Cardiovascular Health Risk Factors Research Articles

The association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters in young Saudi females

ObjectivesIn this study, we assessed the possible association of adiposity, physical fitness, vitamin D levels and haemodynamic parameters as intermediate risk factors for cardiovascular health in young Saudi women.MethodsA total of 87 young healthy Saudi women were recruited in this cross-sectional study during 2014–2015. The body weight, height, waist and hip circumference, and plasma 25-hydroxyvitamin D (25[OH] D) levels were measured. The exercise stress test was performed to determine the pulse rate, blood pressure (BP), ECG, and VO2max. Multiple linear regression models were generated for the resting (r) and maximum (m) diastolic (D) and systolic (s) arterial BP and pulse rate (PR), adiposity markers, VO2max, and plasma levels of 25(OH) D.ResultsA multiple linear regression model was significant for the rDBP, mDBP, rSBP, and mSBP with adjusted R2 (6.5, 10.2, 8.3, and 4.5%, respectively). Except for VO2max in the mDBP model, none of the included risk factors were significant according to the t-test.ConclusionThis study showed the association of high adiposity and decreased physical fitness with haemodynamic parameters in young Saudi women. An exaggerated exercise DBP might predict future cardiovascular risk in unfit young women.

EPIDEMIOLOGICAL STUDY OF PREVALENCE OF ANEMIA AND ASSOCIATED RISK FACTORS IN A RURAL COMMUNITY; A HOME-BASED SCREENING

Objective: The prevalence of anemia is disproportionately high in developing countries due to poverty, inadequate diet, certain diseases, pregnancy and lactation, and poor access to health services. It is a risk factor for cardiovascular health and early death in adult. To estimate the prevalence of anemia and its associated risk factors in a rural a community in India.Methodology: Based on inclusion and exclusion criteria, an observational house-to-house survey was conducted for a period of 6 months, by screening for anemia, using digital strip type hemoglobin meter. Result: Out of 200 people, 146 were anemic of which 77 were with mild anemia, 67 with moderate anemia and only 3 had severe anemia. There were more number of anemic patients in the group of normal and underweight (Normal=86, 58.90%; Underweight=27, 18.49%) than that of overweight and obese (Overweight=22, 15.06%; Obese=11, 7.53%). The newly diagnosed cases of anemia were 138 and previously diagnosed cases of anemia were 8. Out of 146 anemic populations, 13 were hyperlipidemics, 20 were hypertensives, 18 were diabetics, 5 were thyroid patients and 4 were cardiac patients. Conclusion: This screening program helps to diagnose anemia in a selected population and benefit avoiding further complications by offering adequate patient counseling. Study population was enriched with information on nutrition intake and importance of maintaining hemoglobin concentration at normal level in day-to-day life of an individual.Keywords: Anemia, Nutrition, Screening, Hemoglobin.

Abstract P198: Association Between Parity and Inflammation Varies by Acculturation Level Among Mexican American Women of Childbearing Age

Introduction: Parity is an independent risk factor for cardiovascular health. Its association with cardiovascular disease risk among Mexican American women is less established, even though this population currently has the highest fertility rate in the U.S. We examined the association of parity with a cardiovascular risk biomarker, C-reactive protein (CRP), among Mexican American women of childbearing age. Methods: Participants (N=1,346) were currently non-pregnant women of Mexican background, aged 16-49 years, in the National Health and Nutrition Examination Survey (NHANES) 1999-2006. The association between parity status [classified as live birth ≤ one year ago, live birth > one year ago, or nulliparous (reference group)] and elevated CRP (>3.0 mg/L) was examined using binary logistic regression. Since greater acculturation is associated with greater cardiovascular health risk among Mexican American women, an interaction between parity and acculturation was considered. Acculturation (scores 0 to 5) was defined based on nativity status, duration of residence in the U.S. (0-Mexico-born, U.S. resident < 10 years, 1-Mexico-born, U.S. resident 10-19 years, 2-Mexico-born, U.S. resident ≥20 years, 3- U.S. born), and language use at home (0-Spanish, 1-bilingual, 2-English). Scores 0-1, 2-3, 4-5 represented low, moderate, and high acculturation level, respectively. Results: The association of parity status with elevated CRP varied by acculturation level ( P for interaction = 0.01). In stratified analyses, live birth ≤ one year ago and live birth > one year ago, compared to nulliparity, was associated with higher odds of elevated CRP among women with low acculturation but not among women with moderate or high acculturation level. Additional adjustment for access to health care and lifestyle factors did not change results. Conclusions: In this cross-sectional study, parity is associated with a higher likelihood of elevated CRP in women with low acculturation.

