Biological Cardiovascular Disease Risk Factors Research Articles

A Study to assess the knowledge regarding prevention of Cardiovascular Diseases (CVD) among Obese women in selected urban community areas at Mangalore

Background: Cardiovascular disease (CVD) is the leading cause of death in women and primary target for prevention. Obesity is an important biological risk factor for cardiovascular disease (CVD). The main aim of this study was to answer the question regarding knowledge about preventive measures of CVD. A further aim was to replicate previous findings that obese individuals are at higher risk of developing other biological risk factors for CVD. Objectives of the study: To identify the knowledge level of obese women regarding prevention of cardiovascular disease in a selected community at Mangalore. Method: A descriptive study was conducted among 50 obese women who were selected by Purposive sampling technique. The study was conducted in local areas, at Mangalore. Data was collected through baseline information, structured knowledge questionnaire. The data collected was analysed and interpreted based on descriptive and inferential statistics. Result: Majority of the samples belonged in the age group of 40-45 years (40%), most of their BMI were in obese category (64%), nearly half of the subjects completed pre university education (40%), 64% of the subjects were office workers and have not attained menopause, almost half of them had 2 pregnancies (48%) and majority of them did not undergo hormone replacement therapy (80%), family history of CVD and obesity were 72% and 56% respectively, majority of people had personal history of diabetes mellitus (36%). With regard to level of knowledge, among 50 obese women 50% had average knowledge, 34% had good knowledge, 6% had very good knowledge and 10% had poor knowledge about prevention of cardiovascular diseases. There was a significant association for age, type of occupation, number of pregnancies, hormone replacement therapy and personal history of CVD with knowledge of obese women and no association found for BMI, menopause, family history of CVD and obesity. Conclusion: Knowledge level of obese women regarding prevention of cardiovascular diseases is comparatively low. Various multisectoral approaches are required to improve their knowledge which would help to improve their quality of life.

Prevalence of Cardiovascular Disease Risk Factors in Vologda Oblast Districts

Relevance. There are large regional disparities in prevalence of non-communicable disease risk factors, as well as in the cardiovascular disease (CVD) incidence and mortality rates in Russian Federation (RF). Aim. To demonstrate the disparities in prevalence of CVD risk factors between Vologda Oblast districts. Materials and methods. Databases created in 2009 at the State-financed health institution of the Vologda Oblast «Vologda Regional Center for Medical Prevention», based on the results of a survey conducted within the framework of the World Health Organization CINDI program. CINDI questionnaire; cross-sectional study; the data was processed using R programming language and the Statistica software package 12. Results. The most common behavioral CVD risk factors in different Vologda Oblast districts included inadequate fruits and vegetables consumption (30–90%) and alcohol abuse (40–80%); hypertension (40–60%), overweight and obesity (30–55%) were the most frequent biological CVD risk factors; the most prevalent socio-economic risk factors included low education level (75–90%) and unemployment (20–40%). Participants residing in rural municipalities differed from urban okrugs (cities) dwellers in a higher prevalence of smoking (p < 0.01), alcohol abuse (p < 0.001), inadequate fruits and vegetables consumption (p < 0.0001), overweight and obesity (p < 0.05), unemployment (p < 0.0001), low education level (p < 0.0001), as well as a low overall assessment of their health (p < 0.05). Conclusions. We detected disparities in CVD risk factors prevalence between Vologda Oblast districts in 2009. Both behavioral and biological CVD risk factors were more common in participants from rural municipalities. The CVD risk factors distribution between the RF subjects’ districts requires further scientific research.

Design and Implementation of the Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT).

The Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT) is a prospective cohort study in Puerto Rico (PR) aiming to identify trends and longitudinal associations in risk factors for cardiovascular disease (CVD). In 2019, PROSPECT investigators started recruiting a sample of 2,000 adults aged 30-75 years in PR using multistage probabilistic sampling of households and community approaches. Culturally sensitive trained research assistants assess participants, at baseline and at 2-year follow-up, in private rooms at a network of partner clinics. The study collects comprehensive data on demographic factors, socioeconomic and environmental factors, medical history, health conditions, lifestyle behaviors, psychosocial status, and biomarkers of CVD and stress. PROSPECT will estimate the prevalence and incidence of psychosocial, lifestyle, and biological CVD risk factors, describe variations in risk factors by urbanicity (urban areas vs. rural areas) and exposure (before and after) to natural disasters, and determine predictors of longitudinal changes in CVD risk factors. The study has 4 coordinated operational strategies: 1) research productivity (including synergy with existing epidemiologic cohorts of Hispanics/Latinos for comparison); 2) research infrastructure (biorepository, ancillary studies, and clinical research network); 3) capacity-building, education, and training; and 4) community outreach, dissemination, and policy. PROSPECT will inform public health priorities to help reduce CVD in PR.

Risk factors for cardiovascular disease in the Chinese population: recent progress and implications

Abstract Cardiovascular disease (CVD) is the leading cause of death in both urban and rural areas of China. The current evidence regarding CVD risk factors was primarily established in Western countries, with limited generalizability to the Chinese population. In China, a growing number of population-based prospective cohort studies have emerged that have yielded substantial research data on CVD risk factors in the past five years. The research studies have covered biological risk factors (e.g., blood lipids, blood pressure, blood glucose, adiposity), lifestyle risk factors (e.g., smoking, alcohol, diet, physical activity), environmental risk factors (e.g., ambient and indoor air pollution), and risk prediction. This study aimed to systematically review the research progress on CVD risk factors in the Chinese population in the past five years. Prospective studies in China have identified biological, lifestyle, and environmental risk factors for CVD and its main subtypes, along with some protective factors unique to the Chinese (e.g., spicy food and green tea). This review aimed to provide high-quality evidence for achieving the Outline of Healthy China 2030, developing disease prevention guidelines and measures, and deepening efforts for popularization of health knowledge.

Prediction of cardiovascular health by non-exercise estimated cardiorespiratory fitness

ObjectiveTo estimate the incidence of major biological cardiovascular disease (CVD) risk factors in adults using non-exercise estimated cardiorespiratory fitness (eCRF).Methods200 039 healthy people (99 957 women), aged ≥18 years (38.5±12.1...

Clustering and Tracking the Stability of Biological CVD Risk Factors in Adolescents: The Malaysian Health and Adolescents Longitudinal Research Team Study (MyHeARTs).

Background: Cardiovascular disease (CVD) risk factors tend to cluster and progress from adolescence to young adulthood. Reliable and meaningful clustering of CVD risk factors is essential to circumvent loss of information. Tracking adverse and high-risk profiles of adolescents is hoped to curb CVD progression later in life. The study aims to investigate the clustering of biological CVD risk factor among adolescents in Malaysia and the transitions between clusters over time.Method: The Malaysian Health and Adolescents Longitudinal Research Team study (MyHeARTs) examined school students aged 13 in 2012 and re-examined them in 2014 and 2016. In a two-stage stratified cluster sampling, 1,361 students were recruited, of which, 1,320 had complete data. In the follow-up, there were 881 and 637 students in 2014 and in 2016, respectively. Pearson's correlation coefficients were used to identify and remove highly correlated CVD risk factors. All risk factors were standardized into z-scores. The hierarchical and non-hierarchical (k-means) cluster analyses were used to classify students into high, medium and low risk clusters in each screening year. The tracking and stability of cluster transitions through cross-classification were enumerated with Pearson's inter-age correlations and percentages.Results: Three significant clusters of high, medium and low risk groups were derived from the clustering of eight biological CVD risk factors. The transitions between risk clusters from one screening year to the other were categorized as either stagnant, improved or adverse. The number of students who had adverse transitions increased from 15.5% (13–15 year) to 19.5% (15–17 year), 13.8 to 18.2% among the girls and 19.9 to 22.8% among the boys. For girls, the number of them who remained at high risk over the two transition periods were about the same (13.6 vs. 13.8%) whereas for boys, the percentage reduced from 14.6 to 12.3%.Conclusion: Over time, more than 12% of adolescents remained in the high risk cluster. There were sizable adverse transitions over time as more adolescents appear to be shifting toward an increased risk of having CVD. Collaborative and constant measures should be taken by parents, school, health promotion boards and policy makers to curb the multiplicative effect of clustering CVD risk factors among adolescents.

