Evidence map›Paper›PMID 26134404›Full record

SynthesisPloS one2015

Race/Ethnic Differences in the Associations of the Framingham Risk Factors with Carotid IMT and Cardiovascular Events.

Crystel M Gijsberts, Karlijn A Groenewegen, Imo E Hoefer, Marinus J C Eijkemans, Folkert W Asselbergs, Todd J Anderson, Annie R Britton, Jacqueline M Dekker, Gunnar Engström, Greg W Evans and 27 more

Open access · goldAbstract readComparative StudyMeta-Analysis
In one paragraph

Synthesis in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
93citing papers in PubMed, 8 pooled it
4.9field-weighted citation impact, top 4% of its field
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

93 citing papers in PubMed, 8 syntheses or guidelines pooled it, 201 citations in OpenAlex.

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  11. Towards responsible artificial intelligence in healthcare-getting real about real-world data and evidence.Journal of the American Medical Informatics Association : JAMIA · 2025
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33 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

37 authors at 20 institutions in 10 countries.

Crystel M GijsbertsDepartment of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
Karlijn A GroenewegenJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Imo E HoeferDepartment of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Interuniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands.
Marinus J C EijkemansJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Folkert W AsselbergsDepartment of Cardiology, Division Heart and Lungs, University Medical Centre Utrecht, Utrecht, The Netherlands; Durrer Center for Cardiogenetic Research, ICIN-Netherlands Heart Institute, Utrecht, The Netherlands; Institute of Cardiovascular Science, faculty of Population Health Sciences, University College London, London, United Kingdom.
Todd J AndersonDepartment of Cardiac Sciences and Libin Cardiovascular Institute of Alberta, University of Calgary, Alberta, Canada.
Annie R BrittonDepartment of Epidemiology and Public Health University College London, London, United Kingdom.
Jacqueline M DekkerInstitute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Gunnar EngströmDept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
Greg W EvansDepartment of Biostatistical Sciences and Neurology, Wake Forest School of Medicine, Winston-Salem, NC, United States of America.
Jacqueline de GraafDepartment of General Internal Medicine, Division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Diederick E GrobbeeJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands; University of Malaya Medical Center, Kuala Lumpur, Malaysia.
Bo HedbladDept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
Suzanne HolewijnDepartment of General Internal Medicine, Division of Vascular Medicine, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
Ai IkedaOsaka Medical Center for Health Science and Promotion, Osaka, Japan.
Kazuo KitagawaDepartment of Neurology, Tokyo Women Medical University, Tokyo, Japan.
Akihiko KitamuraOsaka Medical Center for Health Science and Promotion, Osaka, Japan.
Dominique P V de KleijnInteruniversity Cardiology Institute of the Netherlands, Utrecht, The Netherlands; Cardiovascular Research Institute & Surgery, Singapore, Singapore; Department of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Eva M LonnDepartment of Medicine, Division of Cardiology and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
Matthias W LorenzDepartment of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany.
Ellisiv B MathiesenBrain and Circulation Research Group, Department of Clinical Medicine, University of Tromsø, Tromsø, Norway.
Giel NijpelsInstitute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
Shuhei OkazakiStroke Center, Department of Neurology, Osaka University Graduate School of Medicine, Osaka, Japan.
Daniel H O'LearyDepartment of Radiology, Tufts Medical Center, Boston, MA, United States of America.
Gerard PasterkampDepartment of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands.
Sanne A E PetersJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Joseph F PolakDepartment of Radiology, Tufts Medical Center, Boston, MA, United States of America.
Jacqueline F PriceCentre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
Christine RobertsonCentre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
Christopher M RemboldCardiology Division, Department of Internal Medicine, University of Virginia, Charlottesville, VA, United States of America.
Maria RosvallDept of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.
Tatjana RundekDepartment of Neurology, Miller School of Medicine, University of Miami, Miami, FL, United States of America.
Jukka T SalonenMAS-Metabolic Analytical Services Oy, Helsinki, Finland.
Matthias SitzerDepartment of Neurology, University Hospital, Goethe-University, Frankfurt am Main, Germany and Department of Neurology Klinikum Herford, Germany.
Coen D A StehouwerDepartment of Internal Medicine and Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht, The Netherlands.
Michiel L BotsJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Hester M den RuijterDepartment of Experimental Cardiology, University Medical Center Utrecht, Utrecht, the Netherlands; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
University Medical Center Utrecht · NLAmsterdam UMC Location VUmc · NLNetherlands Heart Institute · NLSkåne University Hospital · SETufts Medical Center · USUniversity of Edinburgh · GBGoethe University Frankfurt · DEHerford Hospital · DELund University · SEMaastricht University · NLMcMaster University · CAOsaka University · JPRadboud University Medical Center · NLRadboud University Nijmegen · NLTokyo Women's Medical University · JPUiT The Arctic University of Norway · NOUniversity College London · GBUniversity of Calgary · CAUniversity of Miami · USUniversity of Virginia · US

