Occupational groups and ischaemic heart disease in New Zealand – a longitudinal linkage study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.A Barnes ◽  
A Eng ◽  
M Corbin ◽  
H.J Denison ◽  
A t'Mannetje ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Health Data ◽  
Funding Source ◽  
Inverse Association ◽  
Occupational Groups ◽  
Routinely Collected Health Data ◽  
Machine Operators

Abstract Background/Introduction Occupation is a poorly characterised risk factor for cardiovascular disease (CVD), with females and minority populations particularly under-represented in research. There is also a lack of longitudinal studies using detailed health data that does not rely on self-reports. Purpose This study aimed to address these gaps by assessing the association between a range of occupational groups and ischaemic heart disease (IHD) in New Zealand (NZ), through linkage of population-based occupational surveys to routinely collected health data. Half of the study population were females and 40% were indigenous Māori (who comprise 15% of the total 4.8 million NZ population), which enabled sex and ethnicity-specific aspects of the relationship between occupation and IHD to be assessed. Methods Two probability-based sample surveys of the NZ adult population (New Zealand Workforce Survey (NZWS); 2004–2006; n=3003) and of the Māori population (NZWS Māori; 2009–2010; n=2107), for which detailed occupational histories and lifestyle factors were collected, were linked with routinely collected health data available through Statistics NZ. Cox regression was used to calculate hazard ratios (HR) for “ever-worked” in any one of nine major occupational groups, with “never worked” in that occupational group defined as the reference group. Analyses were controlled for age, deprivation and smoking, and stratified by sex and ethnicity. Results The strongest associations were found for “plant/machine operators and assemblers” and “elementary workers”, particularly among female Māori (HR 2.19, 95% CI 1.16–4.13 and HR 2.03, 1.07–3.82 respectively). In contrast, inverse associations with IHD across all groups were observed for “technicians and associate professionals”, which was significant for NZWS males (HR 0.52, 0.32–0.84). There were some sex and ethnic differences, particularly for “clerks”, where a positive association was found for NZWS males (HR 1.81, 1.19–2.74), whilst an inverse association was observed for Māori females (HR 0.42, 0.22–0.82). Duration analyses (≤2 years, 2–10 years and 10+ years) showed significant dose-response trends for “clerks” in NZWS males, and “plant/machine operators and assemblers” and “elementary workers” in Māori females. Further adjustments for other potential confounders such diabetes mellitus, hypertension and high cholesterol did not affect the results. Conclusion Associations between occupation and IHD differed significantly across occupational groups and between sexes and ethnicities, even within the same occupational groups. This suggests that results may not be generalised across these groups and occupational interventions to reduce IHD risk may therefore need different approaches depending on the population and specific groups of interest. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Health Research Council (HRC) of New Zealand

scholarly journals O6C.1 Ischaemic heart disease and occupation: a linkage between two new zealand surveys and the integrated data infrastructure

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A55.2-A55
Author(s):  
J Douwes ◽  
L Ellison-Loschmann ◽  
Marine Corbin ◽  
L Barnes ◽  
HJ Denison ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Occupational Exposures ◽  
Health Data ◽  
P Value ◽  
Odds Ratios ◽  
General Survey ◽  
Occupational Groups ◽  
Machine Operators

