scholarly journals Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2

2019 ◽  
Vol 8 ◽  
Author(s):  
Seiji Matsumoto ◽  
W. Lawrence Beeson ◽  
David J. Shavlik ◽  
Gina Siapco ◽  
Karen Jaceldo-Siegl ◽  
...  

AbstractThe association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rachael R Baiduc ◽  
Brittany Bogle ◽  
Franklyn Gonzalez ◽  
Elizabeth Dinces ◽  
David J Lee ◽  
...  

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sheila F Castaneda ◽  
Patricia Gonzalez ◽  
Linda C Gallo ◽  
Gregory A Talavera ◽  
Addie L Fortmann ◽  
...  

Background: Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress. Minimal research has been conducted exploring the relationship between psychological distress and CVD risk among Hispanic/ Latinos (H/L) of different background groups. The aim of this study was to investigate which CVD risk factors were most strongly correlated with psychological distress. Methods: The multi-site prospective population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of H/L adults (n = 16,415) ages 18-74 in four US communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified two-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010 US Population Census. Analyses involve 15,464 participants with complete data. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale and 10 item Spielberger Trait Anxiety Scale), socio-demographics (i.e., age, education, health insurance, gender, and H/L background), acculturation (i.e., years in the U.S., country of birth, and language), and CVD risk factors [i.e., dyslipidemia (HDL cholesterol < 40, LDL cholesterol ≥ 160,or triglycerides ≥ 200), body mass index (BMI), current cigarette smoking, diabetes (i.e., fasting time > 8 hr AND fasting glucose ≥ 126, or fasting time ≤ 8 hr AND fasting glucose ≥ 200, or post-OGTT glucose ≥ 200, or A1C≥ 6.5 or on medication), and hypertension (blood pressure ≥140/90 or on mediations)] were measured during the HCHS/SOL baseline exam. Associations between CVD risk factors and psychological distress were assessed using multiple linear regression models with depression and anxiety as dependent variables, accounting for the complex survey design and sampling weights, and controlling for socio-demographic and acculturation covariates. Results: Current smoking, diabetes, and BMI were significantly associated with depression and anxiety symptoms, after adjusting for covariates. Mean depressive symptomatology was 1.66 higher among smokers, .58 higher among diabetics, and increased by .04 for every one unit increase in BMI; mean anxiety symptomatology was 1.31 higher among smokers, .58 higher among diabetics, and increased by .05 for every one unit increase in BMI, adjusting for other factors. Dyslipidemia and hypertension were not associated with depression or anxiety. Discussion: Results demonstrate that certain CVD risk factors (i.e., smoking, diabetes, and BMI) were associated with psychological distress. Among the multiple CVD risk factors, current smoking was the strongest correlate; indicating its importance in CVD risk reduction among patients with depressive symptomatology.


2021 ◽  
Vol 10 (6) ◽  
Author(s):  
Bongeka Z. Zuma ◽  
Justin T. Parizo ◽  
Areli Valencia ◽  
Gabriela Spencer‐Bonilla ◽  
Manuel R. Blum ◽  
...  

Background Persistent racial/ethnic disparities in cardiovascular disease (CVD) mortality are partially explained by healthcare access and socioeconomic, demographic, and behavioral factors. Little is known about the association between race/ethnicity‐specific CVD mortality and county‐level factors. Methods and Results Using 2017 county‐level data, we studied the association between race/ethnicity‐specific CVD age‐adjusted mortality rate (AAMR) and county‐level factors (demographics, census region, socioeconomics, CVD risk factors, and healthcare access). Univariate and multivariable linear regressions were used to estimate the association between these factors; R 2 values were used to assess the factors that accounted for the greatest variation in CVD AAMR by race/ethnicity (non‐Hispanic White, non‐Hispanic Black, and Hispanic/Latinx individuals). There were 659 740 CVD deaths among non‐Hispanic White individuals in 2698 counties; 100 475 deaths among non‐Hispanic Black individuals in 717 counties; and 49 493 deaths among Hispanic/Latinx individuals across 267 counties. Non‐Hispanic Black individuals had the highest mean CVD AAMR (320.04 deaths per 100 000 individuals), whereas Hispanic/Latinx individuals had the lowest (168.42 deaths per 100 000 individuals). The highest CVD AAMRs across all racial/ethnic groups were observed in the South. In unadjusted analyses, the greatest variation ( R 2 ) in CVD AAMR was explained by physical inactivity for non‐Hispanic White individuals (32.3%), median household income for non‐Hispanic Black individuals (24.7%), and population size for Hispanic/Latinx individuals (28.4%). In multivariable regressions using county‐level factor categories, the greatest variation in CVD AAMR was explained by CVD risk factors for non‐Hispanic White individuals (35.3%), socioeconomic factors for non‐Hispanic Black (25.8%), and demographic factors for Hispanic/Latinx individuals (34.9%). Conclusions The associations between race/ethnicity‐specific age‐adjusted CVD mortality and county‐level factors differ significantly. Interventions to reduce disparities may benefit from being designed accordingly.


