scholarly journals Serial measures of circulating biomarkers of dairy fat and total and cause-specific mortality in older adults: the Cardiovascular Health Study

2018 ◽  
Vol 108 (3) ◽  
pp. 476-484 ◽  
Author(s):  
Marcia C de Oliveira Otto ◽  
Rozenn N Lemaitre ◽  
Xiaoling Song ◽  
Irena B King ◽  
David S Siscovick ◽  
...  
Keyword(s):  
Older Adults ◽  
Total Mortality ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Heptadecanoic Acid ◽  
Stroke Mortality ◽  
Dairy Fat ◽  
Specific Mortality ◽  
Cvd Mortality

ABSTRACT Background Controversy has emerged about the benefits compared with harms of dairy fat, including concerns over long-term effects. Previous observational studies have assessed self-reported estimates of consumption or a single biomarker measure at baseline, which may lead to suboptimal estimation of true risk. Objective The aim of this study was to investigate prospective associations of serial measures of plasma phospholipid fatty acids pentadecanoic (15:0), heptadecanoic (17:0), and trans-palmitoleic (trans-16:1n–7) acids with total mortality, cause-specific mortality, and cardiovascular disease (CVD) risk among older adults. Design Among 2907 US adults aged ≥65 y and free of CVD at baseline, circulating fatty acid concentrations were measured serially at baseline, 6 y, and 13 y. Deaths and CVD events were assessed and adjudicated centrally. Prospective associations were assessed by multivariate-adjusted Cox models incorporating time-dependent exposures and covariates. Results During 22 y of follow-up, 2428 deaths occurred, including 833 from CVD, 1595 from non-CVD causes, and 1301 incident CVD events. In multivariable models, circulating pentadecanoic, heptadecanoic, and trans-palmitoleic acids were not significantly associated with total mortality, with extreme-quintile HRs of 1.05 for pentadecanoic (95% CI: 0.91, 1.22), 1.07 for heptadecanoic (95% CI: 0.93, 1.23), and 1.05 for trans-palmitoleic (95% CI: 0.91, 1.20) acids. Circulating heptadecanoic acid was associated with lower CVD mortality (extreme-quintile HR: 0.77; 95% CI: 0.61, 0.98), especially stroke mortality, with a 42% lower risk when comparing extreme quintiles of heptadecanoic acid concentrations (HR: 0.58; 95% CI: 0.35, 0.97). In contrast, heptadecanoic acid was associated with a higher risk of non-CVD mortality (HR: 1.27; 95% CI: 1.07, 1.52), which was not clearly related to any single subtype of non-CVD death. No significant associations of pentadecanoic, heptadecanoic, or trans-palmitoleic acids were seen for total incident CVD, coronary heart disease, or stroke. Conclusions Long-term exposure to circulating phospholipid pentadecanoic, heptadecanoic, or trans-palmitoleic acids was not significantly associated with total mortality or incident CVD among older adults. High circulating heptadecanoic acid was inversely associated with CVD and stroke mortality and potentially associated with higher risk of non-CVD death.

Abstract MP06: Circulating Fatty Acids in the De Novo Lipogenesis Pathway and Total and Cause-Specific Mortality Among Older Adults: The Cardiovascular Health Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Heidi T Lai ◽  
Marcia C de Oliveira Otto ◽  
Jason H Wu ◽  
Yujin Lee ◽  
Xiaoling Song ◽  
...  
Keyword(s):  
Older Adults ◽  
Fatty Acids ◽  
De Novo ◽  
Total Mortality ◽  
De Novo Lipogenesis ◽  
Cardiovascular Health Study ◽  
Specific Mortality ◽  
Changes Over Time ◽  
Over Time

