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Martínez-González MÁ, Hernández Hernández A. Effect of the Mediterranean diet in cardiovascular prevention. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:574-582. [PMID: 38336153 DOI: 10.1016/j.rec.2024.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 01/25/2024] [Indexed: 02/12/2024]
Abstract
The Mediterranean diet is the best evidence-based model for cardiovascular prevention. In addition to 2 major randomized secondary prevention trials (Lyon Heart and CORDIOPREV) and 1 primary prevention trial (PREDIMED) that have demonstrated these benefits, there is an unprecedented body of high-quality prospective epidemiological evidence supporting these beneficial effects. The key elements of this traditional pattern are the abundant use of extra-virgin olive oil and high consumption of foods of natural plant-based origin (fruits, vegetables, nuts, and legumes) and fish, along with a reduction in processed meats, red meats, and ultraprocessed products. Moderate consumption of wine, preferably red wine, with meals is an essential element of this traditional pattern. Although removing wine consumption from the Mediterranean diet has been associated with a reduction in its preventive efficacy, doubts have recently arisen about the possible adverse effect of even low or moderate intake of any alcoholic beverages. A new large Spanish trial, UNATI, which will begin in June 2024, will randomize 10 000 drinkers aged 50 to 75 years to abstention or moderate consumption. UNATI aims to answer these doubts with the best possible evidence.
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Affiliation(s)
- Miguel Á Martínez-González
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Centro de Investigación Biomédica en Red de Fisiopatología de la Obesidad y la Nutrición (CIBEROBN), Spain; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, United States.
| | - Aitor Hernández Hernández
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain; Departamento de Cardiología, Clínica Universidad de Navarra, Madrid, Spain
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Te Hoonte F, Spronk M, Sun Q, Wu K, Fan S, Wang Z, Bots ML, Van der Schouw YT, Uijl A, Vernooij RWM. Ideal cardiovascular health and cardiovascular-related events: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:966-985. [PMID: 38149986 DOI: 10.1093/eurjpc/zwad405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 12/28/2023]
Abstract
AIMS The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs). METHODS AND RESULTS EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effects meta-analysis. This meta-analysis included 59 studies (1 881 382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared with those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) {hazard ratio [HR] = 0.60 [95% confidence interval (CI) 0.44-0.83]} to 82% lower risk for myocardial infarction [HR = 0.18 (95% CI 0.12-0.28)]. Intermediate CVH was associated with 27-57% lower risk in CVDs and CMDs compared with poor CVH, with the highest hazard for AF [HR = 0.73 (95% CI 0.59-0.91)] and the lowest hazard for peripheral arterial disease [HR = 0.43 (95% CI 0.30-0.60)]. CONCLUSION Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. Life Simple's 7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs.
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Affiliation(s)
- Femke Te Hoonte
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Merve Spronk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Qi Sun
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Kangrui Wu
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Shiqi Fan
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Ziyi Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Yvonne T Van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Alicia Uijl
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Division of Cardiology, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Robin W M Vernooij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
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Ren Y, Cheng L, Song Y, Yang Y, Xiang L, Wei C, Zhao T, Yu S, Zhang J, Wang T, Yang L, Zhang X, Yan W, Wang P. Ideal cardiovascular health index and high-normal blood pressure in elderly people: evidence based on real-world data. Sci Rep 2024; 14:10166. [PMID: 38702348 PMCID: PMC11068865 DOI: 10.1038/s41598-024-60906-w] [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: 08/09/2023] [Accepted: 04/29/2024] [Indexed: 05/06/2024] Open
Abstract
Limited information is available on the cardiovascular health (CVH) index and risk of high-normal blood pressure (HNBP) in elderly people. Randomized cluster sampling, multivariate logistic regression, and mediating effects analysis were used in this study analyze the relationship between CVH index and HNBP in the elderly. 1089 non-hypertensive residents aged 65 years or older completed the study. The positive rate of HNBP was 75.85% (male vs. female: 76.13% vs. 75.64%, P = 0.852); The ideal rate of CVH (ideal CVH index ≥ 5 items) was 14.51% (male vs. female: 15.91% vs. 13.46%, P = 0.256). Compared with people with 0-2 ideal CVH index, the risk of HNBP in people with 4 ideal indexes and ≥ 5 ideal indexes decreased by 50% and 63%, respectively, and their OR (95% CI) were 0.50 (0.31, 0.81) and 0.37 (0.21, 0.66), respectively. The results of the trend test showed that the risk of HNBP decreased by 32% for every increase in the ideal CVH index (trend P < 0.001) and TyG index does not play a mediating role in this relationship. That is, increasing the number of ideal CVH index may effectively reduce the risk of HNBP in elderly by one-third.
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Affiliation(s)
- Yongcheng Ren
- Henan Provincial Key Laboratory of Digital Medicine, Affiliated Central Hospital of Huanghuai University, Zhumadian, Henan, China.
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China.
| | - Lulu Cheng
- Henan Provincial Key Laboratory of Digital Medicine, Affiliated Central Hospital of Huanghuai University, Zhumadian, Henan, China
| | - Yaoyu Song
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Yuting Yang
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Lin Xiang
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Chaohua Wei
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Tiantian Zhao
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Shengnan Yu
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Juan Zhang
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Tiezhen Wang
- Digital Medicine Center, Pingyu People's Hospital, Zhumadian, 463000, Henan, China
| | - Lei Yang
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Xiaofang Zhang
- Institute of Health Data Management, Huanghuai University, Zhumadian, 463000, China
| | - Wei Yan
- Henan Provincial Key Laboratory of Digital Medicine, Affiliated Central Hospital of Huanghuai University, Zhumadian, Henan, China.
| | - Pengfei Wang
- Henan Provincial Key Laboratory of Digital Medicine, Affiliated Central Hospital of Huanghuai University, Zhumadian, Henan, China.
