scholarly journals Association Between Metabolic Syndrome and an Increased Risk of Hospitalization for Heart Failure in Population of HFpEF

2021 ◽  
Vol 8 ◽  
Author(s):  
Ying Zhou ◽  
Liyao Fu ◽  
Jiaxing Sun ◽  
Zhaowei Zhu ◽  
Zhenhua Xing ◽  
...  
Keyword(s):  
Heart Failure ◽  
Metabolic Syndrome ◽  
Heart Function ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Multivariable Adjustment

Background: The association between metabolic syndrome and the development of heart failure (HF) with preserved ejection fraction (HFpEF) has not been completely clarified.Aim: To evaluate the association between metabolic syndrome and the risk of HF hospitalization for patients with HFpEF.Methods: Patient data were obtained from the American cohort of the Treatment of Preserved Cardiac Function Heart Failure with an Aldosterone Antagonist (TOPCAT) trial database. Data for the primary outcome (hospitalization for HF) and secondary outcomes (all-cause mortality, cardiovascular mortality, and all-cause hospitalization) were collected, and hazard ratios (HRs) for the patients with and without metabolic syndrome were analyzed by applying a multivariable Cox proportional hazard model.Results: Among the 1,548 total participants, 1,197 had metabolic syndrome. The patients with metabolic syndrome exhibited worse heart function and a lower quality of life than those without metabolic syndrome. During the 3.3 years of follow-up, 351 patients were hospitalized for HF. After a multivariable adjustment, the risk of hospitalization for HF and all-cause hospitalization (adjusted HR = 1.42, 95% CI: 1.01–2.00; p = 0.042 and adjusted HR = 1.27; 95% CI: 1.04–1.54; p = 0.017, respectively) were independently associated with HFpEF for the patients with metabolic syndrome. In addition, the risks of HF hospitalization and all-cause hospitalization among 267 propensity score-matched patients were higher for patients with metabolic syndrome (HR = 1.53, 95% CI = 1.05–2.23, and p = 0.025 and HR = 1.34, 95% CI = 1.08–1.67, and p = 0.009, respectively).Conclusion: The risks of HF hospitalization and all-cause hospitalization were higher for patients with HFpEF having metabolic syndrome than for those without metabolic syndrome.

scholarly journals Soft drink consumption is associated with increased incidence of the metabolic syndrome only in women

2017 ◽  
Vol 117 (2) ◽  
pp. 315-324 ◽  
Author(s):  
Yunjin Kang ◽  
Jihye Kim
Keyword(s):  
Metabolic Syndrome ◽  
Soft Drink ◽  
Soft Drinks ◽  
Soft Drink Consumption ◽  
The Metabolic Syndrome ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Specific Association

AbstractProspective studies on the association between soft drink consumption and incident risk of the metabolic syndrome (MetS) have not been carried out in Asians. We explored the sex-specific association between soft drink consumption and incident risk of the MetS in Korean adults during 10 years of follow-up. A total of 5797 subjects who were free of the MetS at baseline were studied. Soft drink consumption was assessed using a semi-quantitative FFQ. Time-dependent Cox proportional hazard model was used to examine hazard ratios (HR) of incidence of the MetS and its components in relation to soft drink consumption. In women, the multivariable-adjusted HR for developing the MetS was 1·8-fold higher in frequent consumers of soft drinks (≥4 servings/week) compared with rare consumers (95 % CI 1·23, 2·64). The adjusted HR for elevated blood pressure increased by 2-fold (95 % CI 1·24, 3·14) and for hypertriacylglycerolaemia by 1·9-fold (95 % CI 1·19, 2·88) in frequent consumers of soft drinks compared with rare consumers. However, in men, there was no association between soft drink consumption and incident risk of the MetS or its components. Frequent soft drink consumption was associated with increased risk of developing the MetS and its components only in middle-aged Korean women, suggesting sex differences for the risk of the MetS related to diet.

