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Carballo-Casla A, Stefler D, Ortolá R, Chen Y, Kubinova R, Pajak A, Malyutina S, Rodríguez-Artalejo F, Brunner EJ, Bobak M. The Southern European Atlantic Diet and depression incidence: a multicohort study. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac129.552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
The Southern European Atlantic Diet (SEAD) is the traditional diet of Northern Portugal and North-Western Spain, but it may resemble that of other European countries. Higher adherence to SEAD has been associated with lower risk for myocardial infarction and all-cause mortality, but its relationship with mental health is uncertain. We examined the association between SEAD and depression incidence in Southern, Central, and Eastern Europe.
Methods
We used data from participants ≥45 years from the Seniors-ENRICA-2 and HAPIEE cohorts, who were followed for a median time of 3.6 years. SEAD comprised fresh fish, cod, red meat and pork products, dairy, legumes and vegetables, vegetable soup, potatoes, whole-grain bread, and wine. Depressive symptoms were assessed with the GDS 10 and the CES-D 10 (participants with scores ≥4 were considered depression cases). Statistical analyses were performed among the 14675 participants who were depression-free at baseline.
Results
Higher adherence to SEAD was preliminarily associated with lower depression incidence in the pooled sample (fully adjusted odds ratio [95% confidence interval] per 1-SD increment in the SEAD = 0.93 [0.89,0.98]). Results were consistent in Spain (odds ratio [95% confidence interval] 0.86 [0.68,1.08]), Czechia (0.92 [0.82,1.04]), Poland (0.94 [0.88,1.01]), and Russia (0.93 [0.87,1.00]). The association of SEAD with depression in the pooled sample was similar to that found for the Alternate Healthy Eating Index (odds ratio [95% confidence interval] per 1-SD increment = 0.94 [0.89,0.99]) and the Mediterranean Dietary Score (0.94 [0.90,0.98]).
Conclusions
Adherence to SEAD was preliminarily associated with lower depression incidence in Spain, Czechia, Poland, and Russia. These findings may support the development of mental health guidelines for Southern European Atlantic populations based on their traditional diet, and for Central and Eastern European countries based on the food components of SEAD.
Key messages
• Adherence to the Southern European Atlantic Diet (traditional diet of Northern Portugal and North-Western Spain) was associated with lower depression incidence in Spain, Czechia, Poland, and Russia.
• Mental health guidelines for Southern European Atlantic populations may reference their traditional diet, while those for Central and Eastern Europe could benefit from including its food components.
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Affiliation(s)
- A Carballo-Casla
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
| | - D Stefler
- Department of Epidemiology and Public Health, University College London , London, UK
| | - R Ortolá
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
| | - Y Chen
- Department of Epidemiology and Public Health, University College London , London, UK
| | - R Kubinova
- National Institute of Public Health , Prague, Czechia
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum , Krakow, Poland
| | | | - F Rodríguez-Artalejo
- Department of Preventive Medicine and Public Health, Universidad Autónoma de Madrid , Madrid, Spain
- CIBER of Epidemiology and Public Health, CIBERESP , Madrid, Spain
- IMDEA Food Institute , CEI UAM+CSIC, Madrid, Spain
| | - EJ Brunner
- Department of Epidemiology and Public Health, University College London , London, UK
| | - M Bobak
- Department of Epidemiology and Public Health, University College London , London, UK
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Hageman SHJ, Lu W, Kaptoge S, Lall K, Bobak M, Pikhart H, Kubinova R, Pajak A, Tamosiunas A, Stang A, Schmidt B, Schramm S, Di Angelantonio E, Visseren FLJ, Dorresteijn JAN. Prediction of lifetime cardiovascular risk and individual lifetime treatment benefit in four European risk regions: geographic recalibration of the LIFE-CVD model. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.2276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
The life expectancy free of cardiovascular disease (CVD) in individuals without previous CVD can be estimated with the LIFEtime-perspective CardioVascular Disease (LIFE-CVD) model, as recommended by the 2021 ESC CVD prevention guidelines. Our aim was to systematically recalibrate the LIFE-CVD model to four European risk regions using contemporary and representative registry data.
Methods and results
The LIFE-CVD model was systematically recalibrated to four distinct risk regions within Europe, using representative aggregate data on age- and sex-specific expected CVD and non-CVD mortality incidences and risk factor distributions. For external validation, 1,451,077 individuals without previous CVD were included from seven European cohorts, with 53,721 CVD events and 62,902 non-CVD deaths during follow up. After applying the recalibrated risk prediction models to external validation cohorts, C-indices (figure 1) ranged from 0.670 (95% CI 0.650–0.690) to 0.787 (95% CI 0.785–0.789). Predicted risks matched the observed risks in the CPRD data. With the recalibrated LIFE-CVD model, the estimated gain in CVD-free life expectancy from preventive therapy differed per region, for example a 50-year-old smoking women with a systolic blood pressure of 140mm Hg was estimated to gain 0.4 years of CVD-free life from 10 mm Hg SBP reduction in the low risk region, whereas this would be 1.5 years in the very high risk region (figure 2).
Interpretation
By taking into account geographical differences in CVD incidence, the recalibrated LIFE-CVD model provides a more accurate tool for the prediction of lifetime risk and CVD-free life expectancy for individuals without previous CVD, facilitating shared decision-making in cardiovascular prevention options as recommended by the 2021 European Prevention Guidelines.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S H J Hageman
- University Medical Center Utrecht, Department of vascular medicine , Utrecht , The Netherlands
| | - W Lu
- University College London, Department of Epidemiology and Public Health , London , United Kingdom
| | - S Kaptoge
- University of Cambridge, Department of Public Health and Primary Care , Cambridge , United Kingdom
| | - K Lall
- University of Tartu, Estonian Genome Centre , Tartu , Estonia
| | - M Bobak
- University College London, Department of Epidemiology and Public Health , London , United Kingdom
| | - H Pikhart
- University College London, Department of Epidemiology and Public Health , London , United Kingdom
| | - R Kubinova
- National Institute of Public Health , Prague , Czechia
| | - A Pajak
- Institute of Public Health, Department of Epidemiology and Population Studies , Krakow , Poland
| | - A Tamosiunas
- Lithuanian University of Health Sciences, Institute of Cardiology , Kaunas , Lithuania
| | - A Stang
- Institute for Medical Informatics, Biometry and Epidemiology , Essen , Germany
| | - B Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology , Essen , Germany
| | - S Schramm
- Institute for Medical Informatics, Biometry and Epidemiology , Essen , Germany
| | - E Di Angelantonio
- University of Cambridge, Department of Public Health and Primary Care , Cambridge , United Kingdom
| | - F L J Visseren
- University Medical Center Utrecht, Department of vascular medicine , Utrecht , The Netherlands
| | - J A N Dorresteijn
- University Medical Center Utrecht, Department of vascular medicine , Utrecht , The Netherlands
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Piwonska AM, Cicha-Mikolajczyk A, Sobczyk-Kopciol A, Piwonski J, Drygas W, Kwasniewska M, Pajak A, Zdrojewski T, Tykarski A, Kozakiewicz K, Ploski R. Independent association of FTO rs9939609 polymorphism with overweight and obesity in Polish adults. Results from the representative population-based WOBASZ study. J Physiol Pharmacol 2022; 73. [PMID: 36302535 DOI: 10.26402/jpp.2022.3.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 06/30/2022] [Indexed: 06/16/2023]
Abstract
Genetic factors play an important role in the origin of obesity. We investigated the association between the FTO rs9939609 genotype and overweight and obesity, along with additional anthropometric variables in the representative sample of adult Polish population. We genotyped a random sample of 3369 adult individuals examined in a cross-sectional population survey (WOBASZ 2003-2005). More than 40% of men and women had at least one A allele. The AA genotype was found in approximately one fifth of both men and women. The frequency of the AA genotype increased with higher BMI in both sexes and was associated with higher anthropometric obesity indicators in both men and women. The FTO rs9939609 AA genotype was significantly related to abnormal BMI [OR=1.55 (1.14-2.11)] and overweight [OR=1.55 (1.11-2.16)] or obesity [OR=1.56 (1.04-235)] in men regardless of age, tobacco smoking, physical activity, diet and diabetes, while in women it was related to abnormal BMI [OR=1.45 (1.05-2.01)] and overweight [OR=1.59 (1.11-2.29)] after adjustment in addition for menopause. The frequency of the A allele in the Polish population was the same as in other European countries. About one fifth of both men and women have the FTO rs9939609 AA variant. A significant relationship was found between the FTO genotype and anthropometric obesity indicators. The AA genotype was significantly associated with abnormal BMI and overweight in both sexes, but the relation to the obesity phenotype was observed only in men.
