Abstract P123: Percentage of Deaths Attributable to Poor Cardiovascular Health Behaviors: Findings from the Aerobics Center Longitudinal Study

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Xuemei Sui ◽  
Jiajia Zhang ◽  
Duck-chul Lee ◽  
Enrique G Artero ◽  
Steven N Blair
Keyword(s):  
Longitudinal Study ◽  
Health Behaviors ◽  
Cardiorespiratory Fitness ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Premature Death ◽  
Targeted Interventions ◽  
History Of ◽  
Aerobics Center Longitudinal Study

Introduction: Although cigarette smoking, physical inactivity, obesity, and poor diet each have been linked to the risk of premature death, little is known about their relative individual and combined impact, adapted from the American Heart Association (AHA)’s new cardiovascular health construct, on mortality outcomes. We hypothesized that the individual and the combined health behaviors were inversely associated with all-cause mortality. The purpose of the study is to estimate the mortality effects of the 4 AHA defined cardiovascular health behaviors by examining the associated population attributable fractions (PAFs) of individual and combination factors. Methods: The study included 11240 (24% women) participants from the Aerobics Center Longitudinal Study (ACLS). Slightly modified AHA cardiovascular health behaviors (smoking, BMI, cardiorespiratory fitness and diet) were collected between 1987 and 1999 as part of the clinical examination. We used cardiorespiratory fitness as an objective marker of recent physical activity habits. Individuals with a history of a cardiovascular disease, or cancer were excluded. The cohort was followed to December 2003 or death. PAFs were calculated after adjusting for age, gender, hypertension, diabetes, hypercholesterolemia, family history of CVD, and the four health behaviors. Results: Two hundred and sixty-eight deaths were documented during an average 12 years of follow-up. Low fitness had the highest PAFs at the 5 th , 10 th , and 15 th year of follow-up, respectively: 6.6% (95% CI: 1.6% - 11.4%), 6.4% (95% CI: 1.5% - 11.0%), and 5.5% (95% CI: 1.3% - 9.6%). Current smokers had the second highest PAFs at the 5 th , 10 th , and 15 th year of follow-up, respectively: 5.4% (95% CI: 0.1% - 10.3%), 5.2% (95% CI: 0.1% - 9.9%), and 5.0% (95% CI: 0.2% - 9.5%). Additional adjustment for other confounders in the model did not change the above associations. The PAFs for overweight or obese and unhealthy diet were not significant in the current study. Conclusion: Assuming a causal relationship between smoking, low fitness and mortality, avoidance of these two cardiovascular health risk factors would have prevented 13% of the deaths in the ACLS population. Targeted interventions to increase fitness as well as stopping smoking would most likely promote longevity.

The Association of Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

2019 ◽  
Vol 16 (11) ◽  
pp. 968-975
Author(s):  
Leanna M. Ross ◽  
Jacob L. Barber ◽  
Alexander C. McLain ◽  
R. Glenn Weaver ◽  
Xuemei Sui ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cardiorespiratory Fitness ◽  
Mixed Models ◽  
Cardiovascular Health ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
The Poor ◽  
Longitudinal Associations ◽  
Aerobics Center Longitudinal Study

Background: This study examined the cross-sectional and longitudinal associations of cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH). Methods: CRF and the 7 CVH components were measured in 11,590 (8865 males; 2725 females) adults at baseline and in 2532 (2160 males; 372 females) adults with at least one follow-up examination from the Aerobics Center Longitudinal Study. Ideal CVH score was calculated as a composite of 7 measures, each scored 0 to 2. CVH groups were based on participant point score: ≤7 (poor), 8 to 11 (intermediate), and 12 to 14 (ideal). Analyses included general linear, logistic regression, and linear mixed models. Results: At baseline, participants in the high CRF category had 21% and 45% higher mean CVH scores than those in the moderate and poor CRF categories (P < .001). The adjusted odds (95% confidence interval) of being in the poor CVH group at baseline were 4.9 (4.4–5.4) and 16.9 (14.3–19.9) times greater for individuals with moderate and low CRF, respectively, compared with those with high CRF (P < .001). Longitudinal analysis found that for every 1-minute increase in treadmill time, CVH score increased by 0.23 units (P < .001) independent of age, sex, exam number, and exam year. Conclusions: Higher CRF is associated with better CVH profiles, and improving CRF over time is independently associated with greater improvements in CVH.