scholarly journals Farming tasks and the development of rheumatoid arthritis in the agricultural health study

2019 ◽  
pp. oemed-2018-105361 ◽  
Author(s):  
Christine G Parks ◽  
Armando Meyer ◽  
Laura E Beane Freeman ◽  
Jonathan Hofmann ◽  
Dale P Sandler
Keyword(s):  
Rheumatoid Arthritis ◽  
Self Report ◽  
Health Study ◽  
Proportional Hazard ◽  
Agricultural Health ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Cox Proportional Hazard Models ◽  
Agricultural Health Study

ObjectivesFarming has been associated with rheumatoid arthritis (RA). Some studies have evaluated the effects of pesticides, but other agricultural exposures may also affect immune response.MethodsWe investigated non-pesticide agricultural exposures in relation to RA in licensed pesticide applicators (n=27 175, mostly male farmers) and their spouses (n=22 231) in the Agricultural Health Study (AHS) cohort (1993–1997) who completed at least one follow-up survey through 2015. Incident RA cases (n=229 applicators and 249 spouses) were identified based on self-report confirmed by use of disease-modifying antirheumatic drugs or medical records. Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) were estimated by Cox proportional hazard models adjusting for applicator status, state, smoking, education and specific pesticide use, allowing estimates to vary by median age when hazards assumptions were not met.ResultsOverall, RA was associated with regularly applying chemical fertilisers (HR=1.50; 95% CI 1.11 to 2.02), using non-gasoline solvents (HR=1.40; 95% CI 1.09 to 1.80), and painting (HR=1.26; 95% CI 1.00 to 1.59). In older applicators (>62 years), RA was associated with driving combines (HR=2.46; 95% CI 1.05 to 5.78) and milking cows (HR=2.56; 95% CI 1.01 to 6.53). In younger participants (≤62 years), RA was inversely associated with raising animals as well as crops (HR=0.68; 95% CI 0.51 to 0.89 vs crops only). Associations with specific crops varied by age: some (eg, hay) were inversely associated with RA in younger participants, while others (eg, alfalfa) were associated with RA in older participants.ConclusionThese findings suggest several agricultural tasks and exposures may contribute to development of RA.

Prediction of Cardiovascular Events in Patients with Ankylosing Spondylitis and Psoriatic Arthritis: Role of Lipoproteins in a High-risk Population

2012 ◽  
Vol 39 (7) ◽  
pp. 1433-1440 ◽  
Author(s):  
ANNE GRETE SEMB ◽  
TORE K. KVIEN ◽  
DAVID A. DeMICCO ◽  
RANA FAYYAD ◽  
CHUAN-CHUAN WUN ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Ankylosing Spondylitis ◽  
Density Lipoprotein ◽  
High Risk Population ◽  
Proportional Hazard ◽  
Mortality And Morbidity ◽  
Cox Proportional Hazard ◽  
Hazard Ratios ◽  
Increased Risk

Objective.To evaluate lipids and apolipoproteins as predictors of cardiovascular mortality and morbidity (CVD) in patients with spondyloarthritis (SpA).Methods.In the pooled cohort of participants in the IDEAL, TNT, and CARDS trials, 50 had ankylosing spondylitis (AS), 36 had psoriatic arthritis (PsA), and 21,641 did not have AS or PsA (non-SpA). We compared lipid levels at baseline between AS or PsA and non-SpA, and hazard ratios (HR) for CVD were calculated in a Cox proportional hazard model.Results.Atherogenic lipids were lower in samples from AS, but not in PsA, compared to non-SpA. The HR for 1 SD increase in baseline lipids for future CVD was for total cholesterol 1.39 (95% CI 0.82, 2.36) in AS, 1.01 (95% CI 0.44, 2.31) in PsA, and 1.10 (95% CI 1.07, 1.14) in non-SpA. Both high-density lipoprotein (HDL) and apolipoprotein (ApoA-1) were significantly associated with CVD in AS (HR 3.67, 95% CI 1.47, 9.06, and HR 1.89, 95% CI 1.02, 3.54, respectively), in contrast to PsA (HDL: HR 1.03, 95% CI 0.49, 2.15; ApoA-1: HR 0.79, 95% CI 0.34, 1.89) and non-SpA (HDL: HR 0.86, 95% CI 0.84, 0.89; ApoA-1: HR 0.88, 95% CI 0.85, 0.91).Conclusion.HDL and ApoA-1 were surprisingly associated with increased risk of future CVD in patients with AS, whereas these lipids were protective in non-SpA.