Physical activity less than the recommended amount may prevent the onset of major biological risk factors for cardiovascular disease: a cohort study of 198 919 adults

ObjectivesWe examined the dose–response relationship between physical activity (PA) and incidence of cardiovascular disease (CVD) risk factors in adults in Taiwan.MethodsThis study included 1 98 919 participants, aged 18–97 years,...

Clustering and Stability of Biological CVD Risk Factors Among Adolescents in Malaysia

Background: Cardiovascular disease (CVD) begins early in life but often is not manifested until adulthood. Tackling risk factors of CVD during adolescence is imperative to curb the rising burden of CVD death in Malaysia.

Relation Between a Simple Lifestyle Risk Score and Established Biological Risk Factors for Cardiovascular Disease

Although cardiovascular disease (CVD) and diabetes mellitus are largely lifestyle driven, lifestyle metrics are not used in clinical practice. This study examined the relevance of using a simple lifestyle risk score designed for primary care medicine by testing its ability to predict biological CVD risk factors in a cohort of 3,712 individuals involved in a workplace health evaluation or management program ("Grand Défi Entreprise" project). Using a lifestyle risk score based on waist circumference, fitness, nutritional quality, and physical activity level, employees were categorized into 3 distinct estimated lifestyle risk levels (low, intermediate, and high). A biological CVD risk score was also calculated, which included high-density lipoprotein cholesterol (HDL-C), triglycerides (TG), cholesterol-to-HDL-C ratio, blood pressure, hemoglobin glycated levels, and medication use. Diastolic blood pressure, TG levels, and the cholesterol-to-HDL-C ratio increased across categories of lifestyle risk score, whereas HDL-C decreased (p <0.05). Calculated Framingham and diabetes risk scores as well as the prevalence of hypertriglyceridemic waist phenotype also increased across categories of lifestyle risk score (p <0.05). Finally, 1-way analysis of variance revealed that the biological risk score significantly increased across the lifestyle risk score categories (p <0.0001). Our study provides evidence that lifestyle variables can be measured and targeted in clinical practice.

Link between healthy lifestyle and psychological well-being in Lithuanian adults aged 45–72: a cross-sectional study

ObjectiveThis study uses a cross-sectional study design to analyse the connection between psychological well-being (PWB) and components of a healthy lifestyle in the Lithuanian population aged 45–72. The purpose of...

Chronic Stress and Endothelial Dysfunction: The Multi-Ethnic Study of Atherosclerosis (MESA)

Endothelial dysfunction may represent an important link between chronic stress and cardiovascular disease (CVD) risk. However, few studies have examined the impact of chronic stress on endothelial dysfunction. The purpose of this study was to examine whether chronic stress was associated with flow-mediated dilation (FMD) and 2 biomarkers of endothelial dysfunction (intercellular adhesion molecule-1 (ICAM-1) and E-selectin) in a multiethnic sample of adults (ages 45-84 years). Data come from the baseline examination of Multi-Ethnic Study of Atherosclerosis participants. Chronic stress was assessed based on self-report of the presence and severity of ongoing problems in 5 domains. FMD was obtained using high-resolution ultrasound; biomarkers were assayed in different subsets of participants. Higher chronic stress was associated with lower absolute FMD (mm FMD) in models adjusted for demographic and socioeconomic characteristics (0.169mm in high-stress participants vs. 0.178 and 0.179mm in medium and low-stress participants; P for trend = 0.04). This association remained unchanged with further adjustment for behavioral and biological CVD risk factors. Higher stress was related to higher ICAM-1 in models adjusted for sociodemographic characteristics and biological risk factors (P for trend = 0.005), but this association attenuated with adjustment for cigarette smoking (P for trend = 0.07). Chronic stress was not associated with E-selectin. Our findings suggest chronic stress is related to endothelial dysfunction, possibly in part through other stress-associated CVD risk factors such as cigarette smoking.

