Association Of Coronary Heart Disease Research Articles

Jeremy Morris as a pioneer of behavioural epidemiology, social medicine and public health.

Seventy years ago, the Scottish epidemiologist Jeremy Morris published his seminal papers in exercise epidemiology, providing evidence of the positive relationship between physical activity levels and reduced mortality. Today, we may remember Morris's pivotal role in establishing physical activity as a key factor in preventive medicine and public health. The roots of the role of behavioural epidemiology in modern public health lay in Morris's research on the association of coronary heart disease with physical activity at work. In consequence, a new focus for public health emerged, with an emphasis on chronic disease as well as modification of lifestyle and individual behaviour. While the immense value of his research on the health benefits of exercise is widely recognised, his influence on the teaching of social medicine is generally less well-known. Morris was involved in the pioneering course of MSc in Social Medicine at the London School of Hygiene, which was emblematic of the redefining of public health in the late 1960s. Morris gave legitimacy to a wide range of issues regarded at that time as soft and second class, including health promotion, sociology and the care of people with disability and chronic conditions. In consequence of his observation of a relationship between socioeconomic status and individual behaviour patterns in regard to exercise, nutrition and smoking, Morris urged that greater attention be paid to inequalities.

Lipoprotein Characteristics and Incident Coronary Heart Disease: Prospective Cohort of Nearly 90 000 Individuals in UK Biobank.

Background Associations of coronary heart disease (CHD) with plasma lipids are well described, but the associations with characteristics of lipoproteins (which transport lipids) remain unclear. Methods and Results UK Biobank is a prospective study of 0.5 million adults. Analyses were restricted to 89 422 participants with plasma lipoprotein and apolipoprotein measures from Nightingale nuclear magnetic resonance spectroscopy and without CHD at baseline. CHD risk was positively associated with concentrations of very-low-density lipoproteins, intermediate-density lipoproteins, and low-density lipoproteins (LDL), and inversely associated with high-density lipoproteins. Hazard ratios (99% CIs) per SD were 1.22 (1.17-1.28), 1.16 (1.11-1.21), 1.20 (1.15-1.25), and 0.90 (0.86-0.95), respectively. Larger subclasses of very-low-density lipoproteins were less strongly associated with CHD risk, but associations did not materially vary by size of LDL or high-density lipoprotein. Given lipoprotein particle concentrations, lipid composition (including cholesterol) was not strongly related to CHD risk, except for triglyceride in LDL particles. Apolipoprotein B was highly correlated with LDL concentration (r=0.99), but after adjustment for apolipoprotein B, concentrations of very-low-density lipoprotein and high-density lipoprotein particles remained strongly related to CHD risk. Conclusions This large-scale study reliably quantifies the associations of nuclear magnetic resonance-defined lipoprotein characteristics with CHD risk. CHD risk was most strongly related to particle concentrations, and separate measurements of lipoprotein concentrations may be of greater value than the measurement by apolipoprotein B, which was largely determined by LDL concentration alone. Furthermore, there was strong evidence of positive association with mean triglyceride molecules per LDL particle but little evidence of associations with total triglycerides or other lipid and lipoprotein fractions after accounting for lipoprotein concentrations.

Hyperhomocysteinemia as an Independent Risk Factor for Coronary Heart Disease. Comparison with Conventional Risk Factors.

