Dietary Vitamin B6 Intake Associated with a Decreased Risk of Cardiovascular Disease: A Prospective Cohort Study

Although the biological mechanisms underlying the beneficial effects of vitamin B6 on cardiovascular disease (CVD) have been reported on, epidemiological studies have yielded controversial results, and data on the Korean population are limited. This study examined the association between dietary vitamin B6 intake and CVD incidence in Koreans. A total of 9142 participants of the Korean Genome and Epidemiology Study, aged 40–69 years, who did not have CVD or cancer at the baseline were included in the analysis. Dietary data were assessed using a validated semi-quantitative food frequency questionnaire. CVD incidence was assessed using biennial questionnaires and confirmed through repeated personal interviews. Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox proportional hazard regression models. After multivariate adjustment, a higher vitamin B6 intake was significantly associated with a decreased CVD risk in men (HR: 0.44; 95% CI: 0.25–0.78); no such association was observed in women. Dose-response analysis confirmed the presence of inverse linearity between vitamin B6 intake and CVD incidence in men (p for nonlinearity = 0.3). A higher dietary intake level of vitamin B6 was associated with a reduced CVD risk in Korean men. These observations require further verification in other populations.

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Antidepressant Use and the Risk of Major Adverse Cardiovascular Events in Patients Without Known Cardiovascular Disease: A Retrospective Cohort Study

Frontiers in Pharmacology ◽

10.3389/fphar.2020.594474 ◽

2020 ◽

Vol 11 ◽

Author(s):

Ha Young Jang ◽

Jae Hyun Kim ◽

Yun-Kyoung Song ◽

Ju-Young Shin ◽

Hae-Young Lee ◽

...

Keyword(s):

Cardiovascular Disease ◽

Risk Score ◽

Cardiovascular Events ◽

Major Adverse Cardiovascular Events ◽

Cvd Risk ◽

Hazard Ratios ◽

Increased Risk ◽

History Of ◽

Antidepressant Use ◽

Cox Proportional Hazard Regression

Aims: Conflicting data exist on whether an association exists between antidepressants and the risk of major adverse cardiovascular events (MACEs) in patients with depression. This may be due to the use of various study designs and residual or unmeasured confounding. We aimed to assess the association between antidepressant use and the risk of MACEs while considering various covariates, including severity of depression and the cardiovascular disease (CVD) risk score.Methods: Patients newly diagnosed with depression with no history of ischemic heart disease and stroke were followed-up from 2009 to 2015. We conducted Cox proportional hazard regression analysis to estimate hazard ratios (HRs) for each antidepressant for MACE risk.Result: We followed-up (median, 4.4 years) 31,830 matched patients with depression (15,915 antidepressant users and 15,915 non-users). In most patients (98.7%), low-dose tricyclic antidepressants (TCAs) were related with a significantly increased risk of MACEs [adjusted HR = 1.20, 95% confidence interval (CI) = 1.03–1.40]. Duration response relationship showed a gradually increasing HR from 1.15 (95% CI = 0.98–1.33; <30 days of use) to 1.84 (95% CI = 1.35–2.51; ≥365 days of use) (p for trend <0.01). High Korean atherosclerotic CVD risk score (≥7.5%) or unfavorable lifestyle factors (smoking, alcohol intake, and exercise) were significantly associated with MACEs.Conclusion: Even at low doses, TCA use was associated with MACEs during primary prevention. Longer duration of TCA use correlated with higher HR. Careful monitoring is needed with TCA use in patients with no known CVD history.

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Plasma Branched-Chain Amino Acids and Incident Cardiovascular Disease in the PREDIMED Trial

Clinical Chemistry ◽

10.1373/clinchem.2015.251710 ◽

2016 ◽

Vol 62 (4) ◽

pp. 582-592 ◽

Cited By ~ 91

Author(s):

Miguel Ruiz-Canela ◽

Estefania Toledo ◽

Clary B Clish ◽

Adela Hruby ◽

Liming Liang ◽

...

