1
|
Vishwanath S, Hopper I, Cloud GC, Chong TTJ, Shah RC, Donnan GA, Williamson JD, Eaton CB, Wolfe R, Reid CM, Tonkin AM, Orchard SG, Fitzgerald S, Murray AM, Woods RL, Nelson MR, Sood A, Steves CJ, Ryan J. The impact of incident stroke on cognitive trajectories in later life. Alzheimers Res Ther 2024; 16:111. [PMID: 38762556 PMCID: PMC11102228 DOI: 10.1186/s13195-024-01479-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 05/07/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Cognitive impairment is common after stroke, and a large proportion of stroke patients will develop dementia. However, there have been few large prospective studies which have assessed cognition both prior to and after stroke. This study aims to determine the extent to which incident stroke impacts different domains of cognitive function in a longitudinal cohort of older community-dwelling individuals. METHODS 19,114 older individuals without cardiovascular disease or major cognitive impairment were recruited and followed over a maximum 11 years. Stroke included ischaemic and haemorrhagic stroke and was adjudicated by experts. Cognitive function was assessed regularly using Modified Mini-Mental State Examination (3MS), Hopkins Verbal Learning Test-Revised (HVLT-R), Symbol Digit Modalities Test (SDMT), and Controlled Oral Word Association Test (COWAT). Linear mixed models were used to investigate the change in cognition at the time of stroke and decline in cognitive trajectories following incident stroke. RESULTS During a median follow-up period of 8.4 [IQR: 7.2, 9.6] years, 815 (4.3%) participants experienced a stroke. Over this time, there was a general decline observed in 3MS, HVLT-R delayed recall, and SDMT scores across participants. However, for individuals who experienced a stroke, there was a significantly greater decline across all cognitive domains immediately after the event immediately after the event (3MS: -1.03 [95%CI: -1.45, -0.60]; HVLT-R: -0.47 [-0.70, -0.24]; SDMT: -2.82 [-3.57, -2.08]; COWAT: -0.67 [-1.04, -0.29]) and a steeper long-term decline for three of these domains (3MS -0.62 [-0.88, -0.35]; COWAT: -0.30 [-0.46, -0.14]); HVLT-R: -0.12 [95%CI, -0.70, -0.24]). However individuals with stroke experienced no longer-term decline in SDMT compared to the rest of the participants. CONCLUSIONS These findings highlight the need for comprehensive neuropsychology assessments for ongoing monitoring of cognition following incident stroke; and potential early intervention.
Collapse
Affiliation(s)
- Swarna Vishwanath
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Ingrid Hopper
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Department of Cardiology and General Medicine Unit, Alfred Health, Melbourne, Australia
| | - Geoffrey C Cloud
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
| | - Trevor T-J Chong
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, VIC, Australia
- Department of Clinical Neurosciences, St. Vincent's Hospital, Melbourne, VIC, Australia
| | - Raj C Shah
- Department of Family and Preventive Medicine, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Geoffrey A Donnan
- Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Jeff D Williamson
- Sticht Center for Healthy Aging and Alzheimer's Prevention, Department of Internal Medicine, Section on Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Brown University Warren Alpert Medical School and School of Public Health, Pawtucket, RI, USA
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- School of Population Health, Curtin University, Western Australia, Australia
| | - Andrew M Tonkin
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Sharyn Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Anne M Murray
- Berman Center for Outcomes & Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Medicine, Division of Geriatrics Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Ajay Sood
- Department of Family and Preventive Medicine, Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Claire J Steves
- Department of Twin Research & Genetic Epidemiology, King's College London, London, UK
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3004, Australia.
| |
Collapse
|
2
|
Smith SE, Driban JB, Eaton CB, Schaefer LF, Miao QR, Roberts MB, Cauley JA, McAlindon TE, Duryea J. Gender and Age Differences in the Associations Between Cortical Thickness and Hand Osteoarthritis Severity: Data from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2024:S1063-4584(24)01199-3. [PMID: 38768803 DOI: 10.1016/j.joca.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 05/07/2024] [Accepted: 05/14/2024] [Indexed: 05/22/2024]
Abstract
OBJECTIVE To evaluate gender differences in the association between metacarpal cortical thickness - a surrogate for bone density - and severity of radiographic hand osteoarthritis (HOA) in a longitudinal observational study. METHOD Hand radiographs of 3,575 participants (2039 F/1536 M) from the Osteoarthritis Initiative were assessed at baseline and 48 months. A reader used a semi-automated software tool to calculate Tcort, a measurement of the cortical thickness, for metacarpals 2-4. Average Tcort at baseline and change in Tcort from baseline to 48 months was determined and stratified by gender and age for 7 5-year age groups. Spearman's rank correlation coefficients were calculated for the association of baseline Tcort and 2 measures of baseline HOA severity: the sum of Kellgren and Lawrence (KL) grade and total number of joints with radiographic HOA. Longitudinally, logistic regression was used to assess the relationship of Tcort loss to new finger joint radiographic HOA, increase in KL grades, and incident hand pain. RESULTS Male Tcort was higher than females. Significant correlations between Tcort and radiographic severity were noted for women but not men, with stronger associations among women >60 years (rho=-0.25; 95% CI= -0.31- -0.19). Statistically significant associations were seen between Tcort change and radiographic osteoarthritis change among women but not men, with substantial gender differences for Tcort change, particularly ages 50 to 70 years (p<0.01; e.g.Tcort change ages 55 to <60: Males=-0.182(0.118), Females=-0.219(0.124). CONCLUSION We found significant HOA-related gender differences in cortical thickness, suggesting the involvement of female bone loss during and after menopause.
Collapse
Affiliation(s)
- Stacy E Smith
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Jeffrey B Driban
- Department of Population and Quantitative Health Sciences, UMass Chan Medical School, Worcester, MA, USA.
| | - Charles B Eaton
- Department of Family Medicine Warren Alpert Medical School, Brown University, Providence, RI, USA; Center for Primary Care and Prevention, Kent Hospital, Warwick, RI, USA.
| | - Lena F Schaefer
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Quinley R Miao
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Mary B Roberts
- Center for Primary Care and Prevention, Kent Hospital, Warwick, RI, USA.
| | | | - Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology; Tufts Medical Center, Boston, MA, USA.
| | - Jeffrey Duryea
- Division of Musculoskeletal Imaging and Intervention, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
3
|
Selvaraj S, Claggett B, Shah SH, Mentz RJ, Khouri MG, Manichaikul AW, Khan SS, Rich SS, Mosley TH, Levitan EB, Arora P, Goyal P, Haring B, Eaton CB, Cheng RK, Wells GL, Manson JE, Fontana M, Solomon SD. Cardiovascular Burden of the V142I Transthyretin Variant. JAMA 2024:2818877. [PMID: 38734952 PMCID: PMC11089467 DOI: 10.1001/jama.2024.4467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/20/2024] [Indexed: 05/13/2024]
Abstract
Importance Individual cohort studies concur that the amyloidogenic V142I variant of the transthyretin (TTR) gene, present in 3% to 4% of US Black individuals, increases heart failure (HF) and mortality risk. Precisely defining carrier risk across relevant clinical outcomes and estimating population burden of disease are important given established and emerging targeted treatments. Objectives To better define the natural history of disease in carriers across mid to late life, assess variant modifiers, and estimate cardiovascular burden to the US population. Design, Setting, and Participants A total of 23 338 self-reported Black participants initially free from HF were included in 4 large observational studies across the US (mean [SD], 15.5 [8.2] years of follow-up). Data analysis was performed between May 2023 and February 2024. Exposure V142I carrier status (n = 754, 3.2%). Main Outcomes and Measures Hospitalizations for HF (including subtypes of reduced and preserved ejection fraction) and all-cause mortality. Outcomes were analyzed by generating 10-year hazard ratios for each age between 50 and 90 years. Using actuarial methods, mean survival by carrier status was estimated and applied to the 2022 US population using US Census data. Results Among the 23 338 participants, the mean (SD) age at baseline was 62 (9) years and 76.7% were women. Ten-year carrier risk increased for HF hospitalization by age 63 years, predominantly driven by HF with reduced ejection fraction, and 10-year all-cause mortality risk increased by age 72 years. Only age (but not sex or other select variables) modified risk with the variant, with estimated reductions in longevity ranging from 1.9 years (95% CI, 0.6-3.1) at age 50 to 2.8 years (95% CI, 2.0-3.6) at age 81. Based on these data, 435 851 estimated US Black carriers between ages 50 and 95 years are projected to cumulatively lose 957 505 years of life (95% CI, 534 475-1 380 535) due to the variant. Conclusions and Relevance Among self-reported Black individuals, male and female V142I carriers faced similar and substantial risk for HF hospitalization, predominantly with reduced ejection fraction, and death, with steep age-dependent penetrance. Delineating the individual contributions of, and complex interplay among, the V142I variant, ancestry, the social construct of race, and biological or social determinants of health to cardiovascular disease merits further investigation.
Collapse
Affiliation(s)
- Senthil Selvaraj
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Duke Molecular Physiology Institute, Durham, North Carolina
| | - Brian Claggett
- Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Svati H. Shah
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
- Duke Molecular Physiology Institute, Durham, North Carolina
| | - Robert J. Mentz
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Michel G. Khouri
- Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Ani W. Manichaikul
- Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Sadiya S. Khan
- Division of Cardiology, Department of Medicine and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Stephen S. Rich
- Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Thomas H. Mosley
- The MIND Center, University of Mississippi Medical Center, Jackson
| | | | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham
| | - Parag Goyal
- Department of Medicine, Weill Cornell Medicine, New York, New York
| | - Bernhard Haring
- Department of Medicine III, Saarland University, Homburg, Saarland, Germany
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Department of Family Medicine, Department of Epidemiology, Warren Alpert Medical Scholl of Brown University, Brown University School of Public Health, Providence, Rhode Island
| | | | - Gretchen L. Wells
- Division of Cardiovascular Disease, University of Alabama at Birmingham
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | | | - Scott D. Solomon
- Division of Cardiology, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| |
Collapse
|
4
|
Salis Z, Driban JB, McAlindon TE, Eaton CB, Sainsbury A. Association of Weight Loss and Weight Gain With Structural Defects and Pain in Hand Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Care Res (Hoboken) 2024; 76:652-663. [PMID: 38130021 PMCID: PMC11039366 DOI: 10.1002/acr.25284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/13/2023] [Accepted: 12/19/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Our aim was to define the association of weight change (weight loss or weight gain) with the incidence and progression of hand osteoarthritis (OA), assessed either by radiography or by pain, using data from the Osteoarthritis Initiative. METHODS Among the 4,796 participants, we selected 4,598 participants, excluding those with cancer or rheumatoid arthritis or a body mass index under 18.5 kg/m2. We investigated the association of weight change with incidence and progression of radiographic hand OA and the development and resolution of hand pain. Using multivariable logistic regression, we investigated the association of weight change from baseline to the 4-year follow-up with the incidence and progression of radiographic hand OA at the 4-year follow-up. Additionally, multivariable repeated-measure mixed-effects logistic regression analyzed the association of weight change with the development and resolution of hand pain across 2-year, 4-year, 6-year, and 8-year follow-ups. RESULTS No statistically significant associations were observed between weight change and the investigated outcomes. Specifically, for each 5% weight loss, the odds ratios for the incidence and progression of radiographic hand OA were 0.90 (95% confidence interval [95% CI] 0.67-1.23) and 0.92 (95% CI 0.84-1.00), respectively. Similarly, for each 5% weight loss, the odds ratios for the development and resolution of hand pain at the 8-year follow-up were 1.00 (95% CI 0.92-1.09) and 1.07 (95% CI 0.91-1.25), respectively. CONCLUSION Our study found no evidence of an association between weight change and the odds of incidence or progression of radiographic hand OA over 4 years, nor the development or resolution of hand pain over 8 years.
Collapse
Affiliation(s)
- Zubeyir Salis
- Division of Rheumatology, Geneva University Hospital and Faculty of Medicine, University of Geneva, Geneva, Switzerland
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
- The University of New South Wales, Centre for Big Data Research in Health, Kensington, NSW, Australia
| | - Jeffrey B. Driban
- UMass Chan Medical School, Department of Population and Quantitative Health Sciences
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology; Tufts Medical Center; Boston, MA, USA
| | - Charles B. Eaton
- Alpert Medical School of Brown University, Providence, Rhode Island; Center for Primary Care and Prevention, Pawtucket, Rhode Island; and Brown University School of Public Health, Providence, Rhode Island
| | - Amanda Sainsbury
- The University of Western Australia, School of Human Sciences, Perth, WA, Australia
| |
Collapse
|
5
|
Lo GH, Patarini JC, Richard MJ, McAlindon TE, Kriska AM, Rockette-Wagner B, Eaton CB, Hochberg MC, Kwoh CK, Nevitt MC, Driban JB. Gardening/yardwork in people with knee osteoarthritis is not associated with symptom or structural progression over 48 months: data from the Osteoarthritis Initiative. Clin Rheumatol 2024; 43:1755-1762. [PMID: 38561590 DOI: 10.1007/s10067-024-06912-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Revised: 02/09/2024] [Accepted: 02/15/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To evaluate the relationship of gardening/yardwork with symptomatic and structural progression in those with pre-existing radiographic knee osteoarthritis (OA) in the Osteoarthritis Initiative (OAI), an observational study designed to evaluate potential and known biomarkers and risk factors of knee OA. METHODS We conducted a cohort study nested within the OAI, including participants ≥ 50 years old with radiographic OA in at least one knee at the time of OAI enrollment. A participant reported the level of gardening/yardwork activity in a self-administered survey. Logistic regression analyses were used to evaluate the association of gardening/yardwork on new frequent knee pain, Kellgren-Lawrence (KL) worsening, medial joint space narrowing (JSN) worsening, and improved frequent knee pain. RESULTS Of 1808 knees (1203 participants), over 60% of knees had KL grade = 2, 65% had medial JSN, and slightly more than a third had frequent knee symptoms. Gardeners/yardworkers and non-gardners/yardworkers had similar "worsening" outcomes for new knee pain (29% vs. 29%), KL worsening (19% vs. 18%), and medial JSN (23% vs. 24%). The adjusted odds ratio (OR) for the "worsening" outcomes of new knee pain, KL worsening, and medial JSN worsening were 1.0 (0.7-1.3), 1.0 (0.8-1.3), and 1.1 (0.9-1.4), respectively. The gardeners/yardworkers had an adjusted OR of 1.2 (0.9-1.7) for improved knee pain compared with non-gardners/yardworkers. CONCLUSION Gardening/yardwork is not associated with knee OA progression and should not be discouraged in those with knee OA. Key Points • Gardening/yardwork is not associated with knee OA symptomatic or structural progression. • Gardening/yardwork should not be discouraged in people with knee OA.
Collapse
Affiliation(s)
- Grace H Lo
- Department of Medicine, Baylor College of Medicine, 1 Baylor Plaza, BCM-285, Houston, TX, USA.
- Medical Care Line and Research Care Line, Michael E. DeBakey Medical Center, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Houston, TX, USA.
| | - Julieann C Patarini
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Michael J Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Andrea M Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA
| | - Marc C Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - C Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Jeffrey B Driban
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| |
Collapse
|
6
|
Lo GH, Richard MJ, Kriska AM, McAlindon TE, Harkey M, Rockette-Wagner B, Eaton CB, Hochberg MC, Kwoh CK, Nevitt MC, Bhakta PB, McLaughlin CP, Driban JB. Bicycling over a Lifetime Is Associated with Less Symptomatic Knee Osteoarthritis: Data from the Osteoarthritis Initiative. Med Sci Sports Exerc 2024:00005768-990000000-00512. [PMID: 38600648 DOI: 10.1249/mss.0000000000003449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024]
Abstract
INTRODUCTION To evaluate the relationship between a history of bicycling and symptomatic and structural outcomes of knee osteoarthritis (OA), the most common form of arthritis. METHODS This was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), where we investigated OAI participants with complete data on bicycling, knee pain, and radiographic evidence of knee OA. We used a self-administered questionnaire at the 96-month OAI visit to identify participation in bicycling during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and > 50 years old). Using logistic regression, we evaluated the influence of prior bicycling status (any history, history for each time period, number of periods cycling) on three outcomes at the 48-month OAI visit: frequent knee pain, radiographic OA (ROA), and symptomatic radiographic OA (SOA), adjusting for age and gender. RESULTS 2607 participants were included; 44.2% were male; mean age was 64.3 (SD 9.0) years; body mass index was 28.5 (SD 4.9) kg/m 2 . The adjusted risk ratio for the outcome of frequent knee pain, ROA, and SOA among those who reported any history of bicycling compared to non-bicyclers was 0.83 (0.73-0.92), 0.91 (0.85-0.98), and 0.79 (0.68-0.90), respectively. We observed a dose-response among those who participated in bicycling during more time periods. CONCLUSIONS People who participated in bicycling had a lower prevalence of frequent knee pain, ROA, and SOA. The benefit appeared cumulative. This study indicates that bicycling may be favorable to knee health and should be encouraged.
Collapse
Affiliation(s)
| | - Michael J Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA
| | - Andrea M Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA
| | - Matthew Harkey
- Department of Kinesiology, Michigan State University, East Lansing, MI
| | | | | | - Marc C Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - C Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Preeya B Bhakta
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | | | - Jeffrey B Driban
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA
| |
Collapse
|
7
|
LaMonte MJ, LaCroix AZ, Nguyen S, Evenson KR, Di C, Stefanick ML, Hyde ET, Anuskiewicz B, Eaton CB. Accelerometer-Measured Physical Activity, Sedentary Time, and Heart Failure Risk in Women Aged 63 to 99 Years. JAMA Cardiol 2024; 9:336-345. [PMID: 38381446 PMCID: PMC10882503 DOI: 10.1001/jamacardio.2023.5692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 12/27/2023] [Indexed: 02/22/2024]
Abstract
Importance Heart failure (HF) prevention is paramount to public health in the 21st century. Objective To examine incident HF and its subtypes with preserved ejection fraction (HFpEF) and reduced EF (HFrEF) according to accelerometer-measured physical activity (PA) and sedentary time. Design, Setting, and Participants This was a prospective cohort study, the Objective Physical Activity and Cardiovascular Health (OPACH) in Older Women study, conducted from March 2012 to April 2014. Included in the analysis were women aged 63 to 99 years without known HF, who completed hip-worn triaxial accelerometry for 7 consecutive days. Follow-up for incident HF occurred through February 2022. Data were analyzed from March to December 2023. Exposure Daily PA (total, light, moderate to vigorous PA [MVPA], steps) and sedentary (total, mean bout duration) behavior. Main Outcomes and Measures Adjudicated incident HF, HFpEF, and HFrEF. Results A total of 5951 women (mean [SD] age, 78.6 [6.8] years) without known HF were included in this analysis. Women self-identified with the following race and ethnicity categories: 2004 non-Hispanic Black (33.7%), 1022 Hispanic (17.2%), and 2925 non-Hispanic White (49.2%). There were 407 HF cases (257 HFpEF; 110 HFrEF) identified through a mean (SD) of 7.5 (2.6) years (range, 0.01-9.9 years) of follow-up. Fully adjusted hazard ratios (HRs) for overall HF, HFpEF, and HFrEF associated with a 1-SD increment were 0.85 (95% CI, 0.75-0.95), 0.78 (95% CI, 0.67-0.91), and 1.02 (95% CI, 0.81-1.28) for minutes per day total PA; 0.74 (95% CI, 0.63-0.88), 0.71 (95% CI, 0.57-0.88), and 0.83 (95% CI, 0.62-1.12) for steps per day; and 1.17 (95% CI, 1.04-1.33), 1.29 (95% CI, 1.10-1.51), and 0.94 (95% CI, 0.75-1.18) for minutes per day total sedentary. Cubic spline curves for overall HF and HFpEF were significant inverse for total PA and steps per day and positive for total sedentary. Light PA and MVPA were inversely associated with overall HF (HR per 1 SD: 0.88; 95% CI, 0.78-0.98 and 0.84; 95% CI, 0.73-0.97) and HFpEF (0.80; 95% CI, 0.70-0.93 and 0.85; 95% CI, 0.72-1.01) but not HFrEF. Associations did not meaningfully differ when stratified by age, race and ethnicity, body mass index, physical function, or comorbidity score. Results for sedentary bout duration were inconsistent. Conclusions and Relevance Higher accelerometer-measured PA (MVPA, light PA, steps per day) was associated with lower risk (and greater total sedentary time with higher risk) of overall HF and HFpEF in a racially and ethnically diverse cohort of older women. Increasing PA and reducing sedentary time for primary HFpEF prevention may have relevant implications for cardiovascular resilience and healthy aging in later life.
