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Hein M, Wacquier B, Conenna M, Lanquart JP, Point C. Impact of Intermittent Hypoxia Related to Obstructive Sleep Apnoea Syndrome on Low-Grade Inflammation in Hypertensive Patients: Potential Implications for Cardiovascular Risk. Life (Basel) 2024; 14:592. [PMID: 38792613 PMCID: PMC11122566 DOI: 10.3390/life14050592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024] Open
Abstract
There is evidence for a particular relationship between low-grade inflammation (LGI) and intermittent hypoxia (IH) related to obstructive sleep apnoea syndrome (OSAS). However, despite the potential deleterious cardiovascular consequences associated with this LGI in hypertensive patients, few studies have investigated the impact of IH related to OSAS on CRP levels in this subpopulation. In total, 1404 hypertensive patients were selected retrospectively from the Sleep Laboratory database. CRP levels ≥3 mg/L but <10 mg/L were used as cut-offs to identify hypertensive patients with LGI. Logistic regressions were conducted to examine the risk of LGI associated with IH related to OSAS in hypertensive patients. LGI was frequent (33.8%) in hypertensive patients. After adjustment for confounders, multivariate logistic regressions revealed that only moderate to severe OSAS (apnoea-hypopnoea index ≥ 15/h) with high IH (oxygen desaturation index ≥ 15/h) [OR 1.51 (95% CI 1.06-2.14)] was significantly associated with LGI in hypertensive patients (p-value = 0.045). Consistent with our hypothesis, our results demonstrated the existence of a particular subtype of hypertensive patients at high cardiovascular risk characterised by the presence of LGI induced by IH hypoxia related to moderate to severe OSAS, which justifies the establishment of adequate management of this pathology to allow better cardiovascular prevention in this subpopulation.
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Affiliation(s)
- Matthieu Hein
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Brussels, Belgium; (B.W.); (M.C.); (J.-P.L.); (C.P.)
- Laboratoire de Psychologie Médicale et Addictologie (ULB312), Université Libre de Bruxelles, ULB, 1020 Brussels, Belgium
| | - Benjamin Wacquier
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Brussels, Belgium; (B.W.); (M.C.); (J.-P.L.); (C.P.)
| | - Matteo Conenna
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Brussels, Belgium; (B.W.); (M.C.); (J.-P.L.); (C.P.)
| | - Jean-Pol Lanquart
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Brussels, Belgium; (B.W.); (M.C.); (J.-P.L.); (C.P.)
| | - Camille Point
- Hôpital Universitaire de Bruxelles, Service de Psychiatrie et Laboratoire du Sommeil, Université Libre de Bruxelles, ULB, 1070 Brussels, Belgium; (B.W.); (M.C.); (J.-P.L.); (C.P.)
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Vu TT, Zhao L, Liu L, Schiman C, Lloyd‐Jones DM, Daviglus ML, Liu K, Garside DB, Stamler J, Fries JF, Shih YT, Allen NB. Favorable Cardiovascular Health at Young and Middle Ages and Dementia in Older Age-The CHA Study. J Am Heart Assoc 2020; 8:e009730. [PMID: 30590968 PMCID: PMC6405697 DOI: 10.1161/jaha.118.009730] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Background Data are sparse on the association of cardiovascular health (CVH) in younger/middle age with the incidence of dementia later in life. Methods and Results We linked the CHA (Chicago Heart Association Detection Project in Industry) study data, assessed in 1967 to 1973, with 1991 to 2010 Medicare and National Death Index data. Favorable CVH was defined as untreated systolic blood pressure/diastolic blood pressure ≤120/≤80 mm Hg, untreated serum total cholesterol <5.18 mmol/L, not smoking, bone mass index <25 kg/m2, and no diabetes mellitus. International Classification of Diseases, Ninth Revision (ICD‐9) codes and claims dates were used to identify the first dementia diagnosis. Cox models were used to estimate hazard ratios of incident dementia after age 65 years by baseline CVH status. Among 10 119 participants baseline aged 23 to 47 years, 32.4% were women, 9.2% were black, and 7.3% had favorable baseline CVH. The incidence rate of dementia during follow‐up after age 65 was 13.9%. After adjustment, the hazard ratio for incident dementia was lowest in those with favorable baseline CVH and increased with higher risk factor burden (P‐trend<0.001). The hazards of dementia in those with baseline favorable, moderate, and 1‐only high‐risk factor were lower by 31%, 26%, and 20%, respectively, compared with those with ≥2 high‐risk factors. The association was attenuated but remained significant (P‐trend<0.01) when the model was further adjusted for competing risk of death. Patterns of associations were similar for men and women, and for those with a higher and lower baseline education level. Conclusions In this large population‐based study, a favorable CVH profile at younger age is associated with a lower risk of dementia in older age.