Palmitate‐Induced Glycosylation of Cyclooxygenase‐2 in Primary Human Vascular Smooth Muscle Cells

Obesity is a major risk factor for cardiovascular health and function. One possible cause of obesity is poor nutrition, including the consumption of diets high in saturated fatty acids. Since vascular inflammation is a key etiological factor in cardiovascular disease, we investigated the effect of saturated fatty acid exposure on the modulation of COX‐2 in primary human male brain and aortic vascular smooth muscle cells. Cells were treated chronically (12 to 18 hr) with vehicle (5% BSA and 0.1% ethanol) or palmitate. Protein levels were assessed via western blotting and light microscopy was used to visualize cell density and morphology. Two distinct bands corresponding to the reported 72 and 74 kDa COX‐2 glycoforms were detected following palmitate treatment. A dose‐dependent increase in both forms was observed with the greatest increase observed in the 74 kDa glycoform (enzymatically active form). Glycosylation inhibition with tunicamycin abolished palmitate‐induced increases in the COX‐2 glycoforms and augmented band density of a lower migrating non‐glycosylated form (64 kDa). Palmitate also increased cell density and altered cell morphology. Although selective COX‐2 inhibition with NS‐398 further enhanced COX‐2 levels in the presence of palmitate, it reversed the palmitate dependent changes in cell density and morphology. In conclusion, this study suggest that palmitate alters COX‐2 function potentially by altering its post‐translation modification in vascular smooth muscle. This potential novel regulation of COX‐2 by saturated fatty acids may contribute as a mechanism in the development of cardiovascular disease in part by altering the structure, function, and health of vascular tissue. Support: University of Arizona Sarver Heart Center

OP035: Vitamin D Status and Mortality in Patients with Stable Angina

of follow-up (PWV2). Samples for FGF-23 and 25(OH)D3 were determined cross-sectionally. Patients were divided into two groups cccording to 25(OH)D3 levels: Insufficiency (group 1, 25(OH)D3 30 ng/mL). Results: Patients in Group 1 (n: 91) had significantly higher annual mean values of phosphorus, CaxP product and FGF-23 compared to Group 2 (n: 26) (p < 0.018, 0.044 and 0.046, respectively). Administered elementary calcium dose was significantly higher in Group 1 than in Group 2 (p < 0.014). Patients in Group 1 had higher PWV1 and PWV2 measurements compared to Group 2 (p < 0.018 and 0.011). Serum levels of 25(OH)D3 were negatively correlated with mean phosphorus (p = 0.039) and mean administered elemantary calcium dose (P= 0.017). On multivariate analysis, levels of 25(OH)D3 were independently associated with the adjusted dose of elementary calcium (P< 0.002). Conclusion: Low level of 25(OH)D3 is not only a primary risk factor for cardiovascular health but might occur as a result of high phosphorus level or high cumulative calcium intake. While targeting to control renal osteodistrophy and achieving a higher 25(OH)D3 and lower FGF 23 for better outcome, better phosphorus control and minimum calcium supplementation should be the priority in the plan.

