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Song L, Ying J, Li M, Ying L, Zhao C. Propensity score matched cohort study on magnesium supplementation and mortality in critically ill patients with HFpEF. Sci Rep 2025; 15:1944. [PMID: 39809943 PMCID: PMC11733161 DOI: 10.1038/s41598-025-85931-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2024] [Accepted: 01/07/2025] [Indexed: 01/16/2025] Open
Abstract
Heart failure with preserved ejection fraction (HFpEF) emerges as a singular subclass of heart failure, bereft of specific therapeutic options. Magnesium, an indispensable trace element, is essential to the preservation of cardiac integrity. However, the association between magnesium supplementation and mortality in HFpEF patients remains unclear. This study extracted HFpEF patient data from the MIMIC-IV database between 2008 and 2019. Propensity score matching was conducted to ensure that patients receiving magnesium supplementation (including magnesium sulfate and magnesium oxide) were balanced with those not receiving it in terms of baseline characteristics. The primary analysis focused on the 28-day all-cause mortality rate, with secondary endpoints encompassing ICU and one-year mortality rates, along with the duration of hospitalization. After matching, the study's final cohort balanced at 1970 patients, with 985 patients per group. The results showed that magnesium intake significantly contributed to a decrease in the 28-day all-cause mortality rate (hazard ratio [HR], 0.682; 95% confidence interval [CI], 0.539-0.863), particularly in subgroups such as older patients (HR, 0.65; 95% CI 0.52-0.81), females (HR, 0.55; 95% CI 0.41-0.73), and those with hypertension (HR, 0.62; 95% CI 0.48-0.79) or without diabetes (HR, 0.54; 95% CI 0.41-0.71). Although magnesium treatment improved both ICU and one-year mortality rates, it concurrently resulted in extended ICU and hospital stays. Mediation analysis indicated that blood urea nitrogen partially mediated the association between magnesium intake and mortality, accounting for approximately 22.73% of the observed effect. Magnesium supplementation has illustrated a significant potential for mitigating the mortality rate in the HFpEF patient, particularly among the elderly, female, and individuals with hypertension. Therefore, magnesium supplementation stands as a potentially valuable supplementary treatment modality for patients with HFpEF. Further comprehensive research is warranted to explore its effects more deeply.
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Affiliation(s)
- Lijun Song
- Department of Critical Care Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, Zhejiang, China.
| | - Jianjun Ying
- Department of General Medicine, Yiwu Traditional Chinese Medicine Hospital, Yiwu, 322000, Zhejiang, China
| | - Min Li
- Department of Critical Care Medicine, the Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, 322000, Zhejiang, China
| | - Lan Ying
- Department of Emergency Medicine, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, Zhejiang, China
| | - Chenliang Zhao
- Intensive Care Medicine, Heyou Hospital, Foshan, 528306, Guangdong, China
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Zhao D, Chen P, Chen M, Chen L, Wang L. Association of Magnesium Depletion Score with Congestive Heart Failure: Results from the NHANES 2007-2016. Biol Trace Elem Res 2024; 202:454-465. [PMID: 37198357 DOI: 10.1007/s12011-023-03697-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 05/03/2023] [Indexed: 05/19/2023]
Abstract
The magnesium depletion score (MDS) is considered a new valuable and reliable predictor of body magnesium status. This study aimed to explore the association between MDS and congestive heart failure (CHF) among US adults. A total of 19,227 eligible participants from the 2007-2016 National Health and Nutrition Examination Survey were enrolled in this study and then divided into three groups according to the level of MDS (none to low: MDS=0-1, middle: MDS=2, high: MDS=3-5). Sample-weighted logistic regression models were applied to calculate odds ratios (ORs) and 95% confidence intervals (CIs) exploring the independent relationship between MDS and CHF. The estimated prevalence of CHF increased with the increasing level of MDS (none to low: 0.86%, middle: 4.06%, high: 13.52%; P < 0.001). Compared to those in the none-to-low group, participants in the middle and high groups were at significantly higher risk of CHF after adjusting for various covariates (model 3: OR=1.55, 95%CI: 1.05-2.30, P < 0.001; OR=3.20, 95%CI: 2.07-4.96, P < 0.001; respectively). Subgroup analyses indicated that adequate dietary magnesium intake could reduce the risk of CHF in participants who did not meet the recommended dietary allowance (RDA) for magnesium. Besides, there was an interaction between coronary artery disease and MDS on CHF (P for interaction < 0.001). These findings indicated that MDS, a novel indicator estimating magnesium deficiency, is associated with the risk of CHF in non-institutionalized US civilians. Participants whose dietary magnesium intake reaches the RDA might be at lower risk.