The present study was designed to evaluate the strength of association of raised plasma homocysteine concentration as a risk factor for coronary heart disease independent of conventional risk factor. It was a case control study conducted at Punjab Institute of Cardiology Lahore. A total of 210 subjects aged 25 to 60 years comprising of 105 newly admitted patients of CHD as cases and 105 age and sex matched healthy individuals with no history of CHD as control were recruited for the study. Fasting blood samples were obtained from cases and controls. Plasma homocysteine was analyzed by fluorescence polarization immunoassay (FPIA) method on automated immunoassay analyzer (Abbott IMX). Total cholesterol, triglyceride and HDL cholesterol were analyzed using calorimetric kit methods. The concentration of LDL cholesterol was calculated using Friedewald formula. The patients were also assessed for traditional risk factors such as age, sex, family history of CVD, hypertension, smoking and physical activity, and were compared with control subjects. The collected data was entered in SPSS version 24 for analysis and interpretation.The mean age in controls and experimental groups were 43.00± 8.42 years and 44.72± 8.59 years with statistically same distribution (p- value= 0.144). The mean plasma homocysteine for cases was 22.33± 9.22 µmol/L where as it was 12.59±3.73 µmol/L in control group. Highly significant difference was seen between the mean plasma level of homocysteine in cases and controls (p˂0.001).Simple logistic regression indicates a strong association of coronary heart disease with hyperhomocysteinemia (OR 7.45), which remained significantly associated with coronary heart disease by multivariate logistic regression (OR 7.10, 95%C1 3.12-12.83, p=0.000). The present study concludes that elevated levels of Plasma homocysteine is an independent risk factor for coronary heart disease independent of conventional risk factors and can be used as an indicator for predicting the future possibility for the onset of CVD.

Risk of cardiovascular disease in women and men with subfertility: the Trøndelag Health Study

To investigate the association between subfertility and risk of cardiovascular disease (CVD) outcomes. Prospective study. Population-based cohort. We studied 31,629 women and 17,630 men participating in the Trøndelag Health Study. Self-reported subfertility. As men were not directly asked about fertility, male partners of female participants were identified through linkage to the Medical Birth Registry of Norway and assigned the fertility information obtained from their partners. The primary outcomes were stroke and coronary heart disease in women and men with and without a history of subfertility. The secondary outcomes were myocardial infarction and angina (subgroups of coronary heart disease) and any CVD (stroke or coronary heart disease). Information on CVD was available by linkage to hospital records. We used Cox proportional hazards models adjusted for age at participation in the Trøndelag Health Study (linear + squared), birth year, smoking history, cohabitation, and education. Cardiometabolic factors were assessed in separate models. A total of 17% of women and 15% of men reported subfertility. In women, subfertility was modestly associated with an increased risk of stroke (age-adjusted hazard ratio [aaHR], 1.19; 95% confidence interval [CI], 1.02-1.39; adjusted hazard ratio [aHR]; 1.18; 95% CI, 1.01-1.37) and coronary heart disease (aaHR, 1.19; 95% CI, 1.06-1.33; aHR, 1.16; 95% CI, 1.03-1.30) compared with fertile women. In men, we observed a weak positive association for stroke (aaHR, 1.11; 95% CI, 0.91-1.34; aHR, 1.10; 95% CI, 0.91-1.33) and a weak inverse association for coronary heart disease (aaHR, 0.92; 95% CI, 0.81-1.05; aHR, 0.93; 95% CI, 0.81-1.06). We observed modestly increased risks of CVD outcomes in women and some weak associations in men, although with no strong statistical evidence on sex differences. We acknowledge that we were only able to include men linked to pregnancies ending at 12 completed gestational weeks or later, potentially resulting in selection bias and misclassification of history of subfertility in analyses of male partners. Despite the large sample size, our results indicate the need for larger studies to obtain precise results in both sexes and determine whether there are true sex differences.

A Study on Left Ventricular Dysfunction in Diabetes Mellitus with No Overt Cardiac Symptoms or Signs

The association of coronary heart disease and DM is well known, but epidemiologic and clinical data from the last 2 decades reveal heart failure also to be a major contributor to cardiovascular morbidity and mortality in patients with DM and also develop congestive heart failure even in the absence of coronary heart diseases, hypertension or any known structural heart disease. Methodology: Written informed consent was taken from all the patients who were recruited in the study. Data was collected in the case proforma which included clinical examination. Relevant investigations were carried out and recorded. Results: The chest X-ray of patients, 4(4.4%) showed COPD, 7(7.8%) showed pneumonia and rest all patients had normal chest X-ray. ECG was reported as normal in all the patients 90(100%). Urine routine was reported as normal in 73(81.1%) of patients. Conclusion: Out of all the diastolic parameters statistically significant difference was observed in ‘A’ velocity, E/A ratio and DT parameters.

