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Lang X, Feng D, Huang S, Liu Y, Zhang K, Shen X, Huang J, Wang Q. How to help aortic dissection survivors with recovery?: A health promotion program based on the comprehensive theory of health behavior change and literature review. Medicine (Baltimore) 2023; 102:e33017. [PMID: 36800621 PMCID: PMC9935995 DOI: 10.1097/md.0000000000033017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
For aortic dissection survivors, health promotion can help them recover from the disease, which requires systematic program support. The aim of this study was to construct a health promotion program for aortic dissection survivors. Literature search, group discussion, and expert consultation were used. The Integrated Theory of Health Behavior Change was the theoretical basis of the program. Multiple medical-related databases were searched. Based on a literature search and group discussion, 3 primary items, 8 secondary items, and 34 tertiary items were formed. After 2 rounds of expert consultation (number of experts = 25), 3 primary items, 16 secondary items, and 54 tertiary items were retained. The authority coefficients of the 2 rounds of experts were 0.890 and 0.905, respectively. The Kendall W coefficient of the 2 rounds were 0.210 to 0.370 (P < .05) and 0.221 to 0.378 (P < .05), respectively. The mean importance value and coefficient of variation of each item were >3.5 and <0.25, respectively. The health promotion program constructed in this study was reasonable and scientific, which could provide a reference for clinical work.
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Affiliation(s)
- Xiaorong Lang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Danni Feng
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Sufang Huang
- Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
- * Correspondence: Sufang Huang, Emergency Department, Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province 430030, China (e-mail: )
| | - Yucheng Liu
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Kexin Zhang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiaoxuan Shen
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Jingjing Huang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Quan Wang
- School of Nursing, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, Hubei Province, China
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Aortic dissection: global epidemiology. CARDIOLOGY PLUS 2022. [DOI: 10.1097/cp9.0000000000000028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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Otaki Y, Watanabe T, Konta T, Watanabe M, Fujimoto S, Sato Y, Asahi K, Yamagata K, Tsuruya K, Narita I, Kasahara M, Shibagaki Y, Iseki K, Moriyama T, Kondo M, Watanabe T. A Body Shape Index and Aortic Disease-Related Mortality in Japanese General Population. J Atheroscler Thromb 2022. [PMID: 36070887 DOI: 10.5551/jat.63753] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Aortic diseases (ADs), including aortic dissection, aortic aneurysm, and aortic rupture, are fatal, with extremely high mortality rates. A body shape index (ABSI), an anthropometric measure calculated as waist circumference adjusted by height and weight, improves the predictive capacity for mortality. However, whether ABSI is a risk factor for AD-related mortality in the general population remains unclear. METHODS We used a nationwide database of 630,842 individuals (aged 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" between 2008 and 2010. RESULTS During the follow-up period of 3.8 years, 159 AD-related deaths occurred, including 105 aortic dissections and 54 aortic aneurysm ruptures. The subjects were divided into three groups based on ABSI tertiles. Kaplan-Meier analysis demonstrated that the 3rd tertile (with the highest ABSI) had the greatest risk among the three groups. Multivariate Cox proportional hazard regression analysis demonstrated that ABSI was significantly associated with AD-related death after adjusting for confounding risk factors. Neither waist circumference nor body mass index consistently predicted AD-related death in the multivariate model. The prediction capacity was significantly improved by the addition of ABSI to the confounding risk factors. CONCLUSIONS We demonstrated for the first time that ABSI, a surrogate marker for abdominal visceral fat tissue, was associated with AD-related deaths in the general population, suggesting the importance of central adiposity in the development of AD.
