Abstract P026: The Association between Alcohol Consumption and Risk of Heart Failure may be Modified by Sex - the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Alexandra Gonçalves ◽  
Pardeep S Jhund ◽  
Brian Claggett ◽  
Wayne Rosamond ◽  
Anita Deswal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Alcohol Consumption ◽  
Alcohol Intake ◽  
Smoking Status ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Risk Of Death ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

Introduction: Alcohol is a known cardiac toxin, yet the nature of the association between alcohol consumption and the development of heart failure (HF) in the community, and whether this relationship is different in men and women, is unclear. Therefore we assessed the association between alcohol intake and the development of HF or death in men and women in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: We examined 14,993 participants in ARIC without prevalent HF at baseline (1987-89) who were followed through 2009 (median of 20.6 years). Self-reported alcohol consumption was defined as the number of drinks per day (1 drink=14g of alcohol). Using Cox proportional hazards models, we examined the association of alcohol intake with the composite outcome of death or hospitalization for HF, stratified by sex, adjusting for age, diabetes, hypertension, coronary heart disease, body mass index, total cholesterol, physical activity, education level, smoking status, and incident myocardial infarction as a time varying covariate. Results: The risk for HF or death in men was lowest among those who consumed 0-1 drink/day (HR 0.81, 95% CI, 0.72-0.90) compared with those who did not consume alcohol. In contrast, in women the risk associated with consuming 1 or 2 drinks/day was not significantly different from the non-drinkers (0-1 drink HR 1.03, 95% CI 0.89-1.20; 1-2 drinks, HR 1.09, 95% CI 0.81-1.46, P for interaction by sex 0.01). Drinking ≥3 drinks/day increased the risk of HF or death by 40% in men (HR 1.44, 95% CI 1.20-1.72) but more than doubled the risk in women (HR 2.44, 95% CI 1.34-4.47). Conclusion: Consumption of ≥3 alcoholic drinks/day is associated with increased risk for death/HF in both men and women, with a higher risk in women, even adjusting for body size and other covariates. Compared to alcohol abstinence, low alcohol consumption was associated with a lower risk of death/HF in men but not in women. These findings suggest that the toxic and protective effects of alcohol may be different in men and women.

Abstract 19523: Liver Injury in Alcohol Drinkers and Incidence of Heart Failure - The Atherosclerosis Risk in Communities Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Odilson M Silvestre ◽  
Alexandra Gonçalves ◽  
Gabriela Q Roca ◽  
Brian Claggett ◽  
Chiadi E Ndumele ◽  
...  
Keyword(s):  
Heart Failure ◽  
Liver Damage ◽  
Alcohol Intake ◽  
Liver Enzymes ◽  
Liver Toxicity ◽  
Cox Proportional Hazards ◽  
Atherosclerosis Risk In Communities ◽  
Elevated Liver Enzymes ◽  
Increased Risk ◽  
Atherosclerosis Risk

Introduction: Alcohol liver toxicity occurs earlier than heart toxicity, but it is unknown if markers of liver damage predict incident heart failure (HF). Methods: We studied 10,263 participants from the Atherosclerosis Risk in Communities (ARIC) study, mean age 62.2±5.5 years, free of HF, who had liver enzymes measured in 2010 from stored Visit 4 (1996-99) samples. Liver enzymes were considered elevated when alanine aminotransferase (ALT) >24 UI/L(men) and >21 UI/L(women); aspartate aminotransferase (AST) > 32 UI/L(men) and >28 UI/L(women); gama-glutamyl transpeptidase (GGT)>56 UI/L(men) and >50 UI/L(women); AST:ALT ratio ≥2. Participants were classified into 3 categories based on self-reported drinking: never (21%), former (29%), and current drinkers (50%). Multivariable Cox proportional hazards models were used to evaluate the relationship between liver enzymes and incident HF (hospitalization or death) occurring after Visit 4 through 12/31/2012. Results: During 13.2 years of follow-up, HF occurred in 1399 (13%) participants. Higher AST, GGT, and AST:ALT ratio were associated with higher alcohol intake and incident HF among current drinkers (Figure). Compared to current drinkers with normal liver enzymes, current drinkers with increased level of AST or GGT had a higher risk of HF (1.38 HR 95%CI 1.09-1.73, p=0.005 and 1.34 HR 95% CI 1.04-1.74, p=0.02, respectively). AST:ALT ratio≥2 was associated with a 35% increased risk of HF (1.35 HR 95% CI 1.01-1.82, p=0.04) in the current drinkers group, adjusting for age, sex, race, center, hypertension, BMI, LDL, smoking, diabetes, statin use, coronary disease, quantity of alcohol, and kidney function. Elevated liver enzymes were not associated with higher incidence of HF among never and former drinkers participants. Conclusion: Liver damage, as marked by elevation of AST, GGT or an AST: ALT ratio≥2, was related to a higher risk of incident HF among alcohol drinkers, independently of the quantity of alcohol intake.

