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Kazemi A, Soltani S, Aune D, Hosseini E, Mokhtari Z, Hassanzadeh Z, Jayedi A, Pitanga F, Akhlaghi M. Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies. Int J Behav Nutr Phys Act 2024; 21:45. [PMID: 38659024 PMCID: PMC11044601 DOI: 10.1186/s12966-024-01593-8] [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: 10/21/2023] [Accepted: 04/14/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD). METHODS PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model. RESULTS A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77-0.86), CHD (HR = 0.83; 0.79-0.88), and stroke (HR = 0.83; 0.79-0.88), but not AF (HR = 0.98; 0.92-1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF. CONCLUSIONS Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Soltani
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Elham Hosseini
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Mokhtari
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hassanzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, 7153675541, Shiraz, Iran.
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Cheval B, Csajbók Z, Formánek T, Sieber S, Boisgontier MP, Cullati S, Cermakova P. Association between physical-activity trajectories and cognitive decline in adults 50 years of age or older. Epidemiol Psychiatr Sci 2021; 30:e79. [PMID: 35035880 PMCID: PMC8728586 DOI: 10.1017/s2045796021000688] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/17/2021] [Indexed: 11/21/2022] Open
Abstract
Aims To investigate the associations of physical-activity trajectories with the level of cognitive performance and its decline in adults 50 years of age or older. Methods We studied 38729 individuals (63 ± 9 years; 57% women) enrolled in the Survey of Health, Ageing and Retirement in Europe (SHARE). Physical activity was self-reported and cognitive performance was assessed based on immediate recall, verbal fluency, and delayed recall. Physical-activity trajectories were estimated using growth mixture modelling and linear mixed effects models were used to investigate the associations between the trajectories and cognitive performance. Results The models identified two physical-activity trajectories of physical activity: constantly-high physical activity (N=27634: 71%) and decreasing physical activity (N=11095; 29%). Results showed that participants in the decreasing physical-activity group exhibited a lower level of cognitive performance compared to the high physical-activity group (immediate recall: ß=0.94; 95% confidence interval [CI]=0.92 to 0.95; verbal fluency: ß=0.98; 95% CI=0.97 to 0.98; delayed recall: ß=0.95; 95% CI=0.94 to 0.97). Moreover, compared with participants in the constantly-high physical-activity group, participants in the decreasing physical-activity group showed a steeper decline in all cognitive measures (immediate recall: ß=-0.04; 95% CI=-0.05 to -0.04; verbal fluency: ß=-0.22; 95% CI=-0.24 to -0.21; delayed recall: ß=-0.04; 95% CI=-0.05 to -0.04). Conclusions Physical-activity trajectories are associated with the level and evolution of cognitive performance in adults over 50 years. Specifically, our findings suggest that a decline in physical activity over multiple years is associated with a lower level and a steeper decline in cognitive performance.
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Affiliation(s)
- Boris Cheval
- Swiss Center for Affective Sciences, University of Geneva, Geneva, Switzerland
- Laboratory for the Study of Emotion Elicitation and Expression (E3Lab), Department of Psychology, University of Geneva, Geneva, Switzerland
| | - Zsófia Csajbók
- National Institute of Mental Health, Klecany, Czech Republic
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
- Faculty of Science, Charles University, Prague, Czech Republic
| | - Tomáš Formánek
- National Institute of Mental Health, Klecany, Czech Republic
- EpiCentre, Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Stefan Sieber
- LIVES Centre, Swiss Centre of Expertise in Life Course Research, Carouge, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Matthieu P. Boisgontier
- School of Rehabilitation Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- Bruyère Research Institute, Ottawa, Canada
| | - Stéphane Cullati
- Population Health Laboratory, University of Fribourg, Fribourg, Switzerland
- Department of Readaptation and Geriatrics, University of Geneva, Geneva, Switzerland
| | - Pavla Cermakova
- National Institute of Mental Health, Klecany, Czech Republic
- Second Faculty of Medicine, Charles University, Prague, Czech Republic
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Health Behavior Trajectories in High Cardiovascular Risk Populations: Secondary Analysis of a Clinical Trial. J Cardiovasc Nurs 2021; 36:E80-E90. [PMID: 34495915 DOI: 10.1097/jcn.0000000000000850] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND The application of latent class growth analysis (LCGA) has been limited in behavioral studies on high-cardiovascular-risk populations. AIM The current study aimed to identify distinct health behavior trajectories in high-cardiovascular-risk populations using LCGA. We also examined the baseline individual characteristics associated with different health behavior trajectories and determined which trajectory is associated with improved cardiovascular risk outcomes at 52 weeks. METHODS This secondary analysis of a clinical trial included 200 patients admitted to primary care clinics. Latent class growth analysis was conducted to identify the trajectories of physical activity and dietary intake; these were measured at 4 different time points during a 52-week study period. Analysis of variance/χ2 test was used to assess the associations between baseline individual characteristics and trajectories, and logistic regression analysis was used to identify associations between trajectories and cardiovascular risk outcomes at 52 weeks. RESULTS Three trajectories were identified for physical activity (low-, moderate-, and high-stable). Risk perception, patient activation, and depressive symptoms predicted the trajectories. High-stable trajectory for physical activity was associated with better cardiovascular risk outcomes at the 52-week follow-up. Two trajectories (low-stable and high-decreasing) were identified for percent energy from fat, but the factors that can predict trajectories were limited. CONCLUSIONS Interventions are needed to target patients who begin with a lower physical activity level, with the goal of enhanced cardiovascular health. The predictors identified in the study may facilitate earlier and more tailored interventions.
