Uri Goldbourt - Academia.edu (original) (raw)

Papers by Uri Goldbourt

The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2011

to compare the mortality rates of elderly demented and nondemented subjects and the differential ... more to compare the mortality rates of elderly demented and nondemented subjects and the differential association of midlife risk factors with mortality according to dementia status. : Prospective historical study. community based. from the 10,059 male Jewish civil servants who participated in the Israel Ischemic Heart Disease study in the 1960s, the 1,713 who were evaluated for dementia in 1999/2000 and who were unequivocally classified as demented or nondemented. : Midlife sociodemographic and cardiovascular risk factors, late-life dementia, and mortality. over a period of 6 years, 718 (42%) subjects died. Of the 307 demented subjects, 71.8% died and of the 1,407 nondemented subjects, 35.4% died. Multivariate survival analyses showed that compared with subjects without dementia, demented subjects had a hazard ratio [HR] for mortality of 2.27 (95% confidence interval [CI] 1.92-2.68). Other risk factors associated with mortality were socioeconomic status (HR 0.94 [0.88-1.00]), higher sys...

Journal of Clinical Medicine, 2021

The objective of this study was to estimate the probability of long-term overall survival based o... more The objective of this study was to estimate the probability of long-term overall survival based on total number of risk factors (RF). We also sought to examine the role of midlife clinical, behavioral, and psychosocial predictors of longevity in a large cohort of Israeli men. This study was based on the Israeli Ischemic Heart Disease (IIHD) cohort that included over 10,000 men who were followed up for mortality over more than four decades. During the 43 years of follow-up, 4634 (46.1%) men survived to 80 years of age or older. We considered cigarette smoking, diabetes mellitus, high systolic blood pressure, hypercholesterolemia, low socioeconomic status, and serious family problems as RF at ages 40–65. Cox proportional hazards regression models, with age as the time scale, were constructed to estimate the hazard ratios (HRs) for failure to survive 80 years of age. Compared with men free of all the above RF, those with one identified RF (HR = 1.58, 95% CI: 1.42–1.75) and counterparts...

Mayo Clinic Proceedings, 2017

Objective: To assess the association between dispositional optimism, defined as generalized posit... more Objective: To assess the association between dispositional optimism, defined as generalized positive expectations about the future, and long-term mortality in young survivors of myocardial infarction (MI). Patients and Methods: A subcohort of 664 patients 65 years and younger, drawn from the longitudinal Israel Study of First Acute Myocardial Infarction, completed an adapted Life Orientation Test (LOT) questionnaire during their index hospitalization between February 15, 1992, and February 15, 1993. Additional sociodemographic, clinical, and psychosocial variables were assessed at baseline; mortality follow-up lasted through December 31, 2015. Cox proportional hazards regression models were fit to assess the hazard ratios for mortality associated with LOT-derived optimism. Results: The mean age of the participants was 52.4AE8.6 years; 98 (15%) were women. The median follow-up period was 22.4 years (25th-75th percentiles, 16.1-22.8 years), during which 284 patients (43%) had died. The mean LOT score was 16.5AE4.1. Incidence density rates for mortality in increasing optimism tertiles were 25.4, 25.8, and 16.0 per 1000 person-years, respectively (P<.01). With sequential adjustment for sociodemographic, clinical, and psychosocial variables, a decreased mortality was associated with the upper tertile (adjusted hazard ratio, 0.67; 95% CI, 0.47-0.95). A nonlinear inverse relationship was observed using spline analysis, with the slope increasing sharply beyond the median LOT score. Conclusion: Higher levels of optimism during hospitalization for MI were associated with reduced mortality over a 2-decade follow-up period. Optimism training and positive psychology should be examined as part of psychosocial interventions and rehabilitation after MI.

