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Ghaddar F, Zeidan RK, Salameh P, Maupas-Schwalm F. Physical activity and odds of coronary heart disease among Lebanese women. BMC Public Health 2024; 24:516. [PMID: 38373923 PMCID: PMC10875797 DOI: 10.1186/s12889-024-18042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND It is known that physical activity (PA) is protective against cardiovascular morbidity and mortality. However, few studies have examined the association between PA, sedentary lifestyle and coronary heart disease (CHD) in women. This case-control study investigates the relationship between PA and sedentary behavior on CHD odds in Lebanese women over forty. METHODS One thousand five hundred selected Lebanese women (300 cases and 1200 controls) were included between 2018-2019. Cases were hospitalized women newly diagnosed with CHD, whereas the control groups were free of any heart diseases. Data on socio-demographic, lifestyle, cardiovascular factors, PA and sedentary lifestyle were collected. Multivariate logistic regressions, adjusted for covariates, were performed to investigate the association of PA domains and sedentary behavior with CHD. RESULTS A sedentary lifestyle combined with low activity levels increased the odds of CHD. Among cases, 46.7% participated in moderate or vigorous PA against almost 60.3% of controls. 36.3% of coronary patients had more than 10 h/day of sedentary time, with a positive correlation with CHD (adjusted OR: 1.533, 95%CI: 1.046-2.247). Conversely, moderate and high levels (respectively 600-3000 and ≥ 3000 metabolic equivalents [MET]-minutes/week) of domestic/garden PA revealed lower CHD odds (OR: 0.566, 95%CI: 0.396-0.808 and 0.193, 0.065-0.578 respectively). The detrimental influence of sedentary lifestyle appeared to be significantly reversed by weekly moderate PA, especially as weekly sedentary time was less (OR: 0.616, 95%CI: 0.427-0.888/ 6 to10h of sedentary time and OR: 0.537, 95% CI: 0.37-0.779/ ≤ 6 h), and except sedentary time exceeding 10 h daily. Two PA patterns revealed lower CHD odds: transport-related and domestic/garden PA, as early as low amount, even after adjustment for possible confounders. CONCLUSION The current study highlights the importance of combating sedentary behaviors and engaging in regular, easily accessible PA to reduce the odds of coronary disease among aging women. Therefore, better information regarding the benefits of physical activities such as transportation-related activities or gardening would be helpful in enhancing the prevention of CHD in aging women.
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Affiliation(s)
- Fatima Ghaddar
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon.
| | - Rouba K Zeidan
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
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Bodaghi AB, Ebadi E, Gholami MJ, Azizi R, Shariati A. A decreased level of high-density lipoprotein is a possible risk factor for type 2 diabetes mellitus: A review. Health Sci Rep 2023; 6:e1779. [PMID: 38125279 PMCID: PMC10731824 DOI: 10.1002/hsr2.1779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 10/19/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Introduction Type 2 diabetes mellitus (T2DM) is characterized primarily by dyslipidemia and hyperglycemia due to insulin resistance. High-density lipoprotein (HDL) play a significant role in preventing the incidence of dyslipidemia and its complications. HDL has different protective functions, such as reducing oxidation, vascular inflammation, and thrombosis; additionally, its anti-diabetic role is one of the most significant recent discoveries about HDL and some of its constituent lipoproteins. Methods This research reviews ongoing studies and preliminary investigations into the assessment of relation between decreased level of HDL and T2DM. Results The levels of HDL and its functions contribute to glucose hemostasis and the development of T2DM through four possible mechanisms, including insulin secretion by beta cells, peripheral insulin sensitivity, non-insulin-dependent glucose uptake, and adipose tissue metabolic activity. Additionally, the anti-oxidant properties of HDL protect beta cells from apoptosis caused by oxidative stress and inflammation induced by low-density lipoprotein, which facilitate insulin secretion. Conclusion Therefore, HDL and its compositions, especially Apo A-I, play an important role in regulating glucose metabolism, and decreased levels of HDL can be considered a risk factor for DM. Different factors, such as hypoalphalipoproteinemia that manifests as a consequence of genetic factors, such as Apo A-I deficiency, as well as secondary causes arising from lifestyle choices and underlying medical conditions that decrease the level of HDL, could be associated with DM. Moreover, intricate connections between HDL and diabetic complications extend beyond glucose metabolism to encompass complications like cardiovascular disease and kidney disease. Therefore, the exact interactions between HDL level and DM should be evaluated in future studies.
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Affiliation(s)
- Ali Bayat Bodaghi
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Erfan Ebadi
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Mohammad Javad Gholami
- Student Research CommitteeKhomein University of Medical SciencesKhomeinIran
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Reza Azizi
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
| | - Aref Shariati
- Molecular and Medicine Research CentreKhomein University of Medical SciencesKhomeinIran
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Franczyk B, Gluba-Brzózka A, Ciałkowska-Rysz A, Ławiński J, Rysz J. The Impact of Aerobic Exercise on HDL Quantity and Quality: A Narrative Review. Int J Mol Sci 2023; 24:ijms24054653. [PMID: 36902082 PMCID: PMC10003711 DOI: 10.3390/ijms24054653] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 02/17/2023] [Accepted: 02/22/2023] [Indexed: 03/06/2023] Open
Abstract
High-density lipoproteins comprise roughly 25-30% of the circulating proteins involved in the transport of lipids in circulation. These particles differ in size and lipid composition. Recent evidence suggests that the quality of HDL particles (which depends on shape, size and the composition of proteins and lipids determining HDL functionality) may be more important than their quantity. The functionality of HDL is mirrored by its cholesterol efflux activity, as well as its antioxidant (including the protection of LDL against oxidation), anti-inflammatory and antithrombotic properties. The results of many studies and meta-analyses imply the beneficial impact of aerobic exercise on HDL-C levels. Physical activity was found to be usually associated with an increase in HDL cholesterol and a decrease in LDL cholesterol and triglycerides. Exercise, apart from inducing quantitative alterations in serum lipids, exerts a beneficial impact on HDL particle maturation, composition and functionality. The Physical Activity Guidelines Advisory Committee Report underlined the importance of establishing a program recommending exercises that enable attainment of maximal advantage at the lowest level of risk. The aim of this manuscript is to review the impact of different types of aerobic exercise (various intensities and durations) on the level and quality of HDL.
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Affiliation(s)
- Beata Franczyk
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland
| | - Anna Gluba-Brzózka
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland
- Correspondence: ; Tel.: +48-42-639-3750
| | | | - Janusz Ławiński
- Department of Urology, Institute of Medical Sciences, Medical College of Rzeszow University, 35-055 Rzeszow, Poland
| | - Jacek Rysz
- Department of Nephrology, Hypertension and Family Medicine, Medical University of Lodz, 90-549 Lodz, Poland
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Cowan LT, Tome J, Mallhi AK, Tarasenko YN, Palta P, Evenson KR, Lakshminarayan K. Changes in physical activity and risk of ischemic stroke: The ARIC study. Int J Stroke 2023; 18:173-179. [PMID: 35361010 PMCID: PMC9887651 DOI: 10.1177/17474930221094221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Limited data exist regarding the impact of changes in physical activity (PA) over time on ischemic stroke risk. Exploring this understudied area could help improve stroke prevention strategies and promote PA during the lifespan. METHODS We evaluated 11,089 Atherosclerosis Risk in Communities (ARIC) participants recruited in 1987-1989 who completed Visit 3 (1993-1995). We classified PA as meeting recommendations, not meeting recommendations, or no PA. Categories of increased, decreased, stable high, and stable low PA and a continuous PA variable were also evaluated. Crude and adjusted Cox regression models were used to characterize the association of 6-year changes in PA and ischemic stroke risk. RESULTS Participants had a mean age of 60 years. During a median of 21 years, 762 ischemic stroke events occurred. Compared to the participants with recommended PA at both visits, those with no PA had 46% higher hazards of ischemic stroke (hazard ratio (HR) = 1.46 (95% confidence interval (CI) = 1.17, 1.82)), and those with recommended PA at Visit 1 and no PA at Visit 3 also had 37% higher hazards (HR = 1.37 (95% CI = 1.02, 1.83)). Participants who increased their PA from Visit 1 to Visit 3 had 23% lower hazard than those with stable low PA at both visits (HR = 0.77 (95% CI = 0.63, 0.94)), while those who decreased their PA had 25% higher hazards compared to those with stable high PA at both visits (HR = 1.25 (95% CI = 1.01, 1.54)). CONCLUSION Physical inactivity during midlife increases ischemic stroke risk, while meeting PA recommendations reduces it.
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Affiliation(s)
- Logan T Cowan
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Joana Tome
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Arshpreet Kaur Mallhi
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Yelena N Tarasenko
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Priya Palta
- Division of General Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kamakshi Lakshminarayan
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Vu K, Claggett BL, John JE, Skali H, Solomon SD, Mosley TH, Williams JE, Kucharska‐Newton A, Biering‐Sørensen T, Shah AM. Depressive Symptoms, Cardiac Structure and Function, and Risk of Incident Heart Failure With Preserved Ejection Fraction and Heart Failure With Reduced Ejection Fraction in Late Life. J Am Heart Assoc 2021; 10:e020094. [PMID: 34796739 PMCID: PMC9075356 DOI: 10.1161/jaha.120.020094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 05/24/2021] [Indexed: 12/31/2022]
Abstract
Background Depressive symptoms are associated with heightened risk of heart failure (HF), but their association with cardiac function and with HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF) in late life is unclear. We aimed to determine the prevalence of depression in HFpEF and in HFrEF in late life, and the association of depressive symptoms with cardiac function and incident HFpEF and HFrEF. Methods and Results We studied 6025 participants (age, 75.3±5.1 years; 59% women; 20% Black race) in the ARIC (Atherosclerosis Risk in Communities) study at visit 5 who underwent echocardiography and completed the Center for Epidemiologic Studies Depression Scale questionnaire. Among HF-free participants (n=5086), associations of Center for Epidemiologic Studies Depression Scale score with echocardiography and incident adjudicated HFpEF and HFrEF were assessed using multivariable linear and Cox proportional hazards regression. Prevalent HFpEF, but not HFrEF, was associated with a higher prevalence of depression compared with HF-free participants (P<0.001 and P=0.59, respectively). Among HF-free participants, Center for Epidemiologic Studies Depression Scale score was not associated with cardiac structure and function after adjusting for demographics and comorbidities (all P>0.05). Over 5.5-year follow-up, higher Center for Epidemiologic Studies Depression Scale score was associated with heightened risk of incident HFpEF (hazard ratio [HR] [95% CI], 1.06 [1.04-1.12]; P=0.02), but not HFrEF (HR [95% CI], 1.02 [0.96-1.08]; P=0.54), independent of echocardiographic measures, NT-proBNP (N-terminal pro-B-type natriuretic peptide), troponin, and hs-CRP (high-sensitivity C-reactive protein) (HR [95% CI], 1.06 [1.00-1.12]; P=0.04). Conclusions Worse depressive symptoms predict incident HFpEF in late life, independent of common comorbidities, cardiac structure and function, and prognostic biomarkers. Further studies are necessary to understand the mechanisms linking depression to risk of HFpEF.
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Affiliation(s)
- Katja Vu
- Brigham and Women’s HospitalHarvard Medical SchoolBostonMA
- Herlev and Gentofte HospitalUniversity of CopenhagenCopenhagenDenmark
| | | | - Jenine E. John
- Brigham and Women’s HospitalHarvard Medical SchoolBostonMA
| | - Hicham Skali
- Brigham and Women’s HospitalHarvard Medical SchoolBostonMA
| | | | | | | | | | | | - Amil M. Shah
- Brigham and Women’s HospitalHarvard Medical SchoolBostonMA
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Nagelkirk PR, Soave K, Altherr C, Del Pozzi A. Regular Resistance Training Enhances Fibrinolytic Potential but Does Not Affect Coagulation. Med Sci Sports Exerc 2021; 53:2318-2323. [PMID: 34115732 DOI: 10.1249/mss.0000000000002724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
PURPOSE This study aimed to identify effects of an 8-wk, whole-body RT program on coagulation and fibrinolysis. METHODS Sixteen healthy women and men (23 ± 5 yr) completed an RT program three times per week for 8 wk. Exercises included 2-3 sets of 8-12 repetitions performed at approximately 60%-80% of a one repetition maximum. Strength, body composition, and body circumferences were assessed before and after training. Plasma samples were obtained before and after training, and analyzed for active tissue plasminogen activator (tPA activity), total tissue plasminogen activator (tPA antigen), active plasminogen activator inhibitor-1 (PAI-1 activity), total plasminogen activator inhibitor-1 (PAI-1 antigen), fibrinogen, and coagulation factors VII (FVII) and VIII (FVIII). RESULTS Significant increases in lean mass, arm and thigh circumferences, maximal chest press (PRE: 57.8 ± 37.5 kg, POST: 73.3 ± 43.2 kg), and leg press (PRE: 189.5 ± 96.0 kg, POST: 256.7 ± 97.9 kg) were observed (P < 0.05 for all). PAI-1 activity (PRE: 20.3 ± 32.5 IU·mL-1, POST 9.5 ± 20.9 IU·mL-1) and PAI-1 antigen decreased (PRE: 10.2 ± 9.0 ng·dL-1, POST: 7.2 ± 5.7 ng·dL-1; both, P < 0.05). No change in tPA activity or tPA antigen occurred. Fibrinogen, FVII, and FVIII did not change after training. CONCLUSIONS Inhibition of fibrinolysis was decreased after training, and coagulation was unaffected. These results suggest that regular RT may beneficially influence the risk of a thrombotic event. More research is warranted to understand the mechanisms through which RT affects hemostasis.
