Abstract P413: Chocolate Consumption is Associated with a Lower Risk of Heart Failure in Lean US Male Physicians

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Andrew B Petrone ◽  
J. Michael Gaziano ◽  
Luc Djousse
Keyword(s):  
Heart Failure ◽  
Lower Risk ◽  
Cox Regression ◽  
Secondary Analysis ◽  
Health Study ◽  
Adjusted Relative Risk ◽  
Hazard Ratios ◽  
Lower Blood ◽  
History Of

Background: Previous studies have suggested that dark chocolate consumption may lower blood pressure, a major risk factor for heart failure. However, limited and inconsistent data are available on the association of chocolate consumption with the incidence rate of heart failure. Objective: To test the hypothesis that chocolate consumption is associated with a lower risk of heart failure. Methods: We prospectively studied 20,278 men from the Physicians’ Health Study. Chocolate consumption was assessed between 1999 and 2002 via a food frequency questionnaire and heart failure was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted relative risk of heart failure. Results: During a median follow-up of 9.3 years, there were 876 new cases of heart failure. The mean age at baseline was 66.4 ± 9.2 years. Median chocolate consumption was 1-3 times per month. Hazard ratios (95% CI) for heart failure were 1.0 (ref), 0.87 (0.73-1.04), 0.80 (0.66-0.98), and 0.87 (0.72-1.04), for chocolate consumption of less than 1/month, 1-3/month, 1/week, and 2+/week, respectively, after adjusting for age, body mass index (BMI), smoking, alcohol intake, exercise, and history of atrial fibrillation. In a secondary analysis, chocolate consumption was inversely associated with risk of heart failure in men whose BMI was <25 kg/m 2 but not in those with BMI of 25+ kg/m 2 ( Figure 1 ), p for interaction=0.0895. Conclusions: Our data suggest that moderate consumption of chocolate might be associated with a lower risk of heart failure, especially in lean individuals.

Abstract P382: Fried Food Consumption is Associated with a Higher Risk of Heart Failure among US Male Physicians

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Luc Djousse ◽  
Andrew Petrone ◽  
John M Gaziano
Keyword(s):  
Heart Failure ◽  
Food Intake ◽  
Food Consumption ◽  
Prospective Cohort ◽  
Cox Regression ◽  
Health Study ◽  
Median Frequency ◽  
Fried Food ◽  
Hazard Ratios

Background: While previous studies have reported a positive relation of fried food consumption with type 2 diabetes, hypertension, and obesity, no previous study has examined the relation of total fried food intake with risk of heart failure (HF) in a prospective cohort. Objective: To test the hypothesis that fried food consumption is positively associated with risk of HF in male physicians. Methods: A prospective cohort of 19,968 participants from the Physicians’ Health Study. Frequency of fried food consumption was assessed between 1999 and 2002 using a food frequency questionnaire and HF was ascertained through annual follow-up questionnaires with validation in a subsample. We used Cox regression to estimate multivariable adjusted hazard ratios of HF. Results: During a median follow-up of 10.6 years, 862 cases of HF occurred. The mean age at baseline was 66.4 ± 9.2 years. Median frequency of fried food consumption was <1 time per week. Multivariable adjusted hazard ratios (95% CI) were: 1.0 (ref), 1.18 (1.01-1.37), 1.25 (1.02-1.54), and 1.68 (1.19-2.36) for fried food consumption of <1/week, 1-3/week, 4-6/week, and 7+/week, respectively (p for linear trend: 0.0004), after adjustment for age, alcohol use, smoking, exercise, and history of myocardial infarction, coronary artery bypass graph or angioplasty (Fig). Additional adjustment of total trans fats did not alter the findings. In a secondary analysis, body mass index did not modify the relation of fried foods with HF risk. Conclusions: Our data show a positive association between fried food intake and risk of HF in US male physicians.

scholarly journals Statistical Investigation of Correlation between Cardiovascular Event ad Hypertension

