1
|
Te Hoonte F, Spronk M, Sun Q, Wu K, Fan S, Wang Z, Bots ML, Van der Schouw YT, Uijl A, Vernooij RWM. Ideal cardiovascular health and cardiovascular-related events: a systematic review and meta-analysis. Eur J Prev Cardiol 2024; 31:966-985. [PMID: 38149986 DOI: 10.1093/eurjpc/zwad405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 12/07/2023] [Accepted: 12/21/2023] [Indexed: 12/28/2023]
Abstract
AIMS The aim of this study was to systematically review and quantitatively summarize the evidence on the association between Life Simple's 7 (LS7) and multiple cardiovascular diseases (CVDs) and cardiometabolic diseases (CMDs). METHODS AND RESULTS EMBASE and PubMed were searched from January 2010 to March 2022 for observational studies that investigated the association between ideal cardiovascular health (CVH) with CVD or CMD outcomes in an adult population. Two reviewers independently selected studies according to the eligibility criteria, extracted data, and evaluated risk of bias. Data were analysed with a random-effects meta-analysis. This meta-analysis included 59 studies (1 881 382 participants). Participants with ideal CVH had a considerably lower risk of a variety of CVDs and CMDs as compared with those with poor CVH, varying from 40% lower risk for atrial fibrillation (AF) {hazard ratio [HR] = 0.60 [95% confidence interval (CI) 0.44-0.83]} to 82% lower risk for myocardial infarction [HR = 0.18 (95% CI 0.12-0.28)]. Intermediate CVH was associated with 27-57% lower risk in CVDs and CMDs compared with poor CVH, with the highest hazard for AF [HR = 0.73 (95% CI 0.59-0.91)] and the lowest hazard for peripheral arterial disease [HR = 0.43 (95% CI 0.30-0.60)]. CONCLUSION Ideal and moderate CVH were associated with a lower incidence of CVDs and CMDs than poor CVH. Life Simple's 7 holds significant potential for promoting overall CVH and thereby contributing to the prevention of CVDs.
Collapse
Affiliation(s)
- Femke Te Hoonte
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Merve Spronk
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Qi Sun
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Kangrui Wu
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Shiqi Fan
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| | - Ziyi Wang
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Michiel L Bots
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Yvonne T Van der Schouw
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
| | - Alicia Uijl
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Cardiology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
- Division of Cardiology, Department of Medicine, Karolinska Institute, Stockholm, Sweden
| | - Robin W M Vernooij
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Universiteitsweg 100, 3584 CG, Utrecht, The Netherlands
- Department of Nephrology and Hypertension, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands
| |
Collapse
|
2
|
Qin P, Liu D, Feng Y, Yang X, Li Y, Wu Y, Hu H, Zhang J, Li T, Li X, Zhao Y, Chen C, Hu F, Zhang M, Liu Y, Sun X, Hu D. Association between cardiovascular health metrics and risk of incident type 2 diabetes mellitus: the Rural Chinese Cohort Study. Acta Diabetol 2022; 59:1063-1071. [PMID: 35643944 DOI: 10.1007/s00592-022-01896-x] [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: 02/17/2022] [Accepted: 04/19/2022] [Indexed: 11/01/2022]
Abstract
AIMS The evidence for association between cardiovascular health (CVH) metrics and type 2 diabetes mellitus (T2DM) in Chinese population is limited. We explored the association between the number of ideal CVH metrics and risk of incident T2DM in a rural Chinese population. MATERIALS AND METHODS A total of 12,150 rural Chinese participants (median age 51 years) were enrolled. A Cox proportional-hazards model was used to assess the association between the number of ideal CVH metrics and risk of incident T2DM by using hazard ratios (HRs) and 95% confidence intervals (CIs). We another conducted multiplicative and additive interaction effect between the number of ideal CVH metrics and sex or age on incident T2DM, and subgroup analyses of the association were also conducted by sex and age. RESULTS During a median of 6.01 years of follow-up, 840 incident cases of T2DM occurred. The number of ideal CVH metrics was negatively associated with risk of incident T2DM (per unit increase: HR = 0.76, 95% CI 0.70-0.82). We also observed both multiplicative and additive interaction effect between lower number of ideal CVH metrics and sex on incident T2DM, and multiplicative interaction effect between lower number of ideal CVH metrics and age on incident T2DM was observed. The association remained statistically significant for both men and women, or participants with age < 65 years. CONCLUSIONS Increasing number of ideal CVH metrics was associated with reduced risk of incident T2DM, which presented age- and sex-related differential associations.
