Ischemic Heart Disease In Men Research Articles

Relationship between cumulative exposure to occupational lifting throughout working life and risk of ischemic heart disease in men and women. The Copenhagen Aging and Midlife Biobank.

Ischemic heart disease (IHD) causes mortality and morbidity. High levels of occupational physical activity (OPA) increases IHD risk, and occupational lifting (OL) is suggested as a detrimental OPA exposure. This study investigated the association between accumulated OL throughout working life, and risk for IHD, and potential sex and hypertension differences. Data from Copenhagen Ageing and Midlife Biobank linked to register-based information on incident IHD during 9 years follow-up in the Danish National Patient Registry were included. The outcome was the odds of IHD from baseline (2009-2011) to end of follow-up (2018), among participants without IHD at baseline. Accumulated OL was assessed by linking occupational codes to a Job Exposure Matrix, creating a measure in ton-years (lifting 1,000 kg/day/year). Multivariable logistic regression tested associations between level of accumulated OL and IHD, among the 6,606 included individuals (68% men). During follow-up, 7.3% men and 3.6% women were hospitalized with IHD. Among all participants, the odds for IHD were 47% (OR 1.47, 95% CI 1.05-2.06) higher among those with ≥5 to <10 ton-years, 39% (OR 1.39, 95% CI 1.06-1.83) higher among those with ≥10 to <30 ton-years, and 62% (OR 1.62, 95% CI 1.18-2.22) higher among those with ≥30 ton-years, compared to no accumulated OL. However, these increased odds were in the same direction in the fully-adjusted model but statistically insignificant, ≥5 to <10 ton-years OR 1.28, 95% CI 0.88-1.88; ≥10 to <30 ton-years OR 1.20, 95% CI 0.85-1.69; and ≥30 ton-years OR 1.22, 95% CI 0.81-1.84. No statistically significant interactions, nor any associations, between OL and sex, or hypertension were seen.

Mediators of the Effect of Obesity on Stroke and Heart Disease Risk: Decomposing Direct and Indirect Effects.

The prevalence of overweight and obesity are well known risk factors of atherosclerotic cardiovascular disease (ASCVD). We aimed to examine the association between body mass index (BMI) and ASCVD over a 23-year follow-up in young adults. We also qualified how much of the effects of obesity on ASCVD were mediated through blood pressure, cholesterol, and glucose. Data are from the Korean Life Course Health Study, a cohort study of 226,955 Korean young adults aged 20-39. At baseline, the participants undertook routine health assessments where their BMI was measured in 1992-1994; and the metabolic mediators including systolic blood pressure (SBP), fasting serum glucose (FSG), and total cholesterol (TC) were re-measured in 2002-2004. The main outcomes of the study include incident events of ischemic heart disease (IHD), stroke, and ASCVD between 2005 and 2015. Cox proportional model was used to calculate adjusted hazard ratios (HRs) for ASCVD. In both men and women, the direct effect of BMI on ASCVD was greater than the indirect effect. The percentage of excess HR of BMI mediated by all of the metabolic mediators, including SBP, FSG, and TC, was 45.7% for stroke and 18.7% for IHD in men and 27.5% for stroke and 17.6% for IHD in women. High BMI in young adults increases the risk of metabolic mediators in their middle age, and metabolic mediators explain the adverse effects of high BMI on stroke risk than IHD risk.

Adenosine 5'monophosphate-activated protein kinase activation reduces the risks of psoriasis and its comorbidities: a Mendelian randomization study in the UK Biobank.

Whether metformin and its adenosine 5'monophosphate-activated protein kinase (AMPK) activation protect from psoriasis risk is unconcluded. We investigated the effect of AMPK, a pharmacological target of metformin, on the risk of psoriasis and its comorbidities and mortality among participants in the UK Biobank (UKB). To avoid immortal time biases in pharmacoepidemiologic studies, Mendelian randomization was used to infer the AMPK pathway-dependent effects. The cut-off age for distinguishing early-onset/late-onset psoriasis (EOP/LOP) was set at 60 years, based on the incident psoriasis peak in UKB. A genetic instrument comprising 44 single-nucleotide polymorphisms associated with glycated haemoglobin (HbA1c), serving as a proxy for AMPK genetic risk score (negatively associated with AMPK activation), was employed as previously reported in the literature. Log-binomial models were used to estimate the effect size of AMPK regarding relative risk (RR) and 95% CI. A total of 407 159 participants were analysed, including 9126 EOP and 3324 LOP. The AMPK genetic risk score was associated with a 12.4% increase in the risk of LOP in men (RR = 1.124, 95% CI: 1.022-1.236). This association was not significant for EOP or women. AMPK genetic risk score exhibited an elevated risk of ischemic heart disease (RR = 1.217, 95% CI 1.062-1.395) in male psoriasis patients. AMPK activation may protect against LOPs and associated ischemic heart disease in men. A sex-specific, comorbidity-targeted intervention for psoriasis is needed.