Association of coronary heart disease and sleep disorders among men in a medium-sized urban city of Western Siberia

The aim of the study was to establish the association of the prevalence of coronary heart disease (CHD) and sleep disorders among men between the ages of 25 and 64 belonging to an open population of a medium-sized urban city of Western Siberia. Materials and methods . A cross-sectional epidemiological study was conducted on a representative sample of the population among males of 25–64 years old in Tyumen. The prevalence of coronary heart disease was determined based on standard epidemiological methods. Self-assessments by participants in the study of quality of sleep was determined by the World Health Organization (WHO) Monitoring Trends and Determinants in Cardiovascular Disease-Psychosocial Program (WHO MONICA-psychosocial). When calculating the odds ratio of developing coronary heart disease), self-reports of satisfactory, good, or very good sleep were regarded as a lack of an indicator; while very bad and bad sleep were considered positive indicators. Results. The prevalence of CHD according to the extended epidemiological criteria for men in an open urban population was 12.4%; the detection rate of “definite” and “possible” CHD was almost equal. The age-standardized prevalence rate of sleep disorders was 50.9%. There is a significant risk of developing CHD with extended criteria (5.05), as well as “definite” (5.28) and “possible” (3.13) forms in the male population at 25–64 years of age. In the 55 to 64 age group, there is a significant risk of developing CHD according to the extended criteria (5.57) and the “definite” form of CHD (10.21). Conclusion. Thus, the findings suggest the importance of further study of sleep disorders in working age men in Siberian populations, its relationships with conventional and non-conventional risk factors of CHD, as well as the feasibility of preventive measures aimed at reducing the influence of psycho-emotional stress factors among the Russian population.

Association Between Occupational Exposure to Pesticides and Cardiovascular Disease Incidence: The Kuakini Honolulu Heart Program.

BackgroundPreviously, Kuakini Honolulu Heart Program researchers reported that occupational exposure to pesticides was significantly associated with total mortality. The current study examines occupational exposure to pesticides in relation to incident cardiovascular disease, defined as coronary heart disease or cerebrovascular accident.Methods and ResultsWith the Occupational Safety Health Administration exposure scale used as an estimate of exposure, statistical analyses were performed on a cohort of 7557 Japanese‐American men from the Kuakini Honolulu Heart Program. Hazard ratios for cardiovascular disease incidence were calculated for various levels of pesticide exposure using Cox proportional hazards models. In the first 10 years of follow‐up, a positive association was observed between age‐adjusted cardiovascular disease incidence and high levels of pesticide exposure (hazard ratio=1.46, 95% CI=1.10‐1.95, P=0.009). This relationship remained significant after adjustment for other cardiovascular disease risk factors (hazard ratio=1.42, 95% CI=1.05‐1.92, P=0.021). No significant association for coronary heart disease or cerebrovascular accident incidence with pesticide exposure was observed when examined separately, possibly due to a smaller number of events.ConclusionsThese findings suggest that occupational exposure to pesticides may play a role in the development of cardiovascular diseases. The results are novel, as the association between occupational exposure to pesticides and cardiovascular disease incidence has not been examined previously in this unique cohort.

CircRNA‑miRNA association for coronary heart disease.

Coronary heart disease (CHD) is a major cause of morbidity and mortality and an important public health problem globally, but the mechanism of CHD is still complex and unclear. The purpose of the current study was to explore the mechanism underlying CHD using high-throughput technology. The study participants were patients with coronary angiography (CAG)-proven severity of coronary artery stenosis. Patients were divided into control and test group based on specific inclusion criteria, and data were collected regarding the results of routine inspection and the Gensini score (GS). We explored the mechanism underlying CHD with high-throughput integration of circular RNA (circRNA)-microRNA (miRNA) data. Through the expression of circRNA-miRNA, we discovered a total of 110 circRNAs to be differentially expressed in the two groups. Of these, 73 were upregulated and 37 downregulated in the CHD (fold ≥2.0 and P<0.05). Among 18 miRNAs, 13 were upregulated and 5 were downregulated in the CHD group (fold ≥2.0 and P<0.05). Enrichment analysis showed that circRNAs participate in a variety of disease development processes, biological processes, molecular functions, cellular components, and pathways (P<0.05). The mechanism underlying CHD may be closely related to up- or downregulated circRNA and miRNA and co-expression of circRNA-miRNA specifically involved regulate multiple pathways and multiple cellular and molecular biological processes.

