Life Course Effects of Socioeconomic and Lifestyle Factors on Metabolic Syndrome and 10-Year Risk of Cardiovascular Disease: A Longitudinal Study in Taiwan Adults

The objective of the study was to explore the dynamic effects of socioeconomic status (SES) and lifestyle behaviors on the risks of metabolic syndrome (MS) or cardiovascular disease (CVD) in life course. The data of 12,825 subjects (6616 males and 6209 females) who underwent repeated examinations and answered repeated questionnaires from 2006 to 2014 at the Major Health Screening Center in Taiwan, was collected and analyzed. The trajectory of trends in the subjects’ SES and lifestyle mobility over time was observed, and the effects of factors with potential impacts on health were tested and analyzed using multiple logistic regression and a generalized estimated equation model. A 10% increase in MS prevalence was observed over the nine-year period. The average Framingham CVD score for people with MS was estimated to be about 1.4% (SD = 1.5%). Except for middle-aged women, marriage was found to raise the risk of CVD, whereas increasing education and work promotions independently reduced CVD risk for the majority of subjects. However, the risk of CVD was raised by half for young men who had a job or lost a job in comparison to continuously unemployed young men. Physical activity was only found to be advantageous for disease prevention in those aged less than 40 years; increased exercise levels were useless for reducing CVD risk among older men. Alcohol drinking and betel chewing caused increased CVD risk in the old and young subjects, respectively, whereas vegetarian diets and vitamin C/E intake were helpful in preventing CVD, even if those habits were ceased in later life. For middle-aged women, getting sufficient sleep reduced CVD risk. We concluded that SES and lifestyle behaviors may have different effects on health over time, among various populations. Accordingly, suggestions can be provided to healthcare workers in designing health promotion courses for people at different life stages.

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Skin Carotenoid Status Is a Potential Surrogate Marker for Cardiovascular Disease Risk Determination in Middle-Aged and Older Adults

Current Developments in Nutrition ◽

10.1093/cdn/nzaa041_036 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 132-132

Author(s):

Darel Wee Kiat Toh ◽

Clarinda Sutanto ◽

Wen Wei Loh ◽

Wan Yee Lee ◽

Yuanhang Yao ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Risk Prediction ◽

Disease Risk ◽

Surrogate Marker ◽

Cvd Risk Factors ◽

Middle Aged ◽

Cvd Risk ◽

Metabolic Syndrome Components

Abstract Objectives The study aimed to examine the associations between skin carotenoid status and plasma carotenoids with classical cardiovascular disease (CVD) risk factors among a middle-aged and older Singaporean population. It was hypothesized that skin carotenoid status and plasma carotenoids could be used as an indicator for CVD risk. Methods This cross-sectional study recruited 45 men and 59 women, aged 50 to 75 years, from a community in Singapore (n = 104). Dietary information was obtained using 3-day food records, skin carotenoid status was measured using resonance Raman spectroscopy and plasma carotenoids were analyzed with high-performance liquid chromatography. CVD risk was determined using classical risk factors including blood pressure (BP), serum lipid-lipoprotein concentrations, as well as overall CVD risk predictors such as the number of metabolic syndrome components and a 10-year CVD risk prediction using the Framingham Heart Study risk score calculator. Results Multiple linear regression with covariate adjustments indicated that skin carotenoid status and plasma carotenoids were inversely associated with systolic BP (skin: standardized regression coefficient (β) = −0.341, P < 0.001; plasma: β = −0.258, P < 0.05), diastolic BP (skin: β = −0.378, P < 0.001; plasma: β = −0.309, P < 0.005) as well as both the number of metabolic syndrome components (skin: β = −0.383, P < 0.001; plasma: β = −0.434, P < 0.001) and the 10-year CVD risk prediction (skin: β = −0.347, P < 0.001; plasma: β = −0.334, P < 0.001). The associations between skin carotenoid status with metabolic syndrome and the 10-year CVD risk were null with the inclusion of plasma carotenoids as a covariate which suggested its role as a mediator. Despite the positive linear association between skin carotenoid status and dietary carotenoids intake (Pearson's coefficient: 0.204, P < 0.001), dietary carotenoids were not directly correlated with the CVD risk factors analyzed. Conclusions Skin carotenoid status can function not only as a dietary biomarker, but also, as a potential surrogate marker for CVD risk in middle-aged and older Singaporeans. Funding Sources National University of Singapore Ministry of Education, Singapore Agency for Science, Technology and Research (Singapore).