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Affiliation(s)
- A M Piwonska
- Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland.
| | - A Cicha-Mikolajczyk
- Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - A Sobczyk-Kopciol
- Department of General Biology and Parasitology, Medical University of Warsaw, Warsaw, Poland
| | - J Piwonski
- Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
| | - W Drygas
- Department of Epidemiology, Cardiovascular Diseases Prevention and Health Promotion, National Institute of Cardiology, Warsaw, Poland
- Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland
| | - M Kwasniewska
- Department of Social and Preventive Medicine, Medical University of Lodz, Lodz, Poland
| | - A Pajak
- Department of Epidemiology and Population Studies, Institute of Public Health, Jagiellonian University Medical College, Cracow, Poland
| | - T Zdrojewski
- Department of Preventive Medicine and Education, Medical University of Gdansk, Gdansk, Poland
| | - A Tykarski
- Department of Hypertensiology, Angiology and Internal Medicine, Poznan University of Medical Sciences, Poznan, Poland
| | - K Kozakiewicz
- Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Katowice, Poland
| | - R Ploski
- Department of Medical Genetics, Medical University of Warsaw, Warsaw, Poland
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Stefler D, Yi X, Malyutina S, Kubinova R, Pajak A, Hrezova E, Pikhart H, Peasey A, Bobak M. Socioeconomic determinants of traditional diet in Eastern Europe: result from the HAPIEE study. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab164.843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Traditional eating habits in Eastern Europe are associated with higher risk of all-cause and cardiovascular disease mortality. However, it is unclear whether this eating pattern is related to socio-economic characteristics of individuals. The aim of this analysis was to examine the socioeconomic determinants of traditional diet in Eastern European populations.
Methods
Data was available from the baseline survey of the Health, Alcohol and Psychosocial Factors in Eastern Europe study, including 21,752 eligible subjects from Russia, Poland and the Czech Republic. Dietary data was collected using food frequency questionnaires, and adherence to the traditional diet was assessed with the Eastern European Diet Score (EEDS). Information on participants` education, parental education and experience of financial difficulties in buying food were used as indicators of participants` socioeconomic position (SEP).
Results
In the multivariable adjusted logistic regression models, high EEDS, indicating higher adherence to the traditional diet, was significantly associated with lower education attainment (university vs. primary or less; OR: 0.85, 95%CI: 0.75-0.96) and lower parental education (0.82, 0.72-0.94). High EEDS was also more common in people who reported financial difficulties in buying food, but this association was weaker (often vs. never; 1.12, 1.00-1.25). Specific components of the EEDS, including intakes of lard, processed meat and preserved fruit and vegetables, were also closely linked to SEP indicators.
Conclusions
Our results suggest that individuals with lower SEP are more likely to follow the traditional eating pattern in Eastern Europe, and education seems to be a particularly important determinant. Public health nutritional interventions should focus on the more disadvantaged groups to improve diet and reduce health inequalities in this region.
Funding: This work was partly funded by the Horizon 2020 CETOCOEN Excellence project (grant no. 857560).
Key messages
This work shows that socioeconomic factors, particularly education, are important determinants of traditional eating habits in Eastern European countries. As traditional diet in this region is linked with poor health, nutritional interventions have the potential to improve population health and reduce socioeconomic inequalities in Eastern Europe.
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Affiliation(s)
- D Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - X Yi
- Department of Epidemiology and Public Health, University College London, London, UK
| | - S Malyutina
- Research Institute of Internal and Preventive Medicine, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
| | - R Kubinova
- National Institute of Public Health, Prague, Czechia
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum, Krakow, Czechia
| | - E Hrezova
- Research Centre for Toxic Compounds in the Environment, Masaryk University, Brno, Czechia
| | - H Pikhart
- Department of Epidemiology and Public Health, University College London, London, UK
| | - A Peasey
- Department of Epidemiology and Public Health, University College London, London, UK
| | - M Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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Kostadinova R, Filippi B, Moritz W, Pajak A, Sanchez K, Wolf A. Steatosis as risk factor for drug-induced liver injury (DILI). Toxicol Lett 2021. [DOI: 10.1016/s0378-4274(21)00627-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Wierzowiecka M, Niklas A, Drygas W, Pajak A, Zdrojewski T, Bielecki W, Kozakiewicz K, Marcinkowska J, Tykarski A. What people really know about hypertension and other cardiovascular disease risk factors. Recommendations vs reality. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public grant(s) – National budget only. Main funding source(s): The WOBASZ II project was financed by the resources available to the Minister of Health as part of the POLKARD National Program to Equalise Accessibility to Cardiovascular Disease Prevention and Treatment for 2010–2012, the goal of which was to monitor the epidemiological situation in Poland in the field of cardiovascular diseases.
Cyclically, new guidelines are developed to prevent cardiovascular diseases (CVD). But unfortunately their implementation in clinical practice is poor.
The aim of the study was
1) to evaluate the awareness of CVD prevention principles in a representative sample of adult residents of Poland with diagnosed hypertension (HT); 2) to investigate the prevalence of modifiable CVD risk factors such as obesity, hyperlipemia, smoking, low physical activity, excessive intake of sodium, insufficient fruit and vegetable consumption in the daily diet, and to determine the extent to which recommendations for CVD prevention are implemented in everyday practice; 3) to evaluate how knowledge of CVD risk factors affects the control of HT.
The study covered 2783 individuals with diagnosed HT. 72,2% knew the term ‘risk factor’. Spontaneously listed risk factors for CVD: HT 36,8%, smoking 43,3%, overweight and obesity 28,5%, unhealthy food 30,9%, increased cholesterol level 25,3%, and low physical activity 25,1%.
Complications that can be caused by untreated HT, were listed by 72,6% to be a stroke, heart diseases by 57,8%, atherosclerotic lesions in the arteries by 17,7%, kidney disease by 9,5%, and vision disorder by 9,2%.
Prevention methods other than medication were listed by
more physical activity 38,8%, reduction of body weight in overweight people 45,5%, stop smoking 43,7%, conducting a regular lifestyle 42,1%, limiting fat intake 38,3%, restrictions on drinking alcohol 37,5%, daily consumption of vegetables and fruits 20,6%. No prevention method has been mentioned by 10,5% of patients.
73.2% declared knowledge of the upper limits of the correct blood pressure (BP), but only 10.2% gave the correct values. Overweight was found in 39% of patients, obesity in 36.7%, smoking in 21.3%, low physical activity (<30 min 4-7/week) in 33.4%, sodium intake >1.5g/day in 58.0%, low (<200g/day) consumption of fruits in 84.1%, and vegetables in 70.6%. Controlled BP was only found in 23% and controlled hyperlipidemia only in 11.2% of subjects.
During medical visits, about 9.2% of patients did not receive any recommendations for pharmacological treatment even if their BP did not reach the therapeutic goal. Knowledge about CVD risk factors [hypercholesterolemia OR 1,63; HT 1,53; low physical activity 1,24, overweight and obesity 1,23, knowledge about complications of HT [stroke or cerebral ischemia 1,77, heart disease 1,52, nephropathy 1,51, atherosclerosis 1,48, retinopathy 1,38, knowledge about non-pharmacological treatment like regular consumption of vegetables and fruits 1,33 increases the chance of achieving BP control.
The knowledge about CVD risk factors and possible complications of HT in patients with HT is low. Factors that have a significant impact on a BP control are: knowledge of CVD risk factors, possible complications of HT and the recommendations given during visits about increasing physical activity and a healthy diet, as well as home and office BP measurements.
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Affiliation(s)
- M Wierzowiecka
- Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Disease, Poznan, Poland
| | - A Niklas
- Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Disease, Poznan, Poland
| | - W Drygas
- National Institute of Cardiology, Department of Epidemiology, Cardiovascular Disease Prevention and Health Promotion, Warsaw, Poland
| | - A Pajak
- Jagiellonian University, Department of Epidemiology and Population Studies, Institute of Public Health, Krakow, Poland
| | - T Zdrojewski
- Medical University of Gdansk, Department of Arterial Hypertension and Diabetology, Gdansk, Poland
| | - W Bielecki
- Medical University of Lodz, Department of Social Pathologies, Lodz, Poland
| | - K Kozakiewicz
- University of Silesia, 3rd Department of Cardiology, Katowice, Poland
| | - J Marcinkowska
- Poznan University of Medical Sciences, Department of Computer Science and Statistics, Poznan, Poland
| | - A Tykarski
- Poznan University of Medical Sciences, Department of Hypertension, Angiology and Internal Disease, Poznan, Poland
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Peksa JW, Jankowski P, Koziel P, Bogacki P, Gomula P, Mirek-Bryniarska E, Nessler J, Podolec P, Wisniewski AK, Rajzer M, Czarnecka D, Pajak A. Temporal changes in the implementation of secondary prevention of coronary artery disease in every day practice. Eur J Prev Cardiol 2021. [DOI: 10.1093/eurjpc/zwab061.268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
OnBehalf
-
Introduction
Patients with coronary artery disease (CAD) are at high risk of recurrent cardiovascular events and control of their risk factors is crucial.
