Feasibility and preliminary efficacy of a positive psychology-based intervention to promote health behaviors in heart failure: The REACH for Health study

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

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Abstract P011: Heart Failure and the Obesity Paradox Among Participants in the in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽

10.1161/circ.127.suppl_12.ap011 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Raegan W Durant ◽

Todd M Brown ◽

Emily B Levitan ◽

Joshua S Richman ◽

Nicole Redmond ◽

...

Keyword(s):

Heart Failure ◽

Health Behaviors ◽

Normal Weight ◽

Community Dwelling ◽

Prior History ◽

Central Adiposity ◽

All Cause Mortality ◽

History Of ◽

Regards Study

Background: Overweight and obese adults living with heart failure (HF) have lower mortality compared to those of normal weight. However, the specific relationships of overall weight status and central adiposity with mortality among those with HF are less well-defined. We examined the relationships among body mass index (BMI), waist circumference (WC) and mortality among patients hospitalized for HF in the REGARDS Study. Methods: REGARDS is a national cohort of US community-dwelling adults aged >45 recruited from 2003 to 2007. We measured all-cause mortality rates among 565 participants hospitalized with HF who were normal weight (BMI 18.5-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), or obese (BMI > 30.0 kg/m 2 ) at baseline. Underweight participants (BMI < 18.5 kg/m 2 ) were excluded. Baseline WC, weight, and height were measured during an in-home exam. Index HF hospitalizations during follow-up were adjudicated by a panel of experts. Vital status was determined using the Social Security Death Index or the National Death Index. Cox proportional models estimated hazard ratios for all-cause mortality following the index HF hospitalization. Models were sequentially adjusted for WC, sociodemographics, HF severity (EF and BNP during HF hospitalization, prior history of HF, prior history of diastolic dysfunction), comorbidities, and health behaviors. Results: Among 565 participants hospitalized for HF, 116 (21%) were normal weight, 209 (37%) overweight, and 240 (42%) obese at baseline. Over a mean follow-up of 2.5 years, 253 deaths occurred. In multivariable analyses, overweight was associated with lower all-cause mortality in all models (Table). Each 1-cm increase in WC was associated with higher risk of all-cause mortality, but the relationship was not statistically significant after health behaviors were added in the final model. . Conclusions: Among adults hospitalized for HF, overweight as assessed by BMI may be associated with lower risk for mortality. However, central adiposity may confer higher risk of mortality.

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Association Between Adiponectin and Heart Failure Risk in the Physicians' Health Study

Obesity ◽

10.1038/oby.2012.153 ◽

2012 ◽

Cited By ~ 1

Author(s):

Luc Djoussé ◽

Jemma B. Wilk ◽

Naomi Q. Hanson ◽

Robert J. Glynn ◽

Michael Y. Tsai ◽

...

Keyword(s):

Heart Failure ◽

Health Study ◽

Failure Risk

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Egg Consumption and Risk of Heart Failure in the Physicians’ Health Study

Circulation ◽

10.1161/circulationaha.107.734210 ◽

2008 ◽

Vol 117 (4) ◽

pp. 512-516 ◽

Cited By ~ 53

Author(s):

Luc Djoussé ◽

J. Michael Gaziano

Keyword(s):

Heart Failure ◽

Health Study ◽

Egg Consumption

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Dietary vitamin D and risk of heart failure in the Physicians' Health Study

Clinical Nutrition ◽

10.1016/j.clnu.2015.04.011 ◽

2016 ◽

Vol 35 (3) ◽

pp. 650-653 ◽

Cited By ~ 9

Author(s):

Jeremy Robbins ◽

Andrew B. Petrone ◽

J. Michael Gaziano ◽

Luc Djoussé

Keyword(s):

Heart Failure ◽

Vitamin D ◽

Health Study ◽

Dietary Vitamin ◽

Dietary Vitamin D

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Associations among Physical Activity, Diet, and Obesity Measures Change during Adolescence

Journal of Nutrition and Metabolism ◽

10.1155/2015/805065 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 6

Author(s):

Janne H. Maier ◽

Ronald Barry

Keyword(s):

Physical Activity ◽

Body Composition ◽

Health Behaviors ◽

Diet Quality ◽

Activity Patterns ◽

Health Study ◽

Blood Institute ◽

Age Related ◽

Juvenile Obesity ◽

Positive Correlations

Background. Obesity in youth is highly prevalent. Physical activity and diet are influential in obesity development. However, there is a knowledge gap regarding links between activity and diet quality and their combined influence on obesity during adolescence.Objectives. We used five years of data from 2379 adolescent girls in the National Heart Lung and Blood Institute Growth and Health Study to evaluate the association between physical activity and diet quality during adolescence and to assess both as correlates of obesity.Design. Diet, activity, and body composition measures were evaluated pairwise for correlation. A canonical correlation analysis was used to evaluate relationships within and between variable groups. All statistics were examined for trends over time.Results. We found positive correlations between physical activity and diet quality that became stronger with age. Additionally we discovered an age-related decrease in association between obesity correlates and body composition.Conclusion. These results suggest that while health behaviors, like diet and activity, become more closely linked during growth, obesity becomes less influenced by health behaviors and other factors. This should motivate focus on juvenile obesity prevention capitalizing on the pliable framework for establishing healthy diet and physical activity patterns while impact on body composition is greatest.

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Abstract P382: Fried Food Consumption is Associated with a Higher Risk of Heart Failure among US Male Physicians

Circulation ◽

10.1161/circ.131.suppl_1.p382 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Luc Djousse ◽

Andrew Petrone ◽

John M Gaziano

Keyword(s):

Heart Failure ◽

Food Intake ◽

Food Consumption ◽

Prospective Cohort ◽

Cox Regression ◽

Health Study ◽

Median Frequency ◽

Fried Food ◽

Hazard Ratios

Background: While previous studies have reported a positive relation of fried food consumption with type 2 diabetes, hypertension, and obesity, no previous study has examined the relation of total fried food intake with risk of heart failure (HF) in a prospective cohort. Objective: To test the hypothesis that fried food consumption is positively associated with risk of HF in male physicians. Methods: A prospective cohort of 19,968 participants from the Physicians’ Health Study. Frequency of fried food consumption was assessed between 1999 and 2002 using a food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted hazard ratios of HF. Results: During a median follow-up of 10.6 years, 862 cases of HF occurred. The mean age at baseline was 66.4 ± 9.2 years. Median frequency of fried food consumption was <1 time per week. Multivariable adjusted hazard ratios (95% CI) were: 1.0 (ref), 1.18 (1.01-1.37), 1.25 (1.02-1.54), and 1.68 (1.19-2.36) for fried food consumption of <1/week, 1-3/week, 4-6/week, and 7+/week, respectively (p for linear trend: 0.0004), after adjustment for age, alcohol use, smoking, exercise, and history of myocardial infarction, coronary artery bypass graph or angioplasty (Fig). Additional adjustment of total trans fats did not alter the findings. In a secondary analysis, body mass index did not modify the relation of fried foods with HF risk. Conclusions: Our data show a positive association between fried food intake and risk of HF in US male physicians.

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