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Affiliation(s)
- Yoichiro Otaki
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University School of Medicine
| | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | | | - Yuji Sato
- Dialysis Division, University of Miyazaki Hospital
| | - Koichi Asahi
- The Japan Specific Health Checkups study (J-SHC study) Group
| | | | | | - Ichiei Narita
- The Japan Specific Health Checkups study (J-SHC study) Group
| | - Masato Kasahara
- The Japan Specific Health Checkups study (J-SHC study) Group
| | - Yugo Shibagaki
- The Japan Specific Health Checkups study (J-SHC study) Group
| | - Kunitoshi Iseki
- The Japan Specific Health Checkups study (J-SHC study) Group
| | | | - Masahide Kondo
- The Japan Specific Health Checkups study (J-SHC study) Group
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Tanimura T, Teramoto M, Tamakoshi A, Iso H. Association of Physical Activity with Aortic Disease in Japanese Men and Women: The Japan Collaborative Cohort Study. J Atheroscler Thromb 2022; 30:408-414. [PMID: 35793980 PMCID: PMC10067333 DOI: 10.5551/jat.63416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Evidence of the effects of physical activity on mortality from aortic diseases, especially in Asian populations, remains limited. This study aimed to examine these effects using data from a large long-term cohort study of Japanese men and women. METHODS Between 1988 and 1990, 32,083 men and 43,454 women in Japan, aged 40-79 years with no history of coronary heart disease, stroke, aortic diseases, or cancer, filled in questionnaires on time spent walking and participating in sports and were followed up until 2009. Multivariable hazard ratios (HRs) with 95% confidence intervals (CIs) of aortic disease mortality and its types (aortic aneurysm and dissection) according to the time spent walking and participating in sports were calculated after adjusting for potential confounding factors using the Cox proportional hazards model. RESULTS During a median follow-up of 19.1 years, a total of 173 deaths from aortic disease (91 cases of aortic dissection and 82 of aortic aneurysm) were documented. Sports participation time was inversely associated with the risk of death from aortic aneurysm: the multivariable HRs (95% CIs) were 0.68 (0.40-1.16) for <1 h/week, 0.50 (0.19-1.35) for 3-4 h/week, and 0.31 (0.10-0.93) for ≥ 5 h/week (p for trend=0.23) compared with 1-2 h/week. The time spent walking was not associated with death from aortic aneurysm, dissection, and total aortic diseases. CONCLUSIONS Greater time spent in sports participation was associated with a reduced risk of mortality from aortic aneurism in the Japanese population. Further studies are needed to investigate the relationship between physical activity and aortic dissection.
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Affiliation(s)
- Tadayuki Tanimura
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Masayuki Teramoto
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
| | - Akiko Tamakoshi
- Department of Public Health, Division of Preventive Medicine, Hokkaido University, Graduate School of Medicine
| | - Hiroyasu Iso
- Public Health, Department of Social Medicine, Osaka University Graduate School of Medicine
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Zhang X, Liu Y, Li S, Lichtenstein AH, Chen S, Na M, Veldheer S, Xing A, Wang Y, Wu S, Gao X. Alcohol consumption and risk of cardiovascular disease, cancer and mortality: a prospective cohort study. Nutr J 2021; 20:13. [PMID: 33522924 PMCID: PMC7852289 DOI: 10.1186/s12937-021-00671-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 01/27/2021] [Indexed: 12/24/2022] Open
Abstract
Background Studies regarding whether light to moderate alcohol consumption is associated with a lower risk of cardiovascular diseases (CVD) have generated mixed results. Further, few studies have examined the potential impact of alcohol consumption on diverse disease outcomes simultaneously. We aimed to prospectively study the dose-response association between alcohol consumption and risk of CVD, cancer, and mortality. Methods This study included 83,732 adult Chinese participants, free of CVD and cancer at baseline. Participants were categorized into 6 groups based on self-report alcohol consumption: 0, 1–25, 26–150, 151–350, 351–750, and > 750 g alcohol/wk. Incident cases of CVD, cancers, and mortality were confirmed by medical records. Hazard ratios (HRs) for the composite risk of these three outcomes, and each individual outcome, were calculated using Cox proportional hazard model. Results During a median follow-up of 10.0 years, there were 6411 incident cases of CVD, 2947 cancers and 6646 deaths. We observed a J-shaped relation between alcohol intake and risk of CVD, cancer, and mortality, with the lowest risk at 25 g/wk., which is equivalent to ~ 2 servings/wk. Compared to consuming 1–25 g/wk., the adjusted HR for composite outcomes was 1.38 (95% confidence interval (CI):1.29–1.49) for non-drinker, 1.15 (95% CI: 1.04–1.27) for 26–150 g/wk., 1.22 (95% CI: 1.10–1.34) for 151–350 g/wk., 1.33 (95% CI: 1.21–1.46) for 351–750 g/wk., and 1.57 (95% CI: 1.30–1.90) for > 750 g/wk., after adjusting for age, sex, lifestyle, social economic status, and medication use. Conclusions Light alcohol consumption at ~ 25 g/wk was associated with lower risk of CVD, cancer, and mortality than none or higher consumption in Chinese adults. Supplementary Information The online version contains supplementary material available at 10.1186/s12937-021-00671-y.