BackgroundAssociations between ischaemic heart disease (IHD) and occupation are poorly understood. We linked two previously conducted New Zealand workforce surveys with routinely collected health data to assess occupational risk factors of IHD in New Zealand.MethodsTwo probability-based sample surveys of the general New Zealand adult population (2004–2006; n=3003) and of the New Zealand indigenous peoples (M&_x0101;ori; 2009–2010; n=2107), for which occupational history was collected, were linked with health data up to the end of 2017 using Statistics New Zealand individual-level microdata. Incident IHD events were identified using hospitalisations, prescriptions and deaths. The odds ratios associated with ever being employed in occupational groups were estimated by logistic regression adjusting for age, smoking and socio-economic status separately for males and females in each cohort.ResultsA total of 282 IHD cases were identified in both surveys. Statistically significant elevated IHD risks were observed for male clerks in the general survey (OR=1.60, 95%CI=1.02–2.49) and agriculture and fishery male workers in the M&_x0101;ori survey (OR=1.70, 95%CI=1.02–2.82). Among females, the odds ratios for agriculture and fishery workers were 1.69 (95%CI=0.81–3.51) and 1.49 (95%CI=0.81–2.75) in the general survey and the M&_x0101;ori survey, respectively. A statistically significant increased risk was observed for female plant and machine operators and assemblers in the M&_x0101;ori survey (OR=1.87, 95%CI=1.05–3.31). In the general survey, male plant and machine operators and assemblers had an odds ratio of 1.26 (95%CI=0.81–1.95). We also identified borderline increased odds ratios for trades workers among males in the general survey (OR=1.39, 95%CI=0.92–2.12, p-value=0.12) and among females in the M&_x0101;ori survey (OR=2.26, 95%CI=0.98–5.21, p-value=0.06).ConclusionThis study identified associations between several occupational groups and IHD in the New Zealand population. Further analyses will be conducted to assess specific occupational exposures associated with IHD risk.

scholarly journals mHealth interventions in the management of heart failure, ischaemic heart disease and hypertension: a systematic review and meta-analysis of randomised controlled trials

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Indraratna ◽  
D Tardo ◽  
J Yu ◽  
K Delbaere ◽  
M Brodie ◽  
...  
Keyword(s):  
Heart Failure ◽  
Systematic Review ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Meta Analysis ◽  
Funding Source ◽  
Smartphone Applications ◽  
Coronary Syndrome ◽  
Significant Difference ◽  
The Impact

Abstract Introduction Cardiovascular disease (CVD) remains the leading cause of death in the world. Mobile phones have become ubiquitous in most developed societies. Smartphone applications, telemonitoring and clinician-driven short message service (SMS) allow for novel methods in managing chronic cardiovascular conditions such as ischaemic heart disease, heart failure and hypertension. Purpose To evaluate the impact of mobile phone-based interventions (MPIs) on mortality, hospitalisations and blood pressure and body mass index (BMI) in patients diagnosed with either acute coronary syndrome, heart failure or hypertension. Methods A systematic review was conducted using seven electronic databases, identifying all randomised control trials (RCTs) featuring an MPI in the management of these conditions. Meta-analysis was performed by using standard analytical techniques. The odds ratio (OR) was used as a summary statistic. Results Twenty-six RCTs including 6,713 patients were identified. Of these 26 studies, 13 examined text messaging intereventions, 10 studied telemonitoring interventions and three described smartphone applications with other functions. Twelve studies were included for meta-analysis. In patients with heart failure (n=1683), MPIs were associated with a significantly lower rate of all-cause hospital admissions at six months (31% vs. 36%, OR 0.77, 95% CI 0.62–0.97, p=0.03, I2 = 0). A significant difference was also demonstrated for heart-failure admissions (14.0% vs. 18.5%, OR 0.69, 95% CI 0.48 to 0.98, p=0.04, I2 = 26%). There was no difference in mortality (10.4% vs. 11.6% p=0.45). In patients with hypertension, the difference in systolic BP was 4.3mmHg less in the intervention group (95% CI: −7.8 to −0.78 mmHg, p=0.02). Four studies examined medication compliance as an endpoint in patients with ischaemic heart disease, and all four demonstrated a significant difference favouring the MPI group (see table 1). However, due to variable quantification of compliance, meta-analysis was not possible. There was no significant difference in the change in BMI from four studies after six or more months (mean difference −0.46, 95% CI: −1.44 to 0.52, P=0.36). Conclusions The available data suggests MPIs may have a role as valuable adjuncts in the management of chronic CVD. Figure 1 Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Health and Medical Research Council (NHMRC)

Abstract P067: Nut Consumption is Associated with a Lower Risk of Death among US Male Physicians

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
John Gaziano
Keyword(s):  
Coronary Heart Disease ◽  
Heart Disease ◽  
Lower Risk ◽  
Unsaturated Fatty Acids ◽  
Cox Regression ◽  
Adjusted Relative Risk ◽  
Inverse Association ◽  
Risk Of Death ◽  
All Cause Mortality ◽  
Nut Intake

