scholarly journals Cardiovascular mortality risk in young adults with isolated systolic hypertension: findings from population-based MONICA/KORA cohort study

2021 ◽  
Author(s):  
Atasoy Seryan ◽  
Middeke Martin ◽  
Johar Hamimatunnisa ◽  
Peters Annette ◽  
Heier Margit ◽  
...  
Keyword(s):  
Young Adults ◽  
Systolic Hypertension ◽  
Antihypertensive Medication ◽  
Population Based ◽  
Protective Effects ◽  
Isolated Systolic Hypertension ◽  
Cvd Risk ◽  
Increased Risk ◽  
Cvd Mortality

AbstractThe clinical significance of isolated systolic hypertension in young adults (ISHY) remains a topic of debate due to evidence ISHY could be a spurious condition resulting from exageratted pulse pressure amplification in “young tall men with elastic arteries”. Hence, we aimed to investigate whether ISHY is associated with an increased risk of cardivascular (CVD) mortality in a sample of 5597 young adults (49.8% men, 50.2% women) between 25 and 45 years old from the prospective population-based MONICA/KORA cohort. ISHY was prevalent in 5.2% of the population, affecting mostly men (73.1%), and associated with increased smoking, obesity, and hypercholesterolemia in comparison to participants with normal blood pressure (BP). Within a follow-up period of 25.3 years (SD ± 5.2; 141,768 person–years), 133(2.4%) CVD mortality cases were observed. Participants with ISHY had a hazard ratio (HR) of 1.89(1.01–3.53, p < 0.05) times higher risk of CVD mortality than participants with normal BP, even following adjustment for CVD risk factors. However, adjustment for antihypertensive medication (HR 0.46; 0.26–0.81, p < 0.001) and increasing height (HR 0.96; 0.93–0.99, p < 0.05) revealed independently protective effects against CVD mortality, suggesting that although ISHY is associated with an increased risk of CVD mortality, the protective effects of increasing height or antihypertensive medication should be considered in treatment rationale.

scholarly journals Obesity, Abdominal Obesity and Chronic Kidney Disease in Young Adults: A Nationwide Population-Based Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 1065
Author(s):  
Eun Hui Bae ◽  
Sang Yeob Lim ◽  
Jin-Hyung Jung ◽  
Tae Ryom Oh ◽  
Hong Sang Choi ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Young Adults ◽  
Kidney Disease ◽  
Abdominal Obesity ◽  
Population Based ◽  
Baseline Body Mass Index ◽  
Increased Risk ◽  
Baseline Examination ◽  
New Onset

Obesity has become a pandemic. It is one of the strongest risk-factors of new-onset chronic kidney disease (CKD). However, the effects of obesity and abdominal obesity on the risk of developing CKD in young adults has not been elucidated. From a nationwide health screening database, we included 3,030,884 young adults aged 20–39 years without CKD during a baseline examination in 2009–2010, who could follow up during 2013–2016. Patients were stratified into five levels based on their baseline body mass index (BMI) and six levels based on their waist circumference (WC; 5-cm increments). The primary outcome was the development of CKD. During the follow up, until 2016, 5853 (0.19%) participants developed CKD. Both BMI and WC showed a U-shaped relationship with CKD risk, identifying the cut-off values as a BMI of 21 and WC of 72 cm in young adults. The obesity group (odd ratio [OR] = 1.320, 95% confidence interval [CI]: 1.247–1.397) and abdominal obesity group (male WC ≥ 90, female WC ≥ 85) (OR = 1.208, 95%CI: 1.332–1.290) showed a higher CKD risk than the non-obesity or non-abdominal obesity groups after adjusting for covariates. In the CKD risk by obesity composite, the obesity displayed by the abdominal obesity group showed the highest CKD risk (OR = 1.502, 95%CI: 1.190–1.895), especially in those under 30 years old. During subgroup analysis, the diabetes mellitus (DM) group with obesity or abdominal obesity paradoxically showed a lower CKD risk compared with the non-obesity or non-abdominal obesity group. Obesity and abdominal obesity are associated with increased risk of developing CKD in young adults but a decreased risk in young adults with diabetes.