Keyword(s):

Cardiovascular Disease ◽

Amino Acids ◽

Cardiovascular Death ◽

Branched Chain Amino Acids ◽

Control Group ◽

Cvd Risk ◽

Hazard Ratios ◽

Increased Risk ◽

Branched Chain

Abstract BACKGROUND The role of branched-chain amino acids (BCAAs) in cardiovascular disease (CVD) remains poorly understood. We hypothesized that baseline BCAA concentrations predict future risk of CVD and that a Mediterranean diet (MedDiet) intervention may counteract this effect. METHODS We developed a case-cohort study within the Prevención con Dieta Mediterránea (PREDIMED), with 226 incident CVD cases and 744 noncases. We used LC-MS/MS to measure plasma BCAAs (leucine, isoleucine, and valine), both at baseline and after 1 year of follow-up. The primary outcome was a composite of incident stroke, myocardial infarction, or cardiovascular death. RESULTS After adjustment for potential confounders, baseline leucine and isoleucine concentrations were associated with higher CVD risk: the hazard ratios (HRs) for the highest vs lowest quartile were 1.70 (95% CI, 1.05–2.76) and 2.09 (1.27–3.44), respectively. Stronger associations were found for stroke. For both CVD and stroke, we found higher HRs across successive quartiles of BCAAs in the control group than in the MedDiet groups. With stroke as the outcome, a significant interaction (P = 0.009) between baseline BCAA score and intervention with MedDiet was observed. No significant effect of the intervention on 1-year changes in BCAAs or any association between 1-year changes in BCAAs and CVD were observed. CONCLUSIONS Higher concentrations of baseline BCAAs were associated with increased risk of CVD, especially stroke, in a high cardiovascular risk population. A Mediterranean-style diet had a negligible effect on 1-year changes in BCAAs, but it may counteract the harmful effects of BCAAs on stroke.

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Abstract 17: Association of Race and Sex with Cardiovascular Disease and Non-Cardiovascular Disease Mortality: The REasons for Geographic and Racial Differences in Stroke study

Circulation ◽

10.1161/circ.135.suppl_1.17 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Gabriel S Tajeu ◽

Monika M Safford ◽

George Howard ◽

Rikki M Tanner ◽

Paul Muntner

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Racial Differences ◽

Proportional Hazards ◽

Cox Proportional Hazards ◽

Hazard Ratio ◽

Cvd Risk ◽

Hazard Ratios ◽

Stroke Study ◽

Cvd Mortality

Introduction: Black Americans have higher rates of cardiovascular disease (CVD) mortality compared with whites. Differences in sociodemographic, psychosocial, CVD, and other risk factors may explain increased mortality risk. Methods: We analyzed data from 29,015 REasons for Geographic and Racial Differences in Stroke study participants to determine factors that may explain the higher hazard ratio for CVD and non-CVD mortality in blacks compared with whites. Cause of death was adjudicated by trained investigators. Within age-sex sub-groups, we used Cox proportional hazards regression with progressive adjustment to estimate black:white hazard ratios. Results: Overall, 41.0% of participants were black, and 54.9% were women. Over a mean follow-up of 7.1 years (maximum 12.3 years), 5,299 participants died (1,797 CVD and 3,502 non-CVD deaths). Among participants < 65 years of age, the age and region adjusted black:white hazard ratio for CVD mortality was 2.28 (95% CI: 1.68-3.10) and 2.32 (95% CI: 1.80-3.00) for women and men, respectively, and for participants ≥ 65 was 1.54 (95% CI: 1.30-1.82) and 1.35 (95% CI: 1.16-1.57) for women and men, respectively ( Table ). The higher black:white hazard ratios for CVD mortality were no longer statistically significant after multivariable adjustment, with the largest attenuation occurring with sociodemographic and CVD risk factor adjustment. Among participants < 65 years of age, the age and region adjusted black:white hazard ratios for non-CVD mortality were 1.51 (95% CI: 1.24-1.85) and 1.76 (95% CI: 1.46-2.13) for women and men, respectively, and for participants ≥ 65 was 1.12 (95% CI: 1.00-1.26) and 1.34 (95% CI: 1.20-1.49) for women and men, respectively. The higher black:white hazard ratios for non-CVD mortality were attenuated after adjustment for sociodemographics. Conclusions: Black:white differences are larger for CVD than non-CVD causes of death. The increased CVD mortality for blacks compared with whites is primarily explained by sociodemographic and CVD risk factors.