Collapse
Affiliation(s)
- Pei Qin
- Shenzhen Qianhai Shekou Free Zone Hospital, No. 36 Gongye 7th Road, Luohu District, Shenzhen, Guangdong, 518001, People's Republic of China
| | - Dechen Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Yifei Feng
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xingjin Yang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Li
- Shenzhen Qianhai Shekou Free Zone Hospital, No. 36 Gongye 7th Road, Luohu District, Shenzhen, Guangdong, 518001, People's Republic of China
| | - Yuying Wu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Huifang Hu
- Shenzhen Qianhai Shekou Free Zone Hospital, No. 36 Gongye 7th Road, Luohu District, Shenzhen, Guangdong, 518001, People's Republic of China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Jinli Zhang
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Tianze Li
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Xi Li
- Shenzhen Qianhai Shekou Free Zone Hospital, No. 36 Gongye 7th Road, Luohu District, Shenzhen, Guangdong, 518001, People's Republic of China
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Yang Zhao
- Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Chuanqi Chen
- Department of Endocrinology, Shenzhen Qianhai Shekou Free Trade Zone Hospital, Shenzhen, Guangdong, People's Republic of China
| | - Fulan Hu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Ming Zhang
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Yu Liu
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Xizhuo Sun
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China
| | - Dongsheng Hu
- Shenzhen Qianhai Shekou Free Zone Hospital, No. 36 Gongye 7th Road, Luohu District, Shenzhen, Guangdong, 518001, People's Republic of China.
- Department of Biostatistics and Epidemiology, School of Public Health, Shenzhen University Health Science Center, No. 1066 Xueyuan Avenue, 30 Nanshan District, Shenzhen, Guangdong, 518060, People's Republic of China.
| |
Collapse
|
3
|
Wang A, Tian X, Zuo Y, Chen S, Wu S, Wang Y. Mediation effect of arterial stiffness on ideal cardiovascular health and stroke. Nutr Metab Cardiovasc Dis 2021; 31:2382-2390. [PMID: 34162503 DOI: 10.1016/j.numecd.2021.05.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/30/2021] [Accepted: 05/03/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Ideal cardiovascular health (CVH) metrics was associated with stroke, but the causal pathway was poorly investigated. Arterial stiffness was a major factor associated with both ideal CVH metrics and stroke. This study aimed to investigate whether the effect of ideal CVH metrics on stroke was mediated and enhanced by arterial stiffness. METHODS AND RESULTS A total of 15,297 participants were included in current study. Arterial stiffness was measured by brachial-ankle pulse wave velocity (baPWV). Causal mediation analyses were used to separate the overall effects of ideal CVH metrics on stroke into indirect effects (mediated by arterial stiffness) and direct effects (mediated through pathways other than arterial stiffness). After a median follow-up of 5.88 years, 324 total stroke events (292 ischemic stroke and 31 hemorrhagic stroke) occurred. Mediation analysis showed 23.94% of the relation between ideal CVH and total stroke was mediated by baPWV (95% confidence interval [CI] of the indirect effect: 0.93-0.95). Further analysis showed the ideal CVH < median combined with baPWV ≥1400 cm/s was associated with the highest risk of total stroke (hazard ratio: 5.62; 95% CI, 3.53-8.96), compared with CVH ≥ median combined with baPWV < 1400 cm/s. Similar results were observed for ischemic stroke, but not for hemorrhagic stroke. CONCLUSIONS Arterial stiffness played a mediating role in the associations between ideal CVH metrics and risk of total and ischemic stroke. Combined ideal CVH metrics and baPWV is a reasonable and useful tool for the assessment and prevention of stroke.