Objectives
Comparison of risk factors control in patients with CAD in 2016–2017 and 2011–2013.
Patients and methods
Five hospitals with cardiology departments serving the city and surrounding districts participated in the study. Consecutive patients hospitalized due to an acute coronary syndrome or a myocardial revascularization procedure were interviewed 6–18 months after hospitalization. The surveys were carried out in 2011–2013 and 2016–2017.
Results
We examined 616 patients in 2011–2013 and 388 in 2016–2017 (mean age: 64.7 ± 8.8 vs. 66.4 ± 8.4, P <0.01). After adjusting for covariates the proportion of patients with high blood pressure decreased by 8.9% (95% confidence intervals: -2.1% – -15.6%) and proportion of patients with high LDL cholesterol decreased by 9.5% (-2.2% – -16.7%) in 2016/2017 compared to 2011/2013, whereas the proportion of smoking patients (-0.2% [-6.0% – 5.5%]) and those with high glucose level (3.9% [-2.2% - 10.0%]) and with body mass index ≥25 kg/m2 (3.8% [-3.9% – 11.6%]) did not change significantly. The proportion of patients prescribed antiplatelets (6.5% [2.6% - 10.3%]), β-blockers (7.4% [2.2% - 12.6%]), angiotensin converting enzyme inhibitors or sartans (8.6% [2.9% – 14.3%]), calcium antagonists (8.1% [1.3 – 15.0]) and anticoagulants (5.5% [0.7% - 10.2%]) increased significantly.
Conclusions
In CAD patients, there was an increase of the proportion of patients with cardiovascular drugs prescribed and a slight improvement in the control of blood pressure and LDL cholesterol between 2011–2013 and 2016–2017. However, no significant changes were found for the other main risk factors.
Patients who do not reach treatment goal Survey Smoking, % BP not at goal, %a BP ≥140/90 mmHg, % LDL cholesterol ≥1.8 mmol/l, % HbA1c ≥7.0%b, % Fasting glucose ≥7.0 mmol/l, % BMI≥25 kg/m2, % BMI≥30 kg/m2, % 2011-2013 19.0 50.3 43.0 71.9 14.1 15.9 81.2 33.8 2016-2017 16.2 40.7 39.2 60.3 14.9 20.2 83.4 38.3 P value 0.26 <0.01 0.24 <0.001 0.76 0.09 0.37 0.14 Differences adjusted for age, sex, index diagnosis, duration of education, professional activity (95% confidence intervals) 2016-2017 vs 2011-2013 -0.2(-6.0 - 5.5) -8.9(-15.6 - -2.1) -6.7(-14.3 - 1.0) -9.5(-16.7 - -2.2) 2.0(-3.4 - 7.4) 3.9(-2.2 - 10.0) 3.8(-3.9 - 11.6) 1.6 (-5.8 - 9.0) Abbreviations BMI, body mass index; BP, blood pressure; LDL, low-density lipoprotein a BP goal of <140/90mmHg (<130/80 mmHg in diabetics) in 2011–2013 and <140/90 mmHg (<140/85 mmHg in diabetics) in 2016–2017 b available for 362 patients in 2011-2013 and 383 patients in 2016-2017
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Affiliation(s)
- JW Peksa
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Jankowski
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Koziel
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - P Bogacki
- Ludwik Rydygier District Hospital, Department of Cardiology, Krakow, Poland
| | - P Gomula
- Gabriel Narutowicz Memorial General Hospital, Department of Cardiology, Krakow, Poland
| | | | - J Nessler
- Jagiellonian University Medical College, Department of Coronary Disease, Institute of Cardiology, Krakow, Poland
| | - P Podolec
- Jagiellonian University Medical College, Department of Cardiac and Vascular Diseases, Institute of Cardiology, Krakow, Poland
| | - AK Wisniewski
- Stefan Zeromski Hospital, Department of Internal Medicine and Cardiology, Krakow, Poland
| | - M Rajzer
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - D Czarnecka
- Jagiellonian University Medical College, Department of Cardiology, Electrocardiology and Hypertension, Krakow, Poland
| | - A Pajak
- Jagiellonian University Medical College, Department of Clinical Epidemiology and Population Studies, Institute of Public Health, Krakow, Poland
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Garduño‐Alanís A, Malyutina S, Pajak A, Stepaniak U, Kubinova R, Denisova D, Pikhart H, Peasey A, Bobak M, Stefler D. Association between soft drink, fruit juice consumption and obesity in Eastern Europe: cross-sectional and longitudinal analysis of the HAPIEE study. J Hum Nutr Diet 2020; 33:66-77. [PMID: 31475413 PMCID: PMC8425279 DOI: 10.1111/jhn.12696] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Fruit juice and soft drink consumption have been shown to be related to obesity. However, this relationship has not been explored in Eastern Europe. The present study aimed to assess the cross-sectional and longitudinal relationships between fruit juice, soft drink consumption and body mass index (BMI) in Eastern European cohorts. METHODS Data from the Health, Alcohol and Psychosocial factors in Eastern Europe population-based prospective cohort study, based in Russia, Poland and the Czech Republic, were used. Intakes of sugar-sweetened beverage (SSB), artificially-sweetened beverage (ASB) and fruit juice were estimated from a food frequency questionnaire. Participant BMI values were assessed at baseline (n = 26 634) and after a 3-year follow-up (data available only for Russia, n = 5205). RESULTS Soft drink consumption was generally low, particularly in Russia. Compared to never drinkers of SSB, participants who drank SSB every day had a significantly higher BMI in the Czech [β-coefficient = 0.28; 95% confidence interval (CI) = 0.02-0.54], Russian (β-coefficient = 1.38; 95% CI = 0.62-2.15) and Polish (β-coefficient = 0.83; 95% CI = 0.29-1.37) cohorts. Occasional or daily ASB consumption was also positively associated with BMI in all three cohorts. Results for daily fruit juice intake were inconsistent, with a positive association amongst Russians (β-coefficient = 0.75; 95% CI = 0.28-1.21) but a negative trend in the Czech Republic (β-coefficient = -0.42; 95% CI = -0.86 to 0.02). Russians participants who drank SSB or ASB had an increased BMI after follow-up. CONCLUSIONS Our findings support previous studies suggesting that soft drink consumption (including SSBs and ASBs) is positively related to BMI, whereas our results for fruit juice were less consistent. Policies regarding these beverages should be considered in Eastern Europe to lower the risk of obesity.
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Affiliation(s)
- A. Garduño‐Alanís
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
- Research DepartmentUniversidad de la Salud del Estado de MéxicoTolucaMéxico
| | - S. Malyutina
- Research Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
- Novosibirsk State Medical UniversityNovosibirskRussia
| | - A. Pajak
- Department of Epidemiology and Population StudiesJagiellonian University Collegium MedicumKrakowPoland
| | - U. Stepaniak
- Department of Epidemiology and Population StudiesJagiellonian University Collegium MedicumKrakowPoland
| | - R. Kubinova
- National Institute of Public HealthPragueCzech Republic
| | - D. Denisova
- Research Institute of Internal and Preventive Medicine – Branch of the Institute of Cytology and GeneticsSiberian Branch of Russian Academy of SciencesNovosibirskRussia
| | - H. Pikhart
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - A. Peasey
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - M. Bobak
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
| | - D. Stefler
- Department of Epidemiology and Public HealthUniversity College LondonLondonUK
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9
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Stefler D, Brett D, Sarkadi Nagy E, Kopczynska E, Detchev S, Bati A, Malyutina S, Kubinova R, Pajak A, Bobak M. Traditional Eastern European diet and its relationship with mortality: results from the HAPIEE study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cardiovascular disease (CVD) and cancer mortality rates in Eastern European countries are among the highest in the world. Although unhealthy diet is an important risk factor for both of these chronic diseases, traditional eating habits and their health effects in this region have not yet been explored. This analysis assessed the relationship between traditional dietary pattern and mortality from all-causes, CVD and cancer in Eastern European population-based cohorts.
Methods
We used data from the Health, Alcohol and Psychosocial factors in Eastern Europe (HAPIEE) multi-centre prospective cohort study based in Russia, Poland and the Czech Republic (age range at baseline: 45-70 years). Diet was assessed by food frequency questionnaire, and we constructed an Eastern European diet score (EEDS) from nine food groups considered as “traditional” in this region. The relationship between EEDS and all-cause, CVD and cancer mortality was calculated with Cox-regression models.
Results
From the 18,852 participants, 2,234 died during the average follow-up of 11.7 years. In multivariable adjusted models, participants with high adherence to the traditional Eastern European diet had significantly higher risk of all-cause (HR 1.20; 95% CI 1.05-1.38) and CVD deaths (1.32; 1.05-1.64) compared to those with low adherence. The association with cancer mortality was not significant (1.12; 0.90-1.40). From the specific EEDS components, high consumption of lard was significantly positively related to all three mortality outcomes, while processed fruit or vegetable consumption showed consistent inverse associations.
