Trends in Mortality Rate from Cardiovascular Disease in Brazil, 1980-2012

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Antonio de Padua Mansur

2016-01-01

Full Text Available Abstract Background: Studies have questioned the downward trend in mortality from cardiovascular diseases (CVD in Brazil in recent years. Objective: to analyze recent trends in mortality from ischemic heart disease (IHD and stroke in the Brazilian population. Methods: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and the Ministry of Health. Risk of death was adjusted by the direct method, using as reference the world population of 2000. We analyzed trends in mortality from CVD, IHD and stroke in women and men in the periods of 1980-2006 and 2007-2012. Results: there was a decrease in CVD mortality and stroke in women and men for both periods (p < 0.001. Annual mortality variations for periods 1980-2006 and 2007-2012 were, respectively: CVD (total: -1.5% and -0.8%; CVD men: -1.4% and -0.6%; CVD women: -1.7% and -1.0%; DIC (men: -1.1% and 0.1%; stroke (men: -1.7% and -1.4%; DIC (women: -1.5% and 0.4%; stroke (women: -2.0% and -1.9%. From 1980 to 2006, there was a decrease in IHD mortality in men and women (p < 0.001, but from 2007 to 2012, changes in IHD mortality were not significant in men [y = 151 + 0.04 (R2 = 0.02; p = 0.779] and women [y = 88-0.54 (R2 = 0.24; p = 0.320. Conclusion: Trend in mortality from IHD stopped falling in Brazil from 2007 to 2012.

Cholecystokinin in plasma predicts cardiovascular mortality in elderly females

DEFF Research Database (Denmark)

Gøtze, Jens P.; Rehfeld, Jens F; Alehagen, Urban

2016-01-01

BACKGROUND: Cholecystokinin (CCK) and gastrin are related gastrointestinal hormones with documented cardiovascular effects of exogenous administration. It is unknown whether measurement of endogenous CCK or gastrin in plasma contains information regarding cardiovascular mortality. METHODS......: Mortality risk was evaluated using Cox proportional hazard regression and Kaplan-Meier analyses. Elderly patients in a primary care setting with symptoms of cardiac disease, i.e. shortness of breath, peripheral edema, and/or fatigue, were evaluated (n=470). Primary care patients were followed for 13years...... information was obtained from 4th quartile gastrin concentrations on 5-year cardiovascular mortality risk. CONCLUSIONS: CCK in plasma is an independent marker of cardiovascular mortality in elderly female patients. The study thus introduces measurement of plasma CCK in gender-specific cardiovascular risk...

Space-Time Analysis to Identify Areas at Risk of Mortality from Cardiovascular Disease

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Poliany C. O. Rodrigues

2015-01-01

Full Text Available This study aimed at identifying areas that were at risk of mortality due to cardiovascular disease in residents aged 45 years or older of the cities of Cuiabá and Várzea Grande between 2009 and 2011. We conducted an ecological study of mortality rates related to cardiovascular disease. Mortality rates were calculated for each census tract by the Local Empirical Bayes estimator. High- and low-risk clusters were identified by retrospective space-time scans for each year using the Poisson probability model. We defined the year and month as the temporal analysis unit and the census tracts as the spatial analysis units adjusted by age and sex. The Mann-Whitney U test was used to compare the socioeconomic and environmental variables by risk classification. High-risk clusters showed higher income ratios than low-risk clusters, as did temperature range and atmospheric particulate matter. Low-risk clusters showed higher humidity than high-risk clusters. The Eastern region of Várzea Grande and the central region of Cuiabá were identified as areas at risk of mortality due to cardiovascular disease in individuals aged 45 years or older. High mortality risk was associated with socioeconomic and environmental factors. More high-risk clusters were observed at the end of the dry season.

Soluble TWEAK and Cardiovascular Morbidity and Mortality in ...

African Journals Online (AJOL)

Introduction: Cardiovascular disease (CVD) is a major cause of morbidity and mortality in chronic kidney patients (CKD). The aim of this study was to demonstrate the role of soluble tumor necrosis factor (TNF) weak inducer of apoptosis (sTWEAK) as a marker of cardiovascular morbidity and mortality in CKD patients.

Depressive symptoms, physical inactivity and risk of cardiovascular mortality in older adults: the Cardiovascular Health Study

Science.gov (United States)

Win, Sithu; Parakh, Kapil; Eze-Nliam, Chete M; Gottdiener, John S; Kop, Willem J

2011-01-01

Background Depressed older individuals have a higher mortality than older persons without depression. Depression is associated with physical inactivity, and low levels of physical activity have been shown in some cohorts to be a partial mediator of the relationship between depression and cardiovascular events and mortality. Methods A cohort of 5888 individuals (mean 72.8±5.6 years, 58% female, 16% African-American) from four US communities was followed for an average of 10.3 years. Self-reported depressive symptoms (10-item Center for Epidemiological Studies Depression Scale) were assessed annually and self-reported physical activity was assessed at baseline and at 3 and 7 years. To estimate how much of the increased risk of cardiovascular mortality associated with depressive symptoms was due to physical inactivity, Cox regression with time-varying covariates was used to determine the percentage change in the log HR of depressive symptoms for cardiovascular mortality after adding physical activity variables. Results At baseline, 20% of participants scored above the cut-off for depressive symptoms. There were 2915 deaths (49.8%), of which 1176 (20.1%) were from cardiovascular causes. Depressive symptoms and physical inactivity each independently increased the risk of cardiovascular mortality and were strongly associated with each other (all pphysical inactivity had greater cardiovascular mortality than those with either individually (pPhysical inactivity reduced the log HR of depressive symptoms for cardiovascular mortality by 26% after adjustment. This was similar for persons with (25%) and without (23%) established coronary heart disease. Conclusions Physical inactivity accounted for a significant proportion of the risk of cardiovascular mortality due to depressive symptoms in older adults, regardless of coronary heart disease status. PMID:21339320

Cohort-specific trends in stroke mortality in seven European countries were related to infant mortality rates

NARCIS (Netherlands)

Amiri, M.; Kunst, A. E.; Janssen, F.; Mackenbach, J. P.

2006-01-01

Objectives: To assess, in a population-based study, whether secular trends in cardiovascular disease mortality in seven European countries were correlated with past trends in infant mortality rate (IMR) in these countries. Study Design and Setting: Data on ischemic heart disease (IHD) and stroke

Overweight Without Central Obesity, Cardiovascular Risk, and All-Cause Mortality.

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He, Xin; Liu, Chen; Chen, Yili; He, Jiangui; Dong, Yugang

2018-04-12

To assess the association of overweight without central obesity with risks of mortality. We included 14,299 participants in the Third National Health and Nutrition Examination Survey (from October 18, 1988, through October 15, 1994). According to their body mass index and waist circumference, participants were categorized into 7 anthropometric groups. Logistic regression models were used to assess the relation of cardiovascular risk factors (hypertension, diabetes, or hypercholesterolemia) and 10-year cardiovascular risk to anthropometric groups. Cox proportional hazards models were used to assess the risk of all-cause mortality, and competing-risks regression models were used for calculating cardiovascular and noncardiovascular mortality. Compared with those with normal body mass index and waist circumference, overweight men without central obesity were more likely to have all 3 cardiovascular risk factors and a high cardiovascular risk, whereas women in this anthropometric group were more likely to have hypercholesterolemia. In proportional hazards models, overweight without central obesity was associated with lower all-cause mortality among men in the population with cardiovascular risk factors (hazard ratio, 0.71; 95% CI, 0.56-0.89; P=.004) and the general population (hazard ratio, 0.72; 95% CI, 0.60-0.87; P=.001), whereas results of these comparisons among women were not significant (P>.05). In competing risk analyses, overweight men without central obesity had a lower risk of noncardiovascular mortality, but not cardiovascular mortality. Although overweight without central obesity was associated with cardiovascular risk factors and a high cardiovascular risk among men, men in this anthropometric group had a lower mortality risk. Copyright © 2018 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Abdominal obesity in Japanese-Brazilians: which measure is best for predicting all-cause and cardiovascular mortality?

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Marselle Rodrigues Bevilacqua

Full Text Available This study aimed to verify which anthropometric measure of abdominal obesity was the best predictor of all-cause and cardiovascular mortality in Japanese-Brazilians. The study followed 1,581 subjects for 14 years. Socio-demographic, lifestyle, metabolic, and anthropometric data were collected. The dependent variable was vital status (alive or dead at the end of the study, and the independent variable was presence of abdominal obesity according to different baseline measures. The mortality rate was estimated, and Poisson regression was used to obtain mortality rate ratios with abdominal obesity, adjusted simultaneously for the other variables. The mortality rate was 10.68/thousand person-years. Male gender, age > 60 years, and arterial hypertension were independent risk factors for mortality. The results indicate that prevalence of abdominal obesity was high among Japanese-Brazilians, and that waist/hip ratio was the measure with the greatest capacity to predict mortality (especially cardiovascular mortality in this group.

Cardiovascular Mortality Caused by Exposure to Radon

International Nuclear Information System (INIS)

Johnson, J. R.; Duport, P.

2004-01-01

Cardiovascular diseases (CVD) are reported as the cause of morbidity and mortality in humans exposed to (high) therapeutic doses of radiation, A-bomb explosions, accidental (Chernobyl liquidators) and occupational level of radiation while CVD risk does not appear to be elevated in other populations exposed to radiation CVD mortality also appears to be elevated, proportionally with radon progeny exposure in Newfoundland fluorspar miners. In addition, radiation exposure does not seem to increase and may indeed decrease CVD mortality or morbidity in mammals exposed to radiation in the laboratory. We have calculated the doses to blood and coronary artery wall from radon and progeny, and have concluded radon exposure may indeed increase the incidence of cardiovascular diseases and that a thorough investigation of that risk is justified, even at environmental and occupational levels. These contradictory observations suggest that radiation may be considered as one of many risk factors for cardiovascular diseases. As such, it may be necessary to reduce not only other risk factors as far as possible, but also to minimize exposures to radiation to further reduce the burden of cardiovascular diseases in the population. (Author) 27 refs

Cardiovascular and noncardiovascular mortality among men and women starting dialysis

DEFF Research Database (Denmark)

Carrero, Juan J; de Jager, Dinanda J; Verduijn, Marion

2011-01-01

Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women.......Although women have a survival advantage in the general population, women on dialysis have similar mortality to men. We hypothesized that this paired mortality risk during dialysis may be explained by a relative excess of cardiovascular-related mortality in women....

Cardiovascular and respiratory hospitalizations and mortality among users of tiotropium in Denmark

DEFF Research Database (Denmark)

de Luise, Cynthia; Lanes, Stephan F; Jacobsen, Jacob

2007-01-01

.17). Compared to periods of non-use, tiotropium was associated with reduced respiratory and overall mortality and was not associated with increased cardiac mortality. An increase in COPD hospitalization is inconsistent with clinical trial data and suggests preferential prescribing due to disease severity.......Tiotropium (Spiriva is an inhaled, once-daily anticholinergic medication for chronic obstructive pulmonary disease (COPD). We conducted a population-based cohort study to examine the risk of cardiovascular and respiratory hospitalizations and mortality with tiotropium. Using the Danish healthcare...... registries, we identified persons >/=40 years old in three counties who were hospitalized for COPD from 1/1/1977 to 12/31/2003. Respiratory and cardiovascular medications were assessed from dispensing records. Cox regression was used to compute incidence rate ratios (RR) and 95% confidence intervals (CI...

The Effect of Donepezil Treatment on Cardiovascular Mortality

OpenAIRE

Sato, K; Urbano, R; Yu, C; Yamasaki, F; Sato, T; Jordan, J; Robertson, D; Diedrich, A

2010-01-01

The acetylcholinesterase inhibitor donepezil hydrochloride improves cognitive function in patients with Alzheimer’s disease and vascular dementia. Given acetylcholine’s important actions on the heart, we undertook a retrospective cohort investigation to assess whether donepezil usage affects cardiovascular mortality. In patients treated with donepezil, hazard ratios for total and cardiovascular mortality were 0.68 (P = 0.045, 95% confidence interval 0.46–0.99) and 0.54 (P = 0.042, 95% confide...

Chronic cardiovascular disease mortality in mountaintop mining areas of central Appalachian states.

Science.gov (United States)

Esch, Laura; Hendryx, Michael

2011-01-01

To determine if chronic cardiovascular disease (CVD) mortality rates are higher among residents of mountaintop mining (MTM) areas compared to mining and nonmining areas, and to examine the association between greater levels of MTM surface mining and CVD mortality. Age-adjusted chronic CVD mortality rates from 1999 to 2006 for counties in 4 Appalachian states where MTM occurs (N = 404) were linked with county coal mining data. Three groups of counties were compared: MTM, coal mining but not MTM, and nonmining. Covariates included smoking rate, rural-urban status, percent male population, primary care physician supply, obesity rate, diabetes rate, poverty rate, race/ethnicity rates, high school and college education rates, and Appalachian county. Linear regression analyses examined the association of mortality rates with mining in MTM areas and non-MTM areas and the association of mortality with quantity of surface coal mined in MTM areas. Prior to covariate adjustment, chronic CVD mortality rates were significantly higher in both mining areas compared to nonmining areas and significantly highest in MTM areas. After adjustment, mortality rates in MTM areas remained significantly higher and increased as a function of greater levels of surface mining. Higher obesity and poverty rates and lower college education rates also significantly predicted CVD mortality overall and in rural counties. MTM activity is significantly associated with elevated chronic CVD mortality rates. Future research is necessary to examine the socioeconomic and environmental impacts of MTM on health to reduce health disparities in rural coal mining areas. © 2011 National Rural Health Association.

Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study.

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Raaschou-Nielsen, Ole; Andersen, Zorana Jovanovic; Jensen, Steen Solvang; Ketzel, Matthias; Sørensen, Mette; Hansen, Johnni; Loft, Steffen; Tjønneland, Anne; Overvad, Kim

2012-09-05

Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association. We followed up 52 061 participants in a Danish cohort for mortality in the nationwide Register of Causes of Death, from enrollment in 1993-1997 through 2009, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO₂) since 1971 as indicator of traffic air pollution and used Cox regression models to estimate mortality rate ratios (MRRs) with adjustment for potential confounders. Mean levels of NO₂ at the residence since 1971 were significantly associated with mortality from cardiovascular disease (MRR, 1.26; 95% confidence interval [CI], 1.06-1.51, per doubling of NO₂ concentration) and all causes (MRR, 1.13; 95% CI, 1.04-1.23, per doubling of NO₂ concentration) after adjustment for potential confounders. For participants who ate fruit and vegetables per day, the MRR was 1.45 (95% CI, 1.13-1.87) for mortality from cardiovascular disease and 1.25 (95% CI, 1.11-1.42) for mortality from all causes. Traffic air pollution is associated with mortality from cardiovascular diseases and all causes, after adjustment for traffic noise. The association was strongest for people with a low fruit and vegetable intake.

Arsenic in public water supplies and cardiovascular mortality in Spain

International Nuclear Information System (INIS)

Medrano, Ma Jose; Boix, Raquel; Pastor-Barriuso, Roberto; Palau, Margarita; Damian, Javier; Ramis, Rebeca; Barrio, Jose Luis del; Navas-Acien, Ana

2010-01-01

Background: High-chronic arsenic exposure in drinking water is associated with increased cardiovascular disease risk. At low-chronic levels, as those present in Spain, evidence is scarce. In this ecological study, we evaluated the association of municipal drinking water arsenic concentrations during the period 1998-2002 with cardiovascular mortality in the population of Spain. Methods: Arsenic concentrations in drinking water were available for 1721 municipalities, covering 24.8 million people. Standardized mortality ratios (SMRs) for cardiovascular (361,750 deaths), coronary (113,000 deaths), and cerebrovascular (103,590 deaths) disease were analyzed for the period 1999-2003. Two-level hierarchical Poisson models were used to evaluate the association of municipal drinking water arsenic concentrations with mortality adjusting for social determinants, cardiovascular risk factors, diet, and water characteristics at municipal or provincial level in 651 municipalities (200,376 cardiovascular deaths) with complete covariate information. Results: Mean municipal drinking water arsenic concentrations ranged from 10 μg/L. Compared to municipalities with arsenic concentrations 10 μg/L, respectively (P-value for trend 0.032). The corresponding figures were 5.2% (0.8% to 9.8%) and 1.5% (-4.5% to 7.9%) for coronary heart disease mortality, and 0.3% (-4.1% to 4.9%) and 1.7% (-4.9% to 8.8%) for cerebrovascular disease mortality. Conclusions: In this ecological study, elevated low-to-moderate arsenic concentrations in drinking water were associated with increased cardiovascular mortality at the municipal level. Prospective cohort studies with individual measures of arsenic exposure, standardized cardiovascular outcomes, and adequate adjustment for confounders are needed to confirm these ecological findings. Our study, however, reinforces the need to implement arsenic remediation treatments in water supply systems above the World Health Organization safety standard of 10 μg/L.

Lower estimated glomerular filtration rate and higher albuminuria are associated with all-cause and cardiovascular mortality. A collaborative meta-analysis of high-risk population cohorts

NARCIS (Netherlands)

van der Velde, Marije; Matsushita, Kunihiro; Coresh, Josef; Astor, Brad C.; Woodward, Mark; Levey, Andrew S.; de Jong, Paul E.; Gansevoort, Ron T.

Screening for chronic kidney disease is recommended in people at high risk, but data on the independent and combined associations of estimated glomerular filtration rate (eGFR) and albuminuria with all-cause and cardiovascular mortality are limited. To clarify this, we performed a collaborative

Orosomucoid in urine predicts cardiovascular and over-all mortality in patients with Type II diabetes

DEFF Research Database (Denmark)

Christiansen, Merete S; Hommel, E; Magid, E

2002-01-01

urinary orosomucoid excretion rate at baseline (odds ratios adjusted for age, sex, duration of diabetes, cardiovascular diseases, weight, medication, HbA1 c, plasma creatinine and urinary albumin excretion rate). Urinary albumin excretion rate was an independent predictor of all-cause mortality when...

Leisure-time running reduces all-cause and cardiovascular mortality risk.

Science.gov (United States)

Lee, Duck-Chul; Pate, Russell R; Lavie, Carl J; Sui, Xuemei; Church, Timothy S; Blair, Steven N

2014-08-05

Although running is a popular leisure-time physical activity, little is known about the long-term effects of running on mortality. The dose-response relations between running, as well as the change in running behaviors over time, and mortality remain uncertain. We examined the associations of running with all-cause and cardiovascular mortality risks in 55,137 adults, 18 to 100 years of age (mean age 44 years). Running was assessed on a medical history questionnaire by leisure-time activity. During a mean follow-up of 15 years, 3,413 all-cause and 1,217 cardiovascular deaths occurred. Approximately 24% of adults participated in running in this population. Compared with nonrunners, runners had 30% and 45% lower adjusted risks of all-cause and cardiovascular mortality, respectively, with a 3-year life expectancy benefit. In dose-response analyses, the mortality benefits in runners were similar across quintiles of running time, distance, frequency, amount, and speed, compared with nonrunners. Weekly running even benefits, with 29% and 50% lower risks of all-cause and cardiovascular mortality, respectively, compared with never-runners. Running, even 5 to 10 min/day and at slow speeds benefits. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China.

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Wang, Xuying; Li, Guoxing; Liu, Liqun; Westerdahl, Dane; Jin, Xiaobin; Pan, Xiaochuan

2015-12-21

Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. We collected data from Beijing and Shanghai, China, during 2007-2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0-27, while the hot effects reached the strongest at lag 0-14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34) to extremely low temperature. People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Effects of Extreme Temperatures on Cause-Specific Cardiovascular Mortality in China

Directory of Open Access Journals (Sweden)

Xuying Wang

2015-12-01

Full Text Available Objective: Limited evidence is available for the effects of extreme temperatures on cause-specific cardiovascular mortality in China. Methods: We collected data from Beijing and Shanghai, China, during 2007–2009, including the daily mortality of cardiovascular disease, cerebrovascular disease, ischemic heart disease and hypertensive disease, as well as air pollution concentrations and weather conditions. We used Poisson regression with a distributed lag non-linear model to examine the effects of extremely high and low ambient temperatures on cause-specific cardiovascular mortality. Results: For all cause-specific cardiovascular mortality, Beijing had stronger cold and hot effects than those in Shanghai. The cold effects on cause-specific cardiovascular mortality reached the strongest at lag 0–27, while the hot effects reached the strongest at lag 0–14. The effects of extremely low and high temperatures differed by mortality types in the two cities. Hypertensive disease in Beijing was particularly susceptible to both extremely high and low temperatures; while for Shanghai, people with ischemic heart disease showed the greatest relative risk (RRs = 1.16, 95% CI: 1.03, 1.34 to extremely low temperature. Conclusion: People with hypertensive disease were particularly susceptible to extremely low and high temperatures in Beijing. People with ischemic heart disease in Shanghai showed greater susceptibility to extremely cold days.

Mortality from cardiovascular diseases in the Semipalatinsk historical cohort, 1960-1999, and its relationship to radiation exposure.

Science.gov (United States)

Grosche, Bernd; Lackland, Daniel T; Land, Charles E; Simon, Steven L; Apsalikov, Kazbek N; Pivina, Ludmilla M; Bauer, Susanne; Gusev, Boris I

2011-11-01

The data on risk of mortality from cardiovascular disease due to radiation exposure at low or medium doses are inconsistent. This paper reports an analysis of the Semipalatinsk historical cohort exposed to radioactive fallout from nuclear testing in the vicinity of the Semipalatinsk Nuclear Test Site, Kazakhstan. The cohort study, which includes 19,545 persons of exposed and comparison villages in the Semipalatinsk region, had been set up in the 1960s and comprises 582,656 person-years of follow-up between 1960 and 1999. A dosimetric approach developed by the U.S. National Cancer Institute (NCI) has been used. Radiation dose estimates in this cohort range from 0 to 630 mGy (whole-body external). Overall, the exposed population showed a high mortality from cardiovascular disease. Rates of mortality from cardiovascular disease in the exposed group substantially exceeded those of the comparison group. Dose-response analyses were conducted for both the entire cohort and the exposed group only. A dose-response relationship that was found when analyzing the entire cohort could be explained completely by differences between the baseline rates in exposed and unexposed groups. When taking this difference into account, no statistically significant dose-response relationship for all cardiovascular disease, for heart disease, or for stroke was found. Our results suggest that within this population and at the level of doses estimated, there is no detectable risk of radiation-related mortality from cardiovascular disease.

Does respiratory health contribute to the effects of long-term air pollution exposure on cardiovascular mortality?

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Heinrich Joachim

2007-03-01

Full Text Available Abstract Background There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between cardiovascular mortality and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investigate whether respiratory health at baseline contributes to the effects of long-term exposure to high levels of air pollution on cardiovascular mortality in a cohort of elderly women. Method We analyzed data from 4750 women, aged 55 at the baseline investigation in the years 1985–1994. 2593 of these women had their lung function tested by spirometry. Respiratory diseases and symptoms were asked by questionnaire. Ambient air pollution exposure was assessed by the concentrations of NO2 and total suspended particles at fixed monitoring sites and by the distance of residency to a major road. A mortality follow-up of these women was conducted between 2001 and 2003. For the statistical analysis, Cox' regression was used. Results Women with impaired lung function or pre-existing respiratory diseases had a higher risk of dying from cardiovascular causes. The impact of impaired lung function declined over time. The risk ratio (RR of women with forced expiratory volume in one second (FEV1 of less than 80% predicted to die from cardiovascular causes was RR = 3.79 (95%CI: 1.64–8.74 at 5 years survival time and RR = 1.35 (95%CI: 0.66–2.77 at 12 years. The association between air pollution levels and cardiovascular death rate was strong and statistically significant. However, this association did only change marginally when including indicators of respiratory health into the regression analysis. Furthermore, no interaction between air pollution and respiratory health

Does respiratory health contribute to the effects of long-term air pollution exposure on cardiovascular mortality?

Science.gov (United States)

Schikowski, Tamara; Sugiri, Dorothea; Ranft, Ulrich; Gehring, Ulrike; Heinrich, Joachim; Wichmann, H-Erich; Krämer, Ursula

2007-03-07

There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between cardiovascular mortality and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investigate whether respiratory health at baseline contributes to the effects of long-term exposure to high levels of air pollution on cardiovascular mortality in a cohort of elderly women. We analyzed data from 4750 women, aged 55 at the baseline investigation in the years 1985-1994. 2593 of these women had their lung function tested by spirometry. Respiratory diseases and symptoms were asked by questionnaire. Ambient air pollution exposure was assessed by the concentrations of NO2 and total suspended particles at fixed monitoring sites and by the distance of residency to a major road. A mortality follow-up of these women was conducted between 2001 and 2003. For the statistical analysis, Cox' regression was used. Women with impaired lung function or pre-existing respiratory diseases had a higher risk of dying from cardiovascular causes. The impact of impaired lung function declined over time. The risk ratio (RR) of women with forced expiratory volume in one second (FEV1) of less than 80% predicted to die from cardiovascular causes was RR = 3.79 (95%CI: 1.64-8.74) at 5 years survival time and RR = 1.35 (95%CI: 0.66-2.77) at 12 years. The association between air pollution levels and cardiovascular death rate was strong and statistically significant. However, this association did only change marginally when including indicators of respiratory health into the regression analysis. Furthermore, no interaction between air pollution and respiratory health on cardiovascular mortality indicating a higher risk of

Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults

DEFF Research Database (Denmark)

Mons, Ute; Müezzinler, Aysel; Gellert, Carolin

2015-01-01

OBJECTIVE: To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological...... 60 and older were included in this study, of whom 37 952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1...... in showing that smoking is a strong independent risk factor of cardiovascular events and mortality even at older age, advancing cardiovascular mortality by more than five years, and demonstrating that smoking cessation in these age groups is still beneficial in reducing the excess risk....

Cardiovascular and noncardiovascular mortality among patients starting dialysis

DEFF Research Database (Denmark)

de Jager, Dinanda J; Grootendorst, Diana C; Jager, Kitty J

2009-01-01

CONTEXT: Cardiovascular mortality is considered the main cause of death in patients receiving dialysis and is 10 to 20 times higher in such patients than in the general population. OBJECTIVE: To evaluate if high overall mortality in patients starting dialysis is a consequence of increased cardiov...

Geographic Variations in Cardiovascular Disease Mortality Among Asian American Subgroups, 2003-2011.

Science.gov (United States)

Pu, Jia; Hastings, Katherine G; Boothroyd, Derek; Jose, Powell O; Chung, Sukyung; Shah, Janki B; Cullen, Mark R; Palaniappan, Latha P; Rehkopf, David H

2017-07-12

There are well-documented geographical differences in cardiovascular disease (CVD) mortality for non-Hispanic whites. However, it remains unknown whether similar geographical variation in CVD mortality exists for Asian American subgroups. This study aims to examine geographical differences in CVD mortality among Asian American subgroups living in the United States and whether they are consistent with geographical differences observed among non-Hispanic whites. Using US death records from 2003 to 2011 (n=3 897 040 CVD deaths), age-adjusted CVD mortality rates per 100 000 population and age-adjusted mortality rate ratios were calculated for the 6 largest Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) and compared with non-Hispanic whites. There were consistently lower mortality rates for all Asian American subgroups compared with non-Hispanic whites across divisions for CVD mortality and ischemic heart disease mortality. However, cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup. There were a number of regional divisions where certain Asian American subgroups (Filipino and Japanese men, Korean and Vietnamese men and women) possessed no mortality advantage compared with non-Hispanic whites. The most striking geographical variation was with Filipino men (age-adjusted mortality rate ratio=1.18; 95% CI, 1.14-1.24) and Japanese men (age-adjusted mortality rate ratio=1.05; 95% CI: 1.00-1.11) in the Pacific division who had significantly higher cerebrovascular mortality than non-Hispanic whites. There was substantial geographical variation in Asian American subgroup mortality for cerebrovascular disease when compared with non-Hispanic whites. It deserves increased attention to prioritize prevention and treatment in the Pacific division where approximately 80% of Filipinos CVD deaths and 90% of Japanese CVD deaths occur in the United States. © 2017 The Authors

Osteoprotegerin and mortality in hemodialysis patients with cardiovascular disease

DEFF Research Database (Denmark)

Winther, Simon; Christensen, Jeppe Hagstrup; Flyvbjerg, Allan

2013-01-01

Abstract BACKGROUND: Patients treated with hemodialysis (HD) have an increased mortality, mainly caused by cardiovascular disease (CVD). Osteoprotegerin (OPG) is a glycoprotein involved in the regulation of the vascular calcification process. Previous studies have demonstrated that OPG.......08; in the adjusted analyses, the p-value for trend was 0.03. CONCLUSIONS: In a high-risk population of hemodialysis patients with previously documented cardiovascular disease, a high level of OPG was an independent risk marker of all-cause mortality....... is a prognostic marker of mortality. The aim of this study was to investigate if OPG was a prognostic marker of all-cause mortality in high-risk patients with end-stage renal disease and CVD. METHODS: We prospectively followed 206 HD patients with CVD. OPG was measured at baseline and the patients were followed...

All-Cause and Cardiovascular Mortality following Treatment with Metformin or Glyburide in Patients with Type 2 Diabetes Mellitus.

Science.gov (United States)

Raee, Mohammad Reza; Nargesi, Arash Aghajani; Heidari, Behnam; Mansournia, Mohammad Ali; Larry, Mehrdad; Rabizadeh, Soghra; Zarifkar, Mitra; Esteghamati, Alireza; Nakhjavani, Manouchehr

2017-03-01

Both metformin and sulfonylurea (SU) drugs are among the most widely-used anti-hyperglycemic medications in patients with type 2 diabetes mellitus (T2DM). Previous studies have shown that treatment with SUs might be associated with decreased survival compared with metformin. This study aimed to evaluate all-cause and cardiovascular mortality rates between glyburide and metformin in patients diagnosed with T2DM. This was a cohort study on 717 patients with T2DM (271 undergoing monotherapy with glyburide and 446 with metformin). Data were gathered from 2001 to 2014. All-cause and cardiovascular mortality were end-points. During the follow-up, 24 deaths were identified, of which 13 were cardiovascular in nature. The group with glyburide monotherapy had greater all-cause mortality (17 (6.3%) in glyburide vs. 7 (1.6%) in metformin, P = 0.001) and cardiovascular mortality (11 (4.1%) in glyburide vs. 2 (0.4%) in metformin; P = 0.001). Metformin was more protective than glyburide for both all-cause (HR: 0.27 [0.10 - 0.73] P-value = 0.01) and cardiovascular mortality (HR: 0.12 [0.20 - 0.66], P-value = 0.01) after multiple adjustments for cardiovascular risk factors. Among adverse cardiovascular events, non-fatal MI was higher in glyburide compared to metformin monotherapy group (3.2% vs. 0.8%; P-value = 0.03), but not coronary artery bypass grafting (P-value = 0.85), stenting (P-value = 0.69), need for angiography (P-value = 0.24), CCU admission (P-value = 0.34) or cerebrovascular accident (P-value = 0.10). Treatment with glyburide is associated with increased all-cause and cardiovascular mortality in patients with T2DM.

Relationships between body mass index, cardiovascular mortality, and risk factors

DEFF Research Database (Denmark)

Dudina, Alexandra; Cooney, Marie Therese; Bacquer, Dirk De

2011-01-01

Although cardiovascular disease (CVD) is the biggest global cause of death, CVD mortality is falling in developed countries. There is concern that this trend may be offset by increasing levels of obesity.......Although cardiovascular disease (CVD) is the biggest global cause of death, CVD mortality is falling in developed countries. There is concern that this trend may be offset by increasing levels of obesity....

Competing risks of cancer mortality and cardiovascular events in individuals with multimorbidity

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Elizabeth A. Bayliss

2014-08-01

Full Text Available Background: Cancer patients with cardiovascular and other comorbidities are at concurrent risk of multiple adverse outcomes. However, most treatment decisions are guided by evidence from single-outcome models, which may be misleading for multimorbid patients. Objective: We assessed the interacting effects of cancer, cardiovascular, and other morbidity burdens on the competing outcomes of cancer mortality, serious cardiovascular events, and other-cause mortality. Design: We analyzed a cohort of 6,500 adults with initial cancer diagnosis between 2001 and 2008, SEER 5-year survival ≥26%, and a range of cardiovascular risk factors. We estimated the cumulative incidence of cancer mortality, a serious cardiovascular event (myocardial infarction, coronary revascularization, or cardiovascular mortality, and other-cause mortality over 5 years, and identified factors associated with the competing risks of each outcome using cause-specific Cox proportional hazard models. Results: Following cancer diagnosis, there were 996 (15.3% cancer deaths, 328 (5.1% serious cardiovascular events, and 542 (8.3% deaths from other causes. In all, 4,634 (71.3% cohort members had none of these outcomes. Although cancer prognosis had the greatest effect, cardiovascular and other morbidity also independently increased the hazard of each outcome. The effect of cancer prognosis on outcome was greatest in year 1, and the effect of other morbidity was greater in individuals with better cancer prognoses. Conclusion: In multimorbid oncology populations, comorbidities interact to affect the competing risk of different outcomes. Quantifying these risks may provide persons with cancer plus cardiovascular and other comorbidities more accurate information for shared decision-making than risks calculated from single-outcome models.

Mortality from Cardiovascular Diseases in the Semipalatinsk Historical Cohort, 1960–1999, and its Relationship to Radiation Exposure

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Grosche, Bernd; Lackland, Daniel T.; Land, Charles E.; Simon, Steven L.; Apsalikov, Kazbek N.; Pivina, Ludmilla M.; Bauere, Susanne; Gusev, Boris I.

2013-01-01

The data on risk of mortality from cardiovascular disease due to radiation exposure at low or medium doses are inconsistent. This paper reports an analysis of the Semipalatinsk historical cohort exposed to radioactive fallout from nuclear testing in the vicinity of the Semipalatinsk Nuclear Test Site, Kazakhstan. The cohort study, which includes 19,545 persons of exposed and comparison villages in the Semipalatinsk region, had been set up in the 1960s and comprises 582,656 person-years of follow-up between 1960 and 1999. A dosimetric approach developed by the U.S. National Cancer Institute (NCI) has been used. Radiation dose estimates in this cohort range from 0 to 630 mGy (wholebody external). Overall, the exposed population showed a high mortality from cardiovascular disease. Rates of mortality from cardiovascular disease in the exposed group substantially exceeded those of the comparison group. Dose–response analyses were conducted for both the entire cohort and the exposed group only. A dose–response relationship that was found when analyzing the entire cohort could be explained completely by differences between the baseline rates in exposed and unexposed groups. When taking this difference into account, no statistically significant dose–response relationship for all cardiovascular disease, for heart disease, or for stroke was found. Our results suggest that within this population and at the level of doses estimated, there is no detectable risk of radiation related mortality from cardiovascular disease. PMID:21787182

Cardiovascular mortality after pre-eclampsia in one child mothers: prospective, population based cohort study.

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Skjaerven, Rolv; Wilcox, Allen J; Klungsøyr, Kari; Irgens, Lorentz M; Vikse, Bjørn Egil; Vatten, Lars J; Lie, Rolv Terje

2012-11-27

To assess the association of pre-eclampsia with later cardiovascular death in mothers according to their lifetime number of pregnancies, and particularly after only one child. Prospective, population based cohort study. Medical Birth Registry of Norway. We followed 836,147 Norwegian women with a first singleton birth between 1967 and 2002 for cardiovascular mortality through linkage to the national Cause of Death Registry. About 23,000 women died by 2009, of whom 3891 died from cardiovascular causes. Associations between pre-eclampsia and cardiovascular death were assessed by hazard ratios, estimated by Cox regression analyses. Hazard ratios were adjusted for maternal education (three categories), maternal age at first birth, and year of first birth The rate of cardiovascular mortality among women with preterm pre-eclampsia was 9.2% after having only one child, falling to 1.1% for those with two or more children. With term pre-eclampsia, the rates were 2.8% and 1.1%, respectively. Women with pre-eclampsia in their first pregnancy had higher rates of cardiovascular death than those who did not have the condition at first birth (adjusted hazard ratio 1.6 (95% confidence interval 1.4 to 2.0) after term pre-eclampsia; 3.7 (2.7 to 4.8) after preterm pre-eclampsia). Among women with only one lifetime pregnancy, the increase in risk of cardiovascular death was higher than for those with two or more children (3.4 (2.6 to 4.6) after term pre-eclampsia; 9.4 (6.5 to 13.7) after preterm pre-eclampsia). The risk of cardiovascular death was only moderately elevated among women with pre-eclamptic first pregnancies who went on to have additional children (1.5 (1.2 to 2.0) after term pre-eclampsia; 2.4 (1.5 to 3.9) after preterm pre-eclampsia). There was little evidence of additional risk after recurrent pre-eclampsia. All cause mortality for women with two or more lifetime births, who had pre-eclampsia in first pregnancy, was not elevated, even with preterm pre-eclampsia in first

Traffic air pollution and mortality from cardiovascular disease and all causes: a Danish cohort study

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Raaschou-Nielsen Ole

2012-09-01

Full Text Available Abstract Background Traffic air pollution has been linked to cardiovascular mortality, which might be due to co-exposure to road traffic noise. Further, personal and lifestyle characteristics might modify any association. Methods We followed up 52 061 participants in a Danish cohort for mortality in the nationwide Register of Causes of Death, from enrollment in 1993–1997 through 2009, and traced their residential addresses from 1971 onwards in the Central Population Registry. We used dispersion-modelled concentration of nitrogen dioxide (NO2 since 1971 as indicator of traffic air pollution and used Cox regression models to estimate mortality rate ratios (MRRs with adjustment for potential confounders. Results Mean levels of NO2 at the residence since 1971 were significantly associated with mortality from cardiovascular disease (MRR, 1.26; 95% confidence interval [CI], 1.06–1.51, per doubling of NO2 concentration and all causes (MRR, 1.13; 95% CI, 1.04–1.23, per doubling of NO2 concentration after adjustment for potential confounders. For participants who ate  Conclusions Traffic air pollution is associated with mortality from cardiovascular diseases and all causes, after adjustment for traffic noise. The association was strongest for people with a low fruit and vegetable intake.

Mild renal insufficiency is associated with increased cardiovascular mortality: The Hoorn study

NARCIS (Netherlands)

Henry, Ronald M.A.; Kostense, Piet J.; Bos, Griêt; Dekker, Jacqueline M.; Nijpels, Giel; Heine, Robert J.; Bouter, Lex M.; Stehouwer, Coen D.A.

2002-01-01

BACKGROUND: Cardiovascular mortality is extremely high in end-stage renal disease. Cardiovascular mortality risk also is increased in selected (high-risk) individuals with mild to moderate impairment of renal function. It is not clear whether a similar association exists in the general population

Widening Geographical Disparities in Cardiovascular Disease Mortality in the United States, 1969-2011

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Gopal K. Singh, PhD

2015-04-01

Full Text Available Objectives: This study examined trends in geographical disparities in cardiovascular-disease (CVD mortality in the United States between 1969 and 2011. Methods: National vital statistics data and the National Longitudinal Mortality Study were used to estimate regional, state, and county-level disparities in CVD mortality over time. Log-linear, weighted least squares, and Cox regression were used to analyze mortality trends and differentials. Results: During 1969-2011, CVD mortality rates declined fastest in New England and Mid-Atlantic regions and slowest in the Southeast and Southwestern regions. In 1969, the mortality rate was 9% higher in the Southeast than in New England, but the differential increased to 48% in 2011. In 2011, Southeastern states, Mississippi and Alabama, had the highest CVD mortality rates, nearly twice the rates for Minnesota and Hawaii. Controlling for individual-level covariates reduced state differentials. State- and county-level differentials in CVD mortality rates widened over time as geographical disparity in CVD mortality increased by 50% between 1969 and 2011. Area deprivation, smoking, obesity, physical inactivity, diabetes prevalence, urbanization, lack of health insurance, and lower access to primary medical care were all significant predictors of county-level CVD mortality rates and accounted for 52.7% of the county variance. Conclusions and Global Health Implications: Although CVD mortality has declined for all geographical areas in the United States, geographical disparity has widened over time as certain regions and states, particularly those in the South, have lagged behind in mortality reduction. Geographical disparities in CVD mortality reflect inequalities in socioeconomic conditions and behavioral risk factors. With the global CVD burden on the rise, monitoring geographical disparities, particularly in low- and middle-income countries, could indicate the extent to which reductions in CVD mortality are

Decline in Cardiovascular Mortality: Possible Causes and Implications.

