TY - JOUR
T1 - Association between Multiple Modifiable Risk Factors of Cardiovascular Disease and Hypertension among Asymptomatic Patients in Central Appalachia
AU - Mamudu, Hadii M.
AU - Paul, Timir K.
AU - Wang, Liang
AU - Veeranki, Sreenivas P.
AU - Panchal, Hemang B.
AU - Alamian, Arsham
AU - Budoff, Matthew
N1 - Publisher Copyright:
© 2017 The Southern Medical Association.
PY - 2017/2/1
Y1 - 2017/2/1
N2 - Objectives The central Appalachian region of the United States is disproportionately burdened with cardiovascular diseases (CVD) and associated risk factors; however, research to inform clinical practice and policies and programs is sparse. This study aimed to examine the association between multiple modifiable risk factors for CVD and hypertension in asymptomatic patients in central Appalachia. Methods Between January 2011 and December 2012, 1629 asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis. Participants were asked to report their hypertension status (yes/no). In addition, data on two nonmodifiable risk factors (sex, age) and five modifiable risk factors (obesity, diabetes mellitus, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Multivariable logistic regression analyses were conducted to assess association between hypertension and risk factors. Results Of the 1629 participants, approximately half (49.8%) had hypertension. Among people with hypertension, 31.4% were obese and 62.3% had hypercholesterolemia. After adjusting for sex and age, obesity and diabetes mellitus were associated with a more than twofold increased odds of having hypertension (odds ratio [OR] 2.02, confidence interval [CI] 1.57-2.60 and OR 2.30, CI 1.66-3.18, respectively). Hypercholesterolemia and sedentary lifestyle were associated with higher odds for hypertension (OR 1.26, CI 1.02-1.56 and OR 1.38, CI 1.12-1.70, respectively), compared with referent groups. Having two, three, and four to five modifiable risk factors was associated with increased odds of having hypertension by about twofold (OR 1.72, CI 1.21-2.44), 2.5-fold (OR 2.55, CI 1.74-3.74), and sixfold (OR 5.96, CI 3.42-10.41), respectively. Conclusions This study suggests that the odds of having hypertension increases with a higher number of modifiable risk factors for CVD. As such, implementing an integrated CVD program for treating and controlling modifiable risk factors for hypertension would likely decrease the future risk of CVD.
AB - Objectives The central Appalachian region of the United States is disproportionately burdened with cardiovascular diseases (CVD) and associated risk factors; however, research to inform clinical practice and policies and programs is sparse. This study aimed to examine the association between multiple modifiable risk factors for CVD and hypertension in asymptomatic patients in central Appalachia. Methods Between January 2011 and December 2012, 1629 asymptomatic individuals from central Appalachia participated in screening for subclinical atherosclerosis. Participants were asked to report their hypertension status (yes/no). In addition, data on two nonmodifiable risk factors (sex, age) and five modifiable risk factors (obesity, diabetes mellitus, hypercholesterolemia, smoking, and sedentary lifestyle) were collected. Multivariable logistic regression analyses were conducted to assess association between hypertension and risk factors. Results Of the 1629 participants, approximately half (49.8%) had hypertension. Among people with hypertension, 31.4% were obese and 62.3% had hypercholesterolemia. After adjusting for sex and age, obesity and diabetes mellitus were associated with a more than twofold increased odds of having hypertension (odds ratio [OR] 2.02, confidence interval [CI] 1.57-2.60 and OR 2.30, CI 1.66-3.18, respectively). Hypercholesterolemia and sedentary lifestyle were associated with higher odds for hypertension (OR 1.26, CI 1.02-1.56 and OR 1.38, CI 1.12-1.70, respectively), compared with referent groups. Having two, three, and four to five modifiable risk factors was associated with increased odds of having hypertension by about twofold (OR 1.72, CI 1.21-2.44), 2.5-fold (OR 2.55, CI 1.74-3.74), and sixfold (OR 5.96, CI 3.42-10.41), respectively. Conclusions This study suggests that the odds of having hypertension increases with a higher number of modifiable risk factors for CVD. As such, implementing an integrated CVD program for treating and controlling modifiable risk factors for hypertension would likely decrease the future risk of CVD.
KW - Appalachia
KW - blood pressure
KW - cardiovascular disease
KW - hypertension
KW - multiple risk factors
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U2 - 10.14423/SMJ.0000000000000602
DO - 10.14423/SMJ.0000000000000602
M3 - Article
AN - SCOPUS:85011702256
SN - 0038-4348
VL - 110
SP - 90
EP - 96
JO - Southern medical journal
JF - Southern medical journal
IS - 2
ER -