Annals of Epidemiology, 2016

Previous research has explored the association between social support (SS), cardiovascular diseas... more Previous research has explored the association between social support (SS), cardiovascular disease, and mortality. Perceived SS (PSS) refers to an individual's attitude toward received SS. This study aimed to: (1) assess the association between PSS levels and long-term mortality among first myocardial infarction (MI) survivors, (2) compare the effect of PSS measured shortly after the first MI to PSS measured 10e13 years after MI, and (3) compare the prognostic role of different PSS components: family, friends, and significant others. Methods: Patients were drawn from the longitudinal prospective Israel Study of First Acute Myocardial Infarction (ISFAMI). PSS, sociodemographic and health variables were assessed in two subcohorts during initial hospitalization from 1992 to 1993 (T1, n ¼ 660) and in 2002e2005 (T2, n ¼ 969). Vital status was determined through 2011. Cox regression models assessed mortality risk associated with PSS. Results: By the end of follow-up, 212 (32%) of the T1 and 229 (24%) of T2 subcohorts had died. Higher PSS levels were associated with lower mortality risk at both T1 and T2 (per one standard deviation [1SD] increase hazard ratio [HR] ¼ 0.85, 95% confidence interval [CI] ¼ 0.75e0.96; HR ¼ 0.74, 95% CI ¼ 0.66 e0.83, respectively). These associations were attenuated on adjustment for sociodemographic and clinical variables (HR ¼ 0.93, 95% CI ¼ 0.80e1.07; HR ¼ 0.88, 95% CI ¼ 0.77e1.00, respectively). PSS from friends was significantly associated with lower mortality risk at both T1 and T2 and remained significant only at T2 after adjustment (HR ¼ 0.85, 95% CI ¼ 0.73e0.98). Conclusions: Higher PSS levels were significantly associated with reduced mortality risk post-MI. This should encourage clinicians to assess post-MI psychosocial status to identify high-risk patients.

Perceived social support following myocardial infarction and long-term development of frailty

European journal of preventive cardiology, Jan 24, 2014

Frailty is a multidimensional geriatric syndrome that indicates increasing vulnerability and decr... more Frailty is a multidimensional geriatric syndrome that indicates increasing vulnerability and decreasing resistance to stressors. Social support (SS) is linked both to cardiovascular disease and to frailty. However, few cohort studies evaluated SS as a potential predictor of frailty, and none involved coronary disease populations. The aim of this study was to evaluate the role of perceived SS (PSS) - a specific component of SS - in the prediction of frailty development in myocardial infarction (MI) survivors, controlling for other psychosocial risk factors. A cohort of 558 patients aged ≤65 years, admitted for first-ever MI to hospitals in central Israel, was studied. PSS and other clinical and sociodemographic variables were assessed at baseline. Frailty was assessed via a frailty index of deficit accumulation 10-13 years later. Logistic regression models were constructed to assess the odds ratios (OR) for frailty associated with PSS as well as other covariates. At last follow-up, 1...

The Israel Medical Association journal : IMAJ, 2006

Obesity is an independent risk factor for ischemic heart disease and affects the status of other ... more Obesity is an independent risk factor for ischemic heart disease and affects the status of other risk factors for cardiovascular disease. To study the attitude of physicians to obesity by examining discharge letters of overweight patients with ischemic heart disease. We used the HOLEM database for this analysis. The HOLEM project was designed to study the NCEP (National Cholesterol Education Program) guideline implementation among patients with IHD at hospital discharge. We documented the recording of risk factors and treatment recommendations for IHD by reviewing the discharge letters of 2994 IHD patients admitted to four central hospitals in Israel between 1998 and 2000. A follow-up visit was held 6-8 weeks after discharge, at which time the diagnosis of IHD was verified, risk factor status was checked, height and weight were measured and drug treatment was reviewed. Mean body mass index was 28.3 kg/m2 and 32% were obese (BMI > or = 30 kg/m2). Only 39.6% of the obese patients a...

Indices related to apo CII and CIII serum concentrations and coronary heart disease: a case–control study

Preventive Medicine, 2003

Triglycerides (TG) are carried in the circulation by diverse lipoprotein particles, which vary in... more Triglycerides (TG) are carried in the circulation by diverse lipoprotein particles, which vary in their lipid and protein content, metabolism, and atherogenicity. Several indices related to apolipoproteins (apo) CII and CIII blood concentration have been proposed to reflect TG metabolism more accurately than the blood level of TG. In the present study we compared the distribution of those indices in coronary heart disease (CHD) patients and controls.. Ninety consecutively discharged patients with CHD and 209 healthy controls were included in the analysis. Demographic, clinical, and laboratory characteristics were obtained. The CHD patients differed appreciably from controls in several TG-related variables. After adjusting for cardiovascular risk factors, significant associations were found between CHD and the following: TG, VLDL-C, apo CIII, apo CIII in HDL, apo CIII in VLDL + LDL, apo CII- to- TG ratio, and apo CIII ratio (CIII in HDL/CIII in VLDL + LDL). Further adjustment for HDL-C substantially attenuated the above associations, except for those regarding apo CIII in VLDL + LDL (odds ratio (OR): 1.69 per 1 SD increment, 95%CI: 1.03-2.77) and apo CIII ratio (OR: 0.40 per 1 SD increment, 95%CI: 0.15-1.00). Our results add to the growing evidence which links apo CIII concentration in VLDL + LDL to CHD. Further confirmation in prospective studies would be required before considering this measurement as a screening tool.