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Affiliation(s)
- Paul R Nagelkirk
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
| | - Kayla Soave
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
| | | | - Andrew Del Pozzi
- Integrative Exercise Physiology Laboratory, Ball State University, Muncie, IN
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Mediano MFF, Mok Y, Coresh J, Kucharska-Newton A, Palta P, Lakshminarayan K, Rosamond WD, Matsushita K, Koton S. Prestroke Physical Activity and Adverse Health Outcomes After Stroke in the Atherosclerosis Risk in Communities Study. Stroke 2021; 52:2086-2095. [PMID: 33784831 PMCID: PMC8154698 DOI: 10.1161/strokeaha.120.032695] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 01/26/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND PURPOSE The association of physical activity (PA) before stroke (prestroke PA) with long-term prognosis after stroke is still unclear. We examined the association of prestroke PA with adverse health outcomes in the ARIC study (Atherosclerosis Risk in Communities). METHODS We included 881 participants with incident stroke occurring between 1993 and 1995 (visit 3) and December 31, 2016. Follow-up continued until December 31, 2017 to allow for at least 1-year after incident stroke. Prestroke PA was assessed using a modified version of the Baecke questionnaire in 1987 to 1989 (visit 1) and 1993 to 1995 (visit 3), evaluating PA domains (work, leisure, and sports) and total PA. We used Cox proportional hazards models to quantify the association between tertiles of accumulated prestroke PA levels over the 6-year period between visits 1 and 3 and mortality, risk of cardiovascular disease, and recurrent stroke after incident stroke. RESULTS During a median follow-up of 3.1 years after incident stroke, 676 (77%) participants had adverse outcomes. Highest prestroke total PA was associated with decreased risks of all-cause mortality (hazard ratio, 0.78 [95% CI, 0.63-0.97]) compared with lowest tertile. In the analysis by domain-specific PA, highest levels of work PA were associated with lower risk for all-cause (hazard ratio, 0.77 [95% CI, 0.62-0.96]) and cardiovascular mortality (hazard ratio, 0.45 [95% CI, 0.29-0.70]), and highest levels of leisure PA were associated with lower all-cause mortality (hazard ratio, 0.72 [95% CI, 0.58-0.89]) compared with lowest tertile of PA. No significant associations for sports PA were observed. CONCLUSIONS Higher levels of total prestroke PA as well as work and leisure PA were associated with lower risk of mortality after incident stroke. Public health strategies to increase lifetime PA should be encouraged to decrease long-term mortality after stroke.
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Affiliation(s)
- Mauro F. F. Mediano
- Evandro Chagas National Institute of Infectious Disease, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
- Department of Research and Education, National Institute of Cardiology, Rio de Janeiro, Brazil
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Yejin Mok
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Anna Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Priya Palta
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Kamakshi Lakshminarayan
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota, United States of America
| | - Wayne D. Rosamond
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, United States of America
| | - Kunihiro Matsushita
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Silvia Koton
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
- Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Kamimura D, Cain-Shields LR, Clark D, Oshunbade AA, Ashley KE, Guild CS, Loprinzi PD, Newton R, Blaha MJ, Suzuki T, Butler J, Hall JE, Correa A, Hall ME. Physical Activity, Inflammation, Coronary Artery Calcification, and Incident Coronary Heart Disease in African Americans: Insights From the Jackson Heart Study. Mayo Clin Proc 2021; 96:901-911. [PMID: 33714604 PMCID: PMC8026689 DOI: 10.1016/j.mayocp.2020.09.042] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/16/2020] [Accepted: 09/23/2020] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To examine associations between physical activity (PA), inflammation, coronary artery calcification (CAC), and incident coronary heart disease (CHD) in African Americans. METHODS Among Jackson Heart Study participants without prevalent CHD at baseline (n=4295), we examined the relationships between PA and high-sensitivity C-reactive protein, the presence of CAC (Agatston score ≥100), and incident CHD. Based on the American Heart Association's Life's Simple 7 metrics, participants were classified as having poor, intermediate, or ideal PA. RESULTS After adjustment for possible confounding factors, ideal PA was associated with lower high-sensitivity C-reactive protein levels (β, -0.15; 95% CI, -0.15 to -0.002) and a lower prevalence of CAC (odds ratio, 0.70; 95% CI, 0.51-0.96) compared with poor PA. During a median of 12.8 years of follow-up, there were 164 incident CHD events (3.3/1000 person-years). Ideal PA was associated with a lower rate of incident CHD compared with poor PA (hazard ratio, 0.55; 95% CI, 0.31-0.98). CONCLUSION In a large community-based African American cohort, ideal PA was associated with lower inflammation levels, a lower prevalence of CAC, and a lower rate of incident CHD. These findings suggest that promotion of ideal PA may be an important way to reduce the risk of subclinical and future clinical CHD in African Americans.
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Affiliation(s)
- Daisuke Kamimura
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan.
| | | | - Donald Clark
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | | | - Kellan E Ashley
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Cameron S Guild
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Paul D Loprinzi
- Center for Health Behavior Research, University of Mississippi, University
| | - Robert Newton
- PA & Ethnic Minority Health Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for Prevention of Heart Disease, Baltimore, MD
| | - Takeki Suzuki
- Department of Medicine, Indiana University School of Medicine, Indianapolis
| | - Javed Butler
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - John E Hall
- Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
| | - Adolfo Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson; Department of Physiology and Biophysics, Mississippi Center for Obesity Research, University of Mississippi Medical Center, Jackson
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Quinn TD, Yorio PL, Smith PM, Seo Y, Whitfield GP, Barone Gibbs B. Occupational physical activity and cardiovascular disease in the United States. Occup Environ Med 2021; 78:724-730. [PMID: 33737330 DOI: 10.1136/oemed-2020-106948] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 01/26/2021] [Accepted: 01/30/2021] [Indexed: 11/04/2022]
Abstract
BACKGROUND Emerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA. METHODS This cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: 'How often does your job involve…' (1) 'repeated lifting, pushing, pulling or bending?' (OE) and (2) 'standing or walking around?' (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1-149 or ≥150 min/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA. RESULTS Odds for CVD were higher when 'always' performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with 'never'. When restricting to never-smokers, odds for CVD were higher when 'always' performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus 'never'. CONCLUSION Associations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further.
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Affiliation(s)
- Tyler D Quinn
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA .,Health and Human Development, University of Pittsburgh School of Education, Pittsburgh, Pennsylvania, USA
| | - Patrick L Yorio
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA
| | - Peter M Smith
- Institute for Work & Health, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Yongsuk Seo
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Pittsburgh, Pennsylvania, USA
| | - Geoffrey P Whitfield
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Bethany Barone Gibbs
- Health and Human Development, University of Pittsburgh School of Education, Pittsburgh, Pennsylvania, USA
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Cuthbertson CC, Nichols HB, Tan X, Kucharska-Newton A, Heiss G, Joshu CE, Platz EA, Evenson KR. Associations of Leisure-Time Physical Activity and Television Viewing with Life Expectancy Cancer-Free at Age 50: The ARIC Study. Cancer Epidemiol Biomarkers Prev 2020; 29:2617-2625. [PMID: 32978174 PMCID: PMC7710595 DOI: 10.1158/1055-9965.epi-20-0870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 07/29/2020] [Accepted: 09/22/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Physical activity has been associated with longer chronic disease-free life expectancy, but specific cancer types have not been investigated. We examined whether leisure-time moderate-to-vigorous physical activity (LTPA) and television (TV) viewing were associated with life expectancy cancer-free. METHODS We included 14,508 participants without a cancer history from the Atherosclerosis Risk in Communities (ARIC) study. We used multistate survival models to separately examine associations of LTPA (no LTPA, RESULTS Compared with no LTPA, participants who engaged in LTPA ≥median had a greater life expectancy cancer-free from colorectal [men-2.2 years (95% confidence interval (CI), 1.7-2.7), women-2.3 years (95% CI, 1.7-2.8)], lung [men-2.1 years (95% CI, 1.5-2.6), women-2.1 years (95% CI, 1.6-2.7)], prostate [1.5 years (95% CI, 0.8-2.2)], and postmenopausal breast cancer [2.4 years (95% CI, 1.4-3.3)]. Compared with watching TV often/very often, participants who seldom/never watched TV had a greater colorectal, lung, and postmenopausal breast cancer-free life expectancy of ∼1 year. CONCLUSIONS Participating in LTPA was associated with longer life expectancy cancer-free from colorectal, lung, prostate, and postmenopausal breast cancer. Viewing less TV was associated with more years lived cancer-free from colorectal, lung, and postmenopausal breast cancer. IMPACT Increasing physical activity and reducing TV viewing may extend the number of years lived cancer-free.
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Affiliation(s)
- Carmen C Cuthbertson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
| | - Hazel B Nichols
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Xianming Tan
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Anna Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Corinne E Joshu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Elizabeth A Platz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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11
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Schilling R, Colledge F, Pühse U, Gerber M. Stress-buffering effects of physical activity and cardiorespiratory fitness on metabolic syndrome: A prospective study in police officers. PLoS One 2020; 15:e0236526. [PMID: 32722703 PMCID: PMC7386627 DOI: 10.1371/journal.pone.0236526] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/07/2020] [Indexed: 01/07/2023] Open
Abstract
Metabolic syndrome (MetS) is a worldwide health concern related to cardiovascular disease. Stress at work increases the risk for MetS, whereas physical activity and cardiorespiratory fitness (CF) have been shown to be potential buffers against stress. The aim of this study was to test the stress-buffering effects of physical activity and CF on the relationship between work stress and MetS. In a prospective study, we followed 97 police officers (mean age = 39.7 years; mean body mass index = 25.74 kg/m2) over one year and assessed MetS, as defined by the National Cholesterol Education Program Adult Treatment Panel III. Stress at work was measured with the Job Content Questionnaire, as well as the Effort-Reward Imbalance Questionnaire. Physical activity was assessed objectively via 7-day accelerometry. CF was assessed with the Åstrand bicycle ergometer test. Hierarchical linear regression models were carried out to predict MetS at follow-up (mean overall MetS score = 1.22), after controlling for baseline levels and sociodemographic background (mean overall MetS score = 1.19). Higher CF levels were significantly associated with lower MetS risk at follow-up (β = -.38). By contrast, no main effects were found for physical activity and work stress. However, high effort and demand were significantly correlated with increased blood pressure (effort: r = .23 for systolic blood pressure; r = .21 for diastolic blood pressure) and waist circumference (effort: r = .26; demand: r = .23). Moreover, no significant interaction effects occurred between work stress and CF/physical activity. The results emphasize the importance of high levels of CF in the prevention of MetS in police officers. Accordingly, provision of regular training opportunities and repeated CF testing should be considered as a strategy in overall corporate health promotion.
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Affiliation(s)
- René Schilling
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
- * E-mail:
| | - Flora Colledge
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Uwe Pühse
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
| | - Markus Gerber
- Department of Sport, Exercise and Health, University of Basel, Basel, Switzerland
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12
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Wang SY, Tan ASL, Claggett B, Chandra A, Khatana SAM, Lutsey PL, Kucharska-Newton A, Koton S, Solomon SD, Kawachi I. Longitudinal Associations Between Income Changes and Incident Cardiovascular Disease: The Atherosclerosis Risk in Communities Study. JAMA Cardiol 2020; 4:1203-1212. [PMID: 31596441 DOI: 10.1001/jamacardio.2019.3788] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Importance Higher income is associated with lower incident cardiovascular disease (CVD). However, there is limited research on the association between changes in income and incident CVD. Objective To examine the association between change in household income and subsequent risk of CVD. Design, Setting, and Participants The Atherosclerosis Risk In Communities (ARIC) study is an ongoing, prospective cohort of 15 792 community-dwelling men and women, of mostly black or white race, from 4 centers in the United States (Jackson, Mississippi; Washington County, Maryland; suburbs of Minneapolis, Minnesota; and Forsyth County, North Carolina), beginning in 1987. For our analysis, participants were followed up until December 31, 2016. Exposures Participants were categorized based on whether their household income dropped by more than 50% (income drop), remained unchanged/changed less than 50% (income unchanged), or increased by more than 50% (income rise) over a mean (SD) period of approximately 6 (0.3) years between ARIC visit 1 (1987-1989) and visit 3 (1993-1995). Main Outcomes and Measures Our primary outcome was incidence of CVD after ARIC visit 3, including myocardial infarction (MI), fatal coronary heart disease, heart failure (HF), or stroke during a mean (SD) of 17 (7) years. Analyses were adjusted for sociodemographic variables, health behaviors, and CVD biomarkers. Results Of the 8989 included participants (mean [SD] age at enrollment was 53 [6] years, 1820 participants were black [20%], and 3835 participants were men [43%]), 900 participants (10%) experienced an income drop, 6284 participants (70%) had incomes that remained relatively unchanged, and 1805 participants (20%) experienced an income rise. After full adjustment, those with an income drop experienced significantly higher risk of incident CVD compared with those whose incomes remained relatively unchanged (hazard ratio, 1.17; 95% CI, 1.03-1.32). Those with an income rise experienced significantly lower risk of incident CVD compared with those whose incomes remained relatively unchanged (hazard ratio, 0.86; 95% CI, 0.77-0.96). Conclusions and Relevance Income drop over 6 years was associated with higher risk of subsequent incident CVD over 17 years, while income rise over 6 years was associated with lower risk of subsequent incident CVD over 17 years. Health professionals should have greater awareness of the influence of income change on the health of their patients.