Author(s):  
Lan N Đoàn ◽  
Yumie Takata ◽  
Karen Hooker ◽  
Carolyn Mendez-Luck ◽  
Veronica L Irvin

Abstract Background The burden of cardiovascular disease (CVD) is increasing in the aging population. However, little is known about CVD risk factors and outcomes for Asian American, Native Hawaiian, and Other Pacific Islander (NH/PI) older adults by disaggregated subgroups. Methods Data were from the Centers for Medicare and Medicaid Services 2011–2015 Health Outcomes Survey, which started collecting expanded racial/ethnic data in 2011. Guided by Andersen and Newman’s theoretical framework, multivariable logistic regression analyses were conducted to examine the prevalence and determinants of CVD risk factors (obesity, diabetes, smoking status, hypertension) and CVD conditions (coronary artery disease [CAD], congestive heart failure [CHF], myocardial infarction [MI], other heart conditions, stroke) for 10 Asian American and NH/PI subgroups and White adults. Results Among the 639 862 respondents, including 26 853 Asian American and 4 926 NH/PI adults, 13% reported CAD, 7% reported CHF, 10% reported MI, 22% reported other heart conditions, and 7% reported stroke. CVD risk factors varied by Asian American and NH/PI subgroup. The prevalence of overweight, obesity, diabetes, and hypertension was higher among most Asian American and NH/PI subgroups than White adults. After adjustment, Native Hawaiians had significantly greater odds of reporting stroke than White adults. Conclusions More attention should focus on NH/PIs as a priority population based on the disproportionate burden of CVD risk factors compared with their White and Asian American counterparts. Future research should disaggregate racial/ethnic data to provide accurate depictions of CVD and investigate the development of CVD risk factors in Asian Americans and NH/PIs over the life course.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
P Jousilahti ◽  
T Laatikainen ◽  
T Harkanen ◽  
K Borodulin ◽  
K Harald ◽  
...  

Abstract Background Systematic monitoring of cardiovascular disease (CVD) risk factors started in eastern Finland already in the 1970s as part of the North Karelia Project. Later on risk factor monitoring was extended to other parts of the country. Purpose In this study we report the trends of main CVD risk factors in Finland from 1992 to 2017. Methods Study population consists of a population-based random sample of 31 402 men and women aged 25–64 years who participated in the FINRISK Studies from 1992 to 2012, and in the FinHealth Study in 2017. Data collection was done every five years. Participation rate decreased from 76% in 1992 to 56% in 2017. Study protocol included self-reported questionnaire data on smoking and other health behavior, measurements of height, weight and blood pressure, and venous blood sample for laboratory analysis. Blood pressure was measured two times, and the average of the measurements was calculated, total serum cholesterol was analyzed using enzymatic method, and LDL cholesterol was calculated using Friedewald formula. Results Smoking prevalence, mean blood pressure and total and LDL cholesterol levels declined markedly during the 25 year follow up but BMI, waist circumference and prevalence of obesity increased (table). CVD risk factor change from 1992 to 2017 Risk factor Men 1992 Men 2017 p value Women 1992 Women 2017 p value Smoking (%) 36.7 20.6 <0.001 25.9 16.5 <0.001 SBP (mmHg) 136.6 131.2 <0.001 130.3 124.5 <0.001 DBP (mmHg) 82.7 81.6 <0.001 78.6 77.8 <0.001 Chol (mmol/L) 5.66 5.17 <0.001 5.42 5.18 <0.001 LDL chol (mmol/L) 3.54 3.16 <0.001 3.26 3.03 <0.001 BMI (kg/m2) 26.2 27.2 <0.001 25.1 26.4 <0.001 WC (cm) 92.8 96.1 <0.001 79.2 86.2 <0.001 Obesity (%) 15.7 23.2 <0.001 14.8 22.7 <0.001 Conclusions The levels of main traditional CVD risk factors have markedly decreased among the Finnish population during the last 25 years but in the same time, obesity has become a major public health challenge.