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Multi-trajectories of lipid indices with incident cardiovascular disease, heart failure, and all-cause mortality: 23 years follow-up of two US cohort studies

Journal of Translational Medicine ◽

10.1186/s12967-021-02966-4 ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Fatemeh Koohi ◽

Davood Khalili ◽

Mohammad Ali Mansournia ◽

Farzad Hadaegh ◽

Hamid Soori

Keyword(s):

Heart Failure ◽

Cardiovascular Disease ◽

Cohort Studies ◽

Significant Risk ◽

Density Lipoprotein ◽

Lipid Levels ◽

Cvd Risk ◽

All Cause Mortality ◽

Over Time

Abstract Background Understanding the distinct patterns (trajectories) of variation in blood lipid levels before diagnosing cardiovascular disease (CVD) might carry important implications for improving disease prevention or treatment. Methods We investigated 14,373 participants (45.5% men) aged 45–84 from two large US prospective cohort studies with a median of 23 years follow-up. First, we jointly estimated developmental trajectories of lipid indices, including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) concentrations using group-based multi-trajectory modeling. Then, the association of identified multi-trajectories with incident CVD, heart failure, and all-cause mortality were examined using Cox proportional hazard model. Results Seven distinct multi-trajectories were identified. The majority of participants (approximately 80%) exhibited decreasing LDL-C but rising TG levels and relatively stable HDL-C levels. Compared to the individuals with healthy and stable LDL-C, HDL-C, and TG levels, those in other groups were at significant risk of incident CVD after adjusting for other conventional risk factors. Individuals with the highest but decreasing LDL-C and borderline high and rising TG levels over time were at the highest risk than those in other groups with a 2.22-fold risk of CVD. Also, those with the highest and increased triglyceride levels over time, over optimal and decreasing LDL-C levels, and the lowest HDL-C profile had a nearly 1.84 times CVD risk. Even individuals in the multi-trajectory group with the highest HDL-C, optimal LDL-C, and optimal TG levels had a significant risk (HR, 1.45; 95% CI 1.02–2.08). Furthermore, only those with the highest HDL-C profile increased the risk of heart failure by 1.5-fold (95% CI 1.07–2.06). Conclusions The trajectories and risk of CVD identified in this study demonstrated that despite a decline in LDL-C over time, a significant amount of residual risk for CVD remains. These findings suggest the impact of the increasing trend of TG on CVD risk and emphasize the importance of assessing the lipid levels at each visit and undertaking potential interventions that lower triglyceride concentrations to reduce the residual risk of CVD, even among those with the optimal LDL-C level.

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Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.137.suppl_1.p006 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Rachael R Baiduc ◽

Brittany Bogle ◽

Franklyn Gonzalez ◽

Elizabeth Dinces ◽

David J Lee ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Hearing Loss ◽

Total Cholesterol ◽

Young Women ◽

Young Men ◽

Health Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

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Abstract 14677: Distribution of 10- and 30-year Predicted Risks for Atherosclerotic Cardiovascular Disease in the United States: NHANES 2015 to 2018

Circulation ◽

10.1161/circ.142.suppl_3.14677 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Nilay S Shah ◽

Hongyan Ning ◽

Amanda Perak ◽

Norrina B Allen ◽

John T Wilkins ◽

...

Keyword(s):

Cardiovascular Disease ◽

Life Course ◽

Risk Model ◽

The United States ◽

Atherosclerotic Cardiovascular Disease ◽

Middle Aged ◽

Ascvd Risk ◽

The Life Course ◽

Predicted Risk

Introduction: Premature fatal cardiovascular disease rates have plateaued in the US. Identifying population distributions of short- and long-term predicted risk for atherosclerotic cardiovascular disease (ASCVD) can inform interventions and policy to improve cardiovascular health over the life course. Methods: Among nonpregnant participants age 30-59 years without prevalent CVD from the National Health and Nutrition Examination Surveys 2015-18, continuous 10 year (10Y) and 30 year (30Y) predicted ASCVD risk were assigned using the Pooled Cohort Equations and a 30-year competing risk model, respectively. Intermediate/high 10Y risk was defined as ≥7.5%, and high 30Y risk was chosen a priori as ≥20%, based on 2019 guideline levels for risk stratification. Participants were combined into low 10Y/low 30Y, low 10Y/high 30Y, and intermediate/high 10Y categories. We calculated and compared risk distributions overall and across race-sex, age, body mass index (BMI), and education using chi-square tests. Results: In 1495 NHANES participants age 30-59 years (representing 53,022,413 Americans), median 10Y risk was 2.3% and 30Y risk was 15.5%. Approximately 12% of individuals were already estimated to have intermediate/high 10Y risk. Of those at low 10Y risk, 30% had high 30Y predicted risk. Distributions differed significantly by sex, race, age, BMI, and education (P<0.01, Figure ). Black males more frequently had high 10Y risk compared with other race-sex groups. Older individuals, those with BMI ≥30 kg/m 2 , and with ≤high school education had a higher frequency of low 10Y/high 30Y risk. Conclusions: More than one-third of middle-aged U.S. adults have elevated short- or long-term predicted risk for ASCVD. While the majority of middle-aged US adults are at low 10Y risk, a large proportion among this subgroup are at high 30Y ASCVD risk, indicating a substantial need for enhanced clinical and population level prevention earlier in the life course.