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Affiliation(s)
- Stephen Y Wang
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.,Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | - Andy S L Tan
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Brian Claggett
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Alvin Chandra
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Sameed Ahmed M Khatana
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts.,Division of Cardiovascular Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Pamela L Lutsey
- University of Minnesota School of Public Health, Minneapolis
| | - Anna Kucharska-Newton
- University of North Carolina Gillings School of Global Public Health, Chapel Hill.,University of Kentucky College of Public Health, Lexington
| | - Silvia Koton
- School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Israel.,Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Scott D Solomon
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Ichiro Kawachi
- Harvard T. H. Chan School of Public Health, Boston, Massachusetts
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13
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Wang C, De Roos AJ, Fujishiro K, Allison MA, Wallace R, Seguin RA, Nassir R, Michael YL. Occupational Physical Activity and Coronary Heart Disease in Women's Health Initiative Observational Study. J Gerontol A Biol Sci Med Sci 2020; 74:1952-1958. [PMID: 30590438 DOI: 10.1093/gerona/gly288] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Women comprise nearly half of the labor force in our society, but the impact of the occupational psychical activity on women's heart health in later life was unclear. We conducted a case-cohort study to assess the association of occupational physical activity (OPA), alone and jointly with leisure-time physical activity (LTPA) and risk of coronary heart disease (CHD). METHODS We included women enrolled in Women's Health Initiative Observational Study who provided an occupational history at baseline and were followed until 2013 for the first occurrence of myocardial infarction or death from CHD (mean age ± SD = 63.4 ± 7.2). A total of 5,243 women free of CHD at baseline were randomly selected into a subcohort and 3,421 CHD events were adjudicated during follow-up. Through linkage of Standard Occupational Classification codes to the Occupational Information Network, we assessed cumulative and most recent exposure of OPA. LTPA was assessed through Women's Health Initiative's physical activity questionnaire. Weighted Cox proportional hazard models were used to evaluate CHD risk. RESULTS After adjustment for demographic and socioeconomic factors, levels of OPA were not associated with CHD risk. Compared with women with low OPA and high LTPA, women with moderate to high cumulative OPA and low LTPA had relative high CHD risk (hazard ratio [HR]: 1.54, 95% confidence interval [CI]: 1.26, 1.88 for moderate OPA and HR: 1.46. 95% CI: 1.20, 1.78 for high OPA). DISCUSSION Results from this study suggest no overall association between lifetime OPA and CHD risk in women, but the impact of OPA varies by LTPA levels.
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Affiliation(s)
- Conglong Wang
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Anneclaire J De Roos
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
| | - Kaori Fujishiro
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, Ohio
| | - Matthew A Allison
- Department of Family Medicine and Public Health University of California, San Diego, La Jolla
| | - Robert Wallace
- Department of Preventive Medicine and Environmental Health, University of Iowa, Ithaca, New York
| | - Rebecca A Seguin
- Division of Nutritional Sciences, Cornell University, Ithaca, New York
| | - Rami Nassir
- Department of Biochemistry and Molecular Medicine, University of California, Davis
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
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14
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Zhou X, van der Werf J, Carson-Chahhoud K, Ni G, McGrath J, Hyppönen E, Lee SH. Whole-Genome Approach Discovers Novel Genetic and Nongenetic Variance Components Modulated by Lifestyle for Cardiovascular Health. J Am Heart Assoc 2020; 9:e015661. [PMID: 32308100 PMCID: PMC7428517 DOI: 10.1161/jaha.119.015661] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Both genetic and nongenetic factors can predispose individuals to cardiovascular risk. Finding ways to alter these predispositions is important for cardiovascular disease prevention. Methods and Results We used a novel whole‐genome approach to estimate the genetic and nongenetic effects on—and hence their predispositions to—cardiovascular risk and determined whether they vary with respect to lifestyle factors such as physical activity, smoking, alcohol consumption, and dietary intake. We performed analyses on the ARIC (Atherosclerosis Risk in Communities) Study (N=6896–7180) and validated findings using the UKBB (UK Biobank, N=14 076–34 538). Lifestyle modulation was evident for many cardiovascular traits such as body mass index and resting heart rate. For example, alcohol consumption modulated both genetic and nongenetic effects on body mass index, whereas smoking modulated nongenetic effects on heart rate, pulse pressure, and white blood cell count. We also stratified individuals according to estimated genetic and nongenetic effects that are modulated by lifestyle factors and showed distinct phenotype–lifestyle relationships across the stratified groups. Finally, we showed that neglecting lifestyle modulations of cardiovascular traits would on average reduce single nucleotide polymorphism heritability estimates of these traits by a small yet significant amount, primarily owing to the overestimation of residual variance. Conclusions Lifestyle changes are relevant to cardiovascular disease prevention. Individual differences in the genetic and nongenetic effects that are modulated by lifestyle factors, as shown by the stratified group analyses, implies a need for personalized lifestyle interventions. In addition, single nucleotide polymorphism–based heritability of cardiovascular traits without accounting for lifestyle modulations could be underestimated.
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Affiliation(s)
- Xuan Zhou
- Australian Centre for Precision Health University of South Australia Adelaide South Australia Australia.,South Australian Health and Medical Research Institute Adelaide South Australia Australia
| | - Julius van der Werf
- School of Environmental and Rural Science University of New England Armidale New South Wales Australia
| | - Kristin Carson-Chahhoud
- Australian Centre for Precision Health University of South Australia Adelaide South Australia Australia
| | - Guiyan Ni
- School of Environmental and Rural Science University of New England Armidale New South Wales Australia.,Institute for Molecular Bioscience University of Queensland Brisbane Queensland Australia
| | - John McGrath
- Queensland Brain Institute University of Queensland Brisbane Queensland Australia.,Queensland Centre for Mental Health Research The Park Centre for Mental Health Wacol Queensland Australia
| | - Elina Hyppönen
- Australian Centre for Precision Health University of South Australia Adelaide South Australia Australia.,South Australian Health and Medical Research Institute Adelaide South Australia Australia
| | - S Hong Lee
- Australian Centre for Precision Health University of South Australia Adelaide South Australia Australia.,South Australian Health and Medical Research Institute Adelaide South Australia Australia
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15
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O'Connor LE, Hu EA, Steffen LM, Selvin E, Rebholz CM. Adherence to a Mediterranean-style eating pattern and risk of diabetes in a U.S. prospective cohort study. Nutr Diabetes 2020; 10:8. [PMID: 32198350 PMCID: PMC7083875 DOI: 10.1038/s41387-020-0113-x] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A Mediterranean-style eating pattern is consistently associated with a decreased diabetes risk in Mediterranean and European populations. However, results in U.S. populations are inconsistent. The objective of this study was to assess whether a Mediterranean-style eating pattern would be associated with diabetes risk in a large, nationally representative U.S. cohort of black and white men and women. METHODS Participants from the Atherosclerosis Risk in Communities study prospective cohort without diabetes, cardiovascular disease, or cancer at baseline (visit 1, 1987-1989; n = 11,991) were included (mean age 54 years, 56% female, 75% white). Alternate Mediterranean Diet scores (aMed) were calculated using the mean dietary intake self-reported at visit 1 and visit 3 (1993-1995) or visit 1 only for participants censored before visit 3. Participants were followed from visit 1 through 31 December 2016 for incident diabetes. We used Cox regression models to characterize associations of aMed (quintiles as well as per 1-point higher) with incident diabetes adjusted for energy intake, age, sex, race and study center, and education (Model 1) for all participants then stratified by race and body mass index (BMI). Model 2 included potential mediating behavioral and clinical measures associated with diabetes. Results are presented as hazard ratios and 95% confidence intervals. RESULTS Over a median follow-up of 22 years, there were 4024 incident cases of diabetes. Higher aMed scores were associated with lower diabetes risk [Model 1: 0.83 (0.73-0.94) for Q5 vs Q1 (p-trend < 0.001) and 0.96 (0.95-0.98) for 1-point higher]. Associations were stronger for black vs white participants (interaction p < 0.001) and weaker for obese vs normal BMI (interaction p < 0.01). Associations were attenuated but statistically significant in Model 2. CONCLUSIONS An eating pattern high in fruits, vegetables, whole grains, legumes, nuts, and fish, and moderate in alcohol was associated with a lower risk of diabetes in a community-based U.S. POPULATION
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Affiliation(s)
- Lauren E O'Connor
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Division of Cancer Prevention, National Cancer Institute, National Institutes of Health, Rockville, MD, USA
| | - Emily A Hu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Casey M Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
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16
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Kats D, Evenson KR, Zeng D, Avery CL, Palta P, Kritchevsky SB, Heiss G. Leisure-time physical activity volume, intensity, and duration from mid- to late-life in U.S. subpopulations by race and sex. The Atherosclerosis Risk In Communities (ARIC) Study. Aging (Albany NY) 2020; 12:4592-4602. [PMID: 32170049 PMCID: PMC7093185 DOI: 10.18632/aging.102916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Accepted: 03/02/2020] [Indexed: 11/25/2022]
Abstract
Mitigating age-related disease and disability presents challenges. Physical activity (PA) may be influential for prolonging health and functioning, warranting characterization of its patterns over the life course in population-based data. With the availability of up to three self-reported assessments of past year leisure-time PA (LTPA) over multiple decades in 15,036 participants (26% African American; 55% women; mean baseline age=54; median follow-up=23 years) from the Atherosclerosis Risk in Communities (ARIC) Study sampled from four U.S. communities, race-sex-stratified trajectories of average weekly intensity (metabolic equivalent of task (MET)), duration (hours), and energy expenditure or volume (MET-h) of LTPA were developed from age 45 to 90 using joint models to accommodate expected non-ignorable attrition. Declines in weekly LTPA intensity, duration, and volume from age 70 to 90 were observed in white women (2.9 to 1.2 MET; 2.5 to 0.6 h; 11.1 to 2.6 MET-h), white men (2.5 to 1.0 MET; 3.5 to 1.8 h; 15.5 to 6.4 MET-h), African American women (2.5 to 2.4 MET; 0.8 to 0.1 h; 6.7 to 6.0 MET-h), and African American men (2.3 to 1.4 MET; 1.5 to 0.6 h; 8.0 to 2.3 MET-h). These data reveal population-wide shifts towards less active lifestyles in older adulthood.
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Affiliation(s)
- Dmitry Kats
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Kelly R. Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Donglin Zeng
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Christy L. Avery
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Priya Palta
- Division of General Medicine, Department of Medicine, Columbia University Medical Center, New York, NY 10032, USA
| | - Stephen B. Kritchevsky
- Sticht Center on Aging, Wake Forest School of Medicine, Wake Forest University, Winston-Salem, NC 27157, USA
| | - Gerardo Heiss
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC 27599, USA
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17
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Hu EA, Steffen LM, Coresh J, Appel LJ, Rebholz CM. Adherence to the Healthy Eating Index-2015 and Other Dietary Patterns May Reduce Risk of Cardiovascular Disease, Cardiovascular Mortality, and All-Cause Mortality. J Nutr 2020; 150:312-321. [PMID: 31529069 PMCID: PMC7373820 DOI: 10.1093/jn/nxz218] [Citation(s) in RCA: 101] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/29/2019] [Accepted: 08/12/2019] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The Healthy Eating Index-2015 (HEI-2015) score measures adherence to recommendations from the 2015-2020 Dietary Guidelines for Americans. The HEI-2015 was altered from the HEI-2010 by reclassifying sources of dietary protein and replacing the empty calories component with 2 new components: saturated fats and added sugars. OBJECTIVES Our aim was to assess whether the HEI-2015 score, along with 3 other previously defined indices, were associated with incident cardiovascular disease (CVD), CVD mortality, and all-cause mortality. METHODS We conducted a prospective analysis of 12,413 participants aged 45-64 y (56% women) from the Atherosclerosis Risk in Communities (ARIC) Study. The HEI-2015, Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension Trial (DASH) scores were computed using the average dietary intakes of Visits 1 (1987-1989) and 3 (1993-1995). Incident CVD, CVD mortality, and all-cause mortality data were ascertained from baseline through 31 December, 2017. We used Cox proportional hazards models to estimate HRs and 95% CIs. RESULTS There were 4509 cases of incident CVD, 1722 cases of CVD mortality, and 5747 cases of all-cause mortality over a median of 24-25 y of follow-up. Compared with participants in the lowest quintile of HEI-2015, participants in the highest quintile had a 16% lower risk of incident CVD (HR: 0.84; 95% CI: 0.76-0.93; P-trend < 0.001), 32% lower risk of CVD mortality (HR: 0.68; 95% CI: 0.58-0.80; P-trend < 0.001), and 18% lower risk of all-cause mortality (HR: 0.82; 95% CI: 0.75-0.89; P-trend < 0.001) after adjusting for demographic and lifestyle covariates. There were similar protective associations for AHEI-2010, aMed, and DASH scores, and no significant interactions by race. CONCLUSIONS Higher adherence to the 2015-2020 Dietary Guidelines for Americans was associated with lower risks of incident CVD, CVD mortality, and all-cause mortality among US adults.
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Affiliation(s)
- Emily A Hu
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Address correspondence to CMR (e-mail: )
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18
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Hu EA, Wu A, Dearborn JL, Gottesman RF, Sharrett AR, Steffen LM, Coresh J, Rebholz CM. Adherence to Dietary Patterns and Risk of Incident Dementia: Findings from the Atherosclerosis Risk in Communities Study. J Alzheimers Dis 2020; 78:827-835. [PMID: 33044177 PMCID: PMC7934551 DOI: 10.3233/jad-200392] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Previous studies have suggested that adherence to healthy dietary patterns during late life may be associated with improved cognition. However, few studies have examined the association between healthy dietary patterns during midlife and incident dementia. OBJECTIVE Our study aimed to determine the association between adherence to healthy dietary patterns at midlife and incident dementia. METHODS We included 13,630 adults from the Atherosclerosis Risk in Communities (ARIC) Study in our prospective analysis. We used food frequency questionnaire responses to calculate four dietary scores: Healthy Eating Index-2015 (HEI-2015), Alternative Healthy Eating Index-2010 (AHEI-2010), alternate Mediterranean (aMed) diet, and Dietary Approaches to Stop Hypertension (DASH). Participants were followed until the end of 2017 for incident dementia. Cox regression models adjusted for covariates were used to estimate risk of incident dementia by quintile of dietary scores. RESULTS Over a median of 27 years, there were 2,352 cases of incident dementia documented. Compared with participants in quintile 1 of HEI-2015, participants in quintile 5 (healthiest) had a 14% lower risk of incident dementia (hazard ratio, HR: 0.86, 95% confidence interval, CI: 0.74-0.99). There were no significant associations of incident dementia with the AHEI-2010, aMed, or DASH scores. There were no significant interactions by sex, age, race, education, physical activity, hypertension, or obesity. CONCLUSION Adherence to the HEI-2015, but not the other dietary scores, during midlife was associated with lower risk of incident dementia. Further research is needed to elucidate whether timing of a healthy diet may influence dementia risk.