scholarly journals Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 588
Author(s):  
Imran Khan ◽  
Minji Kwon ◽  
Nitin Shivappa ◽  
James R. Hébert ◽  
Mi Kyung Kim
Keyword(s):  
Cardiovascular Disease ◽  
Positive Association ◽  
Population Based ◽  
Proportional Hazard ◽  
Dietary Inflammatory Index ◽  
Cvd Risk ◽  
Inflammatory Index ◽  
Cox Proportional Hazard ◽  
Increased Risk

Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]Quintile 5 vs. 1 1.43; 95% CI 1.04–1.96) and in women (HRQuintile 5 vs. 1 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HRQuintile 5 vs. 1 1.80; 95% CI 1.03–3.12), obese men (HRQuintile 5 vs. 1 1.77; 95% CI 1.13–2.76) and men who smoked (HRQuintile 5 vs. 1 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HRQuintile 5 vs. 1 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.

scholarly journals Frailty index as a predictor of all-cause and cause-specific mortality in a Swedish population-based cohort

2017 ◽  
Author(s):  
M Jiang ◽  
AD Foebel ◽  
R Kuja-Halkola ◽  
I Karlsson ◽  
NL Pedersen ◽  
...  
Keyword(s):  
Frailty Index ◽  
Population Based ◽  
Swedish Population ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Specific Mortality ◽  
Younger Men ◽  
Cvd Mortality

AbstractBackgroundFrailty is a complex manifestation of aging and associated with increased risk of mortality and poor health outcomes. Younger individuals (under 65 years) typically have low levels of frailty and are less-studied in this respect. Also, the relationship between the Rockwood frailty index (FI) and cause-specific mortality in community settings is understudied.MethodsWe created and validated a 42-item Rockwood-based FI in The Swedish Adoption/Twin Study of Aging (n=1477; 623 men, 854 women; aged 29-95 years) and analyzed its association with all-cause and cause-specific mortality in up to 30-years of follow-up. Deaths due to cardiovascular disease (CVD), cancer, dementia and other causes were considered as competing risks.ResultsOur FI demonstrated construct validity as its associations with age, sex and mortality were similar to the existing literature. The FI was independently associated with increased risk for all-cause mortality in younger (<65 years; HR per increase in one deficit 1.11, 95%CI 1.07-1.17) and older (≥65 years; HR 1.07, 95%CI 1.04-1.10) women and in younger men (HR 1.05, 95%CI 1.01-1.10). In cause-specific mortality analysis, the FI was strongly predictive of CVD mortality in women (HR per increase in one deficit 1.13, 95%CI 1.09-1.17), whereas in men the risk was restricted to deaths from other causes (HR 1.07, 95%CI 1.01-1.13).ConclusionsThe FI showed good predictive value for all-cause mortality especially in the younger group. The FI predicted CVD mortality risk in women, whereas in men it captured vulnerability to death from various causes.

scholarly journals Isolated Systolic Hypertension and the Long-Term Risk of Stroke: A 20-Year follow-up of the National Health and Nutrition Survey.

Stroke ◽  
2001 ◽  
Vol 32 (suppl_1) ◽  
pp. 363-363
Author(s):  
Yousef M Mohammad ◽  
Adnan Qureshi ◽  
M Fareed K Suri ◽  
Zulfiqar Ali ◽  
Lee R Guterman ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Intracerebral Hemorrhage ◽  
National Health ◽  
Systolic Hypertension ◽  
Isolated Systolic Hypertension ◽  
Stroke Subtypes ◽  
Health And Nutrition ◽  
Increased Risk