A Role for Behavior in the Relationships Between Depression and Hostility and Cardiovascular Disease Incidence, Mortality, and All-Cause Mortality: the Prime Study.

BackgroundBehavioral factors are important in disease incidence and mortality and may explain associations between mortality and various psychological traits.PurposeThese analyses investigated the impact of behavioral factors on the associations between depression, hostility and cardiovascular disease(CVD) incidence, CVD mortality, and all-cause mortality.MethodsData from the PRIME Study (N = 6953 men) were analyzed using Cox proportional hazards models, following adjustment for demographic and biological CVD risk factors, and other psychological traits, including social support.ResultsFollowing initial adjustment, both depression and hostility were significantly associated with both mortality outcomes (smallest SHR = 1.24, p < 0.001). Following adjustment for behavioral factors, all relationships were attenuated both when accounting for and not accounting for other psychological variables. Associations with all-cause mortality remained significant (smallest SHR = 1.14, p = 0.04). Of the behaviors included, the most significant contribution to outcomes was found for smoking, but a role was also found for fruit and vegetable intakes and high alcohol consumption.ConclusionsThese findings demonstrate well-known associations between depression, hostility, and mortality and suggest the potential importance of behaviors in explaining these relationships.

Psychosocial job factors and biological cardiovascular risk factors in Mexican workers.

Psychosocial job factors (PJF) have been implicated in the development of cardiovascular disease. The paucity of data from developing economies including Mexico hampers the development of worksite intervention efforts in those regions. This cross-sectional study of 2,330 Mexican workers assessed PJF (job strain [JS], social support [SS], and job insecurity [JI]) and biological cardiovascular disease risk factors [CVDRF] by questionnaire and on-site physical examinations. Alternative formulations of the JS scales were developed based on factor analysis and literature review. Associations between both traditional and alternative job factor scales with CVDRF were examined in multiple regression models, adjusting for physical workload, and socio-demographic factors. Alternative formulations of the job demand and control scales resulted in substantial changes in effect sizes or statistical significance when compared with the original scales. JS and JI showed hypothesized associations with most CVDRF, but they were inversely associated with diastolic blood pressure and some adiposity measures. SS was mainly protective against CVDRF. Among Mexican workers, alternative PJF scales predicted health outcomes better than traditional scales, and psychosocial stressors were associated with most CVDRF.

Daily marital interaction quality and carotid artery intima-medial thickness in healthy middle-aged adults.

To examine the association between marital interaction quality during daily life and subclinical cardiovascular disease (CVD). Studies have shown that marital status and quality of marriage are associated with cardiovascular health. However, little is known about the role of marital interaction quality during daily life in contributing to these effects. The sample consisted of 281 healthy, employed middle-aged adults who were married or living with a partner in a marital-like relationship (mean age = 42.0 years, 88% white, 52% men). Marital interaction quality was assessed using hourly real-time ecological momentary assessments for 4 days, with participants rating their current or recent partner interactions on positive and negative characteristics (e.g., agreeableness and conflict). Carotid artery intima-medial thickness (IMT) was assessed using ultrasound imaging. Adjusting for demographics, positive marital interaction was inversely associated with IMT (b = -0.02, F(1,275) = 9.18, p = .002), and negative marital interaction was positively associated with IMT (b = 0.02 F(1,275) = 10.29, p = .001). These associations were not accounted for by behavioral and biological CVD risk factors and were consistent across age, sex, race, and education. The associations were also independent of marital interaction frequency, nonmarital social interaction quality, and personality factors. Global reports of marital quality, in contrast, were not associated with IMT. Marital quality as measured during real-time interactions between partners was associated with subclinical CVD in healthy middle-aged adults. This study supports the use of real-time social interaction assessment for characterizing links between social relationships and cardiovascular health.

