Clusters of AMI risk factors and their association with left ventricular hypertrophy: a population-based study within the Skaraborg Project, Sweden.
OBJECTIVES
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.
['Larsson|Charlotte A|CA|', 'Daka|Bledar|B|', 'Gullberg|Bo|B|', 'Råstam|Lennart|L|', 'Lindblad|Ulf|U|']
D000328:Adult D000368:Aged D000428:Alcohol Drinking D016000:Cluster Analysis D003430:Cross-Sectional Studies D005260:Female D006801:Humans D017379:Hypertrophy, Left Ventricular D008019:Life Style D008297:Male D024821:Metabolic Syndrome D008875:Middle Aged D015999:Multivariate Analysis D009203:Myocardial Infarction D012307:Risk Factors D012727:Sex Characteristics D017678:Sex Distribution D012907:Smoking D013548:Sweden D014463:Ultrasonography
AMI Left ventricular hypertrophy Population-based CHD Cardiovascular risk factors Sex differences