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Cleven L, Krell-Roesch J, Nigg CR, Woll A. The association between physical activity with incident obesity, coronary heart disease, diabetes and hypertension in adults: a systematic review of longitudinal studies published after 2012. BMC Public Health 2020; 20:726. [PMID: 32429951 PMCID: PMC7238737 DOI: 10.1186/s12889-020-08715-4] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 04/15/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND A growing body of studies that investigated the longitudinal association between physical activity (PA) and the outcome of incident obesity, coronary heart disease (CHD), diabetes and hypertension has become available in recent years. Thus, the purpose of this systematic review was to provide an update on the association between PA and onset of obesity, CHD, diabetes and hypertension in individuals aged ≥18 years who were free of the respective conditions at baseline. METHODS We systematically searched OVID, Pubmed, and Web of Science databases for pertinent literature published between January of 2012 and February of 2019. To ensure that conclusions are based on high quality evidence, we only included longitudinal studies conducted in samples of ≥500 participants and with ≥5 years of follow-up. RESULT The search yielded 8929 records of which 26 were included in this review. Three studies were conducted on the outcome of incident obesity, eight on incident CHD, nine on incident diabetes, four on incident hypertension, one on the outcome of both diabetes and hypertension, and one on the outcome of CHD, diabetes and hypertension. Overall, there was an association between PA and lower risk of incident obesity, CHD and diabetes, but not hypertension. Higher levels or amount of PA were associated with a reduced risk of new onset of the respective diseases in 20 studies (77%). Whereas four studies reported an elevated risk of incidence of diseases with lower PA levels (15%). PA was not associated with incidence of diseases in two studies (8%). CONCLUSION Higher levels of PA are likely associated with a lower risk of becoming obese, develop CHD or diabetes. These findings replicate and strengthen conclusions from earlier reviews underlining the importance of promoting PA in adults. The associations between PA and incident hypertension were less consistent. More research, particularly using prospective cohort designs in large population-based samples, is needed to further untangle the association between PA and incident hypertension. TRAIL REGISTRATION CRD42019124474 (PROSPERO Protocol registration). Date of registration in PROSPERO 27 February 2019.
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Affiliation(s)
- Laura Cleven
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Janina Krell-Roesch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Translational Neuroscience and Aging Laboratory, Mayo Clinic, Scottsdale, AZ USA
| | - Claudio R. Nigg
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
- Present address: Institute of Sports Science, University of Bern, Bern, Switzerland
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
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Systemic inflammation in traumatic spinal cord injury. Exp Neurol 2019; 325:113143. [PMID: 31843491 DOI: 10.1016/j.expneurol.2019.113143] [Citation(s) in RCA: 52] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 12/06/2019] [Accepted: 12/10/2019] [Indexed: 01/08/2023]
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup P, Wannamethee SG, Jefferis BJ. Trajectories of physical activity from midlife to old age and associations with subsequent cardiovascular disease and all-cause mortality. J Epidemiol Community Health 2019; 74:130-136. [PMID: 31704805 PMCID: PMC6993021 DOI: 10.1136/jech-2019-212706] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Revised: 08/09/2019] [Accepted: 10/19/2019] [Indexed: 01/18/2023]
Abstract
Introduction It is well established that physical activity (PA) protects against mortality and morbidity, but how long-term patterns of PA are associated with mortality and cardiovascular disease (CVD) remains unclear. Methods 3231 men recruited to the British Regional Heart Study, a prospective cohort study, reported usual PA levels at baseline in 1978–1980 (aged 40–59 years) and at 12-year, 16-year and 20-year follow ups. Twenty-year trajectories of PA, spanning from 1978/1980 to 2000, were identified using group-based trajectory modelling. Men were subsequently followed up until 30 June 2016 for mortality through National Health Service central registers and for non-fatal CVD events through primary and secondary care records. Data analyses were conducted in 2019. Results Three PA trajectories were identified: low/decreasing (22.7%), light/stable (51.0%) and moderate/increasing (26.3%). Over a median follow-up of 16.4 years, there were 1735 deaths. Compared with the low/decreasing group, membership of the light/stable (HR 0.83, 95% CI 0.74 to 0.94) and moderate/increasing (HR 0.76, 95% CI 0.66 to 0.88) groups was associated with a lower risk of all-cause mortality. Similar associations were observed for CVD mortality, major coronary heart disease and all CVD events. Associations were only partially explained by a range of confounders. Sensitivity analyses suggested that survival benefits were largely driven by most recent/current PA. Conclusions A dose-response relationship was observed, with higher levels of PA from midlife to old age associated with additional benefits. However, even fairly modest and sustained PA was protective and may be more achievable for the most inactive.
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Affiliation(s)
- Daniel Aggio
- Primary Care and Population Health, University College London, London, UK
| | | | - Olia Papacosta
- Primary Care and Population Health, University College London, London, UK
| | - Lucy T Lennon
- Primary Care and Population Health, University College London, London, UK
| | - Sarah Ash
- Primary Care and Population Health, University College London, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - S Goya Wannamethee
- Primary Care and Population Health, University College London, London, UK
| | - Barbara J Jefferis
- Primary Care and Population Health, University College London, London, UK
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Wang F, Zhang LY, Zhang P, Cheng Y, Ye BZ, He MA, Guo H, Zhang XM, Yuan J, Chen WH, Wang YJ, Yao P, Wei S, Zhu YM, Liang Y. Effect of Physical Activity on Hospital Service Use and Expenditures of Patients with Coronary Heart Disease: Results from Dongfeng-Tongji Cohort Study in China. Curr Med Sci 2019; 39:483-492. [PMID: 31209822 DOI: 10.1007/s11596-019-2063-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 11/30/2018] [Indexed: 01/09/2023]
Abstract
The intervention of behaviors, including physical activity (PA), has become a strategy for many hospitals dealing with patients with chronic diseases. Given the limited evidence available about PA and healthcare use with chronic diseases, this study explored the association between different levels of PA and annual hospital service use and expenditure for inpatients with coronary heart disease (CHD) in China. We analyzed PA information from the first follow-up survey (2013) of the Dongfeng-Tongji cohort study of 1460 CHD inpatients. We examined factors such as PA exercise volume and years of PA and their associations with the number of inpatient visits, number of hospital days, and inpatient costs and total medical costs. We found that the number of hospital days and the number of inpatient visits were negatively associated with intensity of PA level. Similarly, total inpatient and outpatient costs declined when the PA exercise volume levels increased. Furthermore, there were also significant associations between the number of hospital days, inpatient costs or total medical costs and levels of PA years. This study provides the first empirical evidence about the effects of the intensity and years of PA on hospital service use and expenditure of CHD in China. It suggests that the patients' PA, especially the vigorous PA, should be promoted widely to the public and patients in order to relieve the financial burden of CHD.
