scholarly journals The Dietary Approach to Stop Hypertension (DASH) diet is associated with a lower risk of heart failure: A cohort study

2022 ◽  
Author(s):  
Daniel B Ibsen ◽  
Emily B Levitan ◽  
Agneta Åkesson ◽  
Bruna Gigante ◽  
Alicja Wolk
Keyword(s):  
Heart Failure ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Processed Meat ◽  
Dash Diet ◽  
Sweetened Beverages ◽  
Cox Proportional Hazards Models ◽  
Red And Processed Meat

Abstract Aims Trials demonstrate that following the DASH diet lowers blood pressure, which may prevent development of heart failure (HF). We investigated the association between long-term adherence to the DASH diet and food substitutions within the DASH diet on the risk of HF. Methods Men and women aged 45-83 years without previous HF, ischemic heart disease or cancer at baseline in 1998 from the Cohort of Swedish Men (n = 41,118) and the Swedish Mammography Cohort (n = 35,004) were studied. The DASH diet emphasizes intake of fruit, vegetables, whole grains, nuts and legumes and low-fat dairy and deemphasizes red and processed meat, sugar-sweetened beverages and sodium. DASH diet scores were calculated based on diet assessed by food frequency questionnaires in late 1997 and 2009. Incidence of HF was ascertained using the Swedish Patient Register. Multivariable Cox proportional hazards models were used to estimate hazard ratios (HR) with 95% confidence intervals (CI). Results During the median 22 years of follow-up (1998-2019) 12,164 participants developed HF. Those with the greatest adherence to the DASH diet had a lower risk of HF compared to those with the lowest adherence (HR 0.85, 95% CI 0.80, 0.91 for baseline diet and HR 0.83, 95% CI 0.78, 0.89 for long-term diet, comparing quintiles). Replacing 1 serving/day of red and processed meat with emphasized DASH diet foods was associated with an 8-12% lower risk of HF. Conclusion Long-term adherence to the DASH diet and relevant food substitutions within the DASH diet were associated with a lower risk of HF.

scholarly journals Demographics and Clinical Features of Postresuscitation Comorbidities in Long-Term Survivors of Out-of-Hospital Cardiac Arrest: A National Follow-Up Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Chih-Pei Su ◽  
Jr-Hau Wu ◽  
Mei-Chueh Yang ◽  
Ching-Hui Liao ◽  
Hsiu-Ying Hsu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Arrest ◽  
Proportional Hazards ◽  
Patient Characteristics ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Tract Infections ◽  
Hospital Cardiac Arrest ◽  
New Onset

The outcome of patients suffering from out-of-hospital cardiac arrest (OHCA) is very poor, and postresuscitation comorbidities increase long-term mortality. This study aims to analyze new-onset postresuscitation comorbidities in patients who survived from OHCA for over one year. The Taiwan National Health Insurance (NHI) Database was used in this study. Study and comparison groups were created to analyze the risk of suffering from new-onset postresuscitation comorbidities from 2011 to 2012 (until December 31, 2013). The study group included 1,346 long-term OHCA survivors; the comparison group consisted of 4,038 matched non-OHCA patients. Demographics, patient characteristics, and risk of suffering comorbidities (using Cox proportional hazards models) were analyzed. We found that urinary tract infections (n=225, 16.72%), pneumonia (n=206, 15.30%), septicemia (n=184, 13.67%), heart failure (n=111, 8.25%) gastrointestinal hemorrhage (n=108, 8.02%), epilepsy or recurrent seizures (n=98, 7.28%), and chronic kidney disease (n=62, 4.61%) were the most common comorbidities. Furthermore, OHCA survivors were at much higher risk (than comparison patients) of experiencing epilepsy or recurrent seizures (HR = 20.83; 95% CI: 12.24–35.43), septicemia (HR = 8.98; 95% CI: 6.84–11.79), pneumonia (HR = 5.82; 95% CI: 4.66–7.26), and heart failure (HR = 4.88; 95% CI: 3.65–6.53). Most importantly, most comorbidities occurred within the first half year after OHCA.

