Abstract MP80: Psychosocial Factors and Risk of Incident Heart Failure: The Multi-Ethnic Study of Atherosclerosis (MESA)

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Rachel P Ogilvie ◽  
Susan Everson-Rose ◽  
Carlos Rodriguez ◽  
W.T. Longstreth ◽  
Michelle Albert ◽  
...  
Keyword(s):  
Heart Failure ◽  
Health Status ◽  
Psychosocial Factors ◽  
The United States ◽  
Poor Health ◽  
Ethnic Study ◽  
Self Rated Health ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Incident Heart Failure

Background: Heart failure is a major source of morbidity and mortality in the United States. Psychosocial factors have frequently been studied as risk factors for coronary heart disease, but not for heart failure. Methods: We examined the relationship between psychological status and incident heart failure among 6,782 individuals from the Multi-Ethnic Study of Atherosclerosis (MESA) who were free of cardiovascular disease at baseline. Anger, anxiety, chronic burden, depression, and hostility were measured using validated scales and were modeled categorically. Physician reviewers adjudicated incident heart failure events. Cox proportional hazards models were used to generate hazard ratios (HR) and 95% confidence intervals (CI) and adjusted for relevant demographic, behavioral, and physiological covariates. In exploratory analyses, we evaluated interactions between self-rated health and each psychosocial factor, and then stratified by baseline self-rated health (fair/poor and good/very good/excellent). Results: During a mean follow up of 9.3 years, 242 participants developed incident heart failure. Compared to participants in the lowest level, hazard ratios for those categorized in the highest level of anger [HR=1.14 (95%CI: 0.81-1.60)], anxiety [HR=0.74 (95%CI: 0.51-1.07), chronic burden [HR=1.25 (95%CI: 0.90-1.72), depression [HR=1.19 (95%CI: 0.76-1.85), and hostility [HR=0.95 (95%CI: 0.62-1.42) revealed no association with incident heart failure. In the exploratory analysis, interactions between the psychosocial factors and self-rated health were only statistically significant for hostility, but stratified models differed according to baseline health status. Compared to the lowest level, hazard ratios for those categorized in the highest level of anxiety [HR=2.11 (95%CI: 1.00-4.47)], chronic burden [HR=2.25 (95%CI: 1.08-4.67)], and depression [HR=2.15 (95%CI: 0.98-4.68)] revealed a positive association with incident heart failure among participants self-rated poor health at baseline, but there was no association for those with good self-rated health at baseline. For hostility, HRs for the highest versus lowest categorization were larger among those with good self-rated health and for anger, associations were similar regardless of self-rated health status. Conclusions: Overall these five psychosocial factors were not significantly associated with incident heart failure. However, for participants reporting poor health at baseline, anxiety, chronic burden, and depression were associated with an increased risk of heart failure. Future research with greater statistical power is necessary to confirm these findings and seek explanations.

scholarly journals Time to First Cigarette and Self-Reported Health Among US Adult Smokers

2019 ◽  
Vol 12 ◽  
pp. 1179173X1882526 ◽  
Author(s):  
Baksun Sung
Keyword(s):  
United States ◽  
Propensity Score ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Smoking Behavior ◽  
The United States ◽  
Elevated Risk ◽  
Poor Health ◽  
Increased Risk ◽  
Reported Health

Background: Numerous studies have reported that shorter time to first cigarette (TTFC) is linked to elevated risk for smoking-related morbidity. However, little is known about the influence of early TTFC on self-reported health among current smokers. Hence, the objective of this study was to examine the association between TTFC and self-reported health among US adult smokers. Methods: Data came from the 2012-2013 National Adult Tobacco Survey (NATS). Current smokers aged 18 years and older (N = 3323) were categorized into 2 groups based on TTFC: ≤ 5 minutes (n = 1066) and >5 minutes (n = 2257). Propensity score matching (PSM) was used to control selection bias. Results: After adjusting for sociodemographic and smoking behavior factors, current smokers with early TTFC had higher odds for poor health in comparison with current smokers with late TTFC in the prematching (adjusted odds ratio [AOR] = 1.65; 95% confidence interval [CI] = 1.31-2.08) and postmatching (AOR = 1.60; 95% CI = 1.22-2.09) samples. Conclusions: In conclusion, smokers with early TTFC were associated with increased risk of poor health in the United States. To reduce early TTFC, elaborate efforts are needed to educate people about harms of early TTFC and benefits of stopping early TTFC.