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Mensah, George A; Wei, Gina S; Sorlie, Paul D; Fine, Lawrence J; Rosenberg, Yves; Kaufmann, Peter G; Mussolino, Michael E; Hsu, Lucy L; Addou, Ebyan; Engelgau, Michael M; Gordon, David

2017-01-20

If the control of infectious diseases was the public health success story of the first half of the 20th century, then the decline in mortality from coronary heart disease and stroke has been the success story of the century's past 4 decades. The early phase of this decline in coronary heart disease and stroke was unexpected and controversial when first reported in the mid-1970s, having followed 60 years of gradual increase as the US population aged. However, in 1978, the participants in a conference convened by the National Heart, Lung, and Blood Institute concluded that a significant recent downtick in coronary heart disease and stroke mortality rates had definitely occurred, at least in the US Since 1978, a sharp decline in mortality rates from coronary heart disease and stroke has become unmistakable throughout the industrialized world, with age-adjusted mortality rates having declined to about one third of their 1960s baseline by 2000. Models have shown that this remarkable decline has been fueled by rapid progress in both prevention and treatment, including precipitous declines in cigarette smoking, improvements in hypertension treatment and control, widespread use of statins to lower circulating cholesterol levels, and the development and timely use of thrombolysis and stents in acute coronary syndrome to limit or prevent infarction. However, despite the huge growth in knowledge and advances in prevention and treatment, there remain many questions about this decline. In fact, there is evidence that the rate of decline may have abated and may even be showing early signs of reversal in some population groups. The National Heart, Lung, and Blood Institute, through a request for information, is soliciting input that could inform a follow-up conference on or near the 40th anniversary of the original landmark conference to further explore these trends in cardiovascular mortality in the context of what has come before and what may lie ahead. © 2017 American Heart

Sex Differences in Cardiovascular Mortality in Diabetics and Nondiabetic Subjects: A Population-Based Study (Italy

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Paola Ballotari

2015-01-01

Full Text Available The objective of this study is to assess the impact of diabetes on cardiovascular mortality, focusing on sex differences. The inhabitants of Reggio Emilia province on December 31, 2009, aged 20–84 were followed up for three years for mortality. The exposure was determined using Reggio Emilia diabetes register. The age-adjusted death rates were estimated as well as the incidence rate ratios using Poisson regression model. Interaction terms for diabetes and sex were tested by the Wald test. People with diabetes had an excess of mortality, compared with nondiabetic subjects (all cause: IRR = 1.68; 95%CI 1.60–1.78; CVD: IRR = 1.61; 95%CI 1.47–1.76; AMI: IRR = 1.59; 95%CI 1.27–1.99; renal causes: IRR = 1.71; 95%CI 1.22–2.38. The impact of diabetes is greater in females than males for all causes (P=0.0321 and for CVD, IMA, and renal causes. Further studies are needed to investigate whether the difference in cardiovascular risk profile or in the quality of care delivered justifies the higher excess of mortality in females with diabetes compared to males.

Sex differences in cardiovascular mortality in diabetics and nondiabetic subjects: a population-based study (Italy).

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Ballotari, Paola; Ranieri, Sofia Chiatamone; Luberto, Ferdinando; Caroli, Stefania; Greci, Marina; Giorgi Rossi, Paolo; Manicardi, Valeria

2015-01-01

The objective of this study is to assess the impact of diabetes on cardiovascular mortality, focusing on sex differences. The inhabitants of Reggio Emilia province on December 31, 2009, aged 20-84 were followed up for three years for mortality. The exposure was determined using Reggio Emilia diabetes register. The age-adjusted death rates were estimated as well as the incidence rate ratios using Poisson regression model. Interaction terms for diabetes and sex were tested by the Wald test. People with diabetes had an excess of mortality, compared with nondiabetic subjects (all cause: IRR = 1.68; 95%CI 1.60-1.78; CVD: IRR = 1.61; 95%CI 1.47-1.76; AMI: IRR = 1.59; 95%CI 1.27-1.99; renal causes: IRR = 1.71; 95%CI 1.22-2.38). The impact of diabetes is greater in females than males for all causes (P = 0.0321) and for CVD, IMA, and renal causes. Further studies are needed to investigate whether the difference in cardiovascular risk profile or in the quality of care delivered justifies the higher excess of mortality in females with diabetes compared to males.

The decline in mortality from circulatory diseases in Brazil Disminución en la mortalidad por enfermedades cardiovasculares en Brasil

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Cintia Curioni

2009-01-01

Full Text Available OBJECTIVES: Cardiovascular diseases are the leading cause of death in the world. Although mortality rates have declined gradually in developed countries, the scenario is less clear in developing countries. We describe the trends in cardiovascular mortality in Brazil over 24 years and investigate differences according to groups of diseases, sociopolitical region, gender, and age. METHODS: We retrieved official data on mortality and population estimates to calculate standardized mortality rates in six age strata and in the five political regions from 1980 through 2003. The negative binomial distribution model was used to estimate trends for mortality separately for each gender, age group, and geopolitical region during this period. RESULTS: Total cardiovascular standardized mortality rates decreased consistently over 24 years, from 287.3 to 161.9 per 100000 inhabitants, with a mean annual decrease of 3.9%. Reductions in cardiovascular standardized mortality rates were detected in all strata and for all groups of diseases, with stroke exhibiting the largest average decline, from 95.2 to 52.6 per 100000 inhabitants (mean 4.0% per year, followed by coronary disease, from 80.3 to 49.2 per 100000 inhabitants (3.6% per year; the decrease was especially marked in the most developed regions. CONCLUSIONS: Cardiovascular disease standardized mortality rates consistently decreased in Brazil during the study period. The reduction is apparently related to indices of increasing social development. Despite these encouraging findings, a gradual increase in the deaths from cardiovascular disease is expected in the next decades, and additional efforts in prevention are needed.OBJETIVOS: Las enfermedades cardiovasculares constituyen la primera causa de muerte en el mundo. Aunque las tasas de mortalidad han disminuido gradualmente en los países desarrollados, el escenario es menos claro en los países en desarrollo. Se describen las tendencias de la mortalidad por

Excess cardiovascular mortality associated with cold spells in the Czech Republic

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Kyncl Jan

2009-01-01

Full Text Available Abstract Background The association between cardiovascular mortality and winter cold spells was evaluated in the population of the Czech Republic over 21-yr period 1986–2006. No comprehensive study on cold-related mortality in central Europe has been carried out despite the fact that cold air invasions are more frequent and severe in this region than in western and southern Europe. Methods Cold spells were defined as periods of days on which air temperature does not exceed -3.5°C. Days on which mortality was affected by epidemics of influenza/acute respiratory infections were identified and omitted from the analysis. Excess cardiovascular mortality was determined after the long-term changes and the seasonal cycle in mortality had been removed. Excess mortality during and after cold spells was examined in individual age groups and genders. Results Cold spells were associated with positive mean excess cardiovascular mortality in all age groups (25–59, 60–69, 70–79 and 80+ years and in both men and women. The relative mortality effects were most pronounced and most direct in middle-aged men (25–59 years, which contrasts with majority of studies on cold-related mortality in other regions. The estimated excess mortality during the severe cold spells in January 1987 (+274 cardiovascular deaths is comparable to that attributed to the most severe heat wave in this region in 1994. Conclusion The results show that cold stress has a considerable impact on mortality in central Europe, representing a public health threat of an importance similar to heat waves. The elevated mortality risks in men aged 25–59 years may be related to occupational exposure of large numbers of men working outdoors in winter. Early warnings and preventive measures based on weather forecast and targeted on the susceptible parts of the population may help mitigate the effects of cold spells and save lives.

Impact of smoking and smoking cessation on cardiovascular events and mortality among older adults

DEFF Research Database (Denmark)

Mons, Ute; Müezzinler, Aysel; Gellert, Carolin

2015-01-01

OBJECTIVE: To investigate the impact of smoking and smoking cessation on cardiovascular mortality, acute coronary events, and stroke events in people aged 60 and older, and to calculate and report risk advancement periods for cardiovascular mortality in addition to traditional epidemiological...... 60 and older were included in this study, of whom 37 952 died from cardiovascular disease. Random effects meta-analysis of the association of smoking status with cardiovascular mortality yielded a summary hazard ratio of 2.07 (95% CI 1.82 to 2.36) for current smokers and 1.37 (1.25 to 1......, and decreased continuously with time since smoking cessation in former smokers. Relative risk estimates for acute coronary events and for stroke events were somewhat lower than for cardiovascular mortality, but patterns were similar. CONCLUSIONS: Our study corroborates and expands evidence from previous studies...

Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

DEFF Research Database (Denmark)

Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J

2010-01-01

The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy...... cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non......-cardiovascular causes. Severe pre-eclampsia was associated with death from cardiovascular causes only. There was a less than additive effect on cardiovascular mortality hazard ratios with increasing number of pregnancy complications: preterm delivery 1.90 [95% confidence intervals 1.49, 2.43]; preterm delivery...

Study on the association between ambient air pollution and daily cardiovascular and respiratory mortality in an urban district of Beijing.

Science.gov (United States)

Zhang, Fengying; Li, Liping; Krafft, Thomas; Lv, Jinmei; Wang, Wuyi; Pei, Desheng

2011-06-01

The association between daily cardiovascular/respiratory mortality and air pollution in an urban district of Beijing was investigated over a 6-year period (January 2003 to December 2008). The purpose of this study was to evaluate the relative importance of the major air pollutants [particulate matter (PM), SO2, NO2] as predictors of daily cardiovascular/respiratory mortality. The time-series studied comprises years with lower level interventions to control air pollution (2003-2006) and years with high level interventions in preparation for and during the Olympics/Paralympics (2007-2008). Concentrations of PM10, SO2, and NO2, were measured daily during the study period. A generalized additive model was used to evaluate daily numbers of cardiovascular/respiratory deaths in relation to each air pollutant, controlling for time trends and meteorological influences such as temperature and relative humidity. The results show that the daily cardiovascular/respiratory death rates were significantly associated with the concentration air pollutants, especially deaths related to cardiovascular disease. The current day effects of PM10 and NO2 were higher than that of single lags (distributed lags) and moving average lags for respiratory disease mortality. The largest RR of SO2 for respiratory disease mortality was in Lag02. For cardiovascular disease mortality, the largest RR was in Lag01 for PM10, and in current day (Lag0) for SO2 and NO2. NO2 was associated with the largest RRs for deaths from both cardiovascular disease and respiratory disease.

Cardiovascular mortality and exposure to extremely low frequency magnetic fields: a cohort study of Swiss railway workers

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Pfluger Dominik

2008-07-01

Full Text Available Abstract Background Exposure to intermittent magnetic fields of 16 Hz has been shown to reduce heart rate variability, and decreased heart rate variability predicts cardiovascular mortality. We examined mortality from cardiovascular causes in railway workers exposed to varying degrees to intermittent 16.7 Hz magnetic fields. Methods We studied a cohort of 20,141 Swiss railway employees between 1972 and 2002, including highly exposed train drivers (median lifetime exposure 120.5 μT-years, and less or little exposed shunting yard engineers (42.1 μT-years, train attendants (13.3 μT-years and station masters (5.7 μT-years. During 464,129 person-years of follow up, 5,413 deaths were recorded and 3,594 deaths were attributed to cardio-vascular diseases. We analyzed data using Cox proportional hazards models. Results For all cardiovascular mortality the hazard ratio compared to station masters was 0.99 (95%CI: 0.91, 1.08 in train drivers, 1.13 (95%CI: 0.98, 1.30 in shunting yard engineers, and 1.09 (95%CI: 1.00, 1.19 in train attendants.Corresponding hazard ratios for arrhythmia related deaths were 1.04 (95%CI: 0.68, 1.59, 0.58 (95%CI: 0.24, 1.37 and 1.30 (95%CI: 0.87, 1.93 and for acute myocardial infarction 1.00 (95%CI: 0.73, 1.36, 1.56 (95%CI: 1.04, 2.32, and 1.14 (95%CI: 0.85, 1.53. The hazard ratio for arrhythmia related deaths per 100 μT-years of cumulative exposure was 0.94 (95%CI: 0.71, 1.24 and 0.91 (95%CI: 0.75, 1.11 for acute myocardial infarction. Conclusion This study provides evidence against an association between long-term occupational exposure to intermittent 16.7 Hz magnetic fields and cardiovascular mortality.

Effect of the US-Mexico border region in cardiovascular mortality: ecological time trend analysis of Mexican border and non-border municipalities from 1998 to 2012.

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Anaya, Gabriel; Al-Delaimy, Wael K

2017-05-06

An array of risk factors has been associated with cardiovascular diseases, and developing nations are becoming disproportionately affected by such diseases. Cardiovascular diseases have been reported to be highly prevalent in the Mexican population, but local mortality data is poor. The Mexican side of the US-Mexico border has a culture that is closely related to a developed nation and therefore may share the same risk factors of cardiovascular diseases. We wanted to explore if there was higher cardiovascular mortality in the border region of Mexico compared to the rest of the nation. We conducted a population based cross-sectional time series analysis to estimate the effects of education, insurance and municipal size in Mexican border (n = 38) and non-border municipalities (n = 2360) and its association with cardiovascular age-adjusted mortality rates between the years 1998-2012. We used a mixed effect linear model with random effect estimation and repeated measurements to compare the main outcome variable (mortality rate), the covariates (education, insurance and population size) and the geographic delimiter (border/non-border). Mortality due to cardiovascular disease was consistently higher in the municipalities along the US-Mexico border, showing a difference of 78 · 5 (95% CI 58 · 7-98 · 3, p Insurance coverage showed an increase in cardiovascular mortality of 3 · 6 (95% CI 3 · 1-4 · 0, p Mexico border region is disproportionately affected by cardiovascular disease mortality as compared to the non-border region of Mexico. This was not explained by education, population density, or insurance coverage. Proximity to the US culture and related diet and habits can be explanations of the increasing mortality trend.

Large daily stock variation is associated with cardiovascular mortality in two cities of Guangdong, China.

Science.gov (United States)

Lin, Hualiang; Zhang, Yonghui; Xu, Yanjun; Liu, Tao; Xiao, Jianpeng; Luo, Yuan; Xu, Xiaojun; He, Yanhui; Ma, Wenjun

2013-01-01

The current study aimed to examine the effects of daily change of the Shenzhen Stock Exchange Index on cardiovascular mortality in Guangzhou and Taishan, China. Daily mortality and stock performance data during 2006-2010 were collected to construct the time series for the two cities. A distributed lag non-linear model was utilized to examine the effect of daily stock index changes on cardiovascular mortality after controlling for potential confounding factors. We observed a delayed non-linear effect of the stock index change on cardiovascular mortality: both rising and declining of the stock index were associated with increased cardiovascular deaths. In Guangzhou, the 15-25 lag days cumulative relative risk of an 800 index drop was 2.08 (95% CI: 1.38-3.14), and 2.38 (95% CI: 1.31-4.31) for an 800 stock index increase on the cardiovascular mortality, respectively. In Taishan, the cumulative relative risk over 15-25 days lag was 1.65 (95% CI: 1.13-2.42) for an 800 index drop and 2.08 (95% CI: 1.26-3.42) for an 800 index rising, respectively. Large ups and downs in daily stock index might be important predictor of cardiovascular mortality.

Study on the Association between Ambient Air Pollution and Daily Cardiovascular and Respiratory Mortality in an Urban District of Beijing

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Thomas Krafft

2011-06-01

Full Text Available The association between daily cardiovascular/respiratory mortality and air pollution in an urban district of Beijing was investigated over a 6-year period (January 2003 to December 2008. The purpose of this study was to evaluate the relative importance of the major air pollutants [particulate matter (PM, SO2, NO2] as predictors of daily cardiovascular/respiratory mortality. The time-series studied comprises years with lower level interventions to control air pollution (2003–2006 and years with high level interventions in preparation for and during the Olympics/Paralympics (2007–2008. Concentrations of PM10, SO2, and NO2, were measured daily during the study period. A generalized additive model was used to evaluate daily numbers of cardiovascular/ respiratory deaths in relation to each air pollutant, controlling for time trends and meteorological influences such as temperature and relative humidity. The results show that the daily cardiovascular/respiratory death rates were significantly associated with the concentration air pollutants, especially deaths related to cardiovascular disease. The current day effects of PM10 and NO2 were higher than that of single lags (distributed lags and moving average lags for respiratory disease mortality. The largest RR of SO2 for respiratory disease mortality was in Lag02. For cardiovascular disease mortality, the largest RR was in Lag01 for PM10, and in current day (Lag0 for SO2 and NO2. NO2 was associated with the largest RRs for deaths from both cardiovascular disease and respiratory disease.

Dose- and age-dependent cardiovascular mortality among inhabitants of the Chornobyl contaminated areas. 1988-2010 observation period

International Nuclear Information System (INIS)

Buzunov, V.O.; Prikashchikova, K.Je.; Domashevs'ka, T.Je.; Kostyuk, G.V.; Gubyina, Yi.G.; Tereshchenko, S.O.

2014-01-01

Cardiovascular mortality among inhabitants of contaminated areas of Ukraine is dependent on the total cumulative effective doses and age at the time of the Chornobyl accident. It is proved by a significantly higher (p < 0.05) mortality in people exposed to 21.00-50.0 mSv radiation doses compared to those having 5.6-20.99 mSv exposures. Mortality was significantly higher (p < 0.05) in age groups with higher doses as opposed to those with low ones. Maximum mortality was observed among inhabitants aged 40-60, while the lowest death rate - in patients younger than 18 years old. The data obtained also suggest that the radiation factor can be considered here as one accelerating the aging and pathophysiological abnormalities in survivors. Coronary heart disease, cerebrovascular disease, arterial hypertension, diseases of arteries, arterioles and capillaries are the main causes of death from cardiovascular disease in people under investigation

Lipid profile, cardiovascular disease and mortality in a Mediterranean high-risk population: The ESCARVAL-RISK study.

Science.gov (United States)

Orozco-Beltran, Domingo; Gil-Guillen, Vicente F; Redon, Josep; Martin-Moreno, Jose M; Pallares-Carratala, Vicente; Navarro-Perez, Jorge; Valls-Roca, Francisco; Sanchis-Domenech, Carlos; Fernandez-Gimenez, Antonio; Perez-Navarro, Ana; Bertomeu-Martinez, Vicente; Bertomeu-Gonzalez, Vicente; Cordero, Alberto; Pascual de la Torre, Manuel; Trillo, Jose L; Carratala-Munuera, Concepcion; Pita-Fernandez, Salvador; Uso, Ruth; Durazo-Arvizu, Ramon; Cooper, Richard; Sanz, Gines; Castellano, Jose M; Ascaso, Juan F; Carmena, Rafael; Tellez-Plaza, Maria

2017-01-01

The potential impact of targeting different components of an adverse lipid profile in populations with multiple cardiovascular risk factors is not completely clear. This study aims to assess the association between different components of the standard lipid profile with all-cause mortality and hospitalization due to cardiovascular events in a high-risk population. This prospective registry included high risk adults over 30 years old free of cardiovascular disease (2008-2012). Diagnosis of hypertension, dyslipidemia or diabetes mellitus was inclusion criterion. Lipid biomarkers were evaluated. Primary endpoints were all-cause mortality and hospital admission due to coronary heart disease or stroke. We estimated adjusted rate ratios (aRR), absolute risk differences and population attributable risk associated with adverse lipid profiles. 51,462 subjects were included with a mean age of 62.6 years (47.6% men). During an average follow-up of 3.2 years, 919 deaths, 1666 hospitalizations for coronary heart disease and 1510 hospitalizations for stroke were recorded. The parameters that showed an increased rate for total mortality, coronary heart disease and stroke hospitalization were, respectively, low HDL-Cholesterol: aRR 1.25, 1.29 and 1.23; high Total/HDL-Cholesterol: aRR 1.22, 1.38 and 1.25; and high Triglycerides/HDL-Cholesterol: aRR 1.21, 1.30, 1.09. The parameters that showed highest population attributable risk (%) were, respectively, low HDL-Cholesterol: 7.70, 11.42, 8.40; high Total/HDL-Cholesterol: 6.55, 12.47, 8.73; and high Triglycerides/HDL-Cholesterol: 8.94, 15.09, 6.92. In a population with cardiovascular risk factors, HDL-cholesterol, Total/HDL-cholesterol and triglycerides/HDL-cholesterol ratios were associated with a higher population attributable risk for cardiovascular disease compared to other common biomarkers.

US County-Level Trends in Mortality Rates for Major Causes of Death, 1980-2014.

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Dwyer-Lindgren, Laura; Bertozzi-Villa, Amelia; Stubbs, Rebecca W; Morozoff, Chloe; Kutz, Michael J; Huynh, Chantal; Barber, Ryan M; Shackelford, Katya A; Mackenbach, Johan P; van Lenthe, Frank J; Flaxman, Abraham D; Naghavi, Mohsen; Mokdad, Ali H; Murray, Christopher J L

2016-12-13

County-level patterns in mortality rates by cause have not been systematically described but are potentially useful for public health officials, clinicians, and researchers seeking to improve health and reduce geographic disparities. To demonstrate the use of a novel method for county-level estimation and to estimate annual mortality rates by US county for 21 mutually exclusive causes of death from 1980 through 2014. Redistribution methods for garbage codes (implausible or insufficiently specific cause of death codes) and small area estimation methods (statistical methods for estimating rates in small subpopulations) were applied to death registration data from the National Vital Statistics System to estimate annual county-level mortality rates for 21 causes of death. These estimates were raked (scaled along multiple dimensions) to ensure consistency between causes and with existing national-level estimates. Geographic patterns in the age-standardized mortality rates in 2014 and in the change in the age-standardized mortality rates between 1980 and 2014 for the 10 highest-burden causes were determined. County of residence. Cause-specific age-standardized mortality rates. A total of 80 412 524 deaths were recorded from January 1, 1980, through December 31, 2014, in the United States. Of these, 19.4 million deaths were assigned garbage codes. Mortality rates were analyzed for 3110 counties or groups of counties. Large between-county disparities were evident for every cause, with the gap in age-standardized mortality rates between counties in the 90th and 10th percentiles varying from 14.0 deaths per 100 000 population (cirrhosis and chronic liver diseases) to 147.0 deaths per 100 000 population (cardiovascular diseases). Geographic regions with elevated mortality rates differed among causes: for example, cardiovascular disease mortality tended to be highest along the southern half of the Mississippi River, while mortality rates from self-harm and

Flavonoid intake and cardiovascular disease mortality: a prospective study in postmenopausal women.

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Mink, Pamela J; Scrafford, Carolyn G; Barraj, Leila M; Harnack, Lisa; Hong, Ching-Ping; Nettleton, Jennifer A; Jacobs, David R

2007-03-01

Dietary flavonoids may have beneficial cardiovascular effects in human populations, but epidemiologic study results have not been conclusive. We used flavonoid food composition data from 3 recently available US Department of Agriculture databases to improve estimates of dietary flavonoid intake and to evaluate the association between flavonoid intake and cardiovascular disease (CVD) mortality. Study participants were 34 489 postmenopausal women in the Iowa Women's Health Study who were free of CVD and had complete food-frequency questionnaire information at baseline. Intakes of total flavonoids and 7 subclasses were categorized into quintiles, and food sources were grouped into frequency categories. Proportional hazards rate ratios (RR) were computed for CVD, coronary heart disease (CHD), stroke, and total mortality after 16 y of follow-up. After multivariate adjustment, significant inverse associations were observed between anthocyanidins and CHD, CVD, and total mortality [RR (95% CI) for any versus no intake: 0.88 (0.78, 0.99), 0.91 (0.83, 0.99), and 0.90 (0.86, 0.95)]; between flavanones and CHD [RR for highest quintile versus lowest: 0.78 (0.65, 0.94)]; and between flavones and total mortality [RR for highest quintile versus lowest: 0.88 (0.82, 0.96)]. No association was found between flavonoid intake and stroke mortality. Individual flavonoid-rich foods associated with significant mortality reduction included bran (added to foods; associated with stroke and CVD); apples or pears or both and red wine (associated with CHD and CVD); grapefruit (associated with CHD); strawberries (associated with CVD); and chocolate (associated with CVD). Dietary intakes of flavanones, anthocyanidins, and certain foods rich in flavonoids were associated with reduced risk of death due to CHD, CVD, and all causes.

Association of Solid Fuel Use With Risk of Cardiovascular and All-Cause Mortality in Rural China.

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Yu, Kuai; Qiu, Gaokun; Chan, Ka-Hung; Lam, Kin-Bong Hubert; Kurmi, Om P; Bennett, Derrick A; Yu, Canqing; Pan, An; Lv, Jun; Guo, Yu; Bian, Zheng; Yang, Ling; Chen, Yiping; Hu, Frank B; Chen, Zhengming; Li, Liming; Wu, Tangchun

2018-04-03

When combusted indoors, solid fuels generate a large amount of pollutants such as fine particulate matter. To assess the associations of solid fuel use for cooking and heating with cardiovascular and all-cause mortality. This nationwide prospective cohort study recruited participants from 5 rural areas across China between June 2004 and July 2008; mortality follow-up was until January 1, 2014. A total of 271 217 adults without a self-reported history of physician-diagnosed cardiovascular disease at baseline were included, with a random subset (n = 10 892) participating in a resurvey after a mean interval of 2.7 years. Self-reported primary cooking and heating fuels (solid: coal, wood, or charcoal; clean: gas, electricity, or central heating), switching of fuel type before baseline, and use of ventilated cookstoves. Death from cardiovascular and all causes, collected through established death registries. Among the 271 217 participants, the mean (SD) age was 51.0 (10.2) years, and 59% (n = 158 914) were women. A total of 66% (n = 179 952) of the participants reported regular cooking (at least weekly) and 60% (n = 163 882) reported winter heating, of whom 84% (n = 150 992) and 90% (n = 147 272) used solid fuels, respectively. There were 15 468 deaths, including 5519 from cardiovascular causes, documented during a mean (SD) of 7.2 (1.4) years of follow-up. Use of solid fuels for cooking was associated with greater risk of cardiovascular mortality (absolute rate difference [ARD] per 100 000 person-years, 135 [95% CI, 77-193]; hazard ratio [HR], 1.20 [95% CI, 1.02-1.41]) and all-cause mortality (ARD, 338 [95% CI, 249-427]; HR, 1.11 [95% CI, 1.03-1.20]). Use of solid fuels for heating was also associated with greater risk of cardiovascular mortality (ARD, 175 [95% CI, 118-231]; HR, 1.29 [95% CI, 1.06-1.55]) and all-cause mortality (ARD, 392 [95% CI, 297-487]; HR, 1.14 [95% CI, 1.03-1.26]). Compared with persistent solid fuel

Evolution of Cardiovascular Diseases Mortality in the Counties of the State of Rio de Janeiro from 1979 to 2010

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Gabriel Porto Soares

2015-05-01

Full Text Available Background: Cardiovascular Diseases (CVD are the leading cause of death in Brazil. Objective: To estimate total CVD, cerebrovascular disease (CBVD, and ischemic heart disease (IHD mortality rates in adults in the counties of the state of Rio de Janeiro (SRJ, from 1979 to 2010. Methods: The counties of the SRJ were analysed according to their denominations stablished by the geopolitical structure of 1950, Each new county that have since been created, splitting from their original county, was grouped according to their former origin. Population Data were obtained from the Brazilian Institute of Geography and Statistics (IBGE, and data on deaths were obtained from DataSus/MS. Mean CVD, CBVD, and IHD mortality rates were estimated, compensated for deaths from ill-defined causes, and adjusted for age and sex using the direct method for three periods: 1979–1989, 1990–1999, and 2000–2010, Such results were spatially represented in maps. Tables were also constructed showing the mortality rates for each disease and year period. Results: There was a significant reduction in mortality rates across the three disease groups over the the three defined periods in all the county clusters analysed, Despite an initial mortality rate variation among the counties, it was observed a homogenization of such rates at the final period (2000–2010. The drop in CBVD mortality was greater than that in IHD mortality. Conclusion: Mortality due to CVD has steadily decreased in the SRJ in the last three decades. This reduction cannot be explained by greater access to high technology procedures or better control of cardiovascular risk factors as these facts have not occurred or happened in low proportion of cases with the exception of smoking which has decreased significantly. Therefore, it is necessary to seek explanations for this decrease, which may be related to improvements in the socioeconomic conditions of the population.

All-cause and cardiovascular mortality in a consecutive series of patients with diabetic foot osteomyelitis.

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Ricci, Lucia; Scatena, Alessia; Tacconi, Danilo; Ventoruzzo, Giorgio; Liistro, Francesco; Bolognese, Leonardo; Monami, Matteo; Mannucci, Edoardo

2017-09-01

Mortality in patients with type 2 diabetes and diabetic foot osteomyelitis (DFO) have been explored in few small studies with a short follow-up. Aim of the present study is to assess all-cause and cardiovascular mortality and predictors of mortality in a consecutive series of patients with DFO. Patients with a diagnosis of DFO, attending the Diabetic Foot Unit of San Donato Hospital in Arezzo between January 1st, 2012 and December 31st, 2013, were included in this retrospective study. Information on all-cause mortality up to December 1st, 2016, was obtained from the registry of the Local Health Unit of Arezzo, which contains updated records of all persons living in Tuscany. One hundred ninety-four patients were included in the study. During a mean period of observation of 2.8±1.4years, 73 (37.6%) died, with a yearly rate of 13.2%. Of the 73 deaths, 59 were attributable to cardiovascular causes. After adjusting for possible confounders in a Cox analysis, site of osteomyelitis (hindfoot vs mid/forefoot) was associated with a higher mortality, and surgical treatment with a lower mortality. Mortality in patients with DFO appears to be much higher than that reported in clinical series of patients with diabetic foot ulcers, particularly when hindfoot is affected. Copyright © 2017. Published by Elsevier B.V.

Flavonoid intake and cardiovascular disease mortality in a prospective cohort of US adults

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Background: Flavonoids are plant-based phytochemicals with cardiovascular protective properties. Few studies have comprehensively examined flavonoid classes in relation to cardiovascular disease mortality. We examined the association between flavonoid intake and cardiovascular disease (CVD) mortalit...

Sex-Specific Associations Between Self-reported Sleep Duration, Cardiovascular Disease, Hypertension, and Mortality in an Elderly Population.

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Broström, Anders; Wahlin, Ake; Alehagen, Urban; Ulander, Martin; Johansson, Peter

2017-01-05

Both short and long sleep durations have been associated to increased mortality. Knowledge about sex-specific differences among elderly regarding associations between sleep duration, cardiovascular health, and mortality is sparse. The aims of this study are to examine the association between self-reported sleep duration and mortality and to investigate whether this association is sex specific and/or moderated by cardiovascular morbidity, and also to explore potential mediators of sleep duration effects on mortality. A population-based, observational, cross-sectional design with 6-year follow-up with mortality as primary outcome was conducted. Self-rated sleep duration, clinical examinations, echocardiography, and blood samples (N-terminal fragment of proBNP) were collected. A total of 675 persons (50% women; mean age, 78 years) were divided into short sleepers (≤6 hours; n = 231), normal sleepers (7-8 hours; n = 338), and long sleepers (≥9 hours; n = 61). Data were subjected to principal component analyses. Cardiovascular disease (CVD) and hypertension factors were extracted and used as moderators and as mediators in the regression analyses. During follow-up, 55 short sleepers (24%), 68 normal sleepers (20%), and 21 long sleepers (34%) died. Mediator analyses showed that long sleep was associated with mortality in men (hazard ratio [HR], 1.8; P = .049), independently of CVD and hypertension. In men with short sleep, CVD acted as a moderator of the association with mortality (HR, 4.1; P = .025). However, when using N-terminal fragment of proBNP, this effect became nonsignificant (HR, 3.1; P = .06). In woman, a trend to moderation involving the hypertension factor and short sleep was found (HR, 4.6; P = .09). Short and long sleep duration may be seen as risk markers, particularly among older men with cardiovascular morbidity.

Trends in Hospitalization and Mortality Rates Due to Acute Cardiovascular Disease in Castile and León, 2001 to 2015.

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López-Messa, Juan B; Andrés-de Llano, Jesús M; López-Fernández, Laura; García-Cruces, Jesús; García-Crespo, Julio; Prieto González, Miryam

2018-02-01

To analyze hospitalization and mortality rates due to acute cardiovascular disease (ACVD). We conducted a cross-sectional study of the hospital discharge database of Castile and León from 2001 to 2015, selecting patients with a principal discharge diagnosis of acute myocardial infarction (AMI), unstable angina, heart failure, or acute ischemic stroke (AIS). Trends in the rates of hospitalization/100 000 inhabitants/y and hospital mortality/1000 hospitalizations/y, overall and by sex, were studied by joinpoint regression analysis. A total of 239 586 ACVD cases (AMI 55 004; unstable angina 15 406; heart failure 111 647; AIS 57 529) were studied. The following statistically significant trends were observed: hospitalization: ACVD, upward from 2001 to 2007 (5.14; 95%CI, 3.5-6.8; P < .005), downward from 2011 to 2015 (3.7; 95%CI, 1.0-6.4; P < .05); unstable angina, downward from 2001 to 2010 (-12.73; 95%CI, -14.8 to -10.6; P < .05); AMI, upward from 2001 to 2003 (15.6; 95%CI, 3.8-28.9; P < .05), downward from 2003 to 2015 (-1.20; 95%CI, -1.8 to -0.6; P < .05); heart failure, upward from 2001 to 2007 (10.70; 95%CI, 8.7-12.8; P < .05), upward from 2007 to 2015 (1.10; 95%CI, 0.1-2.1; P < .05); AIS, upward from 2001 to 2007 (4.44; 95%CI, 2.9-6.0; P < .05). Mortality rates: downward from 2001 to 2015 in ACVD (-1.16; 95%CI, -2.1 to -0.2; P < .05), AMI (-3.37, 95%CI, -4.4 to -2, 3, P < .05), heart failure (-1.25; 95%CI, -2.3 to -0.1; P < .05) and AIS (-1.78; 95%CI, -2.9 to -0.6; P < .05); unstable angina, upward from 2001 to 2007 (24.73; 95%CI, 14.2-36.2; P < .05). The ACVD analyzed showed a rising trend in hospitalization rates from 2001 to 2015, which was especially marked for heart failure, and a decreasing trend in hospital mortality rates, which were similar in men and women. These data point to a stabilization and a decline in hospital mortality, attributable to established prevention measures. Copyright © 2017 Sociedad Española de Cardiología. Published by

Being born under adverse economic conditions leads to a higher cardiovascular mortality rate later in life: evidence based on individuals born at different stages of the business cycle.

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van den Berg, Gerard J; Doblhammer-Reiter, Gabriele; Christensen, Kaare

2011-05-01

We connect the recent medical and economic literatures on the long-run effects of early-life conditions by analyzing the effects of economic conditions on the individual cardiovascular (CV) mortality rate later in life, using individual data records from the Danish Twin Registry covering births since the 1870s and including the cause of death. To capture exogenous variation of conditions early in life, we use the state of the business cycle around birth. We find significant negative effects of economic conditions around birth on the individual CV mortality rate at higher ages. There is no effect on the cancer-specific mortality rate. From variation within and between monozygotic and dizygotic twin pairs born under different conditions, we conclude that the fate of an individual is more strongly determined by genetic and household-environmental factors if early-life conditions are poor. Individual-specific qualities come more to fruition if the starting position in life is better.

Daytime Napping and the Risk of Cardiovascular Disease and All-Cause Mortality: A Prospective Study and Dose-Response Meta-Analysis.

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Yamada, Tomohide; Hara, Kazuo; Shojima, Nobuhiro; Yamauchi, Toshimasa; Kadowaki, Takashi

2015-12-01

To summarize evidence about the association between daytime napping and the risk of cardiovascular disease and all-cause mortality, and to quantify the potential dose-response relation. Meta-analysis of prospective cohort studies. Electronic databases were searched for articles published up to December 2014 using the terms nap, cardiovascular disease, and all-cause mortality. We selected well-adjusted prospective cohort studies reporting risk estimates for cardiovascular disease and all-cause mortality related to napping. Eleven prospective cohort studies were identified with 151,588 participants (1,625,012 person-years) and a mean follow-up period of 11 years (60% women, 5,276 cardiovascular events, and 18,966 all-cause deaths). Pooled analysis showed that a long daytime nap (≥ 60 min/day) was associated with a higher risk of cardiovascular disease (rate ratio [RR]: 1.82 [1.22-2.71], P = 0.003, I(2) = 37%) compared with not napping. All-cause mortality was associated with napping for ≥ 60 min/day (RR: 1.27 [1.11-1.45], P napping. In contrast, napping for nap time and cardiovascular disease (P for nonlinearity = 0.01). The RR initially decreased from 0 to 30 min/day. Then it increased slightly until about 45 min/day, followed by a sharp increase at longer nap times. There was also a positive linear relation between nap time and all-cause mortality (P for non-linearity = 0.97). Nap time and cardiovascular disease may be associated via a J-curve relation. Further studies are needed to confirm the efficacy of a short nap. © 2015 Associated Professional Sleep Societies, LLC.

MR-proANP improves prediction of mortality and cardiovascular events in patients with STEMI

DEFF Research Database (Denmark)

Lindberg, Søren; Jensen, Jan Skov; Pedersen, Sune H

2015-01-01

drawn immediately before PCI. Plasma MR-proANP was measured using an automated processing assay. Endpoints were all-cause mortality (n = 137) and the combined endpoint (n = 170) of major adverse cardiovascular events (MACE) defined as cardiovascular mortality and admission due to recurrent MI, ischaemic...

Impact of type 2 diabetes mellitus on in-hospital-mortality after major cardiovascular events in Spain (2002-2014).

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de Miguel-Yanes, José M; Jiménez-García, Rodrigo; Hernández-Barrera, Valentín; Méndez-Bailón, Manuel; de Miguel-Díez, Javier; Lopez-de-Andrés, Ana

2017-10-10

Diabetes mellitus has long been associated with cardiovascular events. Nevertheless, the higher burden of traditional cardiovascular risk factors reported in high-income countries is offset by a more widespread use of preventive measures and revascularization or other invasive procedures. The aim of this investigation is to describe trends in number of cases and outcomes, in-hospital mortality (IHM) and length of hospital stay (LHS), of hospital admissions for major cardiovascular events between type 2 diabetes (T2DM) and matched non-diabetes patients. Retrospective study using National Hospital Discharge Database, analyzed in 4 years 2002, 2006, 2010, 2014, in Spain. We included patients (≥ 40 years old) with a primary diagnosis of myocardial infarction, ischemic and hemorrhagic stroke, aortic aneurysm and dissection and acute lower limb ischemia in people with T2DM. Cases were matched with controls (without T2DM) by ICD-9-CM codes, sex, age, province of residence and year. We selected 130,011 matched couples (50,427 with myocardial infarction, 60,236 with stroke, 2599 with aortic aneurysm and dissection and 16,749 with acute lower limb ischemia. Among T2DM patients we found increasing numbers of admissions overtime for stroke (10,794 in 2002 vs 17,559 in 2014), aortic aneurysm and dissection (390 vs 841) and acute lower limb ischemia (3854 vs. 4548). People were progressively older (except for myocardial infarction), had more comorbidities (especially T2DM patients), and were more frequently coded overtime for cardiovascular risk factors (smoking, obesity, hypertension, lipid disorders) and renal diseases. LHS and IHM declined overtime, though IHM only did it significantly in T2DM patients. Multivariable adjustment showed that T2DM patients had a significantly 15% higher mortality rate during admission for myocardial infarction, a 6% higher mortality for stroke, and a 6% higher mortality rate for "all cardiovascular events combined", than non

Heart rate control with adrenergic blockade: Clinical outcomes in cardiovascular medicine

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David Feldman

2010-05-01

Full Text Available David Feldman1, Terry S Elton2, Doron M Menachemi3, Randy K Wexler41Heart Failure/Transplant and VAD Programs, Minneapolis Heart Institute, Minneapolis, Minnesota, USA; 2Division of Pharmacology, College of Pharmacology, The Ohio State University, Columbus, Ohio, USA; 3Heart Failure Services, Edith Wolfson Medical Center, The Heart Institute, Sakler School of Medicine, Tel-Aviv University, Holon, Israel; 4Department of Clinical Family Medicine, The Ohio State University, Columbus, Ohio, USAAbstract: The sympathetic nervous system is involved in regulating various cardiovascular parameters including heart rate (HR and HR variability. Aberrant sympathetic nervous system expression may result in elevated HR or decreased HR variability, and both are independent risk factors for development of cardiovascular disease, including heart failure, myocardial infarction, and hypertension. Epidemiologic studies have established that impaired HR control is linked to increased cardiovascular morbidity and mortality. One successful way of decreasing HR and cardiovascular mortality has been by utilizing β-blockers, because their ability to alter cell signaling at the receptor level has been shown to mitigate the pathogenic effects of sympathetic nervous system hyperactivation. Numerous clinical studies have demonstrated that β-blocker-mediated HR control improvements are associated with decreased mortality in postinfarct and heart failure patients. Although improved HR control benefits have yet to be established in hypertension, both traditional and vasodilating β-blockers exert positive HR control effects in this patient population. However, differences exist between traditional and vasodilating β-blockers; the latter reduce peripheral vascular resistance and exert neutral or positive effects on important metabolic parameters. Clinical evidence suggests that attainment of HR control is an important treatment objective for patients with cardiovascular

Left Ventricular Wall Stress-Mass-Heart Rate Product and Cardiovascular Events in Treated Hypertensive Patients

DEFF Research Database (Denmark)

Devereux, Richard B; Bang, Casper N; Roman, Mary J

2015-01-01

-varying covariate in Cox models assessing predictors of the LIFE primary composite end point (cardiovascular death, MI, or stroke), its individual components, and all-cause mortality. At baseline, the triple product in both treatment groups was, compared with normal adults, elevated in 70% of patients. During...... more, greater heart rate reduction with atenolol resulted in larger reduction of the triple product. Lower triple product during antihypertensive treatment was strongly, independently associated with lower rates of the LIFE primary composite end point, cardiovascular death, and MI, but not stroke.......In the Losartan Intervention for End Point Reduction in Hypertension (LIFE) study, 4.8 years' losartan- versus atenolol-based antihypertensive treatment reduced left ventricular hypertrophy and cardiovascular end points, including cardiovascular death and stroke. However, there was no difference...