Collapse
Affiliation(s)
| | | | | | | | - Chongzhi Di
- Fred Hutchinson Cancer Center, Seattle, Washington
| | | | | | | | | |
Collapse
|
8
|
Dalal PJ, Giro P, Rasmussen-Torvik LJ, Yancy CW, Shah SJ, Reiner AP, Haring B, Martin LW, Wells GL, Manson JE, Kooperberg C, Eaton CB, Patel RB. Heart Failure Risk Among African-American Women With an ICAM1 Missense Variant. JACC Heart Fail 2024:S2213-1779(24)00145-8. [PMID: 38530700 DOI: 10.1016/j.jchf.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Revised: 02/12/2024] [Accepted: 02/14/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND A common genetic variant of ICAM1 among African-American individuals (rs5491; p.K56M) is associated with heart failure (HF) hospitalization, but whether this risk is specific to heart failure with preserved ejection fraction (HFpEF) remains unclear. Older women are at high risk for HFpEF, and the relationship between rs5491 and HFpEF across the age spectrum is unknown. OBJECTIVES This study assessed risk of HF and its subtypes conferred by ICAM1 p.K56M (rs5491). METHODS Associations of rs5491 with risk of HF and its subtypes were estimated among African American individuals in WHI (Women's Health Initiative). The study evaluated whether the association between rs5491 and HF hospitalizations was modified by baseline age. Subsequently, African-American women in WHI and MESA (Multi-Ethnic Study of Atherosclerosis) were pooled and analyses were repeated. RESULTS Among 8,401 women in WHI, the minor allele frequency of rs5491 was 20.7%, and 731 HF hospitalizations occurred over 19.2 years. The rs5491 variant was not associated with HF or its subtypes across WHI. Interaction analyses suggested that age as a continuous variable modified the association of rs5491 with HFpEF hospitalization (interaction P = 0.04). Upon categorizing women into age decades, rs5491 conferred increased risk of HFpEF among women ≥70 years (HR per additional rs5491 allele: 1.82 [95% CI: 1.25-2.65]; P = 0.002) but was not associated with HFpEF risk among women <70 years. Pooling African-American women in WHI (n = 8,401) and MESA (n = 856) demonstrated that the effect modification by age on the association of rs5491 with HFpEF became more significant (interaction P = 0.009), with consistent HFpEF risk effect estimates among women ≥70 years. CONCLUSIONS ICAM1 p.K56M (rs5491) is associated with HFpEF among African-American women ≥70 years.
Collapse
Affiliation(s)
- Prarthana J Dalal
- Division of Hematology and Oncology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Pedro Giro
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Laura J Rasmussen-Torvik
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Clyde W Yancy
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sanjiv J Shah
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alex P Reiner
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Bernhard Haring
- Department of Medicine III, Saarland University Hospital, Homburg, Saarland, Germany; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Lisa Warsinger Martin
- Division of Cardiology, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Gretchen L Wells
- Division of Cardiology, University of Alabama Birmingham Heersink School of Medicine, Birmingham, Alabama, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, Washington, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Department of Family Medicine, Department of Epidemiology, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA; Department of Epidemiology, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Ravi B Patel
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
| |
Collapse
|
9
|
Richard MJ, Lo GH, Driban JB, Canavatchel AR, LaValley M, Zhang M, Price LL, Miller E, Eaton CB, McAlindon TE. Knee cartilage change on magnetic resonance imaging: Should we lump or split topographical regions? A 2-year study of data from the osteoarthritis initiative. Clin Anat 2024; 37:210-217. [PMID: 38058252 PMCID: PMC10922267 DOI: 10.1002/ca.24127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 08/14/2023] [Accepted: 11/09/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE We challenge the paradigm that a simplistic approach evaluating anatomic regions (e.g., medial femur or tibia) is ideal for assessing articular cartilage loss on magnetic resonance (MR) imaging. We used a data-driven approach to explore whether specific topographical locations of knee cartilage loss may identify novel patterns of cartilage loss over time that current assessment strategies miss. DESIGN We assessed 60 location-specific measures of articular cartilage on a sample of 99 knees with baseline and 24-month MR images from the Osteoarthritis Initiative, selected as a group with a high likelihood to change. We performed factor analyses of the change in these measures in two ways: (1) summing the measures to create one measure for each of the six anatomically regional-based summary (anatomic regions; e.g., medial tibia) and (2) treating each location separately for a total of 60 measures (location-specific measures). RESULTS The first analysis produced three factors accounting for 66% of the variation in the articular cartilage changes that occur over 24 months of follow-up: (1) medial tibiofemoral, (2) medial and lateral patellar, and (3) lateral tibiofemoral. The second produced 20 factors accounting for 75% of the variance in cartilage changes. Twelve factors only involved one anatomic region. Five factors included locations from adjoining regions (defined by the first analysis; e.g., medial tibiofemoral). Three factors included articular cartilage loss from disparate locations. CONCLUSIONS Novel patterns of cartilage loss occur within each anatomic region and across these regions, including in disparate regions. The traditional anatomic regional approach is simpler to implement and interpret but may obscure meaningful patterns of change.
Collapse
Affiliation(s)
- Michael J. Richard
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line; Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey VAMC, Houston, TX, USA
- Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, TX, USA
| | - Jeffrey B. Driban
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | - Amanda R. Canavatchel
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| | | | - Ming Zhang
- Boston University, School of Computer Science, Boston, MA, USA
| | - Lori Lyn Price
- Tufts Clinical and Translational Science Institute and The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, MA, USA
| | - Eric Miller
- Department of Electrical and Computer Engineering, Tufts University, Medford, MA, USA
| | - Charles B. Eaton
- Warren Alpert Medical School of Brown University, Department of Family Medicine, Providence, RI and School of Public Health of Brown University, Providence, RI, USA
| | - Timothy E. McAlindon
- Tufts Medical Center, Department of Medicine, Division of Rheumatology, Allergy, and Immunology, Boston, MA, USA
| |
Collapse
|
10
|
Lo GH, Richard MJ, McAlindon TE, Kriska AM, Price LL, Rockette-Wagner B, Eaton CB, Hochberg MC, Kent Kwoh C, Nevitt MC, Driban JB. Strength Training Is Associated With Less Knee Osteoarthritis: Data From the Osteoarthritis Initiative. Arthritis Rheumatol 2024; 76:377-383. [PMID: 37870119 PMCID: PMC10922276 DOI: 10.1002/art.42732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/14/2023] [Accepted: 10/16/2023] [Indexed: 10/24/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship of a history of strength training with symptomatic and structural outcomes of knee osteoarthritis (OA). METHODS This study was a retrospective, cross-sectional study within the Osteoarthritis Initiative (OAI), a multicenter prospective longitudinal observational study. Data were collected at four OAI clinical sites: Memorial Hospital of Rhode Island, the Ohio State University, the University of Pittsburgh, and the University of Maryland/Johns Hopkins. The study included 2,607 participants with complete data on strength training, knee pain, and radiographic evidence of knee OA (male, 44.2%; mean ± SD age 64.3 ± 9.0 years; mean ± SD body mass index 28.5 ± 4.9 kg/m2 ). We used a self-administered questionnaire at the 96-month OAI visit to evaluate the exposure of strength training participation during four time periods throughout a participant's lifetime (ages 12-18, 19-34, 35-49, and ≥50 years old). The outcomes (dependent variables) were radiographic OA (ROA), symptomatic radiographic OA (SOA), and frequent knee pain. RESULTS The fully adjusted odds ratios (95% confidence interval) for frequent knee pain, ROA, and SOA among those who participated in strength training any time in their lives were 0.82 (0.68-0.97), 0.83 (0.70-0.99), and 0.77 (0.63-0.94), respectively. Findings were similar when looking at the specific age ranges. CONCLUSION Strength training is beneficial for future knee health, counteracting long-held assumptions that strength training has adverse effects.
Collapse
Affiliation(s)
- Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
- Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Medical Center, Houston, TX, USA
| | - Michael J. Richard
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | - Andrea M. Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lori Lyn Price
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| | | | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI and Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | - Marc C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts Medical Center, Boston, MA, USA
| |
Collapse
|
11
|
Hou A, Li Y, Shadyab AH, Han J, Eaton CB, Qureshi A, Cho E. Photosensibilisierende Antihypertensiva und das Hautkrebsrisiko bei postmenopausalen Frauen: Photosensitizing antihypertensive medication and risk of skin cancer among postmenopausal women. J Dtsch Dermatol Ges 2024; 22:186-196. [PMID: 38361201 DOI: 10.1111/ddg.15281_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/22/2023] [Indexed: 02/17/2024]
Abstract
ZusammenfassungHintergrundEs gibt nur wenige prospektive Studien, die die Dosis‐Wirkungs‐Beziehung zwischen der Anwendung einiger photosensibilisierender Antihypertensiva und Hautkrebs untersucht haben.Patienten und MethodikAnhand prospektiver Daten aus der Women's Health Initiative Observational Study untersuchten wir den Zusammenhang zwischen der Anwendung von Antihypertensiva und dem Risiko für nicht melanozytären Hautkrebs (NMSC) und dem Melanom bei postmenopausalen Frauen im Alter von 50–79 Jahren (n = 64 918). Dabei wurden multivariable Cox‐Regressionsmodelle (Proportional‐Hazard‐Modelle) verwendet und Hazard Ratios (HR) sowie 95%‐Konfidenzintervalle (KI) berechnet.Ergebnisse8777 NMSC und 1227 Melanom‐Fälle wurden beobachtet. Die Anwendung von Antihypertensiva (HR [95%‐KI]: 1,12 [1,07–1,18]), ACE‐Hemmern (1,09 [1,01–1,18]), Kalziumkanalblockern (1,13 [1,05–1,22]), Diuretika (1,20 [1,12–1,27]), Schleifendiuretika (1,17 [1,07–1,28]) und Thiaziden (1,17 [1,03–1,33]) war jeweils mit einem erhöhten NMSC‐Risiko assoziiert. Das NMSC‐Risiko stieg linear mit der Anwendung mehrerer Antihypertensiva (p‐Trend = 0,02) und mit zunehmender Anwendungsdauer (p‐Trend < 0,01) an. Antihypertensiva (1,15 [1,00–1,31]), Angiotensin‐II‐Rezeptorblocker (1,82 [1,05–3,15]) und Diuretika (1,34 [1,13–1,59]) waren jeweils mit einem erhöhten Melanomrisiko assoziiert. Zwischen der Anwendung von Antihypertensiva und der Melanom‐Inzidenz wurde eine Effektmodifikation durch Exposition gegenüber Sonnenlicht‐Exposition beobachtet (p‐Interaktion = 0,02).SchlussfolgerungenDie Anwendung von Antihypertensiva allgemein und einiger einzelner Klassen von Antihypertensiva ging mit einer erhöhten Inzidenz von NMSC und Melanomen einher, wobei eine Dosis‐Wirkungs‐Beziehung bestand.
Collapse
Affiliation(s)
- Alexander Hou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Yueyao Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Jiali Han
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Charles B Eaton
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| |
Collapse
|
12
|
Fleury ES, Kuiper JR, Buckley JP, Papandonatos GD, Cecil KM, Chen A, Eaton CB, Kalkwarf HJ, Lanphear BP, Yolton K, Braun JM. Evaluating the association between longitudinal exposure to a PFAS mixture and adolescent cardiometabolic risk in the HOME Study. Environ Epidemiol 2024; 8:e289. [PMID: 38343730 PMCID: PMC10852393 DOI: 10.1097/ee9.0000000000000289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/14/2023] [Indexed: 02/15/2024] Open
Abstract
Background Exposure to per- and polyfluoroalkyl substances (PFAS) throughout gestation and childhood may impact cardiometabolic risk. Methods In 179 HOME Study participants (Cincinnati, OH; recruited 2003-2006), we used latent profile analysis to identify two distinct patterns of PFAS exposure from serum concentrations of four PFAS measured at birth and ages 3, 8, and 12 years. We assessed the homeostatic model of insulin resistance, triglycerides-to-high-density lipoprotein cholesterol ratio, leptin-to-adiponectin ratio, systolic blood pressure, visceral fat, and hemoglobin A1c levels at age 12 years. We used multivariable linear regression to assess the association of membership in the longitudinal PFAS mixture exposure group with a summary measure of overall cardiometabolic risk and individual components. Results One PFAS exposure profile (n = 66, 39%) had higher geometric means of all PFAS across all visits than the other. Although adjusted associations were null in the full sample, child sex modified the association of longitudinal PFAS mixture exposure group with overall cardiometabolic risk, leptin-to-adiponectin ratio, systolic blood pressure, and visceral fat (interaction term P values: 0.02-0.08). Females in the higher exposure group had higher cardiometabolic risk scores (ß = 0.43; 95% CI = -0.08, 0.94), systolic blood pressures (ß = 0.6; 95% CI = 0.1, 1.1), and visceral fat (ß = 0.44; 95% CI = -0.13, 1.01); males had lower cardiometabolic risk scores (ß = -0.52; 95% CI = -1.06, -0.06), leptin-to-adiponectin ratios (ß = -0.7; 95% CI = -1.29, -0.1), systolic blood pressures (ß = -0.14; 95% CI = -0.7, 0.41), and visceral fat (ß = -0.52; 95% CI = -0.84, -0.19). Conclusions Exposure to this PFAS mixture throughout childhood may have sex-specific effects on adolescent cardiometabolic risk.
Collapse
Affiliation(s)
| | - Jordan R. Kuiper
- Department of Environmental and Occupational Health, The George Washington University Milken Institute School of Public Health, Washington, D.C
| | - Jessie P. Buckley
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC
| | | | - Kim M. Cecil
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA
| | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI
| | - Heidi J. Kalkwarf
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, RI
| |
Collapse
|
13
|
Hou A, Li Y, Shadyab AH, Han J, Eaton CB, Qureshi A, Cho E. Photosensitizing antihypertensive medication and risk of skin cancer among postmenopausal women. J Dtsch Dermatol Ges 2024; 22:186-194. [PMID: 38345266 DOI: 10.1111/ddg.15281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 09/22/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Few prospective studies exist with an evaluation of a dose-response relationship between use of some photosensitizing antihypertensive medications and skin cancer. PATIENT AND METHODS We used prospective data from the Women's Health Initiative Observational Study to investigate the association between antihypertensive use and risk of non-melanoma skin cancer (NMSC) and melanoma in postmenopausal women aged 50-79 years at baseline (n = 64,918). Multivariable Cox proportional hazards regression models were used and hazard ratios (HRs) and 95 confidence intervals (CIs) were calculated. RESULTS 8,777 NMSC and 1,227 melanoma cases were observed. Use of antihypertensives (HR [95% CI]: 1.12 [1.07-1.18]), ACE inhibitors (1.09 [1.01-1.18]), calcium channel blockers (1.13 [1.05-1.22]), diuretics (1.20 [1.12-1.27]), loop diuretics (1.17 [1.07-1.28]), and thiazides (1.17 [1.03-1.33]) were each associated with higher NMSC risk. NMSC risk linearly increased with use of multiple antihypertensives (p-trend = 0.02) and with longer duration of use (p-trend < 0.01). Antihypertensives (1.15 [1.00-1.31]), angiotensin-II receptor blockers (1.82 [1.05-3.15]), and diuretics (1.34 [1.13-1.59]) were each associated with elevated melanoma risk. Effect modification by solar radiation exposure was found between antihypertensive use and incidence of melanoma (p-interaction = 0.02). CONCLUSIONS Use of antihypertensives overall, and several individual classes thereof, were associated with higher incidence of NMSC and melanoma with dose-response relationship.
Collapse
Affiliation(s)
- Alexander Hou
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, USA
| | - Yueyao Li
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, CA, La Jolla, USA
| | - Jiali Han
- Department of Epidemiology, Indiana University Richard M. Fairbanks School of Public Health, Indianapolis, Indiana, USA
| | - Charles B Eaton
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Abrar Qureshi
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
| | - Eunyoung Cho
- Department of Dermatology, Warren Alpert Medical School, Brown University, Providence, Rhode Island, USA
- Department of Epidemiology, School of Public Health, Brown University, Providence, Rhode Island, USA
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, MA, Boston, USA
| |
Collapse
|
14
|
Schuermans A, Honigberg MC, Raffield LM, Yu B, Roberts MB, Kooperberg C, Desai P, Carson AP, Shah AM, Ballantyne CM, Bick AG, Natarajan P, Manson JE, Whitsel EA, Eaton CB, Reiner AP. Clonal Hematopoiesis and Incident Heart Failure With Preserved Ejection Fraction. JAMA Netw Open 2024; 7:e2353244. [PMID: 38270950 PMCID: PMC10811556 DOI: 10.1001/jamanetworkopen.2023.53244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 12/05/2023] [Indexed: 01/26/2024] Open
Abstract
Importance Clonal hematopoiesis of indeterminate potential (CHIP), the age-related clonal expansion of hematopoietic stem cells with leukemogenic acquired genetic variants, is associated with incident heart failure (HF). Objective To evaluate the associations of CHIP and key gene-specific CHIP subtypes with incident HF with preserved ejection fraction (HFpEF) and reduced ejection fraction (HFrEF). Design, Setting, and Participants This population-based cohort study included participants from 2 racially diverse prospective cohort studies with uniform HF subtype adjudication: the Jackson Heart Study (JHS) and Women's Health Initiative (WHI). JHS participants were enrolled during 2000 to 2004 and followed up through 2016. WHI participants were enrolled during 1993 to 1998 and followed up through 2022. Participants who underwent whole-genome sequencing, lacked prevalent HF at baseline, and were followed up for HF adjudication were included. Follow-up occurred over a median (IQR) of 12.0 (11.0-12.0) years in the JHS and 15.3 (9.0-22.0) years in the WHI. Statistical analysis was performed from June to December 2023. Exposures Any CHIP and the most common gene-specific CHIP subtypes (DNMT3A and TET2 CHIP). Main Outcomes and Measures First incident hospitalized HF events were adjudicated from hospital records and classified as HFpEF (left ventricular ejection fraction ≥50%) or HFrEF (ejection fraction <50%). Results A total of 8090 participants were included; 2927 from the JHS (median [IQR] age, 56 [46-65] years; 1846 [63.1%] female; 2927 [100.0%] Black or African American) and 5163 from the WHI (median [IQR] age, 67 [62-72] years; 5163 [100.0%] female; 29 [0.6%] American Indian or Alaska Native, 37 [0.7%] Asian or Pacific Islander, 1383 [26.8%] Black or African American, 293 [5.7%] Hispanic or Latinx, 3407 [66.0%] non-Hispanic White, and 14 [0.3%] with other race and ethnicity). The multivariable-adjusted hazard ratio (HR) for composite CHIP and HFpEF was 1.28 (95% CI, 0.93-1.76; P = .13), and for CHIP and HFrEF it was 0.79 (95% CI, 0.49-1.25; P = .31). TET2 CHIP was associated with HFpEF in both cohorts (meta-analyzed HR, 2.35 [95% CI, 1.34 to 4.11]; P = .003) independent of cardiovascular risk factors and coronary artery disease. Analyses stratified by C-reactive protein (CRP) in the WHI found an increased risk of incident HFpEF in individuals with CHIP and CRP greater than or equal to 2 mg/L (HR, 1.94 [95% CI, 1.20-3.15]; P = .007), but not in those with CHIP and CRP less than 2 mg/L or those with CRP greater than or equal to 2 mg/L without CHIP, when compared with participants without CHIP and CRP less than 2 mg/L. Conclusions and Relevance In this cohort study, TET2 CHIP was an independent risk factor associated with incident HFpEF. This finding may have implications for the prevention and management of HFpEF, including development of targeted therapies.
