scholarly journals Risks of ischaemic heart disease and stroke in meat eaters, fish eaters, and vegetarians over 18 years of follow-up: results from the prospective EPIC-Oxford study

BMJ ◽  
2019 ◽  
pp. l4897 ◽  
Author(s):  
Tammy Y N Tong ◽  
Paul N Appleby ◽  
Kathryn E Bradbury ◽  
Aurora Perez-Cornago ◽  
Ruth C Travis ◽  
...  
Keyword(s):  
Heart Disease ◽  
Confidence Interval ◽  
Ischaemic Heart Disease ◽  
Prospective Cohort ◽  
Disease Risk ◽  
Haemorrhagic Stroke ◽  
Hazard Ratio ◽  
Blood Cholesterol ◽  
Incident Cases

Abstract Objective To examine the associations of vegetarianism with risks of ischaemic heart disease and stroke. Design Prospective cohort study. Setting The EPIC-Oxford study, a cohort in the United Kingdom with a large proportion of non-meat eaters, recruited across the country between 1993 and 2001. Participants 48 188 participants with no history of ischaemic heart disease, stroke, or angina (or cardiovascular disease) were classified into three distinct diet groups: meat eaters (participants who consumed meat, regardless of whether they consumed fish, dairy, or eggs; n=24 428), fish eaters (consumed fish but no meat; n=7506), and vegetarians including vegans (n=16 254), based on dietary information collected at baseline, and subsequently around 2010 (n=28 364). Main outcome measures Incident cases of ischaemic heart disease and stroke (including ischaemic and haemorrhagic types) identified through record linkage until 2016. Results Over 18.1 years of follow-up, 2820 cases of ischaemic heart disease and 1072 cases of total stroke (519 ischaemic stroke and 300 haemorrhagic stroke) were recorded. After adjusting for sociodemographic and lifestyle confounders, fish eaters and vegetarians had 13% (hazard ratio 0.87, 95% confidence interval 0.77 to 0.99) and 22% (0.78, 0.70 to 0.87) lower rates of ischaemic heart disease than meat eaters, respectively (P<0.001 for heterogeneity). This difference was equivalent to 10 fewer cases of ischaemic heart disease (95% confidence interval 6.7 to 13.1 fewer) in vegetarians than in meat eaters per 1000 population over 10 years. The associations for ischaemic heart disease were partly attenuated after adjustment for self reported high blood cholesterol, high blood pressure, diabetes, and body mass index (hazard ratio 0.90, 95% confidence interval 0.81 to 1.00 in vegetarians with all adjustments). By contrast, vegetarians had 20% higher rates of total stroke (hazard ratio 1.20, 95% confidence interval 1.02 to 1.40) than meat eaters, equivalent to three more cases of total stroke (95% confidence interval 0.8 to 5.4 more) per 1000 population over 10 years, mostly due to a higher rate of haemorrhagic stroke. The associations for stroke did not attenuate after further adjustment of disease risk factors. Conclusions In this prospective cohort in the UK, fish eaters and vegetarians had lower rates of ischaemic heart disease than meat eaters, although vegetarians had higher rates of haemorrhagic and total stroke.

Abstract P509: Olive Oil Consumption and Risk of Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Marta Guasch ◽  
Gang Liu ◽  
Yanping Li ◽  
Laura Sampson ◽  
Joann E Manson ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Confidence Interval ◽  
Olive Oil ◽  
Lower Risk ◽  
Hazard Ratio ◽  
Mediterranean Populations ◽  
Dairy Fat ◽  
Incident Cases

