Abstract WP183: Heart Rate Variability Is Associated With Stroke, Independent Of Traditional Cardiovascular Risk Factors

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Adina Zeki Al Hazzouri ◽  
Mary Haan
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Mexican Americans ◽  
Community Dwelling ◽  
Self Report ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Logistic Regression Models ◽  
Icd 10

Introduction: U.S. Hispanics show higher burden of stroke compared to non-Hispanic whites. Stroke-related disparities may be driven by differences in cardiovascular disease (CVD) risk factors. Subclinical measures of CVD such as Heart Rate Variability (HRV) are highly sensitive and strong predictors of CVD events. Yet, the majority of work is limited to clinical settings. We assessed the hypothesis that reduced HRV is associated with higher prevalence of stroke in community-dwelling older Mexican Americans from the Sacramento Area Latino Study on Aging and that this association persists above and beyond traditional CVD risk factors. Methods: SALSA is a prospective cohort study with 7 annual visits. In a subsample of 869 participants, we assessed HRV at either visit 5 or 6 using the ANS2000 which is an ECG monitor and respiration pacer. Several R waves are detected in a deep breath cycle resulting in the estimation of Regular R bar, a measure of HRV. R bar was analyzed in quartiles (Q1 to Q4= low to high HRV). We ascertained stroke based on self-report of a physician diagnosis, hospitalization, and death based on ICD-10 codes I60 to I69. We used logistic regression models to estimate the associations between quartiles of HRV and the odds of having had a first-ever stroke at any time during the study. We reported prevalence odds ratios (OR) and 95%CI. Results: A total of 124 first-ever strokes occurred across the study period. The odds of a stroke was 109% higher in Quartile 1 HRV (OR=2.09; 95%CI=1.13; 3.90), 65% higher in Quartile 2 (OR=1.65; 95%CI=0.88; 3.10), and 1% higher in Quartile 3 (OR=1.01; 95%CI=0.52; 1.99), as compared to Quartile 4, adjusted for age, sex, income, smoking, alcohol consumption, diabetes, systolic blood pressure, beta blocker and dementia status. Conclusion: Our results suggest that reduced HRV is associated with ever having a stroke, above and beyond traditional CVD risk factors.

scholarly journals Heart Rate Variability Reflects Similar Cardiac Autonomic Function in Explosive and Aerobically Trained Athletes

2021 ◽  
Vol 18 (20) ◽  
pp. 10669
Author(s):  
Alex Claiborne ◽  
Helaine Alessio ◽  
Eric Slattery ◽  
Michael Hughes ◽  
Edwin Barth ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
African American ◽  
Autonomic Function ◽  
Low Frequency ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
African American Athletes ◽  
Sympathovagal Activity

Autonomic cardiac function can be indirectly detected non-invasively by measuring the variation in microtiming of heart beats by a method known as heart rate variability (HRV). Aerobic training for sport is associated with reduced risk for some factors associated with cardiovascular diseases (CVD), but effects on autonomic function in different athlete types are less known.To compare cardiac autonomic modulation using a standard protocol and established CVD risk factors in highly trained intercollegiate athletes competing in aerobic, explosive, and cross-trained sports. A total of 176 college athletes were categorized in distinct sports as explosive (EA), aerobic (AA), or cross-trained (mixed) athletes. Eight different HRV measures obtained at rest were compared across training type and five health factors: systolic (SBP), diastolic blood pressure (DBP), body weight (BW), sex, and race. All athletic types shared favorable HRV measures that correlated with low CVD risk factors and indicated normal sympathovagal balance. A significant correlation was reported between DBP and pNN50 (% RR intervals > 50 ms) (β = −0.214, p = 0.011) and between BW and low-frequency (LF) power (β = 0.205, p = 0.006). Caucasian and African American athletes differed significantly (p < 0.05) with respect to four HRV variables: pNN50, HF power, LF power, and LF/HF ratios. Explosive, aerobic and mixed athletes had similar cardiovascular and autonomic HRV results in all eight HRV parameters measured. All athletes reported LF and pNN50 values that were significantly correlated with two CVD risk factors: DBP and BW. Compared with Caucasian teammates, African American athletes demonstrated lower LF/HF and higher pNN50, indicating an even more favorable resting sympathovagal activity and healthy CV function.