Mitochondrial DNA polymorphism and myocardial ischemia: Association of haplogroup H with heart failure

The pathogenesis of atherosclerosis and ischemic heart disease is associated with oxidative stress and mitochondrial dysfunction. Mitochondrial DNA encodes subunits of mitochondrial respiratory chain and is highly polymorphic in human populations. Mitochondrial DNA can be considered a candidate genetic locus for predisposition to cardiovascular diseases.Aim. To analyze the associations of the mitochondrial genome polymorphism and chronic heart failure in ischemic heart disease.Material and Methods. The study included two groups of individuals: patients with a combination of ischemic heart disease and chronic heart failure (n = 175) and a population sample of residents of Tomsk (n = 424). Percentages of patients with chronic heart failure of NYHA classes II, III, and IV were 37%, 50%, and 13%, respectively. All patients underwent echocardiographic examination; body mass index and the lipid fractions in blood serum were determined. The average was 55.4 years in patients and 47.6 years in the population sample. Polymorphism of mtDNA was studied by sequencing the hypervariable segment of D-loop of mtDNA and subsequent classification of mtDNA haplotypes into the known haplogroups. The mtDNA haplogroup frequencies were compared between the samples using the Chi-square test. The associations of genotype with quantitative trait variability were analyzed by variance analysis.Results. Male patients showed a higher frequency of haplogroup H compared to the population (45.86% in patients and 35.4% in population) and a higher total frequency of haplogroup H subgroups except the most frequent subgroup H1 (36.94% and 25.22%, respectively). The values of significance level (p-value) and odds ratio (OR) were determined as follows: p = 0.04; odds ratio OR = 1.55 (95% confidence interval (CI) 1.02–2.34) for haplogroup H as a whole; p = 0.02; OR = 1.74 (95% CI 1.12–2.70) for haplogroup H without subgroup H1. Analysis of quantitative traits revealed the associations of the same genetic marker (mtDNA haplogroup H) with the levels of high-density lipoproteins (p = 0.03) and triglycerides (p = 0.02) in blood serum of men in the population sample.Conclusion. The obtained results suggested that the most frequent European mtDNA haplogroup H may be a risk factor for the complications of ischemic heart disease in men.

Genetically predicted sex hormone binding globulin and ischemic heart disease in men and women: a univariable and multivariable Mendelian randomization study

Men are more vulnerable to ischemic heart disease (IHD) than women, possibly due to testosterone. Correspondingly, sex hormone binding globulin (SHBG) which lowers circulating testosterone might protect men against IHD. SHBG may also affect IHD independent of testosterone, which has not previously been examined. To assess the sex-specific role of SHBG in IHD, in univariable Mendelian randomization (MR), we used sex-specific, genome-wide significant genetic variants to predict SHBG, and examined their association with IHD in the UK Biobank. We also replicated using genetic instruments from Japanese men and applied to Biobank Japan. To assess the role of SHGB independent of testosterone in men, we used multivariable MR controlling for testosterone. Genetically predicted SHBG was associated with lower IHD risk in men [odds ratio (OR) 0.78 per standard deviation, 95% confidence interval (CI) 0.70 to 0.87], and the association was less clear in women. The estimates were similar in Japanese. The inverse association remained after controlling for testosterone in men (OR 0.79, 95% CI 0.71 to 0.88). SHBG might lower the risk of IHD in men, with a role independent of testosterone. Exploring intervention strategies that increase SHBG is important for targeting IHD treatments.

Birth weight as destiny?