Background: Previous studies have suggested that nut consumption, a good source of unsaturated fatty acids, magnesium, potassium, fiber, antioxidants, and vitamins is associated with a lower risk of coronary heart disease, type 2 diabetes, and sudden cardiac death. However, limited data are available on the association between nut intake and all-cause mortality. Objective: To test the hypothesis that nut consumption is inversely associated with the risk of all-cause mortality. Methods: A prospective cohort study of 20,742 male physicians from the Physicians’ Health Study. Nut intake was assessed between 1999 and 2002 using a food frequency questionnaire and deaths were ascertained by an endpoint committee. We used Cox regression to estimate multivariable adjusted relative risk of death according to nut consumption. In secondary analyses, we evaluated associations of nut consumption with cause-specific mortality (coronary heart disease, stroke, and cancer deaths). Results: During a median follow-up of 9.5 years, there were 2,732 deaths. The mean age at baseline was 66.6 ± 9.3 years. Median intake of nuts was 1 time per week. Multivariable adjusted hazard ratios (95% CI) were: 1.0 (ref), 0.91 (0.83-1.00), 0.85 (0.76-0.95), 0.86 (0.75-0.98), and 0.74 (0.63-0.87) for nut consumption of never, 1-3/month, 1/week, 2-4/week, and 5+/week, respectively (p for linear trend <0.0001), after adjustment for age, body mass index, alcohol use, smoking, exercise, energy intake, saturated fat, fruit and vegetables, red meat intake, and prevalent diabetes and hypertension. In a secondary analysis, nut intake was inversely related to CVD death; however, only a suggestive and non-statistically significant relation was seen for cancer mortality (Table). Conclusions: Our data are consistent with an inverse association between nut consumption and risk of all-cause mortality in US male physicians.

scholarly journals A prospective investigation of plant foods, dietary fibre and ischaemic heart disease in the EPIC cohort

2020 ◽  
Vol 79 (OCE2) ◽  
Author(s):  
Aurora Perez-Cornago ◽  
Francesca L. Crowe ◽  
Paul N. Appleby ◽  
Timothy J Key
Keyword(s):  
Myocardial Infarction ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Dietary Fibre ◽  
Lower Risk ◽  
Fruits And Vegetables ◽  
Cox Regression ◽  
Fruit And Vegetables ◽  
Plant Foods ◽  
Prospective Investigation

AbstractIntroductionThere is evidence that plant-based diets might be associated with a lower risk of IHD; however, previous studies have not reported on intake of subtypes of fruit and vegetables and sources of dietary fibre. This study aims to assess the associations of major plant foods, their subtypes and dietary fibre with risk of ischaemic heart disease (IHD) in the European Prospective Investigation into Cancer and Nutrition (EPIC)-CVD Consortium.Material and methodsWe conducted a prospective analysis of 490,311 men and women in ten European countries without a history of myocardial infarction or stroke at recruitment. Dietary intake was assessed using validated questionnaires and calibrated with 24-hour recall data. Cox regression models, adjusted for IHD risk factors, were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).ResultsDuring a mean of 12.6 years follow-up, we documented 8504 myocardial infarction cases or deaths from IHD. Participants consuming at least eight portions (80 grams each) of fruits and vegetables a day had a 10% lower risk of IHD (HR 0.90, 95% CI: 0.82–0.98) compared with those consuming fewer than three portions a day. The risk of IHD was 6% (95% CI 0.90–0.99; P-trend = 0.009) lower for a 200 g/day higher intake of fruit and vegetables combined, 3% (0.95–1.00; P-trend = 0.021) lower for a 100 g/ day higher fruit intake, and 8% (0.86–0.97; P-trend = 0.006) lower for a 50 g/ day higher intake of bananas. Moreover, risk of IHD was 9% (0.83–0.99; P-trend = 0.032) lower for a 10g/ day higher intake of nuts and seeds, and 10% (0.82–0.98; P-trend = 0.020) lower for a 10g/ day higher intake of total dietary fibre. No associations were observed between legumes, total vegetables and other subtypes of fruit and vegetables and IHD risk.DiscussionThe results from this large prospective study suggest that higher intakes of fruit and vegetables combined, total fruit, bananas, nuts and seeds, and total fibre are associated with a lower risk of IHD. Given the observational design of this study, causality and potential mechanisms should be further investigated.

