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Huang H, Wang J, Dunk MM, Guo J, Dove A, Ma J, Bennett DA, Xu W. Association of Cardiovascular Health With Brain Age Estimated Using Machine Learning Methods in Middle-Aged and Older Adults. Neurology 2024; 103:e209530. [PMID: 38889383 PMCID: PMC11226327 DOI: 10.1212/wnl.0000000000209530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 04/05/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Cardiovascular health (CVH) has been associated with cognitive decline and dementia, but the extent to which CVH affects brain health remains unclear. We investigated the association of CVH, assessed using Life's Essential 8 (LE8), with neuroimaging-based brain age and brain-predicted age difference (brain-PAD). METHODS This longitudinal community-based study was based on UK Biobank participants aged 40-69 years who were free from dementia and other neurologic diseases at baseline. LE8 score at baseline was assessed with 8 measures and tertiled as low, moderate, and high CVH. Structural and functional brain MRI scans were performed approximately 9 years after baseline, and 1,079 measures from 6 neuroimaging modalities were used to model brain age. A Least Absolute Shrinkage and Selection Operator regression model was trained in 4,355 healthy participants and then used to calculate brain age and brain-PAD in the whole population. Data were analyzed using linear regression models. RESULTS The study included 32,646 participants (mean age at baseline 54.74 years; 53.44% female; mean LE8 score: 71.90). In multivariable-adjusted linear regression, higher LE8 score was associated with younger brain age (β [95% CI] -0.037 [-0.043 to -0.031]) and more negative brain-PAD (β [95% CI] -0.043 [-0.048 to -0.038]) (brain looks younger for chronological age). Compared with high CVH, low/moderate CVH was associated with older brain age (β [95% CI] 1.030 [0.852-1.208]/0.475 [0.303-0.647]) and increased brain-PAD (β [95% CI] 1.193 [1.029-1.357]/0.528 [0.370-0.686]). The associations between low CVH and older brain age/brain-PAD remained similar and significant in both middle-aged (β [95% CI] 1.199 [0.992-1.405]/1.351 [1.159-1.542]) and older adults (β [95% CI] 0.764 [0.417-1.110]/0.948 [0.632-1.263]). DISCUSSION Low CVH is associated with older brain age and greater brain-PAD, even among middle-aged adults. Our findings suggest that optimizing CVH could support brain health. The main limitation of our study is that the study sample was healthier than the general population, thus caution is required when generalizing our findings to other populations.
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Affiliation(s)
- Huijie Huang
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Jiao Wang
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Michelle M Dunk
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Jie Guo
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Abigail Dove
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Jun Ma
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - David A Bennett
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
| | - Weili Xu
- From the Department of Epidemiology and Biostatistics (H.H., J.M., W.X.), School of Public Health, Tianjin Medical University; Department of Epidemiology (J.W.), College of Preventive Medicine, Third Military Medical University, China; Aging Research Center (M.M.D., J.G., A.D., W.X.), Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Nutrition and Health (J.G.), China Agricultural University, Beijing, China; and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL
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Zhang W, Zhu A, Ling J, Zhang R, Liu T, Tian T, Niu J, Dong J, Ruan Y. Short-term effects of nitrogen dioxide on inpatient acute myocardial infarction in Lanzhou, China. JOURNAL OF THE AIR & WASTE MANAGEMENT ASSOCIATION (1995) 2024; 74:449-456. [PMID: 38739852 DOI: 10.1080/10962247.2024.2350441] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 04/24/2024] [Indexed: 05/16/2024]
Abstract
Nitrogen dioxide (NO2) represents a deleterious effect on acute myocardial infarction (AMI), but few relevant studies have been conducted in China. We aim to evaluate the acute effects of NO2 exposure on hospitalization for AMI in Lanzhou, China. In this study, we applied a distributional lag nonlinear model (DLNM) to assess the association between NO2 exposure and AMI hospitalization. We explored the sensitivity of various groups through stratified analysis by gender, age, and season. The daily average concentration of NO2 is 47.50 ± 17.38 µg/m3. We observed a significant exposure-response relationship between NO2 concentration and AMI hospitalization. The single pollutant model analysis shows that NO2 is positively correlated with AMI hospitalization at lag1, lag01, lag02, and lag03. The greatest lag effect estimate occurs at lag01, where a 10 µg/m3 increase in NO2 concentrations is significantly associated with a relative risk (RR) of hospitalization due to AMI of 1.027 [95% confidence interval (CI): 1.013, 1.042]. The results of the stratified analysis by gender, age, and season indicate that males, those aged ≥65 years, and the cold season are more sensitive to the deleterious effects caused by NO2 exposure. Short-term exposure to NO2 can enhance the risk of AMI hospitalization in urban Lanzhou.Implications: Exposure to particulate matter can lead to an increased incidence of AMI. Our study once again shows that NO2 exposure increases the risk of AMI hospital admission. AMI is a common and expensive fatal condition. Reducing NO2 exposure will benefit cardiovascular health and save on healthcare costs.