Abstract 37: The Association of Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Leanna M Ross ◽  
Jacob L Barber ◽  
Xuemei Sui ◽  
Steven N Blair ◽  
Mark A Sarzynski
Keyword(s):  
Longitudinal Study ◽  
Cardiorespiratory Fitness ◽  
Cardiovascular Health ◽  
Smoking Status ◽  
Cross Sectional ◽  
Ideal Cardiovascular Health ◽  
Logistic Regression Models ◽  
Using Data ◽  
Middle Aged Adults ◽  
Aerobics Center Longitudinal Study

Purpose: To examine the cross-sectional association between cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH) in middle-aged adults. Methods: The association between CRF and ideal CVH score was examined in 11,590 adults (8,865 men, 2,725 women) from the Aerobics Center Longitudinal Study. CRF was measured as duration in minutes from a maximal treadmill test. The AHA’s ideal CVH score was calculated on a 14 point scale using data on smoking status, BMI, physical activity (MET-min/wk), healthy diet, total cholesterol, blood pressure, and fasting plasma glucose recorded between 1987 and 1999. Participants were grouped into categories of inadequate (0-4), average (5-9), and optimum (10-14) based on their CVH score. Three CRF groups were created from age- and sex-specific quintiles based on the previously established cutpoints of treadmill time: low, moderate, and high CRF. We used general linear and logistic regression models adjusted for age, sex, and year of examination to evaluate the association of CRF with ideal CVH score. Results: The mean CVH score for men was 8.4 ± 2.2 and 9.7 ± 2.0 for women. Approximately 33% of men and 57% of women had optimum CVH, while only a small proportion of participants had inadequate CVH (5.1% M, 1.4% F). Treadmill time was moderately correlated (p<0.0001) with CVH score in both men (r=0.56) and women (r=0.50). CRF explained 16% and sex 18% of the variance in CVH score (both p<0.0001). Our adjusted model found that participants in the optimum CVH category had 20% and 43% higher CRF levels than those in the average and inadequate CVH groups (p<0.0001), respectively ( Figure 1 ). The adjusted odds (95% CI) of having optimum CVH were 14.0 (11.0-17.8) and 3.1 (2.4-4.0) times greater for high CRF and moderate CRF, respectively, compared to low CRF (p<0.0001). Discussion: Higher levels of cardiorespiratory fitness are associated with better cardiovascular health profiles in both men and women. Thus, improving fitness represents a strategy to improve cardiovascular and public health.

scholarly journals Percentage of Deaths Attributable to Poor Cardiovascular Health Lifestyle Factors: Findings from the Aerobics Center Longitudinal Study

2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Xuemei Sui ◽  
Hongjuan Li ◽  
Jiajia Zhang ◽  
Li Chen ◽  
Ling Zhu ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Cardiovascular Health ◽  
Heart Association ◽  
Lifestyle Factors ◽  
Health Lifestyle ◽  
Population Attributable Fractions ◽  
Attributable Fractions ◽  
Unhealthy Diet ◽  
Aerobics Center Longitudinal Study ◽  
Overweight Or Obesity

Purpose. We assessed the effects of the four newly defined American Heart Association (AHA) lifestyle factors on mortality by examining the associated population attributable fractions (PAFs) of these factors. Methods. Slightly modified AHA cardiovascular health factors (smoking, body mass index, cardiorespiratory fitness, and diet) were measured among 11,240 (24% women) participants from the Aerobics Center Longitudinal Study between 1987 and 1999. The cohort was followed to December 31, 2003, or death. PAFs were calculated as the proportionate reduction in death attributable to identified risk factors. Results. During an average 12 years of followup, 268 deaths occurred. Low fitness had the highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 6.6%, 6.4%, and 5.5%. Current smokers had the second highest PAFs at the 5th, 10th, and 15th year of followup, respectively: 5.4%, 5.2%, and 5.0%. Additional adjusting for other confounders in the model did not change the above associations. The PAFs for overweight or obesity and unhealthy diet were not significant in the current analyses. Conclusions. Assuming a causal relationship between smoking, low fitness, and mortality, avoidance of both would have prevented 13% of the deaths in the current population. Preventive interventions to increase physical activity and stop smoking would most likely promote longevity.