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Jon P Durda

Introduction: Macrophages play important roles in atherosclerotic plaque formation and stability. CD163 is a macrophage specific receptor involved in the clearance and endocytosis of hemoglobin-haptoglobin complexes; soluble CD163 (sCD163) may be a useful biomarker to assess macrophage activation. We are not aware of epidemiologic studies of sCD163 levels and cardiovascular disease (CVD) risk. Also it is not known whether common genetic variants are associated with sCD163. Methods: We tested whether sCD163 was associated with carotid intima-media thickness (IMT) and incident clinical events (overall mortality, coronary heart disease [CHD], myocardial infarction [MI], stroke, and congestive heart failure [CHF]) in 4,577 Cardiovascular Health Study (CHS) participants (95% white, 5% black; age range 65-100 y). We used linear regression with adjustment for sex, age, race, study site, current smoking, BMI, hypertension status, systolic blood pressure (SBP) and LDL cholesterol to test for association between sCD163 and IMT. We used 2 Cox proportional hazards models for incident events analyses: (1) adjusting for sex, age, race, study site, and current smoking; (2) model 1 plus BMI, hypertension status, SBP, LDL-cholesterol, C-reactive protein (CRP), interleukin-6 (IL6), and fibrinogen. We also performed a genome-wide association study (GWAS) for sCD163 in 2,769 unrelated CHS white participants, using Hapmap 2 imputed SNPs. Results: sCD163 was positively associated with female sex, white race, age, BMI, SBP, CRP, IL6 and fibrinogen, negatively associated with current smoking status (p&lt0.0001), and not associated with LDL cholesterol or hypertension status. After adjustment for traditional CVD risk factors, sCD163 was positively associated with carotid IMT (p=0.027). In model 1, increased sCD163 levels were associated with overall mortality (p&lt0.0001), incident CHD (p=0.0034), incident stroke (p=0.016), and incident CHF (p&lt0.0001), but not incident MI (p=0.069). None of the model 2 analyses resulted in significant associations (all p&gt0.05). Five variants upstream of chromosome 2q gene MGAT5 (top result rs4954118, p=7.1x10-14) and a single variant (rs314253, p=6.0x10-13) on chromosome 17p between ASGR1 and DLG4 were significantly (p&lt5x10-8) associated with sCD163. The top result near the CD163 gene was for upstream variant rs6488429 (p=8.2x10-5). Conclusions: sCD163 was associated with carotid IMT after accounting for established CVD risk factors. There were associations of sCD163 with mortality and incident clinical CVD, although associations were attenuated after adjustment for other risk factors. Additional studies are needed to evaluate whether results are similar in younger age groups and other populations. The significant results in the GWAS for sCD163 implicate novel molecular pathways that warrant future fine-mapping and functional studies.


2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Moshrik Abd alamir ◽  
Michael Goyfman ◽  
Adib Chaus ◽  
Firas Dabbous ◽  
Leslie Tamura ◽  
...  

Background.The extent of coronary artery calcium (CAC) improves cardiovascular disease (CVD) risk prediction. The association between common dyslipidemias (combined hyperlipidemia, simple hypercholesterolemia, metabolic Syndrome (MetS), isolated low high-density lipoprotein cholesterol, and isolated hypertriglyceridemia) compared with normolipidemia and the risk of multivessel CAC is underinvestigated.Objectives.To determine whether there is an association between common dyslipidemias compared with normolipidemia, and the extent of coronary artery involvement among MESA participants who were free of clinical cardiovascular disease at baseline.Methods.In a cross-sectional analysis, 4,917 MESA participants were classified into six groups defined by specific LDL-c, HDL-c, or triglyceride cutoff points. Multivessel CAC was defined as involvement of at least 2 coronary arteries. Multivariate Poisson regression analysis evaluated the association of each group with multivessel CAC after adjusting for CVD risk factors.Results.Unadjusted analysis showed that all groups except hypertriglyceridemia had statistically significant prevalence ratios of having multivessel CAC as compared to the normolipidemia group. The same groups maintained statistical significance prevalence ratios with multivariate analysis adjusting for other risk factors including Agatston CAC score [combined hyperlipidemia 1.41 (1.06–1.87), hypercholesterolemia 1.55 (1.26–1.92), MetS 1.28 (1.09–1.51), and low HDL-c 1.20 (1.02–1.40)].Conclusion.Combined hyperlipidemia, simple hypercholesterolemia, MetS, and low HDL-c were associated with multivessel coronary artery disease independent of CVD risk factors and CAC score. These findings may lay the groundwork for further analysis of the underlying mechanisms in the observed relationship, as well as for the development of clinical strategies for primary prevention.


2019 ◽  
Vol 3 (Supplement_1) ◽  
Author(s):  
Alexis Moore ◽  
Kathleen Woolf ◽  
David St-Jules ◽  
Collin Popp ◽  
Mary Lou Pompeii ◽  
...  

