1
|
Xu L, Chen Y, Chen S, Wang G, Fu Y, Cai J, Yang X, Wu S, Miao C, Hong J. Relationship between resting heart rate and long-term outcomes in stabilized patients with myocardial infarction: A prospective community-based cohort study. Int J Cardiol 2024; 400:131811. [PMID: 38278489 DOI: 10.1016/j.ijcard.2024.131811] [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: 08/11/2023] [Revised: 01/11/2024] [Accepted: 01/22/2024] [Indexed: 01/28/2024]
Abstract
BACKGROUND Resting heart rate (RHR) during hospitalization has been shown to be associated with adverse outcomes in patients with myocardial infarction (MI). This study aimed to evaluate the long-term prognostic effect of RHR during the stable phase after MI in post-MI patients. METHODS Patients who had prior or new-onset MI and RHR measurements during the stable period after MI between 2006 and 2018 in the community-based Kailuan Study were enrolled. RHR was divided into four groups based on quartiles. Cox regression analysis was used to analyze the association of RHR with primary composite outcome of all-cause death, hospitalization for heart failure (HF), stroke, and recurrent MI and its components. RESULTS A total of 4447 post-MI patients were included. During a median follow-up of 7.5 years, 1813 patients (40.8%) developed primary outcomes. Compared to RHR ≤67 bpm, patients with 72 < RHR ≤80 bpm and RHR >80 bpm had increased risks of primary outcome, with adjusted hazard ratios (95% confidence intervals) of 1.23 (1.08-1.40) and 1.35 (1.18-1.55), respectively. The risk of primary outcome increased by 12% (1.07-1.17) for each 10-bpm increase in RHR. Similar results were observed in all-cause death and hospitalization for HF. Restricted cubic splines revealed a linear relationship between RHR and primary outcome, all-cause death, and hospitalization for HF (P for nonlinearity >0.05). CONCLUSIONS RHR during the stable phase after MI was an independent predictor for primary outcome and all-cause death in post-MI patients, and RHR >72 bpm was associated with increased risk for primary outcome and all-cause death.
Collapse
Affiliation(s)
- Lina Xu
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China
| | - Yonggang Chen
- Department of Cardiology, Tangshan Central Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Guodong Wang
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Yu Fu
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingyi Cai
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xinying Yang
- Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Congliang Miao
- Department of Emergency and Critical Care Medicine, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Jiang Hong
- Department of Critical Care Medicine, Shanghai General Hospital of Nanjing Medical University, Shanghai, China.
| |
Collapse
|
2
|
Nedkoff L, Greenland M, Hyun K, Htun JP, Redfern J, Stiles S, Sanfilippo F, Briffa T, Chew DP, Brieger D. Sex- and Age-Specific Differences in Risk Profiles and Early Outcomes in Adults With Acute Coronary Syndromes. Heart Lung Circ 2024; 33:332-341. [PMID: 38326135 DOI: 10.1016/j.hlc.2023.11.016] [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: 01/29/2023] [Revised: 08/01/2023] [Accepted: 11/30/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Adults <55 years of age comprise a quarter of all acute coronary syndromes (ACS) hospitalisations. There is a paucity of data characterising this group, particularly sex differences. This study aimed to compare the clinical and risk profile of patients with ACS aged <55 years with older counterparts, and measure short-term outcomes by age and sex. METHOD The study population comprised patients with ACS enrolled in the AUS-Global Registry of Acute Coronary Events (GRACE), Cooperative National Registry of Acute Coronary Syndrome Care (CONCORDANCE) and SNAPSHOT ACS registries. We compared clinical features and combinations of major modifiable risk factors (hypertension, smoking, dyslipidaemia, and diabetes) by sex and age group (20-54, 55-74, 75-94 years). All-cause mortality and major adverse events were identified in-hospital and at 6-months. RESULTS There were 16,658 patients included (22.3% aged 20-54 years). Among them, 20-54 year olds had the highest proportion of ST-elevation myocardial infarction compared with sex-matched older age groups. Half of 20-54 year olds were current smokers, compared with a quarter of 55-74 year olds, and had the highest prevalence of no major modifiable risk factors (14.2% women, 12.7% men) and of single risk factors (27.6% women, 29.0% men), driven by smoking. Conversely, this age group had the highest proportion of all four modifiable risk factors (6.6% women, 4.7% men). Mortality at 6 months in 20-54 year olds was similar between men (2.3%) and women (1.7%), although lower than in older age groups. CONCLUSIONS Younger adults with ACS are more likely to have either no risk factor, a single risk factor, or all four modifiable risk factors, than older patients. Targeted risk factor prevention and management is warranted in this age group.
Collapse
Affiliation(s)
- Lee Nedkoff
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; Victor Chang Cardiac Research Institute, Sydney, NSW, Australia.
| | - Melanie Greenland
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia; Oxford Vaccine Group, Department of Paediatrics, University of Oxford, Oxford, United Kingdom
| | - Karice Hyun
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Concord Repatriation General Hospital, ANZAC Research Institute, Sydney, NSW, Australia
| | - Jasmin P Htun
- School of Biomedical Sciences, The University of Western Australia, Perth, WA, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Samantha Stiles
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Frank Sanfilippo
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Tom Briffa
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Perth, WA, Australia
| | - Derek P Chew
- Victorian Heart Institute, Monash University, Melbourne, Vic, Australia
| | - David Brieger
- School of Health Sciences, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
3
|
Sagelv EH, Casolo A, Eggen AE, Heitmann KA, Johansen KR, Løchen ML, Mathiesen EB, Morseth B, Njølstad I, Osborne JO, Hagerupsen K, Pedersen S, Wilsgaard T. Females Display Lower Risk of Myocardial Infarction From Higher Estimated Cardiorespiratory Fitness Than Males: The Tromsø Study 1994-2014. Mayo Clin Proc Innov Qual Outcomes 2024; 8:62-73. [PMID: 38268988 PMCID: PMC10806283 DOI: 10.1016/j.mayocpiqo.2023.12.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2024] Open
Abstract
Objective To examine the dose-response association between estimated cardiorespiratory fitness (eCRF) and risk of myocardial infarction (MI). Patients and Methods Adults who attended Tromsø Study surveys 4-6 (Janurary 1,1994-December 20, 2008) with no previous cardiovascular disease were followed up through December 31, 2014 for incident MI. Associations were examined using restricted cubic splines Fine and Gray regressions, adjusted for education, smoking, alcohol, diet, sex, adiposity, physical activity, study survey, and age (timescale) in the total cohort and subsamples with hyperlipidemia (n=2956), hypertension (n=8290), obesity (n=5784), metabolic syndrome (n=1410), smokers (n=3823), and poor diet (n=3463) and in those who were physically inactive (n=6255). Results Of 14,285 participants (mean age ± SD, 53.7±11.4 years), 979 (6.9%) experienced MI during follow-up (median, 7.2 years; 25th-75th, 5.3-14.6 years). Females with median eCRF (32 mL/kg/min) had 43% lower MI risk (subdistributed hazard ratio [SHR], 0.57; 95% CI, 0.48-0.68) than those at the 10th percentile (25 mL/kg/min) as reference. The lowest MI risk was observed at 47 mL/kg/min (SHR, 0.02; 95% CI, 0.01-0.11). Males had 26% lower MI risk at median eCRF (40 mL/kg/min; SHR, 0.74; 95% CI, 0.63-0.86) than those at the 10th percentile (32 mL/kg/min), and the lowest risk was 69% (SHR, 0.31; 95% CI, 0.14-0.71) at 60 mL/kg/min. The associations were similar in subsamples with cardiovascular disease risk factors. Conclusion Higher eCRF associated with lower MI risk in females and males, but associations were more pronounced among females than those in males. This suggest eCRF as a vital estimate to implement in medical care to identify individuals at high risk of future MI, especially for females.
Collapse
Affiliation(s)
- Edvard H. Sagelv
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Andrea Casolo
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Anne Elise Eggen
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kim Arne Heitmann
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Kristoffer R. Johansen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Maja-Lisa Løchen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Ellisiv B. Mathiesen
- Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - John O. Osborne
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Karianne Hagerupsen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Sigurd Pedersen
- School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| |
Collapse
|
4
|
Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, Shohaimi S, Mohammadi M. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:206. [PMID: 37087452 PMCID: PMC10122825 DOI: 10.1186/s12872-023-03231-w] [Citation(s) in RCA: 48] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/08/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary. METHODS Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of "Prevalence", "Outbreak", "Burden", "Myocardial Infarction", "Myocardial Infarct", and "Heart Attack" were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication. RESULTS Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%. CONCLUSION Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.
Collapse
Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Amir Abdolmaleki
- Department of Operating Room, Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shabnam Rasoulpoor
- Department of Psychiatric Nursing, Miandoab School of Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Asghar Khaleghi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Leila Afshar Hezarkhani
- Neuroscience Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
| |
Collapse
|
5
|
Ahn HJ, Lee H, Park HE, Han D, Chang HJ, Chun EJ, Han HW, Sung J, Jung HO, Choi SY. Changes in metabolic syndrome burden and risk of coronary artery calcification progression in statin-naïve young adults. Atherosclerosis 2022; 360:27-33. [DOI: 10.1016/j.atherosclerosis.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/06/2022] [Accepted: 09/27/2022] [Indexed: 11/15/2022]
|
6
|
Saeed M, Stene LC, Ariansen I, Tell GS, Tapia G, Joner G, Skrivarhaug T. Nine-fold higher risk of acute myocardial infarction in subjects with type 1 diabetes compared to controls in Norway 1973-2017. Cardiovasc Diabetol 2022; 21:59. [PMID: 35477506 PMCID: PMC9047315 DOI: 10.1186/s12933-022-01498-5] [Citation(s) in RCA: 1] [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] [Received: 02/14/2022] [Accepted: 04/09/2022] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND We aimed to study the cumulative incidence and risk factors (sex, age, calendar year of diabetes onset, country of origin and educational level) of acute myocardial infarction (AMI) in subjects with type 1 diabetes and matched controls. METHODS A nationwide cohort of subjects with type 1 diabetes diagnosed at age < 15 years in Norway during 1973-2000 was followed until the first AMI event, emigration, death or 31st of December 2017. The Norwegian Childhood Diabetes Registry was linked to five nationwide registries, and up to ten sex- and age-matched controls per case were included. RESULTS Among 7086 subjects with type 1 diabetes, 170 (2.4%) were identified with incident AMI, compared to 193 (0.3%) of 69,356 controls. Mean age and diabetes duration at first AMI was 40.8 years and 30.6 years, respectively. The probability of AMI after 40 years of follow-up was 8.0% in subjects with type 1 diabetes and 1.1% in controls, aHR 9.05 (95% CI 7.18-11.41). In type 1 diabetes, male sex (aHR 1.45), higher age at onset of diabetes and lower education (higher compared to lower, aHR 0.38) were significantly associated with higher risk of AMI. There was no significant time trend in AMI by calendar year of diabetes onset. CONCLUSIONS We found nine-fold excess risk of AMI in subjects with type 1 diabetes, and three-fold higher risk in subjects with low versus high education. These results highlight a strengthened focus on prevention of cardiovascular disease, and diabetes education tailored to the subjects' educational background.