The Role of Periodontal Disease in Etiology of Myocardial Infarction

Periodontal disease is a chronic inflammatory disease of periodontium and its advanced form is characterized by periodontal ligament loss and destruction of surrounding alveolar bone. Cardiovascular diseases are the most common cause of adult death in the world. Over 80% of cardiovascular disease deaths take place in low-and middleincome countries and occur almost equally in men and women. The main causes of cardiovascular diseases are tobacco use, unhealthy diet, physical inactivity, high blood pressure and high blood cholesterol. The association of coronary heart disease and periodontal disease may be due to an underlying response trait, which places an individual at high risk for developing both periodontal disease and atherosclerosis. It was suggested that periodontal disease, once established provides a biological burden of endotoxin and inflammatory cytokines, especially thromboxane A2, prostaglandin E2, interleukin (IL) 1L=1 α, and tumor necrosis factor-β, which serve to initiate and exacerbate atherogenesis and thromboembolic events. As we known dental infection especially periodontal disease can be tightly connected with cardiovascular disease, that’s the reason why patients who have valvular defect or some other congenital defects such as septal defects, or who have prosthetic valve, should receive antibiotic therapy as prophylaxis before any blood included procedure. It is very important to prevent periodontal disease, or if it’s already present, the treatment should commence as soon as possible to prevent the risk factors from occurring and causing cardiovascular disease.

PO342 Predictors of Effective Electrical Cardioversion of Atrial Fibrillation

Cardiovascular risk factors are closely linked with dementia risk, but whether heart disease predisposes to dementia is uncertain.We systematically reviewed the literature and meta-analyzed risk estimates from longitudinal studies reporting the association of coronary heart disease (CHD) or heart failure (HF) with risk of dementia.We identified 16 studies (1,309,483 individuals) regarding CHD, and seven studies (1,958,702 individuals) about HF. A history of CHD was associated with a 27% increased risk of dementia (pooled relative risk [RR] [95% confidence interval, CI]: 1.27 [1.07–1.50]), albeit with considerable heterogeneity across studies (I2 = 80%). HF was associated with 60% increased dementia risk (pooled RR 1.60 [1.19–2.13]) with moderate heterogeneity (I2 = 59%). Among prospective population-based cohorts, pooled estimates were similar (for CHD, RR 1.26 [1.06–1.49], nine studies; and HF, RR 1.80 [1.41–2.31], four studies) and highly consistent (I2 = 0%).CHD and HF are associated with an increased risk of dementia.

Relation of Carotid Artery Plaque to Coronary Heart Disease and Stroke in Chinese Patients: Does Hyperglycemia Status Matter?

To examine the association of carotid artery plaque with the incident coronary heart disease and stroke events in Chinese patients and explore whether the association differs between patients with and without hyperglycemia. We evaluated plaque, and blood pressure, total cholesterol, triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting serum insulin, fasting plasma glucose, 2 h postprandial glucose and Homeostasis model assessment of insulin resistance in 253 Chinese patients. T-test and X2 test were used to compare the clinical characteristics and Binary logistic regression was applied to analyze the association of coronary heart disease and stroke between patients with and without hyperglycemia. Among 253 patients, 162 patients had hyperglycemia (i. e., diabetes, impaired glucose regulation and stress induced hyperglycemia) and 155 (61.3%) patients had plaque. Fasting plasma glucose, 2 h postprandial glucose and Homeostasis model assessment of insulin resistance, triglycerides, plaque were significantly higher in the hyperglycemia group than non-hyperglycemia. The incident coronary heart disease and stroke events in patients with plaque were 2.254 (95%CI,1.203-4.224) and 2.437 (95%CI,1.042-5.701) times higher than those without plaque, respectively. Among hyperglycemia subgroup, plaque was an independent risk factor for coronary heart disease (OR,3.075,95%CI,1.353-6.992) and stroke (OR,3.571,95%CI,1.460-8.737). The slopes (associations between coronary heart disease/stroke and plaque) were steeper in the hyperglycemia group than those in the non-hyperglycemia group (coronary heart disease OR,3.075 vs. 2.614; stroke OR,3.571 vs. 3.307). The incident coronary heart disease and stroke events in patients with plaque were higher than those without plaque, and this difference was more pronounced for patients with hyperglycemia vs. those without hyperglycemia.