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Affiliation(s)
- Emily A. Hu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Aozhou Wu
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jennifer L. Dearborn
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut
| | - Rebecca F. Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - A. Richey Sharrett
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Casey M. Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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19
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Hu EA, Lazo M, Rosenberg SD, Grams ME, Steffen LM, Coresh J, Rebholz CM. Alcohol Consumption and Incident Kidney Disease: Results From the Atherosclerosis Risk in Communities Study. J Ren Nutr 2020; 30:22-30. [PMID: 30850190 PMCID: PMC6728235 DOI: 10.1053/j.jrn.2019.01.011] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/16/2019] [Accepted: 01/21/2019] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE(S) Moderate alcohol consumption has been found to be associated with lower risk of coronary heart disease and myocardial infarction, which share similar risk factors and pathophysiology with chronic kidney disease (CKD). However, there is inconsistent evidence on the association between alcohol consumption and CKD. DESIGN AND METHODS We conducted a prospective analysis of 12,692 participants aged 45-64 years from the Atherosclerosis Risk in Communities (ARIC) study. We categorized participants into 6 alcohol consumption categories: never drinkers, former drinkers, ≤1 drink per week, 2 to 7 drinks per week, 8 to 14 drinks per week, and ≥15 drinks per week based on food frequency questionnaire responses at visit 1 (1987-1989). Incident CKD was defined as estimated glomerular filtration rate <60 mL/minute/1.73 m2 accompanied by ≥25% estimated glomerular filtration rate decline, a kidney disease-related hospitalization or death or end-stage renal disease. RESULTS During a median follow-up of 24 years, there were 3,664 cases of incident CKD. Current drinkers were more likely to be men, whites, and to have a higher income level and education level. After adjusting for total energy intake, age, sex, race-center, income, education level, health insurance, smoking, and physical activity, there was no significant association between being a former drinker and risk of incident CKD. Participants who drank ≤1 drink per week, 2 to 7 drinks per week, 8 to 14 drinks per week, and ≥15 drinks per week had, respectively, a 12% (hazard ratio [HR]: 0.88, 95% confidence interval [CI]: 0.79-0.97), 20% (HR: 0.80, 95% CI: 0.72-0.89), 29% (HR: 0.71, 95% CI: 0.62-0.83), and 23% (HR: 0.77, 95% CI: 0.65-0.91) lower risk of CKD compared with never drinkers. CONCLUSION(S) Consuming a low or moderate amount of alcohol may lower the risk of developing CKD. Therefore, moderate consumption of alcohol may not likely be harmful to the kidneys.
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Affiliation(s)
- Emily A Hu
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Mariana Lazo
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Sarah D Rosenberg
- Department of Medicine, University of California San Diego, San Diego, California
| | - Morgan E Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Division of Nephrology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, Maryland; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
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20
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Lu Y, Ballew SH, Kwak L, Selvin E, Kalbaugh CA, Schrack JA, Matsushita K, Szklo M. Physical Activity and Subsequent Risk of Hospitalization With Peripheral Artery Disease and Critical Limb Ischemia in the ARIC Study. J Am Heart Assoc 2019; 8:e013534. [PMID: 31642360 PMCID: PMC6898846 DOI: 10.1161/jaha.119.013534] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Whether physical activity is a determinant of peripheral artery disease (PAD) remains unclear. We therefore assessed the association of physical activity (amount and intensity) with subsequent risk of hospitalization with PAD and its severe form, critical limb ischemia, in the ARIC (Atherosclerosis Risk in Communities) study. Methods and Results We included 12 513 participants free of cardiovascular disease at baseline (1987–1989), with a mean age of 53.9 years, 55.3% women, and 25.0% black. Physical activity was assessed using a modified Baecke questionnaire and categorized into poor (no moderate [3 to <6 metabolic equivalents] or vigorous [≥6 metabolic equivalents] exercise), intermediate (1–74 min/wk vigorous or 1–149 min/wk moderate plus vigorous exercise), and recommended (≥75 min/wk vigorous or ≥150 min/wk moderate plus vigorous exercise). We also modeled moderate and vigorous exercise individually. All analyses applied Cox regression models. Intermediate and recommended exercise were seen in 24.7% and 38.1%, respectively. During a median follow‐up of 25.4 years, 434 incident hospitalizations with PAD (166 critical limb ischemia) were documented. Recommended versus poor activity was associated with a lower demographically adjusted PAD risk (hazard ratio, 0.68; 95% CI, 0.54–0.85) but attenuated after accounting for lifestyle factors (hazard ratio, 0.84; 95% CI, 0.66–1.05). When analyzing moderate and vigorous exercise separately, vigorous exercise was robustly related to lower risk of hospitalization with PAD, and critical limb ischemia in particular (hazard ratio, 0.72; 95% CI, 0.54–0.97 per 200 metabolic equivalents*min/wk increment in the most extended model). Conclusions Higher amount and intensity of physical activity were related to lower risks of hospitalization with PAD and critical limb ischemia, further highlighting the importance of engaging in physical activity for vascular health.
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Affiliation(s)
- Yifei Lu
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Shoshana H Ballew
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Lucia Kwak
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Elizabeth Selvin
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Corey A Kalbaugh
- Department of Public Health Sciences Clemson University Clemson SC
| | - Jennifer A Schrack
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Kunihiro Matsushita
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
| | - Moyses Szklo
- Department of Epidemiology Johns Hopkins Bloomberg School of Public Health Baltimore MD
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21
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Cuthbertson CC, Tan X, Heiss G, Kucharska‐Newton A, Nichols HB, Kubota Y, Evenson KR. Associations of Leisure-Time Physical Activity and Television Viewing With Life Expectancy Free of Nonfatal Cardiovascular Disease: The ARIC Study. J Am Heart Assoc 2019; 8:e012657. [PMID: 31495291 PMCID: PMC6818021 DOI: 10.1161/jaha.119.012657] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Accepted: 07/22/2019] [Indexed: 02/06/2023]
Abstract
Background High levels of physical activity have been associated with longer life expectancy free of cardiovascular disease (CVD), but specific types of CVD and sedentary behavior have not been examined. We examined associations of leisure-time moderate-to-vigorous physical activity (LTPA) and television viewing with life expectancy free of 3 types of CVD. Methods and Results We included 13 534 participants from the ARIC (Atherosclerosis Risk in Communities) cohort. We used multistate survival models to estimate associations of LTPA in the past year (no LTPA, less than the median, equal to or greater than the median) and television viewing (often or very often, sometimes, seldom or rarely) with life expectancy at age 50 free of nonfatal coronary heart disease (CHD), stroke, and heart failure (HF). Over 27 years of follow-up, 4519 participants developed one of the 3 nonfatal CVDs and 5475 deaths occurred. Compared with participants who engaged in no LTPA, participants who engaged in LTPA equal to or greater than the median had longer life expectancy free of nonfatal CHD (men: 1.5 years [95% CI, 1.0-2.0]; women: 1.6 years [95% CI, 1.1-2.2]), stroke (men: 1.8 years [95% CI, 1.2-2.3]; women: 1.8 years [95% CI, 1.3-2.3]), and HF (men: 1.6 years [95% CI, 1.1-2.1]; women: 1.7 years [95% CI, 1.2-2.2]). Compared with viewing more television, watching less television was associated with longer life expectancy free of CHD, stroke, and HF (≈0.8 year). Conclusions Higher levels of LTPA and less television viewing were associated with longer life expectancy free of CHD, stroke, and HF. Engaging in LTPA and watching less television may increase the number of years lived free of CHD, stroke, and HF.
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Affiliation(s)
| | - Xianming Tan
- Department of BiostatisticsUniversity of North Carolina at Chapel HillNC
| | - Gerardo Heiss
- Department of EpidemiologyUniversity of North Carolina at Chapel HillNC
| | | | - Hazel B. Nichols
- Department of EpidemiologyUniversity of North Carolina at Chapel HillNC
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease PreventionOsakaJapan
| | - Kelly R. Evenson
- Department of EpidemiologyUniversity of North Carolina at Chapel HillNC
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22
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Yang HC, Liang Y, Hsu HC, Shu JH, Chou RH, Hsu PF, Wang YJ, Ding YZ, Liou TL, Wang YW, Huang SS, Lin CC, Lu TM, Leu HB, Chan WL, Lin SJ. InVestiGation of the Association of Physical Activity and Sedentary Behavior with tHe Occurrence of Future Cardiovascular Disease and Long Term Outcome in General Population Using the HEALTHCARE Database ( VGH-HEALTHCARE). ACTA CARDIOLOGICA SINICA 2019; 35:534-541. [PMID: 31571803 PMCID: PMC6760128 DOI: 10.6515/acs.201909_35(5).20190126a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 01/26/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Current evidence supports the beneficial effect of physical activity in reducing adverse events, however studies on Asian populations are limited and have reported inconsistent findings. The aim of this study was to investigate the association between physical activity and the development of cardiovascular disease, diabetes, hypertension and malignancy in a large Asian cohort. We also investigated interactions between the intensity of physical activity, environmental exposure and biochemical markers. METHODS Subjects who received annual checkups at Taipei Veterans General Hospital were invited to join this study. Information on physical activity was evaluated using the International Physical Activity Questionnaire Short Form (IPAQ-SF). Associations between the occurrence of clinical events including cardiovascular events, diabetes and malignancies and the intensity of physical activity, biochemical markers, imaging findings, personality trait evaluations and nutrition were evaluated. RESULTS In the initial stage of this study, a total of 1010 patients enrolled, 626 (62%) were male, 74 (7.4%) had diabetes, 183 (18.3%) had hypertension, and 220 (21.8%) were smokers. The total cholesterol was 202.1 ± 36.2 mg/dL and low-density lipoprotein-cholesterol was 125.7 ± 32.9 mg/dL, including 49.3 ± 13.1 mg/dL for serum high-density lipoprotein-cholesterol and 120.7 ± 70.7 mg/dL for triglycerides. The fasting glucose level was 93.8 ± 21.9 mg/dL, and HbA1c was 5.7 ± 0.7%. All information collected will be incorporated with future events to analyze the relationship between biochemical parameters, physical activity and future adverse events. CONCLUSIONS These findings will contribute to the understanding of the value of physical activity in determining future cardiovascular and non-cardiovascular events in Asian populations.
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Affiliation(s)
| | - Ying Liang
- Department of Nursing
- Healthcare and Management Center, Taipei Veterans General Hospital
| | - Hsiu-Chuan Hsu
- Department of Nursing
- Healthcare and Management Center, Taipei Veterans General Hospital
| | - Jiah-Hwang Shu
- Department of Nursing
- Healthcare and Management Center, Taipei Veterans General Hospital
| | | | - Pai-Feng Hsu
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
| | - Yuan-Jen Wang
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
| | - Yaw-Zon Ding
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
| | - Teh-Ling Liou
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
| | - Ying-Wen Wang
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
| | - Shao-Sung Huang
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
| | - Chung-Chi Lin
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Institute of Public Health, National Yang-Ming University, Taipei, Taiwan
| | - Tse-Min Lu
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
| | - Hsin-Bang Leu
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
| | - Wan-Leong Chan
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
| | - Shing-Jong Lin
- Healthcare and Management Center, Taipei Veterans General Hospital
- School of Medicine
- Cardiovascular Research Center
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23
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Hu EA, Steffen LM, Grams ME, Crews DC, Coresh J, Appel LJ, Rebholz CM. Dietary patterns and risk of incident chronic kidney disease: the Atherosclerosis Risk in Communities study. Am J Clin Nutr 2019; 110:713-721. [PMID: 31386145 PMCID: PMC6736122 DOI: 10.1093/ajcn/nqz146] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 06/19/2019] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Adherence to healthy dietary patterns, measured by the Healthy Eating Index (HEI), Alternative Healthy Eating Index (AHEI), and alternate Mediterranean diet (aMed) scores, is associated with a reduced risk of cardiovascular disease. The association between these scores and chronic kidney disease (CKD) is undetermined. OBJECTIVE We aimed to estimate the association between the HEI, AHEI, and aMed scores and risk of incident CKD. METHODS We conducted a prospective analysis in 12,155 participants aged 45-64 y from the Atherosclerosis Risk in Communities (ARIC) Study. We calculated HEI-2015, AHEI-2010, and aMed scores for each participant and categorized them into quintiles of each dietary score. Incident CKD was defined as an estimated glomerular filtration rate <60 mL/min/1.73 m2 accompanied by ≥25% decline in estimated glomerular filtration rate, a kidney disease-related hospitalization or death, or end-stage renal disease. We used cause-specific hazard models to estimate risk of CKD from the quintile of the dietary score through to 31 December 2017. RESULTS There were 3980 cases of incident CKD over a median follow-up of 24 y. Participants who had higher adherence to the HEI-2015, AHEI-2010, and aMed scores were more likely to be female, have higher educational attainment, higher income level, be nonsmokers, more physically active, and diabetic compared with participants who scored lower. All 3 dietary scores were associated with lower CKD risk (P-trend < 0.001). Participants who were in the highest quintile of HEI-2015 score had a 17% lower risk of CKD (HR: 0.83; 95% CI: 0.74, 0.92) compared with participants in the lowest quintile. Those in quintile 5 of AHEI-2010 and aMed scores, respectively, had a 20% and 13% lower risk of CKD compared with those in quintile 1. CONCLUSION Higher adherence to healthy dietary patterns during middle age was associated with lower risk of CKD.