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Affiliation(s)
- Diming Zhao
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Pengfei Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Mingjian Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Liang Chen
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China
| | - Liqing Wang
- Department of Cardiovascular Surgery, Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College/National Center for Cardiovascular Diseases, Beijing, China.
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Shugaa Addin N, Schlett CL, Bamberg F, Thorand B, Linseisen J, Seissler J, Peters A, Rospleszcz S. Subclinical Cardiovascular Disease Markers in Relation to Serum and Dietary Magnesium in Individuals from the General Population: The KORA-MRI Study. Nutrients 2022; 14:nu14234954. [PMID: 36500983 PMCID: PMC9741061 DOI: 10.3390/nu14234954] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2022] [Accepted: 11/18/2022] [Indexed: 11/24/2022] Open
Abstract
Several studies have implied a role of magnesium in the development of cardiovascular disease (CVD). Thus, magnesium might serve as a potential risk marker for early CVD. Therefore, we investigated the association of serum magnesium and dietary magnesium intake with markers of subclinical CVD in a population-based study. We used cross-sectional data from the sub-study of the Cooperative Health Research in the Region of Augsburg (KORA-FF4). Markers of subclinical CVD, namely, left and right ventricular structure and function and carotid plaque and carotid wall thickness, were derived by magnetic resonance imaging (MRI). Multivariable-adjusted regression models were applied to assess the relationship between serum and dietary magnesium and MRI-derived subclinical CVD markers. Among 396 included participants (mean age: 56.3 ± 9.2 years; 57.8% male), 181 (45.7%) had low serum magnesium levels (<2.07 mg/dL). Among 311 subjects with complete dietary data (mean age: 56.3 ± 9.1 years; 56.3% male), 154 (49.5%) had low dietary magnesium intake (≤155.2 mg/1000 kcal/day). Serum and dietary magnesium were not correlated (p-value = 0.5). Serum magnesium was significantly associated with presence of carotid plaque (OR 1.62, p-value 0.033). Dietary magnesium was associated with higher left ventricular end-systolic and end-diastolic volume (0.04 mL/m2, 0.06 mL/m2; p-value 0.011, 0.013, respectively), and also with a decrease in left ventricular remodeling index and mean diastolic wall thickness (−0.001 g/mL/m2, −0.002 mm/m2; p-value 0.004, 0.029, respectively). In summary, there was no consistent association of serum and dietary magnesium with imaging markers of subclinical CVD.