Body Adiposity Index and Cardiovascular Health Risk Factors in Caucasians: A Comparison with the Body Mass Index and Others

BackgroundSeveral studies have shown a relation between the adipose tissue accumulation and a higher risk for developing metabolic and cardiovascular diseases. Thus, body fat content and, mainly, the fat distribution or adiposity could be considered as important indicators of health risk. In spite of presenting several limitations, BMI is the most widely used and accepted index for classifying overweight and obesity. The aim of the study was to evaluate the correlations between Body Adiposity Index (BAI), BMI and other adiposity indexes such as WC, WHR and WHtR with cardiovascular and metabolic risk factors. Furthermore, the behavior of BAI and BMI regarding the ability to discriminate overweight or obese individuals was also analyzed.Research Methodology/Principal FindingsA cross-sectional study was conducted in Spanish Caucasian adult workers. Participants in the study (29.214 men and 21.040 women, aged 20–68 years) were systematically selected during their work health periodic examinations. BAI, BMI, WHR, WHtR, body weight, hip and waist circumference (WC) as well as systolic and diastolic blood pressure were measured. Serum levels of high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), triglycerides (TG) and glucose were also determined. Results of the study indicated that BAI was less correlated with cardiovascular risk factors and metabolic risk factors than other adiposity indexes (BMI, WC and WHtR). The best correlations were found for WHtR. In addition, the BAI presented lower discriminatory capacity than BMI for diagnosing metabolic syndrome (MS) using both IDF and ATP III criteria. A different behavior of the BAI in men and women when considering the ability to discriminate overweight or obese individuals was also observed.ConclusionsThe adiposity indexes that include the waist circumference (WHtR and WC) may be better candidates than BAI and BMI to evaluate metabolic and cardiovascular risk in both clinical practice and research.

The prevalence and correlates of behavioral risk factors for cardiovascular health among Southern Brazil adolescents: a cross-sectional study

BackgroundThe adoption of health-related behaviors is an important part of adolescence. This study examined the prevalence and correlates of the isolated and simultaneous presence of behavioral risk factors for cardiovascular health (BRFCH) among adolescents in Curitiba, Southern Brazil.MethodsA cross-sectional study was performed with 1,628 adolescents (aged 11-17.9 years, 52.5% males) that were randomly selected from 44 public schools. Self-report instruments were used to assess the variables. Six BRFCH were analyzed: insufficiently active, excessive TV watching, current alcohol and tobacco use, daily soft drinks consumption and inadequate fruit and vegetable consumption. Sociodemographic and behavioral variables were studied as possible correlates of the presence of BRFCH.ResultsThe BRFCH with the highest prevalence were insufficiently active (50.5%, 95% confidence interval [95% CI]: 48.0-52.9) and daily soft drinks consumption (47.6%, 95% CI: 45.1-50.0). Approximately 30% of the adolescents presented three or more BRFCH simultaneously. Girls, adolescents who did not participate in organized physical activity, and who used computer/video games daily were the main high-risk subgroups for insufficiently active. Boys and those who used computer/video games daily were the high-risk subgroups for daily soft drinks consumption. For excessive TV watching, we identified to be at risk those who were from a high economic class, unemployed, and who used computer/video games daily. For current alcohol use, we identified older adolescents, who were from a high economic class and who worked to be at risk. Older adolescents, who worked and who spent little active time during a physical education class were the high-risk subgroups for current tobacco use. For inadequate fruit and vegetable consumption, we identified those who did not participate in organized physical activity to be at risk. Older adolescents, who were from a high economic class, who did not participate in organized physical activity and who used computer/video games daily were the high-risk subgroups for simultaneous BRFCH.ConclusionsWe found a high prevalence of BRFCH among adolescents, both isolated and simultaneously. The correlates of the presence of BRFCH can contribute to healthy policies among Brazilian adolescents, mainly focusing on high-risk subgroups for a health risk behavior.

Abstract P123: Percentage of Deaths Attributable to Poor Cardiovascular Health Behaviors: Findings from the Aerobics Center Longitudinal Study