Urbanization is Associated with Increased Trends in Cardiovascular Mortality Among Indigenous Populations: the PAI Study

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Anderson da Costa Armstrong

2018-02-01

Full Text Available Abstract Background: The cardiovascular risk burden among diverse indigenous populations is not totally known and may be influenced by lifestyle changes related to the urbanization process. Objectives: To investigate the cardiovascular (CV mortality profile of indigenous populations during a rapid urbanization process largely influenced by governmental infrastructure interventions in Northeast Brazil. Methods: We assessed the mortality of indigenous populations (≥ 30 y/o from 2007 to 2011 in Northeast Brazil (Bahia and Pernambuco states. Cardiovascular mortality was considered if the cause of death was in the ICD-10 CV disease group or if registered as sudden death. The indigenous populations were then divided into two groups according to the degree of urbanization based on anthropological criteria:9,10 Group 1 - less urbanized tribes (Funi-ô, Pankararu, Kiriri, and Pankararé; and Group 2 - more urbanized tribes (Tuxá, Truká, and Tumbalalá. Mortality rates of highly urbanized cities (Petrolina and Juazeiro in the proximity of indigenous areas were also evaluated. The analysis explored trends in the percentage of CV mortality for each studied population. Statistical significance was established for p value < 0.05. Results: There were 1,333 indigenous deaths in tribes of Bahia and Pernambuco (2007-2011: 281 in Group 1 (1.8% of the 2012 group population and 73 in Group 2 (3.7% of the 2012 group population, CV mortality of 24% and 37%, respectively (p = 0.02. In 2007-2009, there were 133 deaths in Group 1 and 44 in Group 2, CV mortality of 23% and 34%, respectively. In 2009-2010, there were 148 deaths in Group 1 and 29 in Group 2, CV mortality of 25% and 41%, respectively. Conclusions: Urbanization appears to influence increases in CV mortality of indigenous peoples living in traditional tribes. Lifestyle and environmental changes due to urbanization added to suboptimal health care may increase CV risk in this population.

Meta-analysis of self-reported daytime napping and risk of cardiovascular or all-cause mortality.

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Liu, Xiaokun; Zhang, Qi; Shang, Xiaoming

2015-05-04

Whether self-reported daytime napping is an independent predictor of cardiovascular or all-cause mortality remains unclear. The aim of this study was to investigate self-reported daytime napping and risk of cardiovascular or all-cause mortality by conducting a meta-analysis. A computerized literature search of PubMed, Embase, and Cochrane Library was conducted up to May 2014. Only prospective studies reporting risk ratio (RR) and corresponding 95% confidence intervals (CI) of cardiovascular or all-cause mortality with respect to baseline self-reported daytime napping were included. Seven studies with 98,163 subjects were included. Self-reported daytime napping was associated with a greater risk of all-cause mortality (RR 1.15; 95% CI 1.07-1.24) compared with non-nappers. Risk of all-cause mortality appeared to be more pronounced among persons with nap duration >60 min (RR 1.15; 95% CI 1.04-1.27) than persons with nap duration napping is a mild but statistically significant predictor for all-cause mortality, but not for cardiovascular mortality. However, whether the risk is attributable to excessive sleep duration or napping alone remains controversial. More prospective studies stratified by sleep duration, napping periods, or age are needed.

Effect of marijuana use on cardiovascular and cerebrovascular mortality: A study using the National Health and Nutrition Examination Survey linked mortality file.

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Yankey, Barbara A; Rothenberg, Richard; Strasser, Sheryl; Ramsey-White, Kim; Okosun, Ike S

2017-11-01

Background Reports associate marijuana use with cardiovascular emergencies. Studies relating marijuana use to cardiovascular mortality are scarce. Recent advance towards marijuana use legalization emphasizes the importance of understanding relationships between marijuana use and cardiovascular deaths; the primary ranked mortality. Recreational marijuana is primarily smoked; we hypothesize that like cigarette smoking, marijuana use will be associated with increased cardiovascular mortalities. Design The design of this study was based on a mortality follow-up. Method We linked participants aged 20 years and above, who responded to questions on marijuana use during the 2005 US National Health and Nutrition Examination Survey to data from the 2011 public-use linked mortality file of the National Center for Health Statistics, Centers for Disease Control and Prevention. Only participants eligible for mortality follow-up were included. We conducted Cox proportional hazards regression analyses to estimate hazard ratios for hypertension, heart disease, and cerebrovascular mortality due to marijuana use. We controlled for cigarette smoking and other relevant variables. Results Of the 1213 eligible participants 72.5% were presumed to be alive. The total follow-up time was 19,569 person-years. Adjusted hazard ratios for death from hypertension among marijuana users compared to non-marijuana users was 3.42 (95% confidence interval: 1.20-9.79) and for each year of marijuana use was 1.04 (95% confidence interval: 1.00-1.07). Conclusion From our results, marijuana use may increase the risk for hypertension mortality. Increased duration of marijuana use is associated with increased risk of death from hypertension. Recreational marijuana use potentially has cardiovascular adverse effects which needs further investigation.

The Diabetic Foot as a Proxy for Cardiovascular Events and Mortality Review.

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Dietrich, Isa; Braga, Gustavo Arruda; de Melo, Fernanda Gomes; da Costa Silva Silva, Ana Carolina Calmon

2017-10-02

This article reviewed very recent papers (2016) discussing or bringing clinical evidences of the possible common pathways leading to diabetic foot syndrome (DFS) and increased mortality rates. Diabetic patients with diabetic foot syndrome have a mortality rate greater than twofold when compared with non-ulcerated diabetics. In addition, the 5-year mortality rate following amputation is estimated at 39-68%, a life expectancy comparable to aggressive types of cancer or advanced congestive heart failure. The majority of patients with diabetic foot ulcer also present insulin resistance, central obesity, dyslipidemia, and hypertension that characterize the metabolic syndrome that, in turn, is associated with an elevated risk of major cardiovascular events. Sensory neuropathy is the primary cause of more the 60% of diabetic foot ulcer. Diabetic peripheral neuropathy is a microvascular complication of diabetes mellitus and in type 2 diabetes, not only hyperglycemia but also other metabolic alterations and persistent inflammatory status due to adiposity play a major role in axon injury. Elevated triglycerides have been showed to be an independent risk factor for lower extremity amputation in diabetic patients. Also, toxic adiposity, oxidative stress, mitochondrial dysfunction, activation of the polyol pathway, accumulation of advanced glycation end products (AGEs), and elevation of inflammatory markers are also implicated in diabetic vascular disease and neuropathy. The hypotheses that the association between DFS and increased rates of mortality reflects the progression of micro- and macrovascular complications are reinforced by the additional association of DFU to renal failure and retinopathy.

Acute cardiovascular events and all-cause mortality in patients with hyperthyroidism: a population-based cohort study.

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Dekkers, Olaf M; Horváth-Puhó, Erzsébet; Cannegieter, Suzanne C; Vandenbroucke, Jan P; Sørensen, Henrik Toft; Jørgensen, Jens Otto L

2017-01-01

Several studies have shown an increased risk for cardiovascular disease (CVD) in hyperthyroidism, but most studies have been too small to address the effect of hyperthyroidism on individual cardiovascular endpoints. Our main aim was to assess the association among hyperthyroidism, acute cardiovascular events and mortality. It is a nationwide population-based cohort study. Data were obtained from the Danish Civil Registration System and the Danish National Patient Registry, which covers all Danish hospitals. We compared the rate of all-cause mortality as well as venous thromboembolism (VTE), acute myocardial infarction (AMI), ischemic and non-ischemic stroke, arterial embolism, atrial fibrillation (AF) and percutaneous coronary intervention (PCI) in the two cohorts. Hazard ratios (HR) with 95% confidence intervals (95% CI) were estimated. The study included 85 856 hyperthyroid patients and 847 057 matched population-based controls. Mean follow-up time was 9.2 years. The HR for mortality was highest in the first 3 months after diagnosis of hyperthyroidism: 4.62, 95% CI: 4.40-4.85, and remained elevated during long-term follow-up (>3 years) (HR: 1.35, 95% CI: 1.33-1.37). The risk for all examined cardiovascular events was increased, with the highest risk in the first 3 months after hyperthyroidism diagnosis. The 3-month post-diagnosis risk was highest for atrial fibrillation (HR: 7.32, 95% CI: 6.58-8.14) and arterial embolism (HR: 6.08, 95% CI: 4.30-8.61), but the risks of VTE, AMI, ischemic and non-ischemic stroke and PCI were increased also 2- to 3-fold. We found an increased risk for all-cause mortality and acute cardiovascular events in patients with hyperthyroidism. © 2017 European Society of Endocrinology.

Endogenous Plasma Erythropoietin, Cardiovascular Mortality and All-Cause Mortality in Renal Transplant Recipients

NARCIS (Netherlands)

Sinkeler, S. J.; Zelle, D. M.; van der Heide, J. J. Homan; Gans, R. O. B.; Navis, G.; Bakker, S. J. L.

Cardiovascular disease (CVD) is the main cause of mortality in renal transplant recipients (RTR). Classical factors only partly explain the excess risk. We hypothesized that high EPO-a marker for inflammation, angiogenesis and hypoxia-is associated with CVD in RTR. A total of 568 RTR (51 +/- 12

Did the Great Recession affect mortality rates in the metropolitan United States? Effects on mortality by age, gender and cause of death.

Science.gov (United States)

Strumpf, Erin C; Charters, Thomas J; Harper, Sam; Nandi, Arijit

2017-09-01

Mortality rates generally decline during economic recessions in high-income countries, however gaps remain in our understanding of the underlying mechanisms. This study estimates the impacts of increases in unemployment rates on both all-cause and cause-specific mortality across U.S. metropolitan regions during the Great Recession. We estimate the effects of economic conditions during the recent and severe recessionary period on mortality, including differences by age and gender subgroups, using fixed effects regression models. We identify a plausibly causal effect by isolating the impacts of within-metropolitan area changes in unemployment rates and controlling for common temporal trends. We aggregated vital statistics, population, and unemployment data at the area-month-year-age-gender-race level, yielding 527,040 observations across 366 metropolitan areas, 2005-2010. We estimate that a one percentage point increase in the metropolitan area unemployment rate was associated with a decrease in all-cause mortality of 3.95 deaths per 100,000 person years (95%CI -6.80 to -1.10), or 0.5%. Estimated reductions in cardiovascular disease mortality contributed 60% of the overall effect and were more pronounced among women. Motor vehicle accident mortality declined with unemployment increases, especially for men and those under age 65, as did legal intervention and homicide mortality, particularly for men and adults ages 25-64. We find suggestive evidence that increases in metropolitan area unemployment increased accidental drug poisoning deaths for both men and women ages 25-64. Our finding that all-cause mortality decreased during the Great Recession is consistent with previous studies. Some categories of cause-specific mortality, notably cardiovascular disease, also follow this pattern, and are more pronounced for certain gender and age groups. Our study also suggests that the recent recession contributed to the growth in deaths from overdoses of prescription drugs in

The Trends in Cardiovascular Diseases and Respiratory Diseases Mortality in Urban and Rural China, 1990-2015.

Science.gov (United States)

Sun, Weiwei; Zhou, Yun; Zhang, Zhuang; Cao, Limin; Chen, Weihong

2017-11-15

With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs) and respiratory diseases (RDs) have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs) from CVDs and RDs in the rural and urban population from 1990 to 2015. Using data from Chinese yearbooks, joinpoint regression analysis was employed to estimate the annual percent change (APC) of mortality rates from CVDs and RDs. YLLs due to CVDs and RDs were calculated by a standard method, adopting recommended standard life expectancy at birth values of 80 years for men and 82.5 years for women. Age-standardized mortality rates and YLL rates were calculated by using the direct method based on the Chinese population from the sixth population census of 2010. Age-standardized mortality rates from CVDs for urban residents and from RDs for both urban and rural residents showed decreasing trends in China from 1990 to 2015. Age-standardized mortality rates from CVDs among rural residents remained constant during above period and outstripped those among urban residents gradually. The age-standardized YLL rates of CVDs for urban and rural residents decreased 35.2% and 8.3% respectively. Additionally, the age-standardized YLL rates of RDs for urban and rural residents decreased 64.2% and 79.0% respectively. The age-standardized mortality and YLL rates from CVDs and RDs gradually decreased in China from 1990 to 2015. We observed more substantial declines of the mortality rates from CVDs in urban areas and from RDs in rural areas.

Variability of nutrients intake, lipid profile and cardiovascular mortality among geographical areas in Spain: The DRECE study.

Science.gov (United States)

Gómez de la Cámara, Agustín; De Andrés Esteban, Eva; Urrútia Cuchí, Gerard; Calderón Sandubete, Enrique; Rubio Herrera, Miguel Ángel; Menéndez Orenga, Miguel; Lora Pablos, David

2017-11-07

It has often been suggested that cardiovascular mortality and their geographical heterogeneity are associated with nutrients intake patterns and also lipid profile. The large Spanish study Dieta y Riesgo de Enfermedades Cardiovasculares en España (DRECE) investigated this theory from 1991 to 2010. Out of the 4,783 Spanish individuals making up the DRECE cohort, 220 subjects (148 men and 72 women) died (4.62%) during the course of the study. The mean age of patients who died from cardiovascular causes (32 in all) was 61.08 years 95% CI (57.47-64.69) and 70.91% of them were males. The consumption of nutrients and the lipid profile by geographical area, studied by geospatial models, showed that the east and southern area of the country had the highest fat intake coupled to a high rate of unhealthy lipid profile. It was concluded that the spatial geographical analysis showed a relationship between high fat intake, unhealthy lipid profile and cardiovascular mortality in the different geographical areas, with a high variability within the country.

Endogenous plasma erythropoietin, cardiovascular mortality and all-cause mortality in renal transplant recipients

NARCIS (Netherlands)

Sinkeler, S. J.; Zelle, D. M.; Homan van der Heide, J. J.; Gans, R. O. B.; Navis, G.; Bakker, S. J. L.

2012-01-01

Cardiovascular disease (CVD) is the main cause of mortality in renal transplant recipients (RTR). Classical factors only partly explain the excess risk. We hypothesized that high EPO--a marker for inflammation, angiogenesis and hypoxia--is associated with CVD in RTR. A total of 568 RTR (51±12 years;

Association between air pollution and cardiovascular mortality in Hefei, China: A time-series analysis.

Science.gov (United States)

Zhang, Chao; Ding, Rui; Xiao, Changchun; Xu, Yachun; Cheng, Han; Zhu, Furong; Lei, Ruoqian; Di, Dongsheng; Zhao, Qihong; Cao, Jiyu

2017-10-01

In recent years, air pollution has become an alarming problem in China. However, evidence on the effects of air pollution on cardiovascular mortality is still not conclusive to date. This research aimed to assess the short-term effects of air pollution on cardiovascular morbidity in Hefei, China. Data of air pollution, cardiovascular mortality, and meteorological characteristics in Hefei between 2010 and 2015 were collected. Time-series analysis in generalized additive model was applied to evaluate the association between air pollution and daily cardiovascular mortality. During the study period, the annual average concentration of PM 10, SO 2 , and NO 2 was 105.91, 20.58, and 30.93 μg/m 3 , respectively. 21,816 people (including 11,876 man, and 14,494 people over 75 years of age) died of cardiovascular diseases. In single pollutant model, the effects of multi-day exposure were greater than single-day exposure of the air pollution. For every increase of 10 μg/m 3 in SO 2 , NO 2 , and PM 10 levels, CVD mortality increased by 5.26% (95%CI: 3.31%-7.23%), 2.71% (95%CI: 1.23%-4.22%), and 0.68% (95%CI: 0.33%-1.04%) at a lag03, respectively. The multi-pollutant models showed that PM 10 and SO 2 remained associated with CVD mortality, although the effect estimates attenuated. However, the effect of NO 2 on CVD mortality decreased to statistically insignificant. Subgroup analyses further showed that women were more vulnerable than man upon air pollution exposure. These findings showed that air pollution could significantly increase the CVD mortality. Copyright © 2017 Elsevier Ltd. All rights reserved.

Cardiovascular disease mortality in the Americas: current trends and disparities.

Science.gov (United States)

de Fatima Marinho de Souza, Maria; Gawryszewski, Vilma Pinheiro; Orduñez, Pedro; Sanhueza, Antonio; Espinal, Marcos A

2012-08-01

To describe the current situation and trends in mortality due to cardiovascular disease (CVD) in the Americas and explore their association with economic indicators. This time series study analysed mortality data from 21 countries in the region of the Americas from 2000 to the latest available year. Age-adjusted death rates, annual variation in death rates. Regression analysis was used to estimate the annual variation and the association between age-adjusted rates and country income. Currently, CVD comprised 33.7% of all deaths in the Americas. Rates were higher in Guyana (292/100 000), Trinidad and Tobago (289/100 000) and Venezuela (246/100 000), and lower in Canada (108/100 000), Puerto Rico (121/100 000) and Chile (125/100 000). Male rates were higher than female rates in all countries. The trend analysis showed that CVD death rates in the Americas declined -19% overall (-20% among women and -18% among men). Most countries had a significant annual decline, except Guatemala, Guyana, Suriname, Paraguay and Panama. The largest annual declines were observed in Canada (-4.8%), the USA (-3.9%) and Puerto Rico (-3.6%). Minor declines were in Mexico (-0.8%) and Cuba (-1.1%). Compared with high-income countries the difference between the median of death rates in lower middle-income countries was 56.7% higher and between upper middle-income countries was 20.6% higher. CVD death rates have been decreasing in most countries in the Americas. Considerable disparities still remain in the current rates and trends.

Increased orosomucoid in urine is an independent predictor of cardiovascular and all-cause mortality in patients with type 2 diabetes at 10 years of follow-up

DEFF Research Database (Denmark)

Svendstrup, Mathilde; Christiansen, Merete Skovdal; Magid, Erik

2013-01-01

To evaluate whether increased urinary orosomucoid excretion rate (UOER) is an independent predictor of cardiovascular and all-cause mortality in type 2 diabetes (T2DM) and type 1 diabetes (T1DM) at 10years of follow-up.......To evaluate whether increased urinary orosomucoid excretion rate (UOER) is an independent predictor of cardiovascular and all-cause mortality in type 2 diabetes (T2DM) and type 1 diabetes (T1DM) at 10years of follow-up....

Worsening calcification propensity precedes all-cause and cardiovascular mortality in haemodialyzed patients.

Science.gov (United States)

Lorenz, Georg; Steubl, Dominik; Kemmner, Stephan; Pasch, Andreas; Koch-Sembdner, Wilhelm; Pham, Dang; Haller, Bernhard; Bachmann, Quirin; Mayer, Christopher C; Wassertheurer, Siegfried; Angermann, Susanne; Lech, Maciej; Moog, Philipp; Bauer, Axel; Heemann, Uwe; Schmaderer, Christoph

2017-10-17

A novel in-vitro test (T 50 -test) assesses ex-vivo serum calcification propensity which predicts mortality in HD patients. The association of longitudinal changes of T 50 with all-cause and cardiovascular mortality has not been investigated. We assessed T 50 in paired sera collected at baseline and at 24 months in 188 prevalent European HD patients from the ISAR cohort, most of whom were Caucasians. Patients were followed for another 19 [interquartile range: 11-37] months. Serum T 50 exhibited a significant decline between baseline and 24 months (246 ± 64 to 190 ± 68 minutes; p < 0.001). With serum Δ-phosphate showing the strongest independent association with declining T 50 (r = -0.39; p < 0.001) in multivariable linear regression. The rate of decline of T 50 over 24 months was a significant predictor of all-cause (HR = 1.51 per 1SD decline, 95% CI: 1.04 to 2.2; p = 0.03) and cardiovascular mortality (HR = 2.15; 95% CI: 1.15 to 3.97; p = 0.02) in Kaplan Meier and multivariable Cox-regression analysis, while cross-sectional T 50 at inclusion and 24 months were not. Worsening serum calcification propensity was an independent predictor of mortality in this small cohort of prevalent HD patients. Prospective larger scaled studies are needed to assess the value of calcification propensity as a longitudinal parameter for risk stratification and monitoring of therapeutic interventions.

Impacts of temperature extremes on cardiovascular morbidity and mortality in the Czech Republic

Science.gov (United States)

Davídkovová, H.; Kyselý, J.; Plavcová, E.; Urban, A.; Kriz, B.; Kyncl, J.

2012-04-01

Elevated mortality associated with high ambient temperatures in summer represents one of the main impacts of weather extremes on human society. Increases in cardiovascular mortality during heat waves have been reported in many European countries; much less is known about which particular cardiovascular disorders are most affected during heat waves, and whether similar patterns are found for morbidity (hospital admissions). Relatively less understood is also cold-related mortality and morbidity in winter, when the relationships between weather and human health are more complex, less direct, and confounded by other factors such as epidemics of influenza/acute respiratory infections. The present study analyses relationships between temperature extremes and cardiovascular morbidity and mortality. We make use of the datasets on hospital admissions and daily mortality in the population of the Czech Republic (about 10.3 million) over 1994-2009. The data have been standardized to remove the effects of the long-term trend and the seasonal and weekly cycles. Periods when the morbidity/mortality data were affected by epidemics of influenza and other acute respiratory infections have been removed from the analysis. We use analogous definitions for hot and cold spells based on quantiles of daily average temperature anomalies, which allows for a comparison of the findings for summer hot spells and winter cold spells. The main aims of the study are (i) to identify deviations of mortality and morbidity from the baseline associated with hot and cold spells, (ii) to compare the hot- and cold-spell effects for individual cardiovascular diseases (e.g. ischaemic heart disease I20-I25, cerebrovascular disease I60-I69, hypertension I10, aterosclerosis I70) and to identify those diagnoses that are most closely linked to temperature extremes, (iii) to identify population groups most vulnerable to temperature extremes, and (iv) to compare the links to temperature extremes for morbidity and

Premature cardiovascular mortality and alcohol consumption before death in Arkhangelsk, Russia: an analysis of a consecutive series of forensic autopsies.

Science.gov (United States)

Sidorenkov, Oleg; Nilssen, Odd; Nieboer, Evert; Kleshchinov, Nikolay; Grjibovski, Andrej M

2011-12-01

High cardiovascular diseases (CVD) mortality among the middle aged is a major cause of reduced life expectancy in Russia, especially among men. Hazardous alcohol consumption is suspected to be a powerful contributing factor. All men (1099) and women (519) aged 30-70 years who died between 1 January 2008 and 31 August 2009 from CVD in the city of Arkhangelsk, north-west Russia, were included. CVD mortality was stratified by age, gender and diagnosis. For the cases diagnosed by forensic pathologists, the blood alcohol concentration (BAC) was determined. The forensic autopsy rate was 72% for men and 62% for women. Age-standardized CVD mortality rate (all age groups) in men was higher than in women. The largest male-female ratio (4.3) was observed in the age group of 50-59 years. Alcoholic and unspecified cardiomyopathies were the most dominant of CVD mortalities in women, and second in men aged types of CVD diagnoses, this observation should be taken into account when planning future research. Our study does not provide evidence that cardiovascular deaths are misclassified cases of acute alcohol poisoning.

Time trends in cardiovascular disease mortality in Russia and Germany from 1980 to 2007 - are there migration effects?

Science.gov (United States)

Deckert, Andreas; Winkler, Volker; Paltiel, Ari; Razum, Oliver; Becher, Heiko

2010-08-17

Cardiovascular disease (CVD) is the leading cause of death in the industrialized world. Large variations in CVD mortality between countries and also between population subgroups within countries have been observed. Previous studies showed significantly lower risks in German repatriates and Jews emigrating from Russia than in the general Russian population. We examined to what degree the migration of large subgroups influenced national CVD mortality rates. We used WHO data to map the CVD mortality distribution in Europe in 2005. Supplemented by data of the Statistisches Bundesamt, the mortality trends in three major CVD groups between 1980 and 2007 in Russia and Germany are displayed, as well as demographic information. The effects of migration on demography were estimated and percentage changes in CVD mortality trends were calculated under the assumption that migration had not occurred. Cardiovascular disease mortality patterns within Europe showed a strong west-east gradient with ratios up to sixfold. In Germany, the CVD mortality levels were low and steadily decreasing, whereas in Russia they fluctuated at high levels with substantial differences between the sexes and strong correlations with political changes and health campaigns. The trends in both Russia and Germany were affected by the migration that occurred in both countries over recent decades. However, our restricted focus in only adjusting for the migration of German repatriates and Jews had moderate effects on the national CVD mortality statistics in Germany (+1.0%) and Russia (-0.6%). The effects on CVD mortality rates due to migration in Germany and Russia were smaller than those due to secular economical changes. However, migration should still be considered as a factor influencing national mortality trends.

A prospective study of low fasting glucose with cardiovascular disease events and all-cause mortality: The Women's Health Initiative.

Science.gov (United States)

Mongraw-Chaffin, Morgana; LaCroix, Andrea Z; Sears, Dorothy D; Garcia, Lorena; Phillips, Lawrence S; Salmoirago-Blotcher, Elena; Zaslavsky, Oleg; Anderson, Cheryl A M

2017-05-01

While there is increasing recognition of the risks associated with hypoglycemia in patients with diabetes, few studies have investigated incident cause-specific cardiovascular outcomes with regard to low fasting glucose in the general population. We hypothesized that low fasting glucose would be associated with cardiovascular disease risk and all-cause mortality in postmenopausal women. To test our hypothesis, we used both continuous incidence rates and Cox proportional hazards models in 17,287 participants from the Women's Health Initiative with fasting glucose measured at baseline. Participants were separated into groups based on fasting glucose level: low (fasting glucose distribution exhibited evidence of a weak J-shaped association with heart failure and mortality that was predominantly due to participants with treated diabetes. Impaired and diabetic fasting glucose were positively associated with all outcomes. Associations for low fasting glucose differed, with coronary heart disease (HR=0.64 (0.42, 0.98)) significantly inverse; stroke (0.73 (0.48, 1.13)), combined cardiovascular disease (0.91 (0.73, 1.14)), and all-cause mortality (0.97 (0.79, 1.20)) null or inverse and not significant; and heart failure (1.27 (0.80, 2.02)) positive and not significant. Fasting glucose at the upper range, but not the lower range, was significantly associated with incident cardiovascular disease and all-cause mortality. Copyright © 2017 Elsevier Inc. All rights reserved.

[Association between metabolic syndrome and the 10 years mortality of cerebro-cardiovascular diseases in the senile population].

Science.gov (United States)

Jin, Meng-meng; Pan, Chang-Yu; Tian, Hui; Liu, Min; Su, Hai-yan

2008-02-01

To assess the prevalence of metabolic syndrome (MS) and its association with mortality of cerebro-cardiovascular diseases in senile population. Data were collected from 1926 people aged 60 and over, who took part in routine health examination in our hospital from 1996 to 1997. All subjects were followed up for 10 years. MS was diagnosed by using the definition recommended by Chinese Diabetic Society in 2004. Cox-proportional hazards models were used in survival analyses and to calculate the relative risk (RR) of cerebro-cardiovascular diseases mortality. The prevalence of MS was 25.03% (n = 482, Group 2) in this population. The 10 year mortality of cerebro-cardiovascular diseases was significantly higher (6.82/1000-person year vs. 2.55/1000-person year, P cerebro-cardiovascular diseases mortality was 2.52 (95% CI 1.367 - 4.661, P cerebro-cardiovascular diseases.

Illiteracy, low educational status, and cardiovascular mortality in India

OpenAIRE

Pednekar, Mangesh S; Gupta, Rajeev; Gupta, Prakash C

2011-01-01

Abstract Background Influence of education, a marker of SES, on cardiovascular disease (CVD) mortality has not been evaluated in low-income countries. To determine influence of education on CVD mortality a cohort study was performed in India. Methods 148,173 individuals aged ≥ 35 years were recruited in Mumbai during 1991-1997 and followed to ascertain vital status during 1997-2003. Subjects were divided according to educational status into one of the five groups: illiterate, primary school (...

Obesity attenuates gender differences in cardiovascular mortality.

Science.gov (United States)

Song, Xin; Tabák, Adam G; Zethelius, Björn; Yudkin, John S; Söderberg, Stefan; Laatikainen, Tiina; Stehouwer, Coen D A; Dankner, Rachel; Jousilahti, Pekka; Onat, Altan; Nilsson, Peter M; Satman, Ilhan; Vaccaro, Olga; Tuomilehto, Jaakko; Qiao, Qing

2014-10-19

To estimate cardiovascular disease (CVD) mortality in relation to obesity and gender. Data from 11 prospective cohorts from four European countries including 23 629 men and 21 965 women, aged 24 to 99 years, with a median follow-up of 7.9 years were analyzed. Hazards ratios (HR) for CVD mortality in relation to baseline body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR) and waist-to-height ratio (WHtR) were estimated using Cox proportional hazards models with age as the timescale. Men had higher CVD mortality than women in all four BMI categories (obesity defined by WC, WHR or WHtR. The gender difference was slightly smaller in obese than in non-obese individuals; but the interaction was statistically significant only between gender and WC (p = 0.02), and WHtR (p = 0.01). None of the interaction terms was significant among non-diabetic individuals. Men had higher CVD mortality than women across categories of anthropometric measures of obesity. The gender difference was attenuated in obese individuals, which warrants further investigation.

Educational differences in cardiovascular mortality: The role of shared family factors and cardiovascular risk factors.

Science.gov (United States)

Kjøllesdal, M K R; Ariansen, I; Mortensen, L H; Davey Smith, G; Næss, Ø

2016-12-01

To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Data from national and regional health surveys in Norway (1974-2003) were linked with data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry. The study population consisted of participants with at least one full sibling among the health survey participants ( n=271,310). Data were available on CVD risk factors, including weight, height, blood pressure, total cholesterol and smoking. The hazards ratio (HR) of CVD mortality was 3.44 (95% confidence interval (CI) 2.98-3.96) in the lowest educational group relative to the highest. The HRs were little altered in the within-sibship analyses. Adjusted for risk factors, the HR for CVD mortality in the cohort analyses was 2.05 (CI 1.77-2.37) in the lowest educational group relative to the highest. The respective HR in the within-sibship analyses was 2.46 (CI 1.48-2.24). Using a sibling design, we did not find that the association between education and CVD mortality was confounded by early life factors shared by siblings, but it was explained to a large extent by CVD risk factors. These results suggest that reducing levels of CVD risk factors could have the greatest effect on mortality in less well-educated people.

The Trends in Cardiovascular Diseases and Respiratory Diseases Mortality in Urban and Rural China, 1990–2015

Directory of Open Access Journals (Sweden)

Weiwei Sun

2017-11-01

Full Text Available With the rapid development of the economy over the past 20 years, the mortality rates from cardiovascular diseases (CVDs and respiratory diseases (RDs have changed in China. This study aimed to analyze the trends of mortality rates and years of life lost (YLLs from CVDs and RDs in the rural and urban population from 1990 to 2015. Using data from Chinese yearbooks, joinpoint regression analysis was employed to estimate the annual percent change (APC of mortality rates from CVDs and RDs. YLLs due to CVDs and RDs were calculated by a standard method, adopting recommended standard life expectancy at birth values of 80 years for men and 82.5 years for women. Age-standardized mortality rates and YLL rates were calculated by using the direct method based on the Chinese population from the sixth population census of 2010. Age-standardized mortality rates from CVDs for urban residents and from RDs for both urban and rural residents showed decreasing trends in China from 1990 to 2015. Age-standardized mortality rates from CVDs among rural residents remained constant during above period and outstripped those among urban residents gradually. The age-standardized YLL rates of CVDs for urban and rural residents decreased 35.2% and 8.3% respectively. Additionally, the age-standardized YLL rates of RDs for urban and rural residents decreased 64.2% and 79.0% respectively. The age-standardized mortality and YLL rates from CVDs and RDs gradually decreased in China from 1990 to 2015. We observed more substantial declines of the mortality rates from CVDs in urban areas and from RDs in rural areas.

Lower Mortality Rate in Elderly Patients With Community?Onset Pneumonia on Treatment With Aspirin

OpenAIRE

Falcone, Marco; Russo, Alessandro; Cangemi, Roberto; Farcomeni, Alessio; Calvieri, Camilla; Barill?, Francesco; Scarpellini, Maria Gabriella; Bertazzoni, Giuliano; Palange, Paolo; Taliani, Gloria; Venditti, Mario; Violi, Francesco

2015-01-01

Background Pneumonia is complicated by high rate of mortality and cardiovascular events (CVEs). The potential benefit of aspirin, which lowers platelet aggregation by inhibition of thromboxane A2 production, is still unclear. The aim of the study was to assess the impact of aspirin on mortality in patients with pneumonia. Methods and Results Consecutive patients admitted to the University?Hospital Policlinico Umberto I (Rome, Italy) with community?onset pneumonia were recruited and prospectiv...

Costs resulting from premature mortality due to cardiovascular causes: A 20-year follow-up of the DRECE study.

Science.gov (United States)

Gómez-de la Cámara, A; Pinilla-Domínguez, P; Vázquez-Fernández Del Pozo, S; García-Pérez, L; Rubio-Herrera, M A; Gómez-Gerique, J A; Gutiérrez-Fuentes, J A; Rivero-Cuadrado, A; Serrano-Aguilar, P

2014-10-01

Cardiovascular diseases are still the leading cause of death in Spain. The DRECE study (Diet and Cardiovascular Disease Risk in Spain), based on a representative cohort of the Spanish general population, analyzed nutritional habits and lifestyle and their association with morbidity and mortality patterns. We estimated the impact, in terms of loss of productivity, of premature mortality attributed to cardiovascular diseases. The loss of productivity attributed to premature mortality was calculated from 1991, based on the potential years of life lost and the potential years of working life lost. During the 20-year follow-up of a cohort of 4779 patients, 225 of these patients died (men, 152). Sixteen percent of the deaths were attributed to cardiovascular disease. The costs due to lost productivity by premature mortality exceeded 29 million euros. Of these, 4 million euros (14% of the total cost) were due to cardiovascular causes. Premature cardiovascular mortality in the DRECE cohort represented a significant social cost due to lost productivity. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

Time trends in cardiovascular disease mortality in Russia and Germany from 1980 to 2007 - are there migration effects?

Directory of Open Access Journals (Sweden)

Deckert Andreas

2010-08-01

Full Text Available Abstract Background Cardiovascular disease (CVD is the leading cause of death in the industrialized world. Large variations in CVD mortality between countries and also between population subgroups within countries have been observed. Previous studies showed significantly lower risks in German repatriates and Jews emigrating from Russia than in the general Russian population. We examined to what degree the migration of large subgroups influenced national CVD mortality rates. Methods We used WHO data to map the CVD mortality distribution in Europe in 2005. Supplemented by data of the Statistisches Bundesamt, the mortality trends in three major CVD groups between 1980 and 2007 in Russia and Germany are displayed, as well as demographic information. The effects of migration on demography were estimated and percentage changes in CVD mortality trends were calculated under the assumption that migration had not occurred. Results Cardiovascular disease mortality patterns within Europe showed a strong west-east gradient with ratios up to sixfold. In Germany, the CVD mortality levels were low and steadily decreasing, whereas in Russia they fluctuated at high levels with substantial differences between the sexes and strong correlations with political changes and health campaigns. The trends in both Russia and Germany were affected by the migration that occurred in both countries over recent decades. However, our restricted focus in only adjusting for the migration of German repatriates and Jews had moderate effects on the national CVD mortality statistics in Germany (+1.0% and Russia (-0.6%. Conclusions The effects on CVD mortality rates due to migration in Germany and Russia were smaller than those due to secular economical changes. However, migration should still be considered as a factor influencing national mortality trends.

Cardiovascular Complications and Short-term Mortality Risk in Community-Acquired Pneumonia.

Science.gov (United States)

Violi, Francesco; Cangemi, Roberto; Falcone, Marco; Taliani, Gloria; Pieralli, Filippo; Vannucchi, Vieri; Nozzoli, Carlo; Venditti, Mario; Chirinos, Julio A; Corrales-Medina, Vicente F

2017-06-01

Previous reports suggest that community-acquired pneumonia (CAP) is associated with an enhanced risk of cardiovascular complications. However, a contemporary and comprehensive characterization of this association is lacking. In this multicenter study, 1182 patients hospitalized for CAP were prospectively followed for up to 30 days after their hospitalization for this infection. Study endpoints included myocardial infarction, new or worsening heart failure, atrial fibrillation, stroke, deep venous thrombosis, cardiovascular death, and total mortality. Three hundred eighty (32.2%) patients experienced intrahospital cardiovascular events (CVEs) including 281 (23.8%) with heart failure, 109 (9.2%) with atrial fibrillation, 89 (8%) with myocardial infarction, 11 (0.9%) with ischemic stroke, and 1 (0.1%) with deep venous thrombosis; 28 patients (2.4%) died for cardiovascular causes. Multivariable Cox regression analysis showed that intrahospital Pneumonia Severity Index (PSI) class (hazard ratio [HR], 2.45, P = .027; HR, 4.23, P < .001; HR, 5.96, P < .001, for classes III, IV, and V vs II, respectively), age (HR, 1.02, P = .001), and preexisting heart failure (HR, 1.85, P < .001) independently predicted CVEs. One hundred three (8.7%) patients died by day 30 postadmission. Thirty-day mortality was significantly higher in patients who developed CVEs compared with those who did not (17.6% vs 4.5%, P < .001). Multivariable Cox regression analysis showed that intrahospital CVEs (HR, 5.49, P < .001) independently predicted 30-day mortality (after adjustment for age, PSI score, and preexisting comorbid conditions). CVEs, mainly those confined to the heart, complicate the course of almost one-third of patients hospitalized for CAP. More importantly, the occurrence of CVEs is associated with a 5-fold increase in CAP-associated 30-day mortality. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For

Estimating the cardiovascular mortality burden attributable to the European Common Agricultural Policy on dietary saturated fats.

Science.gov (United States)

Lloyd-Williams, Ffion; O'Flaherty, Martin; Mwatsama, Modi; Birt, Christopher; Ireland, Robin; Capewell, Simon

2008-07-01

To estimate the burden of cardiovascular disease within 15 European Union countries (before the 2004 enlargement) as a result of excess dietary saturated fats attributable to the Common Agricultural Policy (CAP). A spreadsheet model was developed to synthesize data on population, diet, cholesterol levels and mortality rates. A conservative estimate of a reduction in saturated fat consumption of just 2.2 g was chosen, representing 1% of daily energy intake. The fall in serum cholesterol concentration was then calculated, assuming that this 1% reduction in saturated fat consumption was replaced with 0.5% monounsaturated and 0.5% polyunsaturated fats. The resulting reduction in cardiovascular and stroke deaths was then estimated, and a sensitivity analysis conducted. Reducing saturated fat consumption by 1% and increasing monounsaturated and polyunsaturated fat by 0.5% each would lower blood cholesterol levels by approximately 0.06 mmol/l, resulting in approximately 9800 fewer coronary heart disease deaths and 3000 fewer stroke deaths each year. The cardiovascular disease burden attributable to CAP appears substantial. Furthermore, these calculations were conservative estimates, and the true mortality burden may be higher. The analysis contributes to the current wider debate concerning the relationship between CAP, health and chronic disease across Europe, together with recent international developments and commitments to reduce chronic diseases. The reported mortality estimates should be considered in relation to the current CAP and any future reforms.

Effect of the US-Mexico border region in cardiovascular mortality: ecological time trend analysis of Mexican border and non-border municipalities from 1998 to 2012

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Gabriel Anaya

2017-05-01

Full Text Available Abstract Background An array of risk factors has been associated with cardiovascular diseases, and developing nations are becoming disproportionately affected by such diseases. Cardiovascular diseases have been reported to be highly prevalent in the Mexican population, but local mortality data is poor. The Mexican side of the US-Mexico border has a culture that is closely related to a developed nation and therefore may share the same risk factors of cardiovascular diseases. We wanted to explore if there was higher cardiovascular mortality in the border region of Mexico compared to the rest of the nation. Methods We conducted a population based cross-sectional time series analysis to estimate the effects of education, insurance and municipal size in Mexican border (n = 38 and non-border municipalities (n = 2360 and its association with cardiovascular age-adjusted mortality rates between the years 1998–2012. We used a mixed effect linear model with random effect estimation and repeated measurements to compare the main outcome variable (mortality rate, the covariates (education, insurance and population size and the geographic delimiter (border/non-border. Results Mortality due to cardiovascular disease was consistently higher in the municipalities along the US-Mexico border, showing a difference of 78 · 5 (95% CI 58 · 7-98 · 3, p < 0 · 001 more cardiovascular deaths after adjusting for covariates. Larger municipal size and higher education levels showed a reduction in cardiovascular mortality of 12 · 6 (95% CI 11 · 4-13 · 8, p < 0 · 001 deaths and 8 · 6 (95% CI 5 · 5-11 · 8, p < 0 · 001 deaths respectively. Insurance coverage showed an increase in cardiovascular mortality of 3 · 6 (95% CI 3 · 1-4 · 0, p < 0 · 001 deaths per decile point increase. There was an increase in cardiovascular mortality of 0 · 3 (95% CI −0 · 001-0 · 6

The risk of cardiovascular morbidity and cardiovascular mortality in systemic lupus erythematosus and lupus nephritis

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Hermansen, Marie-Louise; Lindhardsen, Jesper; Torp-Pedersen, Christian

2017-01-01

Objective: . To assess the role of LN as a risk factor for myocardial infarction (MI), stroke and cardiovascular mortality (CVM) in patients with SLE. Methods: . The study was conducted using individual-level data from multiple nationwide registers. We identified a cohort of patients diagnosed wi...

