Evidence map›Paper›PMID 25156990›Full record

Observational studyCirculation2014

Comparison of lifestyle-based and traditional cardiovascular disease prediction in a multiethnic cohort of nonsmoking women.

Nina P Paynter, Michael J LaMonte, JoAnn E Manson, Lisa W Martin, Lawrence S Phillips, Paul M Ridker, Jennifer G Robinson, Nancy R Cook

Abstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
8citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

8 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

Nina P PaynterFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.). npaynter@partners.org.
Michael J LaMonteFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
JoAnn E MansonFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
Lisa W MartinFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
Lawrence S PhillipsFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
Paul M RidkerFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
Jennifer G RobinsonFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).
Nancy R CookFrom Brigham and Women's Hospital and Harvard Medical School, Boston, MA (N.P.P., J.E.M., P.MR., N.R.C.); School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY (M.J.L.); George Washington University School of Medicine, Washington, DC (L.W.M.); Emory University School of Medicine, Atlanta, GA (L.S.P.); and College of Public Health, University of Iowa, Iowa City (J.G.R.).

Funding

Glycemia Reduction Approaches in Diabetes: A comparative effectiveness studyU01DK098246 · NIDDK · GEORGE WASHINGTON UNIVERSITY · PI KRAUSE-STEINRAUF, HEIDI, LACHIN, JOHN M · 2012 to 2022
$238.9M
Screening for IGT: Glucose Challenge vs Predictive ModelR18DK066204 · NIDDK · EMORY UNIVERSITY · PI PHILLIPS, LAWRENCE S · 2004 to 2007
$2.9M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032111 · WH · EMORY UNIVERSITY · PI WATTS, NELSON · 1993 to 2001
$1.6M
Novel Applications of Risk Reclassification Methods in CVD Risk PredictionR01HL113080 · NHLBI · BRIGHAM AND WOMEN'S HOSPITAL · PI COOK, NANCY R · 2013 to 2016
$1.3M
WOMENS HEALTH INITIATIVE-N01WH22110N01WH022110 · WH · FRED HUTCHINSON CANCER RESEARCH CENTER · PI ROSS, PRENTICE · 1992 to 2006
$1.2M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032105 · WH · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI LEWIS, CORA E · 1993 to 2000
$1.2M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032119 · WH · MEMORIAL HOSPITAL OF RHODE ISLAND · PI ASSAF, ANNLOUISE R. · 1993 to 2000
$1.2M
VANGUARD CENTER FOR WOMENS HEALTH INITIATIVEN01WH032100 · WH · FRED HUTCHINSON CANCER RESEARCH CENTER · PI BERESFORD, SHIRLEY AA · 1993 to 2001
$1.1M
CLIN CTR CLIN TRIAL/OBSERVATIONAL STUDY OF WHIN01WH042126 · WH · UNIVERSITY OF CINCINNATI · PI LIU, JAMES H. · 1994 to 2000
$1.0M
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032118 · WH · UNIVERSITY OF TENNESSEE HEALTH SCI CTR · PI JOHNSON, KAREN C · 1993 to 2000
$992k
VANGUARD CENTER FOR WOMEN'S HEALTH INITIATIVEN01WH032122 · WH · STATE UNIVERSITY OF NEW YORK AT BUFFALO · PI TREVISAN, MAURIZIO · 1993 to 2000
$927k
VANGUARD CENTER FOR WOMENS HEALTH INITIATIVEN01WH032108 · WH · NORTHWESTERN UNIVERSITY · PI GREENLAND, PHILIP · 1993 to 2000
$919k
FDA HHS R01 FD003527NHLBI NIH HHS HHSN268200960011CNHLBI NIH HHS HL113080NHLBI NIH HHS N01 WH032105NHLBI NIH HHS N01 WH032118NHLBI NIH HHS N01 WH042107NHLBI NIH HHS R01 HL113080NIDDK NIH HHS DK066204NIDDK NIH HHS R18 DK066204NIDDK NIH HHS R21 DK099716NIDDK NIH HHS U01 DK091958NIDDK NIH HHS U01 DK098246NIDDK NIH HHS U34 DK091958WHI NIH HHS N01 WH022110WHI NIH HHS N01 WH024152WHI NIH HHS N01 WH032100WHI NIH HHS N01 WH032108WHI NIH HHS N01 WH032111WHI NIH HHS N01 WH032115WHI NIH HHS N01 WH032122WHI NIH HHS N01 WH042129WHI NIH HHS N01 WH044221WHI NIH HHS N01WH32102WHI NIH HHS N01WH32106WHI NIH HHS N01WH32109WHI NIH HHS N01WH32113WHI NIH HHS N01WH32119WHI NIH HHS N01WH42126WHI NIH HHS N01WH42132
6 · The paper itself

Abstract

backgroundHealthy levels of lifestyle factors can reduce the risk of cardiovascular disease. However, except for smoking status, often considered a traditional risk factor, their effect on cardiovascular risk prediction is unclear. METHODS AND

resultsWe used a case-cohort design of postmenopausal nonsmokers in the multiethnic Women's Health Initiative Observational Study (1587 cases and 1808 subcohort participants) with a median follow-up of 10 years in noncases. Compared with nonsmokers with no other healthy lifestyle factors (healthy diet, recreational physical activity, moderate alcohol use, and low adiposity), the risk of cardiovascular disease was lower for each additional factor (hazard ratio for trend, 0.82; 95% confidence interval, 0.76-0.89), with a 45% reduction in risk with all factors (95% confidence interval, 0.36-0.84). When lifestyle factors were added to traditional risk factor models (variables from the Pooled Cohort and Reynolds risk scores), only recreational physical activity remained independently associated with the risk of cardiovascular disease. The addition of detailed lifestyle measures to traditional models showed a change in the integrated discrimination improvement and continuous net reclassification improvement (P<0.01 for both) but had little impact on more clinically relevant risk stratification measures.

conclusionsAlthough lifestyle factors have important effects on cardiovascular disease risk factors and subsequent risk, their addition to established cardiovascular disease risk models does not result in clear improvement in overall prediction.

Indexed as

Life StylePostmenopauseAdiposityAgedAlcohol DrinkingAsianBlack PeopleCardiovascular DiseasesCase-Control StudiesFemaleFollow-Up StudiesHispanic or LatinoHumansMiddle AgedMotor ActivityPredictive Value of Testscardiovascular diseaseslifestyleprimary preventionrisk assessment

Identifiers

PMID25156990
PMCPMC4206581

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.