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Affiliation(s)
- Emily A Hu
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Morgan E Grams
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Deidra C Crews
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Josef Coresh
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lawrence J Appel
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Casey M Rebholz
- Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University, Baltimore, MD, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Address correspondence to CMR (E-mail: )
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24
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Garg PK, O'Neal WT, Mok Y, Heiss G, Coresh J, Matsushita K. Life's Simple 7 and Peripheral Artery Disease Risk: The Atherosclerosis Risk in Communities Study. Am J Prev Med 2018; 55:642-649. [PMID: 30342629 PMCID: PMC6198658 DOI: 10.1016/j.amepre.2018.06.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 03/16/2018] [Accepted: 06/15/2018] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The American Heart Association's Life's Simple 7 includes seven metrics of ideal cardiovascular health to target for cardiovascular disease prevention. This study determined the relationship between Life's Simple 7 and incident peripheral artery disease in a biracial cohort of middle- and older-aged adults. METHODS This analysis included 12,865 participants from the Atherosclerosis Risk in Communities study recruited between 1987 and 1989 (mean age=54years, 55% women, 25% black) and free of peripheral artery disease or other cardiovascular disease at baseline. Overall, Life's Simple 7 score was calculated as the sum of the Life's Simple 7 component scores (two points if ideal, one point if intermediate, and zero if poor) and classified as inadequate (zero to four), average (five to nine), or optimal (ten to 14) cardiovascular health and linked to incident peripheral artery disease identified by hospital discharge diagnosis and leg revascularization. Analysis was conducted in 2017. RESULTS A total of 434 incident peripheral artery disease cases occurred over a median follow-up of 24.4years. Compared with the inadequate category (n=1,008), participants in the average (n=8,395) and optimal (n=3,462) categories each had a substantially lower risk of developing peripheral artery disease in a Cox proportional hazards model adjusted for potential confounders (hazard ratio=0.36, 95% CI=0.28, 0.46 for average, and hazard ratio=0.09, 95% CI=0.06, 0.15 for optimal). In a similar model, a one-point higher Life's Simple 7 score was associated with a 25% lower risk of incident peripheral artery disease (hazard ratio=0.75, 95% CI=0.72, 0.79). CONCLUSIONS Better cardiovascular health, as defined by higher Life's Simple 7 score, is associated with a substantially lower risk of peripheral artery disease.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles, California.
| | - Wesley T O'Neal
- Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia
| | - Yejin Mok
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Gerardo Heiss
- Department of Epidemiology, University ofNorth Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina
| | - Joseph Coresh
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Kunihiro Matsushita
- Department of Epidemiology and the Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
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25
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Bahls M, Groß S, Baumeister SE, Völzke H, Gläser S, Ewert R, Markus MRP, Medenwald D, Kluttig A, Felix SB, Dörr M. Association of domain-specific physical activity and cardiorespiratory fitness with all-cause and cause-specific mortality in two population-based cohort studies. Sci Rep 2018; 8:16066. [PMID: 30375472 PMCID: PMC6207740 DOI: 10.1038/s41598-018-34468-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/18/2018] [Indexed: 12/03/2022] Open
Abstract
Physical activity (PA) reduces the risk for mortality. Whether the beneficial effects of PA are domain specific is unclear. We associated leisure time (LTPA), sports (SPA) and work (WPA) related PA and cardiorespiratory fitness (CRF) with all-cause mortality in two German population-based cohorts. We used data of the Study of Health in Pomerania (SHIP, n = 2,935, median age 53; 48% male) and the Cardiovascular Disease, Living and Ageing in Halle study (CARLA, n = 1,776, median age 64 and 54% male). Mortality was determined after a median follow-up of 8.2 years in SHIP (n = 332) and 11.5 years in CARLA (n = 409). LTPA (SHIP: hazard ratio [HR] per standard deviation [SD] 0.82 95%-CI 0.73 to 0.91 and CARLA: HR per SD 0.70: 95%-CI 0.59 to 0.82) and SPA (SHIP: HR per SD 0.80 95%-CI 0.71 to 0.91 and CARLA: HR per SD 0.70 95%-CI 0.60 to 0.82) but not WPA were inversely associated with all-cause mortality. In a subsample CRF was inversely related to mortality and positively to LTPA and sports SPA. No association was found for WPA. Our results may suggest that the inverse association between PA and mortality are partly influenced by higher CRF.
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Affiliation(s)
- Martin Bahls
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany. .,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.
| | - Stefan Groß
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Sebastian E Baumeister
- Chair of Epidemiology, Ludwig-Maximilians-Universität München, UNIKA-T Augsburg, Augsburg, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany.,Institute for Community Medicine, University of Greifswald, Greifswald, Germany
| | | | - Ralf Ewert
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marcello R P Markus
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Daniel Medenwald
- Martin-Luther-Universität Halle-Wittenberg Institute of Medical Epidemiology, Biometry and Informatics, Halle (Saale), Germany
| | - Alexander Kluttig
- Martin-Luther-Universität Halle-Wittenberg Institute of Medical Epidemiology, Biometry and Informatics, Halle (Saale), Germany
| | - Stephan B Felix
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, Greifswald, Germany.,DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
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26
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Vart P, Grams ME, Ballew SH, Woodward M, Coresh J, Matsushita K. Socioeconomic status and risk of kidney dysfunction: the Atherosclerosis Risk in Communities study. Nephrol Dial Transplant 2018; 34:1361-1368. [DOI: 10.1093/ndt/gfy142] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 04/22/2018] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
There is strong evidence of an association between socioeconomic status (SES) and end-stage renal disease (ESRD). However, the association of SES with the risk of chronic kidney disease (CKD) and the rate of change in kidney function is unclear.
Methods
A cohort of 14 086 participants with an estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2 at baseline in the Atherosclerosis Risk in Communities study (1987–89) were studied. The association of annual household income, educational attainment and neighborhood deprivation with incident ESRD, incident CKD and change in eGFR using four measurements over ∼23 years was assessed.
Results
A total of 432 participants developed ESRD and 3510 developed CKD over a median follow-up time of ∼23 years. After adjustment for demographics and baseline eGFR, the hazard ratio (HR) for incident ESRD compared with the high-income group was 1.56 [95% confidence interval (CI) 1.22–1.99 in the medium-income group and 2.30 (95% CI 1.75–3.02) in the low-income group (P-trend < 0.001), and for CKD was 1.10 (95% CI 1.01–1.20) in the medium-income group and 1.30 (95% CI 1.17–1.44) in the low-income group (P-trend < 0.001). After full adjustments, the HR for ESRD was 1.33 (95% CI 1.03–1.70) in the medium-income group and 1.50 (95% CI 1.14–1.98) in the low-income group (P-trend = 0.003) and for CKD was 1.01 (95% CI 0.92–1.10) in the medium-income group and 1.04 (95% CI 0.93–1.16) in the low-income group (P-trend = 0.50). The eGFR decline was 5% and 15% steeper in the medium- and low-income groups, respectively, after full adjustment (P-trend < 0.001). Results were similar, with lower educational attainment and higher neighborhood deprivation being associated with adverse outcomes.
Conclusions
SES (annual household income, educational attainment or neighborhood deprivation) was associated not only with ESRD risk but also with eGFR decline, although the association with CKD appeared weaker.
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Affiliation(s)
- Priya Vart
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Morgan E Grams
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Mark Woodward
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- The George Institute for Global Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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27
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Klimentidis YC, Raichlen DA, Bea J, Garcia DO, Wineinger NE, Mandarino LJ, Alexander GE, Chen Z, Going SB. Genome-wide association study of habitual physical activity in over 377,000 UK Biobank participants identifies multiple variants including CADM2 and APOE. Int J Obes (Lond) 2018; 42:1161-1176. [PMID: 29899525 PMCID: PMC6195860 DOI: 10.1038/s41366-018-0120-3] [Citation(s) in RCA: 205] [Impact Index Per Article: 34.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 04/03/2018] [Accepted: 04/30/2018] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Physical activity (PA) protects against a wide range of diseases. Habitual PA appears to be heritable, motivating the search for specific genetic variants that may inform efforts to promote PA and target the best type of PA for each individual. SUBJECTS/METHODS We used data from the UK Biobank to perform the largest genome-wide association study of PA to date, using three measures based on self-report (nmax = 377,234) and two measures based on wrist-worn accelerometry data (nmax = 91,084). We examined genetic correlations of PA with other traits and diseases, as well as tissue-specific gene expression patterns. With data from the Atherosclerosis Risk in Communities (ARIC; n = 8,556) study, we performed a meta-analysis of our top hits for moderate-to-vigorous PA (MVPA). RESULTS We identified ten loci across all PA measures that were significant in both a basic and a fully adjusted model (p < 5 × 10-9). Upon meta-analysis of the nine top hits for MVPA with results from ARIC, eight were genome-wide significant. Interestingly, among these, the rs429358 variant in the APOE gene was the most strongly associated with MVPA, whereby the allele associated with higher Alzheimer's risk was associated with greater MVPA. However, we were not able to rule out possible selection bias underlying this result. Variants in CADM2, a gene previously implicated in obesity, risk-taking behavior and other traits, were found to be associated with habitual PA. We also identified three loci consistently associated (p < 5 × 10-5) with PA across both self-report and accelerometry, including CADM2. We found genetic correlations of PA with educational attainment, chronotype, psychiatric traits, and obesity-related traits. Tissue enrichment analyses implicate the brain and pituitary gland as locations where PA-associated loci may exert their actions. CONCLUSIONS These results provide new insight into the genetic basis of habitual PA, and the genetic links connecting PA with other traits and diseases.
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Affiliation(s)
- Yann C Klimentidis
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.
| | | | - Jennifer Bea
- Department of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | | | - Lawrence J Mandarino
- Center for Disparities in Diabetes, Obesity and Metabolism, Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Gene E Alexander
- Departments of Psychology and Psychiatry, Neuroscience and Physiological Sciences Interdisciplinary Programs, BIO5 Institute, and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Arizona Alzheimer's Consortium, Phoenix, AZ, USA
| | - Zhao Chen
- Department of Epidemiology and Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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Brigham EP, Steffen LM, London SJ, Boyce D, Diette GB, Hansel NN, Rice J, McCormack MC. Diet Pattern and Respiratory Morbidity in the Atherosclerosis Risk in Communities Study. Ann Am Thorac Soc 2018; 15:675-682. [PMID: 29446981 PMCID: PMC6137676 DOI: 10.1513/annalsats.201707-571oc] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/15/2018] [Indexed: 01/30/2023] Open
Abstract
RATIONALE Dietary intake is a potential risk factor for respiratory morbidity in adult populations. Few studies capture the effect of dietary patterns, representative of the combination of nutrients consumed, on self-reported respiratory morbidity in combination with objective measures of lung function. OBJECTIVES To evaluate patterns of dietary intake in relation to respiratory morbidity and objective measures of lung function in a U.S. POPULATION METHODS The ARIC (Atherosclerosis Risk in Communities) study investigators enrolled 15,792 participants from four U.S. communities between 1987 and 1989 and collected data using a validated food frequency questionnaire to assess diet. Principal component analysis was applied, and patterns representative of "Western" and "Prudent" diets emerged. We investigated cross-sectional associations between dietary patterns and pulmonary assessments that included asthma and chronic obstructive pulmonary disease (COPD) diagnosis, respiratory symptoms, and lung function. Multivariable Poisson regression models included quintiles of dietary patterns and potential confounders. Interaction of dietary patterns with obesity, sex, and smoking status was assessed in relation to all outcomes. RESULTS Higher scores in the "Western" dietary pattern (quintile 5 vs. quintile 1) were associated with higher prevalence of COPD (prevalence ratio [PR], 1.62; 95% confidence ratio [CI], 1.33-1.97), wheeze (PR, 1.37; 95% CI, 1.11-1.69), cough (PR, 1.32; 95% CI, 1.32-1.59), and phlegm (PR, 1.27; 95% CI, 1.05-1.54) and lower percent predicted forced expiratory volume in 1 second (FEV1), percent predicted forced vital capacity (FVC), and FEV1/FVC ratio. Higher scores in the "Prudent" dietary pattern (quintile 5 vs. quintile 1) were associated with lower prevalence of COPD (PR, 0.82; 95% CI, 0.70-0.95) and cough (PR, 0.77; 95% CI, 0.67-0.89) and higher percent predicted FEV1 and FEV1/FVC ratio. The prevalence of asthma was not related to dietary intake. CONCLUSIONS A "Western" dietary pattern was associated with respiratory symptoms, lower lung function, and COPD in ARIC participants.
