scholarly journals Mortality from cardiovascular disease in a cohort of Swedish seafarers

2019 ◽  
Vol 93 (3) ◽  
pp. 345-353 ◽  
Author(s):  
Helena P. Eriksson ◽  
Karl Forsell ◽  
Eva Andersson
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Total Mortality ◽  
Occupational Exposures ◽  
Board Type ◽  
Different Types ◽  
Standardised Mortality Ratios ◽  
Over Time

Abstract Purpose The aim of this study was to investigate whether Swedish seafarers have increased mortality from cardiovascular disease compared with the general population. Methods Register-based longitudinal cohort study of 85,169 Swedish seafarers where all subjects with a minimum of 30 days service registered in the Seafarers’ Register 1985–2013 were included. Mortality from coronary heart disease, cerebrovascular disease and total mortality for comparison were analysed by calculating standardised mortality ratios (SMRs), with 95% confidence intervals (CIs). Mortality was further analysed by gender, duty on board, type of vessel, and over time. Results There was no increase in either mortality from cardiovascular disease or total mortality for seafarers, who had worked solely on passenger ferries. Mortality from coronary heart disease and cerebrovascular disease was increased for male seafarers < 46 years old who had worked on different types of vessels, SMR 1.48 (95% CI 1.06–2.01) and SMR 1.93 (95% CI 1.16–3.02), respectively. Analysing the seafarers by duty showed significantly increased SMRs from coronary heart disease in males aged < 46 of the categories “deck crew” and “engine officer/crew (ever)”. The total mortality for seafarers who had worked on different types of vessels was increased; males SMR 1.05 (95% CI 1.02–1.09) and females SMR 1.17 (95% CI 1.04–1.30), but decreased over time. Conclusions No increased mortality on passenger ferries but younger male seafarers on different types of vessels had increased mortality from cardiovascular disease. Reduction of hazardous occupational exposures onboard is important, such as shift work, stress and noise.

scholarly journals Association of occupational exposures with cardiovascular disease among US Hispanics/Latinos

Heart ◽  
2018 ◽  
Vol 105 (6) ◽  
pp. 439-448 ◽  
Author(s):  
Catherine M Bulka ◽  
Martha L Daviglus ◽  
Victoria W Persky ◽  
Ramon A Durazo-Arvizu ◽  
James P Lash ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Organic Solvents ◽  
Occupational Exposures ◽  
Latino Workers ◽  
Prevalence Ratios

ObjectiveCardiovascular disease (CVD) is a leading cause of mortality and morbidity in the USA. The role of occupational exposures to chemicals in the development of CVD has rarely been studied even though many agents possess cardiotoxic properties. We therefore evaluated associations of self-reported exposures to organic solvents, metals and pesticides in relation to CVD prevalence among diverse Hispanic/Latino workers.MethodsCross-sectional data from 7404 employed individuals, aged 18–74 years, enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) were analysed. Participants from four US cities provided questionnaire data and underwent clinical examinations, including ECGs. CVD was defined as the presence of at least one of the following: coronary heart disease, atrial fibrillation, heart failure or cerebrovascular disease. Prevalence ratios reflecting the relationship between each occupational exposure and CVD as well as CVD subtypes were calculated using Poisson regression models.ResultsHispanic/Latino workers reported exposures to organic solvents (6.5%), metals (8.5%) and pesticides (4.7%) at their current jobs. Overall, 6.1% of participants had some form of CVD, with coronary heart disease as the most common (4.3%) followed by cerebrovascular disease (1.0%), heart failure (0.8%) and atrial fibrillation (0.7%). For individuals who reported working with pesticides, the prevalence ratios for any CVD were 2.18 (95% CI 1.34 to 3.55), coronary heart disease 2.20 (95% CI 1.31 to 3.71), cerebrovascular disease 1.38 (95% CI 0.62 3.03), heart failure 0.91 (95% CI 0.23 to 3.54) and atrial fibrillation 5.92 (95% CI 1.89 to 18.61) after adjustment for sociodemographic, acculturation, lifestyle and occupational characteristics. Metal exposures were associated with an almost fourfold (3.78, 95% CI 1.24 to 11.46) greater prevalence of atrial fibrillation. Null associations were observed for organic solvent exposures.ConclusionsOur results suggest that working with metals and pesticides could be risk factors for CVD among Hispanic/Latino workers. Further work is needed to evaluate these relationships prospectively.

scholarly journals Sex Differences in Coronary Artery Calcium and Mortality from Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults with Diabetes: The Coronary Calcium Consortium