P133 Background and Purpose: Isolated systolic hypertension (ISH) is frequently observed in elderly persons. The effect of ISH on the long-term risk for stroke and stroke subtypes is unclear. We performed this study to evaluate the long-term risk of stroke in persons with ISH. METHODS: We evaluated the incidence of stroke and stroke subtypes(ischemic and hemorrhagic) in a nationally representative cohort of 14,047 adults who participated in the First National Health and Nutrition Examination Survey during the 20-year follow-up. ISH was defined as a systolic blood pressure(BP)>160mmHg and diastolic BP<90mmHg. RESULTS: A total of 376 persons with ISH, 8985 persons with normotension, and 4686 persons with classic hypertension were followed. During the follow-up period, the annual incidences of ischemic stroke and intracerebral hemorrhage for patients with ISH were 1.7% and .05% respectively. After adjusting for differences in age, race,and gender, the risk for ischemic stroke was increased in persons with ISH compared to persons with normotension (odds ratio [OR]=1.6, 95% confidence interval [CI]=1.1 to 2.2). The increased risk was similar to persons with classic hypertension (OR=1.3, 95% CI=1.03 to 1.6). The risk of intracerebral hemorrhage was increased in persons with classic hypertension (OR=3.0, 95% CI=1.5 to 7.1) but not in persons with ISH (OR=0.7, 95% CI=0.1 to 2.3). CONCLUSION: Persons with ISH are at increased risk for ischemic stroke, similar to those with classic hypertension.

Abstract 14731: Association of Longitudinal Changes in CRP, IL-6, and Fibrinogen Level With Cardiovascular Disease Events: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Hooman Bakhshi ◽  
Mohammad R Ostovaneh ◽  
Bharath Ambale Venkatesh ◽  
Matthew Allison ◽  
David Herrington ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Population Based ◽  
Inflammatory Biomarkers ◽  
Cvd Risk ◽  
Longitudinal Changes ◽  
Inflammatory Biomarker ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

Background: Inflammatory biomarkers have been used for cardiovascular disease (CVD) risk stratification. However, the relevance of longitudinal changes in levels of these biomarkers in relation to CVD is unclear. Methods: MESA is a population-based cohort consisting of 6814 participants free of symptomatic cardiovascular disease at baseline. We included all participants who had blood assayed for measurement of inflammatory biomarkers - C-reactive protein (CRP), Interleukin-6 (IL-6), and fibrinogen measured at baseline and follow-up 2-4 years later (n=1,362). Coronary heart disease (CHD) was assessed as any of myocardial infarction, resuscitated cardiac arrest, definite angina, probable angina (if followed by revascularization) and CHD death. CVD was considered a composite of CHD, stroke, stroke death, atherosclerotic death and CVD death. Cox proportional hazard regression analysis was used to assess the association of annual longitudinal changes in inflammatory biomarker level and time to first CHD and CVD event after adjustment for traditional risk factors and demographics. Results: The mean (SD) age was 61.6 (9.8) years and 55% were male. Over 8.6 median (IQR, 8.4-9.3) years of follow-up, there were 87 CHD and 121 CVD events. The median (IQR) CRP (mg/L), IL-6 (pg/ml) and fibrinogen (mg/dl) levels at baseline were 1.74(0.82-3.95) 1.11(0.71-1.72) and 332(292-382); and at follow-up were 1.4(0.69-3.03), 1.76(1.16-2.72) and 421(371-476). An increase in IL6 of 1 pg/mL/year was associated with a 26% increased risk of total CVD events independent of risk factors, while an increase of 1 mg/L/year of CRP was independently associated with a 7% and 6% increased risk of both CHD and CVD events respectively. There were no significant associations with changes in fibrinogen. Conclusion: Longitudinal increases in the inflammatory biomarkers CRP and IL6 are associated with higher risk of future cardiovascular events in a multi-ethnic population.

Abstract MP089: Cardiovascular Protection Profile and All-cause and CVD Mortality among U.S. Adults

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Quanhe Yang ◽  
Mary Cogswell ◽  
W. Dana Flanders ◽  
Yuling Hong ◽  
Zefeng Zhang ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Disease Incidence ◽  
Population Attributable Fraction ◽  
Population Based ◽  
Normal Blood ◽  
Cvd Risk ◽  
Incidence And Mortality ◽  
Reduced Risk ◽  
Cvd Mortality

