive of cardiovascular disease (CVD) events in individuals. Whether this is true for conventional risk factors is unclear. Methods and results: An individual participant meta-analysis was used to associate the annualised progression of systolic blood pressure, total cholesterol, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol with future cardiovascular disease risk in 13 prospective cohort studies of the PROG-IMT collaboration (n = 34,072). Follow-up data included information on a combined cardiovascular disease endpoint of myocardial infarction, stroke, or vascular death. In secondary analyses, annualised progression was replaced with average. Log hazard ratios per standard deviation difference were pooled across studies by a random effects meta-analysis. In primary analysis, the annualised progression of total cholesterol was marginally related to a higher cardiovascular disease risk (hazard ratio (HR) 1.04, 95% confidence interval (CI) 1.00 to 1.07). The annualised progression of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol was not associated with future cardiovascular disease risk. In secondary analysis, average systolic blood pressure (HR 1.20 95% CI 1.11 to 1.29) and low-density lipoprotein cholesterol (HR 1.09, 95% CI 1.02 to 1.16) were related to a greater, while high-density lipoprotein cholesterol (HR 0.92, 95% CI 0.88 to 0.97) was related to a lower risk of future cardiovascular disease events. Conclusion: Averaged measurements of systolic blood pressure, low-density lipoprotein cholesterol and high-density lipoprotein cholesterol displayed significant linear relationships with the risk of future cardiovascular disease events. However, there was no clear association between the annualised progression of these conventional risk factors in individuals with the risk of future clinical endpoints. © The European Society of Cardiology 2019.

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