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Affiliation(s)
- Xinyuan Zhang
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Yan Liu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shanshan Li
- Slone Epidemiology Center, Boston University School of Medicine, Boston, USA
| | - Alice H Lichtenstein
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Muzi Na
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA
| | - Susan Veldheer
- Department of Family and Community Medicine and Public Health Sciences, The Pennsylvania State University College of Medicine, Hershey, USA
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Yanxiu Wang
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, 57 Xinhua East Rd, Tangshan, 063000, China.
| | - Xiang Gao
- Department of Nutritional Sciences, The Pennsylvania State University, 109 Chandlee Lab, University Park, PA, 16802, USA.
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Li LY, Chien WC, Wang JC, Tzeng NS, Chung CH, Lin CY, Tsai SH. Association between abdominal aortic aneurysms and alcohol-related diseases. Medicine (Baltimore) 2020; 99:e22968. [PMID: 33126369 PMCID: PMC7598798 DOI: 10.1097/md.0000000000022968] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Heterogeneous associations exist between alcohol consumption and the initial presentation of cardiovascular diseases (CVDs). Studies regarding the association between abdominal aortic aneurysms (AAAs) and alcohol consumption are still limited and controversial. We hypothesize that patients with alcohol-related diseases are susceptible to AAA formation due to the presence of overlapping epidemiological factors and molecular mechanisms. We aimed to use a nationwide population-based retrospective cohort study to evaluate the association between alcohol-related diseases and AAA.The data were extracted from the National Health Insurance Research Database (NHIRD) in Taiwan. The study outcome assessed was the cumulative incidence of AAA in patients with alcohol-related diseases during a 14-year follow-up period.Our study included 22,878 patients who had alcohol-related diseases; these patients with alcohol-related diseases had a significantly higher cumulative risk of developing AAA 5 years after the index date than did the 91,512 patients without alcohol-related diseases. Patients with alcohol-related diseases also exhibited a significantly increased incidence of AAA compared with the incidence among patients without alcohol-related diseases, according to Cox regression analysis and Fine & Gray's competing risk model (adjusted hazard ratio = 2.379, 95% confidence interval = 1.653 -3.424, P < .001). In addition, male gender, older age, and chronic kidney disease were also associated with an increased risk of developing AAA. An interaction model showed that males with alcohol-related diseases had a 10.4-fold higher risk of AAA than did females without alcohol-related diseases.We observed an association between alcohol-related diseases and AAA even after adjusting for several comorbidities and medications in a nationwide population database.
