Abstract P183: Contribution Of Childhood Risk Factors To Sex Differences In Adult Carotid Imt And Plaques: The Childhood Determinants Of Adult Health Study

Background: Understanding the origins of sex differences in cardiovascular diseases (CVD) may help with prevention. We examined sex differences in carotid artery IMT and plaques in adulthood including the contribution of childhood risk factors. Methods: Boys and girls aged 7-15 years old from the Australian Schools Health and Fitness Survey in 1985 were followed up in the Childhood Determinants of Adult Health study at ages 36-49 years between 2014-19. Sex differences in adult carotid IMT and plaques, identified with 2D ultrasound of left and right carotid arteries, were examined with linear and log binomial regression, respectively. Childhood sociodemographic, psychosocial, health-related behavioural and biomedical risk factors that might contribute to sex differences in carotid IMT/plaques were identified with purposeful model building. Results: Among 1,286 men and women with vascular measurements of carotid IMT (53% women, mean carotid IMT 0.63 mm ± 0.09 standard deviation) women had thinner carotid IMT measurements than men (β coefficients -0.053 95% CI -0.063, -0.043). Adjusting for age standardised waist circumference (WC), waist/hip ratio (WHR), waist/height ratio (WHtR) and systolic blood pressure (SBP) in childhood reduced the sex difference of carotid IMT in adulthood (see Figure), but a significant sex-difference in carotid IMT remained. Women had a 42% lower risk of plaques than men (Relative Risk 0.58 95% CI 0.42, 0.79). School achievement levels, endurance/power fitness and SBP in childhood partially explained the sex difference in the prevalence of plaques at adulthood (see Figure) as the sex difference decreased and became statistically insignificant. Conclusion: Various factors in childhood had contributed to thicker carotid IMT and higher prevalence of carotid plaques in men compared to women. These findings suggest that the origins of adult sex differences in CVD may begin in childhood. There may be benefits of sex-specific primary prevention programs starting in childhood.

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Abstract P146: Sex Differences In The Association Between Systolic Blood Pressure And Carotid Distensibility In Adults

Hypertension ◽

10.1161/hyp.78.suppl_1.p146 ◽

2021 ◽

Vol 78 (Suppl_1) ◽

Author(s):

Mohammad Shah ◽

Jing Tian ◽

Marie-Jeanne BUSCOT ◽

Hoang T Phan ◽

Thomas Marwick ◽

...

Keyword(s):

Blood Pressure ◽

Sex Differences ◽

Early Adulthood ◽

Sociodemographic Factors ◽

Health Study ◽

Adult Health ◽

Linear Regression Models ◽

Carotid Imt ◽

Carotid Plaques ◽

Carotid Distensibility

Background and Aim: We explored sex differences in the association between systolic and diastolic blood pressure (SBP), in early adulthood with carotid plaques, carotid IMT and carotid distensibility (CD) in mid-adulthood. Methods: Participants in the Childhood Determinants of Adult Health study at ages 26-36 years were followed-up at ages 39-49 years. Systolic BP and diastolic BP and carotid ultrasound measures (plaques, IMT and CD) were performed in clinics. We used log binomial and linear regression models with risk factor*gender interactions for predicting these carotid measures. Sex-stratified models adjusted for sociodemographic, health-related behavior and biomedical factors were fitted when likelihood ratio tests suggested the effect of risk factors on outcomes differed by sex. Results: Among 1,286 participants (53% women), men, compared to women, had higher prevalence of carotid plaques (17% vs. 10%), thicker carotid IMT (Mean 0.66 ± 0.09 vs. 0.61 ± 0.07) and lower CD (Mean 1.87 ± 0.60 vs. 2.37 ± 0.77). In women, greater SBP in early adulthood was sharply associated with significantly smaller CD (β -0.016 95%CI -0.023, -0.010 vs. β -0.006 95%CI -0.012, -0.001) than men in mid-adulthood adjusted for sociodemographic factors (Figure 1a). In analyses restricted to women, the effect of SBP on CD has decreased after adjusting for age, education, occupation, DBP and use of contraceptives (β -0.009 95%CI -0.019, 0.000) (Figure 1b). Conclusion: CV health was worse in men than women. However, elevated SBP in women put them at greater risk of poorer CV health compared to men, which was partly explained by sociodemographic, biomedical and female-specific factors.

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Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

BMC Medicine ◽

10.1186/s12916-021-01980-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jessica Gong ◽

Katie Harris ◽

Sanne A. E. Peters ◽

Mark Woodward

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Sex Difference ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Uk Biobank ◽

The Uk

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.