Ethnic differences in case fatality following an acute ischaemic heart disease event in New Zealand: ANZACS-QI 13

2016 ◽  
Vol 23 (17) ◽  
pp. 1823-1830 ◽  
Author(s):  
Corina Grey ◽  
Rod Jackson ◽  
Susan Wells ◽  
Roger Marshall ◽  
Suneela Mehta ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Ethnic Differences ◽  
Case Fatality

Low dose interleukin-2 in patients with stable ischaemic heart disease and acute coronary syndrome (LILACS)

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.X Zhao ◽  
R.S Sriranjan ◽  
Y Lu ◽  
A Hubsch ◽  
F Kaloyirou ◽  
...  
Keyword(s):  
Heart Disease ◽  
Adverse Events ◽  
Ischaemic Heart Disease ◽  
Primary Endpoint ◽  
Dose Escalation ◽  
Low Dose ◽  
Interleukin 2 ◽  
Public Institution ◽  
Funding Source ◽  
Dose Dependent

Abstract Background Regulatory T lymphocytes (Tregs) are critical for immune homeostasis. Pre-clinical models have demonstrated that Tregs can modulate post-ischaemic immune responses and promote myocardial healing. Patients with ischaemic heart disease (IHD) display reduced anti-inflammatory Tregs and increased pro-inflammatory effector T cells (Teffs). Low-dose interleukin-2 (ld-IL2) has been shown to increase Tregs in patients with autoimmune diseases but is currently contraindicated in patients with IHD. Purpose To assess the safety and pharmacodynamic effect of ld-IL-2 in patients with IHD. Methods LILACS was a prospective, randomised, double-blind, placebo-controlled, dose-escalation, Phase I/II clinical trial, which tested ld-IL-2 (aldesleukin) given once daily subcutaneously, for five consecutive days. In Part A, 25 patients with stable IHD were randomised (drug:placebo ratio of 3:2) in 5 dose groups (0.3, 0.6, 1.2, 2.4 and 3x106 IU/day); whilst in Part B, 16 patients with non-ST elevation myocardial infarction (NSTEMI) were randomised (drug:placebo ratio of 6:2) in two dose groups (1.5 and 2.5x106 IU/day). Follow up was performed the day after dosing and again 7 days later. Doses were determined after blinded review. An independent committee reviewed unblinded data prior to commencing Part B. The primary endpoint was safety in parts A and B. Additionally in Part B, a co-primary endpoint was to calculate the dose required to increase Tregs by 75%. [NCT03113773] Results Ld-IL2 was well tolerated for all dose groups with the commonest adverse events being mild injection site reactions. Two serious adverse events, not considered to be drug related, occurred in Part B – one prior to dosing and resulting in withdrawal. The other was a recurrent NSTEMI after dosing ended in a patient with severe triple vessel coronary artery disease awaiting urgent bypass surgery. In Part A, Tregs increased with dose escalation whilst no Teff increases were noted (Figure 1A). In Part B, patients treated with 1.5 and 2.5x106 IU/day doses had a median increase in Tregs of 80.5% (CI 36.2–124.7%, p=0.003) and 108.3% (CI 55.3–161.3%, p=0.002) respectively (Figure 1B). A linear regression model estimated an increase of 43.3% (CI 23.6–63.0%, p=0.0003) per unit dose. The estimated dose to achieve a 75% increase in Tregs was 1.46x106 IU/day (CI 1.06–1.87). No increase in Teffs cells were seen however, a dose-dependent decrease was measured in B cells, whilst NK cells and eosinophils increased at the top 2.5 and 3x106 IU/day dose. A panel of 29 cytokines and chemokines showed a dose-dependent type 1 and 2 cytokine response. Single-cell RNA sequencing was performed on immune cells before and after dosing. Conclusions Ld-IL2 was safe and well-tolerated. An induction dose of 1.5x106 IU per day for 5 days provided an effective expansion of Tregs without increasing Teffs. This work provides important data for the future therapeutic use of ld-IL-2 which is ongoing. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): Medical Research Council, British Heart Foundation Cambridge Centre of Excellence

scholarly journals Educational disparities in ischaemic heart disease among 0.5 million Chinese adults: a cohort study

