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Joseph JJ, Nolan TS, Brock G, Williams A, Zhao S, McKoy A, Kluwe B, Metlock F, Campanelli K, Odei JB, Khumalo MT, Lavender D, Gregory J, Gray DM. Improving mental health in black men through a 24-week community-based lifestyle change intervention: the black impact program. BMC Psychiatry 2024; 24:34. [PMID: 38195473 PMCID: PMC10775551 DOI: 10.1186/s12888-023-05064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 07/29/2023] [Indexed: 01/11/2024] Open
Abstract
BACKGROUND Poor mental health is a leading cause of morbidity and mortality among Black men in the United States. Efforts to improve mental health among Black men have been hampered by a lack of access and utilization of mental health services. Physical activity and social networks have been shown to improve mental health. Thus, we examined the effect of a community team-based physical activity, health education and social needs intervention among Black men on mental health over 24 weeks. METHODS Black adult males (n = 74) from a large Midwestern city participated in Black Impact, a 24-week community-based lifestyle change program adapted from the Diabetes Prevention Program and American Heart Association's (AHA) Check, Change, Control Blood Pressure Self-Management Program, which incorporates AHA's Life's Simple 7 (LS7) framework. Measures of mental health including the Center for Epidemiological Studies Depression Scale (CES-D), Patient Health Questionnaire 2-question depression screener (PHQ-2), and Perceived Stress Scale-10 (PSS-10) were completed at baseline, 12 and 24 weeks. The change in mental health scores from baseline to 12 and 24 weeks were evaluated using linear mixed-effects models adjusting for age, education, and income. The change in cardiovascular health scores, defined as objective metrics of LS7 (LS5 [blood pressure, total cholesterol, fasting glucose, body mass index and smoking]), by baseline mental health were evaluated using linear mixed-effects models with an interaction term (time*baseline mental health variable) and a random intercept for each participant. RESULTS Among 71 Black men (mean age 51, 85% employed) at 24 weeks, CES-D scores decreased from 10.54 to 7.90 (-2.64, 95%CI:-4.74, -0.55), PHQ-2 decreased from 1.04 to 0.63 (-0.41, 95%CI: -0.75, -0.07), and PSS-10 decreased from 14.62 to 12.91 (-1.71, 95%CI: -3.53, 0.12). A 1-unit higher CES-D at baseline was associated with less improvement in LS5 scores by -0.04 (95%CI: -0.076, -0.005) and - 0.032 (95%CI:-0.067, 0.003) units at week 12 and 24, respectively, with similar findings for PSS. CONCLUSIONS The Black Impact community-based lifestyle program has the potential to reduce depressive symptoms and stress in Black men. There is a dire need for larger, randomized studies to test the impact of Black Impact on mental health in Black men to advance health equity. TRIAL REGISTRATION Retrospectively Registered, ClinicalTrials.gov Identifier: NCT04787978.
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Affiliation(s)
- Joshua J Joseph
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA.
| | - Timiya S Nolan
- The Ohio State University College of Nursing, Columbus, OH, USA
- The Ohio State University James Center for Cancer Health Equity, Columbus, OH, USA
| | - Guy Brock
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
| | - Amaris Williams
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
| | - Songzhu Zhao
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
| | - Alicia McKoy
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
- The Ohio State University James Center for Cancer Health Equity, Columbus, OH, USA
| | - Bjorn Kluwe
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
| | - Faith Metlock
- The Ohio State University College of Nursing, Columbus, OH, USA
| | | | - James B Odei
- The Ohio State University College of Public Health, Columbus, OH, USA
| | | | - Dana Lavender
- The African American Male Wellness Agency, Columbus, OH, USA
| | - John Gregory
- The African American Male Wellness Agency, Columbus, OH, USA
- National Center for Urban Solutions, Columbus, OH, USA
| | - Darrell M Gray
- The Ohio State University College of Medicine, Suite 5000, 700 Ackerman Road, Columbus, OH, 43202, USA
- The Ohio State University James Center for Cancer Health Equity, Columbus, OH, USA
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van Zutphen EM, Kok AAL, Muller M, Oude Voshaar RC, Rhebergen D, Huisman M, Beekman ATF. Cardiovascular risk indicators among depressed persons: A special case? J Affect Disord 2023; 329:335-342. [PMID: 36842656 DOI: 10.1016/j.jad.2023.02.092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 02/08/2023] [Accepted: 02/20/2023] [Indexed: 02/26/2023]
Abstract
BACKGROUND Traditional cardiovascular risk indicators only partially explain cardiovascular risks in depressed persons. Depressed persons may exhibit a profile of cardiovascular risk indicators that goes beyond traditional cardiovascular risk indicators, such as symptom severity, insomnia, loneliness and neuroticism, yet research on the added value of these depression-related characteristics in predicting cardiovascular risks of depressed persons is scarce. METHODS Data from N = 1028 depressed Dutch adults without prevalent CVD were derived from two longitudinal depression cohort studies. The outcome was medication-confirmed self-reported CVD. Fifteen depression-related clinical and psychological characteristics were included and tested against traditional cardiovascular risk indicators. Data were analysed using Cox regression models. Incremental values of these characteristics were calculated using c-statistics. RESULTS After a median follow-up of 65.3 months, 12.7% of the participants developed CVD. Only anxiety and depressive symptom severity were associated with incident CVD beyond traditional cardiovascular risk indicators. The c-statistic of the model with traditional cardiovascular risk indicators was 85.47%. This increased with 0.56 or 0.33 percentage points after inclusion of anxiety or depression severity, respectively. LIMITATIONS Other relevant depression-related characteristics were not available in the datasets used. CONCLUSION Anxiety and depressive symptom severity were indicative of an increased cardiovascular risk. Including these as additional risk indicators barely improved the ability to assess cardiovascular risks in depressed persons. Although traditional cardiovascular risk indicators performed well in depressed persons, existing risk prediction algorithms need to be validated in depressed persons.
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Affiliation(s)
- Elisabeth M van Zutphen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands.