scholarly journals Heart rate variability in patients with psoriatic arthritis: associations with systemic inflammation and traditional cardiovascular risk factors

2011 ◽  
Vol 10 (2) ◽  
pp. 88-92
Author(s):  
I. Z. Gaydukova ◽  
D. A. Poddubnyi ◽  
A. P. Rebrov
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Heart Rate Variability ◽  
Cardiovascular Risk ◽  
Systemic Inflammation ◽  
Control Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Spectral Parameters ◽  
Reactive Protein

Aim. To identify the disturbances of vegetative heart regulation and their associations with systemic inflammation activity in patients with psoriatic arthritic (PsA). Material and methods. The main group (MG) included 32 PsA patients without cardiovascular disease, CVD (mean age 44,62±11,6 years; mean PsA duration 10,32±10,2 years; 52,3% men). The control group (CG) included 25 healthy volunteers (mean age 40,33±11,8 years; 49,1% men). Time and spectral parameters of heart rate variability (HRV) were assessed. PsA activity was assessed by DAS index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and fibrinogen (FG) levels. Cardiovascular risk (CVR) was calculated, based on the following parameters: lipid spectr arterial hypertension, body mass index, and family history of CVD. Results. Compared to CG, all HRV parameters were affected in MG patients (p<0,01). HRV parameters were associated with PsA activity (ESR, CRP, FG, enthesitis), as well as with CVD risk factors (dyslipidemia, age). Conclusion. In PsA patients, disturbed vegetative heart regulation was manifested in reduced HRV and activated sympathetic HRV component. These disturbances were associated with traditional CVD risk factors and systemic inflammation activity.

Abstract P313: De-Conditioning Adversely Affects Subclinical Atherosclerosis in a Unique Cohort of Spinal Cord Injury

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Yaga Szlachcic ◽  
Rodney H Adkins ◽  
Jamie C Reiter ◽  
Yanjie Li ◽  
Howard N Hodis
Keyword(s):  
Risk Factors ◽  
Spinal Cord ◽  
Heart Rate ◽  
Spinal Cord Injury ◽  
Subclinical Atherosclerosis ◽  
Cvd Risk Factors ◽  
Peak Heart Rate ◽  
Cvd Risk ◽  
Cord Injury ◽  
Aerobic Conditioning

Introduction: Physical activity is presumed to improve cardiovascular disease (CVD), of which carotid artery intima-media thickness (CIMT) is a common indicator. Individuals with spinal cord injury (SCI) have limited mobility and therefore an expected increased risk for CVD. The purpose of this study was to determine which CVD risk factors predict CIMT among women with SCI, with the ultimate goal of targeting therapy to improve CVD in this population. Methods: One hundred twenty-two women with SCI who attended an outpatient SCI clinic and met inclusion and exclusion criteria participated in this study. SCI was categorized into 1 of 4 categories: complete tetraplegia, incomplete tetraplegia, complete paraplegia, and incomplete paraplegia. Maximum heart rate and VO2 max were obtained using bicycle ergometry with ventilatory gas exchange and continuous electrocardiogram. Hierarchical regression was used to predict CIMT, with the first block including demographic variables (age, race, smoking status) and the second block including physiologic variables (total cholesterol, heart rate, VO2 max, BMI, fasting serum glucose, hemoglobin A1c, and blood pressure). Results: Similar findings were observed for left and right CIMT, therefore only results from right CIMT are reported. The overall model was significant, F(16,46)=8.53, p=.000. Adjusted R square was .54 for the first block of variables and increased significantly (p=.006) to .66 when the second block of variables was added. Significant predictors at alpha=.05 included age (beta=.51, t=4.79, p=.000) and max/peak heart rate (beta=−.336, t=−2.39, p=.02). At alpha=.10, A1c was significant (beta=.187, t=1.99, p=.053). Conclusions: Although low aerobic conditioning is a purported CVD risk factor, quantitative measurements of such lack a demonstrable relationship with subclinical atherosclerosis (CIMT), perhaps because of its reduced importance relative to other CVD risk factors in a mobile population. We found expected relationships with CIMT in our SCI population (i.e., age), however we also found a quantitative measure of aerobic conditioning (max/peak heart rate) to be associated with CIMT. Our data indicate that SCI individuals may bear a greater CVD burden from cardiac de-conditioning than the general population and that investigation of a cohort with mobility limitation may provide a unique opportunity to study the impact of physical conditioning on CVD risk.