Associations of Coronary Heart Disease with Common Carotid Artery Near and Far Wall Intima-Media Thickness: The Multi-Ethnic Study of Atherosclerosis.

Intima-media thickness (IMT) measured on ultrasound images of the common carotid artery (CCA) is associated with cardiovascular risk factors and events. Given the physics of ultrasound, CCA far wall IMT measurements are favored over near wall measurements, but this theoretical advantage is not well studied. A total of 6,606 members of the Multi-Ethnic Study of Atherosclerosis, a longitudinal cohort study (mean age, 62.1years; 52.7% women) who had near wall and far wall CCA IMT measurements. Multivariate linear regression models were used to estimate model goodness of fit of Framingham risk factors with near wall IMT, far wall IMT, and combined mean IMT. Multivariate Cox proportional hazards models were used to estimate hazard ratios for incident coronary heart disease events for each IMT variable. Change in Harrell's C statistic was used to compare the incremental value of each IMT variable when added to Framingham risk factors. Mean IMT had the strongest association with risk factors (R(2)=0.31), followed by near wall (R(2)=0.26) and far wall (R(2)=0.22) IMT. Far wall IMT improved the prediction of coronary artery disease events over the Framingham risk factors (change in C statistic, 0.012; 95% CI, 0.006-0.017; P<.001), as did mean IMT (P=.004), but near wall IMT did not. Far wall CCA IMT showed the strongest association with incident coronary heart disease, whereas mean IMT had the strongest associations with risk factors. This difference might affect the selection of appropriate IMT variables in different studies.

Lead exposure exacerbates cardiovascular risk.