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Affiliation(s)
- Wancheng Zhang
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Anning Zhu
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Jianglong Ling
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Runping Zhang
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Tong Liu
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Tian Tian
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Jingping Niu
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Jiyuan Dong
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
| | - Ye Ruan
- School of Public Health, Lanzhou University, Lanzhou, People's Republic of China
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Jin CD, Kim MH, Lee KM, Yun SC. Effect of Temperature Variation on the Incidence of Acute Myocardial Infarction. J Korean Med Sci 2024; 39:e101. [PMID: 38501185 PMCID: PMC10948260 DOI: 10.3346/jkms.2024.39.e101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/16/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Harsh temperature exposure has been associated with a high risk of cardiovascular events. We sought to investigate the influence of temperature change on long-term incidence of acute myocardial infarction (AMI) in Korean patients. METHODS From the National Health Insurance Service (NHIS) customized health information database (from 2005 to 2014), data from a total of 192,567 AMI patients was assessed according to the International Classification of Disease 10th edition code and matched with temperature reports obtained from the Korea Meteorological Administration database. We analyzed data for a 10-year period on a monthly and seasonal basis. RESULTS The incidence rate per 100,000 year of AMI exhibited a downward trend from 69.1 to 56.1 over the period 2005 to 2014 (P < 0.005), and the seasonal AMI incidence rate per 100,000 year was highest in spring (63.1), and winter (61.3) followed by autumn (59.5) and summer (57.1). On a monthly basis, the AMI incidence rate per 100,000 year was highest during March (64.4) and December (63.9). The highest incidence of AMI occurred during temperature differences of 8-10° in each season. Moreover, AMI incidence tended to increase as the mean temperature decreased (r = -0.233, P = 0.001), and when the mean daily temperature difference increased (r = 0.353, P < 0.001). CONCLUSION The AMI incidence rate per 100,000 year has a decreasing trend over the 10-year period, derived from the Korean NHIS database. Modest daily temperature differences (8-10°) and the spring season are related to higher AMI incidence, indicating that daily temperature variation is more important than the mean daily temperature.
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Affiliation(s)
- Cai De Jin
- Department of Cardiology, Dong-A University Hospital, Busan, Korea
- Department of Cardiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan, Korea.
| | - Kwang Min Lee
- Department of Cardiology, Dong-A University Hospital, Busan, Korea
| | - Sung-Cheol Yun
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Zhang Z, Yu B, Sun Y, Zhang K, Tan X, Lu Y, Wang N, Xia F. Self-Reported Outdoor Light Exposure Time and Incident Heart Failure. J Am Heart Assoc 2024; 13:e031830. [PMID: 38348794 PMCID: PMC11010087 DOI: 10.1161/jaha.123.031830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 01/03/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND A healthy lifestyle is an important factor for preventing heart failure. However, the association between outdoor light exposure time and heart failure is still unknown. The aim of this study was to examine the association between outdoor light exposure time and the incidence of heart failure. METHODS AND RESULTS This cohort study included participants from the UK Biobank recruited from 2006 to 2010 who were 40 to 70 years of age and free of heart failure at baseline. The mean follow-up time was 12.61 years. The outdoor light exposure time was self-reported at baseline. A restricted cubic spline was performed to examine the potential nonlinear relationship between outdoor light exposure and the incidence of heart failure. Cox proportional hazard models were used to estimate the hazard ratios (HRs) and 95% CIs. During a mean follow-up of 12.61 years, 13 789 participants were first diagnosed with heart failure. There was a nonlinear (J-shaped) trend between outdoor light time and heart failure risk. Cox proportional hazard regression models showed that, compared with participants who received an average of 1.0 to 2.5 hours of outdoor light per day, those with <1.0 hours or >2.5 hours had a higher risk of heart failure after the model was adjusted for age and sex (<1.0 hours: HR, 1.27 [95% CI, 1.18-1.36]; >2.5 hours: HR, 1.11 [95% CI, 1.07-1.15]). These associations were still significant in the fully adjusted models (<1.0 hours: HR, 1.10 [95% CI, 1.03-1.18]; >2.5 hours: HR, 1.07 [95% CI, 1.03-1.11]). CONCLUSIONS We found a J-shaped association between outdoor light exposure time and the risk of incident heart failure, suggesting that moderate exposure to outdoor light may be a prevention strategy for heart failure.
