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Pihlman J, Nuotio J, Rovio S, Pahkala K, Ruohonen S, Jokinen E, Laitinen TP, Burgner DP, Hutri-Kähönen N, Tossavainen P, Taittonen L, Kähönen M, Viikari JSA, Raitakari OT, Magnussen CG, Juonala M. Exposure to parental smoking and cardiac structure and function in adulthood: the Cardiovascular Risk in Young Finns Study. Scand J Public Health 2024; 52:15-23. [PMID: 36071613 DOI: 10.1177/14034948221119611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS The relationship between childhood tobacco smoke exposure and cardiac structure and function in midlife is unclear. We investigated the association between parental smoking with cardiac structure and function in adulthood. METHODS 1250 participants (56.5% female) from the Cardiovascular Risk in Young Finns Study who had data on parental smoking and/or serum cotinine, a biomarker of exposure to tobacco smoke, at baseline 1980 (age 3-18 years) and echocardiography performed in 2011. Parental smoking hygiene (i.e., smoking in the vicinity of children) was categorized by parental smoking and serum cotinine levels in offspring. Dimensions of the left ventricle, diastolic and systolic function, and cardiac remodeling were used as outcomes. Analyses were adjusted for sex, age, and covariates (blood pressure (BP), serum lipids, body mass index, socioeconomic status, smoking (only in adulthood)) in childhood and adulthood. RESULTS Parental smoking was not associated with systolic or diastolic function in adulthood. Participants exposed to parental smoking (odds ratio (OR) 1.90, 95%CI 1.23-2.92), hygienic parental smoking (OR 1.74, 95%CI 1.12-2.71), and non-hygienic parental smoking (OR 1.88, 95%CI 1.02-3.45) had higher odds of concentric remodeling (relative wall thickness >85th sex-specific percentile without left ventricular hypertrophy). These associations were attenuated after adjustment for child and adult covariates in the non-hygienic parental smoking group. CONCLUSIONS Exposure to parental smoking in childhood was associated with a higher likelihood of concentric remodeling and thicker left ventricular and interventricular septal walls in midlife, which was not improved by parents who smoked hygienically. Parental smoking was not related to systolic or diastolic function in this relatively young population.
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Affiliation(s)
- Jukka Pihlman
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Joel Nuotio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Suvi Rovio
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Katja Pahkala
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Saku Ruohonen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Finland
| | - Tomi P Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Finland
| | - David P Burgner
- Murdoch Children's Research Institute, The Royal Children's Hospital, Australia
- Department of Paediatrics, University of Melbourne, Australia
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Finland
| | - Leena Taittonen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Finland
- Vaasa Central Hospital, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Faculty of Medicine and Health Technology, Tampere University, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Finland
| | - Olli T Raitakari
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Finland
| | - Costan G Magnussen
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Finland
- Menzies Institute for Medical Research, University of Tasmania, Australia
| | - Markus Juonala
- Department of Medicine, University of Turku and Division of Medicine, Turku University Hospital, Finland
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Sabogal C, Su S, Tingen M, Kapuku G, Wang X. Cigarette smoking related DNA methylation in peripheral leukocytes and cardiovascular risk in young adults. Int J Cardiol 2020; 306:203-205. [PMID: 31757649 DOI: 10.1016/j.ijcard.2019.11.103] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 08/29/2019] [Accepted: 11/13/2019] [Indexed: 01/16/2023]
Abstract
There is strong evidence linking changes in DNA methylation with cigarette smoking, and smoking has long been associated with cardiovascular disease; however not many studies have investigated the effects of smoking related DNA methylation changes on cardiovascular risk, especially in young adults. We explored this relationship in 480 African American and European American men and women aged 27.3 ± 3.5. Out of the DNA methylation data obtained from Illumina 450 k in peripheral leukocytes, 62 CpG sites that have been associated with smoking in multiple studies were selected. Of these, 48 were significantly related to smoking within our population. These CpG sites were then used to predict 2 subclinical markers of cardiovascular health: carotid intima media thickness and left ventricular mass (LVM). There was a significant association (FDR < 0.05) between LVM and 13 of these CpG sites. We constructed a DNA methylation score using these CpG sites and found a significant association between this score and LVM (p < 0.01). Mediation test showed that 36.5% of the effect of smoking on LVM could be explained by this methylation score. Our data suggests that, in young adult populations, cigarette smoking related DNA methylation changes are already associated with changes in subclinical markers of cardiovascular health.