| | - Almar A L Kok
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands
| | - Majon Muller
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Internal Medicine - Geriatrics, De Boelelaan 1117, Amsterdam, Netherlands; Cardiovascular Sciences, Amsterdam, the Netherlands
| | - Richard C Oude Voshaar
- University of Groningen, University Medical Centre Groningen, Groningen, the Netherlands
| | - Didi Rhebergen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; Mental Health Care Institute GGZ Centraal, Amersfoort, the Netherlands
| | - Martijn Huisman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Public Health, Aging & Later Life, Amsterdam, the Netherlands; Department of Sociology, VU University, Amsterdam, the Netherlands
| | - Aartjan T F Beekman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Psychiatry, De Boelelaan 1117, Amsterdam, the Netherlands; GGZ inGeest Mental Health Care, Amsterdam, the Netherlands; Amsterdam Public Health, Mental Health, Amsterdam, the Netherlands
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Carroll AJ, Huffman MD, Wileyto EP, Khan SK, Fox E, Smith JD, Bauer AM, Leone FT, Schnoll RA, Hitsman B. Change in cardiovascular health among adults with current or past major depressive disorder enrolled in intensive smoking cessation treatment. J Affect Disord 2023; 333:527-534. [PMID: 37119868 DOI: 10.1016/j.jad.2023.04.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/27/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND Elevated depressive symptoms and cigarette smoking are independently associated with poorer cardiovascular health (CVH), but it is unknown whether their treatment can synergistically improve CVH. We sought to characterize CVH of adults with comorbid depression and smoking and examine changes in CVH associated with changes in smoking and depression. METHODS Participants (N = 300, 55 % women) were adult smokers (≥1 cigarette/day) with lifetime major depressive disorder enrolled in a 12-week intervention trial targeting depression and smoking. Multiple linear regression examined prospective associations between changes in depression (Beck Depression Inventory-II), smoking (past 24-hour cigarettes or smoking abstinence), and modified CVH score (per American Heart Association, excluding smoking: diet, physical activity, body mass index, blood glucose, cholesterol, blood pressure). RESULTS Baseline mean CVH score was 5.87/12 points (SD = 2.13). No participants met "ideal" on all CVH components (blood glucose: 48 %, cholesterol: 46 %, physical activity: 38 %, body mass index: 24 %, blood pressure: 22 %, diet: 3 %). CVH scores did not change from baseline to end-of-treatment (M = 0.18 points, SD = 1.36, p = .177), nor did change in depression × smoking predict change in CVH (p = .978). However, greater reductions in depression were significantly associated with greater improvement in CVH (β = -0.04, SE = 0.01, p = .015). LIMITATIONS This study was limited by a short follow-up period, missing blood glucose and cholesterol data, and treatment-seeking smokers. CONCLUSIONS Adults with comorbid depression and smoking had poor CVH. Although integrated treatment for depression and smoking improved both conditions, only reductions in depression were associated with improvements in CVH. These findings have implications for integrating psychosocial treatment into CVH promotion efforts. REGISTRATION NCT02378714 (clinicaltrials.gov).
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Affiliation(s)
- Allison J Carroll
- Departments of Psychiatry and Behavioral Sciences and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America.
| | - Mark D Huffman
- Department of Medicine, Washington University School of Medicine, St. Louis MO, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - E Paul Wileyto
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Sadiya K Khan
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Erica Fox
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Justin D Smith
- Department of Population Health Sciences, University of Utah Eccles School of Medicine, Salt Lake City, UT, United States of America
| | - Anna-Marika Bauer
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Frank T Leone
- Pulmonary, Allergy, and Critical Care Division, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Robert A Schnoll
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Brian Hitsman
- Department of Preventive Medicine, Robert H. Lurie Comprehensive Cancer Center, Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
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Patterson SL, Marcus M, Goetz M, Vaccarino V, Gooding HC. Depression and Anxiety Are Associated With Cardiovascular Health in Young Adults. J Am Heart Assoc 2022; 11:e027610. [PMID: 36533593 PMCID: PMC9798786 DOI: 10.1161/jaha.122.027610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Cardiovascular health (CVH) declines in young adulthood, and mood disorders commonly emerge during this life stage. This study examined the association between depression, anxiety, and CVH metrics among young adults. Methods and Results We conducted a cross-sectional analysis of participants aged 18 to 34 years who completed the Emory Healthy Aging Study Health History Questionnaire (n=875). We classified participants as having poor, intermediate, or ideal levels of the 8 CVH metrics using definitions set forth by the American Heart Association with adaptions when necessary. We defined depression and anxiety as absent, mild, or moderate to severe using standard cutoffs for Patient Health Questionnaire and General Anxiety Disorder scales. We used multivariable regression to examine the association between depression and anxiety and CVH, adjusting for age, sex, race and ethnicity, income, and education. The mean participant age was 28.3 years, and the majority identified as women (724; 82.7%); 129 (14.7%) participants had moderate to severe anxiety, and 128 (14.6%) participants had moderate to severe depression. Compared with those without anxiety, participants with moderate to severe anxiety were less likely to meet ideal levels of physical activity (adjusted prevalence ratio [aPR], 0.60 [95% CI, 0.44-0.82]), smoking (aPR, 0.90 [95% CI, 0.82-0.99]), and body mass index (aPR, 0.79 [95% CI, 0.66-0.95]). Participants with moderate to severe depression were less likely than those without depression to meet ideal levels of physical activity (aPR, 0.48 [95% CI, 0.34-0.69]), body mass index (aPR, 0.75 [95% CI, 0.61-0.91]), sleep (aPR, 0.79 [95% CI, 0.66-0.94]), and blood pressure (aPR, 0.92 [95% CI, 0.86-0.99]). Conclusions Anxiety and depression are associated with less ideal CVH in young adults. Interventions targeting CVH behaviors such as physical activity, diet, and sleep may improve both mood and CVH.
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Affiliation(s)
- Sierra L. Patterson
- Department of EpidemiologyUniversity of North Carolina at Chapel HillChapel HillNC
| | - Michele Marcus
- Department of EpidemiologyRollins School of Public HealthAtlantaGA,Department of Environmental HealthRollins School of Public HealthAtlantaGA
| | | | - Viola Vaccarino
- Department of EpidemiologyRollins School of Public HealthAtlantaGA
| | - Holly C. Gooding
- Department of PediatricsEmory University School of MedicineAtlantaGAUnited States,Children’s Healthcare of AtlantaAtlantaGA
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Comparing cardiovascular disease incidence and prevalence between depressed and non-depressed older persons over time: Cohort differences in the Longitudinal Aging Study Amsterdam. J Psychosom Res 2022; 162:111015. [PMID: 36162162 DOI: 10.1016/j.jpsychores.2022.111015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 08/01/2022] [Accepted: 08/17/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Previous studies suggest that prevention of cardiovascular disease (CVD) is more difficult in depressed persons. Although the prevalence and incidence of CVD decreased over the past decades, it is uncertain whether this is also true for depressed persons. This study examined whether changes in the prevalence and incidence of CVD differ between depressed and non-depressed older persons. METHODS Longitudinal data from three community-based representative birth cohorts aged 55-65 years of the Longitudinal Aging Study Amsterdam were used; N = 1070 born in 1926-1937, N = 995 born in 1938-1947, N = 1019 born in 1948-1957. The outcome included fatal and non-fatal CVD. Depression was defined as ≥16 points on the Center for Epidemiological Studies Depression Scale or a general practitioner's diagnosis of depression. Data were analysed with for age and sex adjusted logistic regression and cox regression models. RESULTS Comparing cohort 2 and 3 with cohort 1 in the complete sample, the prevalence of CVD decreased by 2% (OR = 0.98, 95%CI = 0.76-1.26) and 32% (OR = 0.68, 95%CI = 0.52-0.89), respectively, and the three-year incidence of CVD decreased by 6% (OR = 0.94, 95%CI = 0.63-1.41) and 26% (OR = 0.74, 95%CI = 0.48-1.15), respectively. The 13-year incidence of CVD decreased by 19% (HR = 0.81, 95%CI = 0.67-0.99) in cohort 2 compared to cohort 1. These decreases did not differ statistically significantly between depressed and non-depressed respondents (p-values of interaction terms: 0.35-0.98). CONCLUSION Substantial decreases in the prevalence and incidence of CVD were observed in depressed and non-depressed older persons. Although this is encouraging, cardiovascular risk remained higher in depressed persons over time, warranting tailored prevention programs for depressed older persons.
