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Kouvari M, Panagiotakos DB, Chrysohoou C, Georgousopoulou E, Notara V, Tousoulis D, Pitsavos C, ATTICA & GREECS Studies Investigators. Gender-specific, Lifestyle-related Factors and 10-year Cardiovascular Disease Risk; the ATTICA and GREECS Cohort Studies. Curr Vasc Pharmacol 2019; 17:401-410. [DOI: 10.2174/1570161116666180608121720] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 06/01/2018] [Accepted: 06/04/2018] [Indexed: 01/02/2023]
Abstract
Background:
Lifestyle remains a huge driving force of Cardiovascular Diseases (CVD) onset/
progression. Lifestyle-patterns are highly dependent on gender-related attitudes.
Objective:
To evaluate the gender-specific association of lifestyle-related factors (adherence to Mediterranean
diet (MedDiet), Physical Activity (PA), smoking) with 10-year first and recurrent CVD events.
Methods:
Two prospective studies, the ATTICA (2002-2012, n=3,042 subjects free-of-CVD) and
GREECS (2004-2014, n=2,172 subjects with Acute Coronary Syndrome (ACS)) were undertaken.
Baseline adherence to MedDiet (MedDietScore <27/≥27, range 0-55), PA (sedentary/physically active)
and smoking (current/never) was tested against 10-year first (ATTICA) and recurrent (GREECS) CVD
events, in men and women.
Results:
The “superiority” of men over women regarding overall CVD events was revealed in both first
(ATTICA, 19.7% men vs. 11.7% women, p<0.001) and recurrent CVD events, but less significantly
(GREECS, 38.8% men vs. 32.9% women, p=0.016). Gender-stratified analysis revealed that: lower
adherence to MedDiet in women (Odds Ratio (OR)=1.22, 95% Confidence Interval (95%CI) 1.03, 1.51)
and PA (OR=1.35, 95%CI 1.01, 1.85) and smoking (OR=1.28, 95%CI 1.04, 1.82) in men, were independent
predictors of 10-year first CVD event; whereas, adherence to MedDiet (OR=1.28, 95%CI 1.01,
1.59), PA (OR=1.25, 95%CI 1.01, 2.50) and smoking (OR=1.15, 95%CI 1.01, 1.30) in women, yet only
adherence to MedDiet (OR=1.27, 95%CI 1.01, 1.35) and PA (OR=1.27, 95%CI 1.02, 1.59) in men,
were independent predictors of 10-year CVD recurrent events.
Conclusion:
Differences between men and women, in the effect-size measures of lifestyle-related factors,
underline different paths for men and women, probably contributing to better designing strategies
for primary and secondary CVD prevention.
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Affiliation(s)
- Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Demosthenes B. Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Christina Chrysohoou
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Ekavi Georgousopoulou
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Venetia Notara
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
| | - Dimitrios Tousoulis
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
| | - Christos Pitsavos
- First Cardiology Clinic, School of Medicine, University of Athens, Athens, Greece
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Cullen L, Greenslade JH, Menzies L, Leong A, Than M, Pemberton C, Aldous S, Pickering J, Dalton E, Crosling B, Foreman R, Parsonage WA. Time to presentation and 12-month health outcomes in patients presenting to the emergency department with symptoms of possible acute coronary syndrome. Emerg Med J 2016; 33:390-5. [DOI: 10.1136/emermed-2015-204978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 12/06/2015] [Indexed: 11/04/2022]
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Kadda O, Manginas A, Stavridis G, Balanos D, Kotiou M, Panagiotakos DB. Gender Analysis in the Outcomes of a Lifestyle Intervention Among Patients Who Had an Open Heart Surgery. Angiology 2015; 67:66-74. [PMID: 25818103 DOI: 10.1177/0003319715577293] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED The aim of this study was to evaluate the gender-oriented differences in the outcomes of a lifestyle intervention trial (diet, smoking cessation, and exercise) among patients who had open heart surgery. A randomized, nonblind intervention study was performed on 500 patients who had open heart surgery. Immediately after hospital discharge, 250 patients were randomly allocated lifestyle intervention by receiving oral and written information in the form of a booklet with specific educational information for postoperative rehabilitation. The remaining 250 patients received the regular oral instructions. The applied lifestyle intervention proved to be beneficial only in men as far as quitting smoking (relative risk [RR]: 0.36, confidence interval [CI]: 0.16-0.80; P = .01) and returning to work (RR: 0.35, CI: 0.13-0.92; P = .03) are concerned. For both genders, no significant associations between dietary and physical activity recommendations were observed. CONCLUSION Lifestyle nursing intervention immediately after open heart surgery had a beneficial effect on men 1 year after the surgery but not on women. Thus, there is a need for gender-specific studies among women.
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Affiliation(s)
- Olga Kadda
- Department of Critical Care, School of Medicine, University of Athens, Athens, Greece
| | | | - George Stavridis
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Dimitris Balanos
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Maria Kotiou
- Department of Cardiac Surgery, Onassis Cardiac Surgery Center, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University, Athens, Greece
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