Collapse
Affiliation(s)
- Maryam Saeed
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway. .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway. .,Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway.
| | - Lars C Stene
- Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway.,Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Ariansen
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - German Tapia
- Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Joner
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Torild Skrivarhaug
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Oslo Diabetes Research Centre, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
7
|
Relative contribution of trends in myocardial infarction event rates and case fatality to declines in mortality: an international comparative study of 1·95 million events in 80·4 million people in four countries. Lancet Public Health 2022; 7:e229-e239. [DOI: 10.1016/s2468-2667(22)00006-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/21/2021] [Accepted: 12/23/2021] [Indexed: 01/20/2023]
|
8
|
Wright FL, Townsend N, Greenland M, Goldacre MJ, Smolina K, Lacey B, Nedkoff L. Long-term trends in population-based hospitalisation rates for myocardial infarction in England: a national database study of 3.5 million admissions, 1968-2016. J Epidemiol Community Health 2022; 76:45-52. [PMID: 34253559 PMCID: PMC8666807 DOI: 10.1136/jech-2021-216689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/28/2021] [Indexed: 11/29/2022]
Abstract
AIM To analyse the timing and scale of temporal changes in rates of hospitalised myocardial infarction (MI) in England by age and sex from 1968 to 2016. METHODS MI admissions for adults aged 15-84 years were identified from electronic hospital data. We calculated age-standardised and age-specific rates, and examined trends using joinpoint. RESULTS From 1968 to 2016, there were 3.5 million admissions for MI in England (68% men). Rates increased in the early years of the study in both men and women, peaked in the mid-1980s (355 per 100 000 population in men; 127 in women) and declined by 38.8% in men and 37.4% in women from 1990 to 2011. From 2012, however, modest increases were observed in both sexes. Long-term trends in rates over the study period varied by age and sex, with those aged 70 years and older having the greatest and most sustained increases in the early years (1968-1985). During subsequent years, rates decreased in most age groups until 2010-2011. The exception was younger women (35-49 years) and men (15-34 years) who experienced significant increases from the mid-1990s to 2007 (range +2.1%/year to 4.7%/year). From 2012 onwards, rates increased in all age groups except the oldest, with the most marked increases in men aged 15-34 years (7.2%/year) and women aged 40-49 (6.9%-7.3%/year) . CONCLUSION Despite substantial declines in hospital admission rates for MI in England since 1990, the burden of annual admissions remains high. Continued surveillance of trends and coronary disease preventive strategies are warranted.
Collapse
Affiliation(s)
- F Lucy Wright
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health and Big Data Institute, University of Oxford, Oxford, UK
| | | | - Melanie Greenland
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael J Goldacre
- Unit of Health-Care Epidemiology, Nuffield Department of Population Health and Big Data Institute, University of Oxford, Oxford, UK
| | - Kate Smolina
- School of Population and Public Health, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Ben Lacey
- Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health and Big Data Institute, University of Oxford, Oxford, UK
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
9
|
Gerdts E, de Simone G. Hypertension in Women: Should There be a Sex-specific Threshold? Eur Cardiol 2021; 16:e38. [PMID: 34733358 PMCID: PMC8548871 DOI: 10.15420/ecr.2021.17] [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: 05/02/2021] [Accepted: 07/18/2021] [Indexed: 12/13/2022] Open
Abstract
Conventionally, hypertension is defined by the same blood pressure (BP) threshold (systolic BP ≥140 and/or diastolic BP ≥90 mmHg) in both women and men. Several studies have documented that women with hypertension are more prone to develop BP-associated organ damage and that high BP is a stronger risk factor for cardiovascular disease (CVD) in women than men. While healthy young women have lower BP than men, a steeper increase in BP is found in women from the third decade of life. Studies have documented that the BP-attributable risk for acute coronary syndromes (ACS), heart failure and AF increases at a lower level of BP in women than in men. Even high normal BP (130–139/80–89 mmHg) is associated with an up to twofold higher risk of ACS during midlife in women, but not in men. Whether sex-specific thresholds for definition of hypertension would improve CVD risk detection should be considered in future guidelines for hypertension management and CVD prevention.
Collapse
Affiliation(s)
- Eva Gerdts
- Department of Clinical Science, Center for Research on Cardiac Disease in Women, University of Bergen Bergen, Norway
| | - Giovanni de Simone
- Department of Advanced Biomedical Sciences and Hypertension Center, Federico II University Naples, Italy
| |
Collapse
|
10
|
Dattoli-García CA, Jackson-Pedroza CN, Gallardo-Grajeda AL, Gopar-Nieto R, Araiza-Garygordobil D, Arias-Mendoza A. [Infarto agudo de miocardio: revisión sobre factores de riesgo, etiología, hallazgos angiográficos y desenlaces en pacientes jóvenes]. ARCHIVOS DE CARDIOLOGIA DE MEXICO 2021; 91:485-492. [PMID: 33471784 PMCID: PMC8641454 DOI: 10.24875/acm.20000386] [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] [Indexed: 12/04/2022] Open
Abstract
La enfermedad cardiovascular persiste como primera causa mundial de muerte en los adultos. La población de adultos jóvenes ha cursado con cambios en el estilo de vida con el paso de las décadas, favoreciendo la aparición de ateroesclerosis en etapas más tempranas y como consecuencia la aparición de eventos cardiovasculares de manera más prematura. Se ha identificado que dentro de los factores de riesgo más comunes, la mayoría de ellos son potencialmente modificables. En comparación con adultos mayores, se ha identificado con mayor prevalencia la presencia de etiologías no ateroescleróticas de infarto de miocardio, como la disección coronaria espontánea, alteraciones anatómicas, embolia y espasmo coronarios. Los hallazgos angiográficos y desenlaces son diferentes de acuerdo con el grupo de edad y el sexo. Por dicho motivo realizamos una búsqueda en PubMed de los estudios y registros publicados para el estudio del infarto agudo de miocardio en paciente jóvenes. Con dicha información realizamos la presente revisión con el objetivo de una mejor comprensión de los hallazgos comunes en este grupo y realizar su comparación con grupos de mayor edad.
Collapse
Affiliation(s)
- Carlos A Dattoli-García
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| | - Cynthia N Jackson-Pedroza
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| | - Andrea L Gallardo-Grajeda
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| | - Rodrigo Gopar-Nieto
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| | - Diego Araiza-Garygordobil
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| | - Alexandra Arias-Mendoza
- Servicio de Urgencias y Unidad Coronaria, Instituto Nacional de Cardiología, Ciudad de México, México
| |
Collapse
|
11
|
Kringeland E, Tell GS, Midtbø H, Igland J, Haugsgjerd TR, Gerdts E. Stage 1 hypertension, sex, and acute coronary syndromes during midlife: the Hordaland Health Study. Eur J Prev Cardiol 2021; 29:147-154. [PMID: 33993298 DOI: 10.1093/eurjpc/zwab068] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/15/2021] [Accepted: 04/11/2021] [Indexed: 12/17/2022]
Abstract
AIMS Hypertension has been suggested as a stronger risk factor for acute coronary syndromes (ACS) in women than men. Whether this also applies to stage 1 hypertension [blood pressure (BP) 130-139/80-89 mmHg] is not known. METHODS AND RESULTS We tested associations of stage 1 hypertension with ACS in 12 329 participants in the Hordaland Health Study (mean baseline age 41 years, 52% women). Participants were grouped by baseline BP category: Normotension (BP < 130/80 mmHg), stage 1 and stage 2 hypertension (BP ≥140/90 mmHg). ACS was defined as hospitalization or death due to myocardial infarction or unstable angina pectoris during 16 years of follow-up. At baseline, a lower proportion of women than men had stage 1 and 2 hypertension, respectively (25 vs. 35% and 14 vs. 31%, P < 0.001). During follow-up, 1.4% of women and 5.7% of men experienced incident ACS (P < 0.001). Adjusted for diabetes, smoking, body mass index, cholesterol, and physical activity, stage 1 hypertension was associated with higher risk of ACS in women [hazard ratio (HR) 2.18, 95% confidence interval (CI) 1.32-3.60], while the association was non-significant in men (HR 1.30, 95% CI 0.98-1.71). After additional adjustment for systolic and diastolic BP, respectively, stage 1 diastolic hypertension was associated with ACS in women (HR 2.79 [95% CI 1.62-4.82]), but not in men (HR 1.24 [95% CI 0.95-1.62]), while stage 1 systolic hypertension was not associated with ACS in either sex. CONCLUSION Among subjects in their early 40s, stage 1 hypertension was a stronger risk factor for ACS during midlife in women than in men.
Collapse
Affiliation(s)
- Ester Kringeland
- Department of Clinical Science, University of Bergen, PO Box 7804, 5020 Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, PO Box 973 Sentrum, 5808 Bergen, Norway
| | - Helga Midtbø
- Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway
| | - Teresa R Haugsgjerd
- Department of Global Public Health and Primary Care, University of Bergen, PO Box 7804, 5020 Bergen, Norway
| | - Eva Gerdts
- Department of Clinical Science, University of Bergen, PO Box 7804, 5020 Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Jonas Lies vei 65, 5021 Bergen, Norway
| |
Collapse
|
12
|
Saeed M, Tapia G, Ariansen I, Stene LC, Seljeflot I, Tell GS, Skrivarhaug T, Joner G. Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study. Diabetes Care 2021; 44:810-816. [PMID: 33408220 PMCID: PMC7896257 DOI: 10.2337/dc20-1712] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 12/07/2020] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes. RESEARCH DESIGN AND METHODS A population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973-1982 was examined in 2002-2003 at a mean age of 33 years (range 21-44), with mean diabetes duration of 24 years (range 19-30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression. RESULTS Of 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5-16). IL-6 (aHR 1.32 [95% CI 1.07-1.63]), galectin-3 (aHR 1.44 [95% CI 1.09-1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04-1.81]) were significant predictors of CHD after adjustment for conventional risk factors. CONCLUSIONS Galectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.
Collapse
Affiliation(s)
- Maryam Saeed
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - German Tapia
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Inger Ariansen
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Lars C Stene
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Ingebjørg Seljeflot
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.,Department of Cardiology, Center for Clinical Heart Research, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Torild Skrivarhaug
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Geir Joner
- Division of Pediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
13
|
Murat B, Kivanc E, Dizman R, Ozge Mert G, Murat S. Gender differences in clinical characteristics and in-hospital and one-year outcomes of young patients with ST-segment elevation myocardial infarction under the age of 40. J Cardiovasc Thorac Res 2021; 13:116-124. [PMID: 34326965 PMCID: PMC8302902 DOI: 10.34172/jcvtr.2021.17] [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: 12/08/2020] [Accepted: 01/25/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction: Although the incidence of acute ST-segment elevation myocardial infarction (STEMI) in the elderly population has decreased in recent years, this is not the case for young people. At the same time, no reduction in hospitalization rate after STEMI was shown in young people. Clinical characteristics, risk factors, angiographic findings, in-hospital and one-year outcomes of patients under the age of 40 and their gender differences were investigated. Methods: This study has been performed retrospectively in two centers. Between January 2015 and April 2019, 212 patients aged 18-40 years with STEMI and who underwent reperfusion therapy were included. The gender differences were compared. Results: The median age of (male 176; 83.0% and female 36; 17.0%) patients included in the study was 36 (33-38) for men and 36 (34-38) for women. Chest pain was the most common complaint for both genders (96.0% vs. 94.4%; P = 0.651). While men presented more often with Killip class 1,women presented more often with Killip class 2. The anterior myocardial infarction (MI) was the most common MI type and it was higher in women than in man (P = 0.027). At one year of follow-up, the prevalence of all-cause hospitalization was 24%, MI 3.8%, coronary angiography 15.1%, cardiovascular death 1.4%, and all-cause death 0.47%, there was no gender difference. Conclusion: Anterior MI was the most common type of MI and it was more common in women than in men. Left anterior descending artery was the most common involved coronary artery. The most common risk factor is smoking. In terms of in-hospital outcome, left ventricular ejection fraction was significantly lower in women. There was no significant difference in one-year outcomes between both genders.
