Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study

Christopher A. Pumill, Christopher G. Bush, Melissa A. Greiner, Michael E. Hall, Shannon M Dunlay, Adolfo Correa, Lesley H. Curtis, Takeki Suzuki, Chantelle Hardy, Chad T. Blackshear, Emily C. O'Brien, Robert J. Mentz

Research output: Contribution to journalArticle

Abstract

Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age- and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional-hazards with stepwise models. Results: Overall, 5,290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (n = 2179), 38-40 cm (n = 1552), and >40 cm (n = 1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4% [99% CI, 10.7-16.7] in the largest NC tertile vs 6.5% [99% CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction, or coronary heart disease (all P ≥.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99% CI, 0.99-1.10], P =.06). Conclusions: In this large cohort of African American individuals, a larger NC was associated with increased risk for HF hospitalization following adjustment for age and sex, but this risk was not statistically significant after adjusting for other clinical variables. Although NC is not independently associated with increased risk for cardiovascular events, it may offer prognostic information particularly related to HF hospitalization.

Original languageEnglish (US)
Pages (from-to)72-79
Number of pages8
JournalAmerican Heart Journal
Volume212
DOIs
StatePublished - Jun 1 2019

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Neck
Hospitalization
Heart Failure
African Americans
Risk Adjustment
Incidence
Population Characteristics
Coronary Disease
Stroke
Myocardial Infarction
Mortality
Research

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Pumill, C. A., Bush, C. G., Greiner, M. A., Hall, M. E., Dunlay, S. M., Correa, A., ... Mentz, R. J. (2019). Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study. American Heart Journal, 212, 72-79. https://doi.org/10.1016/j.ahj.2019.03.001

Neck circumference and cardiovascular outcomes : Insights from the Jackson Heart Study. / Pumill, Christopher A.; Bush, Christopher G.; Greiner, Melissa A.; Hall, Michael E.; Dunlay, Shannon M; Correa, Adolfo; Curtis, Lesley H.; Suzuki, Takeki; Hardy, Chantelle; Blackshear, Chad T.; O'Brien, Emily C.; Mentz, Robert J.

In: American Heart Journal, Vol. 212, 01.06.2019, p. 72-79.

Research output: Contribution to journalArticle

Pumill, CA, Bush, CG, Greiner, MA, Hall, ME, Dunlay, SM, Correa, A, Curtis, LH, Suzuki, T, Hardy, C, Blackshear, CT, O'Brien, EC & Mentz, RJ 2019, 'Neck circumference and cardiovascular outcomes: Insights from the Jackson Heart Study', American Heart Journal, vol. 212, pp. 72-79. https://doi.org/10.1016/j.ahj.2019.03.001
Pumill, Christopher A. ; Bush, Christopher G. ; Greiner, Melissa A. ; Hall, Michael E. ; Dunlay, Shannon M ; Correa, Adolfo ; Curtis, Lesley H. ; Suzuki, Takeki ; Hardy, Chantelle ; Blackshear, Chad T. ; O'Brien, Emily C. ; Mentz, Robert J. / Neck circumference and cardiovascular outcomes : Insights from the Jackson Heart Study. In: American Heart Journal. 2019 ; Vol. 212. pp. 72-79.
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abstract = "Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age- and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional-hazards with stepwise models. Results: Overall, 5,290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (n = 2179), 38-40 cm (n = 1552), and >40 cm (n = 1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4{\%} [99{\%} CI, 10.7-16.7] in the largest NC tertile vs 6.5{\%} [99{\%} CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction, or coronary heart disease (all P ≥.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99{\%} CI, 0.99-1.10], P =.06). Conclusions: In this large cohort of African American individuals, a larger NC was associated with increased risk for HF hospitalization following adjustment for age and sex, but this risk was not statistically significant after adjusting for other clinical variables. Although NC is not independently associated with increased risk for cardiovascular events, it may offer prognostic information particularly related to HF hospitalization.",
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AU - Pumill, Christopher A.

AU - Bush, Christopher G.

AU - Greiner, Melissa A.

AU - Hall, Michael E.

AU - Dunlay, Shannon M

AU - Correa, Adolfo

AU - Curtis, Lesley H.

AU - Suzuki, Takeki

AU - Hardy, Chantelle

AU - Blackshear, Chad T.

AU - O'Brien, Emily C.

AU - Mentz, Robert J.

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N2 - Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age- and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional-hazards with stepwise models. Results: Overall, 5,290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (n = 2179), 38-40 cm (n = 1552), and >40 cm (n = 1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4% [99% CI, 10.7-16.7] in the largest NC tertile vs 6.5% [99% CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction, or coronary heart disease (all P ≥.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99% CI, 0.99-1.10], P =.06). Conclusions: In this large cohort of African American individuals, a larger NC was associated with increased risk for HF hospitalization following adjustment for age and sex, but this risk was not statistically significant after adjusting for other clinical variables. Although NC is not independently associated with increased risk for cardiovascular events, it may offer prognostic information particularly related to HF hospitalization.

AB - Background: Emerging data suggest that neck circumference (NC) is associated with cardiometabolic risk factors. Limited research is available regarding the association between NC and cardiovascular outcomes in African Americans. Methods: Using data from the Jackson Heart Study, we included participants with recorded NC measurements at baseline (2000-2004). Baseline characteristics for the included population were summarized by tertiles of NC. We then calculated age- and sex-adjusted cumulative incidence of clinical cardiovascular outcomes and performed Cox proportional-hazards with stepwise models. Results: Overall, 5,290 participants were categorized into tertiles of baseline NC defined as ≤37 cm (n = 2179), 38-40 cm (n = 1552), and >40 cm (n = 1559). After adjusting for age and sex, increasing NC was associated with increased risk of heart failure (HF) hospitalization (cumulative incidence = 13.4% [99% CI, 10.7-16.7] in the largest NC tertile vs 6.5% [99% CI, 4.7-8.8] in the smallest NC tertile), but not mortality, stroke, myocardial infarction, or coronary heart disease (all P ≥.1). Following full risk adjustment, there was a nominal increase in the risk of HF hospitalization with increasing NC, but this was not statistically significant (hazard ratio per 1-cm increase, 1.04 [99% CI, 0.99-1.10], P =.06). Conclusions: In this large cohort of African American individuals, a larger NC was associated with increased risk for HF hospitalization following adjustment for age and sex, but this risk was not statistically significant after adjusting for other clinical variables. Although NC is not independently associated with increased risk for cardiovascular events, it may offer prognostic information particularly related to HF hospitalization.

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