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Affiliation(s)
- Thanh‐Huyen T. Vu
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Lihui Zhao
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Lei Liu
- Division of BiostatisticsWashington University School of MedicineSt. LouisMO
| | - Cuiping Schiman
- School of Public AffairsPennsylvania State University HarrisburgMiddletownPA
| | - Donald M. Lloyd‐Jones
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
- Department of MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Martha L. Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoIL
| | - Kiang Liu
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - Daniel B. Garside
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoIL
| | - Jeremiah Stamler
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
| | - James F. Fries
- Department of MedicineSchool of MedicineStanford UniversityStanfordCA
| | - Ya‐Chen Tina Shih
- Department of Health Services ResearchThe University of Texas MD Anderson Cancer CenterHoustonTX
| | - Norrina B. Allen
- Department of Preventive MedicineFeinberg School of MedicineNorthwestern UniversityChicagoIL
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Vu THT, Daviglus ML, Liu K, Allen NB, Garside DB, Lloyd-Jones DM. Long-term favorable cardiovascular risk profile and 39-year development of major and minor electrocardiographic abnormalities – The Chicago Healthy Aging Study (CHAS). J Electrocardiol 2018; 51:863-869. [DOI: 10.1016/j.jelectrocard.2018.06.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 06/08/2018] [Accepted: 06/26/2018] [Indexed: 12/01/2022]
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Effects of Multivitamin, Multimineral and Phytonutrient Supplementation on Nutrient Status and Biomarkers of Heart Health Risk in a Russian Population: A Randomized, Double Blind, Placebo Controlled Study. Nutrients 2018; 10:nu10020120. [PMID: 29370120 PMCID: PMC5852696 DOI: 10.3390/nu10020120] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 12/25/2022] Open
Abstract
The primary objective of this clinical study was to evaluate the effect of a dietary multivitamin, multimineral and phytonutrient (VMP) supplement on blood nutrient status and biomarkers of heart health risk in a Russian population. One hundred twenty healthy adults (40-70 years) were recruited for a 56-day (eight-week) randomized, double blind, placebo controlled study with parallel design. Subjects were divided into two groups and received either a VMP or a placebo (PLA) supplement. Blood nutrient levels of β-carotene, α-tocopherol, vitamin C, B6, B12, red blood cell (RBC) folate, Zinc and Selenium were measured at baseline and on Days 28 and 56, and quercetin was measured at baseline and on Day 56. Blood biomarkers of heart health, i.e. homocysteine (Hcy), high-sensitivity C-reactive protein (hs-CRP), oxidized LDL (ox-LDL), gamma-glutamyl transferase (GGT), uric acid and blood lipid profile, were measured at baseline and Day 56. Dietary VMP supplementation for 56 days significantly increased circulating levels of quercetin, vitamin C, RBC folate and partially prevented the decline in vitamin B6 and B12 status. Both serum Hcy and GGT were significantly reduced (-3.97 ± 10.09 µmol/L; -1.68 ± 14.53 U/L, respectively) after VMP supplementation compared to baseline. Dietary VMP supplementation improved the nutrient status and reduced biomarkers of heart health risk in a Russian population.
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Chen CC, Liu K, Hsu CC, Chang HY, Chung HC, Liu JS, Liu YH, Tsai TL, Liaw WJ, Lin IC, Wu HW, Juan CC, Chiu HC, Lee MM, Hsiung CA. Healthy lifestyle and normal waist circumference are associated with a lower 5-year risk of type 2 diabetes in middle-aged and elderly individuals: Results from the healthy aging longitudinal study in Taiwan (HALST). Medicine (Baltimore) 2017; 96:e6025. [PMID: 28178143 PMCID: PMC5313000 DOI: 10.1097/md.0000000000006025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Type 2 diabetes mellitus (DM) is known to be closely associated with lifestyle and obesity and has a prevalence that increases with age. This study aimed to assess the short-term composite effect of diet, physical activity, psychosocial health, and waist circumference (WC) on the incidence of DM in the elderly and to provide a lifestyle-based predictive index.We used baseline measurements (2009-2013) of 5349 community-dwelling participants (aged 55 years and older, 52% female) of the Healthy Aging Longitudinal Study in Taiwan (HALST) for fasting plasma glucose, HbA1C, serum cholesterol, triglycerides, blood pressures, WC, and outcomes of home-visit questionnaire. Principal component analysis (PCA) was used to identify participants with a healthy lifestyle (HLF: higher diet, physical activity, and psychosocial scores) and a lower WC, with cutoffs determined by the receiver-operating characteristics. A Cox regression model was applied to 3424 participants without DM at baseline by linking to their National Health Insurance records (median follow-up of 3.1 years).In total, 247 new DM cases (7.2%) were identified. The HLF and lower WC group had a relative risk (RR) of DM of 0.54 (95% CI 0.35-0.82) compared to the non-HLF and higher WC group. When stratified by the presence of impaired glucose tolerance (IGT) or metabolic syndrome (MS), only participants with IGT/MS showed significant risks (RR 0.55; 95% CI 0.33-0.92). However, except for WC, the individual lifestyle factors were nonsignificant in the overall model without PCA.A composite protective effect of HLF and normal WC on DM within 5 years was observed, especially in those with IGT or MS. Psychosocial health constituted an important lifestyle factor in the elderly. The cutoffs identified could be used as a lifestyle-based risk index for DM. Maintaining an HLF to prevent DM is especially important for the elderly.