- Digital Medicine Center, Pingyu People's Hospital, Zhumadian, 463000, Henan, China.
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Hernández-Martínez A, Duarte-Junior MA, Sotos-Prieto M, Ortolá R, Banegas JR, Rodríguez-Artalejo F, Soriano-Maldonado A, Martínez-Gómez D. Cardiovascular health in Spain based on the Life's Essential 8 and its association with all-cause and cardiovascular mortality: the ENRICA cohort. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:372-380. [PMID: 37783370 DOI: 10.1016/j.rec.2023.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023]
Abstract
INTRODUCTION AND OBJECTIVES The American Heart Association has recently developed the Life's Essential 8 (LE8) score to encourage prevention of cardiovascular disease (CVD). This study assessed the distribution of LE8 in the Spanish adult population and its association with all-cause and CVD death. METHODS We used data from 11 616 individuals aged 18 years and older (50.5% women) from the ENRICA study, recruited between 2008 and 2010 and followed up until 2020 to 2022. The LE8 score includes 8 metrics (diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids and glucose, and blood pressure) and ranges from 0 to 100. The association of LE8 score with mortality was summarized with hazard ratios (HR), obtained from Cox regression. RESULTS In total, 13.2% of participants (range, 6.1%-16.9% across regions) had low cardiovascular health (LE8 ≤ 49). During a median follow-up of 12.9 years, 908 total deaths occurred, and, during a median follow-up of 11.8 years, 207 CVD deaths were ascertained. After adjustment for the main potential confounders and compared with being in the least healthy (lowest) quartile of LE8, the HR (95%CI) of all-cause mortality for the second, third and fourth quartiles were 0.68 (0.56-0.83), 0.63 (0.51-0.78), and 0.53 (0.39-0.72), respectively. The corresponding figures for CVD mortality, after accounting for competing mortality risks, were 0.62 (0.39-0.97), 0.55 (0.32-0.93), and 0.38 (0.16-0.89). CONCLUSIONS A substantial proportion of the Spanish population showed low cardiovascular health. A higher LE8 score, starting from the second quartile, was associated with lower all-cause and CVD mortality.
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Affiliation(s)
- Alba Hernández-Martínez
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - Miguel Angelo Duarte-Junior
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain
| | - Mercedes Sotos-Prieto
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States
| | - Rosario Ortolá
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - José R Banegas
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Fernando Rodríguez-Artalejo
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
| | - Alberto Soriano-Maldonado
- Departamento de Educación, Facultad de Ciencias de la Educación, Universidad de Almería, Almería, Spain; SPORT Research Group (CTS-1024), CIBIS (Centro de Investigación para el Bienestar y la Inclusión Social) Research Center, University of Almería, Almería, Spain.
| | - David Martínez-Gómez
- Departamento de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain; Instituto Madrileño de Estudios Avanzados - Alimentación (IMDEA-Food Institute), Campus de Excelencia Internacional de la Universidad Autónoma de Madrid y del Consejo Superior de Investigaciones Científicas (CEI UAM+CSIC), Madrid, Spain
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5
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Augé-Bailac F, Rosselló X. Value of the Life's Essential 8 score in cardiovascular health and mortality. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2024; 77:381-382. [PMID: 38280547 DOI: 10.1016/j.rec.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 10/25/2023] [Indexed: 01/29/2024]
Affiliation(s)
- Ferran Augé-Bailac
- Servicio de Cardiología, Hospital Universitario Son Espases, Palma, Islas Baleares, Spain
| | - Xavier Rosselló
- Servicio de Cardiología, Hospital Universitario Son Espases, Palma, Islas Baleares, Spain; Institut d'Investigació Sanitària Illes Balears (IdISBa), Palma, Islas Baleares, Spain; Departamento de Medicina, Facultad de Medicina, Universitat de les Illes Balears (UIB), Palma, Islas Baleares, Spain; Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
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García-Perea A, Fernández-Cruz E, de la O-Pascual V, Gonzalez-Zorzano E, Moreno-Aliaga MJ, Tur JA, Martinez JA. Nutritional and Lifestyle Features in a Mediterranean Cohort: An Epidemiological Instrument for Categorizing Metabotypes Based on a Computational Algorithm. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:610. [PMID: 38674256 PMCID: PMC11051796 DOI: 10.3390/medicina60040610] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Revised: 04/05/2024] [Accepted: 04/06/2024] [Indexed: 04/28/2024]
Abstract
Background and Objectives: Modern classification and categorization of individuals' health requires personalized variables such as nutrition, physical activity, lifestyle, and medical data through advanced analysis and clustering methods involving machine learning tools. The objective of this project was to categorize Mediterranean dwellers' health factors and design metabotypes to provide personalized well-being in order to develop professional implementation tools in addition to characterizing nutritional and lifestyle features in such populations. Materials and Methods: A two-phase observational study was conducted by the Pharmacists Council to identify Spanish nutritional and lifestyle characteristics. Adults over 18 years of age completed questionnaires on general lifestyle habits, dietary patterns (FFQ, MEDAS-17 p), physical activity (IPAQ), quality of life (SF-12), and validated well-being indices (LS7, MEDLIFE, HHS, MHL). Subsequently, exploratory factor, clustering, and random forest analysis methods were conducted to objectively define the metabotypes considering population determinants. Results: A total of 46.4% of the sample (n = 5496) had moderate-to-high adherence to the Mediterranean diet (>8 points), while 71% of the participants declared that they had moderate physical activity. Almost half of the volunteers had a good self-perception of health (49.9%). Regarding lifestyle index, population LS7 showed a fair cardiovascular health status (7.9 ± 1.7), as well as moderate quality of life by MEDLIFE (9.3 ± 2.6) and MHL scores (2.4 ± 0.8). In addition, five metabotype models were developed based on 26 variables: Westernized Millennial (28.6%), healthy (25.1%), active Mediterranean (16.5%), dysmetabolic/pre-morbid (11.5%), and metabolically vulnerable/pro-morbid (18.3%). Conclusions: The support of tools related to precision nutrition and lifestyle integrates well-being characteristics and contributes to reducing the impact of unhealthy lifestyle habits with practical implications for primary care. Combining lifestyle, metabolic, and quality of life traits will facilitate personalized precision interventions and the implementation of targeted public health policies.
