1
|
Jalanko P, Bond B, Laukkanen JA, Brage S, Ekelund U, Laitinen T, Määttä S, Kähönen M, Haapala EA, Lakka TA. Association between arterial health and cognition in adolescents: The PANIC study. Physiol Rep 2024; 12:e16024. [PMID: 38697946 PMCID: PMC11065692 DOI: 10.14814/phy2.16024] [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: 12/13/2023] [Revised: 03/11/2024] [Accepted: 04/11/2024] [Indexed: 05/05/2024] Open
Abstract
We investigated the associations of the measures of arterial health with cognition in adolescents and whether physical activity (PA) or sedentary time (ST) confounds these associations. One hundred sixteen adolescents (71 boys) aged 15.9 ± 0.4 participated in the study. PA and ST were assessed using a combined accelerometer/heart rate monitor. Overall cognition was computed from the results of psychomotor function, attention, working memory, and paired-associate learning tests. Pulse wave velocity was measured by impedance cardiography, carotid intima-media thickness, and carotid artery distensibility by carotid ultrasonography. Systolic and diastolic blood pressure (SBP and DBP) were measured using an aneroid sphygmomanometer. SBP was inversely associated with overall cognition (standardized regression coefficient [β] = -0.216, 95% confidence interval (CI) -0.406 to -0.027, p = 0.025). Pulse wave velocity (β = -0.199, 95% CI -0.382 to -0.017, p = 0.033) was inversely associated with working memory task accuracy. SBP was directly associated with reaction time in the attention (β = 0.256, 95% CI 0.069 to 0.443, p = 0.008) and errors in the paired-associate learning tasks (β = 0.308, 95% CI 0.126 to 0.489, p = 0.001). Blood pressure was inversely associated with overall cognition. PA or ST did not confound the associations. Results suggest that preventing high blood pressure is important for promoting cognition in adolescents.
Collapse
Affiliation(s)
- Petri Jalanko
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Helsinki Clinic for Sports and Exercise MedicineFoundation for Sports and Exercise MedicineHelsinkiFinland
| | - Bert Bond
- Children's Health and Exercise Research Centre, Sport and Health Science, College of Life and Environmental SciencesUniversity of ExeterExeterUK
| | - Jari A. Laukkanen
- Department of Medicine, Institute of Clinical MedicineUniversity of Eastern FinlandKuopioFinland
- Department of MedicineCentral Finland Health Care District Hospital DistrictJyväskyläFinland
| | - Soren Brage
- MRC Epidemiology UnitUniversity of Cambridge School of Clinical MedicineCambridgeUK
| | - Ulf Ekelund
- Department of Sports MedicineNorwegian School of Sport SciencesOsloNorway
| | - Tomi Laitinen
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
| | - Sara Määttä
- Department of Clinical NeurophysiologyKuopio University HospitalKuopioFinland
| | - Mika Kähönen
- Department of Clinical PhysiologyTampere University Hospital and Faculty of Medicine and Health Technology, Tampere UniversityTampereFinland
| | - Eero A. Haapala
- Faculty of Sport and Health SciencesUniversity of JyväskyläJyväskyläFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
| | - Timo A. Lakka
- Department of Clinical Physiology and Nuclear ImagingUniversity of Eastern Finland and Kuopio University HospitalKuopioFinland
- Institute of Biomedicine, School of MedicineUniversity of Eastern FinlandKuopioFinland
- Foundation for Research in Health Exercise and NutritionKuopio Research Institute of Exercise MedicineKuopioFinland
| |
Collapse
|
2
|
Masrouri S, Afaghi S, Khalili D, Shapiro MD, Hadaegh F. Cumulative Blood Pressure in Early Adulthood and Coronary Artery Calcium and Carotid Intima-Media Thickness in Middle Age Among Adults With Maintained Blood Pressure of <130/80 mm Hg: A Post Hoc Analysis. J Am Heart Assoc 2023; 12:e032091. [PMID: 38063213 PMCID: PMC10863794 DOI: 10.1161/jaha.123.032091] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Accepted: 11/07/2023] [Indexed: 12/20/2023]
Abstract
BACKGROUND To examine the association of blood pressure (BP) levels with coronary artery calcium and carotid intima-media thickness (CIMT) in people with maintained BP below the hypertension range based on current definitions. METHODS AND RESULTS In this post hoc analysis of the CARDIA (Coronary Artery Risk Development in Young Adults) prospective observational cohort study conducted in 4 US cities, we examined 1233 study participants (mean [SD] age at year 20 examination was 45.3 [3.5] years; 65.4% women). Participants with BP assessments across 20 years and untreated BP of <130/80 mm Hg were included. Multivariable logistic or linear regression models, adjusted for age, sex, race, education, diabetes, body mass index, serum creatinine, smoking, alcohol intake, physical activity, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and triglycerides, were used to examine the associations between cumulative BP measures with coronary artery calcium and CIMT. Higher long-term cumulative systolic BP and pulse pressure across early adulthood were associated with higher CIMT (both P<0.001) but not coronary artery calcium in the multivariable-adjusted model. The associations remained significant even after adjustment for a single BP measurement at year 0 or year 20. The odds ratio (OR) of a maximal CIMT >1.01 mm was ≈50% higher per 1-SD increase in systolic BP (OR, 1.50 [95% CI, 1.19-1.88]) and pulse pressure (OR, 1.46 [95% CI, 1.19-1.79]). Similar findings for CIMT were observed among individuals with a coronary artery calcium score of 0 as well as those with maintained BP of <120/80 mm Hg throughout young adulthood. CONCLUSIONS Long-term cumulative systolic BP and pulse pressure across early adulthood within the nonhypertensive range were associated with adverse midlife alterations in CIMT.
Collapse
Affiliation(s)
- Soroush Masrouri
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Siamak Afaghi
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Davood Khalili
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| | - Michael D. Shapiro
- Center for Prevention of Cardiovascular Disease, Section on Cardiovascular MedicineWake Forest University School of MedicineWinston SalemNC
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research CenterResearch Institute for Endocrine Sciences, Shahid Beheshti University of Medical SciencesTehranIran
| |
Collapse
|
3
|
Ling Y, Wan Y, Barinas‐Mitchell E, Fujiyoshi A, Cui H, Maimaiti A, Xu R, Li J, Suo C, Zaid M. Varying Definitions of Carotid Intima-Media Thickness and Future Cardiovascular Disease: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2023; 12:e031217. [PMID: 38014663 PMCID: PMC10727343 DOI: 10.1161/jaha.123.031217] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 11/01/2023] [Indexed: 11/29/2023]
Abstract
BACKGROUND Carotid intima-media thickness (cIMT) has been widely used as a predictor of future cardiovascular disease (CVD); however, various definitions of cIMT exist. This study provides a systematic review and meta-analysis of the associations between different cIMT definitions and CVD. METHODS AND RESULTS A systematic review of the different cIMT definitions used in prospective cohort studies was performed. The relationships between cIMT of different definitions (common carotid artery IMT [CCA-IMT], internal carotid artery IMT [ICA-IMT], combined segments [combined-IMT], mean CCA-IMT, and maximum CCA-IMT) with future stroke, myocardial infarction (MI), and CVD events were analyzed using random effects models. Among 2287 articles, 18 articles (14 studies) with >10 different cIMT definitions were identified and included in our meta-analysis. After adjusting for age and sex, a 1-SD increase in CCA-IMT was associated with future stroke (hazard ratio [HR], 1.32 [95% CI, 1.27-1.38]), MI (HR, 1.27 [95% CI, 1.22-1.33]), and CVD events (HR, 1.28 [95% CI, 1.19-1.37]). A 1-SD increase in ICA-IMT was related to future stroke (HR, 1.25 [95% CI, 1.11-1.42]) and CVD events (HR, 1.25 [95% CI, 1.04-1.50]) but not MI (HR, 1.26 [95% CI, 0.98-1.61]). A 1-SD increase in combined-IMT was associated with future stroke (HR, 1.30 [95% CI, 1.08-1.57]) and CVD events (HR, 1.36 [95% CI, 1.23-1.49]). Maximum CCA-IMT was more strongly related than mean CCA-IMT with risk of MI, and both measures were similarly associated with stroke and CVD events. CONCLUSIONS Combined-IMT is more strongly associated with CVD events compared with single-segment cIMT definitions. Maximum CCA-IMT shows a stronger association with MI than mean CCA-IMT. Further research is warranted to validate our findings and to standardize the cIMT measurement protocol, as well as to explore underlying mechanisms.
Collapse
Affiliation(s)
- Yong Ling
- Department of EpidemiologyFudan UniversityShanghaiChina
| | - Yiming Wan
- Department of EpidemiologyFudan UniversityShanghaiChina
| | | | - Akira Fujiyoshi
- Department of HygieneWakayama Medical UniversityWakayamaJapan
| | - Hui Cui
- Department of EpidemiologyFudan UniversityShanghaiChina
| | | | - Rong Xu
- Department of EpidemiologyFudan UniversityShanghaiChina
| | - Jing Li
- Songjiang District Zhongshan Street Community Healthcare CenterShanghaiChina
| | - Chen Suo
- Department of EpidemiologyFudan UniversityShanghaiChina
| | - Maryam Zaid
- Department of EpidemiologyFudan UniversityShanghaiChina
| |
Collapse
|
4
|
Mokoena V, Botes L, Brown SC, Smit FE. Correlation between carotid intima-media thickness and patient outcomes in coronary artery disease in central South Africa. Cardiovasc J Afr 2023; 34:1-6. [PMID: 38032690 DOI: 10.5830/cvja-2023-055] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
OBJECTIVES Carotid intima-medial thickness (CIMT) is a non-invasive tool used to detect atherosclerosis and diagnose cardiovascular disease. This study aimed to determine whether pre-operative CIMT measurements correlated with intra- and postoperative outcomes in patients with acute coronary syndrome (ACS) undergoing coronary artery bypass graft (CABG) surgery. METHODS This retrospective, analytical cohort included 89 patients diagnosed with ACS who received CABG surgery. Patients were divided into two cohorts: group 1: normal CIMT < 0.07 cm and group 2: abnormal CIMT ≥ 0.07 cm. B-mode ultrasound was used to measure the CIMT in all patients. Pre-, intra- and postoperative data and complications were recorded for each patient. RESULTS The study included 77 (86.5%) males and 12 (13.5%) females. Pre-operative mean body mass index was significantly higher (p = 0.03) in group 2 than in group 1. Group 2 had a significantly increased incidence of diabetes (p = 0.008) and hypertension (p = 0.009), and increased NT-proBNP levels (p = 0.02). Intra- and postoperative outcomes between the groups were comparable, with no significant differences. CONCLUSION The study showed no correlation between abnormal CIMT and increased adverse intra- and postoperative patient outcomes. Therefore, the results of this study show CIMT should not be considered a tool to predict adverse events in patients undergoing CABG surgery.
Collapse
Affiliation(s)
- V Mokoena
- Department of Cardiothoracic Surgery, University of the Free State, Bloemfontein, South Africa
| | - L Botes
- Department of Health Sciences, Central University of Technology, Bloemfontein, South Africa
| | - S C Brown
- Department of Paediatric Cardiology, University of the Free State, Bloemfontein, South Africa.
| | - F E Smit
- Department of Cardiothoracic Surgery, University of the Free State, Bloemfontein, South Africa
| |
Collapse
|
5
|
Rajabzadeh F, Akhlaghipour I, Moosavi SS, Nasimi Shad A, Babazadeh Baghan A, Shariati‐Sarabi Z, Payandeh A, Hassan Nejad E. Comparison of the intima-media thickness of the common carotid artery in patients with rheumatoid arthritis: A single-center cross-sectional case-control study, and a brief review of the literature. Health Sci Rep 2023; 6:e1718. [PMID: 38028704 PMCID: PMC10654376 DOI: 10.1002/hsr2.1718] [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: 07/01/2023] [Revised: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 12/01/2023] Open
Abstract
Background and Aim Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disease affecting 0.5%-1% of adults worldwide. The carotid intima-media thickness (CIMT) is a simple, reliable, noninvasive marker for subclinical atherosclerosis. The aim of this study was to compare the intima-media thickness of the common carotid artery in patients with RA with that of healthy patients. Methods In this case-control study, subjects were recruited from the patients who presented to a private rheumatology clinic. RA was documented by a rheumatologist. All subjects underwent an ultrasound examination of the carotid artery to assess CIMT. Subjects with RA filled out the disease activity score (DAS28) questionnaire. Results Sixty-two subjects (31 subjects with RA and 31 healthy subjects) took part in the study. The mean age of the subjects in the RA and the control groups was 42.39 ± 12.98 and 44.48 ± 13.56 years, respectively. Values of CIMT were significantly greater in RA subjects compared with their healthy counterparts (p < 0.001). The CIMT increased significantly with increased disease severity (r = 0.73). Subjects were divided into two age groups (≤40 and >40 years). A comparison of CIMT in the mentioned subgroups revealed a remarkable difference in CIMT values between those of the RA patients and those of their control counterparts in both age groups (p = 0.002 and p < 0.001 for those below and above 40 years, respectively). Conclusion CIMT could be used as an efficient clinical index for identifying the early stages of atherosclerosis and predicting cardiovascular events following atherosclerosis in RA patients.
Collapse
Affiliation(s)
- Farnood Rajabzadeh
- Department of Radiology, Faculty of Medicine, Mashhad Medical SciencesIslamic Azad UniversityMashhadIran
| | - Iman Akhlaghipour
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Arya Nasimi Shad
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Atefeh Babazadeh Baghan
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Asma Payandeh
- Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Ehsan Hassan Nejad
- Department of Radiology, School of MedicineBirjand University of Medical SciencesBirjandIran
| |
Collapse
|
6
|
Blaauw MJT, Berrevoets MAH, Vos WAJW, Groenendijk AL, van Eekeren LE, Vadaq N, Weijers G, van der Ven AJAM, Rutten JHW, Riksen NP. Traditional Cardiovascular Risk Factors Are Stronger Related to Carotid Intima-Media Thickness Than to Presence of Carotid Plaques in People Living With HIV. J Am Heart Assoc 2023; 12:e030606. [PMID: 37804189 PMCID: PMC10757550 DOI: 10.1161/jaha.123.030606] [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: 04/17/2023] [Accepted: 09/08/2023] [Indexed: 10/09/2023]
Abstract
Background Cardiovascular disease is a major cause of morbidity and mortality in people living with HIV, who are at higher risk than the general population. We assessed, in a large cohort of people living with HIV, which cardiovascular, HIV-specific, and lipoproteomic markers were associated with carotid intima-media thickness (cIMT) and carotid plaque presence. We also studied guideline adherence on lipid-lowering medication in individuals with high and very high risk for cardiovascular disease. Methods and Results In 1814 individuals with a median (interquartile range) age of 53 (44-60) years, we found a carotid plaque in 909 (50.1%) and a median (interquartile range) intima-media thickness of 0.66 (0.57-0.76) mm. Ultrasonography was used for the assessment of cIMT and plaque presence. Univariable and multivariable regression models were used for associations with cIMT and presence of plaques. Age, Black race, body mass index, type 2 diabetes, and smoking (pack years) were all positively associated with higher cIMT. Levels of high-density lipoprotein cholesterol, specifically medium and large high-density lipoprotein subclasses, were negatively associated with higher cIMT. Only age and prior myocardial infarction were positively related to the presence of a carotid plaque. Lipid-lowering treatment was prescribed in one-third of people living with HIV, who are at high and very high risk for cardiovascular disease. Conclusions Traditional cardiovascular risk factors were significantly associated with higher cIMT but not with carotid plaques, except for age. HIV-specific factors were not associated with both ultrasound measurements. Future studies are needed to elucidate which factors contribute to plaque formation. Improvement of guideline adherence on prescription of lipid-lowering treatment in high- and very high-risk patients for cardiovascular disease is recommended. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT03994835.