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Nutrients in Fish and Possible Associations with Cardiovascular Disease Risk Factors in Metabolic Syndrome

Nutrients ◽

10.3390/nu10070952 ◽

2018 ◽

Vol 10 (7) ◽

pp. 952 ◽

Cited By ~ 25

Author(s):

Christine Tørris ◽

Milada Cvancarova Småstuen ◽

Marianne Molin

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Fatty Acids ◽

Fish Consumption ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Protective Role ◽

Cvd Risk ◽

The Impact

Non-communicable diseases (NSDs) are responsible for two-thirds of all deaths globally, whereas cardiovascular disease (CVD) alone counts for nearly half of them. To reduce the impact of CVD, targeting modifiable risk factors comprised in metabolic syndrome (e.g., waist circumference, lipid profile, blood pressure, and blood glucose) is of great importance. Beneficial effects of fish consumption on CVD has been revealed over the past decades, and some studies suggest that fish consumption may have a protective role in preventing metabolic syndrome. Fish contains a variety of nutrients that may contribute to health benefits. This review examines current recommendations for fish intake as a source of various nutrients (proteins, n-3 fatty acids, vitamin D, iodine, selenium, and taurine), and their effects on metabolic syndrome and the CVD risk factors. Fatty fish is recommended due to its high levels of n-3 fatty acids, however lean fish also contains nutrients that may be beneficial in the prevention of CVD.

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Abstract MP34: Tai Chi Exercise is More Effective Than Brisk Walking in Reducing Cardiovascular Disease Risk Factors

Circulation ◽

10.1161/circ.137.suppl_1.mp34 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Aileen W Chan ◽

Doris Y Leung ◽

SY Chair ◽

Janet W Sit ◽

Ruth E Taylor-Piliae

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Perceived Stress ◽

Tai Chi ◽

Disease Risk ◽

Moderate Intensity ◽

Brisk Walking ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Over Time

Background: Physical inactivity is one of the major modifiable lifestyle risk factors associated with cardiovascular disease (CVD). Tai Chi (TC) is safe and popular among older adults; yet direct comparisons between TC and brisk walking (BW) on reducing CVD risk factors are lacking. Methods: A total of 246 adults (mean age=64.4±9.8 years, 45.5% men) with hypertension and two other CVD risk factors (i.e., smoker, diabetic, dyslipidemia, or overweight) were randomly assigned to either TC (n=82), BW (n=82), or control (C, n=82) groups. The TC and BW groups had 150 minutes/week, moderate-intensity physical activity for three months; with home-based practice encouraged for another six months. The primary outcome was blood pressure (BP). Secondary outcomes were: fasting blood sugar (FBS), HbA1c, total cholesterol, triglycerides, high and low density lipoprotein, body mass index (BMI), waist circumference and perceived stress. Data were collected at baseline, post-intervention at 3-month, 6-month and 9-month follow-up assessments. Generalized estimating equations models compared changes in the outcomes over time between groups. Results: At baseline, average BP=141/81, smokers=11%, diabetics=58%, dyslipidemia=61%, average BMI=26; with no significant differences between groups. TC significantly lowered BP (systolic -13.33 mmHg; diastolic -6.45 mmHg), FBS (-0.72 mmol/L), HbA1c (-0.39%), and perceived stress (-3.22 score) at 9-months, compared to C group. Pairwise comparisons indicated significantly greater reductions in SBP (p<0.001), DBP (p=0.049), FBS (p=0.001), HbA1c (p=0.002), and perceived stress (p=0.027) in TC group, compared to BW group. No significant changes in other CVD risk indicators over time between groups were observed. Conclusion: TC was better than BW in reducing several CVD risk factors, and can be recommended as a viable exercise to build a healthier life free of CVD.

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Discordant Chronic Conditions and Depressive Symptoms: Longitudinal Associations Among Middle-Aged and Older Couples

The Journals of Gerontology Series B ◽

10.1093/geronb/gbz137 ◽

2019 ◽

Author(s):

Courtney A Polenick ◽

Kira S Birditt ◽

Angela Turkelson ◽

Benjamin C Bugajski ◽

Helen C Kales

Keyword(s):