scholarly journals Towards refining WCRF/AICR cancer prevention recommendations for red and processed meat intake: Insights from Alberta’s Tomorrow Project cohort

2021 ◽  
pp. 1-38
Author(s):  
Ala Al Rajabi ◽  
Geraldine Lo Siou ◽  
Alianu K. Akawung ◽  
Kathryn L McDonald ◽  
Tiffany R. Price ◽  
...  
Keyword(s):  
Cancer Prevention ◽  
Proportional Hazards ◽  
Red Meat ◽  
Cox Proportional Hazards ◽  
Processed Meat ◽  
Carcinogenic Effect ◽  
Meat Intake ◽  
Increased Risk ◽  
Red Meats ◽  
Red And Processed Meat

ABSTRACT Current cancer prevention recommendations advise limiting red meat intake to <500g/week and avoiding consumption of processed meat, but do not differentiate the source of processed meat. We examined the associations of processed meat derived from red vs. non-red meats with cancer risk in a prospective cohort of 26,218 adults who reported dietary intake using the Canadian Diet History Questionnaire. Incidence of cancer was obtained through data linkage with Alberta Cancer Registry with median (IQR) follow-up of 13.3 (5.1) years. Multivariable Cox proportional hazards regression models were adjusted for covariates and stratified by age and gender. The median (IQR) consumption (g/week) of red meat, processed meat from red meat and processed meat from non-red meat were 267.9 (269.9), 53.6 (83.3), and 11.9 (31.8), respectively. High intakes (4th Quartile) of processed meat from red meat was associated with increased risk of gastro-intestinal cancer Adjusted Hazard Ratio (AHR) (95% CI): 1.68 (1.09 – 2.57) and colorectal cancers AHR (95% CI): 1.90 (1.12 – 3.22), respectively in women. No statistically significant associations were observed for intakes of red meat or processed meat from non-red meat. Results suggests that the carcinogenic effect associated with processed meat intake may be limited to processed meat derived from red meats. The findings provide preliminary evidence toward refining cancer prevention recommendations for red and processed meat intake.

Abstract 2791: Silent Brain Infarction Predicts Cardiovascular Events And Mortality In Long-term Hemodialysis Patients

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Toru Aoyama ◽  
Hideki Ishii ◽  
Hiroshi Takahashi ◽  
Takanobu Toriyama ◽  
Toru Aoyama ◽  
...  
Keyword(s):  
Proportional Hazards ◽  
Brain Infarction ◽  
Cox Proportional Hazards ◽  
Powerful Predictor ◽  
Cardiac Events ◽  
Cox Proportional Hazards Models ◽  
Silent Brain Infarction ◽  
Cv Disease ◽  
Overall Mortality

Background: The cardiovascular (CV) events and mortality are significantly higher in hemodialysis (HD) patents compared to the general population. Although it is of clinical concern to predict the occurrence of CV events in long-term HD patients, more powerful predictor has under exploration. We investigated as to whether silent brain infarction (SBI) would be a predictable factor for future CV events and mortality in a large cohort of patients with long-term HD patients. Methods: After cranial magnetic resonance imaging to detect SBI, 202 long-term HD patients (7.1 ± 5.9 years) without symptomatic stroke were prospectively followed up until the incident of CV events (stroke, cardiac events, and death). We analyzed the prognostic role of SBI in CV events with the Kaplan-Meier method and Cox proportional hazards analysis. Results: The prevalence of SBI was quite higher compared to the previous reports (71.8% in all the patients). In overall patients, 60 patients suffered from CV disease (31 for coronary artery disease, 7 for congestive heart failure, 14 for symptomatic stroke) and 29 patients died (16 for CV death) during a follow up period (mean= 23 ± 13 months). In subgroup analysis regarding the presence of SBI, CV event-free survival rate for 4 years was significantly lower in the patients with SBI compared to those without SBI (54.6% vs. 86.7%, p=0.0003). CV and overall mortality were also significantly higher in SBI patients compared with No-SBI patients (CV mortality; 20.5 % vs. 4.3 %, overall mortality; 29.0% vs. 9.1% p< 0.01, respectively). Cox proportional hazards models showed that the presence of SBI was a significant predictor of cerebrovascular and CV events and CV and overall mortality even after adjustment for other CV risk factors listed on the Table . Conclusion: SBI detected with MRI would be powerful predictor of CV events and mortality in long-term HD patients. Hazard ratio (HR) of SBI for future events and mortality