Introduction: Although cigarette smoking, physical inactivity, obesity, and poor diet each have been linked to the risk of premature death, little is known about their relative individual and combined impact, adapted from the American Heart Association (AHA)’s new cardiovascular health construct, on mortality outcomes. We hypothesized that the individual and the combined health behaviors were inversely associated with all-cause mortality. The purpose of the study is to estimate the mortality effects of the 4 AHA defined cardiovascular health behaviors by examining the associated population attributable fractions (PAFs) of individual and combination factors. Methods: The study included 11240 (24% women) participants from the Aerobics Center Longitudinal Study (ACLS). Slightly modified AHA cardiovascular health behaviors (smoking, BMI, cardiorespiratory fitness and diet) were collected between 1987 and 1999 as part of the clinical examination. We used cardiorespiratory fitness as an objective marker of recent physical activity habits. Individuals with a history of a cardiovascular disease, or cancer were excluded. The cohort was followed to December 2003 or death. PAFs were calculated after adjusting for age, gender, hypertension, diabetes, hypercholesterolemia, family history of CVD, and the four health behaviors. Results: Two hundred and sixty-eight deaths were documented during an average 12 years of follow-up. Low fitness had the highest PAFs at the 5 th , 10 th , and 15 th year of follow-up, respectively: 6.6% (95% CI: 1.6% - 11.4%), 6.4% (95% CI: 1.5% - 11.0%), and 5.5% (95% CI: 1.3% - 9.6%). Current smokers had the second highest PAFs at the 5 th , 10 th , and 15 th year of follow-up, respectively: 5.4% (95% CI: 0.1% - 10.3%), 5.2% (95% CI: 0.1% - 9.9%), and 5.0% (95% CI: 0.2% - 9.5%). Additional adjustment for other confounders in the model did not change the above associations. The PAFs for overweight or obese and unhealthy diet were not significant in the current study. Conclusion: Assuming a causal relationship between smoking, low fitness and mortality, avoidance of these two cardiovascular health risk factors would have prevented 13% of the deaths in the ACLS population. Targeted interventions to increase fitness as well as stopping smoking would most likely promote longevity.

Effectiveness of Various Anthropometric Indices in Prediction of Cardiovascular Risk Among Adult Jains

The present study was conducted on Jain population residing in Delhi to elucidate the effectiveness of various anthropometric indices as cardiovascular risk. A cross sectional sample of 48 adult Jain females (mean age=50.5yr) and 62 adult males (mean age=47.4yr) was studied. Various anthropometric and physiological measurements were taken on each subject. In the present study BMI was found to be a greater risk factor for cardiovascular health among Jain females supported by strong correlation of BMI with blood pressure (SBP, p<0.01 and DBP, p<0.001), by high ' ' values (� =0.578 for SBP and � = 0.762 for DBP) and by high odds ratio for hypertension (2.3 times more for DBP). The waist height ratio was found to be a good cardiovascular risk-screening tool among adult Jain males as revealed by a significant positive association of WHtR with blood pressure (DBP, p<0.05), by high ' ' value (� =0.526 for SBP and � = 0.599 for DBP) and by elevated odds ratio for hypertension (21.9 times more for SBP and 3.9 times more for DBP). Our study clearly revealed the gender specificity and relative effectiveness of anthropometric indices in prediction of cardiovascular health among Jain adults (BMI in Jain females and WHtR in Jain males).

Grape Polyphenols Do Not Affect Vascular Function in Healthy Men1–3

Data suggest that polyphenol-rich products may improve endothelial function and other cardiovascular health risk factors. Grape and wine contain high amounts of polyphenols, but effects of these polyphenols have hardly been investigated in isolation in randomized controlled studies. Our objective in this study was to test the chronic effect of polyphenol-rich solids derived from either a wine grape mix or grape seed on flow-mediated dilation (FMD). Blood pressure and other vascular function measures, platelet function, and blood lipids were secondary outcomes. Thirty-five healthy males were randomized in a double-blind, placebo-controlled crossover study consisting of three 2-wk intervention periods separated by 1-wk washout periods. The test products, containing 800 mg of polyphenols, were consumed as capsules. At the end of each intervention period, effects were measured after consumption of a low-fat breakfast (~751 kJ, 25% fat) and a high-fat lunch (~3136 kJ, 78% fat). After the low-fat breakfast, the treatments did not significantly affect FMD. The absolute difference after the wine grape solid treatment was −0.4% (95% CI = −1.8 to 0.9; P = 0.77) and after grape seed solids, 0.2% (95% CI = −1.2 to 1.5; P = 0.94) compared with after the placebo treatment. FMD effects after the high-fat lunch and effects on secondary outcomes also showed no consistent differences between both of the grape solids and placebo treatment. In conclusion, consumption of grape polyphenols has no major impact on FMD in healthy men. Future studies should address whether grape polyphenols can improve FMD and other cardiovascular health risk factors in populations with increased cardiovascular risk.