Depressive Symptoms ◽

Marital Quality ◽

Chronic Conditions ◽

Later Life ◽

Well Being ◽

Middle Aged ◽

Older Couples ◽

Individual Level ◽

The Individual ◽

Over Time

Abstract Objectives Individuals often manage chronic conditions in middle and later life that may diminish well-being. Little is known, however, about discordant conditions (i.e., two or more conditions with competing self-management requirements) among older couples and their links to depressive symptoms. We considered discordant conditions at both the individual level and the couple level (i.e., between spouses), along with their long-term implications for depressive symptoms. Methods The U.S. sample included 1,116 middle-aged and older couples drawn from five waves (2006–2014) of the Health and Retirement Study. Longitudinal actor-partner interdependence models evaluated whether individual-level and couple-level discordant chronic health conditions were concurrently linked to depressive symptoms, and whether these associations became stronger over time. Models controlled for age, minority status, education, prior wave depressive symptoms, and each partner’s baseline report of negative marital quality and number of chronic conditions in each wave. Results Wives and husbands reported significantly greater depressive symptoms when they had individual-level discordant conditions about 2 years after baseline, and these links intensified over time. Beyond this association, husbands had significantly greater depressive symptoms when there were couple-level discordant conditions. Discussion Individual-level and couple-level discordant conditions may have lasting implications for depressive symptoms during midlife and older adulthood.

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Reversal Rate of Clustering of Cardiovascular Disease Risk Factors of Metabolic Syndrome in the General Population: The Niigata Preventive Medicine Study

Journal of Obesity ◽

10.1155/2010/623593 ◽

2010 ◽

Vol 2010 ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

Shinsuke Okada ◽

Akiko Suzuki ◽

Hiroshi Watanabe ◽

Toru Watanabe ◽

Yoshifusa Aizawa

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Risk Factor ◽

Disease Risk ◽

Fasting Blood Glucose ◽

Reversal Rate ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Metabolic Syndrome

The reversal rate from clustering of cardiovascular disease (CVD) risk factors—components of the metabolic syndrome (MetS) is not known.Methods and Results. Among 35,534 subjects who received the annual health examinations at the NiigataHealth Foundation (Niigata, Japan), 4,911 subjects had clustering of 3 or more of the following CVD risk factors: (1) body mass index (BMI) ≥25 Kg/m2, (2) blood pressure ≥130 mm Hg in systolic and/or ≥85 mm Hg in diastolic, (3) triglycerides ≥150 mg/dL, (4) high-density lipoprotein cholesterol ≤40 mg/dL in men, ≤50 mg/dL in women, and (5) fasting blood glucose ≥100 mg/dL. After 5 years 1,929 subjects had a reversal of clustering (39.4%). A reversal occurred more often in males. The subjects with a reversal of clustering had milder level of each risk factor and a smaller number of risk factors, while BMI was associated with the least chance of a reversal.Conclusion. We concluded that a reversal of clustering CVD risk factors is possible in 4/10 subjects over a 5-year period by habitual or medical interventions. Gender and each CVD risk factor affected the reversal rate adversely, and BMI was associated with the least chance of a reversal.

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Serum sex hormone-binding globulin and testosterone in relation to cardiovascular disease risk factors in young men: a population-based study

Acta Endocrinologica ◽

10.1530/eje-13-1046 ◽

2014 ◽

Vol 170 (6) ◽

pp. 863-872 ◽

Cited By ~ 19

Author(s):

D Canoy ◽

T M Barber ◽

A Pouta ◽

A L Hartikainen ◽

M I McCarthy ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Disease Risk ◽

Young Men ◽

Hdl Cholesterol ◽

Sex Hormone ◽

Sex Hormone Binding Globulin ◽

Inverse Association ◽

Hormone Binding ◽

Cvd Risk

ObjectiveReduced sex hormone-binding globulin (SHBG) concentration predicts insulin resistance and type 2 diabetes, but its association with cardiovascular disease (CVD) risk is unclear. We examined the association between SHBG and cardiovascular risk factors, independently of total testosterone (TT), in young men.DesignObservational, cross-sectional study.SettingGeneral community.ParticipantsThe study included 2716 men aged 31 years in the Northern Finland Birth Cohort in 1996 with clinical examination data and fasting blood samples.Outcome variablesBlood pressure (BP), lipids and C-reactive protein (CRP) as biological CVD risk markers.ResultsSHBG concentration was significantly and inversely related to systolic and diastolic BP, triglycerides and CRP, but positively to HDL cholesterol after adjusting for insulin, BMI, waist circumference, smoking, education and physical activity (allP<0.05). These linearly graded associations persisted with additional adjustment for TT. SHBG was significantly associated with total cholesterol only with adjustment for covariates and TT (P<0.05). The direction and magnitude of associations between TT and risk factors were variable, but further adjustment for insulin, adiposity and SHBG showed positive associations between TT and BP, total and LDL-cholesterol and triglycerides and an inverse association with CRP (allP<0.05), but its relation with HDL-cholesterol was no longer significant.ConclusionsIn this cohort of young adult men, higher SHBG concentration was associated with a more favourable CVD risk profile, independently of TT. SHBG concentration modified the associations of TT with CVD risk factors.

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