Long-term exposure to elemental constituents of particulate matter and cardiovascular mortality in 19 European cohorts

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Wang, Meng; Beelen, Rob; Stafoggia, Massimo

2014-01-01

Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only.......Associations between long-term exposure to ambient particulate matter (PM) and cardiovascular (CVD) mortality have been widely recognized. However, health effects of long-term exposure to constituents of PM on total CVD mortality have been explored in a single study only....

Mediterranean Alcohol-Drinking Pattern and the Incidence of Cardiovascular Disease and Cardiovascular Mortality: The SUN Project

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Aitor Hernandez-Hernandez

2015-11-01

Full Text Available Background: We assessed the still unclear effect of the overall alcohol-drinking pattern, beyond the amount of alcohol consumed, on the incidence of cardiovascular clinical disease (CVD. Methods: We followed 14,651 participants during up to 14 years. We built a score assessing simultaneously seven dimensions of alcohol consumption to capture the conformity to a traditional Mediterranean alcohol-drinking pattern (MADP. It positively scored moderate alcohol intake, alcohol intake spread out over the week, low spirit consumption, preference for wine, red wine consumption, wine consumed during meals and avoidance of binge drinking. Results: During 142,177 person-years of follow-up, 127 incident cases of CVD (myocardial infarction, stroke or cardiovascular mortality were identified. Compared with the category of better conformity with the MADP, the low-adherence group exhibited a non-significantly higher risk (HR of total CVD ((95% CI = 1.55 (0.58–4.16. This direct association with a departure from the traditional MADP was even stronger for cardiovascular mortality (HR (95% CI = 3.35 (0.77–14.5. Nevertheless, all these associations were statistically non-significant. Conclusion: Better conformity with the MADP seemed to be associated with lower cardiovascular risk in most point estimates; however, no significant results were found and more powered studies are needed to clarify the role of the MADP on CVD.

Limited Relationship of Voltage Criteria for Electrocardiogram Left Ventricular Hypertrophy to Cardiovascular Mortality.

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Ha, Le Dung; Elbadawi, Ayman; Froelicher, Victor F

2018-01-01

Numerous methods have been proposed for diagnosing left ventricular hypertrophy using the electrocardiogram. They have limited sensitivity for recognizing pathological hypertrophy, at least in part due to their inability to distinguish pathological from physiological hypertrophy. Our objective is to compare the major electrocardiogram-left ventricular hypertrophy criteria using cardiovascular mortality as a surrogate for pathological hypertrophy. This study was a retrospective analysis of 16,253 veterans electrocardiogram-left ventricular hypertrophy, and there were 744 cardiovascular deaths (annual cardiovascular mortality 0.25%). Receiver operating characteristic analysis demonstrated that the greatest area under the curve (AUC) for classification of cardiovascular death was obtained using the Romhilt-Estes score (0.63; 95% confidence interval, 0.61-0.65). Most of the voltage-only criteria had nondiagnostic area under the curves, with the Cornell being the best at 0.59 (95% confidence interval, 0.57-0.62). When the components of the Romhilt-Estes score were examined using step-wise Wald analysis, the voltage criteria dropped from the model. The Romhilt-Estes score ≥ 4, the Cornell, and the Peguero had the highest association with cardiovascular mortality (adjusted hazard ratios 2.2, 2.0, and 2.1, consecutively). None of the electrocardiogram leads with voltage criteria exhibited sufficient classification power for clinical use. Copyright © 2018 Elsevier Inc. All rights reserved.

Prediction of cardiovascular and total mortality in Chinese type 2 diabetic patients by the WHO definition for the metabolic syndrome.

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Ko, G T-C; So, W-Y; Chan, N N; Chan, W-B; Tong, P C-Y; Li, J; Yeung, V; Chow, C-C; Ozaki, R; Ma, R C-W; Cockram, C S; Chan, J C-N

2006-01-01

The aim of this study is to investigate the prevalence of metabolic syndrome (MES) in type 2 diabetic patients and the predictive values of the World Health Organization (WHO) and National Cholesterol Education Programme (NCEP) definitions and the individual components of the MES on total and cardiovascular mortality. A prospective analysis of a consecutive cohort of 5202 Chinese type 2 diabetic patients recruited between July 1994 and April 2001. The prevalence of the MES was 49.2-58.1% depending on the use of various criteria. There were 189 deaths (men: 100 and women: 89) in these 5205 patients during a median (interquartile range) follow-up period of 2.1 (0.3-3.6 years). Of these, 164 (87%) were classified as cardiovascular deaths. Using the NCEP criterion, patients with MES had a death rate similar to those without (3.51 vs. 3.85%). By contrast, based on the WHO criteria, patients with MES had a higher mortality rate than those without (4.3 vs. 2.4%, p = 0.002). Compared to patients with neither NCEP- nor WHO-defined MES, only the group with MES defined by the WHO, but not NCEP, criterion had significantly higher mortality rate (2.6 vs. 6.8%, p hypertension, low BMI and albuminuria were the key predictors for these adverse events. In Chinese type 2 diabetic patients, the WHO criterion has a better discriminative power over the NCEP criterion for predicting death. Among the various components of the MES defined either by WHO or NCEP, hypertension, albuminuria and low BMI were the main predictors of cardiovascular and total mortality.

Cardiovascular Disease and Thyroid Function

DEFF Research Database (Denmark)

Faber, Jens; Selmer, Christian

2014-01-01

Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones at the ce......Thyroid function has a profound effect on the heart, and both all-cause and cardiovascular mortality rates are increased in hyperthyroidism. New-onset atrial fibrillation carries a prolonged risk for the development of hyperthyroidism, suggesting altered availability of thyroid hormones...... at the cellular level. Subclinical hyperthyroidism is associated with increased left ventricular mass of the heart, which reverts after obtaining euthyroidism. Mortality and risk of major cardiovascular events are increased. Subclinical hypothyroidism is also associated with subtle changes in the heart, e.g. its...

Ambient carbon monoxide and cardiovascular mortality: a nationwide time-series analysis in 272 cities in China.

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Liu, Cong; Yin, Peng; Chen, Renjie; Meng, Xia; Wang, Lijun; Niu, Yue; Lin, Zhijing; Liu, Yunning; Liu, Jiangmei; Qi, Jinlei; You, Jinling; Kan, Haidong; Zhou, Maigeng

2018-01-01

Evidence of the acute health effects of ambient carbon monoxide air pollution in developing countries is scarce and mixed. We aimed to evaluate short-term associations between carbon monoxide and daily cardiovascular disease mortality in China. We did a nationwide time-series analysis in 272 major cities in China from January, 2013, to December, 2015. We extracted daily cardiovascular disease mortality data from China's Disease Surveillance Points system. Data on daily carbon monoxide concentrations for each city were obtained from the National Urban Air Quality Real-time Publishing Platform. City-specific associations between carbon monoxide concentrations and daily mortality from cardiovascular disease, coronary heart disease, and stroke were estimated with over-dispersed generalised linear models. Bayesian hierarchical models were used to obtain national and regional average associations. Exposure-response association curves and potential effect modifiers were evaluated. Two-pollutant models were fit to evaluate the robustness of the effects of carbon monoxide on cardiovascular mortality. The average annual mean carbon monoxide concentration in these cities from 2013 to 2015 was 1·20 mg/m 3 , ranging from 0·43 mg/m 3 to 2·45 mg/m 3 . For a 1 mg/m 3 increase in average carbon monoxide concentrations on the present day and previous day (lag 0-1), we observed significant increments in mortality of 1·12% (95% posterior interval [PI] 0·42-1·83) from cardiovascular disease, 1·75% (0·85-2·66) from coronary heart disease, and 0·88% (0·07-1·69) from stroke. These associations did not vary substantially by city, region, and demographic characteristics (age, sex, and level of education), and the associations for cardiovascular disease and coronary heart disease were robust to the adjustment of criteria co-pollutants. We did not find a threshold below which carbon monoxide exposure had no effect on cardiovascular disease mortality. This analysis is, to our

Family aggregation of cardiovascular disease mortality

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Silventoinen, Karri; Hjelmborg, Jacob; Möller, Sören

2017-01-01

Background: Familial factors play an important role in the variation of risk factors of cardiovascular diseases (CVD), but less is known about how they affect the risk of death from CVD. We estimated familial aggregation of CVD mortality for twins offering the maximum level of risk due to genetic...... and other familial factors. Methods: Altogether, 132 771 twin individuals, including 65 196 complete pairs from Denmark, Finland and Sweden born in 1958 or earlier, participated in this study. During the register-based follow-up, 11 641 deaths occurred from coronary heart disease (CHD), including 6280...

[Glycemic targets and cardiovascular morbi-mortality].

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Bordier, Lyse; Bauduceau, Bernard

2013-05-01

The 2008-year was full of learning experience and suspense in diabetologia. The past studies, UKPDS in type 2 diabetic patients and DCCT in type 1 diabetic patients have shown that intensive treatment during a short period did reduce the incidence of microvascular events and in the long term, the incidence of macrovascular events linked to diabetes. The conclusions of recent studies quote, from ACCORD, an increased mortality in the type 2 diabetic patients using intensive therapy, from ADVANCE, a reduction of microvascular complications and from VADT, no effect. The analysis of studies published since 2008 brings lessons for the clinical practice: presence of glycemic memory, absence of tensional memory, usefulness of control of every cardiovascular risk factors, need of early treatment of diabetes. Moreover, to define HbA1c objective, age, duration of diabetes, presence of cardiovascular risk factors, former HbA1c level and potential undesirable effects, such hypoglycaemia, must be considered. The management of type 2 diabetic patients requires an early, not to quick intensive treatment, which avoids hypoglycaemia and is combined with a strict control of cardiovascular risk factors. So, the recent position statement of the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) consideres needs and preferences of each patient and individualizes glycemic targets and treatments. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

Trends of Non-Accidental, Cardiovascular, Stroke and Lung Cancer Mortality in Arkansas Are Associated with Ambient PM2.5 Reductions

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Marie-Cecile G. Chalbot

2014-07-01

Full Text Available The cardiovascular and stroke mortality rates in Arkansas are among the highest in the USA. The annual trends of stroke and cardiovascular mortality are barely correlated to smoking cessation; while the prevalence of risk factors such as obesity; cholesterol and hypertension increased over the 1979–2007 period. The study determined the effect of chronic exposure to PM2.5 on non-accidental; cardiovascular; stroke and lung cancer mortality in Arkansas over the 2000–2010 period using the World Health Organization’s log-linear health impact model. County chronic exposures to PM2.5 were computed by averaging spatially-resolved gridded concentrations using PM2.5 observations. A spatial uniformity was observed for PM2.5 mass levels indicating that chronic exposures were comparable throughout the state. The reduction of PM2.5 mass levels by 3.0 μg/m3 between 2000 and 2010 explained a significant fraction of the declining mortality. The effect was more pronounced in southern and eastern rural Arkansas as compared to the rest of the state. This study provides evidence that the implementation of air pollution regulations has measurable effects on mortality even in regions with high prevalence of major risk factors such as obesity and smoking. These outcomes are noteworthy as efforts to modify the major risk factors require longer realization times.

Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery.

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Lykke, Jacob A; Langhoff-Roos, Jens; Lockwood, Charles J; Triche, Elizabeth W; Paidas, Michael J

2010-07-01

The combined effects of preterm delivery, small-for-gestational-age offspring, hypertensive disorders of pregnancy, placental abruption and stillbirth on early maternal death from cardiovascular causes have not previously been described in a large cohort. We investigated the effects of pregnancy complications on early maternal death in a registry-based retrospective cohort study of 782 287 women with a first singleton delivery in Denmark 1978-2007, followed for a median of 14.8 years (range 0.25-30.2) accruing 11.6 million person-years. We employed Cox proportional hazard models of early death from cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non-cardiovascular causes. Severe pre-eclampsia was associated with death from cardiovascular causes only. There was a less than additive effect on cardiovascular mortality hazard ratios with increasing number of pregnancy complications: preterm delivery 1.90 [95% confidence intervals 1.49, 2.43]; preterm delivery and small-for-gestational-age offspring 3.30 [2.25, 4.84]; preterm delivery, small-for-gestational-age offspring and pre-eclampsia 3.85 [2.07, 7.19]. Thus, we conclude that, separately and combined, preterm delivery and small-for-gestational-age are strong markers of early maternal death from both cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes.

High Neutrophil-to-Lymphocyte Ratio is a Significant Predictor of Cardiovascular and All-Cause Mortality in Patients Undergoing Peritoneal Dialysis

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Xiangxue Lu

2018-03-01

Full Text Available Background/Aims: Chronic inflammation is associated with increased risk of cardiovascular death in patients with end-stage renal disease (ESRD. Although elevated neutrophil-to-lymphocyte ratio (NLR, a novel inflammatory marker, has been shown to predict cardiovascular disease and all-cause mortality in the general population, limited evidence is available for its role in ESRD. Methods: We enrolled 86 patients undergoing peritoneal dialysis (PD for a 36-month follow-up to investigate the association between the NLR and arterial stiffness markers, namely, carotid-femoral pulse wave velocity (cfPWV and carotid augmentation index (AIx, and mortality in PD patients. The primary endpoints were cardiovascular mortality and all-cause mortality. Kaplan–Meier curves were used to show the cumulative incidence of cardiovascular mortality and all-cause mortality. Results: High NLR was found to be a predictor of increased cfPWV (β = 1.150; P < 0.001 and AIx (β = 3.945; P < 0.001 in patients on PD. Patients with higher NLR had lower survival during follow-up. Kaplan–Meier curves showed that the cumulative incidences of both cardiovascular mortality and all-cause mortality were significantly higher in patients with NLR ≥ 4.5 (both P < 0.01. Conclusion: Our results suggest that high NLR is independently associated with arterial stiffness and predicts cardiovascular and all-cause mortality in PD patients.

Coffee consumption after myocardial infarction and risk of cardiovascular mortality

NARCIS (Netherlands)

Dongen, Van Laura H.; Molenberg, Famke; Soedamah-Muthu, Sabita S.; Kromhout, Daan; Geleijnse, Johanna M.

2017-01-01

Background: Consumption of coffee, one of the most popular beverages around the world, has been associated with a lower risk of cardiovascular and all-cause mortality in population-based studies. However, little is known about these associations in patient populations. Objective: This prospective

Association between daily mortality from respiratory and cardiovascular diseases and air pollution in Taiwan.

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Liang, Wen-Miin; Wei, Hsing-Yu; Kuo, Hsien-Wen

2009-01-01

Many studies have investigated the effects of air pollutants on disease and mortality. However, the results remain inconsistent and inconclusive. We thought that the impact of different seasons or ages of people may explain these differences. Measurement of the five pollutants (particulate matter or =65 group). Data on daily mortality caused by respiratory disease, cardiovascular disease, and all other causes including the two aforementioned was collected by the Taiwan Department of Health (DOH). A time-series regression model was used to analyze the relative risk of respiratory and cardiovascular diseases due to air pollution in the summer and winter seasons. Risk of death from all causes and mortality from cardiovascular diseases during winter was significantly positively correlated with levels of SO(2), CO, and NO(2) for both groups of subjects and additionally with PM(10) for the elderly (> or =65 years old) group. There were significant positive correlations with respiratory diseases and levels of O(3) for both groups. However, the only significant positive correlation was with O(3) (RR=1.283) for the elderly group during summer. No other parameters showed significance for either group. Our findings contribute to the evidence of an association between SO(2), CO, NO(2), and PM(10) and mortality from respiratory and cardiovascular diseases, especially among elderly people during the winter season.

Uric acid as a risk factor for cardiovascular disease and mortality in overweight/obese individuals.

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Helle Skak-Nielsen

Full Text Available The predictive value of serum uric acid (SUA for adverse cardiovascular events among obese and overweight patients is not known, but potentially important because of the relation between hyperuricaemia and obesity.The relationship between SUA and risk of cardiovascular adverse outcomes (nonfatal myocardial infarction, nonfatal stroke, resuscitated cardiac arrest or cardiovascular death and all-cause mortality, respectively, was evaluated in a post-hoc analysis of the Sibutramine Cardiovascular OUTcomes (SCOUT trial. Participants enrolled in SCOUT were obese or overweight with pre-existing diabetes and/or cardiovascular disease (CVD. Cox models were used to assess the role of SUA as an independent risk factor.9742 subjects were included in the study; 83.6% had diabetes, and 75.1% had CVD. During an average follow-up time of 4.2 years, 1043 subjects had a primary outcome (myocardial infarction, resuscitated cardiac arrest, stroke, or cardiovascular death, and 816 died. In a univariate Cox model, the highest SUA quartile was associated with an increased risk of cardiovascular adverse outcomes compared with the lowest SUA quartile in women (hazard ratio [HR]: 1.59; 95% confidence interval [CI]: 1.20-2.10. In multivariate analyses, adjusting for known cardiovascular risk factors the increased risk for the highest SUA quartile was no longer statistically significant among women (HR: 0.99; 95% CI: 0.72-1.36 nor was it among men. Analyses of all-cause mortality found an interaction between sex and SUA. In a multivariate Cox model including women only, the highest SUA quartile was associated with an increased risk in all-cause mortality compared to the lowest SUA quartile (HR: 1.51; 95% CI: 1.08-2.12. No relationship was observed in men (HR: 1.06; 95% CI: 0.82-1.36.SUA was not an independent predictor of cardiovascular disease and death in these high-risk overweight/obese people. However, our results suggested that SUA was an independent predictor of all

East-West gradient in cardio-vascular mortality in Austria: how much can we explain by following the pattern of risk factors?

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Stein, Katharina V; Rieder, Anita; Dorner, Thomas E

2011-11-14

Various studies show major regional differences in the prevalence of cardio-vascular disease morbidity and mortality, both in Europe and within European countries. In Austria, these differences are documented by an East-West gradient with declining morbidity and mortality rates when moving from the East to the West of the country. It was the aim of this study to analyse if, and to what extent, socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of this East-West gradient by conducting secondary analyses of an existing Austrian health dataset. The data were analysed using bivariate analyses, as well as univariate and multivariate logistic regression models. These analyses revealed significant East-West gradients for various risk factors, as well as socio-demographic and socio-economic health determinants. There was a gradual decrease of hypertension, diabetes mellitus, obesity, and psycho-social discomfort in both sexes, with the highest prevalences in those Austrian regions with the highest cardio-vascular mortality and a stepwise decrease to the regions with the lowest cardio-vascular mortality. Controlling for educational level significantly raised the odds for diabetes, hypertension and obesity. In the results of the multivariate analyses, factors that significantly and independently predicted diabetes mellitus were geographic location, psycho-social discomfort, lack of physical exercise, and age in both sexes. For women these factors additionally included a low educational level, lack of social support, and being born abroad. Our study shows a clear gradual decline of cardio-vascular mortality and some of its risk factors from East to West in Austria. Concerning these risk factors, the geographic region and psycho-social discomfort showed the greatest association with diabetes mellitus, hypertension, and obesity. Hence, they contribute to the explanation of the variance in spatial cardio-vascular

East-West gradient in cardio-vascular mortality in Austria: how much can we explain by following the pattern of risk factors?

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Stein Katharina V

2011-11-01

Full Text Available Abstract Background Various studies show major regional differences in the prevalence of cardio-vascular disease morbidity and mortality, both in Europe and within European countries. In Austria, these differences are documented by an East-West gradient with declining morbidity and mortality rates when moving from the East to the West of the country. It was the aim of this study to analyse if, and to what extent, socio-demographic and socio-economic determinants, social resources and health behaviour can contribute to the clarification of this East-West gradient by conducting secondary analyses of an existing Austrian health dataset. Results The data were analysed using bivariate analyses, as well as univariate and multivariate logistic regression models. These analyses revealed significant East-West gradients for various risk factors, as well as socio-demographic and socio-economic health determinants. There was a gradual decrease of hypertension, diabetes mellitus, obesity, and psycho-social discomfort in both sexes, with the highest prevalences in those Austrian regions with the highest cardio-vascular mortality and a stepwise decrease to the regions with the lowest cardio-vascular mortality. Controlling for educational level significantly raised the odds for diabetes, hypertension and obesity. In the results of the multivariate analyses, factors that significantly and independently predicted diabetes mellitus were geographic location, psycho-social discomfort, lack of physical exercise, and age in both sexes. For women these factors additionally included a low educational level, lack of social support, and being born abroad. Conclusions Our study shows a clear gradual decline of cardio-vascular mortality and some of its risk factors from East to West in Austria. Concerning these risk factors, the geographic region and psycho-social discomfort showed the greatest association with diabetes mellitus, hypertension, and obesity. Hence, they

Fatty acids linked to cardiovascular mortality are associated with risk factors

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Sven O. E. Ebbesson

2015-08-01

Full Text Available Background: Although saturated fatty acids (FAs have been linked to cardiovascular mortality, it is not clear whether this outcome is attributable solely to their effects on low-density lipoprotein cholesterol (LDL-C or whether other risk factors are also associated with FAs. The Western Alaskan Native population, with its rapidly changing lifestyles, shift in diet from unsaturated to saturated fatty acids and dramatic increase in cardiovascular disease (CVD, presents an opportunity to elucidate any associations between specific FAs and known CVD risk factors. Objective: We tested the hypothesis that the specific FAs previously identified as related to CVD mortality are also associated with individual CVD risk factors. Methods: In this community-based, cross-sectional study, relative proportions of FAs in plasma and red blood cell membranes were compared with CVD risk factors in a sample of 758 men and women aged ≥35 years. Linear regression analyses were used to analyze relations between specific FAs and CVD risk factors (LDL-C, high-density lipoprotein cholesterol, triglycerides, C-reactive protein, systolic blood pressure, diastolic blood pressure, heart rate, body mass index, fasting glucose and fasting insulin, 2-hour glucose and 2-hour insulin. Results: The specific saturated FAs previously identified as related to CVD mortality, the palmitic and myristic acids, were adversely associated with most CVD risk factors, whereas unsaturated linoleic acid (18:2n-6 and the marine n-3 FAs were not associated or were beneficially associated with CVD risk factors. Conclusions: The results suggest that CVD risk factors are more extensively affected by individual FAs than hitherto recognized, and that risk for CVD, MI and stroke can be reduced by reducing the intake of palmitate, myristic acid and simple carbohydrates and improved by greater intake of linoleic acid and marine n-3 FAs.

Long-term cardiovascular mortality in patients with differentiated thyroid carcinoma : An observational study

NARCIS (Netherlands)

Klein Hesselink, Esther; Klein Hesselink, Mariëlle; de Bock, Truuske; Gansevoort, Ronald; Bakker, Stephan; Vredeveld, Eline; van der Horst-Schrivers, Anouk N. A.; van der Horst, Iwan; Kamphuisen, Pieter Willem; Plukker, John; Links, Thera P.; Lefrandt, Johan

2013-01-01

Purpose The primary aim was to study the risk of cardiovascular mortality in patients with differentiated thyroid carcinoma (DTC). Secondary aims were to evaluate all-cause mortality and explore the relation between thyroid-stimulating hormone (TSH; also known as thyrotropin) level and these outcome

Metformin in combination with various insulin secretagogues in type 2 diabetes and associated risk of cardiovascular morbidity and mortality

DEFF Research Database (Denmark)

Mogensen, Ulrik Madvig; Andersson, Charlotte; Fosbøl, Emil Loldrup

2015-01-01

with pharmacologically different ISs. METHODS: Using nationwide administrative Danish registries, we followed all individuals without prior stroke or myocardial infarction who initiated metformin and an IS from 1997 through 2009. Rate ratios (RR) of all-cause mortality, cardiovascular death, and a composite...... of myocardial infarction, stroke, or cardiovascular death were compared between user groups using time-dependent multivariable Poisson regression models. The most common combination, glimepiride+metformin, was used as reference. RESULTS: A total of 56,827 patients were included, 56% male, the mean age was 61...... and cardiovascular risk. Whether glipizide is associated with increased risk compared with other ISs when used in combinations with metformin warrants further study....

Cardiovascular disease morbidity and mortality in patients with type 1 diabetes mellitus: management strategies

NARCIS (Netherlands)

Soedamah-Muthu, S.S.; Stehouwer, C.D.A.

2005-01-01

There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification

Cardiovascular disease morbidity and mortality in patients with type 1 diabetes mellitus: Management Strategies

NARCIS (Netherlands)

Soedamah-Muthu, S.S.; Stehouwer, C.D.A.

2005-01-01

There is an increased risk of cardiovascular disease (CVD) mortality and morbidity in patients with type 1 diabetes mellitus compared with the general population as shown by epidemiologic studies measuring cardiovascular endpoints, as well as by autopsy, angiographic, and coronary calcification

The association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults.

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Wu, Chen-Yi; Hu, Hsiao-Yun; Chou, Yi-Chang; Huang, Nicole; Chou, Yiing-Jenq; Li, Chung-Pin

2015-03-01

To evaluate the association of physical activity with all-cause, cardiovascular, and cancer mortalities among older adults. A study sample consisting of 77,541 community-dwelling Taipei citizens aged ≥ 65 years was selected based on data obtained from the government-sponsored Annual Geriatric Health Examination Program between 2006 and 2010. Subjects were asked how many times they had physical activity for ≥ 30 min during the past 6 months. Mortality was determined by matching cohort identifications with national death files. Compared to subjects with no physical activity, those who had 1-2 times of physical activity per week had a decreased risk of all-cause mortality [hazard ratio (HR): 0.77; 95% confidence interval (CI): 0.71-0.85). Subjects with 3-5 times of physical activity per week had a further decreased risk of all-cause mortality (HR: 0.64; 95% CI: 0.58-0.70). An inverse dose-response relationship was observed between physical activity and all-cause, cardiovascular, and cancer mortality. According to stratified analyses, physical activity was associated with a decreased risk of mortality in most subgroups. Physical activity had an inverse association with all-cause, cardiovascular, and cancer mortality among older adults. Furthermore, most elderly people can benefit from an active lifestyle. Copyright © 2015 Elsevier Inc. All rights reserved.

Filtration Markers, Cardiovascular Disease, Mortality, and Kidney Outcomes in Stable Kidney Transplant Recipients: The FAVORIT Trial.

Science.gov (United States)

Foster, M C; Weiner, D E; Bostom, A G; Carpenter, M A; Inker, L A; Jarolim, P; Joseph, A A; Kusek, J W; Pesavento, T; Pfeffer, M A; Rao, M; Solomon, S D; Levey, A S

2017-09-01

Cystatin C and beta-2-microglobulin (B2M) are filtration markers associated with adverse outcomes in nontransplant populations, sometimes with stronger associations than for creatinine. We evaluated associations of estimated glomerular filtration rate from cystatin C (eGFR cys ), B2M (eGFR B 2M ), and creatinine (eGFR cr ) with cardiovascular outcomes, mortality, and kidney failure in stable kidney transplant recipients using a case-cohort study nested within the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial. A random subcohort was selected (N = 508; mean age 51.6 years, median transplant vintage 4 years, 38% women, 23.6% nonwhite race) with enrichment for cardiovascular events (N = 306; 54 within the subcohort), mortality (N = 208; 68 within the subcohort), and kidney failure (N = 208; 52 within the subcohort). Mean eGFR cr , eGFR cys , and eGFR B 2M were 46.0, 43.8, and 48.8 mL/min/1.73m 2 , respectively. After multivariable adjustment, hazard ratios for eGFR cys and eGFR B 2M mortality; and 9.49 (4.28-21.00) and 15.53 (6.99-34.51; both p mortality, and kidney failure in stable kidney transplant recipients. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Trends in cardiovascular diseases and cancer mortality in 45 countries from five continents (1980-2010).

Science.gov (United States)

Araújo, Fábio; Gouvinhas, Cláudia; Fontes, Filipa; La Vecchia, Carlo; Azevedo, Ana; Lunet, Nuno

2014-08-01

Cardiovascular diseases (CVD) and cancer are worldwide main causes of death with mortality trends varying across countries with different levels of economic development. We analysed trends in CVD and cancer mortality for 37 European countries, five high-income non-European countries and four leading emerging economies (BRICS) using data from the World Health Organization database for the period 1980-2010. In high-income countries, CVD mortality trends are characterized by steep declines over the last decades, while a downward trend in cancer mortality started more recently and was less pronounced. This resulted in the gradual convergence of the CVD and cancer mortality rates, and the latter are already higher in some countries. The absolute number of CVD deaths decreased in most settings, while cancer deaths increased in nearly all countries. Among the BRICS, China and South Africa share a similar pattern of no meaningful variation in both CVD and cancer age-standardized mortality rates and an increase in the overall number of deaths by these causes. Brazil presents trends similar to those of high-income countries, except for the still increasing number of CVD deaths. The substantial decreases in CVD mortality over the last decades have overcome the impact of the growth and ageing of populations in the overall number of deaths, while stabilization in the number of cancer deaths was observed only in some of the high-income countries. © The European Society of Cardiology 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Mortalidade global e cardiovascular e fatores de risco de pacientes em hemodiálise Mortalidad global y cardiovascular y factores de riesgo de pacientes en hemodiálisis Global and cardiovascular mortality and risk factors in patients under hemodialysis treatment

Directory of Open Access Journals (Sweden)

Fátima Aparecida A. Almeida

2010-02-01

% sobreviviendo 141 meses. En el análisis bivariado, el RR de óbito no cardiovascular (ONCV y CV aumentó con edad > 60 años, Hb 126 mg/dl; sólo de ONCV, con baja escolaridad, viudez, Hb 100 mg/dl, producto Ca x P 9,2 mg/dl; disminuyó con PA > 140/90 mmHg (antes de la sesión de HD y Ht > 36%; de óbito CV solamente, aumentó con creatinina > 9,4 mg/dl. En el análisis multivariado, el RR de ONCV y CV aumento con edad > 60 años y Hb 126 mg/dl y el de ONCV con tasa de remoción de urea en la hemodiálisis (Kt/V 60 años y Hb 126 mg/dl y ONCV Kt/V BACKGROUND: There is a high global and cardiovascular mortality rate among patients who need hemodialysis. OBJECTIVE: To assess global and cardiovascular mortality and to identify the risk factors in patients who undergo hemodialysis. METHODS: Observational, prospective study. A total of 334 patients were studied within three years. Primary outcomes: global and cardiovascular mortality. Survival was assessed through Kaplan-Meier method, and the risk variables were identified by means of bivariate and multivariate Cox regression. RESULTS: A total of 189 men (56.6%, aging 48.8 ± 14.2, majority non-white (295, 88.3% and who did finished the elementary school (211, 63.2%. Global mortality rate was 21.6%, with a 50% rate of 146-month survival; cardiovascular mortality rate was 41.7% (30/72, with a 75% rate of 141-month survival. In the bivariate analysis, the relative risk (RR for non-cardiovascular and cardiovascular death increased when age >60 years old was Hb126 mg/dl. Only non-cardiovascular death with low school grade and widow, Hb100 mg/dl, Ca product x P9.2 mg/dl decreased with blood pressure (BP >140/90 mmHg (before hemodialysis session and Ht>36%; Obit due only to cardiovascular factors increased with creatinine >9.4 mg/dl. In the multivariate analysis, non-cardiovascular and cardiovascular RR increased with age >60 years old and Hb126 mg/dl, and non-cardiovascular death RR increased with urea removal rate in hemodialysis (Kt

Disease Human - MDC_CardiovascularMortality2006

Data.gov (United States)

NSGIC Local Govt | GIS Inventory — Polygon feature class based on Zip Code boundaries showing the rate of deaths due to major cardiovascular diseases per 1000 residents of Miami-Dade County in 2006.

Cocoa Intake, Blood Pressure, and Cardiovascular Mortality : the Zutphen eldery study

NARCIS (Netherlands)

Buijsse, G.M.; Feskens, E.J.M.; Kok, F.J.; Kromhout, D.

2006-01-01

Background: Small, short-term, intervention studies indicate that cocoa-containing foods improve endothelial function and reduce blood pressure. We studied whether habitual cocoa intake was cross-sectionally related to blood pressure and prospectively related with cardiovascular mortality. Methods:

Cardiovascular morbidity and mortality in surgically treated hyperthyroidism - a nation-wide cohort study with a long-term follow-up.

Science.gov (United States)

Ryödi, Essi; Salmi, Jorma; Jaatinen, Pia; Huhtala, Heini; Saaristo, Rauni; Välimäki, Matti; Auvinen, Anssi; Metso, Saara

2014-05-01

Previous studies suggest that patients with hyperthyroidism remain at an increased risk of cardiovascular morbidity even after restoring euthyroidism. The mechanisms of the increased risk and its dependency on the different treatment modalities of hyperthyroidism remain unclear. The aim of this long-term follow-up study was to compare the rate of hospitalizations for cardiovascular causes and the mortality in hyperthyroid patients treated surgically with an age- and gender-matched reference population. A population-based cohort study was conducted among 4334 hyperthyroid patients (median age 46 years) treated with thyroidectomy in 1986-2007 in Finland and among 12,991 reference subjects. Firstly, the hospitalizations due to cardiovascular diseases (CVD) were analysed until thyroidectomy. Secondly, the hazard ratios for any new hospitalization due to CVDs after the thyroidectomy were calculated in Cox regression analysis adjusted with the prevalent CVDs at the time of thyroidectomy. The risk of hospitalization due to all CVDs started to increase already 5 years before the thyroidectomy, and by the time of the operation, it was 50% higher in the hyperthyroid patients compared to the controls (P hyperthyroidism. Despite the increased CVD morbidity among the patients, there was no difference in cardiovascular mortality. The present study shows that hyperthyroidism increases the risk of hospitalization due to CVDs and the risk is sustained up to two decades after effective surgical treatment. However, there was no excess CVD mortality in the middle-aged patient cohort studied. © 2013 John Wiley & Sons Ltd.

Relation of Periodontitis to Risk of Cardiovascular and All-Cause Mortality (from a Danish Nationwide Cohort Study)

DEFF Research Database (Denmark)

Hansen, Gorm Mørk; Egeberg, Alexander; Holmstrup, Palle

2016-01-01

Periodontitis and atherosclerosis are highly prevalent chronic inflammatory diseases, and it has been suggested that periodontitis is an independent risk factor of cardiovascular disease (CVD) and that a causal link may exist between the 2 diseases. Using Danish national registers, we identified...... a nationwide cohort of 17,691 patients who received a hospital diagnosis of periodontitis within a 15-year period and matched them with 83,003 controls from the general population. We performed Poisson regression analysis to determine crude and adjusted incidence rate ratios of myocardial infarction, ischemic...... stroke, cardiovascular death, major adverse cardiovascular events, and all-cause mortality. The results showed that patients with periodontitis were at higher risk of all examined end points. The findings remained significant after adjustment for increased baseline co-morbidity in periodontitis patients...

Cardiovascular death and manic-depressive psychosis

DEFF Research Database (Denmark)

Weeke, A; Juel, K; Vaeth, M

2013-01-01

In order to study if tricyclic antidepressant drugs (TCA) in therapeutic doses increase the risk of death due to cardiovascular causes, the relative mortality from cardiovascular diseases was studied in two large groups of first hospitalized manic-depressive patients, one from the TCA era...... to the general population. Among 1133 such cases admitted between 1950 and 1956, the rate was 1.87. Our findings do not support the hypothesis that TCA contribute to the cardiovascular mortality in manic-depressives and even support suggestions that TCA treatment may lower the risk of death by cardiovascular...

Comparative effectiveness of oral antidiabetic drugs in preventing cardiovascular mortality and morbidity: A network meta-analysis.

Directory of Open Access Journals (Sweden)

Gyeongsil Lee

Full Text Available In the Guidance for Industry from the Food and Drug Administration in 2008, excess cardiovascular risk should be ruled out in trials of all new antidiabetic drugs; however, relatively few studies have focused on cardiovascular safety with antidiabetic drug use. We aimed to examine mortality and cardiovascular risk using a network meta-analysis. We searched the Medline, Embase, Cochrane, and ClinicalTrials.gov registry databases in March 2016 to identify randomized controlled trials reporting cardiovascular risk with the following oral antidiabetic drugs: metformin, sulfonylureas, thiazolidinedione (TZD, dipeptidyl peptidase-4 (DPP4 inhibitors, and sodium-glucose co-transporter-2 (SGLT2 inhibitors. We assessed the differences in the risks of all-cause mortality, cardiovascular-related mortality, acute coronary syndrome (ACS, and myocardial infarction (MI among antidiabetic drugs with fixed effect models for direct pairwise comparisons and Bayesian network meta-analyses to integrate direct and indirect comparisons. Of the 101,183 patients in 73 randomized controlled trials, 3,434 (3.4% died. The relative risks of all-cause mortality with SGLT2 inhibitor use were 0.68 (95% credible interval: 0.57-0.80, 0.74 (0.49-1.10, 0.63 (0.46-0.87, 0.71 (0.55-0.90, and 0.65 (0.54-0.78, compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively. The relative risks of cardiovascular-related mortality with SGLT2 inhibitor use were 0.61 (0.50-0.76, 0.81(0.36-1.90, 0.52(0.31-0.88, 0.66(0.49-0.91, and 0.61(0.48-0.77, compared with placebo, metformin, sulfonylurea, TZD, and DPP4 inhibitor, respectively. The relative risks of ACS with SGLT2 inhibitor use was consistent with that of all-cause mortality. SGLT2 inhibitor use was associated with a lower risk of ACS than the other OADs and placebo. The relative risks of MI with SGLT2 inhibitor use were 0.77 (0.63-0.93 and 0.75 (0.60-0.94, compared with placebo and DPP4 inhibitor, respectively. The

Illiteracy, low educational status, and cardiovascular mortality in India.

Science.gov (United States)

Pednekar, Mangesh S; Gupta, Rajeev; Gupta, Prakash C

2011-07-15

Influence of education, a marker of SES, on cardiovascular disease (CVD) mortality has not been evaluated in low-income countries. To determine influence of education on CVD mortality a cohort study was performed in India. 148,173 individuals aged ≥ 35 years were recruited in Mumbai during 1991-1997 and followed to ascertain vital status during 1997-2003. Subjects were divided according to educational status into one of the five groups: illiterate, primary school (≦ 5 years of formal education), middle school (6-8 years), secondary school (9-10 years) and college (> 10 years). Multivariate analyses using Cox proportional hazard model was performed and hazard ratios (HRs) and 95% confidence intervals (CIs) determined. At average follow-up of 5.5 years (774,129 person-years) 13,261 deaths were observed. CVD was the major cause of death in all the five educational groups. Age adjusted all-cause mortality per 100,000 in illiterate to college going men respectively was 2154, 2149, 1793, 1543 and 1187 and CVD mortality was 471, 654, 618, 518 and 450; and in women all-cause mortality was 1444, 949, 896, 981 and 962 and CVD mortality was 429, 301, 267, 426 and 317 (ptrend 0.05). Inverse association of literacy status with all-cause mortality was observed in Indian men and women, while, for CVD mortality it was observed only in men.

Isolated and synergistic effects of PM10 and average temperature on cardiovascular and respiratory mortality.

Science.gov (United States)

Pinheiro, Samya de Lara Lins de Araujo; Saldiva, Paulo Hilário Nascimento; Schwartz, Joel; Zanobetti, Antonella

2014-12-01

OBJECTIVE To analyze the effect of air pollution and temperature on mortality due to cardiovascular and respiratory diseases. METHODS We evaluated the isolated and synergistic effects of temperature and particulate matter with aerodynamic diameter mortality of individuals > 40 years old due to cardiovascular disease and that of individuals > 60 years old due to respiratory diseases in Sao Paulo, SP, Southeastern Brazil, between 1998 and 2008. Three methodologies were used to evaluate the isolated association: time-series analysis using Poisson regression model, bidirectional case-crossover analysis matched by period, and case-crossover analysis matched by the confounding factor, i.e., average temperature or pollutant concentration. The graphical representation of the response surface, generated by the interaction term between these factors added to the Poisson regression model, was interpreted to evaluate the synergistic effect of the risk factors. RESULTS No differences were observed between the results of the case-crossover and time-series analyses. The percentage change in the relative risk of cardiovascular and respiratory mortality was 0.85% (0.45;1.25) and 1.60% (0.74;2.46), respectively, due to an increase of 10 μg/m3 in the PM10 concentration. The pattern of correlation of the temperature with cardiovascular mortality was U-shaped and that with respiratory mortality was J-shaped, indicating an increased relative risk at high temperatures. The values for the interaction term indicated a higher relative risk for cardiovascular and respiratory mortalities at low temperatures and high temperatures, respectively, when the pollution levels reached approximately 60 μg/m3. CONCLUSIONS The positive association standardized in the Poisson regression model for pollutant concentration is not confounded by temperature, and the effect of temperature is not confounded by the pollutant levels in the time-series analysis. The simultaneous exposure to different levels of

Validity of coronary heart diseases and heart failure based on hospital discharge and mortality data in the Netherlands using the cardiovascular registry Maastricht cohort study

NARCIS (Netherlands)

Merry, A.H.; Boer, J.M.; Schouten, L.J.; Feskens, E.J.M.; Verschuren, W.M.; Gorgels, A.P.; Brandt, van den P.A.

