Coffee consumption and abdominal aortic calcification among adults with and without hypertension, diabetes, and cardiovascular diseases

Use of pulse pressure index for cardiovascular outcomes assessment and development of a coronary heart disease model for the elderly

BACKGROUND AND AIMS

Pulse pressure has been commonly used to assess atherosclerosis and cardiovascular outcomes with the defects of fluctuation. However, the pulse pressure index (PPI), a feasible alternative with the advantage of lower fluctuations, has not been sufficiently researched.

METHODS

This study included 10,796 participants over 65 years from the National Health and Nutrition Examination Survey 1999-2018. Cox proportional hazards models, restricted cubic splines and subgroup analysis were used to investigate the association between PPI in the elderly and all-cause and cardiovascular mortality. Subsequently, a prediction model for identifying coronary heart disease (CHD) in elderly individuals was developed using three machine learning algorithms. The impact of each feature on CHD was visualized in the optimal model after comparing the performances of the models.

RESULTS

This study discovered that the highest levels of PPI were associated with a 28% increased all-cause [HR (95%CI) 1.28 (1.16, 1.42), P < 0.001] and a 36% increased risk of cardiovascular mortality [HR (95%CI) 1.36 (1.08, 1.72), P = 0.008] compared with the first quantile of PPI. The nonlinear relationships between PPI and mortality (all-cause: P for Nonlinear = 0.038; cardiovascular: P for Nonlinear = 0.005) were determined using restricted cubic spline curves. Among the three machine-learning models, random forest model showed the best performance (AUC 0.667 (0.638, 0.696)). In descending order of feature importance, PPI came in second place, with a positive relationship with CHD.

CONCLUSIONS

This study indicated a positive correlation between PPI and long-term adverse cardiovascular outcomes among the elderly. Notably, PPI has considerable predictive power for recognizing CHD.

The Role of Xenobiotic Caffeine on Cardiovascular Health: Promises and Challenges

Cardiovascular diseases (CVDs) represent a leading cause of premature mortality and disability worldwide, with their incidence expected to rise, potentially reaching 24 million deaths per year by 2030. These multifactorial diseases, including hypertension, coronary artery disease, arrhythmia, and heart failure, are often linked to metabolic disturbances such as diabetes, oxidative stress, endothelial dysfunction, and inflammation. Natural compounds, such as caffeine, have been explored for their potential therapeutic effects on CVDs. Caffeine, found in coffee, tea, cocoa, and various energy drinks, is a widely consumed psychoactive compound with noted analgesic and anti-inflammatory properties. Despite its long history of use, caffeine's impact on cardiovascular health remains controversial, with both beneficial and harmful effects reported. This review examines the current literature on the effects of caffeine on cardiovascular diseases (CVDs), with an emphasis on preclinical and clinical studies, its pharmacokinetic properties, and the molecular mechanisms it modulates. There is evidence that moderate caffeine intake can be beneficial for some CVDs, such as hypertension, while for other CVDs, such as dyslipidemia, the evidence collected so far suggests that caffeine intake could be detrimental since it increases total cholesterol levels. But variability in dosage, intake patterns, and individual factors (such as genetics and diet) complicates the reliability of results. Additionally, challenges related to dose standardization and the absence of consistent clinical trial designs hinder the full utilization of caffeine in CVD treatment. Nonetheless, caffeine appears to be safe for individuals without significant cardiovascular conditions. Future research should aim for well-designed studies with precise patient cohorts and standardized methodologies to better assess caffeine's role in CVD management.

Association between life's crucial 9 and severe abdominal aortic calcification in U.S. Adults: the mediating role of the systemic inflammatory response index

Background

Life's Crucial 9 (LC9) is an emerging cardiovascular health scoring system that incorporates Life's Essential 8 (LE8) alongside mental health factors. However, its relationship with severe abdominal aortic calcification (SAAC) remains poorly understood.

Objectives

The objective of this study is to investigate the relationship between LC9 scores and the incidence of SAAC in the US population.

Methods

Data from 2,323 participants were analyzed, originating from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cycle. In exploring the dynamics of LC9, its constituents, and their relationship with SAAC, we employed advanced statistical methodologies, specifically multivariable logistic regression and weighted quantile sum regression. Subgroup interaction analyses were conducted to reinforce the conclusions, and mediation analysis was employed to investigate how the systemic inflammatory response index (SIRI) influences the connection between LC9 and SAAC.

