scholarly journals Time-Restricted Eating: A Novel and Simple Dietary Intervention for Primary and Secondary Prevention of Breast Cancer and Cardiovascular Disease

Nutrients ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 3476
Author(s):  
Rebecca A. G. Christensen ◽  
Amy A. Kirkham
Keyword(s):  
Breast Cancer ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dietary Intervention ◽  
Future Research ◽  
Metabolic Disturbances ◽  
Barriers To Adoption ◽  
Cvd Risk ◽  
Dietary Strategy ◽  
The Impact

There is substantial overlap in risk factors for the pathogenesis and progression of breast cancer (BC) and cardiovascular disease (CVD), including obesity, metabolic disturbances, and chronic inflammation. These unifying features remain prevalent after a BC diagnosis and are exacerbated by BC treatment, resulting in elevated CVD risk among survivors. Thus, therapies that target these risk factors or mechanisms are likely to be effective for the prevention or progression of both conditions. In this narrative review, we propose time-restricted eating (TRE) as a simple lifestyle therapy to address many upstream causative factors associated with both BC and CVD. TRE is simple dietary strategy that typically involves the consumption of ad libitum energy intake within 8 h, followed by a 16-h fast. We describe the feasibility and safety of TRE and the available evidence for the impact of TRE on metabolic, cardiovascular, and cancer-specific health benefits. We also highlight potential solutions for overcoming barriers to adoption and adherence and areas requiring future research. In composite, we make the case for the use of TRE as a novel, safe, and feasible intervention for primary and secondary BC prevention, as well as tertiary prevention as it relates to CVD in BC survivors.

scholarly journals Patterns of Immune Activation in HIV and Non HIV Subjects and Its Relation to Cardiovascular Disease Risk

2021 ◽  
Vol 12 ◽  
Author(s):  
Alinda G. Vos ◽  
Caitlin N. Dodd ◽  
Eveline M. Delemarre ◽  
Stefan Nierkens ◽  
Celicia Serenata ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Immune Activation ◽  
Hiv Positive ◽  
Inflammation Markers ◽  
Cvd Risk Factors ◽  
Immune Markers ◽  
Cvd Risk ◽  
The Impact ◽  
Hiv Negative

IntroductionInsight into inflammation patterns is needed to understand the pathophysiology of HIV and related cardiovascular disease (CVD). We assessed patterns of inflammation related to HIV infection and CVD risk assessed with carotid intima media thickness (CIMT).MethodsA cross-sectional study was performed in Johannesburg, South Africa, including participants with HIV who were virally suppressed on anti-retroviral therapy (ART) as well as HIV-negative participants who were family members or friends to the HIV-positive participants. Information was collected on CVD risk factors and CIMT. Inflammation was measured with the Olink panel ‘inflammation’, allowing to simultaneously assess 92 inflammation markers. Differences in inflammation patterns between HIV-positive and HIV-negative participants were explored using a principal component analysis (PCA) and ANCOVA. The impact of differentiating immune markers, as identified by ANCOVA, on CIMT was assessed using linear regression while adjusting for classic CVD risk factors.ResultsIn total, 185 HIV-positive and 104 HIV negative participants, 63% females, median age 40.7 years (IQR 35.4 – 47.7) were included. HIV-positive individuals were older (+6 years, p <0.01) and had a higher CIMT (p <0.01). No clear patterns of inflammation were identified by use of PCA. Following ANCOVA, nine immune markers differed significantly between HIV-positive and HIV-negative participants, including PDL1. PDL1 was independently associated with CIMT, but upon stratification this effect remained for HIV-negative individuals only.ConclusionHIV positive patients on stable ART and HIV negative controls had similar immune activation patterns. CVD risk in HIV-positive participants was mediated by inflammation markers included in this study.

scholarly journals Nutrients in Fish and Possible Associations with Cardiovascular Disease Risk Factors in Metabolic Syndrome

Nutrients ◽  
2018 ◽  
Vol 10 (7) ◽  
pp. 952 ◽  
Author(s):  
Christine Tørris ◽  
Milada Cvancarova Småstuen ◽  
Marianne Molin
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Fatty Acids ◽  
Fish Consumption ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Protective Role ◽  
Cvd Risk ◽  
The Impact