scholarly journals Alcohol intake, tobacco smoking, and esophageal adenocarcinoma survival: a molecular pathology epidemiology cohort study

2019 ◽  
Vol 31 (1) ◽  
pp. 1-11
Author(s):  
R. Stephen McCain ◽  
Damian T. McManus ◽  
Stephen McQuaid ◽  
Jacqueline A. James ◽  
Manuel Salto-Tellez ◽  
...  
Keyword(s):  
Alcohol Consumption ◽  
Cigarette Smoking ◽  
Esophageal Adenocarcinoma ◽  
Alcohol Intake ◽  
Smoking Status ◽  
Glut 1 ◽  
Risk Of Death ◽  
Increased Risk ◽  
Significant Difference ◽  
Risk Of Cancer

Abstract Purpose To investigate the association between cigarette smoking, alcohol consumption, and esophageal adenocarcinoma survival, including stratified analysis by selected prognostic biomarkers. Methods A population-representative sample of 130 esophageal adenocarcinoma patients (n = 130) treated at the Northern Ireland Cancer Centre between 2004 and 2012. Cox proportional hazards models were applied to evaluate associations between smoking status, alcohol intake, and survival. Secondary analyses investigated these associations across categories of p53, HER2, CD8, and GLUT-1 biomarker expression. Results In esophageal adenocarcinoma patients, there was a significantly increased risk of cancer-specific mortality in ever, compared to never, alcohol drinkers in unadjusted (HR 1.96 95% CI 1.13–3.38) but not adjusted (HR 1.70 95% CI 0.95–3.04) analysis. This increased risk of death observed for alcohol consumers was more evident in patients with normal p53 expression, GLUT-1 positive or CD-8 positive tumors. There were no significant associations between survival and smoking status in esophageal adenocarcinoma patients. Conclusions In esophageal adenocarcinoma patients, cigarette smoking or alcohol consumption was not associated with a significant difference in survival in comparison with never smokers and never drinkers in fully adjusted analysis. However, in some biomarker-selected subgroups, ever-alcohol consumption was associated with a worsened survival in comparison with never drinkers. Larger studies are needed to investigate these findings, as these lifestyle habits may not only be linked to cancer risk but also cancer survival.

Abstract MP36: Anemia, Chronic Kidney Disease, and Incident Heart Failure: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Junichi Ishigami ◽  
Morgan E Grams ◽  
Rakhi P Naik ◽  
Melissa C Caughey ◽  
Laura R Loehr ◽  
...  
Keyword(s):  
Heart Failure ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Cross Sectional ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Incident Heart Failure ◽  
Aric Study ◽  
Prevalence Of Anemia