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Affiliation(s)
- Ziteng Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Bowei Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Ying Sun
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Kun Zhang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Xiao Tan
- School of Public HealthZhejiang UniversityHangzhouChina
- Department of Medical SciencesUppsala UniversityUppsalaSweden
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
| | - Fangzhen Xia
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People’s HospitalShanghai JiaoTong University School of MedicineShanghaiChina
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Wang S, Wang J, Guo J, Dove A, Xu H, Qi X, Xu W. Association of Kidney Function With Dementia and Structural Brain Differences: A Large Population-Based Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad192. [PMID: 37578935 PMCID: PMC10733178 DOI: 10.1093/gerona/glad192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Indexed: 08/16/2023] Open
Abstract
BACKGROUND The association between kidney function and dementia risk and the mechanisms underlying this relationship remain unclear. METHODS Within the UK Biobank, 191 970 dementia-free participants aged ≥60 (mean age: 64.1 ± 2.9 years) were followed for 16 years to detect incident dementia. Serum creatinine and Cystatin C were measured at baseline to calculate estimated glomerular filtration rate (eGFR, mL/min/1.73 m2). Kidney function was categorized as normal (eGFR ≥ 90), mildly impaired (60 ≤ eGFR < 90), or moderately to severely impaired (eGFR < 60). Dementia was assessed based on self-reported medical history and medical records. During the follow-up, a subsample of 12 637 participants underwent brain MRI scans. Volumes of total brain, gray matter, white matter, hippocampus, and white matter hyperintensities were assessed. RESULTS Over the follow-up, 5 327 (2.8%) participants developed dementia. Compared to normal kidney function, there was an increased risk of dementia with moderate to severely impaired kidney function (hazard ratio = 1.53, 95% confidence interval [CI]: 1.32-1.76) but not mildly impaired kidney function. In Laplace regression, dementia onset among people with moderate to severely impaired kidney function occurred 1.53 (95% CI: 0.98-2.08) years earlier than those with normal kidney function. Moderate to severely impaired kidney function was related to significantly lower gray matter volume (β = -0.11, 95% CI: -0.19 to -0.03), but not to other brain magnetic resonance imaging measures. CONCLUSIONS Impaired kidney function is associated with about 50% increased risk of dementia and anticipates dementia onset by more than 1.5 years. Brain neurodegeneration may underlie the kidney function-dementia association.
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Affiliation(s)
- Shuqi Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Jiao Wang
- Department of Epidemiology, College of Preventive Medicine, the Army Medical University (Third Military Medical University), Chongqing, China
| | - Jie Guo
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Abigail Dove
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Hong Xu
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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Bromby C, Welsh T. Daylight and dementia: don't stop going outside. Evid Based Nurs 2023; 26:95. [PMID: 36549878 DOI: 10.1136/ebnurs-2022-103578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/09/2022] [Indexed: 12/24/2022]
Affiliation(s)
- Carys Bromby
- Research Institute for the Care of Older People, Bath, UK
| | - Tomas Welsh
- Research Institute for the Care of Older People, Bath, UK
- Older Persons' Unit, Royal United Hospitals Bath NHS Foundation Trust, Bath, Bath and North East Somer, UK
- Translational Health Sciences, University of Bristol, Bristol, Bristol, UK
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Schamilow S, Santonja I, Weitzer J, Strohmaier S, Klösch G, Seidel S, Schernhammer E, Papantoniou K. Time Spent Outdoors and Associations with Sleep, Optimism, Happiness and Health before and during the COVID-19 Pandemic in Austria. Clocks Sleep 2023; 5:358-372. [PMID: 37489436 PMCID: PMC10366917 DOI: 10.3390/clockssleep5030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 06/06/2023] [Accepted: 06/14/2023] [Indexed: 07/26/2023] Open
Abstract
Social restriction measures (SRM) implemented during the COVID-19 pandemic led to a reduction in time spent outdoors (TSO). The aim of this study was to describe TSO and evaluate its association with sleep outcomes, optimism, happiness and health-status before and during SRM. Two online surveys were conducted in 2017 (N = 1004) and 2020, during SRM (N = 1010), in samples representative of the age, sex and region of the Austrian population. Information on the duration of TSO, sleep, optimism, happiness and health-status was collected. Multivariable-adjusted logistic regression models were used to study the association of TSO with chronic insomnia, short sleep, late chronotype, optimism, happiness and self-rated health-status. The mean TSO was 3.6 h (SD: 2.18) in 2017 and 2.6 h (SD: 1.87) during times of SRM. Men and participants who were older, married or in a partnership and lived in a rural area reported longer TSO. Participants who spent less time outdoors were more likely to report short sleep or a late chronotype in both surveys and, in 2020, also chronic insomnia. Less TSO was associated with lower happiness and optimism levels and poor health-status. Our findings suggest that TSO may be a protective factor for sleep, mood and health, particularly during stressful and uncertain times.
