Mortality In Middle-aged Women Research Articles

Baseline mitochondrial DNA copy number and heart failure incidence and its role in overall and heart failure mortality in middle-aged women.

Heart failure (HF) is a leading cause of death in both men and women. However, risk factors seem to differ for men and women and significant gaps in sex-specific knowledge exist. Mitochondria are critical for cardiomyocytes and in this study, we investigated the role of baseline mitochondrial DNA copy number (mtDNA-CN) in HF incidence in middle-aged women and its possible role in the association between myocardial infarction (MI) and HF. Finally, we also investigated whether baseline mtDNA-CN was associated with overall and HF mortality. Baseline levels of mtDNA-CN were quantified by droplet digital PCR in a population-based follow-up study of middle-aged (50-59 years) Swedish women (n = 2,508). The median follow-up period was 17 years. Levels of mtDNA-CN were associated with age, BMI, alcohol, smoking, education, physical activity and lipid biomarkers. Multivariable Cox regression analysis adjusted for potential confounders showed that each standard deviation decrease of baseline mtDNA-CN was associated with higher incidence of HF (HR = 1.34; 95% CI=1.11-1.63). Similar results were obtained when mtDNA-CN levels were categorized into quartiles with lowest vs. highest quartile showing the highest risk of HF incidence (HR = 2.04 95% CI=1.14; 3.63). We could not detect any role of mtDNA-CN in the association between MI and HF incidence. Lower baseline mtDNA-CN levels were associated with both overall (HR = 1.27; 95% CI=1.10-1.46) and HF mortality (HR = 1.93; 95% CI=1.04-3.60); however, in multivariable analysis adjusted for potential confounders, the higher risks of HF mortality were no longer significant (HR=1.57; 95% CI=0.85-2.90). In conclusion, low baseline mtDNA-CN is an easily quantifiable molecular risk factor for HF incidence and may be a risk factor for overall and HF-related mortality.

Nocturnal hypoxaemia is a risk factor for mortality in middle aged women

Nocturnal hypoxaemia is a risk factor for mortality in middle aged women

Risk factors of long-term mortality in middle-aged women: a 27-year follow-up cohort

Objective: This study aimed to evaluate the impact of different risk factors on long-term mortality in middle-aged women.Methods: Women who received preventive health care control between 1990 and 1993 were recruited. Anamnesis and physical examination were recorded. Blood samples for the measurement of glycemia and lipids were taken. Data are reported as of December 2017.Results: We studied 1197 women aged between 40 and 60 years. We observed 183 deaths (survival 84.0%; 95% confidence interval [CI], 81.7–86.1, Kaplan–Meier survival analysis). The main causes of death were cancer (39.9%; 95% CI, 32.7–47.1), cardiovascular disease (22.9%; 95% CI, 16.8–29.1), infectious disease (13.7%; 95% CI, 8.6–18.7), other causes (7.1%, 95% CI, 3.4–10.9), and unspecified cause (6.6%; 95% CI, 2.9–10.2). The final Cox regression model showed the following hazard ratios for mortality: diabetes mellitus 2.51 (95% CI, 1.40–4.51), history of fracture 2.47 (95% CI, 1.15–5.30), history of heart illness 2.06 (95% CI, 1.15–3.72), arterial hypertension 1.51 (95% CI, 1.08–2.11), age 1.07 (95% CI, 1.04–1.10), body mass index 1.06 (95% CI, 1.02–1.09), and sexual intercourse 0.94 (95% CI, 0.89–0.98). Lipid disorders did not reach statistical significance as a risk factor.Conclusion: Diabetes, a history of fractures, and cardiovascular risk factors, except lipids, are markers of long-term mortality in middle-aged women. Physicians should pay special attention to these risk factors.

Causes of death and associated risk factors among climacteric women from Southern Brazil: a population based-study.

