Mediating-Moderating Effect of Allostatic Load on the Association between Dietary Approaches to Stop Hypertension Diet and All-Cause and Cause-Specific Mortality: 2001–2010 National Health and Nutrition Examination Surveys

This secondary analysis of survey data examined mediating-moderating effects of allostatic load score (calculated using the Rodriquez method) on the association between nutrient-based Dietary Approaches to Stop Hypertension (DASH) diet score (Mellen Index) and the all-cause and cause-specific mortality risks among 11,630 adults ≥ 30 years of age from the 2001–2010 National Health and Nutrition Examination Surveys with no history of cardiovascular disease or cancer at baseline, and who were followed-up for ~9.35 years. Multivariable models were adjusted for demographic, socioeconomic, lifestyle, and health characteristics. All-cause, cardiovascular disease, and cancer-specific mortality rates were estimated at 6.5%, 1.1%, and 1.9%, respectively. The median DASH total score was 3.0 (range: 1–8) (with 78.3% scoring < 4.5), whereas the median allostatic load score was 3 (range: 0–9). The DASH diet, fiber, and magnesium were negatively correlated with allostatic load, whereas allostatic load predicted higher all-cause mortality, irrespective of the DASH diet. Whereas protein was protective, potassium increased all-cause mortality risk, irrespective of allostatic load. Potassium was protective against cardiovascular disease-specific mortality but was a risk factor for cancer-specific mortality. Although no moderating effects were observed, mediation by the allostatic load on cardiovascular disease-specific mortality was observed for DASH total score and selected component scores. Direct (but not indirect) effects of DASH through the allostatic load were observed for all-cause mortality, and no direct or indirect effects were observed for cancer-specific mortality. From a public health standpoint, the allostatic load may be a surrogate for the preventive effects of the DASH diet and its components on cardiovascular disease-specific mortality risk.

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Association of sleep duration with all-cause and disease-specific mortality in US adults

Journal of Epidemiology & Community Health ◽

10.1136/jech-2020-215314 ◽

2021 ◽

pp. jech-2020-215314

Author(s):

Lili Yang ◽

Bo Xi ◽

Min Zhao ◽

Costan G Magnussen

Keyword(s):

Cardiovascular Disease ◽

Sleep Duration ◽

Proportional Hazards ◽

Large Population ◽

Cox Proportional Hazards ◽

Increased Risk ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Cancer Specific Mortality ◽

Disease Specific

BackgroundPrevious studies revealed inconsistent findings regarding the association between sleep duration and all-cause and disease-specific mortality. This study aimed to clarify the association of sleep duration with mortality using a large population-based prospective cohort study from the USA.MethodsWe used data from the National Health Interview Survey (2004–2014) linked to National Death Index records to 31 December 2015. A total of 284 754 participants aged ≥18 years were included. Self-reported sleep duration (average time slept in a 24-hour period) was categorised into seven groups: ≤4 hours, 5 hours, 6 hours, 7 hours (reference), 8 hours, 9 hours and ≥10 hours. Study outcomes included all-cause, cardiovascular disease-specific and cancer-specific mortality. Cox proportional hazards models were used to examine the association between sleep duration and mortality.ResultsDuring a median follow-up of 5.25 years, we identified 20 872 deaths, of which 4 129 were cardiovascular disease-related and 5 217 were cancer-related. Compared with 7 hours/day of sleep, both short and long sleep durations were associated with an increased risk of all-cause mortality (≤4 hours: HR=1.46, 95% CI=1.33–1.61; 5 hours: HR=1.22, 95% CI=1.13–1.32; 6 hours: HR=1.10, 95% CI=1.05–1.17; 8 hours: HR=1.22, 95% CI=1.17–1.28; 9 hours: HR=1.41, 95% CI=1.31–1.51; ≥10 hours: HR=2.00, 95% CI=1.88–2.13). Similar results were observed for cardiovascular disease-specific and cancer-specific mortality.ConclusionsOur study indicates that both short (≤6 hours/day) and long (≥8 hours/day) sleep durations increase the risk of mortality compared with sleep of 7 hours/day. A normal sleep duration (about 7 hours) every day is recommended for health benefits.

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Hormone replacement therapy in women with cancer and risk of cancer-specific mortality and cardiovascular disease: a protocol for a cohort study from Scotland and Wales

BMC Cancer ◽

10.1186/s12885-021-08065-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Úna McMenamin ◽

Blánaid Hicks ◽

Carmel Hughes ◽

Peter Murchie ◽

Julia Hippisley-Cox ◽

...