Collapse
Affiliation(s)
- Marc J. T. Blaauw
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
- Department of Internal MedicineElisabeth‐Tweesteden HospitalTilburgthe Netherlands
| | | | - Wilhelm A. J. W. Vos
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
- Department of Internal MedicineOLVGAmsterdamthe Netherlands
| | - Albert L. Groenendijk
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
- Department of Medical Microbiology and Infectious DiseasesErasmus Medical Center (MC)Rotterdamthe Netherlands
| | - Louise E. van Eekeren
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
| | - Nadira Vadaq
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
- Center for Tropical and Infectious Diseases, Faculty of MedicineDiponegoro University, Dr. Kariadi HospitalSemarangIndonesia
| | - Gert Weijers
- Medical UltraSound Imaging Center, Division of Medical ImagingRadboud University Medical CenterNijmegenthe Netherlands
| | - Andre J. A. M. van der Ven
- Department of Internal Medicine and Radboud Center for Infectious DiseasesRadboud University Medical CenterNijmegenthe Netherlands
| | - Joost H. W. Rutten
- Division of Vascular Medicine, Department of Internal MedicineRadboud University Medical CentreNijmegenthe Netherlands
| | - Niels P. Riksen
- Division of Vascular Medicine, Department of Internal MedicineRadboud University Medical CentreNijmegenthe Netherlands
| |
Collapse
|
7
|
Düzyol Ç, Şaşkin H. Association between carotid intima-media thickness and acute kidney injury following isolated coronary artery bypass surgery. Cardiovasc J Afr 2023; 34:198-205. [PMID: 35913033 DOI: 10.5830/cvja-2022-035] [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: 02/25/2022] [Accepted: 07/02/2022] [Indexed: 06/15/2023] Open
Abstract
OBJECTIVE The association between pre-operative carotid intima-media thickness (CIMT) and early postoperative acute kidney injury (AKI) following isolated coronary artery bypass grafting (CABG) was investigated. METHODS Data were sought retrospectively of 237 patients (166 male, 71 female; mean age 61.4 ± 8.1 years; range: 32-74), operated on for isolated CABG with cardiopulmonary bypass (CPB) in a single centre between June 2014 and December 2020, with a serum creatinine level < 1.5 mg/dl and normal carotid arteries on Doppler ultrasonography. AKI diagnosis was made according to the Kidney Disease Improving Global Outcomes 2012 Acute Kidney Injury Guideline. Patients were grouped as group 1 with AKI in the early postoperative period (n = 63) and group 2 without AKI ( n = 174). Univariate analyses were done to determine significant clinical factors, and subsequent multiple logistic regression analysis was done to determine independent predictors of AKI. RESULTS AKI occurred in 63 (26.6%) patients. Pre-operative CIMT was significantly higher in the AKI group (p = 0.0001). Multivariate logistic regression analysis revealed that elevated pre-operative CIMT ( p = 0.005), C-reactive protein ( p = 0.001), erythrocyte sedimentation rate ( p = 0.005), neutrophil-lymphocyte ratio ( p = 0.0001) and platelet-lymphocyte ratio ( p = 0.0001) increased on the postoperative seventh day. C-reactive protein ( p = 0.04), postoperative first day platelet- lymphocyte ratio ( p = 0.0001), postoperative seventh day erythrocyte sedimentation rate ( p = 0.02) and intubation time ( p = 0.02) were independent predictors of early postoperative AKI following isolated CABG. CONCLUSIONS Pre-operative CIMT was found to be an independent predictor of AKI in the early postoperative period of isolated CABG.
Collapse
Affiliation(s)
- Çağrı Düzyol
- Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey.
| | - Hüseyin Şaşkin
- Cardiovascular Surgery Clinic, Derince Training and Research Hospital, Health Sciences University, Kocaeli, Turkey
| |
Collapse
|
8
|
Ge J, Jing F, Ji R, Tian A, Su X, Li W, He G, Pu B, Lei L, Lu J, Li J. Age-Related Trends in the Predictive Value of Carotid Intima-Media Thickness for Cardiovascular Death: A Prospective Population-Based Cohort Study. J Am Heart Assoc 2023:e029656. [PMID: 37345827 DOI: 10.1161/jaha.123.029656] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/23/2023]
Abstract
Background The age-related trends in the predictive ability of carotid intima-media thickness (CIMT) for cardiovascular risk remain unclear. We aimed to identify the age-related trends in the predictive value of CIMT for cardiovascular death. Methods and Results In a prospective cohort of adults aged 35 to 75 years without history of cardiovascular disease who were enrolled between 2014 and 2020, we measured CIMT at baseline and collected the vital status and cause of death. We divided the study population into 4 age groups (35-44, 45-54, 55-64, and 65-75 years). Competing risk models were fitted to estimate the associations between CIMT and cardiovascular death. The added values of CIMT in prediction were assessed by the differences of the Harrell's concordance index and the net reclassification improvement index. We included 369 478 adults and followed them for a median of 4.7 years. A total of 4723 (1.28%) cardiovascular deaths occurred. After adjusting for the traditional risk factors, the hazard ratios for CIMTmean per SD decreased with age, from 1.27 (95% CI, 1.17-1.37) in the 35 to 44 years age group to 1.14 (95% CI, 1.10-1.19) in the 65 to 75 years age group (P for interaction <0.01). Meanwhile, the net reclassification improvement indexes for CIMTmean were attenuated with age, from 22.60% (95% CI, 15.56%-29.64%) in the 35 to 44 years age group to 7.00% (95% CI, -6.82% to 20.83%) in the 65 to 75 years age group. Similar results were found for maximum CIMT in all age groups. Conclusions CIMT may improve cardiovascular risk prediction in the young and middle-aged populations, rather than those aged ≥55 years.
Collapse
Affiliation(s)
- Jinzhuo Ge
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Fuyu Jing
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Runqing Ji
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Aoxi Tian
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Xiaoming Su
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Wei Li
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Guangda He
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Boxuan Pu
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Lubi Lei
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Jiapeng Lu
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
| | - Jing Li
- National Clinical Research Center for Cardiovascular Diseases, National Health Commission Key Laboratory of Clinical Research for Cardiovascular Medications, State Key Laboratory of Cardiovascular Disease Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, National Center for Cardiovascular Diseases Beijing China
- Fuwai Hospital Chinese Academy of Medical Sciences Shenzhen China
| |
Collapse
|
9
|
Tschiderer L, Seekircher L, Izzo R, Mancusi C, Manzi MV, Baldassarre D, Amato M, Tremoli E, Veglia F, Tuomainen TP, Kauhanen J, Voutilainen A, Iglseder B, Lind L, Rundek T, Desvarieux M, Kato A, de Groot E, Aşçi G, Ok E, Agewall S, Beulens JWJ, Byrne CD, Calder PC, Gerstein HC, Gresele P, Klingenschmid G, Nagai M, Olsen MH, Parraga G, Safarova MS, Sattar N, Skilton M, Stehouwer CDA, Uthoff H, van Agtmael MA, van der Heijden AA, Zozulińska-Ziółkiewicz DA, Park HW, Lee MS, Bae JH, Beloqui O, Landecho MF, Plichart M, Ducimetiere P, Empana JP, Bokemark L, Bergström G, Schmidt C, Castelnuovo S, Calabresi L, Norata GD, Grigore L, Catapano A, Zhao D, Wang M, Liu J, Ikram MA, Kavousi M, Bots ML, Sweeting MJ, Lorenz MW, Willeit P. Association of Intima-Media Thickness Measured at the Common Carotid Artery With Incident Carotid Plaque: Individual Participant Data Meta-Analysis of 20 Prospective Studies. J Am Heart Assoc 2023:e027657. [PMID: 37301757 DOI: 10.1161/jaha.122.027657] [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: 02/23/2023] [Accepted: 05/12/2023] [Indexed: 06/12/2023]
Abstract
Background The association between common carotid artery intima-media thickness (CCA-IMT) and incident carotid plaque has not been characterized fully. We therefore aimed to precisely quantify the relationship between CCA-IMT and carotid plaque development. Methods and Results We undertook an individual participant data meta-analysis of 20 prospective studies from the Proof-ATHERO (Prospective Studies of Atherosclerosis) consortium that recorded baseline CCA-IMT and incident carotid plaque involving 21 494 individuals without a history of cardiovascular disease and without preexisting carotid plaque at baseline. Mean baseline age was 56 years (SD, 9 years), 55% were women, and mean baseline CCA-IMT was 0.71 mm (SD, 0.17 mm). Over a median follow-up of 5.9 years (5th-95th percentile, 1.9-19.0 years), 8278 individuals developed first-ever carotid plaque. We combined study-specific odds ratios (ORs) for incident carotid plaque using random-effects meta-analysis. Baseline CCA-IMT was approximately log-linearly associated with the odds of developing carotid plaque. The age-, sex-, and trial arm-adjusted OR for carotid plaque per SD higher baseline CCA-IMT was 1.40 (95% CI, 1.31-1.50; I2=63.9%). The corresponding OR that was further adjusted for ethnicity, smoking, diabetes, body mass index, systolic blood pressure, low- and high-density lipoprotein cholesterol, and lipid-lowering and antihypertensive medication was 1.34 (95% CI, 1.24-1.45; I2=59.4%; 14 studies; 16 297 participants; 6381 incident plaques). We observed no significant effect modification across clinically relevant subgroups. Sensitivity analysis restricted to studies defining plaque as focal thickening yielded a comparable OR (1.38 [95% CI, 1.29-1.47]; I2=57.1%; 14 studies; 17 352 participants; 6991 incident plaques). Conclusions Our large-scale individual participant data meta-analysis demonstrated that CCA-IMT is associated with the long-term risk of developing first-ever carotid plaque, independent of traditional cardiovascular risk factors.
Collapse
Affiliation(s)
- Lena Tschiderer
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Lisa Seekircher
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
| | - Raffaele Izzo
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Costantino Mancusi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Maria V Manzi
- Department of Advanced Biomedical Sciences Federico II University Naples Italy
| | - Damiano Baldassarre
- Department of Medical Biotechnology and Translational Medicine University of Milan Milan Italy
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | - Mauro Amato
- Centro Cardiologico Monzino Stituto di Ricovero e Cura a Carattere Scientifico Milan Italy
| | | | | | - Tomi-Pekka Tuomainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Ari Voutilainen
- Institute of Public Health and Clinical Nutrition University of Eastern Finland Kuopio Finland
| | - Bernhard Iglseder
- Department of Geriatric Medicine Gemeinnützige Salzburger Landeskliniken Betriebsgesellschaft GmbH Christian-Doppler-Klinik Salzburg Austria
- Department of Geriatric Medicine Paracelsus Medical University Salzburg Austria
| | - Lars Lind
- Department of Medicine Uppsala University Uppsala Sweden
| | - Tatjana Rundek
- Department of Neurology University of Miami Miller School of Medicine Miami FL
| | - Moise Desvarieux
- Department of Epidemiology, Mailman School of Public Health Columbia University New York NY
- METHODS Core, Centre de Recherche Epidémiologie et Statistique Paris Sorbonne Cité Institut National de la Santé et de la Recherche Médicale Unité Mixte de Recherche 1153 Paris France
| | - Akihiko Kato
- Blood Purification Unit Hamamatsu University Hospital Hamamatsu Japan
| | - Eric de Groot
- Imagelabonline and Cardiovascular Erichem the Netherlands
- Department of Gastroenterology and Hepatology, Amsterdam University Medical Center-Academic Medical Centre Amsterdam the Netherlands
| | - Gülay Aşçi
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Ercan Ok
- Nephrology Department Ege University School of Medicine Bornova-Izmir Turkey
| | - Stefan Agewall
- Department of Clinical Sciences, Danderyd Hospital Division of Cardiology Karolinska Institutet Stockholm Sweden
- Institute of Clinical Sciences University of Oslo Oslo Norway
| | - Joline W J Beulens
- Department of Epidemiology and Data Science, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | - Christopher D Byrne
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Philip C Calder
- School of Human Development and Health, Faculty of Medicine University of Southampton Southampton UK
- Southampton National Institute for Health and Care Research, Biomedical Research Centre University Hospital Southampton Southampton UK
| | - Hertzel C Gerstein
- Department of Medicine and Population Health Research Institute McMaster University Hamilton Ontario Canada
- Hamilton General Hospital Hamilton Ontario Canada
| | - Paolo Gresele
- Division of Internal and Cardiovascular Medicine, Department of Medicine and Surgery University of Perugia Perugia Italy
| | | | - Michiaki Nagai
- Department of Internal Medicine General Medicine and Cardiology, Hiroshima City Asa Hospital Hiroshima Japan
| | - Michael H Olsen
- Department of Internal Medicine, Holbaek Hospital University of Southern Denmark Odense Denmark
| | - Grace Parraga
- Department of Medical Biophysics, Robarts Research Institute Western University London ON Canada
| | - Maya S Safarova
- Department of Cardiovascular Medicine University of Kansas Medical Center Kansas City KS
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre University of Glasgow Glasgow UK
| | - Michael Skilton
- Charles Perkins Centre, Faculty of Medicine and Health University of Sydney Sydney NSW Australia
| | - Coen D A Stehouwer
- Department of Internal Medicine and Cardiovascular Research Institute Maastricht Maastricht University Medical Centre Maastricht the Netherlands
| | - Heiko Uthoff
- Department of Angiology University Hospital Basel Basel Switzerland
| | - Michiel A van Agtmael
- Department of Internal Medicine Amsterdam University Medical Center, Vrije Universiteit Amsterdam the Netherlands
| | - Amber A van der Heijden
- Department of General Practice, Amsterdam University Medical Center-Location Vrije Universiteit Medical Center Amsterdam the Netherlands
| | | | - Hyun-Woong Park
- Division of Cardiology, Department of Internal Medicine Chungnam National University Sejong Hospital Sejong-si South Korea
| | - Moo-Sik Lee
- Department of Preventive Medicine, College of Medicine Konyang University Daejeon South Korea
- Department of Occupational and Environmental Medicine Konyang University Hospital Daejeon South Korea
| | - Jang-Ho Bae
- Heart Center, Konyang University Hospital Daejeon South Korea
- Department of Cardiology Konyang University College of Medicine Daejeon South Korea
| | - Oscar Beloqui
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Manuel F Landecho
- Department of Internal Medicine University Clinic of Navarra Navarra Spain
| | - Matthieu Plichart
- Paris Cardiovascular Research Centre University Paris Descartes Paris France
- Fondation Santé Service, Hospital at Home Levallois-Perret France
| | | | | | - Lena Bokemark
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Göran Bergström
- Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy University of Gothenburg Gothenburg Sweden
- Department of Clinical Physiology Sahlgrenska University Hospital, Region Västragötaland Gothenburg Sweden
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research University of Gothenburg Gothenburg Sweden
| | - Samuela Castelnuovo
- Centro Dislipidemie, Aziende Socio Sanitarie Territoriali Grande Ospedale Metropolitano Niguarda Milan Italy
| | - Laura Calabresi
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
| | - Giuseppe D Norata
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Società Italiana per lo Studio dell'Aterosclerosi Center for the Study of Atherosclerosis, Bassini Hospital Cinisello Balsamo Italy
| | - Liliana Grigore
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Alberico Catapano
- Department of Pharmacological and Biomolecular Sciences University of Milan Milan Italy
- Stituto di Ricovero e Cura a Carattere Scientifico Multimedica Milan Italy
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Miao Wang
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - Jing Liu
- Department of Epidemiology, Beijing Anzhen Hospital Capital Medical University Beijing China
| | - M Arfan Ikram
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Maryam Kavousi
- Department of Epidemiology Erasmus University Medical Center Rotterdam the Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht the Netherlands
| | - Michael J Sweeting
- Department of Health Sciences University of Leicester Leicester UK
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - Matthias W Lorenz
- Klinik für Neurologie Krankenhaus Nordwest Frankfurt am Main Germany
- Department of Neurology Goethe University Frankfurt am Main Germany
| | - Peter Willeit
- Institute of Health Economics Medical University of Innsbruck Innsbruck Austria
- Department of Public Health and Primary Care University of Cambridge Cambridge UK
| |
Collapse
|
10
|
Nonterah EA, Crowther NJ, Klipstein‐Grobusch K, Oduro AR, Kavousi M, Agongo G, Anderson TJ, Asiki G, Boua PR, Choma SSR, Couper DJ, Engström G, de Graaf J, Kauhanen J, Lonn EM, Mathiesen EB, Micklesfield LK, Okazaki S, Polak JF, Rundek T, Salonen JT, Tollman SM, Tuomainen T, Grobbee DE, Ramsay M, Bots ML. Racial and Ethnic Differences in the Association Between Classical Cardiovascular Risk Factors and Common Carotid Intima-Media Thickness: An Individual Participant Data Meta-Analysis. J Am Heart Assoc 2022; 11:e023704. [PMID: 35876421 PMCID: PMC9375511 DOI: 10.1161/jaha.121.023704] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 03/21/2022] [Indexed: 01/02/2023]
Abstract
Background The major risk factors for atherosclerotic cardiovascular disease differ by race or ethnicity but have largely been defined using populations of European ancestry. Despite the rising prevalence of cardiovascular disease in Africa there are few related data from African populations. Therefore, we compared the association of established cardiovascular risk factors with carotid-intima media thickness (CIMT), a subclinical marker of atherosclerosis, between African, African American, Asian, European, and Hispanic populations. Methods and Results Cross-sectional analyses of 34 025 men and women drawn from 15 cohorts in Africa, Asia, Europe, and North America were undertaken. Classical cardiovascular risk factors were assessed and CIMT measured using B-mode ultrasound. Ethnic differences in the association of established cardiovascular risk factors with CIMT were determined using a 2-stage individual participant data meta-analysis with beta coefficients expressed as a percentage using the White population as the reference group. CIMT adjusted for risk factors was the greatest among African American populations followed by Asian, European, and Hispanic populations with African populations having the lowest mean CIMT. In all racial or ethnic groups, men had higher CIMT levels compared with women. Age, sex, body mass index, and systolic blood pressure had a significant positive association with CIMT in all races and ethnicities at varying magnitudes. When compared with European populations, the association of age, sex, and systolic blood pressure with CIMT was weaker in all races and ethnicities. Smoking (beta coefficient, 0.39; 95% CI, 0.09-0.70), body mass index (beta coefficient, 0.05; 95% CI, 0.01-0.08) and glucose (beta coefficient, 0.13; 95% CI, 0.06-0.19) had the strongest positive association with CIMT in the Asian population when compared with all other racial and ethnic groups. High-density lipoprotein-cholesterol had significant protective effects in African American (beta coefficient, -0.31; 95% CI, -0.42 to -0.21) and African (beta coefficient, -0.26; 95% CI, -0.31 to -0.19) populations only. Conclusions The strength of association between established cardiovascular risk factors and CIMT differed across the racial or ethnic groups and may be due to lifestyle risk factors and genetics. These differences have implications for race- ethnicity-specific primary prevention strategies and also give insights into the differential contribution of risk factors to the pathogenesis of cardiovascular disease. The greatest burden of subclinical atherosclerosis in African American individuals warrants further investigations.
