Abstract P264: Excess Heart Age in HIV Outpatient Study Participants

Cardiovascular disease (CVD) is an important cause of morbidity and mortality among HIV-infected adults. Calculating an individual’s excess heart age, or the difference between their chronological age and predicted heart age, can be useful in describing their risk for developing CVD and motivating behavior change to decrease their CVD risk. The overall mean excess heart age is 7.8 and 5.4 years among U.S. men and women, respectively. We evaluated excess heart age among HIV-infected adults in medical care using sex-specific, cholesterol-based models developed from Framingham general CVD risk prediction equations. Included were HIV Outpatient Study (HOPS) participants aged 30-74 y, who had ≥2 HOPS clinic visits during 2010-2014, had no prior CVD at the start of observation, had >1 y of follow-up, and had non-missing data for all covariates. Age-standardized (2010 U.S. census) and weighted means, prevalence and 95% confidence intervals (CIs) were calculated for participant chronological age, predicted heart age, and excess heart age. From 5,088 HOPS participants assessed for eligibility, 1905 men and 584 women were included in the analysis. Heart age exceeded chronological age by 11.3 and 11.9 y among men and women, respectively (Table). Excess heart age was greatest among non-Hispanic Blacks, persons aged 50-59 y, those with less than high school education, and women with a median CD4+ count ≥500 cells/μL. Predicted heart age was higher than chronological age among HIV-infected men and women and surpassed excess heart age estimates observed in the general U.S. population. Greater excess heart age among HIV-infected adults might result from demographic differences, higher frequency of CVD risk factors including smoking, diabetes, HIV-associated excess chronic inflammation, and possibly lower use rates of antihypertensive or statin drugs. Routine clinical use of heart age calculation may help optimize CVD risk communication and interventions for aging HIV-infected persons.

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Heart Age, Cardiovascular Disease Risk, and Disparities by Sex and Race/Ethnicity Among New York City Adults

Public Health Reports ◽

10.1177/0033354919849881 ◽

2019 ◽

Vol 134 (4) ◽

pp. 404-416 ◽

Cited By ~ 5

Author(s):

Bahman P. Tabaei ◽

Shadi Chamany ◽

Sharon Perlman ◽

Lorna Thorpe ◽

Katherine Bartley ◽

...

Keyword(s):

Cardiovascular Disease ◽

New York ◽

New York City ◽

Risk Factor ◽

York City ◽

Chronological Age ◽

Cvd Risk ◽

Men And Women ◽

Race Ethnicity ◽

Heart Age

Objectives: Cardiovascular disease (CVD) is the leading cause of mortality in the United States. The risk for developing CVD is usually calculated and communicated to patients as a percentage. The calculation of heart age—defined as the predicted age of a person’s vascular system based on the person’s CVD risk factor profile—is an alternative method for expressing CVD risk. We estimated heart age among adults aged 30-74 in New York City and examined disparities in excess heart age by race/ethnicity and sex. Methods: We applied data from the 2011, 2013, and 2015 New York State Behavioral Risk Factor Surveillance System to the non–laboratory-based Framingham risk score functions to calculate 10-year CVD risk and heart age by sex, race/ethnicity, and selected sociodemographic groups and risk factors. Results: Of 6117 men and women in the study sample, the average heart age was 5.7 years higher than the chronological age, and 2631 (43%) adults had a predicted heart age ≥5 years older than their chronological age. Mean excess heart age increased with age (from 0.7 year among adults aged 30-39 to 11.2 years among adults aged 60-74) and body mass index (from 1.1 year among adults with normal weight to 11.8 years among adults with obesity). Non-Latino white women had the lowest mean excess heart age (2.3 years), and non-Latino black men and women had the highest excess heart age (8.4 years). Conclusions: Racial/ethnic and sex disparities in CVD risk persist among adults in New York City. Use of heart age at the population level can support public awareness and inform targeted programs and interventions for population subgroups most at risk for CVD.

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Subjective Time Experience in an Intergenerational Sample

The International Journal of Aging and Human Development ◽

10.2190/2ka0-u4fp-yj4f-n6gg ◽

1981 ◽

Vol 13 (3) ◽

pp. 183-193 ◽

Cited By ~ 5

Author(s):

Pamela E. Cooper ◽

L. Eugene Thomas ◽

Scott J. Stevens ◽

David Suscovich

Keyword(s):

Age Differences ◽

Chronological Age ◽

Subjective Time ◽

Subjective Age ◽

Age And Gender ◽

Men And Women ◽

Adult Men ◽

Time Experience ◽

The Difference ◽

And Gender

The roles chronological age and gender play in subjective time experience were explored in a sample of 294 adult men and women. Subjective time experience (STE: the difference between subjective age and chronological age) was found to vary widely among individuals, with some being “accurate” (SA = CA), and others either “retarded” (SA < CA) or “advanced” (SA > CA). Males were more retarded in STE than females at every point in the lifespan, and patterns of age differences in adulthood differed for the two sexes as well. The results suggest that chronological age may play a key role in transitions in STE, and that chronological age is more significant in the STE of women than in the STE of men.

