Parity and risk of maternal cardiovascular disease: A dose–response meta-analysis of cohort studies

2018 ◽  
Vol 26 (6) ◽  
pp. 592-602 ◽  
Author(s):  
Wenzhen Li ◽  
Wenyu Ruan ◽  
Zuxun Lu ◽  
Dongming Wang
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dose Response ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Response Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Incident Cases

Background Parity has been reported to play an important role in the development of cardiovascular disease; however, the results are still controversial. We aimed to conduct a meta-analysis of cohort studies to assess quantitatively the association between parity and cardiovascular disease risk. Methods PubMed and Web of Science databases were searched to 1 June 2018, supplemented by manual searches of the bibliographies of retrieved articles. And multivariate-adjusted relative risks were pooled by using random-effects models. Restricted cubic spline analysis with four knots was used to explore the relationship of parity and the risk of cardiovascular disease. Results Ten cohort studies involving 150,512 incident cases of cardiovascular disease among 3,089,929 participants were included in the meta-analysis. A significant association between parity and cardiovascular disease risk was observed while comparing parity with nulliparity, with a summarised relative risk of 1.14 (95% confidence interval (CI) 1.09–1.18; I2 = 62.0%, P = 0.002). In the dose–response analysis, we observed a potential non-linear J-shaped dose–response relationship between the number of parity and cardiovascular disease risk, the summary risk estimates for an increase of one live birth was 1.04 (95% CI 1.02–1.05), with significant heterogeneity ( I2 = 89.6%). In addition, the similar J-shaped associations between parturition number and cardiovascular disease, ischaemic heart disease or stroke risk were also observed. Conclusions Our findings suggest that ever parity is related to cardiovascular disease risk and there is an association between the number of pregnancies and the risk of cardiovascular disease. Since the number of included studies was limited, further studies are warranted to confirm our findings.

Shift work and risk of cardiovascular disease morbidity and mortality: A dose–response meta-analysis of cohort studies

2018 ◽  
Vol 25 (12) ◽  
pp. 1293-1302 ◽  
Author(s):  
Dongming Wang ◽  
Wenyu Ruan ◽  
Zhenlong Chen ◽  
Ying Peng ◽  
Wenzhen Li
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Shift Work ◽  
Dose Response ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Morbidity And Mortality ◽  
Prospective Cohort Studies ◽  
Disease Mortality

Background Previous studies have suggested that shift work is associated with a higher risk of cardiovascular disease. However, the quantitative dose–response relationship between duration of shift work and cardiovascular disease risk is still unknown. We aimed to evaluate the dose–response association between duration of shift work and risk of cardiovascular disease morbidity and mortality. Design A systematic review and meta-analysis. Methods PubMed and Embase were searched from inception to 1 December 2017. Prospective cohort studies that reported the associations between duration of shift work and cardiovascular disease risk with at least three categories were included. Data were pooled by using fixed or random effect models. The continuous dose–response associations were assessed by using fixed effect restricted cubic splines with four knots. Results Five prospective cohort studies with 10 reports were included. No evidence of a curvilinear association was observed between duration of shift work and risk of cardiovascular disease, similar findings were observed in cardiovascular disease morbidity and mortality. The summary relative risk (RR) of an increase of 5 years of shift work was 1.05 (1.04–1.07) with moderate heterogeneity ( P = 0.142, I2 = 33.2%) for cardiovascular disease, 1.06 (1.04–1.08) with low heterogeneity ( P = 0.279, I2 = 21.7%) for cardiovascular disease morbidity, and 1.04 (1.02–1.06) with moderate heterogeneity ( P = 0.135, I2 = 38.5%) for cardiovascular disease mortality, respectively. Conclusions Shift work could probably increase the risk of cardiovascular disease and cardiovascular disease mortality in a dose–response way. These findings could have implications for guideline recommendations regarding the risk related to shift schedules.

scholarly journals Egg consumption and risk of cardiovascular disease: three large prospective US cohort studies, systematic review, and updated meta-analysis

BMJ ◽  
2020 ◽  
pp. m513 ◽  
Author(s):  
Jean-Philippe Drouin-Chartier ◽  
Siyu Chen ◽  
Yanping Li ◽  
Amanda L Schwab ◽  
Meir J Stampfer ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Egg Consumption ◽  
Prospective Cohort Studies ◽  
Incident Cardiovascular Disease

