Trends in salt intake from linear time-series regression models.

<p>*p values for reference categories reflect differences of the trend from zero, while all other values reflect differences from the reference group trend.</p

Coronary Heart Disease Events in Framingham Participants with Differing Exposure to Risk Factors During Young Adulthood.

<p>Coronary Heart Disease Events in Framingham Participants with Differing Exposure to Risk Factors During Young Adulthood.</p

Mean sodium consumption by age groups and sex and mean reduction of systolic blood pressure reducing 8% the sodium consumption (Scenario 1) and 40% the sodium consumption (Scenario 2).

<p>SBP: Systolic blood pressure.</p><p>HTN: Hypertensive patients.</p>*<p>: Less than 65 years.</p>**<p>: 65 years and above.</p><p>n/a: Not applicable.</p

Adjusted associations between SBP, DBP, LDL and HDL levels at different ages and CHD events.

<p>Hazard ratios (95% confidence intervals) are adjusted for age (via Cox model), sex, calendar year (via spline), body mass index, diabetes, years with diabetes, smoking status (current/past/never), pack-years of tobacco exposure (via spline), and use of blood pressure and lipid medications. The first column of results (for age 20–39) corresponds to the right-hand column of <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0154288#pone.0154288.t002" target="_blank">Table 2</a>. Categories for systolic blood pressure (SBP) are ≤120 (reference), 121–140, 141–160 and >160 mmHg; for diastolic blood pressure (DBP) are ≤80, 81–90, 91–100, and >100; for low-density lipoprotein cholesterol (LDL) are ≤100 (reference), 101–130, 131–160 and >160 mg/dl; and for high-density lipoprotein cholesterol (HDL) are >65 (reference), 51–65, 36–50, and ≤35 mg/dl. “P Overall” refers to a test of the overall contribution of the risk factor (including early, later, and current exposures) to the model. No participants had an average SBP>160 mmHg from age 20–39. The * indicates a truncated confidence interval.</p

Young Adult Exposure to Cardiovascular Risk Factors and Risk of Events Later in Life: The Framingham Offspring Study

<div><p>Background</p><p>It is unclear whether coronary heart disease (CHD) risk factor exposure during early adulthood contributes to CHD risk later in life. Our objective was to analyze whether extent of early adult exposures to systolic and diastolic blood pressure (SBP, DBP) and low-and high-density lipoprotein cholesterol (LDL, HDL) are independent predictors of CHD events later in life.</p><p>Methods and Findings</p><p>We used all available measurements of SBP, DBP, LDL, and HDL collected over 40 years in the Framingham Offspring Study to estimate risk factor trajectories, starting at age 20 years, for all participants. Average early adult (age 20–39) exposure to each risk factor was then estimated, and used to predict CHD events (myocardial infarction or CHD death) after age 40, with adjustment for risk factor exposures later in life (age 40+). 4860 participants contributed an average of 6.3 risk factor measurements from in-person examinations and 24.5 years of follow-up after age 40, and 510 had a first CHD event. Early adult exposures to high SBP, DBP, LDL or low HDL were associated with 8- to 30-fold increases in later life CHD event rates, but were also strongly correlated with risk factor levels later in life. After adjustment for later life levels and other risk factors, early adult DBP and LDL remained strongly associated with later life risk. Compared with DBP≤70 mmHg, adjusted hazard ratios (HRs) were 2.1 (95% confidence interval: 0.8–5.7) for DBP = 71–80, 2.6 (0.9–7.2) for DBP = 81–90, and 3.6 (1.2–11) for DBP>90 (p-trend = 0.019). Compared with LDL≤100 mg/dl, adjusted HRs were 1.5 (0.9–2.6) for LDL = 101–130, 2.2 (1.2–4.0) for LDL = 131–160, and 2.4 (1.2–4.7) for LDL>160 (p-trend = 0.009). While current levels of SBP and HDL were also associated with CHD events, we did not detect an independent association with early adult exposure to either of these risk factors.</p><p>Conclusions</p><p>Using a mixed modeling approach to estimation of young adult exposures with trajectory analysis, we detected independent associations between estimated early adult exposures to non-optimal DBP and LDL and CHD events later in life.</p></div

Framingham Offspring Study Sample Examinations and Observation Period.

<p>Framingham Offspring Study Sample Examinations and Observation Period.</p

Absolute number of baseline and avoided events in Scenario 1 and 2 from 2013–2023.

*<p>Scenario 1 estimated the impact that the current initiative could have by reducing 8% of sodium consumption, 4% in the first two years (the timeframe that was agreed with the food industries) and then continued the projection without further interventions until 2022.</p>‡<p>Scenario 2 estimated the impact this initiative could have if maintained for the 10 years, progressively reducing sodium consumption by 40%, 4% each year until 2022.</p

Characteristics of participants at the beginning of follow up, stratified by early life exposure to LDL.

<p>Characteristics of participants at the beginning of follow up, stratified by early life exposure to LDL.</p

Trends in geometric mean daily salt intake (grams/day)^*.

<p>*Note that these values come from a spot urine test, and so do not reflect intake over whole 24 hour periods.</p

Data sources for CVD policy model-Argentina.

*<p>International Classification of Diseases, 10th revision (ICD-10) codes: 10 I21, I22 Myocardial Infarction;, ICD-10 I20, I23–I25 angina and other CHD; I472, I490, I46, I50, I514, I515, I519, I709 of poorly defined cardiovascular disease events and death.;</p>**<p>ICD-10 Codes I60–I69 for stroke deaths.</p