scholarly journals Prevalence and Prognostic Value of Heart Failure Stages: An Elderly Inpatient Based Cohort Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Pei-Pei Zheng ◽  
Si-Min Yao ◽  
Di Guo ◽  
Ling-ling Cui ◽  
Guo-Bin Miao ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cohort Study ◽  
Prognostic Value ◽  
Proportional Hazards ◽  
Regression Tree ◽  
Cox Proportional Hazards ◽  
Hospitalized Patients ◽  
Classification And Regression Tree ◽  
Major Adverse Cardiovascular Events ◽  
Cox Proportional Hazards Models

Background: The prevalence and prognostic value of heart failure (HF) stages among elderly hospitalized patients is unclear.Methods: We conducted a prospective, observational, multi-center, cohort study, including hospitalized patients with the sample size of 1,068; patients were age 65 years or more, able to cooperate with the assessment and to complete the echocardiogram. Two cardiologists classified all participants in various HF stages according to 2013 ACC/AHA HF staging guidelines. The outcome was rate of 1-year major adverse cardiovascular events (MACE). The Kaplan–Meier method and Cox proportional hazards models were used for survival analyses. Survival classification and regression tree analysis were used to determine the optimal cutoff of N-terminal pro-brain natriuretic peptide (NT-proBNP) to predict MACE.Results: Participants' mean age was 75.3 ± 6.88 years. Of them, 4.7% were healthy and without HF risk factors, 21.0% were stage A, 58.7% were stage B, and 15.6% were stage C/D. HF stages were associated with worsening 1-year survival without MACE (log-rank χ2 = 69.62, P &lt; 0.001). Deterioration from stage B to C/D was related to significant increases in HR (3.636, 95% CI, 2.174–6.098, P &lt; 0.001). Patients with NT-proBNP levels over 280.45 pg/mL in stage B (HR 2; 95% CI 1.112–3.597; P = 0.021) and 11,111.5 pg/ml in stage C/D (HR 2.603, 95% CI 1.014–6.682; P = 0.047) experienced a high incidence of MACE adjusted for age, sex, and glomerular filtration rate.Conclusions : HF stage B, rather than stage A, was most common in elderly inpatients. NT-proBNP may help predict MACE in stage B.Trial Registration: ChiCTR1800017204; 07/18/2018.

scholarly journals Intoxicated Donors and Heart Transplant Outcomes: Long-Term Safety

2021 ◽  
Author(s):  
David A. Baran ◽  
Justin Lansinger ◽  
Ashleigh Long ◽  
John M. Herre ◽  
Amin Yehya ◽  
...  
Keyword(s):  
Drug Use ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Heart Transplants ◽  
Term Survival ◽  
Ischemic Time ◽  
Cox Proportional Hazards Models ◽  
Donor Shortage ◽  
United Network

Background: The opioid crisis has led to an increase in available donor hearts, although questions remain about the long-term outcomes associated with the use of these organs. Prior studies have relied on historical information without examining the toxicology results at the time of organ offer. The objectives of this study were to examine the long-term survival of heart transplants in the recent era, stratified by results of toxicological testing at the time of organ offer as well as comparing the toxicology at the time of donation with variables based on reported history. Methods: The United Network for Organ Sharing database was requested as well as the donor toxicology field. Between 2007 and 2017, 23 748 adult heart transplants were performed. United Network for Organ Sharing historical variables formed a United Network for Organ Sharing Toxicology Score and the measured toxicology results formed a Measured Toxicology Score. Survival was examined by the United Network for Organ Sharing Toxicology Score and Measured Toxicology Score, as well as Cox proportional hazards models incorporating a variety of risk factors. Results: The number and percent of donors with drug use has significantly increased over the study period ( P <0.0001). Cox proportional hazards modeling of survival including toxicological and historical data did not demonstrate differences in post-transplant mortality. Combinations of drugs identified by toxicology were not associated with differences in survival. Lower donor age and ischemic time were significantly positively associated with survival ( P <0.0001). Conclusions: Among donors accepted for transplantation, neither history nor toxicological evidence of drug use was associated with significant differences in survival. Increasing use of such donors may help alleviate the chronic donor shortage.