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Atrial Fibrillation Manifestations Risk Factors and Sex Differences in a Population-Based Cohort (From the Gutenberg Health Study)

The American Journal of Cardiology ◽

10.1016/j.amjcard.2018.03.028 ◽

2018 ◽

Vol 122 (1) ◽

pp. 76-82 ◽

Cited By ~ 4

Author(s):

Christina Magnussen ◽

Francisco M. Ojeda ◽

Philipp S. Wild ◽

Nils Sörensen ◽

Thomas Rostock ◽

...

Keyword(s):

Risk Factors ◽

Atrial Fibrillation ◽

Sex Differences ◽

Population Based ◽

Health Study ◽

Gutenberg Health Study

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Sex differences in the association between self-reported sleep duration, insomnia symptoms and cardiometabolic risk factors: cross-sectional findings from Brazilian longitudinal study of adult health

Archives of Public Health ◽

10.1186/s13690-020-00429-8 ◽

2020 ◽

Vol 78 (1) ◽

Author(s):

Aline Silva-Costa ◽

Lucia Rotenberg ◽

Aline A. Nobre ◽

Dora Chor ◽

Estela M. Aquino ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Longitudinal Study ◽

Sleep Duration ◽

Cardiometabolic Risk ◽

Cardiometabolic Risk Factors ◽

Adult Health ◽

Cross Sectional ◽

Insomnia Symptoms

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Smoking and Alcohol Habits as Risk Factors for Benign Digestive Diseases in a Japanese Population: The Radiation Effects Research Foundation Adult Health Study

Digestion ◽

10.1159/000087048 ◽

2005 ◽

Vol 71 (4) ◽

pp. 231-237 ◽

Cited By ~ 9

Author(s):

Michiko Yamada ◽

F.Lennie Wong ◽

Saeko Fujiwara ◽

Yoshimi Tatsukawa ◽

Gen Suzuki

Keyword(s):

Risk Factors ◽

Japanese Population ◽

Radiation Effects ◽

Health Study ◽

Adult Health ◽

Digestive Diseases

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Exposure to cardiovascular disease risk factors in childhood is associated with increased carotid extra medial thickness in adulthood: The childhood determinants of adult health study

Atherosclerosis ◽

10.1016/j.atherosclerosis.2016.07.268 ◽

2016 ◽

Vol 252 ◽

pp. e12

Author(s):

H. West ◽

M. Skilton ◽

B. Fraser ◽

T. Dwyer ◽

A. Venn ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Health Study ◽

Adult Health

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Th-W58:3 Cardiovascular risk factors in childhood and carotid artery intima-media thickness in adulthood: The childhood determinants of adult health study

Atherosclerosis Supplements ◽

10.1016/s1567-5688(06)81931-8 ◽

2006 ◽

Vol 7 (3) ◽

pp. 483-484

Author(s):

C.G. Magnussen ◽

A. Venn ◽

T. Dwyer ◽

O.T. Raitakari

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Carotid Artery ◽

Cardiovascular Risk Factors ◽

Intima Media Thickness ◽

Health Study ◽

Adult Health ◽

Media Thickness

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The Sex Difference in Physical Functioning: How Do Risk Factors Contribute?

Innovation in Aging ◽

10.1093/geroni/igab046.2079 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 545-545

Author(s):

Lena Sialino ◽

Susan Picavet ◽

Hanneke Wijnhoven ◽

Anne Loyen ◽

Monique Verschuren ◽

...

Keyword(s):

Risk Factors ◽

Sex Differences ◽

Sex Difference ◽

Physical Functioning ◽

Educational Level ◽

Mixed Model ◽

Mental Health Problems ◽

Healthy Lifestyle ◽

Multivariable Analysis ◽

Physical Functioning Score

Abstract This study explores whether sex differences in the sensitivity to risk factors (strength of the association) and/or in the exposure to risk factors (prevalence) contributes to the sex difference in physical functioning, with women reporting more limitations. Data of the Doetinchem Cohort Study was used (n=5971, initial ages 26-70 years), with follow-up measurements every 5 years (up to 20). Physical functioning (subscale SF-36, range:0-100) and a number of socio-demographic, lifestyle and health-related risk factors were assessed. Mixed-model multivariable analysis was used to investigate sex differences in sensitivity (interaction term with sex) and in exposure (change of the sex difference when adjusting) to risk factors. The physical functioning score among women was 6.75 (95%CL:5.65,7.85,age-adjusted) points lower than among men. In general, men and women had similar risk factors, but pain was more strongly associated with physical functioning (higher sensitivity), and also more prevalent among women (higher exposure). The higher exposure to low educational level and not having a paid job also contributed to the lower physical functioning score among women. In contrast, smoking, mental health problems and a low educational level were more strongly associated with a lower physical functioning score among men and lower physical activity and higher BMI were more prevalent. So, few risk factors seem to contribute the more reported limitations in physical functioning among women aged 26 to 90 years. Our findings provide no indications for reducing this sex difference by promoting a healthy lifestyle but stress the importance of sex differences in pain, work and education.

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