Abstract P315: Three-year Progression of Sleep-disordered Breathing is Associated with Cardiovascular Disease Risk Factors in Young Adults

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Christopher E Kline ◽  
Thomas B Rice ◽  
Patrick J Strollo ◽  
Emma Barinas-Mitchell

Introduction: Sleep-disordered breathing (SDB) is a common sleep disorder that is significantly associated with cardiovascular disease (CVD) risk. Less is known about the short-term cardiovascular implications of mild-severity SDB progression, as mild SDB is less commonly associated with CVD but often develops into more severe SDB over time if left untreated. Hypothesis: We hypothesized that worsening of SDB severity over 3 years would be associated with greater changes in common CVD risk factors (body weight, heart rate [HR], blood pressure [BP], insulin resistance, and C-reactive protein [CRP]). Methods: A sample of 32 adults (38.6±6.4 y; 31.9±4.0 kg/m2; 72% female) who previously had participated in a 1-year lifestyle intervention were followed from 1-year post-intervention (2Y) for an additional 3 years (5Y). At 2Y and 5Y, SDB was assessed with an ambulatory monitor (ResMed ApneaLink); the oxygen desaturation index (ODI; the number of times per hour of recording that the blood oxygen saturation [SaO2] level was reduced by ≥4%) and mean SaO2 served as the primary indices of SDB severity. At 2Y and 5Y, body weight and resting BP and HR were assessed using standard procedures and fasting blood samples were obtained and measured for glucose, insulin, and CRP. Insulin resistance was measured via the Homeostatic Model Assessment method. Multiple linear regression and analysis of covariance were used to examine the associations between changes in SDB severity and changes in CVD risk factors, adjusting for 2Y values of CVD risk factors. Results: ODI at 2Y was 5.3±6.6. At 5Y, ODI had changed (i.e., improved) by -0.2±4.9, with ODI worsening by ≥2 in 7 adults and improving by ≥2 in 11 adults. Mean SaO2 at 2Y was 95.5±1.6% and changed (i.e., improved) by +0.1±1.1% at 5Y; mean SaO2 worsened in 10 adults and improved in 12 adults. Three-year change in ODI, but not SaO2, was significantly associated with weight change (β=.42, P=.02). Compared to those whose ODI worsened or did not change, improved ODI was associated with more favorable changes in CRP (-1.8 vs. +0.8 mg/L; P=.04) and heart rate (-5.0 vs. +0.2 beats/min; P=.05); however, these associations were weakened after further adjustment for weight change (P=.16 and P=.07, respectively). Compared to those whose SaO2 remained unchanged or improved, worsened SaO2 was associated with increased insulin resistance (+1.1 vs. -0.4; P<.01); results were unchanged following adjustment for weight change (P=.01). Changes in ODI and SaO2 were not related to changes in BP. Conclusions: Even marginal worsening of SDB severity over 3 years is associated with elevation in some CVD risk markers. Treatment of mild SDB in young- to middle-aged adults may reduce risk for CVD.

2008 ◽  
Vol 68 (2) ◽  
pp. 242-245 ◽  
Author(s):  
A Stavropoulos-Kalinoglou ◽  
G S Metsios ◽  
V F Panoulas ◽  
K M J Douglas ◽  
A M Nevill ◽  
...  

