Lower Cardiovascular Disease Risk Research Articles

A geographic perspective of the association between physical activity and cardiovascular health: A need for community-level intervention

Cardiovascular diseases (CVDs) are a major cause of death globally, and minority communities are at higher risk of chronic health outcomes. A combination of lifestyle, including physical activity (PA), good nutrition, and reduced stress, can improve life expectancy. This study aimed to analyze the association between CVDs and PA among the adult population (N = 3,956) based on the World Health Organization (WHO) STEPwise Approach to Surveillance (STEPS) survey in Afghanistan. Descriptive statistics, logistic regression, and spatial analytical techniques were used to analyze the data. Based on the WHO STEPS data, the computed prevalence of CVDs, obesity, hypertension, diabetes, and high cholesterol were 7.41%, 45.57%, 34.06%, 9.51%, and 12.16%, respectively. Multivariate logistic analysis indicated that moderate work-related PA was associated with higher odds of CVDs and high cholesterol while inversely associated with obesity. Moderate leisure-related PA was positively associated with obesity. Vigorous leisure-related PA was associated with lower risks of CVDs, obesity, and high cholesterol but had a positive association with hypertension. Spatial analysis revealed a CVD hotspot in the southern region and the risk factors clustered in the northern region. These findings offer valuable insights for community and public health practitioners to design targeted interventions for reducing the burden of CVDs and risk factors in communities in developing countries.

Optimal risk thresholds for prescribing statins as primary prevention of cardiovascular disease in Iranian general population: a benefit-harm modelling study

PurposeThe use of statins for the primary prevention of cardiovascular diseases (CVD) is associated with various beneficial outcomes, alongside certain undesirable effects. This study aims to determine optimal risk thresholds above which statin therapy yields a net benefit, considering both the positive effects and potential adverse effects, as well as their probabilities and patient preferences.MethodsQuantitative benefit-harm balance modeling was applied to the Iranian general population aged 40 to 75 years with no history of CVD. The analysis utilized data from prior studies, including statin effect estimates for different outcomes from a meta-analysis, patient preferences obtained from an Iranian survey, and baseline incidence rates of adverse outcomes sourced from the Global Burden of Disease study for Iran. Outcomes were defined as angina, myocardial infarction, fatal coronary heart disease, fatal or non-fatal stroke, and heart failure. Benefit-harm balance indices were calculated for various combinations of age, sex, and 10-year CVD risk.ResultsStatin therapy was found to be advantageous at a lower 10-year CVD risk threshold in men (18–23%) compared to women (24–28%). Furthermore, individuals aged 40–45 years exhibited a lower risk threshold (18% in men, 24% in women) than those aged 70–75 years (23% in men, 28% in women).ConclusionThe desirable 10-year risk thresholds for statin prescription in the primary prevention of CVD vary by age and gender, ranging from 18 to 28%, encompassing a spectrum of outcomes from angina to CVD mortality. These results suggest hard-CVD risk thresholds of 7.5% to 10% for both sexes.

Nutritional Benefits of Lycopene and Beta‐Carotene: A Comprehensive Overview

ABSTRACTCertain carotene components, such as lycopene and beta‐carotene, are found in tomatoes, carrots, sweet potatoes, etc. and are good for human health. It gives plants their distinctive red color. A class of lipid‐soluble natural pigments known as carotenoids is the precursor of vitamin A and is vital for antioxidant defense against peroxides in cells and tissues. This review provides an overview of the current state of knowledge and research on the sources, structures, physiochemical properties, absorption and metabolism, functional advantages, and prevention of many diseases associated with lycopene and beta‐carotene. These antioxidants have been linked to a lower risk of cardiovascular disease and cancer, and they also help draw pollinators to flowers. Carrots and sweet potatoes are also rich sources of beta‐carotene, which strengthens the immune system and improves eye health. The vivid color of many plants reproductive organs, including flowers and fruits, is caused by carotenoid, a secondary metabolite that is produced in plastids. The distinctive red color and many other health advantages are attributed to lycopene. When ingested through food or supplements, lycopene and beta‐carotene help manage and prevent a number of diseases, including cancer, metabolic, inflammatory, cardiovascular, hepatic, ophthalmic, skeletal, and infertility disorders. The main point is that toxicity is uncommon, and these carotenoids are generally accepted to be safe at different doses. Including these nutrients in your diet can improve your general health and provide illness prevention.