In 1989, Barker et al reported a correlation between lower birth weights and increased risk for death in adulthood from ischemic heart disease in men born between 1911-1930 in England (Lancet 1989;2:577-80. doi: https://doi.org/10.1016/s0140-6736(89)90710-1). Many subsequent studies have affirmed the relationship between birth weight and conditions such as diabetes, hypertension, and obesity. In this volume of The Journal of Pediatrics, Lilja et al report an association between birth weight and stroke in adulthood. The study used a large cohort of Swedish men born in 1945-1961 with recorded birth weight and body measurements until the age of young adult military conscription tests, linked to national disease and cause of death registers. The study found that lower birth weights were associated with an increased risk of stroke, regardless of body mass index in young adulthood. However, men who were overweight in young adulthood were at significantly higher risk. From a public health standpoint, it is important to learn how individuals can mitigate the risks associated with low birth weight and we need more studies such as this one that show how risk is increased or decreased along the lifespan. It is possible that birth weight is destiny, and that the baseline increase in risk incurred by the fetal environment cannot be decreased and disease risks can only be increased by postnatal health. To understand this, we need even deeper studies of how modifiable factors such as early diet and physical exercise interact with perinatal risk factors in both men and women. However, this needs to be studied prospectively with earlier outcomes, so we do not have to wait several more generations to start improving the long-term health of small newborn infants. Article page 162 ▸ Low Birth Weight as an Early-Life Risk Factor for Adult Stroke Among MenThe Journal of PediatricsVol. 237PreviewTo evaluate the association between birth weight and the risk of adult stroke in men, independent of body mass index (BMI) at young adult age. Full-Text PDF Open Access

Genetically Predicted Sex Hormone Binding Globulin and Ischemic Heart Disease: A Sex-Specific Mendelian Randomization Study

Background: Ischemic heart disease (IHD) is a leading contributor to global burden of disease. Men are more vulnerable to IHD than women, which could be partly due to sex hormones. Sex hormone binding globulin (SHBG) which lowers circulating testosterone might protect men against IHD. SHBG may also affect IHD independent of testosterone, which has not previously been examined. Methods: To assess the sex-specific role of SHBG in IHD, in univariable Mendelian randomization (MR), we used sex-specific, genome-wide significant genetic variants (343 for men and 328 for women) to predict SHBG, and examined their association with IHD (25,409 cases in men and 12,511 cases in women) in the UK Biobank. We also replicated using genetic instruments from Japanese men and applied to Biobank Japan. To assess the role of SHGB independent of testosterone in men, we used multivariable MR controlling for testosterone, additionally including 125 SNPs for free testosterone. Findings: Genetically predicted SHBG was associated with lower IHD risk in men (odds ratio (OR) 0.77 per standard deviation, 95% confidence interval (CI) 0.69 to 0.87), but not in women. The estimates were robust to different genetic instruments and similar in Japanese. The inverse association remained after controlling for testosterone in men (OR 0.78, 95% CI 0.70 to 0.87). Interpretation: SHBG might lower the risk of IHD in men, with a role independent of testosterone. Exploring intervention strategies that increase SHBG and understanding the underlying pathways is important for targeting IHD treatments to take account of sex disparity. Funding Information: None. Declaration of Interests: The authors declare that they have no competing interests. Ethics Approval Statement: This research has been conducted using the UK Biobank Resource under Application number 42468. No original data were collected for the MR study. Ethical approval for each of the studies included in the investigation can be found in the original publications (including informed consent from each participant). The UK Biobank has already received ethical approval from the Research Ethics Committee and participants provided written informed consent. The analysis of other publicly available summary statistics does not require additional ethical approval.

Abstract 14635: The Fib-4 Index is a Risk Factor for Incident Cardiovascular Disease in Urban Male Residents: The Suita Study