Introduction: Epidemiologic studies suggest that multiple cardiovascular (CVD) protection-factors (i.e., non-smoking, physically active, normal blood pressure, normal blood glucose, normal total cholesterol, non-obese, and healthy diet) are associated with significantly reduced risk of cardiovascular disease incidence and mortality. Hypothesis: We assessed the hypothesis that the increased number of CVD protection-factors is associated with reduced risk for all-cause and CVD mortality and adherence to low CVD risk profile could result in significant lower rates of all-cause and CVD mortality. Methods: We used the Third National Health and Nutrition Examination Survey (NHANES III 1988-1994) Linked Mortality File (through 2006), a prospective cohort study of a nationally representative sample of 12,861 U.S. adults to examine the prevalence, associations, and population attributable fraction (PAF) of seven CVD protection-factors in relation to risk of all-cause and CVD mortality. Results: Only 3.1% of U.S. adults had all seven CVD protection-factors. The average follow-up was 14.5 years. After multivariable adjustment for potential confounders, hazard ratios (HR) were: 0.30 (95% CI 0.22-0.40), 0.21 (0.12-0.34), and 0.17 (0.09-0.32), comparing individuals with ≥six protection-factors to those with ≤one protection-factors for all-cause, CVD, and IHD mortality respectively. Elevated blood pressure was responsible for the largest number of all-cause and CVD death followed by smoking and poor diet. Overall, 59% (95% CI 27-78) of total deaths and 66% (95% CI 22-88) CVD death would have been avoided during the average of 14.5 years follow-up if the population were changed to the high CVD protection-factors status (with ≥six protection-factors). Conclusions: Few adults in this U.S.-based study population had all seven desirable CVD protection-factors. The presence of an increasing number of CVD protection-factors was associated with a progressively lower risk of total and CVD mortality. Comprehensive population-based initiatives are needed to improve modifiable CVD risk factors, resulting in substantial reductions of all-cause and CVD mortality in the U.S. population.

scholarly journals Association between blood pressure categories and cardiovascular disease mortality in China

PLoS ONE ◽  
2021 ◽  
Vol 16 (7) ◽  
pp. e0255373
Author(s):  
Jie Guo ◽  
Jun Lv ◽  
Yu Guo ◽  
Zheng Bian ◽  
Bang Zheng ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cox Regression ◽  
Cvd Risk ◽  
Hazard Ratios ◽  
Disease Mortality ◽  
Increased Risk ◽  
Diastolic Hypertension ◽  
High Prevalence ◽  
Cvd Mortality

Background Blood pressure (BP) categories are useful to simplify preventions in public health, and diagnostic and treatment approaches in clinical practice. Updated evidence about the associations of BP categories with cardiovascular diseases (CVDs) and its subtypes is warranted. Methods and findings About 0.5 million adults aged 30 to 79 years were recruited from 10 areas in China during 2004–2008. The present study included 430 977 participants without antihypertension treatment, cancer, or CVD at baseline. BP was measured at least twice in a single visit at baseline and CVD deaths during follow-up were collected via registries and the national health insurance databases. Multivariable Cox regression was used to estimate the associations between BP categories and CVD mortality. Overall, 16.3% had prehypertension-low, 25.1% had prehypertension-high, 14.1% had isolated systolic hypertension (ISH), 1.9% had isolated diastolic hypertension (IDH), and 9.1% had systolic-diastolic hypertension (SDH). During a median 10-year follow-up, 9660 CVD deaths were documented. Compared with normal, the hazard ratios (95% CI) of prehypertension-low, prehypertension-high, ISH, IDH, SDH for CVD were 1.10 (1.01–1.19), 1.32 (1.23–1.42), 2.04 (1.91–2.19), 2.20 (1.85–2.61), and 3.81 (3.54–4.09), respectively. All hypertension subtypes were related to the increased risk of CVD subtypes, with a stronger association for hemorrhagic stroke than for ischemic heart disease. The associations were stronger in younger than older adults. Conclusions Prehypertension-high should be considered in CVD primary prevention given its high prevalence and increased CVD risk. All hypertension subtypes were independently associated with CVD and its subtypes mortality, though the strength of associations varied substantially.