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Affiliation(s)
- Nuha Shugaa Addin
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Christopher L. Schlett
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Fabian Bamberg
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Faculty of Medicine, University of Freiburg, 79106 Freiburg, Germany
| | - Barbara Thorand
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
| | - Jakob Linseisen
- Epidemiology, University Hospital of Augsburg, University of Augsburg, 86159 Augsburg, Germany
| | - Jochen Seissler
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- Diabetes Zentrum, Medizinische Klinik und Poliklinik IV, Klinikum der Ludwig-Maximilians-Universität München, 80336 München, Germany
| | - Annette Peters
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Center for Diabetes Research (DZD), 85764 Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, 80802 München, Germany
| | - Susanne Rospleszcz
- Institute for Medical Information Processing, Biometry, and Epidemiology (IBE), Ludwig-Maximilians-Universität (LMU), 85764 München, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, 85764 Neuherberg, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Munich Heart Alliance, 80802 München, Germany
- Correspondence: ; Tel.: +49-089-3187-4234
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The prognostic impact of magnesium in acute heart failure is different according to the presence of diabetes mellitus. Porto Biomed J 2022; 7:e197. [PMID: 37152077 PMCID: PMC10158881 DOI: 10.1097/j.pbj.0000000000000197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 10/17/2022] [Indexed: 12/23/2022] Open
Abstract
Background Hypermagnesemia predicts mortality in chronic heart failure (HF); however, in acute HF, magnesium does not seem to be outcome-associated. Diabetes mellitus (DM) frequently associates with altered magnesium status. We hypothesized that DM might influence the prognostic impact of magnesium in acute HF. Methods This is a retrospective cohort study of hospitalized patients with acute HF. Patients without data on admission serum magnesium were excluded. Follow-up: 1 year from hospital admission. Primary end point: all-cause mortality. Patients were divided according to median serum magnesium (1.64 mEq/L). The Kaplan-Meier survival method was used to determine survival curves according to magnesium levels. The analysis was stratified according to the presence of DM. A multivariable Cox regression analysis was used to study the prognostic impact of magnesium. Results We studied 606 patients. The mean age was 76 ± 12 years, 44.1% were male, 50.7% had DM, and 232 (38.3%) died during follow-up. Median magnesium was 1.64 (1.48-1.79) mEq/L. Patients with magnesium ≥1.64 mEq/L had higher 1-year mortality [141 (46.4%) vs 91 (30.1%), P < .001]. After adjustments for age, sex, history of atrial fibrillation, systolic blood pressure, heart rate, ischemic etiology, B-type natriuretic peptide, estimated glomerular filtration rate, alcohol consumption, antihyperglycaemic agents or glycated hemoglobin, admission glycemia, New York Heart Association class IV, and severe left ventricle systolic dysfunction, serum magnesium ≥1.64 mEq/L was associated with higher mortality only in patients with DM: HR 1.89 (95% confidence interval: 1.19-3.00), P = .007, and 1.27 (95% confidence interval: 0.83-1.94) and P = .26 for non-DM patients. The results were similar if magnesium was analyzed as a continuous variable. Per 0.1 mEq/L increase in magnesium levels, patients with DM had 13% increased risk of 1-year mortality. Conclusions Higher magnesium levels were associated with worse prognosis only in HF patients with DM.
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Liu D, Lu M, Lakshmanan P, Hu Z, Chen X. Increased Provision of Bioavailable Mg through Vegetables Could Significantly Reduce the Growing Health and Economic Burden Caused by Mg Malnutrition. Foods 2021; 10:foods10112513. [PMID: 34828794 PMCID: PMC8620491 DOI: 10.3390/foods10112513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/18/2021] [Accepted: 10/19/2021] [Indexed: 12/05/2022] Open
Abstract
Magnesium (Mg) is an essential mineral nutrient for human health and its deficiency associated with many diseases, including stroke, heart failure, and type 2 diabetes. Vegetables are an important source of dietary Mg for humans. In this study, we quantified vegetable Mg content by a global meat analysis, analyzed human health, and economic impact caused by Mg deficiency. Results revealed that vegetable Mg content showed a large variation with an average value of 19.3 mg 100 g−1 FW. Variation in per capita vegetable-Mg supply in different continents is largely ascribed to continental difference in the amount and the type of vegetables produced. The health and economic loss attributed to Mg deficiency are estimated to be 1.91 million disability-adjusted life years (DALYs) and 15.8 billion dollars (0.14% of GDP), respectively. A scenario analysis indicated that the increasing vegetable production (increased by 8.9% and 20.7% relative to 2017 in 2030 and 2050) and vegetable Mg content (increased by 22% through biofortification) could significantly reduce DALYs (1.24 million years) and economic burden (0.09% of GDP). This study could guide a major re-balance of production practices, species cultivated, and Mg biofortification to provide sufficient vegetable Mg for better human Mg nutrition.
