scholarly journals Association of plasma vitamin C concentration to total and cause-specific mortality: a 16-year prospective study in China

2018 ◽  
Vol 72 (12) ◽  
pp. 1076-1082 ◽  
Author(s):  
Shao-Ming Wang ◽  
Jin-Hu Fan ◽  
Philip R Taylor ◽  
Tram Kim Lam ◽  
Sanford M Dawsey ◽  
...  

BackgroundVitamin C insufficiency occurs across many countries and has been hypothesised to increase risk of various diseases. Few prospective studies with measured circulating vitamin C have related deficiency to disease mortality, particularly in low-income and middle-income countries.MethodsWe randomly selected 948 subjects (473 males and 475 females) aged 53–84 years from a Chinese cohort and measured meta-phosphoric acid-preserved vitamin C concentrations in plasma samples collected in 1999–2000. A total of 551 deaths were accrued from sample collection through 2016, including 141 from cancer, 170 from stroke and 174 from heart diseases. Vitamin C was analysed using season-specific quartiles, as a continuous variable and as a dichotomous variable based on sufficiency status (normal >28 µmol/L vs low ≤28 µmol/L). HRs and 95% CIs were estimated using Cox proportional hazards models.ResultsWe found significant inverse associations between higher plasma vitamin C concentrations and total mortality in quartile (HRQ4 vs Q10.75, 95% CI 0.59 to 0.95), continuous (HRq20umol/L0.90, 95% CI 0.82 to 0.99) and dichotomous analyses (HRnormal-vs-low0.77, 95% CI 0.63 to 0.95). We observed significant lower risks of heart disease (ptrend-by-quantile=0.03) and cancer deaths (pglobal-across-quantile=0.04) for higher vitamin C, whereas the association was attenuated for stroke in adjusted models. Similar inverse associations were found when comparing normal versus low vitamin C for heart disease (HRnormal-vs-low0.62, 95% CI 0.42 to 0.89).ConclusionIn this long-term prospective Chinese cohort study, higher plasma vitamin C concentration was associated with lower total mortality, heart disease mortality and cancer mortality. Our results corroborate the importance of adequate vitamin C to human health.

2021 ◽  
Author(s):  
Xiaobing Feng ◽  
Wenzhen Li ◽  
Man Cheng ◽  
Weihong Qiu ◽  
Ruyi Liang ◽  
...  

Abstract ObjectivesWe expected to explore the associations of hearing loss and hearing thresholds at different frequencies with total and cause-specific mortality.Methods11,732 individuals derived from the National Health and Nutrition Examination Survey (NHANES) 1999-2012 were included in this study. Data of death was extracted from the NHANES Public-Use Linked Mortality File through December 31, 2015. Cox proportional hazards models were used to explore the associations between hearing loss, hearing thresholds at different frequencies and total or cause-specific mortality. ResultsA total of 1,253 deaths occurred with a median follow-up of 12.15 years. A significant positive dose-response relationship between hearing loss in speech frequency and total mortality was observed, and the HRs and 95% CIs were 1.16 (0.91, 1.47), 1.54 (1.19, 2.00) and 1.85 (1.36, 2.50), respectively for mild, moderate and severe speech-frequency hearing loss (SFHL) with a P trend of 0.0003. In addition, moderate (HR: 1.90, 95%CI: 1.20-3.00) and greater (3.50, 1.38-8.86) SFHL significantly elevated risk of heart disease mortality. Moreover, hearing thresholds of >25 dB at 500, 1000, or 2000 Hz were significantly associated with elevated mortality from all causes (1.40, 1.17-1.68; 1.44, 1.20-1.73; and 1.33, 1.10-1.62, respectively) and heart disease (1.89, 1.08-3.34; 1.95, 1.21-3.16; and 1.89, 1.16-3.09, respectively). ConclusionHearing loss is associated with increased risks of total mortality and heart disease mortality, especially for hearing loss at speech frequency. Preventing or inhibiting the pathogenic factors of hearing loss is important for reducing the risk of death.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Zhilei Shan ◽  
Danielle E Haslam ◽  
Colin D Rehm ◽  
Mingyang Song ◽  
Frank B Hu ◽  
...  