scholarly journals Changing Trends in the Prevalence and Disparities of Obesity and Other Cardiovascular Disease Risk Factors in Three Racial/Ethnic Groups of USA Adults

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Camila X. Romero ◽  
Tomas E. Romero ◽  
Judith C. Shlay ◽  
Lorraine G. Ogden ◽  
Dana Dabelea
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ethnic Groups ◽  
Mexican Americans ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Prevalence Of Obesity

Objectives. To examine trends in the prevalence and disparities of traditional cardiovascular disease (CVD) risk factors among the major race/ethnic groups in the USA: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexican Americans (MAs).Methods. We used cross-sectional trend analysis in women and men aged 25–84 years participating in the NHANES surveys, years 1988–1994 (n=14,341) and 1999–2004 (n=12,360).Results. The prevalence of obesity and hypertension increased significantly in NHW and NHB, both in men and women; NHB had the highest prevalence of obesity and hypertension in each time period. Diabetes prevalence showed a nonsignificant increasing trend in all groups and was higher in MA in both periods. Smoking significantly decreased in NHW men and NHB, the latter with the largest decline although the highest prevalence in each period; no changes were noted in MA, who had the lowest prevalence in both periods. Race/ethnic CVD risk factors disparities widened for obesity and hypercholesterolemia, remained unchanged for diabetes and hypertension, and narrowed for smoking.Conclusions. The increasing prevalence of obesity and hypertension underscores the need for better preventive measures, particularly in the NHB group that exhibits the worst trends. The decline in smoking rates may offset some of these unfavorable trends.

Abstract P339: Angina and Silent Myocardial Infarction are Associated with Isolated Small Vessel Peripheral Artery Disease in Community-Dwelling Older Adults: The Rancho Bernardo Study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Jan M Hughes-Austin ◽  
Michael H Criqui ◽  
Elizabeth Barrett-Connor
Keyword(s):  
Risk Factors ◽  
Older Adults ◽  
Peripheral Artery Disease ◽  
Community Dwelling ◽  
Cardiac Ischemia ◽  
Cvd Risk Factors ◽  
Peripheral Artery ◽  
Cvd Risk ◽  
Artery Disease ◽  
Community Dwelling Older Adults