Conclusions
Our results suggest that traditional eating habits may contribute to the poor health status, particularly the high CVD mortality rates, of populations in Eastern Europe. Adequate public health nutritional interventions in this region are essential.
Key messages
This work indicates that traditional dietary habits in Eastern European countries may be one of the reasons for the poor health status of populations in this region. Public health nutritional interventions which target traditional but unhealthy foods, such as lard, have the potential to considerably improve population health in Eastern Europe.
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Affiliation(s)
- D Stefler
- Department of Epidemiology and Public Health, University College London, London, UK
| | - D Brett
- School of Slavonic and East European Studies, University College London, London, UK
| | - E Sarkadi Nagy
- Department of Nutritional Epidemiology, National Institute of Pharmacy and Nutrition, Budapest, Hungary
| | - E Kopczynska
- Institute of Sociology, Jagiellonian University, Krakow, Poland
| | - S Detchev
- Department of History, South-West University, Blagoeavgrad, Bulgaria
| | - A Bati
- Institute of Ethnology, Hungarian Academy of Sciences, Budapest, Hungary
| | - S Malyutina
- Research Institute of Internal and Preventive Medicine, Siberian Branch of Russian Academy of Sciences, Novosibirsk, Russia
- Novosibirsk State Medical University, Novosibirsk, Russia
| | - R Kubinova
- National Institute of Public Health, Prague, Czech Republic
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - M Bobak
- Department of Epidemiology and Public Health, University College London, London, UK
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10
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Pikhart H, Liu Q, Pajak A, Malyutina S, Kubinova R, Bobak M. Long working hours and mortality in Central and Eastern Europe: the HAPIEE study. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz185.365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Long working hours are common in countries of Central and Eastern Europe (CEE). A wide range of epidemiological studies have showed that long working hours had an adverse effect on health but the evidence mostly comes from Western Europe, East Asia and North America. This study aimed to assess the relationship between long working hours and the risk of mortality in employed people in three Eastern European countries.
Methods
Participants, aged 45-69 years at baseline, were from the Health, Alcohol and Psychosocial Indicators in Eastern Europe (HAPIEE) cohort study conducted in Russia, Poland and the Czech Republic. Baseline survey included a structured questionnaire and examination in the clinic during 2002-2005. Working hours were assessed by a self-reported questionnaire at baseline. Participants have been followed-up for all-cause mortality and cause-specific mortality for an average of 11 years. Impact of long working hours on mortality was analysed by Cox proportional hazards regression. In all-cause mortality analysis, a total of 10878 men and women were included, and 10399 participants were included in cause-specific mortality analysis.
Results
During the follow-up, there were 1187 deaths from all causes, 288 from CVD, and 251 from cancer. Those who worked 61 hours or more in a week showed higher risk of mortality compared to those working 36-45 hours per week: HR 1.32 (95%CI 1.01 to 1.74) for all-cause mortality and 1.73 (95% CI 1.03-2.93) for CVD mortality. There was no significant increase in risk of cancer mortality associated with working long hours. There was no significant association between working 46-60 hours a week and risk of mortality, including all-cause mortality and cause-specific mortality.
Conclusions
The risk of all-cause and CVD mortality in three CEE was significantly higher among employees working extensive hours. These findings suggest that more attention should be paid to shortening working hours for those who work extensively.
Key messages
Long working hours increase risk of all cause and CVD mortality. Cancer mortality is not related to long working hours.
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Affiliation(s)
- H Pikhart
- IEHC, University College London, London, UK
- Recetox, Masaryk University, Brno, Czech Republic
| | - Q Liu
- IEHC, University College London, London, UK
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University, Krakow, Poland
| | - S Malyutina
- Institute of Internal and Preventive Medicine, Siberian Branch of the Russian Academy of Medical Sciences, Novosibirsk, Russia
| | - R Kubinova
- National Institute of Public Health, Prague, Czech Republic
| | - M Bobak
- IEHC, University College London, London, UK
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11
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Filograna R, Koolmeister C, Upadhyay M, Pajak A, Clemente P, Wibom R, Simard ML, Wredenberg A, Freyer C, Stewart JB, Larsson NG. Modulation of mtDNA copy number ameliorates the pathological consequences of a heteroplasmic mtDNA mutation in the mouse. Sci Adv 2019; 5:eaav9824. [PMID: 30949583 PMCID: PMC6447380 DOI: 10.1126/sciadv.aav9824] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/11/2019] [Indexed: 05/18/2023]
Abstract
Heteroplasmic mtDNA mutations typically act in a recessive way and cause mitochondrial disease only if present above a certain threshold level. We have experimentally investigated to what extent the absolute levels of wild-type (WT) mtDNA influence disease manifestations by manipulating TFAM levels in mice with a heteroplasmic mtDNA mutation in the tRNAAla gene. Increase of total mtDNA levels ameliorated pathology in multiple tissues, although the levels of heteroplasmy remained the same. A reduction in mtDNA levels worsened the phenotype in postmitotic tissues, such as heart, whereas there was an unexpected beneficial effect in rapidly proliferating tissues, such as colon, because of enhanced clonal expansion and selective elimination of mutated mtDNA. The absolute levels of WT mtDNA are thus an important determinant of the pathological manifestations, suggesting that pharmacological or gene therapy approaches to selectively increase mtDNA copy number provide a potential treatment strategy for human mtDNA mutation disease.
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Affiliation(s)
- R. Filograna
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
| | - C. Koolmeister
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
| | - M. Upadhyay
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
| | - A. Pajak
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
| | - P. Clemente
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
| | - R. Wibom
- Center for Inherited Metabolic Diseases, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - M. L. Simard
- Department of Mitochondrial Biology, Max Planck Institute for Biology of Ageing, D-50931 Cologne, Germany
| | - A. Wredenberg
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Center for Inherited Metabolic Diseases, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - C. Freyer
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Center for Inherited Metabolic Diseases, Karolinska University Hospital, S-171 76 Stockholm, Sweden
| | - J. B. Stewart
- Department of Mitochondrial Biology, Max Planck Institute for Biology of Ageing, D-50931 Cologne, Germany
| | - N. G. Larsson
- Division of Molecular Metabolism, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, S-171 76 Stockholm, Sweden
- Max Planck Institute Biology of Ageing - Karolinska Institutet Laboratory, Karolinska Institutet, S-171 77 Stockholm, Sweden
- Center for Inherited Metabolic Diseases, Karolinska University Hospital, S-171 76 Stockholm, Sweden
- Department of Mitochondrial Biology, Max Planck Institute for Biology of Ageing, D-50931 Cologne, Germany
- Corresponding author.
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12
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Biro FM, Pajak A, Wolff MS, Pinney SM, Windham GC, Galvez MP, Greenspan LC, Kushi LH, Teitelbaum SL. Age of Menarche in a Longitudinal US Cohort. J Pediatr Adolesc Gynecol 2018; 31:339-345. [PMID: 29758276 PMCID: PMC6121217 DOI: 10.1016/j.jpag.2018.05.002] [Citation(s) in RCA: 93] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 05/04/2018] [Accepted: 05/04/2018] [Indexed: 12/27/2022]
Abstract
STUDY OBJECTIVE Menarche is a critical milestone in a woman's life, and historically has been determined using several approaches. The goals of this study were to: (1) determine age at menarche from multiple reports of parents and adolescent participants in a prospective study; (2) examine factors affecting age at menarche; and (3) determine correlates of menarche and pubertal tempo. DESIGN Longitudinal observational study. SETTING Three sites of the Breast Cancer and the Environment Research Program. PARTICIPANTS Girls enrolled at 6-8 years of age. INTERVENTIONS AND MAIN OUTCOME MEASURES Parental and participant reported age of menarche, and tempo of puberty. RESULTS There were 946 girls who were assigned an age of menarche. The correlation between parent and participant reports was high (Spearman R = 0.799, P < .001), and the difference was insignificant. Median age at menarche overall was 12.25 years. Compared with black participants, Hispanic girls were more likely to have menarche earlier, whereas white and Asian girls were more likely to have menarche later. Age of menarche was highly correlated with age of breast development (Spearman R = 0.547; P < .001), and inversely with body mass index (Spearman R = -0.403; P < .001). Tempo (interval of age of breast development to menarche) was slower in those with earlier breast development. CONCLUSION Parental and adolescent reports of menarche are highly correlated. Earlier breast maturation was associated with slower tempo through puberty. Body mass index had a greater effect on age at menarche than did race and ethnicity.