Introduction: Animal protein sources, especially red and processed meat, have been associated with adverse health outcomes. Epidemiological evidence on the isocaloric substitution of plant for animal protein on mortality risk remains limited. Hypothesis: We hypothesized that substituting plant protein for carbohydrates and animal protein would be associated with lower mortality. Method: We included a nationally representative sample of 37 233 US adults ≥20 years with 24-h dietary recall data from eight National Health and Nutrition Examination Survey (NHANES) cycles (1999-2014). Mortality from all causes, heart disease, and cancer were identified through National Death Index linkage (until December 31, 2015). We used Cox proportional hazards regression to estimate the association between plant and animal protein intake and mortality after adjustment for potential confounding factors. Results: During 297 768 person-years of follow-up, 4 866 total deaths occurred, including 849 deaths from heart disease and 1 068 deaths from cancer. After multivariable adjustment, higher intake of total animal protein was not associated with total mortality. Plant protein was associated with lower total mortality; when comparing the lowest with highest quintiles of plant protein intake, the multivariable adjusted HR (95% CIs) of total mortality was 0.73 (0.61, 0.88); P for trend <0.001. The HRs (95% CIs) comparing extreme quintiles were 0.71 (0.48, 1.05) for heart disease mortality, and 0.74 (0.53, 1.04) for cancer mortality. When isocalorically replacing 5% of energy from total animal protein with plant protein, the multivariable HRs were 0.49 (0.32, 0.74) for total mortality, 0.51 (0.28, 0.95) for heart disease mortality, and 0.53 (0.28, 1.00) for cancer mortality. For different food sources of animal protein, isocaloric substitution of 2% of energy from plant protein for protein in unprocessed red meat (0.74, 95% CI: 0.63, 0.87), processed meat (0.68, 95% CI: 0.53, 0.89), total dairy (0.74, 95% CI: 0.58, 0.94), and 1% of energy from plant protein for seafood (0.86, 95% CI: 0.79, 0.93) was each associated with a lower risk of total mortality. Conclusions: Higher plant protein intake was associated with lower total mortality. Isocalorically replacing animal protein with plant protein was associated with lower total mortality.


1970 ◽  
Vol 6 (1) ◽  
pp. 19-23 ◽  
Author(s):  
AM Hossain ◽  
NU Ahmed ◽  
M Rahman ◽  
MR Islam ◽  
G Sadhya ◽  
...  

A hospital based cross sectional study was carried out to analyze prevalence of risk factors for stroke in hospitalized patient in a medical college hospital. 100 patients were chosen using purposive sampling technique. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both urban (54%) and rural (46%) areas and most of them belong to the low-income group (47%). In occupational category; service holder (28%) and retired person (21%) were the highest groups. Most of the study subjects were literate (63%). CT scan study revealed that the incidence of ischaemic stroke was 61% and haemorrhagic stroke 39%. Analysis indicated hypertension as major risk factor for stroke (63%) and major portion of the patients (42.85%) were on irregular or no treatment. Twenty four percent of the patients had heart diseases and out of 24 patients 45.83% were suffering from ischaemic heart disease. The present study detected diabetes in 21% patients. Fifty three percent of the study subjects were smoker, 39% patients had habit of betelnut chewing. Out of 26 female patients, only 23% had history of using oral contraceptives. Majority of the patients were sedentary workers (46%). Thirty seven percent of the stroke patients were obese. Among the stroke patients 9% had previous history of stroke and 3% had TIA respectively. Most of the patients (21%) were awake while they suffered from stroke and the time of occurrence was mostly in the afternoon (46%). This study found that hypertension, cigarette smoking, ischaemic heart disease and diabetes mellitus are the major risk factors prevalent in our community while other risk factors demand further study. Key words: stroke; risk factors; hospitalized patients; Bangladesh. DOI: 10.3329/fmcj.v6i1.7405 Faridpur Med. Coll. J. 2011;6(1): 19-23


Medicina ◽  
2019 ◽  
Vol 55 (10) ◽  
pp. 687 ◽  
Author(s):  
Alessandro Menotti ◽  
Paolo Emilio Puddu

Background and objectives: Previous epidemiological studies have identified a group of heart diseases (here called heart diseases of uncertain etiology—HDUE) whose characteristics were rather different from cases classified as coronary heart disease (CHD), but frequently confused with them. This analysis had the purpose of adding further evidence on this issue based on a large population study. Materials and Methods: Forty-five Italian population samples for a total of 25,272 men and 21,895 women, free from cardiovascular diseases, were examined with measurement of some risk factors. During follow-up, CHD deaths were those manifested as myocardial infarction, other acute ischemic attacks, and sudden death of probable coronary origin, after reasonable exclusion of other causes. Cases of HDUE were those manifested only as heart failure, chronic arrhythmia, and blocks in the absence of typical coronary syndromes. Cox proportional hazards models were computed separately for CHD and HDUE, with 11 risk factors as possible predictors. Results: During an average of 7.4 years (extremes 1–16) there were 223 CHD and 150 HDUE fatal events. Male sex, age, smoking habits, systolic blood pressure, serum cholesterol, and plasma glucose were significantly and directly related to CHD events, while high density lipoprotein (HDL) cholesterol was so in an inverse way. The same risk factors were predictive of HDUE events except serum cholesterol and HDL cholesterol. Multivariable hazards ratio of serum cholesterol (delta = 1 mmol/L) was higher in the CHD model (1.24, 95% CI 1.11–1.39) than in the HDUE model (1.03, 0.5% C.I. 0.89–1.19) and the difference between the respective coefficients was statistically significant (p = 0.0444). Age at death was not different between the two end-points. Conclusions: CHD and HDUE are probably two different morbid conditions, only the first one is likely bound to gross atherosclerotic lesions of coronary arteries and linked to blood lipid levels. We reviewed the problem in epidemiological investigations and addressed inflammation as a potential cofactor to differentiate between CHD and HDUE.