2020 ◽  
Author(s):  
Nathan D Wong ◽  
Amber R Cordola Hsu ◽  
Alan Rozanski ◽  
Leslee J Shaw ◽  
Seamus P. Whelton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Total Mortality ◽  
Design And Methods ◽  
Cvd Mortality

<b>Objective:</b> While diabetes mellitus (DM) has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared to men, it is not clear if this still the case. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in persons with DM; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with DM for total, CVD, and CHD mortality. <p><b>Research Design and Methods:</b> We studied adults with DM from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality endpoints. </p> <p><b>Results:</b> Among 4,503 adults with DM (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC>0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC>100. Age and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total (1.36 vs. 1.21) and CVD mortality (1.67 vs. 1.33) (interaction p=0.01 for both) but similar for CHD mortality (1.53 and 1.48). For CVD mortality, HR’s with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively for women and 1.63 and 3.48, respectively for men (interaction p=0.04). For total mortality HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction p=0.01). </p> <p><b>Conclusion:</b> CAC predicts CHD, CVD, and all-cause mortality in patients with DM; however, greater CAC predicts CVD and total mortality more strongly in women.<b> </b></p>

scholarly journals Differences in declining mortality rates due to coronary heart disease by neighbourhood deprivation

2018 ◽  
Vol 72 (4) ◽  
pp. 314-318 ◽  
Author(s):  
Daniel Oudin Åström ◽  
Jan Sundquist ◽  
Kristina Sundquist
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Rates ◽  
Decision Makers ◽  
Neighbourhood Deprivation ◽  
Deprived Neighbourhoods ◽  
Different Types ◽  
Trends Over Time ◽  
Industrialised Countries ◽  
Over Time

BackgroundCardiovascular disease (CVD) is the main cause of death in most industrialised countries, including those in Europe. The mortality rates due to coronary heart disease (CHD), one of the most serious CVD conditions, have been decreasing in most European countries during the last decades. However, whether the trends over time in CHD mortality rates differ depending on neighbourhood deprivation has rarely been investigated.MethodsFor each year of the study period, 1988–2012, in Sweden, age-standardised mortality rates were calculated for three different types of neighbourhoods, characterised by a Neighbourhood Deprivation Index. Joinpoint regression was used to investigate potential changes in age-standardised mortality rates by neighbourhood deprivation and over time.ResultsOver the study period, age-standardised mortality rates due to CHD were consistently the highest in the deprived neighbourhoods and the lowest in the affluent neighbourhoods. We observed a statistically significant overall decline, ranging from 67% to 59%, in the age-standardised CHD mortality rates for each level of neighbourhood deprivation. Furthermore, the decline for the affluent neighbourhoods was significantly higher compared with the decline in the deprived neighbourhoods.ConclusionAge-standardised CHD mortality rates decreased significantly in Sweden between 1988 and 2012. This decline was more pronounced in the affluent neighbourhoods, which indicates that the improvements in prevention and treatment of CHD have not benefited individuals residing in deprived neighbourhoods to an equal extent. Knowledge of time trends in CHD mortality by level of neighbourhood deprivation may help guide decision-makers in the development of appropriate healthcare policies for deprived neighbourhoods.

scholarly journals Rheumatoid Arthritis and Cardio-Cerebrovascular Disease: A Mendelian Randomization Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Shizheng Qiu ◽  
Meijie Li ◽  
Shunshan Jin ◽  
Haoyu Lu ◽  
Yang Hu
Keyword(s):  
Rheumatoid Arthritis ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Cerebrovascular Disease ◽  
Heart Attack ◽  
Large Scale ◽  
Genome Wide Association Study ◽  
Mendelian Randomization ◽  
Sensitivity Analyses

Significant genetic association exists between rheumatoid arthritis (RA) and cardiovascular disease. The associated mechanisms include common inflammatory mediators, changes in lipoprotein composition and function, immune responses, etc. However, the causality of RA and vascular/heart problems remains unknown. Herein, we performed Mendelian randomization (MR) analysis using a large-scale RA genome-wide association study (GWAS) dataset (462,933 cases and 457,732 controls) and six cardio-cerebrovascular disease GWAS datasets, including age angina (461,880 cases and 447,052 controls), hypertension (461,880 cases and 337,653 controls), age heart attack (10,693 cases and 451,187 controls), abnormalities of heartbeat (461,880 cases and 361,194 controls), stroke (7,055 cases and 454,825 controls), and coronary heart disease (361,194 cases and 351,037 controls) from United Kingdom biobank. We further carried out heterogeneity and sensitivity analyses. We confirmed the causality of RA with age angina (OR = 1.17, 95% CI: 1.04–1.33, p = 1.07E−02), hypertension (OR = 1.45, 95% CI: 1.20–1.75, p = 9.64E−05), age heart attack (OR = 1.15, 95% CI: 1.05–1.26, p = 3.56E−03), abnormalities of heartbeat (OR = 1.07, 95% CI: 1.01–1.12, p = 1.49E−02), stroke (OR = 1.06, 95% CI: 1.01–1.12, p = 2.79E−02), and coronary heart disease (OR = 1.19, 95% CI: 1.01–1.39, p = 3.33E−02), contributing to the understanding of the overlapping genetic mechanisms and therapeutic approaches between RA and cardiovascular disease.