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Nmezi NA, Turkson-Ocran RA, Tucker CM, Commodore-Mensah Y. The Associations between Depression, Acculturation, and Cardiovascular Health among African Immigrants in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6658. [PMID: 35682247 PMCID: PMC9180644 DOI: 10.3390/ijerph19116658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/01/2022] [Revised: 05/17/2022] [Accepted: 05/18/2022] [Indexed: 02/02/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death both globally and in the United States (U.S.). Racial health disparities in cardiovascular health (CVH) persist with non-Hispanic Black adults having a higher burden of CVD morbidity and mortality compared to other racial groups. African immigrants represent an increasingly growing sub-population of the overall U.S. non-Hispanic Black adult population, however little is known about how specific psychological and social factors (i.e., depression and acculturation) influence the CVH of U.S. African immigrants. We sought to examine the association between severity of depression symptomology and CVH among African immigrants, and whether acculturation moderated the relationship between severity of depression symptoms and CVH. Study participants were those in the African Immigrant Health Study conducted in the Baltimore-Washington D.C. area. Severity of depression symptoms were assessed using the Patient Health Questionnaire-8 (PHQ-8). CVH was assessed using the American Heart Association Life's Simple 7 metrics and categorized as poor, intermediate, and ideal CVH. Acculturation measured as length of stay and acculturation strategy was examined as a moderator variable. Multivariable logistic regression was used to examine the association between depression and CVH and the moderating effect of acculturation adjusting for known confounders. In total 317 African immigrants participated in the study. The mean (±SD) age of study participants was 46.9 (±11.1) and a majority (60%) identified as female. Overall, 8.8% of study participants endorsed moderate-to-severe symptoms of depression. African immigrants endorsing moderate-to-severe levels of depression were less likely to have ideal CVH compared to those with minimal-to-mild symptoms of depression (Adjusted Odds Ratio [AOR]: 0.42, 95% CI: 0.17-0.99). Acculturation measured either as length of stay or acculturation strategy did not moderate the relationship between depression and CVH among study participants. Study participants exhibited elevated levels of symptoms of depression. Greater severity of depression symptoms was associated with worse CVH. Efforts to treat and prevent CVD among African immigrants should also include a focus on addressing symptoms of depression within this population.
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Affiliation(s)
- Nwakaego A. Nmezi
- Division of Rehabilitation Psychology and Neuropsychology, Department of Physical Medicine and Rehabilitation, Johns Hopkins University, Baltimore, MD 21218, USA
| | - Ruth-Alma Turkson-Ocran
- Section for Research, Division of General Medicine, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA;
| | - Carolyn M. Tucker
- Department of Psychology, University of Florida, Gainesville, FL 32611, USA;
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Agarwal A, Fazeel RH, Rahman HESA, Alenezi AMK, Alshammari DAS, Alenzi MHE, Albalawi TA, Alenezi YMK, Alenazi RHE. Prevalence of Cardiovascular Disease and Associated Risk Factors among Adult Population Attending Fitness Center/Gymnasium in Arar. ARCHIVES OF PHARMACY PRACTICE 2022. [DOI: 10.51847/sbqqcztmzv] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Cash RE, Anderson SE, Lancaster KE, Lu B, Rivard MK, Camargo CA, Panchal AR. Associations between sleep, stress, and cardiovascular health in emergency medical services personnel. J Am Coll Emerg Physicians Open 2021; 2:e12516. [PMID: 34322683 PMCID: PMC8295241 DOI: 10.1002/emp2.12516] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/28/2021] [Accepted: 07/01/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVE Our objective was to quantify the associations between sleep duration and perceived and chronic stress with ideal cardiovascular health (CVH) among emergency medical services (EMS) personnel from county-based EMS agencies. METHODS We conducted a cross-sectional survey of cardiovascular disease (CVD)-free EMS personnel from 4 US EMS agencies. The questionnaire consisted of the Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), Chronic Burden Scale, and the CVH components (smoking, body mass index, physical activity, diet, blood glucose, blood pressure, cholesterol, each scored 0-2 points). The components were summed and ideal CVH considered 11-14 points. Mixed effects logistic regression models with a random intercept for agency were used to estimate the odds of ideal CVH for good sleep quality (PSQI < 5 points), recommended sleep duration (7 to < 9h), low perceived stress (PSS < 26 points), and low chronic stress (0 recent stressful events). RESULTS We received 379 responses (response rate = 32%). There was low prevalence of good sleep quality (23%) and recommended sleep duration (25%), but 95% reported low perceived stress, and 33% had low chronic stress. Ideal CVH was reported by 30%. No significant associations between ideal CVH and sleep quality, perceived stress, or chronic stress were found. There was a nearly 2-fold increase in the odds of ideal CVH with recommended sleep duration (odds ratio: 1.83, 95% confidence interval: 1.08-3.10). CONCLUSION In this sample of EMS personnel, only recommended sleep duration was associated with ideal CVH. Future longitudinal studies are needed to understand the relationship between sleep, stress, and CVD in this understudied occupational group.
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Affiliation(s)
- Rebecca E. Cash
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Sarah E. Anderson
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Kathryn E. Lancaster
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Bo Lu
- Division of BiostatisticsThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Madison K. Rivard
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of Health Behavior and Health PromotionThe Ohio State University College of Public HealthColumbusOhioUSA
| | - Carlos A. Camargo
- Department of Emergency MedicineMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Ashish R. Panchal
- National Registry of Emergency Medical TechniciansColumbusOhioUSA
- Division of EpidemiologyThe Ohio State University College of Public HealthColumbusOhioUSA
- Department of Emergency MedicineThe Ohio State University Wexner Medical CenterColumbusOhioUSA
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Gaye B, Tajeu GS, Offredo L, Vignac M, Johnson S, Thomas F, Jouven X. Temporal trends of cardiovascular health factors among 366 270 French adults. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2021; 6:138-146. [PMID: 31328232 PMCID: PMC7132943 DOI: 10.1093/ehjqcco/qcz038] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 07/09/2019] [Accepted: 07/14/2019] [Indexed: 11/13/2022]
Abstract
AIMS We aimed to investigate time trends in cardiovascular health (CVH) metrics in the population at large, as well as in important subgroups. METHODS AND RESULTS In this study, we used a community-based sample of 366 270 adults from France who had a standardized examination to assess cardiovascular risk factors between 1992 and 2011 (20 years). Cardiovascular health metrics categorized into ideal, intermediate, and poor categories were computed using smoking, physical activity, body mass index, total cholesterol, blood glucose, and blood pressure. Matching on age, sex, and depression across 5-year periods (1992-96, 1997-2001, 2002-06, and 2007-11) was performed in order to correct for the sociodemographic differences between the examinations at different periods of times. Mean age across all four time periods was 44.7 (SD 13) years and 38% (138 228) were women. Overall, few participants (≤3.5%) met all six ideal CVH metrics at any time point. The prevalence of meeting ≥5 ideal CVH metrics increased from 6.7% in 1992-96 to 15.0% in 2007-11 (P < 0.001). A significant improvement in CVH (meeting ≥5 ideal CVH metrics) from 1992 to 2011 was observed among younger (from 7.5% to 16.6%) and older individuals (from 1.3% to 4.2%), men (from 4.4% to 11.8%) and women (from 10.4% to 20.1%), those with low (from 9.1% to 10.4%) and high education status (from 15% to 18.1%) and those with (from 5.1% to 12.7%) and without depressive symptoms (from 6.8% to 15.1%). However, the rate of improvement was steepest in the most affluent group in comparison with those with lower socio-economic status. CONCLUSION Overall CVH improved from 1992 until 2006 and slightly decreased between 2006 and 2011 in French adults. From 1992 until 2006, the improvement in CVH was less pronounced among those with low socio-economic status as compared to those with a higher socio-economic status.