Integrating hypertension detection and management in HIV care in South Africa: protocol for a stepped-wedged cluster randomized effectiveness-implementation hybrid trial

BackgroundHIV clinical guidelines recommend hypertension detection and management to lower cardiovascular disease risk, but these have not been effectively implemented for people living with HIV (PWH). Addressing this implementation gap requires community-engaged implementation studies focused on addressing implementation barriers specific to the HIV care context.MethodsThis protocol describes a type 2 effectiveness-implementation hybrid study conducted in nine primary care clinics in Johannesburg. The study will evaluate the effect of implementation strategies on guideline-recommended blood pressure assessment and management in HIV clinics and the effects of assessment/management on patient blood pressure. A stepped-wedge, cluster randomized study design was used to randomize clinics to the time at which they receive the implementation strategies and patient intervention. The implementation strategies tested include identifying and preparing care champions, changing record systems, conducting ongoing training, providing audit and feedback, and changing the physical structure/equipment. The patient intervention tested includes detection of elevated blood pressure, educational materials, lifestyle modification advice, and medication where needed. Implementation outcomes include adoption, fidelity (co-primary outcome), cost, and maintenance of the blood pressure assessment protocol in participating clinics, while patient outcomes include reach, effectiveness (co-primary outcome), and long-term effects of the intervention on patient blood pressure. These will be assessed via direct observation, study records, staff logs, medical chart reviews, and patient and healthcare worker surveys. To examine effects on the implementation (intervention fidelity) and effectiveness (patient blood pressure changes) co-primary outcomes, we will use the standard Hussey and Hughes model for analysis of stepped-wedge designs which includes fixed effects for both interventions and time periods, and a random effect for sites. Finally, we will examine the costs for the implementation strategies, healthcare worker time, and patient-facing intervention materials, as well as the cost-effectiveness and cost-utility of the intervention using study records, patient surveys, and a time and motion assessment.DiscussionThis study will address knowledge gaps around implementation of cardiovascular disease preventive practices in HIV care in South Africa. In doing so, it will provide a dual opportunity to promote evidence-based care in the South African HIV care context and help refine implementation research methods to better serve HIV populations globally.Trial registrationClinicalTrials.gov: NCT05846503. Registered on May 6, 2023. https://classic.clinicaltrials.gov/ct2/show/NCT05846503.

Healthy and unhealthy plant-based diets and the risk of cardiovascular diseases: The Rotterdam study and updated meta-analysis

BackgroundConsumption of more plant-based foods is gaining popularity, but the role of healthy versus unhealthy plant-based diets in cardiovascular disease (CVD) risk remains inconclusive. ObjectivesWe investigated associations of plant-based diet indices (PDIs) with incident CVDs in a prospective cohort study and conducted an updated meta-analysis. MethodsWe included 3507 men and 5345 women of the population-based Rotterdam Study. Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for CVD, coronary heart disease (CHD) and stroke with per SD increment of an overall PDI, healthy PDI (hPDI) and unhealthy PDI (uPDI), among men and women separately. We combined our findings with previously published effect estimates in an updated meta-analysis. ResultsWe documented 2015 CVD cases (1231 CHD and 952 stroke) during 107,290 person-years follow-up. Among men, the PDI and hPDI were associated with a 7 % (HR 0.93, 95 % CI 0.87–0.99) and 8 % (HR 0.92, 95 % CI 0.86–0.98) lower CVD risk. Among women, there was evidence suggesting a U-shaped association of the PDI with stroke (pnon-linearity < 0.01). In meta-analyses including up to 43,067 incident CVD cases among 359,740 participants from nine studies, the PDI and hPDI, were associated with a lower CVD risk, while uPDI with a higher CVD risk (pooled HRs [95 % CI], per SD, PDI: 0.94 [0.91–0.97], I2 = 50.4 %; hPDI: 0.94 [0.91–0.98], I2 = 74.7 %; uPDI: 1.03 [1.01–1.06], I2 = 49.0 %). ConclusionsOur findings support recommendations to consume relatively more healthy plant-based foods for CVD prevention. Potential differences by sex and non-linear associations warrant further investigation.