Background: Olive oil intake has been associated with lower risk of cardiometabolic risk factors in Mediterranean populations, but little is known about these associations in the U.S. population, where olive oil intake is relatively low. Objectives: To examine whether olive oil intake is associated with total Cardiovascular Disease (CVD), coronary heart disease (CHD) and stroke risk. Methods: We included 63,867 women from the Nurses’ Health Study (1990 to 2014) and 35,512 men from the Health Professionals Follow-up Study (1990 to 2014) who were free of cancer, heart disease, and stroke at baseline. Diet was assessed using food frequency questionnaires at baseline and then every 4 years. Cumulative average of intake was used in the primary analysis. Cox proportional hazards regression was used to estimate hazard ratios and 95% confidence intervals. Results: During 24 years of follow-up, we documented 10,240 incident cases of CVD, including 6,270 CHD cases and 3,970 stroke cases. After adjusting for major diet and lifestyle factors, compared with non-consumers, those with higher olive oil intake (>1/2 tablespoon/d or > 7g/d) had 15% lower risk of total CVD [pooled hazard ratio (95% confidence interval): 0.85 (0.77, 0.93)] and 21% lower risk of CHD [pooled hazard ratio (95% confidence interval): 0.79 (0.70, 0.89)]. No significant associations were observed for total stroke or ischemic stroke. We estimated that replacing 5g of margarine, butter, mayonnaise, or dairy fat with the equivalent amount of olive oil was associated with 5-7% lower risk of total CVD and CHD. No significant associations were observed when olive oil was compared with other plant oils combined (corn, safflower, soybean and canola oil). Conclusions: Higher olive oil intake was associated with a lower risk of CHD and total CVD in two large prospective cohorts of U.S. men and women. The substitution of margarine, butter, mayonnaise, and dairy fat with olive oil might lead to a lower risk for CHD and CVD.

Abstract P168: Animal & Dairy Protein Intakes Associate With Increased Risk of Heart Failure in Men: The Kuopio Ischaemic Heart Disease Risk Factor Study

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Heli E Virtanen ◽  
Sari Voutilainen ◽  
Timo T Koskinen ◽  
Jaakko Mursu ◽  
Tomi-Pekka Tuomainen ◽  
...  
Keyword(s):  
Heart Failure ◽  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Disease Risk ◽  
Increased Risk ◽  
Risk Factor Study ◽  
Factor Study ◽  
Dairy Protein ◽  
Fermented Dairy

Introduction: Different protein sources, such as processed red meat and fish have indicated distinct associations with risk of heart failure. Whether these distinct associations are partly due to the differences in proteins themselves remains unclear. Thus, we examined the associations of proteins from different food sources with risk of heart failure in Finnish male subjects. Hypothesis: We hypothesized that proteins from different dietary sources would have distinct associations with heart failure risk. Methods: The study included 2441 men aged 42-60 y at the baseline examinations in 1984-1989 in the Kuopio Ischaemic Heart Disease Risk Factor Study. Protein intakes at baseline were assessed with 4-d dietary records. Data on incident heart failure cases were obtained from national registers. The multivariable-adjusted risk of heart failure according to protein intake was estimated by Cox proportional hazard ratios. Multivariable analyses included age, examination year, education, income, family history of ischaemic heart disease, smoking, leisure-time physical activity, and intakes of alcohol, energy, fiber, and saturated, monounsaturated, polyunsaturated and trans fatty acids. Results: During the mean follow-up time of 22.2 y, 334 incident cases of heart failure occurred. Total protein (multivariable-adjusted extreme-quartile HR 1.45, 95% CI: 1.04-2.00, P-trend 0.01), animal protein (HR 1.56, 95% CI: 1.12-2.17, P-trend 0.01) and dairy protein (HR 1.53, 95% CI: 1.11-2.11, P-trend 0.01) intakes were associated with increased risk of heart failure. Especially protein from fermented dairy products associated with higher risk (HR 1.48, 95% CI: 1.08-2.02, P-trend 0.002). Adjustment for the potential effect mediators [body mass index and diseases or medications (coronary heart disease, hypertension, type 2 diabetes, lipid-lowering or heart medications) at baseline and during the follow-up] slightly attenuated the associations, but associations of animal, dairy and fermented dairy protein remained statistically significant. Plant protein intake had no association with heart failure risk (HR 1.00, 95% CI: 0.63-1.59, P-trend 0.82). Conclusions: Our data suggest that high intake of protein, especially from animal and dairy sources, may increase the risk of heart failure.