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Affiliation(s)
- Cesar Sabogal
- Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Shaoyong Su
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Martha Tingen
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Gaston Kapuku
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA
| | - Xiaoling Wang
- Georgia Prevention Institute, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
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3
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Schmidt KMT, Hansen KM, Johnson AL, Gepner AD, Korcarz CE, Fiore MC, Baker TB, Piper ME, Stein JH. Longitudinal Effects of Cigarette Smoking and Smoking Cessation on Aortic Wave Reflections, Pulse Wave Velocity, and Carotid Artery Distensibility. J Am Heart Assoc 2019; 8:e013939. [PMID: 31795823 PMCID: PMC6951052 DOI: 10.1161/jaha.119.013939] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Accepted: 10/30/2019] [Indexed: 02/06/2023]
Abstract
Background We evaluated the effects of smoking and smoking cessation on aortic wave reflections (augmentation index), aortic pulse wave velocity, and carotid artery distensibility and stiffness (distensibility coefficient, Young's elastic modulus). Methods and Results Current smokers underwent carotid, radial, and femoral artery tonometry and carotid ultrasound at baseline and 3 years after a quit attempt. Baseline associations of smoking heaviness markers (exhaled carbon monoxide and cigarettes smoked/d) and effects of smoking cessation at year 3 on changes in arterial measures were assessed using multivariable linear regression models. The 1417 smokers (54% female) were mean (SD) 49.3 (11.6) years old and smoked 17.2 (8.3) cigarettes/d (exhaled carbon monoxide 14.7 [8.2] parts per million). Arterial measures were associated more strongly with age, blood pressure (BP), and waist circumference than with smoking heaviness markers. Augmentation index was associated independently with carbon monoxide (P=0.004). Pulse wave velocity, distensibility coefficient, and Young's elastic modulus had small, inconsistent associations with smoking heaviness markers. At year 3, augmentation index improved with smoking cessation (P=0.006) despite more weight gain (2.54 vs 0.36 kg, P<0.001) and insulin resistance (P=0.001) among abstainers, but distensibility coefficient decreased (P=0.004). Changes in arterial measures were related more strongly to changes in BP than smoking cessation. Conclusions Arterial wave reflection and stiffness measures were associated more strongly with age, BP, and waist circumference than smoking heaviness. Smoking cessation was associated with weight gain and increased insulin resistance. Changes in arterial measures were predicted by changes in BP, highlighting the need to address weight gain and BP changes during a quit attempt.
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Affiliation(s)
| | - Kristin M. Hansen
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | | | - Adam D. Gepner
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | | | - Michael C. Fiore
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Timothy B. Baker
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - Megan E. Piper
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
| | - James H. Stein
- School of Medicine and Public HealthUniversity of WisconsinMadisonWI
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4
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Heiskanen JS, Ruohonen S, Rovio SP, Kytö V, Kähönen M, Lehtimäki T, Viikari JSA, Juonala M, Laitinen T, Tossavainen P, Jokinen E, Hutri-Kähönen N, Raitakari OT. Determinants of left ventricular diastolic function-The Cardiovascular Risk in Young Finns Study. Echocardiography 2019; 36:854-861. [PMID: 30905083 DOI: 10.1111/echo.14321] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 02/28/2019] [Accepted: 02/28/2019] [Indexed: 12/29/2022] Open
Abstract
Decreased left ventricular (LV) diastolic function is associated with increased all-cause mortality and risk for a heart failure. The determinants of LV diastolic function have been mainly studied in elderly populations; however, the origin of LV heart failure may relate to the lifestyle factors acquired during the life course. Therefore, we examined biochemical, physiological, and lifestyle determinants of LV diastolic function in 34-49-year-old participants of the Cardiovascular Risk in Young Finns Study (Young Finns Study). In 2011, clinical examination and echocardiography were performed for 1928 participants (880 men and 1048 women; aged 34-49 years). LV diastolic function was primarily defined using E/é-ratio (population mean 4.8, range 2.1-9.0). In a multivariate model, systolic blood pressure (P < 0.005), female sex (P < 0.005), age (P < 0.005), waist circumference (P = 0.024), smoking (P = 0.028), serum alanine aminotransferase (P = 0.032) were directly associated with E/é-ratio, while an inverse association was found for height (P < 0.005). Additionally, a higher E/é-ratio was found in participants with concentric hypertrophy compared to normal cardiac geometry (P < 0.005). Other indicators of the LV diastolic function including E/A-ratio and left atrial volume index showed similarly strong associations with systolic blood pressure and age. In conclusion, we identified systolic blood pressure, waist circumference and smoking as modifiable determinants of the LV diastolic function in the 34-49-year-old participants of the Young Finns Study.
