scholarly journals Proneurotensin Predicts Cardiovascular Disease in an Elderly Population

2018 ◽  
Vol 103 (5) ◽  
pp. 1940-1947 ◽  
Author(s):  
Ayesha Fawad ◽  
Andreas Bergmann ◽  
Joachim Struck ◽  
Peter M Nilsson ◽  
Marju Orho-Melander ◽  
...  

Abstract Context The gut hormone neurotensin promotes fat absorption, diet-induced weight gain, and liver steatosis. Its stable precursor-hormone fragment “proneurotensin” predicts cardiometabolic disease in middle-aged populations, especially in women. Objective To test if proneurotensin predicts cardiovascular disease (CVD) and diabetes development in an elderly population and whether there are gender differences in this respect. Design, Setting, and Participants Fasting proneurotensin was measured in plasma from 4804 participants (mean age 69 ± 6 years) of the Malmö Preventive Project and subjects were followed up for development of CVD and diabetes during 5.4 years. Main Outcome Measures Multivariate adjusted Cox proportional hazard models CVD were used to relate the proneurotensin to the risk of incident CVD and diabetes in all subjects and in gender-stratified analyses. Results In total, there were 456 first CVD events and 222 incident cases of diabetes. The hazard ratio [HR (95% confidence interval)] for CVD per 1 standard deviation (SD) increment of proneurotensin was 1.10 (1.01 to 1.21); P = 0.037, and the above vs below median HR was 1.27 (1.06 to 1.54); P = 0.011, with similar effect sizes in both genders. There was no significant association between proneurotensin and incident diabetes in the entire population (P = 0.52) or among men (P = 0.52). However, in women proneurotensin predicted diabetes incidence with a per 1 SD increment HR of 1.28 (1.30 to 1.59); P = 0.025 and an above vs below median HR of 1.41 (1.10 to 1.80); P = 0.007. Conclusions In the elderly population, proneurotensin independently predicts development of CVD in both genders, whereas it only predicts diabetes in women.

2020 ◽  
Author(s):  
Conor MacDonald ◽  
Anne-Laure Madika ◽  
Gianluca Severi ◽  
Agnes Fournier ◽  
Marie-Christine Boutron-Ruault

Abstract IntroductionThe non-O blood groups have previously been associated with higher risk of cardiovascular disease in prospective cohort studies. While cross-sectional studies have identified higher serum cholesterol amongst A-group individuals, there is no evidence from prospective studies whether this translates into a higher risk of dyslipidaemia that requires treatment. This study aimed to prospectively determine potential associations between ABO blood groups and risk of incident dyslipidaemia requiring treatment.MethodsWe assessed associations between blood ABO group and dyslipidaemia in women participating in the E3N cohort. We included women who did not have cardiovascular disease at baseline. We used logistic regression to determine associations between ABO group and prevalent dyslipidaemia at baseline. Cox proportional hazard models were used to determine if blood ABO group was associated with an increased risk of incident dyslipidaemia, controlling for potential confounding.ResultsAt baseline, 55,512 women were included, and 10,058 incident cases of dyslipidaemia were identified at a rate of 17.6/1,000 PY. Of these participants, 24,510 reported being of the O-group, and 31,002 of non-O. Non-O blood groups were associated with prevalent dyslipidaemia (OR = 1.17 [1.13: 1.21]). The non-O blood groups were associated with an increased risk of dyslipidaemia (HR non-O = 1.14 [1.10: 1.19]), specifically the A group (HRA = 1.18 [1.13: 1.23]). Interactions with smoking were considered possible (p-interaction = 0.06), with AB smokers showing the highest risk of dyslipidaemia (HRAB smokers = 1.54 [1.12: 2.11]).ConclusionNon-O blood group, specifically the A group were associated with a moderately increased risk of dyslipidaemia.


2019 ◽  
Vol 99 (1) ◽  
pp. 51-59 ◽  
Author(s):  
J. Qi ◽  
Z. Zihang ◽  
J. Zhang ◽  
Y.M. Park ◽  
D. Shrestha ◽  
...  