Cardiovascular disease (CVD) is the leading cause of mortality all over the world. However, majority of CVDs are caused by risk factors that can be controlled, treated or modified, such as hypertension, cholesterol, overweight/obesity, tobacco use, sedentary lifestyles and diabetes. Various environmental toxicants like Lead (Pb) are also important preventable causes of variation in CVDs as reported in different human populations [1]. Although important measures have already been implemented in a number of countries to reduce environmental Pb exposure which includes the use of unleaded gasoline, Pb free paints, solder of canned foods, and glazed ceramics used for storage and preparation of food, it is still a major environmental health hazard in specific communities and targeted high-risk populations [2]. Pb intoxication has been found to be associated with hypertension and promotes atherosclerosis in experimental animals [2, 3]. Hypertensive effects of Pb has also been documented in workers chronically exposed to high Pb levels [4]. Several epidemiological and clinical studies have found a link between chronic Pb exposure and elevated blood pressure [1]. Although a dose–response relationship between Pb exposure and blood pressure has also been reported however shape of the dose response relationship is not completely elucidated, especially at low levels of exposure. It is still not clear what should be the lowest level of Pb exposure that shall not be associated with Pb toxicity and its impact on blood pressure, although in the available studies there seems to be no evidence of a threshold effect [5]. The precise mechanisms explaining a hypertensive effect of low chronic exposure to environmental Pb are unknown. Muntner et al. [6] has reported an inverse association between estimated glomerular filtration rate and blood Pb level at Pb concentration below 5 μg/dl in general population studies, indicating that Pb-induced reductions in renal function could play a major role in hypertension. Enhanced oxidative stress, down-regulation of nitric oxide, stimulation of the renin-angiotensin system and soluble guanylate cyclase are among other potential mechanisms which could result in increased vascular tone and peripheral vascular resistance [5]. Metal-mediated formation of free radicals may enhance lipid peroxidation and changes in calcium and sulfhydryl homeostasis. Pb by promoting the production of reactive oxygen species, triggers a cycle of oxidative stress and inflammation in target tissues. Depletion of sulfhydryl reserves in cells provides an indirect mechanism for redox-inactive metals induced oxidative stress. These findings suggest a possible involvement of oxidative stress in the pathophysiology of Pb toxicity. Although oxidative stress is one of the important factor in the pathophysiology of Pb toxicity, it is not clear whether these alterations are the cause of the oxidative damage or a consequence of it. Increased expression and production of inflammatory markers in association with Pb exposure have also been reported in humans [2]. Most of the data available have been drawn from experimental studies and there are few cohort studies that evaluate the association of Pb with clinical cardiovascular outcomes in general population settings. The National Health and Nutrition Examination Surveys (NHANES) II and III showed a statistically significant increase in cardiovascular mortality with increasing blood Pb levels, although there was an overall decline in Pb levels in the US adults. Similarly the British Regional Heart study showed positive but non-significant association of coronary heart disease or stroke with elevated Pb levels. However, the unresolved issue is the impact of uncontrolled confounding and measurement error on the relative risk estimates in studies of Pb and clinical cardiovascular end points. Similarly the validity of occupational studies on Pb and cardiovascular mortality is limited by different methodological problems like bias of observations in occupationally exposed workers, which cannot be extrapolated to general population [5]. Various factors, both conventional and novel risk factors have been shown to be responsible for the morbidity and mortality of patients with cardiovascular diseases. No attention has so far been given to environmental toxicants and other trace elements such as Pb, which can exacerbate the disease condition. A prospective pro-atherogenic effect, even if modest compared to other conventional risk factors would have a significant impact in sensitive population groups. In view of this it becomes important to explore the precise role and mechanism of Pb in development of atherosclerosis and CVD.

Impact of diabetes, high triglycerides and low HDL cholesterol on risk for ischemic cardiovascular disease varies by LDL cholesterol level: A 15-year follow-up of the Chinese Multi-provincial Cohort Study

AimsA large proportion of ischemic cardiovascular disease occur in people without hypercholesterolemia. We aimed to investigate whether risk factors other than low-density lipoprotein cholesterol (LDL-C) have different impacts on cardiovascular risk in people with low verses high LDL-C levels. MethodsA total of 30,378 participants (35–64 years) were followed for 15 years in the Chinese Multi-provincial Cohort Study. Associations of coronary heart disease (CHD) and ischemic stroke with risk factors other than LDL-C were assessed in participants with low (<130mg/dL) and high (≥130mg/dL) LDL-C levels. ResultsDuring the follow-up, 65.5% of CHD and 70.2% of ischemic stroke events occurred in participants with low LDL-C. High triglycerides predicted CHD (HR=1.74, 95% CI 1.25–2.42, P=0.001), and low HDL-C predicted ischemic stroke (HR=1.54, 95% CI 1.18–2.03, P=0.002) only in participants with low LDL-C. Diabetes predicted CHD in participants with high LDL-C (HR=2.38, 95% CI 1.31–4.34, P=0.005), but not in those with low LDL-C. Older age, male, hypertension, central obesity, and smoking had similar effects on the risk in both groups. ConclusionsTriglycerides and low HDL-C should be addressed in the management of dyslipidemia in people with low LDL-C. When LDL-C is high, tighter management of glycemia and LDL-C is warranted.

E0491 Association of coronary heart disease with carotid artery intima-media thickness and baPWV

ObjectiveTo investigate the association of coronary heart disease with carotid artery intima-media thickness and baPWV, by measuring carotid intimia - media thickness and baPWV.Methods160 patients who had been examined by...