Prognostic Importance and Long-Term Determinants of Self-Rated Health After Initial Acute Myocardial Infarction

Medical Care, 2009

Self-rated health (SRH) is a valid measure of health and its trajectories over time have been fou... more Self-rated health (SRH) is a valid measure of health and its trajectories over time have been found to predict mortality. A better understanding of the determinants of changes in SRH is required, particularly post-myocardial infarction (MI), where rapid changes in health may occur. To evaluate the prognostic importance of SRH and the determinants of its long-term trajectory in patients with MI. Between February 1992 and February 1993, 1521 consecutive patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;or=65 years (19% women) discharged from all hospitals in central Israel after initial acute MI were enrolled and followed-up for a mean of 12 years. Extensive data were obtained at study entry, with SRH measured at baseline (retrospective assessment of pre-MI health status) and at 5 and 10 years. Baseline SRH showed a strong graded association with mortality post-MI. The association was further strengthened when changes in SRH over time were taken into account. Using generalized estimating equations, independent predictors of poor SRH at follow-up were Asian/African origin, low education, poor income, low baseline SRH, comorbidity, impaired ejection fraction, diabetes, dyslipidemia, obesity, and physical inactivity. In a subsample with available psychosocial measures (n = 668), low social support and sense of coherence and high anxiety and depression were also predictive of poor SRH. SRH is an important risk marker after MI and its long-term trajectory is accurately predicted by demographic, socioeconomic, clinical, and psychosocial measures. Monitoring of SRH post-MI is therefore warranted.

Medical Care, 2013

Background: Health disparities are systematic differences in health, favoring members of advantag... more Background: Health disparities are systematic differences in health, favoring members of advantaged over disadvantaged groups in the society. This study examines the contribution of multiple socioeconomic status (SES) measures to ethnic differences in after myocardial infarction (MI) prognosis. Methods: Patients aged 65 years and younger (n = 1040) belonging to Ashkenazi and Mizrahi advantaged and disadvantaged ethnic groups discharged from 8 hospitals in central Israel after incident MI in 1992-1993, were followed up through 2005 for all-cause mortality, recurrent MI, heart failure, and ischemic stroke. Results: Advantaged Ashkenazi had higher education, income, employment, and neighborhood SES compared with disadvantaged Mizrahi. Cardiovascular risk factors varied among the different ethnic groups. Results showed that the association between ethnic group and all outcomes differed substantially between models that included a single SES measure and those that included multiple measures. For example, the hazard ratio for mortality in disadvantaged Mizrahi compared with advantaged Ashkenazi was 1.87 [95% confidence interval (CI), 1.40-2.48] in a model adjusting only for demographic variables; 1.58 (95% CI, 1.18-2.12) in a model adjusting also for income; and 1.03 (95% CI, 0.74-2.04) in a model adjusting for all measured SES indicators. Further adjustment for clinical variables did not appreciably change the results. Conclusions: Findings show that a wide array of modifiable social factors shaped by income, education, and neighborhood socioeconomic conditions can explain ethnic health differences and highlight the importance of using multivariable models of SES.