Collapse
Affiliation(s)
- Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Yingting Zuo
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Yongjun Wang
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
| |
Collapse
|
4
|
Yu S, Guo X, Li GX, Yang H, Zheng L, Sun Y. Lower or higher HDL-C levels are associated with cardiovascular events in the general population in rural China. Lipids Health Dis 2020; 19:152. [PMID: 32586331 PMCID: PMC7315555 DOI: 10.1186/s12944-020-01331-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/17/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The present study aims to estimate whether high-density lipoprotein cholesterol (HDL-C) is correlated with cardiovascular events (CVEs) and cardiovascular mortality (CVM) in a large sample of the general population in rural areas of China. METHODS Adult participants (n = 10,266, age = 53.79 ± 10.49 years; 46.5% men) were enrolled from the Northeast China Rural Cardiovascular Health Study (NCRCHS). Laboratory testing, blood pressure, weight, height, and questionnaires about socioeconomic status were collected. RESULTS In all, 585 nonfatal or fatal CVEs and 212 cardiovascular deaths were documented during a 4.66-year follow-up. Compared to the reference groups (HDL-C between 1.5 and 1.99 mmol/L), either lower or higher levels of HDL-C were correlated with an increased incidence of CVEs but not CVM [hazard ratio (HR) the lowest = 1.369, 95% confidence interval, 1.007-1.861; HR the highest = 1.044, 0.509-2.231]. Elevated CVM was seen in the lowest HDL-C category (1.840; 1.121-3.021). CONCLUSIONS Lower or higher HDL-C was associated with a higher incidence of CVEs but not CVM in the general population of rural China. Perhaps if an appropriate level of HDL-C is maintained, CVEs can be effectively prevented.
Collapse
Affiliation(s)
- Shasha Yu
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Xiaofan Guo
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Guang Xiao Li
- Department of Clinical Epidemiology, Institute of Cardiovascular Diseases, First Hospital of China Medical University, Shenyang, 110001, China
| | - Hongmei Yang
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China
| | - Liqiang Zheng
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, 110004, China
| | - Yingxian Sun
- Department of Cardiology, First Hospital of China Medical University, 155 Nanjing North Street, Heping District, Shenyang, 110001, China.
| |
Collapse
|
5
|
The Prevalence of Hypertension Accompanied by High Homocysteine and its Risk Factors in a Rural Population: A Cross-Sectional Study from Northeast China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14040376. [PMID: 28368353 PMCID: PMC5409577 DOI: 10.3390/ijerph14040376] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2017] [Revised: 03/29/2017] [Accepted: 04/01/2017] [Indexed: 02/03/2023]
Abstract
Previous studies found that hypertension and high homocysteine (HHcy) exhibited a synergistic effect on the risk of cardiovascular diseases. This study aimed to investigate the prevalence of hypertension accompanied by HHcy and its risk factors in the rural areas of northeast China. This study was conducted using a stratified cluster random sampling method, and included 6529 subjects with complete data. Demographic characteristics were obtained from a questionnaire. Blood pressure and anthropometric indices were measured, and serum indices were analyzed. Hypertension accompanied by HHcy was defined as hypertension plus HHcy [homocysteine (Hcy) > 10 µmol/L]. The mean concentration of Hcy was 17.29 μmol/L in the general population. The prevalence of hypertension accompanied by HHcy was so high that it reached 45.1% of our study population and accounted for 86.8% of the total participants with hypertension. Multiple logistic regression analysis indicated that the modifiable risk factors of hypertension accompanied by HHcy included obesity, diabetes, dyslipidemia, and inactive physical activities. We found that the mean level of Hcy, and the prevalences of HHcy and hypertension accompanied by HHcy were very high among the rural population of northeast China. Obesity, diabetes, dyslipidemia, and inactive physical activities were modifiable risk factors of hypertension accompanied by HHcy.