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Affiliation(s)
- Simon Schamilow
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Isabel Santonja
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Jakob Weitzer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Department of Health Promotion and Prevention, Federal Ministry of the Republic of Austria for Social Affairs, Health, Care and Consumer Protection, 1030 Vienna, Austria
| | - Susanne Strohmaier
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
| | - Gerhard Klösch
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Stefan Seidel
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria
| | - Eva Schernhammer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Kyriaki Papantoniou
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, 1090 Vienna, Austria
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Fernández Núñez MB, Campos Suzman L, Maneja R, Bach A, Marquet O, Anguelovski I, Knobel P. The Differences by Sex and Gender in the Relationship Between Urban Greenness and Cardiometabolic Health: A Systematic Review. J Urban Health 2022; 99:1054-1067. [PMID: 36180810 PMCID: PMC9727044 DOI: 10.1007/s11524-022-00685-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In an increasingly urbanized world, where cardiometabolic issues in cities have raised public health concerns, urban greenness is known to be beneficial for some of the most common health issues. However, the examination of the contribution of sex and gender regarding the benefits of urban greenness for people's cardiometabolic health is lacking. For that reason, we conducted a systematic review of previous literature on the topic following the PRISMA methodology. Additionally, we assessed the quality of the included articles, which we found satisfactory as most papers were of very good or good quality. We explored the relationship between urban greenness exposure and cardiovascular risk factors, cardiovascular diseases, and mortality from cardiovascular diseases. Results suggest that urban greenness is protective against cardiovascular risk factors, diseases, and mortality. When stratifying results by sex and gender, findings point to urban greenness being more beneficial for women and females in stroke and cardiovascular risk factors, except for hypertension and lipid accumulation product. On the other hand, males were more protected by urban greenness in terms of cardiovascular diseases and CVD-related mortality, thus proving that sex and gender health inequalities exist. Furthermore, looking towards the future, research needs to use the proper terminology for sex and gender and policy makers should design urban greenness with a gender perspective.
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Affiliation(s)
| | - Lia Campos Suzman
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Roser Maneja
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Albert Bach
- Forest Science and Technology Center of Catalonia, Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
- Environment and Human Health Laboratory (EH2 Lab), Ctra. de St. Llorenç de Morunys, km 2, 25280, Solsona, Spain
| | - Oriol Marquet
- Geography Department, Autonomous University of Barcelona, Barcelona, Spain
| | - Isabelle Anguelovski
- Environmental Science and Technology Institute (ICTA), Universitat Autònoma de Barcelona, Barcelona, Spain
- ICREA, Institució Catalana de Recerca I Estudis Avançats, Barcelona, Spain
| | - Pablo Knobel
- Icahn School of Medicine at Mount Sinai, Department of Environmental Medicine and Public Health, 1 Gustave L. Levy Place, Box 1057, New York, NY, 10029, USA.