Collapse
Affiliation(s)
- Bektas Murat
- Eskisehir City Hospital, Department of Cardiology, Eskisehir, Turkey
| | - Eylem Kivanc
- Eskisehir City Hospital, Department of Cardiology, Eskisehir, Turkey
| | - Rafet Dizman
- Eskisehir City Hospital, Department of Cardiology, Eskisehir, Turkey
| | - Gurbet Ozge Mert
- Eskisehir Yunus Emre State Hospital Department of Cardiology, Eskisehir, Turkey
| | - Selda Murat
- Eskisehir Osmangazi University, Medical Faculty Department of Cardiology, Eskisehir, Turkey
| |
Collapse
|
14
|
Mundal LJ, Hovland A, Igland J, Vetrhus M, Veierød MB, Holven KB, Bogsrud MP, Tell GS, Leren TP, Retterstøl K. Increased risk of peripheral artery disease in persons with familial hypercholesterolaemia: a prospective registry study. Eur J Prev Cardiol 2020; 28:e11-e13. [PMID: 33623989 DOI: 10.1093/eurjpc/zwaa024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/05/2020] [Accepted: 07/23/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Liv J Mundal
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Aker
| | - Anders Hovland
- Division of Internal Medicine, Nordland Hospital, Parkveien 95, 8092 Bodø, Norway.,Department of Clinical Medicine, University of Tromsø, Hansine Hansensveg 18, 9000 Tromsø, Norway
| | - Jannicke Igland
- Department of Health and Social Science, Centre for Evidence-Based Practice, Western Norway University of Applied Science, Haukelandsveien 28, 5020 Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5000 Bergen, Norway
| | - Morten Vetrhus
- Department of Surgery, Vascular Surgery Unit, Stavanger University Hospital, Gerd-Ragna Bloch Thorsens gate 8, 4011 Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Jonas Lies veg 87, 5021 Norway
| | - Marit Bragelien Veierød
- Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, University of Oslo, Sognsvannsveien 9 0372 Oslo, Norway.,Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
| | - Kirsten Bjørklund Holven
- Department of Nutrition, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway.,National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Aker Sykehus, Bygg 6, Trondheimsveien 235, 0587 Oslo, Norway
| | - Martin Prøven Bogsrud
- National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Aker Sykehus, Bygg 6, Trondheimsveien 235, 0587 Oslo, Norway.,Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital, Kirkeveien 166 Laboratoriebygget 0450 Oslo, Norway
| | - Grethe Seppola Tell
- Department of Global Public Health and Primary Care, University of Bergen, Kalfarveien 31, 5000 Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Zander Kaaesgate 7, 5015 Bergen, Norway
| | - Trond Paul Leren
- National Advisory Unit on Familial Hypercholesterolemia, Oslo University Hospital, Aker Sykehus, Bygg 6, Trondheimsveien 235, 0587 Oslo, Norway
| | - Kjetil Retterstøl
- The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Aker.,Institute of Basic Medical Sciences, University of Oslo, Sognsvannsveien 9, 0372 Oslo, Norway
| |
Collapse
|
15
|
Rabanal KS, Igland J, Tell GS, Jenum AK, Klemsdal TO, Ariansen I, Meyer HE, Selmer RM. Validation of the cardiovascular risk model NORRISK 2 in South Asians and people with diabetes. SCAND CARDIOVASC J 2020; 55:56-62. [PMID: 33073627 DOI: 10.1080/14017431.2020.1821909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
OBJECTIVES To evaluate the predictive ability of the previously published NORRISK 2 cardiovascular risk model in Norwegian-born and immigrants born in South Asia living in Norway, and to add information about diabetes and ethnicity in an updated model for South Asians and diabetics (NORRISK 2-SADia). Design. We included participants (30-74 years) born in Norway (n = 13,885) or South Asia (n = 1942) from health surveys conducted in Oslo 2000-2003. Cardiovascular disease (CVD) risk factor information including self-reported diabetes was linked with information on subsequent acute myocardial infarction (AMI) and acute cerebral stroke in hospital and mortality registry data throughout 2014 from the nationwide CVDNOR project. We developed an updated model using Cox regression with diabetes and South Asian ethnicity as additional predictors. We assessed model performance by Harrell's C and calibration plots. Results. The NORRISK 2 model underestimated the risk in South Asians in all quintiles of predicted risk. The mean predicted 13-year risk by the NORRISK 2 model was 3.9% (95% CI 3.7-4.2) versus observed 7.3% (95% CI 5.9-9.1) in South Asian men and 1.1% (95% CI 1.0-1.2) versus 2.7% (95% CI 1.7-4.2) observed risk in South Asian women. The mean predictions from the NORRISK 2-SADia model were 7.2% (95% CI 6.7-7.6) in South Asian men and 2.7% (95% CI 2.4-3.0) in South Asian women. Conclusions. The NORRISK 2-SADia model improved predictions of CVD substantially in South Asians, whose risks were underestimated by the NORRISK 2 model. The NORRISK 2-SADia model may facilitate more intense preventive measures in this high-risk population.
Collapse
Affiliation(s)
- Kjersti Stormark Rabanal
- Department of Public Health, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway.,Research Department, Stavanger University Hospital, Stavanger, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Grethe Seppola Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Anne Karen Jenum
- General Practice Research Unit (AFE), Department of General Practice, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | | | - Inger Ariansen
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Haakon Eduard Meyer
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Randi Marie Selmer
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| |
Collapse
|
16
|
Honigberg MC, Riise HKR, Daltveit AK, Tell GS, Sulo G, Igland J, Klungsøyr K, Scott NS, Wood MJ, Natarajan P, Rich-Edwards JW. Heart Failure in Women With Hypertensive Disorders of Pregnancy: Insights From the Cardiovascular Disease in Norway Project. Hypertension 2020; 76:1506-1513. [PMID: 32829667 DOI: 10.1161/hypertensionaha.120.15654] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Hypertensive disorders of pregnancy (HDP) have been associated with heart failure (HF). It is unknown whether concurrent pregnancy complications (small-for-gestational-age or preterm delivery) or recurrent HDP modify HDP-associated HF risk. In this cohort study, we included Norwegian women with a first birth between 1980 and 2004. Follow-up occurred through 2009. Cox models examined gestational hypertension and preeclampsia in the first pregnancy as predictors of a composite of HF-related hospitalization or HF-related death, with assessment of effect modification by concurrent small-for-gestational-age or preterm delivery. Additional models were stratified by final parity (1 versus ≥2 births) and tested associations with recurrent HDP. Among 508 422 women, 565 experienced incident HF over a median 11.8 years of follow-up. After multivariable adjustment, gestational hypertension in the first birth was not significantly associated with HF (hazard ratio, 1.41 [95% CI, 0.84-2.35], P=0.19), whereas preeclampsia was associated with a hazard ratio of 2.00 (95% CI, 1.50-2.68, P<0.001). Among women with HDP, risks were not modified by concurrent small-for-gestational-age or preterm delivery (Pinteraction=0.42). Largest hazards of HF were observed in women whose only lifetime birth was complicated by preeclampsia and women with recurrent preeclampsia. HF risks were similar after excluding women with coronary artery disease. In summary, women with preeclampsia, especially those with one lifetime birth and those with recurrent preeclampsia, experienced increased HF risk compared to women without HDP. Further research is needed to clarify causal mechanisms.
Collapse
Affiliation(s)
- Michael C Honigberg
- From the Cardiology Division (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Department of Medicine (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Corrigan Women's Heart Health Program, Cardiology Division (M.C.H., N.S.S., M.J.W.), Massachusetts General Hospital, Harvard Medical School, Boston.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA (M.C.H., P.N.).,Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston (M.C.H., P.N.)
| | | | - Anne Kjersti Daltveit
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen (A.K.D., G.S.T., G.S., J.I., K.K.)
| | - Grethe S Tell
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen (A.K.D., G.S.T., G.S., J.I., K.K.).,Department of Global Public Health and Primary Care, Bergen, Norway (G.S.T., K.K.)
| | - Gerhard Sulo
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen (A.K.D., G.S.T., G.S., J.I., K.K.)
| | - Jannicke Igland
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen (A.K.D., G.S.T., G.S., J.I., K.K.)
| | - Kari Klungsøyr
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen (A.K.D., G.S.T., G.S., J.I., K.K.).,Department of Global Public Health and Primary Care, Bergen, Norway (G.S.T., K.K.)
| | - Nandita S Scott
- From the Cardiology Division (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Department of Medicine (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Corrigan Women's Heart Health Program, Cardiology Division (M.C.H., N.S.S., M.J.W.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Malissa J Wood
- From the Cardiology Division (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Department of Medicine (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Corrigan Women's Heart Health Program, Cardiology Division (M.C.H., N.S.S., M.J.W.), Massachusetts General Hospital, Harvard Medical School, Boston
| | - Pradeep Natarajan
- From the Cardiology Division (M.C.H., N.S.S., M.J.W., P.N.), Massachusetts General Hospital, Harvard Medical School, Boston.,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA (M.C.H., P.N.).,Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston (M.C.H., P.N.)
| | - Janet W Rich-Edwards
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston (J.W.R.-E.).,Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA (J.W.R.-E.)
| |
Collapse
|
17
|
Haugsgjerd TR, Egeland GM, Nygård OK, Vinknes KJ, Sulo G, Lysne V, Igland J, Tell GS. Association of dietary vitamin K and risk of coronary heart disease in middle-age adults: the Hordaland Health Study Cohort. BMJ Open 2020; 10:e035953. [PMID: 32444431 PMCID: PMC7247390 DOI: 10.1136/bmjopen-2019-035953] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 02/21/2020] [Accepted: 04/17/2020] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE The role of vitamin K in the regulation of vascular calcification is established. However, the association of dietary vitamins K1 and K2 with risk of coronary heart disease (CHD) is inconclusive. DESIGN Prospective cohort study. SETTING We followed participants in the community-based Hordaland Health Study from 1997 - 1999 through 2009 to evaluate associations between intake of vitamin K and incident (new onset) CHD. Baseline diet was assessed by a past-year food frequency questionnaire. Energy-adjusted residuals of vitamin K1 and vitamin K2 intakes were categorised into quartiles. PARTICIPANTS 2987 Norwegian men and women, age 46-49 years. METHODS Information on incident CHD events was obtained from the nationwide Cardiovascular Disease in Norway (CVDNOR) Project. Multivariable Cox regression estimated HRs and 95% CIs with test for linear trends across quartiles. Analyses were adjusted for age, sex, total energy intake, physical activity, smoking and education. A third model further adjusted K1 intake for energy-adjusted fibre and folate, while K2 intake was adjusted for energy-adjusted saturated fatty acids and calcium. RESULTS During a median follow-up time of 11 years, we documented 112 incident CHD cases. In the adjusted analyses, there was no association between intake of vitamin K1 and CHD (HRQ4vsQ1 = 0.92 (95% CI 0.54 to 1.57), p for trend 0.64), while there was a lower risk of CHD associated with higher intake of energy-adjusted vitamin K2 (HRQ4vsQ1 = 0.52 (0.29 to 0.94), p for trend 0.03). Further adjustment for potential dietary confounders did not materially change the association for K1, while the association for K2 was slightly attenuated (HRQ4vsQ1 = 0.58 (0.28 to 1.19)). CONCLUSIONS A higher intake of vitamin K2 was associated with lower risk of CHD, while there was no association between intake of vitamin K1 and CHD. TRIAL REGISTRATION NUMBER NCT03013725.
Collapse
Affiliation(s)
- Teresa R Haugsgjerd
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Grace M Egeland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Health Registries, Research and Development, Norwegian Institute of Public Health, Bergen, Norway
| | - Ottar K Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- Centre for nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Gerhard Sulo
- Oral Health Centre of Expertise in Western Norway, Bergen, Norway
- Centre for Disease Burden, Norwegian Institute of Public Health, Bergen, Norway
| | - Vegard Lysne
- Centre for nutrition, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| |
Collapse
|
18
|
Jortveit J, Pripp AH, Langørgen J, Halvorsen S. Incidence, risk factors and outcome of young patients with myocardial infarction. Heart 2020; 106:1420-1426. [DOI: 10.1136/heartjnl-2019-316067] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 12/30/2019] [Accepted: 01/08/2020] [Indexed: 11/04/2022] Open
Abstract
ObjectiveThe decline in the incidence and mortality of acute myocardial infarction (AMI) has been less among younger compared with older individuals. The aim of this nationwide study was to assess the current incidence, risk factors and outcome of AMI in patients <45 years of age.MethodsAll patients ≤80 years of age registered in the Norwegian Myocardial Infarction Register in 2013–2016 were included in this observational, nationwide cohort study. Follow-up was conducted through linkage with the Norwegian Patient Registry through 2017.ResultsAmong a total of 33 439 patients ≤80 years with AMI, 1468 (4.4%) were <45 years old. The incidence of AMI was 2.1 per 100 000 person-years in people aged 20–29 years, 16.9 in people aged 30–39 years and 97.6 in people aged 40–49 years. Compared with older patients, patients <45 years were more likely to be male (81%), current smokers (56%), obese (30%) and have a family history of premature AMI (44%), and their low-density lipoprotein-cholesterol levels were higher. Patients <45 years were more likely to have non-obstructive coronary artery disease (14% vs 10%, p<0.001) compared with older patients. During a median follow-up time of 2.4 years, 135 (9%) patients <45 years experienced a new AMI, stroke or death, and 58 (4%) patients died.ConclusionsThe rate of AMI was low in people <45 years old in Norway, but almost one in ten patients with AMI <45 years old died or experienced a new cardiovascular event during follow-up. Increased efforts to improve risk factor control in these patients are warranted.