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Affiliation(s)
- Bamba Gaye
- Department of Epidemiology, INSERM U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - Gabriel S Tajeu
- Department of Health Services Administration and Policy, Temple University, 1801 N Broad St, Philadelphia, PA 19122, USA
| | - Lucile Offredo
- Department of Epidemiology, INSERM U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - Maxime Vignac
- Department of Epidemiology, INSERM U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 15 Rue de l'École de Médecine, 75006 Paris, France
| | - Stacey Johnson
- Institut de Recherche bio-Médicale et d'Épidémiologie du Sport (IRMES), EA 7329, Institut National du Sport, de l'Expertise et de la Performance (INSEP), 11, av. du Tremblay, 75012 Paris, France
| | - Frédérique Thomas
- Preventive and Clinical Investigation Center, 6 rue La Pérouse, 75116 Paris, France
| | - Xavier Jouven
- Department of Epidemiology, INSERM U970, Paris Cardiovascular Research Center, 56 rue Leblanc, 75015 Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, 15 Rue de l'École de Médecine, 75006 Paris, France.,Department of Cardiology, AP-HP, Georges Pompidou European Hospital, 20 rue Leblanc, 75015, Paris, France
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Vulser H, Lemogne C, Boutouyrie P, Côté F, Perier MC, Van Sloten T, Hoertel N, Danchin N, Limosin F, Jouven X, Empana JP. Depression, antidepressants and low hemoglobin level in the Paris Prospective Study III: A cross-sectional analysis. Prev Med 2020; 135:106050. [PMID: 32156564 DOI: 10.1016/j.ypmed.2020.106050] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 03/04/2020] [Accepted: 03/06/2020] [Indexed: 02/07/2023]
Abstract
Anemia is known to be associated with depression both in community and clinical populations. However, it is still unknown if this association depends or not on antidepressant intake. We investigated the respective association of depression and antidepressant intake with low hemoglobin level in a large community-based cohort. In 8640 volunteers aged 50 to 75 recruited between June 2008 and June 2012 in Paris (France), we assessed hemoglobin levels (g/dl), depressive symptoms and antidepressant intake. We examined the association of both depression and antidepressant intake with hemoglobin level, adjusting for numerous socio-demographic and health variables. We also assessed the association with specific antidepressant classes. Depression and antidepressant intake were independently associated with lower hemoglobin level (β = -0.074; p = .05 and β = -0.100; p = .02 respectively in the fully-adjusted model). Regarding antidepressant classes, selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) intake were associated with lower hemoglobin level (β = -0.11; p = .01). To conclude, both depression and antidepressant intake were associated with lower hemoglobin level. In particular, as SSRI or SNRIs intake was also related to lower hemoglobin level, these classes should be used with caution in depressed individuals at risk for anemia.
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Affiliation(s)
- Hélène Vulser
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France.
| | - Cédric Lemogne
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Pharmacology, Paris, France
| | - Francine Côté
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, Necker Enfants Malades Hospital, Department of Hematology, Institut Imagine, INSERM U1183 CNRS ERL 8254, Laboratory of Excellence GR-Ex, Paris, France
| | - Marie-Cécile Perier
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
| | - Thomas Van Sloten
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; Cardiovascular Research Institute Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Nicolas Hoertel
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Nicolas Danchin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France; Preventive and Clinical Investigation Center, Paris, France
| | - Frédéric Limosin
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Psychiatry, Paris, France; Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, INSERM, Université de Paris, Paris, France
| | - Xavier Jouven
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France; AP-HP.Centre - Université de Paris, European Georges-Pompidou Hospital, Department of Cardiology, Paris, France
| | - Jean-Philippe Empana
- Université de Paris, Paris Descartes Faculty of Medicine, Paris, France; Inserm, UMR-S970, Paris Cardiovascular Research Center, Team 4 Integrative Epidemiology of Cardiovascular disease, Paris, France
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Chewing capacity and ideal cardiovascular health in adulthood: A cross-sectional analysis of a population-based cohort study. Clin Nutr 2020; 39:1440-1446. [DOI: 10.1016/j.clnu.2019.05.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Revised: 05/24/2019] [Accepted: 05/30/2019] [Indexed: 11/18/2022]
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12
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Carroll AJ, Huffman MD, Zhao L, Jacobs DR, Stewart JC, Kiefe CI, Brunner W, Liu K, Hitsman B. Associations between depressive symptoms, cigarette smoking, and cardiovascular health: Longitudinal results from CARDIA. J Affect Disord 2020; 260:583-591. [PMID: 31539696 PMCID: PMC6931258 DOI: 10.1016/j.jad.2019.09.049] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/08/2019] [Accepted: 09/08/2019] [Indexed: 12/13/2022]
Abstract
INTRODUCTION Depression is associated with increased risk of incident and recurrent cardiovascular disease, while the association between depression and cardiovascular health (CVH) remains unknown. Because the natural course of depression varies widely, different patterns of depression, as well as co-occurring factors such as cigarette smoking, may influence this relationship. We examined potential interactions between longitudinal patterns of depression and smoking with CVH. METHODS Using data from the Coronary Artery Risk Development in Young Adults (CARDIA) study, we modeled trajectories of depression (Center for Epidemiologic Studies Depression scale scores; Years 5, 10, 15, 20) and smoking (cigarettes/day; Years 0, 2, 5, 7, 10, 15, 20). We calculated a modified American Heart Association (AHA) CVH Score (weight, blood glucose, cholesterol, blood pressure, physical activity, and diet; Year 20); higher scores indicate better CVH. Generalized linear models evaluated associations between depression trajectories, smoking trajectories, and their interaction with CVH Score. RESULTS The depression trajectory x smoking trajectory interaction was not associated with CVH Score, but main effects of depression trajectory (p < .001) and smoking trajectory (p < .001) were observed. Participants with patterns of subthreshold depression (β = -0.26, SE=0.08), increasing depression (β = -0.51 SE = 0.14), and high depression (β = -0.65, SE = 0.32) had lower CVH Scores than those without depression. Compared to never smokers, participants who quit smoking had higher CVH Scores (β = 0.38, SE = 0.11), while participants with the greatest smoking exposure had lower CVH Scores (β = -0.49, SE = 0.22). LIMITATIONS CVH Scores were adapted from the AHA guidelines based on the available CARDIA data. CONCLUSIONS Deleterious depression and smoking trajectories are independently but not synergistically associated with worse CVH.
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Affiliation(s)
- Allison J Carroll
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Cardiac Surgery, Department of Surgery, Northwestern Medicine, Chicago, IL, USA.