De novo lipogenesis (DNL) is a crucial metabolic pathway that convert excess carbohydrates to fatty acids (FA) for energy and storage. Both DNL and the synthesized FA have biologic effects that may affect cardiometabolic risk. Yet, the association between DNL FA and mortality and CVD are not well-established in older adults, especially using serial biomarkers which objectively allow more accurate estimates of long-term FA exposure, as well as changes over time. We investigated the longitudinal association between serial levels of circulating DNL FA and total mortality, cause-specific mortality, and total CVD among 3,869 older U.S. adults (mean age 75 y) free of prevalent CVD at baseline. Levels of plasma phospholipid palmitic (16:0), palmitoleic (16:1n-7), stearic (18:0), and oleic acid (18:1n-9) were quantified at baseline, year 6, and year 13. Outcomes were centrally adjudicated using multiple sources. Risk was assessed in multivariable-adjusted Cox models with time-varying FA and covariates. During 46,974 person-years, 3,227 deaths (including 1,131 from CVD, 2,096 from non-CVD causes) and 1,754 incident total CVD events occurred. After multivariable-adjustment, cumulative levels of 16:0, 16:1n-7 and 18:1n-9 were each positively, while 18:0 was inversely, associated with total mortality ( Table ). Associations were generally similar for CVD vs. non-CVD mortality, and vs. total incident CVD (not shown). Among non-CVD deaths, associations for dementia and pulmonary deaths were generally similar to total mortality; while only 16:0 and 18:1n-9 were positively associated with cancer mortality. Higher long-term levels of circulating 16:0, 16:1n-7 and 18:1n-9 were positively, while 18:0 was inversely, associated with total mortality in older adults. Novel findings highlight the potential relevance of DNL later in life, and the need for further experimental research and interventions on the relevant underlying physiology and long-term health effects of DNL FA. Findings for FA changes over time to be presented.

Abstract MP35: Physical Activity Before and After Cancer Diagnosis and Total and Cause-Specific Mortality

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Paulette D Chandler ◽  
Deirdre Tobias ◽  
Jule E Buring ◽  
I-Min Lee ◽  
Daniel Chasman ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cancer Diagnosis ◽  
Cancer Mortality ◽  
Total Mortality ◽  
Health Study ◽  
Specific Mortality ◽  
Before And After ◽  
After Cancer ◽  
Cvd Mortality

Background: Given the increased prevalence of cancer survivors in the United States, it is imperative to define risk factors for potential reductions in total and cause-specific mortality. Physical activity (PA) represents a promising target for intervention. Design: We prospectively evaluated PA from questionnaires before and after cancer diagnosis with total and cause-specific mortality among 13,297 subjects diagnosed with invasive cancer combined from the Physicians’ Health Study (PHS) (n=6328), Physicians’ Health Study II (PHS II) (n=912), and Women's Health Study (WHS) (n=6057). WHS and PHS participants were free of baseline cancer; PHS II participants reported no active cancer at baseline. We ascertained PA before and after an incident cancer diagnosis based on reports on repeated follow-up questionnaires. Death was ascertained by medical records and death certificates. Cox regression estimated combined hazard ratios (HRs) of mortality by PA adjusted for age, randomized treatments, BMI, and other lifestyle/demographic factors. We evaluated the interaction between PA before and after cancer diagnosis by comparing PA ≤1 versus ≥2 times/wk. Results: The mean follow-up after cancer diagnosis was 8.0, 7.5, and 5.2 y for WHS, PHS, and PHS II, respectively, during which there were 5623 deaths (WHS, 2164; PHS, 3269; PHS II; 190). Higher PA before cancer diagnosis was associated with significantly lower mortality. Compared with PA ≤ once/wk, the HRs (95% CIs) associated with PA 2-4 and >4 times/wk were 0.87 (0.82-0.93) and 0.88 (0.82-0.94) for total mortality; 0.77 (0.63-0.95) and 0.79 (0.62-0.997) for CVD mortality, and 0.90 (0.83-0.98) and 0.90 (0.83-0.98) for cancer mortality. Higher PA after cancer diagnosis was associated with significantly lower total and cancer mortality and non-significantly lower CVD mortality, with HRs (95% CIs) of 0.65 (0.58-0.72) and 0.66 (0.59-0.73) for total mortality; 0.78 (0.59-1.03) and 0.82 (0.61-1.10) for CVD mortality, and 0.66 (0.57-0.77) and 0.64 (0.55-0.74) for cancer mortality. There was a significant interaction of PA before and after cancer diagnosis for total (p int =0.02) and cancer (p int =0.007) mortality, but not CVD mortality (p int =0.38). Conclusions: Greater PA both before and after cancer diagnosis were significantly associated with lower total and cancer mortality. Higher PA before cancer diagnosis was also associated with lower CVD mortality. PA may be an important target for lower mortality after cancer diagnosis.

scholarly journals Common variants in the CRP gene in relation to longevity and cause-specific mortality in older adults: The Cardiovascular Health Study

2008 ◽  
Vol 197 (2) ◽  
pp. 922-930 ◽  
Author(s):  
Lucia A. Hindorff ◽  
Kenneth M. Rice ◽  
Leslie A. Lange ◽  
Paula Diehr ◽  
Indrani Halder ◽  
...  
Keyword(s):  
Older Adults ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Common Variants ◽  
Specific Mortality

scholarly journals Prospective study of restless legs syndrome and total and cardiovascular mortality among women

