Nighttime ambulatory pulse pressure predicts cardiovascular and all‐cause mortality among middle‐aged participants in the 21‐year follow‐up

Abstract To date, there is no scientific consensus on whether insomnia symptoms increase mortality risk. We investigated longitudinal associations between time-varying insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awakening, and non-restorative sleep) and all-cause mortality among middle-aged and older adults during 14 years of follow-up. Data were obtained from 2004 through 2018 survey waves of the Health and Retirement Study in the United States for a population-representative sample of 15,511 respondents who were ≥50 years old in 2004. Respondents were interviewed biennially and followed through the end of the 2018 survey wave for the outcome. Marginal structural discrete-time survival analyses were employed to account for time-varying confounding and selection bias. Of the 15,511 cohort respondents (mean [±SD] age at baseline, 63.7 [±10.2] years; 56.0% females), 5,878 (31.9%) died during follow-up. At baseline (2004), 41.6% reported experiencing at least one insomnia symptom. Respondents who experienced one (HR=1.11; 95% CI: 1.03–1.20), two (HR=1.12; 95% CI: 1.01–1.23), three (HR=1.15; 95% CI: 1.05–1.27), or four (HR=1.32; 95% CI: 1.12–1.56) insomnia symptoms had on average a higher hazard of all-cause mortality, compared to those who were symptom-free. For each insomnia symptom, respondents who experienced difficulty initiating sleep (HR=1.12; 95% CI: 1.02–1.22), early-morning awakening (HR=1.09; 95% CI: 1.01–1.18), and nonrestorative sleep (HR=1.17; 95% CI: 1.09–1.26), had a higher hazard of all-cause mortality compared to those not experiencing the symptom. The findings demonstrate significant associations between insomnia symptoms and all-cause mortality, both on a cumulative scale and independently, except for difficulty maintaining sleep. Further research should investigate the underlying mechanisms linking insomnia symptoms and mortality.

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Adiposity change and mortality in middle-aged to older Chinese: an 8-year follow-up of the Guangzhou Biobank Cohort Study

BMJ Open ◽

10.1136/bmjopen-2020-039239 ◽

2020 ◽

Vol 10 (12) ◽

pp. e039239

Author(s):

Ying Yue Huang ◽

Chao Qiang Jiang ◽

Lin Xu ◽

Wei Sen Zhang ◽

Feng Zhu ◽

...

Keyword(s):

Cohort Study ◽

Outcome Measures ◽

Mortality Risk ◽

Cancer Mortality ◽

Secondary Outcome ◽

Middle Aged ◽

All Cause Mortality ◽

Older Chinese ◽

Cvd Mortality

ObjectiveTo examine the associations of change in body mass index (BMI) and waist circumference (WC) over an average of 4 years with subsequent mortality risk in middle-aged to older Chinese.DesignProspective cohort study based on the Guangzhou Biobank Cohort Study.SettingCommunity-based sample.Participants17 773 participants (12 956 women and 4817 men) aged 50+ years.Primary and secondary outcome measuresPrimary outcome measure was all-cause mortality. Secondary outcome measures were cardiovascular disease (CVD) and cancer mortality. Causes of death were obtained via record linkage, and coded according to the International Classification of Diseases (tenth revision).Results1424 deaths (53.4% women) occurred in the 17 773 participants (mean age 61.2, SD 6.8 years) during an average follow-up of 7.8 (SD=1.5) years, and 97.7% of participants did not have an intention of weight loss . Compared with participants with stable BMI, participants with BMI loss (>5%), but not gain, had a higher risk of all-cause mortality (HR=1.49, 95% CI 1.31 to 1.71), which was greatest in those who were underweight (HR=2.45, 95% CI 1.31 to 4.59). Similar patterns were found for WC. In contrast, for participants with a BMI of ≥27.5 kg/m2, BMI gain, versus stable BMI, was associated with 89% higher risk of all-cause mortality (HR=1.89, 95% CI 1.25 to 2.88), 72% higher risk of CVD mortality (HR=1.72, 95% CI 0.80 to 3.72) and 2.27-fold risk of cancer mortality (HR=2.27, 95% CI 1.26 to 4.10).ConclusionIn older people, unintentional BMI/WC loss, especially in those who were underweight was associated with higher mortality risk. However, BMI gain in those with obesity showed excess risks of all-cause and cancer mortality, but not CVD mortality. Frequent monitoring of changes in body size can be used as an early warning for timely clinical investigations and interventions and is important to inform appropriate health management in older Chinese.