Collapse
Affiliation(s)
- Engelbert A. Nonterah
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
- Julius Global HealthJulius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Nigel J. Crowther
- Department of Chemical PathologyFaculty of Health SciencesNational Health Laboratory ServiceUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Kerstin Klipstein‐Grobusch
- Julius Global HealthJulius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
- Division of Epidemiology and BiostatisticsSchool of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Abraham R. Oduro
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
| | - Maryam Kavousi
- Department of EpidemiologyErasmus University Medical CentreRotterdamthe Netherlands
| | - Godfred Agongo
- Navrongo Health Research CentreGhana Health ServiceNavrongoGhana
- Department of Biochemistry and Forensic ScienceCK Tedam University of Technology and Applied Sciences (UTAS)NavrongoGhana
| | - Todd J. Anderson
- Department of Cardiac Sciences and Libin Cardiovascular Institute of AlbertaUniversity of CalgaryAlbertaCanada
| | - Gershim Asiki
- African Population and Health Research Centre (APHRC)NairobiKenya
| | - Palwendé R. Boua
- Clinical Research Unit of NanoroInstitut de Recherché en Sciences de la SantéNanoroBurkina Faso
| | - Solomon S. R. Choma
- Department of Pathology and Medical SciencesDIMAMO Health and Demographic Surveillance SystemUniversity of LimpopoSouth Africa
| | - David J. Couper
- Collaborative Studies Coordinating CenterDepartment of BiostatisticsUniversity of North Carolina at Chapel HillNC
| | - Gunnar Engström
- Department of Clinical Sciences in MalmöLund UniversitySkåne University HospitalMalmöSweden
| | - Jacqueline de Graaf
- Division of Vascular MedicineDepartment of General Internal MedicineNijmegen University Medical CentreNijmegenthe Netherlands
| | - Jussi Kauhanen
- The Institute of Public Health and clinical NutritionSchool of MedicineFaculty of Health SciencesUniversity of Eastern Finland (UEF)HelsinkiFinland
| | - Eva M. Lonn
- Division of Cardiology and Population Health Research InstituteDepartment of MedicineMcMaster UniversityHamiltonOntarioCanada
| | - Ellisiv B. Mathiesen
- Brain and Circulation Research GroupInstitute of Clinical MedicineUniversity of TromsøNorway
| | - Lisa K. Micklesfield
- South African Medical Research Council/Developmental Pathways for Health Research Unit (DPHRU)Department of PaediatricsSchool of Clinical MedicineFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Shuhei Okazaki
- Department of Neurology, Stroke CenterOsaka University Graduate School of MedicineOsakaJapan
| | | | | | | | - Stephen M. Tollman
- South African Medical Research Council/Wits Rural Public Health and Health Transitions Research Unit (Agincourt)School of Public HealthFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Tomi‐Pekka Tuomainen
- The Institute of Public Health and clinical NutritionSchool of MedicineFaculty of Health SciencesUniversity of Eastern Finland (UEF)HelsinkiFinland
| | - Diederick E. Grobbee
- Julius Global HealthJulius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Michéle Ramsay
- Sydney Brenner Institute of Molecular BioscienceFaculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
| | - Michiel L. Bots
- Julius Global HealthJulius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | | |
Collapse
|
11
|
Álvarez-Bueno C, Cavero-Redondo I, Bruno RM, Saz-Lara A, Sequí-Dominguez I, Notario-Pacheco B, Martinez-Vizcaino V. Intima Media Thickness and Cognitive Function Among Adults: Meta-Analysis of Observational and Longitudinal Studies. J Am Heart Assoc 2022; 11:e021760. [PMID: 35179392 PMCID: PMC9075078 DOI: 10.1161/jaha.121.021760] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Background Carotid structural changes measured by intima media thickness (IMT) have been related to cognitive complaints during aging. Therefore, the aims of this meta‐analysis were (1) to elucidate the relationship between vascular status, measured as IMT, and cognitive domains distinguishing between global cognition, executive functions, memory and attention; and (2) to explore whether demographic (ie, age and sex), clinical (ie, body mass index and IMT baseline values), and procedure characteristics influence this association. Methods and Results We performed a systematic review of MEDLINE (via PubMed), Scopus, and Web of Science databases from their inception to June 2021. Studies meeting the following inclusion criteria were included: (1) the participants were adults; (2) the exposure was carotid IMT; (3) the outcome was cognitive function, including global cognition, executive function, memory, and attention measured using standardized tests; and (4) the study design was cross‐sectional or longitudinal including unadjusted and adjusted analyses. A total of 19 cross‐sectional and 15 longitudinal studies were included and demographic (age and sex), clinical (body mass index and baseline IMT values), and procedure characteristics were analyzed as potential mediator or moderators of the association. Conclusions Our data support negative associations between IMT and cognitive function in cross‐sectional studies. The association between IMT and cognition lost significance in longitudinal studies and when controlling for covariates in cross‐sectional studies. Finally, the strength of these associations seems not to be modified by age, sex, body mass index, and baseline IMT values. This systematic review and meta‐analysis adds to the evidence supporting the use of IMT as a measure for identifying patients at risk of cognitive decline.
Collapse
Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Universidad Politécnica y Artística del Paraguay Asunción Paraguay
| | - Iván Cavero-Redondo
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Rehabilitation in Health Research Center (CIRES)Universidad de las Americas Santiago Chile
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa Italy.,INSERM U970 and Université de Paris Paris France
| | - Alicia Saz-Lara
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain
| | | | | | - Vicente Martinez-Vizcaino
- Health and Social Research Center Universidad de Castilla-La Mancha Cuenca Spain.,Facultad de Ciencias de la Salud Universidad Autónoma de Chile Talca Chile
| |
Collapse
|
12
|
Simon OA, Görbe A, Hegyi P, Szakó L, Oštarijaš E, Dembrovszky F, Kiss S, Czopf L, Erőss B, Szabó I. Helicobacter pylori Infection Is Associated With Carotid Intima and Media Thickening: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2022; 11:e022919. [PMID: 35060390 PMCID: PMC9238483 DOI: 10.1161/jaha.121.022919] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Background Helicobacter pylori (H. pylori) infection affects ≈4.4 billion people worldwide. Several studies suggest that this pathogen impacts the digestive system, causing diverse and severe conditions, and results in extragastrointestinal disorders like vascular diseases. Our study aims to examine the association between H. pylori infection and carotid intima‐media thickness. Methods and Results Electronic databases (MEDLINE, Embase, CENTRAL, Web of Science, and Scopus) were searched for studies, comparing the thickness of the carotid intima‐media in H. pylori–infected and noninfected individuals listed until October 20, 2020. Statistical analyses were performed using the random effects meta‐analysis of model of weighted mean differences with the corresponding 95% CI using the DerSimonian and Laird method. The protocol was registered in advance in PROSPERO (International Prospective Register of Systematic Reviews; CRD42021224485). Thirteen studies were found meeting inclusion criteria for our systematic review and meta‐analysis, presenting data on the thickness of the carotid intima‐media considering the presence of H. pylori infection. Altogether, 2298 individuals’ data were included (1360 H. pylori positive, 938 negative). The overall carotid intima‐media thickness was significantly larger among infected patients compared with uninfected participants (weighted mean difference: 0.07 mm; 95% CI, 0.02–0.12; P=0.004; I2=91.1%; P<0.001). In case of the right common carotid artery, the intima‐media thickening was found to be significant as well (weighted mean difference, 0.08 mm; 95% CI, 0.02–0.13, P=0.007; I2=85.1%; P<0.001), while it showed no significance in the left common carotid artery (weighted mean difference, 0.12 mm; 95% CI, −0.05 to 0.28, P=0.176; I2=97.4%; P<0.001). Conclusions H. pylori infection is associated with increased carotid intima‐media thickness. Therefore, the infection may indirectly contribute to the development of major vascular events.
Collapse
Affiliation(s)
- Orsolya Anna Simon
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,János Szentágothai Research Centre University of Pécs Hungary.,Division of Gastroenterology First Department of Medicine Medical School University of Pécs Hungary
| | - Anikó Görbe
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary
| | - Péter Hegyi
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,First Department of Medicine University of Szeged Hungary
| | - Lajos Szakó
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,János Szentágothai Research Centre University of Pécs Hungary
| | - Eduard Oštarijaš
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,János Szentágothai Research Centre University of Pécs Hungary
| | - Fanni Dembrovszky
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,János Szentágothai Research Centre University of Pécs Hungary
| | - Szabolcs Kiss
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary.,János Szentágothai Research Centre University of Pécs Hungary.,Doctoral School of Clinical Medicine University of Szeged Hungary
| | - László Czopf
- Division of Cardiology First Department of Medicine Medical School University of Pécs Hungary
| | - Bálint Erőss
- Institute for Translational Medicine, Medical SchoolUniversity of Pécs Hungary
| | - Imre Szabó
- Division of Gastroenterology First Department of Medicine Medical School University of Pécs Hungary
| |
Collapse
|
13
|
Polak JF, Backlund JYC, Budoff M, Raskin P, Bebu I, Lachin JM. Coronary Artery Disease Events and Carotid Intima-Media Thickness in Type 1 Diabetes in the DCCT/EDIC Cohort. J Am Heart Assoc 2021; 10:e022922. [PMID: 34873921 PMCID: PMC9075257 DOI: 10.1161/jaha.121.022922] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Carotid artery intima‐media thickness (IMT) is associated with the risk of subsequent cardiovascular events in the general population. This association has not been established in type 1 diabetes. Methods and Results We studied if carotid IMT is associated with the risk of a first coronary artery disease event in participants with type 1 diabetes in the EDIC (Epidemiology of Diabetes Interventions and Complications) study, the long‐term observational follow‐up of the DCCT (Diabetes Control and Complications Trial). Between 1994 and 1996, common carotid artery and internal carotid artery IMT were measured with high‐resolution ultrasound in 1309 study participants with a mean age of 35 years and diabetes duration of 13.8 years; 52% were men. Cox proportional hazards models evaluated the association of standardized common carotid artery IMT and internal carotid artery IMT with subsequent cardiovascular events over the next 17 years. Models were adjusted for age, sex, mean hemoglobin A1c levels, and traditional cardiovascular risk factors. Associations of common carotid artery IMT with subsequent CAD were significant after adjustment for imaging device, sex, and age (hazard ratio [HR], 1.23 per 0.09 mm [95% CI, [1.04–1.45]; P=0.0141), but did not remain significant after further adjustment for traditional risk factors and hemoglobin A1c (HR, 1.14 per 0.09 mm [95% CI, 0.97–1.33]; P=0.1206). No significant associations with subsequent coronary artery disease events were seen for internal carotid artery IMT. Conclusions In the DCCT/EDIC cohort with type 1 diabetes, common carotid artery IMT, but not internal carotid artery IMT, is weakly associated with subsequent coronary artery events, an association eliminated after adjusting for coexistent traditional cardiovascular risk factors. Registration URL: https://www.clinicaltrials.gov; Unique identifiers: NCT00360815 and NCT00360893.
Collapse
Affiliation(s)
- Joseph F Polak
- Department of Radiology Lemuel Shattuck HospitalTufts University School of Medicine and Boston University School of Medicine Boston MA
| | - Jye-Yu C Backlund
- The Biostatistics Center The George Washington University Rockville MD
| | - Matt Budoff
- UCLA School of MedicineLos Angeles Biomedical Research Institute Torrance CA
| | - Philip Raskin
- University of Texas Southwestern Medical Center Dallas TX
| | - Ionut Bebu
- The Biostatistics Center The George Washington University Rockville MD
| | - John M Lachin
- The Biostatistics Center The George Washington University Rockville MD
| | | |
Collapse
|
14
|
Wang W, Norby FL, George KM, Alonso A, Mosley TH, Gottesman RF, Meyer ML, Lutsey PL. Association of Carotid Intima-Media Thickness and Other Carotid Ultrasound Features With Incident Dementia in the ARIC-NCS. J Am Heart Assoc 2021; 10:e020489. [PMID: 33870735 PMCID: PMC8200760 DOI: 10.1161/jaha.120.020489] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Background Increased carotid intima‐media thickness, interadventitial diameter, presence of carotid plaque, and lower distensibility are predictors for cardiovascular disease. These indices likely relate to cerebrovascular disease, and thus may constitute a form of vascular contributions to dementia and Alzheimer disease–related dementia. Therefore, we assessed the relationship of carotid measurements and arterial stiffness with incident dementia in the ARIC (Atherosclerosis Risk in Communities) study. Methods and Results A total of 12 459 ARIC participants with carotid arterial ultrasounds in 1990 to 1992 were followed through 2017 for dementia. Dementia cases were identified using in‐person and phone cognitive status assessments, hospitalization discharge codes, and death certificate codes. Cox proportional hazards models were used to estimate the hazard ratios (HRs) for incident dementia. Participants were aged 57±6 at baseline, 57% were women, and 23% were Black individuals. Over a median follow‐up time of 24 years, 2224 dementia events were ascertained. After multivariable adjustments, the highest quintile of carotid intima‐media thickness and interadventitial diameter in midlife was associated with increased risk of dementia (HR [95% CIs], 1.25 [1.08–1.45]; and 1.22 [1.04–1.43], respectively) compared with its respective lowest quintile. Presence of carotid plaque did not have a significant association with dementia (HR [95% CI], 1.06 [0.97–1.15]). Higher distensibility was associated with lower risk of dementia (HR [95% CI] highest versus lowest quintile, 0.76 [0.63–0.91]). Conclusions Greater carotid intima‐media thickness, interadventitial diameter, and lower carotid distensibility are associated with an increased risk of incident dementia. These findings suggest that both atherosclerosis and carotid stiffness may be implicated in dementia risk.