BP in Young Adults with CKD and Associations with Cardiovascular Events and Decline in Kidney Function

2021 ◽  
pp. ASN.2020081156
Author(s):  
Alexander J. Kula ◽  
David K. Prince ◽  
Joseph T. Flynn ◽  
Nisha Bansal
Keyword(s):  
Heart Failure ◽  
Young Adults ◽  
Cardiovascular Events ◽  
Treatment Strategies ◽  
Proportional Hazard ◽  
Ckd Progression ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
The Relationship

BackgroundBP is an important modifiable risk factor for cardiovascular events and CKD progression in middle-aged or older adults with CKD. However, studies describing the relationship between BP with outcomes in young adults with CKD are limited.MethodsIn an observational study, we focused on 317 young adults (aged 21–40 years) with mild to moderate CKD enrolled in the Chronic Renal Insufficiency Cohort (CRIC) Study. Exposures included baseline systolic BP evaluated continuously (per 10 mm Hg increase) and in categories (<120, 120–129, and ≥130 mm Hg). Primary outcomes included cardiovascular events (heart failure, myocardial infarction, stroke, or all-cause death) and CKD progression (50% decline of eGFR or ESKD). We used Cox proportional hazard models to test associations between baseline systolic BP with cardiovascular events and CKD progression.ResultsCardiovascular events occurred in 52 participants and 161 had CKD progression during median follow-up times of 11.3 years and 4.1 years, respectively. Among those with baseline systolic BP ≥130 mm Hg, 3%/yr developed heart failure, 20%/yr had CKD progression, and 2%/yr died. In fully adjusted models, baseline systolic BP ≥130 mm Hg (versus systolic BP<120 mm Hg) was significantly associated with cardiovascular events or death (hazard ratio [HR], 2.13; 95% confidence interval [95% CI], 1.05 to 4.32) and CKD progression (HR, 1.68; 95% CI, 1.10 to 2.58).ConclusionsAmong young adults with CKD, higher systolic BP is significantly associated with a greater risk of cardiovascular events and CKD progression. Trials of BP management are needed to test targets and treatment strategies specifically in young adults with CKD.

Abstract P388: Which Obesity-related Indicator is Better for Predicting Incident Hypertension? Results from the population-based cohort study of Japan

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Michikazu Nakai ◽  
Makoto Watanabe ◽  
Kunihiro Nishimura ◽  
Misa Takegami ◽  
Yoshihiro Kokubo ◽  
...  
Keyword(s):  
Cohort Study ◽  
Population Based ◽  
Proportional Hazard ◽  
Japanese Men ◽  
Men And Women ◽  
Established Risk Factor ◽  
Cox Proportional Hazard ◽  
C Statistic ◽  
Hazard Ratios