Effects of yoga on cardiovascular disease risk factors: A systematic review and meta-analysis

BackgroundThe aim of this review was to systematically assess and meta-analyze the effects of yoga on modifiable biological cardiovascular disease risk factors in the general population and in high-risk disease groups. MethodsMEDLINE/PubMed, Scopus, the Cochrane Library, and IndMED were screened through August 2013 for randomized controlled trials (RCTs) on yoga for predefined cardiovascular risk factors in healthy participants, non-diabetic participants with high risk for cardiovascular disease, or participants with type 2 diabetes mellitus. Risk of bias was assessed using the Cochrane risk of bias tool. ResultsForty-four RCTs with a total of 3168 participants were included. Risk of bias was high or unclear for most RCTs. Relative to usual care or no intervention, yoga improved systolic (mean difference (MD)=−5.85mmHg; 95% confidence interval (CI)=−8.81, −2.89) and diastolic blood pressure (MD=−4.12mmHg; 95%CI=−6.55, −1.69), heart rate (MD=−6.59bpm; 95%CI=−12.89, −0.28), respiratory rate (MD=−0.93breaths/min; 95%CI=−1.70, −0.15), waist circumference (MD=−1.95cm; 95%CI=−3.01, −0.89), waist/hip ratio (MD=−0.02; 95%CI=−0.03, −0.00), total cholesterol (MD=−13.09mg/dl; 95%CI=−19.60, −6.59), HDL (MD=2.94mg/dl; 95%CI=0.57, 5.31), VLDL (MD=−5.70mg/dl; 95%CI=−7.36, −4.03), triglycerides (MD=−20.97mg/dl; 95%CI=−28.61, −13.32), HbA1c (MD=−0.45%; 95%CI=−0.87, −0.02), and insulin resistance (MD=−0.19; 95%CI=−0.30, −0.08). Relative to exercise, yoga improved HDL (MD=3.70mg/dl; 95%CI=1.14, 6.26). ConclusionsThis meta-analysis revealed evidence for clinically important effects of yoga on most biological cardiovascular disease risk factors. Despite methodological drawbacks of the included studies, yoga can be considered as an ancillary intervention for the general population and for patients with increased risk of cardiovascular disease.

Relationship Between Cardiorespiratory Fitness and Cardiovascular Diseases Risk Factor in Iranian Children