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Factors Associated With Weight Gain in People Treated With Dolutegravir

Open Forum Infectious Diseases ◽

10.1093/ofid/ofaa195 ◽

2020 ◽

Vol 7 (6) ◽

Cited By ~ 6

Author(s):

Lucia Taramasso ◽

Paolo Bonfanti ◽

Elena Ricci ◽

Giancarlo Orofino ◽

Nicola Squillace ◽

...

Keyword(s):

Weight Gain ◽

Female Gender ◽

Proportional Hazard ◽

Cd4 Counts ◽

Factors Associated ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Tenofovir Alafenamide ◽

Cox Proportional Hazard Regression

Abstract Background An unexpected excess in weight gain has recently been reported in the course of dolutegravir (DTG) treatment. The aim of the present study was to investigate whether weight gain differs among different DTG-containing regimens. Methods Adult naïve and experienced people with HIV (PWH) initiating DTG-based antiretroviral therapy (ART) between July 2014 and December 2019 in the Surveillance Cohort Long-Term Toxicity Antiretrovirals (SCOLTA) prospective cohort were included. We used an adjusted general linear model to compare weight change among backbone groups and a Cox proportional hazard regression model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for weight increases >10% from baseline. Results A total of 713 participants, 25.3% women and 91% Caucasian, were included. Of these, 195 (27.4%) started DTG as their first ART regimen, whereas 518 (72.6%) were ART-experienced. DTG was associated with abacavir/lamivudine in 326 participants, tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in 148, boosted protease inhibitors in 60, rilpivirine in 45, lamivudine in 75, and tenofovir alafenamide (TAF)/FTC in 59. At 6 and 12 months, weight gain was highest among PWH on TDF/FTC+DTG and TAF/FTC+DTG. Baseline CD4 <200 cells/mm3 (HR, 1.84; 95% CI, 1.15 to 2.96), being ART-naïve (HR, 2.24; 95% CI, 1.24 to 4.18), and treatment with TDF/FTC+DTG (HR, 1.92; 95% CI, 1.23 to 2.98) or TAF/FTC+DTG (HR, 3.80; 95% CI, 1.75 to 8.23) were associated with weight gain >10% from baseline. Higher weight (HR, 0.97 by 1 kg; 95% CI, 0.96 to 0.99) and female gender (HR, 0.54; 95% CI, 0.33 to 0.88) were protective against weight gain. Conclusions Naïve PWH with lower CD4 counts and those on TAF/FTC or TDF/FTC backbones were at higher risk of weight increase in the course of DTG-based ART.

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Tea consumption and the risk of atherosclerotic cardiovascular disease and all-cause mortality: The China-PAR project

European Journal of Preventive Cardiology ◽

10.1177/2047487319894685 ◽

2020 ◽

Vol 27 (18) ◽

pp. 1956-1963 ◽

Cited By ~ 2

Author(s):

Xinyan Wang ◽

Fangchao Liu ◽

Jianxin Li ◽

Xueli Yang ◽

Jichun Chen ◽

...