scholarly journals MECHANISMS IN ENDOCRINOLOGY: Heart failure and thyroid dysfunction

2012 ◽  
Vol 167 (5) ◽  
pp. 609-618 ◽  
Author(s):  
Bernadette Biondi
Keyword(s):  
Heart Failure ◽  
Thyroid Dysfunction ◽  
Clinical Symptoms ◽  
Systolic Function ◽  
Evidence Synthesis ◽  
The United States ◽  
Antithyroid Drugs ◽  
Cardiac Symptoms ◽  
Appropriate Treatment ◽  
Increased Risk

ContextHeart failure (HF) is a major cause of morbidity and mortality in Europe and in the United States. The aim of this review article was to assess the results of the prospective studies that evaluated the risk of HF in patients with overt and subclinical thyroid disease and discuss the mechanism of this dysfunction.Evidence AcquisitionReports published with the following search terms were searched:, thyroid, hypothyroidism, hyperthyroidism, subclinical hyperthyroidism, subclinical hypothyroidism, levothyroxine, triiodothyronine, antithyroid drugs, radioiodine, deiodinases, clinical symptoms, heart rate, HF, systolic function, diastolic function, systemic vascular resistance, endothelial function, amiodarone and atrial fibrillation. The investigation was restricted to reports published in English.Evidence SynthesisThe outcome of this analysis suggests that patients with untreated overt thyroid dysfunction are at increased risk of HF. Moreover, persistent subclinical thyroid dysfunction is associated with the development of HF in patients with serum TSH <0.1 or >10 mU/l.ConclusionsThe timely recognition and effective treatment of cardiac symptoms in patients with thyroid dysfunction is mandatory because the prognosis of HF may be improved with the appropriate treatment of thyroid dysfunction.

Abstract 12427: Racial Disparities in Hospitalization for Atrial Fibrillation: The Nationwide Inpatient Sample 2001-09

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Gene F Kwan ◽  
Danielle M Enserro ◽  
Allan J Walkey ◽  
Renda S Wiener ◽  
Emelia J Benjamin ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Racial Differences ◽  
Nationwide Inpatient Sample ◽  
The United States ◽  
Census Bureau ◽  
Outcome Data ◽  
Hospitalization Rates ◽  
Increased Risk ◽  
Modifiable Factors

Introduction: Racial differences in atrial fibrillation (AF) prevalence and disparities in treatment are well established; however, racial differences in outcomes among patients hospitalized with AF are less clear. We assessed racial differences in complications related to AF in a representative sample of AF hospitalization in the United States. Methods: We identified adults (≥ 40 years) with a principal diagnosis of AF and length of stay (LOS) among survivors of 1-30 days using weighted national estimates from the Nationwide Inpatient Sample. We excluded patients undergoing cardiac surgery or with missing covariates. Annual AF hospitalization rates by race were calculated using the total US population obtained from the US Census Bureau. We used multivariable regression models (covariates listed in Table) to examine associations of race with heart failure and hospital mortality among patients admitted with AF. Results: 2,244,036 AF hospitalizations (85% White, 6.7% Black, 5.0% Hispanic and 1.4% Asian/Pacific Islander) were analyzed from 2001-09. Hospitalization and outcome data by year are summarized in the table. Across all studied years, Blacks had lower AF hospitalization rates than Whites. Yet in all study years, mean LOS was longer for Blacks (range 4.2-4.6 days) than Whites (range 3.4-3.6 days). Blacks consistently had increased risk of in-hospital heart failure (Odds Ratio [OR] ranged from 1.5 [1.4, 1.7] to 1.7 [1.6, 1.9] across years) and death (OR, 1.5 [1.1, 2.1] to 2.3 [1.7, 3.0]) compared with Whites after adjustment for comorbidities. Conclusions: Although Blacks have lower incidence of hospitalizations for AF, they experience higher risk of heart failure, longer LOS, and greater mortality compared with Whites hospitalized with AF. Further public health investigation is warranted to examine the causes for disparities in outcomes among Blacks with AF and identify modifiable factors that may improve outcomes of Blacks with AF.