| | - Mark D Huffman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Division of Food Policy, The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Lihui Zhao
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - David R Jacobs
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, USA
| | - Catarina I Kiefe
- Department of Population and Quantitative Health Sciences, University of Massachusetts Medical School, Worcester, MA, USA
| | - Wendy Brunner
- Center for Rural Community Health, Bassett Resarch Institute, Cooperstown, NY, USA
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Brian Hitsman
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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Fukunaga A, Inoue Y, Kochi T, Hu H, Eguchi M, Kuwahara K, Miki T, Kurotani K, Nanri A, Kabe I, Mizoue T. Prospective Study on the Association Between Adherence to Healthy Lifestyles and Depressive Symptoms Among Japanese Employees: The Furukawa Nutrition and Health Study. J Epidemiol 2019; 30:288-294. [PMID: 31155542 PMCID: PMC7280053 DOI: 10.2188/jea.je20190018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background While a growing body of research suggests a protective role of healthy lifestyle against depression, evidence from prospective studies is scarce. We constructed a healthy lifestyle index (HLI) and examined its prospective association with depressive symptoms in a Japanese working population. Methods Participants were 917 employees (19–68 years old) who were free from depressive symptoms at baseline in 2012–2013 and attended the 3-year follow-up survey. The HLI (range: 0–7 points) was constructed by assigning 1 point to each healthy lifestyle factor, namely, (1) normal body mass index (18.5–24.9 kg/m2), (2) non-smoking, (3) no or moderate alcohol intake (≤23 g ethanol/day), (4) adequate physical activity (≥7.5 metabolic equivalent-hours/week), (5) high vegetable intake (≥350 g/day), (6) high fruit intake (≥200 g/day), and (7) adequate sleep duration (6–8.9 hours/day), which was categorized into three groups (low: 0–2 points; middle: 3–4 points; and high: 5–7 points). Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Results A total of 155 incident cases (17.0%) of depressive symptoms were identified at the follow-up survey. Compared with the low HLI group, multivariable-adjusted odds ratios of depressive symptoms were 0.74 (95% confidence interval, 0.48–1.15) and 0.55 (95% confidence interval, 0.31–0.99) for the middle and high HLI groups, respectively (P-trend = 0.041). Conclusion The present study suggests the importance of adherence to multiple healthy lifestyle factors in prevention of depressive symptoms.
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Affiliation(s)
- Ami Fukunaga
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Yosuke Inoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Takeshi Kochi
- Department of Health Administration, Furukawa Electric Corporation
| | - Huanhuan Hu
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
| | - Masafumi Eguchi
- Department of Health Administration, Furukawa Electric Corporation
| | - Keisuke Kuwahara
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Teikyo University Graduate School of Public Health
| | - Takako Miki
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Mental Health, Graduate School of Medicine, The University of Tokyo.,Research Fellow of Japan Society for the Promotion of Science
| | - Kayo Kurotani
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Nutritional Epidemiology and Shokuiku, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition
| | - Akiko Nanri
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine.,Department of Food and Health Sciences, International College of Arts and Sciences, Fukuoka Women's University
| | - Isamu Kabe
- Department of Health Administration, Furukawa Electric Corporation
| | - Tetsuya Mizoue
- Department of Epidemiology and Prevention, Center for Clinical Sciences, National Center for Global Health and Medicine
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Hamieh N, Meneton P, Wiernik E, Limosin F, Zins M, Goldberg M, Melchior M, Lemogne C. Depression, treatable cardiovascular risk factors and incident cardiac events in the Gazel cohort. Int J Cardiol 2019; 284:90-95. [DOI: 10.1016/j.ijcard.2018.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/12/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
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15
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Poorer cardiovascular health is associated with psychiatric comorbidity: results from the ELSA-Brasil Study. Int J Cardiol 2019; 274:358-365. [DOI: 10.1016/j.ijcard.2018.06.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 02/08/2023]
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16
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Samieri C, Empana JP. Cardiovascular Health and Cognitive Decline-Reply. JAMA 2018; 320:2483-2484. [PMID: 30561478 DOI: 10.1001/jama.2018.17566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Cécilia Samieri
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, Bordeaux, France
| | - Jean-Philippe Empana
- Université de Paris-Descartes, INSERM, Paris Cardiovascular Research Center, Paris, France
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17
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Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28:1197-1207. [PMID: 30360955 DOI: 10.1016/j.numecd.2018.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. METHODS AND RESULTS We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. CONCLUSION The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
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Affiliation(s)
- Y Peng
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia.
| | - S Cao
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Australia
| | - Z Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Z Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia
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van Sloten TT, Tafflet M, Périer MC, Dugravot A, Climie RED, Singh-Manoux A, Empana JP. Association of Change in Cardiovascular Risk Factors With Incident Cardiovascular Events. JAMA 2018; 320:1793-1804. [PMID: 30398604 PMCID: PMC6248104 DOI: 10.1001/jama.2018.16975] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 10/05/2018] [Indexed: 11/14/2022]
Abstract
Importance There is consistent evidence of the association between ideal cardiovascular health and lower incident cardiovascular disease (CVD); however, most studies used a single measure of cardiovascular health. Objective To examine how cardiovascular health changes over time and whether these changes are associated with incident CVD. Design, Setting, and Participants Prospective cohort study in a UK general community (Whitehall II), with examinations of cardiovascular health from 1985/1988 (baseline) and every 5 years thereafter until 2015/2016 and follow-up for incident CVD until March 2017. Exposures Using the 7 metrics of the American Heart Association (nonsmoking; and ideal levels of body mass index, physical activity, diet, blood pressure, fasting blood glucose, and total cholesterol), participants with 0 to 2, 3 to 4, and 5 to 7 ideal metrics were categorized as having low, moderate, and high cardiovascular health. Change in cardiovascular health over 10 years between 1985/1988 and 1997/1999 was considered. Main Outcome and Measure Incident CVD (coronary heart disease and stroke). Results The study population included 9256 participants without prior CVD (mean [SD] age at baseline, 44.8 [6.0] years; 2941 [32%] women), of whom 6326 had data about cardiovascular health change. Over a median follow-up of 18.9 years after 1997/1999, 1114 incident CVD events occurred. In multivariable analysis and compared with individuals with persistently low cardiovascular health (consistently low group, 13.5% of participants; CVD incident rate per 1000 person-years, 9.6 [95% CI, 8.4-10.9]), there was no significant association with CVD risk in the low to moderate group (6.8% of participants; absolute rate difference per 1000 person-years, -1.9 [95% CI, -3.9 to 0.1]; HR, 0.84 [95% CI, 0.66-1.08]), the low to high group, (0.3% of participants; absolute rate difference per 1000 person-years, -7.7 [95% CI, -11.5 to -3.9]; HR, 0.19 [95% CI, 0.03-1.35]), and the moderate to low group (18.0% of participants; absolute rate difference per 1000 person-years, -1.3 [95% CI, -3.0 to 0.3]; HR, 0.96 [95% CI, 0.80-1.15]). A lower CVD risk was observed in the consistently moderate group (38.9% of participants; absolute rate difference per 1000 person-years, -4.2 [95% CI, -5.5 to -2.8]; HR, 0.62 [95% CI, 0.53-0.74]), the moderate to high group (5.8% of participants; absolute rate difference per 1000 person-years, -6.4 [95% CI, -8.0 to -4.7]; HR, 0.39 [95% CI, 0.27-0.56]), the high to low group (1.9% of participants; absolute rate difference per 1000 person-years, -5.3 [95% CI, -7.8 to -2.8]; HR, 0.49 [95% CI, 0.29-0.83]), the high to moderate group (9.3% of participants; absolute rate difference per 1000 person-years, -4.5 [95% CI, -6.2 to -2.9]; HR, 0.66 [95% CI, 0.51-0.85]), and the consistently high group (5.5% of participants; absolute rate difference per 1000 person-years, -5.6 [95% CI, -7.4 to -3.9]; HR, 0.57 [95% CI, 0.40-0.80]). Conclusions and Relevance Among a group of participants without CVD who received follow-up over a median 18.9 years, there was no consistent relationship between direction of change in category of a composite metric of cardiovascular health and risk of CVD.