2021 ◽  
pp. jech-2020-216314
Author(s):  
Lu Chen ◽  
Yunlong Tan ◽  
Canqing Yu ◽  
Yu Guo ◽  
Pei Pei ◽  
...  
Keyword(s):  
Heart Disease ◽  
Educational Attainment ◽  
Ischaemic Heart Disease ◽  
Rural Areas ◽  
Dietary Habits ◽  
Case Fatality ◽  
Health Behaviours ◽  
Inverse Association ◽  
Middle Income ◽  
Increased Risk

BackgroundThe relationship between educational attainment and ischaemic heart disease (IHD) is limited in evidence in middle-income countries like China. Exploring lifestyle-related mediators, which might be not universal between socioeconomic status and health outcomes in diverse regions, can contribute to interventions targeted at the Chinese to narrow the educational gap in IHD.MethodsBased on the China Kadoorie Biobank of 489 594 participants aged 30–79 years who did not have heart disease or stroke at baseline, this study examined the association of educational attainment with IHD. Total IHD cases were further divided into acute myocardial infarction (AMI) cases and non-AMI cases. The Cox proportional hazard model was performed to estimate the HRs and 95% CIs for mortality and incidence of IHD. Logistic regression was used to estimate the ORs and 95% CIs for case fatality.ResultsDuring the median follow-up period of 11.1 years, this study documented 45 946 (6668) incident IHD (AMI) cases and 5948 (3689) deaths altogether. Lower educational attainment was associated with increased risk of incident AMI as well as death and fatality of total IHD including its subtypes (ptrend <0.001). Although the risk of incident non-AMI was greater for participants with higher levels of education in the whole population (ptrend <0.001), an inverse association of education with its incidence was found in participants from <50 years age group and rural areas. Smoking and dietary habits were the two most potent mediating factors in the associations of education with mortality and AMI incidence; whereas, physical activity was the major mediating factor for non-AMI incidence in the whole population.DiscussionInterventions targeting unhealthy lifestyles are ideal ways to narrow the educational gap in IHD while solving ‘upstream’ causes of health behaviours might be the most fundamental ones.

scholarly journals Occupational Exposures and Ischaemic Heart Disease: Results from The Entire New Zealand Population

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Amanda Eng ◽  
Marine Corbin ◽  
Hayley Denison ◽  
Lucy Barnes ◽  
Andrea 't Mannetje ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Heart Disease ◽  
New Zealand ◽  
Noise Exposure ◽  
Cox Regression ◽  
Statistical Significance ◽  
Working Hours ◽  
Occupational Exposures ◽  
Loud Noise ◽  
Long Working Hours

IntroductionIschaemic Heart Disease (IHD) is a leading cause of death in Western countries. Common occupational exposures such as loud noise, long working hours, and sedentary work have been associated with increased IHD risks, but inconsistently. Objectives and ApproachThis study examines associations between incident IHD and exposure to long working hours, sedentary work, and loud noise. Individual-level microdata from Statistics New Zealand Integrated Data Infrastructure (IDI) were extracted for adults (age 20-64 years) with occupation recorded on the 2013 Census. The number of working hours was extracted from the Census, and exposure to sedentary work and loud noise was assessed through job exposure matrices (JEMs). IHD events (from 2013 to end of 2018) were identified using hospitalisations, prescriptions and deaths. Hazard ratios (HRs) were calculated using cox regression adjusted for age, socioeconomic status, and smoking. Results were stratified by sex and ethnicity. ResultsA total of 20,610 IHD cases were identified from 1,594,680 individuals employed at time of Census. Both short (<35) and long (55+) working hours were associated with an increased IHD risk in crude analyses, but effects disappeared after adjustment for age and socioeconomic status. For females, sedentary work (>90% of the time compared to <50%) was associated with a reduced risk (HR(Non-Māori)=0.86, 95%CI=0.75-0.99; HR(Māori)=0.71, 95%CI=0.44-1.14). For males, exposure to the highest noise category (>90dBA) compared to no exposure (<80dBA) was associated with elevated HRs without reaching statistical significance (HR(Non-Māori)=1.12, 95%CI=0.96-1.29; HR(Māori)=1.25, 95%CI=0.89-1.75). For females exposure to the 80-85dBA category compared to no exposure also showed elevated HRs (HR(Non-Māori)=1.14; 95%CI=1.04-1.26; HR(Māori)=1.16; 95%CI=0.93-1.46), but too few females were employed in jobs with the highest noise exposure. ConclusionThese preliminary analyses do not support sedentary work or long working hours as IHD risk factors, but do suggest a modest increase in IHD risk associated with occupational exposure to noise.