Introduction: The fibrosis index based on four factors (FIB-4 index) is a score that predicts liver fibrosis easily, quickly, and inexpensively, but there is little evidence of its relationship with the onset of cardiovascular disease in general population in Japan. Therefore, we examined the relationship between incident cardiovascular disease (CVD) by the FIB-4 index level in urban area residents. Methods: We studied 5,333 follow-up Japanese individuals (2,478 men, 2,855 women) with no history of CVD in the Suita Study. The platelet count was measured at the time of medical examination. The FIB-4 index was calculated using age (yrs), alanine aminotransferase (ALT, IU/L), aspartate aminotransferase (AST, IU/L), and platelet count (PLT, 10^9/L) as follow: FIB-4 index = (AST x Age) / (PLT x (square root of ALT)). The primary endpoint was CVD events, including stroke or ischemic heart disease. The risk of CVD was analyzed by the FIB-4 index level using the Cox proportional hazards model adjusted by the components of the ischemic heart disease risk score in the Suita Study. Results: The percentage of the FIB-4 index ≥2.67 in the 30s to 80s at the baseline survey was 0%, 1%, 2%, 7,%, 21%, 43% for men, and 0%, 0%, 1%, 5%, 16%, 39% for women, respectively. During the mean follow-up period of 9.3 years, 195 strokes and 137 ischemic heart diseases were observed. Based on men with FIB-4 index &lt;1.30, the adjusted hazard ratio (95% confidence interval) for incident CVD in men with FIB-4 index ≥2.67 was 1.91 (1.05-3.47), those for incident ischemic heart disease in men with FIB-4 index 1.30-2.66 and ≥2.67 were 2.49 (1.33-4.64) and 3.29 (1.32-8.16), respectively. Conclusion: The FIB-4 index was considered to be useful as a predictor of ischemic heart disease in urban men in Japan.

Changes in life expectancy and contribution of causes of deaths and age groups in Belgium, 1997-2018

Abstract Background Concerns have been expressed about a recent decreasing growth of life expectancy (LE) in some developed countries. This study examines whether a slowing down in the LE increase was observed in Belgium between 1997 and 2018, and describes the contribution of causes of deaths (COD) and age groups to the 2000-2015 change in LE. Methods Changes in yearly LE increase were analyzed by linear regression and joinpoint regression analysis. The contribution of age and COD to the change in LE in Belgium was measured with the Arriaga decomposition method using 3-year moving average to reduce random fluctuations over years. Results No significant breakpoint was identified. The slope of the linear regression of annual LE changes in men was practically flat (slope = -0.0002, CI: -0.014, 0.013) and slightly, but not significantly, decreasing in women (slope = -0.002, CI: -0.019, 0.015). A larger increase in LE was observed in men compared to women and in people aged 70 years and over compared to younger ages. The COD contributing the most to the increase in LE was ischemic heart disease in men and in women. It was followed by transport accident and lung cancer in men and by cerebrovascular diseases and other circulatory diseases in women. Dementia, Alzheimer, and Parkinson contributed negatively to the LE increase in men and in women. The largest negative contributor was lung cancer in women. Conclusions In contrast to neighboring countries, no evidence for a significant stalling of life expectancy were found in Belgium between 1997 and 2018. Progress in reducing the major causes of deaths (cardiovascular diseases, some cancers, and transport accidents) have contributed to the increase of LE, but some COD are impeding further progress, particularly lung cancer in women. Key messages No evidence of stalling life expectancy in Belgium between 1997 and 2018. Monitoring causes of deaths is crucial to identify conditions impeding progress in life expectancy.

Incidence of Ischaemic Heart Disease in Men and Women With End-Stage Kidney Disease: A Cohort Study

The incidence of ischaemic heart disease (IHD) has fallen consistently in the general population; attributed to effective primary prevention strategies. Differences in incidence have been demonstrated by sex. Whether this fall in incidence and sex differences is mirrored in people with end-stage kidney disease (ESKD) is unclear. We aimed to establish the relative risk of IHD events in the ESKD population. We performed a retrospective cohort study from 2000 to 2010 in people with ESKD in New South Wales. We performed data linkage of the Australia and New Zealand Dialysis and Transplant Registry and state wide hospital admission and death registry data and compared this to general population data. The primary outcome was the incidence rate, incidence rate ratio (IRR), and time-trend for any IHD event. We calculated these using indirect standardisation by IHD event. 10,766 participants, contributed 44,149 years of observation time. Incidence rates were substantially higher than the general population for all IHD events (any IHD event: IRR 1.8, 95% confidence interval [CI] 1.7-1.9 for men, IRR 3.4, 95% CI 3.1-3.6 for women). Excess risk was higher in younger people (age 30-49 IRR 4.8, 95% CI 4.2-5.4), and in women with a three-fold increase risk overall and nearly a 10-fold increase in risk in young women (female age 30-49 years: IRR 9.8 95% CI 7.7-12.3), results were similar for angina and acute myocardial infarction. Ischaemic heart disease rates showed some decline for men over time, (ratio of IRR 0.93, 95% CI 0.90-0.95) but were stable for women (ratio of IRR 0.97, 95% CI 0.94-1.01). People with ESKD have substantially higher rates of IHD than the general population, especially women, in whom no improvement appears evident over the past 10 years.