Periodontitis is positively linked to cardiovascular disease (CVD), diabetes, cancer, and increased mortality. Empirically derived clusters of IgG antibodies against 19 selected periodontal microorganisms have been associated with hyperglycemia. We further investigated associations between these serum IgG antibody clusters and all-cause and CVD mortality in a representative US population. Participants free of CVD and cancer and aged ≥40 y at baseline ( N = 6,491) from the Third National Health and Nutrition Examination Survey (1988 to 1994) were followed up until December 31, 2011. Antibodies were categorized into 4 clusters: red-green, orange-red, yellow-orange, and orange-blue. Over a 23-y follow-up, 2,702 deaths occurred, including 810 CVD-related deaths. In fully adjusted Cox proportional hazard models, the red-green cluster was positively associated with all-cause mortality (tertile 3 vs. tertile 1: hazard ratio [HR] = 1.43, 95% CI = 1.08 to 1.90, P = 0.015). The yellow-orange cluster was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.78, 95% CI = 0.63 to 0.97, P = 0.028) and CVD mortality (tertile 2 vs. tertile 1: HR = 0.57, 95% CI = 0.42 to 0.77, P = 0.005). The orange-blue cluster (composed of antibodies against Eubacterium nodatum and Actinomyces naeslundii) was inversely associated with all-cause mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.55 to 0.78, P < 0.0001) and CVD mortality (tertile 3 vs. tertile 1: HR = 0.65, 95% CI = 0.47 to 0.88, P = 0.007). These antibodies could predict prognosis or be potential intervention targets to prevent systemic effects of periodontal disease if further studies establish a causal relationship.


2021 ◽  
Author(s):  
Roi Tschernichovsky ◽  
Lior H Katz ◽  
Estela Derazne ◽  
Matan Ben-Zion Berliner ◽  
Maya Simchoni ◽  
...  

Abstract Background Gliomas manifest in a variety of histological phenotypes with varying aggressiveness. The etiology of glioma remains largely unknown. Taller stature in adulthood has been linked with glioma risk. The aim of this study was to discern whether this association can be detected in adolescence. Methods The cohort included 2,223,168 adolescents between the ages of 16-19. Anthropometric measurements were collected at baseline. Incident cases of glioma were extracted from the Israel National Cancer Registry over a follow-up period spanning 47,635,745 person-years. Cox proportional hazard models were used to estimate the hazard ratio for glioma and glioma subtypes according to height, body mass index (BMI) and sex. Results 1,195 patients were diagnosed with glioma during the study period. Mean(SD) age at diagnosis was 38.1 (11.7) years. Taller adolescent height (per 10cm increase) was positively associated with the risk for glioma of any type (HR 1.15; p=0.002). The association was retained in subgroup analyses for low-grade glioma (HR 1.17; p=0.031), high-grade glioma (HR 1.15; p=0.025), oligodendroglioma (HR 1.31; p=0.015), astrocytoma (HR 1.12; p=0.049), and a category of presumed IDH-mutated glioma (HR 1.17; p=0.013). There was a trend towards a positive association between height and glioblastoma, however this had borderline statistical significance (HR: 1.15; p=0.07). After stratification of the cohort by sex, height remained a risk factor for men, but not for women. Conclusions The previously - established association between taller stature in adulthood and glioma risk can be traced back to adolescence. The magnitude of association differs by glioma subtype.


Author(s):  
Mara Caroline ◽  
Ryan Bradley ◽  
Mimi Guarneri

The older population is challenging to treat for numerous reasons, including comorbid conditions and increased susceptibility to adverse drug reactions, limiting medical therapy. They are at increased risk for loneliness and depression, which strongly impacts their cardiovascular outcomes, and they also have different values, usually prioritizing quality of life over mortality objectives. Finally, the elderly are underrepresented in cardiovascular clinical trials, thus limiting the applicability of guideline recommendations. This chapter emphasizes the importance of a comprehensive assessment of individual circumstances when assessing cardiovascular health in the elderly population. The chapter focuses on the role of nutrition, resiliency, and exercise for the prevention and treatment of cardiovascular disease. Nutrient deficiencies commonly seen with cardiovascular drugs are also discussed, as well as specific integrative strategies for optimizing dyslipidemia, atrial fibrillation, and heart failure in this population.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
E Chowdhury ◽  
M R Nelson ◽  
M E Ernst ◽  
K L Margolis ◽  
L J Beilin ◽  
...  