Neurology ◽  
2017 ◽  
Vol 90 (2) ◽  
pp. e135-e141 ◽  
Author(s):  
Yinge Li ◽  
Yanping Li ◽  
John W. Winkelman ◽  
Arthur S. Walters ◽  
Jiali Han ◽  
...  
Keyword(s):  
Restless Legs Syndrome ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Model ◽  
Health Study ◽  
Restless Legs ◽  
Specific Mortality ◽  
Cvd Mortality

ObjectiveWe prospectively examined whether women with physician-diagnosed restless legs syndrome (RLS) had a higher risk of total and cardiovascular disease (CVD) mortality relative to those without RLS.MethodsThe current study included 57,417 women (mean age 67 years) from the Nurses' Health Study without cancer, renal failure, and CVD at baseline (2002). Main outcomes were total and CVD mortality. We used the Cox proportional hazards model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for all-cause and CVD-specific mortality based on RLS status, adjusting for age, presence of major chronic diseases, and other potential confounders.ResultsWe documented 6,448 deaths during 10 years of follow-up. We did not observe a significant association between presence of physician-diagnosed RLS and high risk of total mortality (adjusted HR 1.15, 95% CI 0.98–1.34). When cause-specific mortality was studied, participants with RLS had a significantly higher risk of CVD mortality (adjusted HR 1.43, 95% CI 1.02–2.00) relative to those without RLS after adjustment for potential confounders. Longer duration of RLS diagnosis was significantly associated with a higher risk of CVD mortality (p for trend = 0.04). Excluding participants with common RLS comorbidities strengthened the association between RLS and total (adjusted HR 1.43, 95% CI 1.03–1.97) and CVD mortality (adjusted HR 2.27, 95% CI 1.21–4.28). However, we did not find a significant association between RLS and mortality due to cancer and other causes.ConclusionsWomen with RLS had a higher CVD mortality rate, which may not be fully explained by common co-occurring disorders of RLS.

scholarly journals Consumption of Total Olive Oil and Risk of Total and Cause-Specific Mortality in US Adults

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1036-1036
Author(s):  
Marta Guasch-Ferre ◽  
Yanping Li ◽  
Walter Willett ◽  
Qi Sun ◽  
Laura Sampson ◽  
...  
Keyword(s):  
Olive Oil ◽  
Lower Risk ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Men And Women ◽  
Dairy Fat ◽  
Risk Of Mortality ◽  
Specific Mortality

Abstract Objectives The association between olive oil intake and the risk of mortality has not been evaluated before in the US population. Our objective was to examine whether olive oil intake is associated with total and cause-specific mortality in two prospective cohorts of US men and women. We hypothesize that higher olive oil consumption is associated with lower risk of total and cause-specific mortality. Methods We followed 61,096 women (Nurses’ Health Study, 1990–2016) and 31,936 men (Health Professionals Follow-up Study, 1990–2016) who were free of diabetes, cardiovascular disease and cancer at baseline. Diet was assessed by a semi quantitative food frequency questionnaire at baseline and then every 4 years. Cox proportional hazards regressions were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). Results During 26 years of follow-up, 32,868 deaths occurred. Compared with those participants who never consumed olive oil, those with higher olive oil intake (>1/2 tablespoon/d or >8g/d) had 15% lower risk of total mortality [pooled hazard ratio (95% confidence interval): 0.85 (0.81, 0.88)] after adjustment for potential confounders. Higher olive oil intake was associated with 15% lower risk of CVD death [0.85 (0.78, 0.92)], 38% lower risk of neurodegenerative disease death [0.62 (0.54, 0.71)], and 12% lower risk of respiratory death [0.88 (0.77, 1.00)]. Replacing 10 g of margarine, mayonnaise, and dairy fat with the equivalent amount of olive oil was associated with 7–20% lower risk of total mortality, and death from CVD, cancer, neurodegenerative, and respiratory diseases. No significant associations were observed when olive oil was replacing other vegetable oils combined (corn, safflower, soybean and canola oil). Conclusions We observed that higher olive oil intake was associated with a lower risk of total mortality and cause-specific mortality in a large prospective cohort of U.S. men and women. The substitution of margarine, mayonnaise, and dairy fat with olive oil was associated with a reduced risk of mortality. Funding Sources This work was supported by grants from the National Institutes of Health.

scholarly journals Changes in Plant-Based Diet Quality and Total and Cause-Specific Mortality

