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Rønningen PS, Berge T, Solberg MG, Enger S, Pervez MO, Orstad EB, Kvisvik B, Aagaard EN, Lyngbakken MN, Ariansen I, Røsjø H, Steine K, Tveit A. Impact of Blood Pressure in the Early 40s on Left Atrial Volumes in the Mid-60s: Data From the ACE 1950 Study. J Am Heart Assoc 2022; 11:e023738. [PMID: 35621203 PMCID: PMC9238725 DOI: 10.1161/jaha.121.023738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Background Echocardiographic measures of left atrial volumes are powerful predictors of cardiovascular events and important for assessing diastolic dysfunction. Despite this, there is limited knowledge of factors influencing left atrial remodeling. In particular, the impact of blood pressure in those in their early 40s on left atrial volumes later in life has not been sufficiently elucidated. Methods and Results We linked data from individuals born in 1950 who participated in the Age 40 Program, and the ACE (Akershus Cardiac Examination) 1950 Study. We divided the study population into quartiles of systolic blood pressure in their early 40s and assessed the proportion of individuals with an enlarged left atrium in their mid‐60s. The associations between blood pressure and left atrial volumes were assessed in linear regression analyses. Of the 2591 individuals included in this study, 1302 (50.3%) were women, and the mean age in the Age 40 Program was 40.1±0.3 years. Systolic blood pressure was 128.1±13.6 mm Hg and diastolic blood pressure was 78.3±9.5 mm Hg. Mean age in the ACE 1950 Study was 64.0±0.6 years. The proportion of individuals with an enlarged left atrium increased across the quartiles of systolic blood pressure (P=0.001). Systolic blood pressure was independently associated with left atrial volumes; the end‐systolic volume was 0.09 mL (95% CI, 0.04–0.14 mL) larger per 1‐mm Hg higher systolic blood pressure. Conclusions Our findings suggest that increased blood pressure in those in their early 40s is relevant for left atrial remodeling later in life. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01555411.
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Affiliation(s)
- Peter Selmer Rønningen
- Department of Medical Research Bærum HospitalVestre Viken Hospital Trust Gjettum Norway.,Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Trygve Berge
- Department of Medical Research Bærum HospitalVestre Viken Hospital Trust Gjettum Norway
| | - Magnar Gangås Solberg
- Department of Medical Research Bærum HospitalVestre Viken Hospital Trust Gjettum Norway.,Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Steve Enger
- Department of Medical Research Bærum HospitalVestre Viken Hospital Trust Gjettum Norway
| | - Mohammad Osman Pervez
- Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Eivind Bjørkan Orstad
- Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Brede Kvisvik
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway.,Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Erika Nerdrum Aagaard
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway.,Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Magnus Nakrem Lyngbakken
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway.,Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Inger Ariansen
- Deparment of Chronic Diseases and Ageing Norwegian Institute of Public Health Oslo Norway
| | - Helge Røsjø
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway.,Division for Research and Innovation Akershus University Hospital Lørenskog Norway
| | - Kjetil Steine
- Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway.,Division of Medicine Department of Cardiology Akershus University Hospital Lørenskog Norway
| | - Arnljot Tveit
- Department of Medical Research Bærum HospitalVestre Viken Hospital Trust Gjettum Norway.,Faculty of Medicine Institute of Clinical Medicine University of Oslo Oslo Norway
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2
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Cohen LP, Vittinghoff E, Pletcher MJ, Allen NB, Shah SJ, Wilkins JT, Chang PP, Ndumele CE, Newman AB, Ives D, Maurer MS, Oelsner EC, Moran AE, Zhang Y. Association of Midlife Cardiovascular Risk Factors With the Risk of Heart Failure Subtypes Later in Life. J Card Fail 2021; 27:435-444. [PMID: 33238139 PMCID: PMC7987686 DOI: 10.1016/j.cardfail.2020.11.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 11/12/2020] [Accepted: 11/16/2020] [Indexed: 12/22/2022]
Abstract
BACKGROUND Independent associations between cardiovascular risk factor exposures during midlife and later life development of heart failure (HF) with preserved ejection fraction (HFpEF) versus reduced EF (HFrEF) have not been previously studied. METHODS We pooled data from 4 US cohort studies (Atherosclerosis Risk in Communities, Cardiovascular Health, Health , Aging and Body Composition, and Multi-Ethnic Study of Atherosclerosis) and imputed annual risk factor trajectories for body mass index, systolic and diastolic blood pressure, low-density lipoprotein and high-density lipoprotein cholesterol, and glucose starting from age 40 years. Time-weighted average exposures to each risk factor during midlife and later life were calculated and analyzed for associations with the development of HFpEF or HFrEF. RESULTS A total of 23,861 participants were included (mean age at first in-person visit, 61.8 ±1 0.2 years; 56.6% female). During a median follow-up of 12 years, there were 3666 incident HF events, of which 51% had EF measured, including 934 with HFpEF and 739 with HFrEF. A high midlife systolic blood pressure and low midlife high-density lipoprotein cholesterol were associated with HFrEF, and a high midlife body mass index, systolic blood pressure, pulse pressure, and glucose were associated with HFpEF. After adjusting for later life exposures, only midlife pulse pressure remained independently associated with HFpEF. CONCLUSIONS Midlife exposure to cardiovascular risk factors are differentially associated with HFrEF and HFpEF later in life. Having a higher pulse pressure during midlife is associated with a greater risk for HFpEF but not HFrEF, independent of later life exposures.