Changes in causes and age of death in an eastern German county over a period of 14 years. Comparison of rural and urban populations. Focus on COPD and ischemic heart disease

We aimed to determine whether the causes of death, age of death and burden of disease have changed in the last years and whether there are differences between males and females as well as urban and rural populations. We investigated the causes of death, comorbidities and age of death as a cross-sectional study of an entire Thuringian county (approximately 100,000 inhabitants; 5 small cities with a total of 63,050 inhabitants and about 36,950 inhabitants in the countryside) for a 14-year period. All death certificates that were issued between 2002 and 2015 were reviewed for a total of 18,868 cases. The data were checked, and causes of death were coded by ICD-10 code. Because traditionally most corpses are cremated in Germany, in 79.68% of all cases a second inspection of the corpse by a pathologist, forensic pathologist or coroner was carried out for clarification of the cause of death according to the Thuringian laws. During the 14-year period, the age of death increased from 70.61 years to 74.49 years for males and from 78.94 years to 82.44 years for females. While in most of the investigated diseases the age of death also increased in parallel to the average age of death, an antiparallel development was found for COPD: the age of death for males with COPD was reduced by 0.045 years and for females by 0.15 years during the observation period. The burden of disease as measured by disability-adjusted life years (DALY) also steadily increased for COPD in both genders. The highest number of lost years of life was found for lung/bronchial cancer in both genders and for breast cancer. The highest burden of disease was calculated for ischemic heart disease in men and breast cancer in women. In general, the age of death in rural areas was nearly the same as in urban areas. Only for death from ischemic heart disease was there an increase in the age of death for men living in rural areas after the opening of a local cardiac catheterization laboratory in 2008. In all cases men exhibited an earlier age of death than women. While in all other investigated diseases the age of death increased, it dropped for COPD. COPD seems to have become a more frequent cause of death in recent years.

Cytoskeletal transgelin 2 contributes to gender-dependent adipose tissue expandability and immune function.

During adipogenesis, preadipocytes' cytoskeleton reorganizes in parallel with lipid accumulation. Failure to do so may impact the ability of adipose tissue (AT) to shift between lipid storage and mobilization. Here, we identify cytoskeletal transgelin 2 (TAGLN2) as a protein expressed in AT and associated with obesity and inflammation, being normalized upon weight loss. TAGLN2 was primarily found in the adipose stromovascular cell fraction, but inflammation, TGF-β, and estradiol also prompted increased expression in human adipocytes. Tagln2 knockdown revealed a key functional role, being required for proliferation and differentiation of fat cells, whereas transgenic mice overexpressing Tagln2 using the adipocyte protein 2 promoter disclosed remarkable sex-dependent variations, in which females displayed "healthy" obesity and hypertrophied adipocytes but preserved insulin sensitivity, and males exhibited physiologic changes suggestive of defective AT expandability, including increased number of small adipocytes, activation of immune cells, mitochondrial dysfunction, and impaired metabolism together with decreased insulin sensitivity. The metabolic relevance and sexual dimorphism of TAGLN2 was also outlined by genetic variants that may modulate its expression and are associated with obesity and the risk of ischemic heart disease in men. Collectively, current findings highlight the contribution of cytoskeletal TAGLN2 to the obese phenotype in a gender-dependent manner.-Ortega, F. J., Moreno-Navarrete, J. M., Mercader, J. M., Gómez-Serrano, M., García-Santos, E., Latorre, J., Lluch, A., Sabater, M., Caballano-Infantes, E., Guzmán, R., Macías-González, M., Buxo, M., Gironés, J., Vilallonga, R., Naon, D., Botas, P., Delgado, E., Corella, D., Burcelin, R., Frühbeck, G., Ricart, W., Simó, R., Castrillon-Rodríguez, I., Tinahones, F. J., Bosch, F., Vidal-Puig, A., Malagón, M. M., Peral, B., Zorzano, A., Fernández-Real, J. M. Cytoskeletal transgelin 2 contributes to gender-dependent adipose tissue expandability and immune function.