Breastfeeding in infancy and cardiovascular disease in middle-aged and older adulthood: a prospective study of 0.36 million UK Biobank participants

BackgroundCardiovascular disease originates in early life. We aimed to investigate the association between breastfeeding in infancy and cardiovascular disease in adult life. MethodsWe followed 364,240 participants from UK Biobank aged 40–73 years from 2006 – 2010 to 2021. Information on breastfeeding in infancy was self-reported by questionnaire. Cox proportional hazard regression models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CI) for the association between breastfeeding and cardiovascular disease in middle-aged and older adulthood. The multivariable Cox models were used by adjusting for the age (used as the time scale), sex, ethnicity, assessment centre, birth weight, multiple birth status, maternal smoking during pregnancy, Townsend deprivation index, smoking status, alcohol drinker status, physical activity, and menopausal status for women. Binary and multinomial multivariable logistic regression models were used to explore the associations of breastfeeding in infancy with cardiovascular disease risk factors including obesity, body composition, metabolic and inflammatory disorders. ResultsDuring a median of 12.6 years of follow-up, we documented 29,796 new cases of cardiovascular disease, including 24,797 coronary heart disease and 6229 stroke. The multivariable adjusted HRs for breastfed versus non-breastfed were 0.94 (95% CI: 0.91, 0.96) for cardiovascular disease, 0.94 (95% CI: 0.91, 0.96) for coronary heart disease, and 0.95 (95% CI: 0.89, 1.01) for stroke. Furthermore, the strength of observed association between breastfeeding and cardiovascular disease seems to decrease with age (P for interaction <0.001), and increase with polygenic risk for cardiovascular disease (P for interaction <0.001). Consistently, breastfeeding in infancy was associated with cardiovascular disease risk factors including lower body mass index 0.92 (95% CI: 0.89, 0.95), body fat percentage 0.85 (95% CI: 0.83, 0.87), android to gynoid fat ratio 0.89 (95% CI: 0.83, 0.96), visceral adipose tissue 0.92 (95% CI: 0.84, 1.01), as well as lower C-reactive protein level 0.95 (95% CI: 0.94, 0.97) and a lower risk of metabolic syndrome 0.89 (95% CI: 0.85, 0.92). ConclusionsBreastfeeding in infancy was associated with a lower risk of cardiovascular disease in middle-aged and older adulthood. Promoting breastfeeding is vital not only for promoting child health, but also for halting the increasing trend of cardiovascular disease in adults.

Physical activity and heart rate in PTSD inpatients: Moderation by custody of a service dog

Posttraumatic stress disorder is associated with autonomic hyperarousal often shown to involve elevated resting heart rate and, simultaneously if somewhat paradoxically, reduced physical activity. Both are risk factors for cardiovascular disease and so may contribute to its elevated prevalence in persons with this diagnosis. Epidemiological studies have observed dog owners to exhibit lower rates of cardiovascular disease. Non-randomized between-group studies have found service dog companionship to be associated with increased physical activity and with lower resting heart rate. A challenge to research in this area is its vulnerability to selection biases in group assignment which could lead to over-estimation of advantages or disadvantages associated with pet or service dog contact and companionship. The current study executed a within-subjects design investigating physical activity and heart rate in a sample of U.S. military Veterans engaged in residential treatment for PTSD and a concurrent service animal training intervention. A mean of 37 days of continuously-recorded day-time physical activity and heart rate were obtained from 45 participants. On days when they had custody of a familiar service-dog-in-training, participants exhibited increased physical activity accompanied by a small reduction in concurrent, activity-adjusted heart rate. Though observed in a specialized context, these short-term findings align with prior observations of lowered risk of cardiovascular disease in association with pet dog ownership. Extended longitudinal designs will be necessary to determine whether such short-term effects truly mediate lowered long-term risk.