Abstract Objectives A higher percentage of protein consumed from plants may have cardiovascular benefits and be associated with lower mortality in chronic kidney disease (CKD) patients. The purpose of this study was to examine the association of self-reported dietary protein intake with cardiovascular disease (CVD) risk factors in patients with type 2 diabetes (T2D) and CKD. Methods Baseline 3-day food records were obtained from 202 participants of an ongoing lifestyle intervention study, and analyzed using Nutrition Data System for Research (2014). Participants were categorized into tertiles based on total protein intake (<66.9 g, 66.9–92.4 g, > 92.4 g) and percent of total protein coming from plant sources (<27.9%, 27.9–37.8%, >37.8%). CVD risk factors included estimated glomerular filtration rate (eGFR), pulse wave velocity (PWV), fasting lipids (total cholesterol, LDL-cholesterol, HDL-cholesterol, triglycerides [TG]), and hemoglobin A1c [HbA1c]). Analyses of covariance examined mean differences in CVD risk factors among the tertiles, controlling for age and total energy intake. Results The participants were 57% male, 89% non-Hispanic, 69% white, and 66 ± 9 years of age with a mean body mass index of 33.6 ± 5 kg/m2. Prior myocardial infarction was reported by 25(12.6%) of participants. Average daily protein intake was 83.3 ± 29.3 g (0.9 ± 0.3 g/kg body weight), with the average % of protein consumed from plant sources 34 ± 13%. There were no statistically significant differences between the total protein intake tertiles for the CVD risk factors (eGFR [P = .36], PWV [P = .86], total cholesterol [P = .09], LDL-cholesterol [P = .26], HDL-cholesterol [P = .88], TG [P = .88], HbA1c [P = .82]. Additionally, there were no statistically significant differences between the % of total protein intake from plant sources tertiles for the CVD risk factors (eGFR [P = .32], PWV [P = .92], total cholesterol [P = .29], LDL-cholesterol [P = .10], HDL-cholesterol [P = .57], TG [P = .13], HbA1c [P = .93]. Conclusions Contrary to expectations, CVD risk factors did not differ among tertiles for total protein intake or % of total protein from plant sources. These findings suggest that, at baseline, dietary protein was not associated with CVD risk factors in patients with T2D and CKD. Funding Sources National Institutes of Health (NIDDK, NINR).


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Monik C Jimenez ◽  
Kathrine Tucker ◽  
Fatima Rodriguez ◽  
James B Meigs ◽  
Lenny Lopez

Introduction: Low blood levels of dehydroepiandrosterone sulfate (DHEAS) have been shown to have strong positive associations with diabetes, cardiovascular disease (CVD) mortality and stroke. However, the underlying pathways remain unclear, given limited data to systematically examine associations of DHEAS with CVD risk. In exploratory analyses we tested the association between CVD risk factors and DHEAS levels in a large population of Latinos. Methods: Among 1,450 participants in the Boston Puerto Rican Health Study between the ages of 45-75 years at baseline, socio-demographic, behavior, medical history, anthropometric and blood pressure data were collected at in-home interviews conducted by trained staff. A certified phlebotomist collected fasting blood samples. All samples were assayed for DHEAS, lipids, and C-reactive protein (CRP), HbA1c, insulin and glucose (GL). Spearman correlations were estimated between DHEAS and continuous CVD risk factors (lipids, systolic blood pressure [SBP] and diastolic blood pressure [DBP], CRP, GL, HbA1c, insulin, body mass index [BMI], waist circumference, physical activity and alcohol consumptions). We used robust multivariable linear regression models adjusted for potential confounders and intermediates with α=0.05 to estimate the association selected CVD risk factors and DHEAS levels. CVD risk factors were identified from a set of potential candidate predictors (age, female gender, history of heart disease, diabetes status, SBP, DBP, total and high density cholesterol [TC, HDL], triglycerides [TG], GL, CRP) using stepwise linear regression with an entry criterion of α=0.20 and exit criterion of α=0.10. Results: The mean DHEAS concentration among women was 70.7 μg/dL (s.d. 53.9; median=70.7) and among men was 119 μg/dL (s.d. 87.7; median=100). In age and sex adjusted Spearman correlations, TC, low density lipoprotein cholesterol, physical activity and alcohol were positively significantly correlated with DHEAS, while BMI and waist circumference were inversely correlated. In robust multivariable linear regression adjusted for potential confounders, age (-8.3; 95%CI:-10.0,-6.5; per 5 yrs), sex (β=-32.5; 95%CI:-38.4,-26.6) and TG (β=-0.5; 95%CI:-0.7,-0.2; per 10 mg/dl) were significantly inversely associated with DHEAS concentration, while TC (β=0.9; 95%CI:0.2,1.6;per 10 mg/dL) and GL (β=0.7; 95%CI:0.2, 1.2;per 10 mg/dL) were positively associated, albeit non-statistically significant. Adjustment for history of CVD, diabetes and BMI, only marginally attenuated these associations. Conclusions: Our data provide support for a significant association between TG levels and DHEAS concentrations even after adjustment for potential confounders and intermediates, which has been previously untested. These results suggest that DHEAS may work through lipid pathways.


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