Collapse
Affiliation(s)
- Art Schuermans
- Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Faculty of Medicine, KU Leuven, Leuven, Belgium
| | - Michael C. Honigberg
- Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Bing Yu
- School of Public Health, The University of Texas Health Science Center, Houston
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Brown University, Pawtucket, Rhode Island
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Pinkal Desai
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, New York
| | - April P. Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson
| | - Amil M. Shah
- Division of Cardiovascular Medicine, University of Texas Southwestern Medical Center, Dallas
| | | | - Alexander G. Bick
- Division of Genomic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Pradeep Natarajan
- Program in Medical and Population Genetics and Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston
- Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - JoAnn E. Manson
- Division of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health and Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Care New England, Center for Primary Care and Prevention, Pawtucket, Rhode Island
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Alexander P. Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| |
Collapse
|
15
|
Bennett SJ, Hunt RP, Breathett K, Eaton CB, Garcia L, Jiménez M, Johns TS, Mouton CP, Nassir R, Nuño T, Urrutia RP, Wactawski-Wende J, Cené CW. Racial and Ethnic Differences in Self-Reported COVID-19 Exposure Risks, Concerns, and Behaviors Among Diverse Participants in the Women's Health Initiative Study. J Gerontol A Biol Sci Med Sci 2023; 78:2294-2303. [PMID: 37267463 PMCID: PMC10692417 DOI: 10.1093/gerona/glad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Indexed: 06/04/2023] Open
Abstract
BACKGROUND Racial and ethnic disparities in coronavirus disease 2019 (COVID-19) risk are well-documented; however, few studies in older adults have examined multiple factors related to COVID-19 exposure, concerns, and behaviors or conducted race- and ethnicity-stratified analyses. The Women's Health Initiative (WHI) provides a unique opportunity to address those gaps. METHODS We conducted a secondary analysis of WHI data from a supplemental survey of 48 492 older adults (mean age 84 years). In multivariable-adjusted modified Poisson regression analyses, we examined predisposing factors and COVID-19 exposure risk, concerns, and behaviors. We hypothesized that women from minoritized racial or ethnic groups, compared to non-Hispanic White women, would be more likely to report: exposure to COVID-19, a family or friend dying from COVID-19, difficulty getting routine medical care or deciding to forego care to avoid COVID-19 exposure, and having concerns about the COVID-19 pandemic. RESULTS Asian women and non-Hispanic Black/African American women had a higher risk of being somewhat/very concerned about risk of getting COVID-19 compared to non-Hispanic White women and each was significantly more likely than non-Hispanic White women to report forgoing medical care to avoid COVID-19 exposure. However, Asian women were 35% less likely than non-Hispanic White women to report difficulty getting routine medical care since March 2020 (adjusted relative risk 0.65; 95% confidence interval 0.57, 0.75). CONCLUSIONS We documented COVID-related racial and ethnic disparities in COVID-19 exposure risk, concerns, and care-related behaviors that disfavored minoritized racial and ethnic groups, particularly non-Hispanic Black/African American women.
Collapse
Affiliation(s)
- Serenity J Bennett
- College of Arts & Sciences, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Rebecca P Hunt
- Fred Hutchinson Cancer Center, Public Health Sciences, Seattle, Washington, USA
| | - Khadijah Breathett
- Division of Cardiovascular Medicine, Krannert Institute of Cardiology, Indiana University, Indianapolis, Indiana, USA
| | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Pawtucket, Rhode Island, USA
| | - Lorena Garcia
- Department of Public Health Sciences, University of California, Davis, Davis, California, USA
| | - Monik Jiménez
- Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Tanya S Johns
- Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Charles P Mouton
- Department of Family Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Rami Nassir
- Department of Pathology, University of California, Davis, Davis, California, USA
| | - Tomas Nuño
- Department of Epidemiology & Biostatistics, University of Arizona, Tucson, Arizona, USA
| | - Rachel P Urrutia
- Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Jean Wactawski-Wende
- School of Public Health and Health Professions, University at Buffalo, Buffalo, New York, USA
| | - Crystal W Cené
- Department of Medicine, University of California San Diego, La Jolla, California, USA
| |
Collapse
|
16
|
Park JW, Dulin AJ, Scarpaci MM, Dionne LA, Needham BL, Sims M, Kanaya AM, Kandula NR, Loucks EB, Fava JL, Eaton CB, Howe CJ. Examining the Relationship Between Multilevel Resilience Resources and Cardiovascular Disease Incidence, Overall and by Psychosocial Risks, Among Participants in the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. Am J Epidemiol 2023; 192:1864-1881. [PMID: 37442807 PMCID: PMC11043787 DOI: 10.1093/aje/kwad159] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 12/20/2022] [Accepted: 07/11/2023] [Indexed: 07/15/2023] Open
Abstract
We examined relationships between resilience resources (optimism, social support, and neighborhood social cohesion) and cardiovascular disease (CVD) incidence and assessed potential effect-measure modification by psychosocial risk factors (e.g., stress, depression) among adults without CVD in 3 cohort studies (2000-2018): the Jackson Heart Study, the Multi-Ethnic Study of Atherosclerosis, and the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study. We fitted adjusted Cox models accounting for within-neighborhood clustering while censoring at dropout or non-CVD death. We assessed for effect-measure modification by psychosocial risks. In secondary analyses, we estimated standardized risk ratios using inverse-probability-weighted Aalen-Johansen estimators to account for confounding, dropout, and competing risks (non-CVD deaths) and obtained 95% confidence intervals (CIs) using cluster bootstrapping. For high and medium (versus low) optimism (n = 6,243), adjusted hazard ratios (HRs) for incident CVD were 0.94 (95% CI: 0.78, 1.13) and 0.90 (95% CI: 0.75, 1.07), respectively. Corresponding HRs were 0.88 (95% CI: 0.74, 1.04) and 0.92 (95% CI: 0.79, 1.06) for social support (n = 7,729) and 1.10 (95% CI: 0.94, 1.29) and 0.99 (95% CI: 0.85, 1.16) for social cohesion (n = 7,557), respectively. Some psychosocial risks modified CVD HRs. Secondary analyses yielded similar findings. For optimism and social support, an inverse relationship was frequently most compatible with the data, but a positive relationship was also compatible. For neighborhood social cohesion, positive and null relationships were most compatible. Thus, specific resilience resources may be potential intervention targets, especially among certain subgroups.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Chanelle J Howe
- Correspondence to Dr. Chanelle Howe, Center for Epidemiologic Research, Department of Epidemiology, School of Public Health, Brown University, Box G-S121-2, Providence, RI 02912 (e-mail: )
| |
Collapse
|
17
|
Ward RJ, Driban JB, MacKay JW, McAlindon TE, Lu B, Eaton CB, Lo GH, Barbe MF, Harkey MS. Meniscal degeneration is prognostic of destabilzing meniscal tear and accelerated knee osteoarthritis: Data from the Osteoarthritis Initiative. J Orthop Res 2023; 41:2418-2423. [PMID: 37094976 PMCID: PMC10592659 DOI: 10.1002/jor.25575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 04/03/2023] [Accepted: 04/17/2023] [Indexed: 04/26/2023]
Abstract
The objective of this study was to assess the prognostic potential of magnetic resonance (MR)-detected meniscal degeneration in relation to incident destabilizing meniscal tears (radial, complex, root, or macerated) or accelerated knee osteoarthritis (AKOA). We used existing MR data from a case-control study of three groups from the Osteoarthritis Initiative without radiographic KOA at baseline: AKOA, typical KOA, and no KOA. From these groups, we included people without medial and lateral meniscal tear at baseline (n = 226) and 48-month meniscal data (n = 221). Intermediate-weighted fat-suppressed MR images annually from baseline to the 48-month visit were graded using a semiquantitative meniscal tear classification criterion. Incident destabilizing meniscal tear was defined as progressing from an intact meniscus to a destabilizing tear by the 48-month visit. We used two logistic regression models to assess whether: (1) presence of medial meniscal degeneration was associated with an incident medial destabilizing meniscal tear, and (2) presence of meniscal degeneration in either meniscus was associated with incident AKOA over the next 4 years. People with the presence of a medial meniscal degeneration had three times the odds of developing an incident destabilizing medial meniscal tear within 4 years compared with a person without medial meniscus degeneration (odds ratio [OR]: 3.03; 95% confidence interval [CI]: 1.40-6.59). People with meniscal degeneration had five times the odds of developing incident AKOA within 4 years compared with a person without meniscal degeneration in either meniscus (OR: 5.04; 95% CI: 2.57-9.89). Meniscal degeneration on MR is clinically meaningful as it relates to future poor outcomes.
Collapse
Affiliation(s)
- Robert J. Ward
- Department of Radiology, Saint Georges University, Grenada
WI, USA; Sullivan’s Island Imaging, Sullivan’s Island SC, USA
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, & Immunology, Tufts
Medical Center, Boston MA, USA
| | - James W. MacKay
- Norwich Medical School, University of East Anglia, Norwich,
UK & Department of Radiology, University of Cambridge, Cambridge, UK
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, & Immunology, Tufts
Medical Center, Boston MA, USA
| | - Bing Lu
- Division of Rheumatology, Immunology & Allergy, Brigham
& Women’s Hospital and Harvard Medical School, Boston MA, USA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical
School of Brown University, Pawtucket RI, USA
| | - Grace H. Lo
- Medical Care Line and Research Care Line, Houston VA
HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E.
DeBakey Medical Center, Houston TX, USA
- Section of Immunology, Allergy, and Rheumatology, Baylor
College of Medicine, Houston TX, USA
| | - Mary F. Barbe
- Center for Translational Medicine, Temple University School
of Medicine, Philadelphia PA, USA
| | - Matthew S. Harkey
- Department of Kinesiology, Michigan State University, East
Lansing MI, USA
| |
Collapse
|
18
|
Mathiessen A, Onuoha I, Luh R, Driban JB, Roberts MB, Eaton CB, McAlindon TE, Duryea J. Radiographic joint space width in individuals with hand osteoarthritis: Are their "healthy" joints really healthy? Osteoarthritis Cartilage 2023:S1063-4584(23)00947-0. [PMID: 37865135 DOI: 10.1016/j.joca.2023.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 10/08/2023] [Accepted: 10/09/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVES We aimed to investigate the systemic nature of hand osteoarthritis (OA). We hypothesized that people who suffer from hand OA would display narrower radiographic joint space width (JSW) - not only in joints with apparent radiographic OA but also in their unaffected "healthy" joints. METHOD We examined 3394 participants from the Osteoarthritis Initiative with available dominant hand radiographs at baseline. Cases were defined as having interphalangeal OA (IPOA) based on a Kellgren and Lawrence (KL) score of ≥2 in two or more finger joints, whereas controls did not have IPOA. We used custom software to make JSW measurements of the metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints in fingers 2-5 per hand. In joint-level analyses, we included only KL score=0, allowing us to compare all joints without IPOA in cases and controls. We used generalized estimating equation models to compare JSW between both groups, adjusted for age, gender, metacarpal length, and joint type. RESULTS Finger joints without radiographic OA had significantly narrower JSW in the IPOA group compared to finger joints in the control group (p < 0.001). The differences were significant across all joint types and for both total JSW measurements as well as for central and lateral sub-regions within each joint group (p < 0.001). CONCLUSION Unaffected finger joints in people with IPOA had narrower joint space than joints of healthy controls. This implies a systemic nature of hand OA, in which people may have a predisposition for general cartilage deterioration.
Collapse
Affiliation(s)
- Alexander Mathiessen
- Brigham and Women's Hospital, Boston, MA, USA; Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | | | - Rebecca Luh
- Brigham and Women's Hospital, Boston, MA, USA
| | | | - Mary B Roberts
- Center for Primary Care and Prevention, Kent Hospital, Warwick, RI, USA
| | - Charles B Eaton
- Department of Family Medicine Warren Alpert Medical School of Brown University, Providence, RI, USA; Department of Epidemiology, School of Public Health of Brown University, Providence, RI, USA
| | | | | |
Collapse
|
19
|
Driban JB, Vo N, Duryea J, Schaefer LF, Haugen IK, Eaton CB, Roberts MB, Lu B, McAlindon T. Hand joints without radiographic osteoarthritis maintain their joint space width over 4 years despite what's happening elsewhere in the hand. Rheumatology (Oxford) 2023:kead480. [PMID: 37695305 DOI: 10.1093/rheumatology/kead480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Revised: 07/28/2023] [Accepted: 08/29/2023] [Indexed: 09/12/2023] Open
Abstract
OBJECTIVES We aimed to determine if hand osteoarthritis is characterized by systemic cartilage loss by assessing if radiographically normal joints had greater joint space width (JSW) loss during four years in hands with incident or prevalent osteoarthritis elsewhere in the hand compared with hands without osteoarthritis. METHODS We used semi-automated software to measure JSW in the distal and proximal interphalangeal joints of 3,368 participants in the Osteoarthritis Initiative who had baseline and 48-month hand radiographs. A reader scored 16 hand joints (including the thumb-base) for Kellgren-Lawrence (KL) Grade. A joint had osteoarthritis if scored as KL ≥ 2. We identified three groups based on longitudinal hand osteoarthritis status: 1) no hand osteoarthritis (KL < 2 in all 16 joints) at the baseline and 48-month visits, 2) incident hand osteoarthritis (KL < 2in all 16 joints at baseline and then ≥1 joint with KL ≥ 2 at 48-months), and 3) prevalent hand osteoarthritis (≥1 joint with KL ≥ 2 at baseline and 48-months). We then assessed if JSW in radiographically normal joints (KL = 0) differed across these three groups. We calculated unpooled effect sizes to help interpret the differences between groups. RESULTS We observed small differences in JSW loss that are unlikely to be clinically important between radiographically normal joints between those without hand osteoarthritis (n = 1054) and those with incident (n = 102) or prevalent hand osteoarthritis (n = 2212) (effect size range: -0.01 to 0.24). These findings were robust when examining JSW loss dichotomized based on meaningful change and in other secondary analyses. CONCLUSIONS Hand osteoarthritis is not a systemic disease of cartilage.
Collapse
Affiliation(s)
- Jeffrey B Driban
- Division of Rheumatology, Allergy, & Immunology; Tufts Medical Center; Boston, MA; USA
| | - Nhung Vo
- Division of Rheumatology, Allergy, & Immunology; Tufts Medical Center; Boston, MA; USA
| | - Jeff Duryea
- Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Lena F Schaefer
- Department of Radiology, South Nuremberg Hospital, Nuremberg, Germany
| | - Ida K Haugen
- Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - Charles B Eaton
- Alpert Medical School of Brown University, Providence, RI, USA. Center for Primary Care and Prevention, Pawtucket, RI, USA. Brown University School of Public Health, Providence, RI, USA
| | - Mary B Roberts
- Center for Primary Care and Prevention, Pawtucket, RI, USA
| | - Bing Lu
- Department of Public Health Sciences, University of Connecticut Health Center, Farmington CT, USA
| | - Timothy McAlindon
- Division of Rheumatology, Allergy, & Immunology; Tufts Medical Center; Boston, MA; USA
| |
Collapse
|
20
|
Brewer PL, D'Agata AL, Roberts MB, Saquib N, Schnatz PF, Manson J, Eaton CB, Sullivan MC. The co-occurrence and cumulative prevalence of hypertension, rheumatoid arthritis, and hypothyroidism in preterm-born women in the Women's Health Initiative. J Dev Orig Health Dis 2023; 14:459-468. [PMID: 37198934 DOI: 10.1017/s2040174423000120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
Emerging evidence suggests that preterm-born individuals (<37 weeks gestation) are at increased risk of developing chronic health conditions in adulthood. This study compared the prevalence, co-occurrence, and cumulative prevalence of three female predominant chronic health conditions - hypertension, rheumatoid arthritis [RA], and hypothyroidism - alone and concurrently. Of 82,514 U.S. women aged 50-79 years enrolled in the Women's Health Initiative, 2,303 self-reported being born preterm. Logistic regression was used to analyze the prevalence of each condition at enrollment with birth status (preterm, full term). Multinomial logistic regression models analyzed the association between birth status and each condition alone and concurrently. Outcome variables using the 3 conditions were created to give 8 categories ranging from no disease, each condition alone, two-way combinations, to having all three conditions. The models adjusted for age, race/ethnicity, and sociodemographic, lifestyle, and other health-related risk factors. Women born preterm were significantly more likely to have any one or a combination of the selected conditions. In fully adjusted models for individual conditions, the adjusted odds ratios (aORs) were 1.14 (95% CI, 1.04, 1.26) for hypertension, 1.28 (1.12, 1.47) for RA, and 1.12 (1.01, 1.24) for hypothyroidism. Hypothyroidism and RA were the strongest coexisting conditions [aOR 1.69, 95% CI (1.14, 2.51)], followed by hypertension and RA [aOR 1.48, 95% CI (1.20, 1.82)]. The aOR for all three conditions was 1.69 (1.22, 2.35). Perinatal history is pertinent across the life course. Preventive measures and early identification of risk factors and disease in preterm-born individuals are essential to mitigating adverse health outcomes in adulthood.