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Affiliation(s)
- Emily P. Brigham
- Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota; and
| | - Stephanie J. London
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, U.S. Department of Health and Human Services, Research Triangle Park, North Carolina
| | - Danielle Boyce
- Division of Pulmonary and Critical Care Medicine, School of Medicine
| | - Gregory B. Diette
- Division of Pulmonary and Critical Care Medicine, School of Medicine
- Bloomberg School of Public Health, and
| | - Nadia N. Hansel
- Division of Pulmonary and Critical Care Medicine, School of Medicine
- Bloomberg School of Public Health, and
| | - Jessica Rice
- Division of Pediatric Pulmonary Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Meredith C. McCormack
- Division of Pulmonary and Critical Care Medicine, School of Medicine
- Bloomberg School of Public Health, and
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Garg PK, O'Neal WT, Chen LY, Loehr LR, Sotoodehnia N, Soliman EZ, Alonso A. American Heart Association's Life Simple 7 and Risk of Atrial Fibrillation in a Population Without Known Cardiovascular Disease: The ARIC (Atherosclerosis Risk in Communities) Study. J Am Heart Assoc 2018; 7:JAHA.117.008424. [PMID: 29650711 PMCID: PMC6015412 DOI: 10.1161/jaha.117.008424] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background The American Heart Association has defined metrics of ideal cardiovascular health known as Life's Simple 7 (LS7) to prevent cardiovascular disease. We examined the association between LS7 and incident atrial fibrillation (AF) in a biracial cohort of middle‐ and older‐aged adults without known cardiovascular disease. Methods and Results This analysis included 13 182 ARIC (Atherosclerosis Risk in Communities) study participants (mean baseline age=54±5.7 years; 56% women; 25% black) free of AF and cardiovascular disease. An overall LS7 score was calculated as the sum of the LS7 component scores and classified as inadequate (0‐4), average (5‐9), or optimal (10‐14) cardiovascular health. The primary outcome was incident AF, identified primarily by ECG and hospital discharge coding of AF through December 31, 2014. A total of 2266 (17%) incident AF cases were detected over a median follow‐up of 25.1 years. Compared with the inadequate category (n=1057), participants in the average (n=8629) and optimal (n=3496) categories each had a lower risk of developing AF in a multivariable Cox proportional hazards model (hazard ratio 0.59, 95% confidence interval 0.51, 0.67 for average; and hazard ratio 0.38, 95% confidence interval 0.32, 0.44 for optimal). In a similar model, a 1‐point‐higher LS7 score was associated with a 12% lower risk of incident AF (hazard ratio 0.88, 95% confidence interval 0.86, 0.89). Conclusions A higher LS7 score is strongly associated with a lower risk of AF in individuals without baseline cardiovascular disease. Determining whether interventions that improve the population's cardiovascular health also reduce AF incidence is needed.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles, CA
| | - Wesley T O'Neal
- Division of Cardiology, Emory University School of Medicine, Atlanta, GA
| | - Lin Y Chen
- Division of Cardiology, University of Minnesota Medical School, Minneapolis, MN
| | - Laura R Loehr
- Department of Epidemiology, Gillings School of Public Health University of North Carolina, Chapel Hill, NC
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Division of Cardiology, University of Washington School of Medicine, Seattle, WA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC.,Section on Cardiology, Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA
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Fischer ME, Cruickshanks KJ, Dillard LK, Nondahl DM, Klein BEK, Klein R, Pankow JS, Tweed TS, Schubert CR, Dalton DS, Paulsen AJ. An Epidemiologic Study of the Association between Free Recall Dichotic Digits Test Performance and Vascular Health. J Am Acad Audiol 2018; 30:282-292. [PMID: 30461399 DOI: 10.3766/jaaa.17079] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Associations between vascular health-related factors and hearing loss defined using audiometric pure-tone thresholds have been found. Studies have not focused on a potential relationship between vascular health-related factors and central auditory processing. PURPOSE The aim of this study was to evaluate, on a population level, the relationship of vascular health-related factors with central auditory function. RESEARCH DESIGN A cross-sectional, population study. STUDY SAMPLE Subjects were participants in the Epidemiology of Hearing Loss Study (EHLS) or the Beaver Dam Offspring Study (BOSS)-prospective studies of aging and sensory loss. BOSS participants were the adult offspring of participants in the EHLS. Participants who completed the Dichotic Digits Test (DDT) during the fourth examination period of the EHLS (2008-2010) or the second examination period of the BOSS (2010-2013) were included (n = 3,655, mean age = 61.1 years). DATA COLLECTION AND ANALYSIS The DDT-free recall test was conducted using 25 sets of triple-digit pairs at a 70 dB HL presentation level. The total number of correctly repeated digits from the right and left ears was converted to a percentage correct and used as an outcome. The percentage correct in the left ear was subtracted from the percentage correct in the right ear and used as an outcome. Vascular health-related measures obtained during the examination included blood pressure, mean carotid intima-media thickness, femoral pulse wave velocity (PWV), hemoglobin A1C, and non-high-density lipoprotein (HDL) cholesterol, and, in the EHLS participants, C-reactive protein and interleukin-6. Information on vascular health-related history and behaviors was self-reported. General linear modeling produced estimates of the age- and sex-adjusted least squares means for each vascular factor, and multiple linear regression was used for multivariable modeling of each outcome. RESULTS After multivariable adjustment, participants with diabetes had a significantly lower (worse) mean DDT-free recall total score (-2.08 percentage points, p < 0.001) than those without diabetes. Participants who exercised at least once per week had a significantly higher (better) mean DDT-free recall total score (+1.07 percentage points, p < 0.01) than those who did not exercise at least once per week. Alcohol consumption was associated with a higher DDT-free recall total score (+0.15 percentage points per +25 g ethanol, p < 0.01). In multivariable modeling of the right-left ear difference in DDT-free recall scores, participants with a history of cardiovascular disease (CVD) or higher PWV demonstrated significantly larger differences (CVD: +3.11 percentage points, p = 0.02; PWV: +0.36 percentage points per 1 m/sec, p < 0.01). Higher levels of non-HDL cholesterol were associated with smaller right-left ear differences (-0.22 percentage points per 10 mg/dL, p = 0.01). Adjustment for handedness did not affect the results. CONCLUSIONS Vascular health-related factors may play a role in central auditory function.
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Affiliation(s)
- Mary E Fischer
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Karen J Cruickshanks
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI.,Department of Population Health Sciences, University of Wisconsin, Madison, WI
| | - Lauren K Dillard
- Department of Communication Sciences and Disorders, University of Wisconsin, Madison, WI
| | - David M Nondahl
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Barbara E K Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - James S Pankow
- Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN
| | - Ted S Tweed
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Carla R Schubert
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Dayna S Dalton
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
| | - Adam J Paulsen
- Department of Ophthalmology and Visual Sciences, University of Wisconsin, Madison, WI
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Pitanga FJG, Matos SMA, Almeida MDC, Barreto SM, Aquino EML. Leisure-Time Physical Activity, but not Commuting Physical Activity, is Associated with Cardiovascular Risk among ELSA-Brasil Participants. Arq Bras Cardiol 2018; 110:36-43. [PMID: 29412240 PMCID: PMC5831300 DOI: 10.5935/abc.20170178] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Accepted: 07/04/2017] [Indexed: 12/04/2022] Open
Abstract
Background Despite reports in the literature that both leisure-time physical activity
(LTPA) and commuting physical activity (CPA) can promote health benefits,
the literature lacks studies comparing the associations of these domains of
physical activity with cardiovascular risk scores. Objective To investigate the association between LTPA and CPA with different
cardiovascular risk scores in the cohort of the Longitudinal Study of Adult
Health ELSA-Brasil. Methods Cross-sectional study with data from 13,721 participants of both genders,
aged 35-74 years, free of cardiovascular disease, from ELSA Brazil. Physical
activity was measured using the International Physical Activity
Questionnaire (IPAQ). Five cardiovascular risk scores were used: Framingham
score - coronary heart disease (cholesterol); Framingham score - coronary
heart disease (LDL-C); Framingham score - cardiovascular disease
(cholesterol); Framingham score - cardiovascular disease (body mass index,
BMI); and pooled cohort equations for atherosclerotic cardiovascular disease
(ASCVD). Associations adjusted for confounding variables between physical
activity and different cardiovascular risk scores were analyzed by logistic
regression. Confidence interval of 95% (95%CI) was considered. Results LTPA is inversely associated with almost all cardiovascular risk scores
analyzed, while CPA shows no statistically significant association with any
of them. Dose-response effect in association between LTPA and cardiovascular
risk scores was also found, especially in men. Conclusions LTPA was shown to be associated with the cardiovascular risk scores analyzed,
but CPA not. The amount of physical activity (duration and intensity) was
more significantly associated, especially in men, with cardiovascular risk
scores in ELSA-Brasil.
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SES, Heart Failure, and N-terminal Pro-b-type Natriuretic Peptide: The Atherosclerosis Risk in Communities Study. Am J Prev Med 2018; 54:229-236. [PMID: 29241718 PMCID: PMC5828682 DOI: 10.1016/j.amepre.2017.10.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Revised: 09/14/2017] [Accepted: 10/20/2017] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Compared with coronary heart disease and stroke, the association between SES and the risk of heart failure is less well understood. METHODS In 12,646 participants of the Atherosclerosis Risk in Communities Study cohort free of heart failure history at baseline (1987-1989), the association of income, educational attainment, and area deprivation index with subsequent heart failure-related hospitalization or death was examined while accounting for cardiovascular disease risk factors and healthcare access. Because SES may affect threshold of identifying heart failure and admitting for heart failure management, secondarily the association between SES and N-terminal pro-b-type natriuretic peptide (NT-proBNP) levels, a marker reflecting cardiac overload, was investigated. Analysis was conducted in 2016. RESULTS During a median follow-up of 24.3 years, a total of 2,249 participants developed heart failure. In a demographically adjusted model, the lowest-SES group had 2.2- to 2.5-fold higher risk of heart failure compared with the highest SES group for income, education, and area deprivation. With further adjustment for time-varying cardiovascular disease risk factors and healthcare access, these associations were attenuated but remained statistically significant (e.g., hazard ratio=1.92, 95% CI=1.69, 2.19 for the lowest versus highest income), with no racial interaction (p>0.05 for all SES measures). Similarly, compared with high SES, low SES was associated with both higher baseline level of NT-proBNP in a multivariable adjusted model (15% higher, p<0.001) and increase over time (~1% greater per year, p=0.023). CONCLUSIONS SES was associated with clinical heart failure as well as NT-proBNP levels inversely and independently of traditional cardiovascular disease factors and healthcare access.
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Florido R, Kwak L, Lazo M, Nambi V, Ahmed HM, Hegde SM, Gerstenblith G, Blumenthal RS, Ballantyne CM, Selvin E, Folsom AR, Coresh J, Ndumele CE. Six-Year Changes in Physical Activity and the Risk of Incident Heart Failure: ARIC Study. Circulation 2018; 137:2142-2151. [PMID: 29386202 DOI: 10.1161/circulationaha.117.030226] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 12/20/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Higher physical activity (PA) is associated with lower heart failure (HF) risk; however, the effect of changes in PA on HF risk is unknown. METHODS We evaluated 11 351 ARIC study (Atherosclerosis Risk in Communities) participants (mean age 60 years) who attended visit 3 (1993-1995) and did not have a history of cardiovascular disease. Exercise PA was assessed using a modified Baecke questionnaire and categorized according to American Heart Association guidelines as recommended, intermediate, or poor. We used Cox regression models to characterize the association of 6-year changes in PA between the first (1987-1989) and third ARIC visits and HF risk. RESULTS During a median of 19 years of follow-up, 1750 HF events occurred. Compared with those with poor activity at both visits, the lowest HF risk was seen for those with persistently recommended activity (hazard ratio, 0.69; 95% confidence interval, 0.60-0.80). However, those whose PA increased from poor to recommended also had reduced HF risk (hazard ratio, 0.77; 95% confidence interval 0.63-0.93). Among participants with poor baseline activity, each 1 SD higher PA at 6 years (512.5 METS*minutes/week, corresponding to ≈30 minutes of brisk walking 4 times per week) was associated with significantly lower future HF risk (hazard ratio, 0.89, 95% confidence interval, 0.82-0.96). CONCLUSIONS Although maintaining recommended activity levels is associated with the lowest HF risk, initiating and increasing PA, even in late middle age, are also linked to lower HF risk. Augmenting PA may be an important component of strategies to prevent HF.
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Affiliation(s)
- Roberta Florido
- Department of Medicine, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease (R.F., G.G., R.S.B., C.E.N.).,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.F., L.K., E.S., J.C., C.E.N.)
| | - Lucia Kwak
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.F., L.K., E.S., J.C., C.E.N.)
| | - Mariana Lazo
- Department of General Internal Medicine (M.L.), Johns Hopkins University School of Medicine, Baltimore, MD
| | - Vijay Nambi
- Michael E DeBakey Veterans Affairs Hospital, Houston, TX (V.N.).,Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX (V.N., C.M.B.)
| | - Haitham M Ahmed
- Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH (H.M.A.)
| | - Sheila M Hegde
- Department of Medicine, Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA (S.M.H.)
| | - Gary Gerstenblith
- Department of Medicine, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease (R.F., G.G., R.S.B., C.E.N.)
| | - Roger S Blumenthal
- Department of Medicine, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease (R.F., G.G., R.S.B., C.E.N.)
| | - Christie M Ballantyne
- Division of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX (V.N., C.M.B.)
| | - Elizabeth Selvin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.F., L.K., E.S., J.C., C.E.N.)
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis (A.R.F.)
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.F., L.K., E.S., J.C., C.E.N.)
| | - Chiadi E Ndumele
- Department of Medicine, Johns Hopkins Ciccarone Center for the Prevention of Heart Disease (R.F., G.G., R.S.B., C.E.N.) .,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (R.F., L.K., E.S., J.C., C.E.N.)
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Al-Mallah MH, Elshawi R, Ahmed AM, Qureshi WT, Brawner CA, Blaha MJ, Ahmed HM, Ehrman JK, Keteyian SJ, Sakr S. Using Machine Learning to Define the Association between Cardiorespiratory Fitness and All-Cause Mortality (from the Henry Ford Exercise Testing Project). Am J Cardiol 2017; 120:2078-2084. [PMID: 28951020 DOI: 10.1016/j.amjcard.2017.08.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Revised: 08/02/2017] [Accepted: 08/08/2017] [Indexed: 10/19/2022]
Abstract
Previous studies have demonstrated that cardiorespiratory fitness is a strong marker of cardiovascular health. Machine learning (ML) can enhance the prediction of outcomes through classification techniques that classify the data into predetermined categories. The aim of the analysis is to compare the prediction of 10 years of all-cause mortality (ACM) using statistical logistic regression (LR) and ML approaches in a cohort of patients who underwent exercise stress testing. We included 34,212 patients (55% males, mean age 54 ± 13 years) free of coronary artery disease or heart failure who underwent exercise treadmill stress testing between 1991 and 2009 and had complete 10-year follow-up. The primary outcome of this analysis was ACM at 10 years. The probability of 10-years ACM was calculated using statistical LR and ML, and the accuracy of these methods was calculated and compared. A total of 3,921 patients died at 10 years. Using statistical LR, the sensitivity to predict ACM was 44.9% (95% confidence interval [CI] 43.3% to 46.5%), whereas the specificity was 93.4% (95% CI 93.1% to 93.7%). The sensitivity of ML to predict ACM was 87.4% (95% CI 86.3% to 88.4%), whereas the specificity was 97.2% (95% CI 97.0% to 97.4%). The ML approach was associated with improved model discrimination (area under the curve for ML [0.923 (95% CI 0.917 to 0.928)]) compared with statistical LR (0.836 [95% CI 0.829 to 0.846], p<0.0001). In conclusion, our analysis demonstrates that ML provides better accuracy and discrimination of the prediction of ACM among patients undergoing stress testing.