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Affiliation(s)
- Chu-Chih Chen
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Kiang Liu
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Chih-Chen Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Hsiao-Chun Chung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | - Jih-Shin Liu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
| | | | | | | | - I-Ching Lin
- Department of Family Medicine, Changhua Christian Hospital, Changhua
| | - Hsi-Wen Wu
- Family Medicine, Community Health Department, Mennonite Christian Hospital, Hualien
| | | | - Hou-Chang Chiu
- Department of Neurology, Shin Kong Wu Ho Su Memorial Hospital, Taipei
- College of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan
| | - Marion M. Lee
- Division of Cancer Epidemiology, Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Chao A. Hsiung
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan
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Chung E, Kim Y, Usen O. Associations Between Parity, Obesity, and Cardiovascular Risk Factors Among Middle-Aged Women. J Womens Health (Larchmt) 2016; 25:818-25. [PMID: 26886718 DOI: 10.1089/jwh.2015.5581] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Several studies have demonstrated an association between parity and the risk of developing cardiovascular disease (CVD) in middle-aged women; however, some inconsistencies still remain in the literature after accounting for obesity. The purpose of this study was to examine the association between parity and the risk factors of CVD while accounting for current obesity status in middle-aged women. METHOD Data for this study came from the National Health and Nutrition Examination Survey 2007-2012. The final analytic sample included 2024 middle-aged women (40-60 years old). General linear models predicting CVD risk factors based on parity (nulliparous, 1, 2, 3, and ≥4) were established after controlling for study covariates. Least square adjusted means of CVD risk factors and associated 95% confidence intervals were estimated across parity and body mass index (BMI) levels. RESULTS Women with ≥4 parity (8.34%; standard error [SE] = 0.84) showed significantly distinct demographic characteristics and health conditions, including obesity (49.08%; SE = 3.55). There were no significant associations between parity and CVD risk factors after controlling for covariates. Follow-up analyses showed consistent results across parity; however, CVD risk factors were significantly increased with higher BMI levels, regardless of parity status. CONCLUSIONS Our results suggest that parity is not a significant predictor of CVD risk factors in middle-aged women, whereas current overweight or obesity status is more important when explaining the risk of the development of CVD.
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Affiliation(s)
- Eunhee Chung
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
| | - Youngdeok Kim
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
| | - Oduware Usen
- Department of Kinesiology and Sport Management, Texas Tech University , Lubbock, Texas
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Protective Effects of L-Malate against Myocardial Ischemia/Reperfusion Injury in Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2016; 2016:3803657. [PMID: 26941825 PMCID: PMC4752987 DOI: 10.1155/2016/3803657] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 12/22/2015] [Indexed: 12/25/2022]
Abstract
Objective. To investigate the protective effects of L-malate against myocardial ischemia/reperfusion (I/R) injury in rats. Methods. Male Sprague-Dawley rats were randomly assigned to the following groups: sham (sham), an ischemia/reperfusion (I/R) model group (model), an DMF pretreated group (DMF), and 5 L-malate pretreated groups (15, 60, 120, 240, or 480 mg/kg, gavage) before inducing myocardial ischemia. Plasma LDH, cTn-I, TNF-α, hs-CRP, SOD, and GSH-PX were measured 3 h later I/R. Areas of myocardial infarction were measured; hemodynamic parameters during I/R were recorded. Hearts were harvested and Western blot was used to quantify Nrf2, Keap1, HO-1, and NQO-1 expression in the myocardium. Results. L-malate significantly reduced LDH and cTn-I release, reduced myocardial infarct size, inhibited expression of inflammatory cytokines, and partially preserved heart function, as well as increasing antioxidant activity after myocardial I/R injury. Western blot confirmed that L-malate reduced Kelch-like ECH-associated protein 1 in ischemic myocardial tissue, upregulated expression of Nrf2 and Nrf2 nuclear translocation, and increased expression of heme oxygenase-1 and NAD(P)H:quinone oxidoreductase 1, which are major targets of Nrf2. Conclusions. L-malate may protect against myocardial I/R injury in rats and this may be associated with activation of the Nrf2/Keap1 antioxidant pathway.
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Affiliation(s)
- Niki Katsiki
- Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece
| | - Genovefa Kolovou
- Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece
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