Determinants Of Cardiovascular Disease Research Articles

Presence and Determinants of Cardiovascular Disease and Mortality in Individuals With Type 1 Diabetes of Long Duration: The FinnDiane 50 Years of Diabetes Study.

The aim of this study was to determine the incidence of cardiovascular disease (CVD) and mortality as well as their risk factors in type 1 diabetes (T1D) of >50 years' duration. From 5,396 individuals included in the Finnish Diabetic Nephropathy Study (FinnDiane), 729 diagnosed in 1967 or earlier survived with T1D for >50 years. In this FinnDiane 50-year cohort, cumulative incidence of CVD events was assessed from the diagnosis of diabetes, and the excess CVD risk, compared with 12,710 matched individuals without diabetes. In addition, risk factors for different types of CVD (both nonfatal and fatal) and mortality were analyzed, and cause-specific hazard ratios were estimated during a median follow-up of 16.6 years from the baseline visit (median duration of diabetes 39 years at baseline). In individuals with diabetes duration of >50 years, the 60-year cumulative incidence of CVD from the diagnosis of diabetes was 64.3% (95% CI 62.5-66.0). Compared with individuals without diabetes, the standardized incidence ratio for CVD was 7.4 (6.5-8.3); in those with normoalbuminuria, it was 4.9 (4.0-5.9). Mean HbA1c and HbA1c variability, dyslipidemia, BMI, kidney disease, age, and diabetes duration were the variables associated with incident CVD. In particular, HbA1c was associated with peripheral artery disease (PAD). The standardized mortality ratio compared with the Finnish background population was 3.2 (2.8-3.7). The factors associated with mortality were diabetes duration, increased HbA1c variability, inflammation, insulin resistance, kidney disease, and PAD. Individuals with T1D of very long duration are at a high risk of CVD. In addition, throughout the lifespan, optimal glycemic control remains central to CVD and excess mortality prevention.

THE ASSOCIATION BETWEEN N-TERMINAL PRO-BRAIN NATRIURETIC PEPTIDE AND CARDIOVASCULAR DISEASE IS CONDITIONED BY PRESENCE OF INCREASED ARTERIAL STIFFNESS

Abstract Objective: The aim of this study was to evaluate whether the cardiovascular risk associated with increased N-terminal pro-brain natriuretic peptide (NT-proBNP) is modified by arterial stiffness assessed as carotid to femoral pulse wave velocity (PWV) in apparently healthy individuals. Design and method: This was a population-based cohort study comprising of 1858 healthy subjects included in the 10-year follow-up of the MONItoring of trends and determinants in CArdiovascular disease (MONICA) study. The primary outcome was major adverse cardiovascular events (MACE) after 16 years of follow-up. MACE was defined as cardiovascular death, sudden death, heart failure, arrhythmia, myocardial infarction, chronic ischemic heart disease, cerebrovascular disease, peripheral or central arterial disease. The association between NT-proBNP and MACE was evaluated with Cox proportional-hazards regression stratified for presence of increased arterial stiffness (PWV > 12m/s) and adjusted for traditional risk factors for cardiovascular disease. NT-proBNP was evaluated both as a continuous variable (log transformed) and dichotomously using the 90th percentile as cut-off (110pg/ml) allowing for group-wise comparisons. Results: 314 events were recorded during a median follow-up of 16.0 years (interquartile range: 14.7–16.0). In multivariable regression with both log (NT-proBNP) and log (PWV) included in the model, we found that log (NT-proBNP) was associated with MACE: HR = 1.28 [1.13–1.45] (P < 0.001). There was a significant positive interaction between log (NT-proBNP) and log (PWW): HR = 1.53 [1.02–2.29] (P = 0.042). In subjects with PWV < 12m/s, log (NT-proBNP) was not associated with MACE: HR = 1.07 [0.91–1.26] (P = 0.429). In subjects with increased PWV, log (NT-proBNP) was associated with MACE, HR = 1.68 [1.39–2–04] (P < 0.001). In multivariable categorical analysis using subjects with PWV < 12m/s and NT-proBNP < 110pg/ml as reference group we found: 1) Increased NT-proBNP without increased PWV was not associated with MACE: HR 0.92 [0.52–1.64] (P = 0.790). 2) Increased PWV and normal NT-proBNP showed borderline significant association with MACE HR 1.35 [0.99–1.84] (P = 0.052). 3) Increased PWV and increased NT-proBNP was associated with MACE: HR 3.21 [2.14–4.80] (P < 0.001). Conclusions: The association between increased NT-proBNP and MACE was positively modified by increased arterial stiffness. NT-proBNP was only associated with MACE in subjects with simultaneously increased arterial stiffness.