scholarly journals Association of ideal cardiovascular health at age 50 with incidence of dementia: 25 year follow-up of Whitehall II cohort study

BMJ ◽  
2019 ◽  
pp. l4414 ◽  
Author(s):  
Séverine Sabia ◽  
Aurore Fayosse ◽  
Julien Dumurgier ◽  
Alexis Schnitzler ◽  
Jean-Philippe Empana ◽  
...  
Keyword(s):  
Cohort Study ◽  
Confidence Interval ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Hazard Ratio ◽  
Blood Cholesterol ◽  
Health Score ◽  
Ideal Cardiovascular Health ◽  
Incidence Of Dementia

AbstractObjectivesTo examine the association between the Life Simple 7 cardiovascular health score at age 50 and incidence of dementia.DesignProspective cohort study.SettingCivil service departments in London (Whitehall II study; study inception 1985-88).Participants7899 participants with data on the cardiovascular health score at age 50.ExposuresThe cardiovascular health score included four behavioural (smoking, diet, physical activity, body mass index) and three biological (fasting glucose, blood cholesterol, blood pressure) metrics, coded on a three point scale (0, 1, 2). The cardiovascular health score was the sum of seven metrics (score range 0-14) and was categorised into poor (scores 0-6), intermediate (7-11), and optimal (12-14) cardiovascular health.Main outcome measureIncident dementia, identified through linkage to hospital, mental health services, and mortality registers until 2017.Results347 incident cases of dementia were recorded over a median follow-up of 24.7 years. Compared with an incidence rate of dementia of 3.2 (95% confidence interval 2.5 to 4.0) per 1000 person years among the group with poor cardiovascular health, the absolute rate differences per 1000 person years were −1.5 (95% confidence interval −2.3 to −0.7) for the group with intermediate cardiovascular health and −1.9 (−2.8 to −1.1) for the group with optimal cardiovascular health. Higher cardiovascular health score was associated with a lower risk of dementia (hazard ratio 0.89 (0.85 to 0.95) per 1 point increment in the cardiovascular health score). Similar associations with dementia were observed for the behavioural and biological subscales (hazard ratios per 1 point increment in the subscores 0.87 (0.81 to 0.93) and 0.91 (0.83 to 1.00), respectively). The association between cardiovascular health at age 50 and dementia was also seen in people who remained free of cardiovascular disease over the follow-up (hazard ratio 0.89 (0.84 to 0.95) per 1 point increment in the cardiovascular health score).ConclusionAdherence to the Life Simple 7 ideal cardiovascular health recommendations in midlife was associated with a lower risk of dementia later in life.

scholarly journals Protein Intake and Functional Integrity in Aging: The Framingham Heart Study Offspring

2018 ◽  
Vol 75 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Adela Hruby ◽  
Shivani Sahni ◽  
Douglas Bolster ◽  
Paul F Jacques
Keyword(s):  
Confidence Interval ◽  
Physical Function ◽  
Framingham Heart Study ◽  
Protein Intake ◽  
Hazard Ratio ◽  
Functional Integrity ◽  
Heart Study ◽  
Cox Proportional Hazard Models ◽  
Incident Cases

Abstract Background Higher protein intake is linked to maintenance of muscle mass and strength, but few studies have related protein to physical function and disability in aging. Methods In participants of the Framingham Heart Study Offspring, we examined associations between protein intake (g/d), estimated from food frequency questionnaires, and maintenance of functional integrity, as a functional integrity score based on responses to 17 questions from Katz Activities of Daily Living, Nagi, and Rosow-Breslau questionnaires, repeated up to five times (1991/1995–2011/2014) over 23 years of follow-up. Cox proportional hazard models were used to estimate risk of incident loss of functional integrity (functional integrity score ≤ 15th percentile). Results In 2,917 participants (age 54.5 [9.8] years), baseline protein intake was 77.2 (15.6) g/d. The functional integrity score (baseline, mean 98.9, range 82.4–100.0) was associated with objective performance (gait speed, grip strength) and lower odds of falls, fractures, and frailty. Across follow-up, there were 731 incident cases of loss of functional integrity. In fully adjusted models, participants in the highest category of protein intake (median 92.2 g/d) had 30% lower risk of loss of functional integrity (hazard ratio [95% confidence interval] 0.70 [0.52, 0.95], p trend = .03), versus those with the lowest intake (median 64.4 g/d). However, sex-stratified analyses indicated the association was driven by the association in women alone (hazard ratio [95% confidence interval] 0.49 [0.32, 0.74], p trend = .002) and was nonsignificant in men (hazard ratio [95% confidence interval] 1.14 [0.70, 1.86], p trend = .59). Conclusions Higher protein intake was beneficially associated with maintenance of physical function in middle-aged, high-functioning U.S. adults over the span of two decades. This association was particularly evident in women.