2021 ◽  
Vol 292 ◽  
pp. 03077
Author(s):  
Linfei Dai ◽  
Mingyang Song ◽  
Danni Zhang
Keyword(s):  
Heart Failure ◽  
Blood Pressure ◽  
Cardiovascular Diseases ◽  
Cardiovascular Mortality ◽  
Secondary Analysis ◽  
Cardiovascular Prevention ◽  
Statistical Investigation ◽  
Hazard Ratios ◽  
History Of

Cardiovascular disease is one of the most severe health killers in modern life. In this study, the association among the risk of cardiovascular diseases, patients’ blood pressure and treatment was analyzed. This study makes a secondary analysis on the data from the Evidence for Cardiovascular Prevention from Observational Cohorts in Japan (EPOCH-JAPAN) database. Participants have recruited 39705 representative participants with diverse blood pressure. The results show that the treated participants have a higher proportion of diabetes mellitus, dyslipidemia, and history of cardiovascular diseases (P<0.0001), compared with untreated participants. During the 10-year follow-up period, there were 2032 cardiovascular deaths distributed among coronary heart disease(CHD), heart failure, and stroke. The treated participants showed an significantly risk for cardiovascular mortality (Hazard ratios (HR):1.5; 95% confidence intervals (CI):1.36-1.66), CHD (HR:1.53, 95%CI: 1.23-1.9), heart failure (HR:1.39; 95%CI: 1.09-1.76) and stroke (HR:1.48; 95%CI: 1.28-1.72). Especially for the participants under antihypertensive medication, their risk of cardiovascular mortality was 1.5 times higher than that of the untreated participants.

scholarly journals Pregnancy, pregnancy loss and the risk of diabetes in Chinese women: findings from the China Kadoorie Biobank

2019 ◽  
Vol 35 (3) ◽  
pp. 295-303
Author(s):  
Sanne A. E. Peters ◽  
◽  
Ling Yang ◽  
Yu Guo ◽  
Yiping Chen ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Cox Regression ◽  
Chinese Women ◽  
Later Life ◽  
Induced Abortion ◽  
Hazard Ratios ◽  
Increased Risk ◽  
History Of ◽  
Incident Cases

AbstractPregnancy and pregnancy loss may be associated with increased risk of diabetes in later life. However, the evidence is inconsistent and sparse, especially among East Asians where reproductive patterns differ importantly from those in the West. We examined the associations of pregnancy and pregnancy loss (miscarriage, induced abortion, and still birth) with the risk of incident diabetes in later life among Chinese women. In 2004–2008, the nationwide China Kadoorie Biobank recruited 302 669 women aged 30–79 years from 10 (5 urban, 5 rural) diverse localities. During 9.2 years of follow-up, 7780 incident cases of diabetes were recorded among 273,383 women without prior diabetes and cardiovascular disease at baseline. Cox regression yielded multiple-adjusted hazard ratios (HRs) for the risk of diabetes associated with pregnancy and pregnancy loss. Overall, 99% of women had been pregnant, of whom 10%, 53%, and 6% reported having a history of miscarriage, induced abortion, and stillbirth, respectively. Among ever pregnant women, each additional pregnancy was associated with an adjusted HR of 1.04 (95% CI 1.03; 1.06) for diabetes. Compared with those without pregnancy loss, women with a history of pregnancy loss had an adjusted HR of 1.07 (1.02; 1.13) and the HRs increased with increasing number of pregnancy losses, irrespective of the number of livebirths; the adjusted HR was 1.03 (1.00; 1.05) for each additional pregnancy loss. The strength of the relationships differed marginally by type of pregnancy loss. Among Chinese women, a higher number of pregnancies and pregnancy losses were associated with a greater risk of diabetes.