Collapse
|
19
|
Mortality following first-time hospitalization with acute myocardial infarction in Norway, 2001-2014: Time trends, underlying causes and place of death. Int J Cardiol 2019; 294:6-12. [PMID: 31387821 DOI: 10.1016/j.ijcard.2019.07.084] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 07/19/2019] [Accepted: 07/28/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Trends on cause-specific mortality following acute myocardial infarction (AMI) are poorly described and no studies have analyzed where do AMI patients die. We analyzed trends in 28-day and one-year mortality following an incident AMI with focus on changes over time in the underlying cause and place of death. METHODS We identified in the 'Cardiovascular Disease in Norway' Project all patients 25+ years, hospitalized with an incident AMI in Norway, 2001-2014. Information on date, underlying cause and place of death was obtained from the Cause of Death Registry. RESULTS Of 144,473 patients included in the study, 11.4% died within first 28 days. The adjusted 28-day mortality declined by 5.2% per year (ptrend < 0.001). Of 118,881 patients surviving first 28 days, 10.1% died within one year. The adjusted one-year CVD mortality declined by 6.2% per year (ptrend < 0.001) while non-CVD mortality increased by 1.4% per year (ptrend < 0.001), mainly influenced by increased risk of dying from neoplasms. We observed a shift over time in the underlying cause of death toward more non-CVD deaths, and in the place of death toward more deaths occurring in nursing homes. CONCLUSIONS We observed a decline in 28-day mortality following an incident AMI hospitalization. One-year CVD mortality declined while one-year risk of dying from non-CVD conditions increased. The resulting shift toward more non-CVD deaths and deaths occurring outside a hospital need to be considered when formulating priorities in treating and preventing adverse events among AMI survivors.
Collapse
|
20
|
Svendsen K, Jacobs DR, Røyseth IT, Garstad KW, Byfuglien MG, Granlund L, Mørch-Reiersen LT, Telle-Hansen VH, Retterstøl K. Community pharmacies offer a potential high-yield and convenient arena for total cholesterol and CVD risk screening. Eur J Public Health 2019; 29:17-23. [PMID: 30239673 DOI: 10.1093/eurpub/cky190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background Moderately elevated blood total cholesterol (TC), blood glucose (BG) and blood pressure (BP) are rarely symptomatic and as such many individuals remain untreated. We studied the yield of an in-pharmacy screening for identifying undetected high TC and strategies to reach those with absence of prior measurement of TC, BG and BP. Methods A cross-sectional TC screening study with complementary TC measurements and self-administered questionnaire was conducted for 1 week in each of 2012 and 2014 in 148 and 149 BootsTM Norge AS community pharmacies nationwide in Norway. Results Non-medicated adults (n = 21 090) with mean age 54.5 ± 16.0 were included. The study population resembled the Norwegian population in regards to body mass index, educational level, smokers and physical inactivity level, but with an overrepresentation of middle-aged women. Of 20 743 with available data, 11% (n = 2337) were unaware of their high TC ≥7.0 mmol/L, and an additional 8% were unaware of TC ≥6.2 mmol/L. More than 40% of the study sample had not measured TC or BG before. In order for future screenings to reach those who are less likely to have previously measured TC and BG, our results suggest that young, low-educated, overweight men and women should be targeted for TC measurement, whereas normal weigh men in all ages should be targeted for BG measurement. Conclusions In total 19% in an in-pharmacy screening were unaware of their elevated TC of ≥6.2 mmol/L. We also identified characteristics that could be used reach those who are less likely to have measured TC and BG.
Collapse
Affiliation(s)
- Karianne Svendsen
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, Oslo, Norway
| | - David R Jacobs
- Division of Epidemiology & Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Ida Tonning Røyseth
- Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, Oslo, Norway
| | | | | | | | | | - Vibeke H Telle-Hansen
- Faculty of Health Sciences, Oslo Metropolitan University, St. Olavs plass, Oslo, Norway
| | - Kjetil Retterstøl
- Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Blindern, Oslo, Norway.,The Lipid Clinic, Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Nydalen, Oslo, Norway
| |
Collapse
|
21
|
Fossum S, Næss Ø, Halvorsen S, Tell GS, Vikanes ÅV. Long-term cardiovascular morbidity following hyperemesis gravidarum: A Norwegian nationwide cohort study. PLoS One 2019; 14:e0218051. [PMID: 31188868 PMCID: PMC6561562 DOI: 10.1371/journal.pone.0218051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 05/24/2019] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE To investigate whether exposure to hyperemesis gravidarum (hyperemesis) is associated with subsequent maternal cardiovascular morbidity. DESIGN Nationwide cohort study. SETTING Medical Birth Registry of Norway (1967-2002) linked to the nationwide Cardiovascular Disease in Norway project 1994-2009 (CVDNOR) and the Cause of Death Registry. POPULATION Women in Norway with singleton births from 1967 to 2002, with and without hyperemesis, were followed up with respect to cardiovascular outcomes from 1994 to 2009. METHODS Cox proportional hazards regression model was applied to estimate hazard ratios (HRs) with 95% confidence interval (CI). MAIN OUTCOME MEASURES The first hospitalisation due to nonfatal stroke, myocardial infarction or angina pectoris, or cardiovascular death. RESULTS Among 989 473 women with singleton births, 13 212 (1.3%) suffered from hyperemesis. During follow-up, a total of 43 482 (4.4%) women experienced a cardiovascular event. No association was found between hyperemesis and the risk of a fatal or nonfatal cardiovascular event (adjusted HR 1.08; 95% CI 0.99-1.18). Women with hyperemesis had higher risk of hospitalisation due to angina pectoris (adjusted HR 1.28; 95% CI 1.15-1.44). The risk of cardiovascular death was lower among hyperemetic women in age-adjusted analysis (HR 0.73; 95% CI 0.59-0.91), but the association was no longer significant when adjusting for possible confounders. CONCLUSION Women with a history of hyperemesis did not have increased risk of a cardiovascular event (nonfatal myocardial infarction or stroke, angina pectoris or cardiovascular death) compared to women without.
Collapse
Affiliation(s)
- Stine Fossum
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Øyvind Næss
- Faculty of Medicine, University of Oslo, Oslo, Norway
- Division for Mental and Physical Health, National Institute of Public Health, Oslo, Norway
| | - Sigrun Halvorsen
- Department of Cardiology, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Grethe S. Tell
- Division for Mental and Physical Health, National Institute of Public Health, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Åse V. Vikanes
- The Intervention Center, Oslo University Hospital, Oslo, Norway
- Institute for Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
22
|
Riise HKR, Sulo G, Tell GS, Igland J, Egeland G, Nygard O, Selmer R, Iversen AC, Daltveit AK. Hypertensive pregnancy disorders increase the risk of maternal cardiovascular disease after adjustment for cardiovascular risk factors. Int J Cardiol 2019; 282:81-87. [DOI: 10.1016/j.ijcard.2019.01.097] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/21/2019] [Accepted: 01/28/2019] [Indexed: 12/29/2022]
|
23
|
Sulo G, Igland J, Tell GS. Reply to Letter to Editor: Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project. Eur J Prev Cardiol 2019; 26:333. [DOI: 10.1177/2047487318809513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
24
|
Renninger M, Løchen ML, Ekelund U, Hopstock LA, Jørgensen L, Mathiesen EB, Njølstad I, Schirmer H, Wilsgaard T, Morseth B. The independent and joint associations of physical activity and body mass index with myocardial infarction: The Tromsø Study. Prev Med 2018; 116:94-98. [PMID: 30218724 DOI: 10.1016/j.ypmed.2018.09.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 08/07/2018] [Accepted: 09/11/2018] [Indexed: 11/30/2022]
Abstract
Physical activity and overweight are associated with myocardial infarction (MI). However, their joint association with MI remains unclear. Our objective was to examine the independent and joint association between leisure-time physical activity (LTPA), body mass index (BMI) and MI. This prospective cohort study included 16,572 men and women (47.5% women) aged 20-54 years who took part in the second Tromsø Study. At baseline in 1979-80 LTPA was assessed by questionnaire. Data on MI was collected and adjudicated through hospital and causes of death registries between 1979 and 2013. Cox proportional hazards models were used to examine the independent and joint associations between LTPA, BMI and MI. The final sample included 16,104 individuals. During a median follow up of 34 years, 1613 incident cases of MI were recorded. Physical inactivity and elevated BMI were both independently associated with MI (p for trend 0.02 and <0.001). In joint analyses, normal weight, inactive individuals had a 20% higher risk of MI compared to their active counterparts (hazard ratio (HR) 1.20 (1.02-1.41)). The highest risk of MI was seen in obese, inactive individuals when compared to normal weight, active individuals (HR 3.20 (2.30-4.44)). The risk of MI increased with increasing BMI regardless of the activity level. HRs were lower for active compared to inactive individuals within the same BMI category. The findings suggest that LTPA and BMI are independently associated with risk of MI. LTPA seems to attenuate but not eliminate the risk of MI associated with excess bodyweight.
Collapse
Affiliation(s)
- Marius Renninger
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Medical Informatics, Biometry and Epidemiology (IBE), Ludwig-Maximilians-Universität München, Munich, Germany
| | - Maja-Lisa Løchen
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Cardiology, University Hospital of North Norway, Tromsø, Norway
| | - Ulf Ekelund
- Department of Sport Medicine, Norwegian School of Sport Sciences, Oslo, Norway; Norwegian Institute for Public Health, Oslo, Norway
| | - Laila A Hopstock
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Lone Jørgensen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Clinical Therapeutic Services, University Hospital of Northern Norway, Tromsø, Norway
| | - Ellisiv B Mathiesen
- Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Department of Neurology, University Hospital of North Norway, Tromsø, Norway
| | - Inger Njølstad
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Henrik Schirmer
- Department of Cardiology, University Hospital of North Norway, Tromsø, Norway; Department of Clinical Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tom Wilsgaard
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Bente Morseth
- School of Sport Sciences, UiT The Arctic University of Norway, Tromsø, Norway; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway; Centre for Clinical Research and Education, University Hospital of North Norway Trust, Tromsø, Norway.
| |
Collapse
|
25
|
Ruiz PLD, Stene LC, Bakken IJ, Håberg SE, Birkeland KI, Gulseth HL. Decreasing incidence of pharmacologically and non-pharmacologically treated type 2 diabetes in Norway: a nationwide study. Diabetologia 2018; 61:2310-2318. [PMID: 29995214 PMCID: PMC6182655 DOI: 10.1007/s00125-018-4681-4] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Accepted: 06/06/2018] [Indexed: 01/16/2023]
Abstract
AIMS/HYPOTHESIS This study aimed to examine recent time trends in the incidence and prevalence of type 2 diabetes in Norway. METHODS In this Norwegian nationwide cohort study, we linked data from national registries with prospectively collected data on diabetes medication and diabetes diagnoses for all residents in Norway aged 30 to 89 years (>3.2 million people). We analysed trends in incidence and prevalence of type 2 diabetes from 2009 to 2014 by type of treatment, sex, age, education level and place of birth. RESULTS During 15,463,691 person-years of follow-up from 2009 to 2014, we identified 75,496 individuals with new-onset type 2 diabetes. Of these, 36,334 (48%) were treated with blood-glucose-lowering drugs within 6 months of diagnosis. A low education level and being born in Asia, Africa or South America were significant risk factors for incident type 2 diabetes. While the prevalence of type 2 diabetes increased from 4.9% to 6.1% during the study period, the incidence decreased significantly from 609 cases per 100,000 person-years in 2009 to 398 cases per 100,000 in 2014, an annual reduction of 10.1% (95% CI -10.5, -9.6). A declining incidence was seen for both pharmacologically and non-pharmacologically treated type 2 diabetes, and in all subgroups defined by sex, age group, education level and place of birth. CONCLUSIONS/INTERPRETATIONS This nationwide study shows that, despite a decreasing incidence of type 2 diabetes in Norway, the prevalence continues to rise, probably due to diagnosis at a younger age and increased longevity.