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Affiliation(s)
- Fang Wang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Liu-Yi Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Zhang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yao Cheng
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Bei-Zhu Ye
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Mei-An He
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Huan Guo
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Xiao-Min Zhang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jing Yuan
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Wei-Hong Chen
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - You-Jie Wang
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Ping Yao
- Institute of Occupational Medicine and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Sheng Wei
- Department of Epidemiology and Biostatistics and the Ministry of Education (MOE) Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi-Mei Zhu
- School of Media, Communication and Sociology, University of Leicester, Leicester, LE1 7JA, UK
| | - Yuan Liang
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Aggio D, Papachristou E, Papacosta O, Lennon LT, Ash S, Whincup PH, Wannamethee SG, Jefferis BJ. Association Between 20-Year Trajectories of Nonoccupational Physical Activity From Midlife to Old Age and Biomarkers of Cardiovascular Disease: A 20-Year Longitudinal Study of British Men. Am J Epidemiol 2018; 187:2315-2323. [PMID: 30124747 PMCID: PMC6211233 DOI: 10.1093/aje/kwy157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2018] [Revised: 07/20/2018] [Accepted: 07/23/2018] [Indexed: 01/31/2023] Open
Abstract
The trajectories of physical activity (PA) from midlife into old age and their associations with established and novel cardiovascular disease (CVD) risk factors in later life remain unclear. This study examined associations between 20-year nonoccupational PA trajectories and a range of CVD biomarkers at ages 60-79 years. We used data from a sample of 3,331 men (mean baseline age = 50.2 ± 5.8 years) recruited in 1978-1980, with follow-up after 12, 16, and 20 years, reporting habitual nonoccupational PA at each wave. At the 20-year follow-up, surviving men attended a physical examination and provided a fasting blood sample. Group-based trajectory modeling was used to identify trajectories. Adjusted regression analyses examined the association between trajectory-group membership and several cardiometabolic, cardiac, and inflammatory markers at follow-up. Three distinct 20-year trajectories were identified: low/decreasing (21.3%), light/stable (51.8%), and moderate/increasing (27.0%). Compared with the low/decreasing group, membership in the light/stable and moderate/increasing trajectory groups was associated with a more favorable cardiometabolic profile and lower levels of inflammation and endothelial dysfunction. Although following a moderate-increasing PA trajectory was most favorable, more modest but sustained doses of PA into old age may be sufficient to lower CVD risk.
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Affiliation(s)
- Daniel Aggio
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
| | - Efstathios Papachristou
- Department of Psychology and Human Development, University College London, London, United Kingdom
| | - Olia Papacosta
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Lucy T Lennon
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Sarah Ash
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Peter H Whincup
- Population Health Research Institute, St George’s University of London, London, United Kingdom
| | - S Goya Wannamethee
- Department of Primary Care and Population Health, University College London, London, United Kingdom
| | - Barbara J Jefferis
- Department of Primary Care and Population Health, University College London, London, United Kingdom
- University College London Physical Activity Research Group, London, United Kingdom
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Li J, Gu C, Li D, Chen L, Lu Z, Zhu L, Huang H. Effects of serum N-terminal pro B-type natriuretic peptide and D-dimer levels on patients with acute ischemic stroke. Pak J Med Sci 2018; 34:994-998. [PMID: 30190768 PMCID: PMC6115578 DOI: 10.12669/pjms.344.15432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Objective: To detect the serum levels of D-dimer and N-terminal pro B-type natriuretic peptide (NT-pro BNP) in patients with Acute Ischemic Stroke (AIS), and to explore the risk factors of AIS. Methods: A total of 246 AIS patients treated in our hospital from January 2015 to January 2017 were selected. Meanwhile, 240 healthy subjects were selected as a control group. The D-dimer and NT-pro BNP levels of the two groups were compared. Correlations of such levels with age, gender, blood lipid, Intima-Media Thickness (IMT), fibrinogen and degree of neurological deficits were analyzed. Results: The AIS group had significantly higher levels of Triglyceride (TG), Low-Density Lipoprotein (LDL), D-dimer, NT-pro BNP and fibrinogen as well as IMT than those of the control group, but the High-Density Lipoprotein (HDL) level of the AIS group was significantly lower (P<0.05). The patients with different genders and ages had significantly different D-dimer and NT-pro BNP levels (P<0.05). The D-dimer and NT-pro BNP levels were correlated with gender and age. Such levels of females were significantly higher than those of males (P<0.05). The D-dimer and NT-pro BNP levels of the ≥60 years old group significantly exceeded those of the <60 years old group (P<0.05). The levels of D-dimer and NT-pro BNP were negatively correlated with that of HDL (P<0.05), but positively correlated with TG, LDL and fibrinogen levels, IMT, and National Institutes of Health Stroke Scale score (P<0.05). Multivariate Logistic regression analysis showed that the OR values of D-dimer and NT-pro BNP were 3.65 and 6.96 respectively. Conclusion: Serum D-dimer and NT-pro BNP levels usually increased in AIS patients, and the levels were significantly correlated with AIS onset.