Periodontitis as a risk factor for cerebrovascular accident: a case-control study in the Indian population

Chronic infections have been reported to be risk factors for coronary heart disease and ischemic stroke. However, the association of coronary heart disease and ischemic stroke with periodontal disease, which is also a chronic inflammatory disease, needs to be evaluated. The present case-control study was designed to determine if an association exists between periodontal disease and cerebrovascular accident in the Indian population. This case-control study consisted of 200 subjects (100 cases and 100 controls) who were 33-68 years of age. Cases were examined within 5 d after their first acute ischemic attack. Clinical parameters recorded included plaque index, gingival index, probing pocket depth and clinical attachment loss. The medical questionnaire collected information on family history of stroke, dietary history, history of smoking and history of alcohol consumption. Cases were additionally scrutinized for diabetes, hypertension and total serum cholesterol level. The education level of patients was also considered. The mean plaque index, gingival index, probing pocket depth and clinical attachment loss values of subjects with cerebrovascular accident were significantly higher when compared with those of the control group (p < 0.05). In fully adjusted logistic regression analysis, a probing pocket depth of > 4.5 mm was found to be the most significant factor for stroke (odds ratio = 8.5; confidence interval = 1.1-68.2) followed by hypertension (odds ratio = 7.6; confidence interval = 3.3-17.1) and smoking (odds ratio = 3.1; confidence interval = 1.3-7.4). The data from this study support the proposed link between periodontitis and cerebrovascular accident in the Indian population. However, further studies are necessary to verify and quantify the role of oral infections and genetic factors in the process of atherosclerosis.

Spatial analysis of MODIS aerosol optical depth, PM2.5, and chronic coronary heart disease

BackgroundNumerous studies have found adverse health effects of acute and chronic exposure to fine particulate matter (PM2.5). Air pollution epidemiological studies relying on ground measurements provided by monitoring networks are often limited by sparse and unbalanced spatial distribution of the monitors. Studies have found correlations between satellite aerosol optical depth (AOD) and PM2.5 in some land regions. Satellite aerosol data may be used to extend the spatial coverage of PM2.5 exposure assessment. This study was to investigate correlation between PM2.5 and AOD in the conterminous USA, to derive a spatially complete PM2.5 surface by merging satellite AOD data and ground measurements based on the potential correlation, and to examine if there is an association of coronary heart disease with PM2.5.ResultsYears 2003 and 2004 daily MODIS (Moderate Resolution Imaging Spectrometer) Level 2 AOD images were collated with US EPA PM2.5 data covering the conterminous USA. Pearson's correlation analysis and geographically weighted regression (GWR) found that the relationship between PM2.5 and AOD is not spatially consistent across the conterminous states. The average correlation is 0.67 in the east and 0.22 in the west. GWR predicts well in the east and poorly in the west. The GWR model was used to derive a PM2.5 grid surface using the mean AOD raster calculated using the daily AOD data (RMSE = 1.67 μg/m3). Fitting of a Bayesian hierarchical model linking PM2.5 with age-race standardized mortality rates (SMRs) of chronic coronary heart disease found that areas with higher values of PM2.5 also show high rates of CCHD mortality: = 0.802, posterior 95% Bayesian credible interval (CI) = (0.386, 1.225).ConclusionThere is a spatial variation of the relationship between PM2.5 and AOD in the conterminous USA. In the eastern USA where AOD correlates well with PM2.5, AOD can be merged with ground PM2.5 data to derive a PM2.5 surface for epidemiological study. The study found that chronic coronary heart disease mortality rate increases with exposure to PM2.5.

Involvement of Interleukin‐1 Genotypes in the Association of Coronary Heart Disease With Periodontitis

