Association between Changes in Status Based on Multiple Metabolic Syndrome Criteria and Cardiovascular Disease Risk.

The clinical value of metabolic syndrome is uncertain. Thus, we examined cardiovascular disease (CVD) and diabetes risk prediction by the National Cholesterol Education Program (NCEP)-Adult Treatment Panel III (ATPIII), International Diabetes Federation, and World Health Organization definitions of the metabolic syndrome. We analyzed the risks associated with metabolic syndrome, the NCEP multiple risk factor categories, and 2-h glucose values in the San Antonio Heart Study (n = 2,559; age range 25-64 years; 7.4 years of follow-up). Both ATPIII metabolic syndrome plus age > or = 45 years (odds ratio 9.25 [95% CI 4.85-17.7]) and multiple (two or more) risk factors plus a 10-year coronary heart disease (CHD) risk of 10-20% (11.9 [6.00-23.6]) had similar CVD risk in men without CHD, as well as CHD risk equivalents. In women counterparts, multiple (two or more) risk factors plus a 10-year CHD risk of 10-20% was infrequent (10 of 1,254). However, either a 10-year CHD risk of 5-20% (7.72 [3.42-17.4]) or ATPIII metabolic syndrome plus age > or = 55 years (4.98 [2.08-12.0]) predicted CVD. ATPIII metabolic syndrome increased the area under the receiver operating characteristic curve of a model containing age, sex, ethnic origin, family history of diabetes, and 2-h and fasting glucose values (0.857 vs. 0.842, P = 0.013). All three metabolic syndrome definitions imparted similar CVD and diabetes risks. Metabolic syndrome is associated with a significant CVD risk, particularly in men aged > or = 45 years and women aged > or = 55 years. The metabolic syndrome predicts diabetes beyond glucose intolerance alone.

1313-P: Association between Changes in Metabolic Syndrome (MetS) Status and Development of Cardiovascular Diseases (CVD)

Previous research focused primarily on static metabolic syndrome (MetS) status, with less discussion on the effects of its dynamic changes on cardiovascular diseases (CVD), stroke, and all-cause mortality. This study examines the impact of MetS status changes on these health outcomes. This study used data from two prospective cohorts: the China Longitudinal Study of Health and Retirement (CHARLS) and the Wuhan Elderly Health Examination Center community (WEHECC). MetS was determined using the ATP III criteria. Participants were classified based on changes in MetS status, defined as MetS-free, MetS-recovery, MetS-developed, and MetS-chronic, assessed at baseline and at follow-up (three years later for CHARLS and six years later for WEHECC cohort). The primary outcomes for CHARLS included all-cause mortality, physician-diagnosed CVD, and stroke, while WEHECC cohort focused solely on all-cause mortality. Logistic regression models were utilized to calculate the odds ratios (ORs) and 95% confidence intervals (95% CI). Over the follow-up period from 2015 to 2018 in CHARLS, 335 participants (7.1%) developed CVD, and 237 (5.1%) experienced a stroke. Relative to the MetS-free group, individuals with MetS-chronic displayed higher risks of CVD (OR, 1.63 [95% CI, 1.25 to 2.13]) and stroke (OR, 2.95 [95% CI, 2.11 to 4.15]). In the WEHECC cohort, 40 participants died by 2022, with the MetS-chronic group showing a increased risk of all-cause mortality (OR, 2.76 [CI, 1.03 to 7.39]). Changes in MetS status are associated with different risks of CVD, stroke, and mortality, with chronic MetS significantly increasing these risks compared to MetS-free.

Preeclampsia: Exposing Future Cardiovascular Risk in Mothers and Their Children

Androgens exert sexually dimorphic effects on angiogenesis: novel insight into the relationship between androgens and cardiovascular disease