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Affiliation(s)
- Jia Li
- Jia Li, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Chengzhi Gu
- Chengzhi Gu, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Dan Li
- Dan Li, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Lan Chen
- Lan Chen, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Zhenhui Lu
- Zhenhui Lu, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Lianhai Zhu
- Lianhai Zhu, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
| | - Huaiyu Huang
- Huaiyu Huang, Department of Neurology, Second Affiliated Hospital of Nantong University, Nantong 226001, Jiangsu Province, China
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Cheng W, Zhang Z, Cheng W, Yang C, Diao L, Liu W. Associations of leisure-time physical activity with cardiovascular mortality: A systematic review and meta-analysis of 44 prospective cohort studies. Eur J Prev Cardiol 2018; 25:1864-1872. [PMID: 30157685 DOI: 10.1177/2047487318795194] [Citation(s) in RCA: 109] [Impact Index Per Article: 18.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Background Many cohort studies within the past few decades have shown the protective effect of leisure-time physical activity on cardiovascular mortality. To summarise the evidence from prospective cohort studies on the relationship between the amount of leisure-time physical activity and the risk of cardiovascular mortality, a dose–response meta-analysis was conducted in this study. Methods and results Electronic databases, including PubMed and Embase databases, Scopus and Cochrane Library, were systemically retrieved by two investigators from inception to 14 June 2018 for related studies. The maximum adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were extracted, and a dose–response analysis was conducted using the restricted cubic splines. Finally, a total of 44 studies comprising 1,584,181 participants was enrolled into this meta-analysis. The HRs of cardiovascular mortality for moderate and high leisure-time physical activity were 0.77 (95% CI 0.74–0.81) and 0.73 (95% CI 0.69–0.77), respectively. Among these 44 studies, 19 were eligible for the dose–response meta-analysis, which suggested a linear negative correlation of leisure-time physical activity with cardiovascular mortality, regardless of age, gender and the presence of underlying cardiovascular disease or not. Conclusions Leisure-time physical activity shows a linear negative correlation with the risk of cardiovascular mortality regardless of age, gender and the presence of cardiovascular disease or not. However, the cardiovascular benefits of leisure-time physical activity is decreased for those aged over 65 years or those with a history of cardiovascular disease. Moreover, leisure-time physical activity displays more cardiovascular benefits to people followed up for over 10 years than to those followed up for less than 10 years. Besides, high-intensity leisure-time physical activity has more obvious cardiovascular benefits than those of moderate-intensity leisure-time physical activity.
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Affiliation(s)
- Wenke Cheng
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
| | - Zhen Zhang
- Department of Oncology, Affiliated Hospital of Qinghai University, China
| | - Wensi Cheng
- School of Nursing, Heze Medical College, China
| | - Chong Yang
- Department of Obstetrics, Zaozhuang Municipal Hospital, China
| | - Linlin Diao
- Department of Cardiology, Zaozhuang Municipal Hospital, China
| | - Weijun Liu
- Department of Cardiology, Affiliated Hospital of Qinghai University, China
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Parsons TJ, Sartini C, Welsh P, Sattar N, Ash S, Lennon LT, Wannamethee SG, Lee IM, Whincup PH, Jefferis BJ. Objectively measured physical activity and cardiac biomarkers: A cross sectional population based study in older men. Int J Cardiol 2018; 254:322-327. [PMID: 29407114 PMCID: PMC5958950 DOI: 10.1016/j.ijcard.2017.11.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 10/09/2017] [Accepted: 11/02/2017] [Indexed: 01/31/2023]
Abstract
BACKGROUND N-terminal pro-brain natriuretic peptide (NT-proBNP) and high sensitivity Troponin T (hsTnT) are markers of cardiac injury used in diagnosis of heart failure and myocardial infarction respectively, and associated with increased risk of cardiovascular disease. Since physical activity is protective against cardiovascular disease and heart failure, we investigated whether higher levels of physical activity, and less sedentary behaviour were associated with lower NT-proBNP and hsTnT. METHODS AND RESULTS Cross sectional study of 1130 men, age 70-91years, from the British Regional Heart Study, measured in 2010-2012. Fasting blood samples were analysed for NT-proBNP and hsTnT. Physical activity and sedentary behaviour were measured using ActiGraph GT3X accelerometers. Relationships between activity and NT-proBNP or hsTnT were non-linear; biomarker levels were lower with higher total activity, steps, moderate/vigorous activity and light activity only at low to moderate levels of activity. For example, for each additional 10min of moderate/vigorous activity, NT-proBNP was lower by 35.7% (95% CI -47.9, -23.6) and hsTnT by 8.4% (95% CI -11.1, -5.6), in men who undertook <25 or 50min of moderate/vigorous activity per day respectively. Biomarker levels increased linearly with increasing sedentary behaviour, but not independently of moderate/vigorous activity. CONCLUSION Associations between biomarkers and moderate/vigorous activity (and between hsTnT and light activity) were independent of sedentary behaviour, suggesting activity is driving the relationships. In these older men with concomitantly low levels of physical activity, activity may be more important in protecting against cardiac health deterioration in less active individuals, although reverse causality might be operating.
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Affiliation(s)
- Tessa J Parsons
- UCL Department of Primary Care & Population Health, United Kingdom.