Keyword(s):

Cardiovascular Disease ◽

Disease Incidence ◽

Atherosclerotic Cardiovascular Disease ◽

Tea Consumption ◽

Hazard Ratios ◽

Disease Mortality ◽

All Cause Mortality ◽

Cox Proportional Hazard Regression ◽

Study Participants

Aims The role of tea consumption in the primary prevention of atherosclerotic cardiovascular disease remains unclear in cohort studies. This prospective cohort study aimed to investigate the associations of tea consumption with the risk of atherosclerotic cardiovascular disease and all-cause mortality. Methods We included 100,902 general Chinese adults from the project of Prediction for ASCVD Risk in China (China-PAR) in 15 provinces across China since 1998. Information on tea consumption was collected through standardized questionnaires. Outcomes were identified by interviewing study participants or their proxies, and checking hospital records and/or death certificates. Cox proportional hazard regression models were used to calculate hazard ratios and their corresponding 95% confidence intervals related to tea consumption. Results During a median follow-up of 7.3 years, 3683 atherosclerotic cardiovascular disease events, 1477 atherosclerotic cardiovascular disease deaths, and 5479 all-cause deaths were recorded. Compared with never or non-habitual tea drinkers, the hazard ratio and 95% confidence interval among habitual tea drinkers was 0.80 (0.75–0.87), 0.78 (0.69–0.88), and 0.85 (0.79–0.90) for atherosclerotic cardiovascular disease incidence, atherosclerotic cardiovascular disease mortality, and all-cause mortality, respectively. Habitual tea drinkers had 1.41 years longer of atherosclerotic cardiovascular disease-free years and 1.26 years longer of life expectancy at the index age of 50 years. The observed inverse associations were strengthened among participants who kept the habit during the follow-up period. Conclusion Tea consumption was associated with reduced risks of atherosclerotic cardiovascular disease and all-cause mortality, especially among those consistent habitual tea drinkers.

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The Effects of Nut Consumption on Vascular Function

Nutrients ◽

10.3390/nu11010116 ◽

2019 ◽

Vol 11 (1) ◽

pp. 116 ◽

Cited By ~ 10

Author(s):

Samantha Morgillo ◽

Alison M. Hill ◽

Alison M. Coates

Keyword(s):

Cardiovascular Disease ◽

Vascular Function ◽

Wave Reflection ◽

Epidemiological Studies ◽

Cvd Risk ◽

Future Studies ◽

Tree Nut ◽

Increased Risk ◽

Flow Mediated Dilatation ◽

Chronic Study

Vascular stiffness can be measured using numerous techniques including assessments of central haemodynamics, aortic arterial stiffness, and indices of aortic wave reflection and endothelial dilatation. Impaired vascular function is associated with increased risk of cardiovascular disease (CVD). Epidemiological studies indicate that regular nut consumption reduces CVD risk, with one of the proposed mechanisms being via improvements in vascular function. This narrative review summarizes the evidence from a systematic search of the literature of the effects of tree nut and peanut consumption on measures of vascular function excluding flow mediated dilatation. A total of 16 studies were identified, with a mix of acute controlled studies (n = 3), an uncontrolled pre/post chronic study (n = 1), chronic crossover (n = 7) and parallel studies (n = 5). Nut types tested included almonds, peanuts, pine nuts, pistachios and walnuts, with dose and length of supplementation varying greatly across studies. Most studies (n = 13) included individuals at risk for CVD, according to various criteria. Findings were inconsistent, with ten studies reporting no significant changes in vascular function and six studies (one acute and five chronic studies) reporting improvements in at least one measure of vascular function. In summary, nuts have the potential to improve vascular function and future studies should consider the population, dose and length of nut supplementation as well as suitability of the different vascular function techniques.