Collapse
Affiliation(s)
- Pamela L Brewer
- College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
| | - Amy L D'Agata
- College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
| | - Mary B Roberts
- Center for Primary Care and Prevention, Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, Rhode Island, USA
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Saudi Arabia
| | - Peter F Schnatz
- Department of Obstetrics and Gynecology and Internal Medicine, Reading Hospital/Tower Health/Drexel University, Reading, Pennsylvania, USA
| | - JoAnn Manson
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Charles B Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Providence, Rhode Island, USA
| |
Collapse
|
21
|
Cloud GC, Williamson JD, Thao LTP, Tran C, Eaton CB, Wolfe R, Nelson MR, Reid CM, Newman AB, Lockery J, Fitzgerald SM, Murray AM, Shah RC, Woods RL, Donnan GA, McNeil JJ. Low-Dose Aspirin and the Risk of Stroke and Intracerebral Bleeding in Healthy Older People: Secondary Analysis of a Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2325803. [PMID: 37494038 PMCID: PMC10372701 DOI: 10.1001/jamanetworkopen.2023.25803] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 05/31/2023] [Indexed: 07/27/2023] Open
Abstract
Importance Low-dose aspirin has been widely used for primary and secondary prevention of stroke. The balance between potential reduction of ischemic stroke events and increased intracranial bleeding has not been established in older individuals. Objective To establish the risks of ischemic stroke and intracranial bleeding among healthy older people receiving daily low-dose aspirin. Design, Setting, and Participants This secondary analysis of the Aspirin in Reducing Events in the Elderly (ASPREE) randomized, double-blind, placebo-controlled trial of daily low-dose aspirin was conducted among community-dwelling people living in Australia or the US. Participants were older adults free of symptomatic cardiovascular disease. Recruitment took place between 2010 and 2014, and participants were followed up for a median (IQR) of 4.7 (3.6-5.7) years. This analysis was completed from August 2021 to March 2023. Interventions Daily 100-mg enteric-coated aspirin or matching placebo. Main Outcomes and Measures Stroke and stroke etiology were predetermined secondary outcomes and are presented with a focus on prevention of initial stroke or intracranial bleeding event. Outcomes were assessed by review of medical records. Results Among 19 114 older adults (10 782 females [56.4%]; median [IQR] age, 74 [71.6-77.7] years), 9525 individuals received aspirin and 9589 individuals received placebo. Aspirin did not produce a statistically significant reduction in the incidence of ischemic stroke (hazard ratio [HR], 0.89; 95% CI, 0.71-1.11). However, a statistically significant increase in intracranial bleeding was observed among individuals assigned to aspirin (108 individuals [1.1%]) compared with those receiving placebo (79 individuals [0.8%]; HR, 1.38; 95% CI, 1.03-1.84). This occurred by an increase in a combination of subdural, extradural, and subarachnoid bleeding with aspirin compared with placebo (59 individuals [0.6%] vs 41 individuals [0.4%]; HR, 1.45; 95% CI, 0.98-2.16). Hemorrhagic stroke was recorded in 49 individuals (0.5%) assigned to aspirin compared with 37 individuals (0.4%) in the placebo group (HR, 1.33; 95% CI, 0.87-2.04). Conclusions and Relevance This study found a significant increase in intracranial bleeding with daily low-dose aspirin but no significant reduction of ischemic stroke. These findings may have particular relevance to older individuals prone to developing intracranial bleeding after head trauma. Trial Registration ISRCTN.org Identifier: ISRCTN83772183.
Collapse
Affiliation(s)
- Geoffrey C. Cloud
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Australia
| | - Jeff D. Williamson
- Sticht Center for Healthy Aging and Alzheimer’s Prevention, Department of Internal Medicine, Section on Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Le Thi Phuong Thao
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Cammie Tran
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Brown University School of Public Health, Pawtucket, Rhode Island
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Mark R. Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Anne B. Newman
- Department of Epidemiology Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jessica Lockery
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Sharyn M. Fitzgerald
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Anne M. Murray
- Department of Medicine, Geriatrics Division, Hennepin HealthCare and Berman Center for Clinical Research, Hennepin HealthCare Research Institute, Minneapolis, Minnesota
| | - Raj C. Shah
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Geoffrey A. Donnan
- Melbourne Brain Centre, University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| |
Collapse
|
22
|
Reiner AP, Roberts MB, Honigberg MC, Kooperberg C, Desai P, Bick AG, Natarajan P, Manson JE, Whitsel EA, Eaton CB. Association of Clonal Hematopoiesis of Indeterminate Potential with Incident Heart Failure with Preserved Ejection Fraction. medRxiv 2023:2023.06.07.23291038. [PMID: 37333361 PMCID: PMC10274994 DOI: 10.1101/2023.06.07.23291038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Background Clonal hematopoiesis of indeterminate potential (CHIP) was recently identified as a risk factor for incident heart failure (HF). Whether CHIP is associated selectively with risk of heart failure with reduced ejection fraction (HFrEF) or heart failure with preserved ejection fraction (HFpEF) subtypes is unknown. Objectives To evaluate whether CHIP is associated with incident HF subtypes, HFrEF versus HFpEF. Methods We obtained CHIP status from whole genome sequencing of blood DNA in participants without prevalent HF from a multi-ethnic sample of post-menopausal women without prevalent HF (N=5,214) from the Women's Health Initiative (WHI). Cox proportional hazards models were performed, adjusting for demographic and clinical risk factors. Results CHIP was significantly associated with a 42% (95%CI 6%, 91%) increased risk of HFpEF (P=0.02). In contrast, there was no evidence of association between CHIP and risk of incident HFrEF. When the three most common CHIP subtypes were assessed individually, the risk of HFpEF was more strongly associated with TET2 (HR=2.5; 95%CI 1.54, 4.06; P<0.001), than DNMT3A or ASXL1. Conclusion CHIP, particularly mutations in TET2, represents a potential new risk factor for incident HFpEF.
Collapse
Affiliation(s)
- Alex P. Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Brown University, Pawtucket, Rhode Island
| | - Michael C. Honigberg
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts
- Harvard Medical School, Boston, Massachusetts
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Pinkal Desai
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, New York
| | - Alexander G. Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee
| | - Pradeep Natarajan
- Harvard Medical School, Boston, Massachusetts
- Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts
- Cardiovascular Disease Initiative of the Broad Institute of Harvard and MIT, Cambridge, Massachusetts
| | - JoAnn E. Manson
- Harvard Medical School, Boston, Massachusetts
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts
| | - Eric A. Whitsel
- Department of Epidemiology, Gillings School of Global Public Health and Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island
- Care New England, Center for Primary Care and Prevention, Pawtucket, Rhode Island
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| |
Collapse
|
23
|
Kulick ER, Eliot MN, Szpiro AA, Coull BA, Tinker LF, Eaton CB, Whitsel EA, Stewart JD, Kaufman JD, Wellenius GA. Long-term exposure to ambient particulate matter and stroke etiology: Results from the Women's Health Initiative. Environ Res 2023; 224:115519. [PMID: 36813070 PMCID: PMC10074439 DOI: 10.1016/j.envres.2023.115519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 02/03/2023] [Accepted: 02/16/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Ambient particulate matter (PM) air pollution is a leading cause of global disability and accounts for an annual 2.9 million deaths globally. PM is established as an important risk factor for cardiovascular disease, however the evidence supporting a link specifically between long-term exposure to ambient PM and incident stroke is less clear. We sought to evaluate the association of long-term exposure to different size fractions of ambient PM with incident stroke (overall and by etiologic subtypes) and cerebrovascular deaths within the Women's Health Initiative, a large prospective study of older women in the US. METHODS We studied 155,410 postmenopausal women without previous cerebrovascular disease enrolled into the study between 1993 and 1998, with follow-up through 2010. We assessed geocoded participant address-specific concentrations of ambient PM (fine [PM2.5], respirable [PM10] and coarse [PM10-2.5]), as well as nitrogen dioxide [NO2] using spatiotemporal models. We classified hospitalization events into ischemic, hemorrhagic, or other/unclassified stroke. Cerebrovascular mortality was defined as death from any stroke etiology. We used Cox proportional hazard models to calculate hazard ratios (HR) and 95% confidence intervals (CI), adjusting for individual and neighborhood-level characteristics. RESULTS During a median follow-up time of 15 years, participants experienced 4,556 cerebrovascular events. The hazard ratio for all cerebrovascular events was 2.14 (95% CI: 1.87, 2.44) comparing the top versus bottom quartiles of PM2.5. Similarly, there was a statistically significant increase in events comparing the top versus bottom quartiles of PM10 and NO2 (HR: 1.17; 95% CI: 1.03, 1.33 and HR:1.26; 95% CI: 1.12, 1.42). The strength of association did not vary substantially by stroke etiology. There was little evidence of an association between PMcoarse and incident cerebrovascular events. CONCLUSIONS Long-term exposure to fine (PM2.5) and respirable (PM10) particulate matter as well as NO2 was associated with a significant increase of cerebrovascular events among postmenopausal women. Strength of the associations were consistent by stroke etiology.
Collapse
Affiliation(s)
- Erin R Kulick
- Department of Epidemiology and Biostatistics, Temple University College of Public Health, Philadelphia, PA, USA; Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.
| | - Melissa N Eliot
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA
| | - Adam A Szpiro
- Department of Biostatistics, University of Washington, Seattle, WA, 98195, USA
| | - Brent A Coull
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - Lesley F Tinker
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Memorial Hospital of Rhode Island and Alpert Medical School of Brown University, Pawtucket, RI, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA; Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - James D Stewart
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, 27599, USA
| | - Joel D Kaufman
- Departments of Environmental and Occupational Health Sciences, Medicine, and Epidemiology, University of Washington, Seattle, WA, USA
| | - Gregory A Wellenius
- Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Environmental Health, Boston University School of Public Health, Boston, MA, USA
| |
Collapse
|
24
|
Brewer PL, D'Agata AL, Roberts MB, Wild RA, Shadyab AH, Saquib N, Manson J, Eaton CB, Sullivan MC. Association of Preterm Birth With Prevalent and Incident Hypertension, Early-Onset Hypertension, and Cardiovascular Disease in the Women's Health Initiative. Am J Cardiol 2023; 192:132-138. [PMID: 36791524 DOI: 10.1016/j.amjcard.2023.01.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 02/16/2023]
Abstract
Increasing evidence suggests preterm birth is a risk factor for hypertension and cardiovascular disease (CVD) in adulthood. Whether there is effect modification by hypertension on CVD risk is unknown. To investigate the associations between preterm birth, hypertension, and incident CVD, we identified 2,303 women aged 50 to 79 years who self-reported being born preterm from the Women's Health Initiative. Using multivariable logistic regression, prevalent hypertension at enrollment, age at hypertension diagnosis, and antihypertensive medication use were compared by birth status (preterm, full-term). Risk of incident hypertension, coronary heart disease, and CVD were analyzed using multivariable Cox proportional-hazard models. Both models adjusted for age, race/ethnicity, education, smoking, physical activity, body mass index, and diabetes mellitus. Significant associations were found between preterm birth and prevalent hypertension (37% vs 33.1%; adjusted odds ratio 1.26 [95% confidence interval (CI) 1.15 to 1.28] p = <0.0001), early-onset hypertension (<50 years) (14.7% vs 11.7%; adjusted odds ratio 1.31, 95% CI 1.15 to 1.48, p = <0.0001), and incident hypertension (53.2% vs 51%; ajusted hazard ratio 1.10, 95% CI 1.03 to 1.19, p = 0.008). Preterm-born women reported taking more antihypertensive medications (2.9% vs 2.6%, p = 0.04). Preterm birth had a nonsignificant association with CVD risk, but when stratified by prevalent hypertension, women born preterm without hypertension had elevated CVD risk compared with women born full-term without prevalent hypertension. Women with prevalent hypertension, preterm and full-term, had similar magnitudes of elevations in CVD risk. In conclusion, preterm birth increases the risk of hypertension and coronary heart disease. With 10% of the population born preterm, birth history should be assessed as a CVD risk factor.
Collapse
Affiliation(s)
- Pamela L Brewer
- College of Nursing, University of Rhode Island, Providence, Rhode Island.
| | - Amy L D'Agata
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| | - Mary B Roberts
- Center for Primary Care and Prevention, Care New England Medical Group/Primary Care and Specialty Services, Pawtucket, Rhode Island
| | - Robert A Wild
- Departments of Biostatistics and Epidemiology; Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City, Oklahoma
| | - Aladdin H Shadyab
- School of Medicine, University of California San Diego, San Diego, California
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia
| | - JoAnn Manson
- Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Charles B Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island; Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island
| | - Mary C Sullivan
- College of Nursing, University of Rhode Island, Providence, Rhode Island
| |
Collapse
|
25
|
LaMonte MJ, Miremad MM, Nguyen S, Lacroix AZ, Hovey KM, Roberts MB, Soliman A, Eaton CB. Abstract P225: Physical Activity and Heart Failure Prognosis in Older Postmenopausal Women. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
Background:
Accumulating evidence suggests that participating in physical activity (PA) following heart failure (HF) diagnosis is associated with better prognosis, including lower mortality risk. Few studies have focused on this relationship in postmenopausal women, in whom HF burden is high.
Methods:
The present study, conducted in the Women’s Health Initiative, included 2,181 postmenopausal women (mean age 68 years; 85% white, 10% black, 3% Hispanic at enrollment in 1993-1998) who were diagnosed postbaseline with incident hospitalized acute HF and had at least one self-reported PA assessment before and after (mean age 73 at latter assessment) HF diagnosis. Total recreational PA was summarized in metabolic equivalent (MET) hours per week. Women were followed for all-cause mortality from their post-HF PA assessment through March 2014. Cox regression with age as the time scale was used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for mortality associated with PA categories (before/after HF): Inactive (<7.5 MET-hr/wk)/Inactive, n=1,048; Active (≥7.5 MET-hr/wk)/Inactive, n=407; Inactive/Active, n=212; Active/Active, n=514.
Results:
There were 1,047 (48%) deaths during a mean follow-up of 12 years. Crude mortality rates per 1,000 person-years [number of deaths] across the above PA groups were 42.4 [533], 42.1 [206], 36.9 [94], and 34.7 [214]. After adjusting for age (timescale), race and ethnicity, and WHI study component, HRs (95% CI) for mortality across the PA groups were 1.00 (referent), 0.94 (0.79, 1.10), 0.80 (0.64, 1.01), and 0.60 (0.51, 0.71). Further adjustment for baseline education, BMI, physical function, smoking, menopausal hormone use, history of diabetes, hypertension, myocardial infarction, stroke, coronary revascularization, atrial fibrillation, and incident myocardial infarction during follow-up prior to HF diagnosis attenuated these associations but did not eliminate statistical significance for the Active/Active group: 1.00 (referent), 1.04 (0.87, 1.24), 0.87 (0.69, 1.10), 0.74 (0.62, 0.89). A similar pattern of results was evident when cardiovascular mortality was the study outcome.
Conclusions:
Maintaining PA levels following hospitalization for acute HF was associated with lower all-cause mortality in older postmenopausal women, an understudied population in this regard. Among women whose PA following HF diagnosis was higher than their pre-HF PA level, there was a trend for lower mortality although this did not achieve statistical significance. Studies are needed to determine whether PA is associated with prognosis in HF subtypes, such as HF with preserved ejection which is a prevalent HF subtype in older women.
Collapse
|
26
|
Soliman AI, Wactawski-Wende J, Millen AE, Eaton CB, Gray SL, Lamonte MJ. Abstract P435: Proton Pump Inhibitor Use and Risk of Incident Primary Cardiovascular Disease: A Systematic Review and Meta-Analysis. Circulation 2023. [DOI: 10.1161/circ.147.suppl_1.p435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Background:
The risk of secondary cardiovascular events associated with proton pump inhibitor (PPI) use and their interaction with thienopyridine antiplatelets such as clopidogrel is well established. Recent evidence from
in-vitro
and animal studies suggests PPIs may impact cardiovascular disease (CVD) irrespective of antiplatelet use. However, whether PPI use is associated with primary cardiovascular events in humans remains uncertain.
Methods:
Systematic searches were conducted in the MEDLINE and EMBASE databases from their inception to September 2022. Inclusion criteria included studies that examined participants free from cardiovascular disease at baseline who were followed over time to assess any of the following outcomes according to PPI use: incident myocardial infarction (MI), incident ischemic stroke (IS), or CVD mortality. Hazard ratios (HR) and their 95% confidence intervals (CI) were abstracted, combined estimates and heterogeneity (I
2
) were calculated using the random-effects model in RevMan 5.4 software.
Results:
A total of 15 observational studies met the inclusion criteria, 2,272,479 participants were studied for MI, 2,689,943 for IS, and 1,591,428 for CVD mortality. The mean age of participants ranged from 49.3 to 82.2 years. Compared to non-use, PPI use was associated with 30% higher risk of incident MI (HR: 1.30, 95%CI: 1.10-1.53, I
2
=91%) and 15% higher risk of CVD mortality (HR: 1.15, 95%CI: 1.05-1.26, I
2
=56%). However, there was no statistically significant association with incident IS (HR: 1.05, 95%CI: 0.91-1.22, I
2
=96%).
Conclusion:
The meta-analysis results from published studies suggests PPI use is associated with higher risk of incident MI and CVD mortality. However, these findings should be interpreted with caution given the considerable heterogeneity among published studies and the possibility of residual confounding. More studies are needed to address these limitations and determine the validity of these associations.
Collapse
|
27
|
Zhang Z, Li N, Buckley JP, Cecil KM, Chen A, Eaton CB, Kalkwarf HJ, Lanphear BP, Yolton K, Braun JM. Associations between eating behaviours and cardiometabolic risk among adolescents in the Health Outcomes and Measures of the Environment study. Pediatr Obes 2023; 18:e12979. [PMID: 36094787 PMCID: PMC10392767 DOI: 10.1111/ijpo.12979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Revised: 07/18/2022] [Accepted: 08/08/2022] [Indexed: 02/06/2023]
Abstract
BACKGROUND Eating behaviours are associated with childhood obesity, but their associations with cardiometabolic risk are less clear. OBJECTIVES We evaluated cross-sectional associations between eating behaviours and cardiometabolic risk among 185 adolescents (age 12.4 ± 0.7 years; 53% female; body mass index (BMI)-z 0.72 ± 1.37) from Cincinnati, Ohio (HOME Study; enrolled 2003-2006). METHODS Caregivers assessed adolescents' eating behaviours with the Child Eating Behaviour Questionnaire. We computed adolescents' cardiometabolic risk scores based on HOMA-IR, triglycerides to high-density lipoprotein cholesterol ratio, adiponectin to leptin ratio, systolic blood pressure, and cross-sectional area of fat inside the abdominal cavity. Using multivariable linear regression models, we estimated associations of eating behaviour subscales with cardiometabolic risk scores or individual risk components. RESULTS Emotional overeating (ß = 1.34, 95% CI: 0.67, 2.01), food responsiveness (ß = 0.99, 95% CI: 0.41, 1.57), and emotional undereating (ß = 0.64, 95% CI: 0.08, 1.21) were associated with higher cardiometabolic risk scores. Satiety responsiveness (ß = -0.79, 95% CI: -1.59, 0.00) was associated with lower cardiometabolic risk scores. Adjusting for adolescent BMI-z at age 12 attenuated these associations, suggesting that adiposity may mediate these associations. CONCLUSION Hedonistic eating behaviours were associated with higher cardiometabolic risk in these adolescents.
Collapse
Affiliation(s)
- Zhuoya Zhang
- Department of Epidemiology, Brown University, Providence, Rhode Island, United States
| | - Nan Li
- Biogen, Cambridge, Massachusetts, United States
| | - Jessie P. Buckley
- Department of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Kim M. Cecil
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
- Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Aimin Chen
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island, United States
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States
- Kent Memorial Hospital, Warwick, Rhode Island, United States
| | - Heidi J. Kalkwarf
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
- Division of Gastroenterology, Hepatology, and Nutrition, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, United States
| | - Bruce P. Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kimberly Yolton
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, Ohio, United States
| | - Joseph M. Braun
- Department of Epidemiology, Brown University, Providence, Rhode Island, United States
| |
Collapse
|
28
|
Park JW, Howe CJ, Dionne LA, Scarpaci MM, Needham BL, Sims M, Kanaya AM, Kandula NR, Fava JL, Loucks EB, Eaton CB, Dulin AJ. Social support, psychosocial risks, and cardiovascular health: Using harmonized data from the Jackson Heart Study, Mediators of Atherosclerosis in South Asians Living in America Study, and Multi-Ethnic Study of Atherosclerosis. SSM Popul Health 2022; 20:101284. [PMID: 36387018 PMCID: PMC9646650 DOI: 10.1016/j.ssmph.2022.101284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 11/03/2022] [Accepted: 11/03/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Social support may have benefits on cardiovascular health (CVH). CVH is evaluated using seven important metrics (Life's Simple 7; LS7) established by the American Heart Association (e.g., smoking, diet). However, evidence from longitudinal studies is limited and inconsistent. The objective of this study is to examine the longitudinal relationship between social support and CVH, and assess whether psychosocial risks (e.g., anger and stress) modify the relationship in a racially/ethnically diverse population. Methods Participants from three harmonized cohort studies - Jackson Heart Study, Mediators of Atherosclerosis in South Asians Living in America, and Multi-Ethnic Study of Atherosclerosis - were included. Repeated-measures modified Poisson regression models were used to examine the overall relationship between social support (in tertiles) and CVH (LS7 metric), and to assess for effect modification by psychosocial risk. Results Among 7724 participants, those with high (versus low) social support had an adjusted prevalence ratio (aPR) and 95% confidence interval (CI) for ideal or intermediate (versus poor) CVH of 0.99 (0.96-1.03). For medium (versus low) social support, the aPR (95% CI) was 1.01 (0.98-1.05). There was evidence for modification by employment and anger. Those with medium (versus low) social support had an aPR (95% CI) of 1.04 (0.99-1.10) among unemployed or low anger participants. Corresponding results for employed or high anger participants were 0.99 (0.94-1.03) and 0.97 (0.91-1.03), respectively. Conclusion Overall, we observed no strong evidence for an association between social support and CVH. However, some psychosocial risks may be modifiers. Prospective studies are needed to assess the social support-CVH relationship by psychosocial risks in racially/ethnically diverse populations.