Headache as a risk factor for dementia: A prospective population-based study

Cephalalgia ◽  
2013 ◽  
Vol 34 (5) ◽  
pp. 327-335 ◽  
Author(s):  
Knut Hagen ◽  
Eystein Stordal ◽  
Mattias Linde ◽  
Timothy J Steiner ◽  
John-Anker Zwart ◽  
...  
Keyword(s):  
Risk Factor ◽  
Cohort Study ◽  
Cox Regression ◽  
Subsequent Development ◽  
Population Based ◽  
Health Study ◽  
Cox Regression Analysis ◽  
Hazard Ratios ◽  
Increased Risk

Background Headache has not been established as a risk factor for dementia. The aim of this study was to determine whether any headache was associated with subsequent development of vascular dementia (VaD), Alzheimer’s disease (AD) or other types of dementia. Methods This prospective population-based cohort study used baseline data from the Nord-Trøndelag Health Study (HUNT 2) performed during 1995–1997 and, from the same Norwegian county, a register of cases diagnosed with dementia during 1997–2010. Participants aged ≥20 years who responded to headache questions in HUNT 2 were categorized (headache free; with any headache; with migraine; with nonmigrainous headache). Hazard ratios (HRs) for later inclusion in the dementia register were estimated using Cox regression analysis. Results Of 51,383 participants providing headache data in HUNT 2, 378 appeared in the dementia register during the follow-up period. Compared to those who were headache free, participants with any headache had increased risk of VaD ( n = 63) (multivariate-adjusted HR = 2.3, 95% CI 1.4–3.8, p = 0.002) and of mixed dementia (VaD and AD ( n = 52)) (adjusted HR = 2.0, 95% CI 1.1–3.5, p = 0.018). There was no association between any headache and later development of AD ( n = 180). Conclusion In this prospective population-based cohort study, any headache was a risk factor for development of VaD.

scholarly journals Pre-eclampsia and risk of later kidney disease: nationwide cohort study

BMJ ◽  
2019 ◽  
pp. l1516 ◽  
Author(s):  
Jonas H Kristensen ◽  
Saima Basit ◽  
Jan Wohlfahrt ◽  
Mette Brimnes Damholt ◽  
Heather A Boyd
Keyword(s):  
Chronic Kidney Disease ◽  
Cohort Study ◽  
Kidney Disease ◽  
Outcome Measure ◽  
Cox Regression ◽  
Hazard Ratio ◽  
Hazard Ratios ◽  
Gestational Age At Delivery ◽  
History Of

ABSTRACTObjectiveTo investigate associations between pre-eclampsia and later risk of kidney disease.DesignNationwide register based cohort study.SettingDenmark.PopulationAll women with at least one pregnancy lasting at least 20 weeks between 1978 and 2015.Main outcome measureHazard ratios comparing rates of kidney disease between women with and without a history of pre-eclampsia, stratified by gestational age at delivery and estimated using Cox regression.ResultsThe cohort consisted of 1 072 330 women followed for 19 994 470 person years (average 18.6 years/woman). Compared with women with no previous pre-eclampsia, those with a history of pre-eclampsia were more likely to develop chronic renal conditions: hazard ratio 3.93 (95% confidence interval 2.90 to 5.33, for early preterm pre-eclampsia (delivery <34 weeks); 2.81 (2.13 to 3.71) for late preterm pre-eclampsia (delivery 34-36 weeks); 2.27 (2.02 to 2.55) for term pre-eclampsia (delivery ≥37 weeks). In particular, strong associations were observed for chronic kidney disease, hypertensive kidney disease, and glomerular/proteinuric disease. Adjustment for cardiovascular disease and hypertension only partially attenuated the observed associations. Stratifying the analyses on time since pregnancy showed that associations between pre-eclampsia and chronic kidney disease and glomerular/proteinuric disease were much stronger within five years of the latest pregnancy (hazard ratio 6.11 (3.84 to 9.72) and 4.77 (3.88 to 5.86), respectively) than five years or longer after the latest pregnancy (2.06 (1.69 to 2.50) and 1.50 (1.19 to 1.88). By contrast, associations between pre-eclampsia and acute renal conditions were modest.Conclusions Pre-eclampsia, particularly early preterm pre-eclampsia, was strongly associated with several chronic renal disorders later in life. More research is needed to determine which women are most likely to develop kidney disease after pre-eclampsia, what mechanisms underlie the association, and what clinical follow-up and interventions (and in what timeframe post-pregnancy) would be most appropriate and effective.