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Affiliation(s)
- Laura P Cohen
- Columbia University Irving Medical Center, Columbia University, New York, New York
| | - Eric Vittinghoff
- University of California, San Francisco, San Francisco, California
| | - Mark J Pletcher
- University of California, San Francisco, San Francisco, California
| | - Norrina B Allen
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Sanjiv J Shah
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - John T Wilkins
- Northwestern University Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Patricia P Chang
- University of North Carolina School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Chiadi E Ndumele
- Johns Hopkins University Medical Center, Johns Hopkins University, Baltimore, Maryland
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Diane Ives
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Mathew S Maurer
- Columbia University Irving Medical Center, Columbia University, New York, New York
| | - Elizabeth C Oelsner
- Columbia University Irving Medical Center, Columbia University, New York, New York
| | - Andrew E Moran
- Columbia University Irving Medical Center, Columbia University, New York, New York
| | - Yiyi Zhang
- Columbia University Irving Medical Center, Columbia University, New York, New York.
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3
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Olesen TB, Pareek M, Stidsen JV, Blicher MK, Rasmussen S, Vishram-Nielsen JKK, Maagaard L, H Olsen M. Association between antecedent blood pressure, hypertension-mediated organ damage and cardiovascular outcome. Blood Press 2020; 29:232-240. [PMID: 32157916 DOI: 10.1080/08037051.2020.1735930] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Purpose: The objective of this study was to test if combining antecedent systolic blood pressure (SBP) with traditional risk factors and hypertension-mediated organ damage (HMOD) improves risk stratification for subsequent cardiovascular disease.Materials and methods: 1910 subjects participated in this study. Antecedent SBP was defined as the average of measurements obtained in 1982 and in 1987. Current SBP was obtained in 1993. HMOD were examined in 1993. HMOD was defined as either atherosclerotic plaque(s), increased pulse wave velocity, increased urine albumin creatinine ratio (above the 90th percentile) or left ventricular hypertrophy. Major adverse cardiovascular events (MACE) including myocardial infarction, cerebrovascular disease, heart failure and arrhythmia were obtained from national registries.Results: Subjects were divided into two age categories: a middle-aged group (aged 41 or 51) and an older group (aged 61 or 71). From 1993 to 2010, 425 events were observed. In multivariable analysis with both current and antecedent SBP adjusted for traditional risk factors, current SBP was associated with each measure of HMOD whilst antecedent SBP was not significantly associated with urine albumin creatinine ratio in the older group, LVMI in the middle-aged group, or the presence of plaque in any of the age groups (all p > 0.15). When current and antecedent SBP were evaluated together, current SBP was not associated with MACE in the middle-aged subgroup [HR = 1.09 (0.96-1.22), p = 0.18] but remained associated with MACE in the older subgroup [HR = 1.21 (1.10-1.34), p < 0.01]. Contrariwise, antecedent SBP was only associated with MACE in the middle-aged subgroup [HR = 1.24 (1.04-1.48), p = 0.02]. Adding antecedent SBP to traditional risk factors did not improve the predictive accuracy of the survival model.Conclusion: In healthy non-medicated middle-aged subjects, antecedent SBP is associated with cardiovascular outcome independently of current BP, traditional risk factors and HMOD. However, improvement in risk stratification seems to be limited.