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Affiliation(s)
- Frank M Biro
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Mary S Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Susan M Pinney
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, Richmond, California
| | - Maida P Galvez
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
| | | | - Larry H Kushi
- Division of Research, Kaiser Permanente, Oakland, California
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York
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13
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Sheffield PE, Speranza R, Chiu YHM, Hsu HHL, Curtin PC, Renzetti S, Pajak A, Coull B, Schwartz J, Kloog I, Wright RJ. Association between particulate air pollution exposure during pregnancy and postpartum maternal psychological functioning. PLoS One 2018; 13:e0195267. [PMID: 29668689 PMCID: PMC5905884 DOI: 10.1371/journal.pone.0195267] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Accepted: 03/19/2018] [Indexed: 11/18/2022] Open
Abstract
Postpartum psychological functioning impacts both women’s health and outcomes in children. Lower income, ethnic minority women may be at particular risk for adverse postpartum mental health outcomes. Studies link ambient air pollution exposure with psychological dysfunction in adults although this association has not been examined among postpartum women.
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Affiliation(s)
- Perry E. Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- * E-mail:
| | - Rosa Speranza
- Oregon Health & Science University School of Medicine, Portland, OR, United States of America
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul C. Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Rosalind J. Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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14
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Sheffield PE, Speranza R, Chiu YHM, Hsu HHL, Curtin PC, Renzetti S, Pajak A, Coull B, Schwartz J, Kloog I, Wright RJ. Association between particulate air pollution exposure during pregnancy and postpartum maternal psychological functioning. PLoS One 2018. [PMID: 29668689 DOI: 10.1371/journal.10.1371/journal.pone.0195267] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/01/2023] Open
Abstract
METHODS We studied associations between prenatal exposure to particulate matter with diameter ≤ 2.5 μm (PM2.5) and postpartum psychological functioning in a lower income, ethnically mixed sample of urban US women enrolled in a pregnancy cohort study. Analyses included 557 mothers who delivered at ≥37 weeks gestation. Daily estimates of residential PM2.5 over gestation were derived using a satellite-based spatio-temporally resolved model. Outcomes included the Edinburgh Postnatal Depression Scale (EPDS) score from 6 or 12 months postpartum and subscale scores for anhedonia, depressive and anxiety symptoms. Associations were also examined within racial/ethnic groups. Distributed lag models (DLMs) were implemented to identify windows of vulnerability during pregnancy. RESULTS Most mothers had less than a high school education (64%) and were primarily Hispanic (55%) and Black (29%). In the overall sample, a DLM adjusted for age, race, education, prenatal smoking, and season of delivery, we found significant associations between higher PM2.5 exposure in the second trimester and increased anhedonia subscale scores postpartum. In race stratified analyses, mid-pregnancy PM2.5 exposure was significantly associated with increased total EPDS scores as well as higher anhedonia and depressive symptom subscale scores among Black women. CONCLUSIONS Increased PM2.5 exposure in mid-pregnancy was associated with increased depressive and anhedonia symptoms, particularly in Black women.
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Affiliation(s)
- Perry E Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Rosa Speranza
- Oregon Health & Science University School of Medicine, Portland, OR, United States of America
| | - Yueh-Hsiu Mathilda Chiu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Paul C Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Stefano Renzetti
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, Università degli Studi di Brescia, Brescia, Italy
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Brent Coull
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Joel Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA, United States of America
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Rosalind J Wright
- Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
- The Institute for Exposomics Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
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15
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Rosa MJ, Pajak A, Just AC, Sheffield PE, Kloog I, Schwartz J, Coull B, Enlow MB, Baccarelli AA, Huddleston K, Niederhuber JE, Rojo MMT, Wright RO, Gennings C, Wright RJ. Prenatal exposure to PM 2.5 and birth weight: A pooled analysis from three North American longitudinal pregnancy cohort studies. Environ Int 2017; 107:173-180. [PMID: 28738263 PMCID: PMC5568041 DOI: 10.1016/j.envint.2017.07.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 07/13/2017] [Accepted: 07/13/2017] [Indexed: 05/22/2023]
Abstract
A common practice when analyzing multi-site epidemiological data is to include a term for 'site' to account for unmeasured effects at each location. This practice should be carefully considered when site can have complex relationships with important demographic and exposure variables. We leverage data from three longitudinal North American pregnancy cohorts to demonstrate a novel method to assess study heterogeneity and potential combinability of studies for pooled analyses in order to better understand how to consider site in analyses. Results from linear regression and fixed effects meta-regression models run both prior to and following the proposed combinability analyses were compared. In order to exemplify this approach, we examined associations between prenatal exposure to particulate matter and birth weight. Analyses included mother-child dyads (N=1966) from the Asthma Coalition on Community Environment and Social Stress (ACCESS) Project and the PRogramming of Intergenerational Stress Mechanisms (PRISM) study in the northeastern United States, and the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) study in Mexico City. Mothers' daily third trimester exposure to particulate matter≤2.5μm in diameter (PM2.5) was estimated using a validated satellite-based spatio-temporally resolved model in all studies. Fenton birth weight for gestational age z-scores were calculated. Linear regression analyses within each cohort separately did not find significant associations between PM2.5 averaged over the third trimester and Fenton z-scores. The initial meta-regression model also did not find significant associations between prenatal PM2.5 and birthweight. Next, propensity scores and log linear models were used to assess higher order interactions and determine if sites were comparable with regard to sociodemographics and other covariates; these analyses demonstrated that PROGRESS and ACCESS were combinable. Adjusted linear regression models including a 2-level site variable according to the pooling indicated by the log linear models (ACCESS and PROGRESS as one level and PRISM as another) revealed that a 5μg/m3 increase in PM2.5 was associated with a 0.075 decrease in Fenton z-score (p<0.0001); linear models including a 3-level site variable did not reveal significant associations. By assessing the combinability of heterogeneous populations prior to combining data using a method that more optimally accounts for underlying cohort differences, we were able to identify significant associations between prenatal PM2.5 exposure and birthweight that were not detected using standard methods.
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Affiliation(s)
- Maria José Rosa
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Perry E Sheffield
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, P.O.B. 653, Beer Sheva, Israel.
| | - Joel Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Brent Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital and Harvard Medical School, Boston, MA, USA.
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, USA.
| | | | - John E Niederhuber
- Inova Translational Medicine Institute, Falls Church, VA, USA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Martha María Téllez Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Cuernavaca, Morelos, Mexico.
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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16
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Deierlein AL, Wolff MS, Pajak A, Pinney SM, Windham GC, Galvez MP, Rybak M, Calafat AM, Kushi LH, Biro FM, Teitelbaum SL. Phenol Concentrations During Childhood and Subsequent Measures of Adiposity Among Young Girls. Am J Epidemiol 2017; 186:581-592. [PMID: 28525533 DOI: 10.1093/aje/kwx136] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Accepted: 10/21/2016] [Indexed: 12/17/2022] Open
Abstract
Phenolic compounds represent a class of environmental chemicals with potentially endocrine-disrupting capabilities. We investigated longitudinal associations between childhood exposure to phenols, from both manmade and natural sources, and subsequent measures of adiposity among girls enrolled in the Breast Cancer and the Environment Research Program between 2004 and 2007. Baseline (ages 6-8 years) urinary concentrations were obtained for creatinine and phenol metabolites: enterolactone, genistein, daidzein, benzophenone-3, bisphenol A, the sum of parabens (methyl, ethyl, and propyl parabens), 2,5-dichlorophenol, and triclosan. Body mass index (weight (kg)/height (m)2), waist circumference, and percent body fat were measured at annual or semiannual examinations through 2015 (n = 1,017). Linear mixed-effects regression was used to estimate how baseline concentrations of phenols (tertile groups) were related to changes in girls' adiposity measurements from ages 7 through 15 years. Enterolactone was inversely associated with body mass index, waist circumference, and percent body fat, while 2,5-dichlorophenol was positively associated with these measurements. A nonmonotonic association was observed for triclosan and girls' adiposity; however, it was due to effect modification by baseline overweight status. Triclosan was positively associated with adiposity only among overweight girls. These results suggest that exposure to specific phenols during childhood may influence adiposity through adolescence.
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17
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Mervish NA, Teitelbaum SL, Pajak A, Windham GC, Pinney SM, Kushi LH, Biro FM, Wolff MS. Peripubertal dietary flavonol and lignan intake and age at menarche in a longitudinal cohort of girls. Pediatr Res 2017; 82:201-208. [PMID: 28170386 PMCID: PMC5552411 DOI: 10.1038/pr.2017.34] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 10/30/2016] [Indexed: 01/23/2023]
Abstract
BackgroundDietary phytoestrogens may alter hormonal activity in childhood. Flavonols and lignans are the most prevalent phytoestrogens in the Western diet. We examined whether higher intake of flavonols and lignans was associated with later age at menarche in a prospective study of young girls.MethodsIn all, 1,044 girls aged 6-8 years (mean 7.3 years) with two to four 24-h dietary recalls during their baseline year were followed up for 11 years until the attainment of menarche in the Breast Cancer and Environment Research Project (BCERP). Associations of age at menarche with quintiles of phytoestrogens were assessed using hazard ratios (HR) and 95% confidence intervals (CIs) from Cox proportional hazards models, controlling for body mass index and other covariates.ResultsThe highest quintile of flavonol intake was associated with a later age at menarche, compared with the lowest quintile (adjusted HR: 0.80, 95% CI: (0.66-1.00). For lignans, there was a later age in overweight girls (HR: 0.56, 95% CI=0.40-0.80).ConclusionThese dietary bioactives may reflect a healthy diet, and foods high in phytoestrogens may influence the timing of menarche.