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Experiences of a National Web-Based Heart Age Calculator for Cardiovascular Disease Prevention: User Characteristics, Heart Age Results, and Behavior Change Survey (Preprint)

10.2196/preprints.19028 ◽

2020 ◽

Author(s):

Carissa Bonner ◽

Natalie Raffoul ◽

Tanya Battaglia ◽

Julie Anne Mitchell ◽

Carys Batcup ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Experimental Studies ◽

Emotional Responses ◽

Lifestyle Changes ◽

Small Samples ◽

Cvd Risk ◽

Web Based ◽

Heart Age

BACKGROUND Heart age calculators are used worldwide to engage the public in cardiovascular disease (CVD) prevention. Experimental studies with small samples have found mixed effects of these tools, and previous reports of population samples that used web-based heart age tools have not evaluated psychological and behavioral outcomes. OBJECTIVE This study aims to report on national users of the Australian heart age calculator and the follow-up of a sample of users. METHODS The heart age calculator was launched in 2019 by the National Heart Foundation of Australia. Heart age results were calculated for all users and recorded for those who signed up for a heart age report and an email follow-up over 10 weeks, after which a survey was conducted. CVD risk factors, heart age results, and psychological and behavioral questions were analyzed using descriptive statistics and chi-square tests. Open responses were thematically coded. RESULTS There were 361,044 anonymous users over 5 months, of which 30,279 signed up to receive a heart age report and 1303 completed the survey. There were more women (19,840/30,279, 65.52%), with an average age of 55.67 (SD 11.43) years, and most users knew blood pressure levels (20,279/30,279, 66.97%) but not cholesterol levels (12,267/30,279, 40.51%). The average heart age result was 4.61 (SD 4.71) years older than the current age, including (23,840/30,279, 78.73%) with an older heart age. For the survey, most users recalled their heart age category (892/1303, 68.46%), and many reported lifestyle improvements (diet 821/1303, 63.01% and physical activity 809/1303, 62.09%). People with an older heart age result were more likely to report a doctor visit (538/1055, 51.00%). Participants indicated strong emotional responses to heart age, both positive and negative. CONCLUSIONS Most Australian users received an older heart age as per international and UK heart age tools. Heart age reports with follow-up over 10 weeks prompted strong emotional responses, high recall rates, and self-reported lifestyle changes and clinical checks for more than half of the survey respondents. These findings are based on a more engaged user sample than previous research, who were more likely to know blood pressure and cholesterol values. Further research is needed to determine which aspects are most effective in initiating and maintaining lifestyle changes. The results confirm high public interest in heart age tools, but additional support is needed to help users understand the results and take appropriate action.

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Association of cancer treatment with excess heart age among young breast cancer survivors.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.12081 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 12081-12081

Author(s):

Jacqueline B Vo ◽

Shoshana M. Rosenberg ◽

Philip Daniel Poorvu ◽

Kathryn Jean Ruddy ◽

Rulla Tamimi ◽

...

Keyword(s):