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Affiliation(s)
- Jarkko S Heiskanen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Saku Ruohonen
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Orion Pharma, Turku, Finland
| | - Suvi P Rovio
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Ville Kytö
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Heart Center, Turku University Hospital, Tyks T-Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology, Tampere University Hospital and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Jorma S A Viikari
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Markus Juonala
- Department of Medicine, University of Turku, Turku, Finland.,Division of Medicine, Turku University Hospital, Turku, Finland
| | - Tomi Laitinen
- Department of Clinical Physiology, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland
| | - Päivi Tossavainen
- Department of Pediatrics, PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Eero Jokinen
- Department of Paediatric Cardiology, Hospital for Children and Adolescents, University of Helsinki, Helsinki, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Faculty of Medicine and Life Sciences, University of Tampere and Tampere University Hospital, Tampere, Finland
| | - Olli T Raitakari
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland.,Department of Clinical Physiology and Nuclear Medicine, University of Turku, Turku, Finland
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5
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Li J, Cui R, Eshak ES, Yamagishi K, Imano H, Muraki I, Hayama-Terada M, Kiyama M, Okada T, Iso H. Association of cigarette smoking with radial augmentation index: the Circulatory Risk in Communities Study (CIRCS). Hypertens Res 2018; 41:1054-1062. [DOI: 10.1038/s41440-018-0106-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/29/2018] [Accepted: 05/02/2018] [Indexed: 01/12/2023]
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6
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Effect of present versus previous smoking on non-invasive haemodynamics. Sci Rep 2018; 8:13643. [PMID: 30206258 PMCID: PMC6134124 DOI: 10.1038/s41598-018-31904-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 08/29/2018] [Indexed: 12/19/2022] Open
Abstract
We examined cardiovascular function in 637 volunteers (19-72 years) without antihypertensive medication in never smokers (n = 365), present smokers (n = 81) and previous smokers (n = 191, median abstinence 10 years). Haemodynamics during passive head-up tilt were recorded using whole-body impedance cardiography and radial pulse wave analysis. Results were adjusted for age, sex, body mass index, LDL cholesterol and alcohol use. Systolic and diastolic blood pressure, heart rate, and pulse wave velocity were not different between the groups. Supine aortic reflection times did not differ, while upright values were shorter in present versus previous smokers (p = 0.04). Heart rate adjusted augmentation index was increased in the supine position in present smokers versus controls (p = 0.045), and in present (p < 0.001) and previous (p = 0.031) smokers versus controls in the upright position. Supine and upright cardiac output was higher (p ≤ 0.016) and systemic vascular resistance lower (p ≤ 0.001) in present versus previous smokers. In spite of the long abstinence, in the upright position previous smokers had lower cardiac output (p = 0.032) and higher systemic vascular resistance (p = 0.014) than never smokers. In the absence of differences in blood pressure and arterial stiffness, present smokers presented with hyperdynamic circulation and enhanced wave reflection compared with previous smokers.
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7
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Kamimura D, Cain LR, Mentz RJ, White WB, Blaha MJ, DeFilippis AP, Fox ER, Rodriguez CJ, Keith RJ, Benjamin EJ, Butler J, Bhatnagar A, Robertson RM, Winniford MD, Correa A, Hall ME. Cigarette Smoking and Incident Heart Failure: Insights From the Jackson Heart Study. Circulation 2018; 137:2572-2582. [PMID: 29661945 PMCID: PMC6085757 DOI: 10.1161/circulationaha.117.031912] [Citation(s) in RCA: 89] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2017] [Accepted: 02/15/2018] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cigarette smoking has been linked with several factors associated with cardiac dysfunction. We hypothesized that cigarette smoking is associated with left ventricular (LV) structure and function, and incident heart failure (HF) hospitalization. METHODS We investigated 4129 (never smoker n=2884, current smoker n=503, and former smoker n=742) black participants (mean age, 54 years; 63% women) without a history of HF or coronary heart disease at baseline in the Jackson Heart Study. We examined the relationships between cigarette smoking and LV structure and function by using cardiac magnetic resonance imaging among 1092 participants, cigarette smoking and brain natriuretic peptide levels among 3325 participants, and incident HF hospitalization among 3633 participants with complete data. RESULTS After adjustment for confounding factors, current smoking was associated with higher mean LV mass index and lower mean LV circumferential strain (P<0.05, for both) in comparison with never smoking. Smoking status, intensity, and burden were associated with higher mean brain natriuretic peptide levels (all P<0.05). Over 8.0 years (7.7-8.0) median follow-up, there were 147 incident HF hospitalizations. After adjustment for traditional risk factors and incident coronary heart disease, current smoking (hazard ratio, 2.82; 95% confidence interval, 1.71-4.64), smoking intensity among current smokers (≥20 cigarettes/d: hazard ratio, 3.48; 95% confidence interval, 1.65-7.32), and smoking burden among ever smokers (≥15 pack-years: hazard ratio, 2.06; 95% confidence interval, 1.29-3.3) were significantly associated with incident HF hospitalization in comparison with never smoking. CONCLUSIONS In blacks, cigarette smoking is an important risk factor for LV hypertrophy, systolic dysfunction, and incident HF hospitalization even after adjusting for effects on coronary heart disease.