Low Serum Bicarbonate and Cardiovascular Disease Risk in Children with CKD

Low Serum Bicarbonate and Cardiovascular Disease Risk in Children with CKD

Estimated glucose disposal rate for predicting cardiovascular events and mortality in patients with non-diabetic chronic kidney disease: a prospective cohort study

BackgroundEvidence suggests that insulin resistance (IR) is an autonomous risk factor for cardiovascular disease (CVD). Nevertheless, the association between estimated glucose disposal rate (eGDR), a novel indicator of IR, and incident CVD and mortality in chronic kidney disease (CKD) patients without diabetes remains uncertain.MethodsThe study included 19,906 participants from the UK Biobank who had an estimated glomerular filtration rate (eGFR) < 60 ml/min/1.73m2 or a urinary albumin-to-creatinine ratio (UACR) ≥ 30 mg/g and no history of CVD and diabetes. Individuals were divided into three categories based on tertiles of eGDR. The outcome was a composite CVD (coronary heart disease (CHD) and stroke) and mortality (all-cause, non-accidental, and cardiovascular mortality). Furthermore, a cohort of 1,600 individuals from the US National Health and Nutrition Examination Survey (NHANES) was applied to validate the association between eGDR and mortality. The Cox proportional hazards regression models were used to examine the association between eGDR and event outcomes.ResultsDuring a follow-up of around 12 years, 2,860 CVD, 2,249 CHD, 783 stroke, 2,431 all-cause, 2,326 non-accidental and 492 cardiovascular deaths were recorded from UK Biobank. Higher eGDR level was not only associated with lower risk of CVD (hazard ratio [HR] 0.641, 95% confidence interval [CI] 0.559–0.734), CHD (HR 0.607, 95% CI 0.520–0.709), stroke (HR 0.748, 95% CI 0.579–0.966), but also related to reduced risk of all-cause (HR 0.803, 95% CI 0.698–0.923), non-accidental (HR 0.787, 95% CI 0.682–0.908), and cardiovascular mortality (HR 0.592, 95% CI 0.423–0.829). Validation analyses from NHANES yielded consistent relationship on mortality.ConclusionsIn these two large cohorts of CKD patients without DM, a higher eGDR level was associated with a decreased risk of CVD and mortality.

Changes in 10-Year Predicted Cardiovascular Disease Risk for a Multiethnic Semirural Population in South East Asia: Prospective Study.

Cardiovascular disease (CVD) risk factors tend to cluster and interact multiplicatively and have been incorporated into risk equations such as the Framingham risk score, which can reasonably predict CVD over short- and long-term periods. Beyond risk factor levels at a single time point, recent evidence demonstrated that risk trajectories are differentially related to CVD risk. However, factors associated with suboptimal control or unstable CVD risk trajectories are not yet established. This study aims to examine factors associated with CVD risk trajectories in a semirural, multiethnic community-dwelling population. Data on demographic, socioeconomic, lifestyle, mental health, and cardiovascular factors were measured at baseline (2013) and during follow-up (2018) of the South East Asia Community Observatory cohort. The 10-year CVD risk change transition was computed. The trajectory patterns identified were improved; remained unchanged in low, moderate, or high CVD risk clusters; and worsened CVD risk trajectories. Multivariable regression analyses were used to examine the association between risk factors and changes in Framingham risk score and predicted CVD risk trajectory patterns with adjustments for concurrent risk factors. Of the 6599 multiethnic community-dwelling individuals (n=3954, 59.92% female participants and n=2645, 40.08% male participants; mean age 55.3, SD 10.6 years), CVD risk increased over time in 33.37% (n=2202) of the sample population, while 24.38% (n=1609 remained in the high-risk trajectory pattern, which was reflected by the increased prevalence of all major CVD risk factors over the 5-year follow-up. Meanwhile, sex-specific prevalence data indicate that 21.44% (n=567) of male and 41.35% (n=1635) of female participants experienced an increase in CVD risk. However, a stark sex difference was observed in those remaining in the high CVD risk cluster, with 45.1% (n=1193) male participants and 10.52% (n=416) female participants. Regarding specific CVD risk factors, male participants exhibited a higher percentage increase in the prevalence of hypertension, antihypertensive medication use, smoking, and obesity, while female participants showed a higher prevalence of diabetes. Further regression analyses identified that Malay compared to Chinese (P<.001) and Indian (P=.04) ethnicity, nonmarried status (P<.001), full-time employment (P<.001), and depressive symptoms (P=.04) were all significantly associated with increased CVD risk scores. In addition, lower educational levels and frequently having meals from outside were significantly associated to higher odds of both worsening and remaining in high CVD risk trajectories. Sociodemographics and mental health were found to be differently associated with CVD risk trajectories, warranting future research to disentangle the role of psychosocial disparities in CVD. Our findings carry public health implications, suggesting that the rise in major risk factors along with psychosocial disparities could potentially elevate CVD risk among individuals in underserved settings. More prevention efforts that continuously monitor CVD risk and consider changes in risk factors among vulnerable populations should be emphasized.