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Affiliation(s)
- Thomas T. van Sloten
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Cardiovascular Research Institute Maastricht, Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Muriel Tafflet
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Marie-Cécile Périer
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
| | - Aline Dugravot
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Rachel E. D. Climie
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
- Menzies Institute for Medical Research, University of Tasmania, Hobert, Australia
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Archana Singh-Manoux
- INSERM, U1018, Centre for Research in Epidemiology and Population Health, Villejuif, France
- Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Jean-Philippe Empana
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
- INSERM, UMR-S970, Paris Cardiovascular Research Center, Integrative Epidemiology of Cardiovascular Disease (Team 4), Paris, France
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The Status of Cardiovascular Health in Rural and Urban Areas of Janów Lubelski District in Eastern Poland: A Population-Based Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15112388. [PMID: 30373289 PMCID: PMC6266283 DOI: 10.3390/ijerph15112388] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 10/24/2018] [Accepted: 10/26/2018] [Indexed: 01/17/2023]
Abstract
Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the lack of cardiovascular disease and the presence of seven key factors and health behaviors. In this study, we aimed to estimate the prevalence of ideal and poor CVH among the Polish adult population based on the example of the inhabitants of Janów district in Lubelskie Voivodship, taking the chosen socio-demographic factors into consideration. This is a cross-sectional study conducted among 3901 adults without cardiovascular diseases, aged between 35 and 64 years. Participants completed a questionnaire, and they had anthropometric and physiological measurements taken. Blood samples were analyzed for fasting glucose and cholesterol levels. Ideal CVH was found in 5.4% of the participants, with the advantage of being toward city dwellers over those living in the rural areas (6.3% vs. 5.0%) p = 0.02. In the case of the residents of rural areas, their likelihood of having an ideal body mass index (BMI) was found to be 22% lower (odds ratio (OR) = 0.78; 95% CI: 0.66–0.92), their likelihood of having an ideal diet was found to be 27% lower (OR = 0.71; 95% CI: 0.54–0.94), their likelihood of having perfect blood pressure was found to be 29% lower (OR = 0.71; 95% CI: 0.56–0.89), and their likelihood of having the perfect glucose levels was found to be 28% lower (OR = 0.72; 95% CI: 0.63–0.84), than the residents of urban areas. The prevalence of ideal cardiovascular behaviors and factors is lower in the rural community compared with people living in the city. Results indicate that more effort should be dedicated toward the country’s health policy, specifically concerning primary prevention. Preventive actions in the field of cardiovascular disease should be addressed to the residents of rural areas to a larger extent.
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van Nieuwenhuizen B, Zafarmand MH, Beune E, Meeks K, Aikins ADG, Addo J, Owusu-Dabo E, Mockenhaupt FP, Bahendeka S, Schulze MB, Danquah I, Spranger J, Klipstein-Grobusch K, Appiah LT, Smeeth L, Stronks K, Agyemang C. Ideal cardiovascular health among Ghanaian populations in three European countries and rural and urban Ghana: the RODAM study. Intern Emerg Med 2018; 13:845-856. [PMID: 29667109 PMCID: PMC6132772 DOI: 10.1007/s11739-018-1846-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 03/28/2018] [Indexed: 01/28/2023]
Abstract
Cardiovascular health (CVH) is a construct defined by the American Heart Association (AHA) as part of its 2020 Impact Goal definition. CVH has, until now, not been evaluated in Sub-Saharan African populations. The aim of this study was to investigate differences in the prevalence of ideal CVH and its constituent metrics among Ghanaians living in rural and urban Ghana and Ghanaian migrants living in three European countries. The AHA definition of CVH is based on 7 metrics: smoking, body mass index, diet, physical activity, blood pressure, total cholesterol, and fasting plasma glucose. These were evaluated among 3510 Ghanaian adults (aged 25-70 years) residing in rural and urban Ghana and three European cities (Amsterdam, London and Berlin) in the multi-centre RODAM study. Differences between groups were assessed using logistic regression with adjustments for gender, age, and education. Only 0.3% of all participants met all 7 metrics of the AHA's definition of ideal CVH. Compared to rural Ghana (25.7%), the proportions and adjusted odds ratio (OR) of individuals who had 6-7 CVH metrics in the ideal category were substantially lower in urban Ghana, (7.5%; OR 0.204, 95% CI 0.15-0.29), Amsterdam (4.4%; 0.13, 0.08-0.19), Berlin (2.7%; 0.06, 0.03-0.11), and London (1.7%; 0.04, 0.02-0.09), respectively. The proportion of ideal CVH for the various metrics ranged from 96% for all sites in the smoking metric to below 6% in the diet metric. The proportion of ideal CVH is extremely low in Ghanaians, especially among those living in urban Ghana and Ghanaian migrants in Europe.
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Affiliation(s)
- Benjamin van Nieuwenhuizen
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Mohammad Hadi Zafarmand
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Erik Beune
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Karlijn Meeks
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Ama de-Graft Aikins
- Regional Institute for Population Studies, University of Ghana, P. O. Box LG 96, Legon, Ghana
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ellis Owusu-Dabo
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Frank P Mockenhaupt
- Institute of Tropical Medicine and International Health, Charité-University Medicine Berlin, Augustenburger Platz 1, 13353, Berlin, Germany
| | | | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
| | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Arthur-Scheunert-Allee 114-116, 14558, Nuthetal, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitaetsmedizin Berlin, Luisenstr. 57, 10117, Berlin, Germany
| | - Joachim Spranger
- Department of Endocrinology and Metabolism, Charité-Universitaetsmedizin Berlin, Berlin, Germany
- Center for Cardiovascular Research (CCR), Charite-Universitaetsmedizin Berlin, Berlin, Germany
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Karien Stronks
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Charles Agyemang
- Department of Public Health, Academic Medical Center, Amsterdam Public Health research institute, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Cardiovascular risk goes up as your mood goes down: Interaction of depression and socioeconomic status in determination of cardiovascular risk in the CONSTANCES cohort. Int J Cardiol 2018; 262:99-105. [DOI: 10.1016/j.ijcard.2018.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 01/05/2023]
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22
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23
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Poirat L, Gaye B, Perier MC, Thomas F, Guibout C, Climie RE, Offredo L, Tafflet M, Lemogne C, Pannier B, Boutouyrie P, Jouven X, Empana JP. Perceived stress is inversely related to ideal cardiovascular health: The Paris Prospective Study III. Int J Cardiol 2018; 270:312-318. [PMID: 29936046 DOI: 10.1016/j.ijcard.2018.06.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 03/26/2018] [Accepted: 06/11/2018] [Indexed: 02/04/2023]
Affiliation(s)
- L Poirat
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
| | - B Gaye
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M C Perier
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - F Thomas
- Preventive and Clinical Investigation Center, Paris, France
| | - C Guibout
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - R E Climie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Baker Heart and Diabetes Institute, Melbourne, Australia; Menzies Institute for Medical Research, University of Tasmanian, Hobart, Australia
| | - L Offredo
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - M Tafflet
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - C Lemogne
- Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Psychiatry Department, Paris, France; INSERM, U894, Psychiatry and Neuroscience Center, Paris, France
| | - B Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - P Boutouyrie
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Pharmacology Department, Paris, France
| | - X Jouven
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France; AP-HP, Georges Pompidou European Hospital, Cardiology Department, Paris, France
| | - J P Empana
- INSERM, U970, Paris Cardiovascular Research Center, Department of Epidemiology, Paris, France; Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.