Collapse
|
6
|
Li C, Chang Y, Li Y, Chen S, Chen Y, Ye N, Dai D, Sun Y. Advanced glycation end products promote the proliferation and migration of primary rat vascular smooth muscle cells via the upregulation of BAG3. Int J Mol Med 2017; 39:1242-1254. [PMID: 28350077 PMCID: PMC5403185 DOI: 10.3892/ijmm.2017.2938] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Accepted: 03/24/2017] [Indexed: 12/31/2022] Open
Abstract
The present study was aimed to investigate the role of reactive oxygen species (ROS) on advanced glycation end product (AGE)-induced proliferation and migration of vascular smooth muscle cells (VSMCs) and whether Bcl-2‑associated athanogene 3 (BAG3) is involved in the process. Primary rat VSMCs were extracted and cultured in vitro. Cell viability was detected by MTT assay and cell proliferation was detected by EdU incorporation assay. Cell migration was detected by wound healing and Transwell assays. BAG3 was detected using qPCR and western blot analysis. Transcriptional and translational inhibitors (actinomycin D and cycloheximide, respectively) were used to study the effect of AGEs on the expression of BAG3 in VSMCs. Lentiviral plasmids containing short hairpin RNA (shRNA) against rat BAG3 or control shRNA were transduced into VSMCs. Cellular ROS were detected by 2',7'-dichlorofluorescein diacetate (DCFH-DA) staining. Mitochondrial membrane potential was detected by tetramethylrhodamine methyl ester (TMRE) staining. AGEs significantly increased the expression of BAG3 in a dose-and time-dependent manner. Furthermore, AGEs mainly increased the expression of BAG3 mRNA by increasing the RNA synthesis rather than inhibiting the RNA translation. BAG3 knockdown reduced the proliferation and migration of VSMCs induced by AGEs. BAG3 knockdown reduced the generation of ROS and sustained the mitochondrial membrane potential of VSMCs. Reduction of ROS production by N-acetylcysteine (NAC), a potent antioxidant, also reduced the proliferation and migration of VSMCs. On the whole, the present study demonstrated for the first time that AGEs could increase ROS production and promote the proliferation and migration of VSMCs by upregulating BAG3 expression. This study indicated that BAG3 should be considered as a potential target for the prevention and/or treatment of vascular complications of diabetes.
Collapse
Affiliation(s)
- Cunshu Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Ye Chang
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yuan Li
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Shuang Chen
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yintao Chen
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Ning Ye
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Dongxue Dai
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| | - Yingxian Sun
- Department of Cardiology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, P.R. China
| |
Collapse
|
7
|
Guo H, Sun F, Zhang H, Dong L, Gu X, Tian Y. Interankle Systolic Blood Pressure Difference Is a Marker of Prevalent Stroke in Chinese Adults: A Cross-Sectional Study. J Clin Hypertens (Greenwich) 2016; 19:58-66. [PMID: 27412923 DOI: 10.1111/jch.12872] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2016] [Revised: 05/12/2016] [Accepted: 05/20/2016] [Indexed: 11/26/2022]
Affiliation(s)
- Hong Guo
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
- Key Laboratory of Cardiovascular Medicine Research; Ministry of Education; Harbin Medical University; Harbin China
- Heilongjiang Academy of Medical Sciences; Harbin Medical University; Harbin China
| | - Fengyu Sun
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
| | - Haiyu Zhang
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
| | - Lihang Dong
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
| | - Xingbo Gu
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
| | - Ye Tian
- Department of Cardiology; The First Affiliated Hospital of Harbin Medical University; Cardiovascular Institute; Harbin Medical University; Harbin China
- Key Laboratory of Cardiovascular Medicine Research; Ministry of Education; Harbin Medical University; Harbin China
- Heilongjiang Academy of Medical Sciences; Harbin Medical University; Harbin China
- Department of Pathophysiology; Key Laboratory of Cardiovascular Pathophysiology; Harbin Medical University; Harbin China
| |
Collapse
|