Results

In fully adjusted models, an increase of 10 points in LC9 scores was associated with a 26% reduction in the prevalence of SAAC, achieving statistical significance (P < 0.001). As LC9 scores increased, a significant decline in SAAC prevalence was noted (P < 0.05). The WQS analysis pinpointed strong links between the occurrence of SAAC and variables including exposure to tobacco, blood pressure levels, blood glucose concentrations, and mental health status, the odds ratio stood at 0.244, with the 95% CI extending from 0.119 to 0.495. SIRI was positively correlated with SAAC (P < 0.05) and decreased with rising LC9 scores (β = -0.09, P < 0.001). Mediation analysis revealed that the SIRI significantly influenced the linkage between LC9 and SAAC, accounting for 5.8% of the mediation effect, with a statistically significant p-value (P < 0.001).

Conclusion

This research highlights a robust inverse relationship between elevated LC9 scores and reduced SAAC incidence, suggesting the significant role of LC9 as a key factor in diminishing the frequency of SAAC. Furthermore, SIRI mediates this relationship.

Associations between Life's Essential 8 and abdominal aortic calcification among US Adults: a cross-sectional study

BACKGROUND

Cardiovascular health (CVH) and abdominal aortic calcification (AAC) are closely linked to cardiovascular disease (CVD) and related mortality. However, the relationship between CVH metrics via Life's Essential 8 (LE8) and AAC remains unexplored.

METHODS

The study analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cohort, which included adults aged 40 or above. The research used the LE8 algorithm to evaluate CVH. Semi-quantitative AAC-24 scoring techniques were employed to assess AAC, categorized into no calcification, mild to moderate calcification, and severe calcification.

RESULTS

The primary analysis involved 2,478 participants. Following adjustments for multiple factors, the LE8 score exhibited a significant association with ACC risk (Mild-moderate ACC: 0.87, 95% CI: 0.81,0.93; Severe ACC: 0.77, 95% CI: 0.69,0.87, all P < 0.001), indicating an almost linear dose-response relationship. Compared to the low CVH group, the moderate CVH group showed lower odds ratios (OR) for mild-moderate and severe calcification (OR = 0.78, 95% CI: 0.61-0.99, P = 0.041; OR = 0.68, 95% CI: 0.46-0.99, P = 0.047, respectively). Moreover, the high CVH group demonstrated even lower ORs for mild-moderate and severe calcification (OR = 0.46, 95% CI: 0.31, 0.69, P < 0.001; OR = 0.29, 95% CI: 0.14, 0.59, P = 0.001, respectively). Interactions were found between chronic kidney disease (CKD) condition, history of CVD, marital status and CVH metrics to ACC. Participants without CKD exhibited a more pronounced negative association between the CVH metric and both mild-moderate and severe ACC. Those lacking a history of CVD, and never married/widowed/divorced/separated showed a stronger negative association between the CVH metric and severe ACC.

CONCLUSIONS

The novel CVH metrics demonstrated an inverse correlation with the risk of AAC. These findings suggest that embracing improved CVH levels may assist in alleviating the burden of ACC.

The association of moderate-to-vigorous physical activity and sedentary behaviour with abdominal aortic calcification

BACKGROUND AND AIMS

The increasing prevalence of metabolic and cardiovascular diseases poses a significant challenge to global healthcare systems. Regular physical activity (PA) is recognized for its positive impact on cardiovascular risk factors. This study aimed to investigate the relationship between moderate-to-vigorous physical activity (MVPA), sedentary behavior (SB), and abdominal aortic calcification (AAC) using data from the National Health and Nutrition Examination Survey (NHANES).

METHODS

The study used data from NHANES participants aged 40 and above during the 2013-2014 cycle. AAC scores were assessed using the Kauppila scoring system, and MVPA and SB were self-reported. Sociodemographic variables were considered, and multivariable linear regression models were used to analyze associations between MVPA, SB, and AAC scores. Subgroup analyses were conducted based on age, sex, BMI, hypertension, and diabetes.

RESULTS

The study included 2843 participants. AAC prevalence was higher in older age groups, smokers, and those with diabetes or hypertension. Lower socioeconomic status was associated with higher AAC prevalence. Individuals engaged in any level of MVPA exhibited lower AAC rates compared to inactive individuals. Not engaging in occupational MVPA (β = 0.46, 95% confidence interval = 0.24‒0.67, p < .001) and prolonged SB (β = 0.28, 95% confidence interval = 0.04‒0.52, p = .023) were associated with higher AAC scores. However, no significant associations were found for transportation and leisure time MVPA. Subgroup analysis revealed age and hypertension as effect modifiers in the MVPA-AAC relationship.

CONCLUSIONS

This study highlights the potential benefits of engaging in occupational MVPA and reducing SB in mitigating AAC scores, particularly among older individuals and those with hypertension.