Collapse
Affiliation(s)
- Jee Won Park
- Center for Epidemiologic Research, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University, Providence, RI, USA
- Program in Epidemiology, University of Delaware, Newark, DE, USA
| | - Chanelle J. Howe
- Center for Epidemiologic Research, Brown University, Providence, RI, USA
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Laura A. Dionne
- Center for Health Promotion and Health Equity Research, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, USA
| | | | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Alka M. Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | | | - Joseph L. Fava
- Center for Health Promotion and Health Equity Research, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Eric B. Loucks
- Department of Epidemiology, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity Research, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Akilah J. Dulin
- Center for Epidemiologic Research, Brown University, Providence, RI, USA
- Center for Health Promotion and Health Equity Research, Department of Behavioral and Social Sciences, Brown University, Providence, RI, USA
| |
Collapse
|
29
|
Saunders GRB, Wang X, Chen F, Jang SK, Liu M, Wang C, Gao S, Jiang Y, Khunsriraksakul C, Otto JM, Addison C, Akiyama M, Albert CM, Aliev F, Alonso A, Arnett DK, Ashley-Koch AE, Ashrani AA, Barnes KC, Barr RG, Bartz TM, Becker DM, Bielak LF, Benjamin EJ, Bis JC, Bjornsdottir G, Blangero J, Bleecker ER, Boardman JD, Boerwinkle E, Boomsma DI, Boorgula MP, Bowden DW, Brody JA, Cade BE, Chasman DI, Chavan S, Chen YDI, Chen Z, Cheng I, Cho MH, Choquet H, Cole JW, Cornelis MC, Cucca F, Curran JE, de Andrade M, Dick DM, Docherty AR, Duggirala R, Eaton CB, Ehringer MA, Esko T, Faul JD, Fernandes Silva L, Fiorillo E, Fornage M, Freedman BI, Gabrielsen ME, Garrett ME, Gharib SA, Gieger C, Gillespie N, Glahn DC, Gordon SD, Gu CC, Gu D, Gudbjartsson DF, Guo X, Haessler J, Hall ME, Haller T, Harris KM, He J, Herd P, Hewitt JK, Hickie I, Hidalgo B, Hokanson JE, Hopfer C, Hottenga J, Hou L, Huang H, Hung YJ, Hunter DJ, Hveem K, Hwang SJ, Hwu CM, Iacono W, Irvin MR, Jee YH, Johnson EO, Joo YY, Jorgenson E, Justice AE, Kamatani Y, Kaplan RC, Kaprio J, Kardia SLR, Keller MC, Kelly TN, Kooperberg C, Korhonen T, Kraft P, Krauter K, Kuusisto J, Laakso M, Lasky-Su J, Lee WJ, Lee JJ, Levy D, Li L, Li K, Li Y, Lin K, Lind PA, Liu C, Lloyd-Jones DM, Lutz SM, Ma J, Mägi R, Manichaikul A, Martin NG, Mathur R, Matoba N, McArdle PF, McGue M, McQueen MB, Medland SE, Metspalu A, Meyers DA, Millwood IY, Mitchell BD, Mohlke KL, Moll M, Montasser ME, Morrison AC, Mulas A, Nielsen JB, North KE, Oelsner EC, Okada Y, Orrù V, Palmer ND, Palviainen T, Pandit A, Park SL, Peters U, Peters A, Peyser PA, Polderman TJC, Rafaels N, Redline S, Reed RM, Reiner AP, Rice JP, Rich SS, Richmond NE, Roan C, Rotter JI, Rueschman MN, Runarsdottir V, Saccone NL, Schwartz DA, Shadyab AH, Shi J, Shringarpure SS, Sicinski K, Skogholt AH, Smith JA, Smith NL, Sotoodehnia N, Stallings MC, Stefansson H, Stefansson K, Stitzel JA, Sun X, Syed M, Tal-Singer R, Taylor AE, Taylor KD, Telen MJ, Thai KK, Tiwari H, Turman C, Tyrfingsson T, Wall TL, Walters RG, Weir DR, Weiss ST, White WB, Whitfield JB, Wiggins KL, Willemsen G, Willer CJ, Winsvold BS, Xu H, Yanek LR, Yin J, Young KL, Young KA, Yu B, Zhao W, Zhou W, Zöllner S, Zuccolo L, Batini C, Bergen AW, Bierut LJ, David SP, Gagliano Taliun SA, Hancock DB, Jiang B, Munafò MR, Thorgeirsson TE, Liu DJ, Vrieze S. Genetic diversity fuels gene discovery for tobacco and alcohol use. Nature 2022; 612:720-724. [PMID: 36477530 PMCID: PMC9771818 DOI: 10.1038/s41586-022-05477-4] [Citation(s) in RCA: 93] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 10/25/2022] [Indexed: 12/12/2022]
Abstract
Tobacco and alcohol use are heritable behaviours associated with 15% and 5.3% of worldwide deaths, respectively, due largely to broad increased risk for disease and injury1-4. These substances are used across the globe, yet genome-wide association studies have focused largely on individuals of European ancestries5. Here we leveraged global genetic diversity across 3.4 million individuals from four major clines of global ancestry (approximately 21% non-European) to power the discovery and fine-mapping of genomic loci associated with tobacco and alcohol use, to inform function of these loci via ancestry-aware transcriptome-wide association studies, and to evaluate the genetic architecture and predictive power of polygenic risk within and across populations. We found that increases in sample size and genetic diversity improved locus identification and fine-mapping resolution, and that a large majority of the 3,823 associated variants (from 2,143 loci) showed consistent effect sizes across ancestry dimensions. However, polygenic risk scores developed in one ancestry performed poorly in others, highlighting the continued need to increase sample sizes of diverse ancestries to realize any potential benefit of polygenic prediction.
Collapse
Affiliation(s)
| | - Xingyan Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Fang Chen
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Seon-Kyeong Jang
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Mengzhen Liu
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Chen Wang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Shuang Gao
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Yu Jiang
- Department of Epidemiology & Population Health at Stanford University, Stanford, CA, USA
| | | | - Jacqueline M Otto
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Clifton Addison
- Jackson Heart Study (JHS) Graduate Training and Education Center (GTEC), Department of Epidemiology and Biostatistics, School of Public Health, Jackson State University, Jackson, MS, USA
| | - Masato Akiyama
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Ocular Pathology and Imaging Science, Kyushu University Graduate School of Medical Sciences, Fukuoka, Japan
| | - Christine M Albert
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Fazil Aliev
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Donna K Arnett
- Dean's Office and Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA
| | - Allison E Ashley-Koch
- Department of Medicine and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Aneel A Ashrani
- Division of Hematology, Department of Medicine, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Kathleen C Barnes
- Division of Biomedical Informatics & Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Tempus, Chicago, IL, USA
| | - R Graham Barr
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Traci M Bartz
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Diane M Becker
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lawrence F Bielak
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Emelia J Benjamin
- Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | | | - John Blangero
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | | | - Jason D Boardman
- Institute of Behavioral Science, University of Colorado Boulder, Boulder, CO, USA
| | - Eric Boerwinkle
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Dorret I Boomsma
- Netherlands Twin Register, Dept Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Meher Preethi Boorgula
- Division of Biomedical Informatics & Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Donald W Bowden
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jennifer A Brody
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Brian E Cade
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Sameer Chavan
- Division of Biomedical Informatics & Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Yii-Der Ida Chen
- Institute for Translational Genomics and Population Sciences, Department of Pediatrics, Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Cheng
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
- UCSF Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA, USA
| | - Michael H Cho
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Hélène Choquet
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, USA
| | - John W Cole
- Department of Neurology, Baltimore Veterans Affairs Medical Center, Baltimore, MD, USA
- Division of Vascular Neurology, Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Marilyn C Cornelis
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Joanne E Curran
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Mariza de Andrade
- Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
| | - Danielle M Dick
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Virginia, USA
- Huntsman Mental Health Institute, Salt Lake City, UT, USA
| | - Ravindranath Duggirala
- Department of Human Genetics and South Texas Diabetes and Obesity Institute, University of Texas Rio Grande Valley School of Medicine, Brownsville, TX, USA
| | - Charles B Eaton
- Department of Family Medicine, Brown University, Providence, RI, USA
| | - Marissa A Ehringer
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Tõnu Esko
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Jessica D Faul
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Lilian Fernandes Silva
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland, Kuopio, Finland
| | - Edoardo Fiorillo
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, Italy
| | - Myriam Fornage
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Barry I Freedman
- Department of Internal Medicine-Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Maiken E Gabrielsen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Melanie E Garrett
- Department of Medicine and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University School of Medicine, Durham, NC, USA
| | - Sina A Gharib
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, University of Washington, Seattle, WA, USA
- Center for Lung Biology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Christian Gieger
- Research Unit Molecular Epidemiology, Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Nathan Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Virginia, USA
| | - David C Glahn
- Department of Psychiatry & Behavioral Sciences, Boston Children's Hospital & Harvard Medical School, Boston, MA, USA
| | - Scott D Gordon
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Charles C Gu
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
| | - Dongfeng Gu
- Department of Epidemiology and Key Laboratory of Cardiovascular Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Daniel F Gudbjartsson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- School of Engineering and Natural Sciences, University of Iceland, Reykjavik, Iceland
| | - Xiuqing Guo
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Jeffrey Haessler
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Michael E Hall
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Toomas Haller
- Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kathleen Mullan Harris
- Department of Sociology and the Carolina Population Center, University of North Carolina, Chapel Hill, NC, USA
| | - Jiang He
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
- Translational Sciences Institute, Tulane University, New Orleans, LA, USA
| | - Pamela Herd
- McCourt School of Public Policy, Georgetown University, Washington, DC, USA
| | - John K Hewitt
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department Of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Ian Hickie
- Youth Mental Health & Technology Team, Brain and Mind Centre, University of Sydney, Sydney, Australia
| | - Bertha Hidalgo
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - John E Hokanson
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christian Hopfer
- Department of Psychiatry, University of Colorado Anschutz Medical Center, Denver, CO, USA
| | - JoukeJan Hottenga
- Netherlands Twin Register, Dept Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Lifang Hou
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Hongyan Huang
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yi-Jen Hung
- Institute of Preventive Medicine, National Defense Medical Center, New Taipei City, Taiwan
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Kristian Hveem
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Research, Innovation and Education, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Shih-Jen Hwang
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Chii-Min Hwu
- Section of Endocrinology and Metabolism, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - William Iacono
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Marguerite R Irvin
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Yon Ho Jee
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Eric O Johnson
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, Research Triangle Park, NC, USA
- Fellow Program, RTI International, Research Triangle Park, NC, USA
| | - Yoonjung Y Joo
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Institute of Data Science, Korea University, Seoul, South Korea
| | | | - Anne E Justice
- Department of Population Health Sciences, Geisinger, Danville, PA, USA
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Yoichiro Kamatani
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Robert C Kaplan
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Matthew C Keller
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department Of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | - Tanika N Kelly
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
- Translational Sciences Institute, Tulane University, New Orleans, LA, USA
| | - Charles Kooperberg
- Department of Biostatistics, University of Washington, Seattle, WA, USA
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Tellervo Korhonen
- Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Peter Kraft
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Kenneth Krauter
- Department of Molecular, Cellular and Developmental Biology, University of Colorado, Boulder, CO, USA
| | - Johanna Kuusisto
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
- Center for Medicine and Clinical Research, Kuopio University Hospital, Kuopio, Finland
| | - Markku Laakso
- Institute of Clinical Medicine, Internal Medicine, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Jessica Lasky-Su
- Brigham and Women's Hospital, Department of Medicine, Channing Division of Network Medicine, Boston, MA, USA
| | - Wen-Jane Lee
- Department of Medical Research, Taichung Veterans General Hospital, Taichung City, Taiwan
| | - James J Lee
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Daniel Levy
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Kevin Li
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Yuqing Li
- Department of Epidemiology & Biostatistics, University of California, San Francisco, CA, USA
| | - Kuang Lin
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Penelope A Lind
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Biomedical Sciences, Faculty of Medicine, University of Queensland, Brisbane, Australia
- School of Biomedical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Chunyu Liu
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Donald M Lloyd-Jones
- Departments of Preventive Medicine, Medicine, and Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Sharon M Lutz
- Department of Population Medicine, Harvard Pilgrim Health Care Institute, Boston, MA, USA
- Department of Biostatics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jiantao Ma
- Population Sciences Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
- Division of Nutrition Epidemiology and Data Science, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
| | - Reedik Mägi
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Ani Manichaikul
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Nicholas G Martin
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Ravi Mathur
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, Research Triangle Park, NC, USA
| | - Nana Matoba
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Genetics, UNC Neuroscience Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Patrick F McArdle
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Matt McGue
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - Matthew B McQueen
- Department of Integrative Physiology, University of Colorado, Boulder, CO, USA
| | - Sarah E Medland
- Psychiatric Genetics, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | | | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Braxton D Mitchell
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Karen L Mohlke
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Matthew Moll
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - May E Montasser
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alanna C Morrison
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Antonella Mulas
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, Italy
| | - Jonas B Nielsen
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan, Ann Arbor, MI, USA
| | - Kari E North
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Elizabeth C Oelsner
- Department of Medicine, Columbia University Medical Center, New York, NY, USA
| | - Yukinori Okada
- Laboratory for Systems Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, Japan
- Department of Genome Informatics, Graduate School of Medicine, the University of Tokyo, Tokyo, Japan
| | - Valeria Orrù
- Istituto di Ricerca Genetica e Biomedica, Consiglio Nazionale delle Ricerche (CNR), Monserrato, Italy
| | - Nicholette D Palmer
- Department of Biochemistry, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Teemu Palviainen
- Institute for Molecular Medicine Finland - FIMM, University of Helsinki, Helsinki, Finland
| | - Anita Pandit
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - S Lani Park
- Population Sciences of the Pacific Program, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Ulrike Peters
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig Maximilians University Munich, Munich, Germany
- German Centre for Cardiovascular Research, DZHK, Partner Site Munich, Munich, Germany
| | - Patricia A Peyser
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Tinca J C Polderman
- Department of Clinical Developmental Psychology, Vrije Universiteit, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | - Nicholas Rafaels
- Division of Biomedical Informatics & Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Susan Redline
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Robert M Reed
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Alex P Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - John P Rice
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Stephen S Rich
- Center for Public Health Genomics, Department of Public Health Sciences, University of Virginia School of Medicine, Charlottesville, VA, USA
| | - Nicole E Richmond
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Carol Roan
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Jerome I Rotter
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Michael N Rueschman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | | | - Nancy L Saccone
- Division of Biostatistics, Washington University School of Medicine, St. Louis, MO, USA
- Department of Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - David A Schwartz
- Division of Pulmonary Sciences and Critical Care Medicine; Department of Medicine and Immunology, University of Colorado, Aurora, CO, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA, USA
| | | | | | - Kamil Sicinski
- Center for Demography of Health and Aging, University of Wisconsin-Madison, Madison, WI, USA
| | - Anne Heidi Skogholt
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nicholas L Smith
- Department of Epidemiology, University of Washington, Seattle, WA, USA
- Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, USA
- Seattle Epidemiologic Research and Information Center, Department of Veterans Affairs Office of Research and Development, Seattle, WA, USA
| | - Nona Sotoodehnia
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
- Division of Cardiology, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Michael C Stallings
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
- Department Of Psychology and Neuroscience, University of Colorado Boulder, Boulder, CO, USA
| | | | - Kari Stefansson
- deCODE Genetics/Amgen, Inc., Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Jerry A Stitzel
- Institute for Behavioral Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Xiao Sun
- Department of Epidemiology, Tulane University, New Orleans, LA, USA
| | - Moin Syed
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | | | - Amy E Taylor
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Kent D Taylor
- The Institute for Translational Genomics and Population Sciences, Department of Pediatrics, The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Marilyn J Telen
- Department of Medicine and Duke Comprehensive Sickle Cell Center, Duke University School of Medicine, Durham, NC, USA
| | - Khanh K Thai
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, USA
| | - Hemant Tiwari
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Constance Turman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Program in Genetic Epidemiology and Statistical Genetics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Tamara L Wall
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Robin G Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
- MRC Population Health Research Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - David R Weir
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Scott T Weiss
- Brigham and Women's Hospital, Department of Medicine, Channing Division of Network Medicine, Boston, MA, USA
| | - Wendy B White
- Jackson Heart Study Undergraduate Training and Education Center, Tougaloo College, Tougaloo, MS, USA
| | - John B Whitfield
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kerri L Wiggins
- Department of Medicine, University of Washington, Seattle, WA, USA
| | - Gonneke Willemsen
- Netherlands Twin Register, Dept Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Cristen J Willer
- Department of Internal Medicine, Division of Cardiology, University of Michigan, Ann Arbor, MI, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - Bendik S Winsvold
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, NTNU, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Huichun Xu
- Division of Endocrinology, Diabetes and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Lisa R Yanek
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jie Yin
- Kaiser Permanente Northern California (KPNC), Division of Research, Oakland, CA, USA
| | - Kristin L Young
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kendra A Young
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bing Yu
- Human Genetics Center, Department of Epidemiology, Human Genetics, and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, USA
| | - Wei Zhou
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Sebastian Zöllner
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Health Data Science Centre, Fondazione Human Technopole, Milan, Italy
| | - Chiara Batini
- Department of Population Health Sciences, University of Leicester, Leicester, UK
| | - Andrew W Bergen
- Oregon Research Institute, Springfield, OR, USA
- BioRealm, LLC, Walnut, CA, USA
| | - Laura J Bierut
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Sean P David
- Outcomes Research Network & Department of Family Medicine, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Family Medicine, University of Chicago, Chicago, IL, USA
| | - Sarah A Gagliano Taliun
- Department of Medicine, Université de Montréal, Montréal, Québec, Canada
- Department of Neurosciences, Université de Montréal, Montréal, Québec, Canada
- Research Centre, Montréal Heart Institute, Montréal, Québec, Canada
| | - Dana B Hancock
- GenOmics, Bioinformatics, and Translational Research Center, RTI International, Research Triangle Park, NC, USA
| | - Bibo Jiang
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA
| | - Marcus R Munafò
- MRC Integrative Epidemiology Unit, Population Health Sciences, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | - Dajiang J Liu
- Department of Public Health Sciences, Penn State College of Medicine, Hershey, PA, USA.
