371: CVD risk factors and lifestyle in the elderly – a three years' follow up: The PEP family heart study

ObjectivesWe examined the dose–response relationship between physical activity (PA) and incidence of cardiovascular disease (CVD) risk factors in adults in Taiwan.MethodsThis study included 1 98 919 participants, aged 18–97 years, free of CVD, cancer and diabetes at baseline (1997–2013), who were followed until 2016. At baseline, participants were classified into five PA levels: inactive’ (0 metabolic equivalent of task (MET)-h/week), ‘lower insufficiently active’ (0.1–3.75 MET-h/week), ‘upper insufficiently active’ (3.75–7.49 MET-h/week), ‘active’ (7.5–14.99 MET-h/week) and ‘highly active’ (≥15 MET-h/week]. CVD risk factors were assessed at baseline and at follow-up by physical examination and laboratory tests. Analyses were performed with Cox regression and adjusted for the main confounders.ResultsDuring a mean follow-up of 6.0±4.5 years (range 0.5–19 years), 20 447 individuals developed obesity, 19 619 hypertension, 21 592 hypercholesterolaemia, 14 164 atherogenic dyslipidaemia, 24 275 metabolic syndrome and 8548 type 2 diabetes. Compared with inactive participants, those in the upper insufficiently active (but not active) category had a lower risk of obesity (HR 0.92; 95% CI 0.88 to 0.95), atherogenic dyslipidaemia (0.96; 0.90 to 0.99), metabolic syndrome (0.95; 0.92 to 0.99) and type 2 diabetes (0.91; 0.86 to 0.97). Only highly active individuals showed a lower incidence of CVD risk factors than their upper insufficiently active counterparts.ConclusionCompared with being inactive, doing half the recommended amount of PA is associated with a lower incidence of several common biological CVD risk factors. Given these benefits, half the recommended amount of PA is an evidence based target for inactive adults.

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Impact of risk factors associated with cardiovascular outcomes in patients with rheumatoid arthritis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2017-211735 ◽

2017 ◽

Vol 77 (1) ◽

pp. 48-54 ◽

Cited By ~ 75

Author(s):

Cynthia S Crowson ◽

Silvia Rollefstad ◽

Eirik Ikdahl ◽

George D Kitas ◽

Piet L C M van Riel ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Total Cholesterol ◽

Smoking Prevalence ◽

Disease Activity Score ◽

Population Attributable Risk ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Impact

ObjectivesPatients with rheumatoid arthritis (RA) have an excess risk of cardiovascular disease (CVD). We aimed to assess the impact of CVD risk factors, including potential sex differences, and RA-specific variables on CVD outcome in a large, international cohort of patients with RA.MethodsIn 13 rheumatology centres, data on CVD risk factors and RA characteristics were collected at baseline. CVD outcomes (myocardial infarction, angina, revascularisation, stroke, peripheral vascular disease and CVD death) were collected using standardised definitions.Results5638 patients with RA and no prior CVD were included (mean age: 55.3 (SD: 14.0) years, 76% women). During mean follow-up of 5.8 (SD: 4.4) years, 148 men and 241 women developed a CVD event (10-year cumulative incidence 20.9% and 11.1%, respectively). Men had a higher burden of CVD risk factors, including increased blood pressure, higher total cholesterol and smoking prevalence than women (all p<0.001). Among the traditional CVD risk factors, smoking and hypertension had the highest population attributable risk (PAR) overall and among both sexes, followed by total cholesterol. The PAR for Disease Activity Score and for seropositivity were comparable in magnitude to the PAR for lipids. A total of 70% of CVD events were attributable to all CVD risk factors and RA characteristics combined (separately 49% CVD risk factors and 30% RA characteristics).ConclusionsIn a large, international cohort of patients with RA, 30% of CVD events were attributable to RA characteristics. This finding indicates that RA characteristics play an important role in efforts to reduce CVD risk among patients with RA.