Collapse
Affiliation(s)
- Wendy Wang
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| | - Faye L Norby
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN.,Department of Cardiology Center for Cardiac Arrest Prevention Cedars-Sinai Smidt Heart Institute Los Angeles CA
| | - Kristen M George
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN.,Division of Public Health Sciences University of California Davis Davis CA
| | - Alvaro Alonso
- Department of Epidemiology Rollins School of Public Health Emory University Atlanta GA
| | - Thomas H Mosley
- The MIND Center University of Mississippi Medical Center Jackson MS
| | | | - Michelle L Meyer
- Department of Emergency Medicine University of North Carolina at Chapel Hill NC
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health School of Public Health University of Minnesota Minneapolis MN
| |
Collapse
|
15
|
Liu X, Sun Y, Zhan Y, Jiang Y. Prevalence and risk of subclinical carotid atherosclerosis in the global population with HIV: a systematic review and meta-analysis. Int J STD AIDS 2021; 32:411-420. [PMID: 33494655 DOI: 10.1177/0956462420972854] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 12/14/2022]
Abstract
The current evidence regarding the prevalence of subclinical carotid atherosclerosis (SCA) for people living with HIV(PLWH) is inconsistent. In this study, we aimed to synthesize data on the prevalence and association of SCA patients with HIV infection. We searched PubMed, EMBASE, Web of Science, Medline, SinoMed, and CNKI from inception to March 2, 2020. The pooled proportion, odds ratio (OR) with 95% confidence intervals (CIs) were calculated. For inclusion, SCA was measured by carotid intima-media thickness (CIMT), with a B-mode ultrasound machine. Twenty-six studies consisting of 6590 participants were identified. The overall prevalence of SCA was 31.6% (95% CI 13.4-53.3; I2 = 99%; 4 studies) according to CIMT ≥ 0.78 mm criteria, and 32.3% (19.6-46.4; 97%; 10 studies) according to CIMT ≥ 0.90 mm criteria. SCA prevalence was higher in Europe, over 40 years old and male. What's more, PLWH have a higher likelihood of developing SCA comorbidity than HIV-negative controls (pooled OR 2.66, 95% CI 1.57-4.50, I2 = 74%; 9 studies), even after sensitivity analysis (pooled OR 2.58, 1.54-4.31, 73%). This study suggests a high prevalence and risk of SCA in the global population with HIV. As a result, subclinical carotid atherosclerosis deserves more attention from policymakers, HIV health-care providers, researchers, and stakeholders.
Collapse
Affiliation(s)
- Xuan Liu
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yang Sun
- The Institute of Medical Information, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yongle Zhan
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yu Jiang
- Department of Epidemiology and Biostatistics, School of Population Medicine and Public Health, 12501Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
16
|
Shimoda S, Kitamura A, Imano H, Cui R, Muraki I, Yamagishi K, Umesawa M, Sankai T, Hayama-Terada M, Kubota Y, Shimizu Y, Okada T, Kiyama M, Iso H. Associations of Carotid Intima-Media Thickness and Plaque Heterogeneity With the Risks of Stroke Subtypes and Coronary Artery Disease in the Japanese General Population: The Circulatory Risk in Communities Study. J Am Heart Assoc 2020; 9:e017020. [PMID: 32990124 PMCID: PMC7792402 DOI: 10.1161/jaha.120.017020] [Citation(s) in RCA: 14] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background Evidence on the associations of carotid intima-media thickness and carotid plaque characteristics with stroke subtypes and coronary artery disease risks in Asians is limited. This study investigated these associations in the Japanese general population. Methods and Results Maximum intima-media thicknesses of both the common carotid artery and internal carotid artery and carotid plaque characteristics were evaluated in 2943 Japanese subjects aged 40 to 75 years without history of cardiovascular disease. Subjects were followed up for a median of 15.1 years. Using a multivariate Cox proportional hazard model, we found that hazard ratios (HRs) and 95% CIs for the highest (≥1.07 mm) versus lowest (≤0.77 mm) quartiles of maximum intima-media thicknesses of the common carotid artery were 1.97 (1.26-3.06) for total stroke, 1.52 (0.67-3.41) for hemorrhagic stroke, 2.45 (1.41-4.27) for ischemic stroke, 3.60 (1.64-7.91) for lacunar infarction, 1.53 (0.69-3.41) for nonlacunar cerebral infarction, 2.68 (1.24-5.76) for coronary artery disease, and 2.11 (1.44-3.12) for cardiovascular disease (similar results were found for maximum intima-media thicknesses of the internal carotid artery). HRs(95% CIs) for heterogeneous plaque versus no plaque were 1.58 (1.09-2.30) for total stroke, 1.25 (0.58-2.70) for hemorrhagic stroke, 1.74 (1.13-2.67) for ischemic stroke, 1.84 (1.03-3.19) for lacunar infarction, 1.58 (0.80-3.11) for nonlacunar cerebral infarction, 2.11 (1.20-3.70) for coronary artery disease, and 1.71 (1.25-2.35) for cardiovascular disease. Conclusions Maximum intima-media thicknesses of the common carotid artery, maximum intima-media thicknesses of the internal carotid artery, and heterogeneous plaque were associated with the risks of stroke, lacunar infarction, coronary artery disease, and cardiovascular disease in Asians.
Collapse
Affiliation(s)
- Saeko Shimoda
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Akihiko Kitamura
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan.,Research Team for Social Participation and Community Health Tokyo Metropolitan Institute of Gerontology Tokyo Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Hironori Imano
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan.,Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Renzhe Cui
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Isao Muraki
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| | - Kazumasa Yamagishi
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan.,Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center University of Tsukuba Ibaraki Japan.,Ibaraki Western Medical Center Ibaraki Japan
| | - Mitsumasa Umesawa
- Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center University of Tsukuba Ibaraki Japan.,Department of Public Health Dokkyo Medical University Tochigi Japan
| | - Tomoko Sankai
- Department of Public Health and Nursing, Faculty of Medicine University of Tsukuba Ibaraki Japan
| | - Mina Hayama-Terada
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan.,Yao Public Health Center, Yao City Office Osaka Japan
| | - Yasuhiko Kubota
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Yuji Shimizu
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Takeo Okada
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Masahiko Kiyama
- Osaka Center for Cancer and Cardiovascular Disease Prevention Osaka Japan
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine Osaka University Graduate School of Medicine Osaka Japan
| |
Collapse
|
17
|
Gore MO, Ayers CR, Khera A, deFilippi CR, Wang TJ, Seliger SL, Nambi V, Selvin E, Berry JD, Hundley WG, Budoff M, Greenland P, Drazner MH, Ballantyne CM, Levine BD, de Lemos JA. Combining Biomarkers and Imaging for Short-Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults. J Am Heart Assoc 2020; 9:e015410. [PMID: 32698652 PMCID: PMC7792258 DOI: 10.1161/jaha.119.015410] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 05/08/2020] [Indexed: 12/30/2022]
Abstract
Background Current strategies for cardiovascular disease (CVD) risk assessment focus on 10-year or longer timeframes. Shorter-term CVD risk is also clinically relevant, particularly for high-risk occupations, but is under-investigated. Methods and Results We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi-Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from CVD at baseline (N=16 581). Measurements included N-terminal pro-B-type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high-sensitivity cardiac troponin T (abnormal >5 ng/L); high-sensitivity C-reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by ECG (abnormal if present); carotid intima-media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by ECG was independently associated with increased 3-year risk of global CVD (myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional CVD risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3-year multivariable-adjusted global CVD risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2-, 3-, 4.5- and 8-fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic CVD (fatal or non-fatal myocardial infarction or stroke). Conclusions A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3-year global and atherosclerotic CVD risk compared with a standard approach using traditional risk factors.
Collapse
Affiliation(s)
- Maria Odette Gore
- Department of MedicineUniversity of Colorado Anschutz Medical CampusAuroraCO
- Department of MedicineDenver Health and Hospital AuthorityDenverCO
- Community Health DepartmentColorado Prevention CenterAuroraCO
| | - Colby R. Ayers
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - Amit Khera
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | | | - Thomas J. Wang
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - Stephen L. Seliger
- Department of MedicineUniversity of Maryland School of MedicineBaltimoreMD
| | - Vijay Nambi
- Department of MedicineBaylor College of MedicineHoustonTX
- Houston Methodist DeBakey Heart and Vascular CenterHoustonTX
- Department of MedicineMichael E. DeBakey Veterans Affairs HospitalHoustonTX
| | - Elizabeth Selvin
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMD
| | - Jarett D. Berry
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - W. Gregory Hundley
- Departments of Medicine and Radiological SciencesWake Forest Health SciencesWinston‐SalemNC
| | | | - Philip Greenland
- Department of Preventive MedicineFeinberg School of Medicine, Northwestern UniversityChicagoIL
| | - Mark H. Drazner
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - Christie M. Ballantyne
- Department of MedicineBaylor College of MedicineHoustonTX
- Houston Methodist DeBakey Heart and Vascular CenterHoustonTX
| | - Benjamin D. Levine
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| | - James A. de Lemos
- Department of MedicineUniversity of Texas Southwestern Medical CenterDallasTX
| |
Collapse
|
18
|
Veldsman T, Swanepoel M, Monyeki MA, Brits JS, Malan L. Relationship between physical activity and carotid intima-media thickness among teachers in South Africa: the SABPA study. Cardiovasc J Afr 2020; 31:304-313. [PMID: 32716021 DOI: 10.5830/cvja-2020-024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/30/2020] [Accepted: 06/23/2020] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE To determine the relationship between objectively measured physical activity (PA) and carotid intima-media thickness (CIMT) in teachers in South Africa. METHODS A cross-sectional study was conducted among 215 teachers aged 25 to 65 years (mean age 49.67 ± 8.43 years) who participated in the Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) prospective cohort study. CIMT was measured using the SonoSite Micromaxx ultrasound over seven consecutive days. Other measurements obtained included body mass index (BMI), waist circumference, 24-hour ambulatory blood pressure, and C-reactive protein (CRP) and fasting blood total cholesterol levels. Data were analysed using Statistical Package for Social Sciences (SPSS) version 25. RESULTS The prevalence of obesity according to BMI and sedentary behaviour was above 30%; hypertension was 38.9% and CRP 41.1 mg/dl. Male teachers showed higher mean values for CIMT than female teachers (0.75 ± 0.16 vs 0.66 ± 0.12 mm; p ≤ 0.05). A borderline negative association existed between CIMT and mean seven-day awake metabolic equivalent of task (r = -0.19; p = 0.08) in female teachers in the light-PA group. CIMT was inversely associated with total energy expenditure (r = -0.31; p = 0.05) in sedentary male teachers. CONCLUSIONS Participation in light PA was associated with lower CIMT values in female teachers. Given the health implications of cardiovascular disease risk among teachers, PA intervention studies are recommended to determine effective interventions to provide information on how to decrease the progression of subclinical atherosclerosis in this population.
Collapse
Affiliation(s)
- Tamrin Veldsman
- Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa.
| | - Mariette Swanepoel
- Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Makama A Monyeki
- Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Johanna S Brits
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| | - Leoné Malan
- Hypertension in Africa Research Team (HART), North-West University, Potchefstroom, South Africa
| |
Collapse
|
19
|
Vos AG, Barth RE, Klipstein-Grobusch K, Tempelman HA, Devillé WLJ, Dodd C, Coutinho RA, Grobbee DE. Cardiovascular Disease Burden in Rural Africa: Does HIV and Antiretroviral Treatment Play a Role?: Baseline Analysis of the Ndlovu Cohort Study. J Am Heart Assoc 2020; 9:e013466. [PMID: 32223395 PMCID: PMC7428654 DOI: 10.1161/jaha.119.013466] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background HIV is associated with an increased risk of cardiovascular disease (CVD) in high‐income countries. Little is known about the CVD burden in sub‐Saharan Africa, where 70% of the world's HIV‐positive population lives. This study aims to provide insight into the burden of CVD risk in a rural setting in sub‐Saharan Africa considering HIV infection and antiretroviral therapy (ART). Methods and Results A cross‐sectional analysis was conducted of the baseline of the Ndlovu Cohort study including HIV‐negative and HIV‐positive participants in rural South Africa between 2014 and 2017. Information was collected on demographics, socioeconomic status, and CVD risk factors. Carotid intima‐media thickness measurement was performed. The influence of HIV and ART on the burden of CVD was determined by comparing HIV‐positive participants who were ART naive on first‐line or second‐line ART with HIV‐negative participants. In total, 1927 participants were included, of whom 887 (46%) were HIV positive and 54% women. The median age was 38 years. Overall, 690 participants (79%) were on ART, with 613 (89%) on first‐line and 77 (11%) on second‐line therapy. Participants with HIV had lower values for most of the CVD risk factors but higher C‐reactive protein levels than HIV‐negative participants. ART‐naive, HIV‐positive participants had similar carotid intima‐media thickness compared with HIV‐negative participants but carotid intima‐media thickness was increased for participants on ART aged 30 years and older compared with HIV‐negative participants. Conclusions HIV‐positive participants presented with a favorable CVD risk profile compared with HIV‐negative participants. However, carotid intima‐media thickness was increased in HIV‐positive participants on ART, indicating a higher burden of subclinical CVD for the HIV‐positive population.
Collapse
Affiliation(s)
- Alinda G Vos
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands.,Department of Internal Medicine & Infectious Diseases University Medical Center Utrecht the Netherlands.,Wits Reproductive Health and HIV Institute Faculty of Health Sciences University of Witwatersrand Johannesburg South Africa
| | - Roos E Barth
- Department of Internal Medicine & Infectious Diseases University Medical Center Utrecht the Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands.,Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | | | - Walter L J Devillé
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands
| | - Caitlin Dodd
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands
| | - Roel A Coutinho
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands
| | - Diederick E Grobbee
- Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht the Netherlands
| | | |
Collapse
|
20
|
Wagner S, Lioret S, Girerd N, Duarte K, Lamiral Z, Bozec E, Van den Berghe L, Hoge A, Donneau AF, Boivin JM, Mercklé L, Zannad F, Laville M, Rossignol P, Nazare JA. Association of Dietary Patterns Derived Using Reduced-Rank Regression With Subclinical Cardiovascular Damage According to Generation and Sex in the STANISLAS Cohort. J Am Heart Assoc 2020; 9:e013836. [PMID: 32200718 PMCID: PMC7428593 DOI: 10.1161/jaha.119.013836] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Background The diet impact on cardiovascular diseases has been investigated widely, but the association between dietary patterns (DPs) and subclinical cardiovascular damage remains unclear. More informative DPs could be provided by considering metabolic syndrome components as intermediate markers. This study aimed to identify DPs according to generation and sex using reduced‐rank regression (RRR) with metabolic syndrome components as intermediate markers and assess their associations with intima‐media thickness, left ventricular mass, and carotid‐femoral pulse‐wave velocity in an initially healthy population‐based family study. Methods and Results This study included 1527 participants from the STANISLAS (Suivi Temporaire Annuel Non‐Invasif de la Santé des Lorrains Assurés Sociaux) cohort fourth examination. DPs were derived using reduced‐rank regression according to generation (G1: age ≥50 years; G2: age <50 years) and sex. Associations between DPs and cardiovascular damage were analyzed using multivariable linear regression models. Although identified DPs were correlated between generations and sex, qualitative differences were observed: whereas only unhealthy DPs were found for both men generations, healthy DPs were identified in G2 (“fruity desserts”) and G1 (“fiber and w3 oil”) women. The “alcohol,” “fast food and alcohol,” “fried, processed, and dairy products,” and “meat, starch, sodas, and fat” DPs in G1 and G2 men and in G1 and G2 women, respectively, were associated with high left ventricular mass (β [95% CI], 0.23 [0.10–0.36], 0.76 [0.00–1.52], 1.71 [0.16–3.26], and 1.80 [0.45–3.14]). The “alcohol” DP in G1 men was positively associated with carotid‐femoral pulse‐wave velocity (0.22 [0.09–0.34]). Conclusions The DPs that explain the maximum variation in metabolic syndrome components had different associations with subclinical cardiovascular damage across generation and sex. Our results indicate that dietary recommendations should be tailored according to age and sex. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT01391442.