Background: Classic CVD risk factors associated with isolated small vessel peripheral artery disease (iSV-PAD) include older age, male sex, longer smoking duration, and higher LDL cholesterol levels. These CVD risk factors have been linked to atherosclerosis in several vascular beds and to cardiac ischemia. It is not known whether iSV-PAD shares these same links, especially in community-dwelling older adults. Thus, in the Rancho Bernardo (RB) Study, we investigated whether iSV-PAD was associated with measures of atherosclerosis and cardiac ischemia. Methods: Among 965 RB Study participants with complete measures of ankle-brachial index (ABI), toe-brachial index (TBI), and measures of cardiac ischemia [self-reported angina, major Q wave on electrocardiogram (ECG), and any ECG abnormality], we evaluated associations between cardiac ischemia and iSV-PAD. In a subset of 387 RB participants free of diagnosed CVD, we evaluated associations between measures of atherosclerosis [coronary artery calcium (CAC) (Agatston scores and calcium volume) and internal carotid intima-media thickness (cIMT)] with iSV-PAD. Isolated SV-PAD was defined by bilateral normal ABI (1.0-1.4) with bilateral TBI < 0.7. Associations of measures of atherosclerosis and cardiac ischemia with iSV-PAD were evaluated using logistic regression in staged models, adjusted for age, sex, anthropometrics, lifestyle, comorbidities, and medications. Results: More likely to have iSV-PAD were participants who ever had angina (OR=2.1, 95% CI: 1.04-4.2) or had major Q wave on ECG (OR=4.2, 95% CI: 1.1-15.5). There were too few to stratify by sex. No statistically significant associations were observed for measures of atherosclerosis with iSV-PAD. (Figure 1) Conclusion: Strong associations of cardiac ischemia, coupled with null associations of atherosclerosis, with iSV-PAD suggest that iSV-PAD may indicate vascular pathology different from atherosclerosis. Further investigation of endothelial dysfunction and iSV-PAD may elucidate underlying pathology.

Abstract P367: Association Between Resting Heart Rate and Progression of Valvular Calcification

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Kojo Amoakwa ◽  
Oluwaseun E Fashanu ◽  
Martin Tibuakuu ◽  
Di Zhao ◽  
Eliseo Guallar ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Rate ◽  
Cardiac Computed Tomography ◽  
Resting Heart Rate ◽  
Annual Change ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cut Points ◽  
Valvular Calcification

Background: Mitral annular calcification (MAC) and aortic valvular calcification (AVC) are progressive and linked to increased cardiovascular disease (CVD) morbidity and mortality. Few known modifiable risk factors associated with the progression of MAC and AVC exist. Resting heart rate (RHR) is an established independent risk factor for CVD. Due to the potential hemodynamic effects of RHR on development or progression of valve calcification, we assessed whether RHR is associated with the incidence and progression of MAC and AVC in a community-based cohort free of CVD and atrial fibrillation at baseline. Methods: We obtained RHR from baseline 12-lead electrocardiograms of 5,498 MESA cohort participants. We studied RHR as a continuous variable (per 1 SD increment) and also categorized at clinical cut points of < 60, 60 - 69, 70 - 79, and ≥ 80 bpm. MAC and AVC were quantified (using Agatston scoring) from cardiac computed tomography scans obtained at baseline and at follow-up examinations 2 or 3. We examined associations between RHR and incident MAC/AVC and annual change in MAC/AVC scores, after adjusting for demographics, CVD risk factors, physical activity, and atrioventricular nodal blocker medication use. We used progressively adjusted parametric survival models for incident MAC/AVC and linear regression models for annual change in MAC/AVC. Results: At baseline, participants had a mean age of 62±10 years and mean RHR of 63±10 bpm; 12.3% and 8.9% had prevalent AVC and MAC [Agatston Units (AU) >0], respectively. Over a median follow up time of 2.3 years, 4.1% and 4.5% developed incident AVC and MAC, respectively. Each 10 bpm higher RHR was significantly associated with incident MAC [Hazard Ratio 1.18 (95% CI 1.03-1.36)], but not incident AVC. However, RHR (per 10 bpm) was associated with AVC progression [β coeff 1.62 (0.45-2.80) AU/year], but not MAC progression. The association of RHR on annual change in AVC was modified by age and sex (p-interactions 0.006 and <0.02, respectively) but not race/ethnicity. Each 10 bpm higher RHR was significantly associated with AVC progression for age > 62 years [β coeff 2.94 (0.55, 5.34) AU/year] and male sex [3.49 (1.31, 5.67) AU/year]. The association between RHR and AVC progression was not significant for age ≤ 62 or female sex. Similar trends were seen using clinical cut-points for RHR. Conclusion: Higher RHR predicted incident MAC and AVC progression independent of traditional CVD risk factors. Future studies are needed to determine whether this association is causal and whether modification of RHR through lifestyle or pharmacologic interventions can reduce valvular calcium progression.