| | - Scott Vrieze
- Department of Psychology, University of Minnesota, Minneapolis, MN, USA.
| |
Collapse
|
30
|
Eaton CB, McAlindon T, Driban J. Reply. Arthritis Rheumatol 2022; 74:1862. [PMID: 35766815 DOI: 10.1002/art.42276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/05/2022] [Indexed: 11/07/2022]
Affiliation(s)
- Charles B Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | | | | |
Collapse
|
31
|
Braun JM, Papandonatos GD, Li N, Sears CG, Buckley JP, Cecil KM, Chen A, Eaton CB, Kalkwarf HJ, Kelsey KT, Lanphear BP, Yolton K. Physical activity modifies the relation between gestational perfluorooctanoic acid exposure and adolescent cardiometabolic risk. Environ Res 2022; 214:114021. [PMID: 35952751 PMCID: PMC9637371 DOI: 10.1016/j.envres.2022.114021] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/27/2022] [Accepted: 07/29/2022] [Indexed: 06/11/2023]
Abstract
OBJECTIVE Exposure to per- and polyfluoroalkyl substances (PFAS) - endocrine disrupting chemicals - may increase cardiometabolic risk. We evaluated whether adolescent lifestyle factors modified associations between gestational PFAS exposure and cardiometabolic risk using a prospective cohort study. METHODS In 166 mother-child pairs (HOME Study), we measured concentrations of four PFAS in maternal serum collected during pregnancy. When children were age 12 years, we calculated cardiometabolic risk scores from visceral adiposity area, blood pressure, and fasting serum biomarkers. We assessed adolescent physical activity and Healthy Eating Index scores using the Physical Activity Questionnaire for Older Children (PAQ-C), actigraphy, and 24-h diet recalls. Using multivariable linear regression and weighted quantile sum regression, we examined whether physical activity or diet modified covariate-adjusted associations of PFAS and their mixture with cardiometabolic risk scores. RESULTS Physical activity modified associations between perfluorooctanoic acid (PFOA) and cardiometabolic risk scores. Each doubling of PFOA was associated with worse cardiometabolic risk scores among children with PAQ-C scores < median (β:1.4; 95% CI:0.5, 2.2, n = 82), but not among those with PAQ-C scores ≥ median (β: 0.2; 95% CI: 1.2, 0.7, n = 84) (interaction p-value = 0.01). Associations were most prominent for insulin resistance, leptin-adiponectin ratio, and visceral fat area. We observed results suggesting that physical activity modified the association of PFAS mixture with cardiometabolic risk scores, insulin resistance, and visceral fat area (interaction p-values = 0.17, 0.07, and 0.10, respectively); however, the 95% CIs of the interaction terms included the null value. We observed similar, but attenuated patterns for PFOA and actigraphy-based measures of physical activity. Diet did not modify any associations. Physical activity or diet did not modify associations for other PFAS. CONCLUSIONS Childhood physical activity modified associations of prenatal serum PFOA concentrations with children's cardiometabolic risk in this cohort, indicating that lifestyle interventions may ameliorate the adverse effects of PFOA exposure.
Collapse
Affiliation(s)
- Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, 02912, Box G-S121, United States.
| | - George D Papandonatos
- Department of Biostatistics, School of Public Health, Brown University, Providence, RI, United States
| | - Nan Li
- Department of Epidemiology, Brown University, Providence, RI, 02912, Box G-S121, United States
| | - Clara G Sears
- Division of Environmental Medicine, Department of Medicine, University of Louisville, Louisville, KY, United States
| | - Jessie P Buckley
- Department of Environmental Health and Engineering, Johns Hopkins University School of Public Health, Baltimore, MD, United States
| | - Kim M Cecil
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Charles B Eaton
- Department of Epidemiology, Brown University, Providence, RI, 02912, Box G-S121, United States; Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States; Kent Memorial Hospital, Warwick, RI, United States
| | - Heidi J Kalkwarf
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States; Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Karl T Kelsey
- Department of Epidemiology, Brown University, Providence, RI, 02912, Box G-S121, United States; Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, United States
| | - Bruce P Lanphear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada
| | - Kimberly Yolton
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
| |
Collapse
|
32
|
Dulin AJ, Park JW, Scarpaci MM, Dionne LA, Sims M, Needham BL, Fava JL, Eaton CB, Kanaya AM, Kandula NR, Loucks EB, Howe CJ. Examining relationships between perceived neighborhood social cohesion and ideal cardiovascular health and whether psychosocial stressors modify observed relationships among JHS, MESA, and MASALA participants. BMC Public Health 2022; 22:1890. [PMID: 36221065 PMCID: PMC9552445 DOI: 10.1186/s12889-022-14270-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 09/27/2022] [Accepted: 09/29/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Psychosocial stressors increase the risks for cardiovascular disease across diverse populations. However, neighborhood level resilience resources may protect against poor cardiovascular health (CVH). This study used data from three CVH cohorts to examine longitudinally the associations of a resilience resource, perceived neighborhood social cohesion (hereafter referred to as neighborhood social cohesion), with the American Heart Association's Life's Simple 7 (LS7), and whether psychosocial stressors modify observed relationships. METHODS We examined neighborhood social cohesion (measured in tertiles) and LS7 in the Jackson Heart Study, Multi-Ethnic Study of Atherosclerosis, and Mediators of Atherosclerosis in South Asians Living in America study. We used repeated-measures, modified Poisson regression models to estimate the relationship between neighborhood social cohesion and LS7 (primary analysis, n = 6,086) and four biological metrics (body mass index, blood pressure, cholesterol, blood glucose; secondary analysis, n = 7,291). We assessed effect measure modification by each psychosocial stressor (e.g., low educational attainment, discrimination). RESULTS In primary analyses, adjusted prevalence ratios (aPR) and 95% confidence intervals (CIs) for ideal/intermediate versus poor CVH among high or medium (versus low) neighborhood social cohesion were 1.01 (0.97-1.05) and 1.02 (0.98-1.06), respectively. The psychosocial stressors, low education and discrimination, functioned as effect modifiers. Secondary analyses showed similar findings. Also, in the secondary analyses, there was evidence for effect modification by income. CONCLUSION We did not find much support for an association between neighborhood social cohesion and LS7, but did find evidence of effect modification. Some of the effect modification results operated in unexpected directions. Future studies should examine neighborhood social cohesion more comprehensively and assess for effect modification by psychosocial stressors.
Collapse
Affiliation(s)
- Akilah J Dulin
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA.
- Center for Health Promotion and Health Equity Research, Brown University School of Public Health, Box G-S121-8, 02912, Providence, RI, USA.
| | - Jee Won Park
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Matthew M Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA
| | - Laura A Dionne
- Center for Health Promotion and Health Equity, Brown University, Providence, RI, USA
| | - Mario Sims
- Department of Social Medicine, Population and Public Health, University of California Riverside School of Medicine, Riverside, CA, USA
| | - Belinda L Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Joseph L Fava
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, USA
| | - Charles B Eaton
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, USA
- Center for Primary Care and Prevention Kent Memorial Hospital, Warwick, RI, USA
| | - Alka M Kanaya
- Division of General Internal Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Namratha R Kandula
- Department of Internal Medicine, Northwestern University, Chicago, IL, USA
| | - Eric B Loucks
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
| | - Chanelle J Howe
- Center for Epidemiologic Research, Department of Epidemiology, Brown University, Providence, RI, USA
| |
Collapse
|
33
|
Lo GH, Vinod S, Richard MJ, Harkey MS, McAlindon TE, Kriska AM, Rockette-Wagner B, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, Driban JB. Association Between Walking for Exercise and Symptomatic and Structural Progression in Individuals With Knee Osteoarthritis: Data From the Osteoarthritis Initiative Cohort. Arthritis Rheumatol 2022; 74:1660-1667. [PMID: 35673832 PMCID: PMC9529782 DOI: 10.1002/art.42241] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 04/26/2022] [Accepted: 05/17/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE To assess the relationship between walking for exercise and symptomatic and structural disease progression in individuals with knee osteoarthritis (OA). METHODS We assessed a nested cohort of participants age 50 years or older within the Osteoarthritis Initiative, a community-based observational study in which subjects were enrolled between 2004 and 2006. We focused on 4 dichotomous outcomes from baseline to the 48-month visit, involving determination of the frequency of knee pain and radiographic severity of knee OA on posteroanterior semiflexed knee radiographs. The outcomes assessed included 1) new frequent knee pain, 2) worsening of radiographic severity of knee OA based on the Kellgren/Lawrence grade, 3) progression of medial joint space narrowing, and 4) improved frequent knee pain. We used a modified version of the Historical Physical Activity Survey Instrument to ascertain those subjects who reported walking for exercise after age 50 years. The survey was administered at the 96-month visit (2012-2014). RESULTS Of 1,212 participants with knee OA, 45% were male and 73% reported walking for exercise. The mean ± SD age was 63.2 ± 7.9 years, and the mean ± SD body mass index was 29.4 ± 4.6 kg/m2 . The likelihood of new frequent knee pain was reduced in participants with knee OA who walked for exercise as compared to those who were non-walkers (odds ratio [OR] 0.6, 95% confidence interval [95% CI] 0.4-0.8), and progression of medial joint space narrowing was less common in walkers compared to non-walkers (OR 0.8, 95% CI 0.6-1.0). CONCLUSION In individuals with knee OA who were age 50 years or older, walking for exercise was associated with less frequent development of knee pain. These findings support the notion that walking for exercise should be encouraged for people with knee OA. Furthermore, we offer a proof of concept that walking for exercise could be disease modifying, which warrants further study.
Collapse
Affiliation(s)
- Grace H. Lo
- Michael E. DeBakey VA Medical Center, Baylor College of Medicine, Houston, TX
- Baylor College of Medicine, Houston, TX
| | | | | | | | | | - Andrea M. Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA
| | | | - Charles B. Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI and Department of Epidemiology, School of Public Health of Brown University, Providence, RI
| | - Marc C. Hochberg
- Department of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | | | - C. Kent Kwoh
- University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ
| | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | | |
Collapse
|
34
|
Lo GH, Richard MJ, McAlindon TE, Park C, Strayhorn MT, Harkey MS, Price LL, Eaton CB, Driban JB. Increased risk of incident knee osteoarthritis in those with greater work-related physical activity. Occup Environ Med 2022; 79:543-549. [PMID: 35618387 PMCID: PMC9337839 DOI: 10.1136/oemed-2022-108212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 05/05/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Occupations involving greater physical activity may increase risk for knee osteoarthritis (OA). Existing studies have not evaluated work-related physical activity before OA onset. Hence, we aimed to evaluate the association between work-related physical activity and knee OA incidence. METHODS We performed a person-based longitudinal study using Osteoarthritis Initiative (OAI) data among people who volunteered or worked for pay without baseline radiographic knee OA or knee pain. Bilateral knee radiographs were obtained at baseline and annual follow-ups. We defined radiographic OA as Kellgren-Lawrence grade ≥2. Questions from the Physical Activity Scale for the Elderly at baseline and annual OAI visits provided information about work-related physical activity level and hours. We performed logistic regression with work-related physical activity level ( mainly sitting , standing and some walking , walking while handling some materials ) and hours as predictors. The outcome was incident person-based radiographic OA within the ensuing 12 months, over 48 months. RESULTS Among 951 participants (2819 observations), higher work-related physical activity levels had greater adjusted ORs for incident radiographic OA (people with jobs with standing and some walking : 1.11 (0.60-2.08), and walking while handling some materials : 1.90 (1.03-3.52), when compared with those with mainly sitting work-related activity ). There was no association between number of hours worked and incident radiographic OA. CONCLUSIONS People performing work that require walking while handling some materials have greater odds of incident knee OA than those with jobs mostly involving sitting. Strategies are needed to mitigate risk factors predisposing them to radiographic OA.
Collapse
Affiliation(s)
- Grace H Lo
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA .,Medical Care Line and Research Care Line, Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Michael J Richard
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Timothy E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| | - Chantel Park
- Division of Rheumatology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA
| | - Michael T Strayhorn
- Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.,Houston VA HSR&D Center for Innovations in Quality, Effectiveness and Safety, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas, USA
| | - Matthew S Harkey
- Department of Kinesiology, Michigan State University, East Lansing, Michigan, USA
| | - Lori Lyn Price
- The Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Boston, Massachusetts, USA
| | - Charles B Eaton
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Epidemiology, School of Public Health of Brown University, Providence, Rhode Island, USA
| | - Jeffrey B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts, USA
| |
Collapse
|
35
|
Koo P, Muntner P, Hall ME, Gjelsvik A, McCool FD, Eaton CB. Relationship Between Risks for Obstructive Sleep Apnea, Resistant Hypertension, and Aldosterone Among African American Adults in the Jackson Heart Study. Am J Hypertens 2022; 35:875-883. [PMID: 35901013 PMCID: PMC9527775 DOI: 10.1093/ajh/hpac091] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 05/02/2022] [Accepted: 07/23/2022] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND African Americans have a higher prevalence of resistant hypertension compared with Caucasians. Racial differences in obstructive sleep apnea (OSA) and increased aldosterone level may explain the racial disparity in resistant hypertension prevalence. Therefore, the purpose of this study is to investigate if aldosterone level and hypertension status differ by risks for OSA (e.g., obesity, loud snoring, and daytime sleepiness) and how aldosterone level varies with hypertension severity and control among African Americans. METHODS A cross-sectional analysis was performed using baseline data on 5,052 African American adults in the Jackson Heart Study to investigate the relationships of interest using multivariable linear and multinomial logistic regression models adjusted for potential confounders. Risks for OSA were defined by a "risk score" consisting of the number of risks for OSA. RESULTS Of the 5,052 participants, 623 had no risks for OSA. Body mass index was the highest among those with a risk score of 6. About 39% of the sample had no hypertension, 29% had controlled hypertension, 26% had uncontrolled hypertension, and 6% had resistant hypertension. Higher odds of having uncontrolled hypertension or resistant hypertension were present in those with a higher risk score compared with those without risks for OSA. Log-aldosterone level increased with each additional risk for OSA (P-trend <0.05). Similarly, log-aldosterone also increased with more severe hypertension (P-trend <0.001). The highest aldosterone level was found in those with resistant hypertension that was inadequately controlled with medications. CONCLUSIONS Risks for OSA were positively associated with resistant hypertension and higher aldosterone level in African American adults.
Collapse
Affiliation(s)
| | - Paul Muntner
- Department of Epidemiology, University of Alabama at Birmingham School of Public Health, Birmingham, Alabama, USA
| | - Michael E Hall
- Division of Cardiovascular Diseases, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Annie Gjelsvik
- Department of Epidemiology, Brown School of Public Health, Providence, Rhode Island, USA
| | - Franklin Dennis McCool
- Division of Pulmonary, Critical Care, and Sleep Medicine, Memorial Hospital of Rhode Island, Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Memorial Hospital of Rhode Island, Alpert Medical School of Brown University and Brown School of Public Health, Providence, Rhode Island, USA
| |
Collapse
|
36
|
LaMonte MJ, Manson JE, Anderson GL, Baker LD, Bea JW, Eaton CB, Follis S, Hayden KM, Kooperberg C, LaCroix AZ, Limacher MC, Neuhouser ML, Odegaard A, Perez MV, Prentice RL, Reiner AP, Stefanick ML, Van Horn L, Wells GL, Whitsel EA, Rossouw JE. Contributions of the Women's Health Initiative to Cardiovascular Research: JACC State-of-the-Art Review. J Am Coll Cardiol 2022; 80:256-275. [PMID: 35835498 DOI: 10.1016/j.jacc.2022.05.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/05/2022] [Accepted: 05/06/2022] [Indexed: 11/25/2022]
Abstract
The WHI (Women's Health Initiative) enrolled 161,808 racially and ethnically diverse postmenopausal women, ages 50-79 years, from 1993 to 1998 at 40 clinical centers across the United States. In its clinical trial component, WHI evaluated 3 randomized interventions (menopausal hormone therapy; diet modification; and calcium/vitamin D supplementation) for the primary prevention of major chronic diseases, including cardiovascular disease, in older women. In the WHI observational study, numerous clinical, behavioral, and social factors have been evaluated as predictors of incident chronic disease and mortality. Although the original interventions have been completed, the WHI data and biomarker resources continue to be leveraged and expanded through ancillary studies to yield novel insights regarding cardiovascular disease prevention and healthy aging in women.
Collapse
Affiliation(s)
- Michael J LaMonte
- Department of Epidemiology and Environmental Health, University at Buffalo-SUNY, Buffalo, New York, USA.
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Garnet L Anderson
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Laura D Baker
- Department of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Jennifer W Bea
- Department of Health Promotion Science, University of Arizona, Tucson, Arizona, USA
| | - Charles B Eaton
- Department of Family Medicine and Epidemiology, Brown University, Providence, Rhode Island, USA
| | - Shawna Follis
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrea Z LaCroix
- Division of Epidemiology, Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, California, USA
| | - Marian C Limacher
- Department of Internal Medicine, University of Florida, Gainesville, Florida, USA
| | - Marian L Neuhouser
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Andrew Odegaard
- Department of Epidemiology, University of California, Irvine, California, USA
| | - Marco V Perez
- Department of Medicine, Stanford University, Palo Alto, California, USA
| | - Ross L Prentice
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Alexander P Reiner
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University, Stanford, California, USA
| | - Linda Van Horn
- Department of Preventive Medicine, Northwestern University, Chicago, Illinois, USA
| | - Gretchen L Wells
- Department of Medicine, University of Alabama, Birmingham, Alabama, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Jacques E Rossouw
- National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA
| | | |
Collapse
|
37
|
Liu T, Xu C, Driban JB, McAlindon T, Eaton CB, Lu B. Excessive alcohol consumption and the risk of knee osteoarthritis: a prospective study from the Osteoarthritis Initiative. Osteoarthritis Cartilage 2022; 30:697-701. [PMID: 35150844 PMCID: PMC9038654 DOI: 10.1016/j.joca.2022.01.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 02/02/2023]
Abstract
OBJECTIVE To examine the association of alcohol consumption with risk of incident knee osteoarthritis (OA) in a large prospective cohort study. DESIGN In the Osteoarthritis Initiative, 2,846 participants aged 45-79 years and free from radiographic knee OA in at least one knee at baseline were followed up to 96 months. Information on baseline alcohol consumption was obtained from the Block Brief Food Frequency Questionnaire. Incident cases of radiographic knee OA (ROA) were defined as Kellgren-Lawrence grade changing from zero or one to ≥ two during the follow-up time. Incident symptomatic OA (SxOA) was defined as ROA with knee pain worsening. The Cox proportional hazards models were used to assess the independent association between alcohol consumption and risk of knee. RESULTS During 96 months' follow-up, we identified 691 knees with incident ROA, and 496 knees with incident SxOA among 2,846 subjects. Compared to non-drinkers, excessive alcohol consumption was significantly associated with increased risk of ROA (HR ≥ 30 g/d vs none = 1.93, 95% CI: 1.28-2.89) and SxOA (HR ≥ 30 g/d vs none = 1.61, 95% CI: 1.04-2.48). Similar association was observed for liquor consumption (HR liquor≥15 g/d vs none = 1.71, 95% CI: 1.16-2.52 for ROA; HR liquor≥15 g/d vs none = 1.59, 95% CI: 1.04-2.39 for SxOA). Light to moderate alcohol consumption was not associated with knee OA risk. CONCLUSION Our results suggest that excessive alcohol drinking was associated with an increased risk of knee OA. Further studies are needed in other populations.