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Affiliation(s)
| | - Edwin Fernández-Cruz
- IMDEA-Food Institute (Madrid Institute for Advances Studies), 28049 Madrid, Spain
- Faculty of Health Sciences, International University of La Rioja (UNIR), 26006 Logroño, Spain
| | - Victor de la O-Pascual
- IMDEA-Food Institute (Madrid Institute for Advances Studies), 28049 Madrid, Spain
- Faculty of Health Sciences, International University of La Rioja (UNIR), 26006 Logroño, Spain
| | | | - María J. Moreno-Aliaga
- CIBEROBN (Pathophysiology of Obesity and Nutrition), Carlos III Health Institute, 28029 Madrid, Spain
- Center for Nutrition Research and Department of Nutrition, Food Sciences and Physiology, University of Navarra, 31008 Pamplona, Spain
- IdISNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Josep A. Tur
- CIBEROBN (Pathophysiology of Obesity and Nutrition), Carlos III Health Institute, 28029 Madrid, Spain
- Research Group on Community Nutrition and Oxidative Stress, University of the Balearic Islands-IUNICS, 07122 Palma de Mallorca, Spain
- IDISBA, Health Research Institute of the Balearic Islands, 07120 Palma de Mallorca, Spain
| | - J. Alfredo Martinez
- IMDEA-Food Institute (Madrid Institute for Advances Studies), 28049 Madrid, Spain
- CIBEROBN (Pathophysiology of Obesity and Nutrition), Carlos III Health Institute, 28029 Madrid, Spain
- Department of Medicine, Dermatology, and Toxicology, University of Valladolid, 47005 Valladolid, Spain
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Armas-Padrón AM, Sicilia-Sosvilla M, Ruiz-Esteban P, Torres A, Hernández D. Cardiovascular health and target end-organ damage and comorbidities in hypertensive patients from a Spanish primary care urban population. Nefrologia 2024; 44:77-89. [PMID: 37150674 DOI: 10.1016/j.nefroe.2023.04.004] [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] [Received: 09/30/2022] [Accepted: 12/09/2022] [Indexed: 05/09/2023] Open
Abstract
We hypothesized that a poorer cardiovascular health status is related to a higher risk of hypertension-mediated organ-damage (HMOD) or hypertension-related comorbidities (HRC). We assessed the relationship between cardiovascular health metrics (CVHM) and HMOD-HRC in 243 hypertensive patients from primary care center followed for two years. We recorded the baseline CVHM score (Life's Simple 7) plus clinical data, including prevalent and incident HMOD-HRC, hospitalization and mortality. The prevalence of ideal CVHM scores was very low in both men and women. The patients with healthier CVHM scores were younger, and had a lower prevalence of diabetes, cardiovascular disease and chronic kidney disease. We recorded 264 cases of HMOD-HRC (225 at baseline and 39 during follow-up). Nine patients died and 64 had any-cause hospitalization during follow-up. A lower prevalence of HMOD-HRC and unfavorable outcomes was observed as the number of ideal CVHM increased (P<0.05). Multivariate logistic regression adjusted for confounders showed a lower CVHM score (0-1) was associated with increased odds of HMOD-HRC (4.04, 95% CI 1.26-12.94; P=0.019) and composite endpoint (HMOD-HRC, death or all-cause hospitalization) (3.43, 95% CI 1.19-9.92; P=0.023). Individual components were less predictive than the cumulative CVHM score. Few hypertensive patients in this urban population had ideal CVHM scores. An inverse relationship between scores and outcomes (HMOD-HRC, death or hospitalizations) was observed. Interventions to increase this score may improve prognosis among community-based hypertensive patients.
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Affiliation(s)
- Ana María Armas-Padrón
- La Cuesta Primary Healthcare Centre, Universidad de la Laguna, La Laguna, E-38320 Tenerife, Spain
| | - Miriam Sicilia-Sosvilla
- La Cuesta Primary Healthcare Centre, Universidad de la Laguna, La Laguna, E-38320 Tenerife, Spain
| | - Pedro Ruiz-Esteban
- Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012), E-29010 Málaga, Spain
| | - Armando Torres
- Nephrology Department, Instituto de Tecnologías Biomédicas-Universidad La Laguna, Hospital Universitario de Canarias, REDinREN (RD16/0009/0031), E-38320 Tenerife, Spain
| | - Domingo Hernández
- Nephrology Department, Hospital Regional Universitario de Málaga, University of Málaga, Instituto de Investigación Biomédica de Málaga (IBIMA), REDinREN (RD16/0009/0006 and RICORS RD21/0005/0012), E-29010 Málaga, Spain.