scholarly journals Effects of depression, metabolic syndrome, and cardiorespiratory fitness on mortality: results from the Cooper Center Longitudinal Study

2017 ◽  
Vol 47 (14) ◽  
pp. 2414-2420 ◽  
Author(s):  
C. D. Rethorst ◽  
D. Leonard ◽  
C. E. Barlow ◽  
B. L. Willis ◽  
M. H. Trivedi ◽  
...  
Keyword(s):  
Metabolic Syndrome ◽  
Longitudinal Study ◽  
Cardiorespiratory Fitness ◽  
Mortality Risk ◽  
Heart Association ◽  
Premature Mortality ◽  
Substantial Impact ◽  
Blood Institute ◽  
History Of ◽  
History Of Depression

BackgroundDepression and metabolic syndrome (MetS) are frequently comorbid disorders that are independently associated with premature mortality. Conversely, cardiorespiratory fitness (CRF) is associated with reduced mortality risk. These factors may interact to impact mortality; however, their effects have not been assessed concurrently. This analysis assessed the mortality risk of comorbid depression/MetS and the effect of CRF on mortality in those with depression/MetS.MethodsProspective study of 47 702 adults in the Cooper Center Longitudinal Study. Mortality status was attained from the National Death Index. History of depression was determined by patient response (yes or no) to a standardized medical history questionnaire. MetS was categorized using the American Heart Association/National Heart, Lung, and Blood Institute criteria. CRF was estimated from the final speed/grade of a treadmill graded exercise test.Results13.9% reported a history of depression, 21.4% met criteria for MetS, and 3.0% met criteria for both MetS and history of depression. History of depression (HR = 1.24, p = 0.003) and MetS (HR = 1.28, p < 0.001) were independently associated with an increased mortality risk, with the greatest mortality risk among individuals with both a history of depression and MetS (HR = 1.59, p < 0.001). Higher CRF was associated with a significantly lower risk of mortality (p < 0.001) in all individuals, including those with MetS and/or a history of depression.ConclusionsThose with higher levels CRF had reduced mortality risk in the context of depression/MetS. Interventions that improve CRF could have substantial impact on the health of persons with depression/MetS.

Abstract P011: Heart Failure and the Obesity Paradox Among Participants in the in the REasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Raegan W Durant ◽  
Todd M Brown ◽  
Emily B Levitan ◽  
Joshua S Richman ◽  
Nicole Redmond ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Behaviors ◽  
Normal Weight ◽  
Community Dwelling ◽  
Prior History ◽  
Central Adiposity ◽  
All Cause Mortality ◽  
History Of ◽  
Regards Study

Background: Overweight and obese adults living with heart failure (HF) have lower mortality compared to those of normal weight. However, the specific relationships of overall weight status and central adiposity with mortality among those with HF are less well-defined. We examined the relationships among body mass index (BMI), waist circumference (WC) and mortality among patients hospitalized for HF in the REGARDS Study. Methods: REGARDS is a national cohort of US community-dwelling adults aged >45 recruited from 2003 to 2007. We measured all-cause mortality rates among 565 participants hospitalized with HF who were normal weight (BMI 18.5-24.9 kg/m 2 ), overweight (BMI 25.0-29.9 kg/m 2 ), or obese (BMI > 30.0 kg/m 2 ) at baseline. Underweight participants (BMI < 18.5 kg/m 2 ) were excluded. Baseline WC, weight, and height were measured during an in-home exam. Index HF hospitalizations during follow-up were adjudicated by a panel of experts. Vital status was determined using the Social Security Death Index or the National Death Index. Cox proportional models estimated hazard ratios for all-cause mortality following the index HF hospitalization. Models were sequentially adjusted for WC, sociodemographics, HF severity (EF and BNP during HF hospitalization, prior history of HF, prior history of diastolic dysfunction), comorbidities, and health behaviors. Results: Among 565 participants hospitalized for HF, 116 (21%) were normal weight, 209 (37%) overweight, and 240 (42%) obese at baseline. Over a mean follow-up of 2.5 years, 253 deaths occurred. In multivariable analyses, overweight was associated with lower all-cause mortality in all models (Table). Each 1-cm increase in WC was associated with higher risk of all-cause mortality, but the relationship was not statistically significant after health behaviors were added in the final model. . Conclusions: Among adults hospitalized for HF, overweight as assessed by BMI may be associated with lower risk for mortality. However, central adiposity may confer higher risk of mortality.