| | - Claudio Sartini
- UCL Department of Primary Care & Population Health, United Kingdom
| | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, United Kingdom
| | - Naveed Sattar
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, United Kingdom
| | - Sarah Ash
- UCL Department of Primary Care & Population Health, United Kingdom
| | - Lucy T Lennon
- UCL Department of Primary Care & Population Health, United Kingdom
| | | | - I-Min Lee
- Brigham and Women's Hospital, Harvard Medical School, United States
| | - Peter H Whincup
- Population Health Research Institute, St George's University of London, United Kingdom
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Elhakeem A, Murray ET, Cooper R, Kuh D, Whincup P, Hardy R. Leisure-time physical activity across adulthood and biomarkers of cardiovascular disease at age 60-64: A prospective cohort study. Atherosclerosis 2017; 269:279-287. [PMID: 29180005 PMCID: PMC5825380 DOI: 10.1016/j.atherosclerosis.2017.11.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 11/09/2017] [Accepted: 11/16/2017] [Indexed: 12/12/2022]
Abstract
Background and aims This study examined associations between leisure-time physical activity (LTPA) across adulthood (from age 36) and cardiovascular disease (CVD) biomarkers at age 60–64. Methods LTPA was reported by study participants from the MRC National Survey of Health and Development at ages 36, 43, 53 and 60–64 (n = 1754) and categorised as inactive, moderately active (1–4/month) or most active (5+/month) at each age. Linear regression was used to examine associations between a cumulative adulthood LTPA score (range = 0–8), and change in LTPA between ages 36 and 60–64 (i.e. always inactive, became inactive, became active, always active) and inflammatory [C-reactive protein (CRP), interleukin-6 (IL-6)], endothelial [tissue-Plasminogen Activator (t-PA), E-selectin] and adipokine [leptin, adiponectin] measures extracted from overnight fasting blood samples at age 60–64. Results The more active a participant was over adulthood, the better their biomarker profile, e.g. fully-adjusted difference in t-PA (both sexes) and adiponectin (women) per unit increase in the LTPA score (95% confidence interval) = −2.2% (−3.6; −0.8) and 2.0% (0.2; 3.8). Those that became active at age 60–64 showed slightly healthier biomarker profiles than those that became inactive [e.g. fully-adjusted difference in IL-6 = −9.9% (−23.9; 4.1) vs. −3.8% (−12.4; 4.8)], although the best profiles were seen for those always active [IL-6: −15.0% (−24.2; −5.7)], when compared with the always inactive group. Conclusions Greater accumulation of LTPA across adulthood was associated with a more favourable CVD biomarker profile in early old age. Earlier uptake and long-term maintenance of LTPA may provide the greatest benefits for CVD prevention. Greater LTPA over 28 years related to healthier atherosclerotic biomarker profiles. Taking up LTPA related to better biomarker levels than staying inactive over life. Differences in biomarker levels by LTPA were only partly mediated by body size. Earlier uptake and long-term maintenance of LTPA may provide greatest benefits.
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Affiliation(s)
- Ahmed Elhakeem
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
| | - Emily T Murray
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Peter Whincup
- Population Health Research Institute, St George's University of London, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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Parsons TJ, Sartini C, Welsh P, Sattar N, Ash S, Lennon LT, Wannamethee SG, Lee IM, Whincup PH, Jefferis BJ. Physical Activity, Sedentary Behavior, and Inflammatory and Hemostatic Markers in Men. Med Sci Sports Exerc 2017; 49:459-465. [PMID: 28222056 DOI: 10.1249/mss.0000000000001113] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
PURPOSE This study aimed to determine whether higher levels of physical activity (PA) and less sedentary behavior (SB) are associated with less inflammation, indicated by inflammatory and hemostatic biomarkers, in older men. METHODS A cross-sectional study of 1139 men, from the British Regional Heart Study (mean ± SD age = 78 ± 5 yr), and longitudinal analyses of 490 men with two PA measures 1 yr apart were used in this study. Single fasting venous blood samples were analyzed for several biomarkers. PA and SB were measured using ActiGraph GT3X accelerometers. Total time and time spent in bouts of moderate to vigorous PA (MVPA), light PA, and SB were derived. Linear regression analyses were used to investigate associations. RESULTS Cross-sectionally, higher total PA, daily steps, and MVPA were all associated with lower levels of interleukin 6 (IL-6), C-reactive protein (CRP), tissue plasminogen activator (tPA), von Willebrand factor (vWF), and D-dimer, whereas higher levels of SB were associated with higher levels of IL-6, CRP, and tPA. Each additional 10 min of MVPA was associated with a 3.2% lower IL-6 (95% confidence interval [CI] = -4.5% to -1.8%), 5.6% lower CRP (95% CI = -7.8 to -3.3), 2.2% lower tPA (95% CI = -3.0 to -1.4), 1.2% lower vWF (95% CI = -2.1 to -0.3), and 1.8% lower D-dimer (95% CI = -2.9 to -0.7), and for CRP, vWF, and D-dimer independently of SB. Associations between SB and IL-6 or tPA were independent of MVPA. Longer bouts of PA or SB were not more strongly associated with outcomes than shorter bouts. Longitudinal analyses were inconsistent with these findings, possibly because of power limitations. CONCLUSION Although PA (particularly MVPA) was generally associated with inflammatory and hemostatic biomarkers, we found no evidence that longer bouts were more important than shorter bouts.
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Affiliation(s)
- Tessa J Parsons
- 1UCL Department of Primary Care and Population Health, UCL Medical School, London, UNITED KINGDOM; 2UCL Physical Activity Research Group, London, UNITED KINGDOM; 3Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, UNITED KINGDOM; 4Brigham and Women's Hospital, Harvard Medical School, Boston, MA; and 5Population Health Research Institute, St George's University of London, Cranmer Terrace, London, UNITED KINGDOM
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Lineweaver TT, Kugler J, Rabellino A, Stephan Y. Beliefs about age-related changes in physical functioning across the adult life span and their relationship with physical activity levels of older adults. AGING NEUROPSYCHOLOGY AND COGNITION 2017; 25:613-631. [PMID: 28753072 DOI: 10.1080/13825585.2017.1356903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Physical activity declines across the adult life span despite the well-established links between physical activity and health-related, psychological, cognitive, and social benefits. We contrasted the beliefs young and older adults hold about how aging affects both physical abilities and physical activity and determined whether older adults' beliefs about physical aging relate to their engagement in physical activity. Using visual rating scales, 56 young and 49 community-dwelling older adults indicated the extent to which a typical woman or typical man aged 20-90 possesses six different physical abilities and engages in three different types of physical activity. Stereotypes of physical aging were ability- and activity-specific, and older adults endorsed more positive views than their younger peers. Stereotypical beliefs predicted older adults' engagement in moderate-intensity activity. This study offers intriguing avenues for future research and suggests that better understanding physical aging stereotypes may contribute toward designing interventions that promote lifelong physical activity.