Author(s):  
David Aguilar ◽  
Caroline Sun ◽  
Ron C. Hoogeveen ◽  
Vijay Nambi ◽  
Elizabeth Selvin ◽  
...  

Background Circulating galectin‐3 levels provide prognostic information in patients with established heart failure (HF), but the associations between galectin‐3 levels and other incident cardiovascular events in asymptomatic individuals at midlife and when remeasured ≈15 years later are largely uncharacterized. Methods and Results Using multivariable Cox proportional hazards models, we identified associations between plasma galectin‐3 levels (hazard ratio [HR] per 1 SD increase in natural log galectin‐3) and incident coronary heart disease, ischemic stroke, HF hospitalization, and total mortality in ARIC (Atherosclerosis Risk in Communities) participants free of cardiovascular disease at ARIC visit 4 (1996–1998; n=9247) and at ARIC visit 5 (2011–2013; n=4829). Higher galectin‐3 level at visit 4 (median age 62) was independently associated with incident coronary heart disease (adjusted HR, 1.30; 95% CI, 1.06–1.60), ischemic stroke (HR, 1.42; 95% CI, 1.01–2.00), HF (HR, 1.44; 95% CI, 1.17–1.76), and mortality (HR, 1.56; 95% CI, 1.35–1.80). At visit 5 (median age, 74), higher galectin‐3 level was associated with incident HF (HR, 1.93; 95% CI, 1.15–3.24) and total mortality (HR, 1.70; 95% CI, 1.15–2.52), but not coronary heart disease or stoke. Individuals with the greatest increase in galectin‐3 levels from visit 4 to visit 5 were also at increased risk of incident HF and total mortality. Conclusions In a large, biracial community‐based cohort, galectin‐3 measured at midlife and older age was associated with increased risk of cardiovascular events. An increase in galectin‐3 levels over this period was also associated with increased risk.


2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Solmon Gebremariam ◽  
Tamirat Moges

Introduction. Causes of acute heart failure in children range from simple myocarditis complicating chest infection to complex structural heart diseases.Objective.To describe patterns, predictors of mortality, and management outcomes of acute heart failure in children.Methods.In retrospective review, between February 2012 and October 2015 at a tertiary center, 106 admitted cases were selected consecutively from discharge records. Data were extracted from patients chart and analyzed using SPSS software package.t-test and statistical significance atPvalue < 0.05 with 95% CI were used.Result. Acute heart failure accounted for 2.9% of the total pediatric admissions. The age ranged from 2 months up to 14 years with mean age of 8 years. Male to female ratio is 1 : 2.1. Rheumatic heart disease accounted for 53.7%; pneumonia, anemia, infective endocarditis, and recurrence of acute rheumatic fever were the main precipitating causes. Death occurred in 19% of cases. Younger age at presentation, low hemoglobin concentration, and undernutrition were associated with death withPvalue of 0.00, 0.01, and 0.02, respectively.Conclusions and Recommendation. Pediatric heart failure in our settings is diagnosed mainly in older age groups and mostly precipitated due to preventable causes. Significant mortality is observed in relation to factors that can be preventable in children with underlying structural heart disease. Early suspicion and diagnosis of cases may reduce the observed high mortality.


2018 ◽  
Vol 10 (2) ◽  
pp. 206-211 ◽  
Author(s):  
Mohammad Arifur Rahman ◽  
Afzalur Rahman ◽  
Syed Nasir Uddin ◽  
AKM Monwarul Islam ◽  
Tariq Ahmed Chowdhury ◽  
...  

In the 21st century, Rheumatic fever (RF) and Rheumatic heart disease (RHD) are neglected diseases of marginalized communities. Globally, RHD remains the most-common cardiovascular disease in young people aged <25 years. Although RF and RHD have been almost eradicated in areas with established economies, migration from low-income to high-income settings might be responsible for a new burden of RHD in high-income countries. Globally, the prevalence of rheumatic fever (RF) and rheumatic heart disease (RHD) has declined sharply but, in developing countries, RF is still aleading cause of heart disease and, consequently, death in children and young adults. In 2005, it was estimated that over 2.4 million children aged 5-14 years were having RHD globally and 79% of all these cases were from lessdeveloped countries.Cardiovasc. j. 2018; 10(2): 206-211


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