Non-communicable diseases (NSDs) are responsible for two-thirds of all deaths globally, whereas cardiovascular disease (CVD) alone counts for nearly half of them. To reduce the impact of CVD, targeting modifiable risk factors comprised in metabolic syndrome (e.g., waist circumference, lipid profile, blood pressure, and blood glucose) is of great importance. Beneficial effects of fish consumption on CVD has been revealed over the past decades, and some studies suggest that fish consumption may have a protective role in preventing metabolic syndrome. Fish contains a variety of nutrients that may contribute to health benefits. This review examines current recommendations for fish intake as a source of various nutrients (proteins, n-3 fatty acids, vitamin D, iodine, selenium, and taurine), and their effects on metabolic syndrome and the CVD risk factors. Fatty fish is recommended due to its high levels of n-3 fatty acids, however lean fish also contains nutrients that may be beneficial in the prevention of CVD.

scholarly journals Risk Factors for Cardiovascular Disease (CVD) in Adults with Type 1 Diabetes: Findings from Prospective Real-life T1D Exchange Registry

2020 ◽  
Vol 105 (5) ◽  
pp. e2032-e2038 ◽  
Author(s):  
Viral N Shah ◽  
Ryan Bailey ◽  
Mengdi Wu ◽  
Nicole C Foster ◽  
Rodica Pop-Busui ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Diabetic Nephropathy ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Impact

Abstract Context Cardiovascular disease (CVD) is a major cause of mortality in adults with type 1 diabetes. Objective We prospectively evaluated CVD risk factors in a large, contemporary cohort of adults with type 1 diabetes living in the United States. Design Observational study of CVD and CVD risk factors over a median of 5.3 years. Setting The T1D Exchange clinic network. Patients Adults (age ≥ 18 years) with type 1 diabetes and without known CVD diagnosed before or at enrollment. Main Outcome Measure Associations between CVD risk factors and incident CVD were assessed by multivariable logistic regression. Results The study included 8,727 participants (53% female, 88% non-Hispanic white, median age 33 years [interquartile ratio {IQR} = 21, 48], type 1 diabetes duration 16 years [IQR = 9, 26]). At enrollment, median HbA1c was 7.6% (66 mmol/mol) (IQR = 6.9 [52], 8.6 [70]), 33% used a statin, and 37% used blood pressure medication. Over a mean follow-up of 4.6 years, 325 (3.7%) participants developed incident CVD. Ischemic heart disease was the most common CVD event. Increasing age, body mass index, HbA1c, presence of hypertension and dyslipidemia, increasing duration of diabetes, and diabetic nephropathy were associated with increased risk for CVD. There were no significant gender differences in CVD risk. Conclusion HbA1c, hypertension, dyslipidemia and diabetic nephropathy are important risk factors for CVD in adults with type 1 diabetes. A longer follow-up is likely required to assess the impact of other traditional CVD risk factors on incident CVD in the current era.

404Impact of cardiovascular risk factors for the development of cardiovascular disease: Results from MORGAM and BiomarCaRE consortia

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
C Magnussen
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Substantial Reduction ◽  
Density Lipoprotein ◽  
Daily Smoking ◽  
Cvd Risk ◽  
Coronary Death ◽  
Cardiac Revascularization ◽  
The Impact