Abstract P267: Geographic Patterns of Cardiovascular Disease Risk Factor Prevalence in the Continental US

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Matthew S Loop ◽  
George Howard ◽  
Gustavo de los Campos ◽  
Mohammad Z Al-Hamdan ◽  
Monika M Safford ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Geographic Variation ◽  
Smoking Prevalence ◽  
Local Population ◽  
Community Dwelling ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Risk Factor Prevalence

Objectives: Our understanding of geographic variation in cardiovascular disease (CVD) risk factors is based upon self-reported variables or geographically limited coverage. Our objective was to explore geographic variation in measured hypertension, measured diabetes, measured dyslipidemia, and self-reported current smoking prevalence. Methods: We used baseline data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) cohort, whose community-dwelling participants were recruited nationally between 2003 and 2007. Participants underwent a telephone interview and in-home examination. Hypertension, diabetes, and dyslipidemia were based on physiologic measures or reported medication use. Current cigarette smoking was self-reported. Using participants’ residential latitude and longitude, we tested for clustering of each risk factor using the difference in Ripley’s K functions test and, when we found evidence of clustering, used thin plate regression splines (TPRS) in a logistic regression framework to create age- race-, and sex-adjusted maps of risk factor prevalence. Results: Risk factor status and location data were available for 27,787 of the 30,239 participants (92%). Mean (±SD) age of these participants was 65(±9) years, 41% were black, 55% were women, 59% had hypertension, 22% had diabetes, 54% had dyslipidemia, and 15% were current smokers. We found statistically significant geographic clustering of hypertension, diabetes, and smoking prevalence, but not dyslipidemia. The regions with the highest prevalence varied across risk factors (Figure 1). Conclusions: Louisiana and Mississippi might require the most intense management of CVD risk factors. These maps show variation across and within administrative units, providing an accurate representation of geographic variation in risk factor prevalence. High resolution maps could be put to use by healthcare organizations to justify requests for higher reimbursement rates based upon local population health.

scholarly journals A Meta-analysis of Vitamin K Status and Cardiovascular Disease (OR33-01-19)

2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
M Kyla Shea ◽  
Daniel Weiner ◽  
Gregory Matuszek ◽  
Sarah Booth ◽  
Kathryn Barger
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Vitamin K ◽  
Cardiovascular Health ◽  
Proportional Hazards ◽  
Meta Analysis ◽  
Cox Proportional Hazards ◽  
Community Dwelling ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Objectives Evidence suggests low vitamin K status may be associated with an increased cardiovascular disease (CVD) risk in people with CVD risk factors. The objective of this study was to summarize the association between vitamin K status and CVD, overall and according to baseline CVD risk, by conducting a participant-level meta-analysis using data from the Framingham Offspring Study, the Health, Aging, and Body Composition Study (Health ABC), and the Multi-ethnic Study of Atherosclerosis (MESA). Methods Circulating phylloquinone (vitamin K1), measured from baseline fasting blood samples, was categorized as ≤0.5 nM, >0.5 - ≤1.0 nM and >1.0 nM. CVD was defined as confirmed ischemic heart disease, angina, resuscitated cardiac arrest, fatal or non-fatal myocardial infarction or stroke. Multivariable Cox proportional hazards models were used to evaluate the association between circulating phylloquinone and incident CVD overall and stratified according to baseline CVD risk factors. Results Among the 3622 participants (mean (SD) baseline age 65 (11), 45% men, 65% white), there were 785 CVD events over a median of 13.0 years. Overall the risk for CVD did not differ significantly according to circulating phylloquinone categories [HR(95%CI) for CVD, compared to plasma phylloquinone >1.0 nM: ≤0.5 nM = 1.15 (0.96–1.38); >0.5 - ≤1.0 nM = 0.99 (0.84–1.18)]. However, lower circulating phylloquinone was associated with higher incident CVD risk in those with diabetes, with a normal BMI, and in women (Table). Conclusions Overall, we did not detect any significant differences in CVD risk across circulating phylloquinone categories in community-dwelling adults. However, low circulating phylloquinone was associated with a higher CVD risk among certain sub-groups, but additional studies are needed to clarify if improving vitamin K status will benefit the cardiovascular health of certain segments of the population. Funding Sources Supported by NHLBI R21HL133421 and the USDA ARS Cooperative Agreement (58‐1950‐7‐707). Supporting Tables, Images and/or Graphs