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Affiliation(s)
- Thomas B Olesen
- Department of Internal Medicine, Kolding Hospital, Kolding, Denmark.,Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Manan Pareek
- Department of Cardiology, North Zealand Hospital, Hillerød, Denmark.,Department of Internal Medicine, Yale New Haven Hospital, Yale University School of Medicine, New Haven, CT, USA
| | - Jacob V Stidsen
- Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark
| | - Marie K Blicher
- Department of Internal Medicine, Kolding Hospital, Kolding, Denmark
| | - Susanne Rasmussen
- Department of Clinical Physiology and Nuclear Medicine, Herlev Hospital, University of Copenhagen, Copenhagen, Denmark.,Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark
| | - Julie K K Vishram-Nielsen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region of Denmark, Copenhagen, Denmark.,Department of Cardiology, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark
| | - Louise Maagaard
- Department of Internal Medicine, Kolding Hospital, Kolding, Denmark
| | - Michael H Olsen
- Centre for Individualized Medicine in Arterial Diseases (CIMA), Odense University Hospital, Odense, University of Southern Denmark, Odense, Denmark.,Cardiology Section, Department of Internal Medicine, Holbæk Hospital, Holbæk, Denmark
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The relationship between pubertal timing and markers of vascular and cardiac structure and function in men and women aged 60-64 years. Sci Rep 2019; 9:11037. [PMID: 31363129 PMCID: PMC6667431 DOI: 10.1038/s41598-019-47164-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2018] [Accepted: 07/02/2019] [Indexed: 01/19/2023] Open
Abstract
Earlier age at menarche has been associated with higher risk of coronary heart disease, but the mechanisms underlying the association remain unclear. We assessed the relationship of pubertal timing, in both men (n = 672) and women (n = 713), with vascular (carotid intima-media thickness (cIMT), pulse wave velocity (PWV)) and cardiac (left ventricular (LV) structure and function) measures recorded at age 60–64 yrs in a British birth cohort study. Regression models found that earlier menarche was associated with higher (more adverse) LV mass, LV end diastolic volume and left atrial volume, but not with other cardiac measures, cIMT or PWV. Associations were attenuated after adjustment for either adult or childhood BMI (e.g. mean difference in LV mass per year later menarche: −4.2 g (95% CI:−7.0,−1.4) reducing to −2.2 g (95% CI:−4.7,0.4) after adjustment for adult BMI). There were no associations among men, despite those fully mature at 15 yrs having higher blood pressure than the least mature group by 10.21 mmHg (95% CI:19.45,0.98). Any effect of pubertal timing on vascular and cardiac structure and function is likely to be small and primarily confounded by pre-pubertal BMI and/or mediated through adult adiposity.
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5
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Tsui A, Kuh D, Cardozo L, Davis D. Vascular risk factors for male and female urgency urinary incontinence at age 68 years from a British birth cohort study. BJU Int 2018; 122:118-125. [PMID: 29512315 PMCID: PMC6221119 DOI: 10.1111/bju.14137] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objective To investigate the prevalence of urgency urinary incontinence (UUI) at age 68 years and the contribution of vascular risk factors to male and female UUI pathogenesis in addition to the associations with raised body mass index (BMI). Subjects and methods In all, 1 762 participants from the Medical Research Council (MRC) National Survey for Health and Development birth cohort who answered the International Consultation on Incontinence Questionnaire short form (ICIQ‐SF), at age 68 years, were included. Logistic regression was used to estimate associations between UUI and earlier life vascular risk factors including: lipid status, diabetes, hypertension, BMI, previous stroke or transient ischaemic attack (TIA) diagnosis; adjusting for smoking status, physical activity, co‐presentation of stress UI symptoms, educational attainment; and in women only, type of menopause, age at period cessation, and use of hormone replacement therapy (HRT). Results UUI was reported by 12% of men and 19% of women at age 68 years. Female sex, previous stroke or TIA diagnosis, increased BMI and hypertension (in men only) at age 60–64 years were independent risk factors for UUI. Female sex, increased BMI, and a previous diagnosis of stroke/TIA increased the relative risk of more severe UUI symptoms. Type and timing of menopause and HRT use did not alter the estimated associations between UUI and vascular risk factors in women. Conclusion Multifactorial mechanisms lead to UUI and vascular risk factors may contribute to the pathogenesis of bladder overactivity in addition to higher BMI. Severe UUI appears to be a distinct presentation with more specific contributory mechanisms than milder UUI.