Circulation ◽  
2019 ◽  
Vol 140 (12) ◽  
pp. 979-991 ◽  
Author(s):  
Megu Y. Baden ◽  
Gang Liu ◽  
Ambika Satija ◽  
Yanping Li ◽  
Qi Sun ◽  
...  
Keyword(s):  
Diet Quality ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Total Mortality ◽  
Cox Proportional Hazards ◽  
Environmental Benefits ◽  
Health Study ◽  
Specific Mortality ◽  
Cvd Mortality

Background: Plant-based diets have been associated with lower risk of type 2 diabetes mellitus and cardiovascular disease (CVD) and are recommended for both health and environmental benefits. However, the association between changes in plant-based diet quality and mortality remains unclear. Methods: We investigated the associations between 12-year changes (from 1986 to 1998) in plant-based diet quality assessed by 3 plant-based diet indices (score range, 18–90)—an overall plant-based diet index (PDI), a healthful PDI, and an unhealthful PDI—and subsequent total and cause-specific mortality (1998–2014). Participants were 49 407 women in the Nurses’ Health Study (NHS) and 25 907 men in the Health Professionals Follow-Up Study (HPFS) who were free from CVD and cancer in 1998. Multivariable-adjusted Cox proportional-hazards models were used to estimate hazard ratios (HRs) and 95% CIs. Results: We documented 10 686 deaths including 2046 CVD deaths and 3091 cancer deaths in the NHS over 725 316 person-years of follow-up and 6490 deaths including 1872 CVD deaths and 1772 cancer deaths in the HPFS over 371 322 person-years of follow-up. Compared with participants whose indices remained stable, among those with the greatest increases in diet scores (highest quintile), the pooled multivariable-adjusted HRs for total mortality were 0.95 (95% CI, 0.90–1.00) for PDI, 0.90 (95% CI, 0.85–0.95) for healthful PDI, and 1.12 (95% CI, 1.07–1.18) for unhealthful PDI. Among participants with the greatest decrease (lowest quintile), the multivariable-adjusted HRs were 1.09 (95% CI, 1.04–1.15) for PDI, 1.10 (95% CI, 1.05–1.15) for healthful PDI, and 0.93 (95% CI, 0.88–0.98) for unhealthful PDI. For CVD mortality, the risk associated with a 10-point increase in each PDI was 7% lower (95% CI, 1–12%) for PDI, 9% lower (95% CI, 4–14%) for healthful PDI, and 8% higher (95% CI, 2–14%) for unhealthful PDI. There were no consistent associations between changes in plant-based diet indices and cancer mortality. Conclusions: Improving plant-based diet quality over a 12-year period was associated with a lower risk of total and CVD mortality, whereas increased consumption of an unhealthful plant-based diet was associated with a higher risk of total and CVD mortality.

Copper, ceruloplasmin, and long-term cardiovascular and total mortality (The Ludwigshafen Risk and Cardiovascular Health Study)

2014 ◽  
Vol 48 (6) ◽  
pp. 706-715 ◽  
Author(s):  
T. B. Grammer ◽  
M. E. Kleber ◽  
G. Silbernagel ◽  
S. Pilz ◽  
H. Scharnagl ◽  
...  
Keyword(s):  
Cardiovascular Health ◽  
Total Mortality ◽  
Health Study ◽  
Cardiovascular Health Study

scholarly journals Loss of height predicts total and cardiovascular mortality: a cohort study of northern European women

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049122
Author(s):  
Sofia Klingberg ◽  
Kirsten Mehlig ◽  
Rojina Dangol ◽  
Cecilia Björkelund ◽  
Berit Lilienthal Heitmann ◽  
...  
Keyword(s):  
Physical Activity ◽  
Cardiovascular Mortality ◽  
Total Mortality ◽  
Population Based ◽  
Height Loss ◽  
Stroke Mortality ◽  
Northern European ◽  
Specific Mortality ◽  
European Women ◽  
Cvd Mortality