Well-Being and Cardiovascular Health: Insights From the UK Biobank Study.

Cardiovascular diseases (CVDs) are a leading global health concern. Emerging evidence suggests a potential protective role of well-being in reducing CVD risk. We conducted a cohort analysis using the UK Biobank data set, encompassing 121 317 participants. We assessed the well-being of participants using a well-being index derived from baseline questionnaires. Well-being categories were derived by latent class analysis using general happiness and satisfaction with family, friendships, health, and finance situations. The relationship between well-being and 4 major CVDs was analyzed using Cox proportional hazards models and Mendelian randomization. The study also examined the impacts of well-being on lifestyle factors and inflammatory markers, and its mediating role in the well-being-CVD relationship. Higher well-being was associated with a significantly reduced risk of various CVDs. Latent class analysis identified 4 distinct well-being groups (low, variable, moderate-to-high, and high satisfaction), with higher satisfaction levels generally associated with lower risk of CVDs. Mendelian randomization suggested potential causal relationships between well-being and reduced risk of CVDs. Participants with greater well-being demonstrated healthier behaviors and lower levels of inflammatory markers. Mediation analysis indicated that lifestyle and inflammatory markers partially mediated the relationship between well-being and CVDs. This study demonstrates a robust inverse association between well-being and the risks of CVDs, suggesting that enhancing well-being may be a viable strategy for CVD prevention. The role of lifestyle factors and inflammation as a mediator provides insight into possible biological pathways linking psychological states and cardiovascular health.

Association of benzodiazepine and Z-hypnotic use with cardiovascular disease risk: insights from a prospective study of 10 million people in China.

To assess the association between Benzodiazepines (BZDs) or Z-hypnotic use and cardiovascular diseases (CVD) incidence in residents in Beijing, China. We included 2,415,573 individuals with a prescription record for BZDs or Z-hypnotics in the Beijing Medical Claim Data for Employees database during 2010-2017, and 8,794,356 non-users with other prescriptions for the same period. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox proportional risk models for 712,850 exposed and 712,850 unexposed participants who were matched 1:1 by propensity score. BZDs or Z-hypnotics users had a higher risk of CVD than non-users, with an HR of 1.11 (95% CI: 1.10, 1.13). Compared with non-users, those who used them for less than 3 months had the lowest risk of CVD, and those for more than 5 years had the highest risk, with HRs of 0.50 (0.48, 0.51) and 1.78 (1.72, 1.83), respectively. The risk of CVD was relatively low in those who used only one of the long-acting BZDs, short-acting BZDs, or Z-hypnotics compared to unexposed individuals. Individuals exposed to all three types of drugs had the highest risk, 2.33 (2.22, 2.44) times that of non-users. Users below the median dose had a lower risk of CVD compared to non-users, whereas users exceeding the median dose had an increased risk. BZD or Z-hypnotic use in general was nominally associated with an elevated risk of CVD. However, for short-term, single-type, and low-to-moderate-dose users, not only did this elevated risk disappear, but drug use also demonstrated a protective effect.

Metabolic revitalization: exploring erythrocyte fatty acid profile following laparoscopic sleeve gastrectomy.