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Affiliation(s)
- Tara T Lineweaver
- a Department of Psychology , Butler University , Indianapolis , IN , USA
| | - Jennifer Kugler
- a Department of Psychology , Butler University , Indianapolis , IN , USA
| | | | - Yannick Stephan
- b Department of Psychology , University of Montpellier , Montpellier , France
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Biomarkers associated with sedentary behaviour in older adults: A systematic review. Ageing Res Rev 2017; 35:87-111. [PMID: 28025174 DOI: 10.1016/j.arr.2016.12.002] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Revised: 10/30/2016] [Accepted: 12/12/2016] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Pathomechanisms of sedentary behaviour (SB) are unclear. We conducted a systematic review to investigate the associations between SB and various biomarkers in older adults. METHODS Electronic databases were searched (MEDLINE, EMBASE, CINAHL, AMED) up to July 2015 to identify studies with objective or subjective measures of SB, sample size ≥50, mean age ≥60years and accelerometer wear time ≥3days. Methodological quality was appraised with the CASP tool. The protocol was pre-specified (PROSPERO CRD42015023731). RESULTS 12701 abstracts were retrieved, 275 full text articles further explored, from which 249 were excluded. In the final sample (26 articles) a total of 63 biomarkers were detected. Most investigated markers were: body mass index (BMI, n=15), waist circumference (WC, n=15), blood pressure (n=11), triglycerides (n=12) and high density lipoprotein (HDL, n=15). Some inflammation markers were identified such as interleukin-6, C-reactive protein or tumor necrosis factor alpha. There was a lack of renal, muscle or bone biomarkers. Randomized controlled trials found a positive correlation for SB with BMI, neck circumference, fat mass, HbA1C, cholesterol and insulin levels, cohort studies additionally for WC, leptin, C-peptide, ApoA1 and Low density lipoprotein and a negative correlation for HDL. CONCLUSION Most studied biomarkers associated with SB were of cardiovascular or metabolic origin. There is a suggestion of a negative impact of SB on biomarkers but still a paucity of high quality investigations exist. Longitudinal studies with objectively measured SB are needed to further elucidate the pathophysiological pathways and possible associations of unexplored biomarkers.
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Arbeev KG, Ukraintseva SV, Yashin AI. Dynamics of biomarkers in relation to aging and mortality. Mech Ageing Dev 2016; 156:42-54. [PMID: 27138087 PMCID: PMC4899173 DOI: 10.1016/j.mad.2016.04.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2015] [Revised: 04/08/2016] [Accepted: 04/26/2016] [Indexed: 02/06/2023]
Abstract
Contemporary longitudinal studies collect repeated measurements of biomarkers allowing one to analyze their dynamics in relation to mortality, morbidity, or other health-related outcomes. Rich and diverse data collected in such studies provide opportunities to investigate how various socio-economic, demographic, behavioral and other variables can interact with biological and genetic factors to produce differential rates of aging in individuals. In this paper, we review some recent publications investigating dynamics of biomarkers in relation to mortality, which use single biomarkers as well as cumulative measures combining information from multiple biomarkers. We also discuss the analytical approach, the stochastic process models, which conceptualizes several aging-related mechanisms in the structure of the model and allows evaluating "hidden" characteristics of aging-related changes indirectly from available longitudinal data on biomarkers and follow-up on mortality or onset of diseases taking into account other relevant factors (both genetic and non-genetic). We also discuss an extension of the approach, which considers ranges of "optimal values" of biomarkers rather than a single optimal value as in the original model. We discuss practical applications of the approach to single biomarkers and cumulative measures highlighting that the potential of applications to cumulative measures is still largely underused.
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Affiliation(s)
- Konstantin G Arbeev
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA.
| | - Svetlana V Ukraintseva
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA
| | - Anatoliy I Yashin
- Biodemography of Aging Research Unit (BARU), Social Science Research Institute, Duke University, 2024 W. Main St., Room A102F, Box 90420, Durham, NC 27705, USA
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Klenk J, Dallmeier D, Denkinger MD, Rapp K, Koenig W, Rothenbacher D. Objectively Measured Walking Duration and Sedentary Behaviour and Four-Year Mortality in Older People. PLoS One 2016; 11:e0153779. [PMID: 27082963 PMCID: PMC4833405 DOI: 10.1371/journal.pone.0153779] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 04/04/2016] [Indexed: 11/18/2022] Open
Abstract
Background Physical activity is an important component of health. Recommendations based on sensor measurements are sparse in older people. The aim of this study was to analyse the effect of objectively measured walking and sedentary duration on four-year mortality in community-dwelling older people. Methods Between March 2009 and April 2010, physical activity of 1271 participants (≥65 years, 56.4% men) from Southern Germany was measured over one week using a thigh-worn uni-axial accelerometer (activPAL; PAL Technologies, Glasgow, Scotland). Mortality was assessed during a four-year follow-up. Cox-proportional-hazards models were used to estimate the associations between walking (including low to high intensity) and sedentary duration with mortality. Models were adjusted for age and sex, additional epidemiological variables, and selected biomarkers. Results An inverse relationship between walking duration and mortality with a minimum risk for the 3rd quartile (102.2 to128.4 minutes walking daily) was found even after multivariate adjustment with HRs for quartiles 2 to 4 compared to quartile 1 of 0.45 (95%-CI: 0.26; 0.76), 0.18 (95%-CI: 0.08; 0.41), 0.39 (95%-CI: 0.19; 0.78), respectively. For sedentary duration an age- and sex-adjusted increased mortality risk was observed for the 4th quartile (daily sedentary duration ≥1137.2 min.) (HR 2.05, 95%-CI: 1.13; 3.73), which diminished, however, after full adjustment (HR 1.63, 95%-CI: 0.88; 3.02). Furthermore, our results suggest effect modification between walking and sedentary duration, such that in people with low walking duration a high sedentary duration was noted as an independent factor for increased mortality. Conclusions In summary, walking duration was clearly associated with four-year overall mortality in community-dwelling older people.