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Ribot-Rodríguez R, Higuera-Gómez A, San-Cristobal R, Micó V, Martínez JA. Comparison of Seven Healthy Lifestyle Scores Cardiometabolic Health: Age, Sex, and Lifestyle Interactions in the NutrIMDEA Web-Based Study. J Epidemiol Glob Health 2023; 13:653-663. [PMID: 37634195 PMCID: PMC10686948 DOI: 10.1007/s44197-023-00140-1] [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] [Received: 05/02/2023] [Accepted: 07/05/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND Global health status concerns both the assessment of wellbeing as well as the associated individualized determinants including quality of life and lifestyle factors. This study aimed to evaluate seven cardiometabolic health related scores and the influence, as well as interactions of lifestyle, heart-related and health-related quality of life (HRQoL) factors in order to inform the future implementation of precision public health (PPH). METHODS Data collected from 17,333 participants who were enrolled of the NutrIMDEA study. The data collection period was between May 2020 and November 2020 through an online survey. The baseline questionnaire collected information on socio-demographic data, cardiometabolic history, anthropometric variables and lifestyle aspects. Also, physical and mental component scores of SF12 Health Survey (PCS12/MCS12) were assessed as HRQoL features, which were applied to estimated seven scores (LS7, HLS, 20-years DRS %, FBS, CLI, WAI derived, LWB-I). RESULTS Most indices (except FBS, CLI, 20-years DRS % and WAI derived) showed that cardiometabolic outcomes and HRQoL measures were dependent on interactions by age and sex. The largest ponderal effect was found in PA total and Mediterranean Diet Score (MEDAS-14) interaction using LS7 as reference. However, using LWB-I as standard, the greatest effect was found in the quality-of-life feature MCS12. Noteworthy, LS7 showed good discrimination against PCS12, while LWB-I demonstrated excellent discrimination to MCS12. CONCLUSIONS A major finding was the interplay between MEDAS-14 and PA on the LS7 scale as well as major effects of lifestyle factors and MCS12/PCS12 among scores, which need to be accounted with precision when implementing cardiometabolic screenings with PPH purposes.
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Affiliation(s)
- R Ribot-Rodríguez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049, Madrid, Spain
| | - A Higuera-Gómez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049, Madrid, Spain
| | - R San-Cristobal
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049, Madrid, Spain.
- Centre Nutrition, Santé et Société (NUTRISS), Institut sur la Nutrition et les Aliments Fonctionnels de l'Université Laval (INAF), Université Laval, Quebec, QC, Canada.
- School of Nutrition, Université Laval, Quebec, QC, G1V 0A6, Canada.
| | - V Micó
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049, Madrid, Spain
| | - J A Martínez
- Precision Nutrition and Cardiometabolic Health, IMDEA-Food Institute (Madrid Institute for Advanced Studies), Campus of International Excellence (CEI) UAM+CSIC, 28049, Madrid, Spain
- CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III (ISCIII), 28029, Madrid, Spain
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9
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Di Castelnuovo A, Bonaccio M, Costanzo S, De Curtis A, Persichillo M, Panzera T, Bracone F, Baldassarre D, Roncaglioni MC, Baviera M, Cerletti C, Donati MB, de Gaetano G, Iacoviello L. The Moli-sani risk score, a new algorithm for measuring the global impact of modifiable cardiovascular risk factors. Int J Cardiol 2023; 389:131228. [PMID: 37527754 DOI: 10.1016/j.ijcard.2023.131228] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 06/10/2023] [Accepted: 07/28/2023] [Indexed: 08/03/2023]
Abstract
BACKGROUND Cardiovascular (CV) disease is preventable through interventions targeting modifiable factors. Most algorithms based on modifiable CV risk factors (CV-rf) have been developed in US populations and do not account for the role of diet. We aimed to assess an algorithm based on modifiable CV-rf including diet, using data from an Italian population. METHODS To derive the Moli-sani Risk Score (MRS), we used data on 16,656 men and women (age ≥ 35 y) from the population of the Moli-sani Study. The Risk-and-Prevention-Study, Italy (N = 8606) acted as external validation cohort and the Life's-Simple-7 score was used as benchmark. The MRS targeted at fatal or non-fatal CV events and included 9 common modifiable CV-rf. RESULTS After 8.1 years (median) of follow-up, 816 events occurred in the derivation cohort. The MRS was calculated as a weighted sum of its 9 components, with weights reflecting the strength of the association. In comparison with individuals in the first, those in the fourth quartile of the score had hazard ratio (HR) for CV events equal to 3.18 (95%CI: 2.54-3.97). One more point in the score was associated with 7% (6%-8%) and 4% (3%-5%) higher hazard of events in the derivation and validation cohort, respectively. The MRS performed better than the Life's Simple-7 for discrimination. CONCLUSION We propose the Moli-sani Risk Score, a validated, performing algorithm able to measure the combined impact that modifiable CV-rf have on CV risk. The score can be used to design preventive interventions, quantify the effectiveness of interventions, and compare different preventive strategies.
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Affiliation(s)
| | - Marialaura Bonaccio
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Amalia De Curtis
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | | | - Teresa Panzera
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Francesca Bracone
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Damiano Baldassarre
- Centro Cardiologico Monzino, IRCCS, Milan, Italy; Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy
| | - Maria Carla Roncaglioni
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy
| | - Marta Baviera
- Laboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri-IRCCS, Milan, Italy
| | - Chiara Cerletti
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | | | - Giovanni de Gaetano
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli (IS), Italy; Department of Medicine and Surgery, University of Insubria, Varese, Italy.
