TY - JOUR

T1 - Multiplicative and additive interactions between risk factors for coronary heart disease

AU - Iakunchykova, Olena

AU - Lange, Theis

AU - Leon, David A

PY - 2024

Y1 - 2024

N2 - here are a series of well-established risk factors of coronary heart disease (CHD): hypertension, high total cholesterol, smoking, diabetes, older age and male sex. Some studies have paid attention to interactions between them, but have mainly looked at multiplicative interactions with age and/or sex. For example, relative risks associated with many risk factors are larger at younger compared to older ages. The dominant approach to quantifying the association of risk factors with disease is the use of multiplicative models, such as Cox regression. They allow estimation of the association between risk factor and disease as a ratio in hazard between exposed and unexposed groups as well as estimation of the multiplicative interactions between risk factors. An alternative approach is to fit additive hazards model that provides the excess risk due to the presence of risk factor and opportunity to quantify interactions on additive scale. The examination of interactions on the additive scale is rarely done, despite calls for the wider use of absolute measures in epidemiology and public health practice

AB - here are a series of well-established risk factors of coronary heart disease (CHD): hypertension, high total cholesterol, smoking, diabetes, older age and male sex. Some studies have paid attention to interactions between them, but have mainly looked at multiplicative interactions with age and/or sex. For example, relative risks associated with many risk factors are larger at younger compared to older ages. The dominant approach to quantifying the association of risk factors with disease is the use of multiplicative models, such as Cox regression. They allow estimation of the association between risk factor and disease as a ratio in hazard between exposed and unexposed groups as well as estimation of the multiplicative interactions between risk factors. An alternative approach is to fit additive hazards model that provides the excess risk due to the presence of risk factor and opportunity to quantify interactions on additive scale. The examination of interactions on the additive scale is rarely done, despite calls for the wider use of absolute measures in epidemiology and public health practice

KW - Humans

KW - Risk Factors

KW - Coronary Disease/epidemiology

U2 - 10.1016/j.annepidem.2023.11.012

DO - 10.1016/j.annepidem.2023.11.012

M3 - Journal article

C2 - 38043838

VL - 91

SP - 82

EP - 84

JO - Annals of Epidemiology

JF - Annals of Epidemiology

SN - 1047-2797

ER -