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Affiliation(s)
- Dunyi Liu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
| | - Ming Lu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
| | - Prakash Lakshmanan
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
- Sugarcane Research Institute, Guangxi Academy of Agricultural Sciences, Nanning 530007, China
- Queensland Alliance for Agriculture and Food Innovation, University of Queensland, St. Lucia, QLD 4067, Australia
| | - Ziyi Hu
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
| | - Xinping Chen
- Key Laboratory of Efficient Utilization of Soil and Fertilizer Resources, College of Resources and Environment, Southwest University, Chongqing 400715, China; (D.L.); (M.L.); (Z.H.)
- Interdisciplinary Research Center for Agriculture Green Development in Yangtze River Basin, Southwest University, Chongqing 400715, China;
- Correspondence: ; Tel.: +86-23-6825-1082
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Magnesium intake and vascular structure and function: the Hoorn Study. Eur J Nutr 2021; 61:653-664. [PMID: 34491389 PMCID: PMC8854245 DOI: 10.1007/s00394-021-02667-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 08/20/2021] [Indexed: 11/30/2022]
Abstract
Purpose Circulating and dietary magnesium have been shown to be inversely associated with the prevalence of cardiovascular disease (CVD) and mortality in both high and low-risk populations. We aimed to examine the association between dietary magnesium intake and several measures of vascular structure and function in a prospective cohort. Methods We included 789 participants who participated in the vascular screening sub-cohort of the Hoorn Study, a population-based, prospective cohort study. Baseline dietary magnesium intake was estimated with a validated food frequency questionnaire and categorised in energy-adjusted magnesium intake tertiles. Several measurements of vascular structure and function were performed at baseline and most measurements were repeated after 8 years of follow-up (n = 432). Multivariable linear and logistic regression was performed to study the cross-sectional and longitudinal associations of magnesium intake and intima-media thickness (IMT), augmentation index (Aix), pulse wave velocity (PWV), flow-mediated dilatation (FMD), and peripheral arterial disease (PAD). Results Mean absolute magnesium intake was 328 ± 83 mg/day and prior CVD and DM2 was present in 55 and 41% of the participants, respectively. Multivariable regression analyses did not demonstrate associations between magnesium intake and any of the vascular outcomes. Participants in the highest compared to the lowest magnesium intake tertile demonstrated in fully adjusted cross-sectional analyses a PWV of −0.21 m/s (95% confidence interval −1.95, 1.52), a FMD of −0.03% (−0.89, 0.83) and in longitudinal analyses an IMT of 0.01 mm (−0.03, 0.06), an Aix of 0.70% (−1.69, 3.07) and an odds ratio of 0.84 (0.23, 3.11) for PAD Conclusion We did not find associations between dietary magnesium intake and multiple markers of vascular structure and function, in either cross-sectional or longitudinal analyses. Supplementary Information The online version contains supplementary material available at 10.1007/s00394-021-02667-0.