Abstract Background Knowledge about the impact of modifiable risk factors for cardiovascular disease (CVD) onset is essential to improve CVD prevention. Purpose We estimated population-attributable fractions (PAFs) of body-mass-index (BMI), systolic blood pressure (SBP), diabetes, blood lipids (non-high-density lipoprotein cholesterol; non-HDL-C) and daily smoking for CVD. Methods Harmonized data from MOnica Risk, Genetics, Archiving and Monograph (MORGAM) and Biomarkers for Cardiovascular Risk Assessment in Europe (BiomaCaRE) consortia were used to calculate hazard ratios (HRs; 95% CI) and PAFs for incident CVD (myocardial infarction or coronary death, unstable angina, cardiac revascularization, ischemic stroke). PAFs for single risk factors or any combination of them were estimated using methods by Laaksonen 2011. Results We included 150,190 participants (77,801 men and 72,389 women) without CVD at baseline. Strongest associations were seen for SBP ≥160 mmHg (HR 1.79, 1.67–1.92 men; HR 1.93, 1.75–2.14 women), diabetes (HR 2.02, 1.86–2.20 men; HR 2.29, 2.06–2.55 women), non-HDL-C ≥220 mg/dL (HR 3.11, 2.49–3.88 men; HR 2.27, 1.68–3.05 women), daily smoking (HR 1.82, 1.73–1,90 men; HR 2.16, 2.0–2.33 women). Table 1 provides PAFs for incident CVD. Overall PAFs for men and women were 73.7% (67.7–79.1) and 73.3% (64.9–80.9). Table 1. PAFs (%) for 5-year incident CVD Risk factor/category PAFs (95% CI), men PAFs (95% CI), women Underweight 0.1 (−0.1, 0.3) 0.2 (−0.1, 0.6) Pre-obesity 6.6 (4.3, 8.9) 4.3 (1.5, 6.9) Obesity 3.9 (2.7, 5.3) 8.0 (5.3, 10.5) SBP 130 to <140 mmHg 2.8 (1.7, 4.0) 2.7 (1.3, 4.0) SBP 140 to <160 mmHg 9.7 (8.1, 11.3) 9.3 (6.7, 11.6) SBP ≥160 mmHg 11.3 (9.7, 12.8) 18.9 (16.2, 21.8) Diabetes 5.2 (4.5, 6.2) 7.8 (6.5, 9.4) non-HDL-C 100 to <145 mg/dL 4.3 (1.8, 6.4) 3.3 (0.5, 6.5) non-HDL-C 145 to <185 mg/dL 13.9 (9.8, 17.5) 11.3 (6.0, 16.2) non-HDL-C 185 to <220 mg/dL 15.8 (12.8, 18.4) 12.8 (8.8, 17.0) non-HDL-C ≥220 mg/dL 16.7 (14.6, 18.5) 17.0 (12.5, 21.1) Daily smoking 16.5 (15.0, 18.3) 12.3 (10.7, 13.7) The N CVD events/N used was 8,302/77,801 for men and 4,071/72,389 for women. Conclusion Uncontrolled risk factors, especially non-HDL-C and SBP in the highest category, daily smoking and diabetes had the highest impact for incident CVD. All risk factors combined accounted for a PAF of 73%. Targeting risk factors would lead to a substantial reduction of CVD onset. Acknowledgement/Funding BiomarCaRE: EU Seventh Framework Programme (FP7/2007-2013), No. HEALTH-F2-2011-278913. MORGAM: EU FP 7 CHANCES (HEALTH-F3-2010-242244).

Abstract MP53: The Impact of the Obesity Epidemic on Atherosclerotic Cardiovascular Disease Risk Scores: The CARDIA Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Duke Appiah ◽  
Pamela J Schreiner ◽  
Raegan W Durant ◽  
Sharina D Person ◽  
Catarina I Kiefe ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Disease Risk ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Obesity Epidemic ◽  
Ascvd Risk ◽  
The Impact

Introduction: Cardiovascular disease (CVD) mortality has decreased over recent decades, in part, due to changes in the prevalence of risk factors. However, few studies have explored the impact of the obesity epidemic on CVD risk prediction in young adults. Hypothesis: We assessed the hypothesis that BMI trends are positively associated with changes in 10-year AHA/ACC atherosclerotic cardiovascular disease (ASCVD) risk scores from young adulthood to middle age beyond the effect of other CVD risk factors included in the scores (age, sex, race, lipids, blood pressure, hypertension medication, diabetes, smoking). METHODS: Data were obtained from 2437 black and white men and women aged 18-30 years at baseline (1985-1986) enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study with follow-up exams at year 0, 5, 10, 15, 20 and 25 (ages 43-55 years). Repeated-measures regression was used to model the association between ASCVD risk scores and time-varying BMI measures. RESULTS: The average 10-year ASCVD risk increased from 0.6% at baseline (mean age: 25.3) to 3.9% at year 25 (mean age: 50.3) with the change higher for men (blacks: 1.0 to 8.2%, whites: 0.3 to 4.6%) than women (blacks: 0.5 to 3.6%, whites: 1.2 to 1.4%). The overall prevalence of obesity at baseline and year 25 was 10% and 42% respectively. BMI trends were positively associated with 10-year change in ASCVD risk scores (0.12% per 1 kg/m2 increase, p<0.001). BMI adjustment minimally reduced risk scores trends with the greatest change between unadjusted and adjusted risk scores observed among black women (0.1 to 3.0%) (Figures A and B). CONCLUSION: In young adults, BMI trends are associated positively with 10-year changes in ASCVD risk independent of other risk factors. This adds to the evidence that weight control in early adulthood is an important predictor of lower future CVD risk.