IL-6 as a Mediator of the Association Between Traditional Risk Factors and Future Myocardial Infarction: A Nested Case-Control Study.

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Predictive Importance of Blood Pressure Characteristics With Increasing Age in Healthy Men and Women: The MORGAM Project.

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An evaluation of lipid profile and pro-inflammatory cytokines as determinants of cardiovascular disease in those with diabetes: a study on a Mexican American cohort

Sedentary life styles coupled with high-calorie diets and unhealthy social habits such as smoking, have put an ever-increasing number of people at risk of cardiovascular disorders (CVD), worldwide. A concomitant increase in the prevalence of type 2-diabetes (hyperglycemia), a risk factor for CVD, has further contributed towards escalating CVD-related mortalities. The increase in number of cases of type 2-diabetes underscores the importance of early diagnosis of cardiovascular disease in those with diabetes. In this work, we have evaluated the sensitivity and specificity of dyslipidemia and proinflammatory cytokines to be used as biomarkers for predicting the risk of CVD in those with diabetes. We hypothesize that interplay between dyslipidemia and diabetes-induced low-grade inflammation in those with type 2-diabetes increases the risk of CVD. A total of 215 participants were randomly recruited from the Cameron County Hispanic Cohort (CCHC). Of these, 99% were Mexican Americans living on Texas-Mexico border. Levels of cytokines, adipokines and lipid profile were measured. Cardiovascular disease (CVD) for this study was defined as prior diagnosis of heart attack, angina and stroke, while diabetes was defined by fasting blood glucose (FBG) of > 100 mg/dL and HbA1c of > 6.5, in accordance with American Diabetes Association (ADA) guidelines. Depending on type and distribution of data, various statistical tests were performed. Our results demonstrated higher rates of heart attack (14% vs 11.8%) and stroke (19.8% vs 10%) in those with diabetes as compared to non-diabetes. The odds of having a heart attack were eight times higher in the presence of elevated triglycerides and pro-inflammatory markers (TNFα and IL6) as compared to presence of pro-inflammatory markers only. The odds for heart attack among those with diabetes, increased by 20 fold in presence of high levels of triglycerides, TNFα, and IL6 when coupled with low levels of high-density lipid cholesterol (HDL-C). Lastly, our analysis showed that poorly controlled diabetes, characterized by HbA1c values of > 6.5 increases the odds of stroke by more than three fold. The study quantifies the role of lipid profile and pro-inflammatory markers in combination with standard risk factors towards predicting the risk of CVD in those with type 2-diabetes. The findings from the study can be directly translated for use in early diagnosis of heart disease and guiding interventions leading to a reduction in CVD-associated mortality in those with type 2-diabetes.

Changes in physical activity and mortality risk among an adult Lithuanian urban population: results from a cohort study