Does gender influence the outcome of ischemic heart disease?

Diseases of the cardiovascular system (myocardial infarction, stroke, heart failure, hypertensive heart disease, cardiomyopathy) account for 40% of all deaths in men and up to 49% of all deaths in women. For a long time it was thought that the clinical picture of ischemic heart disease in men and women was similar. Now, however, there are more reports suggesting that diverse manifestations of the symptoms of ischemic disease may be related to differences between sexes.The disparity between women and men is also evident in the diagnostic process, and various pathological mechanisms of cardiovascular diseases, in particular myocardial ischemia in men and women, affect the differences in the results of diagnostic tests. Vasomotor dysfunction is particularly frequent in women, as their coronary vessels are more sensitive to the catecholamines released during mental stress, resulting in spasm and ischemic myocardium. Moreover, a much lower dose of acetylcholine induced vasoconstriction, which indicates that women are more sensitive to this neurotransmitter. Therefore, coronary vasomotor disorders in the form of epicardial and microvascular dysfunction are more often seen in women. All these mentioned factors resulted in higher mortality and poorer quality of life of women suffering from ischemic heart disease.

Metabolically Healthy Obesity and Ischemic Heart Disease: A 10-Year Follow-Up of the Inter99 Study.

Recent studies have suggested that a subgroup of obese individuals is not at increased risk of obesity-related complications. This subgroup has been referred to as metabolically healthy obese. To investigate whether obesity is a risk factor for development of ischemic heart disease (IHD) irrespective of metabolic health. In all, 6238 men and women from the Danish prospective Inter99 study were followed during 10.6 (standard deviation = 1.7) years. General community. Participants were classified according to body mass index and four metabolic risk factors (low high-density lipoprotein cholesterol, elevated blood pressure, triglycerides, and fasting plasma glucose). Metabolically healthy individuals were defined as having no metabolic risk factors, and metabolically unhealthy individuals were defined as having a minimum of one. IHD. During follow-up, 323 participants developed IHD. Metabolically healthy obese men had increased risk of IHD compared with metabolically healthy normal-weight men [hazard ratio (HR), 3.1; 95% confidence interval (CI), 1.1 to 8.2)]. The corresponding results for women were less pronounced (HR, 1.8; 95% CI, 0.7 to 4.8). Being metabolically healthy but overweight was not associated with higher risk of IHD in men (HR, 1.1; 95% CI, 0.5 to 2.4), and in women the risk was only slightly increased and insignificant (HR, 1.5; 95% CI, 0.8 to 3.0). A substantial proportion of metabolically healthy individuals became metabolically unhealthy after 5 years of follow-up. When these changes in exposure status were taken into account, slightly higher risk estimates were found. Being obese is associated with higher incidence of IHD irrespective of metabolic status, and we question the feasibility of denoting a subgroup of obese individuals as metabolically healthy.

Risk factors in females with ischemic heart disease

Ischemic heart disease has been proved to be one of the most actual sociomedical problems of today. According to the World Health Organization, the ischemic heart disease is ranked first in the world in terms of morbidity and mortality among men and women. In recent years, mortality due to ischemic heart disease in men tends to decrease, whereas in women it remains stable. Analysis of scientific literature has allowed to conclude that the prevalence of risk factors in women as compared to men, and their importance in different age groups is not the same. In women, the risk factors are identified on average 10 years later than in men, but their negative impact on women's health is much stronger, which is manifested by higher death rates due to ischemic heart disease in women as compared to men.