Collapse
Affiliation(s)
- Paz L D Ruiz
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Post box 4404, Nydalen, 0403, Oslo, Norway.
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway.
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway.
| | - Lars C Stene
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Post box 4404, Nydalen, 0403, Oslo, Norway
| | - Inger J Bakken
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Siri E Håberg
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Kåre I Birkeland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Transplantation Medicine, Oslo University Hospital, Oslo, Norway
| | - Hanne L Gulseth
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Post box 4404, Nydalen, 0403, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
26
|
Increased plasma trimethylamine- N -oxide is associated with incident atrial fibrillation. Int J Cardiol 2018; 267:100-106. [DOI: 10.1016/j.ijcard.2018.04.128] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/16/2018] [Accepted: 04/30/2018] [Indexed: 11/18/2022]
|
27
|
Puaschitz NG, Assmus J, Strand E, Karlsson T, Vinknes KJ, Lysne V, Drevon CA, Tell GS, Dierkes J, Nygård O. Adherence to the Healthy Nordic Food Index and the incidence of acute myocardial infarction and mortality among patients with stable angina pectoris. J Hum Nutr Diet 2018; 32:86-97. [PMID: 30091209 DOI: 10.1111/jhn.12592] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND The Healthy Nordic Food Index (HNFI) has been associated with beneficial effects on markers of cardiovascular disease (CVD). Whether such effects are present among patients with established coronary heart disease is unknown. In the present study, we investigated the association between adherence to the HNFI and the risk of acute myocardial infarction (AMI) (fatal or nonfatal) and death among patients with stable angina pectoris. METHODS In the Western Norway B-vitamin Intervention Trial, participants completed a 169-item semi-quantitative food frequency questionnaire. The HNFI was calculated from six food groups (fish, cabbage, apples/pears, root vegetables, whole grain bread and oatmeal), scoring 0-6. Three adherence groups were defined: 0-1 points (low), 2-3 points (medium) or 4-6 points (high). Cox regression analyses investigated associations between adherence to the HNFI and outcomes. RESULTS Among 2019 men (79.7%) and women with mean age of 61.7 years, 307 patients experienced an AMI event during a median (25th and 75th percentiles) follow-up of 7.5 (6.3 and 8.7) years. Median follow-up for total mortality was 10.5 (9.3 and 11.7) years; 171 patients died from CVD and 380 from any cause. No association between HNFI and the risk of AMI was detected. However, the HNFI was associated with a reduced risk of all-cause death, both by linear estimates [hazard ratio (95% confidence interval = 0.91 (0.84-0.98)] and by comparison of the highest with the lowest adherence group [hazard ratio (95% confidence interval = 0.70 (0.52-0.95)]. CONCLUSIONS The results of the present study suggest that a Healthy Nordic diet may reduce mortality in patients with established CVD.
Collapse
Affiliation(s)
- N G Puaschitz
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - J Assmus
- Department of Research and Development, Haukeland University Hospital, Bergen, Norway
| | - E Strand
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - T Karlsson
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - K J Vinknes
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - V Lysne
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - C A Drevon
- Department of Nutrition, Faculty of Medicine, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Division of Mental and Physical Health, Department of Non-Communicable Diseases, Norwegian Institute of Public Health, Oslo, Norway
| | - J Dierkes
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway.,KG Jebsen Centre for Diabetes Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| |
Collapse
|
28
|
Olsen T, Vinknes KJ, Svingen GFT, Pedersen ER, Dhar I, Tell GS, Blomhoff R, Ueland PM, Midttun Ø, Refsum H, Nygård OK. The risk association of plasma total homocysteine with acute myocardial infarction is modified by serum vitamin A. Eur J Prev Cardiol 2018; 25:1612-1620. [DOI: 10.1177/2047487318788587] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Background Plasma total homocysteine (tHcy) has been implicated in the development of cardiovascular disease, but the mechanisms remain unclear. Vitamin A (Vit-A) is involved in homocysteine metabolism and we therefore explored the potential interaction between plasma tHcy and serum Vit-A in relation to incident acute myocardial infarction. Methods Cox proportional hazards models were used to assess the prospective relationships between tHcy and acute myocardial infarction in 2205 patients from Western Norway undergoing elective coronary angiography for suspected stable angina pectoris. Results are reported as hazard ratio per standard deviation increase in log-transformed tHcy. An interaction term for tHcy × Vit-A was added to multivariate models including age, sex, smoking, apolipoprotein B fasting, statin and aspirin prescription and estimated glomerular filtration rate. Results Geometric mean (geometric standard deviation) age of the participants (64.3% men) was 62.3 (1.24) years. Plasma tHcy was higher among participants in the upper versus lower Vit-A tertile. During 7 (2.4) years of follow-up, 15.1% suffered an AMI. A significant association of plasma tHcy with AMI in the total study population was observed. When we stratified the population according to Vit-A tertiles, plasma tHcy was associated with acute myocardial infarction only in the upper Vit-A tertile (hazard ratio per SD: 1.25, 95% confidence interval: 1.04–1.53, pinteraction = 0.03). Conclusions The risk relationship between plasma tHcy and acute myocardial infarction was modified by serum concentrations of Vit-A in patients with suspected stable angina pectoris. This finding may clarify the relationship between tHcy and cardiovascular disease.
Collapse
Affiliation(s)
- Thomas Olsen
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Kathrine J Vinknes
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Gard FT Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Centre for Diabetes Research, University of Bergen, Norway
| | - Indu Dhar
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Division of Mental and Physical Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Rune Blomhoff
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
- Department of Clinical Service, Division of Cancer Medicine, Oslo University Hospital, Norway
| | - Per M Ueland
- Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
- Bevital AS, Bergen, Norway
| | | | - Helga Refsum
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Norway
| | - Ottar K Nygård
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Centre for Diabetes Research, University of Bergen, Norway
- Department of Clinical Science, Faculty of Medicine, University of Bergen, Norway
| |
Collapse
|
29
|
Zuo H, Nygård O, Ueland PM, Vollset SE, Svingen GFT, Pedersen ER, Midttun Ø, Meyer K, Nordrehaug JE, Nilsen DWT, Tell GS. Association of plasma neopterin with risk of an inpatient hospital diagnosis of atrial fibrillation: results from two prospective cohort studies. J Intern Med 2018; 283:578-587. [PMID: 29573355 DOI: 10.1111/joim.12748] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Link between inflammation and atrial fibrillation (AF) has been increasingly recognized. Neopterin, a biomarker of cellular immune activation, may be associated with incident AF. OBJECTIVE To investigate the association between plasma neopterin levels and risk of an inpatient hospital diagnosis of AF, and to evaluate a joint association of neopterin and a nonspecific inflammatory marker C-reactive protein (CRP) in two prospective cohorts. METHODS We performed a prospective analysis from a community-based cohort (the Hordaland Health Study (HUSK), n = 6891), and validated the findings in a cohort of patients with suspected stable angina pectoris (the Western Norway Coronary Angiography Cohort (WECAC), n = 2022). RESULTS In both cohorts, higher plasma levels of neopterin were associated with an increased risk of incident AF after adjustment for age, sex, body mass index, current smoking, diabetes, hypertension and renal function. The multivariable-adjusted hazard ratio (HR) (95% CI) per one SD increment of log-transformed neopterin was 1.20 (1.10-1.32) in HUSK and 1.26 (1.09-1.44) in WECAC. Additional adjustment for CRP did not materially affect the risk association for neopterin. The highest risk of AF was found among individuals with both neopterin and CRP levels above the median (HR: 1.54; 95% CI: 1.16-2.05 in HUSK and HR: 1.67; 95% CI: 1.11-2.52 in WECAC). CONCLUSIONS Our findings indicate an association of plasma neopterin with risk of an inpatient hospital diagnosis of AF, which remains after adjustment for traditional risk factors as well as for CRP. This study highlights a role of cellular immune activation, in addition to inflammation, in AF pathogenesis.
Collapse
Affiliation(s)
- H Zuo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - P M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - S E Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,The Norwegian Institute of Public Health, Bergen, Norway
| | - G F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - E R Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | | | - J E Nordrehaug
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - D W T Nilsen
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Non-communicable Diseases, Norwegian Institute of Public Health, Bergen, Norway
| |
Collapse
|
30
|
Sulo G, Igland J, Vollset SE, Ebbing M, Egeland GM, Ariansen I, Tell GS. Trends in incident acute myocardial infarction in Norway: An updated analysis to 2014 using national data from the CVDNOR project. Eur J Prev Cardiol 2018; 25:1031-1039. [PMID: 29808757 DOI: 10.1177/2047487318780033] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background We updated the information on trends of incident acute myocardial infarction in Norway, focusing on whether the observed trends during 2001-2009 continued throughout 2014. Methods All incident (first) acute myocardial infarctions in Norwegian residents age 25 years and older were identified in the Cardiovascular Disease in Norway 1994-2014 project. We analysed overall and age group-specific (25-64 years, 65-84 years and 85 + years) trends by gender using Poisson regression analyses and report the average annual changes in rates with their 95% confidence intervals. Results During 2001-2014, 221,684 incident acute myocardial infarctions (59.4% men) were identified. Hospitalised cases accounted for 79.9% of all incident acute myocardial infarctions. Overall, incident acute myocardial infarction rates declined on average 2.6% per year (incidence rate ratio 0.974, 95% confidence interval 0.972-0.977) in men and 2.8% per year (incidence rate ratio 0.972, 95% confidence interval 0.971-0.974) in women, contributed by declining rates of hospitalisations (1.8% and 1.9% per year in men and women, respectively) and deaths (6.0% and 5.8% per year in men and women, respectively). Declining rates were observed in all three age groups. The overall acute myocardial infarction incidence rates continued to decline from 2009 onwards, with a steeper decline compared to 2001-2009. During 2009-2014, gender-adjusted acute myocardial infarction incidence among adults age 25-44 years declined 5.3% per year, contributed mostly by declines in hospitalisation rates (5.1% per year). Conclusion Acute myocardial infarction incidence rates continued to decline after 2009 in Norway in both men and women. The decline started to involve individuals aged 25-44 years, marking a turning point in the previously reported stagnation of rates during 2001-2009.