P3422Contrasting the risk for atherosclerotic cardiovascular disease events among individuals with lower extremity peripheral artery disease, coronary heart disease and cerebrovascular disease

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Hubbard ◽  
L D Colantonio ◽  
R S Rosenson ◽  
T M Brown ◽  
E A Jackson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Extremity ◽  
Cerebrovascular Disease ◽  
Event Rate ◽  
Hazard Ratio ◽  
Adjusted Hazard Ratio ◽  
History Of ◽  
Artery Disease

Abstract Background Having more vascular conditions, including coronary heart disease (CHD), cerebrovascular disease and lower extremity artery disease (LEAD), may increase the risk for atherosclerosis cardiovascular disease (ASCVD) events. Specific vascular conditions may increase the ASCVD event rate more than others. Purpose To compare the risk for future ASCVD events associated with the number and type of vascular conditions among adults with a history of CHD, cerebrovascular disease and/or LEAD. Methods We analyzed data from US adults ≥19 years of age with commercial or Medicare health insurance who had a history of CHD, cerebrovascular disease and/or LEAD as of December 31, 2014 (N=901,391). Individuals were followed through December 31, 2016 (median follow-up: 2 years) for ASCVD events, including myocardial infarction, coronary revascularization, stroke, carotid revascularization and lower extremity amputation or revascularization. Results Among individuals included in the current analysis (mean age 63 years, 45% female), 70%, 23% and 7% had 1, 2 and 3 vascular conditions, respectively. After adjustment for sociodemographic and cardiovascular risk factors, the hazard ratio for ASCVD among individuals with 2 and 3 versus 1 vascular conditions was 1.88 (1.85, 1.92) and 2.93 (2.86, 3.00), respectively. Among individuals with 1 vascular condition, the rate of ASCVD events per 1,000 person-years was 46.5 (95% CI 44.1, 49.0), 29.6 (95% CI 29.0, 30.1) and 19.9 (95% CI 19.2, 20.8) for those with LEAD, CHD and cerebrovascular disease, respectively. The multivariable-adjusted hazard ratio (95% CI) for ASCVD events comparing individuals with LEAD only and CHD only versus those with cerebrovascular disease only was 1.84 (1.77, 1.92) and 1.12 (1.08, 1.16), respectively. Among individuals with 2 vascular conditions, the ASCVD event rate per 1,000 person-years was higher in those with LEAD and CHD (122.0, 95% CI 112.5, 132.2) and with LEAD and cerebrovascular disease (92.4, 95% CI 79.9, 106.4), versus those with CHD and cerebrovascular disease (59.1, 95% CI 54.8, 63.6). The multivariable-adjusted hazard ratio (95% CI) comparing individuals with LEAD and CHD and those with LEAD and cerebrovascular disease versus those with CHD and cerebrovascular disease was 1.48 (1.44, 1.53) and 1.49 (1.41, 1.58), respectively. Conclusion Among adults with vascular disease, having LEAD confers a higher risk for future ASCVD events than CHD or cerebrovascular disease and this group may benefit from more intensive risk reduction treatment. Acknowledgement/Funding Amgen Inc.

scholarly journals Sex Differences in Coronary Artery Calcium and Mortality from Coronary Heart Disease, Cardiovascular Disease, and All Causes in Adults with Diabetes: The Coronary Calcium Consortium

2020 ◽  
Author(s):  
Nathan D Wong ◽  
Amber R Cordola Hsu ◽  
Alan Rozanski ◽  
Leslee J Shaw ◽  
Seamus P. Whelton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Cox Regression ◽  
Total Mortality ◽  
Design And Methods ◽  
Cvd Mortality