scholarly journals Mortality in Patients with Diabetic Foot Ulcers: Causes, Risk Factors, and Their Association with Evolution and Severity of Ulcer

2020 ◽  
Vol 9 (9) ◽  
pp. 3009
Author(s):  
José Antonio Rubio ◽  
Sara Jiménez ◽  
José Luis Lázaro-Martínez
Keyword(s):  
Diabetic Foot ◽  
Cox Regression ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Hazard Ratios ◽  
History Of

Background: This study reviews the mortality of patients with diabetic foot ulcers (DFU) from the first consultation with a Multidisciplinary Diabetic Foot Team (MDFT) and analyzes the main cause of death, as well as the relevant clinical factors associated with survival. Methods: Data of 338 consecutive patients referred to the MDFT center for a new DFU during the 2008–2014 period were analyzed. Follow-up: until death or until 30 April 2020, for up to 12.2 years. Results: Clinical characteristics: median age was 71 years, 92.9% had type 2 diabetes, and about 50% had micro-macrovascular complications. Ulcer characteristics: Wagner grade 1–2 (82.3%), ischemic (49.2%), and infected ulcers (56.2%). During follow-up, 201 patients died (59.5%), 110 (54.7%) due to cardiovascular disease. Kaplan—Meier curves estimated a reduction in survival of 60% with a 95% confidence interval (95% CI), (54.7–65.3) at 5 years. Cox regression analysis adjusted to a multivariate model showed the following associations with mortality, with hazard ratios (HRs) (95% CI): age, 1.07 (1.05–1.08); HbA1c value < 7% (53 mmol/mol), 1.43 (1.02–2.0); active smoking, 1.59 (1.02–2.47); ischemic heart or cerebrovascular disease, 1.55 (1.15–2.11); chronic kidney disease, 1.86 (1.37–2.53); and ulcer severity (SINBAD system) 1.12 (1.02–1.26). Conclusion: Patients with a history of DFU have high mortality. Two less known predictors of mortality were identified: HbA1c value < 7% (53 mmol/mol) and ulcer severity.

scholarly journals Polyunsaturated fatty acids and the risk of multiple sclerosis

2017 ◽  
Vol 23 (14) ◽  
pp. 1830-1838 ◽  
Author(s):  
Kjetil Bjørnevik ◽  
Tanuja Chitnis ◽  
Alberto Ascherio ◽  
Kassandra L Munger
Keyword(s):  
Multiple Sclerosis ◽  
Fatty Acids ◽  
Cox Regression ◽  
Health Study ◽  
Dietary Pufa ◽  
Pufa Intake ◽  
Hazard Ratios ◽  
Supplemental Vitamin ◽  
Total Pufa

Background: Results from previous studies on polyunsaturated fatty acid (PUFA) intake and multiple sclerosis (MS) risk are conflicting. Objective: To prospectively investigate the association between dietary intake of PUFA and MS risk. Methods: We followed 80,920 women from Nurses’ Health Study (1984–2004) and 94,511 women from Nurses’ Health Study II (1991–2009) who reported on diet using a validated food frequency questionnaire every 4 years and identified 479 incident MS cases during follow-up. We used Cox regression to estimate hazard ratios (HRs) and 95% confidence intervals (CIs), for the effect of PUFA intake on MS risk adjusting for age, latitude of residence at age 15, ancestry, cigarette smoking, supplemental vitamin D intake, body mass index, and total energy intake. Results: Higher intake of total PUFA at baseline was associated with a lower risk of MS (HR top vs bottom quintile: 0.67, 95% CI: 0.49–0.90, p trend = 0.01). Among the specific types of PUFA, only α-linolenic acid (ALA) was inversely associated with MS risk (HR top vs bottom quintile: 0.61, 95% CI: 0.45–0.83, p trend = 0.001). The long-chain fatty acids eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) were not associated with MS risk. Conclusion: Low dietary PUFA intake may be another modifiable risk factor for MS.