scholarly journals Comparative clinical outcomes between direct oral anticoagulants and warfarin among elderly patients with non-valvular atrial fibrillation in the CMS medicare population

2019 ◽  
Vol 48 (2) ◽  
pp. 240-249 ◽  
Author(s):  
Alpesh Amin ◽  
Allison Keshishian ◽  
Oluwaseyi Dina ◽  
Amol Dhamane ◽  
Anagha Nadkarni ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Oral Anticoagulants ◽  
Direct Oral Anticoagulants ◽  
Cox Proportional Hazards ◽  
Cardiac Events ◽  
Cox Proportional Hazards Models ◽  
Medicare Patients ◽  
Similar Risk

AbstractAtrial fibrillation (AF) prevalence increases with age; > 80% of US adults with AF are aged ≥ 65 years. Compare the risk of stroke/systemic embolism (SE), major bleeding (MB), net clinical outcome (NCO), and major adverse cardiac events (MACE) among elderly non-valvular AF (NVAF) Medicare patients prescribed direct oral anticoagulants (DOACs) vs warfarin. NVAF patients aged ≥ 65 years who initiated DOACs (apixaban, dabigatran, and rivaroxaban) or warfarin were selected from 01JAN2013-31DEC2015 in CMS Medicare data. Propensity score matching was used to balance DOAC and warfarin cohorts. Cox proportional hazards models estimated the risk of stroke/SE, MB, NCO, and MACE. 37,525 apixaban–warfarin, 18,131 dabigatran–warfarin, and 55,359 rivaroxaban–warfarin pairs were included. Compared to warfarin, apixaban (HR: 0.69; 95% CI 0.59–0.81) and rivaroxaban (HR: 0.82; 95% CI 0.73–0.91) had lower risk of stroke/SE, and dabigatran (HR: 0.88; 95% CI 0.72–1.07) had similar risk of stroke/SE. Apixaban (MB: HR: 0.61; 95% CI 0.57–0.67; NCO: HR: 0.64; 95% CI 0.60–0.69) and dabigatran (MB: HR: 0.79; 95% CI 0.71–0.89; NCO: HR: 0.84; 95% CI 0.76–0.93) had lower risk of MB and NCO, and rivaroxaban had higher risk of MB (HR: 1.08; 95% CI 1.02–1.14) and similar risk of NCO (HR: 1.04; 95% CI 0.99–1.09). Compared to warfarin, apixaban had a lower risk for stroke/SE, MB, and NCO; dabigatran had a lower risk of MB and NCO; and rivaroxaban had a lower risk of stroke/SE but higher risk of MB. All DOACs had lower risk of MACE compared to warfarin.

Multivitamin use and risk of prostate cancer recurrence: Data from the Cancer of the Prostate Strategic Urologic Research Endeavor (CaPSURE).

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 70-70
Author(s):  
Erin Van Blarigan ◽  
Stacey A. Kenfield ◽  
Benjamin E Cedars ◽  
Jenny Broering ◽  
Janet E. Cowan ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cancer Recurrence ◽  
Primary Treatment ◽  
Cox Proportional Hazards ◽  
Age At Diagnosis ◽  
P Value ◽  
Gleason Grade