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Jefferies HJ, Lemoine S, McIntyre CW. High magnesium dialysate does not improve intradialytic hemodynamics or abrogate myocardial stunning. Hemodial Int 2020; 24:506-515. [DOI: 10.1111/hdi.12863] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 07/14/2020] [Accepted: 07/15/2020] [Indexed: 12/27/2022]
Affiliation(s)
| | - Sandrine Lemoine
- University of Lyon Lyon France
- Lilibeth Caberto Kidney Clinical Research Unit University of Western Ontario London Ontario Canada
- Lawson Health Research Institute London Ontario Canada
| | - Christopher W. McIntyre
- Lilibeth Caberto Kidney Clinical Research Unit University of Western Ontario London Ontario Canada
- Lawson Health Research Institute London Ontario Canada
- Department of Medical Biophysics University of Western Ontario London Ontario Canada
- Division of Nephrology London Health Sciences Centre London Ontario Canada
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Wu WC, Huang M, Taveira TH, Roberts MB, Martin LW, Wellenius GA, Johnson KC, Manson JE, Liu S, Eaton CB. Relationship Between Dietary Magnesium Intake and Incident Heart Failure Among Older Women: The WHI. J Am Heart Assoc 2020; 9:e013570. [PMID: 32192409 PMCID: PMC7428611 DOI: 10.1161/jaha.119.013570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Women represent a large proportion of the growing heart failure (HF) epidemic, yet data are lacking regarding optimal dietary and lifestyle prevention strategies for them. Specifically, the association between magnesium intake and HF in a multiracial cohort of women is uncertain. Methods and Results We included 97 725 postmenopausal women from the WHI (Women's Health Initiative) observational studies and placebo arms of the hormone trial. Magnesium intake was measured at baseline by a 122‐item validated food‐frequency questionnaire and stratified into quartiles based on diet only, total intake (diet with supplements), and residual intake (calibration by total energy). Incident hospitalized HF (2153 events, median follow‐up 8.1 years) was adjudicated by medical record abstraction. In Cox proportional hazards models, we evaluated the association between magnesium intake and HF adjusting for potential confounders. Analyses were repeated on a subcohort (n=18 745; median‐follow‐up, 13.2 years) for whom HF cases were subclassified into preserved ejection fraction (526 events), reduced ejection fraction (291 events) or unknown (168 events). Most women were white (85%) with a mean age of 63. Compared with the highest quartile of magnesium intake, women in the lowest quartile had an increased risk of incident HF, with adjusted hazard ratios of 1.32 (95% CI, 1.02–1.71) for diet only (P trend=0.03), 1.26 (95% CI, 1.03–1.56) for total intake, and 1.31 (95% CI, 1.02–1.67) for residual intake. Results did not significantly vary by race. Subcohort analyses showed low residual magnesium intake was associated with HF with reduced ejection fraction (hazard ratio, 1.81, lowest versus highest quartile; 95% CI, 1.08–3.05) but not HF with preserved ejection fraction. Conclusions Low magnesium intake in a multiracial cohort of postmenopausal women was associated with a higher risk of incident HF, especially HF with reduced ejection fraction.
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Affiliation(s)
- Wen-Chih Wu
- Division of Cardiology Veterans Affairs Medical Center & The Miriam Hospital Alpert Medical School Brown University Providence RI.,Department of Epidemiology Brown University School of Public Health Providence RI
| | - Mengna Huang
- Channing Division of Network Medicine Brigham and Women's Hospital Boston MA
| | - Tracey H Taveira
- Division of Cardiology Veterans Affairs Medical Center & The Miriam Hospital Alpert Medical School Brown University Providence RI.,University of Rhode Island, College of Pharmacy Kingston RI
| | - Mary B Roberts
- Center for Primary Care and Prevention and the Department of Family Medicine Memorial Hospital of Rhode Island Pawtucket RI
| | - Lisa W Martin
- Division of Cardiology George Washington University School of Medicine and Health Sciences Washington DC
| | - Gregory A Wellenius
- Department of Epidemiology Brown University School of Public Health Providence RI
| | - Karen C Johnson
- Department of Preventive Medicine University of Tennessee Health Science Center Memphis TN
| | - JoAnn E Manson
- Brigham and Women's Hospital Harvard Medical School Boston MA
| | - Simin Liu
- Department of Epidemiology Brown University School of Public Health Providence RI
| | - Charles B Eaton
- Center for Primary Care and Prevention and the Department of Family Medicine Memorial Hospital of Rhode Island Pawtucket RI.,Department of Epidemiology Brown University School of Public Health Providence RI
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