The impact of cardiovascular risk factors on global longitudinal strain over a decade in the general population: the copenhagen city heart study

Abstract Background Global longitudinal strain (GLS) of the left ventricle (LV) has proved to be a strong predictor of cardiovascular morbidity and mortality. GLS declines throughout adult-life as the LV remodels and adapts. Information on the impact of cardiac risk factors such as male sex, obesity, smoking status, hypertension, hypercholesterolemia, and diabetes on GLS through time has not yet been investigated. Purpose The aim of the present study was to investigate the impact of age, sex, body mass index (BMI), smoking status (current and previous vs never), mean arterial blood pressure (MAP), total plasma cholesterol (TPC), and HbA1c on GLS in the general population over a 10-year period. Method A total of 689 citizens recruited from the general population participated in the 4th and 5th Copenhagen City Heart Study (CCHS4 and CCHS5) a prospective longitudinal study. At CCHS4 the mean age was 51 years and 45% were male. The average decline in GLS during the follow-up period was −0.65%. All participants underwent two echocardiographic examinations median 10.4 [IQR: 10.2, 10.9] years apart along with thorough health examinations. All analyses were adjusted for baseline GLS value (CCHS4 value). Results In regression models, increasing age, male sex, increasing BMI, MAP, hypertension, increasing HbA1c, and diabetes proved to be significantly associated with increased decline in GLS. Relationship between significant continuous cardiovascular risk factors and ΔGLS are displayed in restricted spline curves (Figure 1). In a multivariable regression model including all the investigated cardiovascular risk factors, estimated glomerular filtration rate, plasma pro B-type natriuretic peptide, heart rate, and previous ischemic heart disease, age (standardized β-coef. = −0.10, P=0.005), male sex (standardized β-coef. = −0.16, P<0.001), and MAP (standardized β-coef. = −0.07, P=0.009) remained independent predictors of an accelerated decline in GLS during a 10-year period. Restricted cubic spline curves Conclusion In the general population increasing age, male sex, and increasing MAP are all independently associated with an accelerated decline in GLS over a 10-year period.

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Abstract 003: Change in Cardiovascular Risk Factors Associated with Weight Gain in the Dallas Heart Study

Circulation ◽

10.1161/circ.125.suppl_10.a003 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Tiffany M Powell ◽

Colby R Ayers ◽

James A de Lemos ◽

Amit Khera ◽

Susan G Lakoski ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Weight Gain ◽

Cardiovascular Risk Factors ◽

Average Weight ◽

Men And Women ◽

Significant Weight Gain ◽

Heart Study ◽

Dallas Heart Study ◽

The Impact

Background: Concerning trends in weight gain from 2000-2009 exist in the Dallas Heart Study (DHS), a probability-based sample of Dallas County residents aged 30-65. However, the impact of significant weight gain (≥ 5% increase in body weight) on cardiovascular risk factors (CVRF) in this contemporary, multi-ethnic population is not known. Methods: We measured weight, LDL-c, blood pressure (SBP and DBP), and fasting glucose (FG) in 2,022 DHS participants (58% female) at study entry in 2000 and in 2009. Using logistic regression stratified by sex and race/ethnicity, we determined the age-adjusted odds of worsening CVRF (any increase in LDL-c, SBP, DBP or FG) for people who gained significant weight compared to those who did not. Results: Among women, 43% (N=500) gained significant weight, compared to 42% of men (N=355). Despite similar average weight gain (9.7±5.8 kg for women vs. 10±5.6 kg for men, p=0.4), women who gained significant weight had almost twice as large an increase in LDL-c (14±34 vs. 8±39 mg/dl, p=0.01) and SBP (12±18 vs. 6±19 mmHg, p<0.001) compared with men who gained significant weight. Increases in DBP (5±10 vs. 4±11 mmHg, p=0.05) and FG (4±29 vs. 2±32 mg/dl, p=0.30) were not significantly different between men and women. Among those with significant weight gain who were not on medications, SBP and LDL-c increases were higher in women compared with men (p<0.05). Differences in the amount of weight gained stratified by race and sex were modest (Table). Black women who gained significant weight were likely to have a worsening of all CVRF, while Hispanic women had the highest likelihood of having an increase in SBP associated with weight gain. In contrast, significant weight gain among men was not associated with worsening CVRF. Conclusions: Significant weight gain was associated with a deleterious impact on CVRF among women but not men. Disparate effects of weight gain between men and women highlight the importance of targeting aggressive weight control interventions toward women to help prevent adverse cardiac outcomes.

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