70 Background: Multivitamin (MV) use is common among men with prostate cancer (PCa). Yet, data on MV use and risk of PCa recurrence are limited. Methods: We conducted a prospective study among 1,373 men with non-metastatic PCa to examine whether MV use after diagnosis was associated with risk of recurrence. Participants completed a comprehensive lifestyle survey a median of 2 y after diagnosis and were followed through 2016. We defined an event of recurrence as the first of the following: PCa death, bone metastasis from PCa, biochemical recurrence, or initiation of secondary treatment. Multivariate Cox Proportional Hazards regression models were used to calculate hazards ratios (HRs) and 95% confidence intervals (CI) for the association between MV use and PCa recurrence. We adjusted for time between diagnosis and the survey, age at diagnosis, Gleason grade, clinical T-stage, PSA at diagnosis, smoking, BMI, walking pace, and primary treatment. We also explored whether age at diagnosis, BMI, time since diagnosis, smoking, or clinical features (grade, stage, treatment) modified the association between MV use and recurrence. Results: We observed 142 events of PCa recurrence over a median follow-up of 10 y; 858 (62%) men were current MV users, 216 (16%) were past users, and 299 (22%) were never users. Overall, MV use was not associated with risk of PCa recurrence (current vs. never HR: 0.69; 95% CI: 0.45, 1.07; p-trend: 0.09). However, long-term MV users (≥10 y; n = 396) had a 56% lower risk of PCa recurrence compared to never users (HR: 0.44; 95% CI: 0.25, 0.78; p-trend: 0.006). Additionally, treatment modified the association between MV use and risk of PCa recurrence ( p-interaction: 0.02). Among the 845 men who had a radical prostatectomy (RP), current MV users had a 44% lower risk of PCa recurrence compared to past/never users (HR: 0.56; 95% CI: 0.34, 0.91; p-value: 0.02). MV use was not associated with risk of PCa recurrence among the 441 men who did not have a RP. Conclusions: Long-term MV use may be associated with lower risk of PCa recurrence.

scholarly journals Metformin vs sulfonylurea use and risk of dementia in US veterans aged ≥65 years with diabetes

Neurology ◽  
2017 ◽  
Vol 89 (18) ◽  
pp. 1877-1885 ◽  
Author(s):  
Ariela R. Orkaby ◽  
Kelly Cho ◽  
Jean Cormack ◽  
David R. Gagnon ◽  
Jane A. Driver
Keyword(s):  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Hazard Ratio ◽  
Confounding By Indication ◽  
Cox Proportional Hazards Models ◽  
Incident Dementia ◽  
Us Veterans

Objective:To determine whether metformin is associated with a lower incidence of dementia than sulfonylureas.Methods:This was a retrospective cohort study of US veterans ≥65 years of age with type 2 diabetes who were new users of metformin or a sulfonylurea and had no dementia. Follow-up began after 2 years of therapy. To account for confounding by indication, we developed a propensity score (PS) and used inverse probability of treatment weighting (IPTW) methods. Cox proportional hazards models estimated the hazard ratio (HR) of incident dementia.Results:We identified 17,200 new users of metformin and 11,440 new users of sulfonylureas. Mean age was 73.5 years and mean HbA1c was 6.8%. Over an average follow-up of 5 years, 4,906 cases of dementia were diagnosed. Due to effect modification by age, all analyses were conducted using a piecewise model for age. Crude hazard ratio [HR] for any dementia in metformin vs sulfonylurea users was 0.67 (95% confidence interval [CI] 0.61–0.73) and 0.78 (95% CI 0.72–0.83) for those <75 years of age and ≥75 years of age, respectively. After PS IPTW adjustment, results remained significant in veterans <75 years of age (HR 0.89; 95% CI 0.79–0.99), but not for those ≥75 years of age (HR 0.96; 95% CI 0.87–1.05). A lower risk of dementia was also seen in the subset of younger veterans who had HbA1C values ≥7% (HR 0.76; 95% CI 0.63–0.91), had good renal function (HR 0.86; 95% CI 0.76–0.97), and were white (HR 0.87; 95% CI 0.77–0.99).Conclusions:After accounting for confounding by indication, metformin was associated with a lower risk of subsequent dementia than sulfonylurea use in veterans <75 years of age. Further work is needed to identify which patients may benefit from metformin for the prevention of dementia.