ObjectivesThe purpose of this study was to investigate changes in physical activity and the association of these changes with the risk of all-cause mortality and mortality from cardiovascular disease (CVD) among an adult and elderly Lithuanian urban population. Study designProspective cohort study. MethodsData from four surveys are presented. In total, there were 2416 participants (1071 men and 1345 women) who took part in one of the initial three surveys in the framework of the Multinational Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) study since 1986 and also in the follow-up survey in 2006 (with follow-up over 15 years). Study participants were followed-up for mortality events from 2006 until 31 December 2017. The mean duration of the follow-up for endpoints period was 10.55 (standard deviation 2.33) years. ResultsOver 15 years of follow-up, 50.9% of men and 56.7% of women were physically active at initial and follow-up surveys, and approximately 10.0% of respondents were physically inactive. Over this period, 22.8% of men and 24.8% of women increased their physical activity level, and 14.1% of men and 10.1% of women decreased their physical activity level. The findings from the Cox proportional hazards regression multivariable analysis showed that a decrease in physical activity level during the follow-up period was related to a higher risk for all-cause mortality and mortality from CVD risk in women (hazard ratio [HR] = 1.82, P = 0.039; and HR = 5.40, P = 0.014, respectively). In men, a clear association of physical inactivity was ascertained only to all-cause mortality risk and only for non-smokers (HR = 2.07, P = 0.013). ConclusionsA decrease in physical activity levels in women is a strong predictor for all-cause mortality risk and mortality from CVD risk. Physical inactivity in male non-smokers is a strong predictor for all-cause mortality risk.

Comparison of Short- and Long-Term Prognosis between ST-Elevation and Non-ST-Elevation Myocardial Infarction.

Background: Available data comparing long-term prognosis according to the type of acute coronary syndrome (ACS) are scarce, contradictory, and outdated. Our aim was to compare short- and long-term mortality in ST-elevated (STEMI) and non-ST-elevated myocardial infarction (non-STEMI) ACS patients. Methods: Patients presenting with an inaugural ACS during the year 2006 and living in one of the three areas in France covered by the Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA) registry were included. Results: A total of 1822 patients with a first ACS—1121 (61.5%) STEMI and 701 (38.5%) non-STEMI—were included in the study. At the 28-day follow-up, the mortality rates were 6.7% and 4.7% (p = 0.09) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 28-day probability of death was significantly lower for non-STEMI ACS patients (Odds Ratio = 0.58 (0.36–0.94), p = 0.03). At the 10-year follow-up, the death rates were 19.6% and 22.8% (p = 0.11) for STEMI and non-STEMI patients, respectively, and after adjustment of potential confounding factors, the 10-year probability of death did not significantly differ between non-STEMI and STEMI events (OR = 1.07 (0.83–1.38), p = 0.59). Over the first year, the mortality rate was 7.2%; it then decreased and stabilized at 1.7% per year between the 2nd and 10th year following ACS. Conclusion: STEMI patients have a worse vital prognosis than non-STEMI patients within 28 days following ACS. However, at the 10-year follow-up, STEMI and non-STEMI patients have a similar vital prognosis. From the 2nd year onwards following the occurrence of a first ACS, the patients become stable coronary artery disease patients with an annual mortality rate in the 2% range, regardless of the type of ACS they initially present with.

FKBPL is associated with metabolic parameters and is a novel determinant of cardiovascular disease

Type 2 diabetes (T2D) is associated with increased risk of cardiovascular disease (CVD). As disturbed angiogenesis and endothelial dysfunction are strongly implicated in T2D and CVD, we aimed to investigate the association between a novel anti-angiogenic protein, FK506-binding protein like (FKBPL), and these diseases. Plasma FKBPL was quantified by ELISA cross-sectionally in 353 adults, consisting of 234 T2D and 119 non–diabetic subjects with/without CVD, matched for age, BMI and gender. FKBPL levels were higher in T2D (adjusted mean: 2.03 ng/ml ± 0.90 SD) vs. non-diabetic subjects (adjusted mean: 1.79 ng/ml ± 0.89 SD, p = 0.02), but only after adjustment for CVD status. In T2D, FKBPL was negatively correlated with fasting blood glucose, HbA1c and diastolic blood pressure (DBP), and positively correlated with age, known diabetes duration, waist/hip ratio, urinary albumin/creatinine ratio (ACR) and fasting C-peptide. FKBPL plasma concentrations were increased in the presence of CVD, but only in the non-diabetic group (CVD: 2.02 ng/ml ± 0.75 SD vs. no CVD: 1.68 ng/ml ± 0.79 SD, p = 0.02). In non-diabetic subjects, FKBPL was positively correlated with an established biomarker for CVD, B-type Natriuretic Peptide (BNP), and echocardiographic parameters of diastolic dysfunction. FKBPL was a determinant of CVD in the non-diabetic group in addition to age, gender, total-cholesterol and systolic blood pressure (SBP). FKBPL may be a useful anti-angiogenic biomarker in CVD in the absence of diabetes and could represent a novel CVD mechanism.