Journal of the American College of Cardiology, 1999

The purpose of this study was to investigate the significance of the possible negative interactio... more The purpose of this study was to investigate the significance of the possible negative interaction between aspirin and angiotensin-converting enzyme (ACE) inhibitors. BACKGROUND Several provocative reports have recently suggested that aspirin is unsafe in patients with heart failure and has negative interaction with ACE inhibitors that might attenuate their beneficial effects upon survival. METHODS We analyzed mortality data of 11,575 patients with coronary artery disease screened for the Bezafibrate Infarction Prevention trial. A total of 1,247 patients (11%) were treated with ACE inhibitors. Of them, 618 patients (50%) used aspirin. RESULTS Five-year mortality was lower among patients on ACE inhibitors and aspirin than patients on ACE inhibitors without aspirin (19% vs. 27%; p Ͻ 0.001). After adjusting for confounders, treatment with aspirin and ACE inhibitors remained associated with lower mortality risk than using ACE inhibitors only (relative risk [RR] ϭ 0.71; 95% confidence interval [CI] ϭ 0.56 to 0.91). Subgroup analysis of 464 patients with congestive heart failure treated with ACE inhibitors revealed 221 patients (48%) on aspirin and 243 patients not on aspirin. Although clinical characteristics and therapy were similar, patients taking aspirin experienced lower mortality than patients who did not (24% vs. 34%; p ϭ 0.001). After adjustment, treatment with aspirin was still associated with lower mortality (RR ϭ 0.70; 95% CI ϭ 0.49 to 0.99). CONCLUSIONS Among coronary artery disease patients with and without heart failure who are treated with ACE inhibitors, the use of aspirin was associated with lower mortality than treatment without aspirin. Our findings contradict the claim that aspirin attenuates the beneficial effect of ACE inhibitors and supports its use in patients with coronary artery disease treated with ACE inhibitors.

Prevalence and prognostic value of predischarge ventricular ectopic activity in elderly acute myocardial infarction patients

Journal of the American College of Cardiology, 1996

Journal of the American College of Cardiology, 2009

We compared long-term survival after acute myocardial infarction (AMI) of never-smokers, pre-AMI ... more We compared long-term survival after acute myocardial infarction (AMI) of never-smokers, pre-AMI quitters, post-AMI quitters, and persistent smokers and assessed whether cigarette reduction among persistent smokers is associated with lower mortality. Background Quitting smoking has been shown to improve outcome after AMI. However, longitudinal cohort data with repeated assessments of smoking and information on multiple confounders are lacking. Moreover, little is known about the importance, if any, of reductions in the amount smoked. Methods Consecutive patients Յ65 years of age, discharged from 8 hospitals in central Israel after first AMI in 1992 to 1993, were followed through 2005. Extensive data, including self-reported smoking habits, were obtained at baseline and 4 times during follow-up. Cox proportional hazards regressions were used to assess the hazard ratios (HRs) for death associated with smoking categories modeled as time-dependent variables. Results At baseline, smokers were younger, more likely to be male, and had a lower prevalence of hypertension and diabetes than nonsmokers. Over a median follow-up of 13.2 years, 427 deaths occurred in 1,521 patients. The multivariable-adjusted HRs for mortality were 0.57 (95% confidence interval [CI]: 0.43 to 0.76) for neversmokers, 0.50 (95% CI: 0.36 to 0.68) for pre-AMI quitters, and 0.63 (95% CI: 0.48 to 0.82) for post-AMI quitters, compared with persistent smokers. Among persistent smokers, upon multivariable adjustment including pre-AMI intensity, each reduction of 5 cigarettes smoked daily after AMI was associated with an 18% decline in mortality risk (p Ͻ 0.001). Conclusions Smoking cessation either before or after AMI is associated with improved survival. Among persistent smokers, reducing intensity after AMI appears to be beneficial.

International Journal of Cardiology, 2012

Background: Low socioeconomic status (SES) has been associated with increased cardiovascular risk... more Background: Low socioeconomic status (SES) has been associated with increased cardiovascular risk. However, the association between SES and stroke incidence in patients with acute myocardial infarction (AMI) has not been studied. We assessed the association between a multidimensional SES construct and long-term ischemic stroke incidence after AMI in a prospective community-based cohort study. Methods: A total of 1261 consecutive patients aged ≤ 65 years discharged after first AMI from 8 hospitals in central Israel in 1992-1993 were followed for ischemic stroke for a mean (SD) period of 11 (4) years. The number of unfavorable SES factors, including lower than average family income, ≤ 8 years of education, unemployment, and absence of a steady partner, was the primary exposure. We estimated the directly adjusted cumulative incidence of stroke treating non-stroke death as a competing event using the Fine and Gray model for a subdistribution function. Results: Low SES was associated with older age, female sex, higher risk factor prevalence, increased AMI severity and inferior treatment. Ischemic stroke was diagnosed in 142 patients. The adjusted cumulative incidence of ischemic stroke gradually increased with the number of unfavorable SES factors. The multivariable adjusted HRs (95% confidence intervals) for ischemic stroke were 1.5(0.9-2.4), 2.0(1.2-3.2) and 2.1(1.2-3.6) in patients with 1, 2 and ≥ 3 unfavorable SES factors respectively, compared with those with none. Conclusions: Our data support a dose-response relationship between SES and stroke risk after AMI and suggest a multidimensional vulnerability related to SES. These findings should be considered in planning secondary prevention strategies post-AMI.