A Survey of Lifestyle Risk Factors for Cardiovascular Health Among Young Hong Kong Chinese Women: Implications for Long-Term Cardiovascular Health

To establish baseline data in a population of young Chinese women from which lifestyle risk factors for cardiovascular disease (CVD) and the implications for long-term cardiovascular health can be examined. In a cross-sectional postal survey, a 125-item questionnaire (a translated version of the Minnesota Women's Health Survey) assessing lifestyle risk factors and perceptions of health was mailed to 987 Hong Kong Chinese nurses aged 26 years and returned by 617, yielding a response rate of 63%. Of the women surveyed, 7% reported they smoked, 21% consumed alcohol regularly, and 32% exercised regularly. Ten percent reported being overweight or obese, 31% were underweight, and 8% used oral contraception. The findings have important implications for the long-term cardiovascular health of this group of young women health professionals. Baseline data of lifestyle cardiovascular risk factors demonstrate that approximately two thirds of the women in this study are at risk of developing CVD when the findings are interpreted within the classification of CVD risk in women developed by the American Heart Association. Further research is necessary to assess women's awareness of risk factors and perceived personal risk.

Circulating Bioactive Androgens in Midlife Women

It is important to characterize the biological activity of circulating androgenic steroid hormones during the menopausal transition because these appear to impact the metabolic and cardiovascular health risk factors of women. The objective of the study was to develop and characterize a cell-based bioassay that measures the androgen receptor-mediated signal transduction in serum. This was a clinically relevant experimental study nested in a sample population of a longitudinal cohort study. The study was conducted at a university laboratory. A receptor-mediated luciferase expression bioassay based on HEK 293 cells that were stably cotransfected with plasmids containing the human androgen receptor and luciferase gene was developed. In 49 samples from menstruating women aged 42-52 yr, total testosterone (T) and SHBG concentrations were measured by immunoassay; free T concentrations were calculated from the total T and SHBG concentrations. Mean total T concentration of the sample was 1.15 nm (sd 0.46, range 0.57-3.86 nm). The mean bioactive androgen detected was 1.00 nm (sd 0.24, range 0.53-1.60 nm). Calculated free T (mean 0.0156 nm) was significantly lower than the levels of bioactive androgens measured by receptor-mediated bioassay. There was significant positive correlation between bioactive androgen levels and total T values in young women and polycystic ovarian disorder patients, whereas no correlation was found between the two values in middle-aged women. An androgen receptor-mediated bioassay can provide additional information in the evaluation of total bioactive androgens in midlife women. Our data suggest that levels of circulating SHBG may have a significant impact on the levels of total circulating bioavailable androgens.

Racism and Cardiovascular Disease in African Americans

This article provides an overview of the evidence on the ways racism can affect the disproportionate rates of cardiovascular disease (CVD) in African Americans. It describes the significant health disparities in CVD for blacks and whites and suggests that racial disparities should be understood within the context of persistent inequities in societal institutions and relations. Evidence and potential pathways for exploring effects of 3 levels of racism on cardiovascular health risk factors and outcomes are reviewed. First, institutional racism can lead to limited opportunities for socioeconomic mobility, differential access to goods and resources, and poor living conditions that can adversely affect cardiovascular health. Second, perceived/personally mediated racism acts as a stressor and can induce psychophysiological reactions that negatively affect cardiovascular health. Third, in race-conscious societies, such as the United States, the negative self-evaluations of accepting negative cultural stereotypes as true (internalized racism) can have deleterious effects on cardiovascular health. Few population-based studies have examined the relationship between racism and CVD. The findings, though suggestive of a positive association, are neither consistent nor clear. The research agenda of the Jackson Heart Study in addressing the role of racism in CVD is presented.