Breast Cancer ◽

Blood Pressure ◽

Cancer Survivors ◽

Cancer Treatment ◽

Endocrine Therapy ◽

Breast Cancer Survivors ◽

Cvd Risk ◽

Young Breast Cancer ◽

Heart Age

12081 Background: Young women with breast cancer may be at increased risk for premature development of cardiovascular disease (CVD) in part due to their cancer treatment. Limited data are available on CVD risk among young breast cancer survivors. Methods: Women aged 30-40 years at diagnosis with stage 0-III breast cancer enrolled in a prospective cohort study of women diagnosed with breast cancer at ≤40 were eligible for inclusion in this analysis. Data were obtained from serial surveys and electronic medical records at breast cancer diagnosis and 5-year follow-up. We calculated “excess heart age,” which incorporates a CVD risk-based score (calculated using age, systolic blood pressure, blood pressure medication, diabetes, smoking, body mass index) to estimate the difference in years between an individual’s chronological age and their CVD-risk adjusted age. Multivariable logistic regression models (adjusting for age at diagnosis, stage, and race) were fitted to evaluate associations between treatment (radiation, endocrine therapy, anthracyclines, and trastuzumab) and having a change in excess heart age ≥2 years from baseline to 5 years. Results: Among 372 young breast cancer survivors, mean age at diagnosis was 36.6 (SD 2.89), 93% were white, and 79% were diagnosed with stage I or II breast cancer. Mean excess heart age was.32 (SD: 6.16) years at baseline, which declined to -.07 (SD 6.64) at 5-year follow-up (p=.17). At 5 years, 31% (n=114) of women experienced an increase of at least 2 years in their excess heart age since diagnosis, and their mean excess heart age was 4.34 years (range -9 to 30). In multivariable analyses, receipt of trastuzumab was associated with higher odds (OR: 1.68, 95% CI: 1.02-2.77) of experiencing an increase of ≥2 years in excess heart age between diagnosis and 5 years of follow-up. Endocrine therapy, anthracyclines, and radiation were not significantly associated with a change in excess heart age of ≥2 years at 5 years post-diagnosis. Conclusions: At 5 years post-diagnosis, approximately 1/3 of young breast cancer survivors experienced a change from baseline in their excess heart age of ≥2 years. Further research is warranted to confirm findings regarding trastuzumab and excess heart age, and potential effects on longer-term cardiac outcomes in this population. Extended follow-up of this cohort may further quantify CVD risk over time.[Table: see text]

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Comparative analysis of an innovative app versus conventional techniques to improve patient compliance after minor oral surgical procedures (Preprint)

10.2196/preprints.35997 ◽

2021 ◽

Author(s):

Deborah Sybil ◽

Meenakshi Krishna ◽

Priyanshu Kumar Shrivastava ◽

Shradha Singh ◽

Imran Khan

Keyword(s):

Tooth Extraction ◽

Compliance Rate ◽

Phone Call ◽

Oral Surgical Procedures ◽

Operative Care ◽

The Difference ◽

Complications Rate ◽

Study Participants ◽

Improve Patient

BACKGROUND Certain factors such as compliance, comprehension, retention of instructions, and other unaccounted elements impact the objectives of post-operative care. It is imperative that patients follow the instructions and prescribed regimen diligently for a smooth and placid healing. Keeping the same principles in view, ExoDont was designed by our team, an android-based mHealth app which ensures a smooth post-operative period for the patients after a dental extraction. Besides providing post-operative instructions at defined intervals, the app also sends out drug reminders as an added advantage over other available conventional modes. OBJECTIVE To compare the compliance rate of individuals with respect to the prescribed regimen, postoperative instructions, and additionally, assess any significant changes in post-operative complications rate under the three categories namely Verbal, Verbal plus Written, and ExoDont group. METHODS The patients after tooth extraction were randomly assigned to the aforementioned groups and a one week follow-up through a phone call was planned to obtain the responses from study participants. The result obtained from the three groups was then statistically analyzed. RESULTS The compliance rate in patients for post-operative instructions and prescribed drug adherence was statistically significant in the group using ExoDont app than in Verbal or Verbal plus Written group. However, the difference in the incidence of postoperative complication rate was not significant among the three groups. CONCLUSIONS As evident from the result, it is anticipated that the ExoDont app will be revolutionary in not only circumventing the unaccounted possibilities of missing the prescribed dose and post-operative instructions but also ensure a smooth post-operative phase and easy recovery for the patients.

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Leucocyte Telomere Length and Risk of Cardiovascular Disease in a Cohort of 1,397 Danish Men and Women

Cardiology ◽

10.1159/000441819 ◽

2015 ◽

Vol 133 (3) ◽

pp. 173-177 ◽

Cited By ~ 13

Author(s):

Hanne Ellehoj ◽

Laila Bendix ◽

Merete Osler

Keyword(s):

Telomere Length ◽

Regression Models ◽

Proportional Hazard ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Men And Women ◽

Cox Proportional Hazard ◽

Increased Risk ◽

Cox Proportional Hazard Regression

Objectives: Short leucocyte telomere length (LTL) might be a risk factor for cardiovascular diseases (CVD). The present study examines the relation between LTL and incident fatal or non-fatal CVD, ischaemic heart disease (IHD) and stroke in a Danish cohort followed for 29 years. Methods: In total, 1,397 men and women who participated in health examinations with blood sampling in 1981-1984 were followed for CVD outcomes until the end of 2012 by linkage to national registers. Cox proportional hazard regression models were used to analyse the relation between LTL and CVD adjusting for potential confounding CVD risk factors. Results: During the follow-up, 603 participants experienced an incident fatal or non-fatal CVD. The survival analysis showed that baseline LTL was not associated with CVD outcomes. In the subanalysis with IHD as outcome, those with middle and short LTL had an increased hazard rate ratio of 1.97 (95% CI 1.31-2.93) and 1.55 (95% CI 1.02-2.35), respectively, which was attenuated when confounding factors were adjusted for. For stroke, the pattern of associations was similar but less precisely estimated. Conclusions: In this study short, LTL was not associated with an increased risk of CVD, but modestly associated with an increased risk of IHD.