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A high consumption of tomato and lycopene is associated with a lower risk of cancer mortality: results from a multi-ethnic cohort

Public Health Nutrition ◽

10.1017/s1368980019003227 ◽

2020 ◽

Vol 23 (9) ◽

pp. 1569-1575 ◽

Cited By ~ 1

Author(s):

Mohsen Mazidi ◽

Gordon A Ferns ◽

Maciej Banach

Keyword(s):

Cancer Mortality ◽

Outcome Data ◽

Competing Risk ◽

Cox Models ◽

Beneficial Effects ◽

Health And Nutrition ◽

Hazard Ratios ◽

Competing Risk Models ◽

Cox Proportional Hazard Regression ◽

Risk Of Cancer

AbstractObjective:We investigated the association between the consumption of tomato and lycopene and cancer mortality among US adults.Design:Prospective.Setting:The National Health and Nutrition Examination Survey (1999–2010).Participants:Participants with estimated dietary data on tomato and lycopene consumption were included. Outcome data up until 31 December 2011 were also ascertained. Cox proportional hazard regression models were used to relate baseline tomato and lycopene consumption with cancer mortality. We conducted a competing-risk survival analysis to account for deaths from other causes.Results:Adjusted Cox models showed that tomato and lycopene intake were inversely related (hazard ratio (95 % CI)) to cancer mortality: 0·86 (0·81, 0·92) and 0·79 (0·74, 0·82), respectively. In the adjusted competing-risk models, the sub-hazard ratios (95 % CI) were 0·89 (0·83, 0·94) and 0·82 (0·78, 0·86) for cancer mortality for tomato and lycopene intake, respectively. No significant interaction was found for the association between tomato and lycopene consumption and cancer mortality while comparing older (aged >50 years) v. younger adults (Pinteraction > 0·173 for all) and obese v. non-obese (Pinteraction > 0·352 for all).Conclusions:Our results demonstrate the potential beneficial effects of a high dietary intake of tomato and lycopene on cancer death. Further prospective studies are needed to explore the association.

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Multi-Fetal Pregnancy, Preeclampsia, and Long-Term Cardiovascular Disease

Hypertension ◽

10.1161/hypertensionaha.120.14860 ◽

2020 ◽

Vol 76 (1) ◽

pp. 167-175 ◽

Cited By ~ 1

Author(s):

Lina Bergman ◽

Paliz Nordlöf-Callbo ◽

Anna Karin Wikström ◽

Jonathan M. Snowden ◽

Susanne Hesselman ◽

...

Keyword(s):

Cardiovascular Disease ◽

Inflammatory Factors ◽

Singleton Pregnancy ◽

Medical Birth Register ◽

Hazard Ratios ◽

Increased Risk ◽

National Patient ◽

Swedish Medical ◽

Cox Proportional Hazard Regression ◽

Joint Contribution

This Swedish register-based cohort study determined the separate and joint contribution of preeclampsia and multi-fetal pregnancy on a woman’s risk of cardiovascular disease (CVD) later in life. The study included 892 425 first deliveries between 1973 and 2010 of women born 1950 until 1971, identified in the Swedish Medical Birth Register. A composite outcome of CVD was retrieved through linkage with the National Patient and Cause of Death Registers. Cox proportional hazard regression was used to assess the risk of CVD in women who had preeclampsia in a singleton or multi-fetal pregnancy, adjusting for potential confounders, and presented as adjusted hazard ratios. Compared with women who had a singleton pregnancy without preeclampsia (the referent group), women with preeclampsia in a singleton pregnancy had an increased risk of CVD (adjusted hazard ratio 1.75 [95% CI, 1.64–1.86]). Women who had a multi-fetal pregnancy without or with preeclampsia did not have an increased risk of future CVD (adjusted hazard ratios 0.94 [95% CI, 0.79–1.10] and 1.25 [95% CI, 0.83–1.86], respectively). As opposed to preeclampsia in a first singleton pregnancy, preeclampsia in a first multi-fetal pregnancy was not associated with increased risk of future CVD. This may support the theory that preeclampsia in multi-fetal pregnancies more often occurs as a result of the larger pregnancy-related burden on the maternal cardiovascular system and excessive placenta-shed inflammatory factors, rather than the woman’s underlying cardiovascular phenotype.