Association between social trust and the risk of cardiovascular disease in older adults in Korea: a nationwide retrospective cohort study

BackgroundAlthough social capital has been shown to be one of the important social determinants of health, the association between social trust and the risk of cardiovascular disease (CVD) is not clear yet. We aimed to investigate the association of social trust with CVD risk using a large Korean population based data.MethodsThe data of this study was derived from the Korean National Health Insurance Service database. Community-level social trust was determined from the Korean Community Health Survey. The study population consisted of 2,156,829 participants. According to social trust index measured in the area of residence during 2011, participants were followed-up from 1 January 2012 to 31 December 2016. Multivariate Cox proportional hazards regression was used to determine the adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for CVD risk according to quintiles of social trust.ResultsCompared to participants with the lowest quintile of social trust, those within the highest quintile had lower risk for CVD (aHR 0.91, 95% CI = 0.89 to 0.93), CHD (aHR 0.92, 95% CI = 0.89 to 0.95), and stroke (aHR 0.90, 95% CI = 0.87 to 0.93). The risk-reducing association of high social trust on CVD risk was preserved after additional adjustments for lifestyle behaviors including smoking, alcohol consumption, and physical activity.ConclusionHigher social trust was associated with reduced risk of CVD even after considering lifestyle behaviors. Social trust in a community level is an important determinant of CVD and enhancing social trust may lead to reduced risk of CVD.

Sex- and age-related differences in the predictive capability of circulating biomarkers: from the MONICA 10 cohort

Objectives The purpose of this study was to assess whether high-sensitivity C-reactive protein (hs-CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), and soluble urokinase plasminogen activator receptor (suPAR) differed in their ability to predict cardiovascular outcomes beyond traditional risk factors in younger and older men and women without known cardiovascular disease. Design. Prospective population-based cohort study of 1951 individuals from the MONItoring of trends and determinants in Cardiovascular disease (MONICA) study, examined 1993–1994. Participants were stratified into four groups based on sex and age. Subjects aged 41 or 51 years were classified as younger; those aged 61 or 71 years were classified as older. The principal endpoint was death from cardiovascular causes. Predictive capabilities of biomarkers were tested using Cox proportional-hazards regression, Harrell’s concordance-index, net reclassification improvement, and classification and regression tree (CART) analysis. Results. Median follow-up was 18.5 years, during which 19/597 younger men, 100/380 older men, 12/607 younger women, and 46/367 older women had died from a cardiovascular cause. NT-proBNP was independently associated with death from cardiovascular causes among all participants (p ≤ .02) except younger women (p = .70), whereas hs-CRP was associated with this endpoint in men (p ≤ .007), and suPAR in older men only (p < .001). None of the biomarkers improved discrimination ability beyond traditional risk factors (p ≥ .07). However, NT-proBNP enhanced reclassification in men and older women. CART-analysis showed that NT-proBNP was generally of greater value among men, and suPAR among women. Conclusions. Hs-CRP, NT-proBNP, and suPAR displayed different associations with cardiovascular death among apparently healthy younger and older men and women.