International Journal of Cardiology, 2014

This article appeared in a journal published by Elsevier. The attached copy is furnished to the a... more This article appeared in a journal published by Elsevier. The attached copy is furnished to the author for internal non-commercial research and education use, including for instruction at the authors institution and sharing with colleagues. Other uses, including reproduction and distribution, or selling or licensing copies, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Tex form) to their personal website or institutional repository. Authors requiring further information regarding Elsevier's archiving and manuscript policies are encouraged to visit: http://www.elsevier.com/authorsrights Author's personal copy Multilevel socioeconomic status and incidence of frailty post myocardial infarction ☆ , ☆☆ ,★

Recovery of self-rated health as a predictor of recurrent ischemic events after first myocardial infarction: A 13-year follow-up

Health Psychology, 2014

Following the trajectory hypothesis for the validity of self-rated health (SRH), we tested whethe... more Following the trajectory hypothesis for the validity of self-rated health (SRH), we tested whether subjective recovery of health, that is, return to the same or higher level of SRH after a major health event, independently predicts better long-term prognosis. Participants were 640 patients (≤ 65 years) admitted to the eight medical centers in central Israel with incident MI in a 1-year period (mean age 54, 17% female). Baseline data were collected within days of the index MI. SRH in the preceding year was assessed at baseline, and current SRH was assessed 3-6 months later. Recurrent ischemic events (recurrent MI, hospitalization with unstable angina pectoris, or cardiac death) were recorded during a mean follow-up of 13 years. A reduced risk of recurrent events was associated with an upward change of one level (e.g., from 3 at T1 to 4 at T2) in SRH (HR = 0.76, 95%CI: 0.69-0.85), controlling for baseline retrospective SRH. Risk was still significantly lower for each unit of improvement after adjusting for sociodemographics, preevent comorbidity, cardiac risk factors, MI severity, and early post-MI events (HR = 0.85, 95% CI 0.75-0.95). Individuals who perceived themselves 3-6 months after a first MI to be healthier than they had been in the year preceding the MI were more likely to survive event-free throughout the next 13 years, controlling for baseline retrospective SRH and multiple cardiac risk factors. Failure to experience such subjective recovery of one&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s health is a serious risk factor, which indicates that SRH should be monitored regularly after a MI.

European Journal of Epidemiology, 2010

The benefits of leisure time physical activity (LTPA) in cardiovascular prevention are well estab... more The benefits of leisure time physical activity (LTPA) in cardiovascular prevention are well established. While cardiac rehabilitation programmes have been demonstrated as improving myocardial infarction (MI) prognosis, the strength of the association between LTPA and post-MI survival has yet to be quantified. We evaluated long-term survival after MI of inactive, irregularly active, and regularly active patients and examined trajectories of LTPA and their relationship to mortality risk. Consecutive patients aged B65 years (n = 1,521), discharged from 8 hospitals in central Israel after first MI in 1992-1993, were followed through 2005. Extensive clinical and sociodemographic data, including self-reported LTPA habits, were obtained at baseline and at 4 subsequent interviews. Pre-MI inactive patients (54%) had lower socioeconomic status, higher prevalence of risk factors and comorbidities and more severe MI. The point prevalence rate of regular LTPA at all follow-up interviews was approximately 40% and 18% were regularly active throughout the entire follow-up. Over a median follow-up of 13.2 years, 427 deaths occurred. After multivariable adjustment, no association was observed between pre-MI LTPA and death. However, with LTPA categories modelled as time-dependent variables, providing an estimation of cumulative assessment and accounting for changes in LTPA post-MI, a strong inverse graded association was revealed (multivariableadjusted hazard ratios, 0.56 [95% CI: 0.42-0.74] for regular and 0.71 [95% CI: 0.54-0.95] for irregular activity vs. none). Similar estimates were obtained among pre-MI sedentary patients. In summary, after MI, regularly active patients had about half the risk of dying compared with inactive patients, irrespective of pre-MI habits. Keywords Leisure time physical activity Á Myocardial infarction Á Secondary prevention Á Longitudinal study Á Epidemiology Á Long-term follow-up Á Survival Abbreviations ACS Acute coronary syndromes CABG Coronary artery bypass graft CHD Coronary heart disease CI Confidence interval CVD Cardiovascular disease HR Hazard ratio This study is conducted for the Israel Study Group on First Acute Myocardial Infarction. See the ''Appendix'' for a list of participating medical centres and investigators.