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Affiliation(s)
- Daisuke Kamimura
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
| | - Loretta R Cain
- Department of Data Sciences (L.R.C.), University of Mississippi Medical Center, Jackson
| | - Robert J Mentz
- Department of Medicine, Division of Cardiology, Duke University School of Medicine, Durham, NC (R.J.M.)
| | - Wendy B White
- Tougaloo College, MS (W.B.W.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease and Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD (M.J.B.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Andrew P DeFilippis
- Division of Cardiovascular Medicine, University of Louisville, KY (A.P.D., A.B.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Ervin R Fox
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
| | - Carlos J Rodriguez
- Department of Medicine and Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.J.R.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Rachel J Keith
- Diabetes and Obesity Center, University of Louisville School of Medicine, KY (R.J.K., A.B.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Emelia J Benjamin
- Department of Medicine, Boston University School of Medicine and Department of Epidemiology, Boston University School of Public Health, MA (E.J.B.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Javed Butler
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Aruni Bhatnagar
- Division of Cardiovascular Medicine, University of Louisville, KY (A.P.D., A.B.)
- Diabetes and Obesity Center, University of Louisville School of Medicine, KY (R.J.K., A.B.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Rose M Robertson
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN (R.M.R.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Michael D Winniford
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
| | - Adolfo Correa
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
| | - Michael E Hall
- Department of Medicine (D.K., E.R.F., J.B., M.D.W., A.C., M.E.H.)
- American Heart Association Tobacco Regulation and Addiction Center, Dallas, TX (W.B.W., M.J.B., A.P.D., C.J.R., R.J.K., E.J.B., J.B., A.B., R.M.R., M.D.W., M.E.H.)
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8
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Leigh JA, Kaplan RC, Swett K, Balfour P, Kansal MM, Talavera GA, Perreira K, Blaha MJ, Benjamin EJ, Robertson R, Bhartnagar A, Rodriguez CJ. Smoking intensity and duration is associated with cardiac structure and function: the ECHOcardiographic Study of Hispanics/Latinos. Open Heart 2017; 4:e000614. [PMID: 28761681 PMCID: PMC5515129 DOI: 10.1136/openhrt-2017-000614] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Revised: 03/07/2017] [Accepted: 03/29/2017] [Indexed: 11/16/2022] Open
Abstract
Objective Cardiovascular disease is the leading cause of death in smokers and this relationship is complicated by the multiplicity of cardiovascular effects of smoking. However, the relationship between intensity and duration of cigarette smoking and echocardiographic measures of right and left ventricular structure and function has been poorly studied. Methods We examined ECHO-SOL (Echocardiographic Study of Hispanics/Latinos) participants, a subset of the Hispanic Community Health Study/Study of Latinos. Participants were administered a detailed tobacco exposure questionnaire and a comprehensive echocardiography exam. Multivariable linear regression models (adjusted for age, sex, obesity, hypertension and diabetes statuses) were performed using sampling weights. Statistical significance was defined at p<0.01. Results There were 1818 ECHO-SOL participants (57.4% women, mean age 56.4 years). Among current smokers (n=304), increased duration of smoking, as measured by a younger age of smoking initiation, was significantly associated with higher mean left ventricular mass (LVM) and lower right ventricular (RV) function (lower right ventricular stroke volumes). More cigarettes smoked per day was significantly associated with higher mean LVM, worse diastolic function (higher E/e′ ratio), worse LV geometry (increased relative wall thickness) and worse RV function (decreasing right ventricular stroke volume). Among current smokers, higher mean lifetime pack-years (a combined measure of smoking intensity and duration) was associated with higher LVM, worse LV geometry, worse diastolic function, greater RV dilatation and worse RV function. Conclusions There is a dose–response relationship between intensity and duration of cigarette tobacco smoking with unfavourable changes of multiple measures of right-sided and left-sided cardiac structure and function.
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Affiliation(s)
- J Adam Leigh
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | | | - Katrina Swett
- Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Pelbreton Balfour
- University of Virginia Health System, Charlottesville, Virginia, USA
| | | | | | - Krista Perreira
- University of North Carolina, Chapel Hill, North Carolina, USA
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9
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Gender Differences of Arterial Stiffness and Arterial Age in Smokers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060565. [PMID: 28587127 PMCID: PMC5486251 DOI: 10.3390/ijerph14060565] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/18/2017] [Revised: 05/07/2017] [Accepted: 05/23/2017] [Indexed: 11/16/2022]
Abstract
The present study aimed to find gender differences for arterial stiffness and arterial aging in smokers. A total of 147 smokers (71 male and 76 female, matched for age) were explored using an Arteriograph in a cross-sectional survey. Pulse wave velocity (PWV), arterial age (AA), brachial and aortic augmentation index (AixBrach, AixAo), and blood pressure variables were assessed. Data about smoking intensity, such as the number of cigarettes smoked daily, smoking period, and smoking pack years (SPY) were used. No significant differences were found for PWV, AA, AixBrach and AixAo. Significant correlations were found between SPY and PWV, augmentation indices, and AA, respectively. The cut-off values for SPY were higher for an increased arterial stiffness in male compared to female smokers (18.5 and 7.5 pack year, respectively). SPY is significantly associated with an increased arterial stiffness in smokers regardless of gender, and with an increased SBPAo only in female smokers. The results of our study indicate gender differences for arterial stiffness and arterial age in smokers.