Collapse
Affiliation(s)
- Sandra Wagner
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Sandrine Lioret
- Paris University Paris France.,UMR1153 Center for Research in Epidemiology and StatisticS (CRESS) Research Team on Early Life Origins of Health Inserm Paris France
| | - Nicolas Girerd
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Kevin Duarte
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Zohra Lamiral
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Erwan Bozec
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Laurie Van den Berghe
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Axelle Hoge
- Département des Sciences de la Santé Publique Université de Liège Belgium
| | | | - Jean-Marc Boivin
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Ludovic Mercklé
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Faiez Zannad
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Martine Laville
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| | - Patrick Rossignol
- INSERM CIC 1433 Nancy CHRU Inserm U1116 FCRIN INI-CRCT University of Lorraine Nancy France
| | - Julie-Anne Nazare
- CarMeN Laboratory Centre de Recherche en Nutrition Humaine Rhône-Alpes Univ-Lyon Université Claude Bernard Lyon1 Hospices Civils de Lyon F-CRIN/FORCE Network Pierre Bénite, Lyon France
| |
Collapse
|
21
|
Vachiat A, Dix-Peek T, Duarte R, Manga P. Endothelial dysfunction in HIV-positive patients with acute coronary syndromes. Cardiovasc J Afr 2020; 31:58-64. [PMID: 32191257 DOI: 10.5830/cvja-2019-040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 04/18/2018] [Accepted: 07/08/2019] [Indexed: 11/06/2022] Open
Abstract
AIM This study investigated endothelial function in HIV-positive patients with acute coronary syndrome (ACS). Flow-mediated dilatation, pulse-wave velocity, carotid intima-media thickness and endothelial biomarkers were used to non-invasively investigate endothelial dysfunction. METHODS Twenty HIV-positive patients with ACS (HIV+/ACS) were compared to 20 HIV-negative patients with ACS (HIV-/ACS) and 20 HIV-positive patients without ACS (HIV+/no ACS). RESULTS Endothelial function measured by flow-mediated dilatation (FMD) was similar in both the HIV+/ACS (5.2; IQR 1.4-13.4%) and HIV-/ACS groups (3.7; IQR 2.3-4.4%) (p = 0.78). Arterial stiffness, measured by pulse-wave velocity (PWV) was low in all three cohorts. Carotid intima-media thickness (CIMT) was also low in all three cohorts. The vascular cellular adhesion molecule-1 (VCAM-1) levels in HIV-positive patients with and without ACS were significantly higher than in the HIV-/ACS cohort (p = 0.033 and 0.024, respectively). CONCLUSIONS Non-invasive investigations such as FMD, CIMT and PWV did not identify patients with HIV who were at high risk of ACS. Endothelial biomarkers may be more useful markers to identify HIV-positive patients who have endothelial dysfunction and increased risk of ACS.
Collapse
Affiliation(s)
- Ahmed Vachiat
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
| | - Therese Dix-Peek
- Molecular Biology Laboratory, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Raquel Duarte
- Molecular Biology Laboratory, Department of Internal Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Pravin Manga
- Division of Cardiology, Department of Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| |
Collapse
|
22
|
Abstract
Background Because of the increasing numbers of congenital patients surviving into adulthood, early diagnosis and prevention of acquired cardiovascular disease is reasonable. The aim of this study was to detect diagnostic subgroups of adults with congenital heart disease (ACHD) that have increased carotid intima‐media thickness (cIMT), a subclinical marker of cardiovascular damage. Methods and Results This study enrolled 831 ACHD patients (392 women, aged 38.8±11.7 years) from May 2015 to February 2019 at their regular outpatient visit. Far wall cIMT was measured using a semiautomatic ultrasound system at 4 angles. Age, sex, height, weight, blood pressure, smoking status, and antihypertensive medication were registered and entered in a multiple linear regression model to compare diagnostic subgroups to 191 healthy controls (111 women, aged 36.7±13.5 years). There were no significant differences in cIMT of ACHD (0.538±0.086 mm) compared with healthy controls (0.541±0.083 mm; P=0.649) after adjusting for the aforementioned covariates. Only patients with coarctation of the aorta showed significantly higher cIMT values (0.592±0.075 mm; P<0.001) compared with healthy controls. In addition, ACHD patients who were men (P=0.032), older (P<0.001), and were prescribed antihypertensive medications (P=0.003) were all found to have thicker cIMT values. Conclusions Overall, we determined that within the ACHD cohort, only those patients with a history of coarctation have higher cIMT values. To better determine the mechanism of abnormal vasculature, further basic research is needed.
Collapse
Affiliation(s)
- Barbara Reiner
- Department of Paediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Technical University Munich Munich Germany.,Institute of Preventive Pediatrics Technical University Munich Munich Germany
| | - Renate Oberhoffer
- Department of Paediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Technical University Munich Munich Germany.,Institute of Preventive Pediatrics Technical University Munich Munich Germany
| | - Anna-Luisa Häcker
- Department of Paediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Technical University Munich Munich Germany.,Institute of Preventive Pediatrics Technical University Munich Munich Germany
| | - Peter Ewert
- Department of Paediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Technical University Munich Munich Germany
| | - Jan Müller
- Department of Paediatric Cardiology and Congenital Heart Disease German Heart Centre Munich Technical University Munich Munich Germany.,Institute of Preventive Pediatrics Technical University Munich Munich Germany
| |
Collapse
|
23
|
Belem da Silva CT, Hoffmann MS, Sant Anna RT, Wehrmeister FC, Gonçalves H, Oliveira IO, Oliveira PD, Vargas da Silva AM, Kieling C, Manfro GG, Menezes AMB. Early Emotional Symptoms Predicting Carotid Atherosclerosis in Youth: Results From a Birth Cohort in Latin America. J Am Heart Assoc 2020; 8:e011011. [PMID: 30651035 PMCID: PMC6497357 DOI: 10.1161/jaha.118.011011] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Background Emotional disorders are risk factors for atherosclerosis and consequent cardiovascular disease. However, it is not clear whether emotional symptoms (ESs) have direct effects on cardiovascular disease. The aim of the present study is to investigate the effects of early ESs on carotid atherosclerosis in young adults. Methods and Results We tested the association between expression of ESs at 11 and 15 years of age and carotid intima‐media thickness at 18 years of age in the 1993 Pelotas Birth Cohort (N=5249, n=4336 with complete mental health data). ESs were assessed using the Strengths and Difficulties Questionnaire. Propensity score weighting procedure was run using generalized boosted regression model to adjust for potential confounding between exposure and outcome. We also tested whether traditional cardiovascular risk factors could mediate this relationship. Adjusted high expression of ESs, both at 11 and 15 years of age, led to mean increases in carotid intima‐media thickness of 1.84 and 2.58 μm, respectively, at 18 years of age (both P<0.001). Longitudinal effects of ESs on atherosclerosis were direct and not significantly mediated by traditional cardiovascular risk factors. Male sex at age 15 years significantly enhanced the effects of ESs on carotid intima‐media thickness at age 18 years (P<0.001 for interaction): although high expression of ESs led to mean increases of 1.14 μm in females (P<0.05), it led to mean increases of 5.83 μm in males (P<0.001). Conclusions In this large birth cohort, expression of ESs in adolescence was longitudinally associated with a higher carotid intima‐media thickness in young adults. The association is direct and not mediated by traditional cardiovascular risk factors. Interactions by sex might have important implications for designing future interventions.
Collapse
Affiliation(s)
| | | | - Roberto Tofani Sant Anna
- 3 Instituto de Cardiologia Fundação Universitária de Cardiologia Clinical Research Center Porto Alegre Rio Grande do Sul Brazil
| | | | - Helen Gonçalves
- 4 Postgraduate Program in Epidemiology Federal University of Pelotas Rio Grande do Sul Brazil
| | - Isabel O Oliveira
- 5 Department of Physiology and Pharmacology Federal University of Pelotas Capão do Leão Rio Grande do Sul Brazil
| | - Paula Duarte Oliveira
- 4 Postgraduate Program in Epidemiology Federal University of Pelotas Rio Grande do Sul Brazil
| | | | - Christian Kieling
- 7 Graduate Program in Psychiatry and Behavioral Sciences Federal University of Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
| | - Gisele Gus Manfro
- 7 Graduate Program in Psychiatry and Behavioral Sciences Federal University of Rio Grande do Sul Porto Alegre Rio Grande do Sul Brazil
| | - Ana M B Menezes
- 4 Postgraduate Program in Epidemiology Federal University of Pelotas Rio Grande do Sul Brazil
| |
Collapse
|
24
|
Arnold M, Linden A, Clarke R, Guo Y, Du H, Bian Z, Wan E, Yang M, Wang L, Chen Y, Chen J, Long H, Gu Q, Collins R, Li L, Chen Z, Parish S. Carotid Intima-Media Thickness but Not Carotid Artery Plaque in Healthy Individuals Is Linked to Lean Body Mass. J Am Heart Assoc 2019; 8:e011919. [PMID: 31364443 PMCID: PMC6761650 DOI: 10.1161/jaha.118.011919] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 06/11/2019] [Indexed: 01/08/2023]
Abstract
Background Lean body mass has been identified as a key determinant of left ventricular mass and wall thickness. However, the importance of lean body mass or other body-size measures as normative determinants of carotid intima-media thickness (cIMT), a widely used early indicator of atherosclerosis, has not been well established. Methods and Results Carotid artery ultrasound measurements of cIMT and carotid artery plaque burden (derived from plaque number and maximum size) and measurements of body size, including height, body mass index, weight, body fat proportion, and lean body mass ([1-body fat proportion]×weight), were recorded in 25 020 participants from 10 regions of China. Analyses were restricted to a healthy younger subset (n=6617) defined as never or long-term ex-regular smokers aged <60 years (mean age, 50) without previous ischemic heart disease, stroke, diabetes mellitus, or hypertension and with plasma non-high-density lipoprotein cholesterol <4 mmol/L. Among these 6617 participants, 86% were women (because most men smoked) and 9% had carotid artery plaque. In both women and men separately, lean body mass was strongly positively associated with cIMT, but was not associated with plaque burden: overall, each 10 kg higher lean body mass was associated with a 0.03 (95% CI, 0.03-0.04) mm higher cIMT (P=5×10-33). Fat mass, height, and other body-size measures were more weakly associated with cIMT. Conclusions The strong association of lean body mass with cIMT, but not with plaque burden, in healthy adults suggests a normative relationship rather than reflecting atherosclerotic pathology. Common mechanisms may underlie the associations of lean body mass with cIMT and with nonatherosclerotic vascular traits.
Collapse
Affiliation(s)
- Matthew Arnold
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Andrew Linden
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Robert Clarke
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Yu Guo
- Chinese Academy of Medical SciencesBeijingChina
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
- MRC Population Health Research UnitUniversity of OxfordOxfordUnited Kingdom
| | - Zheng Bian
- Chinese Academy of Medical SciencesBeijingChina
| | - Eric Wan
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Meng Yang
- Division of Ultrasound DiagnosisPeking Union Medical College HospitalBeijingChina
| | - Liang Wang
- Division of Ultrasound DiagnosisPeking Union Medical College HospitalBeijingChina
| | - Yuexin Chen
- Centre of Vascular SurgeryPeking Union Medical College HospitalBeijingChina
| | | | - Huajun Long
- NCDs Prevention and Control DepartmentLiuyang CDCLiuyangChina
| | | | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Liming Li
- Chinese Academy of Medical SciencesBeijingChina
- Department of Epidemiology and BiostatisticsSchool of Public HealthPeking University Health Science CenterBeijingChina
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
| | - Sarah Parish
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUnited Kingdom
- MRC Population Health Research UnitUniversity of OxfordOxfordUnited Kingdom
| |
Collapse
|
25
|
Abstract
Background Assessing and optimizing cardiovascular health (CVH) early in life, such as in pregnancy, could lead to a longer lifetime spent in better CVH and reduce the risk of cardiovascular disease. This might especially benefit women with a hypertensive disorder of pregnancy (HDP) who are more likely to develop atherosclerosis and cardiovascular disease. We hypothesized that CVH in pregnancy is related to later life CVH and carotid intima-media thickness (CIMT), and that these associations differ between women with a normotensive pregnancy and women with an HDP. Methods and Results This study was conducted within the prospective population-based Generation R Study. CVH in pregnancy was based on 5 metrics (blood pressure, total-cholesterol, glucose, smoking, and body mass index). Postpartum CVH additionally included physical activity and diet scores, according to the American Heart Association classification. Postpartum CVH and CIMT were measured 10 years after pregnancy. Results were analyzed for women with a normotensive pregnancy and those with an HDP. Women with a normotensive pregnancy (n=1786) and women with an HDP (n=138) were evaluated from early pregnancy until 10 years postpartum. Better CVH in early pregnancy was associated with a smaller CIMT and better postpartum CVH in all women, especially in those with an HDP (CIMT: -9.82 μm [95% CI: -17.98, -1.67]). Conclusions Already in pregnancy, better CVH is associated with a smaller CIMT and better CVH 10 years postpartum, especially in women with an HDP. As pregnancy is an incentive for women to improve lifestyle, assessing CVH in pregnancy might help improve postpartum CVH and reduce cardiovascular disease risk.
Collapse
Affiliation(s)
- Laura Benschop
- Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam the Netherlands.,Department of Epidemiology Erasmus Medical Center Rotterdam the Netherlands
| | | | - Sara J C Schelling
- Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam the Netherlands
| | - Eric A P Steegers
- Department of Obstetrics and Gynecology Erasmus Medical Center Rotterdam the Netherlands
| | | |
Collapse
|
26
|
Nonterah EA, Boua PR, Klipstein-Grobusch K, Asiki G, Micklesfield LK, Agongo G, Ali SA, Mashinya F, Sorgho H, Nakanabo-Diallo S, Debpuur C, Kyobutungi C, Alberts M, Norris S, Tollman S, Tinto H, Soo CC, Mukomana F, Hazelhurst S, Wade AN, Kahn K, Oduro AR, Grobbee DE, Sankoh O, Ramsay M, Bots ML, Crowther NJ. Classical Cardiovascular Risk Factors and HIV are Associated With Carotid Intima-Media Thickness in Adults From Sub-Saharan Africa: Findings From H3Africa AWI-Gen Study. J Am Heart Assoc 2019; 8:e011506. [PMID: 31304842 PMCID: PMC6662137 DOI: 10.1161/jaha.118.011506] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Studies on the determinants of carotid intima-media thickness ( CIMT ), a marker of sub-clinical atherosclerosis, mostly come from white, Asian, and diasporan black populations. We present CIMT data from sub-Saharan Africa, which is experiencing a rising burden of cardiovascular diseases and infectious diseases. Methods and Results The H3 (Human Hereditary and Health) in Africa's AWI-Gen (African-Wits-INDEPTH partnership for Genomic) study is a cross-sectional study conducted in adults aged 40 to 60 years from Burkina Faso, Kenya, Ghana, and South Africa. Cardiovascular disease risk and ultrasonography of the CIMT of right and left common carotids were measured. Multivariable linear and mixed-effect multilevel regression modeling was applied to determine factors related to CIMT. Data included 8872 adults (50.8% men), mean age of 50±6 years with age- and sex-adjusted mean (±SE) CIMT of 640±123μm. Participants from Ghana and Burkina Faso had higher CIMT compared with other sites. Age (β = 6.77, 95%CI [6.34-7.19]), body mass index (17.6[12.5-22.8]), systolic blood pressure (7.52[6.21-8.83]), low-density lipoprotein cholesterol (5.08[2.10-8.06]) and men (10.3[4.75- 15.9]) were associated with higher CIMT. Smoking was associated with higher CIMT in men. High-density lipoprotein cholesterol (-12.2 [-17.9- -6.41]), alcohol consumption (-13.5 [-19.1--7.91]) and HIV (-8.86 [-15.7--2.03]) were inversely associated with CIMT. Conclusions Given the rising prevalence of cardiovascular diseases risk factors in sub-Saharan Africa, atherosclerotic diseases may become a major pan-African epidemic unless preventive measures are taken particularly for prevention of hypertension, obesity, and smoking. HIV -specific studies are needed to fully understand the association between HIV and CIMT in sub-Saharan Africa.