Collapse
Affiliation(s)
- Gerhard Sulo
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Jannicke Igland
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Stein Emil Vollset
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway.,2 Centre for Disease Burden, Norwegian Institute of Public Health, Norway
| | - Marta Ebbing
- 3 Department of Health Registries, Norwegian Institute of Public Health, Norway
| | - Grace M Egeland
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway.,3 Department of Health Registries, Norwegian Institute of Public Health, Norway
| | - Inger Ariansen
- 4 Division of Mental and Physical Health, Norwegian Institute of Public Health, Norway
| | - Grethe S Tell
- 1 Department of Global Public Health and Primary Care, University of Bergen, Norway.,4 Division of Mental and Physical Health, Norwegian Institute of Public Health, Norway
| |
Collapse
|
31
|
Zuo H, Svingen GFT, Tell GS, Ueland PM, Vollset SE, Pedersen ER, Ulvik A, Meyer K, Nordrehaug JE, Nilsen DWT, Bønaa KH, Nygård O. Plasma Concentrations and Dietary Intakes of Choline and Betaine in Association With Atrial Fibrillation Risk: Results From 3 Prospective Cohorts With Different Health Profiles. J Am Heart Assoc 2018; 7:JAHA.117.008190. [PMID: 29650710 PMCID: PMC6015426 DOI: 10.1161/jaha.117.008190] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Background Although choline metabolism has been associated with atherosclerotic heart disease, less research attention has been paid to the associations of choline and its oxidative metabolite betaine with cardiac arrhythmias. Methods and Results We evaluated associations of plasma concentrations and dietary intakes of choline and betaine with long‐term atrial fibrillation (AF) risk in a community‐based cohort, HUSK ([the Hordaland Health Study] n=6949), and validated the findings in 2 patient cohorts: the Western Norway Coronary Angiography Cohort (n=4164) and the NORVIT (Norwegian B‐Vitamin) Trial (n=3733). Information on AF was obtained from the CVDNOR (Cardiovascular Disease in Norway) project. In HUSK, WECAC (Western Norway Coronary Angiography Cohort), and NORVIT, 552, 411, and 663 AF cases were identified during a median follow‐up time of 10.9, 7.3, and, 8.7 years, respectively. Plasma concentrations of choline and betaine were significantly positively associated with later AF risk after multivariable adjustments in HUSK. Such associations were independently replicated in the 2 external prospective patient cohorts. The pooled hazard ratio was 1.13 (95% confidence interval 1.08‐1.19, P<0.001) and 1.16 (95% confidence interval 1.10‐1.22, P<0.001) per SD increment for log‐transformed choline and betaine, respectively. Moreover, dietary intake of choline was marginally associated with AF risk (pooled hazard ratio 1.29, 95% confidence interval 1.01‐1.66, fifth versus first quintile), whereas no significant association was observed between dietary betaine and AF risk. Conclusions Our findings indicate that plasma concentrations as well as dietary intake of choline, but not betaine, are associated with subsequent risk of AF, suggesting a potential role of choline metabolism in the pathogenesis of AF. Clinical Trial Registration URL: https://www.clinicaltrials.gov.Unique identifier: NCT00671346.
Collapse
Affiliation(s)
- Hui Zuo
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Gard F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Division of Mental and Physical Health, Department of Noncommunicable Diseases, Norwegian Institute of Public Health, Bergen, Norway
| | - Per M Ueland
- Department of Clinical Science, University of Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | - Stein E Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Centre for Burden of Disease, Norwegian Institute of Public Health, Bergen, Norway
| | - Eva R Pedersen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | | | | | - Jan E Nordrehaug
- Department of Clinical Science, University of Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Dennis W T Nilsen
- Department of Clinical Science, University of Bergen, Norway.,Department of Cardiology, Stavanger University Hospital, Stavanger, Norway
| | - Kaare H Bønaa
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Community Medicine, The Arctic University of Norway, Tromsø, Norway.,Clinic for Heart Disease, St. Olav's University Hospital, Trondheim, Norway
| | - Ottar Nygård
- Department of Clinical Science, University of Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| |
Collapse
|
32
|
Strand E, Rebnord EW, Flygel MR, Lysne V, Svingen GFT, Tell GS, Løland KH, Berge RK, Svardal A, Nygård O, Pedersen ER. Serum Carnitine Metabolites and Incident Type 2 Diabetes Mellitus in Patients With Suspected Stable Angina Pectoris. J Clin Endocrinol Metab 2018; 103:1033-1041. [PMID: 29325058 DOI: 10.1210/jc.2017-02139] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Accepted: 01/04/2018] [Indexed: 02/13/2023]
Abstract
CONTEXT Carnitine and its metabolites are centrally involved in fatty acid metabolism. Although elevated circulating concentrations have been observed in obesity and insulin resistance, prospective studies examining whether these metabolites are associated with incident type 2 diabetes mellitus (T2D) are sparse. OBJECTIVE We performed a comprehensive evaluation of metabolites along the carnitine pathway relative to incident T2D. DESIGN A total of 2519 patients (73.1% men) with coronary artery disease, but without T2D, were followed for median 7.7 years until the end of 2009, during which 173 (6.9%) new cases of T2D were identified. Serum levels of free carnitine, its precursors trimethyllysine (TML) and γ-butyrobetaine, and the esters acetyl-, propionyl-, (iso)valeryl-, octanoyl-, and palmitoylcarnitine were measured by liquid chromatography/tandem mass spectrometry. Risk associations were explored by logistic regression and reported per (log-transformed) standard deviation increment. RESULTS Median age at inclusion was 62 years and median body mass index (BMI) 26.0 kg/m2. In models adjusted for age, sex, fasting status, BMI, estimated glomerular filtration rate, glycated hemoglobin A1c, triglyceride and high-density lipoprotein cholesterol levels, and study center, serum levels of TML and palmitoylcarnitine associated positively [odds ratio (95% confidence interval), 1.22 (1.04 to 1.43) and 1.24 (1.04 to 1.49), respectively], whereas γ-butyrobetaine associated negatively [odds ratio (95% confidence interval) 0.81 (0.66 to 0.98)] with T2D risk. CONCLUSION Serum levels of TML, γ-butyrobetaine, and the long-chained palmitoylcarnitine predict long-term risk of T2D independently of traditional risk factors, possibly reflecting dysfunctional fatty acid metabolism in patients susceptible to T2D development.
Collapse
Affiliation(s)
- Elin Strand
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Eirik W Rebnord
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Malin R Flygel
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Vegard Lysne
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Gard F T Svingen
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Kjetil H Løland
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Rolf K Berge
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Asbjørn Svardal
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
| | - Ottar Nygård
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Eva R Pedersen
- Department of Clinical Science, University of Bergen, Haukeland University Hospital, Bergen, Norway
- KG Jebsen Center for Diabetes Research, University of Bergen, Children and Youth Hospital, Bergen, Norway
| |
Collapse
|
33
|
Foreword by the Guest Editors of the new section of the IJC, “Migration and cardiovascular disease”. Int J Cardiol 2018; 254:353-355. [DOI: 10.1016/j.ijcard.2017.12.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 12/06/2017] [Indexed: 11/20/2022]
|
34
|
Zuo H, Tell GS, Ueland PM, Nygård O, Vollset SE, Midttun Ø, Meyer K, Ulvik A. The PAr index, an indicator reflecting altered vitamin B-6 homeostasis, is associated with long-term risk of stroke in the general population: the Hordaland Health Study (HUSK). Am J Clin Nutr 2018; 107:105-112. [PMID: 29381795 PMCID: PMC5972613 DOI: 10.1093/ajcn/nqx012] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 10/19/2017] [Indexed: 12/15/2022] Open
Abstract
Background Vitamin B-6 homeostasis is altered during inflammation and immune activation. It is unknown whether altered vitamin B-6 homeostasis is associated with the risk of stroke. Objective We investigated the relation between the ratio plasma 4-pyridoxic acid: (pyridoxal + pyridoxal-5'-phosphate) (PAr) as an indicator of altered vitamin B-6 homeostasis and the risk of stroke in the general population. Design We conducted a prospective analysis of the community-based Hordaland Health Study (HUSK) in 6891 adults (born during 1925-1927 and 1950-1951) without known stroke at baseline (1998-1999). Participants were followed via linkage to the CVDNOR (Cardiovascular Disease in Norway) project and the Cause of Death Registry. HRs and 95% CIs were calculated using Cox proportional hazards analyses. Results A total of 390 participants (193 men and 197 women) developed stroke over a median follow-up period of 11 y. Study participants with elevated PAr experienced a higher risk of incident stroke in an essentially linear dose-response fashion. The HR (95% CI) for the highest compared with the lowest quartile of PAr was 1.97 (1.42, 2.73; P-trend <0.001) for total stroke and 2.09 (1.42, 3.09; P-trend <0.001) for ischemic stroke after adjustment for age, sex, body mass index (BMI), smoking, education, physical activity, estimated glomerular filtration rate, hypertension, diabetes, total cholesterol, and statin use. PAr had greater predictive strength than did C-reactive protein, current smoking, diabetes, hypertension, estimated glomerular filtration rate, and physical activity. The associations were similar in subgroups stratified by age group, sex, BMI, current smoking, hypertension, diabetes, and statin use at baseline. Conclusions Higher plasma PAr was independently associated with increased risk of incident stroke in all participants and across all subgroups stratified by conventional risk predictors. Our novel findings point to and expand the range of inflammation and immune activation processes that may be relevant for the pathogenesis and prevention of stroke. This trial was registered at clinicaltrials.gov as NCT03013725.
Collapse
Affiliation(s)
- Hui Zuo
- Departments of Global Public Health and Primary Care and Clinical Science, University of Bergen, Bergen, Norway,Address correspondence to HZ (e-mail: )
| | - Grethe S Tell
- Departments of Global Public Health and Primary Care and Clinical Science, University of Bergen, Bergen, Norway,Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
| | - Per M Ueland
- Departments of Clinical Science, University of Bergen, Bergen, Norway,Laboratory of Clinical Biochemistry
| | - Ottar Nygård
- Departments of Clinical Science, University of Bergen, Bergen, Norway,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Stein E Vollset
- Departments of Global Public Health and Primary Care and Clinical Science, University of Bergen, Bergen, Norway,The Norwegian Institute of Public Health, Bergen, Norway
| | | | | | | |
Collapse
|
35
|
Zuo H, Nygård O, Vollset SE, Ueland PM, Ulvik A, Midttun Ø, Meyer K, Igland J, Sulo G, Tell GS. Smoking, plasma cotinine and risk of atrial fibrillation: the Hordaland Health Study. J Intern Med 2018; 283:73-82. [PMID: 28940460 DOI: 10.1111/joim.12689] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cigarette smoking has been identified as a major modifiable risk factor for coronary heart disease and mortality. However, findings on the relationship between smoking and atrial fibrillation (AF) have been inconsistent. Furthermore, findings from previous studies were based on self-reported smoking. OBJECTIVE To examine the associations of smoking status and plasma cotinine levels, a marker of nicotine exposure, with risk of incident AF in the Hordaland Health Study. METHODS We conducted a prospective analysis of 6682 adults aged 46-74 years without known AF at baseline. Participants were followed via linkage to the Cardiovascular Disease in Norway (CVDNOR) project and the Cause of Death Registry. Smoking status was assessed by both questionnaire and plasma cotinine levels. RESULTS A total of 538 participants developed AF over a median follow-up period of 11 years. Using questionnaire data, current smoking (HR: 1.41, 95% CI: 1.09-1.83), but not former smoking (HR: 1.03, 95% CI: 0.83-1.28), was associated with an increased risk of AF after adjustment for gender, age, body mass index, hypertension, physical activity and education. Using plasma cotinine only, the adjusted HR (95% CI) was 1.40 (1.12-1.75) for participants with cotinine ≥85 nmol L-1 compared to those with cotinine <85 nmol L-1 . However, the risk increased with elevated plasma cotinine levels until 1199 nmol L-1 (HR: 1.55, 95% CI: 1.16-2.05 at the third group vs. the reference group) and plateaued at higher levels. CONCLUSIONS Current, but not former smokers, had a higher risk of developing AF. Use of plasma cotinine measurement corroborated this finding.