scholarly journals Use of sodium glucose cotransporter 2 inhibitors and risk of major cardiovascular events and heart failure: Scandinavian register based cohort study

BMJ ◽  
2019 ◽  
pp. l4772 ◽  
Author(s):  
Björn Pasternak ◽  
Peter Ueda ◽  
Björn Eliasson ◽  
Ann-Marie Svensson ◽  
Stefan Franzén ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Events ◽  
Sglt2 Inhibitor ◽  
Cardiovascular Death ◽  
Sglt2 Inhibitors ◽  
Major Cardiovascular Events ◽  
Hazard Ratios ◽  
History Of

Abstract Objective To investigate the cardiovascular effectiveness of sodium glucose cotransporter 2 (SGLT2) inhibitors in routine clinical practice. Design Cohort study using data from nationwide registers and an active-comparator new-user design. Setting Denmark, Norway, and Sweden, from April 2013 to December 2016. Participants 20 983 new users of SGLT2 inhibitors and 20 983 new users of dipeptidyl peptidase 4 (DPP4) inhibitors, aged 35-84, matched by age, sex, history of major cardiovascular disease, and propensity score. Main outcome measures Primary outcomes were major cardiovascular events (composite of myocardial infarction, stroke, and cardiovascular death) and heart failure (hospital admission for heart failure or death due to heart failure). Secondary outcomes were the individual components of the cardiovascular composite and any cause death. In the primary analyses, patients were defined as exposed from treatment start throughout follow-up (analogous to intention to treat); additional analyses were conducted with an as-treated exposure definition. Cox regression was used to estimate hazard ratios. Results Mean age of the study cohort was 61 years, 60% were men, and 19% had a history of major cardiovascular disease. Of the total 27 416 person years of follow-up in the SGLT2 inhibitor group, 22 627 (83%) was among patients who initiated dapagliflozin, 4521 (16%) among those who initiated empagliflozin, and 268 (1%) among those who initiated canagliflozin. During follow-up, 467 SGLT2 inhibitor users (incidence rate 17.0 events per 1000 person years) and 662 DPP4 inhibitor users (18.0) had a major cardiovascular event, whereas 130 (4.7) and 265 (7.1) had a heart failure event, respectively. Hazard ratios were 0.94 (95% confidence interval 0.84 to 1.06) for major cardiovascular events and 0.66 (0.53 to 0.81) for heart failure. Hazard ratios were consistent among subgroups of patients with and without history of major cardiovascular disease and with and without history of heart failure. Hazard ratios for secondary outcomes, comparing SGLT2 inhibitors with DPP4 inhibitors, were 0.99 (0.85 to 1.17) for myocardial infarction, 0.94 (0.77 to 1.15) for stroke, 0.84 (0.65 to 1.08) for cardiovascular death, and 0.80 (0.69 to 0.92) for any cause death. In the as-treated analyses, hazard ratios were 0.84 (0.72 to 0.98) for major cardiovascular events, 0.55 (0.42 to 0.73) for heart failure, 0.93 (0.76 to 1.14) for myocardial infarction, 0.83 (0.64 to 1.07) for stroke, 0.67 (0.49 to 0.93) for cardiovascular death, and 0.75 (0.61 to 0.91) for any cause death. Conclusions In this large Scandinavian cohort, SGLT2 inhibitor use compared with DPP4 inhibitor use was associated with reduced risk of heart failure and any cause death, but not with major cardiovascular events in the primary intention-to-treat analysis. In the additional as-treated analyses, the magnitude of the association with heart failure and any cause death became larger, and a reduced risk of major cardiovascular events that was largely driven by the cardiovascular death component was observed. These data help inform patients, practitioners, and authorities regarding the cardiovascular effectiveness of SGLT2 inhibitors in routine clinical practice.