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Risk classification in primary prevention of CVD according to QRISK2 and JBS3 ‘heart age’, and prevalence of elevated high-sensitivity C reactive protein in the UK cohort of the EURIKA study

Open Heart ◽

10.1136/openhrt-2018-000849 ◽

2018 ◽

Vol 5 (2) ◽

pp. e000849 ◽

Cited By ~ 5

Author(s):

Ieuan Johns ◽

Konstantinos E Moschonas ◽

Jesús Medina ◽

Nicholas Ossei-Gerning ◽

George Kassianos ◽

...

Keyword(s):

Primary Prevention ◽

High Sensitivity ◽

Low Risk ◽

Chronological Age ◽

C Reactive Protein ◽

Cvd Risk ◽

Treatment Threshold ◽

Reactive Protein ◽

Risk Patients ◽

Heart Age

ObjectivesThis study assessed cardiovascular disease (CVD) risk classification according to QRISK2, JBS3 ‘heart age’ and the prevalence of elevated high-sensitivity C reactive protein (hsCRP) in UK primary prevention patients.MethodThe European Study on Cardiovascular Prevention and Management in Usual Daily Practice (EURIKA) (NCT00882336) was a cross-sectional study conducted in 12 European countries. 673 UK outpatients aged ≥50 years, without clinical CVD but with at least one conventional CVD risk factor, were recruited. 10-year CVD risk was calculated using QRISK2. JBS3 ‘heart age’ and hsCRP level were assessed according to risk category.ResultsQRISK2 and JBS3 heart age was calculated for 285 of the 305 patients free from diabetes mellitus and not receiving a statin. QRISK2 classified 28%, 39% and 33% of patients as low (<10%), intermediate (10% to <20%) and high (≥20%) risk, respectively. Two-thirds of low-risk patients and half of intermediate-risk patients had a heart age ≥5 years and ≥10 years higher than their chronological age, respectively. Half of low-risk patients had hsCRP levels ≥2 mg/L and approximately 40% had levels ≥3 mg/L. Approximately 80% of low-risk patients had both elevated hsCRP and heart age relative to their chronological age.ConclusionsAlmost 40% more patients in this ‘at risk’ group would be eligible for statin therapy following the lowering of the National Institute for Health and Care Excellence treatment threshold to ≥10% 10-year risk. Of patients falling below this treatment threshold, almost all were at increased lifetime risk as measured by JBS3, and of these, the majority had elevated hsCRP levels. These patients with high absolute risk may benefit from early primary CVD prevention.

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Cardiovascular Disease Risk in a Semirural Community in Malaysia

Asia Pacific Journal of Public Health ◽

10.1177/1010539509343973 ◽

2009 ◽

Vol 21 (4) ◽

pp. 410-420 ◽

Cited By ~ 20

Author(s):

Chia Yook Chin ◽

Srinivas Pengal

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Disease Risk ◽

Survey Methods ◽

Cardiovascular Disease Risk ◽

Epidemiological Survey ◽

Cvd Risk ◽

Men And Women ◽

The Mean

Background and aim. It has been argued that cardiovascular disease (CVD) is not very prevalent in developing countries, particularly in a rural community. This study examined the prevalence of CVD risk of a semirural community in Malaysia through an epidemiological survey. Methods. Subjects were invited to a free health screening service carried out over a period of 6 weeks. Then, a follow-up study of the initial nonresponders was done in the villages that showed a poorer response. The survey was conducted using a standardized questionnaire. Hypertension was defined as blood pressure ≥140/90 mm Hg. The Framingham Coronary Disease Risk Prediction Score (FRS) was used as a measure of CVD risk. Results. A total of 1417 subjects participated in this survey. The response rate was 56%. A follow-up survey of the nonresponders did not show any differences from the initial responders in any systematic way. The prevalence of CVD risk factors was high in both men and women. The mean (±SD) FRS was 9.4 (±2.5) and 11.3 (±4.1) for men and women, respectively. The mean predicted coronary heart disease (CHD) risk was high at 20% to 25% for men and medium at 11% to 13% for women. Overall, 55.8% of the men had >20% risk of having a CHD event in the next 10 years whereas women’s risk was lower, with 15.1% having a risk of ≥20%. Conclusion. The prevalence of CVD risk even in a semirural community of a developing country is high. Every effort should be made to lower these risk factors.