Mindfulness-Based Interventions and Cardiovascular Risk Factors in US Racial/Ethnic Minority Populations: A Systematic Review of Implementation Data to Address Health Disparities

2021 ◽  
Author(s):  
Tonya Faye Sanchez ◽  
E. Karina Santamaria ◽  
Dana Rubenstein ◽  
Judson Brewer ◽  
Don Operario
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Contextual Factors ◽  
Cardiovascular Disease Risk ◽  
The United States ◽  
Future Research ◽  
Minority Populations ◽  
Cvd Risk

Abstract Cardiovascular disease (CVD) is a persistent public health challenge. Mindfulness-based Interventions (MBI) have been researched for CVD risk factors, though their effectiveness, generalizability, and potential for implementation to racial and ethnic minorities remain unclear. This review examines studies of MBI on CVD risk for characteristics of and variations in implementation (i.e., intervention design, delivery, uptake, and contextual factors) and analyzes potential barriers and challenges to implementation. A systematic review in February 2020 identified 30 studies from 5 databases and hand searches. Included studies were randomized controlled trials testing meditation or mindfulness-based interventions against any control to measure change or improvement in cardiovascular health measures or risk behaviors in adults living in the United States or territories. Analysis of the implementation characteristics and contextual factors of included studies was conducted using the Oxford Implementation Index. Thirty reports from 26 distinct trials were selected for inclusion, examining outcomes related to diet (k [number of studies] = 13), smoking (k = 11), obesity (k = 9), exercise (k = 4), diabetes (k = 3), and blood lipids (k = 2). All studies were published between 2011 and 2020 and correspond to early stages of research. As such, numerous limitations and implementation characteristics with potential consequence for CVD risk disparities were reported. This review outlines several potential targets for future research. Based on reported findings across all included studies, MBI could be of benefit for cardiovascular disease risk. Further research is needed to explore acceptability, feasibility, and effectiveness in minority populations.

The Association Between the rs2234693 and rs9340799 Estrogen Receptor α Gene Polymorphisms and Risk Factors for Cardiovascular Disease: A Review

2010 ◽  
Vol 12 (1) ◽  
pp. 84-97 ◽  
Author(s):  
Krista Casazza ◽  
Grier P. Page ◽  
Jose R. Fernandez
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Estrogen Receptor ◽  
Estrogen Receptor Α ◽  
Female Reproduction ◽  
Cvd Risk ◽  
Testing Algorithms ◽  
The Impact ◽  
The Relationship ◽  
Estrogen Receptor Α Gene

Although estrogen is primarily thought of as the hormone involved in female reproduction, it also plays a role in many additional physiological and pathological processes. Recent studies have demonstrated an association between estrogen and clustered risk factors for cardiovascular disease (CVD), such as lipid and glucose metabolism and obesity-related phenotypes, as well as occurrence and severity of CVD. Evidence suggesting a genetic basis for this link is accumulating. Several polymorphisms of the estrogen receptor (ER) α (ESR1) gene exist that may influence the impact of estrogen, leading to clinically relevant phenotypes. Based on the relationship ERS1 seems to exhibit with CVD risk factors, these polymorphisms may play a role in the mediation of vasoprotective effects, modulation of cardiovascular physiology, and development of risk factors for CVD. The two most frequently studied polymorphisms located in ESR1 are often identified by their restriction endonucleases Pvull (rs2234693) and Xbal (rs9340799). ln this review, we have evaluated and summarized the results of studies involving rs2234693 and rs9340799 and clustered risk factors accompanying development of CVD. Despite inconsistent findings, together these studies provide some support for a relationship between polymorphisms in ESR1 and risk factors for CVD. These summarized findings do not yet support inclusion of ESR1 genotypes in genetic testing algorithms for predisposition to CVD, but they do indicate that further investigation into the potential connection between ESR1 and risk factors for CVD is warranted.