Ecological features of the association between mortality and determinants or salient risk factors of cardiovascular disease

The multifactorial emergence of the association between mortality and major risk factors of cardiovascular disease is not clearly established. Diverse countries have been monitoring and evaluating mortality and risk factors associated with cardiovascular disease as the levels and trajectories undergo continuous changes. Understanding the combined impacts of these alterations are crucial in taking precautionary measures in counteracting and managing cardiovascular disease. Mortality and risk factor data have been applied expansively for the monitoring and evaluation of cardiovascular disease issues and the spatiotemporal variations across populations. There are extant inequitable distribution of resources in the disparate regions and populations around the world in the quantification and analysis of the mortality, morbidity, risk factors or determinants of cardiovascular disease. The diagnosis of cardiovascular disease tends to be devoid of diagnostic tests of high specificity and sensitivity in certain instances. Poor diet is a leading etiologic factor of suboptimal health in cardiovascular disease. Diet, nutrition and scientific policy measures have accelerated, resulting in ambiguities, and also creating opportunities to obviate the excruciating health and economic burden in cardiovascular disease and other cardiometabolic disorders in vulnerable populations. These indicate that expansive spatiotemporal variations in the incidence between populations are attributable to inter alia certain contradictions in the modalities of event ascertainment, culture, and economic burden. This paper enhances and introduces novel issues, challenges and opportunities in the ecological presentations of the association between mortality and determinants or risk factors of cardiovascular disease.

Temporal Trends of the Incidence of Ischemic Heart Disease in Iran Over 15 Years: A Comprehensive Report from a Multi-Centric Hospital-Based Registry.

BackgroundWe sought to explore the temporal trend of ischemic heart disease (IHD) incidence rate (IR) in a large city of Iran.MethodsThe study population comprised hospitalized patients who were living in Isfahan, Iran, with first or recurrent IHD during the period of 2001 to 2016. To identify patients, clinical diagnostic codes were applied according to the International Classification of Diseases 10 (ICD-10: I20.0, I21–I25) and the “World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease” diagnostic categories (WHO-MONICA). Using a direct method, we calculated age-, sex-, and place-of-residence-adjusted incidence rates based on multiple reference populations. To examine the long-term trend for the IR, a bootstrap robust zero-truncated negative binomial regression model was used.ResultsA total of 102,254 hospitalized patients, with a mean (SD) age of 61.85 (12.79), were registered between 2001 and 2016. After an initial reduction from 2006 to 2010, crude and adjusted IRs of IHD increased between 2010 and 2016. We further observed a significant increasing long-term temporal trend in the IR with an average annual change of 1.42% to 3.36% over the study period.ConclusionOur findings showed a decreasing trend in the IR of IHD between 2006 and 2010, possibly attributed to the comprehensive community-based interventions named “Isfahan Healthy Heart Program” performed from 2001 to 2007, followed by an increase in the adjusted IR of IHD between 2010 and 2016 in Isfahan; this indicates the importance of continuing the preventive measures to preclude the risk factors of cardiovascular diseases in our population.

Nontraditional Biomarkers for Cardiovascular Disease in Patients With Chronic Kidney Disease

Cardiovascular disease (CVD) is the leading cause of death among patients who have chronic kidney disease (CKD). Nowadays, CKD per se is considered one of the coronary heart disease (CHD) risk equivalents. Apart from traditional CVD risk factors, there are several possible determinants for CVD in patients with CKD, for example, uremic toxins, increased inflammatory stage, abnormal bone mineral metabolism, and positive calcium balance. In this narrative review, we offer a summary of the extensively studied biomarkers for CVD in patients with CKD, including uremic toxins (p-cresol, indoxyl sulfate, and advanced glycated end products), and a novel indicator of arterial stiffness, cardio-ankle vascular index (CAVI), which is an independent prognostic predictor for CVD. For the uremic toxins, we reviewed their metabolisms, particularly, how the reduced renal function in CKD patients affect their clearance and their clearance with dialysis. Also, we pay attention to the recent evidence on how those uremic toxins contribute to CVD and their clinical associations. We do not include the possible treatment targeting at those uremic toxins. As for the novel indicator of arterial stiffness, we reviewed the clinical application of CAVI in comparison to the standard indicator for arterial stiffness, pulse wave velocity.&#x0D;

Associations of polyphenolic compounds consumption and the risk of dyslipidemia in the Siberian population