<b>Objective:</b> While diabetes mellitus (DM) has been previously noted to be a stronger risk factor for cardiovascular disease (CVD) in women compared to men, it is not clear if this still the case. Coronary artery calcium (CAC) predicts coronary heart disease (CHD) and CVD in persons with DM; however, its sex-specific impact is less defined. We compared the relation of CAC in women versus men with DM for total, CVD, and CHD mortality. <p><b>Research Design and Methods:</b> We studied adults with DM from a large registry of patients with CAC scanning with mortality follow-up over 11.5 years. Cox regression examined the relation of CAC with mortality endpoints. </p> <p><b>Results:</b> Among 4,503 adults with DM (32.5% women) aged 21-93 years, 61.2% of women and 80.4% of men had CAC>0. Total, CVD, and CHD mortality rates were directly related to CAC; women had higher total and CVD death rates than men when CAC>100. Age and risk factor-adjusted hazard ratios (HRs) per log unit CAC were higher among women versus men for total (1.36 vs. 1.21) and CVD mortality (1.67 vs. 1.33) (interaction p=0.01 for both) but similar for CHD mortality (1.53 and 1.48). For CVD mortality, HR’s with CAC scores of 101-400 and >400 were 3.67 and 6.27, respectively for women and 1.63 and 3.48, respectively for men (interaction p=0.04). For total mortality HRs were 2.56 and 4.05 for women, respectively, and 1.88 and 2.66 for men, respectively (interaction p=0.01). </p> <p><b>Conclusion:</b> CAC predicts CHD, CVD, and all-cause mortality in patients with DM; however, greater CAC predicts CVD and total mortality more strongly in women.<b> </b></p>

scholarly journals Physical activity trajectories are associated with the risk of all-cause and cardiovascular disease mortality in patients with coronary heart disease. A systematic review and meta-analysis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
N Gonzalez ◽  
M Wilhelm ◽  
A Arango ◽  
V Gonzalez ◽  
C Mesa ◽  
...  
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Meta Analysis ◽  
Increased Activity ◽  
Over Time ◽  
Cvd Mortality

Abstract Background Current guidelines recommend that adults with chronic health conditions should engage in regular physical activity (PA), and avoid inactivity. Yet, the exact role of PA trajectories in the mortality risk of patients with coronary heart disease (CHD) remains unclear. Purpose We aimed to perform a systematic review and meta-analysis on the association of longitudinal trajectories of PA with all-cause and cardiovascular disease (CVD) mortality in patients with CHD. Methods We performed a systematic review and meta-analysis based on PRISMA statement. Six electronic databases were searched for cohort studies that analysed the association of PA trajectories (inactive over time, active over time, increased activity over time, and decreased activity over time) with the risk of all-cause and CVD mortality in patients with CHD. Study quality was evaluated by the Newcastle Ottawa scale. We used the inverse variance weighted method to combine summary measures using random-effects models to minimize the effect of between-study heterogeneity. The study is registered in PROSPERO. Results We meta-analyzed nine longitudinal cohorts involving 33,576 patients (25010 acute CHD, 8566 chronic CHD, mean age 62.5 years, 34% women, median follow-up duration 7.2 years), according to four PA trajectories. All studies assessed PA through validated questionnaires. The definitions of activity and inactivity at baseline and follow-ups were in agreement with current PA guidelines. Trajectories were calculated based on comparison of activity status at baseline and follow-up. All the studies defined increased activity over time as moving from the inactive to the active category, and decreased activity over time as moving from the active to the inactive category. Compared to patients remaining inactive over time, the lowest risk of all-cause and CVD mortality was observed in patients remaining active over time (HR [95% CI]: 0.50 [0.39–0.63] and 0.48 [0.35–0.68], respectively), followed by patients who increased their PA over time (HR [95% CI]:0.55 [0.44–0.7] and 0.63 [0.51–0.78], respectively), and patients who decreased activity over time (HR [95% CI]: 0.80 [0.64–0.99] and 0.91 [0.67–1.24], respectively). These results were consistent both in the acute and chronic CHD settings. The overall risk of bias was low, and no evidence of publication bias was observed. Multiple sensitivity analyses provided consistent results. Conclusions In patients with CHD, the risk of all-cause and CVD mortality is progressively reduced from being inactive over time, to decreased activity over time, to increased activity over time, to being active over time. These findings highlight the benefits of adopting a more physically active lifestyle in patients with chronic and acute CHD, independent of previous PA levels. Future studies should clarify the complex interactions between motivations and disease severity as potential drivers for PA trajectories FUNDunding Acknowledgement Type of funding sources: Public Institution(s). Main funding source(s): University of Bern

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

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