Abstract P321: Pregnancy Loss is Associated With Subclinical Cardiovascular Disease in Mexican Women

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Sandra A Hartasanchez ◽  
Mario Flores ◽  
Adriana Monge ◽  
Elsa Yunes ◽  
Carlos Cantu-Brito ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Pregnancy Loss ◽  
Carotid Atherosclerosis ◽  
Intima Media Thickness ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Logistic Regression Models ◽  
Underlying Mechanisms ◽  
The Impact

Introduction: Cardiovascular disease (CVD) in women often develops in the absence of conventional risk factors. Prenatal loss, a common pregnancy outcome, may result in physiologic changes that could affect future risk of myocardial infarction. Little is known about the impact of pregnancy loss on early markers of CVD risk. Hypothesis: Pregnancy loss affects carotid artery intima-media thickness (CIMT). Methods: We conducted a cross-sectional analysis among 1,769 disease-free women from the Mexican Teachers’ Cohort who had been pregnant to evaluate the relation between pregnancy loss and CIMT. In 2008 participants answered a baseline questionnaire on reproductive history, risk factors for chronic disease and medical conditions that was updated in 2011. We defined pregnancy loss as abortion and/or stillbirth. Between 2012 and 2016, CIMT was measured by trained neurologists using ultrasound in three clinical sites. We log-transformed CIMT and defined carotid atherosclerosis as CIMT ≥0.8mm or plaque. We used multivariable linear and logistic regression models to assess the relation between pregnancy loss, CIMT and carotid atherosclerosis. Results: Mean age of participants was 49.8 (SD ± 5.1) years. The prevalence of pregnancy loss was 22% (394 of 1769) , while we observed carotid atherosclerosis in 23% (405 of 1769) of participants. Comparing participants who reported a pregnancy loss to those who did not, the multivariable-adjusted odds ratio for carotid atherosclerosis was 1.52 (95% CI 1.12, 2.06). Women who experienced a stillbirth had 2.32 higher odds (95% CI 1.03, 5.21) of carotid atherosclerosis than those who did not. Mean CIMT appeared to be higher in women who reported a pregnancy loss relative to those who did not, however, in multivariable analyses, pregnancy loss and stillbirth were not significantly associated with CIMT. Conclusions: Abortion and stillbirth may be associated with a higher risk of CVD. Additional investigation on potential underlying mechanisms for this association is required.

Abstract P206: The Risk for Cardiovascular Disease Attributable to Traditional Risk Factors Increases

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Susanne Rospleszcz ◽  
Barbara Thorand ◽  
Tonia de las Heras Gala ◽  
Christa Meisinger ◽  
Rolf Holle ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Systolic Blood Pressure ◽  
Population Attributable Risk ◽  
Temporal Trends ◽  
Cvd Risk ◽  
Traditional Risk Factors ◽  
The Impact