Objective: Obesity is an established risk factor for hypertension (HT), but it is still controversial which obesity-related indicator is superior in predictability. This study compared the predictability among three indicators, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR), in the population-based prospective cohort study of Japan, the Suita study. Methods: Participants who had no HT at baseline (1,591 men and 1,973 women) aged 30-84 years were included in this study. The Cox proportional hazard model was used to estimate hazard ratios (HRs) of each indicator for incident HT with the adjustment for age, cigarette smoking and alcohol drinking. Harrell’s C statistics were also estimated for comparison of indicators’ accuracy. Results: During median follow-up of 7.2 years, 1,325 participants (640 men and 685 women) developed HT. HR (95% CI) of BMI, WC and WHtR for incident HT corresponding to a 1 SD increase was 1.25 (1.15-1.35), 1.21 (1.12-1.31) and 1.23 (1.14-1.34) in men while 1.32 (1.22-1.42), 1.27 (1.18-1.37) and 1.32 (1.21-1.44) in women, respectively. Also, C-statistic (95% CI) of BMI, WC and WHtR was 0.64 (0.62-0.66), 0.63 (0.61-0.65) and 0.63 (0.61-0.66) in men while 0.69 (0.67-0.71), 0.69 (0.67-0.71) and 0.69 (0.67-0.71) in women, respectively. Using 95% CI of each C-statistics, there were no statistical differences among three indicators in both men and women. Conclusion: In this study, we showed that all three indicators (BMI, WC and WHtR) were estimated similarly to predict the risk of developing HT in both Japanese men and women.

scholarly journals Positive Association of Dietary Inflammatory Index with Incidence of Cardiovascular Disease: Findings from a Korean Population-Based Prospective Study

Nutrients ◽  
2020 ◽  
Vol 12 (2) ◽  
pp. 588
Author(s):  
Imran Khan ◽  
Minji Kwon ◽  
Nitin Shivappa ◽  
James R. Hébert ◽  
Mi Kyung Kim
Keyword(s):  
Cardiovascular Disease ◽  
Positive Association ◽  
Population Based ◽  
Proportional Hazard ◽  
Dietary Inflammatory Index ◽  
Cvd Risk ◽  
Inflammatory Index ◽  
Cox Proportional Hazard ◽  
Increased Risk

Recently, diets with higher inflammatory potentials based on the dietary inflammatory index (DII®) have been shown to be associated with increased cardiovascular disease (CVD) risk in the general population. We aimed to prospectively investigate the association between the DII and CVD risk in the large Korean Genome and Epidemiology Study_Health Examination (KoGES_HEXA) cohort comprised of 162,773 participants (men 55,070; women 107,703). A validated semi-quantitative food frequency questionnaire (SQ-FFQ) was used to calculate the DII score. Statistical analyses were performed by using a multivariable Cox proportional hazard model. During the mean follow-up of 7.4 years, 1111 cases of CVD were diagnosed. Higher DII score was associated with increased risk of CVD in men (hazard ratio [HR]Quintile 5 vs. 1 1.43; 95% CI 1.04–1.96) and in women (HRQuintile 5 vs. 1 1.19; 95% CI 0.85–1.67), although not significant for women. The risk of CVD was significantly higher in physically inactive men (HRQuintile 5 vs. 1 1.80; 95% CI 1.03–3.12), obese men (HRQuintile 5 vs. 1 1.77; 95% CI 1.13–2.76) and men who smoked (HRQuintile 5 vs. 1 1.60; 95% CI 1.10–2.33), respectively. The risk of developing stroke was significantly higher for men (HRQuintile 5 vs. 1 2.06; 95% CI 1.07–3.98; p = 0.003), but not for women. A pro-inflammatory diet, as indicated by higher DII scores, was associated with increased risk of CVD and stroke among men.

scholarly journals What Is the Ideal Blood Pressure Threshold for the Prevention of Atrial Fibrillation in Elderly General Population?