European Journal of Cardiovascular Prevention & Rehabilitation, 2008

Background Population-based data on the impact of socioeconomic status (SES) on long-term surviva... more Background Population-based data on the impact of socioeconomic status (SES) on long-term survival after myocardial infarction (Ml) are lacking. We evaluated the association of income and education with all-cause mortality and cardiac mortality post-MI and assessed income-by-education interaction. Design Prospective cohort study. Methods Between February 1992 and February 1993, 1521 consecutive patients aged 65 years or less (19% women) discharged from all hospitals in central Israel after incident acute MI were enrolled and followed up through December 2005. Data on SES indicators, cardiovascular risk factors, MI characteristics and severity, comorbidities, and acute treatment were assessed at baseline. Results Low SES, as defined by income and education, was associated with older age, female sex, and higher prevalence of risk factors and comorbidities. Further, low SES patients presented with more severe disease and received fewer cardiac procedures and medications. During follow-...

Coronary Artery Disease, 1994

Post-cardiac arrest care was implemented in 2010 and has been shown to improve the survival of pa... more Post-cardiac arrest care was implemented in 2010 and has been shown to improve the survival of patients with coronary heart disease (CHD). However, the findings varied for different survival conditions. We conducted a retrospective longitudinal study of records from 2007 to 2013 in the National Health Insurance Research Database. We evaluated the differences in short-term (2-day and 7-day) and long-term (30-day and survival to discharge) survival after the implementation of post-cardiac arrest care and among age subgroups. We reviewed inpatient datasets in accordance with the International Classification of Disease Clinical Modification, 9th revision codes (ICD-9-CM). Eligible participants were identified as those with simultaneous diagnoses of cardiac arrest (ICD-9-CM codes: 427.41 or 427.5) and CHD (ICD-9-CM codes: 410-414). Multiple logistic regression was applied to establish the relationship between calendar year and survival outcomes.

Circulation, 2010

Background— Neighborhood of residence has been suggested to affect cardiovascular risk above and ... more Background— Neighborhood of residence has been suggested to affect cardiovascular risk above and beyond personal socioeconomic status (SES). However, such data are currently lacking for patients with myocardial infarction (MI). We examined all-cause and cardiac mortality according to neighborhood SES in a cohort of MI patients. Methods and Results— Consecutive patients ≤65 years of age discharged from 8 hospitals in central Israel after incident MI in 1992 to 1993 were followed up through 2005. Individual data were obtained at study entry, including education, income, and employment. Neighborhood SES was estimated through a composite census-derived index developed by the Israel Central Bureau of Statistics. During follow-up, 326 deaths occurred in 1179 patients. Patients residing in disadvantaged neighborhoods had higher mortality rates, with 13-year survival estimates of 61%, 74%, and 82% in increasing tertiles ( P trend <0.001). After adjustment for sociodemographic variables, ...

Ethnic groups and high sensitivity C-reactive protein in Israel

Biomarkers, 2008

High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic... more High-sensitivity C-reactive protein (hs-CRP) is a biomarker that correlates with atherothrombotic risk and outcome. hs-CRP is influenced by various modifiable and non-modifiable factors. We studied the relationship between ethnic background and hs-CRP level, among the Jewish population in Israel. A total of 3659 men and 2180 women were divided into two ethnic groups (Ashkenazi and Sephardic Jews), based on the knowledge of Jewish immigration patterns throughout the centuries. Mean hs-CRP levels were calculated for each group and were adjusted for various factors known to influence hs-CRP. Sephardic Jews were found to have higher adjusted mean hs-CRP levels (2.0 mg l(-1) for men and 3.9 mg l(-1) for women) compared with Ashkenazi Jews (1.5 mg l(-1) for men and 2.9 mg l(-1) for women). Ethnic background emerged as an independent significant predictor of hs-CRP levels. We demonstrated that ethnicity is an important factor when considering hs-CRP as a marker of atherothrombotic risk.