Whose Moral Community? Religiosity, Secularity, and Self-rated Health across Communal Religious Contexts

2018 ◽  
Vol 59 (2) ◽  
pp. 185-199 ◽  
Author(s):  
Samuel Stroope ◽  
Joseph O. Baker
Keyword(s):  
The United States ◽  
Poor Health ◽  
Negative Effects ◽  
Religion And Health ◽  
Self Rated Health ◽  
Unique Data ◽  
Individual Health ◽  
Health Gap ◽  
Health Promoting ◽  
The Relationship

Scholars have long theorized that religious contexts provide health-promoting social integration and regulation. A growing body of literature has documented associations between individual religiosity and health as well as macro–micro linkages between religious contexts, religious participation, and individual health. Using unique data on individuals and county contexts in the United States, this study offers new insight by using multilevel analysis to examine meso–micro relationships between religion and health. We assess whether and how the relationship between individual religiosity and health depends on communal religious contexts. In highly religious contexts, religious individuals are less likely to have poor health, while nonreligious individuals are markedly more likely to have poor health. In less religious contexts, religious and nonreligious individuals report similar levels of health. Consequently, the health gap between religious and nonreligious individuals is largest in religiously devout contexts, primarily due to the negative effects on nonreligious individuals’ health in religious contexts.

scholarly journals O7D.3 Working conditions and health behaviour as causes of educational inequalities in self-rated health: an inverse odds weighting approach

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A67.1-A67
Author(s):  
Jolinda Schram ◽  
Joost Oude Groeniger ◽  
Merel Schuring ◽  
Karin Proper ◽  
Sandra van Oostrom ◽  
...  
Keyword(s):  
Working Conditions ◽  
Health Behaviour ◽  
Health Behaviours ◽  
Poor Health ◽  
Total Effect ◽  
Physical Work ◽  
Educational Inequalities ◽  
Self Rated Health ◽  
Increased Risk ◽  
Low Education

BackgroundThis study aims to estimate to what extent working conditions and health behaviours mediate the increased risk of low educated workers to report a poor health.MethodsRespondents of the longitudinal Survey of Health, Ageing, and Retirement in Europe (SHARE) in 18 European countries were selected aged between 50 years and 64 years, in paid employment at baseline and with information on education and self-rated health (n=15,126). Health behaviours and physical and psychosocial work characteristics were measured at baseline, while self-rated health was measured at 2 year follow up. We used loglinear regression models and Inverse Odds Weighting causal mediation analysis to estimate the total effect of low education on self-rated health and to decompose the effect into natural direct (NDE) and natural indirect effects (NIE).ResultsLower educated workers were more likely to be in poor health compared to higher educated workers. The total effect of low education on self-rated health was RR=1.81 [95% CI 1.66–1.97]. For work conditions, having a physical demanding job was the strongest mediator, followed by lack of job control and lack of job rewards. NIE through working conditions was RR=1.16 [95% CI 1.06–1.25], explaining about 30% of educational inequalities in self-rated health. For health behaviour, body mass index and alcohol were the strongest mediators, followed by smoking. NIE though health behaviour was RR=1.14 [95% CI 1.07–1.20], explaining about 27% of educational inequalities in self-rated health.ConclusionsPreventive interventions focusing on reducing physical work demands as well as improving health behaviour may contribute to reducing educational inequalities in self-rated health among workers in Europe.

scholarly journals Medicare spending, managed care and pre-Medicare insurance coverage and associated risks of mortality, deterioration of self-rated health and mental health after four years of Medicare coverage

2014 ◽  
Vol 3 (5) ◽  
pp. 20
Author(s):  
Yi-Sheng Chao
Keyword(s):  
Mental Health ◽  
Health Status ◽  
Managed Care ◽  
Mental Health Center ◽  
Insurance Coverage ◽  
Health Spending ◽  
The United States ◽  
Self Rated Health ◽  
Medicare Coverage ◽  
Medicare Spending