Epidemiologic studies demonstrated an association between periodontitis (PE) and coronary heart disease (CHD). The coexistence of the two disease entities could be dependent on mutual risk factors, and polymorphism of the interleukin (IL)-1 gene cluster associated with the severity of PE might also be involved in the pathogenesis of CHD. The study consisted of 225 dentate white subjects, including 97 patients with CHD and 128 controls. Patients with confirmed diagnoses of CHD were recruited after being discharged from a cardiology department, and controls without CHD were recruited consecutively from the Copenhagen City Heart Study. Mean alveolar bone level (ABL) was measured on radiographs. ABL was stratified into ABL1 (ABL < or = 2 mm), ABL2 (2 mm <ABL < or = 4 mm), and ABL3 (ABL >4 mm). Genotypes were analyzed by amplifying the polymorphic regions of the IL-1 gene cluster using polymerase chain reaction, followed by restriction digestion and gel electrophoresis. In the univariate analysis, allele 2 of IL-1B+3954 and IL-1B-511 was associated with ABL (P = 0.040 and P = 0.039, respectively), whereas no association was found with allele 2 of IL-1A+4845 or IL-1RN variable number tandem repeat (VNTR) (P = 0.445 and P = 0.375, respectively). A lower ABL was associated with the occurrence of allele 2 of IL-1B-511. The multiple logistic regression analysis also showed a significant association of allele 1 of IL-1B-511 with high ABL (P = 0.049) and of allele 2 of IL-1A+4845 with high ABL among individuals with CHD (P = 0.050). There was no association between any of the polymorphisms of IL-1 and CHD in the univariate or multiple analyses. However, in a binary multiple logistic regression model, carriage of allele 1 of IL-1RN VNTR was found to be associated with the occurrence of both CHD and ABL3 (P = 0.016). Allele 1 of IL-1RN VNTR may be associated with the coexistence of CHD and PE in a multiple regression model.

Plasma Levels of HDL Subpopulations and Remnant Lipoproteins Predict the Extent of Angiographically-Defined Coronary Artery Disease in Postmenopausal Women

The association of coronary heart disease (CHD) with subpopulations of triglyceride (TG)-rich lipoproteins and high-density lipoproteins (HDL) is established in men, but has not been well characterized in women. Plasma HDL subpopulation concentrations, quantified by 2-dimensional gel electrophoresis, and plasma remnant-like particle cholesterol (RLP-C) concentrations were measured in 256 postmenopausal women with established CHD and in 126 CHD-free postmenopausal women. Coronary artery disease was assessed in women with CHD by quantitative coronary angiography. Plasma RLP-C and prebeta1 HDL concentrations were higher and alpha1 and alpha2 HDL concentrations were lower in CHD than in CHD-free women. After adjustment for conventional CHD-risk factors, plasma levels of RLP-C were positively associated with the degree of coronary artery disease. In similar analyses, plasma prebeta1 HDL particle concentrations were positively associated and alpha2 HDL particle concentrations were inversely associated with the extent of coronary atherosclerosis. Plasma TG, low density lipoprotein cholesterol, and HDL cholesterol levels were not associated with the degree of coronary atherosclerosis. The degree of coronary atherosclerosis in postmenopausal women is linked to a dysregulation of the TG/HDL metabolism. Subpopulations of TG-rich and HDL lipoproteins are better predictors of disease than TG and HDL cholesterol concentrations.

Association between alcoholic beverage consumption and incidence of coronary heart disease in whites and blacks: the Atherosclerosis Risk in Communities Study.

The authors evaluated the relation between consumption of alcoholic beverages and incidence of coronary heart disease in White and African-American participants in the Atherosclerosis Risk in Communities Study. The average duration of follow-up was 9.8 years between 1987 and 1998. The association was analyzed by means of Cox proportional hazards regression models. The authors found a positive association between ethanol consumption and incident coronary heart disease for Black men (for a 13-g/day increment in ethanol consumption, adjusted hazard ratio (HR) = 1.13, 95% confidence interval (CI): 1.01, 1.28) and an inverse association for White men (HR = 0.88, 95% CI: 0.79, 0.99). There was an inverse association of coronary heart disease with rare drinking (HR = 0.47, 95% CI: 0.28, 0.80) and with consumption of > or =70 g of ethanol per week (HR = 0.49, 95% CI: 0.24, 0.98) in White women and with consumption of > or =210 g/week (HR = 0.56, 95% CI: 0.33, 0.95) in White men. In Black men, the association was positive for consumption of 140-<210 g/week (HR = 2.61, 95% CI: 1.11, 6.17). The contrasting findings in Whites and Black men in this cohort raise the question of whether the cardioprotective effect of alcohol is real or may be confounded by lifestyle characteristics of drinkers.