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Nadruz W, Claggett B, Gonçalves A, Querejeta-Roca G, Fernandes-Silva MM, Shah AM, Cheng S, Tanaka H, Heiss G, Kitzman DW, Solomon SD. Smoking and Cardiac Structure and Function in the Elderly: The ARIC Study (Atherosclerosis Risk in Communities). Circ Cardiovasc Imaging 2017; 9:e004950. [PMID: 27625349 DOI: 10.1161/circimaging.116.004950] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 07/21/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Cigarette smoking has been associated with higher risk of incident heart failure independent of coronary artery disease, but the impact of tobacco use on cardiac structure and function in the general population is uncertain. This study evaluated the relationship between smoking and echocardiographic measures in a large elderly cohort. METHODS AND RESULTS We studied 4580 participants free of overt coronary artery disease, heart failure, and significant valvular disease from the fifth visit of the ARIC study (Atherosclerosis Risk in Communities) who underwent transthoracic echocardiography. Participants were classified into 3 categories based on self-reported smoking habits: never (43.2%), former (50.5%), and current smokers (6.3%). Pack-years and years of smoking were also estimated. Compared with never smokers, current smokers had greater left ventricular (LV) mass index (80.4±1.1 versus 76.7±0.4 g/m(2); P<0.001), LV mass/volume ratio (1.93±0.03 versus 1.83±0.03 g/mL; P<0.001), higher prevalence of LV hypertrophy (15% versus 9%; P=0.008), and worse diastolic function, as reflected by higher E/E' ratio (11.7±0.2 versus 10.9±0.1; P<0.001), after adjusting for potential confounding factors. In contrast, former smokers showed similar echocardiographic features when compared with never smokers. Furthermore, estimated pack-years and years of smoking, measures of cumulative cigarette exposure, were associated with greater LV mass index, LV mass/volume ratio, and worse diastolic function (higher E/E' ratio) in current smokers after multivariable analysis (all P<0.01). CONCLUSIONS Active smoking and cumulative cigarette exposure were associated with subtle alterations in LV structure and function in an elderly, community-based population free of overt coronary artery disease and heart failure.
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Affiliation(s)
- Wilson Nadruz
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Brian Claggett
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Alexandra Gonçalves
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Gabriela Querejeta-Roca
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Miguel M Fernandes-Silva
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Amil M Shah
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Susan Cheng
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Hirofumi Tanaka
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Gerardo Heiss
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Dalane W Kitzman
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.)
| | - Scott D Solomon
- From the Cardiovascular Division, Brigham and Women's Hospital, Boston, MA (W.N., B.C., A.G., G.Q.-R., M.M.F.-S., A.M.S., S.C., S.D.S.); Department of Internal Medicine, University of Campinas, Brazil (W.N.); Department of Physiology and Cardiovascular Surgery, University of Porto Medical School, Portugal (A.G.); Department of Kinesiology and Health Education, University of Texas, Austin (H.T.); Department of Epidemiology, University of North Carolina, Chapel Hill (G.H.); and Department of Cardiology, Wake Forest School of Medicine, Winston-Salem, NC (D.W.K.).
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11
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Mandraffino G, Aragona CO, Scuruchi M, Mamone F, D'Ascola A, Alibrandi A, Cinquegrani M, Morace C, Oreto L, Saitta C, Mormina E, Carerj S, Saitta A, Imbalzano E. Biglycan expression, earlier vascular damage and pro-atherogenic profile improvement after smoke cessation in young people. Atherosclerosis 2017; 257:109-115. [DOI: 10.1016/j.atherosclerosis.2017.01.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 12/12/2016] [Accepted: 01/12/2017] [Indexed: 12/24/2022]
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12
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Casaccia S, Sirevaag EJ, Richter EJ, O'Sullivan JA, Scalise L, Rohrbaugh JW. Features of the non-contact carotid pressure waveform: Cardiac and vascular dynamics during rebreathing. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2016; 87:102501. [PMID: 27802696 DOI: 10.1063/1.4964624] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This report amplifies and extends prior descriptions of the use of laser Doppler vibrometry (LDV) as a method for assessing cardiovascular activity, on a non-contact basis. A rebreathing task (n = 35 healthy individuals) was used to elicit multiple effects associated with changes in autonomic drive as well as blood gases including hypercapnia. The LDV pulse was obtained from two sites overlying the carotid artery, separated by 40 mm. A robust pulse signal was obtained from both sites, in accord with the well-described changes in carotid diameter over the blood pressure cycle. Emphasis was placed on extracting timing measures from the LDV pulse, which could serve as surrogate measures of pulse wave velocity (PWV) and the associated arterial stiffness. For validation purposes, a standard measure of pulse transit time (PTT) to the radial artery was obtained using a tonometric sensor. Two key measures of timing were extracted from the LDV pulse. One involved the transit time along the 40 mm distance separating the two LDV measurement sites. A second measure involved the timing of a late feature of the LDV pulse contour, which was interpreted as reflection wave latency and thus a measure of round-trip travel time. Both LDV measures agreed with the conventional PTT measure, in disclosing increased PWV during periods of active rebreathing. These results thus provide additional evidence that measures based on the non-contact LDV technique might provide surrogate measures for those obtained using conventional, more obtrusive assessment methods that require attached sensors.