Background: Both chronic kidney disease (CKD) measures, estimated glomerular filtration rate (eGFR) and albumin-to-creatinine ratio (ACR), are associated with incident heart failure (HF). Anemia is thought to play an important role in this association, particularly when eGFR is reduced, but this concept has not been rigorously evaluated. Methods: Using data from 5,539 participants in the Atherosclerosis Risk in Communities (ARIC) study at the fourth visit (1996-98), we first assessed the prevalence ratio (PrR) of anemia for eGFR and ACR using cross-sectional Poisson models, and then prospectively quantified the associations of eGFR, ACR, and anemia with incident HF using Cox proportional hazard models. Results: Based on the WHO definition, 477 (8.6%) participants had anemia at baseline. Both CKD measures were associated with increased prevalence of anemia independently of each other and other potential confounders (PrR, 1.22 [95% confidence interval, 1.11-1.34] with every 1SD decrease in eGFR; and 1.12 [1.03-1.23] with every 1SD increase in log 10 ACR). There were 724 (13.1%) cases of incident HF over median follow-up of 14.8 years. Lower eGFR and higher ACR were independently associated with increased risk of HF regardless of anemia status (Figure A for eGFR, and B for ACR). The association between anemia and HF risk was generally consistent in the range of eGFR below 90 ml/min/1.73m 2 and ACR between 5 and 300 mg/g, without significant interaction between both CKD measures and anemic status (e.g., hazard ratio for anemia vs. no anemia: 1.40 [0.81-2.41] at eGFR 60 ml/min/1.73m 2 and 1.37 [0.67-2.80] at ACR 30 mg/g). Conclusions: Reduced eGFR and elevated ACR were independently associated with higher prevalence of anemia and HF risk. The contribution of anemia to HF risk was overall consistent across CKD ranges of eGFR and ACR. Our results suggest the need of clinical attention on anemia and related HF risk in persons with low eGFR as well as those with high ACR.

scholarly journals Alcohol consumption and risk of heart failure: the Atherosclerosis Risk in Communities Study

2015 ◽  
Vol 36 (15) ◽  
pp. 939-945 ◽  
Author(s):  
A. Goncalves ◽  
B. Claggett ◽  
P. S. Jhund ◽  
W. Rosamond ◽  
A. Deswal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Alcohol Consumption ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk

scholarly journals Vital exhaustion and sudden cardiac death in the Atherosclerosis Risk in Communities Study

Heart ◽  
2017 ◽  
Vol 104 (5) ◽  
pp. 423-429 ◽  
Author(s):  
Brittany M Bogle ◽  
Nona Sotoodehnia ◽  
Anna M Kucharska-Newton ◽  
Wayne D Rosamond
Keyword(s):  
Risk Factors ◽  
Sudden Cardiac Death ◽  
Cardiac Death ◽  
Disease Risk ◽  
Ventricular Tachyarrhythmia ◽  
Atherosclerosis Risk In Communities ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Atherosclerosis Risk ◽  
Aric Study

ObjectiveVital exhaustion (VE), a construct defined as lack of energy, increased fatigue and irritability, and feelings of demoralisation, has been associated with cardiovascular events. We sought to examine the relation between VE and sudden cardiac death (SCD) in the Atherosclerosis Risk in Communities (ARIC) Study.MethodsThe ARIC Study is a predominately biracial cohort of men and women, aged 45–64 at baseline, initiated in 1987 through random sampling in four US communities. VE was measured using the Maastricht questionnaire between 1990 and 1992 among 13 923 individuals. Cox proportional hazards models were used to examine the hazard of out-of-hospital SCD across tertiles of VE scores.ResultsThrough 2012, 457 SCD cases, defined as a sudden pulseless condition presumed due to a ventricular tachyarrhythmia in a previously stable individual, were identified in ARIC by physician record review. Adjusting for age, sex and race/centre, participants in the highest VE tertile had an increased risk of SCD (HR 1.48, 95% CI 1.17 to 1.87), but these findings did not remain significant after adjustment for established cardiovascular disease risk factors (HR 0.94, 95% CI 0.73 to 1.20).ConclusionsAmong participants of the ARIC study, VE was not associated with an increased risk for SCD after adjustment for cardiovascular risk factors.