scholarly journals THE RELATIONSHIP BETWEEN INFLAMMATORY DIETARY PATTERN AND INCIDENCE OF PERIODONTITIS

2021 ◽  
pp. 1-36
Author(s):  
Ahmed A. Alhassani ◽  
Frank B. Hu ◽  
Bernard A. Rosner ◽  
Fred K. Tabung ◽  
Walter C. Willett ◽  
...  
Keyword(s):  
Confidence Interval ◽  
Periodontal Disease ◽  
Secondary Analysis ◽  
Hazard Ratio ◽  
Reduced Rank Regression ◽  
Rank Regression ◽  
Increased Risk ◽  
Cox Proportional Hazard Models ◽  
Study Population

ABSTRACT The long-term inflammatory impact of diet could potentially elevate the risk of periodontal disease through modification of systemic inflammation. The aim of the present study was to prospectively investigate the associations between a food based, reduced rank regression (RRR) derived, empirical dietary inflammatory pattern (EDIP) and incidence of periodontitis. The study population was composed of 34,940 men from the Health Professionals Follow-Up Study, who were free of periodontal disease and major illnesses at baseline (1986). Participants provided medical and dental history through mailed questionnaires every 2 years, and dietary data through validated semi-quantitative food frequency questionnaires every 4 years. We used Cox proportional hazard models to examine the associations between EDIP scores and validated self-reported incidence of periodontal disease over a 24-year follow-up period. No overall association between EDIP and the risk of periodontitis was observed; the hazard ratio comparing the highest EDIP quintile (most proinflammatory diet) to the lowest quintile was 0.99 (95% confidence interval: 0.89 -1.10, p-value for trend = 0.97). A secondary analysis showed that among obese non-smokers (i.e. never and former smokers at baseline), the hazard ratio for periodontitis comparing the highest EDIP quintile to the lowest was 1.39 (95% confidence interval: 0.98 -1.96, p-value for trend = 0.03). In conclusion, no overall association was detected between EDIP and incidence of self-reported periodontitis in the study population. From the subgroups evaluated EDIP was significantly associated with increased risk of periodontitis only among nonsmokers who were obese. Hence, this association must be interpreted with caution.

scholarly journals Estimation and determinants of direct medical costs of ischaemic heart disease, stroke and hypertensive heart disease: evidence from two major hospitals in Cameroon

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Leopold Ndemnge Aminde ◽  
Anastase Dzudie ◽  
Yacouba N. Mapoure ◽  
Jacques Cabral Tantchou ◽  
J. Lennert Veerman
Keyword(s):  
Diabetes Mellitus ◽  
Heart Disease ◽  
Ischaemic Stroke ◽  
Ischaemic Heart Disease ◽  
Economic Burden ◽  
Hypertensive Heart Disease ◽  
Haemorrhagic Stroke ◽  
Medical Costs ◽  
Communicable Diseases ◽  
Direct Medical Costs