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Affiliation(s)
| | - Wu-Chien Chien
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health, National Defense Medical Center
- Taiwanese Injury Prevention and Safety Promotion Association
| | - Jen-Chun Wang
- Department of Emergency Medicine
- Institute of Clinical Medicine, National Yang-Ming University
| | - Nian-Sheng Tzeng
- Department of Psychiatry, Tri-Service General Hospital
- Student Counseling Center
| | - Chi-Hsiang Chung
- Department of Medical Research, Tri-Service General Hospital
- School of Public Health, National Defense Medical Center
- Taiwanese Injury Prevention and Safety Promotion Association
| | - Chih-Yuan Lin
- Department of Surgery, Division of Cardiovascular Surgery, Tri-Service General Hospital
| | - Shih-Hung Tsai
- Department of Emergency Medicine
- Department of Physiology and Biophysics, Graduate Institute of Physiology, National Defense Medical Center, Taipei, Taiwan
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7
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Abdelhameed AS, Xin F, Wei X. Early Mortality in Patients who Received Extensive Surgical Management for Acute Type A Aortic Dissection - Analysis of 452 Consecutive Cases from a Single-center Experience. Braz J Cardiovasc Surg 2020; 35:521-529. [PMID: 32864933 PMCID: PMC7454641 DOI: 10.21470/1678-9741-2019-0258] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Objective To detect the potential risk factors associated with early mortality in patients who received extensive surgical management, in the form of total arch replacement plus frozen elephant trunk and arch debranching (hybrid repair technique), for acute type A aortic dissection. Methods The clinical and surgical data of 452 surgically treated patients with acute type A aortic dissection at our center, between March 2010 and December 2016, have been retrieved. Uni and multivariate logistic regression analyses were carried out to detect the effect of various preoperative demographics and different perioperative variables on early mortality. Results Overall 30-day mortality occurred in 70 out of 452 patients (15.4%). The principal causes of death were multiple organ failure (n=38), cardiac failure (n=18), and severe pulmonary infection (n=10). Risk factors for early mortality were identified with multivariate analysis. Preoperatively, overweight (P<0.025), alcohol drinking (P<0.002), coronary artery disease (P<0.014), hemodynamic shock (P<0.006), and elevated white blood cells count (P<0.002) were associated with higher mortality rate. Postoperatively, prolonged operation time (P<0.008), stroke (P<0.0001), and acute renal dysfunction (P<0.0001) were highly associated with death. Conclusion Considering the advantages of extensive surgical management for acute type A aortic dissection over the other less aggressive surgical approaches, it should be advised whenever indicated, provided that being carried out by experts in the field of adult aortic surgery in high-volume centers. The surgeon should be aware of the patient’s preoperative comorbidities and other risk factors for early mortality, in particular, prolonged operation time.
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Affiliation(s)
- Ahmed Sayed Abdelhameed
- Department of Cardiothoracic Surgery, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Feng Xin
- Department of Cardiothoracic Surgery, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
| | - Xiang Wei
- Department of Cardiothoracic Surgery, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China
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Hori S, Hori E, Umemura K, Shibata T, Okamoto S, Kubo M, Horie Y, Kuroda S. Anatomical Variations of Vertebrobasilar Artery are Closely Related to the Occurrence of Vertebral Artery Dissection-An MR Angiography Study. J Stroke Cerebrovasc Dis 2020; 29:104636. [PMID: 32008922 DOI: 10.1016/j.jstrokecerebrovasdis.2020.104636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/09/2019] [Accepted: 12/31/2019] [Indexed: 01/22/2023] Open
Abstract
GOAL Intracranial arterial dissection is a major cause of ischemic stroke and subarachnoid hemorrhage in relatively young patients. We assessed the hypothesis that the tortuosity of the vertebrobasilar artery is associated with the occurrence of vertebral artery (VA) dissection, using MR angiography (MRA). MATERIALS AND METHODS This study enrolled 43 patients with VA dissection, and 63 age- and sex-matched healthy subjects were used as the controls. MRA was employed to evaluate the presence of dominant VA and the lateral shift of vertebrobasilar junction in both groups. The VA diameters were considered different when the difference was greater than .3 mm. These anatomical variations were divided into 3 types: Type 1 (vertebrobasilar junction within 2 mm from the midline), Type 2 (>2 mm-lateral shift of vertebrobasilar junction to the ipsilateral side of the dominant VA), and Type 3 (>2 mm-lateral shift of vertebrobasilar junction to the contralateral side of the dominant VA). FINDINGS The presence of dominant VA and the lateral shift of vertebrobasilar junction were more prevalent in patients with VA dissection than in the controls (OR: 3.46, P = .013, and OR: 4.51, P = .001, respectively). The lateral shift of vertebrobasilar junction was classified into Type 1 (n = 6), Type 2 (n = 13), and Type 3 (n = 17) among patients with VA dissection, while into Type 1 (n = 20), Type 2 (n = 8), and Type 3 (n = 7) among the controls. Type 3 predominance was observed in patients with VA dissection (P = .02). CONCLUSIONS Anatomical variations of the vertebrobasilar artery may play an important role in the occurrence of VA dissection.