2009-01-01

Incidence rates of cardiovascular diseases are often estimated by linkage to hospital discharge and mortality registries. The validity depends on the quality of the registries and the linkage. Therefore, we validated incidence rates of coronary heart disease (CHD), acute myocardial infarction,

Usefulness of serum interleukin-18 in predicting cardiovascular mortality in patients with chronic kidney disease--systems and clinical approach.

Science.gov (United States)

Formanowicz, Dorota; Wanic-Kossowska, Maria; Pawliczak, Elżbieta; Radom, Marcin; Formanowicz, Piotr

2015-12-16

The aim of this study was to check if serum interleukin-18 (IL-18) predicts 2-year cardiovascular mortality in patients at various stages of chronic kidney disease (CKD) and history of acute myocardial infarction (AMI) within the previous year. Diabetes mellitus was one of the key factors of exclusion. It was found that an increase in serum concentration of IL-18 above the cut-off point (1584.5 pg/mL) was characterized by 20.63-fold higher risk of cardiovascular deaths among studied patients. IL-18 serum concentration was found to be superior to the well-known cardiovascular risk parameters, like high sensitivity C-reactive protein (hsCRP), carotid intima media thickness (CIMT), glomerular filtration rate, albumins, ferritin, N-terminal prohormone of brain natriuretic peptide (NT-proBNP) in prognosis of cardiovascular mortality. The best predictive for IL-18 were 4 variables, such as CIMT, NT-proBNP, albumins and hsCRP, as they predicted its concentration at 89.5%. Concluding, IL-18 seems to be important indicator and predictor of cardiovascular death in two-year follow-up among non-diabetic patients suffering from CKD, with history of AMI in the previous year. The importance of IL-18 in the process of atherosclerotic plaque formation has been confirmed by systems analysis based on a formal model expressed in the language of Petri nets theory.

Cardiovascular mortality in relation to birth weight of children and grandchildren in 500,000 Norwegian families.

Science.gov (United States)

Naess, Oyvind; Stoltenberg, Camilla; Hoff, Dominic A; Nystad, Wenche; Magnus, Per; Tverdal, Aage; Davey Smith, George

2013-11-01

Cardiovascular diseases (CVDs) have been related to low birth weight, suggesting the foetal environment may program future risk. Alternatively, common genetic factors for both low birth weight and CVD could explain such associations. We investigated associations between offspring birth weight and paternal and maternal cardiovascular mortality and offspring birth weight and cardiovascular mortality among all four grandparents, and further assessed the mediating role of maternal smoking during pregnancy. All births from 1967 to 2008 that could be linked to parents and grandparents comprised the population (n = 1,004,255). The mortality follow-up among parents was from 1970 to 2008 and among grandparents from 1960 to 2008. The association of grandparental mortality with maternal smoking during pregnancy was analysed in a subpopulation of those born after 1997 (n = 345,624). Per quintile higher in birth weight was related to 0.82 (0.75-0.89) hazard ratio from coronary heart disease in mothers and 0.94 (0.92-0.97) in fathers. For stroke, these were 0.85 (0.78-0.92) and 0.94 (0.89-1.00), respectively. In grandparents for cardiovascular causes, the effects were 0.95 (0.93-0.96) (maternal grandmother), 0.97 (0.96-0.98) (maternal grandfather), 0.96 (0.94-0.98) (paternal grandmother), and 0.98 (0.98-1.00) (paternal grandfather). Adjusting for maternal smoking in pregnancy in the subpopulation accounted for much of the effect on grandparental cardiovascular mortality in all categories of birth weight. For grandparental diabetes mortality, U-shaped associations were seen with grandchild birth weight for the maternal grandmother and inverse associations for all other grandparents. Associations between CVD mortality in all four grandparents and grandchild birth weight exist, and while genetic and environmental factors may contribute to these, it appears that there is an important role for maternal smoking during pregnancy (and associated paternal smoking) in generating these

Review of six year cardiovascular mortality at a tertiary hospital in ...

African Journals Online (AJOL)

Review of six year cardiovascular mortality at a tertiary hospital in south-east Nigeria. ... E Iheanyi, OM Oghale, K Uwanuruochi, CO Odigwe, A Chuku ... The mean age at death was highest for stroke, 65.0years, likewise the mean duration of ...

Diabetic retinopathy is associated with mortality and cardiovascular disease incidence: the EURODIAB prospective complications study

NARCIS (Netherlands)

van Hecke, M.V.; Dekker, J.M.; Stehouwer, C.D.A.; Polak, B.C.P.; Fuller, J.H.; Sjolie, A.K.; Kofinis, A.; Rottiers, R.; Porta, M.; Chaturvedi, N.

2005-01-01

OBJECTIVE - To study the relationship of nonproliferative and proliferative retinopathy with all-cause mortality and cardiovascular disease (CVD) incidence in type 1 diabetic patients and, additionally, the role of cardiovascular risk factors in these associations. RESEARCH DESIGN AND METHODS - This

Association of "Elevated Blood Pressure" and "Stage 1 Hypertension" With Cardiovascular Mortality Among an Asian Population.

Science.gov (United States)

Talaei, Mohammad; Hosseini, Naeimeh; Koh, Angela S; Yuan, Jian-Min; Koh, Woon-Puay

2018-04-10

The new American College of Cardiology/American Heart Association high blood pressure (BP) guidelines in the United States have lowered definition of hypertension by defining normal as systolic/diastolic BP hypertension as systolic between 130 and 139 mm Hg or diastolic between 80 and 89 mm Hg. We investigated the association between the new hypertension definition and cardiovascular disease mortality among Chinese in Singapore. We used data from 30 636 participants of a population-based cohort, the SCHS (Singapore Chinese Health Study), who had BPs measured using a standard protocol at ages 46 to 85 years between 1994 and 2005. Information on lifestyle factors was collected at recruitment (1993-1998) and follow-up 1 interviews (1999 and 2004). Mortality was identified via nationwide registry linkage up to December 31, 2016. Neither elevated BP (hazard ratio, 0.89; 95% confidence interval, 0.74-1.07) nor stage 1 hypertension (hazard ratio, 0.94; 95% confidence interval, 0.81-1.11) was associated with increased risk of cardiovascular mortality compared with normal BP in the whole cohort. Stage 1 hypertension was associated with increased cardiovascular risk only in those hypertension may not be associated with increased cardiovascular mortality across all ages among Chinese in Singapore, but that the at-risk subpopulation is limited to those <65 years of age and without a prior cardiovascular disease. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention.

Science.gov (United States)

Cooper, R; Cutler, J; Desvigne-Nickens, P; Fortmann, S P; Friedman, L; Havlik, R; Hogelin, G; Marler, J; McGovern, P; Morosco, G; Mosca, L; Pearson, T; Stamler, J; Stryer, D; Thom, T

2000-12-19

A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality from cardiovascular diseases; levels and trends in risk factors for cardiovascular diseases; disparities in cardiovascular diseases by race/ethnicity, socioeconomic status, and geography; trends in cardiovascular disease preventive and treatment services; and strategies for efforts to reduce cardiovascular diseases overall and to reduce disparities among subpopulations. The conference concluded that coronary heart disease mortality is still declining in the United States as a whole, although perhaps at a slower rate than in the 1980s; that stroke mortality rates have declined little, if at all, since 1990; and that there are striking differences in cardiovascular death rates by race/ethnicity, socioeconomic status, and geography. Trends in risk factors are consistent with a slowing of the decline in mortality; there has been little recent progress in risk factors such as smoking, physical inactivity, and hypertension control. There are increasing levels of obesity and type 2 diabetes, with major differences among subpopulations. There is considerable activity in population-wide prevention, primary prevention for higher risk people, and secondary prevention, but wide disparities exist among groups on the basis of socioeconomic status and geography, pointing to major gaps in efforts to use available, proven approaches to control cardiovascular diseases. Recommendations for strategies to attain the year 2010 health objectives were made.

Particle size and chemical constituents of ambient particulate pollution associated with cardiovascular mortality in Guangzhou, China

International Nuclear Information System (INIS)

Lin, Hualiang; Tao, Jun; Du, Yaodong; Liu, Tao; Qian, Zhengmin; Tian, Linwei; Di, Qian; Rutherford, Shannon; Guo, Lingchuan; Zeng, Weilin; Xiao, Jianpeng; Li, Xing; He, Zhihui; Xu, Yanjun; Ma, Wenjun

2016-01-01

Though significant associations between particulate matter (PM) air pollution and cardiovascular diseases have been widely reported, it remains unclear what characteristics, such as particle size and chemical constituents, may be responsible for the effects. A time-series model was applied to examine the cardiovascular effects of particle size (for the period of 2009–2011) and chemical constituents (2007–2010) in Guangzhou, we controlled for potential confounders in the model, such as time trends, day of the week, public holidays, meteorological factors and influenza epidemic. We found significant associations of cardiovascular mortality with PM_1_0, PM_2_._5 and PM_1; the excess risk (ER) was 6.10% (95% CI: 1.76%, 10.64%), 6.11% (95% CI: 1.76%, 10.64%) and 6.48% (95% CI: 2.10%, 11.06%) for per IQR increase in PM_1_0, PM_2_._5 and PM_1 at moving averages for the current day and the previous 3 days (lag_0_3), respectively. We did not find significant effects of PM_2_._5_-_1_0 and PM_1_-_2_._5. For PM_2_._5 constituents, we found that organic carbon, elemental carbon, sulfate, nitrate and ammonium were significantly associated with cardiovascular mortality, the corresponding ER for an IQR concentration increase at lag_0_3 was 1.13% (95% CI: 0.10%, 2.17%), 2.77% (95% CI: 0.72%, 4.86%), 2.21% (95% CI: 1.05%, 3.38%), 1.98% (95% CI: 0.54%, 3.44%), and 3.38% (95% CI: 1.56%, 5.23%), respectively. These results were robust to adjustment of other air pollutants and they remained consistent in various sensitivity analyses by changing model parameters. Our study suggests that PM_1 and constituents from combustion and secondary aerosols might be important characteristics of PM pollution associated with cardiovascular mortality in Guangzhou. - Highlights: • PM_1_0, PM_2_._5 and PM_1 were significantly associated with cardiovascular mortality. • We did not find significant cardiovascular effects of PM_2_._5_-_1_0 and PM_1_-_2_._5. • PM_1 might be most responsible for

Metabolic syndrome, major depression, generalized anxiety disorder, and ten-year all-cause and cardiovascular mortality in middle aged and elderly patients.

Science.gov (United States)

Butnoriene, Jurate; Bunevicius, Adomas; Saudargiene, Ausra; Nemeroff, Charles B; Norkus, Antanas; Ciceniene, Vile; Bunevicius, Robertas

2015-01-01

Studies investigating specifically whether metabolic syndrome (MetS) and common psychiatric disorders are independently associated with mortality are lacking. In a middle-aged general population, we investigated the association of the MetS, current major depressive episode (MDE), lifetime MDE, and generalized anxiety disorder (GAD) with ten-year all-cause and cardiovascular disease mortality. From February 2003 until January 2004, 1115 individuals aged 45 years and older were randomly selected from a primary care practice and prospectively evaluated for: (1) MetS (The World Health Organization [WHO], National Cholesterol Education Program/Adult Treatment Panel III and International Diabetes Federation [IDF] definitions); (2) current MDE and GAD, and lifetime MDE (Mini International Neuropsychiatric Interview); and (3) conventional cardiovascular risk factors. Follow-up continued through January, 2013. During the 9.32 ± 0.47 years of follow-up, there were 248 deaths, of which 148 deaths were attributed to cardiovascular causes. In women, WHO-MetS and IDF-MetS were associated with greater all-cause (HR-values range from 1.77 to 1.91; p-values ≤ 0.012) and cardiovascular (HR-values range from 1.83 to 2.77; p-values ≤ 0.013) mortality independent of cardiovascular risk factors and MDE/GAD. Current GAD predicted greater cardiovascular mortality (HR-values range from 1.86 to 1.99; p-values ≤ 0.025) independently from MetS and cardiovascular risk factors. In men, the MetS and MDE/GAD were not associated with mortality. In middle aged women, the MetS and GAD predicted greater 10-year cardiovascular mortality independently from each other; 10-year all-cause mortality was independently predicted by the MetS. MetS and GAD should be considered important and independent mortality risk factors in women. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Cardiovascular, respiratory, and total mortality attributed to PM2.5 in Mashhad, Iran.

Science.gov (United States)

Bonyadi, Ziaeddin; Ehrampoush, Mohammad Hasan; Ghaneian, Mohammad Taghi; Mokhtari, Mehdi; Sadeghi, Abbas

2016-10-01

Poor air quality is one of the most important environmental problems in many large cities of the world, which can cause a wide range of acute and chronic health effects, including partial physiological disorders and cardiac death due to respiratory and cardiovascular diseases. According to the latest edition of the national standard for air quality, maximum contamination level is 15 μg/m(3) per year and 35 μg/m(3) per day. The aim of this study was to evaluate cardiovascular, respiratory, and total mortality attributed to PM2.5 in the city of Mashhad during 2013. To this end, the Air Q model was used to assess health impacts of PM2.5 and human exposure to it. In this model, the attributable proportion of health outcome, annual number of excess cases of mortality for all causes, and cardiovascular and respiratory diseases were estimated. The results showed that the number of excess cases of mortality for all causes and cardiovascular and respiratory diseases attributable to PM2.5 was 32, 263, and 332 μg/m(3), respectively. Moreover, the annual average of PM2.5 in Mashhad was obtained to be 37.85 μg/m(3). This study demonstrated that a high percentage of mortality resulting from this pollutant could be due to the high average concentration of PM2.5 in the city during 2013. In this case, using the particle control methods, such as optimal use of fuel, management of air quality in urban areas, technical inspection of vehicles, faster development of public transport, and use of industrial technology can be effective in reducing air pollution in cities and turning existing situations into preferred ones.

Chronic kidney disease, cardiovascular disease and mortality: A prospective cohort study in a multi-ethnic Asian population.

Science.gov (United States)

Lim, Cynthia C; Teo, Boon Wee; Ong, Peng Guan; Cheung, Carol Y; Lim, Su Chi; Chow, Khuan Yew; Meng, Chan Choon; Lee, Jeannette; Tai, E Shyong; Wong, Tien Y; Sabanayagam, Charumathi

2015-08-01

Few studies have examined the impact of chronic kidney disease (CKD) on adverse cardiovascular outcomes and deaths in Asian populations. We evaluated the associations of CKD with cardiovascular disease (CVD) and all-cause mortality in a multi-ethnic Asian population. Prospective cohort study of 7098 individuals who participated in two independent population-based studies involving Malay adults (n = 3148) and a multi-ethnic cohort of Chinese, Malay and Indian adults (n = 3950). CKD was assessed from CKD-EPI estimated glomerular filtration rate (eGFR) and urine albumin-to-creatinine ratio (UACR). Incident CVD (myocardial infarction, stroke and CVD mortality) and all-cause mortality were identified by linkage with national disease/death registries. Over a median follow-up of 4.3 years, 4.6% developed CVD and 6.1% died. Risks of both CVD and all-cause mortality increased with decreasing eGFR and increasing albuminuria (all p-trend <0.05). Adjusted hazard ratios (HR (95% confidence interval)) of CVD and all-cause mortality were: 1.54 (1.05-2.27) and 2.21 (1.67-2.92) comparing eGFR <45 vs ≥60; 2.81 (1.49-5.29) and 2.34 (1.28-4.28) comparing UACR ≥300 vs <30. The association between eGFR <60 and all-cause mortality was stronger among those with diabetes (p-interaction = 0.02). PAR of incident CVD was greater among those with UACR ≥300 (12.9%) and that of all-cause mortality greater among those with eGFR <45 (16.5%). In multi-ethnic Asian adults, lower eGFR and higher albuminuria were independently associated with incident CVD and all-cause mortality. These findings extend previously reported similar associations in Western populations to Asians and emphasize the need for early detection of CKD and intervention to prevent adverse outcomes. © The European Society of Cardiology 2014.

Does respiratory health contribute to the effects of long-term air pollution exposure on cardiovascular mortality?

OpenAIRE

Heinrich Joachim; Gehring Ulrike; Ranft Ulrich; Sugiri Dorothea; Schikowski Tamara; Wichmann H-Erich; Krämer Ursula

2007-01-01

Abstract Background There is growing epidemiological evidence that short-term and long-term exposure to high levels of air pollution may increase cardiovascular morbidity and mortality. In addition, epidemiological studies have shown an association between air pollution exposure and respiratory health. To what extent the association between cardiovascular mortality and air pollution is driven by the impact of air pollution on respiratory health is unknown. The aim of this study was to investi...

Preditores cardiovasculares da mortalidade em idosos longevos Cardiovascular mortality predictors in the oldest old

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Luiz Pedro Marafon

2003-06-01

Full Text Available O objetivo deste trabalho é investigar a associação entre fatores de risco e morbidade cardiovascular com mortalidade em idosos longevos. Noventa e um por cento da população com idade ³ 80 anos (n = 193 de Veranópolis, Rio Grande do Sul, no ano de 1996, foram avaliados para a detecção de fatores de risco e morbidade cardiovascular. Acompanhou-se esta população durante 3 anos e registraram-se os casos de óbitos. Os dados foram analisados por análise univariada e multivariada por regressão logística. Ocorreram 41 (21% óbitos (20 homens e 21 mulheres. As mortes foram distribuídas ao longo do período estudado como se segue: 3 (7,3% no primeiro ano, 8 (19,5% no segundo ano e 30 (73,2% no terceiro ano. Observou-se associação significativa de óbito com as seguintes características: pressão arterial diastólica (PAD, colesterol total (CT, LDL-C, ApoA-I, acidente vascular encefálico prévio (AVC, bloqueio do ramo direito (BRD e hipertrofia ventricular esquerda (HVE ao ECG. Os sobreviventes apresentaram níveis mais elevados de PAD, CT, LDL-C e ApoA-I. AVC, BRD e HVE. A análise multivariada mostrou que as variáveis eram fatores de risco independentes. Os fatores de risco cardiovascular parecem atuar de forma diferenciada em longevos.This article investigates the association between cardiovascular risk factors and cardiovascular morbidity and mortality in the oldest old. In 1996, 91% of the population ³ 80 years of age from Veranópolis, Rio Grande do Sul State, Brazil, were evaluated to detect cardiovascular risk factors and morbidity. The sample was followed up for three years, with the assessment of deaths. The analysis was done using univariate statistics and multivariate logistic regression analysis. There were 41 deaths (21%: 20 men and 21 women. Deaths were distributed by year as follow: 03 (7.3% in the first year, 08 (19.5% in the second, and 30 (73.2% in the third. There was a significant and independent association

Illiteracy, low educational status, and cardiovascular mortality in India

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Gupta Prakash C

2011-07-01

Full Text Available Abstract Background Influence of education, a marker of SES, on cardiovascular disease (CVD mortality has not been evaluated in low-income countries. To determine influence of education on CVD mortality a cohort study was performed in India. Methods 148,173 individuals aged ≥ 35 years were recruited in Mumbai during 1991-1997 and followed to ascertain vital status during 1997-2003. Subjects were divided according to educational status into one of the five groups: illiterate, primary school (≦ 5 years of formal education, middle school (6-8 years, secondary school (9-10 years and college (> 10 years. Multivariate analyses using Cox proportional hazard model was performed and hazard ratios (HRs and 95% confidence intervals (CIs determined. Results At average follow-up of 5.5 years (774,129 person-years 13,261 deaths were observed. CVD was the major cause of death in all the five educational groups. Age adjusted all-cause mortality per 100,000 in illiterate to college going men respectively was 2154, 2149, 1793, 1543 and 1187 and CVD mortality was 471, 654, 618, 518 and 450; and in women all-cause mortality was 1444, 949, 896, 981 and 962 and CVD mortality was 429, 301, 267, 426 and 317 (ptrend trend trend > 0.05. Conclusions Inverse association of literacy status with all-cause mortality was observed in Indian men and women, while, for CVD mortality it was observed only in men.

38 CFR 4.104 - Schedule of ratings-cardiovascular system.

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2010-07-01

...-cardiovascular system. 4.104 Section 4.104 Pensions, Bonuses, and Veterans' Relief DEPARTMENT OF VETERANS AFFAIRS SCHEDULE FOR RATING DISABILITIES Disability Ratings The Cardiovascular System § 4.104 Schedule of ratings—cardiovascular system. Diseases of the Heart Rating Note (1): Evaluate cor pulmonale, which is a form of...

Mortality and reduced growth hormone secretion

DEFF Research Database (Denmark)

Stochholm, Kirstine; Christiansen, Jens; Laursen, Torben

2007-01-01

BACKGROUND: Data regarding the mortality rates of patients with growth hormone deficiency (GHD), whether or not treated with growth hormone (GH), are limited, but an increased mortality rate among hypopituitary patients compared with the general population has been documented. Cardiovascular dise...

Long-term exposure to ambient air pollution and mortality due to cardiovascular disease and cerebrovascular disease in Shenyang, China.

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Pengfei Zhang

Full Text Available BACKGROUND: The relationship between ambient air pollution exposure and mortality of cardiovascular and cerebrovascular diseases in human is controversial, and there is little information about how exposures to ambient air pollution contribution to the mortality of cardiovascular and cerebrovascular diseases among Chinese. The aim of the present study was to examine whether exposure to ambient-air pollution increases the risk for cardiovascular and cerebrovascular disease. METHODOLOGY/PRINCIPAL FINDINGS: We conducted a retrospective cohort study among humans to examine the association between compound-air pollutants [particulate matter <10 µm in aerodynamic diameter (PM(10, sulfur dioxide (SO(2 and nitrogen dioxide (NO(2] and mortality in Shenyang, China, using 12 years of data (1998-2009. Also, stratified analysis by sex, age, education, and income was conducted for cardiovascular and cerebrovascular mortality. The results showed that an increase of 10 µg/m(3 in a year average concentration of PM(10 corresponds to 55% increase in the risk of a death cardiovascular disease (hazard ratio [HR], 1.55; 95% confidence interval [CI], 1.51 to 1.60 and 49% increase in cerebrovascular disease (HR, 1.49; 95% CI, 1.45 to 1.53, respectively. The corresponding figures of adjusted HR (95%CI for a 10 µg/m(3 increase in NO(2 was 2.46 (2.31 to 2.63 for cardiovascular mortality and 2.44 (2.27 to 2.62 for cerebrovascular mortality, respectively. The effects of air pollution were more evident in female that in male, and nonsmokers and residents with BMI<18.5 were more vulnerable to outdoor air pollution. CONCLUSION/SIGNIFICANCE: Long-term exposure to ambient air pollution is associated with the death of cardiovascular and cerebrovascular diseases among Chinese populations.

Rate of change in renal function and mortality in elderly treated hypertensive patients.

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Chowdhury, Enayet K; Langham, Robyn G; Ademi, Zanfina; Owen, Alice; Krum, Henry; Wing, Lindon M H; Nelson, Mark R; Reid, Christopher M

2015-07-07

Evidence relating the rate of change in renal function, measured as eGFR, after antihypertensive treatment in elderly patients to clinical outcome is sparse. This study characterized the rate of change in eGFR after commencement of antihypertensive treatment in an elderly population, the factors associated with eGFR rate change, and the rate's association with all-cause and cardiovascular mortality. Data from the Second Australian National Blood Pressure study were used, where 6083 hypertensive participants aged ≥65 years were enrolled during 1995-1997 and followed for a median of 4.1 years (in-trial). Following the Second Australian National Blood Pressure study, participants were followed-up for a further median 6.9 years (post-trial). The annual rate of change in the eGFR was calculated in 4940 participants using creatinine measurements during the in-trial period and classified into quintiles (Q) on the basis of the following eGFR changes: rapid decline (Q1), decline (Q2), stable (Q3), increase (Q4), and rapid increase (Q5). A rapid decline in eGFR in comparison with those with stable eGFRs during the in-trial period was associated with older age, living in a rural area, wider pulse pressure at baseline, receiving diuretic-based therapy, taking multiple antihypertensive drugs, and having blood pressure <140/90 mmHg during the study. However, a rapid increase in eGFR was observed in younger women and those with a higher cholesterol level. After adjustment for baseline and in-trial covariates, Cox-proportional hazard models showed a significantly greater risk for both all-cause (hazard ratio, 1.28; 95% confidence interval, 1.09 to 1.52; P=0.003) and cardiovascular (hazard ratio, 1.40; 95% confidence interval, 1.11 to 1.76; P=0.004) mortality in the rapid decline group compared with the stable group over a median of 7.2 years after the last eGFR measure. No significant association with mortality was observed for a rapid increase in eGFR. In elderly persons with

Fasting insulin, insulin resistance, and risk of cardiovascular or all-cause mortality in non-diabetic adults: a meta-analysis.

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Zhang, Xiaohong; Li, Jun; Zheng, Shuiping; Luo, Qiuyun; Zhou, Chunmei; Wang, Chaoyang

2017-10-31

Studies on elevated fasting insulin or insulin resistance (IR) and cardiovascular or all-cause mortality risk in non-diabetic individuals have yielded conflicting results. This meta-analysis aimed to evaluate the association of elevated fasting insulin levels or IR as defined by homeostasis model assessment of IR (HOMA-IR) with cardiovascular or all-cause mortality in non-diabetic adults. We searched for relevant studies in PubMed and Emabse databases until November 2016. Only prospective observational studies investigating the association of elevated fasting insulin levels or HOMA-IR with cardiovascular or all-cause mortality risk in non-diabetic adults were included. Risk ratio (RR) with its 95% confidence intervals (CIs) was pooled for the highest compared with the lowest category of fasting insulin levels or HOMA-IR. Seven articles involving 26976 non-diabetic adults were included. The pooled, adjusted RR of all-cause mortality comparing the highest with the lowest category was 1.13 (95% CI: 1.00-1.27; P =0.058) for fasting insulin levels and 1.34 (95% CI: 1.11-1.62; P =0.002) for HOMA-IR, respectively. When comparing the highest with the lowest category, the pooled adjusted RR of cardiovascular mortality was 2.11 (95% CI: 1.01-4.41; P =0.048) for HOMA-IR in two studies and 1.40 (95% CI: 0.49-3.96; P =0.526) for fasting insulin levels in one study. IR as measured by HOMA-IR but not fasting insulin appears to be independently associated with greater risk of cardiovascular or all-cause mortality in non-diabetic adults. However, the association of fasting insulin and HOMA-IR with cardiovascular mortality may be unreliable due to the small number of articles included. © 2017 The Author(s).

Platelet count is associated with cardiovascular disease, cancer and mortality

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Vinholt, P J; Hvas, A M; Frederiksen, H

2016-01-01

count (100-450×10(9)/L) and mortality, development of future cardiovascular disease (myocardial infarction, ischaemic stroke, or peripheral vascular disease), venous thromboembolism, bleeding or cancer in the general population. MATERIAL AND METHODS: We conducted a register-based cohort study of 21......,252 adults (≥20years) from the Danish General Suburban Population Study (GESUS). Laboratory results from GESUS were linked to information from national registers regarding morbidity and death. Cox proportional hazard regression was conducted with adjustment for age, sex, smoking status, haemoglobin......, leukocyte count, C-reactive protein and Charlson comorbidity index. RESULTS: We found a U-shaped relationship between mortality and platelet count. Mortality was significantly increased for platelet count 300×10(9)/L. When categorizing platelet count using the interval 201-250×10(9)/L...

Isolated and synergistic effects of PM10 and average temperature on cardiovascular and respiratory mortality

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Samya de Lara Lins de Araujo Pinheiro

2014-12-01

Full Text Available OBJECTIVE To analyze the effect of air pollution and temperature on mortality due to cardiovascular and respiratory diseases. METHODS We evaluated the isolated and synergistic effects of temperature and particulate matter with aerodynamic diameter 40 years old due to cardiovascular disease and that of individuals > 60 years old due to respiratory diseases in Sao Paulo, SP, Southeastern Brazil, between 1998 and 2008. Three methodologies were used to evaluate the isolated association: time-series analysis using Poisson regression model, bidirectional case-crossover analysis matched by period, and case-crossover analysis matched by the confounding factor, i.e., average temperature or pollutant concentration. The graphical representation of the response surface, generated by the interaction term between these factors added to the Poisson regression model, was interpreted to evaluate the synergistic effect of the risk factors. RESULTS No differences were observed between the results of the case-crossover and time-series analyses. The percentage change in the relative risk of cardiovascular and respiratory mortality was 0.85% (0.45;1.25 and 1.60% (0.74;2.46, respectively, due to an increase of 10 μg/m3 in the PM10 concentration. The pattern of correlation of the temperature with cardiovascular mortality was U-shaped and that with respiratory mortality was J-shaped, indicating an increased relative risk at high temperatures. The values for the interaction term indicated a higher relative risk for cardiovascular and respiratory mortalities at low temperatures and high temperatures, respectively, when the pollution levels reached approximately 60 μg/m3. CONCLUSIONS The positive association standardized in the Poisson regression model for pollutant concentration is not confounded by temperature, and the effect of temperature is not confounded by the pollutant levels in the time-series analysis. The simultaneous exposure to different levels of

Calculating the Rate of Senescence From Mortality Data

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Koopman, Jacob J E; Rozing, Maarten P; Kramer, Anneke

2016-01-01

, they do not fit mortality rates at young and old ages. Therefore, we developed a method to calculate senescence rates from the acceleration of mortality directly without modeling the mortality rates. We applied the different methods to age group-specific mortality data from the European Renal Association......, the rate of senescence can be calculated directly from non-modeled mortality rates, overcoming the disadvantages of an indirect estimation based on modeled mortality rates....

Association of coffee consumption with all-cause and cardiovascular disease mortality.

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Liu, Junxiu; Sui, Xuemei; Lavie, Carl J; Hebert, James R; Earnest, Conrad P; Zhang, Jiajia; Blair, Steven N

2013-10-01

To evaluate the association between coffee consumption and mortality from all causes and from cardiovascular disease. Data from the Aerobics Center Longitudinal Study representing 43,727 participants with 699,632 person-years of follow-up were included. Baseline data were collected by an in-person interview on the basis of standardized questionnaires and a medical examination, including fasting blood chemistry analysis, anthropometry, blood pressure, electrocardiography, and a maximal graded exercise test, between February 3, 1971, and December 30, 2002. Cox regression analysis was used to quantify the association between coffee consumption and all-cause and cause-specific mortality. During the 17-year median follow-up, 2512 deaths occurred (804 [32%] due to cardiovascular disease). In multivariate analyses, coffee intake was positively associated with all-cause mortality in men. Men who drank more than 28 cups of coffee per week had higher all-cause mortality (hazard ratio [HR], 1.21; 95% CI, 1.04-1.40). However, after stratification based on age, younger (coffee consumption (>28 cups per week) and all-cause mortality after adjusting for potential confounders and fitness level (HR, 1.56; 95% CI, 1.30-1.87 for men; and HR, 2.13; 95% CI, 1.26-3.59 for women). In this large cohort, a positive association between coffee consumption and all-cause mortality was observed in men and in men and women younger than 55 years. On the basis of these findings, it seems appropriate to suggest that younger people avoid heavy coffee consumption (ie, averaging >4 cups per day). However, this finding should be assessed in future studies of other populations. Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Associations of fats and carbohydrate intake with cardiovascular disease and mortality in 18 countries from five continents (PURE): a prospective cohort study.

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Dehghan, Mahshid; Mente, Andrew; Zhang, Xiaohe; Swaminathan, Sumathi; Li, Wei; Mohan, Viswanathan; Iqbal, Romaina; Kumar, Rajesh; Wentzel-Viljoen, Edelweiss; Rosengren, Annika; Amma, Leela Itty; Avezum, Alvaro; Chifamba, Jephat; Diaz, Rafael; Khatib, Rasha; Lear, Scott; Lopez-Jaramillo, Patricio; Liu, Xiaoyun; Gupta, Rajeev; Mohammadifard, Noushin; Gao, Nan; Oguz, Aytekin; Ramli, Anis Safura; Seron, Pamela; Sun, Yi; Szuba, Andrzej; Tsolekile, Lungiswa; Wielgosz, Andreas; Yusuf, Rita; Hussein Yusufali, Afzal; Teo, Koon K; Rangarajan, Sumathy; Dagenais, Gilles; Bangdiwala, Shrikant I; Islam, Shofiqul; Anand, Sonia S; Yusuf, Salim

2017-11-04

The relationship between macronutrients and cardiovascular disease and mortality is controversial. Most available data are from European and North American populations where nutrition excess is more likely, so their applicability to other populations is unclear. The Prospective Urban Rural Epidemiology (PURE) study is a large, epidemiological cohort study of individuals aged 35-70 years (enrolled between Jan 1, 2003, and March 31, 2013) in 18 countries with a median follow-up of 7·4 years (IQR 5·3-9·3). Dietary intake of 135 335 individuals was recorded using validated food frequency questionnaires. The primary outcomes were total mortality and major cardiovascular events (fatal cardiovascular disease, non-fatal myocardial infarction, stroke, and heart failure). Secondary outcomes were all myocardial infarctions, stroke, cardiovascular disease mortality, and non-cardiovascular disease mortality. Participants were categorised into quintiles of nutrient intake (carbohydrate, fats, and protein) based on percentage of energy provided by nutrients. We assessed the associations between consumption of carbohydrate, total fat, and each type of fat with cardiovascular disease and total mortality. We calculated hazard ratios (HRs) using a multivariable Cox frailty model with random intercepts to account for centre clustering. During follow-up, we documented 5796 deaths and 4784 major cardiovascular disease events. Higher carbohydrate intake was associated with an increased risk of total mortality (highest [quintile 5] vs lowest quintile [quintile 1] category, HR 1·28 [95% CI 1·12-1·46], p trend =0·0001) but not with the risk of cardiovascular disease or cardiovascular disease mortality. Intake of total fat and each type of fat was associated with lower risk of total mortality (quintile 5 vs quintile 1, total fat: HR 0·77 [95% CI 0·67-0·87], p trend fat, HR 0·86 [0·76-0·99], p trend =0·0088; monounsaturated fat: HR 0·81 [0·71-0·92], p trend fat: HR 0·80 [0

Mortality rates among Arab Americans in Michigan.

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Dallo, Florence J; Schwartz, Kendra; Ruterbusch, Julie J; Booza, Jason; Williams, David R

2012-04-01

The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, all-cause and cause-specific mortality rates for Arab Americans were in the range of whites and blacks. However, Arab American men had lower mortality rates from cancer and chronic lower respiratory disease compared to both whites and blacks. Among women, Arab Americans had lower mortality rates from heart disease, cancer, stroke, and diabetes than whites and blacks. Arab Americans are growing in number. Future study should focus on designing rigorous separate analyses for this population.

Inter-arm blood pressure difference and mortality: a cohort study in an asymptomatic primary care population at elevated cardiovascular risk.

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Clark, Christopher E; Taylor, Rod S; Butcher, Isabella; Stewart, Marlene Cw; Price, Jackie; Fowkes, F Gerald R; Shore, Angela C; Campbell, John L

2016-05-01

Differences in blood pressure between arms are associated with increased cardiovascular mortality in cohorts with established vascular disease or substantially elevated cardiovascular risk. To explore the association of inter-arm difference (IAD) with mortality in a community-dwelling cohort that is free of cardiovascular disease. Cohort analysis of a randomised controlled trial in central Scotland, from April 1998 to October 2008. Volunteers from Lanarkshire, Glasgow, and Edinburgh, free of pre-existing vascular disease and with an ankle-brachial index ≤0.95, had systolic blood pressure measured in both arms at recruitment. Inter-arm blood pressure differences were calculated and examined for cross-sectional associations and differences in prospective survival. Outcome measures were cardiovascular events and all-cause mortality during mean follow-up of 8.2 years. Based on a single pair of measurements, 60% of 3350 participants had a systolic IAD ≥5 mmHg and 38% ≥10 mmHg. An IAD ≥5 mmHg was associated with increased cardiovascular mortality (adjusted hazard ratio [HR] 1.91, 95% confidence interval [CI] = 1.19 to 3.07) and all-cause mortality (adjusted HR 1.44, 95% CI = 1.15 to 1.79). Within the subgroup of 764 participants who had hypertension, IADs of ≥5 mmHg or ≥10 mmHg were associated with both cardiovascular mortality (adjusted HR 2.63, 95% CI = 0.97 to 7.02, and adjusted HR 2.96, 95% CI = 1.27 to 6.88, respectively) and all-cause mortality (adjusted HR 1.67, 95% CI = 1.05 to 2.66, and adjusted HR 1.63, 95% CI = 1.06 to 2.50, respectively). IADs ≥15 mmHg were not associated with survival differences in this population. Systolic IADs in blood pressure are associated with increased risk of cardiovascular events, including mortality, in a large cohort of people free of pre-existing vascular disease. © British Journal of General Practice 2016.

Patterns of mortality rates in Darfur conflict.

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Degomme, Olivier; Guha-Sapir, Debarati

2010-01-23

Several mortality estimates for the Darfur conflict have been reported since 2004, but few accounted for conflict dynamics such as changing displacement and causes of deaths. We analyse changes over time for crude and cause-specific mortality rates, and assess the effect of displacement on mortality rates. Retrospective mortality surveys were gathered from an online database. Quasi-Poisson models were used to assess mortality rates with place and period in which the survey was done, and the proportions of displaced people in the samples were the explanatory variables. Predicted mortality rates for five periods were computed and applied to population data taken from the UN's series about Darfur to obtain the number of deaths. 63 of 107 mortality surveys met all criteria for analysis. Our results show significant reductions in mortality rates from early 2004 to the end of 2008, although rates were higher during deployment of fewer humanitarian aid workers. In general, the reduction in rate was more important for violence-related than for diarrhoea-related mortality. Displacement correlated with increased rates of deaths associated with diarrhoea, but also with reduction in violent deaths. We estimated the excess number of deaths to be 298 271 (95% CI 178 258-461 520). Although violence was the main cause of death during 2004, diseases have been the cause of most deaths since 2005, with displaced populations being the most susceptible. Any reduction in humanitarian assistance could lead to worsening mortality rates, as was the case between mid 2006 and mid 2007. Copyright 2010 Elsevier Ltd. All rights reserved.

Neutrophil gelatinase-associated lipocalin levels are U-shaped in the Ludwigshafen Risk and Cardiovascular Health (LURIC study-Impact for mortality.

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Rainer P Woitas

Full Text Available Neutrophil gelatinase-associated lipocalin (NGAL is a glycoprotein released by damaged renal tubular cells and mature neutrophils. It is elevated in kidney injury, but also in patients with coronary artery disease (CAD and myocardial infarction. We investigated the prognostic value of NGAL for total and cardiovascular mortality in patients undergoing coronary angiography without history of renal insufficiency at inclusion into the study.The LURIC study is an ongoing prospective cohort study of patients referred for coronary angiography and is designed to evaluate determinants of cardiovascular health.NGAL was determined in plasma of 2997 persons (mean age: 62.7 years; 69.7% men with a follow up for 10 years. 2358 patients suffered from CAD and 638 did not-these patients served as controls. Stable CAD was found in 1408 and unstable CAD in 950 patients. Death rate from cardiovascular events and all causes was highest in patients within the 4th quartile of NGAL (≥56 ng/ml, p<0.001 vs third quartile, even after adjustment for age and gender. According to multivariable-adjusted Cox analysis adjusting for well-known cardiovascular risk factors, as well as lipid lowering therapy, angiographic CAD, and C-reactive protein we found patients in the highest NGAL quartile being at increased risk for cardiovascular (hazard ratio (HR 1.33, 95%CI 1.05-1.67, p = 0.016 and all cause mortality (HR 1.29 95%CI 1.07-1.55, p = 0.007 compared to those in the third quartile. The lowest risk was seen in the third quartile of NGAL (41-56 ng/ml suggesting a U-shaped relationship between NGAL and mortality. Further adjustment for creatinine abrogated the predictive effect of NGAL. However, the 3rd and 4th quartiles of NGAL were significantly associated with higher neutrophil counts, which were associated with CAD, non-ST elevation and ST-elevation myocardial infarction (p<0.05.Plasma NGAL concentrations are mainly derived from neutrophils and do not predict mortality

Can rheumatoid arthritis (RA) registries provide contextual safety data for modern RA clinical trials? The case for mortality and cardiovascular disease.