Educational inequality in cardiovascular diseases: a sibling approach

2017 ◽  
Vol 46 (1) ◽  
pp. 83-91
Author(s):  
Grethe Søndergaard ◽  
Susanne Oksbjerg Dalton ◽  
Laust Hvas Mortensen ◽  
Merete Osler
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Educational Inequality ◽  
Circulatory System ◽  
Educational Status ◽  
Hazard Ratio ◽  
Cohort Analyses

Aims: Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases, ischaemic heart disease and stroke, respectively, were explained by family factors shared by siblings. Methods: The study population included all individuals born in Denmark between 1950 and 1979 who had at least one full sibling born in the same period. Using Cox regression, data were analysed in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families. Results: A lower educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate of ischaemic heart disease among women less than 45 years who had a primary school education was 94% (hazard ratio 1.94 (1.78–2.12) higher than among those with a vocational education, while it attenuated to 51% (hazard ratio 1.51 (1.34–1.71)) in the within-sibship analysis. Conclusions: Confounding from factors shared by siblings explained the associations between education and the cardiovascular disease outcomes but to varying degrees. This should be taken into account when planning interventions aimed at reducing educational inequalities in the development of cardiovascular disease, ischaemic heart disease and stroke.

Comparison of incidence rates and risk factors of heart failure between two male cohorts born 30 years apart

Heart ◽  
2020 ◽  
Vol 106 (21) ◽  
pp. 1672-1678
Author(s):  
Constantinos Ergatoudes ◽  
Per-Olof Hansson ◽  
Kurt Svärdsudd ◽  
Annika Rosengren ◽  
Erik Östgärd Thunström ◽  
...  
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Physical Inactivity ◽  
Cox Regression ◽  
Incidence Rates ◽  
Cox Regression Analysis ◽  
Increased Risk ◽  
The Impact

ObjectiveTo compare two cohorts of middle-aged men from the general population born 30 years apart for incidence and predictors of heart failure (HF).MethodsTwo population samples of men, born in 1913 (n=855) and in 1943 (n=797), were examined at 50 years of age and followed up for 21 years (1963–1994 and 1993–2014). Cox regression analysis was used to examine the impact of different factors on the risk of developing HF.ResultsEighty men born in 1913 (9.4%) and 42 men born in 1943 (5.3%) developed HF during follow-up; adjusted HRs comparing the two cohorts (born 1943 vs 1913) were: 0.46 (95% CI 0.28 to 0.74, p=0.002). In both cohorts, higher body mass index, higher diastolic blood pressure, treatment for hypertension, onset of either atrial fibrillation (AF), ischaemic heart disease and diabetes mellitus were associated with higher risk of HF. Higher heart rate was associated with an increased risk only in men born in 1913, whereas higher systolic blood pressure (SBP), smoking, higher glucose, higher cholesterol and physical inactivity were associated with an increased risk in men born in 1943. AF contributed higher risk of incident HF, whereas SBP and physical inactivity contributed lower risk in men born in 1943 compared with men born in 1913.ConclusionsMen born in 1943 had half the risk of HF after their 50s than those born 30 years earlier. AF, obesity, ischaemic heart disease, diabetes and hypertension remain important precursors of HF.

Sign in / Sign up

Export Citation Format

Share Document