scholarly journals A cohort study of dietary fibre intake and menarche

2002 ◽  
Vol 5 (2) ◽  
pp. 353-360 ◽  
Author(s):  
Malcolm M Koo ◽  
Thomas E Rohan ◽  
Meera Jain ◽  
John R McLaughlin ◽  
Paul N Corey
Keyword(s):  
Cohort Study ◽  
Dietary Intake ◽  
Dietary Fibre ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Cox Proportional Hazards ◽  
Age At Menarche ◽  
Relative Hazard ◽  
Component Level ◽  
Cox Proportional Hazards Models

AbstractObjective:To evaluate the influence of dietary fibre on menarche in a cohort of pre-menarcheal girls.Design:Prospective cohort study.Setting:Ontario, Canada.Subjects:Free-living pre-menarcheal girls (n = 637), 6 to 14 years of age.Methodology:Information on dietary intake, physical activity and date of menarche was collected at baseline and was updated annually by self-administered questionnaires for three years. Cox proportional hazards models were used to evaluate the association between dietary fibre and menarche, adjusting for age at entry to the study and potential confounders.Results:A higher intake of energy-adjusted dietary fibre was associated with a lower risk of (i.e. a later age at) menarche (relative hazard 0.54, 95% confidence interval (CI) 0.31–0.94 for highest vs. lowest quartile, P for trend = 0.027). At the fibre component level, a higher intake of energy-adjusted cellulose was associated with a lower risk of menarche (relative hazard 0.45, 95% CI 0.26–0.76, P for trend = 0.009).Conclusions:The findings are consistent with the hypothesis that pre-menarcheal dietary intake can influence menarche.

scholarly journals Relationship of exclusive breast-feeding to infections and growth of Tanzanian children born to HIV-infected women

2011 ◽  
Vol 14 (7) ◽  
pp. 1251-1258 ◽  
Author(s):  
Ramadhani S Mwiru ◽  
Donna Spiegelman ◽  
Christopher Duggan ◽  
Karen Peterson ◽  
Enju Liu ◽  
...  
Keyword(s):  
Breast Feeding ◽  
Lower Risk ◽  
Proportional Hazards ◽  
Acute Diarrhoea ◽  
Cox Proportional Hazards ◽  
Watery Diarrhoea ◽  
Exclusive Breast Feeding ◽  
Relative Risks ◽  
Outpatient Visits ◽  
Cox Proportional Hazards Models

AbstractObjectiveWe examined the relationships between exclusive breast-feeding and the risks of respiratory, diarrhoea and nutritional morbidities during the first 2 years of life among children born to women infected with HIV-1.DesignWe prospectively determined the incidence of respiratory illnesses, diarrhoea, fever, hospitalizations, outpatient visits and nutritional morbidities. Generalized estimating equations were used to estimate the relative risks for morbidity episodes and Cox proportional hazards models to estimate the incidence rate ratios of nutritional morbidities.SettingDar es Salaam, Tanzania.SubjectsThe sample consisted of 666 children born to HIV-infected women.ResultsThe 666 children were followed for 2 years. Exclusive breast-feeding was associated with lower risk for cough (rate ratio (RR) = 0·49, 95 % CI 0·41, 0·60, P < 0·0001), cough and fever (RR = 0·44, 95 % CI 0·32, 0·60, P < 0·0001) and cough and difficulty breathing or refusal to feed (RR = 0·31, 95 % CI 0·18, 0·55, P < 0·0001). Exclusive breast-feeding was also associated with lower risk of acute diarrhoea, watery diarrhoea, dysentery, fever and outpatient visits during the first 6 months of life, but showed no effect at 6–24 months of life. Exclusive breast-feeding did not significantly reduce the risks of nutritional morbidities during the first 2 years of life.ConclusionsExclusive breast-feeding is strongly associated with reductions in the risk of respiratory and diarrhoea morbidities during the first 6 months of life among children born to HIV-infected women.

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