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Michaud, Kaleb; Berglind, Niklas; Franzén, Stefan; Frisell, Thomas; Garwood, Christopher; Greenberg, Jeffrey D; Ho, Meilien; Holmqvist, Marie; Horne, Laura; Inoue, Eisuke; Nyberg, Fredrik; Pappas, Dimitrios A; Reed, George; Symmons, Deborah; Tanaka, Eiichi; Tran, Trung N; Verstappen, Suzanne M M; Wesby-van Swaay, Eveline; Yamanaka, Hisashi; Askling, Johan

2016-10-01

We implemented a novel method for providing contextual adverse event rates for a randomised controlled trial (RCT) programme through coordinated analyses of five RA registries, focusing here on cardiovascular disease (CVD) and mortality. Each participating registry (Consortium of Rheumatology Researchers of North America (CORRONA) (USA), Swedish Rheumatology Quality of Care Register (SRR) (Sweden), Norfolk Arthritis Register (NOAR) (UK), CORRONA International (East Europe, Latin America, India) and Institute of Rheumatology, Rheumatoid Arthritis (IORRA) (Japan)) defined a main cohort from January 2000 onwards. To address comparability and potential bias, we harmonised event definitions and defined several subcohorts for sensitivity analyses based on disease activity, treatment, calendar time, duration of follow-up and RCT exclusions. Rates were standardised for age, sex and, in one sensitivity analysis, also HAQ. The combined registry cohorts included 57 251 patients with RA (234 089 person-years)-24.5% men, mean (SD) baseline age 58.2 (13.8) and RA duration 8.2 (11.7) years. Standardised registry mortality rates (per 100 person-years) varied from 0.42 (CORRONA) to 0.80 (NOAR), with 0.60 for RCT patients. Myocardial infarction and major adverse cardiovascular events (MACE) rates ranged from 0.09 and 0.31 (IORRA) to 0.39 and 0.77 (SRR), with RCT rates intermediate (0.18 and 0.42), respectively. Additional subcohort analyses showed small and mostly consistent changes across registries, retaining reasonable consistency in rates across the Western registries. Additional standardisation for HAQ returned higher mortality and MACE registry rates. This coordinated approach to contextualising RA RCT safety data demonstrated reasonable differences and consistency in rates for mortality and CVD across registries, and comparable RCT rates, and may serve as a model method to supplement clinical trial analyses for drug development programmes. Published by the BMJ Publishing

Explaining the decline in coronary heart disease mortality rates in the Slovak Republic between 1993-2008.

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Marek Psota

Full Text Available Between the years 1993 and 2008, mortality rates from coronary heart disease (CHD in the Slovak Republic have decreased by almost one quarter. However, this was a smaller decline than in neighbouring countries. The aim of this modelling study was therefore to quantify the contributions of risk factor changes and the use of evidence-based medical therapies to the CHD mortality decline between 1993 and 2008.We identified, obtained and scrutinised the data required for the model. These data detailed trends in the major population cardiovascular risk factors (smoking, blood pressure, total cholesterol, diabetes prevalence, body mass index (BMI and physical activity levels, and also the uptake of all standard CHD treatments. The main data sources were official statistics (National Health Information Centre and Statistical Office of the Slovak Republic and national representative studies (AUDIT, SLOVAKS, SLOVASeZ, CINDI, EHES, EHIS. The previously validated IMPACT policy model was then used to combine and integrate these data with effect sizes from published meta-analyses quantifying the effectiveness of specific evidence-based treatments, and population-wide changes in cardiovascular risk factors. Results were expressed as deaths prevented or postponed (DPPs attributable to risk factor changes or treatments. Uncertainties were explored using sensitivity analyses.Between 1993 and 2008 age-adjusted CHD mortality rates in the Slovak Republic (SR decreased by 23% in men and 26% in women aged 25-74 years. This represented some 1820 fewer CHD deaths in 2008 than expected if mortality rates had not fallen. The IMPACT model explained 91% of this mortality decline. Approximately 50% of the decline was attributable to changes in acute phase and secondary prevention treatments, particularly acute and chronic treatments for heart failure (≈12%, acute coronary syndrome treatments (≈9% and secondary prevention following AMI and revascularisation (≈8

Explaining the decline in coronary heart disease mortality rates in the Slovak Republic between 1993-2008.

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Psota, Marek; Bandosz, Piotr; Gonçalvesová, Eva; Avdičová, Mária; Bucek Pšenková, Mária; Studenčan, Martin; Pekarčíková, Jarmila; Capewell, Simon; O'Flaherty, Martin

2018-01-01

Between the years 1993 and 2008, mortality rates from coronary heart disease (CHD) in the Slovak Republic have decreased by almost one quarter. However, this was a smaller decline than in neighbouring countries. The aim of this modelling study was therefore to quantify the contributions of risk factor changes and the use of evidence-based medical therapies to the CHD mortality decline between 1993 and 2008. We identified, obtained and scrutinised the data required for the model. These data detailed trends in the major population cardiovascular risk factors (smoking, blood pressure, total cholesterol, diabetes prevalence, body mass index (BMI) and physical activity levels), and also the uptake of all standard CHD treatments. The main data sources were official statistics (National Health Information Centre and Statistical Office of the Slovak Republic) and national representative studies (AUDIT, SLOVAKS, SLOVASeZ, CINDI, EHES, EHIS). The previously validated IMPACT policy model was then used to combine and integrate these data with effect sizes from published meta-analyses quantifying the effectiveness of specific evidence-based treatments, and population-wide changes in cardiovascular risk factors. Results were expressed as deaths prevented or postponed (DPPs) attributable to risk factor changes or treatments. Uncertainties were explored using sensitivity analyses. Between 1993 and 2008 age-adjusted CHD mortality rates in the Slovak Republic (SR) decreased by 23% in men and 26% in women aged 25-74 years. This represented some 1820 fewer CHD deaths in 2008 than expected if mortality rates had not fallen. The IMPACT model explained 91% of this mortality decline. Approximately 50% of the decline was attributable to changes in acute phase and secondary prevention treatments, particularly acute and chronic treatments for heart failure (≈12%), acute coronary syndrome treatments (≈9%) and secondary prevention following AMI and revascularisation (≈8%). Changes in CHD

Subclinical and overt thyroid dysfunction and risk of all-cause mortality and cardiovascular events

DEFF Research Database (Denmark)

Selmer, Christian; Olesen, Jonas Bjerring; Hansen, Morten Lock

2014-01-01

hypothyroidism with TSH of 5-10 mIU/L [IRR 0.92 (95% CI 0.86-0.98)]. CONCLUSIONS: Heart failure is the leading cause of an increased cardiovascular mortality in both overt and subclinical hyperthyroidism. Subclinical hypothyroidism with TSH 5-10 mIU/L might be associated with a lower risk of all-cause mortality....

Does exposure to aircraft noise increase the mortality from cardiovascular disease in the population living in the vicinity of airports? Results of an ecological study in France

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Anne-Sophie Evrard

2015-01-01

Full Text Available The impact of aircraft noise on health is of growing concern. We investigated the relationship between this exposure and mortality from cardiovascular disease, coronary heart disease, myocardial infarction, and stroke. We performed an ecological study on 161 communes (commune being the smallest administrative unit in France close to the following three major French airports: Paris-Charles de Gaulle, Lyon Saint-Exupéry, and Toulouse-Blagnac. The mortality data were provided by the French Center on Medical Causes of Death for the period 2007-2010. Based on the data provided by the French Civil Aviation Authority, a weighted average exposure to aircraft noise (L den AEI was computed at the commune level. A Poisson regression model with commune-specific random intercepts, adjusted for potential confounding factors including air pollution, was used to investigate the association between mortality rates and L den AEI. Positive associations were observed between L den AEI and mortality from cardiovascular disease [adjusted mortality rate ratio (MRR per 10 dB(A increase in L den AEI = 1.18; 95% confidence interval (CI: 1.11-1.25], coronary heart disease [MRR = 1.24 (1.12-1.36], and myocardial infarction [MRR = 1.28 (1.11-1.46]. Stroke mortality was more weakly associated with L den AEI [MRR = 1.08 (0.97-1.21]. These significant associations were not attenuated after the adjustment for air pollution. The present ecological study supports the hypothesis of an association between aircraft noise exposure and mortality from cardiovascular disease, coronary heart disease, and myocardial infarction. However, the potential for ecological bias and the possibility that this association could be due to residual confounding cannot be excluded.

HbA1c levels in non-diabetic older adults - No J-shaped associations with primary cardiovascular events, cardiovascular and all-cause mortality after adjustment for confounders in a meta-analysis of individual participant data from six cohort studies

NARCIS (Netherlands)

Schöttker, B.; Rathmann, W.; Herder, C.; Thorand, B.; Wilsgaard, T.; Feskens, E.J.M.; Trichopoulou, A.

2016-01-01

Background To determine the shape of the associations of HbA1c with mortality and cardiovascular outcomes in non-diabetic individuals and explore potential explanations. Methods The associations of HbA1c with all-cause mortality, cardiovascular mortality and primary cardiovascular events (myocardial

Effect modification of the association between temperature variability and daily cardiovascular mortality by air pollutants in three Chinese cities.

Science.gov (United States)

Luo, Kai; Li, Runkui; Wang, Zongshuang; Zhang, Ruiming; Xu, Qun

2017-11-01

There is limited evidence showing the mortality effects of temperature variability (TV) on cardiovascular diseases. The joint effects between TV and air pollutants are also less well-established. This study aims to assess the effect modification of TV-cardiovascular mortality by air pollutants in three Chinese cities (Beijing, Nanjing and Chengdu). Data of daily mortality, air pollutants and meteorological factors from 2008 to 2011 was collected from each city. TV was calculated as the standard deviation of daily maximum and minimum temperatures over exposure days. The city-specific effect estimates of TV on cardiovascular mortality were calculated using a quasi-Poisson regression model, adjusting for potential confounders (e.g., seasonality and temperature). An interaction term of TV and a three-level air pollutants stratum indicator was included in the models. Effect modifications by air pollutants were assessed by comparing the estimates of TV's effect between pollutant stratums and calculating the corresponding 95% confidential interval of the differences. Multivariate meta-analysis was conducted to obtain the pooled estimates. The data showed that TV was associated with increased risk of cardiovascular mortality, especially for longer TV exposure days (0-8 days, TV08). This association was still observed after adjusting for air pollutants on current day or the previous two days. Stronger estimates were observed in females, but no significant difference between males and females was detected, indicating the absence of evidence of effect modification by gender. Estimates of TV-cardiovascular mortality varied across two season periods (warm and cool season) and age groups, but the evidence of effect modification by age and seasons was absent. Regarding the effect modification of TV-cardiovascular mortality association by air pollutants, a significant effect modification was identified for PM 10, but not for NO 2 and SO 2 in the whole population for all TV

Radiation Exposure and Mortality from Cardiovascular Disease and Cancer in Early NASA Astronauts: Space for Exploration

Science.gov (United States)

Elgart, S. R.; Little, M. P.; Campbell, L. J.; Milder, C. M.; Shavers, M. R.; Huff, J. L.; Patel, Z. S.

2018-01-01

Of the many possible health challenges posed during extended exploratory missions to space, the effects of space radiation on cardiovascular disease and cancer are of particular concern. There are unique challenges to estimating those radiation risks; care and appropriate and rigorous methodology should be applied when considering small cohorts such as the NASA astronaut population. The objective of this work was to establish whether there is evidence for excess cardiovascular disease or cancer mortality in an early NASA astronaut cohort and determine if a correlation exists between space radiation exposure and mortality.

Vitamin D status and incident cardiovascular disease and all-cause mortality

DEFF Research Database (Denmark)

Skaaby, Tea; Husemoen, Lise Lotte Nystrup; Pisinger, Charlotta

2013-01-01

Low vitamin D status has been associated with cardiovascular disease (CVD) and mortality primarily in selected groups, smaller studies, or with self-reported vitamin D intake. We investigated the association of serum vitamin D status with the incidence of a registry-based diagnosis of ischemic...... heart disease (IHD), stroke, and all-cause mortality in a large sample of the general population. A total of 9,146 individuals from the two population-based studies, Monica10 and Inter99, were included. Measurements of serum 25-hydroxyvitamin D at baseline were carried out using the IDS ISYS immunoassay...

Increased cardiovascular mortality more than fifteen years after radiotherapy for breast cancer: a population-based study

International Nuclear Information System (INIS)

Roychoudhuri, Rahul; Robinson, David; Putcha, Venkata; Cuzick, Jack; Darby, Sarah; Møller, Henrik

2007-01-01

Breast radiotherapy as practised in the 1970s and 1980s resulted in significant myocardial exposure, and this was higher when the left breast was treated. It has been proposed that this difference might result in greater cardiovascular mortality following irradiation of the left breast when compared with the right. All cases of female breast cancer diagnosed between 1971 and 1988 and recorded on the Thames Cancer Registry database were followed up to the end of 2003 to identify cases who had died from ischaemic heart disease (IHD) or any cardiovascular disease (CVD). A proportional hazards regression analysis was performed, stratified by time since diagnosis, using as the baseline group those women with right-sided disease who did not receive radiotherapy, and adjusting for age at diagnosis. A total of 20,871 women with breast cancer were included in the analysis, of which 51% had left-sided disease. Mortality at 15+ years after diagnosis was increased in recipients of left-breast radiotherapy compared to non-irradiated women with right-sided breast cancer, both for IHD (hazard ratio 1.59; 95% confidence interval 1.21–2.08; p = 0.001) and all CVD (hazard ratio 1.27; 95% confidence interval 1.07–1.51; p = 0.006). When irradiated women with left-sided breast cancer were compared with irradiated women with right-sided breast cancer, cardiovascular mortality at 15+ years after diagnosis was raised by around 25% (IHD: hazard ratio 1.23; 95% confidence interval 0.95–1.60; p = 0.114; CVD: hazard ratio 1.25; 95% confidence interval 1.05–1.49; p = 0.014). We have found an elevation in cardiovascular mortality more than 15 years after breast radiotherapy in women diagnosed with breast cancer between 1971 and 1988. The risk was greater following irradiation of the left breast compared with the right. This confirms that radiotherapy as practised in the 1970s and 1980s has resulted in significant long-term cardiac toxicity. In absolute terms, the increase in

Effect of depression on mortality and cardiovascular morbidity in type 2 diabetes mellitus after 3 years follow up. The DIADEMA study protocol

Directory of Open Access Journals (Sweden)

de Burgos-Lunar Carmen

2012-07-01

Full Text Available Abstract Background Type 2 diabetes mellitus and depression are highly prevalent diseases that are associated with an increased risk of cardiovascular disease and mortality. There is evidence about a bidirectional association between depressive symptoms and type 2 diabetes mellitus. However, prognostic implications of the joint effects of these two diseases on cardiovascular morbidity and mortality are not well-known. Method/design A three-year, observational, prospective, cohort study, carried out in Primary Health Care Centres in Madrid (Spain. The project aims to analyze the effect of depression on cardiovascular events, all-cause and cardiovascular mortality in patients with type 2 diabetes mellitus, and to estimate a clinical predictive model of depression in these patients. The number of patients required is 3255, all them with type 2 diabetes mellitus, older than 18 years, who regularly visit their Primary Health Care Centres and agree to participate. They are chosen by simple random sampling from the list of patients with type 2 diabetes mellitus of each general practitioner. The main outcome measures are all-cause and cardiovascular mortality and cardiovascular morbidity; and exposure variable is the major depressive disorder. There will be a comparison between depressed and not depressed patients in all-cause mortality, cardiovascular mortality, coronary artery disease and stroke using the Chi-squared test. Logistic regression with random effects will be used to adjust for prognostic factors. Confounding factors that might alter the effect recorded will be taken into account in this analysis. To assess the effect of depression on the mortality, a survival analysis will be used comparing the two groups using the log-rank test. The control of potential confounding variables will be performed by the construction of a Cox regression model. Discussion Our study’s main contribution is to evaluate the increase in the risk of

Transferrin saturation ratio and risk of total and cardiovascular mortality in the general population.

LENUS (Irish Health Repository)

Stack, A G

2014-08-01

The transferrin saturation (TSAT) ratio is a commonly used indicator of iron deficiency and iron overload in clinical practice but precise relationships with total and cardiovascular mortality are unclear.

Excess cardiovascular mortality associated with cold spells in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Kyselý, Jan; Pokorná, Lucie; Kyncl, J.; Kříž, B.

2009-01-01

Roč. 9, 19 (2009), s. 1-11 ISSN 1471-2458 R&D Projects: GA ČR GA205/07/1254 Institutional research plan: CEZ:AV0Z30420517 Keywords : mortality * cardiovascular diseases * cold spells * age * central Europe Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 2.223, year: 2009 http://www.biomedcentral.com/1471-2458/9/19

Mortality Rates Among Arab Americans in Michigan

OpenAIRE

Dallo, Florence J.; Schwartz, Kendra; Ruterbusch, Julie J.; Booza, Jason; Williams, David R.

2012-01-01

The objectives of this study were to: (1) calculate age-specific and age-adjusted cause-specific mortality rates for Arab Americans; and (2) compare these rates with those for blacks and whites. Mortality rates were estimated using Michigan death certificate data, an Arab surname and first name list, and 2000 U.S. Census data. Age-specific rates, age-adjusted all-cause and cause-specific rates were calculated. Arab Americans (75+) had higher mortality rates than whites and blacks. Among men, ...

Mortality after percutaneous coronary revascularization: Prior cardiovascular risk factor control and improved outcomes in patients with diabetes mellitus.

Science.gov (United States)

Noman, Awsan; Balasubramaniam, Karthik; Alhous, M Hafez A; Lee, Kelvin; Jesudason, Peter; Rashid, Muhammad; Mamas, Mamas A; Zaman, Azfar G

2017-06-01

To assess the mortality in patients with diabetes mellitus (DM) following percutaneous coronary intervention (PCI) according to their insulin requirement and PCI setting (elective, urgent, and emergency). DM is a major risk factor to develop coronary artery disease (CAD). It is unclear if meticulous glycemic control and aggressive risk factor management in patients with DM has improved outcomes following PCI. Retrospective analysis of prospectively collected data on 9,224 patients treated with PCI at a regional tertiary center between 2008 and 2011. About 7,652 patients were nondiabetics (non-DM), 1,116 had non-insulin treated diabetes mellitus (NITDM) and 456 had ITDM. Multi-vessel coronary artery disease, renal impairment and non-coronary vascular disease were more prevalent in DM patients. Overall 30-day mortality rate was 2.4%. In a logistic regression model, the adjusted odds ratios (95% confidence intervals [CI]) for 30-day mortality were 1.28 (0.81-2.03, P = 0.34) in NITDM and 2.82 (1.61-4.94, P diabetes, this study reveals higher mortality only in insulin-treated diabetic patients following PCI for stable coronary artery disease and acute coronary syndrome. Importantly, diabetic patients with good risk factor control and managed on diet or oral hypoglycemics have similar outcomes to the non-diabetic population. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc. © 2016 The Authors Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

Cardiovascular diseases

International Nuclear Information System (INIS)

Kodama, Kazunori

1992-01-01

This paper is aimed to discuss the involvement of delayed radiation effects of A-bomb exposure in cardiovascular diseases. First, the relationship between radiation and cardiovascular diseases is reviewed in the literature. Animal experiments have confirmed the relationship between ionizing radiation and vascular lesions. There are many reports which describe ischemic heart disease, cervical and cerebrovascular diseases, and peripheral disease occurring after radiation therapy. The previous A-bomb survivor cohort studies, i.e., the RERF Life Span Study and Adult Health Study, have dealt with the mortality rate from cardiovascular diseases, the prevalence or incidence of cardiovascular diseases, pathological findings, clinical observation of arteriosclerosis, ECG abnormality, blood pressure abnormality, and cardiac function. The following findings have been suggested: (1) A-bomb exposure is likely to be involved in the mortality rate and incidence of ischemic heart disease and cerebrovascular diseases; (2) similarly, the involvement of A-bomb exposure is considered in the prevalence of the arch of aorta; (3) ECG abnormality corresponding to ischemic heart disease may reflect the involvement of A-bomb exposure. To confirm the above findings, further studies are required on the basis of more accurate information and the appropriate number of cohort samples. Little evidence has been presented for the correlation between A-bomb exposure and both rheumatic heart disease and congenital heart disease. (N.K.) 88 refs

Hurricane Sandy (New Jersey): Mortality Rates in the Following Month and Quarter.

Science.gov (United States)

Kim, Soyeon; Kulkarni, Prathit A; Rajan, Mangala; Thomas, Pauline; Tsai, Stella; Tan, Christina; Davidow, Amy

2017-08-01

To describe changes in mortality after Hurricane Sandy made landfall in New Jersey on October 29, 2012. We used electronic death records to describe changes in all-cause and cause-specific mortality overall, in persons aged 76 years or older, and by 3 Sandy impact levels for the month and quarter following Hurricane Sandy compared with the same periods in earlier years adjusted for trends. All-cause mortality increased 6% (95% confidence interval [CI] = 2%, 11%) for the month, 5%, 8%, and 12% by increasing Sandy impact level; and 7% (95% CI = 5%, 10%) for the quarter, 5%, 8%, and 15% by increasing Sandy impact level. In elderly persons, all-cause mortality rates increased 10% (95% CI = 5%, 15%) and 13% (95% CI = 10%, 16%) in the month and quarter, respectively. Deaths that were cardiovascular disease-related increased by 6% in both periods, noninfectious respiratory disease-related by 24% in the quarter, infection-related by 20% in the quarter, and unintentional injury-related by 23% in the month. Mortality increased, heterogeneous by cause, for both periods after Hurricane Sandy, particularly in communities more severely affected and in the elderly, who may benefit from supportive services.

Poverty Mapping Project: Global Subnational Infant Mortality Rates

Data.gov (United States)

National Aeronautics and Space Administration — The Global Subnational Infant Mortality Rates consists of estimates of infant mortality rates for the year 2000. The infant mortality rate for a region or country is...

GT-repeat polymorphism in the heme oxygenase-1 gene promoter is associated with cardiovascular mortality risk in an arsenic-exposed population in northeastern Taiwan

International Nuclear Information System (INIS)

Wu, Meei-Maan; Chiou, Hung-Yi; Chen, Chi-Ling; Wang, Yuan-Hung; Hsieh, Yi-Chen; Lien, Li-Ming; Lee, Te-Chang; Chen, Chien-Jen

2010-01-01

Inorganic arsenic has been associated with increased risk of atherosclerotic vascular disease and mortality in humans. A functional GT-repeat polymorphism in the heme oxygenase-1 (HO-1) gene promoter is inversely correlated with the development of coronary artery disease and restenosis after clinical angioplasty. The relationship of HO-1 genotype with arsenic-associated cardiovascular disease has not been studied. In this study, we evaluated the relationship between the HO-1 GT-repeat polymorphism and cardiovascular mortality in an arsenic-exposed population. A total of 504 study participants were followed up for a median of 10.7 years for occurrence of cardiovascular deaths (coronary heart disease, cerebrovascular disease, and peripheral arterial disease). Cardiovascular risk factors and DNA samples for determination of HO-1 GT repeats were obtained at recruitment. GT repeats variants were grouped into the S (< 27 repeats) or L allele (≥ 27 repeats). Relative mortality risk was estimated using Cox regression analysis, adjusted for competing risk of cancer and other causes. For the L/L, L/S, and S/S genotype groups, the crude mortalities for cardiovascular disease were 8.42, 3.10, and 2.85 cases/1000 person-years, respectively. After adjusting for conventional cardiovascular risk factors and competing risk of cancer and other causes, carriers with class S allele (L/S or S/S genotypes) had a significantly reduced risk of cardiovascular mortality compared to non-carriers (L/L genotype) [OR, 0.38; 95% CI, 0.16-0.90]. In contrast, no significant association was observed between HO-1 genotype and cancer mortality or mortality from other causes. Shorter (GT)n repeats in the HO-1 gene promoter may confer protective effects against cardiovascular mortality related to arsenic exposure.

Association of an inter-arm systolic blood pressure difference with all-cause and cardiovascular mortality: An updated meta-analysis of cohort studies.

Science.gov (United States)

Cao, Kaiwu; Xu, Jingsong; Shangguan, Qing; Hu, Weitong; Li, Ping; Cheng, Xiaoshu; Su, Hai

2015-01-01

To evaluate whether an association exists between an inter-arm systolic blood pressure difference (sIAD) and all-cause and cardiovascular mortality. We searched for cohort studies that evaluated the association of a sIAD and all-cause or cardiovascular mortality in the electronic databases Medline/PubMed and Embase (August 2014). Random effects models were used to calculate pooled hazard ratios (HRs) and 95% confidence intervals (CIs). Nine cohort studies (4 prospective and 5 retrospective) enrolling 15,617 participants were included. The pooled HR of all-cause mortality for a sIAD of ≥ 10 mm Hg was 1.53 (95% CI 1.14-2.06), and that for a sIAD of ≥ 15 mm Hg was 1.46 (1.13-1.88). Pooled HRs of cardiovascular mortality were 2.21 (95% CI 1.52-3.21) for a sIAD of ≥ 10mm Hg, and 1.89 (1.32-2.69) for a sIAD of ≥ 15 mm Hg. In the patient-based cohorts including hospital- and diabetes-based cohorts, both sIADs of ≥ 10 and ≥ 15 mm Hg were associated with increased all-cause (pooled HR 1.95, 95% CI 1.01-3.78 and 1.59, 1.06-2.38, respectively) and cardiovascular mortality (pooled HR 2.98, 95% CI 1.88-4.72 and 2.10, 1.07-4.13, respectively). In the community-based cohorts, however, only a sIAD of ≥ 15 mm Hg was associated with increased cardiovascular mortality (pooled HR 1.94, 95 % CI 1.12-3.35). In the patient populations, a sIAD of ≥ 10 or of ≥ 15 mm Hg could be a useful indictor for increased all-cause and cardiovascular mortality, and a sIAD of ≥ 15 mm Hg might help to predict increased cardiovascular mortality in the community populations. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Distribuição espacial da mortalidade por doenças cardiovasculares no Estado do Paraná, Brasil: 1989-1991 e 2006-2008 Spatial evolution of cardiovascular mortality in Paraná State, Brazil: 1989-1991 and 2006-2008

Directory of Open Access Journals (Sweden)

Erildo Vicente Muller

2012-06-01

Full Text Available Descrever a distribuição espacial da mortalidade por doença cardiovascular na população do Paraná, Brasil (1989-1991 e 2006-2008 e sua correlação com variáveis socioeconômicas. Trata-se de estudo ecológico, com dados de mortalidade e populacionais obtidos, respectivamente, do Departamento de Informática do SUS e do Instituto Brasileiro de Geografia e Estatística. As taxas de mortalidade foram ajustadas pela estimativa bayesiana empírica local. Utilizou-se o índice de Moran I e o coeficiente de Spearman na análise de correlação. Não foram observadas correlações significantes ou dependência espacial entre a mortalidade e as variáveis socioeconômicas. A magnitude da mortalidade foi maior no sexo masculino em ambos os triênios. A força de mortalidade por doenças cardiovasculares diminuiu entre 1989-1991 e 2006-2008, sendo maior no sexo feminino. A construção de mapas temáticos permitiu a visualização das macrorregionais com maior risco de ocorrência do agravo. A redução de mortalidade pode ser, em parte, explicada pelo maior acesso a serviços e pela melhoria das condições de vida e renda.This ecological study aimed to describe the spatial distribution of cardiovascular mortality in Paraná State, Brazil (1989-1991 and 2006-2008 and its correlation with socioeconomic variables, using mortality data from the DATASUS database and population data from IBGE. Mortality rates were adjusted by the local empirical Bayesian method. Correlation analysis used the Moran I index and Spearman coefficient. There were no significant correlations or spatial dependence between mortality and socioeconomic variables. Mortality was higher in males in both periods. Cardiovascular mortality declined from 1989-1991 to 2006-2008 and was higher in females. Construction of thematic maps allowed visualization of the regions with highest cardiovascular risk. The decrease in mortality can be partially explained by expanded access to health

Pulmonary Hypertension, Mortality, and Cardiovascular Disease in CKD and ESRD Patients: A Systematic Review and Meta-analysis.

Science.gov (United States)

Tang, Mengyao; Batty, Jonathan A; Lin, Chiayu; Fan, Xiaohong; Chan, Kevin E; Kalim, Sahir

2018-02-08

Pulmonary hypertension is common in patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD) and may be associated with poor outcomes. The magnitude of the association between pulmonary hypertension and mortality is uncertain due to the small size and variable findings of observational studies. Systematic review and meta-analysis of observational studies using subgroup analyses and metaregression. Patients with ESRD or earlier stages of CKD. Observational studies reporting clinical outcomes in patients with co-existing pulmonary hypertension and CKD or ESRD identified using a systematic search of PubMed and Embase. Pulmonary hypertension diagnosed by Doppler echocardiography. All-cause mortality, cardiovascular mortality, and cardiovascular events. 16 studies, with 7,112 patients with an overall pulmonary hypertension prevalence of 23%, were included. Pulmonary hypertension was associated with increased risk for all-cause mortality among patients with CKD (relative risk [RR], 1.44; 95% CI, 1.17-1.76), with ESRD receiving maintenance dialysis (RR, 2.32; 95% CI, 1.91-2.83), and with a functioning kidney transplant (RR, 2.08; 95% CI, 1.35-3.20). Pulmonary hypertension was associated with increased risk for cardiovascular events in patients with CKD (RR, 1.67; 95% CI, 1.07-2.60) and ESRD receiving dialysis (RR, 2.33; 95% CI, 1.76-3.08). There was an association between pulmonary hypertension and increased risk for cardiovascular mortality in patients with CKD or ESRD (RR, 2.20; 95% CI, 1.53-3.15). Heterogeneity of included studies, possibility of residual confounding, unavailability of individual patient-level data, and possibility of outcome reporting bias. Pulmonary hypertension is associated with a substantially increased risk for death and cardiovascular events in patients with CKD and ESRD. Risk is higher in patients with ESRD receiving dialysis compared with patients with CKD stages 1 to 5. Understanding the effect of interventions to lower

Contribution of lifetime smoking habit in France and Northern Ireland to country and socioeconomic differentials in mortality and cardiovascular incidence: the PRIME Study.

Science.gov (United States)

Yarnell, J W G; Patterson, C C; Arveiler, D; Amouyel, P; Ferrières, J; Woodside, J V; Haas, B; Montaye, M; Ruidavets, J B; Kee, F; Evans, A; Bingham, A; Ducimetière, P

2012-07-01

This study examines the contribution of lifetime smoking habit to the socioeconomic gradient in all-cause and smoking-related mortality and in cardiovascular incidence in two countries. 10,600 men aged 50-59 years were examined in 1991-4 in centres in Northern Ireland and France and followed annually for 10 years. Deaths and cardiovascular events were documented. Current smoking habit, lifetime smoking (pack-years) and other health behaviours were evaluated at baseline. As socio-occupational coding schemes differ between the countries seven proxy socioeconomic indicators were used. Lifetime smoking habit showed marked associations with most socioeconomic indicators in both countries, but lifetime smoking was more than 10 pack-years greater overall in Northern Ireland and smoking patterns differed. Total mortality was 49% higher in Northern Ireland than in France, and smoking-related mortality and cardiovascular incidence were 93% and 92% higher, respectively. Both lifetime smoking and fibrinogen contributed independently to these differentials, but together explained only 42% of the difference in total mortality between countries, adjusted for both biological and lifestyle confounders. Socioeconomic gradients were steeper for total and smoking-related mortality than for cardiovascular incidence. Residual contributions of lifetime smoking habit ranged from 6% to 34% for the seven proxy indicators of socioeconomic position for total and smoking-related mortality. Socioeconomic gradients in cardiovascular incidence were minimal following adjustment for confounders. In Northern Ireland and France lifetime smoking appeared to explain a significant part of the gradients in total and smoking-related mortality between socioeconomic groups, but the contribution of smoking was generally small for cardiovascular incidence.

Association between micronuclei frequency in pollen mother cells of Tradescantia and mortality due to cancer and cardiovascular diseases: A preliminary study in Sao Jose dos Campos, Brazil

International Nuclear Information System (INIS)

Mariani, Rauda Lucia; Martins Jorge, Maria Paulete; Pereira, Sergio Silva; Melione, Luiz Paulo; Carvalho-Oliveira, Regiani; Ma, Te Hsiu; Nascimento Saldiva, Paulo Hilario

2009-01-01

The present study was designed to explore the correlation between the frequency of micronuclei in Trad-MN, measured across 28 biomonitoring stations during the period comprised between 11 of May and 2 of October, 2006, and adjusted mortality rates due to cardiovascular, respiratory diseases and cancer in Sao Jose dos Campos, Brazil, an area with different sources of air pollution. For controlling purposes, mortality rate due to gastrointestinal diseases (an event less prone to be affected by air pollution) was also considered in the analysis. Spatial distribution of micronuclei frequency was determined using average interpolation. The association between health estimators and micronuclei frequency was determined by measures of Pearson's correlation. Higher frequencies of micronuclei were detected in areas with high traffic and close to a petrochemical pole. Significant associations were detected between micronuclei frequency and adjusted mortality rate due to cardiovascular diseases (r = 0.841, p = 0.036) and cancer (r = 0.890, p = 0.018). The association between mortality due to chronic obstructive pulmonary diseases was positive but did not reach statistical significance (r = 0.640, p = 0.172), probably because of the small number of events. Gastrointestinal mortality did not exhibit significant association with micronuclei frequency. Because the small number of observations and the nature of an ecological study, the present findings must be considered with caution and considered as preliminary. Further studies, performed in different conditions of contamination and climate should be done before considering Trad-MN in the evaluation of human health risk imposed by air pollutants. - Bioassay used to explore the correlation between air pollution exposition and mortality rates.

Noncommunicable Diseases: Three Decades Of Global Data Show A Mixture Of Increases And Decreases In Mortality Rates.

Science.gov (United States)

Ali, Mohammed K; Jaacks, Lindsay M; Kowalski, Alysse J; Siegel, Karen R; Ezzati, Majid

2015-09-01

Noncommunicable diseases are the leading health concerns of the modern era, accounting for two-thirds of global deaths, half of all disability, and rapidly growing costs. To provide a contemporary overview of the burdens caused by noncommunicable diseases, we compiled mortality data reported by authorities in forty-nine countries for atherosclerotic cardiovascular diseases; diabetes; chronic respiratory diseases; and lung, colon, breast, cervical, liver, and stomach cancers. From 1980 to 2012, on average across all countries, mortality for cardiovascular disease, stomach cancer, and cervical cancer declined, while mortality for diabetes, liver cancer, and female chronic respiratory disease and lung cancer increased. In contrast to the relatively steep cardiovascular and cancer mortality declines observed in high-income countries, mortality for cardiovascular disease and chronic respiratory disease was flat in most low- and middle-income countries, which also experienced increasing breast and colon cancer mortality. These divergent mortality patterns likely reflect differences in timing and magnitude of risk exposures, health care, and policies to counteract the diseases. Improving both the coverage and the accuracy of mortality documentation in populous low- and middle-income countries is a priority, as is the need to rigorously evaluate societal-level interventions. Furthermore, given the complex, chronic, and progressive nature of noncommunicable diseases, policies and programs to prevent and control them need to be multifaceted and long-term, as returns on investment accrue with time. Project HOPE—The People-to-People Health Foundation, Inc.

Association of Selected Antipsychotic Agents With Major Adverse Cardiovascular Events and Noncardiovascular Mortality in Elderly Persons

DEFF Research Database (Denmark)

Sahlberg, Marie; Holm, Ellen; Gislason, Gunnar H

2015-01-01

events and noncardiovascular mortality associated with individual APs (ziprasidone, olanzapine, risperidone, quetiapine, levomepromazine, chlorprothixen, flupentixol, and haloperidol) in Danish treatment-naïve patients aged ≥70 years. METHODS AND RESULTS: We followed all treatment-naïve Danish citizens...... of treatment, compared with risperidone, incidence rate ratios of major adverse cardiovascular events were higher with use of levomepromazine (3.80, 95% CI 3.43 to 4.21) and haloperidol (1.85, 95% CI 1.67 to 2.05) and lower for treatment with flupentixol (0.54, 95% CI 0.45 to 0.66), ziprasidone (0.31, 95% CI 0...

Milk and dairy consumption and risk of cardiovascular diseases and all-cause mortality

NARCIS (Netherlands)

Guo, Jing; Astrup, Arne; Lovegrove, Julie A.; Gijsbers, Lieke; Givens, David I.; Soedamah-Muthu, Sabita S.

2017-01-01

With a growing number of prospective cohort studies, an updated dose–response meta-analysis of milk and dairy products with all-cause mortality, coronary heart disease (CHD) or cardiovascular disease (CVD) have been conducted. PubMed, Embase and Scopus were searched for articles published up to

Mortality from heart attack in Belgrade population during the period 1990-2004

Directory of Open Access Journals (Sweden)

Ratkov Isidora

2008-01-01

Full Text Available INTRODUCTION In most countries, cardiovascular diseases are the leading disorders, with ischemic heart diseases being the leading cause of death. According to WHO data, every year about 17 million people die of cardiovascular diseases, which is 30% of all deaths. Ischemic heart diseases contribute from one-third to one-half of all deaths due to cardiovascular diseases. Three point eight million men and 3.4 million women in the world die every year from ischemic heart diseases, and in Europe about 2 million. The highest mortality rate from ischemic heart diseases occurs in India, China and Russia. OBJECTIVE The aim of this descriptive epidemiological study was to determine heart attack mortality in Belgrade population during the period 1990-2004. METHOD In the study, we conducted investigation of Belgrade population during the period 1990-2004. Mortality data were obtained from the city institution for statistics. The mortality rates were calculated based on the total Belgrade population obtained from the mean values for the last two register years (1991 and 2002. The mortality rates were standardized using the direct method of standardization according to the world (Segi standard population. RESULTS In the Belgrade population during the period 1990-2004, the participation of mortality rate due to heart attack among deaths from cardiovascular diseases was 17% in males and 10% in females. In Belgrade male population, mean standardized mortality rates (per 100,000 habitants were 50.5 for heart attack, 8.3 for chronic ischemic heart diseases and 4.6 for angina pectoris, while in females the rates were 30.8, 6.7 and 4.2, respectively. Mortality from ischemic heart diseases and from heart attack was higher in males than in females. During the studied 15-year period, on average 755 males and 483 females died due to heart attack every year. Mean standardized mortality rates per 100,000 habitants were 50.0 in male and 31.1 in female population. Males

Lifetime trauma exposure and prospective cardiovascular events and all-cause mortality: findings from the Heart and Soul Study.

Science.gov (United States)

Hendrickson, Carolyn M; Neylan, Thomas C; Na, Beeya; Regan, Mathilda; Zhang, Qian; Cohen, Beth E

2013-01-01

Little is known about the effect of cumulative psychological trauma on health outcomes in patients with cardiovascular disease. The objective of this study was to prospectively examine the association between lifetime trauma exposure and recurrent cardiovascular events or all-cause mortality in patients with existing cardiovascular disease. A total of 1021 men and women with cardiovascular disease were recruited in 2000 to 2002 and followed annually. Trauma history and psychiatric comorbidities were assessed at baseline using the Computerized Diagnostic Interview Schedule for DSM-IV. Health behaviors were assessed using standardized questionnaires. Outcome data were collected annually, and all medical records were reviewed by two independent, blinded physician adjudicators. We used Cox proportional hazards models to evaluate the association between lifetime trauma exposure and the composite outcome of cardiovascular events and all-cause mortality. During an average of 7.5 years of follow-up, there were 503 cardiovascular events and deaths. Compared with the 251 participants in the lowest trauma exposure quartile, the 256 participants in the highest exposure quartile had a 38% greater risk of adverse outcomes (hazard ratio = 1.38, 95% confidence interval = 1.06-1.81), adjusted for age, sex, race, income, education, depression, posttraumatic stress disorder, generalized anxiety disorder, smoking, physical inactivity, and illicit drug abuse. Cumulative exposure to psychological trauma was associated with an increased risk of recurrent cardiovascular events and mortality, independent of psychiatric comorbidities and health behaviors. These data add to a growing literature showing enduring effects of repeated trauma exposure on health that are independent of trauma-related psychiatric disorders such as depression and posttraumatic stress disorder.