Collapse
Affiliation(s)
- Engelbert A Nonterah
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana.,2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Palwende R Boua
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso.,4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kerstin Klipstein-Grobusch
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands.,6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Gershim Asiki
- 10 African Population and Health Research Centre (APHRC) Nairobi Kenya
| | - Lisa K Micklesfield
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Godfred Agongo
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Stuart A Ali
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Felistas Mashinya
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Herman Sorgho
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Seydou Nakanabo-Diallo
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cornelius Debpuur
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | | | - Marianne Alberts
- 11 Dikgale Health Demographic Surveillance Site Department of Pathology and Medical Sciences School of Health Care Sciences Faculty of Health Sciences University of Limpopo Polokwane South Africa
| | - Shane Norris
- 7 MRC/Wits Developmental Pathways for Health Research Unit Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Stephen Tollman
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Halidou Tinto
- 3 Clinical Research Unit of Nanoro Institut de Recherche en Sciences de la Santé Nanoro Burkina Faso
| | - Cassandra C Soo
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Freedom Mukomana
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Scott Hazelhurst
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Alisha N Wade
- 8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Kathleen Kahn
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,8 MRC/Wits Rural Public Health and Health Transitions Research Unit (Agincourt) School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Abraham R Oduro
- 1 Navrongo Health Research Centre Ghana Health Service Navrongo Ghana
| | - Diederick E Grobbee
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Osman Sankoh
- 6 Division of Epidemiology and Biostatistics School of Public Health Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,12 INDEPTH-Network Accra Ghana
| | - Michèle Ramsay
- 4 Sydney Brenner Institute of Molecular Bioscience Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa.,5 Division of Human Genetics Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | - Michiel L Bots
- 2 Julius Global Health Julius Center for Health Sciences and Primary Care University Medical Center Utrecht Utrecht University Utrecht the Netherlands
| | - Nigel J Crowther
- 9 Department of Chemical Pathology National Health Laboratory Services (NHLS) Faculty of Health Sciences University of the Witwatersrand Johannesburg South Africa
| | | |
Collapse
|
27
|
Nguyen MT, Vryer R, Ranganathan S, Lycett K, Grobler A, Dwyer T, Juonala M, Saffery R, Burgner D, Wake M. Telomere Length and Vascular Phenotypes in a Population-Based Cohort of Children and Midlife Adults. J Am Heart Assoc 2019; 8:e012707. [PMID: 31140354 PMCID: PMC6585377 DOI: 10.1161/jaha.119.012707] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 04/30/2019] [Indexed: 12/21/2022]
Abstract
Background Telomere length has been inversely associated with cardiovascular disease in adulthood, but its relationship to preclinical cardiovascular phenotypes across the life course remains unclear. We investigated associations of telomere length with vascular structure and function in children and midlife adults. Methods and Results Population-based cross-sectional CheckPoint (Child Health CheckPoint) study of 11- to 12-year-old children and their parents, nested within the LSAC (Longitudinal Study of Australian Children). Telomere length (telomeric genomic DNA [T]/β-globin single-copy gene [S] [T/S ratio]) was measured by quantitative polymerase chain reaction from blood-derived genomic DNA. Vascular structure was assessed by carotid intima-media thickness, and vascular function was assessed by carotid-femoral pulse-wave velocity and carotid elasticity. Mean (SD) T/S ratio was 1.09 (0.55) in children (n=1206; 51% girls) and 0.81 (0.38) in adults (n=1343; 87% women). Linear regression models, adjusted for potential confounders, revealed no evidence of an association between T/S ratio and carotid intima-media thickness, carotid-femoral pulse-wave velocity, or carotid elasticity in children. In adults, longer telomeres were associated with greater carotid elasticity (0.14% per 10-mm Hg higher per unit of T/S ratio; 95% CI, 0.04%-0.2%; P=0.007), but not carotid intima-media thickness (-0.9 μm; 95% CI, -14 to 13 μm; P=0.9) or carotid-femoral pulse-wave velocity (-0.10 m/s; 95% CI, -0.3 to 0.07 m/s; P=0.2). In logistic regression analysis, telomere length did not predict poorer vascular measures at either age. Conclusions In midlife adults, but not children, there was some evidence that telomere length was associated with vascular elasticity but not thickness. Associations between telomere length and cardiovascular phenotypes may become more evident in later life, with advancing pathological changes.
Collapse
Affiliation(s)
- Minh Thien Nguyen
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Regan Vryer
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Sarath Ranganathan
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Respiratory MedicineRoyal Children's HospitalParkvilleAustralia
| | - Kate Lycett
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Anneke Grobler
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - Terence Dwyer
- George Institute for Global HealthUniversity of OxfordUnited Kingdom
- Menzies InstituteUniversity of TasmaniaHobartTasmaniaAustralia
| | - Markus Juonala
- Department of MedicineUniversity of TurkuFinland
- Division of MedicineTurku University HospitalTurkuFinland
| | - Richard Saffery
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
| | - David Burgner
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Department of PediatricsMonash UniversityClaytonAustralia
- Infectious DiseasesRoyal Children's HospitalParkvilleAustralia
| | - Melissa Wake
- Murdoch Children's Research InstituteParkvilleAustralia
- Department of PediatricsUniversity of MelbourneParkvilleAustralia
- Department of Pediatrics and Liggins InstituteUniversity of AucklandNew Zealand
| |
Collapse
|
28
|
Tan ECL, Tai MLS, Chan WK, Mahadeva S. Association between non-alcoholic fatty liver disease evaluated by transient elastography with extracranial carotid atherosclerosis in a multiethnic Asian community. JGH Open 2018; 3:117-125. [PMID: 31061886 PMCID: PMC6487823 DOI: 10.1002/jgh3.12114] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/14/2018] [Accepted: 10/25/2018] [Indexed: 12/17/2022]
Abstract
Background and Aim There is not much data on the association between non‐alcoholic fatty liver disease (NAFLD) and advanced fibrosis assessed using Fibroscan with carotid intima‐media thickness (CIMT) in the general population. The objective of this study was to evaluate the association between NAFLD and advanced fibrosis, as diagnosed by Fibroscan, with an increased CIMT in the Malaysian population. Methods A cross‐sectional study of government officers and their family members attending a health screening at a public healthcare facility was conducted. All subjects underwent clinical evaluation, biochemical testing, anthropometry, ultrasound carotid Doppler, and Fibroscan examination. Results Data for 251 subjects were analyzed (mean age 47.1 ± 12.4 years, 74.1% male). Prevalence of NAFLD and advanced fibrosis were 57.4 and 17.5%, respectively. Independent factors associated with NAFLD were waist circumference (odds ratio [OR] = 1.077, 95% confidence interval [CI] 1.038–1.118, P < 0.001) and serum alanine aminotransferase (ALT) (OR = 1.039, 95% CI 1.005–1.074, P = 0.024). Independent factors associated with advanced fibrosis were male gender (OR = 4.847, 95% CI 1.369–17.155, P = 0.014) and serum aspartate aminotransferase (AST) (OR = 1.057, 95% CI 1.003–1.113, P = 0.036). Prevalence of increased CIMT was 29.0%. Independent factor associated with increased CIMT was older age (OR = 1.146, 95% CI 1.067–1.231, P < 0.001). Of the subjects, 34.5% with NAFLD had increased CIMT compared to 19.1% of the subjects without NAFLD (P = 0.063). Advanced fibrosis was not associated with increased CIMT. Conclusions Prevalence of NAFLD, advanced liver fibrosis, and increased CIMT were high. NAFLD and advanced liver fibrosis appeared not to be associated with increased CIMT. However, a larger sample size is needed to demonstrate whether there is any association.
Collapse
Affiliation(s)
- Eugene Choon-Li Tan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine University Malaya Kuala Lumpur Malaysia
| | - Mei-Ling Sharon Tai
- Division of Neurology, Department of Medicine, Faculty of Medicine University Malaya Kuala Lumpur Malaysia
| | - Wah-Kheong Chan
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine University Malaya Kuala Lumpur Malaysia
| | - Sanjiv Mahadeva
- Gastroenterology and Hepatology Unit, Department of Medicine, Faculty of Medicine University Malaya Kuala Lumpur Malaysia
| |
Collapse
|
29
|
Blekkenhorst LC, Bondonno CP, Lewis JR, Woodman RJ, Devine A, Bondonno NP, Lim WH, Zhu K, Beilin LJ, Thompson PL, Prince RL, Hodgson JM. Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women. J Am Heart Assoc 2018; 7:JAHA.117.008391. [PMID: 29618474 PMCID: PMC6015430 DOI: 10.1161/jaha.117.008391] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Background Dietary patterns rich in fruits and vegetables are considered to reduce atherosclerotic disease presentation and are reported to be inversely associated with subclinical measures of atherosclerosis, such as carotid artery intima‐media thickness (IMT) and plaque. However, the effect of vegetable intake alone, and relationships to specific types of vegetables containing different phytochemical profiles, is important. The aim of this study was to investigate the associations of total vegetable intake and specific vegetables grouped according to phytochemical constituents with common carotid artery IMT (CCA‐IMT) and carotid plaque severity in a cohort of older adult women (aged ≥70 years). Methods and Results Total vegetable intake was calculated at baseline (1998) using a validated food frequency questionnaire. Vegetable types included cruciferous, allium, yellow/orange/red, leafy green, and legumes. In 2001, CCA‐IMT (n=954) and carotid focal plaque (n=968) were assessed using high‐resolution B‐mode carotid ultrasonography. Mean (SD) total vegetable intake was 199.9 (78.0) g/d. Women consuming ≥3 servings of vegetables each day had ≈4.6% to 5.0% lower mean CCA‐IMT (P=0.014) and maximum CCA‐IMT (P=0.004) compared with participants consuming <2 servings of vegetables. For each 10 g/d higher in cruciferous vegetable intake, there was an associated 0.006 mm (0.8%) lower mean CCA‐IMT (P<0.01) and 0.007 mm (0.8%) lower maximum CCA‐IMT (P<0.01). Other vegetable types were not associated with CCA‐IMT (P>0.05). No associations were observed between vegetables and plaque severity (P>0.05). Conclusions Increasing vegetables in the diet with a focus on consuming cruciferous vegetables may have benefits for the prevention of subclinical atherosclerosis in older adult women. Clinical Trial Registration URL: http://www.anzctr.org.au. Unique identifier: ACTRN12615000750583.
Collapse
Affiliation(s)
- Lauren C Blekkenhorst
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia .,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia.,Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia
| | - Catherine P Bondonno
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Centre for Kidney Research, Children's Hospital at Westmead, New South Wales, Australia.,School of Public Health, Sydney Medical School, University of Sydney, New South Wales, Australia
| | - Richard J Woodman
- Flinders Centre for Epidemiology and Biostatistics, Flinders University, Adelaide, South Australia, Australia
| | - Amanda Devine
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Nicola P Bondonno
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Wai H Lim
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Kun Zhu
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Lawrence J Beilin
- Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| | - Peter L Thompson
- Department of Cardiovascular Medicine, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Richard L Prince
- Medical School, Queen Elizabeth Medical Centre Unit, University of Western Australia, Nedlands, Western Australia, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia.,Medical School, Royal Perth Hospital Unit, University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
30
|
Flores-Torres MH, Lynch R, Lopez-Ridaura R, Yunes E, Monge A, Ortiz-Panozo E, Cantu-Brito C, Hauksdóttir A, Valdimarsdóttir U, Lajous M. Exposure to Violence and Carotid Artery Intima-Media Thickness in Mexican Women. J Am Heart Assoc 2017; 6:e006249. [PMID: 28862944 PMCID: PMC5586461 DOI: 10.1161/jaha.117.006249] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 07/07/2017] [Indexed: 01/22/2023]
Abstract
BACKGROUND Violence against women has become a global public health threat. Data on the potential impact of exposure to violence on cardiovascular disease are scarce. METHODS AND RESULTS We evaluated the association between exposure to violence and subclinical cardiovascular disease in 634 disease-free women from the Mexican Teachers' Cohort who responded to violence-related items from the Life Stressor Checklist and underwent measures of carotid artery intima-media thickness in 2012 and 2013. We defined exposure to violence as having ever been exposed to physical and/or sexual violence. Intima-media thickness was log-transformed, and subclinical carotid atherosclerosis was defined as intima-media thickness ≥0.8 mm or plaque. We used multivariable linear and logistic regression models adjusted for several potential confounders. Mean age was 48.9±4.3 years. Close to 40% of women reported past exposure to violence. The lifetime prevalence of sexual violence was 7.1%, and prevalence of physical violence was 23.5% (7.7% reported both sexual and physical violence). Relative to women with no history of violence, exposure to violence was associated with higher intima-media thickness (adjusted mean percentage difference=2.4%; 95% confidence interval 0.5, 4.3) and subclinical atherosclerosis (adjusted odds ratio=1.60; 95% confidence interval 1.10, 2.32). The association was stronger for exposure to physical violence, especially by mugging or physical assault by a stranger (adjusted mean % difference=4.6%; 95% confidence interval 1.8, 7.5, and odds ratio of subclinical carotid atherosclerosis=2.06; 95% confidence interval 1.22, 3.49). CONCLUSIONS Exposure to violence, and in particular assault by a stranger, was strongly associated with subclinical cardiovascular disease in Mexican middle-aged women.
Collapse
Affiliation(s)
- Mario H Flores-Torres
- School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Rebekka Lynch
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Ruy Lopez-Ridaura
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Elsa Yunes
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Adriana Monge
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Center of Research and Innovation, Instituto Tecnológico y de Estudios Superiores de Monterrey, Monterrey, Mexico
| | - Eduardo Ortiz-Panozo
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
| | - Carlos Cantu-Brito
- Department of Neurology and Psychiatry, National Institute of Nutrition and Medical Sciences, Mexico City, Mexico
| | - Arna Hauksdóttir
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
| | - Unnur Valdimarsdóttir
- Centre of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Solna, Sweden
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Martín Lajous
- Center for Research on Population Health, National Institute of Public Health, Mexico City, Mexico
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA
| |
Collapse
|
31
|
Koskinen J, Magnussen CG, Sinaiko A, Woo J, Urbina E, Jacobs DR, Steinberger J, Prineas R, Sabin MA, Burns T, Berenson G, Bazzano L, Venn A, Viikari JSA, Hutri-Kähönen N, Raitakari O, Dwyer T, Juonala M. Childhood Age and Associations Between Childhood Metabolic Syndrome and Adult Risk for Metabolic Syndrome, Type 2 Diabetes Mellitus and Carotid Intima Media Thickness: The International Childhood Cardiovascular Cohort Consortium. J Am Heart Assoc 2017; 6:JAHA.117.005632. [PMID: 28862940 PMCID: PMC5586423 DOI: 10.1161/jaha.117.005632] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background There is paucity of knowledge concerning the specific age in youth when the associations of metabolic syndrome (MetS) begin to be operative. Thus, we investigated the relation of age to the associations of childhood MetS with adult MetS, type 2 diabetes mellitus and high carotid intima‐media thickness. Methods and Results Five thousand eight‐hundred three participants were analyzed in 4 cohort studies (Cardiovascular Risk in Young Finns, Bogalusa Heart Study, Princeton Lipid Research Study, Insulin Study). International cutoffs and previously used 75th percentile cutoffs were used for children to define MetS and its components. Mean follow‐up period was 22.3 years. Logistic regression was used to calculate risk ratios and 95% confidence intervals. Childhood MetS and overweight were associated with over 2.4‐fold risk for adult MetS from the age of 5 years onward. Risk for type 2 diabetes mellitus was increased from the age of 8 (risk ratio, 2.6–4.1; 95% confidence interval, 1.35–6.76 and 1.12–7.24, respectively) onward for the 2 childhood MetS criteria based on international cut‐off values and for childhood overweight. Risk for high carotid intima‐media thickness was significant at ages 11 to 18 years in relation to childhood MetS or overweight (risk ratio, 2.44–4.22; 95% confidence interval, 1.55–3.55 and 2.55–5.66, respectively). Continuous childhood MetS score was associated with adult MetS from the age of 5, with type 2 diabetes mellitus from the age of 14 and with high carotid intima‐media thickness from the age of 11 years onward. Conclusions Adult MetS was predicted by MetS in childhood beginning at age 5. However, adult type 2 diabetes mellitus and subclinical atherosclerosis were not predicted by childhood data until after age 8. Body mass index measurement alone at the same age points provided similar findings.