BackgroundAging and menopause are particular cardiovascular risk factors for women, due to estrogen deprivation at the time of menopause. Studies show that diabetes mellitus (DM), smoking, hypertension, high body mass index (BMI), and serum lipids are associated with increased risk of cardiovascular disease (CVD), the main cause of female mortality in Brazil. The aim of this study was to assess the mortality rate, causes of death and associated risk factors in a cohort of women from Brazil.MethodsA longitudinal population-based study of menopausal status is currently underway in a city in South Brazil. In 2010, a third follow-up of this population was performed to assess cardiovascular risk and mortality rate between 1995 and 2011. For this analysis, 358 participants were studied. At baseline, participants had completed a standardized questionnaire including demographic, lifestyle, medical and reproductive characteristics. In addition to the contacts with relatives, mortality data were obtained through review of medical records in all city hospitals and the Center for Health Information (NIS/RS-SES). Multivariate-adjusted hazard risk (HR) and 95% confidence intervals (CI95%) were estimated using Cox proportional hazards regression. Survival curves were estimated using the Kaplan-Meier curve.ResultsThere were 17 (4.7%) deaths from all causes during the study period. Seven (41.2%) deaths were caused by CVD, including four cases of stroke and three cases of myocardial infarction. Six (35.3%) deaths were due to cancer, and four (23.5%) were due to other reasons. In the age and smoking-adjusted multivariate models, diabetes (HR 6.645, 95% CI: 1.938–22.79, p = 0.003), alcohol intake (HR 1.228, 95% CI: 1.014-1.487, p = 0.035) and postmenopausal status (HR = 6.216, 95% CI: 0.963–40.143, p = 0.055) were associated with all-cause mortality. A significant association was found between abdominal obesity (WHR ≥ 0.85) and mortality even after the adjustment for BMI (HR = 9.229, 95% IC: 2.083–41.504, p = 0.003).ConclusionCVD was an important cause of mortality in this cohort and DM and/or central adiposity were associated with all-cause mortality. Lifestyle and dietary factors seem to be related to risk of mortality in middle-aged women.

Cancer mortality trend analysis in Italy, 1970–2007

To provide an updated review of cancer mortality trends in Italy, cancer mortality and census data, from 1970 to 2007, were extracted from the WHO mortality database and analyzed using age-specific and standardized rates, and joinpoint regression. Total cancer mortality rates in men have been declining by 1.8% yearly since 1994, reaching a rate of 147 per 100 000 residents (world standard) in 2007. In women, total cancer mortality rates have been decreasing by 1.1% yearly since 1991, resulting in a standardized mortality rate of 85 per 100 000 residents in 2007. Avoided deaths, compared with rates of 1988, from lung, intestinal, stomach, and breast cancers amount to 30 646. In men, trends were driven by cancers of the lung and other tobacco-related sites, intestines, and stomach. Favorable trends for cancers of the breast, intestines, stomach, and uterus contributed to falls in mortality rate in women. Downward trends were seen in both sexes for Hodgkin's lymphoma, bone cancer, and leukemias. Lung cancer in women showed an upward trend, with mortality rates increasing by 2.6% yearly since 1997, becoming the second cause of cancer mortality in middle-aged women. Rising trends were seen in women for oral and pancreatic cancers, as well. The favorable trends in cancer mortality are related to reduced tobacco smoking and alcohol consumption in men, advancements in treatment and management for colorectal cancer, breast cancer, leukemias, and a few other rare treatable cancers, and improved diagnosis of colorectal, breast, and cervical cancers. The greater role of tobacco-related deaths in women suggests the need for targeted strategies.

Renal Dysfunction As a Predictor of Long-Term Mortality in Middle-Aged Women Following an Acute Coronary Syndrome

To evaluate the association between renal dysfunction and long-term prognosis among middle-aged women surviving an acute coronary syndrome (ACS). The Stockholm Female Coronary Risk Study included 291 women <66 years of age, hospitalized for an ACS during the years 1991-1994 in the greater Stockholm area. All patients underwent clinical screening for cardiovascular prognostic factors, including blood samples 3 to 6 months after the event. Creatinine clearance (CCr) was calculated using the Cockcroft-Gaults formula and related to adverse outcome. Hazard ratios (HR) for all-cause and cardiovascular mortality, respectively, in each tertile of CCr, were estimated using Cox proportional hazards regression. There were 40 deaths, including 23 from cardiovascular causes, during a median follow-up of 9 years. The unadjusted HRs for all-cause mortality for the 1st (CCr < 78 mL/min) and 2nd (CCr 78-96 mL/min) tertiles of CCr were 3.17 (95% confidence interval [CI] 1.34-7.45) and 1.76 (95% CI 0.69-4.48), respectively, compared with the 3rd (CCr > 96 mL/min) tertile. The corresponding HRs for cardiovascular mortality were 3.66 (95% CI 1.20-11.1) and 1.28 (95% CI 0.34-4.76). After multivariable adjustment for potential confounders, the association between all-cause mortality and CCr in the 1st compared with the 3rd tertile remained statistically significant (HR 4.37, 95% CI 1.39-13.7). Renal dysfunction is related to long-term mortality in middle-aged women hospitalized for ACS.