Obesity is linked to metabolic disorders. Bariatric surgery offers a promising therapeutic approach, but its impact on fatty acid (FA) profiles within erythrocytes and the associated clinical implications remain underexplored. This study aimed to assess changes in erythrocytes' membranes FA after Laparoscopic Sleeve Gastrectomy (LSG) and to correlate these alterations with clinical parameters. Sixty-one patients with morbid obesity undergoing LSG and 32 healthy controls were enrolled. Erythrocytes' membranes FA were analyzed using gas chromatography. Clinical parameters were assessed, including BMI, blood pressure, and multiple biochemistry markers. Bariatric intervention reduced BMI (41.1 to 32.0) and fat mass (54.1 to 35.2kg). Also, other anthropometric parameters improved significantly. Favorable changes in FA metabolism post LSG, potentially leading to a reduction in cardiovascular disease (CVD) risk, were observed. The OMEGA-3 Index (1.8 vs 3.0), and the eicosapentaenoic/arachidonic (0.1 vs 0.2) FA ratio increased after surgery. The dynamics of metabolism post-LSG, assessed by exploring the ratios of erythrocytes' FA concentration in baseline and 6 months after the surgery, with the corresponding ratios calculated for clinical parameters, evidenced the impact of linoleic (LA) on obesity reduction. The LA ratios increased along with the reduction of BMI (r=-0.32), fat mass (r=-0.39), and waist circumference (r=-0.33) proportions. The opposite relations of LA were held with Excess Weight Loss percentage (r=0.49), and Excess BMI Loss percentage (r=0.5). The study underscores distinct post-LSG changes in erythrocytes' FA profiles potentially associated with reduced weight and BMI, improved inflammatory status, and lowered CVD risk.

Cruciferous vegetables lower blood pressure in adults with mildly elevated blood pressure in a randomized, controlled, crossover trial: the VEgetableS for vaScular hEaLth (VESSEL) study

BackgroundHigher cruciferous vegetable intake is associated with lower cardiovascular disease risk in observational studies. The pathways involved remain uncertain. We aimed to determine whether cruciferous vegetable intake (active) lowers 24-h brachial systolic blood pressure (SBP; primary outcome) compared to root and squash vegetables (control) in Australian adults with mildly elevated BP (SBP 120–160 mmHg inclusive).MethodsIn this randomized, controlled, crossover trial, participants completed two 2-week dietary interventions separated by a 2-week washout. Cruciferous vegetables were compared to root and squash vegetables (~ 300 g/day) consumed with lunch and dinner meals. Participants were blinded to which interventions were the active and control. Adherence was assessed using food diaries and biomarkers (S-methyl cysteine sulfoxide (SMCSO, active) and carotenoids (control)). Twenty-four-hour brachial ambulatory SBP and secondary outcomes were assessed pre- and post each intervention. Differences were tested using linear mixed effects regression.ResultsEighteen participants were recruited (median (IQR) age: 68 (66–70); female: n = 16/18; mean ± SD clinic SBP: 135.9 ± 10.0 mmHg). For both interventions, 72% participants had 100% adherence (IQR: 96.4–100%). SMCSO and carotenoids were significantly different between interventions (mean difference active vs. control SMCSO: 22.93 mg/mL, 95%CI 15.62, 30.23, P < 0.0001; carotenoids: − 0.974 mg/mL, 95%CI − 1.525, − 0.423, P = 0.001). Twenty-four-hour brachial SBP was significantly reduced following the active vs. control (mean difference − 2.5 mmHg, 95%CI − 4.2, − 0.9, P = 0.002; active pre: 126.8 ± 12.6 mmHg, post: 124.4 ± 11.8 mmHg; control pre: 125.5 ± 12.1 mmHg, post: 124.8 ± 13.1 mmHg, n = 17), driven by daytime SBP (mean difference − 3.6 mmHg, 95%CI − 5.4, − 1.7, P < 0.001). Serum triglycerides were significantly lower following the active vs. control (mean difference − 0.2 mmol/L, 95%CI − 0.4, − 0.0, P = 0.047).ConclusionsIncreased intake of cruciferous vegetables resulted in reduced SBP compared to root and squash vegetables. Future research is needed to determine whether targeted recommendations for increasing cruciferous vegetable intake benefits population health.Trial registrationClinical trial registry ACTRN12619001294145. https://www.anzctr.org.au

Relationship between dietary oxidative balance score, anthropometric measurements and socioeconomic factors in women at low risk of cardiovascular disease