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10
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Radovanovic M, Jankovic J, Mandic-Rajcevic S, Dumic I, Hanna RD, Nordstrom CW. Ideal Cardiovascular Health and Risk of Cardiovascular Events or Mortality: A Systematic Review and Meta-Analysis of Prospective Studies. J Clin Med 2023; 12:4417. [PMID: 37445451 DOI: 10.3390/jcm12134417] [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: 06/09/2023] [Revised: 06/25/2023] [Accepted: 06/28/2023] [Indexed: 07/15/2023] Open
Abstract
Cardiovascular diseases (CVD) remain the leading cause of morbidity and mortality worldwide, hence significant efforts have been made to establish behavior and risk factors associated with CVD. The American Heart Association proposed a 7-metric tool to promote ideal cardiovascular health (CVH). Recent data demonstrated that a higher number of ideal CVH metrics was associated with a lower risk of CVD, stroke, and mortality. Our study aimed to perform a systematic review and meta-analysis of prospective studies investigating the association of ideal CVH metrics and CVD, stroke, and cardiovascular mortality (CVM) in the general population. Medline and Scopus databases were searched from January 2010 to June 2022 for prospective studies reporting CVH metrics and outcomes on composite-CVD, coronary heart disease, myocardial infarction, stroke, and CVM. Each CVH metrics group was compared to another. Twenty-two studies totaling 3,240,660 adults (57.8% men) were analyzed. The follow-up duration was 12.0 ± 7.2 years. Our analysis confirmed that a higher number of ideal CVH metrics led to lower risk for CVD and CVM (statistically significant for composite-CVD, stroke, and CVM; p < 0.05). Conclusion: Even modest improvements in CVH are associated with CV-morbidity and mortality benefits, providing a strong public health message about the importance of a healthier lifestyle.
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Affiliation(s)
- Milan Radovanovic
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Janko Jankovic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Stefan Mandic-Rajcevic
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
- Centre-School of Public Health and Health Management, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia
| | - Igor Dumic
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Richard D Hanna
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Cardiology, Mayo Clinic Health System, Eau Claire, WI 54703, USA
| | - Charles W Nordstrom
- Mayo Clinic College of Medicine and Science, Rochester, MN 55905, USA
- Department of Hospital Medicine, Mayo Clinic Health System, Eau Claire, WI 54703, USA
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11
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Díaz-Gutiérrez J, Martínez-González MÁ, Alonso A, Toledo E, Salas-Salvadó J, Sorlí JV, Ros E, Fitó M, Estruch R, Arós F, Fiol M, Lapetra J, Gómez-Gracia E, Serra-Majem L, Pintó X, Portolés O, Babio N, Castañer O, Ruiz-Canela M. American Heart Association's life simple 7 and the risk of atrial fibrillation in the PREDIMED study cohort. Nutr Metab Cardiovasc Dis 2023; 33:1144-1148. [PMID: 36958970 DOI: 10.1016/j.numecd.2023.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 12/17/2022] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
BACKGROUND AND AIMS The American Heart Association proposed 7 ideal cardiovascular health metrics (Life's Simple 7 [LS7]) namely, not smoking, body mass index <25 kg/m2, healthy diet, moderate physical activity ≥150 min/week, total blood cholesterol <200 mg/dL, blood pressure <120/80 mmHg and fasting blood glucose <100 mg/dL. Our objective was to assess the association between these LS7 metrics and the incidence of atrial fibrillation (AF). METHODS AND RESULTS A total of 6,479 participants of the PREDIMED study were included. We calculated the participants' baseline LS7 index ranging 0-7 points to categorize them according to their adherence to these LS7 health metrics. Multivariable Cox regression models were used to estimate Hazard Ratios (HR) and their 95% Confidence Intervals (95% CI). After a median follow-up of 4.8 years, we identified 250 incident cases of AF. After adjusting for potential confounders, adherence to LS7 index was not associated with the incidence of AF (adjusted HR 0.90 [95% CI: 0.56-1.45] for highest vs. lowest LS7 categories). Body mass index <25 kg/m2 was the only health metric individually associated with a lower risk of AF (HR 0.36 [95% CI: 0.16-0.78]). CONCLUSIONS In a high cardiovascular risk Spanish population, adherence to American Heart Association's LS7 metrics was not associated with the risk of incident AF. CLINICAL TRIALS NUMBER ISRCTN35739639.
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Affiliation(s)
- Jesús Díaz-Gutiérrez
- Department of Cardiology, University Hospital Juan Ramón Jiménez, Huelva, Spain; Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain
| | - Miguel Ángel Martínez-González
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Estefanía Toledo
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Jordi Salas-Salvadó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus. Reus, Spain
| | - Jose V Sorlí
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Emilio Ros
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Endocrinology & Nutrition Service, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - Montse Fitó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Ramón Estruch
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Internal Medicine, Institut d'Investigacions Biomèdiques August Pi Sunyer (IDIBAPS), Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Fernando Arós
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Cardiology, University Hospital of Alava, Vitoria, Spain
| | - Miquel Fiol
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; lles Balears Health Research Institute (IdISBa), Hospital Son Espases, Palma de Mallorca, Spain
| | - José Lapetra
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Family Medicine, Research Unit, Distrito Sanitario Atención Primaria Sevilla, Sevilla, Spain
| | - Enrique Gómez-Gracia
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Departament of Preventive Medicine, University of Málaga, Málaga, Spain
| | - Lluis Serra-Majem
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Research Institute of Biomedical and Health Sciences (IUIBS), University of Las Palmas de Gran Canaria & CHUIMI Canarian Health Service, Las Palmas, Spain
| | - Xavier Pintó
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Internal Medicine Department, Hospital Universitari de Bellvitge (IDIBELL), University of Barcelona, Barcelona, Spain
| | - Olga Portolés
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Department of Preventive Medicine, University of Valencia, Valencia, Spain
| | - Nancy Babio
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Universitat Rovira i Virgili, Departament de Bioquímica i Biotecnologia, Unitat de Nutrició Humana. Reus, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV). Hospital Universitari San Joan de Reus. Reus, Spain
| | - Olga Castañer
- Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain; Cardiovascular Risk and Nutrition (Regicor Study Group), Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Miguel Ruiz-Canela
- Department of Preventive Medicine and Public Health, School of Medicine, University of Navarra, IdiSNA, Pamplona, Spain; Consorcio CIBER, M.P. Fisiopatología de la Obesidad y Nutrición (CIBERObn), Instituto de Salud Carlos III (ISCIII), Madrid, Spain.