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Effect of air pollution on gout development: a nationwide population-based observational study

QJM ◽

10.1093/qjmed/hcaa286 ◽

2020 ◽

Author(s):

W -S Hu ◽

C -L Lin

Keyword(s):

Air Pollution ◽

Fine Particulate Matter ◽

Population Based ◽

Proportional Hazard ◽

Cox Proportional Hazard ◽

Hazard Ratios ◽

Yearly Average ◽

Cox Proportional Hazard Regression ◽

Particulate Matter 2.5 ◽

Total Hydrocarbons

Summary Objective To investigate the effect of air pollution on gout development. Methods A total of 170318 participants were enrolled. These pollutants were considered: carbon monoxide (CO), fine particulate matter 2.5 (PM2.5), total hydrocarbons (THC) and methane (CH4). The yearly average concentrations were calculated from 2000 to 2011. Univariate and multivariate analyses by Cox proportional hazard regression models were adopted to estimate hazard ratios for gout in the Q2–Q4 concentrations of air pollutants compared with the Q1 concentration. Results In THC, relative to the Q1 concentration, the risk of gout was higher in participants exposed to the Q2–Q4 concentrations [adjusted hazard ratio (aHR), 1.10 with 95% confidence interval (CI), 1.01–1.19 in the Q2 concentration of THC; aHR, 4.20 with 95% CI, 3.93–4.49 in the Q3 concentration of THC; aHR, 5.65 with 95% CI, 5.29–6.04 in the Q4 concentration of THC]. In regard to CH4, when the Q1 concentration was defined as the reference, the risks of gout were increased for participants exposed to the Q2, Q3 and Q4 concentrations (aHR, 1.16 with 95% CI, 1.06–1.26 in the Q2 concentration of CH4; aHR, 2.37 with 95% CI, 2.20–2.55 in the Q3 concentration of CH4; aHR, 8.73 with 95% CI, 8.16–9.34 in the Q4 concentration of CH4). Conclusions Association between air pollution and risk of gout was noted.

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Renal Dysfunction, Metabolic Syndrome and Cardiovascular Disease Mortality

Journal of Nutrition and Metabolism ◽

10.1155/2010/167162 ◽

2010 ◽

Vol 2010 ◽

pp. 1-8 ◽

Cited By ~ 12

Author(s):

David Martins ◽

Chizobam Ani ◽

Deyu Pan ◽

Omolola Ogunyemi ◽

Keith Norris

Keyword(s):

Cardiovascular Disease ◽

Metabolic Syndrome ◽

Predictive Accuracy ◽

Analysis Techniques ◽

Cox Proportional Hazard ◽

Disease Mortality ◽

Nationally Representative ◽

Cox Proportional Hazard Regression ◽

Cvd Mortality

Background. Renal disease is commonly described as a complication of metabolic syndrome (MetS) but some recent studies suggest that Chronic Kidney disease (CKD) may actually antecede MetS. Few studies have explored the predictive utility of co-clustering CKD with MetS for cardiovascular disease (CVD) mortality.Methods. Data from a nationally representative sample of United States adults (NHANES) was utilized. A sample of 13115 non-pregnant individuals aged years, with available follow-up mortality assessment was selected. Multivariable Cox Proportional hazard regression analysis techniques explored the relationship between co-clustered CKD, MetS and CVD mortality. Bayesian analysis techniques tested the predictive accuracy for CVD Mortality of two models using co-clustered MetS and CKD and MetS alone.Results. Co-clustering early and late CKD respectively resulted in statistically significant higher hazard for CVD mortality (HR = 1.80, CI = 1.45–2.23, and HR = 3.23, CI = 2.56–3.70) when compared with individuals with no MetS and no CKD. A model with early CKD and MetS has a higher predictive accuracy (72.0% versus 67.6%), area under the ROC (0.74 versus 0.66), and Cohen's kappa (0.38 versus 0.21) than that with MetS alone.Conclusion. The study findings suggest that the co-clustering of early CKD with MetS increases the accuracy of risk prediction for CVD mortality.

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