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Affiliation(s)
- Alex Tsui
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Linda Cardozo
- Department of Urogynaecology, King's College Hospital, London, UK
| | - Daniel Davis
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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6
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Arnold KF, Ellison G, Gadd SC, Textor J, Tennant P, Heppenstall A, Gilthorpe MS. Adjustment for time-invariant and time-varying confounders in 'unexplained residuals' models for longitudinal data within a causal framework and associated challenges. Stat Methods Med Res 2018; 28:1347-1364. [PMID: 29451093 PMCID: PMC6484949 DOI: 10.1177/0962280218756158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
‘Unexplained residuals’ models have been used within lifecourse epidemiology to
model an exposure measured longitudinally at several time points in relation to
a distal outcome. It has been claimed that these models have several advantages,
including: the ability to estimate multiple total causal effects in a single
model, and additional insight into the effect on the outcome of
greater-than-expected increases in the exposure compared to traditional
regression methods. We evaluate these properties and prove mathematically how
adjustment for confounding variables must be made within this modelling
framework. Importantly, we explicitly place unexplained residual models in a
causal framework using directed acyclic graphs. This allows for theoretical
justification of appropriate confounder adjustment and provides a framework for
extending our results to more complex scenarios than those examined in this
paper. We also discuss several interpretational issues relating to unexplained
residual models within a causal framework. We argue that unexplained residual
models offer no additional insights compared to traditional regression methods,
and, in fact, are more challenging to implement; moreover, they artificially
reduce estimated standard errors. Consequently, we conclude that unexplained
residual models, if used, must be implemented with great care.
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Affiliation(s)
- K F Arnold
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
| | - Gth Ellison
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
| | - S C Gadd
- 2 School of Medicine, University of Leeds, Leeds, UK
| | - J Textor
- 3 Tumor Immunology Lab, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Pwg Tennant
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,4 School of Healthcare, University of Leeds, Leeds, UK
| | - A Heppenstall
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,5 School of Geography, University of Leeds, Leeds, UK
| | - M S Gilthorpe
- 1 Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.,2 School of Medicine, University of Leeds, Leeds, UK
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7
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Wei FF, Yang WY, Thijs L, Zhang ZY, Cauwenberghs N, Van Keer J, Huang QF, Mujaj B, Kuznetsova T, Allegaert K, Verhamme P, Staessen JA. Conventional and Ambulatory Blood Pressure as Predictors of Diastolic Left Ventricular Function in a Flemish Population. J Am Heart Assoc 2018; 7:JAHA.117.007868. [PMID: 29437597 PMCID: PMC5850199 DOI: 10.1161/jaha.117.007868] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Background No longitudinal study compared associations of echocardiographic indexes of diastolic left ventricular function studies with conventional (CBP) and daytime ambulatory (ABP) blood pressure in the general population. Methods and Results In 780 Flemish (mean age, 50.2 years; 51.7% women), we measured left atrial volume index (LAVI), peak velocities of the transmitral blood flow (E) and mitral annular movement (e′) in early diastole and E/e′ 9.6 years (median) after CBP and ABP. In adjusted models including CBP and ABP, we expressed associations per 10/5‐mm Hg systolic/diastolic blood pressure increments. LAVI and E/e′ were 0.65/0.40 mL/m2 and 0.17/0.09 greater with higher systolic/diastolic ABP (P≤0.028), but not with higher baseline CBP (P≥0.086). e′ was lower (P≤0.032) with higher diastolic CBP (−0.09 cm/s) and ABP (−0.19 cm/s). When we substituted baseline CBP by CBP recorded concurrently with echocardiography, LAVI and E/e′ remained 0.45/0.38 mL/m2 and 0.15/0.08 greater with baseline ABP (P≤0.036), while LAVI (+0.53 mL/m2) and E/e′ (+0.19) were also greater (P<0.001) in relation to concurrent systolic CBP. In categorized analyses of baseline data, sustained hypertension or masked hypertension compared with normotension or white‐coat hypertension was associated with greater LAVI (24.0 versus 22.6 mL/m2) and E/e′ (7.35 versus 6.91) and lower e′ (10.7 versus 11.6 cm/s; P≤0.006 for all) with no differences (P≥0.092) between normotension and white‐coat hypertension or between masked hypertension and sustained hypertension. Conclusions ABP is a long‐term predictor of diastolic left ventricular function, statistically outperforming distant but not concurrent CBP. Masked hypertension and sustained hypertension carry equal risk for deterioration of diastolic left ventricular function.