Expressing emotions effectively is central to social functioning and has links to health and cardiovascular disease (CVD) risk. Previous work has linked the ability to smile to lower CVD risk in men but has not studied other expressions or considered the context of these skills. To test whether the ability to express fear, anger, sadness, happiness, and disgust cross-sectionally predict CVD risk in both genders and whether links are moderated by the ability to decode others' emotional signals. A community sample of 125 men and women (30-75 years) provided trait emotion data before a laboratory visit where blood was drawn and performance-based assessments of the ability to signal and decode emotions were administered. Expressive accuracy was scored using FaceReader software. Projected CVD risk was calculated using Framingham, a New Zealand (NZ) specific, and Atherosclerosis CVD (ASCVD) risk algorithms. Accuracy expressing happiness predicted lower projected risk, whereas greater accuracy expressing fear and sadness predicted higher risk. Gender frequently moderated these links; greater accuracy expressing happiness predicted lower risk in men but not women. Conversely, greater accuracy expressing fear predicted higher risk in men, whereas greater accuracy expressing sadness predicted lower risk in women but, again, higher risk in men. The ability to accurately decode others' emotions moderated some links. The ability to signal emotion has complex links to health parameters. The ability to flexibly regulate expressions in accordance with gender norms may be one useful way of thinking about adaptive expressive regulation.

Background: Metabolic syndrome is a cluster of metabolically related cardiovascular disease (CVD) risk factors that increases the risk of CVDs by 2-fold and the risk of developing type 2 diabetes mellitus by 3-fold. Previous studies revealed that the development of metabolic syndrome and its components can be influenced by various life style factors. Metabolic syndrome can be determined in an individual by different criteria - proposed by international Diabetes Federation (IDF), National cholesterol Education programme-Adult Treatment panel (NCEP -ATP- III) and y WHO. Objective: The main objective of this study was to assess the influence of substance use on the development of metabolic syndrome among adults in Jimma town, South West Ethiopia as determined by IDF and NCEP ATP -III criteria. Methods: A community based cross-sectional study was conducted to assess the risk factors of Metabolic syndrome (Met S) by using IDF ( Met S IDF) and NCEP ATP III criteria (Met S ATP-III) .The study was conducted in accordance with the Stepwise approach of the World Health Organization. Interviewer administered questionnaires was used for basic data collection; anthropometric measurements such as height , weight ,waist circumference , BMI and blood pressure measurements(systolic /diastolic) were done; blood sample were collected; lipid profile such as total cholesterol, triglyceride ,HDL-C, LDL -C and plasma glucose analyses were done. The prevalence of metabolic syndrome was determined based on the IDF and ATP III definitions from the anthropometric measurements and biochemical estimations. The association between Met S and substance use such as smoking, alcohol, khat chewing and coffee drinking were verified by chi-square and regression analysis using SPSS version 19. Results and discussion: The population of Jimma town comprises of different ethnic, religious, economic, educational and occupational categories with variations in their life style habits. Cigarette smoking was directly associated with the development of Met S. Alcohol consumption was not significantly associated with Met S; moderate alcohol consumers are at a reduced risk of Met S compared to abstainers; consumption of wine was found to be inversely correlated with development of Met S (Met S IDF =0 % and Met S ATP III= 0 %); beer and local arrack (teje) consumption was directly associated with the development of Met S; heavy alcohol consumption was significantly associated with greater risk of developing Met S. Moderate khat chewers had shown a lesser prevalence of Met S compared to abstainers (Met S IDF: chewer =11%, non chewer=18.3% and Met S ATP III: chewer= 7.3, non chewer=11.4%); but heavy chewers had shown a significantly higher prevalence of Met S. Generally, coffee consumers had shown a less prevalence rate compared to abstainers (Met S IDF: coffee consumers =15.9%, non consumers=22.2% and % and Met S ATP III: coffee consumers =9.9%, non consumers=14.2%); moderate coffee consumption (4-6 cups/day) was associated with a reduced risk of Met S (Met S IDF =5.5% and Met S ATP III=3.7%). Logistic regression analysis revealed that cigarette smoking, not drinking coffee, are directly associated with the development of Metabolic syndrome IDF. Drinking alcohol every day (AOR=0.798), drinking beer (AOR=0.870), drinking local arrack (tejje) (AOR=0.578), taking any forms of alcohol for long duration (AOR=1.614) were also directly associated. Cigarette smoking habit is directly associated with the development of Metabolic syndrome ATP-III; drinking beer (AOR=0.752) and local arrack (tejje) (AOR=0.678) are also directly associated. Conclusions: Cigarette smoking was found to be a serious risk factor. Even though heavy alcoholism and heavy khat usage are risk factors, moderate alcoholism, occasional Khat chewing and moderate coffee drinking were all found to reduce the risk of being affected with Met S compared to abstainers.