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Western dietary pattern increases risk of cardiovascular disease in Iranian adults: a prospective population-based study

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0508 ◽

2017 ◽

Vol 42 (3) ◽

pp. 326-332 ◽

Cited By ~ 9

Author(s):

Parvin Mirmiran ◽

Zahra Bahadoran ◽

Azita Zadeh Vakili ◽

Fereidoun Azizi

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dietary Patterns ◽

Dietary Pattern ◽

Regression Models ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Western Dietary Pattern ◽

Increased Risk

Limited data are available regarding the association of major dietary patterns and risk of cardiovascular disease (CVD) in Middle Eastern countries. We aimed to evaluate the association of major dietary patterns, using factor analysis, with the risk of CVD. Participants without CVD (n = 2284) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 4.7 years. Dietary intake of participants was assessed at baseline (2006–2008); biochemical variables were evaluated at baseline and follow-up examination. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary pattern scores. Linear regression models were used to indicate association of dietary pattern scores with changes of CVD risk factors over the study period. Two major dietary patterns, Western and traditional, were identified. During a mean 4.7 ± 1.4 years of follow-up, 57 participants experienced CVD-related events. In the fully adjusted model, we observed an increased risk of CVD-related events in the highest compared to the lowest tertile category of Western dietary pattern score (HR = 2.07, 95% CI = 1.03–4.18, P for trend = 0.01). Traditional dietary pattern was not associated with incidence of CVD or CVD risk factors. A significant association was observed between the Western dietary pattern and changes in serum insulin (β = 5.88, 95% CI = 0.34–11.4). Our findings confirm that the Western dietary pattern, characterized by higher loads of processed meats, salty snacks, sweets, and soft drinks, is a dietary risk factor for CVD in the Iranian population.

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Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa015 ◽

2020 ◽

Vol 105 (5) ◽

pp. e2032-e2038 ◽

Cited By ~ 4

Author(s):

Viral N Shah ◽

Ryan Bailey ◽

Mengdi Wu ◽

Nicole C Foster ◽

Rodica Pop-Busui ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Type 1 Diabetes ◽

Diabetic Nephropathy ◽

The United States ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Impact

Abstract Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era.

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The contribution of stress to the social patterning of clinical and subclinical CVD risk factors in African Americans: The Jackson Heart Study

Social Science & Medicine ◽

10.1016/j.socscimed.2012.06.003 ◽

2012 ◽

Vol 75 (9) ◽

pp. 1697-1707 ◽

Cited By ~ 36

Author(s):

Samson Y. Gebreab ◽

Ana V. Diez-Roux ◽

DeMarc A. Hickson ◽

Shawn Boykin ◽

Mario Sims ◽

...

Keyword(s):

Risk Factors ◽

African Americans ◽

Jackson Heart Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Heart Study ◽

The Social ◽

Subclinical Cvd

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Tumor-necrosis Factor Inhibitors Improve Aortic Stiffness in Patients With Longstanding Rheumatoid Arthritis

10.21203/rs.3.rs-126056/v1 ◽

2020 ◽

Author(s):

Alessandro Giollo ◽

Giovanni Cioffi ◽

Federica Ognibeni ◽

Giovanni Orsolini ◽

Andrea Dalbeni ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Aortic Stiffness ◽

Term Treatment ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Long Term Treatment ◽

Necrosis Factor

Abstract Background. Major cardiovascular disease (CVD) benefits of disease-modifying anti-rheumatic drugs (DMARDs) therapy occur in early RA patients with treat-to-target strategy. However, it is unknown whether long-term DMARDs treatment in established RA could be useful to improve CVD risk profile.Methods. Ultrasound aortic stiffness index (AoSI) has to be considered a proxy outcome measure in established RA patients. We measured AoSI in a group of RA patients on long-term treatment with tumour necrosis factor inhibitors (TNFi) or conventional synthetic DMARDs (csDMARDs). Eligible participants were assessed at baseline and after 12 months; changes in serum lipids, glucose and arterial blood pressure were assessed. All patients were on stable medications during the entire follow-up. Results. We included 107 (64 TNFi and 43 csDMARDs) RA patients. Most patients (74%) were in remission or low disease activity and had some CVD risk factors (45.8% hypertension, 59.8% dyslipidemia, 45.3% smoking). The two groups did not differ significantly for baseline AoSI (5.95±3.73% vs 6.08±4.20%, p=0.867). Follow-up AoSI was significantly increased from baseline in the csDMARDs group (+1.00%; p<0.0001) but not in the TNFi group (+0.15%, p=0.477). Patients on TNFi had significantly lower follow-up AoSI from baseline than the csDMARD group (-1.02%, p<0.001; ANCOVA corrected for baseline AoSI, age and systolic blood pressure). Furthermore, follow-up AoSI was significantly lower in TNFi users with 1-2 or >2 CVD risk factors than in those without. Conclusion. Long-term treatment with TNFi was associated with reduced aortic stiffness in patients with established RA and several CVD risk factors.