Dear Editor, Cardiovascular Diseases (CVD) are the leading cause of global mortality, accounting for almost 17 million deaths annually.[1] Therefore, CVD is responsible for a substantial amount of money spent by health care systems for its treatment, and treatment of its symptoms. Although, CVD events occur most frequently during or after the fifth decade of life, there are evidences indicating that the precursors of CVD have origins in childhood.[2] In addition, adverse CVD risk factors during childhood have been shown to track into adulthood.[3] One of the most recognized CVD risk factor in children is the cardiorespiratory fitness,[4] which influences the cardiovascular health in children and adolescents. However, the association between cardiorespiratory fitness and cardiovascular risk factors in children has remained unclear. Therefore, the aim of this study was to evaluate the relationship between cardiorespiratory fitness with cardiovascular disease risk factors in 8 to 12 years old children in southern Iran. A total of 132 children at an elementary school in Noorabad, with the age of 9.73±1.38 years, standing height of 134.5±11.77 cm, body weight 32.04±8.65 kg and body mass index 17.46±2.58 who were volunteer to participate in this study were enrolled. They were informed about the study and an informed consent was provided from each participant. Standing height was measured to the nearest 1 mm using a wall mounted stadiometer. Weight was measured using an electronic scale to the nearest 0.1 kg. Body Mass Index (BMI) was calculated as participants’ weight in kilograms divided by the square of their height in meters (Kg/m2). Body fat percentage (BF%) was calculated by Jackson formula: BF%=(1.51×BMI)-(0.7×Age)-(3.6×Sex)+1.4 Both systolic and diastolic blood pressures were taken using an automated sphygmomanometer and a children-sized cuff. For blood collection, following an overnight fasting, 5 ml intravenous blood sample was taken from the children’s antecubital vein. Standard enzymatic methods were used for measuring levels of serum total cholesterol, triglycerides, high-density lipoprotein cholesterol (HDL-C) and glucose levels. Low-density lipoprotein cholesterol (LDL-C) concentration was calculated by the Friedewald formula [LDL=TC-HDL-T.G/5(mg/dl)]. Cardiovascular fitness was determined as treadmill time to exhaustion by Bruce protocol. The length of the time that each child could tolerate on running treadmill was the test score and used to estimate the VO2max: VO2max=14/76-1/379(T)+0/451(T)-0/012(T). Linear regression model of the relationships between cardiorespiratory fitness and cardiovascular disease risk factors in children were presented in Table 1, which shows that high levels of cardiorespiratory fitness were inversely associated with BMI, BF%, TG and LDL. Therefore, higher cardiorespiratory fitness is associated with a better lipid profile in children, and obesity as a cardiovascular risk factor can be most successfully influenced by improving cardiorespiratory fitness. Table 1 Linear regression model of the relationships between cardiorespiratory fitness and cardiovascular disease risk factors in children. It should be mentioned that our results were in agreement with other reports in the literature, for example, Ruiz et al. evaluated the associations between cardiorespiratory fitness and metabolic risk factors in 873 healthy children aged 9–10 years,[5] that showed that cardiorespiratory fitness was negatively associated with a clustering of metabolic risk factors. The results of our study add supportive evidence to the body of knowledge suggesting that cardiorespiratory fitness in children is an important health marker, and children/adolescents with higher physical activity have a lower number of biological risk factors for CVD.

Community-Responsive Interventions to Reduce Cardiovascular Risk in American Indians

American Indian and Alaska Native (AI/AN) populations bear a heavy burden of cardiovascular disease (CVD), and they have the highest rates of risk factors for CVD, such as cigarette smoking, obesity, and diabetes, of any U.S. population group. Yet, few randomized controlled trials have been launched to test potential preventive interventions in Indian Country. Five randomized controlled trials were initiated recently in AI/AN communities to test the effectiveness of interventions targeting adults and/or children to promote healthy behaviors that are known to impact biological CVD risk factors. This article provides a context for and an overview of these five trials. The high burden of CVD among AI/AN populations will worsen unless behaviors and lifestyles affecting CVD risk can be modified. These five trials, if successful, represent a starting point in addressing these significant health disparities.

Prevalence of Cardiovascular Disease Risk Factors Among US Adolescents, 1999−2008

Overweight and obesity during adolescence are associated with an increased risk for cardiovascular disease (CVD) risk factors. The objective of this study was to examine the recent trends in the prevalence of selected biological CVD risk factors and the prevalence of these risk factors by overweight/obesity status among US adolescents. The NHANES is a cross-sectional, stratified, multistage probability sample survey of the US civilian, noninstitutionalized population. The study sample included 3383 participants aged 12 to 19 years from the 1999 through 2008 NHANES. Among the US adolescents aged 12 to 19 years, the overall prevalence was 14% for prehypertension/hypertension, 22% for borderline-high/high low-density lipoprotein cholesterol, 6% for low high-density lipoprotein cholesterol (<35 mg/dL), and 15% for prediabetes/diabetes during the survey period from 1999 to 2008. No significant change in the prevalence of prehypertension/hypertension (17% and 13%) and borderline-high/high low-density lipoprotein cholesterol (23% and 19%) was observed from 1999-2000 to 2007-2008, but the prevalence of prediabetes/diabetes increased from 9% to 23%. A consistent dose-response increase in the prevalence of each of these CVD risk factors was observed by weight categories: the estimated 37%, 49%, and 61% of the overweight, obese, and normal-weight adolescents, respectively, had at least 1 of these CVD risk factors during the 1999 through 2008 study period. The results of this national study indicate that US adolescents carry a substantial burden of CVD risk factors, especially those youth who are overweight or obese.

