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Lefferts EC, Lee D. Greater Adherence to Life's Essential 8 for Cardiovascular Health Is Associated With Lower Arterial Stiffness in Survivors of Cancer. J Am Heart Assoc 2024; 13:e032886. [PMID: 38842278 PMCID: PMC11255755 DOI: 10.1161/jaha.123.032886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 05/01/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND Survivors of cancer have elevated risk of cardiovascular disease, likely stemming from the negative impact of anticancer therapies on vascular function. Arterial stiffness is a strong indicator of vascular function and independent predictor of cardiovascular disease. The American Heart Association recommends Life's Essential 8 for optimal cardiovascular health. It is currently unknown, however, whether greater adherence to Life's Essential 8 is associated with low arterial stiffness in survivors of cancer. METHODS AND RESULTS This cross-sectional study included 172 older adult (≥65 years) survivors of cancer (74±6 years; 58% female). Life's Essential 8 100-point cardiovascular health score, with higher scores indicative of better cardiovascular health, was calculated based on 8 components: diet, physical activity, nicotine exposure, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. Participants were classified as having low (<60), moderate (60-79), or high (≥80) cardiovascular health. Pulse wave velocity (PWV) was used to assess arterial stiffness; with high arterial stiffness defined as a pulse wave velocity ≥10 m/s. The mean cardiovascular health score was 72±11 and 40 survivors (23%) had high arterial stiffness. Compared with low cardiovascular health, the odds ratio of high arterial stiffness was 0.12 (95% CI, 0.03-0.50) and 0.02 (95% CI, 0.003-0.18) for moderate and high cardiovascular health, respectively. Every 10-point increase in the cardiovascular health score was associated with a 0.43 m/s reduction in pulse wave velocity (P<0.001). CONCLUSIONS Greater adherence to the American Heart Association's Life's Essential 8 was associated with lower prevalence of high arterial stiffness in older adult survivors of cancer. Prospective studies with larger samples are needed.
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Affiliation(s)
| | - Duck‐Chul Lee
- Department of Kinesiology, College of Human SciencesIowa State UniversityAmesIAUSA
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Li L, Zhang J, Zhang X, Huo Z, Jiang J, Wu Y, Zhu C, Chen S, Du X, Li H, Wei X, Ji C, Wu S, Huang Z. Association of Cumulative Exposure to Cardiovascular Health Behaviors and Factors with the Onset and Progression of Arterial Stiffness. J Atheroscler Thromb 2024; 31:368-381. [PMID: 37926522 PMCID: PMC10999723 DOI: 10.5551/jat.64469] [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: 07/11/2023] [Accepted: 09/10/2023] [Indexed: 11/07/2023] Open
Abstract
AIM This study aims to explore the association of cumulative exposure to cardiovascular health behaviors and factors with the onset and progression of arterial stiffness. METHODS In this study, 24,110 participants were examined from the Kailuan cohort, of which 11,527 had undergone at least two brachial-ankle pulse wave velocity (baPWV) measurements. The cumulative exposure to cardiovascular health behaviors and factors (cumCVH) was calculated as the sum of the cumCVH scores between two consecutive physical examinations, multiplied by the time interval between the two. A logistic regression model was constructed to evaluate the association of cumCVH with arterial stiffness. Generalized linear regression models were used to analyze how cumCVH affects baPWV progression. Moreover, a Cox proportional hazards regression model was used to analyze the effect of cumCVH on the risk of arterial stiffness. RESULTS In this study, participants were divided into four groups, according to quartiles of cumCVH exposure levels, namely, quartile 1 (Q1), quartile 2 (Q2), quartile 3 (Q3), and quartile 4 (Q4). Logistic regression analysis showed that compared with the Q1 group, the incidence of arterial stiffness in terms of cumCVH among Q2, Q3, and Q4 groups decreased by 16%, 30%, and 39%, respectively. The results of generalized linear regression showed that compared with the Q1 group, the incidence of arterial stiffness in the Q3 and Q4 groups increased by -25.54 and -29.83, respectively. The results of Cox proportional hazards regression showed that compared with the Q1 group, the incidence of arterial stiffness in cumCVH among Q2, Q3, and Q4 groups decreased by 11%, 19%, and 22%, respectively. Sensitivity analyses showed consistency with the main results. CONCLUSIONS High cumCVH can delay the progression of arterial stiffness and reduce the risk of developing arterial stiffness.