No modifying effect of education level on the association between lifestyle behaviors and cardiovascular mortality: the Japan Collaborative Cohort Study

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Eguchi, Eri; Iso, Hiroyasu; Honjo, Kaori; Yatsuya, Hiroshi; Tamakoshi, Akiko

2017-01-01

We examined the effect of education level on the association between healthy lifestyle behaviors and cardiovascular mortality in the Japanese population. A total of 42,647 community-based men and women aged 40–79 years were enrolled at baseline (1988–1990), followed through 2009. The components of the healthy lifestyle score included the intake of fruits, fish, and milk; body mass index; exercise; avoidance of smoking; moderate alcohol intake; and moderate sleep duration. During the 19.3 years of follow-up, 8,314 all-cause and 2,377 total cardiovascular mortality cases were noted. Inverse associations were observed between healthy lifestyle scores and total cardiovascular disease (CVD) for both the lower and higher education level groups. Multivariable hazard ratios (95% confidence interval) for CVD mortality from the highest to the lowest healthy lifestyle scores, and the population attributable fraction (95% CIs) without healthy lifestyle scores of 7–8 were 0.51 (0.33–0.52) and 42% (24–58%), and 0.38 (0.27–0.47) and 55% (36–69%) for the higher and lower education levels, respectively. Our findings suggest that the association between higher CVD mortality and lower education level can be explained by the individuals’ lower adherence to a healthy lifestyle; hence, lifestyle modification would be beneficial for the prevention of cardiovascular mortality, irrespective of the education level. PMID:28057921

Effect of small-dose levosimendan on mortality rates and organ functions in Chinese elderly patients with sepsis

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Wang X

2017-05-01

Full Text Available Xin Wang,1,* Shikui Li2,* 1Intensive Care Unit, 2Cardiothoracic Surgery, Daqing Oilfield General Hospital, Daqing, Heilongjiang, People’s Republic of China *These authors contributed equally to this work Aim: As a primary cause of death not only in Western countries but also in the People’s Republic of China, sepsis is diagnosed as abnormal organ functions as a result of a disordered response to a severe infection. This study was designed to assess the effect of small-dose levosimendan without a loading dose on mortality rates and organ functions in Chinese elderly patients with sepsis.Methods: Following a prospective, randomized, and double-blinded design, 240 Chinese elderly patients with sepsis shock were admitted to the intensive care unit (ICU. All patients were randomly and evenly assigned into a levosimendan group (number of patients =120 and a control group (number of patients =120. The control group underwent standard care, and the levosimendan group was administered levosimendan in addition to standard care.Results: All participants, comprising 134 males (55.8% and 106 females (44.2%, were 70 (67–73 years old. Baseline characteristics, preexisting illnesses, initial infections, organ failures, and additional agents and therapies showed no significant difference between the two groups (P>0.05 for all. There were no significant differences in mortality rates at 28 days, at ICU discharge, and at hospital discharge between the two groups (P>0.05 for all. The number of days of ICU and hospital stay in the levosimendan group was significantly less than for those in the control group (P<0.05 for all. Mean daily total sequential organ failure assessment score and all organ scores except the cardiovascular scores showed no significant difference between the two groups (P>0.05 for all. Cardiovascular scores in the levosimendan group were significantly higher than those in the control group (P<0.05 for all.Conclusion: Small

Prognostic factors of congenital diaphragmatic hernia accompanied by cardiovascular malformation.

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Takahashi, Shigehiro; Sago, Haruhiko; Kanamori, Yutaka; Hayakawa, Masahiro; Okuyama, Hiroomi; Inamura, Noboru; Fujino, Yuji; Usui, Noriaki; Taguchi, Tomoaki

2013-08-01

Congenital diaphragmatic hernia is associated with cardiovascular malformation. Many prognostic factors have been identified for isolated congenital diaphragmatic hernia; however, reports of concurrent congenital diaphragmatic hernia and cardiovascular malformation in infants are limited. This study evaluated congenital diaphragmatic hernia associated with cardiovascular malformation in infants. Factors associated with prognosis for patients were also identified. This retrospective cohort study was based on a Japanese survey of congenital diaphragmatic hernia patients between 2006 and 2010. Frequency and outcome of cardiovascular malformation among infants with congenital diaphragmatic hernia were examined. Severity of congenital diaphragmatic hernia and cardiovascular malformation were compared as predictors of mortality and morbidity. Cardiovascular malformation was identified in 76 (12.3%) of 614 infants with congenital diaphragmatic hernia. Mild cardiovascular malformation was detected in 19 (33.9%) and severe cardiovascular malformation in 37 (66.1%). Their overall survival rate at discharge was 46.4%, and the survival rate without morbidity was 23.2%. Mortality and morbidity at discharge were more strongly associated with severity of cardiovascular malformation (adjusted OR 7.69, 95%CI 1.96-30.27; adjusted OR 7.93, 95%CI 1.76-35.79, respectively) than with severity of congenital diaphragmatic hernia. The prognosis for infants with both congenital diaphragmatic hernia and cardiovascular malformation remains poor. Severity of cardiovascular malformation is a more important predictive factor for mortality and morbidity than severity of congenital diaphragmatic hernia. © 2013 The Authors. Pediatrics International © 2013 Japan Pediatric Society.

Spatial patterns of heat-related cardiovascular mortality in the Czech Republic

Czech Academy of Sciences Publication Activity Database

Urban, Aleš; Burkart, K.; Kyselý, Jan; Schuster, Ch.; Plavcová, Eva; Hanzlíková, Hana; Štěpánek, Petr; Lakes, T.

2016-01-01

Roč. 13, č. 3 (2016), č. článku 284. ISSN 1660-4601 R&D Projects: GA ČR(CZ) GAP209/11/1985 Institutional support: RVO:68378289 ; RVO:67179843 Keywords : heat stress * mortality * socioeconomic status * spatial differences * cardiovascular disease Subject RIV: DG - Athmosphere Sciences, Meteorology; DG - Athmosphere Sciences, Meteorology (UEK-B) Impact factor: 2.101, year: 2016 http://www.mdpi.com/1660-4601/13/3/284

Risk assessment for cardiovascular and respiratory mortality due to air pollution and synoptic meteorology in 10 Canadian cities.

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Vanos, Jennifer K; Hebbern, Christopher; Cakmak, Sabit

2014-02-01

Synoptic weather and ambient air quality synergistically influence human health. We report the relative risk of mortality from all non-accidental, respiratory-, and cardiovascular-related causes, associated with exposure to four air pollutants, by weather type and season, in 10 major Canadian cities for 1981 through 1999. We conducted this multi-city time-series study using Poisson generalized linear models stratified by season and each of six distinctive synoptic weather types. Statistically significant relationships of mortality due to short-term exposure to carbon monoxide, nitrogen dioxide, sulphur dioxide, and ozone were found, with significant modifications of risk by weather type, season, and mortality cause. In total, 61% of the respiratory-related mortality relative risk estimates were significantly higher than for cardiovascular-related mortality. The combined effect of weather and air pollution is greatest when tropical-type weather is present in the spring or summer. Crown Copyright © 2013. Published by Elsevier Ltd. All rights reserved.

Established risk factors account for most of the racial differences in cardiovascular disease mortality.

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Sean O Henderson

Full Text Available BACKGROUND: Cardiovascular disease (CVD mortality varies across racial and ethnic groups in the U.S., and the extent that known risk factors can explain the differences has not been extensively explored. METHODS: We examined the risk of dying from acute myocardial infarction (AMI and other heart disease (OHD among 139,406 African-American (AA, Native Hawaiian (NH, Japanese-American (JA, Latino and White men and women initially free from cardiovascular disease followed prospectively between 1993-1996 and 2003 in the Multiethnic Cohort Study (MEC. During this period, 946 deaths from AMI and 2,323 deaths from OHD were observed. Relative risks of AMI and OHD mortality were calculated accounting for established CVD risk factors: body mass index (BMI, hypertension, diabetes, smoking, alcohol consumption, amount of vigorous physical activity, educational level, diet and, for women, type and age at menopause and hormone replacement therapy (HRT use. RESULTS: Established CVD risk factors explained much of the observed racial and ethnic differences in risk of AMI and OHD mortality. After adjustment, NH men and women had greater risks of OHD than Whites (69% excess, P<0.001 and 62% excess, P = 0.003, respectively, and AA women had greater risks of AMI (48% excess, P = 0.01 and OHD (35% excess, P = 0.007. JA men had lower risks of AMI (51% deficit, P<0.001 and OHD (27% deficit, P = 0.001, as did JA women (AMI, 37% deficit, P = 0.03; OHD, 40% deficit, P = 0.001. Latinos had underlying lower risk of AMI death (26% deficit in men and 35% in women, P = 0.03. CONCLUSION: Known risk factors explain the majority of racial and ethnic differences in mortality due to AMI and OHD. The unexplained excess in NH and AA and the deficits in JA suggest the presence of unmeasured determinants for cardiovascular mortality that are distributed unequally across these populations.

Cardiovascular Risk Factors and 5-year Mortality in the Copenhagen Stroke Study

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Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

2005-01-01

population. METHODS: We studied 905 ischemic stroke patients from the community-based Copenhagen Stroke Study. Patients had a CT scan and stroke severity was measured by the Scandinavian Stroke Scale on admission. A comprehensive evaluation was performed by a standardized medical examination...... and questionnaire for cardiovascular risk factors, age, and sex. Follow-up was performed 5 years after stroke, and data on mortality were obtained for all, except 6, who had left the country. Five-year mortality was calculated by the Kaplan-Meier procedure and the influence of multiple predictors was analyzed...... by Cox proportional hazards analyses adjusted for age, gender, stroke severity, and risk factor profile. RESULTS: In Kaplan-Meier analyses atrial fibrillation (AF), ischemic heart disease, diabetes, and previous stroke were associated with increased mortality, while smoking and alcohol intake were...

Cardiovascular risk factors and 5-year mortality in the Copenhagen Stroke Study

DEFF Research Database (Denmark)

Kammersgaard, Lars Peter; Olsen, Tom Skyhøj

2005-01-01

population. METHODS: We studied 905 ischemic stroke patients from the community-based Copenhagen Stroke Study. Patients had a CT scan and stroke severity was measured by the Scandinavian Stroke Scale on admission. A comprehensive evaluation was performed by a standardized medical examination...... and questionnaire for cardiovascular risk factors, age, and sex. Follow-up was performed 5 years after stroke, and data on mortality were obtained for all, except 6, who had left the country. Five-year mortality was calculated by the Kaplan-Meier procedure and the influence of multiple predictors was analyzed...... by Cox proportional hazards analyses adjusted for age, gender, stroke severity, and risk factor profile. RESULTS: In Kaplan-Meier analyses atrial fibrillation (AF), ischemic heart disease, diabetes, and previous stroke were associated with increased mortality, while smoking and alcohol intake were...

The effect of adherence to statin therapy on cardiovascular mortality: quantification of unmeasured bias using falsification end-points

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Maarten J. Bijlsma

2016-04-01

Full Text Available Abstract Background To determine the clinical effectiveness of statins on cardiovascular mortality in practice, observational studies are needed. Control for confounding is essential in any observational study. Falsification end-points may be useful to determine if bias is present after adjustment has taken place. Methods We followed starters on statin therapy in the Netherlands aged 46 to 100 years over the period 1996 to 2012, from initiation of statin therapy until cardiovascular mortality or censoring. Within this group (n = 49,688, up to 16 years of follow-up, we estimated the effect of adherence to statin therapy (0 = completely non-adherent, 1 = fully adherent on ischemic heart diseases and cerebrovascular disease (ICD10-codes I20-I25 and I60-I69 as well as respiratory and endocrine disease mortality (ICD10-codes J00-J99 and E00-E90 as falsification end points, controlling for demographic factors, socio-economic factors, birth cohort, adherence to other cardiovascular medications, and diabetes using time-varying Cox regression models. Results Falsification end-points indicated that a simpler model was less biased than a model with more controls. Adherence to statins appeared to be protective against cardiovascular mortality (HR: 0.70, 95 % CI 0.61 to 0.81. Conclusions Falsification end-points helped detect overadjustment bias or bias due to competing risks, and thereby proved to be a useful technique in such a complex setting.

Social capital, mortality, cardiovascular events and cancer: a systematic review of prospective studies.

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Choi, Minkyoung; Mesa-Frias, Marco; Nuesch, Eveline; Hargreaves, James; Prieto-Merino, David; Bowling, Ann; Snith, G Davey; Ebrahim, Shah; Dale, Caroline; Casas, Juan P

2014-12-01

Social capital is considered to be an important determinant of life expectancy and cardiovascular health. Evidence on the association between social capital and all-cause mortality, cardiovascular disease (CVD) and cancer was systematically reviewed. Prospective studies examining the association of social capital with these outcomes were systematically sought in Medline, Embase and PsycInfo, all from inception to 8 October 2012. We categorized the findings from studies according to seven dimensions of social capital, including social participation, social network, civic participation,social support, trust, norm of reciprocity and sense of community, and pooled the estimates across studies to obtain summary relative risks of the health outcomes for each social capital dimension. We excluded studies focusing on children, refugees or immigrants and studies conducted in the former Soviet Union. Fourteen prospective studies were identified. The pooled estimates showed no association between most social capital dimensions and all-cause mortality, CVD or cancer. Limited evidence was found for association of increased mortality with social participation and civic participation when comparing the most extreme risk comparisons. Evidence to support an association between social capital and health outcomes is limited. Lack of consensus on measurements for social capital hinders the comparability of studies and weakens the evidence base.

Coffee intake, cardiovascular disease and all-cause mortality: observational and Mendelian randomization analyses in 95 000-223 000 individuals.

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Nordestgaard, Ask Tybjærg; Nordestgaard, Børge Grønne

2016-12-01

Coffee has been associated with modestly lower risk of cardiovascular disease and all-cause mortality in meta-analyses; however, it is unclear whether these are causal associations. We tested first whether coffee intake is associated with cardiovascular disease and all-cause mortality observationally; second, whether genetic variations previously associated with caffeine intake are associated with coffee intake; and third, whether the genetic variations are associated with cardiovascular disease and all-cause mortality. First, we used multivariable adjusted Cox proportional hazard regression models evaluated with restricted cubic splines to examine observational associations in 95 366 White Danes. Second, we estimated mean coffee intake according to five genetic variations near the AHR (rs4410790; rs6968865) and CYP1A1/2 genes (rs2470893; rs2472297; rs2472299). Third, we used sex- and age adjusted Cox proportional hazard regression models to examine genetic associations with cardiovascular disease and all-cause mortality in 112 509 Danes. Finally, we used sex and age-adjusted logistic regression models to examine genetic associations with ischaemic heart disease including the Cardiogram and C4D consortia in a total of up to 223 414 individuals. We applied similar analyses to ApoE genotypes associated with plasma cholesterol levels, as a positive control. In observational analyses, we observed U-shaped associations between coffee intake and cardiovascular disease and all-cause mortality; lowest risks were observed in individuals with medium coffee intake. Caffeine intake allele score (rs4410790 + rs2470893) was associated with a 42% higher coffee intake. Hazard ratios per caffeine intake allele were 1.02 (95% confidence interval: 1.00-1.03) for ischaemic heart disease, 1.02 (0.99-1.02) for ischaemic stroke, 1.02 (1.00-1.03) for ischaemic vascular disease, 1.02 (0.99-1.06) for cardiovascular mortality and 1.01 (0.99-1.03) for all-cause mortality. Including

Dietary Patterns Are Associated with Cardiovascular and Cancer Mortality among Swiss Adults in a Census-Linked Cohort

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Jean-Philippe Krieger

2018-03-01

Full Text Available Defining dietary guidelines requires a quantitative assessment of the influence of diet on the development of diseases. The aim of the study was to investigate how dietary patterns were associated with mortality in a general population sample of Switzerland. We included 15,936 participants from two population-based studies (National Research Program 1A (NRP1A and Monitoring of Trends and Determinants in Cardiovascular Disease (MONICA—1977 to 1993 who fully answered a simplified 24-h dietary recall. Mortality data were available through anonymous record linkage with the Swiss National Cohort (follow-up of up to 37.9 years. Multiple correspondence analysis and hierarchical clustering were used to define data-driven qualitative dietary patterns. Mortality hazard ratios were calculated for all-cause, cancer and cardiovascular mortality using Cox regression. Two patterns were characterized by a low dietary variety (“Sausage and Vegetables”, “Meat and Salad”, two by a higher variety (“Traditional”, “High-fiber foods” and one by a high fish intake (“Fish”. Males with unhealthy lifestyle (smokers, low physical activity and high alcohol intake were overrepresented in the low-variety patterns and underrepresented in the high-variety and “Fish” patterns. In multivariable-adjusted models, the “Fish” (hazard ratio = 0.82, 95% CI (0.68–0.99 and “High-fiber foods” (0.85 (0.72–1.00 patterns were associated with lower cancer mortality. In men, the “Fish” (0.73 (0.55–0.97 and “Traditional” (0.76 (0.59–0.98 patterns were associated with lower cardiovascular mortality. In summary, our results support the notion that dietary patterns affect mortality and that these patterns strongly cluster with other health determinants.

[The standardized mortality numbers of patients with gastrointestinal tumors and cardiovascular diseases in four wine regions and in one not-wine region of Hungary between 2000-2010].

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Nagy, János; Sipka, Sándor; Kocsis, Judit; Horváth, Zsolt

2017-06-01

Eating habits act on mortalities from gastrointestinal tumors and cardiovascular diseases. To investigate the role of wine drinking on these mortalities in Hungary. The standardized mortality data of people from 206,159 subjects died of gastrointestinal tumors and cardiovascular diseases between 2000-2010 were compared in four wine regions: Tokaj (white), Eger (red), Balaton (white), Szekszárd/Villány (red) and in Hódmezővásárhely (not-wine region). The significantly smallest number of tumors (664) occurred in Tokaj, but the cardiovascular mortality here was the highest (5955). On the other hand, the fewest cardiovascular mortality occurred in Szekszárd/Villány (3907), but showing here (831) and in Eger (934) the highest values of tumor death. The protective effect of red wine on cardiovascular mortality was verified. Surprisingly, the low value of gastrointestinal mortality in "Tokaj" - besides the higher level of selenium in tap water - shows some hidden features of these white wines. Orv Hetil. 2017; 158(25): 992-998.

Mortality trends among Japanese dialysis patients, 1988-2013: a joinpoint regression analysis.

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Wakasugi, Minako; Kazama, Junichiro James; Narita, Ichiei

2016-09-01

Evaluation of mortality trends in dialysis patients is important for improving their prognoses. The present study aimed to examine temporal trends in deaths (all-cause, cardiovascular, noncardiovascular and the five leading causes) among Japanese dialysis patients. Mortality data were extracted from the Japanese Society of Dialysis Therapy registry. Age-standardized mortality rates were calculated by direct standardization against the 2013 dialysis population. The average annual percentage of change (APC) and the corresponding 95% confidence interval (CI) were computed for trends using joinpoint regression analysis. A total of 469 324 deaths occurred, of which 25.9% were from cardiac failure, 17.5% from infectious disease, 10.2% from cerebrovascular disorders, 8.6% from malignant tumors and 5.6% from cardiac infarction. The joinpoint trend for all-cause mortality decreased significantly, by -3.7% (95% CI -4.2 to -3.2) per year from 1988 through 2000, then decreased more gradually, by -1.4% (95% CI -1.7 to -1.2) per year during 2000-13. The improved mortality rates were mainly due to decreased deaths from cardiovascular disease, with mortality rates due to noncardiovascular disease outnumbering those of cardiovascular disease in the last decade. Among the top five causes of death, cardiac failure has shown a marked decrease in mortality rate. However, the rates due to infectious disease have remained stable during the study period [APC 0.1 (95% CI -0.2-0.3)]. Significant progress has been made, particularly with regard to the decrease in age-standardized mortality rates. The risk of cardiovascular death has decreased, while the risk of death from infection has remained unchanged for 25 years. © The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Does IQ explain socio-economic differentials in total and cardiovascular disease mortality? Comparison with the explanatory power of traditional cardiovascular disease risk factors in the Vietnam Experience Study

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Batty, G David; Shipley, Martin J; Dundas, Ruth

2009-01-01

The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance in this ......The aim of this study was to examine the explanatory power of intelligence (IQ) compared with traditional cardiovascular disease (CVD) risk factors in the relationship of socio-economic disadvantage with total and CVD mortality, that is the extent to which IQ may account for the variance...

Exercise-induced hypertension, cardiovascular events, and mortality in patients undergoing exercise stress testing: a systematic review and meta-analysis.

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Schultz, Martin G; Otahal, Petr; Cleland, Verity J; Blizzard, Leigh; Marwick, Thomas H; Sharman, James E

2013-03-01

The prognostic relevance of a hypertensive response to exercise (HRE) is ill-defined in individuals undergoing exercise stress testing. The study described here was intended to provide a systematic review and meta-analysis of published literature to determine the value of exercise-related blood pressure (BP) (independent of office BP) for predicting cardiovascular (CV) events and mortality. Online databases were searched for published longitudinal studies reporting exercise-related BP and CV events and mortality rates. We identified for review 12 longitudinal studies with a total of 46,314 individuals without significant coronary artery disease, with total CV event and mortality rates recorded over a mean follow-up of 15.2±4.0 years. After adjustment for age, office BP, and CV risk factors, an HRE at moderate exercise intensity carried a 36% greater rate of CV events and mortality (95% CI, 1.02-1.83, P = 0.039) than that of subjects without an HRE. Additionally, each 10mm Hg increase in systolic BP during exercise at moderate intensity was accompanied by a 4% increase in CV events and mortality, independent of office BP, age, or CV risk factors (95% CI, 1.01-1.07, P = 0.02). Systolic BP at maximal workload was not significantly associated with the outcome of an increased rate of CV, whether analyzed as a categorical (HR=1.49, 95% CI, 0.90-2.46, P = 0.12) or a continuous (HR=1.01, 95% CI, 0.98-1.04, P = 0.53) variable. An HRE at moderate exercise intensity during exercise stress testing is an independent risk factor for CV events and mortality. This highlights the need to determine underlying pathophysiological mechanisms of exercise-induced hypertension.

Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults: the Rancho Bernardo Study.

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Oh, Jee-Young; Allison, Matthew A; Barrett-Connor, Elizabeth

2017-01-01

Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading cause of death in the United States and worldwide. We aimed to observe the association of HTN and diabetes mellitus with all-cause and CVD mortality in older white adults. All community-dwelling Rancho Bernardo Study participants who were at least 55 years old and had carefully measured blood pressure and plasma glucose from 75-g oral glucose tolerance test at the baseline visit (1984-1987, n = 2186) were followed up until death or the last clinic visit in 2013 (median 14.3 years, interquartile range 8.4-21.3). In unadjusted analyses, diabetes mellitus was associated with all-cause mortality [hazard ratio 1.40, 95% confidence interval (CI) 1.23-1.60] and CVD mortality (hazard ratio 1.67, 95% CI 1.39-2.00); HTN with all-cause mortality [hazard ratio 1.93 (1.73-2.15)] and CVD mortality [hazard ratio 2.45 (2.10-2.93)]. After adjustment for cardiovascular risk factors, including age, BMI, triglycerides, HDL-cholesterol, smoking, exercise, and alcohol consumption, diabetes mellitus was associated with CVD mortality only (hazard ratio 1.25, P = 0.0213). Conversely, HTN was associated with both all-cause (hazard ratio 1.34, P diabetes mellitus and HTN was associated with all-cause (hazard ratio 1.38, P = 0.0002) and CVD mortality (hazard ratio 1.70, P diabetes mellitus. Having both confers a modest increase in the hazards for these types of mortality.

Mortality rates in people with intellectual disabilities

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Rachael Williams

2017-04-01

National English data confirm that patients with ID have higher mortality rates than those without. Mortality rates for patients with ID were higher across all age/sex groups and causes, with almost half of deaths classified as avoidable.

Mortality due to Cardiovascular Diseases in Women and Men in the Five Brazilian Regions, 1980-2012

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Antonio de Padua Mansur

2016-01-01

Full Text Available Abstract Background: Studies have shown different mortalities due to cardiovascular diseases (CVD, ischemic heart disease (IHD and cerebrovascular diseases (CbVD in the five Brazilian regions. Socioeconomic conditions of those regions are frequently used to justify differences in mortality due to those diseases. In addition, studies have shown a reduction in the differences between the mortality rates of the five Brazilian regions. Objective: To update CVD mortality data in women and men in the five Brazilian regions. Methods: Mortality and population data were obtained from the Brazilian Institute of Geography and Statistics and Ministry of Health. Risk of death was adjusted by use of the direct method, with the 2000 world standard population as reference. We analyzed trends in mortality due to CVD, IHD and CbVD in women and men aged ≥ 30 years in the five Brazilian regions from 1980 to 2012. Results: Mortality due to: 1 CVD: showed reduction in the Northern, West-Central, Southern and Southeastern regions; increase in the Northeastern region; 2 IHD: reduction in the Southeastern and Southern regions; increase in the Northeastern region; and unchanged in the Northern and West-Central regions; 3 CbVD: reduction in the Southern, Southeastern and West-Central regions; increase in the Northeastern region; and unchanged in Northern region. There was also a convergence in mortality trends due to CVD, IHD, and CbVD in the five regions. Conclusion: The West-Central, Northern and Northeastern regions had the worst trends in CVD mortality as compared to the Southeastern and Southern regions. (Arq Bras Cardiol. 2016; [online].ahead print, PP.0-0

Daytime napping and mortality, with a special reference to cardiovascular disease: the JACC study.

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Tanabe, Naohito; Iso, Hiroyasu; Seki, Nao; Suzuki, Hiroshi; Yatsuya, Hiroshi; Toyoshima, Hideaki; Tamakoshi, Akiko

2010-02-01

Daytime napping is associated with elevated risk of all-cause mortality in the elderly. However, the association with cardiovascular disease (CVD) risk is inconsistent. From 1988 to 1990, a total of 67 129 Japanese non-workers or daytime workers (27 755 men and 39 374 women) aged 40-79 years, without a history of stroke, heart disease or cancer, completed a lifestyle questionnaire. They were followed for mortality until the end of 2003. During the 879 244 person-year follow-up, 9643 deaths (2852 from CVD, 3643 from cancer, 2392 from other internal causes, 738 from external causes and 18 from unspecified causes) were observed. After adjustment for possible confounders, subjects with a daytime napping habit had elevated hazard ratios (HRs) for mortality from all causes [HR 1.19, 95% confidence interval (CI) 1.14-1.24, P napping was diminished among overweight subjects, but pronounced in those with weight loss after age 20 years, with non-regular employment, with lower education level and with a follow-up period napping is associated with elevated risk of CVD mortality as well as non-cardiovascular/non-cancer and external deaths. Daytime napping may elevate risk of CVD death through some biological effects but, to a larger extent, some comorbid disorders causing weight loss or associated with non-regular employment and low education level could explain this association.

Association Between Baseline LDL-C Level and Total and Cardiovascular Mortality After LDL-C Lowering: A Systematic Review and Meta-analysis.

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Navarese, Eliano P; Robinson, Jennifer G; Kowalewski, Mariusz; Kolodziejczak, Michalina; Andreotti, Felicita; Bliden, Kevin; Tantry, Udaya; Kubica, Jacek; Raggi, Paolo; Gurbel, Paul A

2018-04-17

Effects on specific fatal and nonfatal end points appear to vary for low-density lipoprotein cholesterol (LDL-C)-lowering drug trials. To evaluate whether baseline LDL-C level is associated with total and cardiovascular mortality risk reductions. Electronic databases (Cochrane, MEDLINE, EMBASE, TCTMD, ClinicalTrials.gov, major congress proceedings) were searched through February 2, 2018, to identify randomized clinical trials of statins, ezetimibe, and PCSK9-inhibiting monoclonal antibodies. Two investigators abstracted data and appraised risks of bias. Intervention groups were categorized as "more intensive" (more potent pharmacologic intervention) or "less intensive" (less potent, placebo, or control group). The coprimary end points were total mortality and cardiovascular mortality. Random-effects meta-regression and meta-analyses evaluated associations between baseline LDL-C level and reductions in mortality end points and secondary end points including major adverse cardiac events (MACE). In 34 trials, 136 299 patients received more intensive and 133 989 received less intensive LDL-C lowering. All-cause mortality was lower for more vs less intensive therapy (7.08% vs 7.70%; rate ratio [RR], 0.92 [95% CI, 0.88 to 0.96]), but varied by baseline LDL-C level. Meta-regression showed more intensive LDL-C lowering was associated with greater reductions in all-cause mortality with higher baseline LDL-C levels (change in RRs per 40-mg/dL increase in baseline LDL-C, 0.91 [95% CI, 0.86 to 0.96]; P = .001; absolute risk difference [ARD], -1.05 incident cases per 1000 person-years [95% CI, -1.59 to -0.51]), but only when baseline LDL-C levels were 100 mg/dL or greater (P baseline LDL-C level. Meta-regression showed more intensive LDL-C lowering was associated with a greater reduction in cardiovascular mortality with higher baseline LDL-C levels (change in RRs per 40-mg/dL increase in baseline LDL-C, 0.86 [95% CI, 0.80 to 0.94]; P baseline LDL-C levels were 100

The contribution of hypoxia to the association between sleep apnoea, insomnia, and cardiovascular mortality in community-dwelling elderly with and without cardiovascular disease.

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Johansson, Peter; Svensson, Erland; Alehagen, Urban; Jaarsma, Tiny; Broström, Anders

2015-06-01

This study explores if nightly hypoxia (i.e. percentage of sleep time with oxygen saturation lower than 90% (SaO2insomnia in community-dwelling elderly with and without cardiovascular disease (CVD). A second aim was to explore a potential cut-off score for hypoxia to predict insomnia and the association of the cut-off with clinical characteristics and cardiovascular mortality. A total of 331 community-dwelling elderly aged 71-87 years underwent one-night polygraphic recordings. The presence of insomnia was recorded by a self-report questionnaire. The presence of CVD was objectively established and mortality data were collected after three and six years. In both patients with CVD (n=119) or without CVD (n=212) SDB was associated with hypoxia (pinsomnia (pinsomnia. Hypoxia of more than 1.5% of sleep time with SaO2causing insomnia. According to this criterion 32% (n=39) and 26% (n=55) of those with and without CVD had hypoxia, respectively. These groups did not differ with respect to age, gender, body mass index, diabetes, hypertension, respiratory disease or levels of SDB. However, in the CVD group, hypoxia was associated with cardiovascular mortality at the three-year follow-up (p=0.008) and higher levels of insomnia (p=0.002). In the elderly with CVD, SDB mediated by hypoxia can be associated with more insomnia and a worse prognosis. © The European Society of Cardiology 2014.

Association of the Aspartate Aminotransferase to Alanine Aminotransferase Ratio with BNP Level and Cardiovascular Mortality in the General Population: The Yamagata Study 10-Year Follow-Up

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Miyuki Yokoyama

2016-01-01

Full Text Available Background. Early identification of high risk subjects for cardiovascular disease in health check-up is still unmet medical need. Cardiovascular disease is characterized by the superior increase in aspartate aminotransferase (AST to alanine aminotransferase (ALT. However, the association of AST/ALT ratio with brain natriuretic peptide (BNP levels and cardiovascular mortality remains unclear in the general population. Methods and Results. This longitudinal cohort study included 3,494 Japanese subjects who participated in a community-based health check-up, with a 10-year follow-up. The AST/ALT ratio increased with increasing BNP levels. And multivariate logistic analysis showed that the AST/ALT ratio was significantly associated with a high BNP (≥100 pg/mL. There were 250 all-cause deaths including 79 cardiovascular deaths. Multivariate Cox proportional hazard regression analysis revealed that a high AST/ALT ratio (>90 percentile was an independent predictor of all-cause and cardiovascular mortality after adjustment for confounding factors. Kaplan-Meier analysis demonstrated that cardiovascular mortality was higher in subjects with a high AST/ALT ratio than in those without. Conclusions. The AST/ALT ratio was associated with an increase in BNP and was predictive of cardiovascular mortality in a general population. Measuring the AST/ALT ratio during routine health check-ups may be a simple and cost-effective marker for cardiovascular mortality.

Does IQ predict total and cardiovascular disease mortality as strongly as other risk factors? Comparison of effect estimates using the Vietnam Experience Study

DEFF Research Database (Denmark)

Batty, G D; Shipley, M J; Gale, C R

2008-01-01

To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality.......To compare the strength of the relation of two measurements of IQ and 11 established risk factors with total and cardiovascular disease (CVD) mortality....

Cardiac Troponin Elevation Predicts Mortality in Patients Undergoing Orthotopic Liver Transplantation

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David Snipelisky

2013-01-01

Full Text Available Introduction. While patients undergoing orthotopic liver transplantation (OLT have high cardiovascular event rates, preoperative risk stratification may not necessarily predict those susceptible patients. Troponin T (TnT may help predict patients at risk for cardiovascular complications. Methods. Consecutive patients undergoing OLT at Mayo Clinic in Florida between 1998 and 2010 who had TnT obtained within 10 days following surgery were included. Three groups were compared based on TnT level: (1 normal (TnT ≤0.01 ng/mL, (2 intermediate (TnT 0.02–0.11 ng/mL, and (3 elevated (TnT >0.11 ng/mL. Overall and cardiovascular mortality was assessed. Results. Of the 78 patients included, there was no difference in age, gender, severity of liver disease, and echocardiographic findings. Patients in the normal and intermediate TnT groups had a lower overall mortality rate (14.3% and 0%, resp. when compared with those with elevated TnT (50%; P=0.001. Patients in the elevated TnT group had a cardiovascular mortality rate of 37.5% compared with 1.4% in the other groups combined (P<0.01. The elevated TnT group had a much higher mortality rate when compared with those in the intermediate group (P<0.0001. Conclusion. TnT may accurately help risk stratify patients in the early postoperative setting to better predict cardiovascular complications.

Inequalities in mortality: study rates, not standardised mortality ratios [Letter

NARCIS (Netherlands)

Bonneux, L.G.A.

2010-01-01

In their study from 1921 to 2007 Thomas and colleagues conclude on the basis of standardised mortality ratios that inequalities in mortality continue to rise and are now almost as high as in the 1930s. Relative ratios are, however, misleading when absolute rates change strongly. I calculated the

External gamma radiation and mortality from cardiovascular diseases in the German WISMUT uranium miners cohort study, 1946-2008

Energy Technology Data Exchange (ETDEWEB)

Kreuzer, M.; Dufey, F.; Sogl, M.; Schnelzer, M.; Walsh, L. [Federal Office for Radiation Protection, Department of Radiation Protection and Health, Neuherberg (Germany)

2013-03-15

It is currently unclear whether exposure of the heart and vascular system, at lifetime accumulated dose levels relevant to the general public (<500 mGy), is associated with an increased risk of cardiovascular disease. Therefore, data from the German WISMUT cohort of uranium miners were investigated for evidence of a relationship between external gamma radiation and death from cardiovascular diseases. The cohort comprises 58,982 former employees of the Wismut company. There were 9,039 recorded deaths from cardiovascular diseases during the follow-up period from 1946 to 2008. Exposures to external gamma radiation were estimated using a detailed job-exposure matrix. The exposures were based on expert ratings for the period 1946-1954 and measurements thereafter. The excess relative risk (ERR) per unit of cumulative gamma dose was obtained with internal Poisson regression using a linear ERR model with baseline stratification by age and calendar year. The mean cumulative gamma dose was 47 mSv for exposed miners (86 %), with a maximum of 909 mSv. No evidence for an increase in risk with increasing cumulative dose was found for mortality from all cardiovascular diseases (ERR/Sv = -0.13; 95 % confidence interval (CI): -0.38; 0.12) and ischemic heart diseases (n = 4,613; ERR/Sv = -0.03; 95 % CI: -0.38, 0.32). However, a statistically insignificant increase (n = 2,073; ERR/Sv = 0.44; 95 % CI: -0.16, 1.04) for mortality from cerebrovascular diseases was observed. Data on smoking, diabetes, and overweight are available for subgroups of the cohort, indicating no major correlation with cumulative gamma radiation. Confounding by these factors or other risk factors, however, cannot be excluded. In conclusion, the results provide weak evidence for an increased risk of death due to gamma radiation only for cerebrovascular diseases. (orig.)

Valor preditivo da frequência cardíaca em repouso do teste ergométrico na mortalidade Valor predictivo de la frecuencia cardíaca en reposo del test ergométrico en la mortalidad Predictive value of resting heart rate for cardiovascular and all-cause mortality

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Jaqueline Eilert Fagundes

2010-12-01

, de enero de 1995 a junio de 2007. Fueron analizados 7.055 pacientes, siendo 1.645 (23,3% del grupo caso (óbitos y 5.410 (76,7% del grupo control (vivos. Fue calculado el punto de corte de la FCR para mortalidad, a través de la curva ROC y realizado el análisis multivariado para las variables seleccionadas. Los desenlaces fueron mortalidad CV y general. RESULTADOS: La incidencia de mortalidad CV fue de 674 casos (9,5%; la FCR > 78 lpm fue el punto de corte. Después de ajustado para las variables seleccionadas, el odds ratio (OR para FCR > 78 lpm fue de 3,5 (IC 95% = 2,9 - 4,2 para mortalidad CV y 3,6 (IC 95% = 3,2 - 4,0 para mortalidad general. CONCLUSIÓN: La FCR > 78 lpm es un predictor independiente de mortalidad cardiovascular y general.BACKGROUND: Resting heart rate (which ranges from 60 to 80 bpm is one of the simplest cardiovascular parameters, and has been considered as a predictor of cardiovascular and all-cause mortality. OBJECTIVE: To determine the predictive value of resting heart rate (RHR before exercise stress testing (ET for cardiovascular (CV and all-cause mortality. METHODS: This was a case-control study using data from the database of the Exercise Testing Laboratory of a cardiac hospital and the death records of the Health Department of a city located in the South of Brazil from January 1995 to June 2007. A total of 7,055 patients were studied; 1,645 (23.3% in the case group (deceased and 5,410 (76.7% in the control group (alive. The cut-off value of RHR for mortality was derived from the ROC curve, and a multivariate analysis was performed for the selected variables. The study's outcome measures were cardiovascular and all-cause mortality. RESULTS: Six hundred and seventy-four patients died of cardiovascular diseases (9.5%; the cut-off value was RHR > 78 bpm. After adjusting for selected variables, the odds ratio (OR of RHR > 78 bpm was 3.5 (95% CI 2.9 to 4.2 for CV mortality and 3.6 (95% CI 3.2 to 4.0 for all-cause mortality. CONCLUSION

Milk Consumption and Mortality from All Causes, Cardiovascular Disease, and Cancer: A Systematic Review and Meta-Analysis.

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Larsson, Susanna C; Crippa, Alessio; Orsini, Nicola; Wolk, Alicja; Michaëlsson, Karl

2015-09-11

Results from epidemiological studies of milk consumption and mortality are inconsistent. We conducted a systematic review and meta-analysis of prospective studies assessing the association of non-fermented and fermented milk consumption with mortality from all causes, cardiovascular disease, and cancer. PubMed was searched until August 2015. A two-stage, random-effects, dose-response meta-analysis was used to combine study-specific results. Heterogeneity among studies was assessed with the I² statistic. During follow-up periods ranging from 4.1 to 25 years, 70,743 deaths occurred among 367,505 participants. The range of non-fermented and fermented milk consumption and the shape of the associations between milk consumption and mortality differed considerably between studies. There was substantial heterogeneity among studies of non-fermented milk consumption in relation to mortality from all causes (12 studies; I² = 94%), cardiovascular disease (five studies; I² = 93%), and cancer (four studies; I² = 75%) as well as among studies of fermented milk consumption and all-cause mortality (seven studies; I² = 88%). Thus, estimating pooled hazard ratios was not appropriate. Heterogeneity among studies was observed in most subgroups defined by sex, country, and study quality. In conclusion, we observed no consistent association between milk consumption and all-cause or cause-specific mortality.

Sleep duration and mortality: The effect of short or long sleep duration on cardiovascular and all-cause mortality in working men and women.

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Heslop, Pauline; Smith, George Davey; Metcalfe, Chris; Macleod, John; Hart, Carole

2002-07-01

There is evidence to suggest that insufficient sleep may have an adverse effect on physical and psychological health. Previous studies have reported that when adjusting for major risk factors for cardiovascular disease and a number of demographic and social variables, sleeping 7-8 h each night is associated with lower mortality. These studies, however, have excluded any consideration of stress, which is known to be related to a number of behavioural risk factors for disease and, like sleep, may influence neurochemical, hormonal and immunological functioning. This study revisits the associations between sleep duration, cardiovascular disease risk factors and mortality, taking into account the perceived stress of individuals. The data come from a cohort of working Scottish men and women recruited between 1970 and 1973; approximately half of the cohort was screened for a second time, 4-7 years after the baseline examination. For both men and women, higher self-perceived stress was associated with a reduction in the hours of sleep reported. The pattern of mortality from all causes and the pattern of mortality from cardiovascular disease were consistent for both men and women. When sleep was measured on one occasion only, the risk of dying was reduced for men sleeping more than 8 h in every 24 h compared with those sleeping 7-8 h over the same period. This was after adjustment had been made for age, marital status, social class, cardiovascular risk factors and stress. The risk of dying was increased for women sleeping less than 7 h in every 24 h compared with those sleeping 7-8 h over the same period, after similar adjustments. When the data from the 1st and 2nd screening were considered longitudinally, both men and women who reported that they slept less than 7 h on both occasions that they were questioned, had a greater risk of dying from any cause than those who had reported sleeping 7-8 h at both screenings, after adjusting for age, marital status, social class and

Cardiovascular morbidity and mortality risk factors in peritoneal dialysis patients

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Jovanović Dijana B.