Collapse
Affiliation(s)
- Juha Koskinen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland .,Heart Center, Turku University Hospital, Turku, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Alan Sinaiko
- Department of Pediatrics, University of Minnesota, Minneapolis, MN
| | - Jessica Woo
- Division of Biostatistics and Epidemiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati College of Medicine, Cincinnati, OH
| | - Elaine Urbina
- Division of Cardiology, Department of Pediatrics, Cincinnati Children's Hospital Medical Center and University of Cincinnati, Cincinnati, OH
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Masonic Children's Hospital, Minneapolis, MN
| | - Ronald Prineas
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Matthew A Sabin
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Trudy Burns
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Gerald Berenson
- Department of Epidemiology, Tulane Center for Cardiovascular Health, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
| | - Lydia Bazzano
- Departments of Epidemiology and Biostatistics and Bioinformatics, Tulane University Health Sciences Center, Tulane University, New Orleans, LA
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, University of Tampere School of Medicine and Tampere University Hospital, Tampere, Finland
| | - Olli Raitakari
- Department of Clinical Physiology and Nuclear Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Terence Dwyer
- Murdoch Children's Research Institute, Royal Children's Hospital, Parkville, Australia.,Department of Pediatrics, University of Melbourne, Parkville, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| |
Collapse
|
32
|
Boss HM, van der Graaf Y, Visseren FLJ, Van den Berg-Vos RM, Bots ML, de Borst GJ, Cramer MJ, Kappelle LJ, Geerlings MI. Physical Activity and Characteristics of the Carotid Artery Wall in High-Risk Patients-The SMART (Second Manifestations of Arterial Disease) Study. J Am Heart Assoc 2017; 6:JAHA.116.005143. [PMID: 28736388 PMCID: PMC5586269 DOI: 10.1161/jaha.116.005143] [Citation(s) in RCA: 7] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Physical activity reduces the risk of vascular disease. This benefit is not entirely explained through an effect on vascular risk factors. We examined the relationship of physical activity and characteristics of the carotid artery wall in patients with vascular disease or risk factors. Methods and Results Cross‐sectional analyses were performed in 9578 patients from the SMART (Second Manifestations of Arterial Disease) study, a prospective cohort study among patients with vascular disease or risk factors. Physical activity was assessed using questionnaires. Carotid intima‐media thickness and carotid artery stenosis of both common carotid arteries was measured. In a subset of 3165 participants carotid diastolic diameter and distension were assessed. Carotid stiffness was expressed as the distensibility coefficient and Young's elastic modulus. Regression analyses adjusted for vascular risk factors showed that physical activity was inversely associated with diastolic diameter (fifth versus first quintile B=−0.13 mm; 95% CI, −0.21 to −0.05) and decreased risk of carotid artery stenosis (relative risk, 0.58; 95% CI, 0.48–0.69). A light level of physical activity was associated with less carotid stiffness (second versus first quintile; Young's elastic modulus B=−0.11 kPa−1×10−3; 95% CI, −0.16 to −0.06; distensibility coefficient B=0.93 kPa×103; 95% CI, 0.34–1.51), but there was no additional benefit with increasing levels of physical activity. In patients with vascular disease, physical activity was inversely associated with common carotid intima‐media thickness, but not in patients with vascular risk factors. Conclusions In patients with vascular disease or risk factors, increased physical activity was associated with smaller carotid diastolic diameter, decreased risk of carotid artery stenosis, and less carotid stiffness, but it only showed benefits on carotid intima‐media thickness in patients with vascular disease.
Collapse
Affiliation(s)
- H Myrthe Boss
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands.,Department of Neurology, OLVG West, Amsterdam, The Netherlands
| | - Yolanda van der Graaf
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Gert Jan de Borst
- Department of Vascular Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten J Cramer
- Department of Cardiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - L Jaap Kappelle
- Department of Neurology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Mirjam I Geerlings
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | |
Collapse
|
33
|
Abstract
BACKGROUND Familial hypercholesterolemia is one of the most common inherited metabolic diseases and is an autosomal dominant disorder meaning heterozygotes, or carriers, are affected. Those who are homozygous have severe disease. The average worldwide prevalence of heterozygous familial hypercholesterolemia is at least 1 in 500, although recent genetic epidemiological data from Denmark and next generation sequencing data suggest the frequency may be closer to 1 in 250. Diagnosis of familial hypercholesterolemia in children is based on elevated total cholesterol and low-density lipoprotein cholesterol levels or DNA-based analysis, or both. Coronary atherosclerosis has been detected in men with heterozygous familial hypercholesterolemia as young as 17 years old and in women with heterozygous familial hypercholesterolemia at 25 years old. Since the clinical complications of atherosclerosis occur prematurely, especially in men, lifelong treatment, started in childhood, is needed to reduce the risk of cardiovascular disease. In children with the disease, diet was the cornerstone of treatment but the addition of lipid-lowering medications has resulted in a significant improvement in treatment. Anion exchange resins, such as cholestyramine and colestipol, were found to be effective, but they are poorly tolerated. Since the 1990s studies carried out on children aged 6 to 17 years with heterozygous familial hypercholesterolemia have demonstrated significant reductions in their serum total and low-density lipoprotein cholesterol levels. While statins seem to be safe and well-tolerated in children, their long-term safety in this age group is not firmly established. This is an update of a previously published version of this Cochane Review. OBJECTIVES To assess the effectiveness and safety of statins in children with heterozygous familial hypercholesterolemia. SEARCH METHODS Relevant studies were identified from the Group's Inborn Errors and Metabolism Trials Register and Medline.Date of most recent search: 20 February 2017. SELECTION CRITERIA Randomized and controlled clinical studies including participants up to 18 years old, comparing a statin to placebo or to diet alone. DATA COLLECTION AND ANALYSIS Two authors independently assessed studies for inclusion and extracted data. MAIN RESULTS We found 26 potentially eligible studies, of which we included nine randomized placebo-controlled studies (1177 participants). In general, the intervention and follow-up time was short (median 24 weeks; range from six weeks to two years). Statins reduced the mean low-density lipoprotein cholesterol concentration at all time points (moderate quality evidence). Serum aspartate and alanine aminotransferase, as well as creatinine kinase concentrations, did not differ between treated and placebo groups at any time point (low quality evidence). The risks of myopathy (low quality evidence) and clinical adverse events (moderate quality evidence) were very low and also similar in both groups. In one study simvastatin was shown to improve flow-mediated dilatation of the brachial artery (low quality evidence), and in another study treatment with pravastatin for two years induced a significant regression in carotid intima media thickness (low quality evidence). AUTHORS' CONCLUSIONS Statin treatment is an effective lipid-lowering therapy in children with familial hypercholesterolemia. No significant safety issues were identified. Statin treatment seems to be safe in the short term, but long-term safety remains unknown. Children treated with statins should be carefully monitored and followed up by their pediatricians and their care transferred to an adult lipidologist once they reach 18 years of age. Large long-term randomized controlled trials are needed to establish the long-term safety issues of statins.
Collapse
Affiliation(s)
- Alpo Vuorio
- Vantaa and Finnish Institute of Occupational HealthMehiläinen Airport Health CentreLappeenrantaFinland
| | | | - Petri T Kovanen
- Wihuri Research InstituteKalliolinnatie 4HelsinkiFinlandFIN‐00140
| | - Steve E Humphries
- BHF Laboratories, Royal Free and University College Medical SchoolCenter for Cardiovascular GeneticsThe Rayne Institute5 University StreetLondonUKWC1E 6JJ
| | - Serena Tonstad
- Ullevål University HospitalDept. of Preventive CardiologyOlsoNorway
| | - Albert Wiegman
- Academic Medical CenterDepartment of PediatricsMeibergdreef 9AmsterdamNetherlands1105 AZ
| | - Euridiki Drogari
- National and Kapodistrian University of Athens, Medical SchoolUnit of Metabolic Disorders, First Department of PediatricsAthensGreece
| | | |
Collapse
|
34
|
Ryder JR, Pankratz ND, Dengel DR, Pankow JS, Jacobs DR, Sinaiko AR, Gooty V, Steinberger J. Heritability of Vascular Structure and Function: A Parent-Child Study. J Am Heart Assoc 2017; 6:JAHA.116.004757. [PMID: 28154165 PMCID: PMC5523771 DOI: 10.1161/jaha.116.004757] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background Understanding the heritable contribution of vascular measures, from parent to offspring, may aid in risk stratification and atherosclerosis prevention efforts. We hypothesized that measures of vascular structure and function would be heritable in this cohort of parents and their adolescent offspring. Methods and Results High‐resolution ultrasound scans of the brachial and carotid arteries were obtained in parents (n=558) and their offspring (n=369). Lumen diameter and flow‐mediated dilation were measured in the brachial artery. Intima‐media thickness, lumen diameter, incremental elastic modulus, diameter distensibility, and cross‐sectional distensibility were measured, and carotid cross‐sectional compliance was measured in the carotid artery. Carotid–radial pulse wave velocity was obtained using SphygmoCor®. Heritability analysis (h2, expressed as %) using Sequential Oligogenic Linkage Analysis Routines was performed on the entire cohort and adjusted for age, sex, race, body–mass index, smoking, and mean arterial pressure. Data are presented as mean±SE. Measures of brachial artery diameter (h2=25±9%, P=0.001), lumen diameter (h2=55±9%, P<0.001), intima‐media thickness (h2=29±13%, P=0.014), diameter distensibility (h2=28±7%, P<0.001), cross‐sectional distensibility (h2=27±7%, P<0.001), and pulse wave velocity (h2=26±9%, P<0.001) were significantly heritable. Flow‐mediated dilation and incremental elastic modulus were not significantly heritable. Similar associations were observed in analysis restricted to siblings and complete Trios (mother, father, and child). Conclusions These data show that the majority of noninvasive measures of vascular structure and function are heritable, suggesting that measurement of these subclinical risk factors in parents may be helpful in assessing childhood risk for future cardiovascular disease.
Collapse
Affiliation(s)
- Justin R Ryder
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Nathan D Pankratz
- Department of Lab Medicine and Pathology, University of Minnesota Medical School, Minneapolis, MN
| | - Donald R Dengel
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN.,School of Kinesiology, University of Minnesota, Minneapolis, MN
| | - James S Pankow
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - David R Jacobs
- Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN
| | - Alan R Sinaiko
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Vasu Gooty
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, MN
| |
Collapse
|
35
|
Abstract
Background There are few longitudinal studies that have comprehensively examined the intima‐media thickness (IMT) growth pattern and its determinants among racial population groups. Methods and Results Mean and maximum IMT were measured by B‐mode ultrasonography up to 3 times in 253 white and 268 black participants, aged 13 to 36 years (mean age±standard deviation 24±3.2 years old). The development of IMT was assessed using individual growth curve modeling. A total of 521 participants with 1015 IMT measurements were eligible for this study. We found higher IMT in both left and right sides in blacks compared to whites (P<0.001) in young adulthood. Both whites and blacks showed a strong linear increase in mean IMT with age. Body mass index and father's education level were associated with mean IMT, and only body mass index was associated with maximum IMT (P<0.05). We did not observe an interaction between age and race/ethnicity on the growth of IMT, suggesting that blacks and whites developed IMT in similar patterns. Interestingly, we found a faster increase in mean left‐side IMT than mean right‐side IMT (χ2=11.5, P<0.001) in both black and white subjects as well as in males and females. Conclusions Our findings provide compelling prospective evidence that blacks may have thicker IMT compared to whites as young adults. These racial differences could not be explained by traditional risk factors. This implies that differences in this precursor of atherosclerosis may explain racial disparity in cerebrovascular disease.
Collapse
Affiliation(s)
- Guang Hao
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Xiaoling Wang
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Frank A Treiber
- Technology Applications Center for Healthful Lifestyles, Colleges of Nursing and Medicine, Medical University of South Carolina, Charleston, SC
| | - Harry Davis
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Sharika Leverett
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Shaoyong Su
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| | - Gaston Kapuku
- Department of Pediatrics, Medical College of Georgia, Georgia Prevention Institute, Augusta University, Augusta, GA
| |
Collapse
|
36
|
Jones MR, Magid HS, Al-Rifai M, McEvoy JW, Kaufman JD, Hinckley Stukovsky KD, Szklo M, Polak J, Burke GL, Post WS, Blaha MJ, Navas-Acien A. Secondhand Smoke Exposure and Subclinical Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis. J Am Heart Assoc 2016; 5:e002965. [PMID: 27993830 PMCID: PMC5210438 DOI: 10.1161/jaha.115.002965] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Accepted: 10/14/2016] [Indexed: 01/19/2023]
Abstract
BACKGROUND Few studies have evaluated the association between secondhand smoke (SHS) and subclinical cardiovascular disease among ethnically diverse populations. This study assesses the impact of SHS on inflammation and atherosclerosis (carotid intima-media thickness, coronary artery calcification, and peripheral arterial disease). METHODS AND RESULTS We examined 5032 nonsmoking adults aged 45 to 84 years without prior cardiovascular disease participating in the Multi-Ethnic Study of Atherosclerosis (MESA) from 2000 to 2002. SHS exposure was determined by self-report, and urinary cotinine was measured in a representative subset (n=2893). The multi-adjusted geometric mean ratios (95% CIs) for high-sensitivity C-reactive protein and interleukin-6 comparing 407 participants with SHS ≥12 h/wk versus 3035 unexposed participants were 1.13 (1.02-1.26) and 1.04 (0.98-1.11), respectively. The multi-adjusted geometric mean ratio for carotid intima-media thickness was 1.02 (0.97-1.07). Fibrinogen and coronary artery calcification were not associated with SHS. The prevalence of peripheral arterial disease (ankle-brachial index ≤0.9 or ≥1.4) was associated with detectable urinary cotinine (odds ratio, 2.10; 95% CI, 1.09-4.04) but not with self-reported SHS. Urinary cotinine was not associated with inflammation or carotid intima-media thickness. CONCLUSIONS Despite limited exposure assessment, this study supports the association of SHS exposure with inflammation and peripheral arterial disease.
Collapse
Affiliation(s)
- Miranda R Jones
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Hoda S Magid
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Mahmoud Al-Rifai
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - John W McEvoy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - Joel D Kaufman
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Karen D Hinckley Stukovsky
- Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA
| | - Moyses Szklo
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Joseph Polak
- Department of Radiology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston- Salem, NC
| | - Wendy S Post
- Division of Cardiology, Johns Hopkins University, Baltimore, MD
| | - Michael J Blaha
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University, Baltimore, MD
| | - Ana Navas-Acien
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
- Department of Environmental Health Sciences, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| |
Collapse
|
37
|
Chen LY, Leening MJG, Norby FL, Roetker NS, Hofman A, Franco OH, Pan W, Polak JF, Witteman JCM, Kronmal RA, Folsom AR, Nazarian S, Stricker BH, Heckbert SR, Alonso A. Carotid Intima-Media Thickness and Arterial Stiffness and the Risk of Atrial Fibrillation: The Atherosclerosis Risk in Communities (ARIC) Study, Multi-Ethnic Study of Atherosclerosis (MESA), and the Rotterdam Study. J Am Heart Assoc 2016; 5:JAHA.115.002907. [PMID: 27207996 PMCID: PMC4889172 DOI: 10.1161/jaha.115.002907] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND We evaluated the association of carotid intima-media thickness (cIMT), carotid plaque, carotid distensibility coefficient (DC), and aortic pulse wave velocity (PWV) with incident atrial fibrillation (AF) and their role in improving AF risk prediction beyond the Cohorts for Heart and Aging Research in Genomic Epidemiology (CHARGE)-AF risk score. METHODS AND RESULTS We analyzed data from 3 population-based cohort studies: Atherosclerosis Risk in Communities (ARIC) Study (n=13 907); Multi-Ethnic Study of Atherosclerosis (MESA; n=6640), and the Rotterdam Study (RS; n=5220). We evaluated the association of arterial indices with incident AF and computed the C-statistic, category-based net reclassification improvement (NRI), and relative integrated discrimination improvement (IDI) of incorporating arterial indices into the CHARGE-AF risk score (age, race, height weight, systolic and diastolic blood pressure, antihypertensive medication use, smoking, diabetes, previous myocardial infarction, and previous heart failure). Higher cIMT (meta-analyzed hazard ratio [95% CI] per 1-SD increment, 1.12 [1.08-1.16]) and presence of carotid plaque (1.30 [1.19-1.42]) were associated with higher AF incidence after adjustment for CHARGE-AF risk-score variables. Lower DC and higher PWV were associated with higher AF incidence only after adjustment for the CHARGE-AF risk-score variables excepting height, weight, and systolic and diastolic blood pressure. Addition of cIMT or carotid plaque marginally improved CHARGE-AF score prediction as assessed by the relative IDI (estimates, 0.025-0.051), but not when assessed with the C-statistic and NRI. CONCLUSIONS Higher cIMT, presence of carotid plaque, and greater arterial stiffness are associated with higher AF incidence, indicating that atherosclerosis and arterial stiffness play a role in AF etiopathogenesis. However, arterial indices only modestly improve AF risk prediction.