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Affiliation(s)
- Fang-Fei Wei
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Wen-Yi Yang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Lutgarde Thijs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Zhen-Yu Zhang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Nicholas Cauwenberghs
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Jan Van Keer
- Division of Cardiology, University Hospitals Leuven, Leuven, Belgium
| | - Qi-Fang Huang
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Blerim Mujaj
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Tatiana Kuznetsova
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Karel Allegaert
- Department of Development and Regeneration, University of Leuven, Belgium.,Department of Pediatric Surgery and Intensive Care, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Peter Verhamme
- Centre for Molecular and Vascular Biology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium
| | - Jan A Staessen
- Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium .,Cardiovascular Research Institute Maastricht (CARIM), Maastricht University, Maastricht, The Netherlands
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8
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Longitudinal Changes in LV Structure and Diastolic Function in Relation to Arterial Properties in General Population. JACC Cardiovasc Imaging 2017; 10:1307-1316. [DOI: 10.1016/j.jcmg.2016.10.018] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 10/12/2016] [Accepted: 10/20/2016] [Indexed: 01/09/2023]
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9
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Bergerot C, Davidsen ES, Amaz C, Thibault H, Altman M, Bellaton A, Moulin P, Derumeaux G, Ernande L. Diastolic function deterioration in type 2 diabetes mellitus: predictive factors over a 3-year follow-up. Eur Heart J Cardiovasc Imaging 2017; 19:67-73. [DOI: 10.1093/ehjci/jew331] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 12/21/2016] [Indexed: 12/11/2022] Open
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10
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Hardy R, Ghosh AK, Deanfield J, Kuh D, Hughes AD. Birthweight, childhood growth and left ventricular structure at age 60-64 years in a British birth cohort study. Int J Epidemiol 2016; 45:1091-1102. [PMID: 27413103 PMCID: PMC5841632 DOI: 10.1093/ije/dyw150] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2016] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND High left ventricular mass (LVM) is an independent predictor of cardiovascular disease and mortality, but information relating LVM in older age to growth in early life is limited. We assessed the relationship of birthweight, height and body mass index (BMI) and overweight across childhood and adolescence with later life left ventricular (LV) structure. METHODS We used data from the MRC National Survey of Health and Development (NSHD) on men and women born in 1946 in Britain and followed up ever since. We use regression models to relate prospective measures of birthweight and height and BMI from ages 2-20 years to LV structure at 60-64 years. RESULTS Positive associations of birthweight with LVM and LV end diastolic volume (LVEDV) at 60-64 years were largely explained by adult height. Higher BMI, greater changes in BMI and greater accumulation of overweight across childhood and adolescence were associated with higher LVM and LVEDV and odds of concentric hypertrophy. Those who were overweight at two ages in early life had a mean LVM 11.5 g (95% confidence interval: -2.19,24.87) greater, and a mean LVEDV 10.0 ml (3.7,16.2) greater, than those who were not overweight. Associations were at least partially mediated through adult body mass index. Body size was less consistently associated with relative wall thickness (RWT), with the strongest association being observed with pubertal BMI change [0.007 (0.001,0.013) per standard deviation change in BMI 7-15 years]. The relationships between taller childhood height and LVM and LVEDV were explained by adult height. CONCLUSIONS Given the increasing levels of overweight in contemporary cohorts of children, these findings further emphasize the need for effective interventions to prevent childhood overweight.
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Affiliation(s)
- Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK,
| | - Arjun K Ghosh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
- Barts Heart Centre, London, UK
- International Centre for Circulatory Health, Imperial College London, UK and
| | - John Deanfield
- Institute of Cardiovascular Science, University College London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Alun D Hughes
- Institute of Cardiovascular Science, University College London, UK
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