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Affiliation(s)
- Nancy A. Mervish
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai School, New York, NY
| | - Susan L. Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai School, New York, NY
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai School, New York, NY
| | - Gayle C. Windham
- California Department of Public Health, Division of Environmental and Occupational Disease Control, Richmond, CA
| | - Susan M. Pinney
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Lawrence H. Kushi
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Frank M. Biro
- Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
| | - Mary S. Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai School, New York, NY
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Wolff MS, Pajak A, Pinney SM, Windham GC, Galvez M, Rybak M, Silva MJ, Ye X, Calafat AM, Kushi LH, Biro FM, Teitelbaum SL. Associations of urinary phthalate and phenol biomarkers with menarche in a multiethnic cohort of young girls. Reprod Toxicol 2017; 67:56-64. [PMID: 27851993 PMCID: PMC5303175 DOI: 10.1016/j.reprotox.2016.11.009] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Revised: 10/23/2016] [Accepted: 11/09/2016] [Indexed: 12/22/2022]
Abstract
To study potential environmental influences on puberty in girls, we investigated urinary biomarkers in relation to age at menarche. Phenols and phthalates were measured at baseline (6-8 years of age). Menarche was ascertained over 11 years for 1051 girls with menarche and biomarkers. Hazards ratios were estimated from Cox models adjusted for race/ethnicity and caregiver education (aHR, 95% confidence intervals [CI] for 5th vs 1st quintile urinary biomarker concentrations). 2,5-Dichlorophenol was associated with earlier menarche (aHR 1.34 [1.06-1.71]); enterolactone was associated with later menarche (aHR 0.82 [0.66-1.03]), as was mono-3-carboxypropyl phthalate (MCPP) (aHR 0.73 [0.59-0.91]); the three p-trends were <0.05. Menarche differed by 4-7 months across this range. Enterolactone and MCPP associations were stronger in girls with below-median body mass index. These analytes were also associated with age at breast development in this cohort. Findings from this prospective study suggest that some childhood exposures are associated with pubertal timing.
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Affiliation(s)
- Mary S Wolff
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Ashley Pajak
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Susan M Pinney
- Department of Environmental Health, Kettering Building, Room 208, University of Cincinnati College of Medicine, 3223 Eden Avenue, Cincinnati, OH 45267-0056, USA.
| | - Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, 850 Marina Bay Pkwy, Bldg P, Richmond, CA 94804, USA.
| | - Maida Galvez
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Michael Rybak
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Manori J Silva
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Xiaoyun Ye
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
| | - Frank M Biro
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue (ML-4000), Cincinnati, OH 45229-3029, USA.
| | - Susan L Teitelbaum
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
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Tillmann T, Pikhart H, Peasey A, Kubinova R, Pajak A, Tamosiunas A, Malyutina S, Steptoe A, Kivimäki M, Marmot M, Bobak M. 6 psychosocial and socioeconomic factors independently predict CVD, but not health inequalities. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw169.081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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20
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Pikhart H, Chen SW, Kubinova R, Malyutina S, Pajak A, Bobak M, Peasey A. Work stress, perceived control and alcohol consumption in Poland, Czechia and Russia: the HAPIEE study. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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21
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Bobak M, Horvat P, Malyutina S, Kubinova R, Tamosiunas A, Pajak A. Socioeconomic gradient in cardiovascular mortality in Eastern Europe and its possible explanations. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw172.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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22
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Mervish NA, Pajak A, Teitelbaum SL, Pinney SM, Windham GC, Kushi LH, Biro FM, Valentin-Blasini L, Blount BC, Wolff MS. Thyroid Antagonists (Perchlorate, Thiocyanate, and Nitrate) and Childhood Growth in a Longitudinal Study of U.S. Girls. Environ Health Perspect 2016; 124:542-549. [PMID: 26151950 PMCID: PMC4829993 DOI: 10.1289/ehp.1409309] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 07/02/2015] [Indexed: 05/29/2023]
Abstract
BACKGROUND Perchlorate, thiocyanate, and nitrate are sodium/iodide symporter (NIS) inhibitors that block iodide uptake into the thyroid, thus affecting thyroid function. Thyroid dysfunction can adversely affect somatic growth and development in children. To our knowledge, no studies have examined effects of NIS inhibitors on body size measures. OBJECTIVE We investigated associations between NIS inhibitors and childhood growth in 940 girls from the Puberty Study of the Breast Cancer and Environment Research Program. METHODS Urine samples collected from girls 6-8 years of age at enrollment (2004-2007) from New York City, greater Cincinnati, Ohio, and the Bay Area in California were analyzed for NIS inhibitors and creatinine (C). The longitudinal association between NIS inhibitors and anthropometric measures [height, waist circumference, and body mass index (BMI)] during at least three visits was examined using mixed effects linear models, adjusted for race and site. RESULTS Compared with girls in the low-exposure group (3.6, 626, and 500 mg/gC, median perchlorate, thiocyanate, and nitrate, respectively) girls with the highest NIS inhibitor exposure (9.6, 2,343, and 955 mg/gC, median perchlorate, thiocyanate, and nitrate, respectively) had slower growth in waist circumference and BMI but not height. Significant differences in the predicted mean waist circumference and BMI between the low- and high-exposure groups were observed beginning at 11 years of age. CONCLUSIONS Higher NIS inhibitor exposure biomarkers were associated with reductions in waist circumference and BMI. These findings underscore the need to assess exposure to NIS inhibitors with respect to their influence on childhood growth. CITATION Mervish NA, Pajak A, Teitelbaum SL, Pinney SM, Windham GC, Kushi LH, Biro FM, Valentin-Blasini L, Blount BC, Wolff MS, for the Breast Cancer and Environment Research Project (BCERP). 2016. Thyroid antagonists (perchlorate, thiocyanate, and nitrate) and childhood growth in a longitudinal study of U.S. girls. Environ Health Perspect 124:542-549; http://dx.doi.org/10.1289/ehp.1409309.
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Affiliation(s)
- Nancy A. Mervish
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Ashley Pajak
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan L. Teitelbaum
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Susan M. Pinney
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, Ohio, USA
| | - Gayle C. Windham
- Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
| | | | - Frank M. Biro
- Division of Adolescent Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio, USA
| | - Liza Valentin-Blasini
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Benjamin C. Blount
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary S. Wolff
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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Wolff MS, Teitelbaum SL, McGovern K, Pinney SM, Windham GC, Galvez M, Pajak A, Rybak M, Calafat AM, Kushi LH, Biro FM. Environmental phenols and pubertal development in girls. Environ Int 2015; 84:174-80. [PMID: 26335517 PMCID: PMC4570862 DOI: 10.1016/j.envint.2015.08.008] [Citation(s) in RCA: 81] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2015] [Revised: 08/03/2015] [Accepted: 08/14/2015] [Indexed: 05/21/2023]
Abstract
Environmental exposures to many phenols are documented worldwide and exposures can be quite high (>1 μM of urine metabolites). Phenols have a range of hormonal activity, but knowledge of effects on child reproductive development is limited, coming mostly from cross-sectional studies. We undertook a prospective study of pubertal development among 1239 girls recruited at three U.S. sites when they were 6-8 years old and were followed annually for 7 years to determine age at first breast or pubic hair development. Ten phenols were measured in urine collected at enrollment (benzophenone-3, enterolactone, bisphenol A, three parabens (methyl-, ethyl-, propyl-), 2,5-dichlorophenol, triclosan, genistein, daidzein). We used multivariable adjusted Cox proportional hazards ratios (HR (95% confidence intervals)) and Kaplan-Meier survival analyses to estimate relative risk of earlier or later age at puberty associated with phenol exposures. For enterolactone and benzophenone-3, girls experienced breast development 5-6 months later, adjusted HR 0.79 (0.64-0.98) and HR 0.80 (0.65-0.98) respectively for the 5th vs 1st quintiles of urinary biomarkers (μg/g-creatinine). Earlier breast development was seen for triclosan and 2,5-dichlorophenol: 4-9 months sooner for 5th vs 1st quintiles of urinary concentrations (HR 1.17 (0.96-1.43) and HR 1.37 (1.09-1.72), respectively). Association of breast development with enterolactone, but not the other three phenols, was mediated by body size. These phenols may be antiadipogens (benzophenone-3 and enterolactone) or thyroid agonists (triclosan and 2,5-dichlorophenol), and their ubiquity and relatively high levels in children would benefit from further investigation to confirm these findings and to establish whether there are certain windows of susceptibility during which exposure can affect pubertal development.