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Affiliation(s)
- Jochen Klenk
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Department of Geriatrics and Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
- * E-mail:
| | - Dhayana Dallmeier
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
- Agaplesion Bethesda Hospital, Geriatric Research Unit, Ulm University and Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Michael Dieter Denkinger
- Agaplesion Bethesda Hospital, Geriatric Research Unit, Ulm University and Geriatric Center Ulm/Alb-Donau, Ulm, Germany
| | - Kilian Rapp
- Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
- Department of Geriatrics and Geriatric Rehabilitation, Robert-Bosch-Hospital, Stuttgart, Germany
| | - Wolfgang Koenig
- Department of Internal Medicine II-Cardiology, University of Ulm Medical Center, Ulm, Germany
- Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
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Kutner NG, Zhang R, Huang Y, Kaysen GA, Park J. Lower C-reactive protein and better hemodialysis survival are associated with regular exercise activity: Longitudinal outcomes from the ACTIVE-ADIPOSE special study. Hemodial Int 2016; 20:473-83. [PMID: 26954723 DOI: 10.1111/hdi.12408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Introduction Cross-sectional and longitudinal studies in the general population have shown that a physically active lifestyle may have anti-inflammatory properties, but evidence from studies conducted with maintenance hemodialysis (HD) patients is limited. Methods A multicenter prospective cohort of 755 HD participants aged 20-92 was evaluated in a USRDS special study 2009-2013. Kilocalories/week (kcal/week) of leisure time physical activity (LTPA) was estimated from the Minnesota Leisure Time Activity questionnaire. Predialysis serum samples were obtained concurrent with LTPA report date. Generalized estimating equations (GEE) examined association of participants' LTPA and log-normalized CRP across 24 months. Cox proportional hazards models investigated LTPA and survival over a median follow-up of 718 days. Findings Baseline median CRP concentration was lower for participants with 500+ kcal/week LTPA vs. those with <500 kcal/week LTPA (3.4 mg/L vs. 4.6 mg/L; P = 0.03). Participants who reported lower LTPA (<500 kcal/week) at both baseline and 12 months had a borderline significant increase in CRP concentration (within-group change 4.8 [1.9-10.4] to 5.8 [1.6-15.7]; P = 0.08). Lower LTPA was associated with higher log CRP over 24 months in adjusted GEE analyses (β coefficient = 0.16 [95% CI 0.02-0.31]; P = 0.03). 67/364 (18%) and 43/391 (11%) deaths occurred, respectively, among participants reporting <500 vs. 500+ kcal/week LTPA [adjusted mortality hazard ratio 1.63 (CI, 1.07, 2.47)]. Discussion The data suggest that increased estimated levels of LTPA, a physical activity/exercise opportunity widely applicable to HD patients, may be associated with lower CRP concentration as well as better survival outcome.
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Affiliation(s)
- Nancy G Kutner
- Department of Rehabilitation Medicine, School of Medicine, Atlanta, Georgia, USA
| | - Rebecca Zhang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Yijian Huang
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - George A Kaysen
- Department of Medicine and Department of Biochemistry and Molecular Medicine, University of California, Davis, California, USA
| | - Jeanie Park
- Renal Division, Department of Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
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Shen C, Lee SY, Lam TH, Schooling CM. Is Traditional Chinese Exercise Associated With Lower Mortality Rates in Older People? Evidence From a Prospective Chinese Elderly Cohort Study in Hong Kong. Am J Epidemiol 2016; 183:36-45. [PMID: 26646293 DOI: 10.1093/aje/kwv142] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2015] [Accepted: 05/28/2015] [Indexed: 01/13/2023] Open
Abstract
The inverse association of aerobic exercise with death has been well documented. However, evidence on traditional Chinese exercise (TCE) and rate of death in older Chinese is limited. Multivariable Cox regression analysis was used to assess the associations of TCE and other types of physical activity with death from all causes and specific causes in a population-based prospective cohort of 66,820 Chinese persons (≥65 years of age) who were enrolled between July 1998 and December 2001 at all 18 Elderly Health Centers in Hong Kong and followed up until May 31, 2012. During an average of 10.9 years of follow-up, 19,845 deaths occurred. TCE was inversely associated with death from all causes (hazard ratio (HR) = 0.78, 95% confidence interval (CI): 0.74, 0.82), cardiovascular disease (HR = 0.77, 95% CI: 0.70, 0.85), cancer (HR = 0.84, 95% CI: 0.77, 0.92), and respiratory disease (HR = 0.71, 95% CI: 0.63, 0.80) but was not associated with death from accidents (excluding falls) (HR = 0.79, 95% CI: 0.44, 1.42), after adjustment for age, sex, socioeconomic position, alcohol use, smoking, body mass index, and health status. The associations did not vary by amount of TCE. Aerobic exercise had similar inverse associations as TCE, but associations for stretching exercises and walking slowly were less marked. Further studies of TCE are warranted in older Chinese.
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Sepúlveda C, Palomo I, Fuentes E. Primary and secondary haemostasis changes related to aging. Mech Ageing Dev 2015; 150:46-54. [PMID: 26296601 DOI: 10.1016/j.mad.2015.08.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 08/02/2015] [Accepted: 08/11/2015] [Indexed: 12/17/2022]
Abstract
Life expectancy has increased in many countries as a result the world's population is aging. The projections indicate that the proportion of the elderly in a few decades will increase significantly. Aging carries with it a series of physiological changes; one of them is an imbalance in the hemostatic system. Thus the levels or activity of various proteins involved, such as most coagulation factors, natural anticoagulants and the fibrinolytic system are altered so that the hemostatic balance leans toward thrombosis. Also, platelet activity suggests a state of abnormal activation (P-selectin, beta thromboglobulin and platelet factor). In this review we will systematically examine the alterations in the hemostatic components that occur during aging. Therefore, understanding these hemostatic changes could contribute to developing strategies for the proper management of health in old age.