Collapse
Affiliation(s)
- H Zuo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - O Nygård
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - S E Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,The Norwegian Institute of Public Health, Bergen, Norway
| | - P M Ueland
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Laboratory of Clinical Biochemistry, Haukeland University Hospital, Bergen, Norway
| | | | | | | | - J Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - G Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - G S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Bergen, Norway
| |
Collapse
|
36
|
Rabanal KS, Meyer HE, Tell GS, Igland J, Pylypchuk R, Mehta S, Kumar B, Jenum AK, Selmer RM, Jackson R. Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies. BMJ Open 2017; 7:e016819. [PMID: 29217719 PMCID: PMC5728264 DOI: 10.1136/bmjopen-2017-016819] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES The objective was to prospectively examine potential differences in the risk of first cardiovascular disease (CVD) events between South Asians and Europeans living in Norway and New Zealand, and to investigate whether traditional risk factors could explain any differences. METHODS We included participants (30-74 years) without prior CVD in a Norwegian (n=16 606) and a New Zealand (n=129 449) cohort. Ethnicity and cardiovascular risk factor information was linked with hospital registry data and cause of death registries to identify subsequent CVD events. We used Cox proportional hazards regression to investigate the relationship between risk factors and subsequent CVD for South Asians and Europeans, and to calculate age-adjusted HRs for CVD in South Asians versus Europeans in the two cohorts separately. We sequentially added the major CVD risk factors (blood pressure, lipids, diabetes and smoking) to study their explanatory role in observed ethnic CVD risk differences. RESULTS South Asians had higher total cholesterol (TC)/high-density lipoprotein (HDL) ratio and more diabetes at baseline than Europeans, but lower blood pressure and smoking levels. South Asians had increased age-adjusted risk of CVD compared with Europeans (87%-92% higher in the Norwegian cohort and 42%-75% higher in the New Zealand cohort) and remained with significantly increased risk after adjusting for all major CVD risk factors. Adjusted HRs for South Asians versus Europeans in the Norwegian cohort were 1.57 (95% CI 1.19 to 2.07) in men and 1.76 (95% CI 1.09 to 2.82) in women. Corresponding figures for the New Zealand cohort were 1.64 (95% CI 1.43 to 1.88) in men and 1.39 (95% CI 1.11 to 1.73) in women. CONCLUSION Differences in TC/HDL ratio and diabetes appear to explain some of the excess risk of CVD in South Asians compared with Europeans. Preventing dyslipidaemia and diabetes in South Asians may therefore help reduce their excess risk of CVD.
Collapse
Affiliation(s)
- Kjersti S Rabanal
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Haakon E Meyer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Community Medicine, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Grethe S Tell
- Division for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Romana Pylypchuk
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Suneela Mehta
- School of Population Health, University of Auckland, Auckland, New Zealand
| | | | - Anne Karen Jenum
- Faculty of Health and Society, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Randi M Selmer
- Division for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Rod Jackson
- School of Population Health, University of Auckland, Auckland, New Zealand
| |
Collapse
|
37
|
Nedkoff L, Lopez D, Goldacre M, Sanfilippo F, Hobbs M, Wright FL. Identification of myocardial infarction type from electronic hospital data in England and Australia: a comparative data linkage study. BMJ Open 2017; 7:e019217. [PMID: 29133337 PMCID: PMC5695341 DOI: 10.1136/bmjopen-2017-019217] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Revised: 09/24/2017] [Accepted: 09/29/2017] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVE To determine the utility of International Classification of Diseases (ICD) codes in investigating trends in ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) using person-linked electronic hospitalisation data in England and Western Australia (WA). METHODS All hospital admissions with myocardial infarction (MI) as the principal diagnosis were identified from 2000 to 2013 from both jurisdictions. Fourth-digit ICD-10 codes were used to delineate all MI types-STEMI, NSTEMI, unspecified and subsequent MI. The annual frequency of each MI type was calculated as a proportion of all MI admissions. For all MI and each MI type, age-standardised rates were calculated and age-adjusted Poisson regression models used to estimate annual percentage changes in rates. RESULTS In 2000, STEMI accounted for 49% of all MI admissions in England and 59% in WA, decreasing to 35% and 25% respectively by 2013. Less than 10% of admissions were recorded as NSTEMI in England throughout the study period, whereas by 2013, 70% of admissions were NSTEMI in WA. Unspecified MI comprised 60% of all MI admissions in England by 2013, compared with <1% in WA. Trends in age-standardised rates differed for all MI (England, -2.7%/year; WA, +1.7%/year), underpinned by differing age-adjusted trends in NSTEMI (England, -6.1%/year; WA, +10.2%/year). CONCLUSION Differences between the proportion and trends for MI types in English and WA data were observed. These were consistent with the coding standards in each country. This has important implications for using electronic hospital data for monitoring MI and identifying MI types for outcome studies.
Collapse
Affiliation(s)
- Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Derrick Lopez
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Michael Goldacre
- Unit of Health-Care Epidemiology, Nuffield Department of Public Health, University of Oxford, Oxford, UK
| | - Frank Sanfilippo
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Michael Hobbs
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - F Lucy Wright
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
38
|
|
39
|
Increased risk of heart failure and atrial fibrillation in heterozygous familial hypercholesterolemia. Atherosclerosis 2017; 266:69-73. [PMID: 28992466 DOI: 10.1016/j.atherosclerosis.2017.09.027] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/15/2017] [Accepted: 09/27/2017] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS Heart failure (HF) and atrial fibrillation/flutter (AF) are important causes of morbidity and mortality. Subjects with familial hypercholesterolemia (FH) carry a high risk of coronary artery disease (CAD) but it is not known if the risk of HF and AF is increased in FH. The present study investigated the incidence of hospitalization for HF and AF in a genetically verified FH cohort, age 25 years and older, compared to the general population. METHODS Incidence rates of hospitalization for HF and AF were estimated from national registry data. Standardized incidence ratios (SIRs) were calculated. RESULTS 4273 genotyped FH patients (51.7% women) with a total observation period of 18,300 patient years were studied. Overall, the expected number of FH patients with HF was 27.7 and the observed number of cases was 54 (SIR (95% CI) 2.0 (1.5-2.6)). The highest excess risk was observed in the age group 25-49 years, where SIRs were 3.8 (1.2-11.8) and 4.2 (2.0-8.8) in women and men, respectively. The total expected number of FH patients with AF was 39.4 while the observed number of cases was 77 (SIR 2.0 (1.6-2.4)). Among FH patients with an incident event of HF, nearly 90% had a previous diagnosis of CAD, and nearly 40% had suffered from a myocardial infarction. CONCLUSIONS We demonstrate a doubling of the risk of hospitalization for HF or AF in patients with FH. This is could have an important prognostic impact for patients and economic impact for the society.
Collapse
|
40
|
Saner H, Mollet JD, Berlin C, Windecker S, Meier B, Räber L, Zwahlen M, Stute P. No significant gender difference in hospitalizations for acute coronary syndrome in Switzerland over the time period of 2001 to 2010. Int J Cardiol 2017; 243:59-64. [DOI: 10.1016/j.ijcard.2017.05.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/21/2017] [Accepted: 05/09/2017] [Indexed: 11/29/2022]
|
41
|
Davies AJ, Naudin C, Al-Omary M, Khan A, Oldmeadow C, Jones M, Bastian B, Bhagwandeen R, Fletcher P, Leitch J, Boyle A. Disparities in the incidence of acute myocardial infarction: long-term trends from the Hunter region. Intern Med J 2017; 47:557-562. [DOI: 10.1111/imj.13399] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2016] [Revised: 01/14/2017] [Accepted: 02/09/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Allan J. Davies
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
| | - Crystal Naudin
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
| | - Mohammed Al-Omary
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - Arshad Khan
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
| | - Chris Oldmeadow
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - Mark Jones
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - Bruce Bastian
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
| | - Rohan Bhagwandeen
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
| | - Peter Fletcher
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - James Leitch
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| | - Andrew Boyle
- Cardiovascular Department; John Hunter Hospital; Newcastle New South Wales Australia
- School of Medicine and Public Health; University of Newcastle; Newcastle New South Wales Australia
- Hunter Medical Research Institute; Newcastle New South Wales Australia
| |
Collapse
|
42
|
Sulo G, Igland J, Nygård O, Vollset SE, Ebbing M, Poulter N, Egeland GM, Cerqueira C, Jørgensen T, Tell GS. Prognostic Impact of In-Hospital and Postdischarge Heart Failure in Patients With Acute Myocardial Infarction: A Nationwide Analysis Using Data From the Cardiovascular Disease in Norway (CVDNOR) Project. J Am Heart Assoc 2017; 6:JAHA.116.005277. [PMID: 28298373 PMCID: PMC5524033 DOI: 10.1161/jaha.116.005277] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Heart failure (HF) is a serious complication of acute myocardial infarction (AMI). We explored the excess mortality associated with HF as an early or late complication of AMI and describe changes over time in such excess mortality. METHODS AND RESULTS All patients hospitalized with an incident AMI and without history of prior HF hospitalization were followed up to 1 year after AMI discharge for episodes of HF. New HF episodes were classified as in-hospital HF if diagnosed during the AMI hospitalization or postdischarge HF if diagnosed within 1 year after discharge from the incident AMI. Logistic and Cox regression models were used to explore the excess mortality associated with HF categories. Changes over time in the excess mortality were assessed by testing the interaction between HF status and study year. In-hospital HF increased in-hospital mortality 1.79 times (odds ratio [OR], 1.79; 95% CI: 1.68-1.91). The excess mortality associated with HF increased by 4.3 times from 2001 to 2009 (P interaction<0.001) as a consequence of a greater decline of in-hospital mortality among AMI patients without (9% per year) compared to those with in-hospital HF (3% per year). Postdischarge HF increased all-cause and CVD mortality 5.98 times (hazard ratio, 5.98; 95% CI: 5.39-6.64) and 7.93 times (subhazard ratio, 7.93; 95% CI: 6.84 -9.19), respectively. The relative excess 1-year mortality associated with HF did not change significantly over time. CONCLUSIONS Development of HF-either as an early or late complication of AMI-has a negative impact on patients' survival. Changes in the excess mortality associated with HF are driven by modest improvements in survival among AMI patients with HF as compared to those without HF.
Collapse
Affiliation(s)
- Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Ottar Nygård
- Department of Clinical Science, University of Bergen, Norway.,Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Centre for Burden of Disease, Norwegian Institute of Public Health, Bergen, Norway
| | - Marta Ebbing
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway
| | - Neil Poulter
- International Centre for Circulatory Health and Imperial Clinical Trials Unit, National Heart and Lung Institute and School of Public Health, Imperial College, London, United Kingdom
| | - Grace M Egeland
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway
| | - Charlotte Cerqueira
- Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark
| | - Torben Jørgensen
- Research Centre for Prevention and Health, Capital Region, Copenhagen, Denmark.,Department of Public Health, Institute of Clinical Science, University of Copenhagen, Denmark.,Faculty of Medicine, University of Aalborg, Denmark
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway.,Domain for Health Data and Digitalization, Department of Health Registry Research, Norwegian Institute of Public Health, Bergen, Norway
| |
Collapse
|
43
|
Trends in the risk of early and late-onset heart failure as an adverse outcome of acute myocardial infarction: A Cardiovascular Disease in Norway project. Eur J Prev Cardiol 2017; 24:971-980. [DOI: 10.1177/2047487317698568] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
44
|
Selmer R, Igland J, Ariansen I, Tverdal A, Njølstad I, Furu K, Tell GS, Klemsdal TO. NORRISK 2: A Norwegian risk model for acute cerebral stroke and myocardial infarction. Eur J Prev Cardiol 2017; 24:773-782. [PMID: 28206819 DOI: 10.1177/2047487317693949] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background Guidelines for the prevention of cardiovascular disease recommend the estimation of an individual's total risk. We have developed a new model for the prediction of the 10-year risk of incident acute myocardial infarction or cerebral stroke based on Norwegian data, NORRISK 2. Design The model was based on 10-year follow-up of a large population-based cohort (CONOR) through linkage to the CVDNOR project, a database of cardiovascular disease hospital discharge diagnoses and mortality in Norway in 1994-2009. Methods We used the Fine and Gray regression model to estimate the 10-year risk adjusting for competing risk. The model population consisted of participants in 1994-1999 and the external validation population of participants in 2000-2003. We validated the model by area under the receiver operating characteristic curves, calibration plots and analyses of sensitivity and specificity. Results The model population consisted of 31,445 men and 35,267 women aged 40-79 years with 3658 endpoints in men and 2459 in women. The external validation population consisted of 19,980 men and 19,309 women, of whom 1858 men and 874 women had an endpoint during follow-up. The area under the curve was 0.79 (0.79-0.80) in men and 0.84 (0.83-0.85) in women in the model population and was slightly lower in the external validation population. Calibration plots showed good agreement between observed and predicted risk. The sum of sensitivity and specificity was greatest around the suggested risk thresholds. Conclusion The NORRISK 2 model showed good validity in an external dataset and will be a valuable tool to guide decisions about preventive interventions in people without known previous cardiovascular disease.