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Park K, Park BJ. High Level Physical Activity and Prevalence of Cardiovascular Disease Using the Korea National Health and Nutrition Examination Survey Data, 2007-2013. J Prev Med Public Health 2017; 50:320-327. [PMID: 29020758 PMCID: PMC5637061 DOI: 10.3961/jpmph.17.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2017] [Accepted: 08/31/2017] [Indexed: 11/22/2022] Open
Abstract
Objectives The purpose of our study was to evaluate the association between the intensity of physical activity (PA) and prevalence of cardiovascular disease (CVD) using Korean representative data. Methods We analyzed 39 804 participant data from the Korea National Health and Nutrition Examination Survey, 2007-2013. Exposure variable was three levels of PA (low, medium, and high) in a week, and outcome variable was prevalence of CVD based on patient self-recognition and doctor’s diagnosis. Complex logistic regression analysis was performed to evaluate the relationship between level of PA and CVD adjusted by body mass index, hypertension, hypercholesterolemia, diabetes mellitus, stress recognition, household income, smoking, and current drinking. The indices of association w ere estimated as crude prevalence odds ratio (POR), adjusted POR, and their 95% confidence interval (CI). All statistical analyzes were performed using complex sample analysis procedure of the SPSS version 23.0. Results When all variables were adjusted, only high level PA in women showed a significant association with stroke (adjusted POR by patient’s self-recognition, 0.57; 95% CI, 0.32 to 0.99, adjusted POR by doctor’s diagnosis, 0.55; 95% CI, 0.34 to 0.87) and CVD (adjusted POR by doctor’s diagnosis, 0.68; 95% CI, 0.48 to 0.96). Conclusions High level PA in women has a significant reverse association with prevalence of stroke and CVD in Korea. Further study for elucidating the mechanism will be needed.
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Affiliation(s)
- Kyounghoon Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Byung-Joo Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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Physical Activity and Cardiovascular Disease Among Older Adults: The Case of Race and Ethnicity. J Aging Phys Act 2017; 25:505-509. [PMID: 27748648 DOI: 10.1123/japa.2016-0012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The goals of this study were (1) to test the relative contribution of light intensity and moderate-to-vigorous intensity physical activity (MVPA) to cardiovascular disease (CVD) risk in older adults, and (2) to examine the influence of ethnicity. We used pooled data from the 2003-2004 and 2005-2006 waves of the National Health and Nutritional Examination Survey (NHANES). The sample consisted of 1,171 non-Hispanic White, non-Hispanic Black, and Mexican American adults aged 65 and older. Using ordinary least squares regression, we showed no statistically significant relationship between lower CVD risk with light intensity activity. However, greater minutes of MVPA was associated with lower CVD risk. Mexican Americans had statistically significantly higher risk for CVD compared to non-Hispanic Whites after controlling for physical activity. Mexican Americans remain an at-risk group for CVD. Regardless of race or ethnicity, physical activity recommendations among elders should be for at least moderate intensity activity for a more favorable CVD outcome.
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Affiliation(s)
- Sabine Oertelt-Prigione
- Violence Prevention Clinic, Institute of Legal Medicine, Charité – Universitätsmedizin Berlin, Germany
| | - Angela HEM Maas
- Women’s Cardiac Health Program, Department of Cardiology, Radboud University Medical Center, Nijmegen, The Netherlands
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Kim GS, Im E, Rhee JH. Association of physical activity on body composition, cardiometabolic risk factors, and prevalence of cardiovascular disease in the Korean population (from the fifth Korea national health and nutrition examination survey, 2008-2011). BMC Public Health 2017; 17:275. [PMID: 28327105 PMCID: PMC5361821 DOI: 10.1186/s12889-017-4126-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Accepted: 02/13/2017] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Data regarding associations among physical activity (PA) level, body composition, and prevalence of cardiovascular diseases in Asian populations are rare. METHODS The International Physical Activity Questionnaire (IPAQ) was utilized to estimate PA levels and analyze the association of PA level with various body composition parameters and the prevalence of cardiovascular diseases by using data from the Korean National Health and Nutrition Examination Survey from 2008 to 2011. RESULTS Moderate and high PA levels were associated with lower prevalence of hypertension and diabetes mellitus, and lower concentrations of serum ferritin, parathyroid hormone, and alkaline phosphatase. Sarcopenia (low vs. moderate vs. high PA group: 14.3% vs. 10.5% vs. 7.3%, p = 0.001), underweight (5.7% vs. 4.9% vs. 3.5%, p = 0.001), and central obesity (7.8% vs. 6.9% vs. 6.3%, p = 0.002) were more often observed in the low PA group. The prevalence rates of cardiovascular diseases were lower in the moderate (odds ratio [OR], 0.822; 95% confidence interval [CI], 0.737-0.916; p = 0.001) and high activity groups (OR, 0.663; 95% CI, 0.589-0.748; p = 0.001) than in the low activity group, even after adjusting for age, sex, smoking, underlying disease, and general or abdominal obesity and muscle mass. CONCLUSION Regular physical activity was associated with a low prevalence of cardiovascular diseases (stroke, myocardial infarction, stable angina, and chronic renal disease), which was independent of body composition and conventional risk factors in the Korean population, with a positive dose-response relationship.
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Affiliation(s)
- Gwang-Sil Kim
- Division of Cardiology, Department of Internal Medicine, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Eui Im
- Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
| | - Ji-Hyuck Rhee
- Division of Cardiology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea. .,Division of Cardiology, Yongin Severance Hospital, Yonsei University College of Medicine, 225 Geumhak-ro, Cheoin-gu, Yongin, 17046, South Korea.
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40
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Zhou Y, Zhang R, Liu Y, Guo Y, Wang D, He M, Yuan J, Liang Y, Zhang X, Wang Y, Guo H, Wei S, Miao X, Yao P, Wu T, Chen W. Association of regular physical activity with total and cause-specific mortality among middle-aged and older Chinese: a prospective cohort study. Sci Rep 2017; 7:39939. [PMID: 28051177 PMCID: PMC5209661 DOI: 10.1038/srep39939] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2016] [Accepted: 11/29/2016] [Indexed: 12/25/2022] Open
Abstract
Association between physical activity and mortality has rarely been investigated among the Chinese population. Furthermore, the most appropriate amount of physical activity for longevity benefits remains unclear. We used data from the Dongfeng-Tongji cohort, including 24,606 middle-aged and older retired adults in 2008 and followed to 2013, to quantify linear and non-linear dose-response relationships between regular physical activity and mortality risks by Cox proportional hazards model. Compared with participants who did not engage in regular physical activity, those performing regular physical activity had significantly 46%, 56%, and 49% decreased risks of mortality from all causes, circulatory, and respiratory diseases, respectively. Each one-SD increase in regular physical activity was associated with 32% decrease of respiratory disease mortality. There were significant nonlinear dose-response associations between regular physical activity and mortality from all causes and circulatory diseases. Mortality risks decreased monotonically with increased regular physical activity amount, and appeared to reach a threshold at around 100 MET-hours/week. More mortality benefits were found among non-smokers than that among current and former smokers. Our results suggest that middle-aged and older Chinese adults can achieve mortality benefits from regular physical activity at the WHO recommended minimum, and the benefit threshold appears at approximately 100 MET hours/week.
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Affiliation(s)
- Yun Zhou
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Runbo Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuewei Liu
- Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Yanjun Guo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Dongming Wang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Meian He
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jing Yuan
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuan Liang
- Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomin Zhang
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Youjie Wang
- Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huan Guo
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China
| | - Xiaoping Miao
- Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Hubei Provincial Key Laboratory for Applied Toxicology, Hubei Provincial Center for Disease Control and Prevention, Wuhan, Hubei 430079, China
| | - Ping Yao
- Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tangchun Wu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Key Laboratory of Environment and Health in Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Parathyroid hormone and the risk of incident hypertension: the Atherosclerosis Risk in Communities study. J Hypertens 2016; 34:196-203. [PMID: 26867053 DOI: 10.1097/hjh.0000000000000794] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND Recent evidence suggests that parathyroid hormone (PTH) has effects on vascular smooth muscle cells, the rennin-angiotensin system and kidney function, but less is known about its role in the development of hypertension. The distribution of serum PTH also varies by race. METHODS AND RESULTS Therefore, we examined the relation between PTH and incident hypertension and tested for interaction by race among 7504 Atherosclerosis Risk in Communities participants (1264 black, 6240 white, median age 56 years) without initial hypertension in 1990-1992. During a median follow-up of 6 years, 1487 white and 509 black participants developed hypertension. In the overall study population, PTH was not associated with incident hypertension after adjustment for demographics and behavioral risk factors [hazard ratio highest vs. lowest quintiles, 95% confidence interval: 1.11 (0.96-1.28); P for linear trend 0.02]. Although the interaction was not statistically significant (P = 0.60), there was some evidence that the PTH-hypertension association differed by race. Among blacks, PTH was positively associated with incident hypertension, independent of demographics, and behavioral risk factors (P for linear trend 0.003). Among whites, PTH was not associated with hypertension risk. Results were similar when comparing participants with elevated versus nonelevated PTH (≥65 vs. <65 pg/ml): hazard ratio in blacks: 1.24 (1.02-1.54); hazard ratio in whites: 0.95 (0.78-1.16). CONCLUSIONS In this large community-based cohort, PTH levels, overall, were not independently associated with the risk of hypertension. However, we found some evidence that PTH may be associated with hypertension in blacks. Future research should continue to explore potential race differences in the PTH-hypertension association.
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Allen NA. Social Cognitive Theory in Diabetes Exercise Research: An Integrative Literature Review. DIABETES EDUCATOR 2016; 30:805-19. [PMID: 15510532 DOI: 10.1177/014572170403000516] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE This integrative review critically examined the literature on diabetes research using Social Cognitive Theory (SCT) to determine its predictive ability in explaining exercise behavior and to identify key interventions that enhance exercise initiation and maintenance. METHODS Literature published between 1985 and 2002 was searched using the following keywords: SCT, self-efficacy, diabetes mellitus, non-insulin-dependent diabetes mellitus, insulin-dependent diabetes mellitus, physical activity, and exercise. The databases searched were CINAHL, Medline, and PsychInfo. Of the 38 articles retrieved from databases, 13 were reviewed. RESULTS A statistically significant relationship between self-efficacy and exercise behavior was found in correlational studies. Results from the predictive study support the predictability of self-efficacy for exercise behavior. Mixed results were found for the predictive ability of outcome expectancies for exercise behavior. Self-efficacy was predictive of exercise initiation and maintenance over time. The evidence for successful interventions to increase self-efficacy and exercise behavior over time was inconclusive. CONCLUSIONS To better understand exercise behavior and to develop effective exercise interventions, a microanalytic, theory-driven approach to studying exercise behavior is needed. Several suggestions are offered to strengthen exercise self-efficacy.
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Affiliation(s)
- Nancy A Allen
- Graduate School of Nursing, University of Massachusetts, Worcester, USA
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43
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Hegde SM, Gonçalves A, Claggett B, Evenson KR, Cheng S, Shah AM, Folsom AR, Solomon SD. Cardiac structure and function and leisure-time physical activity in the elderly: The Atherosclerosis Risk in Communities Study. Eur Heart J 2016; 37:2544-51. [PMID: 27071820 PMCID: PMC5008418 DOI: 10.1093/eurheartj/ehw121] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2015] [Revised: 12/11/2015] [Accepted: 03/02/2016] [Indexed: 12/16/2022] Open
Abstract
AIMS Adults who engage in leisure-time physical activity (LTPA) have a reduced risk of developing heart failure. We hypothesized that high levels of LTPA are associated with diminished adverse age-related changes in cardiac structure and function. METHODS AND RESULTS We studied 4342 Atherosclerosis Risk in Communities Study participants free of cardiovascular disease who underwent standardized echocardiography. In a cross-sectional analysis, we related LTPA (poor, intermediate, or ideal) to cardiac structure and function. We also related cumulative average LTPA over 24 years and changes in LTPA categories to echocardiographic measures. Cross-sectional analysis demonstrated that ideal LTPA, compared with poor LTPA, was associated with better diastolic function [prevalence of normal diastolic function: 39.8% vs. 31.5%, P < 0.001; mean E/E' ratio (95% CI): 9.8 (9.6, 9.9) vs. 10.4 (10.2, 10.5), P = 0.001] and better systolic function [left-ventricular (LV) longitudinal strain: -18.3 (-18.4, -18.2) vs. -17.9 (-18.0, -17.8), P < 0.001] after adjusting for age, sex, race, and centre. Higher cumulative average LTPA over 24 years or an improvement in LTPA category were also, respectively, related to a more favourable E/E' ratio (P < 0.0001, P = 0.004) and longitudinal LV strain (P = 0.0002, P = 0.002). CONCLUSION Ideal LTPA, higher average levels of LTPA over a 24-year period, and an improvement in LTPA even later in life were associated with more favourable indices of LV diastolic and systolic function in older adults. Sustaining higher levels of LTPA, and even increasing physical activity later in life, may be beneficial for older adults in attenuating expected age-related changes in cardiac structure and function.
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Affiliation(s)
- Sheila M Hegde
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA
| | - Alexandra Gonçalves
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Porto, Portugal
| | - Brian Claggett
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA
| | - Kelly R Evenson
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina-Chapel Hill, NC, USA
| | - Susan Cheng
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA
| | - Amil M Shah
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Scott D Solomon
- Cardiovascular Division, Brigham and Women's Hospital, Harvard Medical School, 75 Francis St, Boston, MA, USA
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Al-Mallah MH, Qureshi WT, Keteyian SJ, Brawner CA, Alam M, Dardari Z, Nasir K, Blaha MJ. Racial Differences in the Prognostic Value of Cardiorespiratory Fitness (Results from the Henry Ford Exercise Testing Project). Am J Cardiol 2016; 117:1449-54. [PMID: 26976790 DOI: 10.1016/j.amjcard.2016.02.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2015] [Revised: 02/08/2016] [Accepted: 02/08/2016] [Indexed: 10/22/2022]
Abstract
The aim of this analysis was to determine whether racial differences exist in the prognostic value of cardiorespiratory fitness (CRF) in black and white patients undergoing stress testing. We included 53,876 patients (mean age 53 ± 13, 49% women) from the Henry Ford Exercise Testing project free of established coronary disease or heart failure who completed a maximal exercise test from 1991 to 2009. Patients were followed for a mean duration of 11.5 years for all-cause mortality, ascertained by linkage with the Death Master File. Follow-up over mean 6.2 years was also available for incident myocardial infarction. Multivariate Cox proportional hazards regression models were used adjusting for demographic variables, risk factors, medications, and reason for stress test referral, including formal interaction testing by race (black vs white). Black patients (n = 16,725) were younger (54 ± 13 vs 52 ± 13, p <0.001) but had higher prevalence of hypertension (73% vs 57%, p <0.001) and obesity (28% vs 21%, p <0.001). On average, black patients achieved a lower CRF compared with whites (8.4 vs 9.5 metabolic equivalents, p <0.0001). A graded increase in mortality risk was noted with decreasing CRF for both black and white patients. In multivariate Cox regression, CRF was a predictor of both myocardial infarction and mortality, with no significant interaction between race, fitness, and outcomes (all interaction terms p >0.10). CRF is a strong predictor of all-cause mortality in both white and black patients, with no significant interaction observed between race, fitness, and outcomes.