What’s new in the other journals?

What’s new in the other journals?

Increasing BMI was associated with increasing risk for overall cancer incidence and mortality in middle-aged women

Source Citation Reeves GK, Pirie K, Beral V, et al. Cancer incidence and mortality in relation to body mass index in the Million Women Study: cohort study. BMJ. 2007;335:1134. 17986716

Combined impact of lifestyle factors on mortality: prospective cohort study in US women

Objective To evaluate the impact of combinations of lifestyle factors on mortality in middle aged women.Design Prospective cohort study.Setting Nurses’ health study, United States.Participants 77 782 women aged 34 to...

Risk Factors for Mortality in Middle-aged Women

Many factors contribute to mortality in older women, but their relative importance and independent contribution have been poorly characterized. From 1990 to 1992, we assessed demographics, lifestyle measures, prevalent disease, medication use, anthropometrics, vital signs, and physical function in 17 748 postmenopausal women. We used proportional hazards modeling to evaluate their association with mortality. During 9 years of follow-up, 1886 women (10.6%) died. The relative hazard (RH) of death was approximately 1.5 (95% confidence interval [CI], 1.5-1.6) per 5 years of age, 1.4 (95% CI, 1.2-1.6) for a history of heart disease, and 1.9 (95% CI, 1.6-2.3) for a history of breast cancer. Modifiable risk factors associated with mortality included smoking (RH, 3.7 [95% CI, 3.1-4.5] for current smokers with a > or =50 pack-year history) and systolic blood pressure (RH, 1.3 [95% CI, 1.1-1.5], fifth vs first quintile). Elevated waist-hip ratio was associated with higher mortality (RH, 1.3 [95% CI, 1.1-1.5], fifth vs first quintile), but obesity was associated with lower mortality (RH, 0.7 [95% CI, 0.6-0.9] for body mass index [calculated as weight in kilograms divided by the square of height in meters] of >35.0 vs 18.5-25.0). Poor results on the timed Up and Go Test, a measure of physical function, were also strongly associated with mortality (RH, 1.7 [95% CI, 1.4-2.0], fifth vs first quintile). Simple measures are sufficient to stratify postmenopausal women into groups at high and low risk of dying. Smoking, central obesity, blood pressure, and physical function are potentially modifiable risk factors, although clinical trials are required to demonstrate that change in these factors affects mortality.

Average blood pressure and cardiovascular disease-related mortality in middle-aged women

The aim of this study was to assess which average blood pressure (BP) component (ie, systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], or mean arterial pressure [MAP]), is most strongly related to cardiovascular disease (CVD)-related mortality and to evaluate whether the strength of the relation varies with follow-up time. This was a prospective cohort study. The studied cohort comprised a population of postmenopausal women (n = 7813) between the ages of 49 and 66 years of age, of whom four BP measurements were available, obtained at four different time points. Average BP, ie, the mean of the four measurements divided by the standard deviation, was entered in Cox proportional hazards models to facilitate direct comparison. Hazard ratios (HR) were calculated adjusted for age, body mass index, presence of diabetes mellitus, smoking habit, and use of BP-lowering medication. In addition analyses were repeated in strata of follow-up time (10, 15, and 20 years). During a mean follow-up of 13.1 years, 463 CVD-related deaths occurred. For SBP and MAP the highest HR for CVD mortality were found; however, the confidence intervals (CI) overlapped (SBP: HR = 1.43, 95% CI = 1.30 to 1.58; DBP: HR = 1.35, 95% CI = 1.23 to 1.50; PP: HR = 1.30, 95% CI = 1.19 to 1.42; MAP: HR = 1.43, 95% CI = 1.30 to 1.58). Analyses in strata of follow-up time did not show a difference in strength of the associations with increasing follow-up time. In this prospective follow-up study of postmenopausal women, SBP and MAP seemed to be strongest related with CVD-related death; however the CI of the HR overlapped.