Abstract Objective To evaluate the association between egg intake and cardiovascular disease risk among women and men in the United States, and to conduct a meta-analysis of prospective cohort studies. Design Prospective cohort study, and a systematic review and meta-analysis of prospective cohort studies. Setting Nurses’ Health Study (NHS, 1980-2012), NHS II (1991-2013), Health Professionals’ Follow-Up Study (HPFS, 1986-2012). Participants Cohort analyses included 83 349 women from NHS, 90 214 women from NHS II, and 42 055 men from HPFS who were free of cardiovascular disease, type 2 diabetes, and cancer at baseline. Main outcome measures Incident cardiovascular disease, which included non-fatal myocardial infarction, fatal coronary heart disease, and stroke. Results Over up to 32 years of follow-up (>5.54 million person years), 14 806 participants with incident cardiovascular disease were identified in the three cohorts. Participants with a higher egg intake had a higher body mass index, were less likely to be treated with statins, and consumed more red meats. Most people consumed between one and less than five eggs per week. In the pooled multivariable analysis, consumption of at least one egg per day was not associated with incident cardiovascular disease risk after adjustment for updated lifestyle and dietary factors associated with egg intake (hazard ratio for at least one egg per day v less than one egg per month 0.93, 95% confidence interval 0.82 to 1.05). In the updated meta-analysis of prospective cohort studies (33 risk estimates, 1 720 108 participants, 139 195 cardiovascular disease events), an increase of one egg per day was not associated with cardiovascular disease risk (pooled relative risk 0.98, 95% confidence interval 0.93 to 1.03, I 2 =62.3%). Results were similar for coronary heart disease (21 risk estimates, 1 411 261 participants, 59 713 coronary heart disease events; 0.96, 0.91 to 1.03, I 2 =38.2%), and stroke (22 risk estimates, 1 059 315 participants, 53 617 stroke events; 0.99, 0.91 to 1.07, I 2 =71.5%). In analyses stratified by geographical location (P for interaction=0.07), no association was found between egg consumption and cardiovascular disease risk among US cohorts (1.01, 0.96 to 1.06, I 2 =30.8%) or European cohorts (1.05, 0.92 to 1.19, I 2 =64.7%), but an inverse association was seen in Asian cohorts (0.92, 0.85 to 0.99, I 2 =44.8%). Conclusions Results from the three cohorts and from the updated meta-analysis show that moderate egg consumption (up to one egg per day) is not associated with cardiovascular disease risk overall, and is associated with potentially lower cardiovascular disease risk in Asian populations. Systematic review registration PROSPERO CRD42019129650.

scholarly journals The association between napping and the risk of cardiovascular disease and all-cause mortality: a systematic review and dose-response meta-analysis

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
Z Pan ◽  
M Huang ◽  
J Huang ◽  
Z Yao
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Studies ◽  
Dose Response ◽  
Prospective Cohort ◽  
Meta Analysis ◽  
Random Effect ◽  
Response Analysis ◽  
Night Sleep ◽  
Prospective Cohort Studies ◽  
All Cause Mortality

Abstract Background Napping is a habit prevalent worldwide and occurs from an early age. Some sleep specialists have suggested it as a potential public health tool due to the prevalence of sleep disorder. However, the association between napping and the risk of cardiovascular disease (CVD) and all-cause mortality remains unclear. Purpose To assess the association between napping and the risk of CVD and all-cause mortality. Methods We conducted a systematic search of Medline, Embase and Cochrane databases from inception through December 2019 for prospective cohort studies investigating the association between napping and the risk of CVD and/or all-cause mortality. Overall estimates were calculated using random effect models with inverse variance weighting. Dose-response meta-analysis was performed using restricted cubic spline models. The results were reported as hazard ratio (HR) and 95% confidence interval (CI). Results A total of 313651 participants (57.8% female, 38.9% took naps) from 20 cohort studies were included in the analysis. Overall, pooled analysis detected no association between daytime nap and CVD (HR 1.13, 95% CI 0.99–1.28). However, in subgroup analysis including only participants who were female (HR 1.31, 95% CI 1.09–1.58), older (age>65 years) (HR 1.36, 95% CI 1.07–1.72), or took a longer nap (nap time>60 minutes) (HR 1.34, 95% CI 1.05–1.63), napping was significantly associated with a higher risk of CVD comparing to not napping. All-cause mortality was associated with napping overall (HR 1.19, 95% CI 1.12–1.26), and effect sizes were even more pronounced in females (HR 1.22, 95% CI 1.13–1.31), older participants (HR 1.27, 95% CI 1.11–1.45) and those who took a long nap (HR 1.30, 95% CI 1.12–1.47). Furthermore, after stratifying participants by night sleep time (<6 and >6h/day), no significant association was detected except those who slept >6h/day at night and took a long nap (HR 1.13, 95% CI 1.03–1.24). Dose-response analysis showed a J-curve relation between nap time and CVD (Figure 1). The HR decreased from 0 to 25 min/day, followed by a sharp increase in the risk at longer times. A positive linear relationship between nap time and all-cause mortality was also observed. Conclusion Long napping over 60 minutes per day is associated with increased risks of CVD and all-cause mortality. Night sleep duration may play a role in the relation between napping and all-cause mortality. Further, large-scale prospective cohort studies need to confirm our conclusion and investigate the underlying mechanisms driving these associations. Funding Acknowledgement Type of funding source: None