Abstract P116: Trait Anger Increases Short-term and Long-term Risk for Recurrent CHD: The Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Janice E Williams ◽  
Sharon B Wyatt ◽  
Kathryn M Rose ◽  
David J Couper ◽  
Anna Kucharska-Newton
Keyword(s):  
Cigarette Smoking ◽  
Trait Anger ◽  
Middle Aged ◽  
Short Term ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Though several large epidemiologic studies have demonstrated the positive association of anger with coronary heart disease (CHD) onset, a dearth of population-based evidence exists regarding the relationship of anger to the clinical course of CHD among people with established disease. Trait anger is conceptualized as a stable personality trait and defined as the tendency to experience frequent and intense anger. Therefore, it is plausible that the effects of trait anger on CHD are long standing. We assessed the hypothesis that trait anger predicts short-term and long-term risk for recurrent CHD among middle-aged men and women. Participants were 611 black or white men and women, ages 48 - 67, who had a history of CHD at the second clinical examination (1990-1992) of the Atherosclerosis Risk in Communities (ARIC) Study. They were followed for the recurrence of CHD (myocardial infarction or fatal CHD) from 1990 through three different time intervals: 1995, 2003, and 2009 (maximum follow-up = 19.0 years). Trait anger (measured at Visit 2) was assessed using the Spielberger Trait Anger Scale, with scores categorized as high, moderate, and low. Cox proportional hazards regression analyses were adjusted for age, sex, race-center, educational level, waist-to-hip ratio, plasma LDL-and HDL-cholesterol levels, hypertension, diabetes, cigarette smoking status, and pack-years of cigarette smoking. After 3 - 5 years of follow-up, the risk for recurrent CHD among participants with high trait anger was more than twice that of their counterparts with low trait anger (2.24 [95% C.I: 1.14 to 4.40]). After 11 - 13 years, the risk was 80% greater (1.80 [95% C.I: 1.17 to 2.78]) and after 17 - 19 years, it was 70% greater (1.70 [95% C.I: 1.15 to 2.52]). The risk for recurrent CHD was strongest in the first time interval but remained strong and statistically significant through 19 years of follow-up. In conclusion, the experience of frequent and intense anger increases short-term and long-term risk for recurrent CHD in middle-aged men and women.

Abstract P079: Alcohol Consumption and Risk of Diabetes in the Atherosclerosis Risk in Communities (ARIC) Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Xintong He ◽  
Natalie Daya ◽  
Casey M. Rebholz ◽  
Mariana Lazo ◽  
Elizabeth Selvin
Keyword(s):  
Body Mass Index ◽  
Alcohol Consumption ◽  
Body Mass ◽  
Lower Risk ◽  
Fasting Glucose ◽  
Diabetes Risk ◽  
Incident Diabetes ◽  
Atherosclerosis Risk In Communities ◽  
Atherosclerosis Risk ◽  
Aric Study

Background: Moderate alcohol consumption has been reported to be associated with lower risk for diabetes with some studies showing a U-shaped association. Whether and how the association might differ by gender or obesity status is controversial. Objective: To evaluate the prospective association between alcohol consumption and the long-term risk of diabetes in the Atherosclerosis Risk in Communities (ARIC) Study. Methods: A prospective analysis of 11,263 ARIC participants without prevalent diabetes (55% women, 81%white, mean age 54 years). Alcohol consumption was assessed at visit 1 (1987-1989). Participants were followed-up for incident diabetes defined by fasting glucose more than 126 mg/dL, non-fasting glucose more than 200 mg/dL, self-reported diagnosis of diabetes or use of diabetic medication. We used Cox models to estimate hazard ratios of diabetes risk by drinking categories in women and men, respectively. Results: During a median follow-up of 21 years, there were 3518 incident diabetes cases. In the fully adjusted model, compared to never drinkers, among women, 7-14 drinks/week was associated with a significantly lower risk of diabetes; whereas among men, 14-21 drinks/week was associated with a significantly lower risk ( Table ). There was a significant interaction between drinking categories and smoking status or between drinking categories and body mass index in women. Among women, a U-shaped association was mainly present among non-smokers, and significant decreasing risk is only found among normal-weight and overweight participants, but not obese participants. Conclusion: Low levels of alcohol intake (1-2 drinks per day for women and 2-3 drinks per day for men) are inversely associated with diabetes risk. The association is modified by smoking and body mass index in women.

