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Exploring clinical predictors of cardiovascular disease in a central Australian Aboriginal cohort
- Source :
- European Journal of Preventive Cardiology. 20:246-253
- Publication Year :
- 2012
- Publisher :
- Oxford University Press (OUP), 2012.
-
Abstract
- Introduction: For Aboriginal populations, predicting individuals at risk of cardiovascular disease (CVD) is difficult due to limitations and inaccuracy in existing risk-prediction algorithms. We examined conventional and novel risk factors associated with insulin resistance and the metabolic syndrome and assessed their relationships with subsequent CVD events. Design: Longitudinal cohort. Methods: Aboriginal people (n = 739) from Central Australia completed population-based risk-factor surveys in 1995 and were followed up in 2005. Principal components analysis (PCA), regression and univariate analyses (using ROC defined cut-off points) were used to identify useful clinical predictors of primary CVD. Results: PCA yielded five components: (1) lipids and liver function; (2) insulin resistance; (3) blood pressure and kidney function; (4) glucose tolerance; and (5) anti-inflammatory (low fibrinogen, high HDL cholesterol). Components 2, 3 and 4, and age were significant independent predictors of incident CVD, and smoking approached significance. In univariate analysis fasting glucose ≥4.8 mmol/l, total:HDL cholesterol ratio ≥5.7, non-HDL cholesterol ≥4.3 mmol/l, gamma-glutamyl transferase ≥70 U/l, albumin creatinine ratio ≥5.7 mg/mmol, systolic blood pressure ≥120 mmHg and diastolic blood pressure ≥70 mmHg were useful predictors of CVD. The co-occurrence of three or more risk variables (fasting glucose ≥4.8 mmol/l, total:HDL cholesterol ratio ≥5.7, blood pressure (systolic ≥120 mmHg; diastolic ≥70 mmHg; albumin:creatinine ratio ≥5.7 mg/mmol and smoking) had sensitivity of 82.0% and specificity of 59.9% for predicting incident CVD. Conclusion: Age is the strongest predictor of CVD for this population. For clinical identification of individuals at high risk, screening for the combination of three or more of hyperglycaemia, dyslipidaemia, hypertension, albuminuria and smoking may prove a useful and efficient strategy. Refereed/Peer-reviewed
- Subjects :
- Blood Glucose
Male
Native Hawaiian or Other Pacific Islander
Time Factors
Epidemiology
Blood Pressure
Comorbidity
Kidney
risk prediction
Risk Factors
Odds Ratio
Prevalence
Insulin
Longitudinal Studies
Aboriginal
Metabolic Syndrome
Principal Component Analysis
education.field_of_study
Univariate analysis
Smoking
Age Factors
Middle Aged
Lipids
Cardiovascular Diseases
Hypertension
Cohort
Female
Inflammation Mediators
Cardiology and Cardiovascular Medicine
Risk assessment
Adult
medicine.medical_specialty
Population
Risk Assessment
Young Adult
Insulin resistance
Internal medicine
medicine
Albuminuria
Humans
education
Dyslipidemias
business.industry
Australia
Odds ratio
medicine.disease
Health Surveys
Indigenous
Endocrinology
Hyperglycemia
Linear Models
Liver function
Insulin Resistance
Metabolic syndrome
business
Biomarkers
Subjects
Details
- ISSN :
- 20474881 and 20474873
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- European Journal of Preventive Cardiology
- Accession number :
- edsair.doi.dedup.....3b67f1048f429e1025da8faa0712ef4c