Collapse
Affiliation(s)
| | - Jannicke Igland
- 2 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | | | | | | | - Kari Furu
- 1 Norwegian Institute of Public Health, Norway
| | - Grethe S Tell
- 1 Norwegian Institute of Public Health, Norway.,2 Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Tor Ole Klemsdal
- 4 Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Norway
| |
Collapse
|
45
|
Abstract
With observational epidemiological studies it has been possible in the 1950-60 s to identify what has been called cardiovascular risk factors. The multifactorial origin of atherothrombotic cardiovascular disease has been elucidated and in multifactorial intervention trials it was demonstrated that lifestyle changes related to smoking, diet and exercise can prevent the incidence of premature cardiovascular events. The application of that knowledge at the level of the community has resulted in a reversal of the cardiovascular disease epidemic. More investment is needed in the prevention of the development of cardiovascular risk from childhood onwards. More studies are needed to examine the long-term effects of low-intensity exposure to environmental factors on the cardiovascular system using the most appropriate study design and biosensors. More epidemiological studies are needed to evaluate societal changes on cardiovascular disease. Given the actual knowledge on how to prevent cardiovascular disease there is a need for a shift from aetiological epidemiological research into preventive research.
Collapse
Affiliation(s)
- Guy De Backer
- Department of Public Health, Ghent University, Belgium
| |
Collapse
|
46
|
Berge LI, Skogen JC, Sulo G, Igland J, Wilhelmsen I, Vollset SE, Tell GS, Knudsen AK. Health anxiety and risk of ischaemic heart disease: a prospective cohort study linking the Hordaland Health Study (HUSK) with the Cardiovascular Diseases in Norway (CVDNOR) project. BMJ Open 2016; 6:e012914. [PMID: 27810977 PMCID: PMC5129078 DOI: 10.1136/bmjopen-2016-012914] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The risk of ischaemic heart disease (IHD) is largely influenced by lifestyle. Interestingly, cohort studies show that anxiety in general is associated with increased risk of IHD, independent of established risk factors for cardiovascular disease. Health anxiety is a specific type of anxiety characterised by preoccupation of having, acquiring or possibly avoiding illness, yet little is known about lifestyle and risk of disease development in this group. AIM Investigate whether health anxiety is prospectively associated with IHD, and whether a potential association can be explained by the presence or absence of established risk factors for cardiovascular diseases. METHODS Incident IHD was studied among 7052 participants in the community-based Hordaland Health Study (HUSK) during 12 years follow-up by linkage to the Cardiovascular Diseases in Norway (CVDNOR) project. Scores above 90th centile of the Whiteley Index defined health anxiety cases. Associations were examined with the Cox proportional regression models. RESULTS During follow-up, 6.1% of health anxiety cases developed IHD compared with 3.0% of non-cases, yielding a gender-adjusted HR of 2.12 (95% CI 1.52 to 2.95). After adjustments for established cardiovascular risk factors, about 70% increased risk of IHD was found among cases with health anxiety (HR: 1.73 (95% CI 1.21 to 2.48)). The association followed a dose-response pattern. CONCLUSIONS This finding corroborates and extends the understanding of anxiety in various forms as a risk factor for IHD. New evidence of negative consequences over time underlines the importance of proper diagnosis and treatment for health anxiety.
Collapse
Affiliation(s)
- Line Iden Berge
- Division of Psychiatry, Helse-Bergen, Sandviken University Hospital, Bergen, Norway
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | | | - Gerhard Sulo
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Jannicke Igland
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Ingvard Wilhelmsen
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Haraldsplass Deaconal University Hospital, Bergen, Norway
| | - Stein Emil Vollset
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Bergen, Norway
| | - Grethe S Tell
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Ann Kristin Knudsen
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
- Norwegian Institute of Public Health, Bergen, Norway
| |
Collapse
|
47
|
Mundal L, Veierød MB, Halvorsen T, Holven KB, Ose L, Iversen PO, Tell GS, Leren TP, Retterstøl K. Cardiovascular disease in patients with genotyped familial hypercholesterolemia in Norway during 1994–2009, a registry study. Eur J Prev Cardiol 2016; 23:1962-1969. [DOI: 10.1177/2047487316666371] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Liv Mundal
- The Lipid Clinic, Oslo University Hospital Rikshospitalet, Norway
| | - Marit B Veierød
- Department of Nutrition, University of Oslo, Norway
- Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Norway
| | - Thomas Halvorsen
- Department of Health Research, SINTEF Technology and Society, Norway
| | - Kirsten B Holven
- Department of Nutrition, University of Oslo, Norway
- National Advisory Unit for Familial Hypercholesterolemia, Oslo University Hospital, Norway
| | - Leiv Ose
- Department of Nutrition, University of Oslo, Norway
| | - Per Ole Iversen
- Department of Nutrition, University of Oslo, Norway
- Department of Hematology, Oslo University Hospital Rikshospitalet, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Department of Health Registries, Norwegian Institute of Public Health, Norway
| | - Trond P Leren
- Unit for Cardiac and Cardiovascular Genetics, Oslo University Hospital Ullevaal, Norway
| | - Kjetil Retterstøl
- The Lipid Clinic, Oslo University Hospital Rikshospitalet, Norway
- Department of Nutrition, University of Oslo, Norway
| |
Collapse
|
48
|
Jortveit J, Leirgul E, Eskedal L, Greve G, Fomina T, Døhlen G, Tell GS, Birkeland S, Øyen N, Holmstrøm H. Mortality and complications in 3495 children with isolated ventricular septal defects. Arch Dis Child 2016; 101:808-13. [PMID: 27091847 DOI: 10.1136/archdischild-2015-310154] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Accepted: 03/28/2016] [Indexed: 11/04/2022]
Abstract
BACKGROUND Ventricular septal defects (VSDs) are the most common congenital heart defects (CHDs). Previous studies indicate an increased risk of endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension, arrhythmias and sudden death in patients with isolated VSDs. The present nationwide cohort study reports mortality and cardiac complications requiring hospitalisation or intervention in children with isolated VSDs. METHODS AND RESULTS Medical information concerning all 943 871 live births in Norway in 1994-2009 was retrieved from the Medical Birth Registry of Norway, the Cardiovascular Disease in Norway project, the Oslo University Hospital's Clinical Registry of Congenital Heart Defects and the Norwegian Cause of Death Registry. Isolated VSDs were identified in 3495 children without known chromosomal aberrations or extracardiac malformations. Surgical or catheter-based treatment of VSD was performed in 181 (5.2%) cases. Twelve (0.3%) children with VSDs died before 2013. There was no operative mortality, and no excess mortality in children with isolated VSDs compared with children without VSDs (adjusted HR 0.8 (0.5 to 1.4), p=0.48). The following conditions were recorded as possible cardiac complications of the VSDs: endocarditis in 3 children (0.9‰), aortic regurgitation in 12 children (3.4‰), left ventricular outflow tract obstructions in no children (0.0‰), pulmonary hypertension in 1 child (0.3‰) and arrhythmias in 16 children (4.6‰). CONCLUSIONS The entire group of children with isolated VSDs had a favourable prognosis without excess mortality. Cardiac complications requiring hospitalisation or intervention, including endocarditis, aortic regurgitation, left ventricular outflow tract obstructions, pulmonary hypertension and arrhythmias, were infrequent during childhood. TRIAL REGISTRATION NUMBER NCT02026557.
Collapse
Affiliation(s)
- Jarle Jortveit
- Department of Cardiology, Sørlandet, Arendal, Norway Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elisabeth Leirgul
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Leif Eskedal
- Department of Research, Sørlandet Hospital, Kristiansand, Norway
| | - Gottfried Greve
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Department of Medical Science, University of Bergen, Bergen, Norway
| | - Tatiana Fomina
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Gaute Døhlen
- Women's and Children's Department, Oslo University Hospital, Oslo, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Division of epidemiology, Norwegian Institute of Public Health, Bergen, Norway
| | - Sigurd Birkeland
- Department of Cardiothoracic Surgery, Oslo University Hospital, Oslo, Norway
| | - Nina Øyen
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Henrik Holmstrøm
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway Women's and Children's Department, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
49
|
Sulo G, Nygård O, Vollset SE, Igland J, Ebbing M, Sulo E, Egeland GM, Tell GS. Higher education is associated with reduced risk of heart failure among patients with acute myocardial infarction: A nationwide analysis using data from the CVDNOR project. Eur J Prev Cardiol 2016; 23:1743-1750. [DOI: 10.1177/2047487316655910] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 06/01/2016] [Indexed: 01/30/2023]
Affiliation(s)
- Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Norway
| | - Ottar Nygård
- Department of Clinical Science, University of Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Centre for Burden of Disease, Norwegian Institute of Public Health, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Marta Ebbing
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Norway
| | - Enxhela Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Grace M Egeland
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Norway
| | - Grethe S Tell
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Domain for Health Data and Digitalization, Norwegian Institute of Public Health, Norway
| |
Collapse
|
50
|
Egeland GM, Igland J, Vollset SE, Sulo G, Eide GE, Tell GS. High population attributable fractions of myocardial infarction associated with waist-hip ratio. Obesity (Silver Spring) 2016; 24:1162-9. [PMID: 27030172 PMCID: PMC5071698 DOI: 10.1002/oby.21452] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Revised: 12/01/2015] [Accepted: 12/02/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To estimate population attributable fractions (PAF) of acute myocardial infarction (AMI) associated with anthropometric measures by sex and age. METHODS The Cohort of Norway study identified 140,790 participants free of cardiovascular disease, 1994-2003. Participants were followed for AMI through 2009 by record linkages through the Cardiovascular Disease in Norway Project. PAFs were adjusted for age, smoking, systolic blood pressure, diabetes, and the ratio of total cholesterol to high-density lipoprotein cholesterol. RESULTS The PAFs associated with a waist-hip ratio (WHR) in the top two quintiles were 26.1% (95% confidence interval, CI 14.6-36.1) for middle-aged women (<60 years, mean of 41 years) and 9.3% (95% CI 3.0-15.1) for similarly aged men after adjustment for body mass index (BMI) and conventional risk factors. However, PAFs associated with anthropometric measures in elderly participants (≥ 60 years, mean of 70 years) were non-significant in multivariable analyses. Also, WHR was a significant predictor of AMI among men and women without an enlarged waist circumference (<102 cm for men and < 88 cm for women) in adjusted analyses. CONCLUSIONS WHR measurements could improve identification of at-risk individuals above and beyond that of conventional risk factors, BMI, or an enlarged waist circumference.
Collapse
Affiliation(s)
- Grace M. Egeland
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Division of EpidemiologyDepartment of Health RegistriesNorwegian Institute of Public HealthBergenNorway
| | - Jannicke Igland
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
| | - Stein Emil Vollset
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Division of EpidemiologyDepartment of Health RegistriesNorwegian Institute of Public HealthBergenNorway
| | - Gerhard Sulo
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Division of EpidemiologyDepartment of Health RegistriesNorwegian Institute of Public HealthBergenNorway
| | - Geir Egil Eide
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Centre for Clinical Research, Haukeland University HospitalBergenNorway
| | - Grethe S. Tell
- Department of Global Public Health and Primary CareUniversity of BergenBergenNorway
- Division of EpidemiologyDepartment of Health RegistriesNorwegian Institute of Public HealthBergenNorway
| |
Collapse
|