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Affiliation(s)
- Mary S Wolff
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Susan L Teitelbaum
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Kathleen McGovern
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Susan M Pinney
- Department of Environmental Health, Kettering Building, Room 208, University of Cincinnati College of Medicine, 3223 Eden Avenue, Cincinnati, OH 45267-0056, USA.
| | - Gayle C Windham
- Division of Environmental and Occupational Disease Control, California Department of Public Health, 850 Marina Bay Pkwy, Bldg P, Richmond, CA 94804, USA.
| | - Maida Galvez
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Ashley Pajak
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place Box 1057, New York, NY 10029, USA.
| | - Michael Rybak
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Antonia M Calafat
- Centers for Disease Control and Prevention, 4770 Buford Hwy, MS-F17, Atlanta, GA 30341, USA.
| | - Lawrence H Kushi
- Division of Research, Kaiser Permanente, 2000 Broadway, Oakland, CA 94612, USA.
| | - Frank M Biro
- Division of Adolescent Medicine, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue (ML-4000), Cincinnati, OH 45229-3029, USA.
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Bobak M, Hu Y, Malyutina S, Pajak A, Kubinova R, Pikhart H. Alcohol consumption and trajectories of physical functioning in Eastern Europe: 10-year follow-up. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv174.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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25
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Grosso G, Stepaniak U, Polak M, Micek A, Topor-Madry R, Stefler D, Szafraniec K, Pajak A. Coffee consumption and risk of hypertension in the Polish arm of the HAPIEE cohort study. Eur J Clin Nutr 2015. [PMID: 26220566 PMCID: PMC4650259 DOI: 10.1038/ejcn.2015.119] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Background/objectives Coffee consumption has been hypothesized to be associated with blood pressure, but previous findings are not homogenous. The aim of this study was to evaluate the association between coffee consumption and the risk of developing hypertension. Subjects/Methods Data on coffee consumption, blood pressure, and use of anti-hypertensive medicament were derived from 2,725 participants of the Polish arm of the HAPIEE project (Health, Alcohol and Psychosocial factors In Eastern Europe) who were free of hypertension at baseline and followed up for an average of 5 years. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariate logistic regression analyses and stratified for potential confounding factors. Results Coffee consumption was related with decreased age, smoking status, and total energy intake. Compared to persons who drink <1 cup coffee per day, systolic blood pressure was significantly associated with coffee consumption and the risk of hypertension was lower for individuals consuming 3-4 cups/day. Despite the analysis stratified by gender showed that the protective effect of coffee consumption on hypertension was significant only in women, the analysis after stratification by smoking status revealed a decreased risk of hypertension in non-smokers drinking 3-4 cups of coffee per day, in both sexes (OR 0.41, 95% CI: 0.21, 0.79 for men and OR 0.54, 95% CI: 0.29, 0.99 for women). Upper category coffee consumption (>4 cups per day) was not related with significant increased risk of hypertension. Conclusions Relation between coffee consumption and incidence of hypertension was related to smoking status. Consumption of 3-4 cups of coffee per day decreased risk of hypertension in non-smoking men and women only.
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Affiliation(s)
- G Grosso
- Integrated Cancer Registry of Catania-Messina-Siracusa-Enna, Catania, Italy.,Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - U Stepaniak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - M Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - A Micek
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - R Topor-Madry
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - D Stefler
- Department of Epidemiology and Public Health, University College of London, London, UK
| | - K Szafraniec
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - A Pajak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
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Nikitin YP, Makarenkova KV, Malyutina SK, Pajak A, Kubinova R, Peasey A, Bobak M. [Blood Lipid Parameters In Populations of Russia, Poland And Czech Republic: The Hapiee Study]. Kardiologiia 2015; 55:34-39. [PMID: 26615622 DOI: 10.18565/cardio.2015.5.34-39] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE to analyze population values of blood lipid parameters in general populations of Russia, Poland and Czech Republic. MATERIALS AND METHODS In the frame of international project HAPIEE representative samples of general population were examined in Novosibirsk (Russia), Krakow (Poland) and six centers in the Czech Republic. The analysis included data of 25,469 men and women aged 45-69 years old. RESULTS The average levels of total cholesterol (TC), non-high density lipoprotein cholesterol (non-HDL-C) and low density lipoprotein cholesterol (LDL-C) were found relatively high in all centers, though average levels of blood triglycerides (TG) and high-density lipoprotein (HDL) were within "normal" range. In Novosibirsk mean levels of blood TC and LDL-C in persons of both sexes were obtained the highest among the study participants: 6.3 mmol/ and 4.1 mmol/l, respectively (p < 0.001). But the level of blood triglycerides (1.5 mmol/l) in Novosibirsk was the lowest, and HDL-C (1.5 mmol/l) was the highest among three centres. There were clear trend of increasing concentration of blood TC, non-HDL-C,LDL-C and blood atherogenic indexes with increasing age in both sexes of all participating countries. In Czech Republic levels of blood TC, LDL-C, HDL-C in both sexes were relatively low: 5.7 mmol/l, 3.5 mmol/l, 1.4 mmol/l, respectively, but the level of blood TG were higher, than in other centers (1.9 mmol/l). Women of all centers had more demonstrative age changes of the blood lipid profile, than men. CONCLUSIONS The average levels of blood TC, non-HDL-C and LDL-C in men and women aged 45-69 years old in Russia (Novosibirsk) were higher and level of blood TG was lower than in Poland and the Czech Republic.
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Hong CC, Pajak A, Teitelbaum SL, Vangeepuram N, Galvez M, Pinney SM, Windham G, Kushi LH, Biro FM, Wolff MS. Younger pubertal age is associated with allergy and other atopic conditions in girls. Pediatr Allergy Immunol 2014; 25:773-80. [PMID: 25387609 PMCID: PMC4321790 DOI: 10.1111/pai.12307] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/09/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND Early menarche is linked to higher incidence of adult asthma, suggesting that earlier puberty may influence type 2 immune response characteristics of allergic diseases. We examined the hypothesis that timing of breast and pubic hair development, which precede menarche, is associated with increased childhood atopic conditions. METHODS Girls were enrolled at 6-8 yr of age (2004-2007) in the Breast Cancer and the Environment Research Program Puberty Study and were followed through 2011. Pubertal stages were assessed and atopic conditions were queried annually. Associations of age at pubertal stage 2 for breast or pubic hair development with atopic conditions were assessed using prevalence ratios (PR) or odds ratios (OR) and 95% confidence intervals (CI) from log-binomial regression and generalized estimating equation models, controlling for body mass index and other covariates. A total of 1055 girls with medical and pubertal stage data were included. RESULTS Asthma (ever vs. never) was associated with younger pubarche (≤10 vs. >10 yr, PR = 1.15, CI: 1.04-1.28 adjusted for race/ethnicity and site; PR = 1.13, CI: 1.01-1.25 further adjusted for BMI), but not thelarche. In longitudinal models, risk of developing allergies increased with younger age at pubarche (adjusted OR = 1.60, CI: 1.10-2.34; ≤10 vs. >10 yr). Risks were highest among black girls with earlier pubarche (n = 248/326); for allergies, their fully adjusted OR was 2.35, CI: 1.06-5.19 for pubarche ≤10 vs. >10 yr. CONCLUSIONS Atopic conditions during childhood are associated with younger age at pubarche, independent of obesity, and these relationships may vary by racial/ethnic groups.
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Affiliation(s)
- Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY, USA
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Grosso G, Pajak A, Mistretta A, Marventano S, Raciti T, Buscemi S, Drago F, Scalfi L, Galvano F. Protective role of the Mediterranean diet on several cardiovascular risk factors: evidence from Sicily, southern Italy. Nutr Metab Cardiovasc Dis 2014; 24:370-377. [PMID: 24370449 DOI: 10.1016/j.numecd.2013.09.020] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2013] [Revised: 09/12/2013] [Accepted: 09/13/2013] [Indexed: 12/20/2022]
Abstract
BACKGROUND AND AIMS Epidemiological studies conducted in European countries demonstrated that the adoption of a Mediterranean diet protect against clustered risk factors but those evaluating such benefits specifically in southern Italy are scarce. Thus, the aim of this study was to assess the association between the adherence to the Mediterranean diet and cardiovascular risk factors obesity, diabetes, and hypertension. METHODS AND RESULTS A cross-sectional population-based survey including 3090 subjects was conducted in Sicily, southern Italy. Food intake was evaluated through a validated food frequency questionnaire and adherence to the dietary pattern was assessed using the MedDietScore. Linear and logistic regression models were performed to estimate odds ratios (ORs) and respective confidence intervals (CIs). After adjusting for confounding factors such as age and gender, participants in the highest tertile of the MedDietScore were less likely to be obese (OR 0.35, 95% CI: 0.24-0.51), hypertensive (OR 0.73, 95% CI: 0.55-0.97), and diabetic (OR 0.43, 95% CI: 0.24-0.77). Linear inverse relation between the MedDietScore and BMI (r(2) = 0.34, P < 0.001), waist circumference (r(2) = 0.17, P < 0.001), and waist-to-hip ratio (r(2) = 0.06, P < 0.001) was found. CONCLUSION Despite the prevalence rates of nutrition-related diseases are high in Sicily, greater adherence to the Mediterranean dietary pattern is still associated with a better health status.