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Affiliation(s)
- S Casaccia
- Department of Industrial Engineering and Mathematical Science, Università Politecnica delle Marche, Ancona, Italy
| | - E J Sirevaag
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri 63110, USA
| | - E J Richter
- Preston M. Green Department of Electrical and Systems Engineering, Washington University in Saint Louis, Saint Louis, Missouri 63130-4899, USA
| | - J A O'Sullivan
- Preston M. Green Department of Electrical and Systems Engineering, Washington University in Saint Louis, Saint Louis, Missouri 63130-4899, USA
| | - L Scalise
- Department of Industrial Engineering and Mathematical Science, Università Politecnica delle Marche, Ancona, Italy
| | - J W Rohrbaugh
- Department of Psychiatry, Washington University School of Medicine, Saint Louis, Missouri 63110, USA
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13
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Kraen M, Frantz S, Nihlén U, Engström G, Löfdahl CG, Wollmer P, Dencker M. Echocardiographic consequences of smoking status in middle-aged subjects. Echocardiography 2016; 34:14-19. [PMID: 27681781 DOI: 10.1111/echo.13375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Smoking is known to have many short- and long-term cardiovascular effects. Cardiac index (CI), which is cardiac output indexed to body surface area, is considered to be a valid measure of cardiac performance. We investigated whether there were any differences in CI or other echocardiographic variables between never smokers, ex-smokers, and current smokers in a cardiopulmonary healthy population. METHODS Subjects (n=355) from a previous population-based respiratory questionnaire survey (never smokers, ex-smokers, and current smokers without significant chronic obstructive lung disease) were examined with echocardiography, and CI (L/min/m2 ) was calculated. RESULTS Current smokers had a higher CI than never smokers 2.61±0.52 L/min/m2 vs. 2.42±0.49 L/min/m2 (P<.01). Ex-smokers had a nonsignificant, numerically higher value for CI than never smokers 2.54±0.54 L/min/m2 vs. 2.42±0.49 L/min/m2 (P>.05). Smoking status had no significant effect on other echocardiographic variables. CONCLUSION We conclude that currents smokers without known cardiac disease or significant chronic obstructive lung disease show signs of slightly altered hemodynamics.
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Affiliation(s)
- Morten Kraen
- Clinical Physiology and Nuclear Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Sophia Frantz
- Clinical Physiology and Nuclear Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Ulf Nihlén
- Respiratory Medicine and Allergology Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Gunnar Engström
- Department of Clinical Science, Cardiovascular Epidemiology Research Group, Lund University, Malmö, Sweden
| | - Claes-Göran Löfdahl
- Respiratory Medicine and Allergology Unit, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Per Wollmer
- Clinical Physiology and Nuclear Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
| | - Magnus Dencker
- Clinical Physiology and Nuclear Medicine Unit, Department of Translational Medicine, Lund University, Malmö, Sweden
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14
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Second derivative of the finger photoplethysmogram and cardiovascular mortality in middle-aged and elderly Japanese women. Hypertens Res 2016; 40:207-211. [PMID: 27682652 DOI: 10.1038/hr.2016.123] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 08/16/2016] [Accepted: 08/18/2016] [Indexed: 01/12/2023]
Abstract
The second derivative of the digital photoplethysmogram (SDPTG) is an indicator of arterial stiffness. The ratio of the height of the d wave to the a wave of the SDPTG (d/a) is associated with functional peripheral vascular tension and represents aortic-blood pressure (BP) augmented by reflection waves from the periphery. This longitudinal study aimed to investigate the relationship between SDPTG and cardiovascular mortality in middle-aged and elderly Japanese women. From 1998 to 2008, we recruited 4373 women (50-79 years old at baseline) who underwent medical check-ups and SDPTG measurement. The SDPTG index (d/a) was calculated from the wave component height, and was divided into quartiles (Q) according to the d/a value. The median follow-up period was 9.0 years. The d/a value was negatively associated with age and BP, and positively associated with heart rate and body height. Using the Cox proportional hazards model, the hazard ratios for cardiovascular mortality for Q2, Q3 and Q4 were significantly higher than that of Q1. In multivariate analysis, the hazard ratio was 2.30 for Q3 (95% confidence interval (CI): 1.06-4.99, P<0.05) and 2.60 for Q4 (95% CI: 1.21-5.60, P<0.05), after adjustment for age, height, body mass index, BP levels, heart rate and other atherosclerosis-related factors. The hazard ratios of cardiovascular mortality for Q3 and Q4 were significantly higher compared with the reference (Q1). Thus, the SDPTG d/a is an independent predictor of cardiovascular mortality in middle-aged and elderly Japanese women.