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Affiliation(s)
- Liuxin Li
- Department of Cardiology, Kailuan Hospital, Tangshan, China
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jingdi Zhang
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Xiaoxue Zhang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Zhenyu Huo
- Graduate School, North China University of Science and Technology, Tangshan, China
| | - Jinguo Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, China Medical University, Shenyang, Liaoning, China
| | - Yuntao Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Chenrui Zhu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xin Du
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Huiying Li
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Xiaoming Wei
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Chunpeng Ji
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, Tangshan, China
| | - Zhe Huang
- Department of Cardiology, Kailuan Hospital, Tangshan, China
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Chen R, Xu J, Shang X, Bulloch G, He M, Wang W, Zhu Z. Association between cardiovascular health metrics and retinal ageing. GeroScience 2023:10.1007/s11357-023-00743-3. [PMID: 36930331 PMCID: PMC10400488 DOI: 10.1007/s11357-023-00743-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/25/2023] [Indexed: 03/18/2023] Open
Abstract
The study aims to investigate associations between cardiovascular health (CVH) metrics and retinal ageing indexed by retinal age gap. A total of 26,354 participants from the UK Biobank study with available CVH metrics and qualified retinal imaging were included in the present analysis. CVH included 7 metrics (smoking, physical activity, diet, body mass index [BMI], total cholesterol, blood pressure [BP], blood glucose). These were summarized to classify the overall CVH as poor (0-7), intermediate (8-10) or ideal (11-14). Retinal age gap was defined as the difference between biological age predicted by fundus images and chronological age. Accelerated and non-accelerated retinal ageing was defined if retinal age gap was in the upper or lower 50% quantiles of the study population, respectively. Linear and logistic regression models estimated the association of overall CVH and each metric of CVH with retinal age gap respectively. Our results showed that in the fully adjusted model, each one-unit score increase in overall CVH was negatively associated with retinal age gap (odds ratio [OR] = 0.89, 95% confidence interval [CI]: 0.87-0.92, P < 0.001). Compared with poor overall CVH, people with intermediate and ideal overall CVH had significantly lower retinal age gap (OR = 0.76, 95%CI: 0.67-0.85, P < 0.001; OR = 0.58, 95%CI: 0.50-0.67, P < 0.001). Similar associations were found between overall CVH and accelerated retinal ageing. CVH metrics including smoking, BMI, BP, and blood glucose were also significantly associated with higher retinal age gap. Taken together, we found a significant and inverse dose-response association between CVH metrics and retinal age gap, indicating that maintaining healthy metrics especially smoking, BMI, BP, and blood glucose may be crucial to slow down biological ageing.
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Affiliation(s)
- Ruiye Chen
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Jinyi Xu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xianwen Shang
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China.,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Gabriella Bulloch
- Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia
| | - Mingguang He
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China. .,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia. .,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia. .,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.
| | - Zhuoting Zhu
- Department of Ophthalmology, Guangdong Academy of Medical Sciences, Guangdong Provincial People's Hospital, Guangzhou, China. .,Centre for Eye Research Australia; Ophthalmology, University of Melbourne, Melbourne, Australia. .,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Australia.
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Li D, Cao F, Cheng W, Xu Y, Yang C. Predictive value of estimated pulse wave velocity for cardiovascular and all-cause mortality in individuals with obesity. Diabetol Metab Syndr 2023; 15:40. [PMID: 36894988 PMCID: PMC9997019 DOI: 10.1186/s13098-023-01011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/01/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Estimated pulse wave velocity (ePWV) has revealed excellent performance in predicting cardiovascular disease (CVD) risk. However, whether ePWV predicts all-cause mortality and CVD mortality in populations with obesity remains elusive. METHODS We performed a prospective cohort including 49,116 participants from the National Health and Nutrition Examination Survey from 2005 to 2014. Arterial stiffness was evaluated by ePWV. Weighted univariate, multivariate Cox regression and receiver operating characteristic curve (ROC) analysis was used to assess the effects of ePWV on the risk of all-cause and CVD mortality. In addition, the two-piecewise linear regression analysis was used to describe the trend of ePWV affecting mortality and identify the thresholds that significantly affect mortality. RESULTS A total of 9929 participants with obesity with ePWV data and 833 deaths were enrolled. Based on the multivariate Cox regression results, the high ePWV group had a 1.25-fold higher risk of all-cause mortality and a 5.76-fold higher risk of CVD mortality than the low-ePWV group. All-cause and CVD mortality risk increased by 123% and 44%, respectively, for every 1 m/s increase in ePWV. ROC results showed that ePWV had an excellent accuracy in predicting all-cause mortality (AUC = 0.801) and CVD mortality (AUC = 0.806). Furthermore, the two-piecewise linear regression analysis exhibited that the minimal threshold at which ePWV affected participant mortality was 6.7 m/s for all-cause mortality and 7.2 m/s for CVD mortality. CONCLUSIONS ePWV was an independent risk factor for mortality in populations with obesity. High ePWV levels were associated with an increased all-cause and CVD mortality. Thus, ePWV can be considered a novel biomarker to assess mortality risk in patients with obesity.
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Affiliation(s)
- Daidi Li
- Blood Purification Center, Bengbu Third People's Hospital, Bengfu, 233000, China
| | - Feng Cao
- Department of General, Visceral and Transplantation Surgery, University Hospital RWTH Aachen, 52074, Aachen, Germany
| | - Wenke Cheng
- Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Yanyan Xu
- Department of General Surgery, The Second Hospital of Anhui Medical University, Hefei, China
| | - Chuang Yang
- Department of Visceral, Transplant, Thoracic and Vascular Surgery, University Hospital Leipzig, Leipzig, Germany.