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Increasing ambulatory pulse pressure predicts the development of left ventricular hypertrophy during long-term follow-up

Journal of Human Hypertension ◽

10.1038/s41371-018-0034-5 ◽

2018 ◽

Vol 32 (3) ◽

pp. 180-189 ◽

Cited By ~ 2

Author(s):

Tero J. W. Pääkkö ◽

Juha S. Perkiömäki ◽

Y. Antero Kesäniemi ◽

Antti S. Ylitalo ◽

Jarmo A. Lumme ◽

...

Keyword(s):

Left Ventricular Hypertrophy ◽

Pulse Pressure ◽

Ventricular Hypertrophy ◽

Left Ventricular ◽

Long Term Follow Up ◽

Ambulatory Pulse Pressure

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Determinants of longevity and all-cause mortality among middle-aged men. Role of 48 personal characteristics in a 40-year follow-up of Italian Rural Areas in the Seven Countries Study

Aging Clinical and Experimental Research ◽

10.1007/bf03324836 ◽

2006 ◽

Vol 18 (5) ◽

pp. 394-404 ◽

Cited By ~ 17

Author(s):

Alessandro Menotti ◽

Mariapaola Lanti ◽

Giuseppe Maiani ◽

Daan Kromhout

Keyword(s):

Rural Areas ◽

Personal Characteristics ◽

Middle Aged ◽

Seven Countries Study ◽

All Cause Mortality

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Impact of obesity and physical inactivity on the long-term change in grip strength among middle-aged and older European adults

Journal of Epidemiology & Community Health ◽

10.1136/jech-2018-211601 ◽

2019 ◽

Vol 73 (7) ◽

pp. 619-624 ◽

Cited By ~ 1

Author(s):

Tianyu Wang ◽

Wenjing Feng ◽

Suyun Li ◽

Qihua Tan ◽

Dongfeng Zhang ◽

...

Keyword(s):

Grip Strength ◽

Chronic Conditions ◽

Physical Inactivity ◽

Middle Aged ◽

Physically Active ◽

Term Change ◽

All Cause Mortality ◽

Gender Specific

BackgroundGrip strength is a well-established predictor of various chronic conditions and all-cause mortality. Body weight and physical activity (PA) are considered potential determinants of muscle strength. This study aimed to investigate gender-specific associations of baseline obesity and physical inactivity with long-term changes in grip strength among middle-aged and older European adults.MethodsData from the Survey of Health, Ageing and Retirement in Europe 2004–2015 which was conducted in 12 countries were analysed. Grip strength was repeatedly measured at five follow-up visits with average 2-year intervals. Obesity and physical inactivity at baseline were primary exposures. Generalised estimated equations stratified by gender were fitted.ResultsThis study included 8616 males and 10 088 females with a median follow-up of 9.42 years. Significant interactions between obesity and time with grip strength were identified in both males (χ2interaction=16.65, p = 0.002) and females (χ2interaction=10.80, p = 0.029). No significant interaction between physical inactivity and time with grip strength was identified in males (χ2interaction=9.42, p = 0.051) or females (χ2interaction=5.62, p = 0.230). Those who were less physically active at baseline had weaker grip strength from the beginning at baseline (β = −2.753, p < 0.001 for males and β = −1.529, p < 0.001 for females) to Visit 6 (β = −2.794, p < 0.001 for males and β = −1.550, p < 0.001 for females). Further combined analysis suggested a trend that exposure to both obesity and physical inactivity was related to the fastest decline rate of grip strength.ConclusionsThis study provides the additional evidence that PA and obesity prevention earlier in life play an important role in maintaining grip strength during ageing.

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Abstract 15189: Impact of Revascularization Strategy on the Prognosis of Young and Middle-aged Patients With Coronary Artery Disease

Circulation ◽

10.1161/circ.142.suppl_3.15189 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Xiaoyan Liu ◽

Chengyue Jin ◽

Xinyu Liu ◽

Yong Wang ◽

Hong Qiu

Keyword(s):