IntroductionThe aim of this study was to investigate the relationship between the dietary oxidative balance score (OBS), an indicator of oxidative stress, anthropometric measures and socioeconomic factors in women at low risk of cardiovascular disease. MethodsThe participants’ 3-day dietary intake, demographic information, anthropometric measurements and blood pressure values were recorded, and the Framingham Risk Score (FRS) and OBS values were determined. Oxidative balance score consists of prooxidant and antioxidant scores. Prooxidant scores were calculated from red meat consumption, total iron and polyunsaturated fatty acid intake, alcohol and cigarette consumption parameters, while antioxidant scores were calculated by assessing cruciferous consumption, dietary total vitamin C, vitamin E, β-carotene, β-cryptoxanthin, β-carotene, β-cryptoxanthin, lycopene, lutein+zeaxanthin and selenium intake. ResultsA total of 145 women were included in the study. Education level was associated with anthropometric measurements, income status with antioxidant and prooxidant scores, and exercise status with OBS (p<0.05). Weight, waist, hip, BMI, waist/hip, and waist/height ratio were significantly lower in subjects with low prooxidant score (p<0.05); there was no significant relationship between age, systolic, diastolic, FRS (p>0.05). ConclusionThe study, conducted in healthy women, showed that dietary oxidative balance scoring is promising in preventing the development of CVD and reducing the burden of disease, and that prospective cohort studies should be conducted in this area.

Abstract P341: Orthostatic Hypertension Does Not Alter the Effect of Intensive Blood Pressure Treatment on Cardiovascular Disease and All-Cause Mortality: An Individual-Level Meta-analysis

Background: Orthostatic hypertension (OHTN) is common among adults with hypertension (HTN) and associated with cardiovascular disease (CVD). It is unclear whether HTN treatment reduces CVD outcomes similarly in adults with OHTN as adults without OHTN. Methods: We performed an individual-level meta-analysis, updating a previous systematic review of MEDLINE, EMBASE, and CENTRAL databases through November 13, 2023, which included randomized trials of blood pressure (BP) pharmacologic treatment (more intensive BP goal or active agent) on CVD or death. CVD events were adjudicated and included fatal and nonfatal coronary heart disease, stroke, and congestive heart failure. OHTN was defined as a rise in systolic BP ≥20 mmHg and/or diastolic BP ≥10 mmHg after changing positions from sitting to standing. Effects were examined overall and by trial type (BP goal or active agent), using Cox proportional hazard models adjusted for age and sex. Results: Of the 9 trials included, there were 29,235 participants followed for median of 4 years (mean age 69.5±10.9 years; 48.3% female; 21.0% with OHTN at baseline). Baseline OHTN was not associated with a higher risk of CVD or death (HR 1.03; 95% CI: 0.95, 1.13). More intensive BP treatment or active therapy lowered risk of CVD or death among those with OHTN at baseline (HR 0.80; 95% CI: 0.69, 0.93) and without OHTN at baseline (HR 0.81; 95% CI: 0.75, 0.87) with no difference between strata ( P -interaction 0.95) ( Figure ). Conclusion: While baseline OHTN was common among adults with HTN, it was not associated with CVD or death and did not alter the protective effect of more intensive treatment. More intensive treatment is an effective approach to prevent CVD events among adults with OHTN.

Leisure Sedentary Behavior, Physical Activities, and Cardiovascular Disease Among Individuals With Metabolic Dysfunction-Associated Fatty Liver Disease.

Metabolic dysfunction-associated fatty liver disease is a significant risk factor for cardiovascular disease (CVD). This study assesses the association between leisure-time physical activity, sedentary behavior, and CVD risk among patients with metabolic dysfunction-associated fatty liver disease, considering genetic predisposition to CVD. This cohort study included 157 794 participants with metabolic dysfunction-associated fatty liver disease from the UK Biobank who were free of CVD at baseline. The study measured leisure-time sedentary behaviors (watching TV, using a computer, and driving) and physical activities (walking for pleasure, light and heavy do-it-yourself activities, strenuous sports, and other exercises) in terms of frequency and duration over the 4 weeks before assessment. Both a Cox proportional hazard model and an isotemporal substitution model were utilized in the study to assess the association between leisure sedentary behavior, physical activities, and CVD risk. During a median 12.5 years of follow-up, 26 355 CVD cases were reported, including 19 746 coronary heart disease, 4836 stroke, and 7398 heart failure cases. High physical activity levels were linked to a significantly lower risk of CVD (21%), coronary heart disease (20%), stroke (15%), and heart failure (31%). In contrast, individuals with >6.5 h/d of sedentary behavior faced a 16% to 21% higher risk of these conditions compared with those with ≤3.5 h/d. Notably, replacing 30 minutes of inactivity with physical activity reduced CVD risks by 3% to 16%, particularly with strenuous sports. A significant interaction was observed between physical activity, sedentary behavior, and genetic predisposition in relation to stroke risk. Among patients with metabolic dysfunction-associated fatty liver disease, higher leisure-time physical activity levels correlate with reduced CVD risks, while increased sedentary behavior is linked to higher CVD risks. Replacing sedentary time with physical activity consistently shows benefits in reducing CVD outcomes, irrespective of genetic predisposition.