Socioeconomic position, gender, health behaviours and biomarkers of cardiovascular disease and diabetes

Socio-economic gradients in cardiovascular disease (CVD) and diabetes have been found throughout the developed world and there is some evidence to suggest that these gradients may be steeper for women. Research on social gradients in biological risk factors for CVD and diabetes has received less attention and we do not know the extent to which gradients in biomarkers vary for men and women. We examined the associations between two indicators of socio-economic position (education and household income) and biomarkers of diabetes and cardiovascular disease (CVD) for men and women in a national, population-based study of 11,247 Australian adults. Multi-level linear regression was used to assess associations between education and income and glucose tolerance, dyslipidaemia, blood pressure (BP) and waist circumference before and after adjustment for behaviours (diet, smoking, physical activity, TV viewing time, and alcohol use). Measures of glucose tolerance included fasting plasma glucose and insulin and the results of a glucose tolerance test (2 h glucose) with higher levels of each indicating poorer glucose tolerance. Triglycerides and High Density Lipoprotein (HDL) Cholesterol were used as measures of dyslipidaemia with higher levels of the former and lower levels of the later being associated with CVD risk. Lower education and low income were associated with higher levels of fasting insulin, triglycerides and waist circumference in women. Women with low education had higher systolic and diastolic BP and low income women had higher 2 h glucose and lower HDL cholesterol. With only one exception (low income and systolic BP), all of these estimates were reduced by more than 20% when behavioural risk factors were included. Men with lower education had higher fasting plasma glucose, 2 h glucose, waist circumference and systolic BP and, with the exception of waist circumference, all of these estimates were reduced when health behaviours were included in the models. While low income was associated with higher levels of 2-h glucose and triglycerides it was also associated with better biomarker profiles including lower insulin, waist circumference and diastolic BP. We conclude that low socio-economic position is more consistently associated with a worse profile of biomarkers for CVD and diabetes for women.

Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort

This study examined associations between exposure to shift-work and risk factors for cardiovascular disease (CVD) and whether the associations are explained by socio-economic circumstances, occupational factors or health behaviours. Biological risk factors for CVD were measured in 7,839 participants of the 1958 British birth cohort at age 45 years who were in paid employment. Regular (>or=1/week) shift-workers included 46% working evenings (1800-2200), 28% weekends, 13% nights (2200-0400) and 14% early mornings (0400-0700). Adverse levels of several CVD risk factors were found in association with increasing participation in any shift-work. Men regularly working all four shift-work types had increased CVD risk factors of approximately 0.1-0.2 standard deviations (e.g. 0.8 kg/m(2) for body mass index; 1.2 cm for waist circumference) than those not regularly working shifts; for women, there was a positive linear trend for triglyceride levels, but a negative trend for diastolic blood pressure. Separate analyses of shift-work types showed associations primarily for night/morning working rather than evening/weekend working. Men had adverse levels of all CVD risk factors except blood pressure and total-cholesterol in association with night or early morning work and women had adverse triglyceride levels. Adjustment for socioeconomic, occupational factors and health behaviours explained most associations except for adiposity and C-reactive protein. Our results highlight night and early morning working associations with an adverse profile of CVD risk factors, which are partly explained by socioeconomic, other occupational factors and health behaviours.