Background: Cardiovascular disease (CVD) is a major cause of mortality and morbidity. Traditional risk factors include systolic blood pressure, diabetes, adiposity, cholesterol and smoking. The prevalence and distribution of these risk factors in the population have changed within the last decades and CVD mortality rates have been declining. However, the impact of these changes on the contribution of the single risk factors to overall CVD risk remains to be investigated. Hypothesis: We assessed the hypothesis that the population attributable risk (PAR) of traditional risk factors changes from 1985 to 2000. Methods: The sample comprises N = 11 760 participants aged 30 - 65 years from four prospective population-based cohort studies enrolled in Southern Germany in 1985, 1990, 1995, and 2000. Participants were followed up for incident CVD events for ten years. We analyzed the traditional risk factors hypertension, defined as systolic blood pressure ≥ 140 mmHg or treatment with antihypertensive medication; diabetes mellitus; obesity, defined as a Body Mass Index ≥ 30 kg/m 2 ; hypercholesterolemia, defined as total cholesterol levels ≥ 200 mg/dL; and smoking. We calculated the PAR first according to Levin’s formula using both crude relative risks as well as adjusted hazard ratios and second as an average of all single sequential PARs according to the formulae by Ferguson. Results: Temporal trends in prevalence varied for the respective risk factors. The prevalence of hypertension decreased slightly for women (from 25.0% in 1985 to 23.0% in 2000) and increased slightly for men (32.3% to 33.3%), whereas the prevalence of diabetes and obesity increased for both women and men. Prevalence of hypercholesterolemia decreased slightly for women (from 73.4% to 71.4%) and more pronounced for men (80.5% to 74.5%). Prevalence of smoking increased for women (20% to 23.6%), but decreased for men (36.4% to 32.4%). CVD events occurred in 2.4% of women in 1985 and 2.3% in 2000; for men, event rates were and 6.2% and 6.3%, respectively. For both women and men the risk factor with the highest PAR in 1985 was hypertension (64.0% and 43.3%, respectively according to Levin’s formula). However, in 2000 the risk factor with the highest PAR was hypercholesterolemia (78.2% and 57.0%, respectively). The PAR for diabetes declined for women and increased for men. The PAR for smoking varied substantially between the studies without a discernible trend. According to Ferguson’s formulae, the PAR of all risk factors taken together increased from 74.3% to 84.2% in women and from 70.8% to 81.8% in men. Conclusion: In conclusion, the CVD risk attributable to traditional risk factors has increased within the last decades. However, different methods of calculating the PAR have to be taken into account. These trends might influence public health policies focusing on the management of these risk factors in order to effectively prevent CVD.

Abstract 17345: Particulate Matter and Risk of Incident Cardiovascular Disease in a Nationwide Cohort of Men

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jaime E Hart ◽  
Jarvis T Chen ◽  
Robin C Puett ◽  
Jeff D Yanosky ◽  
Eric B Rimm ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Particulate Matter ◽  
High Blood Pressure ◽  
Smoking Status ◽  
Sensitivity Analyses ◽  
Cvd Risk ◽  
Ambient Exposure ◽  
The Impact

Introduction: Chronic exposures to particulate matter (PM) have been associated with cardiovascular disease (CVD) morbidity and mortality. We examined the impact of long-term exposures to PM on the risk of incident coronary heart disease (CHD) and stroke among members of the nationwide all-male Health Professionals Follow-Up Study (HPFS) prospective cohort. Methods: HPFS members were followed biennially between 1986-2006 to obtain information on incident disease and to update information on CVD risk factors. Time-varying ambient PM 10 , PM 2.5-10 , and PM 2.5 for the previous 12 months were calculated from monthly predictions at the address level. Multivariate adjusted Cox proportional hazards models were used to estimate [HR (95%CI)] for the association between each fraction of PM and each outcome among 43,371 CVD-free members of the HPFS, adjusting for risk factors and other potential confounders. We also assessed effect modification by region of the country, BMI, smoking status, and comorbidities (hypercholesterolemia, high blood pressure, and diabetes). Sensitivity analyses were conducted restricting the population to men who provided residential (N=15,395), as opposed to work, addresses. Results: The mean (SD) levels of 12-month average PM 10 , PM 2.5-10 , and PM 2.5 were 20.7 (6.2), 8.4 (4.7) and 12.3 (3.4) μg/m 3 . In the full population, there was only modest evidence of increased risks of incident CHD or stroke with increasing PM exposures. Associations with stroke were modified by region, hypercholesterolemia, high blood pressure, and diabetes, with larger effects among those with comorbid conditions and in the Northeast and South. CHD, but not stroke, dose-responses were stronger among those who provided residential as opposed to work addresses; each 10 μg/m 3 increase, was associated with increases in overall CHD [1.10 (95%CI: 1.01-1.20), 1.09 (0.97-1.23), and 1.14 (0.98-1.32) for PM 10 , PM 2.5-10 , and PM 2.5 , respectively]. Conclusions: In this cohort of US men, PM exposures were only modestly associated with elevated risks of CHD and stroke. Comorbidities and region modified the associations with stroke, and residential ambient exposures were more associated with CHD than work ambient exposure.

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