Clusters of AMI risk factors and their association with left ventricular hypertrophy: a population-based study within the Skaraborg Project, Sweden.
OBJECTIVE
Risk factors for acute myocardial infarction (AMI) are known to cluster and to be differently distributed in men and women. The aim of this study was to sex-specifically explore clusters of acknowledged AMI risk factors by factor analysis, and to study whether such clusters are associated with left ventricular hypertrophy (LVH), used as a subclinical measure of CHD.


METHODS
In 2001-2005, 2328 subjects (30-74 years) were randomly selected from two municipalities in Sweden (participation-rate 76%) and were assessed with regard to cardiovascular risk factors; 852 participants also had an echocardiographic examination performed.


RESULTS
Factor analysis identified three identical factors in men and women. WHR, HOMA-ir, systolic blood pressure, and ApoB/ApoA1 loaded significantly on the principal "metabolic factor", leisure-time physical activity and self-rated health loaded significantly on the "vitality factor", and smoking and alcohol consumption loaded significantly on the "addiction factor". The metabolic factor was associated with LVH in both men (P<0.001) and women (P<0.001), whereas the addiction factor was associated with LVH solely in men (P=0.002).


CONCLUSIONS
The consistent pattern in the clustering of acknowledged AMI risk factors suggests common underlying mechanisms in both men and women. However, whereas the metabolic factor was paramount in both men and women in the association with LVH, the addiction factor had an impact solely in men. As LVH often precedes AMI, a deeper understanding of risk factors for LVH, including consideration of the supposed sex differences, can be useful in order to explore prevention strategies for AMI.
Lund University, Department of Clinical Sciences, Malmö, Social Medicine and Global Health, Skåne University Hospital, Jan Waldenströms gata 35, 205 02 Malmö, Sweden; University of Gothenburg, The Sahlgrenska Academy, Department of Public Health and Community Medicine/Primary Health Care, Box 454, 405 30 Göteborg, Sweden. Electronic address: charlotte_a.larsson@med.lu.se.
Charlotte A
CA
Larsson
Bledar
B
Daka
Bo
B
Gullberg
Lennart
L
Råstam
Ulf
U
Lindblad
D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D016000:Cluster Analysis; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000453:epidemiology*; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000453:epidemiology*; D012307:Risk Factors; D012727:Sex Characteristics; D017678:Sex Distribution; D012907:Smoking / Q000453:epidemiology; D013548:Sweden / Q000453:epidemiology; D014463:Ultrasonography
AMI; CHD; Cardiovascular risk factors; Left ventricular hypertrophy; Population-based; Sex differences