Cardiovascular risk factor mediation of the effects of education and Genetic Risk Score on cardiovascular disease: a prospective observational cohort study of the Framingham Heart Study

Figures

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  Figure 1. Causal diagrams of education and genetic contributions to cardiovascular disease (CVD). (A) Causal pathways relating Genetic Risk Score (GRS), the causally order mediators body mass index (BMI), high-density lipoprotein cholesterol (HDL-C) and total cholesterol (TC) and CVD. (B) Causal pathways relating graduate degree education (EDU), the causally order mediators smoking (SMK), HDL-C and systolic blood pressure (SPB) and CVD. The four path-specific effects are denoted by different colours: Green: ΔS→M1Y; Yellow: ΔS→M2Y; Red: ΔS→M3→Y; and Blue: ΔS→Y.

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  Figure 2. Adjusteda associations between explanatory variables and incident cardiovascular disease. Estimates represent Cox proportional hazards regression model adjusted HRs with 95% CIs. aAdjusted for all explanatory variables displayed in figure. HDL, high-density lipoprotein.

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  Figure 3. Effects of education and Genetic Risk Score (GRS) on cardiovascular disease risk factors. For continuous risk factors (A), estimated effects represent adjusteda standardised mean differences in risk factor with 95% CIs for specified level of education (relative to high school or less) or increase GRS. For binary risk factors (B), estimates represent adjusteda ORs of the relationship between main study factor and binary risk factor with 95% CIs. The estimated effects for GRS represent the change in standardised mean difference or odds of risk factor for each 1-SD increase in accumulation of risk alleles. aAdjusted for age, sex, smoking, total cholesterol, HDL cholesterol, body mass index, systolic blood pressure and diabetes unless treated as the outcome variable. HDL, high-density lipoprotein.