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15
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Saladini F, Benetti E, Fania C, Mos L, Casiglia E, Palatini P. Effects of smoking on central blood pressure and pressure amplification in hypertension of the young. Vasc Med 2016; 21:422-428. [DOI: 10.1177/1358863x16647509] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The aim of this study was to investigate the effect of cigarette smoking on peripheral and central blood pressure (BP) in a group of young stage I hypertensives. A total of 344 untreated subjects from the HARVEST study were examined (mean age 37±10 years). Patients were divided into three groups based on smoking status: non-smokers, light smokers (⩽5 cigarettes/day) and moderate-to-heavy smokers (>5 cigarettes/day); and into three groups by age: 18–29, 30–39 and ⩾40 years. Central BP measurements and augmentation index (AIx) were calculated from brachial pressure waveform, with applanation tonometry, by means of the Specaway DAT System plus a Millar tonometer. The central waveform was derived from peripheral BP using the same software system of the SphygmoCor System pulse wave analysis. In addition, two indirect measurements of arterial stiffness were calculated: pulse pressure (PP) and systolic BP amplification. Central systolic BP and PP were higher in smokers than in non-smokers (systolic BP: 121.9±13.1 mmHg in non-smokers, 127.2±16.5 mmHg in light smokers, 126.7±15.3 mmHg in those who smoked >5 cigarettes/day, p=0.009; PP: 37.7±9.8 mmHg, 41.5±13.1 mmHg, 41.9±10.5 mmHg, respectively, p=0.005). Lower systolic BP amplification ( p<0.001) and PP amplification ( p=0.001) were observed in smokers compared to non-smokers. In a two-way ANCOVA analysis, systolic BP amplification markedly declined across the three age groups ( p=0.0002) and from non-smokers to smokers ( p=0.0001), with a significant interaction between smoking and age group ( p=0.05). The AIx was higher in smokers compared to non-smokers ( p=0.024). In young hypertensives, smoking has a detrimental effect on central BP, accelerating the age-related decline in BP amplification.
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Affiliation(s)
| | | | - Claudio Fania
- Department of Medicine, University of Padova, Padova, Italy
| | - Lucio Mos
- Emergency Department, San Daniele del Friuli Town Hospital, Udine, Italy
| | | | - Paolo Palatini
- Department of Medicine, University of Padova, Padova, Italy
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16
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Effoe VS, Chen H, Moran A, Bertoni AG, Bluemke DA, Seeman T, Darwin C, Watson KE, Rodriguez CJ. Acculturation is associated with left ventricular mass in a multiethnic sample: the Multi-Ethnic Study of Atherosclerosis. BMC Cardiovasc Disord 2015; 15:161. [PMID: 26631068 PMCID: PMC4668673 DOI: 10.1186/s12872-015-0157-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2015] [Accepted: 11/24/2015] [Indexed: 12/29/2022] Open
Abstract
Background Acculturation involves stress-related processes and health behavioral changes, which may have an effect on left ventricular (LV) mass, a risk factor for cardiovascular disease (CVD). We examined the relationship between acculturation and LV mass in a multiethnic cohort of White, African-American, Hispanic and Chinese subjects. Methods Cardiac magnetic resonance assessment was available for 5004 men and women, free of clinical CVD at baseline. Left ventricular mass index was evaluated as LV mass indexed by body surface area. Acculturation was characterized based on language spoken at home, place of birth and length of stay in the United States (U.S.), and a summary acculturation score ranging from 0 = least acculturated to 5 = most acculturated. Mean LV mass index adjusted for traditional CVD risk factors was compared across acculturation levels. Results Unadjusted mean LV mass index was 78.0 ± 16.3 g/m2. In adjusted analyses, speaking exclusively English at home compared to non-English language was associated with higher LV mass index (81.3 ± 0.4 g/m2 vs 79.9 ± 0.5 g/m2, p = 0.02). Among foreign-born participants, having lived in the U.S. for ≥ 20 years compared to < 10 years was associated with greater LV mass index (81.6 ± 0.7 g/m2 vs 79.5 ± 1.1 g/m2, p = 0.02). Compared to those with the lowest acculturation score, those with the highest score had greater LV mass index (78.9 ± 1.1 g/m2 vs 81.1 ± 0.4 g/m2, p = 0.002). There was heterogeneity in which measure of acculturation was associated with LV mass index across ethnic groups. Conclusions Greater acculturation is associated with increased LV mass index in this multiethnic cohort. Acculturation may involve stress-related processes as well as behavioral changes with a negative effect on cardiovascular health.
