Table 3.
HR (95% CI) of Incident CVD Outcomes (Year 0–Year 32) According to Quintiles of the Time‐Varying Average APDQS*
| Quintile 1 | Quintile 2 | Quintile 3 | Quintile 4 | Quintile 5 | Each 1‐SD increment (13‐point) | P for Trend‡ | |
|---|---|---|---|---|---|---|---|
| CVD | |||||||
| APDQS (median)† | 50.0 | 58.0 | 64.3 | 71.5 | 81.0 | ||
| Unadjusted cumulative incidence % (n/N)† | 9.0 (89/989) | 7.8 (77/989) | 5.3 (51/961) | 4.8 (49/1015) | 2.3 (23/992) | ||
| Model 1§ | 1 (ref) | 0.86 (0.62–1.17) | 0.68 (0.48–0.96) | 0.69 (0.47–1.01) | 0.39 (0.23–0.64) | 0.74 (0.63–0.87) | <0.001 |
| Model 2|| | 1 (ref) | 0.87 (0.63–1.19) | 0.73 (0.52–1.04) | 0.78 (0.53–1.14) | 0.48 (0.28–0.81) | 0.80 (0.67–0.95) | 0.010 |
| Model 3# | 1 (ref) | 0.83 (0.60–1.15) | 0.72 (0.51–1.03) | 0.79 (0.53–1.16) | 0.54 (0.32–0.93) | 0.81 (0.68–0.96) | 0.018 |
| CHD | |||||||
| APDQS (median)† | 50.0 | 58.0 | 64.3 | 71.5 | 81.0 | ||
| Unadjusted cumulative incidence % (n/N)† | 3.7 (37/989) | 3.6 (35/985) | 3.2 (31/964) | 2.2 (22/1016) | 1.3 (13/992) | ||
| Model 1§ | 1 (ref) | 0.82 (0.51–1.33) | 0.82 (0.50–1.34) | 0.54 (0.30–0.96) | 0.38 (0.19–0.75) | 0.72 (0.57–0.91) | 0.006 |
| Model 2|| | 1 (ref) | 0.84 (0.52–1.36) | 0.91 (0.55–1.48) | 0.63 (0.35–1.12) | 0.48 (0.24–0.97) | 0.78 (0.61–1.00) | 0.051 |
| Model 3# | 1 (ref) | 0.89 (0.54–1.45) | 0.97 (0.59–1.61) | 0.69 (0.38–1.25) | 0.61 (0.30–1.25) | 0.83 (0.65–1.07) | 0.15 |
| Hypertensive‐related CVD | |||||||
| APDQS (median)† | 50.0 | 58.0 | 64.3 | 71.5 | 81.0 | ||
| Unadjusted cumulative incidence % (n/N)† | 7.1 (70/989) | 5.4 (53/986) | 3.4 (33/964) | 3.0 (30/1014) | 1.3 (13/993) | ||
| Model 1§ | 1 (ref) | 0.79 (0.55–1.15) | 0.61 (0.40–0.93) | 0.70 (0.44–1.11) | 0.39 (0.20–0.76) | 0.75 (0.61–0.92) | 0.006 |
| Model 2|| | 1 (ref) | 0.80 (0.55–1.16) | 0.65 (0.43–0.99) | 0.78 (0.49–1.23) | 0.48 (0.24–0.94) | 0.80 (0.65–0.99) | 0.040 |
| Model 3# | 1 (ref) | 0.74 (0.51–1.07) | 0.60 (0.39–0.92) | 0.73 (0.46–1.16) | 0.50 (0.25–0.99) | 0.77 (0.62–0.96) | 0.022 |
APDQS indicates A Priori Diet Quality Score; CHD, coronary heart disease; CVD, cardiovascular disease; and HR, hazard ratio.
Time‐varying variables that were cumulatively averaged over follow‐up at year 0, year 7, and year 20. Specifically, year 0 predicted events over follow‐up from year 0 to year 7, the average of year 0 and year 7 predicted events over follow‐up from after year 7 to year 20, and the average of year 0, year 7, and year 20 predicted events over follow‐up from after year 20 to year 32. Note that if both year 7 and year 20 diet was missing, the model used year 0 data with outcomes over all follow‐up.
Median APDQS, number of cases, and numbers at risk are categories according to quintiles of the average of all available APDQS measurements.
Statistical significance was estimated by modeling APDQS as a continuous variable in the model.
Model 1: year 0 age, sex, race (White or Black), total energy intake (time‐varying average), and maximal educational attainment.
Model 2: model 1+parental history of CVD (yes vs no), year 0 smoking status (never, former, and current), and physical activity level (time‐varying average).
Model 3: model 2+time‐varying comorbidities (hypertension, diabetes mellitus, dyslipidemia [all yes vs no], and body mass index [continuous]).