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Cobb LK, Godino JG, Selvin E, Kucharska-Newton A, Coresh J, Koton S. Spousal Influence on Physical Activity in Middle-Aged and Older Adults: The ARIC Study. Am J Epidemiol 2016; 183:444-51. [PMID: 26337074 DOI: 10.1093/aje/kwv104] [Citation(s) in RCA: 57] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 04/14/2015] [Indexed: 12/14/2022] Open
Abstract
Low physical activity levels are a public health concern. Few studies have assessed the concordance of physical activity change among spouses. We studied this concordance during a 6-year period (baseline: 1987-1989; follow-up: 1993-1995) in 3,261 spousal pairs from the US-based Atherosclerosis Risk in Communities (ARIC) Study. Linear regression was used to examine the association between change in individuals' sport/exercise and leisure physical activity indices (ranging from 1 (low) to 5 (high)) and change in his or her spouse's indices. The association between individual and spousal changes in meeting physical activity recommendations was assessed with logistic regression. Individual changes in the sport/exercise and leisure indices were positively associated with spousal changes. For every standard deviation increase in their wives' sport/exercise index, men's exercise index increased by 0.09 (95% confidence interval: 0.05, 0.12) standard deviation; for every standard deviation increase in their wives' leisure index, men's leisure index increased by 0.08 standard deviation. Results were similar for women. Individuals had higher odds of meeting physical activity recommendations if their spouse met recommendations at both visits or just follow-up. In conclusion, changes in an individual's physical activity are positively associated with changes in his or her spouse's physical activity. Physical activity promotion efforts should consider targeting couples.
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Zhao S, Zhang Z, Long Q, Ma Y, Lian X, Yang Y, Gao W, Chen Z, Wang L. Association between Time of Day of Sports-Related Physical Activity and the Onset of Acute Myocardial Infarction in a Chinese Population. PLoS One 2016; 11:e0146472. [PMID: 26752185 PMCID: PMC4709000 DOI: 10.1371/journal.pone.0146472] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Accepted: 12/17/2015] [Indexed: 12/02/2022] Open
Abstract
Objective To investigate the association between the time of day of sports-related physical activity and the onset of acute myocardial infarction (AMI) in a coronary artery disease (CAD) population in China. Methods Between February 2014 and March 2015, a total of 696 patients from Nanjing, China, who had CAD were studied and divided into two groups (Non-AMI and AMI groups). The work-related activity and sports-related physical activity information were obtained from a self-reporting predesigned patient questionnaire. Results Sports-related physical activity was associated with a lower risk of the onset of AMI, after adjusting the established and potential confounders, with an adjusted odds ratio (OR) of 0.67 (95% CI, 0.47–0.94) compared with those who did not have any sports-related physical activity. A dose–response relationship was observed for intensity, duration, and frequency of sports-related physical activity. Further stratification analysis revealed that the protective effects of sports-related physical activity were significant in the morning and evening groups, and patients who exercised in the evening were at a lower risk of AMI than those doing sports-related physical activity in the morning. The adjusted ORs for doing sports-related physical activity in the morning and evening groups were 0.60(0.36–0.98) and 0.56(0.37–0.87), respectively, compared with inactivity (all P<0.05). On the occurrence of AMI, doing sports-related physical activity in the evening had an adjusted OR of 0.93 (95% CI, 0.54–1.64, P = 0.824) compared with in the morning group. Conclusions Sports-related physical activity is associated with a lower risk of onset of AMI than inactivity in Chinese people. For CAD patients, we suggest they participate in sports-related physical activity of high intensity, long duration, and high frequency. Doing sports-related physical activity in the evening and in the morning have similar benefits on the prevention of the onset of AMI.
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Affiliation(s)
- Shan Zhao
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhen Zhang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Qingqing Long
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yao Ma
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xiaoqing Lian
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yang Yang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Wei Gao
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Zhong Chen
- Department of Cardiology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No. 600 Yishan Road, Shanghai, 200233,China
- * E-mail: (LSW); (ZC)
| | - Liansheng Wang
- Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- * E-mail: (LSW); (ZC)
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De Vito KM, Baer HJ, Dart H, Chiuve SE, Rimm EB, Colditz GA. Validation of a risk prediction tool for coronary heart disease in middle-aged women. BMC WOMENS HEALTH 2015; 15:101. [PMID: 26552598 PMCID: PMC4640388 DOI: 10.1186/s12905-015-0250-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2014] [Accepted: 10/09/2015] [Indexed: 11/29/2022]
Abstract
Background Health risk appraisal tools may be useful for identifying individuals who would benefit from lifestyle changes and increased surveillance. We evaluated the validity of the Your Disease Risk tool (YDR) for estimating relative risk of coronary heart disease (CHD) among middle-aged women. Methods We included 55,802 women in the Nurses’ Health Study who completed a mailed questionnaire about risk factors in 1994 and had no history of heart disease at that time. Participants were followed through 2004 for the occurrence of CHD. We estimated each woman’s 10-year relative risk of CHD using YDR, and we compared the estimated YDR relative risk category (ranging from “very much below average” to “very much above average”) to the observed relative risk for each category using logistic regression. We also examined the discriminatory accuracy of YDR using concordance statistics (c-statistics). Results There were 1165 CHD events during the 10-year follow-up period. Compared to the “about average” category, the observed age-adjusted relative risk was 0.43 (95 % confidence interval: 0.33, 0.56) for the “very much below average” category and 2.48 (95 % confidence interval: 1.68, 3.67) for the “very much above average” category. The age-adjusted c-statistic for the model including the YDR relative risk category was 0.71 (95 % confidence interval: 0.69, 0.72). The model performed better in younger than older women. Conclusion The YDR tool appears to have moderate validity for estimating 10-year relative risk of CHD in this population of middle-aged women. Further research should aim to improve the tool’s performance and to examine its validity in other populations. Electronic supplementary material The online version of this article (doi:10.1186/s12905-015-0250-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Katerina M De Vito
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, Massachusetts, 02120, USA. .,Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| | - Heather J Baer
- Division of General Internal Medicine and Primary Care, Brigham and Women's Hospital, 1620 Tremont Street, Boston, Massachusetts, 02120, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
| | - Hank Dart
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
| | - Stephanie E Chiuve
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. .,Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | - Eric B Rimm
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. .,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA. .,Harvard Medical School, Boston, Massachusetts, USA. .,Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA.
| | - Graham A Colditz
- Alvin J. Siteman Cancer Center and Department of Surgery, Washington University School of Medicine, St. Louis, Missouri, USA.
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Liu L, Wang S, Liu J. Fiber consumption and all-cause, cardiovascular, and cancer mortalities: a systematic review and meta-analysis of cohort studies. Mol Nutr Food Res 2014; 59:139-46. [PMID: 25382817 DOI: 10.1002/mnfr.201400449] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Revised: 10/19/2014] [Accepted: 10/20/2014] [Indexed: 12/11/2022]
Abstract
The present meta-analysis aimed to investigate fiber consumption and all-cause mortality, and cause-specific mortality. MEDLINE and web of science database were searched for cohort studies published from inception to August 2014. Studies were included if they provided a hazard ratio (HR) and corresponding 95% CI for mortality in relation to fiber consumption.We found that, compared with those who consumed lowest fiber, for individuals who ate highest fiber, mortality rate was lower by 23% (HR, 0.77; 95% CI, 0.72-0.81) for CVD, by 17% (HR, 0.83; 95% CI, 0.74-0.91) for cancer, by 23% (HR, 0.77; 95% CI, 0.73-0.81) for all-cause mortality. For each 10 g/day increase in fiber intake, the pooled HR was estimated to be 0.89 (95% CI, 0.86-0.93) for all-cause mortality, 0.80 (95% CI, 0.72-0.88) for CHD mortality, and 0.66 (95% CI, 0.40-0.92) for IHD mortality, 0.91 (95% CI, 0.88-0.94) for cancer. Dietary fiber and CVD mortality showed a strong dose-response relation. Apparently, fiber consumption is inversely associated with all-cause mortality and CVD, IHD, cancer mortality.
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Affiliation(s)
- Lihua Liu
- Institute of Hospital Management, Chinese PLA General Hospital, Beijing, P. R. China
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Klimentidis YC, Chen Z, Arora A, Hsu CH. Association of physical activity with lower type 2 diabetes incidence is weaker among individuals at high genetic risk. Diabetologia 2014; 57:2530-4. [PMID: 25273344 PMCID: PMC4221563 DOI: 10.1007/s00125-014-3380-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Accepted: 08/29/2014] [Indexed: 01/04/2023]
Abstract
AIMS/HYPOTHESIS We examined whether or not the association of physical activity with type 2 diabetes incidence differs according to several types of genetic susceptibility. METHODS In a large prospective cohort with 821 incident cases of type 2 diabetes, we examined interactions of physical activity with: (1) each of 65 type 2 diabetes-associated single nucleotide polymorphisms (SNPs); (2) a genetic risk score (GRS) comprising all 65 SNPs; (3) two GRSs comprised of SNPs implicated in insulin resistance (IR) and insulin secretion; (4) GRSs for fasting insulin (FI) and fasting glucose. RESULTS We found a significant interaction of physical activity and the type 2 diabetes GRS (p interaction = 0.016), suggesting a weaker protective effect of physical activity in those at high genetic risk. Based on the interactions observed with the IR GRS (p interaction = 0.046) and the FI GRS (p interaction = 0.042), it appears that the overall type 2 diabetes GRS interaction most likely occurs through genetic susceptibility to IR as opposed to insulin secretion. Furthermore, this interaction was more pronounced in women (p interaction = 0.0025) than in men (p interaction = 0.46). No single SNP stood out as displaying a strong interaction with physical activity. CONCLUSIONS/INTERPRETATION We conclude that although physical activity appears to have an overall protective effect on type 2 diabetes, this putative effect is weakest among individuals with high genetic risk for type 2 diabetes and IR.
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Affiliation(s)
- Yann C Klimentidis
- Mel and Enid Zuckerman College of Public Health, Division of Epidemiology and Biostatistics, University of Arizona, 1295 N. Martin, Tucson, AZ, 85724, USA,
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Brown SC, Lombard J, Toro M, Huang S, Perrino T, Perez-Gomez G, Plater-Zyberk E, Pantin H, Affuso O, Kumar N, Wang K, Szapocznik J. Walking and proximity to the urban growth boundary and central business district. Am J Prev Med 2014; 47:481-6. [PMID: 24975010 PMCID: PMC4171193 DOI: 10.1016/j.amepre.2014.05.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 03/28/2014] [Accepted: 05/02/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Planners have relied on the urban development boundary (UDB)/urban growth boundary (UGB) and central business district (CBD) to encourage contiguous urban development and conserve infrastructure. However, no studies have specifically examined the relationship between proximity to the UDB/UGB and CBD and walking behavior. PURPOSE To examine the relationship between UDB and CBD distance and walking in a sample of recent Cuban immigrants, who report little choice in where they live after arrival to the U.S. METHODS Data were collected in 2008-2010 from 391 healthy, recent Cuban immigrants recruited and assessed within 90 days of arrival to the U.S. who resided throughout Miami-Dade County FL. Analyses in 2012-2013 examined the relationship between UDB and CBD distances for each participant's residential address and purposive walking, controlling for key sociodemographics. Follow-up analyses examined whether Walk Score(®), a built-environment walkability metric based on distance to amenities such as stores and parks, mediated the relationship between purposive walking and each of UDB and CBD distance. RESULTS Each one-mile increase in distance from the UDB corresponded to an 11% increase in the number of minutes of purposive walking, whereas each one-mile increase from the CBD corresponded to a 5% decrease in the amount of purposive walking. Moreover, Walk Score mediated the relationship between walking and each of UDB and CBD distance. CONCLUSIONS Given the lack of walking and walkable destinations observed in proximity to the UDB/UGB boundary, a sprawl repair approach could be implemented, which strategically introduces mixed-use zoning to encourage walking throughout the boundary's zone.
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Affiliation(s)
- Scott C Brown
- University of Miami Miller School of Medicine, Miami; University of Miami School of Architecture, Coral Gables, Florida.
| | - Joanna Lombard
- University of Miami Miller School of Medicine, Miami; University of Miami School of Architecture, Coral Gables, Florida
| | - Matthew Toro
- University of Miami Miller School of Medicine, Miami
| | - Shi Huang
- University of Miami Miller School of Medicine, Miami
| | | | | | - Elizabeth Plater-Zyberk
- University of Miami Miller School of Medicine, Miami; University of Miami School of Architecture, Coral Gables, Florida
| | - Hilda Pantin
- University of Miami Miller School of Medicine, Miami
| | - Olivia Affuso
- School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama
| | - Naresh Kumar
- University of Miami Miller School of Medicine, Miami
| | - Kefeng Wang
- University of Miami Miller School of Medicine, Miami
| | - José Szapocznik
- University of Miami Miller School of Medicine, Miami; University of Miami School of Architecture, Coral Gables, Florida
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