Keyword(s):

Cardiovascular Disease ◽

Hormone Replacement Therapy ◽

Venous Thromboembolism ◽

Replacement Therapy ◽

Cancer Diagnosis ◽

Hormone Replacement ◽

All Cause Mortality ◽

Specific Mortality ◽

Cancer Specific Mortality ◽

Risk Of Cancer

Abstract Background Hormone replacement therapy (HRT) is widely used and has proven benefits for women with menopausal symptoms. An increasing number of women with cancer experience menopausal symptoms but the safety of HRT use in women with cancer is unclear. There are particular concerns that HRT could accelerate cancer progression in women with cancer, and also that HRT could increase the risk of cardiovascular disease in such women. Therefore, our primary aim is to determine whether HRT use alters the risk of cancer-specific mortality in women with a range of common cancers. Our secondary objectives are to investigate whether HRT alters the risk of second cancers, cardiovascular disease, venous thromboembolism and all-cause mortality. Methods The study will utilise independent population-based data from Wales using the SAIL databank and Scotland based upon the national Prescribing Information System. The study will include women newly diagnosed with common cancers from 2000 to 2016, identified from cancer registries. Women with breast cancers will be excluded. HRT will be ascertained using electronic prescribing in Wales or dispensing records in Scotland. The primary outcome will be time to cancer-specific mortality from national mortality records. Time-dependent cox regression models will be used to calculate hazard ratios (HR) and 95% confidence intervals (95% CIs) for cancer specific death in HRT users compared with non-users after cancer diagnosis after adjusting for relevant confounders, stratified by cancer site. Analysis will be repeated investigating the impact of HRT use immediately before cancer diagnosis. Secondary analyses will be conducted on the risk of second cancers, cardiovascular disease, venous thromboembolism and all-cause mortality. Analyses will be conducted within each cohort and pooled across cohorts. Discussion Our study will provide evidence to inform guidance given to women diagnosed with cancer on the safety of HRT use and/or guide modifications to clinical practice.

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Abstract 3287: Associations of whole food and lifestyle-based inflammation scores with all-cause, cancer- and cardiovascular disease-specific mortality

10.1158/1538-7445.am2017-3287 ◽

2017 ◽

Author(s):

Doratha Byrd ◽

Ashley Holmes ◽

Suzanne Judd ◽

W Dana Flanders ◽

Roberd M. Bostick

Keyword(s):

Cardiovascular Disease ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

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Associations Between Handgrip Strength and Disease-Specific Mortality Including Cancer, Cardiovascular, and Respiratory Diseases in Older Adults: A Meta-Analysis

Journal of Aging and Physical Activity ◽

10.1123/japa.2018-0348 ◽

2020 ◽

Vol 28 (2) ◽

pp. 320-331

Author(s):

Junga Lee

Keyword(s):

Older Adults ◽

Older Women ◽

Respiratory Diseases ◽

Handgrip Strength ◽

Meta Analysis ◽

Adult Participants ◽

All Cause Mortality ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

Several controversial studies linking handgrip strength and health have suggested that low handgrip strength in older adults may be related to health problems and have investigated whether there is a minimum handgrip strength level associated with reduced mortality. Thus, by meta-analysis, the authors identified an association between handgrip strength in older adults and disease-specific mortality and all-cause mortality. Thirty studies with a total of 194,767 older adult participants were included in this meta-analysis. Higher handgrip strength was associated with an 18% decrease in all-cause mortality. Lower handgrip strength was associated with increased all-cause mortality. The minimum handgrip strength in older women that did not increase all-cause mortality was 18.21 kg. Increased handgrip strength showed a decreased all-cause mortality, whereas decreased handgrip strength was associated with increased all-cause mortality. Strengthening the handgrip may help improve disease-specific mortality in older adults.

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Patient Age and Survival After Surgery for Esophageal Cancer

Annals of Surgical Oncology ◽

10.1245/s10434-020-08653-w ◽

2020 ◽

Vol 28 (1) ◽

pp. 159-166 ◽

Cited By ~ 1

Author(s):

Jesper Lagergren ◽

Matteo Bottai ◽

Giola Santoni

Keyword(s):