Collapse
Affiliation(s)
- Tong Liu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Key Laboratory of Environmental Medicine Engineering, Ministry of Education, School of Public Health, Southeast University, Nanjing, Jiangsu, P.R. China
| | - Chang Xu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Rutgers University, School of Public Health, Department of Biostatistics and Epidemiology, New Brunswick, NJ
| | - Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Timothy McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Charles B. Eaton
- Brown University Center for Primary Care and Prevention, Pawtucket, RI,Departments of Family Medicine and Epidemiology, the Warren Alpert Medical School of Brown University, Providence, RI
| | - Bing Lu
- Division of Rheumatology, Inflammation and Immunity, Brigham and Women’s Hospital, Harvard Medical School, Boston MA,Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT
| |
Collapse
|
38
|
Lau ES, Wang D, Roberts M, Taylor CN, Murugappan G, Shadyab AH, Schnatz PF, Farland LV, Wood MJ, Scott NS, Eaton CB, Ho JE. Infertility and Risk of Heart Failure in the Women's Health Initiative. J Am Coll Cardiol 2022; 79:1594-1603. [PMID: 35450577 PMCID: PMC9377329 DOI: 10.1016/j.jacc.2022.02.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 02/08/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND There is growing recognition that reproductive factors are associated with increased risk of future cardiovascular disease. Infertility has been less well studied, although emerging data support its association with increased risk of cardiovascular disease. Whether infertility is associated with future risk of heart failure (HF) is not known. OBJECTIVES This study sought to examine the development of HF and HF subtypes in women with and without history of infertility. METHODS We followed postmenopausal women from the Women's Health Initiative prospectively for the development of HF. Infertility was self-reported at study baseline. Multivariable cause-specific Cox models were used to evaluate the association of infertility with incident overall HF and HF subtypes (heart failure with preserved ejection fraction [HFpEF]: left ventricular ejection fraction of ≥50% vs heart failure with reduced ejection fraction [HFrEF]: left ventricular ejection fraction of <50%]). RESULTS Among 38,528 postmenopausal women (mean age: 63 ± 7 years), 5,399 (14%) participants reported a history of infertility. Over a median follow-up of 15 years, 2,373 developed incident HF, including 807 with HFrEF and 1,133 with HFpEF. Infertility was independently associated with future risk of overall HF (HR: 1.16; 95% CI: 1.04-1.30; P = 0.006). Notably, when examining HF subtypes, infertility was associated with future risk of HFpEF (HR: 1.27; 95% CI: 1.09-1.48; P = 0.002) but not HFrEF (HR: 0.97; 95% CI: 0.80-1.18). CONCLUSIONS Infertility was significantly associated with incident HF. This was driven by increased risk of HFpEF, but not HFrEF, and appeared independent of traditional cardiovascular risk factors and other infertility-related conditions. Future research should investigate mechanisms that underlie the link between infertility and HFpEF.
Collapse
Affiliation(s)
- Emily S Lau
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Research Center, Massachusetts General Hospital, Boston, Massachusetts, USA.
| | - Dongyu Wang
- CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Mary Roberts
- Department of Family Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Christy N Taylor
- Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Gayathree Murugappan
- Department of Obstetrics and Gynecology, Stanford University Medical Center, Stanford, California, USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, California, USA
| | - Peter F Schnatz
- Department of Obstetrics and Gynecology, The Reading Hospital/Tower Health, Reading, Pennsylvania, USA
| | - Leslie V Farland
- Department of Epidemiology and Biostatistics, University of Arizona, Tucson, Arizona, USA; Department of Obstetrics and Gynecology, College of Medicine-Tucson, Tucson, Arizona, USA
| | - Malissa J Wood
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Nandita S Scott
- Cardiology Division, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Charles B Eaton
- Department of Family Medicine, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA
| | - Jennifer E Ho
- CardioVascular Institute and Division of Cardiology, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA. https://twitter.com/JenHoCardiology
| |
Collapse
|
39
|
Tertulien T, Roberts MB, Eaton CB, Cene CW, Corbie-Smith G, Manson JE, Allison M, Nassir R, Breathett K. Association between race/ethnicity and income on the likelihood of coronary revascularization among postmenopausal women with acute myocardial infarction: Women's health initiative study. Am Heart J 2022; 246:82-92. [PMID: 34998968 PMCID: PMC8918000 DOI: 10.1016/j.ahj.2021.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 11/22/2021] [Accepted: 12/25/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Historically, race, income, and gender were associated with likelihood of receipt of coronary revascularization for acute myocardial infarction (AMI). Given public health initiatives such as Healthy People 2010, it is unclear whether race and income remain associated with the likelihood of coronary revascularization among women with AMI. METHODS Using the Women's Health Initiative Study, hazards ratio (HR) of revascularization for AMI was compared for Black and Hispanic women vs White women and among women with annual income <$20,000/year vs ≥$20,000/year over median 9.5 years follow-up(1993-2019). Proportional hazards models were adjusted for demographics, comorbidities, and AMI type. Results were stratified by revascularization type: percutaneous coronary intervention and coronary artery bypass grafting(CABG). Trends by race and income were compared pre- and post-2010 using time-varying analysis. RESULTS Among 5,284 individuals with AMI (9.5% Black, 2.8% Hispanic, and 87.7% White; 23.2% <$20,000/year), Black race was associated with lower likelihood of receiving revascularization for AMI compared to White race in fully adjusted analyses [HR:0.79(95% Confidence Interval:[CI]0.66,0.95)]. When further stratified by type of revascularization, Black race was associated with lower likelihood of percutaneous coronary intervention for AMI compared to White race [HR:0.72(95% CI:0.59,0.90)] but not for CABG [HR:0.97(95%CI:0.72,1.32)]. Income was associated with lower likelihood of revascularization [HR:0.90(95%CI:0.82,0.99)] for AMI. No differences were observed for other racial/ethnic groups. Time periods (pre/post-2010) were not associated with change in revascularization rates. CONCLUSION Black race and income remain associated with lower likelihood of revascularization among patients presenting with AMI. There is a substantial need to disrupt the mechanisms contributing to race, sex, and income disparities in AMI management.
Collapse
|
40
|
Driban JB, Lo GH, Roberts MB, Harkey MS, Schaefer LF, Haugen IK, Smith SE, Duryea J, Lu B, Eaton CB, Hochberg MC, Jackson RD, Kwoh CK, Nevitt MC, McAlindon TE. Racket or Bat Sports: No Association With Thumb-Base Osteoarthritis. J Athl Train 2022; 57:341-351. [PMID: 35439314 PMCID: PMC9020592 DOI: 10.4085/1062-6050-0208.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
CONTEXT Repetitive joint use is a risk factor for osteoarthritis, which is a leading cause of disability. Sports requiring a racket or bat to perform repetitive high-velocity impacts may increase the risk of thumb-base osteoarthritis. However, this hypothesis remains untested. OBJECTIVE To determine if a history of participation in racket or bat sports was associated with the prevalence of thumb-base osteoarthritis. DESIGN Descriptive epidemiologic study. SETTING Four US clinical sites associated with the Osteoarthritis Initiative. PATIENTS OR OTHER PARTICIPANTS We recruited 2309 men and women from the community. Eligible participants had dominant-hand radiographic readings, hand symptom assessments, and historical physical activity survey data. MAIN OUTCOME MEASURE(S) A history of exposure to racket or bat sports (badminton, baseball or softball, racketball or squash, table tennis [or ping pong], tennis [doubles], or tennis [singles]) was based on self-reported recall data covering 3 age ranges (12-18, 19-34, and 35-49 years). Prevalent radiographic thumb-base osteoarthritis was defined as Kellgren-Lawrence grade >2 in the first carpometacarpal joint or scaphotrapezoidal joint at the Osteoarthritis Initiative baseline visit. Symptomatic thumb-base osteoarthritis was defined as radiographic osteoarthritis and hand or finger symptoms. RESULTS Radiographic or symptomatic thumb-base osteoarthritis was present in 355 (34%) and 56 (5%), respectively, of men (total = 1049) and 535 (42%) and 170 (13%), respectively, of women (total = 1260). After adjusting for age, race, and education level, we found no significant associations between a history of any racket or bat sport participation and thumb-base osteoarthritis (radiographic or symptomatic; odds ratios ranged from 0.82 to 1.34). CONCLUSIONS In a community-based cohort, a self-reported history of participation in racket or bat sports was not associated with increased odds of having radiographic or symptomatic thumb-base osteoarthritis in the dominant hand.
Collapse
Affiliation(s)
- Jeffrey B. Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| | - Grace H. Lo
- Department of Medicine, Baylor College of Medicine, Houston, TX
| | - Mary B. Roberts
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | | | | | - Ida K. Haugen
- Department of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Stacy E. Smith
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey Duryea
- Department of
Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Bing Lu
- Department of
Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Charles B. Eaton
- Center for Primary Care and Prevention, Alpert Medical School of Brown University, Pawtucket, RI
| | - Marc C. Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore
| | - Rebecca D. Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University Medical Center, Columbus
| | | | - Michael C. Nevitt
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Timothy E. McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, MA
| |
Collapse
|
41
|
Reding KW, Cheng RK, Vasbinder A, Ray RM, Barac A, Eaton CB, Saquib N, Shadyab AH, Simon MS, Langford D, Branch M, Caan B, Anderson G. Lifestyle and Cardiovascular Risk Factors Associated With Heart Failure Subtypes in Postmenopausal Breast Cancer Survivors. JACC CardioOncol 2022; 4:53-65. [PMID: 35492810 PMCID: PMC9040098 DOI: 10.1016/j.jaccao.2022.01.099] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2021] [Accepted: 01/05/2022] [Indexed: 12/14/2022] Open
Abstract
Background Breast cancer (BC) survivors experience an increased burden of long-term comorbidities, including heart failure (HF). However, there is limited understanding of the risk for the development of HF subtypes, such as HF with preserved ejection fraction (HFpEF), in BC survivors. Objectives This study sought to estimate the incidence of HFpEF and HF with reduced ejection fraction (HFrEF) in postmenopausal BC survivors and to identify lifestyle and cardiovascular risk factors associated with HF subtypes. Methods Within the Women’s Health Initiative, participants with an adjudicated diagnosis of invasive BC were followed to determine the incidence of hospitalized HF, for which adjudication procedures determined left ventricular ejection fraction. We calculated cumulative incidences of HF, HFpEF, and HFrEF. We estimated HRs for risk factors in relation to HF, HFpEF, and HFrEF using Cox proportional hazards survival models. Results In 2,272 BC survivors (28.6% Black and 64.9% White), the cumulative incidences of hospitalized HFpEF and HFrEF were 6.68% and 3.96%, respectively, over a median of 7.2 years (IQR: 3.6-12.3 years). For HFpEF, prior myocardial infarction (HR: 2.83; 95% CI: 1.28-6.28), greater waist circumference (HR: 1.99; 95% CI: 1.14-3.49), and smoking history (HR: 1.65; 95% CI: 1.01-2.67) were the strongest risk factors in multivariable models. With the exception of waist circumference, similar patterns were observed for HFrEF, although none were significant. In relation to those without HF, the risk of overall mortality in BC survivors with hospitalized HFpEF was 5.65 (95% CI: 4.11-7.76), and in those with hospitalized HFrEF, it was 3.77 (95% CI: 2.51-5.66). Conclusions In this population of older, racially diverse BC survivors, the incidence of HFpEF, as defined by HF hospitalizations, was higher than HFrEF. HF was also associated with an increased mortality risk. Risk factors for HF were largely similar to the general population with the exception of prior myocardial infarction for HFpEF. Notably, both waist circumference and smoking represent potentially modifiable factors.
Collapse
Key Words
- BC, breast cancer
- BMI, body mass index
- CVD, cardiovascular disease
- ER, estrogen receptor
- HF, heart failure
- HFpEF, heart failure with preserved ejection fraction
- HFrEF, heart failure with reduced ejection fraction
- LVEF, left ventricular ejection fraction
- MI, myocardial infarction
- PR, progesterone receptor
- WHI, Women’s Health Initiative
- breast cancer
- cancer survivorship
- cardio-oncology
- heart failure
- obesity
Collapse
Affiliation(s)
- Kerryn W Reding
- Biobehavioral Nursing and Health Informatics Department, University of Washington School of Nursing, Seattle, Washington, USA.,Public Health Sciences Division, Fred Hutch Cancer Research Center, Seattle, Washington, USA
| | - Richard K Cheng
- Department of Cardiology, University of Washington School of Medicine, Seattle, Washington, USA
| | - Alexi Vasbinder
- Biobehavioral Nursing and Health Informatics Department, University of Washington School of Nursing, Seattle, Washington, USA.,Department of Internal Medicine, Division of Cardiovascular Medicine, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
| | - Roberta M Ray
- Public Health Sciences Division, Fred Hutch Cancer Research Center, Seattle, Washington, USA
| | - Ana Barac
- MedStar Health Heart and Vascular Institute, Baltimore, Maryland, USA.,Division of Cardiology, Georgetown University School of Medicine, Washington, DC, USA
| | - Charles B Eaton
- Center for Primary Care and Prevention, Alpert School of Medicine, Brown University, Providence, Rhode Island, USA
| | - Nazmus Saquib
- Sulaiman AlRajhi University, Al Qassim, Saudi Arabia
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California-San Diego, San Diego, California, USA
| | - Michael S Simon
- Division of Oncology, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan, USA
| | - Dale Langford
- Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, Washington, USA.,Department of Anesthesiology and Perioperative Medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA
| | - Mary Branch
- Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bette Caan
- Division of Research, Kaiser Permanente Northern California, Oakland, California, USA
| | - Garnet Anderson
- Public Health Sciences Division, Fred Hutch Cancer Research Center, Seattle, Washington, USA
| |
Collapse
|
42
|
Eaton CB, Schaefer L, Duryea J, Driban JB, Lo GH, Roberts MB, Haugen IK, Lu B, Nevitt MC, Hochberg MC, Jackson RD, Kwoh KC, McAlindon TE. Prevalence, Incidence, and Progression of Radiographic and Symptomatic Hand Osteoarthritis: The Osteoarthritis Initiative. Arthritis Rheumatol 2022; 74:992-1000. [PMID: 35077023 DOI: 10.1002/art.42076] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 11/09/2021] [Accepted: 01/21/2022] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To describe prevalence, incidence, and progression of radiographic and symptomatic hand osteoarthritis (OA), and evaluate age, sex, race and risk factors differences. METHODS We assessed both radiographic and symptomatic hand OA at baseline and year 4 for incident disease. A modified poisson regression with a robust variance estimator was used to account for clustering of joints within fingers within persons to estimate the prevalence ratios and relative risk estimates associated with participant characteristics. RESULTS Of 3588 participants, the prevalence hand OA was 41.4% for radiographic hand OA and 12.4 % for symptomatic hand OA. The incidence of hand OA over 48 months was 5.6 % for radiographic hand OA, and 16.9 % for symptomatic hand OA. Over 48 months, 27.3 % participants exhibited OA progression. We found complex differences by age, sex and race with both men and women having increasing prevalent hand OA with age, but women peaking at age 55-65, for incident disease. Women have more symptomatic hand OA than men but only non-significantly higher rates for incident radiographic hand OA. Women have more distal interphalangeal joint disease while men have more metacarpal joint OA. Black men and women have less hand OA than whites but black men have more hand OA than black women at younger ages. CONCLUSION Hand OA is a heterogeneous disease with complex differences by age, sex and race, hand symptoms and patterns of specific joints. Further research investigating the mechanisms behind these differences whether mechanical, metabolic, hormonal, or constitutional is warranted.
Collapse
Affiliation(s)
- C B Eaton
- Department of Family Medicine, Alpert Medical School of Brown University, Providence, RI.,Center for Primary Care and Prevention, Pawtucket, Rhode, Island.,Department of Epidemiology, Brown University School of Public Health Providence, RI
| | - L Schaefer
- Radiology Department, Klinikum Nürnberg Süd, Breslauer Straße 201, 90471, Nürnberg
| | - J Duryea
- Department of Radiology, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - J B Driban
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
| | - G H Lo
- Medical Care Line and Research Care Line, Houston Health Services Research and Development Center of Excellence Michael E. DeBakey VAMC, Houston, Texas. Section of Immunology, Allergy, and Rheumatology, Baylor College of Medicine, Houston, Texas
| | - M B Roberts
- Center for Primary Care and Prevention, Pawtucket, Rhode, Island
| | - I K Haugen
- Dept. of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway
| | - B Lu
- Section of Clinical Sciences, Division of Rheumatology, Immunology & Allergy, Brigham & Women's Hospital and Harvard Medical School, Boston, Massachusetts
| | - M C Nevitt
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA
| | - M C Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD
| | - R D Jackson
- Division of Endocrinology, Diabetes and Metabolism, The Ohio State University, Columbus, OH
| | - K C Kwoh
- University of Arizona Arthritis Center, University of Arizona, Tucson, AZ
| | - T E McAlindon
- Division of Rheumatology, Allergy, and Immunology, Tufts Medical Center, Boston, Massachusetts
| |
Collapse
|
43
|
Miremad M, Lin X, Rasla S, El Meligy A, Roberts MB, Laddu D, Allison M, Martin LW, Shadyab AH, Manson JAE, Chlebowski R, Panjrath G, LaMonte MJ, Liu S, Eaton CB. The association of walking pace and incident heart failure and subtypes among postmenopausal women. J Am Geriatr Soc 2022; 70:1405-1417. [PMID: 35048361 DOI: 10.1111/jgs.17657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/30/2021] [Accepted: 12/16/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND To investigate the association between walking pace and the risk of heart failure (HF) and HF sub-types. METHODS We examined associations of self-reported walking pace with risk of incident HF and HF subtypes of preserved (HFpEF) and reduced (HFrEF) ejection fractions, among 25,183 postmenopausal women, ages 50-79 years. At enrollment into the Women's Health Initiative cohort in 1993-1998, this subset of women was free of HF, cancer, or the inability to walk one block, with self-reported information on walking pace and walking duration. Multivariable Cox regression was used to examine associations of walking pace (casual <2 mph [referent], average 2-3 mph, and fast >3 mph) with incident HF. We also examined the joint association of walking pace and duration with incident HF. RESULTS There were 1455 incident adjudicated acute decompensated HF hospitalization cases during a median of 16.9 years of follow-up. There was a strong inverse association between walking pace and overall risk of HF (HR = 0.73, 95% CI [0.65, 0.83] for average vs. casual walking; HR = 0.66, 95%CI [0.56, 0.78] for fast vs. casual walking). There were similar associations of walking pace with HFpEF (HR = 0.73, 95%CI [0.62, 0.86] average vs. casual; HR = 0.63, 95%CI [0.50, 0.80] for fast vs. casual) and with HFrEF (HR = 0.72, 95%CI [0.57, 0.91] for average vs. casual; HR = 0.74, 95%CI [0.54, 0.99] for fast vs. casual). The risk of HF associated with fast walking with less than 1 h/week walking duration was comparable with the risk of HF among casual and average walkers with more than 2 h/week walking duration. CONCLUSION Walking pace was inversely associated with risks of overall HF, HFpEF, and HFrEF in postmenopausal women. Whether interventions to increase the walking pace in older adults will reduce HF risk and whether fast pace will compensate for the short duration of walking warrants further study.