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Greenspace and mortality in the U.K. Biobank: Longitudinal cohort analysis of socio-economic, environmental, and biomarker pathways. SSM Popul Health 2022; 19:101194. [PMID: 36059376 PMCID: PMC9429791 DOI: 10.1016/j.ssmph.2022.101194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 07/06/2022] [Accepted: 07/29/2022] [Indexed: 11/24/2022] Open
Abstract
Exposure to natural greenspace benefits health through direct and indirect pathways: increasing physical activity, improving mental health, relieving social isolation, reducing exposure to extreme temperature, noise, and air pollution. Understanding the etiologic pathway of greenspace and health is needed. Here, we used a large cohort follow-up data from the U.K. Biobank to quantify the magnitude of behavioural factors, psychological factors, biomarkers/physiological measurements, co-morbid diseases, and environmental exposure as potential mediators in the relationship between greenspace and mortality. We estimated hazard ratios (HR) with Cox proportional hazards models, and undertook exploratory mediation analyses to quantify the relative contribution of five types of mediators. Our results indicate greenspace was strongly associated with lower mortality risks [per IQR of public greenspace (HR = 0.90 (95% CI 0.86-0.84)) and domestic gardens (HR = 0.91, (95% CI 0.88-0.94))]. The protective associations were especially pronounced among those with lower individual-level socioeconomic status or living in places with area-level deprivation. Exploratory mediation analysis detected benefits in pathways through reducing air pollution, relieving social isolation and depression, increased physical activity and time spent outdoor, better lung function (FEV1/FVC), and having higher serum vitamin D levels.
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Dahlén AD, Miguet M, Schiöth HB, Rukh G. The influence of personality on the risk of myocardial infarction in UK Biobank cohort. Sci Rep 2022; 12:6706. [PMID: 35468914 PMCID: PMC9038723 DOI: 10.1038/s41598-022-10573-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Accepted: 04/11/2022] [Indexed: 11/17/2022] Open
Abstract
Personality is a strong determinant for several health-related behaviours and has been linked to the development of cardiovascular diseases. However, the reports of personality's mediating role have been inconsistent with no data available from large population-based cohorts. The study aimed to create proxies for the Big Five personality traits, extraversion, agreeableness, conscientiousness, openness and neuroticism, to examine the longitudinal relationship between personality and myocardial infarction in the UK Biobank. The study sample comprised of 484,205 participants (55% female, 45% male, mean age 56.4 ± 8.1 years) from UK Biobank cohort with a mean follow-up of 7 years. The personality proxies sociability, warmth, diligence, curiosity and nervousness were created using self-reported data on psychological factors, mental health and social support, to match the facets of the Big Five traits. As neuroticism is the only Big Five personality trait available in the UK Biobank, it was included to validate the personality proxies. Myocardial infarction outcome information was collected from hospital records, death registries or was self-reported. Logistic regression and Cox proportional hazard regression were used to estimate odds ratio (OR) and hazard ratios (HR), respectively with 95% confidence intervals (CI) adjusted for demographics (age, sex, socioeconomic status, ethnicity), health-related factors (BMI, diabetes, systolic and diastolic blood pressure) and lifestyle factors (alcohol intake, smoking, and moderate-to-vigorous physical activity). Diligence was found to be significantly associated with lower prevalent myocardial infarction [OR: 0.87; (CI 0.84-0.89)] and lower incident myocardial infarction [HR: 0.88; (CI 0.85-0.92)]. Sociability was also protective against prevalent [OR: 0.89; (CI 0.87-0.92)] and incident [HR: 0.90; (CI 0.87-0.93)] myocardial infarction. Conversely, nervousness inferred a higher risk for both prevalent [OR: 1.10; (CI 1.08-1.12)] and incident [HR: 1.07; (CI 1.04-1.09)] myocardial infarction during follow-up. Sex-stratified analyses revealed that nervousness significantly increases the risk for incident myocardial infarction among women [HR: 1.13; (CI 1.08-1.19)] compared to men [HR: 1.05; (CI 1.02-1.08)]. By using our created proxies, we were able to investigate the impact of personality on the development of myocardial infarction. Persons with higher levels of diligence and sociability mimicking predominantly conscientiousness and extraversion personalities respectively are less likely to experience myocardial infarction, while personalities predominantly characterised by nervousness pose higher risk for developing myocardial infarction. These initial findings invite further validation of the use of the personality proxies in UK Biobank cohort.
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Affiliation(s)
- Amelia D Dahlén
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Husargatan 3, BOX 593, 751 24, Uppsala, Sweden
| | - Maud Miguet
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Husargatan 3, BOX 593, 751 24, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Husargatan 3, BOX 593, 751 24, Uppsala, Sweden
| | - Gull Rukh
- Department of Surgical Sciences, Functional Pharmacology and Neuroscience, Uppsala University, Husargatan 3, BOX 593, 751 24, Uppsala, Sweden.
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Association between extreme ambient temperature and onset of ischemic stroke: Time series study in Wuhan and Yichang, China. eNeurologicalSci 2021. [DOI: 10.1016/j.ensci.2021.100372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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