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Experiences of a National Web-Based Heart Age Calculator for Cardiovascular Disease Prevention: User Characteristics, Heart Age Results, and Behavior Change Survey

Journal of Medical Internet Research ◽

10.2196/19028 ◽

2020 ◽

Vol 22 (8) ◽

pp. e19028

Author(s):

Carissa Bonner ◽

Natalie Raffoul ◽

Tanya Battaglia ◽

Julie Anne Mitchell ◽

Carys Batcup ◽

...

Keyword(s):

Blood Pressure ◽

Cardiovascular Disease ◽

Experimental Studies ◽

Emotional Responses ◽

Lifestyle Changes ◽

Small Samples ◽

Cvd Risk ◽

Web Based ◽

Heart Age

Background Heart age calculators are used worldwide to engage the public in cardiovascular disease (CVD) prevention. Experimental studies with small samples have found mixed effects of these tools, and previous reports of population samples that used web-based heart age tools have not evaluated psychological and behavioral outcomes. Objective This study aims to report on national users of the Australian heart age calculator and the follow-up of a sample of users. Methods The heart age calculator was launched in 2019 by the National Heart Foundation of Australia. Heart age results were calculated for all users and recorded for those who signed up for a heart age report and an email follow-up over 10 weeks, after which a survey was conducted. CVD risk factors, heart age results, and psychological and behavioral questions were analyzed using descriptive statistics and chi-square tests. Open responses were thematically coded. Results There were 361,044 anonymous users over 5 months, of which 30,279 signed up to receive a heart age report and 1303 completed the survey. There were more women (19,840/30,279, 65.52%), with an average age of 55.67 (SD 11.43) years, and most users knew blood pressure levels (20,279/30,279, 66.97%) but not cholesterol levels (12,267/30,279, 40.51%). The average heart age result was 4.61 (SD 4.71) years older than the current age, including (23,840/30,279, 78.73%) with an older heart age. For the survey, most users recalled their heart age category (892/1303, 68.46%), and many reported lifestyle improvements (diet 821/1303, 63.01% and physical activity 809/1303, 62.09%). People with an older heart age result were more likely to report a doctor visit (538/1055, 51.00%). Participants indicated strong emotional responses to heart age, both positive and negative. Conclusions Most Australian users received an older heart age as per international and UK heart age tools. Heart age reports with follow-up over 10 weeks prompted strong emotional responses, high recall rates, and self-reported lifestyle changes and clinical checks for more than half of the survey respondents. These findings are based on a more engaged user sample than previous research, who were more likely to know blood pressure and cholesterol values. Further research is needed to determine which aspects are most effective in initiating and maintaining lifestyle changes. The results confirm high public interest in heart age tools, but additional support is needed to help users understand the results and take appropriate action.

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Heart age estimated using explainable advanced electrocardiography

10.1101/2021.12.08.21267378 ◽

2021 ◽

Author(s):

Thomas Lindow ◽

Israel Palencia-Lamela ◽

Todd T Schlegel ◽

Martin Ugander

Keyword(s):

Artificial Intelligence ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Chronological Age ◽

Advanced Analysis ◽

The Difference ◽

Heart Age ◽

Strong Agreement

BackgroundElectrocardiographic (ECG) Heart Age conveying cardiovascular risk has been estimated by both Bayesian and artificial intelligence approaches. We hypothesized that explainable measures from the 10-second 12-lead ECG could successfully predict Bayesian ECG Heart Age.MethodsAdvanced analysis was performed on ECGs from healthy subjects and patients with cardiovascular risk or proven heart disease. Regression models were used to predict a Bayesian 5-minute ECG Heart Age from the standard resting 10-second 12-lead ECG. The difference between 10-second ECG Heart Age and chronological age was compared.ResultsIn total, 2,771 subjects were included (n=1682 healthy volunteers, n=305 with cardiovascular risk factors, n=784 with cardiovascular disease). Overall, 10-second Heart Age showed strong agreement with the 5-minute Heart Age (R2=0.94, p<0.001, mean±SD bias 0.0±5.1 years). The difference between 10-second ECG Heart Age and chronological age was 0.0±5.7 years in healthy individuals, 7.4±7.3 years in subjects with cardiovascular risk factors (p<0.001), and 14.3±9.2 years for patients with cardiovascular disease (p<0.001).ConclusionsECG Heart Age can be accurately estimated from a 10-second 12-lead ECG in a transparent and explainable fashion based on known ECG measures, without artificial intelligence techniques. The difference between ECG Heart Age and chronological age increases markedly with cardiovascular risk and disease.

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