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Affiliation(s)
- Satoshi Hori
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan.
| | - Emiko Hori
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Kimiko Umemura
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Takashi Shibata
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Soushi Okamoto
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Michiya Kubo
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Yukio Horie
- Department of Neurosurgery, Stroke Center, Saiseikai Toyama Hospital, Toyama, Japan
| | - Satoshi Kuroda
- Department of Neurosurgery, Graduate School of Medicine and Pharmaceutical Science, University of Toyama, Toyama, Japan
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Oikonomou E, Lazaros G, Tsalamandris S, Vogiatzi G, Christoforatou E, Papakonstantinou M, Goliopoulou A, Tousouli M, Chasikidis C, Tousoulis D. Alcohol Consumption and Aortic Root Dilatation: Insights from the Corinthia Study. Angiology 2019; 70:969-977. [DOI: 10.1177/0003319719848172] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
Aortic diameter and progression to thoracic aortic aneurysm are influenced by several factors. In this study, we investigated the association of alcohol consumption with aortic root and ascending aorta dilatation. In the context of the Corinthia study, we examined 1751 patients with echocardiography. Several demographic and clinical characteristics were recorded. Alcohol consumption was assessed based on a questionnaire of frequency, type, and quantity. Accordingly, patients were categorized as everyday alcohol consumers (EDACs) and as social drinkers (SoD). Everyday alcohol consumers were further categorized to group 1: 0 to 1 drink/d; group 2: 1 to 2 drinks/d; and group 3: ≥3 drinks/d. From the study population, 40% were categorized as EDAC and had an increased aortic root diameter (AoRD) and an elevated AoRD index compared with SoD. Interestingly, there was a stepwise increase in aortic root and ascending aorta diameter according to daily alcohol consumption. Specifically, patients consuming ≥3 drinks of alcohol/d had increased indexed aortic by 1.4 mm/m2 compared with SoD even after adjustment for possible confounders. Daily alcohol consumption is associated with increased aortic root diameter. These findings may have important clinical implications, especially in patients with borderline or dilated aortic root, and merit further investigation.
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Affiliation(s)
- Evangelos Oikonomou
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - George Lazaros
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Sotirios Tsalamandris
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Georgia Vogiatzi
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Evangelia Christoforatou
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Margenti Papakonstantinou
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Athina Goliopoulou
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Maria Tousouli
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christos Chasikidis
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Dimitris Tousoulis
- First Cardiology Clinic, ‘Hippokration’ General Hospital, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
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10
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Kimani C, Kadota A, Miura K, Fujiyoshi A, Zaid M, Kadowaki S, Hisamatsu T, Arima H, Horie M, Ueshima H. Differences Between Coronary Artery Calcification and Aortic Artery Calcification in Relation to Cardiovascular Disease Risk Factors in Japanese Men. J Atheroscler Thromb 2018; 26:452-464. [PMID: 30381612 PMCID: PMC6514173 DOI: 10.5551/jat.44784] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIMS Calcification in the coronary and aortic arteries has been linked to cardiovascular morbidity and mortality. The pathophysiological influence of aortic artery calcification (AAC) differs from that of coronary artery calcification (CAC). We aimed to compare the relationships between CAC and AAC and cardiovascular disease (CVD) risk factors. METHODS We examined a random sample of 1035 Japanese men aged 40-79 years. CAC and AAC were measured by computed tomography and scored according to the Agatston method. Using a logistic regression, we calculated the odds ratio (OR) as being in the highest quintile (Q5) of the calcification score compared to the lower quintiles (Q1-Q4) per 1 standard deviation higher CVD risk factor. Models were simultaneously adjusted for age, body mass index (BMI), systolic blood pressure, smoking (pack-year), alcohol intake, hemoglobin A1c, uric acid, estimated glomerular filtration rate (eGFR), serum lipids, and C-reactive protein. Differences in ORs were investigated using a generalized estimating equation. We performed a multiple linear regression using log-transformed CAC and AAC values as dependent variables. RESULTS CAC and AAC were independently associated with age (OR, 95% CI: 2.30 [1.77-2.98] for CAC and 3.48 [2.57-4.73] for AAC), p for difference <0.001), systolic blood pressure (1.29 [1.08-1.53] and 1.28 [1.07-1.54], p for difference=0.270), and smoking (1.22, [1.04-1.43] and 1.34 [1.13-1.58]) p for difference=0.071). Alcohol correlated with AAC only (1.17 [0.97-1.41] for CAC and 1.42 [1.16-1.73] for AAC, p for difference= 0.020). CONCLUSIONS CAC and AAC were associated with similar CVD risk factors. The strength of association slightly differed between CAC and AAC.