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Affiliation(s)
- Valery S Effoe
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - Haiying Chen
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - Andrew Moran
- Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA.
| | - Alain G Bertoni
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
| | - David A Bluemke
- National Institutes of Health/Clinical Center, Bethesda, MD, USA.
| | - Teresa Seeman
- Division of Geriatrics, University of California at Los Angeles, Los Angeles, CA, USA.
| | - Christine Darwin
- University of California at Los Angeles Research Center, Los Angeles, CA, USA.
| | - Karol E Watson
- Division of Cardiology, University of California at Los Angeles School of Medicine, Los Angeles, CA, USA.
| | - Carlos J Rodriguez
- Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA.
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17
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McEvoy JW, Nasir K, DeFilippis AP, Lima JAC, Bluemke DA, Hundley WG, Barr RG, Budoff MJ, Szklo M, Navas-Acien A, Polak JF, Blumenthal RS, Post WS, Blaha MJ. Relationship of cigarette smoking with inflammation and subclinical vascular disease: the Multi-Ethnic Study of Atherosclerosis. Arterioscler Thromb Vasc Biol 2015; 35:1002-10. [PMID: 25745060 DOI: 10.1161/atvbaha.114.304960] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
OBJECTIVE We sought to assess the impact of smoking status, cumulative pack-years, and time since cessation (the latter in former smokers only) on 3 important domains of cardiovascular disease: inflammation, vascular dynamics and function, and subclinical atherosclerosis. APPROACH AND RESULTS The Multi-Ethnic Study of Atherosclerosis (MESA) cohort enrolled 6814 adults without prior cardiovascular disease. Smoking variables were determined by self-report and confirmed with urinary cotinine. We examined cross-sectional associations between smoking parameters and (1) inflammatory biomarkers (high-sensitivity C-reactive protein [hsCRP], interleukin-6, and fibrinogen); (2) vascular dynamics and function (brachial flow-mediated dilation and carotid distensibility by ultrasound, as well as aortic distensibility by MRI); and (3) subclinical atherosclerosis (coronary artery calcification, carotid intima-media thickness, and ankle-brachial index). We identified 3218 never smokers, 2607 former smokers, and 971 current smokers. Mean age was 62 years and 47% were male. There was no consistent association between smoking and vascular distensibility or flow-mediated dilation outcomes. However, compared with never smokers, the adjusted association between current smoking and measures of either inflammation or subclinical atherosclerosis was consistently stronger than for former smoking (eg, odds ratio for hsCRP>2 mg/L of 1.7 [95% confidence interval, 1.5-2.1] versus 1.2 [1.1-1.4], odds ratio for coronary artery calcification>0 of 1.8 [1.5-2.1] versus 1.4 [1.2-1.6], respectively). Similar associations were seen for interleukin-6, fibrinogen, carotid intima-media thickness, and ankle-brachial index. A monotonic association was also found between higher pack-year quartiles and increasing inflammatory markers. Furthermore, current smokers with hsCRP>2 mg/L were more likely to have increased carotid intima-media thickness, abnormal ankle-brachial index, and coronary artery calcification>75th percentile for age, sex, and race (relative to smokers with hsCRP<2 mg/L, interaction P<0.05 for all 3 outcomes). In contrast, time since quitting in former smokers was independently associated with lower inflammation and atherosclerosis (eg, odds ratio for hsCRP>2 mg/L of 0.91 [0.88-0.95] and odds ratio for coronary artery calcification>0 of 0.94 [0.90-0.97] for every 5-year cessation interval). CONCLUSIONS These findings expand our understanding of the harmful effects of smoking and help explain the cardiovascular benefits of smoking cessation.
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Affiliation(s)
- John W McEvoy
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Khurram Nasir
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Andrew P DeFilippis
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Joao A C Lima
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - David A Bluemke
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - W Gregory Hundley
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - R Graham Barr
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Matthew J Budoff
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Moyses Szklo
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Ana Navas-Acien
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Joseph F Polak
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Roger S Blumenthal
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Wendy S Post
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.)
| | - Michael J Blaha
- From the Ciccarone Center for the Prevention of Heart Disease (J.W.M., K.N., A.P.D., R.S.B., M.J. Blaha) and Division of Cardiology (J.A.C.L., W.S.P.), Johns Hopkins University, Baltimore, MD; Center for Wellness and Prevention, Baptist Health South Florida, Miami Beach (K.N.); Division of Cardiology, University of Louisville, Rudd Heart and Lung Center, KY (A.P.D.); Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD (D.A.B.); Division of Cardiology, Wake Forest University Health Center, Winston-Salem, NC (W.G.H.); Division of General Medicine, Division of Pulmonary, Allergy and Critical Care, Department of Medicine and Department of Epidemiology, Columbia University Medical Center, New York, NY (R.G.B.); Los Angeles Biomedical Research Institute at Harbor-UCLA, Los Angeles, CA (M.J. Budoff); Bloomberg School of Public Health, John Hopkins University, Baltimore, MD (M.S., A.N.-A., W.S.P., M.J.B.); and Department of Radiology, Tufts University School of Medicine, Boston, MA (J.F.P.).
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