Trends in cancer mortality in Mexico, 1970–1999

Few data on cancer mortality have been published for Mexico over the last few decades. It is therefore of interest to conduct a systematic and updated analysis of cancer mortality in this country. Age-standardised (world population) mortality rates, at all ages and truncated at age 35-64 years, from major cancers and all cancers combined were computed on the basis of certified deaths derived from the World Health Organization database for the period 1970-99. Mortality rates for all neoplasms showed an upward trend in men of all ages (from 58.2/100,000 in 1970-74 to 87.1/100,000 in 1995-99) and in middle-aged men (from 76.1 to 93.7/100,000, respectively). This reflects the rise until the early 1990s in lung cancer mortality (from 8.1/100,000 in 1970-74 to 15.6/100,000 in 1995-99) and prostate cancer (from 5.5 to 12.2/100,000, respectively). In women, overall mortality rates showed an increase between the early 1970s (75.4/100,000) and the late 1990s (82.3/100,000). Total cancer mortality rates remained low, however, compared with other American countries (e.g. 153.3/100,000 men and 108.6/100,000 women in 1999 in the United States). Truncated rates were stable (126.5/100,000 in 1970-74 and 125.8/100,000 in 1995-99), although they were much higher than overall rates, reflecting exceedingly high rates for uterine (mostly cervical) cancer mortality in middle-aged women (29.5/100,000 in 1995-99). Total cancer mortality in Mexico has remained comparably low on a worldwide scale, and the upward trends in mortality rates for lung and other tobacco-related neoplasms have tended to level off over the last decade. However, steady rises have been observed for other major cancers, including prostate and breast. Cervical cancer remains a major health problem in women.

Relationships among health risk factors and objective physical findings in well rural Appalachian women

This pilot study sought to describe the patterns of health risk factors and objective physical findings in well rural Appalachian women. A retrospective chart review was conducted of the records of 50 women who received a health history, physical examination, and appropriate laboratory testing as part of a rural community wellness project. The most prevalent risk factors found were past or present smoking, history of lung disease, physical inactivity, obesity, and hypercholesterolemia. Higher numbers of risk factors per person were correlated with lower levels of education. The most prevalent physical findings were systolic blood pressure greater than 140 and diastolic greater than 90, diastolic blood pressure greater than 90 with normal systolic, total cholesterol greater than 240, low-density lipoprotein levels greater than 130, and greater than 20% over ideal weight. This sample reveals a high prevalence of risk factors for the leading causes of mortality in middle-aged women, partially accounted for by low formal education levels, poverty, and limited access to health care.

Historical demographic and epidemiological studies of aging in American Samoans.

American Samoan mortality records, from 1920 through 1988, and epidemiological survey data from 1976 are used to examine demographic definitions of the elderly in different time periods and to examine the association of body habitus and blood pressure with mortality among middle-aged and older Samoans. In the 1920s, the average Samoan lived 24 years, but over 50% of deaths occurred prior to age 15. In the 1980s the average Samoan lived about 54 years and 50% of deaths occurred after age 58. The common definition for matua (an elder or true old one) was 50 years in 1962, an age to which only 17% of the population lived in the 1920s; this value increased to 60-65 years by 1976, when 53% of the population survived to age 50 years and 34% to age 65 years. These data suggest that quantitative demographic factors may have constrained Samoan cultural definitions of matua i.e., "elderliness" during the 20th century. Among middleaged and older Samoans who died between 1976 and 1980, body weight, body mass index (BMI), and systolic and diastolic blood pressure were differentially associated with cause-specific mortality by age and sex. None of these risk factors was associated with mortality in older men, but BMI and systolic pressure were significanlty lower among middle-aged men who died. In contrast, all four risk factors were associated positively with mortality in middle-aged women, but in older women only systolic pressure was.

Myocardial Infarction Risk Factors in a Semirural Area in Mid-Sweden: The population study “50-year-old people in Kungsör”

The mortality from ischaemic heart disease is higher in predominantly rural northern and western Sweden than in the more urban eastern and southern districts. This study was performed in a small semirural area in mid-Sweden with lower mortality from ischaemic heart disease in middle-aged men and higher mortality in middle-aged women than the national average. Smoking habits, serum cholesterol, and blood pressure were measured in all 50-year-old men and women in the community (n = 314) during a four-year period. In addition, the feasibility of using the local health care centre as a base for the study was tested. The health centre provided an excellent base for this population study. The non-response rate was less than 3%, indicating that using local facilities and staff well known to the population might be an advantage. The risk factor levels seemed to be higher in Kungsör than in Uppsala, a community with low mortality from ischaemic heart diseases. The differences in risk factor levels could explain some, but not all of the differences in mortality from ischaemic heart diseases. Thus, other risk factors appear to be operating as well.