scholarly journals Dietary Sodium Intake and Risk of Cardiovascular Disease: A Systematic Review and Dose-Response Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (10) ◽  
pp. 2934
Author(s):  
Yi-Jie Wang ◽  
Tzu-Lin Yeh ◽  
Ming-Chieh Shih ◽  
Yu-Kang Tu ◽  
Kuo-Liong Chien
Keyword(s):  
Cardiovascular Disease ◽  
Dose Response ◽  
Disease Risk ◽  
Sodium Intake ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Dietary Sodium ◽  
High Sodium ◽  
High Sodium Intake ◽  
Low Sodium

Dietary sodium intake has received considerable attention as a potential risk factor of cardiovascular disease. However, evidence on the dose-response association between dietary sodium intake and cardiovascular disease risk is unclear. Embase and PubMed were searched from their inception to 17 August 2020 and studies that examined the association between sodium intake and cardiovascular disease in adolescents were not included in this review. We conducted a meta-analysis to estimate the effect of high sodium intake using a random effects model. The Newcastle-Ottawa Scale assessment was performed. A random-effects dose-response model was used to estimate the linear and nonlinear dose-response relationships. Subgroup analyses and meta-regression were conducted to explain the observed heterogeneity. We identified 36 reports, which included a total of 616,905 participants, and 20 of these reports were also used for a dose-response meta-analysis. Compared with individuals with low sodium intake, individuals with high sodium intake had a higher adjusted risk of cardiovascular disease (Rate ratio: 1.19, 95% confidence intervals = 1.08–1.30). Our findings suggest that there is a significant linear relationship between dietary sodium intake and cardiovascular disease risk. The risk of cardiovascular disease increased up to 6% for every 1 g increase in dietary sodium intake. A low-sodium diet should be encouraged and education regarding reduced sodium intake should be provided.

scholarly journals Occupational Asbestos Exposure and Kidney Cancer: Systematic Review and Meta-analysis of Cohort Studies

2020 ◽  
Author(s):  
Chris C Y Pang ◽  
Kevin Phan ◽  
Md Nazmul Karim ◽  
Afsana Afroz ◽  
Matthew Winter ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cohort Studies ◽  
Kidney Cancer ◽  
Meta Analysis ◽  
Asbestos Exposure ◽  
International Agency ◽  
Standardized Mortality Ratio ◽  
Significant Heterogeneity ◽  
Incidence Studies ◽  
Incident Cases

Abstract Objectives An estimated 125 million workers are exposed to asbestos worldwide. Asbestos is classified by the International Agency for Research on Cancer as a Group 1 carcinogen. The association between occupational asbestos exposure and kidney cancer is not well established however. This study aimed to determine the mortality and incidence of kidney cancer in workers who have been exposed to asbestos. We performed a systematic review and meta-analysis to evaluate the association between occupational asbestos exposure and kidney cancer. Methods Medline, EMBASE, and Web of Science were searched according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for articles on occupational asbestos exposure and kidney cancer. The studies reported the standardized mortality ratio (SMR) or standardized incidence ratio (SIR) of kidney cancer in workers exposed to asbestos. SMRs or SIRs with its 95% confidence interval (CI) were pooled using a fixed-effect model. Results Forty-nine cohort studies involving 335 492 workers were selected for analysis. These studies included 468 kidney cancer deaths and 160 incident cases. The overall pooled-SMR of kidney cancer was 0.95 (95% CI: 0.86–1.05), with no significant heterogeneity (PQ = 0.09, I2 = 24.87%). The overall pooled-SIR of kidney cancer was 0.95 (95% CI: 0.79–1.11), with no significant heterogeneity (PQ = 0.68, I2 = 0.00%). Subgroup analysis did not find any increased association with occupational asbestos exposure. There was no evidence of publication bias with Egger’s test P values of 0.08 for mortality studies and 0.99 for incidence studies. Conclusions This systematic review and meta-analysis did not show evidence of association between occupational asbestos exposure and kidney cancer mortality or incidence.