2020 ◽  
Vol 9 (9) ◽  
pp. 2988 ◽  
Author(s):  
Yoon Jung Park ◽  
Pil-Sung Yang ◽  
Hee Tae Yu ◽  
Tae-Hoon Kim ◽  
Eunsun Jang ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Pressure Threshold ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Clinical Covariates ◽  
Blood Pressure Threshold ◽  
Multivariable Adjustment ◽  
Intensive Blood Pressure

Intensive blood pressure (BP) lowering in patients with hypertension at increased risk of cardiovascular disease has been associated with a lowered risk of incident atrial fibrillation (AF). It is uncertain whether maintaining the optimal BP levels can prevent AF in the general elderly population. We included 115,866 participants without AF in the Korea National Health Insurance Service-Senior (≥60 years) cohort from 2002 to 2013. We compared the influence of BP on the occurrence of new-onset AF between octogenarians (≥80 years) and non-octogenarians (<80 years) subjects. With up to 6.7 ± 1.7 years of follow-up, 4393 incident AF cases occurred. After multivariable adjustment for potentially confounding clinical covariates, the risk of AF in non-octogenarians was significantly higher in subjects with BP levels of <120/<80 and ≥140/90 mm Hg, with hazard ratios of 1.15 (95% confidence interval (CI), 1.03–1.28; p < 0.001) and 1.14 (95% CI, 1.04–1.26; p < 0.001), compared to the optimal BP levels (120–129/<80 mm Hg). In octogenarians, the optimal BP range was 130–139/80–89 mm Hg, higher than in non-octogenarians. A U-shaped relationship for the development of incident AF was evident in non-octogenarians, and BP levels of 120–129/<80 mm Hg were associated the lowest risk of incident AF. Compared to non-octogenarians, the lowest risk of AF was associated with higher BP levels of 130–139/80–89 mm Hg amongst octogenarians.

Influence of Changes in Obesity Indicators on the Risk of Hypertension: A Cohort Study in Southern China

2021 ◽  
pp. 1-9
Author(s):  
Xin Peng ◽  
JunXuan Huang ◽  
Yan Liu ◽  
MengJiao Cheng ◽  
Bo Li ◽  
...  
Keyword(s):  
Cohort Study ◽  
Southern China ◽  
Age Groups ◽  
Community Dwelling ◽  
The Body ◽  
Proportional Hazard ◽  
Incident Hypertension ◽  
Cox Proportional Hazard ◽  
Hazard Ratios

<b><i>Objectives:</i></b> The objective of this study was to demonstrate the association between changes in different obesity indicators and the risk of incident hypertension by the age-group among community-dwelling residents in southern China. <b><i>Methods:</i></b> A total of 6,959 non-hypertensive participants aged ≥18 years old were enrolled in this cohort study and completed questionnaire interviews and anthropometric measurements at baseline (2010) and follow-up (2017). A time-dependent covariate Cox proportional hazard model considered the changes in obesity indicators during the follow-up period and calculated the hazard ratios (HRs) to analyze the risk of incident hypertension according to different obesity indicators. <b><i>Results:</i></b> During a mean follow-up of 7.1 years, 1,904 participants were newly diagnosed with hypertension. The body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and waist-to-height ratio (WHtR) were significantly positively associated with an increased future risk of incident hypertension, and BMI was the best predictive indicator of hypertension (obesity in men: HR = 2.65, 95% confidence interval (CI) = 2.20–3.20; obesity in women: HR = 2.80, 95% CI = 2.27–3.45). Compared with the middle-aged and older group, the risk of incident hypertension was highest in the younger group which had the highest baseline obesity indicators. <b><i>Conclusions:</i></b> Changes in obesity indicators were significantly associated with the risk of incident hypertension in all age-groups, and the risk of future incident hypertension increased with the increase in baseline obesity indicators.

scholarly journals Pediatric Ischemic Stroke and Epilepsy: A Nationwide Cohort Study

Stroke ◽  
2021 ◽  
Author(s):  
Heléne E.K. Sundelin ◽  
Torbjörn Tomson ◽  
Johan Zelano ◽  
Jonas Söderling ◽  
Peter Bang ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Population Based ◽  
Proportional Hazard ◽  
Future Planning ◽  
Population Based Study ◽  
First Degree Relatives ◽  
Cox Proportional Hazard ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