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Affiliation(s)
- Cesar Sepúlveda
- Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile
| | - Iván Palomo
- Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile; Centro de Estudios en Alimentos Procesados (CEAP), CONICYT- Regional, Gore Maule R09I2001, Chile.
| | - Eduardo Fuentes
- Department of Clinical Biochemistry and Immunohaematology, Faculty of Health Sciences, Interdisciplinary Excellence Research Program on Healthy Aging (PIEI-ES), Universidad de Talca, Talca, Chile; Centro de Estudios en Alimentos Procesados (CEAP), CONICYT- Regional, Gore Maule R09I2001, Chile.
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Abedinzadeh N, Pedram B, Sadeghian Y, Nodushan SMHT, Gilasgar M, Darvish M, Mokarizadeh A. A histopathological analysis of the epidemiology of coronary atherosclerosis: an autopsy study. Diagn Pathol 2015; 10:87. [PMID: 26137939 PMCID: PMC4490639 DOI: 10.1186/s13000-015-0324-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 06/12/2015] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Atherosclerosis accounts for a large proportion of cardiovascular system associated morbidity and mortality. We studied the possible association between the histopathological changes of the coronary atherosclerotic lesions and the risk of sudden cardiac death (SCD) using autopsy cases. METHODS We performed an autopsy analysis (n = 13, 4 women, 9 men mean age 67.5 years; age range 56-93 years) of SCD which occurred in patients aged over 50 years during March 2010 to December 2013. The following variables were considered: sex, age, medical history, autopsy findings to macroscopic and histological evaluation of the heart. The autopsies were performed according to standard techniques. In all subjects, the heart was dissected following standard autopsy protocol and a 5 cm section of the right coronary artery (RCA) in the atrio-ventricular groove from its origin, a 5 cm segment of the left anterior descending artery (LADA) distal to the origin of the circumflex artery, but including the region of origin of the circumflex branch and left coronary artery (LCA) from its origin till the circumflex branch were excised, dissected out, fixed in 10% formalin, marked for identification and sent for histopathological analysis. RESULTS Atherosclerotic plaques were identified in 6.5% of specimens, 69.34% of males and 30.66% of female. Such plaques were typically concentric and more represented with necrosis, calcification, cholesterol crystals, and giant cells, as well as had a higher inflammatory cell count. Furthermore, intima and media thickness of coronary arteries were significantly higher in studied specimens with visualize the connective tissue layers of the adventitia and the fatty acid containing adipose cells in the periadventitial tissue. Furthermore, the degree of microscopic lesion of atherosclerosis increased proportionally with the increase in the intensity of lipid deposition and with the percentage of collagen in the atherosclerotic plaques. CONCLUSION In this study, age estimate to be a risk factor for coronary atherosclerosis in individuals more than 50 years old and may be used to predict SCD. Altogether, an enhanced understanding of the pathobiologic processes responsible for atherosclerotic changes might allow for early identification of a high-risk coronary plaque and thereby provide a rationale for innovative diagnostic and/or therapeutic strategies for the management of coronary patients and prevention of acute coronary syndromes.
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Affiliation(s)
- Negin Abedinzadeh
- Graduate, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
| | - Behnam Pedram
- Department of Pathobiology, Susangerd Branch Islamic Azad University, Susangerd, Iran.
| | - Yasan Sadeghian
- Graduate, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
| | | | - Maryam Gilasgar
- Graduate, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
| | - Mahsa Darvish
- Graduate, Faculty of Medicine, Shahid Beheshti University of Medical Sciences and Health Services, Tehran, Iran.
| | - Aram Mokarizadeh
- Cellular & Molecular Research Center, and Department of Immunology, Kurdistan University of Medical Sciences, Sanandaj, Iran.
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Enomoto M, Adachi H, Fukami A, Yoshimura A, Obuchi A, Nakamura S, Nohara Y, Nakao E, Umeki Y, Hori K, Fukumoto Y. Circulating Inflammatory and Hemostatic Biomarkers are Associated with All-Cause Death and Cancer Death in a Population of Community-Dwelling Japanese: the Tanushimaru Study. CLINICAL MEDICINE INSIGHTS-CARDIOLOGY 2015; 8:43-8. [PMID: 25922585 PMCID: PMC4399718 DOI: 10.4137/cmc.s17065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 12/08/2014] [Accepted: 12/13/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND In patients with cardiovascular diseases, inflammatory and hemostatic biomarkers are significant indicators of prognosis. We investigated whether circulating inflammatory and hemostatic biomarkers were predictive markers for all-cause death and cancer death in a population of community-dwelling Japanese. METHODS We studied 1,920 healthy Japanese adults who underwent health examinations in 1999. Those who reported a history of inflammatory diseases and malignancy on a baseline questionnaire were excluded. Inflammatory and hemostatic biomarkers were measured in the remaining 1,862 participants, who were followed up periodically for 10 years. Multivariate proportional hazards regression analysis was used to estimate all-cause and cancer mortality. RESULTS A total of 258 participants died during follow-up: 87 from cancer, 38 from cerebro-cardiovascular diseases, and 133 from other diseases. Mean C-reactive protein (CRP) levels at baseline were significantly higher in decedents than in survivors. Mean von Willebrand factor (vWF) levels at baseline were significantly higher in decedents than in survivors. The Cox proportional hazards model after adjustments for age and sex showed that CRP (hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.06-1.51) and vWF (HR, 1.01; 95% CI, 1.00-1.01) were independent predictors of all-cause death. CRP (HR, 1.40; 95% CI, 1.06-1.86) and vWF (HR, 1.01; 95% CI, 1.00-1.02) were also independent predictive markers for cancer death. CONCLUSIONS Serum CRP and vWF were predictors of all-cause death and cancer death in the population of community dwelling Japanese.
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Affiliation(s)
- Mika Enomoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Hisashi Adachi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan. ; Department of Community Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ako Fukami
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Ayako Yoshimura
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Aya Obuchi
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Sachiko Nakamura
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yume Nohara
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Erika Nakao
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoko Umeki
- Department of Community Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Kensuke Hori
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
| | - Yoshihiro Fukumoto
- Department of Internal Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, Kurume, Japan
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