Abstract Introduction Despite readily available treatments, control of high blood pressure (BP) in the ageing population remains suboptimal. Gaps in understanding the management of high BP amongst the elderly exist, as most studies have been in predominantly middle-aged populations. Purpose We explored pharmacological BP lowering treatment and control among elderly hypertensive participants free from overt cardiovascular disease (CVD), and identified factors related to both “untreated” and “treated but uncontrolled” high BP. Methods We analyzed baseline data from 19,114 individuals aged ≥65 years enrolled from Australia and the US in the ASPirin in Reducing Events in the Elderly (ASPREE) study. Hypertension was defined as an average systolic/diastolic BP ≥140/90 mmHg and/or use of any BP-lowering medication. `Controlled hypertensives” were those receiving BP-lowering medication and with BP <140/90 mmHg. Descriptive analyses were used to summarize hypertension control rates; logistic regression was used to investigate relationships with treatment and BP control. Results Overall, 74% (14,213/19,114) of participants were hypertensive, and of these 29% (4,151/14,213) were untreated. Among those treated, 47% (4,732/10,062) had BP <140/90 mmHg. Participants who were untreated were more likely to be men, have higher educational status, and be in good physical health, and less likely to have significant comorbidities. The factors related to “treated but uncontrolled” hypertension included older age, being men, Black race (versus White), using BP lowering monotherapy and residing in Australia (versus US) (Figure 1). Conclusion(s) There were high levels of “untreated” and “treated but uncontrolled” BP, in an otherwise healthy elderly population, suggesting that opportunities for better BP control exist through targeting intervention to high-risk individuals. Acknowledgement/Funding National Institute on Aging and the National Cancer Institute at NIH; NHMRC Australia, Monash University, Victorian Cancer Agency (Australia)


Heart ◽  
2021 ◽  
pp. heartjnl-2021-318972
Author(s):  
Xiaowen Wang ◽  
Jia-Yi Dong ◽  
Renzhe Cui ◽  
Isao Muraki ◽  
Kokoro Shirai ◽  
...  

ObjectiveTo examine whether the relationship between smoking cessation and risk of cardiovascular disease (CVD) was modified by weight gain.MethodsA total of 69 910 participants (29 650 men and 46 260 women) aged 45–74 years were grouped into six groups by smoking status in the first and 5-year surveys: sustained smokers, recent quitters according to postcessation weight gain (no weight gain, 0.1–5.0 kg, >5.0 kg), long-term quitters and never smokers. Quitting smoking within and longer than 5 years were defined as recent and long-term quitters, respectively. We used Cox proportional hazard models to estimate the HR for incident CVD, coronary heart disease (CHD) and stroke.ResultsWe identified 4023 CVDs (889 CHDs and 3217 strokes) during a median of 14.8 years of follow-up. Compared with sustained smokers, the multivariable HR (95% CI) for CVD was 0.66 (0.52 to 0.83) for recent quitters without weight gain, 0.71 (0.55 to 0.90) for recent quitters with weight gain of 0.1–5.0 kg, 0.70 (0.44 to 1.10) for recent quitters with weight gain of >5.0 kg, 0.56 (0.49 to 0.64) for long-term quitters, and 0.60 (0.55 to 0.66) for never smokers. The analysis restricted to men showed a similar association. Prespecified analysis by age suggested that recent quitters overall had a lower HR for CVD among those aged <60 years vs ≥60 years. Similar patterns of association were observed in CHD and stroke.ConclusionsPostcessation weight gain did not attenuate the protective association between smoking cessation and risk of CVD.


2005 ◽  
Vol 15 (2) ◽  
pp. 71-82 ◽  
Author(s):  
F Fantin ◽  
C Rajkumar ◽  
CJ Bulpitt

The elderly population has greatly increased in the last few decades as life expectancy has risen. In 2005 life expectancy at birth for females born in the UK is 80.2 years, compared with 75.2 years for males. This is in contrast to 49 and 45 years respectively in 1901. Cardiovascular disease is still the most important cause of death in the population over the age of 65, causing 40% of deaths in women and 42% in men of this age.


2021 ◽  
Vol 8 ◽  
Author(s):  
Weida Liu ◽  
Runzhen Chen ◽  
Chenxi Song ◽  
Chuangshi Wang ◽  
Ge Chen ◽  
...  