National spending on Medicare keeps growing and managed care is reimbursed differently in the United States. Health returns from Medicare spending are not certain. This study aims to quantify the effects of Medicare spending in the first two years of Medicare coverage, managed care and insurance coverage before Medicare (pre-Medicare) on mortality, mental health and self-rated health status after first four years of Medicare coverage. Individuals, who were interviewed from age 65 to 68 years, without Medicare coverage before age 65 years, were included. Health spending (out-of-pocket, OOP) in the first two years of Medicare coverage, their pre-Medicare characteristics and Medicare managed care were used to predict associated risks of mortality, self-rated health status and mental health (Center for Epidemiologic Studies-Depression, CESD scale). Eligible Medicare enrollees (N = 3,503) in the Health and Retirement Study from 1992 to 2011 were chosen. Total health spending was associated with higher likelihood of worse mental health and self-rated health, but OOP spending was associated with risks of health deterioration (p < .05 for all). More OOP health spending in the first two years of Medicare coverage was associated with slightly higher chance of more mental problems, but the magnitude of this association became smaller over time. Medicare managed care did not seem to be beneficial for mortality, mental health or self-rated health status. Expanding pre-Medicare health coverage (through the Affordable Care Act) may not influence health status after first four years of Medicare coverage. Preventing pre-Medicare health conditions may be the priority.

scholarly journals Serum Bicarbonate Is Associated with Heart Failure in the Multi-Ethnic Study of Atherosclerosis

2016 ◽  
Vol 45 (2) ◽  
pp. 118-126 ◽  
Author(s):  
Jessica B. Kendrick ◽  
Leila Zelnick ◽  
Michel B. Chonchol ◽  
David Siscovick ◽  
Andrew N. Hoofnagle ◽  
...  
Keyword(s):  
Heart Failure ◽  
Left Ventricular ◽  
Serum Bicarbonate ◽  
Community Based ◽  
Baseline Serum ◽  
Ethnic Study ◽  
Adult Participants ◽  
Kidney Disease Progression ◽  
Incident Heart Failure ◽  
Subclinical Cvd

Background: Low serum bicarbonate concentrations are associated with mortality and kidney disease progression. Data regarding associations between bicarbonate and cardiovascular disease (CVD) are scarce. Methods: We performed a cohort study of 6,229 adult participants from the Multi-Ethnic Study of Atherosclerosis, a community-based cohort free of CVD at baseline. Serum bicarbonate was measured at baseline. Cardiovascular outcomes were defined as: (1) subclinical CVD (left ventricular mass [LVM] and aortic pulse pressure [PP] measured at baseline), (2) incident atherosclerotic cardiovascular events (CVE; composite of myocardial infarction, resuscitated cardiac arrest, stroke, coronary heart disease death, and stroke death), and (3) incident heart failure. Results: During a median (interquartile range) follow-up of 8.5 (7.7-8.6) years, 331 (5.3%) participants had an incident CVE and 174 (2.8%) developed incident heart failure. We stratified analyses by use of diuretics because we observed a significant interaction between diuretic use and bicarbonate with study outcomes. Among diuretic nonusers, with adjustment, bicarbonate ≥25 mEq/L was associated with an estimated 3.0 g greater LVM (95% CI 0.5-5.0) and 1.0 mm Hg higher aortic PP (95% CI 0.4-2.0) compared to bicarbonate 23-24 mEq/L. Each 1 mEq/L of bicarbonate increase was associated with a 13% higher risk of incident heart failure (hazards ratio 1.13, 95% CI 1.01-2.11). Among diuretic users, higher bicarbonate was not associated with CVD. Bicarbonate was not associated with incident atherosclerotic CVE irrespective of diuretic use. Conclusion: Among nonusers of diuretics in a large community-based study, higher serum bicarbonate concentrations are associated with subclinical CVD and new heart failure.

Sign in / Sign up

Export Citation Format

Share Document