ObjectiveTo examine height changes in middle-aged northern European women in relation to overall and cardiovascular mortality.DesignPopulation-based cohort studies with longitudinally measured heights and register-based mortality.SettingSweden and Denmark.ParticipantsPopulation-based samples of 2406 Swedish and Danish women born on selected years in 1908–1952, recruited to baseline examinations at ages 30–60, and re-examined 10–13 years later.Main outcome measureTotal and cardiovascular disease (CVD) specific mortality during 17–19 years of follow-up after last height measure.ResultsFor each 1 cm height loss during 10–13 years, the HR (95% CI) for total mortality was 1.14 (1.05 to 1.23) in Swedish women and 1.21 (1.09 to 1.35) in Danish women, independent of key covariates. Low height and high leisure time physical activity at baseline were protective of height loss, independent of age. Considering total mortality, the HR for major height loss, defined as height loss greater than 2 cm, were 1.74 (1.32 to 2.29) in Swedish women and 1.80 (1.27 to 2.54) in Danish women. Pooled analyses indicated that height loss was monotonically associated with an increased mortality, confirming a significant effect above 2 cm height loss. For cause-specific mortality, major height loss was associated with a HR of 2.31 (1.09 to 4.87) for stroke mortality, 2.14 (1.47 to 3.12) for total CVD mortality and 1.71 (1.28 to 2.29) for mortality due to causes other than CVD.ConclusionHeight loss is a marker for excess mortality in northern European women. Specifically the hazard of CVD mortality is increased in women with height loss during middle age, and the results suggest that the strongest cause-specific endpoint may be stroke mortality. The present findings suggest attention to height loss in early and mid-adulthood to identify women at high risk of CVD, and that regular physical activity may prevent early onset height loss.

Abstract 056: Associations of Total and High-Molecular-Weight Adiponectin with All-Cause and Cardiovascular Mortality in Older Persons: The Cardiovascular Health Study (CHS)

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Jorge R Kizer ◽  
David Benkeser ◽  
Alice M Arnold ◽  
Kenneth J Mukamal ◽  
Joachim H Ix ◽  
...  
Keyword(s):  
Older Adults ◽  
Molecular Weight ◽  
High Molecular Weight ◽  
Cardiovascular Health ◽  
Additive Model ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
High Molecular Weight Adiponectin ◽  
Risk Of Death ◽  
Cvd Mortality

Background: Adiponectin (APN) is inversely related to incident cardiovascular disease (CVD) in healthy middle-aged cohorts, but the opposite has been observed among older populations or those with prevalent CVD, where higher APN imparts greater risk of CVD and death. Emerging data suggest, however, that the association of total APN with mortality in elders may be U-shaped. Methods: We tested the hypotheses that both total and high-molecular-weight (HMW) APN (r=0.94) manifest different relations with mortality in subgroups of older adults defined by the presence or absence of prior CVD or heart failure (HF)/atrial fibrillation (AF). Specifically, we hypothesized that total and HMW APN would show similar U-shaped associations with all-cause and CVD death in subjects without prevalent CVD or HF/AF (Group [Gp] 1; n= 3272), but would exhibit positive monotonic associations with these outcomes in subgroups with prevalent CVD but no HF/AF (Gp 2; n=1030), and with prevalent HF/AF (Gp 3; n=383). We addressed these questions in CHS, a population-based US cohort aged 65 and older, of whom 4715 had available samples since 1992–93. Associations were examined with general additive model plots, and modeled with linear splines. Results: During 16 years of follow-up, 1947 all-cause and 634 CVD deaths occurred in Gp 1, 802 and 375 in Gp 2, and 337 and 180 in Gp 3. There was evidence of effect modification by subgroup status for both outcomes (p≤0.034), with total and HMW APN showing significant departures from linearity in their relations with all-cause and CVD mortality in Gp 1 (p≤0.043), but not Gps 2 or 3. The association between total APN and all-cause mortality was U-shaped, such that after adjustment for potential confounders, increasing levels up to 12.4 mg/L (median) were associated with a lower risk of death (HR 0.81 per SD [0.65–0.95]), but above this cutpoint, higher levels imparted a higher risk (HR 1.19 per SD [1.12–1.27]). Further adjustment for putative mediators (glucose, lipids, inflammation) abolished the association in the lower range, but left that in the upper range unaffected. The relationship was largely similar for HMW adiponectin. No significant association between total or HMW APN with mortality was apparent in Gp 2. In Gp 3, both total and HMW APN showed positive adjusted associations with mortality across their distributions, which were magnified after inclusion of putative mediators (HRs 1.31 [1.15–1.50] and 1.36 [1.20–1.55], respectively). Results were comparable for CVD mortality in all Gps. Conclusions: These findings show that total and HMW APN bear similar associations with all-cause and CVD mortality in older adults, and that these differ according to prevalent CVD or HF/AF status. These observations provide a potential explanation for the APN paradox, underscoring the need to better characterize the underpinnings of the hormone’s beneficial and harmful associations.

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