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12
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Domínguez-López I, Arancibia-Riveros C, Marhuenda-Muñoz M, Tresserra-Rimbau A, Toledo E, Fitó M, Ros E, Estruch R, Lamuela-Raventós RM. Association of microbiota polyphenols with cardiovascular health in the context of a Mediterranean diet. Food Res Int 2023; 165:112499. [PMID: 36869451 DOI: 10.1016/j.foodres.2023.112499] [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: 09/21/2022] [Revised: 01/04/2023] [Accepted: 01/20/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND AIMS The Mediterranean diet (MedDiet) is rich in polyphenols, phytochemicals that are beneficial for cardiovascular health. Phenolic compounds have poor bioavailability but they are extensively metabolized by the gut microbiota. Therefore, we aimed to assess the association of microbial phenolic metabolites (MPM) with adherence to the MedDiet, and their relationship with ideal cardiovascular health (ICVH) and cardiovascular risk factors. METHODS AND RESULTS This cross-sectional substudy within the PREDIMED trial included 200 participants from the Barcelona-Clinic recruitment center. Five MPM were identified and quantified using a novel method based on liquid chromatography coupled to mass spectrometry: protocatechuic acid (PCA), enterodiol glucuronide (EDG), enterolactone glucuronide (ELG), vanillic acid glucuronide (VAG) and urolithin B glucuronide (UBG). Multivariable-adjusted regressions were used to evaluate the associations between MPM and MedDiet adherence, ICVH score, biochemical parameters, and blood pressure. Additionally, an MPM score was calculated as the weighted sum of MedDiet adherence and ICVH and found to be directly associated. Among individual polyphenols, UBG was inversely associated with LDL-cholesterol. CONCLUSIONS A score of urinary MPM was associated with higher adherence to the MedDiet and ICVH, and individual MPM were related to better cardiovascular health. These findings suggest that the MedDiet may affect gut microbiota, whose metabolites are linked with cardiovascular health.
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Affiliation(s)
- Inés Domínguez-López
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Camila Arancibia-Riveros
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain
| | - María Marhuenda-Muñoz
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Anna Tresserra-Rimbau
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Estefanía Toledo
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Preventive Medicine and Public Health, University of Navarra, IdiSNA, 31008 Pamplona, Spain
| | - Montserrat Fitó
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unit of Cardiovascular Risk and Nutrition, Institut Hospital del Mar de Investigaciones Médicas (IMIM), 08007 Barcelona, Spain
| | - Emilio Ros
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Endocrinology, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Internal Medicine, Hospital Clinic, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa M Lamuela-Raventós
- Departament de Nutrició, Ciències de l'Alimentació i Gastronomia, Universitat de Barcelona (UB), Av. de Joan XXII, 27-31, 08028 Barcelona, Spain; Institut de Nutrició i Seguretat Alimentària (INSA), Universitat de Barcelona (UB), Santa Coloma de Gramanet, Spain; CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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13
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Cerrillo I, Saralegui-Díez P, Morilla-Romero-de-la-Osa R, González de Molina M, Guzmán GI. Nutritional Analysis of the Spanish Population: A New Approach Using Public Data on Consumption. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1642. [PMID: 36674397 PMCID: PMC9867222 DOI: 10.3390/ijerph20021642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 01/04/2023] [Accepted: 01/11/2023] [Indexed: 06/17/2023]
Abstract
Official population consumption data are frequently used to characterize the diet of countries; however, this information may not always be representative of reality. This study analyses the food consumption of the Spanish population by reconstructing the whole food chain. The results have been compared with the data provided by the National Consumption Panel to which the food losses/waste reported in the literature along the distribution chain have been added. The difference between them allowed a new calculation of the estimated food consumption that was subjected to a dietary-nutritional analysis. Most of the foods were consumed more than those officially reported (range of 5-50%). The unhealthy ratios of consumed foods and recommended servings were: meat products (Rcr = 3.6), fruits and legumes (Rcr = 0.5), and nuts (Rcr = 0.14). Caloric intake surpasses needs. The results were consistent with the data on the prevalence of overweight and obesity in Spain, as well as with the prevalence of associated diseases. To make a judgment about the quality of a country's diet, it is necessary to have reliable data on food consumption, as well as energy and nutrient intake. This study encourages other authors to implement this method to verify and quantify the possible difference between official and real consumption data.