Aim. To identify associations of polyphenols consumption in general, as well as their classes with the risk of dyslipidemia in the population of Novosibirsk aged 45-69.Material and methods. In 2003-2005, in the frames of the HAPIEE international project “Determinants of cardiovascular diseases in Eastern Europe: a multicenter cohort study” the population sample aged 45-69 (9360 people, 4266 men and 5094 women, average age - 57.6 years) was examined in Novosibirsk. For the analysis of nutrition, a Food Frequency Questionnaire (FFQ) was used (141 product names). The content of polyphenolic compounds and their classes was evaluated using the European database Phenol-Explorer 3.6. The eating habits of the population and typically consumed foods were taken into account. The determination of total cholesterol and HDL cholesterol levels were carried out by enzymatic method. Hypercholesterolemia was diagnosed with cholesterol level greater than 5.0 mmol/l (190 mg/dL). Levels of HDL cholesterol &lt;1.0 mmol/l in men and &lt;1.2 mmol/l in women were considered as high-density lipoprotein hypocholesterolemia (hypoHDL-C). The concentration of low-density lipoprotein cholesterol was calculated with the Friedewald formula (1972). HyperLDL-C was diagnosed if level of LDL cholesterol was &lt;3.0 mmol / l.Results. The chance of developing of hypercholesterolemia in the quartile with the highest consumption of “other polyphenols” was 20% less (OR 1.2 confidence interval (CI 1.01-0.14), p = 0.033), phenolic acids by 20% (OR 1.2 (CI 1.01-1.42), p = 0.04) and stilbenes by 37% (OR 1.37 (CI 1.15-1.64), p = 0.001) less than in the quartile of low consumption. The risk of developing hypoHDL-C was lower in the quartile of high polyphenols consumption in general by 18% (OR 1.18 (CI 1.002-1.4), p = 0.051), phenolic acids by 32% (OR 1.32 (CI 1.11-1.57), p = 0.001) and the groups of “other polyphenols” by 20% (OR 1.2 (CI 1.01-1.41), p = 0.04). The chance of hyperLDL-C in the high quartile of consumption of “other polyphenols” decreased by 16% (OR 1.16 (CI 1.002-1.355), p = 0.049) and lignans - by 33% (OR 1.33 (CI 1.14-1, 56), p &lt;0.001) compared with low consumption.Conclusion. Thus, the consumption of polyphenols in general and in classes (phenolic acids, stilbenes, and “other polyphenols”) decreased the risk of dyslipidemia in Siberian population.

Determinants of Cardiovascular Disease among Urban Women with Psoriasis: A Case–Control Study

Abstract Background and Aim Psoriasis have a direct impact on development of cardiovascular risk factors leading to atherosclerosis and metabolic abnormalities. In order to prevent the complications, early and prompt identification of factors through various parameters help in primary and secondary prevention of cardiovascular diseases (CVDs) among these psoriatic patients. Therefore the aim of this study is to determine the prevalence of various determinants for cardiovascular diseases among cases and controls. Methods A hospital based case control study at a tertiary care hospital included women from the out patient department, aged above 18 years who were known cases of psoriasis. 114 patients were recruited with 1:1 ratio between cases and controls. All patients were evaluated using semi structured interview schedule with socio demographic variables, duration of disease, family history, and usage of drugs. Severity of disease was assessed through the psoriasis area severity index (PASI). Body surface area (BSA), body mass index (BMI), waist circumference and blood pressure measurement were done using standard methods. Lipid profile, high sensitivity C-Reactive protein (HsCRP) and blood sugar through calibrated analyzers having quality control. Carotid intima media thickness (CIMT) was assessed by using carotid Doppler technique to measure atherosclerosis. Results One hundred fourteen patients, means 57 pairs of cases and controls were analyzed in this study. Significant determinants among cases were raised such as waist circumference (p = 0.025), diastolic blood pressure (p = 0.0001), low density lipoprotein (p = 0.002) and fasting blood glucose (p = 0.004) when compared to controls. HsCRP and CIMT were also raised among cases but only CIMT was statistically significant when compared to controls (p = 0.0001). We also found raised determinants among psoriatic arthritis patients compared to psoriasis. Conclusion Psoriasis patients had high waist circumference, diastolic blood pressure, low density lipoprotein, fasting blood glucose, and CIMT when compared to controls. Early identification of these determinants make them amenable for prevention.