Esophageal Cancer ◽

Short Term ◽

Term Survival ◽

Long Term Survival ◽

Flexible Parametric Model ◽

All Cause Mortality ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

Abstract Background Esophagectomy for esophageal cancer is associated with a substantial risk of life-threatening complications and a limited long-term survival. This study aimed to clarify the controversial questions of how age influences short-term and long-term survival. Methods This population-based cohort study included almost all patients who underwent curatively intended esophagectomy for esophageal cancer in Sweden in 1987–2010, with follow-up through 2016. The exposure was age, analyzed both as a continuous and categorical variable. The probability of mortality was computed using a novel flexible parametric model approach. The reported probabilities are proper measures of the risk of dying, and the related odds ratios (OR) are therefore more suitable measures of association than hazard ratios. The outcomes were 90-day all-cause mortality, 5-year all-cause mortality, and 5-year disease-specific mortality. A novel flexible parametric model was used to derive the instantaneous probability of dying and the related OR along with 95% confidence intervals (CIs), adjusted for sex, education, comorbidity, tumor histology, pathological tumor stage, and resection margin status. Results Among 1737 included patients, the median age was 65.6 years. When analyzed as a continuous variable, older age was associated with slightly higher odds of 90-day all-cause mortality (OR 1.05, 95% CI 1.02–1.07), 5-year all-cause mortality (OR 1.02, 95% CI 1.01–1.03), and 5-year disease-specific mortality (OR 1.01, 95% CI 1.01–1.02). Compared with patients aged < 70 years, those aged 70–74 years had no increased risk of any mortality outcome, while patients aged ≥ 75 years had higher odds of 90-day mortality (OR 2.85, 95% CI 1.68–4.84), 5-year all-cause mortality (OR 1.56, 95% CI 1.27–1.92), and 5-year disease-specific mortality (OR 1.38, 95% CI 1.09–1.76). Conclusions Patient age 75 years or older at esophagectomy for esophageal cancer appears to be an independent risk factor for higher short-term mortality and lower long-term survival.

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Association Between 6-Minute Walk Test and All-Cause Mortality, Coronary Heart Disease–Specific Mortality, and Incident Coronary Heart Disease

Journal of Aging and Health ◽

10.1177/0898264314525665 ◽

2014 ◽

Vol 26 (4) ◽

pp. 583-599 ◽

Cited By ~ 17

Author(s):

Ali Yazdanyar ◽

Michael M. Aziz ◽

Paul L. Enright ◽

Daniel Edmundowicz ◽

Robert Boudreau ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Walk Test ◽

Incident Coronary Heart Disease ◽

All Cause Mortality ◽

Specific Mortality ◽

Disease Specific Mortality ◽

6 Minute Walk Test ◽

Minute Walk ◽

Disease Specific

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Adolescent Body Mass Index and Cardiovascular Disease–Specific Mortality by Midlife

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-00329 ◽

2017 ◽

Vol 102 (8) ◽

pp. 3011-3020 ◽

Cited By ~ 11

Author(s):

Gilad Twig ◽

Dana Ben-Ami Shor ◽

Ariel Furer ◽

Hagai Levine ◽

Estela Derazne ◽

...

Keyword(s):

Cardiovascular Disease ◽

Body Mass Index ◽

Body Mass ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

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Plasma YKL-40 and Total and Disease-Specific Mortality in the General Population

Clinical Chemistry ◽

10.1373/clinchem.2010.146530 ◽

2010 ◽

Vol 56 (10) ◽

pp. 1580-1591 ◽

Cited By ~ 47

Author(s):

Julia S Johansen ◽

Stig E Bojesen ◽

Anne Tybjærg-Hansen ◽

Anne K Mylin ◽

Paul A Price ◽

...

Keyword(s):

Cardiovascular Disease ◽

General Population ◽

Early Death ◽

Mortality Rates ◽

Term Survival ◽

Hazard Ratios ◽

Heart Study ◽

Specific Mortality ◽

Disease Specific Mortality ◽

Disease Specific

BACKGROUND Increased plasma YKL-40 is associated with short-term survival in patients with cardiovascular disease and cancer. We tested the hypothesis that increased plasma YKL-40 is associated with total and disease-specific mortality in the general population. METHODS We measured plasma YKL-40 in 8899 study participants, aged 20–95 years, in the Copenhagen City Heart Study from the Danish general population who were followed for 16 years: 3059 died, 2158 had ischemic cardiovascular disease, 2271 had cancer, and 2820 had other diseases associated with increased YKL-40. Hazard ratios for early death and absolute 10-year mortality rates were calculated according to plasma YKL-40 percentile groupings computed within sex and age decade: 0%–33%, 34%–66%, 67%–90%, 91%–95%, and 96%–100%. RESULTS Median survival age decreased from 83 years for participants with plasma YKL-40 in category 0%–33% to 69 years in category 96%–100% (trend, P < 0.0001). Risk of early death was increased (multifactorially adjusted hazard ratios) by 10% for YKL-40 category 34%–66%, by 30% for 67%–90%, by 70% for 91%–95%, and by 90% for 96%–100% vs YKL-40 category 0%–33% (trend, P < 0.0001). Corresponding increases in participants with ischemic cardiovascular disease were 10%, 20%, 80%, and 60% (P < 0.0001); in those with cancer were 10%, 20%, 50%, and 70% (P < 0.0001); and in those with other diseases were 10%, 20%, 40%, and 60% (P < 0.0001). Highest absolute 10-year mortality rates were 78% and 90% in women and men, respectively, who were >70 years old, smoked, and were in YKL-40 category 96%–100%. CONCLUSIONS Increased plasma YKL-40 is associated with risk of early death from cardiovascular disease, cancer, and other diseases in the general population.

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