Obesity and cardiovascular disease risk among Africans residing in Europe and Africa: the RODAM study

eHealth interventions for reducing cardiovascular disease risk in men: A systematic review and meta-analysis

Funding Acknowledgements Type of funding sources: Public grant(s) – National budget only. Main funding source(s): Department for the Economy (DfE) studentships Background. Men remain at a higher risk of developing cardiovascular disease (CVD) than women and behavioral risk factor modification is an important preventive measure. However, engaging men in behavior change interventions is challenging. eHealth interventions have the potential to address this gap, though their effectiveness for reducing CVD risk in men is unclear. Purpose. To conduct a systematic review and meta-analysis to evaluate the effectiveness of eHealth interventions for reducing CVD risk in men. Methods. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement and principles laid out by the Cochrane Handbook for Systematic Reviews of Interventions. A search of published randomised controlled trials (RCTs) with no date restrictions up to July 2020 was conducted across five electronic databases: Cochrane Central register of Controlled Trials (CENTRAL), Medline, CINAHL Plus, PsycINFO and SCOPUS. Reference lists of relevant systematic reviews and meta-analyses were manually searched for additional trials not identified during the database search. Eligible studies were RCTs that focused on the use of eHealth to improve a minimum of two major CVD related risk factors in males aged 18 years or older. Results. A total of 3168 records were retrieved from the online database search, with nine trials meeting the inclusion criteria following screening and full-text assessment. Study quality ranged from low to unclear, with one trial at a high risk of bias. Compared to those in a control group or receiving printed materials, participants randomised to an eHealth intervention had statistically significant improvements in BMI (Z=-2.75, p = 0.01), body weight (Z=-3.25, p = 0.01), waist circumference (Z=-2.30, p = 0.02) and systolic (Z=-3.57, p = 0.01) and diastolic (Z=-3.56, p = 0.01) blood pressure. Though less evident, there were also improvements in physical activity and diet in favour of the intervention group. Conclusion. This was the first systematic review and meta-analysis conducted on the effectiveness of eHealth interventions for reducing CVD risk in men. This review suggests that eHealth interventions can reduce CVD risk in adult men through behavior change. However, we were unable to determine the association between intervention characteristics and outcomes. Also, overall, participant adherence to the intervention was poor. Both of these issues should be considered in future studies.

Limited information is available regarding risk of cardiovascular disease and trends for the metabolic syndrome in Asia. We examined the impact of the metabolic syndrome and its components on risk of cardiovascular disease among middle-aged Japanese according to four criteria. We followed 2,613 subjects from a rural Japanese community who participated in cardiovascular health examinations between 1990 and 1993. After 27,477 person-years of follow-up through 2003, there were 42 incidents of ischemic heart disease, 73 total strokes (54 ischemic and 18 hemorrhagic), and 115 total cases of cardiovascular disease. The metabolic syndrome was defined according to the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATPIII), American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI), International Diabetes Federation (IDF), and Japanese criteria. The multivariable hazard ratios (95%CI) associated with the metabolic syndrome based on NCEP-ATPIII criteria were 2.1 (1.1-4.0) for ischemic heart disease, 1.7 (1.0-2.7) for total stroke, 2.0 (1.2-3.5) for ischemic stroke, 1.1 (0.4-2.8) for hemorrhagic stroke, 2.0 (1.3-3.1) for ischemic cardiovascular disease, and 1.7 (1.2-2.5) for total cardiovascular disease. The population-attributable fractions of the metabolic syndrome based on NCEP-ATPIII criteria were 26-27% for ischemic heart disease and ischemic stroke and 20% for total cardiovascular disease. The metabolic syndrome based on AHA/NHLBI, IDF and Japanese criteria had weaker associations with risk of cardiovascular disease, and the association with risk of ischemic heart disease was not statistically significant. The metabolic syndrome based on NCEP-ATP III criteria predicted risks of ischemic heart disease, ischemic stroke and total cardiovascular disease, whereas that based on three other criteria predicted them less effectively.