Gender Disparities in Statin Prescriptions in People With HIV With Low/Moderate to High Cardiovascular Risk.

The REPRIEVE trial suggests that primary cardiovascular disease (CVD) prevention could be considered among people with HIV at low CVD risk. We found cisgender women with low/moderate and high CVD risk are less likely to receive statins than cisgender men. Efforts are needed to guarantee equal access to statin-based CVD prevention.

Association between Planetary Health Diet and Cardiovascular Disease: A Prospective Study from the UK Biobank.

The Planetary Health Diet index (PHDI) prioritizes the well-being of both individuals and the planet but has yielded mixed results on cardiovascular disease (CVD). Our aim was to assess the association between the PHDI and risk of CVD. A cohort of 118,469 individuals aged 40-69 years from the UK Biobank, who were free of CVD at 2009-2012 and followed-up to 2021. The PHDI was calculated using at least two 24-h dietary assessments and included 14 food groups, with a possible range from 0 to130 points. CVD incidence was defined as primary myocardial infarction or stroke and obtained from clinical records and death registries. During a 9.4-year follow-up, 5,257 incident cases of CVD were ascertained. When comparing the highest (89.9-128.5 points) versus the lowest quartile (21.1-71.1 points) of PHDI adherence, the multivariable-adjusted hazard ratio (95% confidence interval) was 0.86 (0.79, 0.94) for CVD, 0.88 (0.80, 0.97) for myocardial infarction, and 0.82 (0.70, 0.97) for stroke. The association was linear until a plateau effect was reached at 80 points of adherence to PHDI. Results remained robust when excluding participants with type 2 diabetes, including only those with three or more diet assessments, or excluding CVD cases in the first three years of follow-up. The food group components of the PHDI more strongly associated with reduced CVD risk were higher consumption of whole grains, whole fruits, fish and lower consumption of added sugars and fruit juices. In this large cohort of middle-aged and older British adults, adherence to the PHDI was associated with lower risk of CVD. These results provide empirical evidence that this dietary pattern, thought to be environmentally sustainable, benefits cardiovascular health.

Single-Person Households: Insights from a Household Survey of Fruit and Vegetable Purchases.

Despite the efforts made to promote consumption, some countries are not increasing their fruit and vegetable intake, while household structures are undergoing relevant changes. Fruit and vegetable consumption is necessary but not sufficient for a healthy diet. Previous research has linked adequate fruit and vegetable consumption to a lower risk of cardiovascular diseases, type 2 diabetes, and some mental health conditions. Furthermore, millions of deaths are reported annually worldwide due to diets low in fruit and vegetables, highlighting their critical public health importance. This study aims to separately analyze the purchases of fruit and vegetables in single-person households. We used three waves of the Family Budget Survey, Encuesta de Presupuestos Familiares, in Chile, which is nationally representative of urban areas and includes over 10,000 households in each wave. We employed descriptive statistics to examine the characteristics of the head of household and the food shopper as well as the structure, composition, and overall characteristics of households. Additionally, we performed separate analyses for fruit and vegetable purchases, using these variables to determine the marginal effect on the probability of purchasing fruit or vegetables through probit models. Results show that, from 2011-2012 to 2021-2022, the share of households not purchasing fruit and vegetables increased from 5.0% to 8.4% and that, in single-person households, it rose from 11.2% to 19.1%. Male-headed, single-person households with low education and income were more likely not to purchase fruit, and these households also have decreasing vegetable purchases. Additionally, household income significantly impacts fruit purchases but does not significantly affect vegetable purchases. Our findings highlight the importance of considering single-person households as a target population segment for future public policies to promote fruit and vegetable consumption.