Hormonal Mechanisms in Atherosclerosis

Abstract Cardiovascular disease is a complex process that includes genetic, inflammatory and endocrine components. During the last decades, much emphasis has been given to cholesterol and lipids as the primary determinants in cardiovascular disease. However, many endocrine and biochemical factors are involved in the atherosclerosis process as well, both systemically and vascular. Multiple obvious data suggest that hormones are responsible for subtle cardiovascular changes long before the development of overt atherosclerotic. Much research remains to be done regarding the interaction between endocrine systems and their role in atherogenesis.

Evaluation of the relationship between cognitive impairment and suboptimal health status in a northern Chinese population: a cross-sectional study.

BackgroundSuboptimal health status (SHS) is an intermediate health status between ideal health and illness. As a determinant of cardiovascular disease and stroke, SHS is hypothesized to be associated with the development of cognitive impairment and dementia. This study aimed to investigate whether individuals with SHS have poor cognitive ability based on a community-based cohort in northern Chinese population.Methods3524 participants who were enrolled in Jidong cohort 2015 in Tangshan City were investigated in this study. Cognitive function was measured with the Mini-Mental State Examination (MMSE). SHS level was evaluated using a self-reporting Suboptimal Health Status Questionnaire-25 (SHSQ-25). The relationship between SHS and cognitive function was analyzed with logistic regression analysis, by which odds ratio (OR) and 95% confidence interval (CI) were calculated.ResultsThe prevalence of cognitive impairment was 3.4% (121/3524) in our study, with the prevalence rates of 1.9% (34/1750) among men and 4.9% (87/1774) in women. The medians of total score of MMSE were 28 (interquartile range (IQR) = 27-29) in the SHS group, and 29 (IQR = 27-30) in the ideal health group. Logistic regression analysis showed that SHS was significantly correlated with cognitive impairment (adjusted OR = 2.936, 95% CI = 1.428-6.033). With regard to gender, the OR was 5.067 (95% CI = 1.346-19.068) in men, which was higher than that in women (OR = 2.324, 95% CI = 1.130-4.779).ConclusionsSHS might be a risk factor for cognitive function in northern Chinese population. Early screening of SHS individuals, as well as urgent treatment of SHS might contribute to the prevention of cognitive impairment.

Effects of soy isoflavones on serum lipids and lipoprotein (a) in peritoneal dialysis patients

Background and aimLipid abnormalities are common in peritoneal dialysis (PD) patients and no effective treatment to decrease serum lipoprotein (a) [Lp(a)] in dialysis patients is known so far. Therefore, this research was designed to investigate the effects of soy isoflavone supplement on serum lipids and Lp(a) in PD patients. Methods & resultsIn this randomized, double-blind, placebo-controlled trial, 40 PD patients were randomly assigned to either the isoflavone or the placebo group. The patients in the isoflavone group received 100 mg soy isoflavone daily for 8 weeks, whereas the placebo group received corresponding placebos. At baseline and the end of the 8th week, 7 mL of blood was obtained from each patient and serum triglycerides, total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL-C), and Lp(a) were measured. Serum Lp(a) reduced significantly up to 10% in the isoflavone group at the end of week 8 compared to baseline (P < 0.05), and the reduction was significant in comparison with the placebo group (P < 0.05). Serum HDL-C increased significantly up to 11.5% in the isoflavone group at the end of week 8 compared to baseline (P = 0.05), and the increment was significant in comparison with the placebo group (P < 0.05). There were no significant differences between the two groups in mean changes of serum triglycerides, total cholesterol, and LDL-C. ConclusionsThis study indicates that daily administration of 100 mg soy isoflavones reduces serum Lp(a) and increases HDL-C concentration which are two determinants of cardiovascular disease in PD patients. ClinicalTrials.govNCT03773029. Registration number and dateNCT03773029 - 2018.