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Chou CH, Yin JH, Lin YK, Yang FC, Chu TW, Chuang YC, Lin CW, Peng GS, Sung YF. The optimal pulse pressures for healthy adults with different ages and sexes correlate with cardiovascular health metrics. Front Cardiovasc Med 2022; 9:930443. [PMID: 36545016 PMCID: PMC9760735 DOI: 10.3389/fcvm.2022.930443] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 11/10/2022] [Indexed: 12/07/2022] Open
Abstract
Background Pulse pressure (PP) may play a role in the development of cardiovascular disease, and the optimal PP for different ages and sexes is unknown. In a prospective cohort, we studied subjects with favorable cardiovascular health (CVH), proposed the mean PP as the optimal PP values, and demonstrated its relationship with healthy lifestyles. Methods and results Between 1996 and 2016, a total of 162,636 participants (aged 20 years or above; mean age 34.9 years; 26.4% male subjects; meeting criteria for favorable health) were recruited for a medical examination program. PP in male subjects was 45.6 ± 9.4 mmHg and increased after the age of 50 years. PP in female subjects was 41.8 ± 9.5 mmHg and increased after the age of 40 years, exceeding that of male subjects after the age of 50 years. Except for female subjects with a PP of 40-70 mmHg, PP increase correlates with both systolic blood pressure (BP) increase and diastolic BP decrease. Individuals with mean PP values are more likely to meet health metrics, including body mass index (BMI) <25 kg/m2 (chi-squared = 9.35, p<0.01 in male subjects; chi-squared = 208.79, p < 0.001 in female subjects) and BP <120/80 mmHg (chi-squared =1,300, p < 0.001 in male subjects; chi-squared =11,000, p < 0.001 in female subjects). We propose a health score (Hscore) based on the sum of five metrics (BP, BMI, being physically active, non-smoking, and healthy diet), which significantly correlates with the optimal PP. Conclusion The mean PP (within ±1 standard deviation) could be proposed as the optimal PP in the adult population with favorable CVH. The relationship between health metrics and the optimal PP based on age and sex was further demonstrated to validate the Hscore.
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Affiliation(s)
- Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yu-Kai Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
| | - Ta-Wei Chu
- Department of Obstetrics and Gynecology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,MJ Health Screening Center, Taipei, Taiwan
| | | | - Chia Wen Lin
- MJ Health Research Foundation, MJ Group, Taipei, Taiwan
| | - Giia-Sheun Peng
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,Division of Neurology, Department of Internal Medicine, Taipei Veterans General Hospital, Hsinchu, Taiwan
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan,*Correspondence: Yueh-Feng Sung
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Armas-Padrón AM, Sicilia-Sosvilla M, Rodríguez-Bello S, López-Carmona MD, Ruiz-Esteban P, Hernández D. Abnormal ankle-brachial index, cardiovascular risk factors and healthy lifestyle factors in hypertensive patients: prospective cohort study from a primary care urban population. BMC PRIMARY CARE 2022; 23:232. [PMID: 36085011 PMCID: PMC9463763 DOI: 10.1186/s12875-022-01837-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 08/30/2022] [Indexed: 11/24/2022]
Abstract
Background Peripheral arterial disease (PAD) and arterial stiffness (AS) may be hypertension-mediated vascular lesions. Both are determined by an abnormal ankle-brachial index (ABI) and are predictors of cardiovascular disease (CVD) and mortality. We assessed the relationship in urban hypertensive patients between an abnormal ABI and an ideal cardiovascular health (CVH) score, plus other healthy factors, with unfavourable outcomes. Methods We studied 243 hypertensive patients from a primary care urban population, followed for two years. Clinical data, comorbid conditions, including hypertension-mediated organ damage (HMOD) and hypertension-related comorbidities (HRC), hospitalizations and mortality were also recorded. Results A low prevalence of ideal CVH was observed in urban hypertensive patients. The ABI ≤ 0.9 group (n = 16) showed a higher proportion of prior CVD other than PAD, mortality and hospitalizations than the ABI > 1.4 group (n = 41), and a poorer lipid, metabolic and renal profile. An inverse relationship between CVH score and ABI ≤ 0.9 and unfavourable outcomes (HMOD, HRC, death or hospitalization) was observed. Chronic kidney disease (CKD) and diabetes were independently associated with an ABI ≤ 0.9. Age, sex, diabetes, CKD, ABI ≤ 0.9 and ideal cholesterol were also associated with outcomes, but not other CVH metrics. Conclusions Besides a low prevalence of ideal CVH, an inverse relationship between CVH score and ABI ≤ 0.9 and unfavourable outcomes was observed in hypertensive patients from an urban population. Stronger efforts to promote ideal CVH may improve outcomes in this particular population. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01837-1.
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