Частота выявления интактных коронарных артерий и факторы, ассоциированные с необструктивной ишемической болезнью сердца у мужчин и женщин

Частота выявления интактных коронарных артерий и факторы, ассоциированные с необструктивной ишемической болезнью сердца у мужчин и женщин

Plasma levels of apolipoprotein E and risk of ischemic heart disease in the general population

Background and aimsTriglyceride-rich lipoproteins are causally associated with high risk of ischemic heart disease (IHD), and apolipoprotein E (apoE) has a central role in their plasma clearance. While both quantitative and qualitative changes of apoE are established causes of rare dyslipidemia syndromes, it remains unclear whether plasma levels of apoE are associated with risk of IHD in the general population. MethodsWe tested whether plasma levels of apoE at enrollment were associated with future risk of IHD and myocardial infarction (MI) in 91,695 individuals from the general population. ResultsMultifactorially adjusted hazard ratios (HRs) for highest versus lowest apoE tertile were 1.15 (1.04–1.27) for IHD and 1.16 (1.00–1.36) for MI in men, and 0.94 (0.84–1.05) and 1.04 (0.85–1.26) in women. These associations were attenuated by adjustments for triglyceride levels. Corresponding HRs for highest versus lowest apoE tertile in ε33 carriers were 1.18 (1.03–1.36) for IHD and 1.21 (0.98–1.49) for MI in men, and 0.91 (0.78–1.06) and 0.93 (0.71–1.21) in women. Thus, the present associations were independent of APOE genotype. ConclusionThese findings suggest that high plasma levels of apoE are associated with IHD in men but not in women. Triglyceride-rich lipoproteins may partly explain these associations.

Testosterone and cardiovascular disease risk

Ageing is accompanied by a reduction in circulating testosterone and progressive accumulation of medical morbidities. There is an intense debate whether low testosterone contributes to ill-health as opposed to being a biomarker for its presence. Prescriptions for testosterone are rising on a background of concern over potential adverse effects. This review examines evidence relating androgens to cardiovascular risk in older men. Observational studies show lower risk of cardiovascular events in older men with higher testosterone, and lower mortality from ischaemic heart disease in men with higher concentrations of its more potent androgenic metabolite dihydrotestosterone. However, randomized controlled trials of testosterone supplementation have been underpowered for the outcome of cardiovascular events. Recent meta-analyses have reached contrasting conclusions regarding cardiovascular adverse events associated with testosterone therapy. Retrospective studies of prescription databases have produced controversial and conflicting results. Additional randomized controlled trials are required to clarify the role of testosterone supplementation in older men in the absence of pituitary or gonadal disease. Pending such studies, testosterone therapy should be considered in androgen-deficient men, with evaluation of potential benefits and risks.

Prolonged duration of breastfeeding does not affect lipid profile in adulthood.

The Hertfordshire study suggested that age of weaning and methods of infant feeding may influence adult serum low-density lipoprotein cholesterol (LDL-C) and mortality from ischemic heart disease in men. Although breastfeeding <1 year appeared to be protective compared with formula, prolonged breastfeeding (>1 year) was associated with increased LDL-C and mortality. This study tested the effect of breastfeeding duration on lipid profile in young adults. Adult volunteers whose mothers could recall the age at which their child was weaned were recruited. We excluded patients with known dyslipidemia, dyslipidemia in a first-degree relative, obesity (body mass index [BMI] >30 kg/m(2)), pregnant or within 3 months of a previous pregnancy, subjects taking medications that may affect lipid profile, or subjects with a chronic medical condition. Nutritional questionnaires and number of weekly hours of exercise were recorded. Lipid profiles were obtained after a night fast. The three groups (no breastfeeding, breastfeeding 0-6 months, or breastfeeding >9 months) did not differ in terms of age, gender, BMI, level of education, amount of exercise, and dietary style. By stepwise background multiple regression analysis taking into account exercise, nutritional habitus, age, BMI, gender, and socioeconomic status, blood lipids were not affected by duration of breastfeeding. Duration of breastfeeding does not affect lipid profiles in young adults. These findings do not support negative messages on the long-term effect of prolonged lactation generated by the Hertfordshire study.

Evaluation of correlation between lifestyle

AbstractObjectives: Cardiovascular diseases are the leading cause of 17’000’000 worldwide deaths annually. If the current trends continue, the number of deaths will increase to 25’000’000 by the year 2020. Lifestyle contributes to many chronic diseases such as coronary heart diseas. The aim of this study was to examine the correlation between lifestyle and ischemic heart disease.Methods: This case-control study was carried out in Damavand sevvom sha’ban hospital. The sample of the study consisted of 65 cases (patients suffering from coronary artery disease) and 65 healthy controls. Data were collected by three questionnaires: General Health Questionnaire(GHQ), FFQ (Food Frequency Questionnaire) and physical activity questionnaire . These questionnaires were completed by interviewing the participants. 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