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LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00005286naa a2200661 4500
001oai:gup.ub.gu.se/316405
003SwePub
008240528s2022 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/3164052 URI
0247 a https://doi.org/10.1093/eurjpc/zwac0692 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Leong, D. P.4 aut
2451 0a Medications for blood pressure, blood glucose, lipids, and anti-thrombotic medications: relationship with cardiovascular disease and death in adults from 21 high-, middle-, and low-income countries with an elevated body mass index
264 c 2022-05-04
264 1b Oxford University Press (OUP),c 2022
520 a Aims Elevated body mass index (BMI) is an important cause of cardiovascular disease (CVD). The population-level impact of pharmacologic strategies to mitigate the risk of CVD conferred by the metabolic consequences of an elevated BMI is not well described. Methods and results We conducted an analysis of 145 986 participants (mean age 50 years, 58% women) from 21 high-, middle-, and low-income countries in the Prospective Urban and Rural Epidemiology study who had no history of cancer, ischaemic heart disease, heart failure, or stroke. We evaluated whether the hazards of CVD (myocardial infarction, stroke, heart failure, or cardiovascular death) differed among those taking a cardiovascular medication (n = 29 174; including blood pressure-lowering, blood glucose-lowering, cholesterol-lowering, or anti-thrombotic medications) vs. those not taking a cardiovascular medication (n = 116 812) during 10.2 years of follow-up. Cox proportional hazard models with the community as a shared frailty were constructed by adjusting age, sex, education, geographic region, physical activity, tobacco, and alcohol use. We observed 7928 (5.4%) CVD events and 9863 (6.8%) deaths. Cardiovascular medication use was associated with different hazards of CVD (interaction P < 0.0001) and death (interaction P = 0.0020) as compared with no cardiovascular medication use. Among those not taking a cardiovascular medication, as compared with those with BMI 20 to <25 kg/m(2), the hazard ratio (HR) [95% confidence interval (95% CI)] for CVD were, respectively, 1.14 (1.06-1.23); 1.45 (1.30-1.61); and 1.53 (1.28-1.82) among those with BMI 25 to <30 kg/m(2); 30 to <35 kg/m(2); and >= 35 kg/m(2). However, among those taking a cardiovascular medication, the HR (95% CI) for CVD were, respectively, 0.79 (0.72-0.87); 0.90 (0.79-1.01); and 1.14 (0.98-1.33). Among those not taking a cardiovascular medication, the respective HR (95% CI) for death were 0.93 (0.87-1.00); 1.03 (0.93-1.15); and 1.44 (1.24-1.67) among those with BMI 25 to <30 kg/m(2); 30 to <35 kg/m(2); and >= 35 kg/m(2). However, among those taking a cardiovascular medication, the respective HR (95% CI) for death were 0.77 (0.69-0.84); 0.88 (0.78-0.99); and 1.12 (0.96-1.30). Blood pressure-lowering medications accounted for the largest population attributable benefit of cardiovascular medications. Conclusion To the extent that CVD risk among those with an elevated BMI is related to hypertension, diabetes, and an elevated thrombotic milieu, targeting these pathways pharmacologically may represent an important complementary means of reducing the CVD burden caused by an elevated BMI.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a Obesity
653 a Cardiovascular
653 a Risk factor
653 a Blood pressure
653 a Lipid-lowering
653 a association
653 a risk
653 a Cardiovascular System & Cardiology
7001 a Rangarajan, S.4 aut
7001 a Rosengren, Annika,d 1951u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine4 aut0 (Swepub:gu)xrosan
7001 a Oguz, A.4 aut
7001 a Alhabib, K. F.4 aut
7001 a Poirier, P.4 aut
7001 a Diaz, R.4 aut
7001 a Dans, A. L.4 aut
7001 a Iqbal, R.4 aut
7001 a Yusufali, A. M.4 aut
7001 a Yeates, K.4 aut
7001 a Chifamba, J.4 aut
7001 a Seron, P.4 aut
7001 a Lopez-Lopez, J.4 aut
7001 a Bahonar, A.4 aut
7001 a Wei, L.4 aut
7001 a Bo, H.4 aut
7001 a Weida, L.4 aut
7001 a Avezum, A.4 aut
7001 a Gupta, R.4 aut
7001 a Mohan, V.4 aut
7001 a Kruger, H. S.4 aut
7001 a Lakshmi, P. V. M.4 aut
7001 a Yusuf, R.4 aut
7001 a Yusuf, S.4 aut
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för molekylär och klinisk medicin4 org
7730 t European journal of preventive cardiologyd : Oxford University Press (OUP)g 29:14, s. 1817-1826q 29:14<1817-1826x 2047-4873x 2047-4881
8564 8u https://gup.ub.gu.se/publication/316405
8564 8u https://doi.org/10.1093/eurjpc/zwac069

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