Collapse
Affiliation(s)
- Lin Y Chen
- Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN
| | - Maarten J G Leening
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Cardiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Nicholas S Roetker
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Albert Hofman
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Oscar H Franco
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Wei Pan
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Joseph F Polak
- Department of Radiology, Tufts University School of Medicine, Boston, MA
| | - Jacqueline C M Witteman
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Richard A Kronmal
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Saman Nazarian
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Bruno H Stricker
- Department of Epidemiology, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands Department of Internal Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands Inspectorate for Health Care, Utrecht, The Netherlands
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA Cardiovascular Health Research Unit, University of Washington, Seattle, WA
| | - Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| |
Collapse
|
38
|
Persson J, Strawbridge RJ, McLeod O, Gertow K, Silveira A, Baldassarre D, Van Zuydam N, Shah S, Fava C, Gustafsson S, Veglia F, Sennblad B, Larsson M, Sabater-Lleal M, Leander K, Gigante B, Tabak A, Kivimaki M, Kauhanen J, Rauramaa R, Smit AJ, Mannarino E, Giral P, Humphries SE, Tremoli E, de Faire U, Lind L, Ingelsson E, Hedblad B, Melander O, Kumari M, Hingorani A, Morris AD, Palmer CNA, Lundman P, Öhrvik J, Söderberg S, Hamsten A. Sex-Specific Effects of Adiponectin on Carotid Intima-Media Thickness and Incident Cardiovascular Disease. J Am Heart Assoc 2015; 4:e001853. [PMID: 26276317 PMCID: PMC4599454 DOI: 10.1161/jaha.115.001853] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Plasma adiponectin levels have previously been inversely associated with carotid intima-media thickness (IMT), a marker of subclinical atherosclerosis. In this study, we used a sex-stratified Mendelian randomization approach to investigate whether adiponectin has a causal protective influence on IMT. METHODS AND RESULTS Baseline plasma adiponectin concentration was tested for association with baseline IMT, IMT progression over 30 months, and occurrence of cardiovascular events within 3 years in 3430 participants (women, n=1777; men, n=1653) with high cardiovascular risk but no prevalent disease. Plasma adiponectin levels were inversely associated with baseline mean bifurcation IMT after adjustment for established risk factors (β=-0.018, P<0.001) in men but not in women (β=-0.006, P=0.185; P for interaction=0.061). Adiponectin levels were inversely associated with progression of mean common carotid IMT in men (β=-0.0022, P=0.047), whereas no association was seen in women (0.0007, P=0.475; P for interaction=0.018). Moreover, we observed that adiponectin levels were inversely associated with coronary events in women (hazard ratio 0.57, 95% CI 0.37 to 0.87) but not in men (hazard ratio 0.82, 95% CI 0.54 to 1.25). A gene score of adiponectin-raising alleles in 6 loci, reported recently in a large multi-ethnic meta-analysis, was inversely associated with baseline mean bifurcation IMT in men (β=-0.0008, P=0.004) but not in women (β=-0.0003, P=0.522; P for interaction=0.007). CONCLUSIONS This report provides some evidence for adiponectin protecting against atherosclerosis, with effects being confined to men; however, compared with established cardiovascular risk factors, the effect of plasma adiponectin was modest. Further investigation involving mechanistic studies is warranted.
Collapse
Affiliation(s)
- Jonas Persson
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.)
| | - Rona J Strawbridge
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Olga McLeod
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Karl Gertow
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Angela Silveira
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Damiano Baldassarre
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (D.B., E.T.) Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Natalie Van Zuydam
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Sonia Shah
- University College London Genetics Institute, University College London, London, United Kingdom (S.S.) Diamantina Institute and Queensland Brain Institute, University of Queensland, Australia (S.S.)
| | - Cristiano Fava
- Division of Internal Medicine C, Department of Medicine, Hospital "Policlinico G.B Rossi", University of Verona, Italy (C.F.) Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Stefan Gustafsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden (S.G., E.I.)
| | - Fabrizio Veglia
- Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Bengt Sennblad
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.) Science for Life Laboratory, Karolinska Institutet, Stockholm, Sweden (B.S.)
| | - Malin Larsson
- IFM Bioinformatics, Linköping University, Linköping, Sweden (M.L.)
| | - Maria Sabater-Lleal
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Karin Leander
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Bruna Gigante
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.) Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Adam Tabak
- Department of Epidemiology and Public Health, University College London, London, United Kingdom (A.T., M.K.) 1st Department of Medicine, Semmelweis University Faculty of Medicine, Semmelweis University, Budapest, Hungary (A.T.)
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, United Kingdom (A.T., M.K.)
| | - Jussi Kauhanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland (J.K.)
| | - Rainer Rauramaa
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland (R.R.) Department of Clinical Physiology and Nuclear Medicine, University Hospital of Kuopio, Kuopio, Finland (R.R.)
| | - Andries J Smit
- Department of Medicine, University Medical Center Groningen, University of Groningen, The Netherlands (A.J.S.)
| | - Elmo Mannarino
- Internal Medicine, Angiology and Arteriosclerosis Diseases, Department of Clinical and Experimental Medicine, University of Perugia, Italy (E.M.)
| | - Philippe Giral
- Assistance Publique - Hopitaux de Paris, Service Endocrinologie-Metabolisme, Groupe Hôpitalier Pitie-Salpetriere, Unités de Prévention Cardiovasculaire, Paris, France (P.G.)
| | - Steve E Humphries
- Centre for Cardiovascular Genetics, University College London, London, United Kingdom (S.E.H.)
| | - Elena Tremoli
- Dipartimento di Scienze Farmacologiche e Biomolecolari, Università di Milano, Milan, Italy (D.B., E.T.) Centro Cardiologico Monzino, IRCCS, Milan, Italy (D.B., F.V., E.T.)
| | - Ulf de Faire
- Division of Cardiovascular Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden (K.L., B.G., U.F.)
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden (L.L.)
| | - Erik Ingelsson
- Department of Medical Sciences, Molecular Epidemiology and Science for Life Laboratory, Uppsala University, Uppsala, Sweden (S.G., E.I.)
| | - Bo Hedblad
- Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Olle Melander
- Clinical Research Center, Department of Clinical Sciences, Skåne University Hospital, Lund University, Malmö, Sweden (C.F., B.H., O.M.)
| | - Meena Kumari
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, United Kingdom (M.K., A.H.)
| | - Aroon Hingorani
- Genetic Epidemiology Group, Department of Epidemiology and Public Health, University College London, London, United Kingdom (M.K., A.H.)
| | - Andrew D Morris
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Colin N A Palmer
- Medical Research Institute, Ninewells Hospital and Medical School, University of Dundee, United Kingdom (N.V.Z., A.D.M., C.A.P.)
| | - Pia Lundman
- Division of Cardiovascular Medicine, Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden (J.P., B.G., P.L.)
| | - John Öhrvik
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | - Stefan Söderberg
- Division of Medicine, Department of Public Health and Clinical Medicine, University of Umeå, Sweden (S.)
| | - Anders Hamsten
- Atherosclerosis Research Unit, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden (R.J.S., O.M.L., K.G., A.S., B.S., M.S.L., J., A.H.)
| | | |
Collapse
|
39
|
Abstract
Background Data on the influence of obesity on atherosclerosis in Hispanics are inconsistent, possibly related to varying cardiometabolic risk among obese individuals. We aimed to determine the association of obesity and cardiometabolic risk with subclinical atherosclerosis in Mexican‐Americans. Methods and Results Participants (n=503) were drawn from the Cameron County Hispanic Cohort. Metabolic health was defined as <2 of the following: blood pressure ≥130/85; triglyceride ≥150 mg/dL; high‐density lipoprotein cholesterol <40 mg/dL (men) or <50 mg/dL (women); fasting glucose ≥100 mg/dL; homeostasis model assessment of insulin resistance value >5.13; or high‐sensitivity C‐reactive protein >3 mg/L. Carotid intima media thickness (cIMT) was measured. A high proportion of participants (77.8%) were metabolically unhealthy; they were more likely to be male, older, with fewer years of education, and less likely to meet daily recommendations regarding fruit and vegetable servings. One‐third (31.8%) had abnormal carotid ultrasound findings. After adjusting for covariates, mean cIMT varied across the obesity phenotypes (P=0.0001); there was no difference among the metabolically unhealthy regardless of whether they were obese or not. In multivariable analysis, after adjusting for covariates, cardiometabolic risk (P=0.0159), but not obesity (P=0.1446), was significantly associated with subclinical atherosclerosis. Conclusions In Mexican‐Americans, cardiometabolic risk has a greater effect on early atherosclerosis development than body mass index. Non‐obese but metabolically unhealthy participants had similar development of subclinical atherosclerosis as their obese counterparts. Interventions to maintain metabolic health among obese and non‐obese patients may be a more important goal than weight loss alone.
Collapse
Affiliation(s)
- Susan T. Laing
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center‐Houston, Houston, TX (S.T.L., B.S., D.D.M.P.)
| | - Beverly Smulevitz
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center‐Houston, Houston, TX (S.T.L., B.S., D.D.M.P.)
| | - Kristina P. Vatcheva
- Division of Epidemiology, School of Public Health, University of Texas Health Science Center‐Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.)
| | - Mohammad H. Rahbar
- Division of Clinical and Translational Sciences, Department of Internal Medicine, University of Texas Health Science Center‐Houston, Houston, TX (M.H.R.)
| | - Belinda Reininger
- Division of Epidemiology, School of Public Health, University of Texas Health Science Center‐Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.)
| | - David D. McPherson
- Division of Cardiology, Department of Internal Medicine, University of Texas Health Science Center‐Houston, Houston, TX (S.T.L., B.S., D.D.M.P.)
| | - Joseph B. McCormick
- Division of Epidemiology, School of Public Health, University of Texas Health Science Center‐Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.)
| | - Susan P. Fisher‐Hoch
- Division of Epidemiology, School of Public Health, University of Texas Health Science Center‐Houston, Brownsville, TX (K.P.V., B.R., J.B.M.C., S.P.F.H.)
| |
Collapse
|
40
|
Effoe VS, Rodriguez CJ, Wagenknecht LE, Evans GW, Chang PP, Mirabelli MC, Bertoni AG. Carotid intima-media thickness is associated with incident heart failure among middle-aged whites and blacks: the Atherosclerosis Risk in Communities study. J Am Heart Assoc 2014; 3:e000797. [PMID: 24815496 PMCID: PMC4309069 DOI: 10.1161/jaha.114.000797] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Increased carotid intima‐media thickness (IMT) is associated with subclinical left ventricular myocardial dysfunction, suggesting a possible role of carotid IMT in heart failure (HF) risk determination. Methods and Results Mean far wall carotid IMT, measured by B‐mode ultrasound, was available for 13 590 Atherosclerosis Risk in Communities study participants aged 45 to 64 years and free of HF at baseline. HF was defined using ICD‐9 428 and ICD‐10 I‐50 codes from hospitalization records and death certificates. The association between carotid IMT and incident HF was assessed using Cox proportional hazards analysis with models adjusted for demographic variables, major CVD risk factors, and interim CHD. There were 2008 incident HF cases over a median follow‐up of 20.6 years (8.1 cases per 1000 person‐years). Mean IMT was higher in those with HF than in those without (0.81 mm±0.23 versus 0.71 mm±0.17, P<0.001). Unadjusted rate of HF for the fourth compared with the first quartile of IMT was 15.4 versus 3.9 per 1000 person‐years; P<0.001. In multivariable analysis, after adjustment, each standard deviation increase in IMT was associated with incident HF (HR 1.20 [95% CI: 1.16 to 1.25]). After adjustment, the top quartile of IMT was associated with HF (HR 1.60 [95% CI: 1.37 to 1.87]). Results were similar across race and gender groups. Conclusions Increasing carotid IMT is associated with incident HF in middle‐aged whites and blacks, beyond risks explained by major CVD risk factors and CHD. This suggests that carotid IMT may be associated with HF through mechanisms different from myocardial ischemia or infarction.
Collapse
Affiliation(s)
- Valery S Effoe
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | | | | | | | | | | | | |
Collapse
|
41
|
Oikonen M, Laitinen TT, Magnussen CG, Steinberger J, Sinaiko AR, Dwyer T, Venn A, Smith KJ, Hutri-Kähönen N, Pahkala K, Mikkilä V, Prineas R, Viikari JSA, Morrison JA, Woo JG, Chen W, Nicklas T, Srinivasan SR, Berenson G, Juonala M, Raitakari OT. Ideal cardiovascular health in young adult populations from the United States, Finland, and Australia and its association with cIMT: the International Childhood Cardiovascular Cohort Consortium. J Am Heart Assoc 2013; 2:e000244. [PMID: 23782922 PMCID: PMC3698791 DOI: 10.1161/jaha.113.000244] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Accepted: 05/10/2013] [Indexed: 11/28/2022]
Abstract
BACKGROUND Goals for cardiovascular (CV) disease prevention were set by the American Heart Association in 2010 for the concept of CV health. Ideal CV health is defined by 7 CV health metrics: blood pressure, glucose, cholesterol, body mass index, and physical activity on recommended levels; nonsmoking; and a healthy diet. We studied the prevalence of ideal CV health and its associations with ultrasonographically measured carotid intima-media thickness (cIMT) cross-sectionally in 5 international populations. METHODS AND RESULTS Prevalence of ideal CV health was assessed among 5785 young adults (age, 36.6 ± 3.2 years) comprising 335 participants from the Minneapolis Childhood Cohort Studies (Minnesota), 723 from the Princeton Follow-up Study, 981 from the Bogalusa Heart Study (BHS), 1898 from the Cardiovascular Risk in Young Finns Study (YFS), and 1848 from the Childhood Determinants of Adult Health Study (CDAH). Only 1% of the participants had all 7 ideal CV health metrics. The number of ideal CV health metrics associated inversely with cIMT in the 4 cohorts in which cIMT was available: for each additional ideal CV health metric, cIMT was 12.7 μm thinner in Minnesota (P=0.0002), 9.1 μm thinner in BHS (P=0.05), 10.4 μm thinner in YFS (P<0.0001), and 3.4 μm thinner in CDAH (P=0.03). CONCLUSIONS The number of ideal CV health metrics was inversely associated with cIMT in the cohorts in which cIMT was available, indicating that ideal CV health metrics are associated with vascular health at the population level. Ideal CV health was rare in this large international sample of young adults, emphasizing the need for effective strategies for health promotion.
Collapse
Affiliation(s)
- Mervi Oikonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Abstract
Pseudoxanthoma elasticum (PXE), which demonstrates progressive build-up of calcium phosphate and proteoglycan deposits in skin, eye, and arteries, has been associated with myocardial infarctions, stroke, and blindness. In a mouse model of PXE, a magnesium-enriched diet prevents mineralization of the vibrissae capsule, an early biomarker for PXE. However, biomarkers for therapeutic responses in PXE have not been identified in humans. Because PXE patients have an increased carotid intima-media thickness (CIMT), a risk factor for cardiovascular disease and stroke, we analyzed the feasibility of CIMT as a treatment endpoint before and after magnesium supplementation in a mouse model of PXE (Abcc6(-/-) ). CIMT was measured in 1-year-old Abcc6(-/-) and Abcc6(+/+) mice fed either standard rodent diet with or without magnesium oxide supplementation for 2 months. Baseline CIMT in Abcc6(-/-) versus Abcc6(+/+) mice was increased (p value = 0.009), whereas CIMT in magnesium-treated versus untreated Abcc6(-/-) mice was reduced (p value = 0.024). CIMT is a novel treatment endpoint in this mouse model and may serve as a predictive biomarker of therapeutic response in PXE patients. In that context, magnesium oxide significantly reduced CIMT in PXE mice, and may be useful for disease prevention in PXE patients.
Collapse
Affiliation(s)
- Erine A Kupetsky-Rincon
- Department of Dermatology and Cutaneous Biology, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
| | | | | |
Collapse
|