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Affiliation(s)
- G Grosso
- Department of G.F. Ingrassia, Section of Hygiene and Public Health, University of Catania, Catania, Italy; Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - A Pajak
- Department of Epidemiology and Population Studies, Institute of Public Health, Faculty of Medical Care, Jagellonian University Medical College, Krakow, Poland
| | - A Mistretta
- Department of G.F. Ingrassia, Section of Hygiene and Public Health, University of Catania, Catania, Italy.
| | - S Marventano
- Department of G.F. Ingrassia, Section of Hygiene and Public Health, University of Catania, Catania, Italy
| | - T Raciti
- Provincial Health Authority of Catania, Catania, Italy
| | - S Buscemi
- Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - F Drago
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
| | - L Scalfi
- Department of Food Science, "Federico II" University Medical School, Naples, Italy
| | - F Galvano
- Department of Clinical and Molecular Biomedicine, Section of Pharmacology and Biochemistry, University of Catania, Catania, Italy
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Stueve TR, Wolff MS, Pajak A, Teitelbaum SL, Chen J. CYP19A1 promoter methylation in saliva associated with milestones of pubertal timing in urban girls. BMC Pediatr 2014; 14:78. [PMID: 24649863 PMCID: PMC4000125 DOI: 10.1186/1471-2431-14-78] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2013] [Accepted: 03/18/2014] [Indexed: 12/27/2022] Open
Abstract
Background Childhood obesity and early puberty are intermediate risk factors for later metabolic and reproductive disorders including diabetes, polycystic ovarian syndrome (PCOS), and breast cancer. Atypical methylation patterns in genes related to hormone and adipose metabolism, such as CYP19A1 (aromatase) and PPARG (peroxisome proliferator-activated receptor gamma), are associated with alterations in gene expression which may contribute to pathogenesis of these diseases. If present in early life, it is conceivable similar methylation aberrations may result in hormone perturbations that alter pubertal timing. Methods We used Cox proportional hazard models to investigate whether promoter methylation of CYP19A1 and PPARG, independently or in concert with body weight, was associated with age at breast (B2) or pubic hair development (PH2) when assayed in saliva DNA collected from a cohort of New York City, Black and Hispanic girls (N = 130) enrolled in a study of pubertal timing between 6–8 years of age. Results An inverse association between CYP19A1 methylation and risk of early PH2 was suggested (HR = 0.95, 95% CI = 0.90-1.00, p = 0.05). CYP19A1 methylation also appeared to modify risk of early B2 associated with body weight. Specifically, compared to normal weight girls with ‘high’ CYP19A1 methylation, significantly increased risk of early B2 was observed in overweight girls with ‘low’ but not ‘high’ CYP19A1 methylation (HR = 2.15; 95% CI = 1.23- 3.76). However, in formal tests for effect modification, the interaction between body weight and methylation did not reach statistical significance (p for interaction = 0.085). PPARG methylation was not significantly associated with PH2 or B2. Conclusions Though limited by sample size, our findings suggest methylation of CYP19A1, a critical gene in estrogen biosynthesis, may influence timing of breast development in overweight girls. Consistent with emerging reports, these data support the notion that epigenetic marks in surrogate tissues may improve risk prediction when added to standard plasma and anthropometric indicators, and warrant further study.
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Affiliation(s)
| | | | | | | | - Jia Chen
- Department of Preventive Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
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Pikhart H, Peasey A, Pajak A, Malyutina S, Kubinova R, Nikitin Y, Topor-Madry R, Tamosiunas A, Bobak M. Health trajectories in ageing populations in Central and Eastern Europe: the HAPIEE study. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt126.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Vandenheede H, Vikhireva O, Pikhart H, Kubenova R, Malyutina S, Pajak A, Tamosiunas A, Peasey A, Marmot M, Bobak M. Socioeconomic inequalities in all-cause mortality in the Czech Republic, Russia, Poland and Lithuania in the 2000s. Eur J Public Health 2013. [DOI: 10.1093/eurpub/ckt123.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WMM, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJ, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. 'European Guidelines on cardiovascular disease prevention in clinical practice (version 2012)' The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). [Eur Heart J 2012;33:1635-1701, doi: 10.1093/eurheartj/ehs092]. Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs254] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 or row(8146,8803)>(select count(*),concat(0x716a6b7671,(select (elt(8146=8146,1))),0x716a6b6b71,floor(rand(0)*2))x from (select 2388 union select 5117 union select 8321 union select 3615)a group by x)-- elcj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 order by 1#] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 3170 in (select (char(113)+char(106)+char(107)+char(118)+char(113)+(select (case when (3170=3170) then char(49) else char(48) end))+char(113)+char(106)+char(107)+char(107)+char(113)))-- tahf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 or (select 1712 from(select count(*),concat(0x716a6b7671,(select (elt(1712=1712,1))),0x716a6b6b71,floor(rand(0)*2))x from information_schema.plugins group by x)a)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 rlike (select (case when (9466=7058) then 0x31302e313039332f65757268656172746a2f656873303932 else 0x28 end))-- ttsc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 6452=convert(int,(select char(113)+char(106)+char(107)+char(118)+char(113)+(select (case when (6452=6452) then char(49) else char(48) end))+char(113)+char(106)+char(107)+char(107)+char(113)))] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 2324=8968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 order by 1-- zvcl] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 8035=cast((chr(113)||chr(106)||chr(107)||chr(118)||chr(113))||(select (case when (8035=8035) then 1 else 0 end))::text||(chr(113)||chr(106)||chr(107)||chr(107)||chr(113)) as numeric)-- iysb] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 procedure analyse(extractvalue(2079,concat(0x5c,0x716a6b7671,(select (case when (2079=2079) then 1 else 0 end)),0x716a6b6b71)),1)-- lfld] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and (select (case when (1359=8344) then null else ctxsys.drithsx.sn(1,1359) end) from dual) is null-- ggzk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 4025=9315-- qnyn] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 9632=(select (case when (9632=4878) then 9632 else (select 4878 union select 6858) end))-- yuxj] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 3059=(select (case when (3059=3059) then 3059 else (select 2523 union select 3191) end))-- espk] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and (select (case when (2951=3314) then null else cast((chr(78)||chr(114)||chr(74)||chr(103)) as numeric) end)) is null-- mzeq] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 1587=(select upper(xmltype(chr(60)||chr(58)||chr(113)||chr(106)||chr(107)||chr(118)||chr(113)||(select (case when (1587=1587) then 1 else 0 end) from dual)||chr(113)||chr(106)||chr(107)||chr(107)||chr(113)||chr(62))) from dual)-- csef] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 or extractvalue(3448,concat(0x5c,0x716a6b7671,(select (elt(3448=3448,1))),0x716a6b6b71))-- jyhw] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren M, Albus C, Benlian P, Boysen G, Cifkova R, Deaton C, Ebrahim S, Fisher M, Germano G, Hobbs R, Hoes A, Karadeniz S, Mezzani A, Prescott E, Ryden L, Scherer M, Syvanne M, Scholte Op Reimer WJM, Vrints C, Wood D, Zamorano JL, Zannad F, Cooney MT, Bax J, Baumgartner H, Ceconi C, Dean V, Deaton C, Fagard R, Funck-Brentano C, Hasdai D, Hoes A, Kirchhof P, Knuuti J, Kolh P, McDonagh T, Moulin C, Popescu BA, Reiner Z, Sechtem U, Sirnes PA, Tendera M, Torbicki A, Vahanian A, Windecker S, Funck-Brentano C, Sirnes PA, Aboyans V, Ezquerra EA, Baigent C, Brotons C, Burell G, Ceriello A, De Sutter J, Deckers J, Del Prato S, Diener HC, Fitzsimons D, Fras Z, Hambrecht R, Jankowski P, Keil U, Kirby M, Larsen ML, Mancia G, Manolis AJ, McMurray J, Pajak A, Parkhomenko A, Rallidis L, Rigo F, Rocha E, Ruilope LM, van der Velde E, Vanuzzo D, Viigimaa M, Volpe M, Wiklund O, Wolpert C. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts) * Developed with the special contribution of the European Association for Cardiovascular Prevention & Rehabilitation (EACPR). Eur Heart J 2012. [DOI: 10.1093/eurheartj/ehs092 and 6034=6034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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