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Use of a pooled cohort to impute cardiovascular disease risk factors across the adult life course.

TitleUse of a pooled cohort to impute cardiovascular disease risk factors across the adult life course.
Publication TypeJournal Article
Year of Publication2019
AuthorsHazzouri, AZeki Al, Vittinghoff, E, Zhang, Y, Pletcher, MJ, Moran, AE, Bibbins-Domingo, K, Golden, SH, Yaffe, K
JournalInt J Epidemiol
Volume48
Issue3
Pagination1004-1013
Date Published2019 06 01
ISSN1464-3685
Abstract<p><b>BACKGROUND: </b>In designing prevention strategies, it may be useful to understand how early and midlife cardiovascular disease risk factor (CVDRF) exposures affect outcomes that primarily occur in mid to late life. Few single US cohorts have followed participants from early adulthood to late life.</p><p><b>METHODS: </b>We pooled four prospective cohorts that represent segments of the adult life course, and studied 15 001 White and Black adults aged 18 to 95 years at enrollment. We imputed early and midlife exposure to body mass index (BMI), glucose, lipids and blood pressure (BP). CVDRF trajectories were estimated using linear mixed models. Using the best linear unbiased predictions, we obtained person-specific estimates of CVDRF trajectories beginning at age 20 until each participant's end of follow-up. We then calculated for each CVDRF, summary measures of early and midlife exposure as time-weighted averages (TWAs).</p><p><b>RESULTS: </b>In the pooled cohort, 33.7% were Black and 54.8% were female. CVDRF summary measures worsened in midlife compared with early life and varied by sex and race. In particular, systolic and diastolic BP were consistently higher over the adult life course among men, and BMI was higher among Blacks, particularly Black women. Simulation studies suggested acceptable imputation accuracy, especially for the younger cohorts. Correlations of true and imputed CVDRF summary measures ranged from 0.53 to 0.99, and agreement ranged from 67% to 99%.</p><p><b>CONCLUSIONS: </b>These results suggest that imputed CVDRFs may be accurate enough to be useful in assessing the effects of early and midlife exposures on later life outcomes.</p>
DOI10.1093/ije/dyy264
Alternate JournalInt J Epidemiol
PubMed ID30535320
PubMed Central IDPMC6659365
Grant ListRF1 AG054443 / AG / NIA NIH HHS / United States
RF1 AG054443 / AG / NIA NIH HHS / United States
K01 AG047273 / AG / NIA NIH HHS / United States
R01 HL107475 / HL / NHLBI NIH HHS / United States
HHSN268201300025C / HL / NHLBI NIH HHS / United States
HHSN268201300026C / HL / NHLBI NIH HHS / United States
HHSN268201300027C / HL / NHLBI NIH HHS / United States
HHSN268201300028C / HL / NHLBI NIH HHS / United States
HHSN268201300029C / HL / NHLBI NIH HHS / United States
HHSN268200900041C / HL / NHLBI NIH HHS / United States
HHSN263201500003I / NH / NIH HHS / United States
N01HC95159 / HL / NHLBI NIH HHS / United States
N01HC95169 / HL / NHLBI NIH HHS / United States
UL1 TR000040 / TR / NCATS NIH HHS / United States
UL1 TR001079 / TR / NCATS NIH HHS / United States
HHSN268201200036C / HL / NHLBI NIH HHS / United States
HHSN268200800007C / HL / NHLBI NIH HHS / United States
HHSN268201800001C / HL / NHLBI NIH HHS / United States
N01HC55222 / HL / NHLBI NIH HHS / United States
N01HC85079 / HL / NHLBI NIH HHS / United States
N01HC85080 / HL / NHLBI NIH HHS / United States
N01HC85081 / HL / NHLBI NIH HHS / United States
N01HC85082 / HL / NHLBI NIH HHS / United States
N01HC85083 / HL / NHLBI NIH HHS / United States
N01HC85086 / HL / NHLBI NIH HHS / United States
U01 HL080295 / HL / NHLBI NIH HHS / United States
U01 HL130114 / HL / NHLBI NIH HHS / United States
R01 AG023629 / AG / NIA NIH HHS / United States
R01 AG028050 / AG / NIA NIH HHS / United States
R01 NR012459 / NR / NINR NIH HHS / United States
ePub date: 
19/06