Objectives:To assess the association of body mass index (BMI) with modifiable cardiovascular disease (CVD) risk factors in patients with rheumatoid arthritis (RA).Methods:BMI, disease activity, selected CVD risk factors and CVD medication were assessed in 378 (276 women) patients with RA. Patients exceeding accepted thresholds in ⩾3 CVD risk factors were classified as having the metabolic syndrome (MetS).Results:BMI independently associated with hypertension (OR = 1.28 (95% CI = 1.22 to 1.34); p = 0.001), high-density lipoprotein (OR = 1.10 (95% CI = 1.06 to 1.15); p = 0.025), insulin resistance (OR = 1.13 (95% CI = 1.08 to 1.18); p = 0.000) and MetS (OR = 1.15 (95% CI = 1.08 to 1.21); p = 0.000). In multivariable analyses, BMI had the strongest associations with CVD risk factors (F1–354 = 8.663, p = 0.000), and this was followed by lipid-lowering treatment (F1–354 = 7.651, p = 0.000), age (F1–354 = 7.541, p = 0.000), antihypertensive treatment (F1–354 = 4.997, p = 0.000) and gender (F1–354 = 4.707, p = 0.000). Prevalence of hypertension (p = 0.004), insulin resistance (p = 0.005) and MetS (p = 0.000) was significantly different between patients with RA who were normal, overweight and obese, and BMI differed significantly according to the number of risk factors present (p = 0.000).Conclusions:Increasing BMI associates with increased CVD risk independently of many confounders. RA-specific BMI cut-off points better identify patients with RA at increased CVD risk. Weight-loss regimens should be developed and applied in order to reduce CVD in patients with RA.


2009 ◽  
Vol 27 (22) ◽  
pp. 3698-3704 ◽  
Author(s):  
Kevin C. Oeffinger ◽  
Beverley Adams-Huet ◽  
Ronald G. Victor ◽  
Timothy S. Church ◽  
Peter G. Snell ◽  
...  

Purpose To determine the prevalence of insulin resistance and other risk factors for cardiovascular disease (CVD) in young adult survivors of childhood acute lymphoblastic leukemia (ALL). Patients and Methods In this cross-sectional evaluation of 118 survivors of childhood ALL (median age, 23.0 years; range, 18 to 37 years), insulin resistance was estimated using the homeostasis model for assessment of insulin resistance (HOMA-IR). Sex-specific comparisons were made with a cohort of 30- to 37-year-old individuals from the same region participating in the Dallas Heart Study (DHS, N = 782). ALL survivors were stratified by treatment with and without cranial radiotherapy (CRT). Results Female ALL survivors had a significantly higher HOMA-IR (CRT, mean 4.6, 95% CI, 3.6 to 5.7; no CRT, mean 3.3, 95% CI, 2.8 to 3.8) in comparison with DHS women (mean 2.4, 95% CI, 2.2 to 2.7). Eighty percent of women treated with CRT had at least three of six CVD risk factors, and they were significantly more likely to have three or more risk factors compared with DHS women (odds ratio [OR], 5.96; 95% CI, 2.15 to 16.47). Male ALL survivors had a significantly higher HOMA-IR (CRT, mean 4.0, 95% CI, 2.8 to 5.6; no CRT, mean 3.4, 95% CI, 2.9 to 3.9) in comparison with DHS men (mean 2.3, 95% CI, 2.1 to 2.6), but were not more likely to have multiple CVD risk factors. Conclusion ALL survivors had an increased prevalence of insulin resistance in comparison with a cohort of older individuals from the same community. Importantly, women treated with CRT seem to have an increased prevalence of multiple CVD risk factors, warranting close monitoring and risk-reducing strategies.


2019 ◽  
Vol 24 (5) ◽  
pp. 405-413
Author(s):  
Adam D Gepner ◽  
Robyn L McClelland ◽  
Claudia E Korcarz ◽  
Rebekah Young ◽  
Joel D Kaufman ◽  
...  