Abstract T P345: Cardiovascular Health Metrics and All-cause and Cardiovascular Disease Mortality among Middle Aged Men in Korea: The Seoul Male Cohort Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Ji Young Kim ◽  
Chul Woo Rhee ◽  
Young-Jin Ko ◽  
Byung-Joo Park ◽  
Dong-Hyun Kim ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Glucose ◽  
Health Behaviors ◽  
Cardiovascular Health ◽  
Fasting Blood Glucose ◽  
Asian Population ◽  
Heart Association ◽  
Middle Aged ◽  
Ideal Cardiovascular Health ◽  
Cvd Mortality

Background: In Korea, Cerebrovascular and cardiovascular diseases (CVD) were the second leading cause of deaths in 2011. In 2010, the American Heart Association (AHA) published cardiovascular health metrics (CVHM) aimed at reducing deaths from all CVDs and stroke, and improving the cardiovascular health of the population as a whole. Despite their implications, the AHA’s metrics have not been broadly studied or previously applied to an Asian population. Objectives: This study estimated the combined association of cardiovascular health behaviors on the risk of all-cause and CVD mortality in middle-aged men in Korea. Methods: In total, 14,533 men aged 40-59 years were enrolled in 1993 and followed-up through 2011. CVHM defined the following lifestyles proposed by the AHA: smoking, physical activity, BMI, healthy diet score, total cholesterol, blood pressure, and fasting blood glucose. The CVHMs score was calculated as a single categorical variable, by assigning 1 point to each ideal healthy behavior vs. 0 points otherwise. All subjects were classified as meeting 0-7 CVHM. The principal outcome variables were all-cause and CVD mortality. The Cox proportional hazard regression model was used to estimate the hazard ratio (HR) of cardiovascular health behavior, and CVHMs score. PARs were calculated from significant CVHMs. Results: During 266,482.8 person-years of follow-up, there were 1,314 deaths in total. Current smoking, blood pressure, and fasting blood glucose were significantly associated with all-cause and CVD mortality. The adjusted PARs for the 3 significant metrics combined were 81% (95% CI, 50-94%) and 96% (66-99%) for all-cause and CVD mortality, respectively. More ideal CVHM was significantly associated with lower risks of all-cause and CVD mortality ( p-trend<.0001 ). The adjusted HRs of the groups with 6-7 vs. 0-2 ideal CVHM were 0.49 (0.35-0.70) and 0.23 (0.10-0.57) for all-cause and CVD mortality, respectively. Conclusions: Among ideal cardiovascular health behaviors, non-smoking, normal blood pressure, and recommended fasting blood glucose levels associated with reduced risks of all-cause and total CVD mortality. There was a strong trend towards decreased all-cause and CVD mortality risk with increasing the number of ideal CVHMs.

Abstract P119: Non-exercise Cardiorespiratory Fitness Prediction Equations: Accuracy Over Time in Apparently Healthy Adults

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
James E Peterman ◽  
Matthew Harber ◽  
Mary Imboden ◽  
Mitchell Whaley ◽  
bradley fleenor ◽  
...  
Keyword(s):  
Cardiorespiratory Fitness ◽  
Heart Association ◽  
Healthy Adults ◽  
Prediction Equations ◽  
Exercise Tests ◽  
Average Percentage ◽  
The Impact ◽  
Over Time ◽  
Apparently Healthy