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Affiliation(s)
- Isabel Cerrillo
- Department of Molecular Biology and Biochemistry Engineering, Area of Nutrition and Food Sciences, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
| | - Pablo Saralegui-Díez
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Rubén Morilla-Romero-de-la-Osa
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Department of Nursing, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41015 Seville, Spain
- Hospital Universitario Virgen del Rocío, Instituto de Biomedicina de Sevilla, Spanish National Research Council (CSIC), Universidad de Sevilla, 41015 Seville, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Hospital Universitario Virgen del Rocío, 41015 Seville, Spain
| | - Manuel González de Molina
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
| | - Gloria I. Guzmán
- Alimentta, Think Tank para la Transición Alimentaria, 18320 Santa Fe, Spain
- Laboratory of the History of Agroecosystems, Pablo de Olavide University, Carretera de Utrera Km 1, 41013 Seville, Spain
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14
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Nève G, Komulainen P, Savonen K, Hassinen M, Männikkö R, Infanger D, Schmidt-Trucksäss A, Rauramaa R. Adherence to Life's simple 7 is associated with better carotid properties. Atherosclerosis 2022; 360:21-26. [DOI: 10.1016/j.atherosclerosis.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 09/15/2022] [Accepted: 09/22/2022] [Indexed: 11/02/2022]
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Tsao CW, Aday AW, Almarzooq ZI, Alonso A, Beaton AZ, Bittencourt MS, Boehme AK, Buxton AE, Carson AP, Commodore-Mensah Y, Elkind MSV, Evenson KR, Eze-Nliam C, Ferguson JF, Generoso G, Ho JE, Kalani R, Khan SS, Kissela BM, Knutson KL, Levine DA, Lewis TT, Liu J, Loop MS, Ma J, Mussolino ME, Navaneethan SD, Perak AM, Poudel R, Rezk-Hanna M, Roth GA, Schroeder EB, Shah SH, Thacker EL, VanWagner LB, Virani SS, Voecks JH, Wang NY, Yaffe K, Martin SS. Heart Disease and Stroke Statistics-2022 Update: A Report From the American Heart Association. Circulation 2022; 145:e153-e639. [PMID: 35078371 DOI: 10.1161/cir.0000000000001052] [Citation(s) in RCA: 2610] [Impact Index Per Article: 1305.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND The American Heart Association, in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, diet, and weight) and health factors (cholesterol, blood pressure, and glucose control) that contribute to cardiovascular health. The Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The American Heart Association, through its Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States to provide the most current information available in the annual Statistical Update. The 2022 Statistical Update is the product of a full year's worth of effort by dedicated volunteer clinicians and scientists, committed government professionals, and American Heart Association staff members. This year's edition includes data on the monitoring and benefits of cardiovascular health in the population and an enhanced focus on social determinants of health, adverse pregnancy outcomes, vascular contributions to brain health, and the global burden of cardiovascular disease and healthy life expectancy. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Michos ED, Khan SS. Further understanding of ideal cardiovascular health score metrics and cardiovascular disease. Expert Rev Cardiovasc Ther 2021; 19:607-617. [PMID: 34053373 DOI: 10.1080/14779072.2021.1937127] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
INTRODUCTION The American Heart Association (AHA) introduced the construct of 'cardiovascular health (CVH)', to focus on primordial prevention to reduce the burden of cardiovascular disease (CVD). The CVH score includes seven health and behavioral metrics (smoking, physical activity, body mass index, diet, total cholesterol, blood pressure, blood glucose), which are characterized as being ideal, intermediate, or poor. AREAS COVERED In this review, we describe the utility of the CVH score for monitoring and promoting wellness, overall and by key sociodemographic groups, and for tracking of temporal trends. EXPERT OPINION Notably, the seven factors are all modifiable, which differs from 10-year CVD risk scores that include non-modifiable components such as age, sex, and race. Numerous epidemiological studies have shown that achievement of a greater number of ideal CVH metrics is associated with lower incidences of CVD, cardiovascular mortality, and all-cause mortality. Longer duration of favorable CVH is associated with greater longevity and compressed morbidity. Nevertheless, the prevalence of favorable CVH is low, with <20% of U.S. adults meeting ≥5 metrics at ideal levels and significant racial/ethnic disparities persist. Many challenges must be overcome to improve CVH at individual and societal levels if the AHA Impact Goals are to be fully realized.
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Affiliation(s)
- Erin D Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sadiya S Khan
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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[Changes in adherence to the Mediterranean diet observed in a Spanish population during confinement for the SARS-CoV-2 pandemic]. NUTR HOSP 2021; 38:109-120. [PMID: 33319567 DOI: 10.20960/nh.03275] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
Introduction Introduction: home confinement due to the COVID-19 pandemic can influence the dietary profiles of the population, suddenly subjected to a stressful factor that implies important modifications in life habits. Among others, a restriction of mobility and a change in the way of carrying out work, going from being face-to-face to non-contact (teleworking). Objective: to know the usual dietary pattern prior to confinement, and to assess the evolution of adherence to the Mediterranean diet weekly until its conclusion. Methods: data were collected using a weekly anonymous online questionnaire that monitored adherence to the Mediterranean diet in real time in an initial sample of 490 adults from Spain. Adherence to the Mediterranean diet was assessed using the MEDAS (Mediterranean Diet Adherence Screener) and modified PREDIMED questionnaires. Results: confinement due to the COVID-19 pandemic influenced the eating habits of the participants, so that adherence to the Mediterranean diet increased at the end of the confinement period, which is of special interest, since it was based on a good initial adherence (MEDAS adherence: 10.03 ± 1.9 initial and 10.47 ± 2.1 final; p = 0.016; modified PREDIMED adherence: 9.26 ± 2.0 initial and 9.89 ± 2.1 final; p < 0.001), without observing clinically relevant changes in body composition as measured by body mass index (BMI) except in women (23.3 kg/m2 ± 2.9 initial and 23.4 kg/m2 ± 2.9 final; p < 0.001), with a slight increase in this parameter, but maintaining on average the healthy values recommended by the guidelines. Conclusions: in the studied population we observed an improvement in adherence to the Mediterranean diet without observing clinically relevant changes in BMI.
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Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines. CLINICA E INVESTIGACION EN ARTERIOSCLEROSIS 2021; 33:85-107. [PMID: 33495044 DOI: 10.1016/j.arteri.2020.11.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 11/16/2020] [Indexed: 11/24/2022]
Abstract
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.