Lipoprotein-Associated Phospholipase A2 and Risk of Carotid Atherosclerosis and Cardiovascular Events in Community-Based Older Adults in China

Angiology ◽  
2017 ◽  
Vol 69 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Chunxiu Wang ◽  
Xianghua Fang ◽  
Yang Hua ◽  
Yutong Liu ◽  
Zhongying Zhang ◽  
...  
Keyword(s):  
Older Adults ◽  
Carotid Artery ◽  
Phospholipase A2 ◽  
Carotid Atherosclerosis ◽  
Cvd Risk ◽  
Community Based ◽  
Chinese Older Adults ◽  
Increased Risk ◽  
Cvd Mortality

We explored the associations between lipoprotein-associated phospholipase A2 (Lp-PLA2) level and carotid atherosclerosis with all phenotypes and cardiovascular disease (CVD) events in Chinese older adults. A total of 1257 adults aged ≥55 years who were free of CVD were enrolled in this cohort study. Lipoprotein-associated phospholipase A2 level was evaluated in 3 categories: Lp-PLA2 < 175, 175≤ Lp-PLA2 < 223, and Lp-PLA2 ≥ 223 ng/mL. The highest level of Lp-PLA2 was independently associated with common carotid artery intima-media thickening (≥1.0 mm; odds ratio [OR]: 1.60, 95% confidence interval [CI]: 1.14-2.26) and carotid plaque (OR: 1.42, 95% CI: 1.01-1.99) in individuals without carotid artery stenosis. At the end of the 5-year follow-up, after adjustment for CVD risk factors and carotid atherosclerosis status, Lp-PLA2 had remained an independent predictor for myocardial infarction (MI; hazard ratio [HR]: 1.90, 95% CI: 1.02-3.55) and CVD death (HR: 1.78, 95% CI: 1.02-3.13). However, no association was found with stroke. Therefore, elevated Lp-PLA2 level in the older adults studied was associated with an increased risk of carotid atherosclerosis and MI and CVD mortality. Lipoprotein-associated phospholipase A2 assessment might be used for MI and CVD death risk prediction.

scholarly journals Association of BMI with risk of CVD mortality and all-cause mortality

2017 ◽  
Vol 20 (7) ◽  
pp. 1226-1234 ◽  
Author(s):  
Chee Cheong Kee ◽  
Mohd Ghazali Sumarni ◽  
Kuang Hock Lim ◽  
Sharmini Selvarajah ◽  
Jamaiyah Haniff ◽  
...  
Keyword(s):  
Dietary Habits ◽  
Cox Regression ◽  
Population Based ◽  
Mortality Data ◽  
Positive Trend ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Never Smokers ◽  
Cvd Mortality

AbstractObjectiveTo determine the relationship between BMI and risk of CVD mortality and all-cause mortality among Malaysian adults.DesignPopulation-based, retrospective cohort study. Participants were followed up for 5 years from 2006 to 2010. Mortality data were obtained via record linkages with the Malaysian National Registration Department. Multiple Cox regression was applied to compare risk of CVD and all-cause mortality between BMI categories adjusting for age, gender and ethnicity. Models were generated for all participants, all participants the first 2 years of follow-up, healthy participants, healthy never smokers, never smokers, current smokers and former smokers.SettingAll fourteen states in Malaysia.SubjectsMalaysian adults (n 32 839) aged 18 years or above from the third National Health and Morbidity Survey.ResultsTotal follow-up time was 153 814 person-years with 1035 deaths from all causes and 225 deaths from CVD. Underweight (BMI<18·5 kg/m2) was associated with a significantly increased risk of all-cause mortality, while obesity (BMI ≥30·0 kg/m2) was associated with a heightened risk of CVD mortality. Overweight (BMI=25·0–29·9 kg/m2) was inversely associated with risk of all-cause mortality. Underweight was significantly associated with all-cause mortality in all models except for current smokers. Overweight was inversely associated with all-cause mortality in all participants. Although a positive trend was observed between BMI and CVD mortality in all participants, a significant association was observed only for severe obesity (BMI≥35·0 kg/m2).ConclusionsUnderweight was associated with increased risk of all-cause mortality and obesity with increased risk of CVD mortality. Therefore, maintaining a normal BMI through leading an active lifestyle and healthy dietary habits should continue to be promoted.

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