We compared systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), and mean arterial pressure (MAP) in predicting the risk of cardiovascular disease (CVD), stratifying results at age 60 years, when DBP decreases while SBP continues to increase. We prospectively followed 11 150 male physicians with no history of CVD or antihypertensive treatment through the 2-year questionnaire, after which follow-up began. Reported blood pressure was averaged from both the baseline and 2-year questionnaires. During a median follow-up of 10.8 years, there were 905 cases of incident CVD. For men aged <60 years (n=8743), those in the highest versus lowest quartiles of average SBP (>/=130 versus <116 mm Hg), DBP (>/=81 versus <73 mm Hg), and MAP (>/=97 versus <88 mm Hg) had relative risks (RRs) of CVD of 2.16, 2.23, and 2.52, respectively. Models with average MAP and PP did not add information compared with models with MAP alone (P>0.05). For men aged >/=60 years (n=2407), those in the highest versus lowest quartiles of average SBP (>/=135 versus <120 mm Hg), PP (>/=55 versus <44 mm Hg), and MAP (>/=99 versus <91 mm Hg) had RRs of CVD of 1.69, 1.83, and 1.43, respectively. The addition of other blood pressure measures did not add information compared with average SBP or PP alone (all P>0.05). These data suggest that average SBP, DBP, and MAP strongly predict CVD among younger men, whereas either average SBP or PP predicts CVD among older men. More research should distinguish whether MAP, highly correlated with SBP and DBP, better predicts CVD.

OBJECTIVETo study the association of depressive symptoms or antidepressant medicine (ADM) use with subsequent cardiovascular disease (CVD) risk factor status in the Look AHEAD (Action for Health in Diabetes) trial of weight loss in type 2 diabetes.RESEARCH DESIGN AND METHODSParticipants (n = 5,145; age [mean ± SD] 58.7 ± 6.8 years; BMI 35.8 ± 5.8 kg/m2) in two study arms (intensive lifestyle [ILI], diabetes support and education [DSE]) completed the Beck Depression Inventory (BDI), reported ADM use, and were assessed for CVD risk factors at baseline and annually for 4 years. Risk factor–positive status was defined as current smoking, obesity, HbA1c >7.0% or insulin use, and blood pressure or cholesterol not at levels recommended by expert consensus panel or medicine to achieve recommended levels. Generalized estimating equations assessed within-study arm relationships of elevated BDI score (≥11) or ADM use with subsequent year CVD risk status, controlled for demographic variables, CVD history, diabetes duration, and prior CVD risk status.RESULTSPrior year elevated BDI was associated with subsequent CVD risk factor–positive status for the DSE arm (A1C [odds ratio 1.30 (95% CI 1.09–1.56)]; total cholesterol [0.80 (0.65–1.00)]; i.e., protective from high total cholesterol) and the ILI arm (HDL [1.40 (1.12–1.75)], triglyceride [1.28 (1.00–1.64)]). Prior year ADM use predicted subsequent elevated CVD risk status for the DSE arm (HDL [1.24 (1.03–1.50)], total cholesterol [1.28 (1.05–1.57)], current smoking [1.73 (1.04–2.88)]) and for the ILI arm (A1C [1.25 (1.08–1.46)], HDL [1.32 (1.11–1.58)], triglycerides [1.75 (1.43–2.14)], systolic blood pressure [1.39 (1.11–1.74)], and obesity [1.46 (1.22–2.18)]).CONCLUSIONSAggressive monitoring of CVD risk in diabetic patients with depressive symptoms or who are treated with ADM may be warranted.

Series Editor: Marja-Riitta Taskinen See page 2276 Solid evidence has confirmed that the Metabolic Syndrome is associated with an increased risk of both type 2 diabetes and cardiovascular disease (CVD). Recognizing the full blown global epidemics of type 2 diabetes and obesity, the prevalence of the metabolic syndrome is rapidly growing and portends a daunting wave of CVD—a threat to human health in this century. Metabolic syndrome is …

Are endogenous sex hormones important for atherosclerotic cardiovascular disease risk in men?