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24
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Brewer LC, Redmond N, Slusser JP, Scott CG, Chamberlain AM, Djousse L, Patten CA, Roger VL, Sims M. Stress and Achievement of Cardiovascular Health Metrics: The American Heart Association Life's Simple 7 in Blacks of the Jackson Heart Study. J Am Heart Assoc 2018; 7:JAHA.118.008855. [PMID: 29871857 PMCID: PMC6015384 DOI: 10.1161/jaha.118.008855] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Background Ideal cardiovascular health metrics (defined by the American Heart Association Life's Simple 7 [LS7]) are suboptimal among blacks, which results in high risk of cardiovascular disease. We examined the association of multiple stressors with LS7 components among blacks. Methods and Results Using a community‐based cohort of blacks (N=4383), we examined associations of chronic stress, minor stressors, major life events, and a cumulative stress score with LS7 components (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting plasma glucose) and an LS7 composite score. Multivariable logistic regression assessed the odds of achieving intermediate/ideal levels of cardiovascular health adjusted for demographic, socioeconomic, behavioral, and biomedical factors. The LS7 components with the lowest percentages of intermediate/ideal cardiovascular health levels were diet (39%), body mass index (47%), and physical activity (51%). Higher chronic, minor, and cumulative stress scores were associated with decreased odds (odds ratio [OR]) of achieving intermediate/ideal levels for smoking (OR [95% confidence interval], 0.80 [0.73–0.88], 0.84 [0.75–0.94], and 0.81 [0.74–0.90], respectively). Participants with more major life events had decreased odds of achieving intermediate/ideal levels for smoking (OR, 0.84; 95% confidence interval, 0.76–0.92) and fasting plasma glucose (OR, 0.90; 95% confidence interval, 0.82–0.98). Those with higher scores for minor stressors and major life events were less likely to achieve intermediate or ideal LS7 composite scores (OR [95% confidence interval], 0.89 [0.81–0.97] and 0.91 [0.84–0.98], respectively). Conclusions Blacks with higher levels of multiple stress measures are less likely to achieve intermediate or ideal levels of overall cardiovascular health (LS7 composite score), specific behaviors (smoking), and biological factors (fasting plasma glucose).
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Affiliation(s)
| | - Nicole Redmond
- National Heart, Lung, and Blood Institute/National Institutes of Health, Bethesda, MD
| | - Joshua P Slusser
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | | | | | - Luc Djousse
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Christi A Patten
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Veronique L Roger
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN.,Department of Health Sciences Research, Mayo Clinic, Rochester, MN
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS
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25
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Seron P, Irazola V, Rubinstein A, Calandrelli M, Ponzo J, Olivera H, Gutierrez L, Elorriaga N, Poggio R, Lanas F. Ideal Cardiovascular Health in the southern cone of Latin America. Public Health 2018; 156:132-139. [PMID: 29427769 PMCID: PMC5826849 DOI: 10.1016/j.puhe.2017.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 12/18/2017] [Accepted: 12/20/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE The American Heart Association developed the concept of 'Ideal Cardiovascular Health', which is based on the presence of ideal levels across seven health factors. The goal of this study is to assess the prevalence of Ideal Cardiovascular Health in the Southern Cone of Latin America. STUDY DESIGN We conducted a cross-sectional analysis as part of CESCAS I cohort. METHODS This report included 5458 participants aged between 35 and 75 years who were selected using stratified multistage probability sampling in Argentina, Chile and Uruguay. Interviews included demographic information, the International Physical Activity Questionnaire, and a food frequency questionnaire on dietary habits. Participants were classified as current, former or non-smokers. Weight, height and blood pressure were measured by trained personnel, and fasting cholesterol and glucose plasma levels were measured. RESULTS Only 0.1% (95% confidence interval [CI]: 0.0-0.2) met the seven criteria that define the Ideal Cardiovascular Health. The least prevalent healthy behaviour was having a healthy diet: 0.5% (95% CI: 0.3-0.7), while the least prevalent health factor was having blood pressure < 120/80 mmHg: 23.6% (95% CI: 22.1-25.0). CONCLUSIONS The prevalence of Ideal Cardiovascular Health is very low in a representative sample of population from the Southern Cone of Latin America, and the levels of healthy lifestyle behaviours are even lower than ideal biochemical parameters. These results highlight the challenge of developing strategies to improve the levels of Ideal Cardiovascular Health at primary prevention levels.
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Affiliation(s)
- P Seron
- Universidad de La Frontera, Claro Solar 115, Temuco, Chile.
| | - V Irazola
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - A Rubinstein
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - M Calandrelli
- Sanatorio San Carlos Bariloche, Av. Ezequiel Bustillo Km. 1, Bariloche, Argentina
| | - J Ponzo
- Universidad de La República, Av. 18 de Julio 1968, Montevideo, Uruguay
| | - H Olivera
- Municipalidad de Marcos Paz, Tucumán 47, Marcos Paz, Argentina
| | - L Gutierrez
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - N Elorriaga
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - R Poggio
- Instituto de Efectividad Clínica y Sanitaria, Emilio Ravignani 2024, Buenos Aires, Argentina
| | - F Lanas
- Universidad de La Frontera, Claro Solar 115, Temuco, Chile
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26
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Gaye B, Tafflet M, Arveiler D, Montaye M, Wagner A, Ruidavets JB, Kee F, Evans A, Amouyel P, Ferrieres J, Empana JP. Ideal Cardiovascular Health and Incident Cardiovascular Disease: Heterogeneity Across Event Subtypes and Mediating Effect of Blood Biomarkers: The PRIME Study. J Am Heart Assoc 2017; 6:JAHA.117.006389. [PMID: 29042430 PMCID: PMC5721848 DOI: 10.1161/jaha.117.006389] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background The aim of this study was to investigate whether the association between baseline cardiovascular health (CVH) and incident cardiovascular disease differs according to coronary heart disease (CHD) and stroke subtypes, and to assess the mediating effect of inflammatory and hemostatic blood biomarkers. Methods and Results The association of ideal CVH with outcomes was derived in 9312 middle‐aged men from Northern Ireland and France (whole cohort) in multivariable Cox proportional hazards regression analysis. The mediating effect of baseline inflammatory and hemostatic blood biomarkers was evaluated in a case–control study nested within the cohort after 10 years of follow‐up. After a median follow‐up of 10 years, 614 first CHD events and 117 first stroke events were adjudicated. Compared with those with poor CVH, those with an ideal CVH profile at baseline had a 72% lower risk of CHD (hazard ratio=0.28; 95% confidence interval, 0.17; 0.46) and a 76% lower risk of stroke (hazard ratio =0.24; 95% confidence interval, 0.06; 0.98). The magnitude of the risk reductions was similar for incident angina and myocardial infarction, but was lower for ischemic stroke. In the controls, the mean concentrations of high‐sensitivity C‐reactive protein, IL‐6, and fibrinogen decreased with higher CVH status. Furthermore, the association of behavioral CVH with incident CHD was partly mediated by high‐sensitivity C‐reactive protein (16.69%), IL‐6 (8.52%), and fibrinogen (7.30%) Conclusions Our study shows no clear heterogeneity in the association of baseline CVH with the main subtypes of cardiovascular disease. This supports a universal promotion of ideal CVH for all cardiovascular disease subtypes. Furthermore, our mediation analysis suggests that the lower risk of CHD associated with ideal CVH is partly mediated by lower inflammatory and hemostatic blood biomarkers.