Abstract MP48: Social Network, Social Support, and the Risk of Incident Stroke: The Atherosclerosis Risk in Communities Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Mako Nagayoshi ◽  
Susan A Everson-Rose ◽  
Hiroyasu Iso ◽  
Thomas H Mosley ◽  
Kathryn M Rose ◽  
...  
Keyword(s):  
Social Support ◽  
Social Network ◽  
Short Form ◽  
Network Size ◽  
Community Dwelling ◽  
Men And Women ◽  
Atherosclerosis Risk In Communities ◽  
Vital Exhaustion ◽  
Increased Risk ◽  
Atherosclerosis Risk

Background and Purpose: Having a small social network and lack of social support have been associated with incident coronary heart disease, but little is known about their association with incident stroke. Thus, we assessed the association of a small social network and lack of social support with risk of incident stroke and evaluated whether the relation was mediated by vital exhaustion and inflammation. Methods: The Atherosclerosis Risk in Communities (ARIC) Study measured social network and social support in 13,686 men and women (mean, 57 ± 5.7 years, 56% female, 24% black; 76% white) initially free of stroke. The 10-item Lubben Social Network Scale and 16-item Interpersonal Support Evaluation List-Short Form were used to assess social network size and social support, respectively. Results: Over a median follow-up of 18.6-years, 905 incident strokes occurred. Relative to participants with a large social network, those with a small social network had a higher risk of stroke [HR (95% CI): 1.43 (1.03-2.00)] after adjustment for demographic and socioeconomic characteristics and marital status ( Table ). Further adjustment for other potential confounders attenuated the association slightly. Vital exhaustion, but not inflammation, partly mediated the association between a small social network and stroke. Social support was unrelated to incident stroke. Conclusions: In this sample of US community-dwelling men and women, having a small social network was associated with excess risk of incident stroke. As with other cardiovascular conditions, having a small social network appears to be associated with modestly increased risk of incident stroke.

Abstract 12385: Past Alcohol Consumption and Incident Atrial Fibrillation

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Shalini Dixit ◽  
Alvaro Alonso ◽  
Elsayed Z Soliman ◽  
Lin Y Chen ◽  
Gregory M Marcus
Keyword(s):  
Atrial Fibrillation ◽  
Alcohol Consumption ◽  
Alcohol Use ◽  
Population Based ◽  
Self Report ◽  
Atherosclerosis Risk In Communities ◽  
Increased Risk ◽  
Before And After ◽  
Dietary Intake Assessment ◽  
Aric Study

Introduction: Although current alcohol consumption appears to be a risk factor for incident atrial fibrillation (AF), limitations related to self-reported alcohol use and confounding in observational studies limit the certainty of conclusions regarding causality. Whether cessation of alcohol consumption can protect against incident AF remains unknown. Methods: We examined all participants in the Atherosclerosis Risk in Communities (ARIC) study, a population-based cohort of 15,792 men and women aged 45-65, without prevalent AF. Past alcohol consumption was assessed via self-report during the baseline dietary intake assessment. Cases of incident AF were ascertained via study ECGs, hospital discharge ICD-9 codes, and death certificates. Results: Among 15,262 participants with complete survey data, 2,898 (19.0%) were former drinkers. During an average follow-up of 17.4 years, there were 380 cases of incident AF in former consumers. Both before and after adjustment for potential confounders, a longer duration of alcohol abstinence was associated with a lower risk of developing AF; previously consuming alcohol for a longer duration and consuming a greater quantity of alcohol were each associated with a higher risk of developing AF (Table). Conclusions: Among former drinkers, the number of years of drinking and the amount of alcohol consumed may each confer an increased risk of AF. Given that a longer duration of abstinence was associated with a decreased risk of AF, modification of alcohol use could potentially play a role in AF prevention.

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