Background and Purpose: The risk of epilepsy after stroke has not been thoroughly explored in pediatric ischemic stroke. We examined the risk of epilepsy in children with ischemic stroke as well as in their first-degree relatives. Methods: In Swedish National Registers, we identified 1220 children <18 years with pediatric ischemic stroke diagnosed 1969 to 2016, alive 7 days after stroke and with no prior epilepsy. We used 12 155 age- and sex-matched individuals as comparators. All first-degree relatives to index individuals and comparators were also identified. The risk of epilepsy was estimated in children with ischemic stroke and in their first-degree relatives using Cox proportional hazard regression model. Results: Through this nationwide population-based study, 219 (18.0%) children with ischemic stroke and 91 (0.7%) comparators were diagnosed with epilepsy during follow-up corresponding to a 27.8-fold increased risk of future epilepsy (95% CI, 21.5–36.0). The risk of epilepsy was still elevated after 20 years (hazard ratio [HR], 7.9 [95% CI, 3.3–19.0]), although the highest HR was seen in the first 6 months (HR, 119.4 [95% CI, 48.0–297.4]). The overall incidence rate of epilepsy was 27.0 per 100 000 person-years (95% CI, 21.1–32.8) after ischemic stroke diagnosed ≤day 28 after birth (perinatal) and 11.6 per 100 000 person-years (95% CI, 9.6–13.5) after ischemic stroke diagnosed ≥day 29 after birth (childhood). Siblings and parents, but not offspring, to children with ischemic stroke were at increased risk of epilepsy (siblings: HR, 1.64 [95% CI, 1.08–2.48] and parents: HR, 1.41 [95% CI, 1.01–1.98]). Conclusions: The risk of epilepsy after ischemic stroke in children is increased, especially after perinatal ischemic stroke. The risk of epilepsy was highest during the first 6 months but remained elevated even 20 years after stroke which should be taken into account in future planning for children affected by stroke.

scholarly journals A Prospective Study of Grip Strength Trajectories and Incident Cardiovascular Disease

2021 ◽  
Vol 8 ◽  
Author(s):  
Weida Liu ◽  
Runzhen Chen ◽  
Chenxi Song ◽  
Chuangshi Wang ◽  
Ge Chen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Disease ◽  
Grip Strength ◽  
Proportional Hazard ◽  
Cox Proportional Hazard ◽  
Cox Proportional Hazard Models ◽  
A Prospective Study

Background: A single measurement of grip strength (GS) could predict the incidence of cardiovascular disease (CVD). However, the long-term pattern of GS and its association with incident CVD are rarely studied. We aimed to characterize the GS trajectory and determine its association with the incidence of CVD (myocardial infarction, angina, stroke, and heart failure).Methods: This study included 5,300 individuals without CVD from a British community-based cohort in 2012 (the baseline). GS was repeatedly measured in 2004, 2008, and 2012. Long-term GS patterns were identified by the group-based trajectory model. Cox proportional hazard models were used to examine the associations between GS trajectories and incident CVD. We identified three GS trajectories separately for men and women based on the 2012 GS measurement and change patterns during 2004–2012.Results: After a median follow-up of 6.1 years (during 2012–2019), 392 participants developed major CVD, including 114 myocardial infarction, 119 angina, 169 stroke, and 44 heart failure. Compared with the high stable group, participants with low stable GS was associated with a higher incidence of CVD incidence [hazards ratio (HR): 2.17; 95% confidence interval (CI): 1.52–3.09; P &lt;0.001], myocardial infarction (HR: 2.01; 95% CI: 1.05–3.83; P = 0.035), stroke (HR: 1.96; 95% CI: 1.11–3.46; P = 0.020), and heart failure (HR: 6.91; 95% CI: 2.01–23.79; P = 0.002) in the fully adjusted models.Conclusions: The low GS trajectory pattern was associated with a higher risk of CVD. Continuous monitoring of GS values could help identify people at risk of CVD.

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