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Metabolic risk factors for cardiovascular disease in a working population: a retrospective cohort study
B Gumbiner1, E M Andresen, F T Hearne
1University of Rochester, NY 14620, USA.
Insights
Cardiovascular disease (CVD) risk factors cluster in young workers, with individuals acquiring more over time. This clustering may signal an underlying metabolic disorder, increasing negative CVD outcomes.
Area of Science:
- Occupational Health
- Cardiovascular Medicine
- Metabolic Disorders
Background:
- Cardiovascular disease (CVD) risk factors often cluster in individuals.
- Underlying metabolic disorders may contribute to the clustering of CVD risk factors.
Purpose of the Study:
- To determine the prevalence of metabolic risk factors for CVD in a young working population.
- To investigate the tendency for individuals with existing risk factors to develop additional ones.
Main Methods:
- Retrospective three-year follow-up study of 9,747 employees at a worksite screening program.
- Assessment of baseline cardiovascular disease (CVD) risk factors: abnormal glucose, lipids, and hypertension.
- Analysis of risk factor incidence and fatal CVD events.
Main Results:
- Prevalence: hypertension 9.8%, abnormal lipids 22.6%, abnormal glucose 1.5%.
- Combinations of two risk factors occurred more often than expected by chance (p < 0.01).
- Individuals with existing risk factors were more likely to develop additional ones, with hypertension and later abnormal glucose showing the highest relative risk (RR 2.0).
Conclusions:
- Young working individuals with cardiovascular disease (CVD) risk factors tend to acquire more over time.
- Clustering of risk factors may indicate an underlying metabolic disorder.
- Identifying individuals with clustered risk factors is crucial for predicting negative CVD outcomes.
Abstract:
Risk factors for cardiovascular disease (CVD) appear to cluster in individuals, possibly because of a single, underlying metabolic disorder. We describe the prevalence of metabolic risk factors for CVD in a young working population and the tendency for individuals with some risk factors to acquire additional factors. This was a retrospective three-year follow-up study of baseline CVD risk factors assessing (1) incidence of risk factors and (2) fatal CVD. The study group consisted of 9,747 Eastman Kodak employees, who participated in a worksite-based cardiovascular screening program in Rochester, New York, which included a medical history, physical examination, and laboratory evaluation. Abnormal metabolic risk factors were defined as (1) an abnormal glucose value (fasting blood sugar greater than 115 mg/dl); (2) abnormal lipids (high-density lipoprotein cholesterol under 35 mg/dl in men or under 45 mg/dl in women; or low-density lipoproteins of 160 or greater; or triglycerides greater than 250 mg/dl), and (3) hypertension (blood pressure systolic above 160 mmHg; or diastolic above 90 mmHg). Subjects were classified as having none, one, two, or all three risk factors. Prevalence of single risk factors were: hypertension 9.8%, abnormal lipids 22.6%, and abnormal glucose 1.5%. Combinations of two risk factors were greater than expected by chance (p < 0.01). Individuals who started with one or more abnormal values tended to have an increased risk of developing others. The highest relative risk (RR) was for those with hypertension and a later diagnosis of abnormal glucose (RR 2.0; 95% CI = 0.87, 4.58). Seven employees of 4,263 with at least one risk factor died of CVD, compared with one of 5,484 employees with no factors (RR 9.0, 95% CI = 1.1, 73.2). In conclusion, this study suggests that young working individuals with CVD risk factors may continue to acquire additional factors. This clustering could be an indication of an underlying metabolic disorder and identify individuals at risk for negative CVD sequelae.
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