Novel technology permits quantification of common carotid artery (CCA) displacement, which is traditionally ignored. We evaluated associations with CCA displacement and cardiovascular disease (CVD) risk and events in a large, multi-ethnic cohort. Right CCA longitudinal displacement (LD), transverse displacement (TD), and grayscale median (GSM) were evaluated using ultrasound speckle-tracking and texture analysis software in 2050 participants. Regression analyses were used to define relationships between CCA LD, TD, GSM, and CVD risk factors. Cox proportional hazards models were used to assess relationships between LD, TD, and incident CVD events. Participants were mean (SD) 64 (10) years old. There were 791 cases with a CVD event over a 12-year median follow-up. The mean LD was 0.29 (0.20) mm. In multivariable models including age, sex, race/ethnicity, heart rate, and CVD risk factors, LD was associated positively with active smoking (β = 0.08, p < 0.001) and inversely with black (β = −0.08, p < 0.001), Chinese (β = −0.05, p < 0.001), and Hispanic (β = −0.04, p < 0.05) race/ethnicities relative to white individuals, heart rate (β = −0.03/10 beats/min, p < 0.001), and diastolic blood pressure (β = −0.01/5 mmHg, p < 0.05). In fully adjusted models, LD and TD were associated with GSM ( p < 0.01), but neither predicted incident CVD events (LD: hazard ratio (HR) 0.77 [0.48 to 1.24], p = 0.3; TD: HR 1.12 [0.8 to 1.57], p = 0.5). CCA LD and TD are associated with race/ethnicity and CVD risk factors but not incident CVD events. LD and TD are not measures of arterial stiffness but their association with GSM suggests that lower LD and TD may be related to structural changes within the carotid arterial wall.


2015 ◽  
Vol 35 (suppl_1) ◽  
Author(s):  
Andrew Grandinetti ◽  
Joseph K Kaholokula

Introduction: Resting heart rate (RHR) has been identified as an independent risk factor for cardiovascular disease and mortality. Hypothesis: Physical activity and RHR are associated with hypertension, dyslipidemia and insulin resistance in a multiethnic population. Methods: Cross-sectional data from 1,440 participants of Native Hawaiian, Japanese, Filipino, Caucasian, and mixed ethnic ancestries were examined. Body fat was estimated using body mass indices (BMI); fat distribution by waist-hip ratios (WHR); and insulin resistance using the Homeostasis Model (HOMA-IR). Total cholesterol, triglycerides, and HDL-cholesterol levels were assayed from fasting plasma samples. LDL cholesterol was calculated using the Friedewald formula. Blood pressure measurements and medical histories were obtained to determine hypertension status. Leisure time physical activity (PA) was estimated by calculating metabolic equivalents (METS) using the Modifiable Activity Questionnaire. Associations were estimated using logistic regression for dichotomous outcomes (HTN) and general linear models (GLM) for continuous variables. Results: Caucasians had lower prevalence of HBP and insulin resistance than all other ethnic groups; there were no statistically significant differences between other ethnic groups on mean RHR. HOMA-IR, RHR, BMI and WHR all differed significantly by ethnic group. Low RHR and high levels of physical activity were inversely associated with insulin resistance. After adjusting for covariates, only RHR remained significantly associated with HBP prevalence. Likewise, only RHR was significantly associated with total cholesterol, LDL and triglycerides. In contrast, HDL cholesterol was positively associated with physical activity but not associated with RHR. Conclusion: The relationship of RHR and PA is complex with RHR and PA actions differing for different CVD risk factors. Since low RHR may be an indicator of cardiovascular fitness, these findings suggest fitness, rather than energy expenditure, may be important in preventing most CVD risk factors, while activity level may be more important for increasing HDL levels. A customized approach to activity plans may need to consider specific patient risk profiles.


2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.


Author(s):  
Magdalena Mijas ◽  
Karolina Koziara ◽  
Andrzej Galbarczyk ◽  
Grazyna Jasienska

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.


2021 ◽  
Vol 12 ◽  
pp. 215013272098095
Author(s):  
Marwa S. Said ◽  
Inas T. El Sayed ◽  
Eman E. Ibrahim ◽  
Ghada M. Khafagy

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.


BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e036213
Author(s):  
Tina Bonde Sorensen ◽  
Robin Wilson ◽  
John Gregson ◽  
Bhavani Shankar ◽  
Alan D Dangour ◽  
...  

ObjectivesTo explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.DesignCross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.Setting28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.ParticipantsData were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.ResultsIncreasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0 kg/m2 (95% CI 0.01 to 1.9) for BMI; 4.2 mm Hg (95% CI 1.0 to 7.4) for SBP; 0.3 mmol/L (95% CI −0.01 to 0.7) for LDL; and −0.01 mmol/L (95% CI −0.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.ConclusionThe association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Michelle Kohansieh ◽  
Amgad N. Makaryus

Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.


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