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Affiliation(s)
- Bamba Gaye
- INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Muriel Tafflet
- INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Dominique Arveiler
- The Strasbourg MONICA Project, Laboratoire d'épidémiologie et de santé publique, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, France
| | - Michèle Montaye
- The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, Lille, France
| | - Aline Wagner
- The Strasbourg MONICA Project, Laboratoire d'épidémiologie et de santé publique, Fédération de Médecine Translationnelle de Strasbourg, Université de Strasbourg, France
| | | | - Frank Kee
- The UKCRC Centre of Excellence for Public Health (NI), The Queen's University, Belfast, Northern Ireland
| | - Alun Evans
- The UKCRC Centre of Excellence for Public Health (NI), The Queen's University, Belfast, Northern Ireland
| | - Philippe Amouyel
- The Lille MONICA Project, INSERM, U1167, Institut Pasteur de Lille, Université Nord de France, Lille, France
| | - Jean Ferrieres
- The Toulouse MONICA Project, Toulouse University School of Medicine, Toulouse, France
| | - Jean-Philippe Empana
- INSERM, U970, Paris Cardiovascular Research Center, University Paris Descartes, Sorbonne Paris Cité, Paris, France
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27
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Simon M, Boutouyrie P, Narayanan K, Gaye B, Tafflet M, Thomas F, Guibout C, Périer MC, Pannier B, Jouven X, Empana JP. Sex disparities in ideal cardiovascular health. Heart 2017; 103:1595-1601. [PMID: 28754808 DOI: 10.1136/heartjnl-2017-311311] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 06/15/2017] [Accepted: 06/20/2017] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To quantify the gap in the distribution of ideal cardiovascular health (CVH) between men and women accounting for comorbidities, socioeconomic and psychological confounding factors. METHODS A cross-sectional analysis was conducted among 9012 French men and women aged 50-75 years who were participants of the Paris Prospective Study 3. Each of the seven metrics was defined according to the American Heart Association criteria, and the CVH was considered as poor (0 or 1 ideal health metric), intermediate (2, 3 or 4 ideal health metrics) and ideal (5-7 ideal health metrics). The odds of intermediate and ideal CVH in women compared with men were estimated by multivariate polytomous logistic regression analysis using poor CVH as the reference category. RESULTS The mean age was 59.49 year (SD 6.25) and there were 38.54% of women. Though women were slightly older, less educated, more deprived, more often depressed, they were twice more often in ideal CVH than men (14.77% vs 6.84%, p<0.0001). After adjustment for age, deprivation score, education and depression, women were four times more often in ideal CVH (OR 4.01, 95% CI 3.42 to 4.69) and two times more often in intermediate CVH (OR 2.07, 95% CI 1.88 to 2.28) than men. CONCLUSION The sex disparities in the prevalence of ideal CVH have the potential to guide sex-specific strategies for improving CVH status in the general population. CLINICAL TRIAL REGISTRATION NCT00741728;Pre-results.
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Affiliation(s)
- Marie Simon
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France
| | - Pierre Boutouyrie
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Department of Pharmacology, Georges Pompidou European Hospital, Paris, France
| | - Kumar Narayanan
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Maxcure Hospitals, Hyderabad, India
| | - Bamba Gaye
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Muriel Tafflet
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | | | - Catherine Guibout
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Marie-Cécile Périer
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
| | - Bruno Pannier
- Preventive and Clinical Investigation Center, Paris, France
| | - Xavier Jouven
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France.,Department of Cardiology, Georges Pompidou European Hospital, APHP, Paris, France
| | - Jean-Philippe Empana
- Department of Epidemiology, INSERM, UMR-S970, Paris Cardiovascular Research Center, Paris, France.,Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France
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28
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Veromaa V, Kautiainen H, Saxen U, Malmberg-Ceder K, Bergman E, Korhonen PE. Ideal cardiovascular health and psychosocial risk factors among Finnish female municipal workers. Scand J Public Health 2016; 45:50-56. [DOI: 10.1177/1403494816677661] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aims: Ideal cardiovascular health has been defined by the American Heart Association as the absence of disease and the presence of seven key health factors and behaviours. However, little is known about the mental aspects associated with ideal cardiovascular health metrics. The objective of this study was to assess the relationships between psychosocial risk factors and ideal cardiovascular health metrics among Finnish women at municipal work units. Method: A cross-sectional study was conducted in Finland among 732 female employees (mean±SD age 48±10 years) from ten work units in 2014. Ideal cardiovascular health metrics were evaluated with a physical examination, laboratory tests, medical history and self-administrated questionnaires. Psychosocial risk factors (social isolation, stress, depressive symptoms, anxiety, hostility and type D personality) were assessed with core questions as suggested by the European Society of Cardiology. Results: The prevalence of having 5–7 ideal cardiovascular health metrics was 183 (25.0%), of whom 54.1% had at least one psychosocial risk factor. Anxiety (31.3%), work stress (30.7%) and type D personality (26.1%) were the most prevalent of the psychosocial risk factors. The prevalence of depressive symptoms ( p<0.001) and type D personality ( p=0.049) decreased linearly according to the sum of ideal cardiovascular health metrics after adjustment for age and years of education. Conclusions: Even women with good cardiovascular health are affected by psychosocial risk factors at municipal work units. Although the association is possibly bidirectional, screening and treating depression and dealing with type D personality might be crucial in improving cardiovascular health among women.
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Affiliation(s)
- Veera Veromaa
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Finland
- Central Satakunta Health Federation of Municipalities, Finland
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, FinlandÕ) Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
- Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Finland
| | - Ulla Saxen
- Department of Psychiatry, Hospital District of Satakunta, Finland
| | - Kirsi Malmberg-Ceder
- Institute of Clinical Medicine, Department of Neurology, University of Turku and Turku, University Hospital, Finland
| | - Elina Bergman
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Finland
| | - Päivi E. Korhonen
- Institute of Clinical Medicine, Family Medicine, University of Turku and Turku University Hospital, Finland
- Central Satakunta Health Federation of Municipalities, Finland
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29
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Xiang X. History of major depression as a barrier to health behavior changes after a chronic disease diagnosis. J Psychosom Res 2016; 85:12-8. [PMID: 27212664 DOI: 10.1016/j.jpsychores.2016.04.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 04/02/2016] [Accepted: 04/04/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To examine whether changes in smoking, drinking, and physical activity after a chronic disease diagnosis differ between middle-aged and older adults with and without a history of major depression. METHODS Individual-level data came from 1996 to 2010 waves of the U.S. Health and Retirement Study. Chronic disease diagnosis was ascertained from self-reports of physician diagnosed diseases. Major depression was assessed by the short-form Composite International Diagnostic Interview. Mixed-effects logistic regressions were performed to estimate the potential moderating effect of a history of major depression. RESULTS Baseline major depression was associated with a more than 3-fold increase (OR=4.48, 95% CI=2.27-8.86) in the odds of smoking and 37% decrease (OR=0.63, 95% CI=0.52-0.75) in the odds of staying physically active, but not with odds of excessive drinking. After a chronic disease diagnosis, the odds of smoking was reduced by 75% (OR=0.25, 95% CI=0.20-0.32), the odds of excessive drinking was reduced by 47% (OR=0.53, 95% CI=0.47-0.61), and the odds of staying physically active was reduced by 30% (OR=0.70, 95% CI=0.63-0.78). There was a significant interaction effect for smoking such that the decline in the odds of smoking was smaller among adults with a history of major depression. CONCLUSION Chronic disease diagnosis may be an important teachable moment for health behavior change, but the behavior changing effect may be smaller for those with a history of major depression especially when it comes to smoking.
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Affiliation(s)
- Xiaoling Xiang
- Center for Education in Health Sciences, Feinberg School of Medicine, Northwestern University, 633 North St. Clair, 20th floor, Chicago, IL 60611, United States.
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