Abstract 17143: Obstructive and Central Sleep Apnea and Risk of Incident Atrial Fibrillation

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Patricia Tung ◽  
Yamini S Levitzky ◽  
Rui Wang ◽  
Stuart F Quan ◽  
Daniel J Gottlieb ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Sleep Apnea ◽  
Central Sleep Apnea ◽  
Health Study ◽  
Apnea Hypopnea Index ◽  
Community Based ◽  
Obstructive Sleep ◽  
History Of

INTRODUCTION: Prior studies have documented a higher prevalence of atrial fibrillation (AF) in those with obstructive sleep apnea (OSA). OSA has been associated with AF recurrence following cardioversion and ablation, and with prevalent and incident AF in cross-sectional and retrospective studies. Central sleep apnea (CSA) also has been associated with AF in patients with heart failure. However, data from prospective cohorts are sparse and few studies have evaluated the association of CSA with AF in population studies. METHODS: We assessed the association of OSA and CSA with incident AF among 3,420 subjects without a history of AF in the Sleep Heart Health Study (SHHS), a prospective, community-based study designed to evaluate the cardiovascular consequences of sleep disordered breathing. Subjects underwent overnight polysomnography at baseline and were followed over time for the development of incident AF, documented at any time after baseline polysomnogram until the end of follow-up. OSA was defined as an obstructive apnea-hypopnea index ≥ 5 and CSA was defined as a central apnea index ≥ 5. RESULTS: At baseline, the sample include 1499 men (44.4%) with a mean age of 62.4 (±10.9); 1569 (45.9%) subjects met criteria for mild to severe OSA and 54 (1.6%) for CSA. Over a mean follow-up of 8.2 years, 382 cases of incident AF were identified. The prevalence of both OSA and CSA was higher among those who developed AF compared to those who did not (OSA 49% vs 44%, p=0.001 and CSA 5% vs 1.2%, p=0.001). After adjustment for multiple AF risk factors, CSA was associated with an approximately 2-fold increased odds of incident AF (RR=2.38, 95% CI, 1.15-4.94; p = 0.02). The association persisted after exclusion of 258 subjects with a history of heart failure (RR=2.78, 95% CI, 1.28-6.04; p = 0.01). We did not find a significant association of OSA with incident AF (Table). CONCLUSION: In our prospective, community-based cohort baseline CSA was associated with incident AF.

Severe Hypoglycemia and Incident Heart Failure among Adults With Type 2 Diabetes

2021 ◽  
Author(s):  
Justin B Echouffo-Tcheugui ◽  
Arnaud D Kaze ◽  
Gregg C Fonarow ◽  
Sam Dagogo-Jack
Keyword(s):  
Heart Failure ◽  
Type 2 Diabetes ◽  
Relative Risk ◽  
Cox Regression ◽  
Severe Hypoglycemia ◽  
Medical Assistance ◽  
Hazard Ratios ◽  
Accord Study

Abstract Context The effect of severe hypoglycemia on the incidence of heart failure (HF) is unclear. Objective We evaluated the association of severe hypoglycemia with incident HF among individuals with type 2 diabetes. Methods We included participants with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. Severe hypoglycemia episodes were assessed during the initial 24 months following randomization and defined using two methods: symptomatic, severe hypoglycemic event requiring medical assistance (first definition) or requiring any assistance (second definition). Participants without HF at baseline and during the first 24 months of the study were prospectively followed for incident HF hospitalization. Multivariable Cox regression was used to generate adjusted hazard ratios (HR) for the association of severe hypoglycemia and incident HF. Results Among 9,208 participants (mean age 63 years, 38% female, 62% White), 365 had ≥ 1 episode of severe hypoglycemic. Over a median follow-up of 3 years, there were 249 incident HF events. After multivariable adjustment for relevant confounders, participants with severe hypoglycemia requiring medical assistance had a 68% higher relative risk of incident HF (HR 1.68, 95% CI 1.06-2.66), as compared to individuals who never experienced any episode of hypoglycemia. Severe hypoglycemia requiring any assistance was also associated with a 49% higher relative risk of HF (HR 1.49, 95% CI 1.01-2.21). Conclusion In a large cohort of adults with type 2 diabetes, severe hypoglycemia was independently associated with greater risk of incident HF.

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