Collapse
Affiliation(s)
| | - Xiaochen Lin
- Department of Epidemiology Brown University Providence Rhode Island USA
- Center for Global Cardio‐metabolic Health Brown University Providence Rhode Island USA
| | - Somwail Rasla
- Division of General Internal Medicine Brown University Providence Rhode Island USA
| | - Amr El Meligy
- Division of General Internal Medicine Brown University Providence Rhode Island USA
| | - Mary B. Roberts
- Center for Primary Care and Prevention Care New England Medical Group/Primary Care and Specialty Services Pawtucket Rhode Island USA
| | - Deepika Laddu
- Department of Physical Therapy University of Illinois at Chicago Chicago Illinois USA
| | - Matthew Allison
- Department of Family Medicine and Public Health University of California San Diego La Jolla California USA
| | - Lisa W. Martin
- Department of Medicine George Washington University Washington District of Columbia USA
| | - Aladdin H. Shadyab
- Department of Family Medicine and Public Health University of California San Diego La Jolla California USA
| | - Jo Ann E. Manson
- Department of Medicine Brigham and Women's Hospital and Harvard Medical School Boston Massachusetts USA
- Department of Epidemiology Harvard T.H. Chan School of Public Health Boston Massachusetts USA
| | - Rowan Chlebowski
- Division of Medical Oncology and Hematology University of California Los Angeles Los Angeles California USA
| | - Gurusher Panjrath
- Department of Medicine George Washington University Washington District of Columbia USA
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental Health University of Buffalo Buffalo New York USA
| | - Simin Liu
- Department of Epidemiology Brown University Providence Rhode Island USA
- Center for Global Cardio‐metabolic Health Brown University Providence Rhode Island USA
- Division of Endocrinology, Warren Alpert Medical School Brown University Providence Rhode Island USA
- Department of Endocrinology Guangdong General Hospital Guangzhou China
| | - Charles B. Eaton
- Department of Epidemiology Brown University Providence Rhode Island USA
- Department of Family Medicine Warren Alpert Medical School of Brown University Providence Rhode Island USA
| |
Collapse
|
44
|
Park JW, Dulin AJ, Needham BL, Sims M, Loucks EB, Fava JL, Dionne LA, Scarpaci MM, Eaton CB, Howe CJ. Examining Optimism, Psychosocial Risks, and Cardiovascular Health Using Life's Simple 7 Metrics in the Multi-Ethnic Study of Atherosclerosis and the Jackson Heart Study. Front Cardiovasc Med 2021; 8:788194. [PMID: 34977194 PMCID: PMC8714850 DOI: 10.3389/fcvm.2021.788194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Background: Optimism has been shown to be positively associated with better cardiovascular health (CVH). However, there is a dearth of prospective studies showing the benefits of optimism on CVH, especially in the presence of adversities, i.e., psychosocial risks. This study examines the prospective relationship between optimism and CVH outcomes based on the Life's Simple 7 (LS7) metrics and whether multilevel psychosocial risks modify the aforementioned relationship. Methods: We examined self-reported optimism and CVH using harmonized data from two U.S. cohorts: Multi-Ethnic Study of Atherosclerosis (MESA) and Jackson Heart Study (JHS). Modified Poisson regression models were used to estimate the relationship between optimism and CVH using LS7 among MESA participants (N = 3,520) and to examine the relationship of interest based on four biological LS7 metrics (body mass index, blood pressure, cholesterol, and blood glucose) among JHS and MESA participants (N = 5,541). For all CVH outcomes, we assessed for effect measure modification by psychosocial risk. Results: Among MESA participants, the adjusted risk ratio (aRR) for ideal or intermediate CVH using LS7 comparing participants who reported high or medium optimism to those with the lowest level of optimism was 1.10 [95% Confidence Interval (CI): 1.04-1.16] and 1.05 (95% CI: 0.99-1.11), respectively. Among MESA and JHS participants, the corresponding aRRs for having all ideal or intermediate (vs. no poor) metrics based on the four biological LS7 metrics were 1.05 (0.98-1.12) and 1.04 (0.97-1.11), respectively. The corresponding aRRs for having lower cardiovascular risk (0-1 poor metrics) based on the four biological LS7 metrics were 1.01 (0.98-1.03) and 1.01 (0.98-1.03), respectively. There was some evidence of effect modification by neighborhood deprivation for the LS7 outcome and by chronic stress for the ideal or intermediate (no poor) metrics outcome based on the four biological LS7 metrics. Conclusion: Our findings suggest that greater optimism is positively associated with better CVH based on certain LS7 outcomes among a racially/ethnically diverse study population. This relationship may be effect measure modified by specific psychosocial risks. Optimism shows further promise as a potential area for intervention on CVH. However, additional prospective and intervention studies are needed.
Collapse
Affiliation(s)
- Jee Won Park
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
| | - Akilah J. Dulin
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Belinda L. Needham
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, United States
| | - Mario Sims
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Eric B. Loucks
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Joseph L. Fava
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
- Centers for Behavioral and Preventive Medicine, The Miriam Hospital, Providence, RI, United States
| | - Laura A. Dionne
- Department of Behavioral and Social Sciences, Center for Health Promotion and Health Equity Research, Brown University, Providence, RI, United States
| | - Matthew M. Scarpaci
- Hassenfeld Child Health Innovation Institute, Brown University, Providence, RI, United States
| | - Charles B. Eaton
- Department of Epidemiology, Brown University, Providence, RI, United States
- Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Chanelle J. Howe
- Center for Epidemiologic Research, Brown University, Providence, RI, United States
- Department of Epidemiology, Brown University, Providence, RI, United States
| |
Collapse
|
45
|
Hansen AL, Søndergaard MM, Hlatky MA, Vittinghof E, Nah G, Stefanick ML, Manson JE, Farland LV, Wells GL, Mongraw-Chaffin M, Gunderson EP, Van Horn L, Wild RA, Liu B, Shadyab AH, Allison MA, Liu S, Eaton CB, Honigberg MC, Parikh NI. Adverse Pregnancy Outcomes and Incident Heart Failure in the Women's Health Initiative. JAMA Netw Open 2021; 4:e2138071. [PMID: 34882182 PMCID: PMC8662370 DOI: 10.1001/jamanetworkopen.2021.38071] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
IMPORTANCE Some prior evidence suggests that adverse pregnancy outcomes (APOs) may be associated with heart failure (HF). Identifying unique factors associated with the risk of HF and studying HF subtypes are important next steps. OBJECTIVE To investigate the association of APOs with incident HF overall and stratified by HF subtype (preserved vs reduced ejection fraction) among postmenopausal women in the Women's Health Initiative (WHI). DESIGN, SETTING, AND PARTICIPANTS In 2017, an APO history survey was administered in the WHI study, a large multiethnic cohort of postmenopausal women. The associations of 5 APOs (gestational diabetes, hypertensive disorders of pregnancy [HDP], low birth weight, high birth weight, and preterm delivery) with incident adjudicated HF were analyzed. In this cohort study, the association of each APO with HF was assessed using logistic regression models and with HF subtypes using multinomial regression, adjusting for age, sociodemographic characteristics, smoking, randomization status, reproductive history, and other APOs. Data analysis was performed from January 2020 to September 2021. EXPOSURES APOs (gestational diabetes, HDP, low birth weight, high birth weight, and preterm delivery). MAIN OUTCOMES AND MEASURES All confirmed cases of women hospitalized with HF and HF subtype were adjudicated by trained physicians using standardized methods. RESULTS Of 10 292 women (median [IQR] age, 60 [55-64] years), 3185 (31.0%) reported 1 or more APO and 336 (3.3%) had a diagnosis of HF. Women with a history of any APO had a higher prevalence of hypertension, diabetes, coronary heart disease, or smoking. Of the APOs studied, only HDP was significantly associated with HF with a fully adjusted odds ratio (OR) of 1.75 (95% CI, 1.22-2.50), and with HF with preserved ejection fraction in fully adjusted models (OR, 2.06; 95% CI, 1.29-3.27). In mediation analyses, hypertension explained 24% (95% CI, 12%-73%), coronary heart disease 23% (95% CI, 11%-68%), and body mass index 20% (95% CI, 10%-64%) of the association between HDP and HF. CONCLUSIONS AND RELEVANCE In this large cohort of postmenopausal women, HDP was independently associated with incident HF, particularly HF with preserved ejection fraction, and this association was mediated by subsequent hypertension, coronary heart disease, and obesity. These findings suggest that monitoring and modifying these factors early in women presenting with HDP may be associated with reduced long-term risk of HF.
Collapse
Affiliation(s)
| | | | - Mark A. Hlatky
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - Eric Vittinghof
- Department of Epidemiology and Biostatistics, University of California San Francisco School of Medicine, San Francisco
| | - Gregory Nah
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| | - Marcia L. Stefanick
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California
| | - JoAnn E. Manson
- Department of Preventive Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Leslie V. Farland
- Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson
| | | | - Morgana Mongraw-Chaffin
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, North Carolina
| | - Erica P. Gunderson
- Lifecourse Epidemiology of Diabetes and Heart Disease in Women and Youth Division of Research, Kaiser Permanente Northern California, Oakland
| | - Linda Van Horn
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Robert A. Wild
- Department of Biostatistics and Epidemiology, Oklahoma University Health Sciences Center, Oklahoma City
- Department of Obstetrics and Gynecology, Oklahoma University Health Sciences Center, Oklahoma City
| | - Buyun Liu
- Department of Epidemiology, University of Iowa, Iowa City
| | | | | | - Simin Liu
- Department of Epidemiology, Public Health Program, Brown University, Providence, Rhode Island
| | - Charles B. Eaton
- Alpert Medical School, Brown University, Pawtucket, Rhode Island
| | - Michael C. Honigberg
- Cardiology Division, Massachusetts General Hospital, Boston
- Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge
| | - Nisha I. Parikh
- Department of Medicine, Division of Cardiology, University of California, San Francisco
| |
Collapse
|
46
|
Bellettiere J, Nguyen S, Eaton CB, Liles S, Laddu-Patel D, Di C, Stefanick ML, LaCroix AZ, LaMonte MJ. The short physical performance battery and incident heart failure among older women: the OPACH study. Am J Prev Cardiol 2021; 8:100247. [PMID: 34553186 PMCID: PMC8441145 DOI: 10.1016/j.ajpc.2021.100247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/11/2021] [Accepted: 08/14/2021] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE Reduced functional capacity is a hallmark of early pre-clinical stages of heart failure (HF). The Short Physical Performance Battery (SPPB) is a valid measure of lower extremity physical function, has relatively low implementation burden, and is associated with cardiovascular disease and mortality. However, the SPPB-HF association is understudied in older women among whom HF burden is high. METHODS Women (n = 5325; mean age 79 ± 7 years; 34% Black, 18% Hispanic, and 49% White) without prior HF completed the SPPB consisting of standing balance, strength, and walking tests that were summarized as a composite score from 0 (lowest) to 12 (highest), categorized as very low (0-3), low (4-6), medium (7-9), or high (10-12). Participants were followed for up to 8 years for incident HF (306 cases identified). Cox proportional hazards regression estimated hazard ratios (HR) adjusting for age, race/ethnicity, education, smoking, alcohol, diabetes, hypertension, COPD, osteoarthritis, depression, BMI, systolic blood pressure, lipids, glucose, and accelerometer-measured moderate-vigorous physical activity (MVPA) and sedentary time. RESULTS Incident HF cases (crude rate per 1000 person-years) in the four SPPB categories (very low to high) were 34 (26.0), 79 (14.5), 128 (9.3), and 65 (5.6). Corresponding multivariable-adjusted HRs (95% CIs) were 2.22 (1.34-3.66), 1.63 (1.11-2.38), 1.39 (1.00-1.94), and 1.00 (referent; P-trend<0.001). Higher HF risk was associated with lower SPPB in women with major modifiable HF risk factors including obesity (HR per 3-unit SPPB decrement: present HR = 1.41, absent HR = 1.41), hypertension (present HR = 1.45, absent HR = 1.30), diabetes (present HR = 1.32, absent HR = 1.44), and lower accelerometer-measured MVPA (<45 min/day HR = 1.29, ≥45 min/day HR = 1.60); all P-interaction>0.10. CONCLUSION Lower SPPB scores were associated with greater risk of incident HF in older women even after accounting for differences in HF risk factors and objectively measured PA. Implementing the SPPB in clinical settings could potentially enhance individual-level HF risk assessment, which should be further explored.
Collapse
Affiliation(s)
- John Bellettiere
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
- Center for Behavioral Epidemiology and Community Health (C-BEACH), School of Public Health, San Diego State University, San Diego, CA, USA
| | - Steve Nguyen
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
| | - Charles B. Eaton
- Departments of Family Medicine and Epidemiology, Schools of Medicine and Public Health, Brown University, Providence, RI, USA
| | - Sandy Liles
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
- Center for Behavioral Epidemiology and Community Health (C-BEACH), School of Public Health, San Diego State University, San Diego, CA, USA
| | - Deepika Laddu-Patel
- College of Applied Health Sciences, University of Illinois, Chicago, IL, USA
| | - Chongzhi Di
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Department of Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Andrea Z. LaCroix
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla CA, USA
| | - Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, SUNY, Buffalo, NY, USA
| |
Collapse
|
47
|
Horace RW, Roberts M, Lu B, Driban JB, McAlindon T, Eaton CB. The association between vitamin K and medial tibial-femoral knee osteoarthritis progression: Data from the osteoarthritis initiative. Osteoarthritis and Cartilage Open 2021; 3:100172. [DOI: 10.1016/j.ocarto.2021.100172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/26/2022] Open
|
48
|
LaMonte MJ, Eaton CB. Physical Activity in the Treatment and Prevention of Heart Failure: An Update. Curr Sports Med Rep 2021; 20:410-417. [PMID: 34357887 PMCID: PMC8351911 DOI: 10.1249/jsr.0000000000000869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Heart failure (HF) is a complex clinical syndrome hallmarked by an inability to match cardiac output with metabolic demand, resulting in exercise intolerance. HF is increasingly prevalent in an aging population and accounts for substantial burden of health care costs and morbidity. Because many of the central and peripheral mechanisms of HF respond favorably to exercise training, its role in HF treatment is becoming established. The role of habitual physical activity in the primary prevention of HF is less clear; however, available evidence is supportive. This article reviews recently published studies on exercise training and usual physical activity in HF treatment and prevention, discusses potential mechanisms, and suggests areas where further research is needed.
Collapse
Affiliation(s)
- Michael J. LaMonte
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo – SUNY, Buffalo, NY, USA
| | - Charles B. Eaton
- Departments of Family Medicine and Epidemiology, Warren Alpert Medical School, Director, Center for Primary Care and Prevention, Brown University, Providence, RI, USA
| |
Collapse
|
49
|
Yu B, Roberts MB, Raffield LM, Zekavat SM, Nguyen NQH, Biggs ML, Brown MR, Griffin G, Desai P, Correa A, Morrison AC, Shah AM, Niroula A, Uddin MM, Honigberg MC, Ebert BL, Psaty BM, Whitsel EA, Manson JE, Kooperberg C, Bick AG, Ballantyne CM, Reiner AP, Natarajan P, Eaton CB. Supplemental Association of Clonal Hematopoiesis With Incident Heart Failure. J Am Coll Cardiol 2021; 78:42-52. [PMID: 34210413 PMCID: PMC8313294 DOI: 10.1016/j.jacc.2021.04.085] [Citation(s) in RCA: 88] [Impact Index Per Article: 29.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 04/05/2021] [Accepted: 04/20/2021] [Indexed: 12/20/2022]
Abstract
BACKGROUND Age-related clonal hematopoiesis of indeterminate potential (CHIP), defined as clonally expanded leukemogenic sequence variations (particularly in DNMT3A, TET2, ASXL1, and JAK2) in asymptomatic individuals, is associated with cardiovascular events, including recurrent heart failure (HF). OBJECTIVES This study sought to evaluate whether CHIP is associated with incident HF. METHODS CHIP status was obtained from whole exome or genome sequencing of blood DNA in participants without prevalent HF or hematological malignancy from 5 cohorts. Cox proportional hazards models were performed within each cohort, adjusting for demographic and clinical risk factors, followed by fixed-effect meta-analyses. Large CHIP clones (defined as variant allele frequency >10%), HF with or without baseline coronary heart disease, and left ventricular ejection fraction were evaluated in secondary analyses. RESULTS Of 56,597 individuals (59% women, mean age 58 years at baseline), 3,406 (6%) had CHIP, and 4,694 developed HF (8.3%) over up to 20 years of follow-up. CHIP was prospectively associated with a 25% increased risk of HF in meta-analysis (hazard ratio: 1.25; 95% confidence interval: 1.13-1.38) with consistent associations across cohorts. ASXL1, TET2, and JAK2 sequence variations were each associated with an increased risk of HF, whereas DNMT3A sequence variations were not associated with HF. Secondary analyses suggested large CHIP was associated with a greater risk of HF (hazard ratio: 1.29; 95% confidence interval: 1.15-1.44), and the associations for CHIP on HF with and without prior coronary heart disease were homogenous. ASXL1 sequence variations were associated with reduced left ventricular ejection fraction. CONCLUSIONS CHIP, particularly sequence variations in ASXL1, TET2, and JAK2, represents a new risk factor for HF.
Collapse
Affiliation(s)
- Bing Yu
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mary B Roberts
- Center for Primary Care and Prevention, Brown University, Pawtucket, Rhode Island, USA
| | - Laura M Raffield
- Department of Genetics, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Seyedeh Maryam Zekavat
- Yale School of Medicine, New Haven, Connecticut, USA; Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Ngoc Quynh H Nguyen
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Mary L Biggs
- Department of Biostatistics, University of Washington, Seattle, Washington, USA; Department of Epidemiology, Gillings School of Global Public Health and Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Michael R Brown
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Gabriel Griffin
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Pinkal Desai
- Division of Hematology and Oncology, Weill Cornell Medical College, New York, New York, USA
| | - Adolfo Correa
- Department of Pediatric and Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Alanna C Morrison
- School of Public Health, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Amil M Shah
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Abhishek Niroula
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA; Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Md Mesbah Uddin
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Michael C Honigberg
- Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Benjamin L Ebert
- Division of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA; Harvard Medical School, Boston, Massachusetts, USA; Howard Hughes Medical Institute, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Bruce M Psaty
- Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Services, University of Washington, Seattle, Washington, USA
| | - Eric A Whitsel
- Department of Epidemiology, Gillings School of Global Public Health and Department of Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - JoAnn E Manson
- Harvard Medical School, Boston, Massachusetts, USA; Division of Preventive Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Alexander G Bick
- Division of Genetic Medicine, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA
| | - Alex P Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Pradeep Natarajan
- Harvard Medical School, Boston, Massachusetts, USA; Division of Cardiology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts, USA; Cardiovascular Disease Initiative of the Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA.
| | - Charles B Eaton
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA; Care New England, Center for Primary Care and Prevention, Pawtucket, Rhode Island, USA; Department of Family Medicine, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
| |
Collapse
|
50
|
Kimball BK, Tutalo RA, Minami T, Eaton CB. Evaluating an integrated chronic obstructive pulmonary disease management program implemented in a primary care setting. J Am Coll Clin Pharm 2021. [DOI: 10.1002/jac5.1428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Brianna K. Kimball
- Pharmacy Services Rhode Island Primary Care Physicians Corporation Cranston Rhode Island USA
| | - Ronald A. Tutalo
- Pharmacy Services Rhode Island Primary Care Physicians Corporation Cranston Rhode Island USA
| | - Taro Minami
- Department of Medicine The Warren Alpert Medical School of Brown University Providence Rhode Island USA
- Division of Pulmonary and Sleep Medicine Care New England Medical Group Providence Rhode Island USA
| | - Charles B. Eaton
- Department of Family Medicine The Warren Alpert Medical School of Brown University Providence Rhode Island USA
- Department of Epidemiology School of Public Health of Brown University Providence Rhode Island USA
| |
Collapse
|