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High prevalence of cardiovascular risk factors and insulin resistance 6 years after hyperglycemia first detected in pregnancy in Cape Town, South Africa

BMJ Open Diabetes Research & Care ◽

10.1136/bmjdrc-2019-000740 ◽

2019 ◽

Vol 7 (1) ◽

pp. e000740

Author(s):

Tawanda Chivese ◽

Shane A Norris ◽

Naomi S Levitt

Keyword(s):

Risk Factors ◽

Insulin Resistance ◽

Metabolic Syndrome ◽

Cape Town ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Index Pregnancy ◽

High Prevalence ◽

In Pregnancy

ObjectiveTo investigate the prevalence and associated cardiovascular risk factors 6 years after hyperglycemia first detected in pregnancy (HFDP) in Cape Town, South Africa.Research design and methodsData were collected during the index pregnancy from all women diagnosed with HFDP at a major referral hospital in Cape Town. Participants were evaluated 6 years later using a cross-sectional study. At follow-up participants had a 75 g oral glucose tolerance test, fasting lipogram, blood pressure and anthropometric measurements, and a fieldworker administered the questionnaire. We used the Adult Treatment Panel III criteria for the diagnosis of metabolic syndrome and individual risk factors. Insulin resistance was assessed using the homeostatic model of insulin resistance.ResultsAt follow-up 220 women were reviewed. Their mean age at follow-up was 37.2 (SD 6.0) years. The prevalence of cardiovascular disease (CVD) risk factors was 60.9% (95% CI 54.3 to 67.2) for metabolic syndrome, 75% (95% CI 65.9 to 82.3) for insulin resistance, 62.3% (95% CI 55.6 to 68.5) for dysglycemia, 41.4% (95% CI 35.0 to 48.0) for raised blood pressure, and 74.6% (95% CI 683 to 79.9) for dyslipidemia. Women with diabetes in pregnancy compared with those with gestational diabetes during the index pregnancy had a higher prevalence of metabolic syndrome (74.3% vs 54.7%, p=0.010) and dysglycemia (88.6% vs 50.0%, p<0.001) at follow-up. Lower school education attainment, having a subsequent pregnancy, waist circumference at follow-up, and fasting blood glucose at HFDP diagnosis were associated with metabolic syndrome.ConclusionWe found a high prevalence of CVD risk factors in South African women within 6 years of HFDP, which highlights the need to develop and evaluate interventions optimizing the cardiometabolic health of this vulnerable group. The main limitations of our research are the lack of a comparative group of women without HFDP and that we did not assess for CVD risk factors before HFDP.

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Abstract MP25: Is Surgical Menopause Associated With Future Cardiovascular Risk Factors Independent Of Antecedent Levels? The Cardia Study

Circulation ◽

10.1161/circ.129.suppl_1.mp25 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Duke Appiah ◽

Pamela J Schreiner ◽

Julie K Bower ◽

Barbara Sternfeld ◽

Cora E Lewis ◽

...