scholarly journals Prospective associations between multidimensional religiosity/spirituality and cardiovascular risk factors in the English longitudinal study of ageing

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
V V Neves ◽  
I J C Schneider ◽  
A Steptoe
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
Alcohol Consumption ◽  
Fruits And Vegetables ◽  
Religious Involvement ◽  
Self Report ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Frequent Attendance ◽  
English Longitudinal Study

Abstract Background Religiosity/Spirituality (R/S) is usually associated with improved cardiovascular disease (CVD) outcomes. If such findings are genuine, they may be explained by the relationship between different R/S dimensions and CVD behavioural and biological risk factors. However, previous studies were mostly cross-sectional, used attendance as main R/S measure and dealt with cofounders inadequately. Hence, more longitudinal research is needed. Purpose This study explored whether multidimensional R/S predicted improvements in future CVD behavioural and physiological risk factors. Methods Participants were 6,844 adults aged 50+ from the English Longitudinal Study of Ageing. Smoking, exercising, drinking, eating fruits/vegetables and R/S were evaluated by self-report at waves 5 (2010/11) and 7 (2014/15). Physical examination and blood samples at waves 4 (2008/09) and 6 (2012/13) involved measurement of blood pressure (BP), body-mass index (BMI), C-reactive Protein (CRP), fibrinogen and HbA1c. Hierarchical multiple regressions controlled for age, gender, wealth, education and ethnicity. Models assessing biomarkers were further adjusted for the four health behaviours and BMI. Data on HbA1c, drinking and eating fruits/vegetables were log-transformed to ensure normal distribution. Results Greater reported spirituality (B=−0.018; CI: −0.035, −0.002; p=.029), praying/meditating daily (B=−0.017; CI: −0.033, −0.002; p=.025) and involvement in organised religion (B=−0.018; CI: −0.033, −0.003; p=0.017) were independently associated with lower fibrinogen at wave 6. Daily prayer/meditation also predicted a higher intake of fruits and vegetables at wave 7 (B=0.004; CI: 0.000, 0.008; p=0.049). However, frequent attendance (OR=0.846; CI: 0.730, 0.982; p=0.027), importance of faith (OR=0.935; CI: 0.879, 0.994; p=0.031) and religious purpose (OR=0.939; CI=0.884, 0.997; p=0.040) independently reduced the odds of meeting exercise recommendations at wave 7. Similarly, frequent attendance predicted higher HbA1c at wave 6 (B=0.002; CI: 0.000, 0.005; p=0.033). R/S was associated with lower systolic and diastolic BP, lower alcohol consumption and greater sedentary behaviour, but these relationships were explained by covariates. Smoking and CRP were unrelated to R/S. Conclusions We found that higher R/S offered partial future cardiovascular protection as it was independently associated with lower fibrinogen and greater intake of fruits and vegetables. However, somewhat unexpectedly, higher R/S also aggravated some CVD risk factors such as HbA1c and engagement in moderate/vigorous exercise. Besides, R/S was associated with lower BP and alcohol consumption at follow-up, but this relationship did not survive adjustment for covariates. Finally, we found no prospective association between R/S and smoking status and CRP. R/S is complicated, and further research should include measures of adverse aspects of religious involvement to clarify the drivers of these detrimental effects of R/S on CVD risk factors. FUNDunding Acknowledgement Type of funding sources: Public grant(s) – National budget only. Main funding source(s): National Institute on AgeingUK Government Departments

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