Coronary Artery ◽

Artery Bypass ◽

Composite Endpoint ◽

Coronary Intervention ◽

Middle Aged ◽

Aged Patients ◽

Term Survival ◽

Incidence And Mortality ◽

All Cause Mortality

Introduction: Despite increasing incidence and mortality of CAD among young and mid-age patients (age ≤ 65), the optimum revascularization strategy remains unclear. We compared outcomes of PCI and CABG in this patient group. Methods: “Coronary artery bypass” and “percutaneous coronary intervention” were used to identify articles in PubMed and Cochrane database published prior to February 2, 2020. Both RCTs and observational studies (OSs) comparing PCI and CABG with data of patients or subgroups patients ≤ 65 years of age were included. The quality of study data was assessed by RoB2 and Newcastle-Ottawa Scale (NOS). The primary end point was all-cause mortality. Secondary endpoint includes MI, stroke, repeat revascularization (RR), and a composite endpoint of major adverse cardiac cerebral events (MACCE). We calculated odds ratio using Mantel-Haenszel method with random effects. Results: A total of 10 RCTs and 20 OSs with 31226 CAD patients were included in our analysis, of which 1 RCT and 4 OSs focused on population ≤ 65 years old while the rest provided subgroup data. The risk of bias RCTs were low to middle, and quality ratings of OSs were 4-8 by NOS. Compared to CABG, PCI was associated with a higher risk of mortality (OR 1.42, 95% CI 1.24-1.62, P<0.001), MACCE (OR 1.99, P<0.001), MI (OR 2.13, P = 0.011), and RR (OR 3.88, P<0.001). The risk of stroke is similar in both groups (OR 0.883, P= 0.506). However, after stratification, mortality rate is similar in studies with follow-up period ≤ 3 years. (OR 1.27, P=0.255) but remain significant with longer follow-up (OR 1.41, P<0.001). Conclusions: Compared to PCI, CABG is associated with lower all-cause mortality in young and middle-aged CAD patients, especially with long follow-up indicating superior long-term survival. Given the longer life-expectancy in this age group, the advantage of CABG is even more prominent. However, given the retrospective nature of this study, dedicated RCT is needed to further address this question.

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Evictions and short-term all-cause mortality: a 3-year follow-up study of a middle-aged Swedish population

International Journal of Public Health ◽

10.1007/s00038-016-0931-8 ◽

2016 ◽

Vol 62 (3) ◽

pp. 343-351 ◽

Cited By ~ 8

Author(s):

Yerko Rojas

Keyword(s):

Middle Aged ◽

Short Term ◽

Swedish Population ◽

Follow Up Study ◽

All Cause Mortality

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Low-density lipoprotein cholesterol and all-cause mortality: findings from the China health and retirement longitudinal study

BMJ Open ◽

10.1136/bmjopen-2020-036976 ◽

2020 ◽

Vol 10 (8) ◽

pp. e036976

Author(s):

Liang Zhou ◽

Ying Wu ◽

Shaobo Yu ◽

Yueping Shen ◽

Chaofu Ke

Keyword(s):

Longitudinal Study ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Total Mortality ◽

Low Density ◽

Low Density Lipoprotein Cholesterol ◽

Middle Aged ◽

Elderly Chinese ◽

All Cause Mortality

ObjectivesTo investigate the relationship between low-density lipoprotein cholesterol (LDL-C) and all-cause mortality among middle-aged and elderly Chinese population.DesignProspective cohort study.SettingThis study used data from the China Health and Retirement Longitudinal Study.ParticipantsMiddle-aged and elderly participants with complete data were enrolled for a 4-year follow-up of total mortality and plasma levels of LDL-C, including 4981 male respondents and 5529 female respondents.ResultsDuring a 4-year follow-up, there were 305 and 219 deaths in men and women, respectively. Compared with the first quintile (Q1) of LDL-C, the adjusted HRs (95% CIs) were 0.818 (0.531 to 1.260) for Q2, 0.782 (0.507 to 1.208) for Q3, 0.605 (0.381 to 0.962) for Q4 and 0.803 (0.506 to 1.274) for Q5 in men. The results from restricted cubic spine (RCS) showed that when the 20th percentile of LDL-C levels (84 mg/dL) was used as the reference, a lower LDL-C concentration (<84 mg/dL) was associated with a higher 4-year all-cause mortality risk. By contrast, both quintile analysis and RCS analysis did not show a statistically significant association in women.ConclusionsCompared with moderately elevated LDL-C (eg, 117–137 mg/dL), a lower plasma level of LDL-C (eg, ≤84 mg/dL) was associated with an increased risk of 4-year all-cause mortality in middle-aged and elderly Chinese men. The results suggest the potential harmful effect of a quite low level of LDL-C on total mortality.

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