Abstract P375: Vascular Age Versus Calendar Age as Surrogate for Atherosclerotic Burden and Cardiovascular Disease Risk

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sanne A Peters ◽  
Karlijn A Groenewegen ◽  
Hester M den Ruijter ◽  
Michiel L Bots
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Intima Media Thickness ◽  
Chronological Age ◽  
Specific Reference ◽  
Communication Tool ◽  
Vascular Age

Background Vascular age is the chronological age of an individual adjusted by their level of atherosclerosis. Vascular age can be used as understandable communication tool towards patients. It has been proposed that carotid intima-media thickness (CIMT) could be used to estimate the vascular age in individuals. The issue on how to best estimate vascular age remains an unanswered question and was evaluated in this study. Methods Data were used from the USE-IMT study collaboration, a global individual patient data meta-analysis including 14 population-based cohorts contributing data for 45 828 individuals. We used two methods to define vascular age. First, vascular age was the age at which a participant’s CIMT value would be at the 50th percentile of the age-and sex specific reference values of the healthy USE-IMT subpopulation (VA50). Second, vascular age was the age at which the estimated cardiovascular risk equals the risk of the observed CIMT value (VArisk). Results Mean (+/- standard deviation [SD]) chronological age, VA50, and VArisk were 58 (9), 63 (19), and 59 (7) years, respectively. VArisk was 0.24 yrs higher in women and 1.5 yrs higher in men than chronological age whereas VA50 was 4.4 yrs higher in women and 5.8 yrs higher in men than chronological age. After adjustment for traditional cardiovascular risk factors, a SD increase in VA50 and VArisk was associated with a 15% (95% confidence interval [CI]: 1.12; 1.19) and 22% (95% CI: 1.17; 1.28) higher risk of cardiovascular disease. For comparison, a SD increase in mean common CIMT increased the risk of cardiovascular disease with 15% (95% CI: 1.12; 1.19). Conclusion We presented two distinct measures a vascular age: VA50, and VArisk. VA50 is a straightforward translation of CIMT and is a measure of the age at which the average person would be expected to have a certain CIMT. In contrast, VArisk incorporates information about expected cardiovascular risk and is the chronological age of a person that conveys the same risk as the CIMT. VA50 and VArisk might provide a convenient transformation of CIMT to a scale that is more easily understood by patients and clinicians.

scholarly journals Pregnancy-related complications and incidence of atrial fibrillation: a systematic review and meta-analysis

EP Europace ◽  
2021 ◽  
Vol 23 (Supplement_3) ◽  
Author(s):  
T Al Bahhawi ◽  
A Aqeeli ◽  
S L Harrison ◽  
D A Lane ◽  
I Buchan ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Cohort Studies ◽  
Observational Studies ◽  
Large Scale ◽  
Data Extraction ◽  
Meta Analysis ◽  
Significant Heterogeneity ◽  
Random Effects Models ◽  
Increased Risk

Abstract Funding Acknowledgements Type of funding sources: None. Background Pregnancy-related complications have been previously associated with incident cardiovascular disease. However, data are scarce on the association between pregnancy-related complications and incident atrial fibrillation (AF). This systematic review examines associations between pregnancy-related complications and incident AF. Methods A systematic search of the literature utilising MEDLINE and EMBASE (Ovid) was conducted from 1990 to 6 April 2020. Observational studies examining the association between pregnancy-related complications including hypertensive disorders of pregnancy (HDP), gestational diabetes, placental abruption, preterm birth, low birth weight, small-for-gestational-age and stillbirth, and incidence of AF were included. Screening and data extraction were conducted independently by two reviewers. Inverse-variance random-effects models were used to pool hazard ratios. Results: Six observational studies met the inclusion criteria one case-control study and five retrospective cohort studies, with four studies eligible for meta-analysis.  Sample sizes ranged from 1,839-1,303,365. Mean/median follow-up for the cohort studies ranged from 7-36 years. Most studies reported an increased risk of incident AF associated with pregnancy-related complications. The pooled summary statistic from four studies reflected a greater risk of incident AF for HDP (hazard ratio (HR) 1.47, 95% confidence intervals (CI) 1.18-1.84; I2 = 84%) and from three studies for pre-eclampsia (HR 1.71, 95% CI 1.41-2.06; I2 = 64%; Figure). Conclusions The results of this review suggest that pregnancy-related complications particularly pre-eclampsia appear to be associated with higher risk of incident AF. The small number of included studies and the significant heterogeneity in the pooled results suggest further large-scale prospective studies are required to confirm the association between pregnancy-related complications and AF. Abstract Figure.

scholarly journals Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome

2011 ◽  
Vol 17 (6) ◽  
pp. 741-760 ◽  
Author(s):  
Konstantinos A. Toulis ◽  
Dimitrios G. Goulis ◽  
Gesthimani Mintziori ◽  
Evangelia Kintiraki ◽  
Evangelos Eukarpidis ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Polycystic Ovary Syndrome ◽  
Disease Risk ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Risk Markers ◽  
Ovary Syndrome
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