Keyword(s):

Risk Factors ◽

Rate Of Change ◽

Cvd Risk Factors ◽

Bilateral Oophorectomy ◽

Cvd Risk ◽

Natural Menopause ◽

Mean Values ◽

Index Visit ◽

Surgical Menopause

Objective: The aim of this study was to compare changes in selected CVD risk factors prior to and after natural or surgical (hysterectomy with or without bilateral oophorectomy) menopause. Methods: Data were obtained from women aged 18 to 30 years at baseline without hysterectomy enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study and followed for 25 years. Piecewise linear mixed effects models were used to examine changes in waist circumference (WC) and HDL-cholesterol (HDL-c) from baseline to index visit (first visit after the date of natural or surgical menopause) and after index visit to the end of observation. Results: During follow up, 639 women reached natural menopause (NM), 304 reported hysterectomy with one or both ovaries conserved (HO) and 153 reported hysterectomy with bilateral oophorectomy (HBO). Baseline mean values of WC were 73.9, 76.4, 75.9 cm, p=0.005 for NM, HO, and HBO respectively while those for HDL-c were 57.6, 54.6, 54.2 mg/dL, p=0.001. After adjustment for race, education, field center, traditional CVD risk factors, lipid-lowering medication, age at and time since menopause, the mean values of WC at the index visit were 88.8, 92.4, 92.0 cm, p=0.001 for NM, HO, and HBO respectively while those for HDL-c were 61.5, 57.0, 57.8 mg/dL, p=0.006. Compared to women with natural menopause, surgically menopausal women (regardless of ovarian status) had higher annual rate of change for WC (0.74 vs. 0.63 cm, p=0.002) as well as lower rate of change for HDL-c (0.15 vs. 0.30 mg/dL, p=0.001) from baseline to index visit. No statistically significant differences in the annual rate of change after index visit to the end of follow up were observed between these two groups for either WC or HDL-c. Conclusion: While surgical menopause is commonly believed to worsen CVD risk, in this population-based sample, we found that women who undergo hysterectomy with or without bilateral oophorectomy had more adverse values for central adiposity and lipids at baseline compared to women with natural menopause. However, antecedent risk factor levels were strongly associated with postmenopausal levels in all women.

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Abstract P291: Psychosocial Factors are Associated with Cardiovascular Disease among African Americans in the Jackson Heart Study

Circulation ◽

10.1161/circ.129.suppl_1.p291 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Mario Sims ◽

Marino Bruce ◽

Sharon Wyatt ◽

Tom Mosley ◽

Daniel Sarpong ◽

...

Keyword(s):

Risk Factors ◽

Negative Affect ◽

Psychosocial Factors ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Major Life Events ◽

Major Life ◽

Heart Study ◽

The Mean ◽

Global Stress

Introduction: African Americans (AA) have a higher risk for cardiovascular disease (CVD) than Whites. This disparity has been attributed to risk factors such as hypertension, diabetes, and obesity. This disparity has also been attributed to psychosocial factors across groups. Using Jackson Heart Study (JHS) data, we examined the associations of negative affect and stress measures with CVD risk factors and prevalent CVD among AA. Hypothesis: Negative affect and stress measures are associated with prevalent CVD risk factors and CVD among men and women in the JHS. Methods: Cross-sectional associations of negative affect (cynicism, anger in, anger out, and depressive symptoms) and stress (global stress, weekly stress, and major life events) with prevalent BMI, hypertension, diabetes and CVD were examined among 5,301 participants 34-85 years old (women=3,360; men=1,941). We estimated mean differences in BMI and prevalence ratios (PR) of hypertension, diabetes and CVD with measures of negative affect and stress and adjusted for demographic and clinical risk factors. Results: Men had higher cynical distrust and anger in scores than women (p<.05). Women had higher depressive symptoms, global stress, weekly stress and major life event scores than men (p<.05). After adjustment for age, sex, education, behaviors and risk factors, each psychosocial factor (except anger out and weekly stress-event) was associated with an increased mean average of BMI. For example, the mean difference in BMI increased by 41% for each 1 SD increase in cynical distrust (p<.01); and the mean difference in BMI increased by 45% for each 1 SD increase in global stress (p<.01). In fully-adjusted models, global perceived stress was associated with prevalent hypertension and diabetes (PR for hypertension: 1.07, 95%CI 1.00,1.07; PR for diabetes: 1.24, 95%CI 1.04, 1.47). Major life events were also associated with hypertension and diabetes. Each psychosocial measure (except cynicism and anger in) was associated with prevalent CVD. Conclusion: Efforts to reduce disparities in CVD may need to address environmental and psychosocial factors that place AA at higher risk.

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