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Association between the Mediterranean lifestyle, metabolic syndrome and mortality: a whole-country cohort in Spain. Cardiovasc Diabetol 2021; 20:5. [PMID: 33402187 PMCID: PMC7786987 DOI: 10.1186/s12933-020-01195-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 12/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background Evidence is limited about the joint health effects of the Mediterranean lifestyle on cardiometabolic health and mortality. The aim of this study was to evaluate the association of the Mediterranean lifestyle with the frequency of the metabolic syndrome (MS) and the risk of all-cause and cardiovascular mortality in Spain. Methods Data were taken from ENRICA study, a prospective cohort of 11,090 individuals aged 18+ years, representative of the population of Spain, who were free of cardiovascular disease (CVD) and diabetes at 2008–2010 and were followed-up to 2017. The Mediterranean lifestyle was assessed at baseline with the 27-item MEDLIFE index (with higher score representing better adherence). Results Compared to participants in the lowest quartile of MEDLIFE, those in the highest quartile had a multivariable-adjusted odds ratio 0.73 (95% confidence interval (CI) 0.5, 0.93) for MS, 0.63. (0.51, 0.80) for abdominal obesity, and 0.76 (0.63, 0.90) for low HDL-cholesterol. Similarly, a higher MELDIFE score was associated with lower HOMA-IR and highly-sensitivity C-reactive protein (P-trend < 0.001). During a mean follow-up of 8.7 years, 330 total deaths (74 CVD deaths) were ascertained. When comparing those in highest vs. lowest quartile of MEDLIFE, the multivariable-adjusted hazard ratio (95% CI) was 0.58 (0.37, 0.90) for total mortality and 0.33 (0.11, 1.02) for cardiovascular mortality. Conclusions The Mediterranean lifestyle was associated with lower frequency of MS and reduced all-cause mortality in Spain. Future studies should determine if this also applies to other Mediterranean countries, and also improve cardiovascular health outside the Mediterranean basin.
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Armario P, Brotons C, Elosua R, Alonso de Leciñana M, Castro A, Clarà A, Cortés O, Díaz Rodriguez Á, Herranz M, Justo S, Lahoz C, Pedro-Botet J, Pérez Pérez A, Santamaria R, Tresserras R, Aznar Lain S, Royo-Bordonada MÁ. [Statement of the Spanish Interdisciplinary Vascular Prevention Committee on the updated European Cardiovascular Prevention Guidelines]. HIPERTENSION Y RIESGO VASCULAR 2020; 38:21-43. [PMID: 33069629 DOI: 10.1016/j.hipert.2020.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/29/2020] [Indexed: 12/23/2022]
Abstract
We present the adaptation for Spain of the updated European Cardiovascular Prevention Guidelines. In this update, greater stress is laid on the population approach, and especially on the promotion of physical activity and healthy diet through dietary, leisure and active transport policies in Spain. To estimate vascular risk, note should be made of the importance of recalibrating the tables used, by adapting them to population shifts in the prevalence of risk factors and incidence of vascular diseases, with particular attention to the role of chronic kidney disease. At an individual level, the key element is personalised support for changes in behaviour, adherence to medication in high-risk individuals and patients with vascular disease, the fostering of physical activity, and cessation of smoking habit. Furthermore, recent clinical trials with PCSK9 inhibitors are reviewed, along with the need to simplify pharmacological treatment of arterial hypertension to improve control and adherence to treatment. In the case of patients with type 2 diabetes mellitus and vascular disease or high vascular disease risk, when lifestyle changes and metformin are inadequate, the use of drugs with proven vascular benefit should be prioritised. Lastly, guidelines on peripheral arterial disease and other specific diseases are included, as is a recommendation against prescribing antiaggregants in primary prevention.
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Affiliation(s)
- Pedro Armario
- Sociedad Española-Liga Española para la Lucha contra la Hipertensión Arterial, Madrid, España.
| | - Carlos Brotons
- Sociedad Española de Medicina de Familia y Comunitaria, Barcelona, España
| | | | | | - Almudena Castro
- Sociedad Española de Cardiología-Coordinadora Nacional Sección de Prevención, Madrid, España
| | - Albert Clarà
- Sociedad Española de Angiología y Cirugía Vascular, Madrid, España
| | - Olga Cortés
- Asociación Española Pediatría de Atención Primaria, Madrid, España
| | | | - María Herranz
- Federación de Asociaciones de Enfermería Comunitaria y Atención Primaria-FAECAP, Madrid, España
| | | | - Carlos Lahoz
- Sociedad Española de Medicina Interna, Madrid, España
| | | | | | | | - Ricard Tresserras
- Sociedad Española de Salud Pública y Administración Sanitaria-SESPAS, Barcelona, España
| | - Susana Aznar Lain
- Facultad de Ciencias del Deporte, Universidad Castilla La Mancha, Toledo, España
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Castellano Vázquez JM, Fernández Alvira JM, Fuster V. Primordial prevention: paramount in cardiovascular prevention. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2020; 73:194-196. [PMID: 31831302 DOI: 10.1016/j.rec.2019.09.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 09/27/2019] [Indexed: 06/10/2023]
Affiliation(s)
- José María Castellano Vázquez
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Instituto de Salud Carlos III, Madrid, Spain; Centro Integral de Enfermedades Cardiovasculares (CIEC), Hospital Universitario Montepríncipe, Grupo HM Hospitales, Madrid, Spain; Facultad de Medicina, Universidad CEU San Pablo, Madrid, Spain.
| | | | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares (CNIC), Instituto de Salud Carlos III, Madrid, Spain; Cardiovascular Institute, the Mount Sinai Medical Center, Nueva York, United States
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Castellano Vázquez JM, Fernández Alvira JM, Fuster V. La prevención primordial, primordial en la prevención cardiovascular. Rev Esp Cardiol 2020. [DOI: 10.1016/j.recesp.2019.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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