Introduction: Mortality risk predictions are improved with routine assessment of cardiorespiratory fitness (CRF). Accordingly, an American Heart Association Scientific Statement suggests routine clinical assessment of CRF in apparently healthy adults minimally using non-exercise prediction equations, which can be calculated from common health metrics. However, no study has assessed the ability of non-exercise CRF prediction equations to accurately detect longitudinal changes. Hypothesis: Changes in estimated CRF (eCRF) would be related to directly-measured changes, yet appreciable misclassification would occur at the individual level. Methods: The sample included 987 apparently healthy adults (324 females; mean±SD age 43.1±10.4 years) who completed 2 cardiopulmonary exercise tests (CPX) at least 3 months apart (3.2±5.4 years follow-up). The change in eCRF from 27 distinct non-exercise prediction equations was compared to the change in directly-measured CRF determined from CPX. A change of ≥5% was used to classify participants as having a directional increase or decrease in CRF. Analysis included Pearson product moment correlations, standard error of estimate (SEE) values, the Benjamini-Hochberg procedure to compare eCRF with directly-measured CRF, and chi-squared tests to examine the impact of follow-up time on the percentage of participants correctly identified as having a directional increase or decrease in CRF. Results: The change in eCRF from each equation was correlated to the change in directly-measured CRF ( P <0.001) with R 2 values ranging from 0.06-0.43 and SEE values ranging from 0.9-5.9 ml·kg -1 ·min -1 . For 16 of the 27 equations, the change in eCRF was significantly different from the change in directly-measured CRF. When classifying directional changes, the prediction equations correctly categorized an average of 54% of individuals as having increased, decreased, or no change in CRF. When examining the influence of follow-up time, the average percentage of individuals correctly classified as having a directional increase in CRF was greater when the time between tests was ≤8months (54%) compared to ≥2years (28%). In contrast, the average percentage correctly classified as having a directional decrease in CRF was lower with tests ≤8months apart (8%) compared to ≥2years (73%). Conclusions: As hypothesized, discernible variability was found in the accuracy between non-exercise prediction equations and the ability of equations to accurately assess changes in directly-measured CRF over time. Considering the appreciable error that prediction equations had with detecting even directional changes in CRF, these results suggest eCRF may have limited clinical utility.

scholarly journals Back pain and its risk factors in Brazilian adolescents: a longitudinal study

2019 ◽  
pp. 204946371987175 ◽  
Author(s):  
Matias Noll ◽  
Cláudia Tarragô Candotti ◽  
Bruna Nichele da Rosa ◽  
Adriane Vieira ◽  
Jefferson Fagundes Loss
Keyword(s):  
Risk Factors ◽  
Back Pain ◽  
Longitudinal Study ◽  
Latin American ◽  
Outcome Variable ◽  
Evaluation Instrument ◽  
Robust Variance ◽  
History Of ◽  
Latin American Countries

Owing to the lack of longitudinal studies in Latin American countries, we aimed to evaluate back pain and its risk factors in a 3-year longitudinal study of Brazilian adolescents. We analysed data of 525 adolescents (aged 11–16 years) attending primary school (fifth to eighth grade) in Brazil. The students were administered the self-reported Back Pain and Body Posture Evaluation Instrument (BackPEI) questionnaire in 2011 and at a follow-up evaluation that was conducted 3 years later (2014). Back pain was the outcome variable; the exposure variables included exercise, behavioural, hereditary and postural factors. Generalized estimating equations were used to perform a Poisson regression model with robust variance to evaluate the risk factors for back pain. The prevalence of back pain at baseline was 56% ( n = 294); this increased significantly at the 3-year follow-up evaluation to 65.9% ( n = 346). The frequency of experiencing back pain also significantly increased after 3 years in both boys ( p = 0.002) and girls ( p = 0.001). The prevalence of back pain increased significantly in adolescents up to the age of 13 years, stabilized in those aged 14 years and older and was higher among girls. A family history of back pain (in the parents), watching television for lengthy periods and carrying a backpack asymmetrically were predictors for back pain.

scholarly journals Cardiorespiratory fitness and risk of prostate cancer: Findings from the Aerobics Center Longitudinal Study

2011 ◽  
Vol 35 (1) ◽  
pp. 59-65 ◽  
Author(s):  
Wonwoo Byun ◽  
Xuemei Sui ◽  
James R. Hébert ◽  
Timothy S. Church ◽  
I-Min Lee ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Longitudinal Study ◽  
Cardiorespiratory Fitness ◽  
Aerobics Center Longitudinal Study
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