Background: A single measurement of grip strength (GS) could predict the incidence of cardiovascular disease (CVD). However, the long-term pattern of GS and its association with incident CVD are rarely studied. We aimed to characterize the GS trajectory and determine its association with the incidence of CVD (myocardial infarction, angina, stroke, and heart failure).Methods: This study included 5,300 individuals without CVD from a British community-based cohort in 2012 (the baseline). GS was repeatedly measured in 2004, 2008, and 2012. Long-term GS patterns were identified by the group-based trajectory model. Cox proportional hazard models were used to examine the associations between GS trajectories and incident CVD. We identified three GS trajectories separately for men and women based on the 2012 GS measurement and change patterns during 2004–2012.Results: After a median follow-up of 6.1 years (during 2012–2019), 392 participants developed major CVD, including 114 myocardial infarction, 119 angina, 169 stroke, and 44 heart failure. Compared with the high stable group, participants with low stable GS was associated with a higher incidence of CVD incidence [hazards ratio (HR): 2.17; 95% confidence interval (CI): 1.52–3.09; P &lt;0.001], myocardial infarction (HR: 2.01; 95% CI: 1.05–3.83; P = 0.035), stroke (HR: 1.96; 95% CI: 1.11–3.46; P = 0.020), and heart failure (HR: 6.91; 95% CI: 2.01–23.79; P = 0.002) in the fully adjusted models.Conclusions: The low GS trajectory pattern was associated with a higher risk of CVD. Continuous monitoring of GS values could help identify people at risk of CVD.


2020 ◽  
Vol 2 (1) ◽  
pp. 32-38
Author(s):  
Yanna Indrayana ◽  
Herpan Syafii Harahap ◽  
Dion Setiawan ◽  
Amanda Halimi

Cardiovascular disease is the major causes of death in the world. Hypertension and diabetes mellitus are the important risk factors for cardiovascular disease. The prevalence of hypertension and diabetes mellitus is higher in the elderly population. Promotive and preventive efforts for the occurrence of hypertension and diabetes mellitus are the important strategies for preventing cardiovascular disease in elderly population. This was a social activity program developingthe preventive strategy against cardiovascular disease and improving of the quality of life of the elderly. This activity program was attended by 66 elderly participants routinely participated in the Panti Sosial Tresna Werdha Puspa Karma, Mataram. This program were consisted of counseling and healthy heart gymnasticsregularly every week for 3 months. The parameters taken in this event are height, body mass index (BMI), abdominal circumference, systolic and diastolic blood pressure, and serum fasting blood glucose (GDP) levels at the beginning and end of the programin order to assess the success of this program in reducingthe risk of suffered from cardiovascular disease. There were significant differences in the mean of body weight, BMI, abdominal circumference, systolic and diastolic blood pressure, and serum GDP levels between the the beginning and end of the programs (p<0.05). This social activity program reduced effectively the risk of cardiovascular disease in the elderly.


Author(s):  
Sangmo Hong ◽  
Jung Hwan Park ◽  
Kyungdo Han ◽  
Chang Beom Lee ◽  
Dong Sun Kim ◽  
...  

Abstract Context Some studies have suggested that patients with type 2 diabetes mellitus (T2DM) concomitant with obesity have better clinical outcomes than normal-weight patients with T2DM. Objective We evaluated associations among obesity, cardiovascular disease (CVD) events, and mortality in elderly patients with T2DM without CVD. Design Retrospective observational study between 2009 and 2017, with a mean follow-up of 7.26 years. Setting Nationwide (Korea). Participants This study included 249,903 elderly (≥65 years) patients with T2DM and no pre-existing CVD using the Korean National Health Information Database. Main Outcome Measures We categorized subjects according to body mass index (BMI) and waist circumference (WC) and analyzed a composite of stroke, myocardial infarction, and all-cause death using Cox proportional hazards regression analysis, adjusting for baseline covariates. Results The incidence rate of composite primary outcomes was 30.95/1,000 person-years. The primary outcome risk had an L-shaped and a U-shaped association with BMI and WC, respectively. In the multivariable Cox proportional hazard models, the risk of primary composite outcomes in the highest BMI group (≥30 kg/m 2; hazards ratio [HR]=0.824, 95% confidence interval [CI]: 0.794−0.855) was lower than in the normal BMI group (≥18.5 and &lt;23 kg/m 2). Conversely, that in the highest WC group (≥100 cm/≥95 cm; men/women; HR=1.434, 95% CI: 1.384‒1.486) was higher than in the normal WC group (&lt;90 cm/&lt;85 cm; men/women). Conclusion Our study with elderly patients with diabetes results suggest that while BMI is an inadequate risk indicator for outcomes related to obesity, WC is a suitable alternative.


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