Association between Single Nucleotide Polymorphisms in Cardiovascular Developmental Critical Genes and Hypertension: A Propensity Score Matching Analysis.

Cardiovascular development critical genes are key determinants in cardiovascular diseases. We hypothesize that SNPs in these genes may play critical roles in the development of hypertension. Therefore, we enrolled 516 paired hypertension patients and controls in a total of 2,742 subjects in a cross-sectional population study by the propensity score matching (PSM) method. Twenty-one SNPs from 5 cardiovascular developmental related genes were detected by the improved multiplex ligase detection reaction (iMLDR) method. Conditioned logistic regression under three different genetic models, namely, additive model, dominant model, and recessive model, was performed. The odds ratio (ORs) and 95% confidence intervals (95% CIs) were used to estimate the associations of SNPs with hypertension. We found that the distribution of genotypes at rs833061, rs3025010, and rs699947 within the VEGFA gene and the distribution of alleles at rs3025010 in hypertension subjects were different from those in controls. Both rs833061 and rs3025010 were associated with hypertension in crude models, but only rs3025010 remains associated with hypertension after adjusting with confounding factors in the additive model and the dominant model. We also found that hypertension subjects with C/T and C/C genotypes at rs3025010 had lower SBP and DBP levels. In addition, rs3025010 could interact with rs6784267 within the CCM3 gene in the association. In conclusion, our findings suggest that rs3025010 may play a role in the pathogenesis of hypertension, which may be a potential target for individualized prevention and treatment of hypertension.

Abstract P521: Dairy Consumption and Risk of Cardiovascular Disease and Mortality in the Million Veteran Program

Background: Dietary habits are a major determinant of cardiovascular disease (CVD) and mortality risk. However, data on the role of dairy intake on the risk of CVD and death has been inconsistent. Objective: The primary objective is to assess whether total consumption of dairy products is associated with a lower risk of CVD and/or total mortality among US Veterans. Methods: In a prospective cohort study of US Veterans from the Million Veteran Program (MVP), dairy intake was collected through a self-reported food frequency questionnaire at baseline. Incidence of composite CVD (including MI, stroke, and cardiovascular death) and total mortality were measured via electronic health records and the National Death Index database. Cox Proportional hazard models were used to compute the multivariable adjusted hazard ratio of CVD and total mortality. Results: A total of 188,833 Veterans were studied with a mean age of 63.3 ± 12.3 years. After a mean follow-up of 3.2 years for CVD and 3.3 years for total mortality, 9,898 cases of CVD and 6,826 deaths occurred. Median dairy consumption was 1.2 servings/day. In a multivariable Cox regression adjusted for age, gender, race, body mass index (BMI), smoking, alcohol use, exercise, diet quality, diabetes mellitus, and level of education; hazard ratios (95% CI) for CVD were 1.00 (0.89-1.14) for dairy intake of 1-2 servings/week, 1.05 (0.92-1.20) for 2-3 servings/week, 1.01 (0.90-1.12) for 3-5 servings/week, 0.97 (0.87-1.08) for 5-7 servings/week, 0.96 (0.87-1.05) for 1-2 servings/day, 1.02 (0.91-1.13) for 2-3 servings/day, 1.02 (0.90-1.15) for 3-4 servings/day, and 1.11 (0.98-1.26) for 4+ servings/day as compared to &lt;1 serving/week. For total mortality, the hazard ratios across consecutive categories of dairy intake were 0.85 (0.73-0.99), 0.83 (0.70-0.99), 0.87 (0.76-0.99), 0.84 (0.74-0.96), 0.94 (0.84-1.06), 1.10 (0.97-1.25), 1.12 (1.04-1.39), and 1.36 (1.18-1.58). Conclusion: Dairy intake was not associated with composite CVD. However, there was suggestive evidence for J-shaped relation of dairy intake with total mortality.