Funding

SUBCLINICAL CARDIOVASCULAR DISEASE COORDINATING CENTER-N01HC95159-268095159N01HC095159 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 1999 to 2006
$304k
SUBCLINICAL CARDIOVASCULAR DISEASE STUDY-ULTRASOUNDN01HC095167 · HC · TUFTS MEDICAL CENTER · PI O'LEARY, DANIEL H. · 1999 to 2001
$62k
CORONARY HEART DISEASE &STROKE IN THE ELDERLYN01HC085080 · HC · WAKE FOREST UNIVERSITY · PI BURKE, GREGORY L · 1988 to 2000
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085081 · HC · JOHNS HOPKINS UNIVERSITY · PI FRIED, LINDA P · 1988 to 2000
–
CHS-Transition Phase -268055222-268055222N01HC055222 · HC · UNIVERSITY OF WASHINGTON · PI KRONMAL, RICHARD A · 2005 to 2006
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65-84N01HC085083 · HC · UNIVERSITY OF CALIFORNIA DAVIS · PI ROBBINS, JOHN A · 1988 to 1999
–
CENTRAL BLOOD ANALYSIS LABORATORY FOR CHSN01HC085086 · HC · UNIVERSITY OF VERMONT &ST AGRIC COLLEGE · PI TRACY, RUSSELL P · 1988 to 2000
–
CORONARY HEART DISEASE AND STROKE IN PEOPLE AGED 65-84N01HC085082 · HC · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI KULLER, LEWIS H · 1988 to 2000
–
CORONARY HEART DISEASE &STROKE IN PEOPLE AGED 65 TO 84N01HC085079 · HC · UNIVERSITY OF WASHINGTON · 1988 to 2005
–
Medical Research Council MR/M006638/1NHLBI NIH HHS HHSN268200800007CNHLBI NIH HHS HHSN268201200036CNHLBI NIH HHS N01 HC055222NHLBI NIH HHS N01 HC085079NHLBI NIH HHS N01 HC085080NHLBI NIH HHS N01 HC085081NHLBI NIH HHS N01 HC085082NHLBI NIH HHS N01 HC085083NHLBI NIH HHS N01 HC085086NHLBI NIH HHS N01 HC095159NHLBI NIH HHS N01 HC095167NHLBI NIH HHS N01-HC-95159NHLBI NIH HHS N01-HC-95167
6 · The paper itself

Abstract

backgroundClinical manifestations and outcomes of atherosclerotic disease differ between ethnic groups. In addition, the prevalence of risk factors is substantially different. Primary prevention programs are based on data derived from almost exclusively White people. We investigated how race/ethnic differences modify the associations of established risk factors with atherosclerosis and cardiovascular events.

methodsWe used data from an ongoing individual participant meta-analysis involving 17 population-based cohorts worldwide. We selected 60,211 participants without cardiovascular disease at baseline with available data on ethnicity (White, Black, Asian or Hispanic). We generated a multivariable linear regression model containing risk factors and ethnicity predicting mean common carotid intima-media thickness (CIMT) and a multivariable Cox regression model predicting myocardial infarction or stroke. For each risk factor we assessed how the association with the preclinical and clinical measures of cardiovascular atherosclerotic disease was affected by ethnicity.

resultsEthnicity appeared to significantly modify the associations between risk factors and CIMT and cardiovascular events. The association between age and CIMT was weaker in Blacks and Hispanics. Systolic blood pressure associated more strongly with CIMT in Asians. HDL cholesterol and smoking associated less with CIMT in Blacks. Furthermore, the association of age and total cholesterol levels with the occurrence of cardiovascular events differed between Blacks and Whites.

conclusionThe magnitude of associations between risk factors and the presence of atherosclerotic disease differs between race/ethnic groups. These subtle, yet significant differences provide insight in the etiology of cardiovascular disease among race/ethnic groups. These insights aid the race/ethnic-specific implementation of primary prevention.

Indexed as

Carotid Intima-Media ThicknessEthnicityRacial GroupsAdultAgedAge DistributionCarotid Artery DiseasesCholesterol, HDLCholesterol, LDLComorbidityDiabetes MellitusDyslipidemiasFemaleFollow-Up StudiesGlobal HealthHumansCholesterol, HDLCholesterol, LDL

Identifiers

PMID26134404
PMCPMC4489855
OpenAlexW1795144871

What OpenQuestion holds

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Registered trials

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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.