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Affiliation(s)
- Cecilia Kimani
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Aya Kadota
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Katsuyuki Miura
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
| | - Akira Fujiyoshi
- Department of Public Health, Shiga University of Medical Science
| | - Maryam Zaid
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science
| | - Sayaka Kadowaki
- Department of Public Health, Shiga University of Medical Science
| | - Takashi Hisamatsu
- Department of Public Health, Shiga University of Medical Science.,Department of Environmental Medicine and Public Health, Faculty of Medicine, Shimane University
| | - Hisatomi Arima
- Department of Preventive Medicine and Public Health, Faculty of Medicine, Fukuoka University
| | - Minoru Horie
- Department of Internal Medicine, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science.,Department of Public Health, Shiga University of Medical Science
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Otaki Y, Watanabe T, Konta T, Watanabe M, Fujimoto S, Sato Y, Asahi K, Yamagata K, Tsuruya K, Narita I, Kasahara M, Shibagaki Y, Iseki K, Moriyama T, Kondo M, Watanabe T. Effect of Hypertension on Aortic Artery Disease-Related Mortality - 3.8-Year Nationwide Community-Based Prospective Cohort Study. Circ J 2018; 82:2776-2782. [PMID: 30298835 DOI: 10.1253/circj.cj-18-0721] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Aortic artery disease (AAD), such as aortic dissection or aortic aneurysm rupture, is fatal, with an extremely high mortality. Because of its low incidence, the risk for the development of AAD has not yet been elucidated. Hypertension (HT) is an established risk factor for cardiovascular disease, but there has been no prospective study on the effect of HT on AAD-related mortality. Methods and Results: We used a nationwide database of 276,197 subjects (aged 40-75 years) who participated in the annual "Specific Health Check and Guidance in Japan" from 2008 to 2010. There were 80 AAD-related deaths during the follow-up period of 1,049,549 person-years. On multivariate Cox proportional hazard regression, HT was an independent risk factor for AAD-related death in apparently healthy subjects. On receiver operating characteristics curve analysis for AAD-related death, abnormal systolic and diastolic blood pressure (SBP and DBP) were 130 mmHg and 82 mmHg, respectively. The prediction capacity was significantly improved by the addition of SBP to confounding risk factors. Notably, further improvement of the C index was observed by addition of DBP to the model with SBP. CONCLUSIONS This is the first report to prospectively show that HT is a risk factor for AAD-related death. Both SBP and DBP are of critical importance in the primary prevention of AAD-related death in apparently healthy subjects.
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Affiliation(s)
- Yoichiro Otaki
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Tetsu Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Tsuneo Konta
- Department of Public Health and Hygiene, Yamagata University School of Medicine
| | - Masafumi Watanabe
- Department of Cardiology, Pulmonology, and Nephrology, Yamagata University School of Medicine
| | - Shouichi Fujimoto
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Yuji Sato
- Dialysis Division, University of Miyazaki Hospital
| | - Koichi Asahi
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Kunihiro Yamagata
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Kazuhiko Tsuruya
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Ichiei Narita
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Masato Kasahara
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Yugo Shibagaki
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Kunitoshi Iseki
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Toshiki Moriyama
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Masahide Kondo
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
| | - Tsuyoshi Watanabe
- Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Check
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