Abstract Background Cardiovascular disease (CVD) is the largest contributor to the non-communicable diseases (NCD) burden in Cameroon, but data on its economic burden is lacking. Methods A prevalence-based cost-of-illness study was conducted from a healthcare provider perspective and enrolled patients with ischaemic heart disease (IHD), ischaemic stroke, haemorrhagic stroke and hypertensive heart disease (HHD) from two major hospitals between 2013 and 2017. Determinants of cost were explored using multivariate generalized linear models. Results Overall, data from 850 patients: IHD (n = 92, 10.8%), ischaemic stroke (n = 317, 37.3%), haemorrhagic stroke (n = 193, 22.7%) and HHD (n = 248, 29.2%) were analysed. The total cost for these CVDs was XAF 676,694,000 (~US$ 1,224,918). The average annual direct medical costs of care per patient were XAF 1,395,200 (US$ 2400) for IHD, XAF 932,700 (US$ 1600) for ischaemic stroke, XAF 815,400 (US$ 1400) for haemorrhagic stroke, and XAF 384,300 (US$ 700) for HHD. In the fully adjusted models, apart from history of CVD event (β = − 0.429; 95% confidence interval − 0.705, − 0.153) that predicted lower costs in patients with IHD, having of diabetes mellitus predicted higher costs in patients with IHD (β = 0.435; 0.098, 0.772), ischaemic stroke (β = 0.188; 0.052, 0.324) and HHD (β = 0.229; 0.080, 0.378). Conclusions This study reveals substantial economic burden due to CVD in Cameroon. Diabetes mellitus was a consistent driver of elevated costs across the CVDs. There is urgent need to invest in cost-effective primary prevention strategies in order to reduce the incidence of CVD and consequent economic burden on a health system already laden with the impact of communicable diseases.

Single Ventricle Palliation in a Developing Sub-Saharan African Country: What Should be Improved?

2019 ◽  
Vol 10 (2) ◽  
pp. 164-170 ◽  
Author(s):  
Valdano Manuel ◽  
Humberto Morais ◽  
Aida L. R. Turquetto ◽  
Gade Miguel ◽  
Leonardo A. Miana ◽  
...  
Keyword(s):  
Confidence Interval ◽  
African Country ◽  
Single Ventricle ◽  
Hazard Ratio ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Lost To Follow Up ◽  
Single Ventricle Palliation

Introduction: Single ventricle physiology management is challenging, especially in low-income countries. Objective: To report the palliation outcomes of single ventricle patients in a developing African country. Methods: We retrospectively studied 83 consecutive patients subjected to single ventricle palliation in a single center between March 2011 and December 2017. Preoperative data, surgical factors, postoperative results, and survival outcomes were analyzed. The patients were divided by palliation stage: I (pulmonary artery banding [PAB] or Blalock–Taussig shunt [BTS]), II (Glenn procedure), or III (Fontan procedure). Results: Of the 83 patients who underwent palliation (stages I-III), 38 deaths were observed (31 after stage I, six after stage II, and one after stage III) for an overall mortality of 45.7%. The main causes of operative mortality were multiple organ dysfunction due to sepsis, shunt occlusion, and cardiogenic shock. Twenty-eight survivors were lost to follow-up (22 after stage I, six after stage II). Thirteen stage II survivors are still waiting for stage III. The mean follow-up was 366 ± 369 days. Five-year survival was 28.4 % for PAB and 30.1% for BTS, while that for stage II and III was 49.8% and 57.1%, respectively. Age (hazard ratio, 0.61; 95% confidence interval: 0.47-0.7; P = .000) and weight at surgery (hazard ratio, 0.45; 95% confidence interval: 0.31-0.64; P = .002) impacted survival. Conclusion: A high-mortality rate was observed in this initial experience, mainly in stage I patients. A large number of patients were lost to follow-up. A task force to improve outcomes is urgently required.

The secondary prevention for ischaemic heart disease after coronary bypass grafting – follow up study

2017 ◽  
Vol 263 ◽  
pp. e158
Author(s):  
Vera Adamkova ◽  
Petr Kacer ◽  
Jaroslav Hubacek ◽  
Ivana Kralova Lesna ◽  
Vera Lanska ◽  
...  
Keyword(s):  
Heart Disease ◽  
Secondary Prevention ◽  
Ischaemic Heart Disease ◽  
Coronary Bypass ◽  
Bypass Grafting ◽  
Coronary Bypass Grafting ◽  
Follow Up Study
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