2008-01-01

Full Text Available Cardiovascular (CVS morbidity and mortality in the endstage renal disease (ESRD patients on peritoneal dialysis therapy is 10-30 folds higher than in general population. The prevalence of well known traditional risk factors such as age, sex, race, arterial hypertension, hyperlipidaemia, diabetes, smoking, physical inactivity is higher in the uraemic patients. Besides these, there are specific, nontraditional risk factors for dialysis patients. Mild inflammation present in peritoneal dialysis (PD patients which can be confirmed by specific inflammatory markers is the cause of CVS morbidity and mortality in these patients. Hypoalbuminaemia, hyperhomocysteinaemia and a higher level of leptin are important predictors of vascular complications as well as CVS events in the PD patients. Plasma norepinephrine, an indicator of sympathetic activity, is high in the ESRD patients and higher in the PD patients than in the patients on haemodialysis (HD. Therefore, norepinephrine may be a stronger risk factor in the PD patients. The same applies to asymmetric dimethylargine (ADMA, an endogenous inhibitor of nitric oxide synthase, which is an important risk factor of CVS morbidity and mortality 15 % higher in the PD than the HD patients. Hyperphosphataemia, secondary hyperparathyroidism and high calcium x phosphate product have been associated with the progression of the coronary artery calcification and valvular calcifications and predict all-cause CVS mortality in the PD patients. Residual renal function (RRF declines with time on dialysis but is slower in the PD than the HD patients. RRF decline is associated with the rise of proinflammatory cytokines and the onset of hypervolaemia and hypertension which increase the risk of CVS diseases, mortality in general and CVS mortality. In conclusion, it is very important to establish all CVS risk factors in the PD patients to prevent CVS diseases and CVS mortality in this population.

Is this back pain killing me? All-cause and cardiovascular-specific mortality in older Danish twins with spinal pain

DEFF Research Database (Denmark)

Fernandez, M; Boyle, E; Hartvigsen, J

2017-01-01

of all-cause and disease-specific cardiovascular mortality in older Danish twins aged ≥70 years. Data from 4391 participants collected at baseline were linked with the Danish Cause of Death Registry with the study ending on 31 December 2014. Two crude and adjusted Cox proportional hazards regression......-significant, although greater in magnitude for monozygotic twins. Conclusions: Older people reporting spinal pain have 13% increased risk of mortality per years lived but the connection is not causal. We found no association between spinal pain and cardiovascular-specific mortality. The influence of shared familial...... factors is unlikely. Significance: Older people reporting spinal pain have 13% increased risk of mortality per year lived. However, this association is not likely to be causal, with the relevant confounders contributing to this relationship. Thus, pain in the spine may be part of a pattern of poor health...

Cardiovascular mortality in Northern Ireland during the 2008-2014 financial crisis years: who got the worst hit?

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Mugtaba Osman

2017-09-01

Full Text Available Background: Internationally, cardiovascular mortality and economic recessions showed an established relationship. Northern Ireland was badly affected by the global financial crisis in 2008-2014 but little is known in terms of how cardiovascular mortality was affected. Objective: The aim of the present study was to investigate the potential impact of the 2008 economic crisis on the annual cerebrovascular accidents CVA and ischaemic heart disease IHD related mortality in Northern Ireland. Method: Mortality data were extracted from Northern Ireland Statistics and Research Agency database. We utilized generalized linear regression Poisson modelling to estimate the impact of economic crisis on the IHD and CVA mortality. Results: We found a significant increase of IHD-deaths during the financial crisis years in males over the age of 65 (β = 49.466, p value = 0.003 and females over the age of 65 (β = 57.721, p value = 0.001. However, CVA-mortality in the post crisis years rose significantly for females who were 65 years or older (β = 56.010, p value = 0.005 but not for males. The rest of the age groups were not significantly affected in terms of either CVA or IHD mortality. Conclusion: For the total population the only age category with significant increase in both IHD and CVA mortality in the post-2008 era was the over 65 (p values < 0.001 and = 0.012, respectively Declaration of interest: None. Keywords: IHD, CVA, Northern Ireland, economic recession, working-age, socio-economic changes

Two-way effect modifications of air pollution and air temperature on total natural and cardiovascular mortality in eight European urban areas.

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Chen, Kai; Wolf, Kathrin; Breitner, Susanne; Gasparrini, Antonio; Stafoggia, Massimo; Samoli, Evangelia; Andersen, Zorana Jovanovic; Bero-Bedada, Getahun; Bellander, Tom; Hennig, Frauke; Jacquemin, Bénédicte; Pekkanen, Juha; Hampel, Regina; Cyrys, Josef; Peters, Annette; Schneider, Alexandra

2018-07-01

Although epidemiological studies have reported associations between mortality and both ambient air pollution and air temperature, it remains uncertain whether the mortality effects of air pollution are modified by temperature and vice versa. Moreover, little is known on the interactions between ultrafine particles (diameter ≤ 100 nm, UFP) and temperature. We investigated whether the short-term associations of particle number concentration (PNC in the ultrafine range (≤100 nm) or total PNC ≤ 3000 nm, as a proxy for UFP), particulate matter ≤ 2.5 μm (PM 2.5 ) and ≤ 10 μm (PM 10 ), and ozone with daily total natural and cardiovascular mortality were modified by air temperature and whether air pollution levels affected the temperature-mortality associations in eight European urban areas during 1999-2013. We first analyzed air temperature-stratified associations between air pollution and total natural (nonaccidental) and cardiovascular mortality as well as air pollution-stratified temperature-mortality associations using city-specific over-dispersed Poisson additive models with a distributed lag nonlinear temperature term in each city. All models were adjusted for long-term and seasonal trend, day of the week, influenza epidemics, and population dynamics due to summer vacation and holidays. City-specific effect estimates were then pooled using random-effects meta-analysis. Pooled associations between air pollutants and total and cardiovascular mortality were overall positive and generally stronger at high relatively compared to low air temperatures. For example, on days with high air temperatures (>75th percentile), an increase of 10,000 particles/cm 3 in PNC corresponded to a 2.51% (95% CI: 0.39%, 4.67%) increase in cardiovascular mortality, which was significantly higher than that on days with low air temperatures (air pollution (>50th percentile), both heat- and cold-related mortality risks increased. Our findings showed that

Estimated Glomerular Filtration Rate, Cardiovascular Events and Mortality Across Age Groups Among Individuals Older Than 60 Years in Southern Europe.

Science.gov (United States)

Salvador-González, Betlem; Gil-Terrón, Neus; Cerain-Herrero, M Jesús; Subirana, Isaac; Güell-Miró, Roser; Rodríguez-Latre, Luisa M; Cunillera-Puértolas, Oriol; Elosua, Roberto; Grau, Maria; Vila, Joan; Pascual-Benito, Luisa; Mestre-Ferrer, Jordi; Ramos, Rafel; Baena-Díez, José Miguel; Soler-Vila, Maria; Alonso-Bes, Eva; Ruipérez-Guijarro, Laura; Álvarez-Funes, Virtudes; Freixes-Villaró, Esther; Rodríguez-Pascual, Mercedes; Martínez-Castelao, Alberto

2018-06-01

Individuals with a decreased estimated glomerular filtration rate (eGFR) are at increased risk of all-cause (ACM) and cardiovascular mortality; there is ongoing debate about whether older individuals with eGFR 45 to 59mL/min/1.73 m 2 are also at increased risk. We evaluated the association between eGFR and ACM and cardiovascular events (CVE) in people aged 60 to 74 and ≥ 75 years in a population with a low coronary disease incidence. We conducted a retrospective cohort study by using primary care and hospital electronic records. We included 130 233 individuals aged ≥ 60 years with creatinine measurement between January 1, 2010 and December 31, 2011; eGFR was estimated by using the Chronic Kidney Disease Epidemiology Collaboration creatinine equation. The independent association between eGFR and the risk of ACM and hospital admission due to CVE were determined with Cox and Fine-Gray regressions, respectively. The median was age 70 years, and 56.1% were women; 13.5% had eGFR < 60 (69.7% eGFR 45-59). During a median follow-up of 38.2 months, 6474 participants died and 3746 had a CVE. For ACM and CVE, the HR in older individuals became significant at eGFR < 60. Fully adjusted HR for ACM in the eGFR 45 to 59 category were 1.61; 95%CI, 1.37-1.89 and 1.19; 95%CI, 1.10-1.28 in 60- to 74-year-olds and ≥ 75-year-olds, respectively; for CVE HR were 1.28; 95%CI, 1.08-1.51 and 1.12; 95%CI, 0.99-1.26. In a region with low coronary disease incidence, the risk of death and CVE increased with decreasing eGFR. In ≥ 75-year-olds, the eGFR 45 to 59 category, which had borderline risk for CVE, included many individuals without significant additional risk. Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

Relationships between body mass index, cardiovascular mortality, and risk factors: a report from the SCORE investigators.

LENUS (Irish Health Repository)

Dudina, Alexandra

2011-10-01

Although cardiovascular disease (CVD) is the biggest global cause of death, CVD mortality is falling in developed countries. There is concern that this trend may be offset by increasing levels of obesity.

Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.

Science.gov (United States)

Caterson, I D; Finer, N; Coutinho, W; Van Gaal, L F; Maggioni, A P; Torp-Pedersen, C; Sharma, A M; Legler, U F; Shepherd, G M; Rode, R A; Perdok, R J; Renz, C L; James, W P T

2012-06-01

The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Overweight/obese subjects (N = 10 744), ≥55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild cardiovascular disease. Modest weight loss over short-term (6 weeks) and longer-term (6-12 months) periods is associated with reduction in subsequent cardiovascular mortality for the following 4-5 years even in those with pre-existing cardiovascular disease. While the sibutramine group experienced more primary outcome events than the placebo group, greater weight loss reduced overall risk of these occurring in both groups. © 2011 Blackwell Publishing Ltd.

Association between prediabetes and risk of cardiovascular disease and all cause mortality: systematic review and meta-analysis

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Huang, Yuli; Cai, Xiaoyan; Mai, Weiyi; Li, Meijun

2016-01-01

Objectives To evaluate associations between different definitions of prediabetes and the risk of cardiovascular disease and all cause mortality. Design Meta-analysis of prospective cohort studies. Data sources Electronic databases (PubMed, Embase, and Google Scholar). Selection criteria Prospective cohort studies from general populations were included for meta-analysis if they reported adjusted relative risks with 95% confidence intervals for associations between the risk of composite cardiovascular disease, coronary heart disease, stroke, all cause mortality, and prediabetes. Review methods Two authors independently reviewed and selected eligible studies, based on predetermined selection criteria. Prediabetes was defined as impaired fasting glucose according to the criteria of the American Diabetes Association (IFG-ADA; fasting glucose 5.6-6.9 mmol/L), the WHO expert group (IFG-WHO; fasting glucose 6.1-6.9 mmol/L), impaired glucose tolerance (2 hour plasma glucose concentration 7.8-11.0 mmol/L during an oral glucose tolerance test), or raised haemoglobin A1c (HbA1c) of 39-47 mmol/mol(5.7-6.4%) according to ADA criteria or 42-47 mmol/mol (6.0-6.4%) according to the National Institute for Health and Care Excellence (NICE) guideline. The relative risks of all cause mortality and cardiovascular events were calculated and reported with 95% confidence intervals. Results 53 prospective cohort studies with 1 611 339 individuals were included for analysis. The median follow-up duration was 9.5 years. Compared with normoglycaemia, prediabetes (impaired glucose tolerance or impaired fasting glucose according to IFG-ADA or IFG-WHO criteria) was associated with an increased risk of composite cardiovascular disease (relative risk 1.13, 1.26, and 1.30 for IFG-ADA, IFG-WHO, and impaired glucose tolerance, respectively), coronary heart disease (1.10, 1.18, and 1.20, respectively), stroke (1.06, 1.17, and 1.20, respectively), and all cause mortality (1.13, 1.13 and 1

A high dietary glycemic index increases total mortality in a Mediterranean population at high cardiovascular risk.

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Itandehui Castro-Quezada

Full Text Available OBJECTIVE: Different types of carbohydrates have diverse glycemic response, thus glycemic index (GI and glycemic load (GL are used to assess this variation. The impact of dietary GI and GL in all-cause mortality is unknown. The objective of this study was to estimate the association between dietary GI and GL and risk of all-cause mortality in the PREDIMED study. MATERIAL AND METHODS: The PREDIMED study is a randomized nutritional intervention trial for primary cardiovascular prevention based on community-dwelling men and women at high risk of cardiovascular disease. Dietary information was collected at baseline and yearly using a validated 137-item food frequency questionnaire (FFQ. We assigned GI values of each item by a 5-step methodology, using the International Tables of GI and GL Values. Deaths were ascertained through contact with families and general practitioners, review of medical records and consultation of the National Death Index. Cox regression models were used to estimate multivariable-adjusted hazard ratios (HR and their 95% CI for mortality, according to quartiles of energy-adjusted dietary GI/GL. To assess repeated measures of exposure, we updated GI and GL intakes from the yearly FFQs and used Cox models with time-dependent exposures. RESULTS: We followed 3,583 non-diabetic subjects (4.7 years of follow-up, 123 deaths. As compared to participants in the lowest quartile of baseline dietary GI, those in the highest quartile showed an increased risk of all-cause mortality [HR = 2.15 (95% CI: 1.15-4.04; P for trend  = 0.012]. In the repeated-measures analyses using as exposure the yearly updated information on GI, we observed a similar association. Dietary GL was associated with all-cause mortality only when subjects were younger than 75 years. CONCLUSIONS: High dietary GI was positively associated with all-cause mortality in elderly population at high cardiovascular risk.

Asociación de la neuropatía autonómica cardiovascular y el intervalo QT prolongado con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2 Association of cardiovascular autonomic neuropathy and prolonged QT interval with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus

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Ray Ticse Aguirre

2011-03-01

Full Text Available Con el objetivo de evaluar la relación entre la neuropatía autonómica cardiovascular (NACV y el intervalo QT corregido (QTc con la morbimortalidad cardiovascular en pacientes con diabetes mellitus tipo 2, se realizó el seguimiento a 5 años de 67 pacientes que acudieron a consulta externa del Servicio de Endocrinología. Se presentaron eventos cardiovasculares en 16 pacientes; el 82% completó el seguimiento y se encontró que el intervalo QTc prolongado fue la única variable que se asoció de forma significativa a morbimortalidad cardiovascular en el análisis de regresión logística múltiple (RR: 13,56; IC 95%: 2,01-91,36 (p=0,0074.In order to evaluate the relationship between cardiovascular autonomic neuropathy and corrected QT interval (QTc with cardiovascular morbidity and mortality in patients with type 2 diabetes mellitus, we followed up for 5 years 67 patients attending the outpatient Endocrinology Service. 82% completed follow-up and cardiovascular events occurred in 16 patients. We found that long QTc interval was the only variable significantly associated with cardiovascular morbidity and mortality in the multiple logistic regression analysis (RR: 13.56, 95% CI: 2.01-91.36 (p = 0.0074.

Relations of Postload and Fasting Glucose With Incident Cardiovascular Disease and Mortality Late in Life: The Cardiovascular Health Study

Science.gov (United States)

Brutsaert, Erika F; Shitole, Sanyog; Biggs, Mary Lou; Mukamal, Kenneth J; deBoer, Ian H; Thacker, Evan L; Barzilay, Joshua I; Djoussé, Luc; Ix, Joachim H; Smith, Nicholas L; Kaplan, Robert C; Siscovick, David S; Psaty, Bruce M; Kizer, Jorge R

2016-01-01

Abstract Background Older adults have a high prevalence of postload hyperglycemia. Postload glucose has shown more robust associations with cardiovascular disease (CVD) and death than fasting glucose, but data in the oldest old are sparse. Methods Fasting and 2-hour postload glucose were measured in community-dwelling older adults, mean age 78, at the 1996–1997 follow-up visit of the Cardiovascular Health Study. We evaluated their associations with atherosclerotic CVD (ASCVD) and mortality using standard Cox regression and competing-risks analyses and assessed improvement in prediction-model discrimination with the c-statistic. Results Among 2,394 participants without treated diabetes and available data on glycemic measures, there were 579 ASCVD events and 1,698 deaths during median follow-up of 11.2 years. In fully adjusted models, both fasting and 2-hour glucose were associated with ASCVD (HR per SD, 1.13 [1.03–1.25] and 1.17 [1.07–1.28], respectively) and all-cause mortality (HR 1.12 [1.07–1.18] and 1.14 [1.08–1.20]). After mutual adjustment, however, the associations for fasting glucose with both outcomes were abolished, but those for postload glucose were largely unchanged. Consistent findings were observed for ASCVD in competing-risks models. Conclusion In adults surviving to advanced old age, postload glucose was associated with ASCVD and mortality independently of fasting glucose, but fasting glucose was not associated with these outcomes independently of postload glucose. These findings affirm the robust association of postload glucose with ASCVD and death late in life. PMID:26314953

Usefulness of proteinuria as a prognostic marker of mortality and cardiovascular events among patients undergoing percutaneous coronary intervention (data from the Evaluation of Oral Xemilofiban in Controlling Thrombotic Events [EXCITE] trial).

Science.gov (United States)

Mercado, Nestor; Brugts, Jasper J; Ix, Joachim H; Shlipak, Michael G; Dixon, Simon R; Gersh, Bernard J; Lemos, Pedro A; Guarneri, Mimi; Teirstein, Paul S; Wijns, William; Serruys, Patrick W; Boersma, Eric; O'Neill, William W

2008-11-01

Proteinuria was associated with cardiovascular events and mortality in community-based cohorts. The association of proteinuria with mortality and cardiovascular events in patients undergoing percutaneous coronary intervention (PCI) was unknown. The association of urinary dipstick proteinuria with mortality and cardiovascular events (composite of death, myocardial infarction, or nonhemorrhagic stroke) in 5,835 subjects of the EXCITE trial was evaluated. Dipstick urinalysis was performed before PCI, and proteinuria was defined as trace or greater. Subjects were followed up for 210 days/7 months after enrollment for the occurrence of events. Multivariate Cox regression analysis evaluated the independent association of proteinuria with each outcome. Mean age was 59 years, 21% were women, 18% had diabetes mellitus, and mean estimated glomerular filtration rate was 90 ml/min/1.73 m(2). Proteinuria was present in 750 patients (13%). During follow-up, 22 subjects (2.9%) with proteinuria and 54 subjects (1.1%) without proteinuria died (adjusted hazard ratio 2.83, 95% confidence interval [CI] 1.65 to 4.84, p use tool as urinary dipstick may be useful to identify and treat patients at high risk of mortality at the time of PCI.

MedRate: a wearable against child mortality

CERN Document Server

CERN. Geneva

2018-01-01

In humanitarian environments, when treating the main causes of child mortality, there are two key vital constants not easily measurable: the heart beat of the foetus and respiration rate of children. During the CERN Medtech:Hack, my team came up with MedRate, an inexpensive wearable able to monitor both. Collaboration is required to make MedRate a reality. Would you join us for a more fair fight against child mortality?

Heat-related mortality projections for cardiovascular and respiratory disease under the changing climate in Beijing, China

Science.gov (United States)

Li, Tiantian; Ban, Jie; Horton, Radley M.; Bader, Daniel A.; Huang, Ganlin; Sun, Qinghua; Kinney, Patrick L.

2015-08-01

Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4%, 47.8%, and 69.0% in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6%,73.8% and 134% in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

Plasma concentration of asymmetric dimethylarginine (ADMA) predicts cardiovascular morbidity and mortality in type 1 diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Lajer, Maria Stenkil; Tarnow, Lise; Jorsal, Anders

2008-01-01

OBJECTIVE: To investigate whether circulating asymmetric dimethylarginine (ADMA) levels are predictive of cardiovascular events, decline in glomerular filtration rate (GFR), end-stage renal disease (ESRD), and all-cause mortality in type 1 diabetic patients. RESEARCH DESIGN AND METHODS: We...... performed a prospective observational follow-up study including 397 type 1 diabetic patients with overt diabetic nephropathy (243 men aged 42.1 +/- 10.5 years, GFR 76 +/- 34 ml/min per 1.73 m(2)) and a control group of 175 patients with longstanding type 1 diabetes and persistent normoalbuminuria (104 men...... aged 42.7 +/- 9.7 years, duration of diabetes 27.7 +/- 8.3 years). Patients were followed for a median 11.3 years (range 0.0-12.9) with yearly measurements of GFR ((51)Cr-EDTA plasma clearance) in patients with diabetic nephropathy. Endpoints were fatal and nonfatal cardiovascular disease (CVD...

Italian cardiovascular mortality charts of the CUORE project: are they comparable with the SCORE charts?

LENUS (Irish Health Repository)

Donfrancesco, Chiara

2010-08-01

The aim of this study was to build risk charts for the assessment of cardiovascular mortality of the CUORE project, an Italian longitudinal study, and to compare them with the systematic coronary risk evaluation (SCORE) project charts for low risk European countries.

Impact of statin adherence on cardiovascular disease and mortality outcomes: a systematic review

Science.gov (United States)

De Vera, Mary A; Bhole, Vidula; Burns, Lindsay C; Lacaille, Diane

2014-01-01

Aims While suboptimal adherence to statin medication has been quantified in real-world patient settings, a better understanding of its impact is needed, particularly with respect to distinct problems of medication taking. Our aim was to synthesize current evidence on the impacts of statin adherence, discontinuation and persistence on cardiovascular disease and mortality outcomes. Methods We conducted a systematic review of peer-reviewed studies using a mapped search of Medline, Embase and International Pharmaceutical Abstracts databases. Observational studies that met the following criteria were included: defined patient population; statin adherence exposure; defined study outcome [i.e. cardiovascular disease (CVD), mortality]; and reporting of statin-specific results. Results Overall, 28 studies were included, with 19 studies evaluating outcomes associated with statin adherence, six with statin discontinuation and three with statin persistence. Among adherence studies, the proportion of days covered was the most widely used measure, with the majority of studies reporting increased risk of CVD (statistically significant risk estimates ranging from 1.22 to 5.26) and mortality (statistically significant risk estimates ranging from 1.25 to 2.54) among non-adherent individuals. There was greater methodological variability in discontinuation and persistence studies. However, findings of increased CVD (statistically significant risk estimates ranging from 1.22 to 1.67) and mortality (statistically significant risk estimates ranging from 1.79 to 5.00) among nonpersistent individuals were also consistently reported. Conclusions Observational studies consistently report an increased risk of adverse outcomes associated with poor statin adherence. These findings have important implications for patients and physicians and emphasize the importance of monitoring and encouraging adherence to statin therapy. PMID:25364801

Dietary patterns and all-cause, cancer, and cardiovascular disease mortality in Japanese men and women: The Japan public health center-based prospective study.

Directory of Open Access Journals (Sweden)

Akiko Nanri

Full Text Available A meta-analysis showed an inverse association of a prudent/healthy dietary pattern with all-cause mortality and no association of a western/unhealthy dietary pattern. However, the association of distinctive dietary patterns of Japanese population with mortality remains unclear. We prospectively investigated the association between dietary patterns and all-cause, cancer, and cardiovascular disease mortality among Japanese adults.Participants were 36,737 men and 44,983 women aged 45-74 years who participated in the second survey of the Japan Public Health Center-based Prospective Study (1995-1998 and who had no history of serious disease. Dietary patterns were derived from principal component analysis of the consumption of 134 food and beverage items ascertained by a food frequency questionnaire. Hazard ratios of death from the second survey to December 2012 were estimated using cox proportional hazard regression analysis.A prudent dietary pattern, which was characterized by high intake of vegetables, fruit, soy products, potatoes, seaweed, mushrooms, and fish, was significantly associated with decreased risk of all-cause and cardiovascular disease mortality. The multivariable-adjusted hazard ratios (95% confidence intervals of all-cause and cardiovascular disease mortality for the highest versus lowest quartile of the prudent dietary pattern score were 0.82 (0.77 to 0.86 and 0.72 (0.64 to 0.79, respectively (P for trend <0.001 in both. A Westernized dietary pattern, characterized by high intake of meat, processed meat, bread, and dairy products, was also inversely associated with risk of all-cause, cancer, and cardiovascular disease mortality. A traditional Japanese dietary pattern was not associated with these risks.The prudent and Westernized dietary patterns were associated with a decreased risk of all-cause and cardiovascular disease mortality in Japanese adults.

Cardiovascular Risk and Its Associated Factors in Health Care Workers in Colombia: A Study Protocol

OpenAIRE

Gamboa Delgado, Edna M; Rojas S?nchez, Lyda Z; Bermon Angarita, Anderson; Rangel D?az, Yully Andrea; Jaraba Su?rez, Silvia J; Serrano D?az, Norma C; Vega Fern?ndez, Evaristo

2015-01-01

Background Cardiovascular diseases are the leading cause of mortality worldwide, for this reason, they are a public health problem. In Colombia, cardiovascular diseases are the main cause of mortality, having a death rate of 152 deaths per 100,000 population. There are 80% of these cardiovascular events that are considered avoidable. Objective The objective of the study is to determine the prevalence of the cardiovascular risk and its associated factors among the institution?s workers in orde...

Depression, anxiety, and the cardiovascular system: the psychiatrist's perspective.

Science.gov (United States)

Roose, S P

2001-01-01

It is becoming clear that the comorbidity of depression and cardiovascular disease does not occur by chance but rather is an inevitable consequence of the relationship between the conditions. Depression in patients with cardiovascular disease is a significant risk factor for developing symptomatic and fatal ischemic heart disease. Moreover, depressed patients have a higher than expected rate of sudden cardiovascular death. Therefore, appropriate treatment of patients with depression and cardiovascular disease cannot be restricted to considerations of either depression or cardiovascular disease in isolation. The tricyclic antidepressants (TCAs) have various effects on the cardiovascular system, including Type IA antiarrhythmic activity that has been associated with an increased risk of mortality in post-myocardial infarction patients. The selective serotonin reuptake inhibitors (SSRIs) are not associated with adverse cardiac effects. The SSRI paroxetine was compared with a therapeutic level of the TCA nortriptyline in a randomized, controlled study and demonstrated a benign cardiovascular profile, while the TCA induced a significantly higher rate of serious adverse cardiovascular events. On the basis of this favorable cardiovascular profile, the SSRIs should therefore be the preferred choice for the treatment of most patients with comorbid depression and cardiovascular disease. Investigation of putative pathophysiologic mechanisms linking depression and cardiovascular mortality, such as the role of platelet activation, will form the basis for further investigation of antidepressant treatments in order to establish if the antidepressants have a beneficial effect on the prognosis of cardiovascular diseases.

The influence of baseline risk on the relation between HbA1c and risk for new cardiovascular events and mortality in patients with type 2 diabetes and symptomatic cardiovascular disease.

Science.gov (United States)

Bots, Sophie H; van der Graaf, Yolanda; Nathoe, Hendrik M W; de Borst, Gert Jan; Kappelle, Jaap L; Visseren, Frank L J; Westerink, Jan

2016-07-19

Strict glycaemic control in patients with type 2 diabetes has proven to have microvascular benefits while the effects on CVD and mortality are less clear, especially in high risk patients. Whether strict glycaemic control would reduce the risk of future CVD or mortality in patients with type 2 diabetes and pre-existing CVD, is unknown. This study aims to evaluate whether the relation between baseline HbA1c and new cardiovascular events or mortality in patients with type 2 diabetes and pre-existing cardiovascular disease (CVD) is modified by baseline vascular risk. A cohort of 1096 patients with type 2 diabetes and CVD from the Second Manifestations of ARTerial Disease (SMART) study was followed. The relation between HbA1c at baseline and future vascular events (composite of myocardial infarction, stroke and vascular mortality) and all-cause mortality was evaluated with Cox proportional hazard analyses in a population that was stratified for baseline risk for vascular events as calculated with the SMART risk score. The mean follow-up duration was 6.9 years for all-cause mortality and 6.4 years for vascular events, in which period 243 and 223 cases were reported, respectively. A 1 % increase in HbA1c was associated with a higher risk for all-cause mortality (HR 1.18, 95 % CI 1.06-1.31). This association was also found in the highest SMART risk quartile (HR 1.33, 95 % CI 1.11-1.60). There was no relation between HbA1c and the occurrence of cardiovascular events during follow-up (HR 1.03, 95 % CI 0.91-1.16). The interaction term between HbA1c and SMART risk score was not significantly related to any of the outcomes. In patients with type 2 diabetes and CVD, HbA1c is related to the risk of all-cause mortality, but not to the risk of cardiovascular events. The relation between HbA1c and all-cause mortality in patients with type 2 diabetes and vascular disease is not dependent on baseline vascular risk.

Cardiovascular diseases mortality following cancer during childhood: long term risk, role of chemotherapy and of radiation dose to heart and brain

International Nuclear Information System (INIS)

Tukenova, Markhaba; Guibout, Catherine; Oberlin, Odile; Doyon, Francoise; Moussannif, Abdedaid; Haddy, Nadia; Diallo, Ibrahima; Vathaire, Florent de; Pacquement, Helene; Hawkins, Mike; Winter, Dave

2008-01-01

Full text: Background: A multi-centric French-UK cohort study was performed to evaluate the role of treatment in the long-term overall and cause-specific mortality among childhood cancer survivors. Methods: This study cohort included 4,120 patients treated for a solid tumours before the age of 17 between 1942-1986, in 8 centres in France and UK and who survived at least 5 years from diagnosis. Detailed clinical and therapeutic data were extracted for each patients from medical records. For 2868 of the 2868 patients who received radiotherapy, radiation doses were estimated using DOS E G software at 188 anatomical sites, including heart (7 sites) and lungs (10 sites). We obtained the death causes of 95 % of dead patients. Overall and cause-specific mortality standardized ratios (SMR), absolute excess risk (AER) of death were studied using Poisson regression. Results: 603 patients died during the follow-up, i.e. 8.5-fold (95 % CI: 7.7-9.1) more than that expected in the general population. A total of 32 patients died of cardiovascular diseases, i.e. 4.8-fold (95 % CI, 3.3 to 6.7) more than expected, 21 of which were cardiac diseases, i.e. 6.0-fold more (95% CI, 3.8 to 9.0). Overall, patients who had received radiotherapy had a 5.4-fold (95% CI, 1.5 to 32.1) higher risk of mortality due to cardiovascular disease than those who had not. Mortality due to cardiac disease was related to the administration of alkylating agents and / or vinca alkaloids, and to that of anthracyclines. Each additional 100 mg of anthracyclines per m 2 of body surface area increased the mortality rate due to heart diseases by 92% (95% CI, 16% to 318%). Patients who had received between 5 to 14.9 Gy to the heart during radiotherapy had a 14.5-fold (95% CI, 2.0 to 291) higher risk of mortality from cardiac diseases than patients who had not received radiotherapy, this ratio being 32.6 (95% CI, 5.6 to 622) in those who had received more than 15 Gy. Conclusion: Childhood cancer survivors are at high

Perinatal mortality in twin pregnancy: an analysis of birth weight-specific mortality rates and adjusted mortality rates for birth weight distributions.

Science.gov (United States)

Fabre, E; González de Agüero, R; de Agustin, J L; Pérez-Hiraldo, M P; Bescos, J L

1988-01-01

The objective of this study is to compare the fetal mortality rate (FMR), early neonatal mortality rate (ENMR) and perinatal mortality rate (PMR) of twin and single births. It is based on a survey which was carried out in 22 Hospital Centers in Spain in 1980, and covered 1,956 twins born and 110,734 singletons born. The FMR in twins was 36.3/1000 and 8.8/1000 for singletons. The ENMR in twins was 36.1/1000 and 5.7/1000 for singletons. The PMR in twins was 71.1/1000 and 14.4/1000 for singletons. When birthweight-specific PMR in twin and singletons births are compared, there were no differences between the rates for groups 500-999 g and 1000-1499 g. For birthweight groups of 1500-1999 g (124.4 vs 283.8/1000) and 2000-2999 g (29.6 vs 73.2/1000) the rates for twins were about twice lower than those for single births. The PMR for 2500 g and over birthweight was about twice higher in twins than in singletons (12.5 vs 5.5/1000). After we adjusted for birthweight there was a difference in the FMR (12.6 vs 9.8/1000) and the PMR (19.1 vs 16.0/1000, and no difference in the ENMR between twins and singletons (5.9 vs 6.4/1000), indicating that most of the differences among crude rates are due to differences in distribution of birthweight.

Case-mix and the use of control charts in monitoring mortality rates after coronary artery bypass

Directory of Open Access Journals (Sweden)

Mohammed Mohammed A

2007-04-01

Full Text Available Abstract Background There is debate about the role of crude mortality rates and case-mix adjusted mortality rates in monitoring the outcomes of treatment. In the context of quality improvement a key purpose of monitoring is to identify special cause variation as this type of variation should be investigated to identify possible causes. This paper investigates agreement between the identification of special cause variation in risk adjusted and observed hospital specific mortality rates after coronary artery bypass grafting in New York hospitals. Methods Coronary artery bypass grafting mortality rates between 1994 and 2003 were obtained from the New York State Department of Health's cardiovascular reports for 41 hospitals. Cross-sectional control charts of crude (observed and risk adjusted mortality rates were produced for each year. Special cause variation was defined as a data point beyond the 99.9% probability limits: hospitals showing special cause variation were identified for each year. Longitudinal control charts of crude (observed and risk adjusted mortality rates were produced for each hospital with data for all ten years (n = 27. Special cause variation was defined as a data point beyond 99.9% probability limits, two out of three consecutive data points beyond 95% probability limits (two standard deviations from the mean or a run of five consecutive points on one side of the mean. Years showing special cause variation in mortality were identified for each hospital. Cohen's Kappa was calculated for agreement between special causes identified in crude and risk-adjusted control charts. Results In cross sectional analysis the Cohen's Kappa was 0.54 (95% confidence interval: 0.28 to 0.78, indicating moderate agreement between the crude and risk-adjusted control charts with sensitivity 0.4 (95% confidence interval 0.17–0.69 and specificity 0.98 (95% confidence interval: 0.95–0.99. In longitudinal analysis, the Cohen's Kappa was 0.61 (95

Dietary n-3 polyunsaturated fatty acid intake and all-cause and cardiovascular mortality in adults on hemodialysis: The DIET-HD multinational cohort study.

Science.gov (United States)

Saglimbene, Valeria M; Wong, Germaine; Ruospo, Marinella; Palmer, Suetonia C; Campbell, Katrina; Larsen, Vanessa Garcia; Natale, Patrizia; Teixeira-Pinto, Armando; Carrero, Juan-Jesus; Stenvinkel, Peter; Gargano, Letizia; Murgo, Angelo M; Johnson, David W; Tonelli, Marcello; Gelfman, Rubén; Celia, Eduardo; Ecder, Tevfik; Bernat, Amparo G; Del Castillo, Domingo; Timofte, Delia; Török, Marietta; Bednarek-Skublewska, Anna; Duława, Jan; Stroumza, Paul; Hoischen, Susanne; Hansis, Martin; Fabricius, Elisabeth; Wollheim, Charlotta; Hegbrant, Jörgen; Craig, Jonathan C; Strippoli, Giovanni F M

2017-12-06

Patients on hemodialysis suffer from high risk of premature death, which is largely attributed to cardiovascular disease, but interventions targeting traditional cardiovascular risk factors have made little or no difference. Long chain n-3 polyunsaturated fatty acids (n-3 PUFA) are putative candidates to reduce cardiovascular disease. Diets rich in n-3 PUFA are recommended in the general population, although their role in the hemodialysis setting is uncertain. We evaluated the association between the dietary intake of n-3 PUFA and mortality for hemodialysis patients. The DIET-HD study is a prospective cohort study (January 2014-June 2017) in 9757 adults treated with hemodialysis in Europe and South America. Dietary n-3 PUFA intake was measured at baseline using the GA 2 LEN Food Frequency Questionnaire. Adjusted Cox regression analyses clustered by country were conducted to evaluate the association of dietary n-3 PUFA intake with cardiovascular and all-cause mortality. During a median follow up of 2.7 years (18,666 person-years), 2087 deaths were recorded, including 829 attributable to cardiovascular causes. One third of the study participants consumed sufficient (at least 1.75 g/week) n-3 PUFA recommended for primary cardiovascular prevention, and less than 10% recommended for secondary prevention (7-14 g/week). Compared to patients with the lowest tertile of dietary n-3 PUFA intake (<0.37 g/week), the adjusted hazard ratios (95% confidence interval) for cardiovascular mortality for patients in the middle (0.37 to <1.8 g/week) and highest (≥1.8 g/week) tertiles of n-3 PUFA were 0.82 (0.69-0.98) and 1.03 (0.84-1.26), respectively. Corresponding adjusted hazard ratios for all-cause mortality were 0.96 (0.86-1.08) and 1.00 (0.88-1.13), respectively. Dietary n-3 PUFA intake was not associated with cardiovascular or all-cause mortality in patients on hemodialysis. As dietary n-3 PUFA intake was low, the possibility that n-3 PUFA supplementation might mitigate

Association between circulating fibroblast growth factor 21 and mortality in end-stage renal disease.

Directory of Open Access Journals (Sweden)

Marina Kohara

Full Text Available Fibroblast growth factor 21 (FGF21 is an endocrine factor that regulates glucose and lipid metabolism. Circulating FGF21 predicts cardiovascular events and mortality in type 2 diabetes mellitus, including early-stage chronic kidney disease, but its impact on clinical outcomes in end-stage renal disease (ESRD patients remains unclear. This study enrolled 90 ESRD patients receiving chronic hemodialysis who were categorized into low- and high-FGF21 groups by the median value. We investigated the association between circulating FGF21 levels and the cardiovascular event and mortality during a median follow-up period of 64 months. A Kaplan-Meier analysis showed that the mortality rate was significantly higher in the high-FGF21 group than in the low-FGF21 group (28.3% vs. 9.1%, log-rank, P = 0.034, while the rate of cardiovascular events did not significantly differ between the two groups (30.4% vs. 22.7%, log-rank, P = 0.312. In multivariable Cox models adjusted a high FGF21 level was an independent predictor of all-cause mortality (hazard ratio: 3.98; 95% confidence interval: 1.39-14.27, P = 0.009. Higher circulating FGF21 levels were associated with a high mortality rate, but not cardiovascular events in patient with ESRD, suggesting that circulating FGF21 levels serve as a predictive marker for mortality in these subjects.

Association between circulating fibroblast growth factor 21 and mortality in end-stage renal disease.

Science.gov (United States)

Kohara, Marina; Masuda, Takahiro; Shiizaki, Kazuhiro; Akimoto, Tetsu; Watanabe, Yuko; Honma, Sumiko; Sekiguchi, Chuji; Miyazawa, Yasuharu; Kusano, Eiji; Kanda, Yoshinobu; Asano, Yasushi; Kuro-O, Makoto; Nagata, Daisuke

2017-01-01

Fibroblast growth factor 21 (FGF21) is an endocrine factor that regulates glucose and lipid metabolism. Circulating FGF21 predicts cardiovascular events and mortality in type 2 diabetes mellitus, including early-stage chronic kidney disease, but its impact on clinical outcomes in end-stage renal disease (ESRD) patients remains unclear. This study enrolled 90 ESRD patients receiving chronic hemodialysis who were categorized into low- and high-FGF21 groups by the median value. We investigated the association between circulating FGF21 levels and the cardiovascular event and mortality during a median follow-up period of 64 months. A Kaplan-Meier analysis showed that the mortality rate was significantly higher in the high-FGF21 group than in the low-FGF21 group (28.3% vs. 9.1%, log-rank, P = 0.034), while the rate of cardiovascular events did not significantly differ between the two groups (30.4% vs. 22.7%, log-rank, P = 0.312). In multivariable Cox models adjusted a high FGF21 level was an independent predictor of all-cause mortality (hazard ratio: 3.98; 95% confidence interval: 1.39-14.27, P = 0.009). Higher circulating FGF21 levels were associated with a high mortality rate, but not cardiovascular events in patient with ESRD, suggesting that circulating FGF21 levels serve as a predictive marker for mortality in these subjects.

Association between the volume of inpatient rehabilitation therapy and the risk of all-cause and cardiovascular mortality in patients with ischemic stroke.

Science.gov (United States)

Hu, Gwo-Chi; Hsu, Chia-Yu; Yu, Hui-Kung; Chen, Jiann-Perng; Chang, Yu-Ju; Chien, Kuo-Liong

2014-02-01

To investigate the relationship between the volume of inpatient rehabilitation therapy and mortality among patients with acute ischemic stroke, as well as to assess whether the association varies with respect to stroke severity. A retrospective study with a cohort of consecutive patients who had acute ischemic stroke between January 1, 2008, and June 30, 2009. Referral medical center. Adults with acute ischemic stroke (N=1277) who were admitted to a tertiary hospital. Not applicable. Stroke-related mortality. During the median follow-up period of 12.3 months (ranging from January 1, 2008, to December 31, 2009), 163 deaths occurred. Greater volume of rehabilitation therapy was associated with a reduced risk of all-cause and cardiovascular mortality (P for trend rehabilitation volume was associated with a 55% lower risk of all-cause mortality (hazard ratio [HR]=.45; 95% confidence interval [CI], .30-.65) and a 50% lower risk of cardiovascular mortality (HR=.50; 95% CI, .31-.82). The association did not vary with respect to stroke severity (P for interaction = .45 and .73 for all-cause and cardiovascular mortality, respectively). The volume of inpatient rehabilitation therapy and mortality were significantly inversely related in the patients with ischemic stroke. Thus, further programs aimed at promoting greater use of rehabilitation services are warranted. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Relations of Postload and Fasting Glucose With Incident Cardiovascular Disease and Mortality Late in Life: The Cardiovascular Health Study.

Science.gov (United States)

Brutsaert, Erika F; Shitole, Sanyog; Biggs, Mary Lou; Mukamal, Kenneth J; deBoer, Ian H; Thacker, Evan L; Barzilay, Joshua I; Djoussé, Luc; Ix, Joachim H; Smith, Nicholas L; Kaplan, Robert C; Siscovick, David S; Psaty, Bruce M; Kizer, Jorge R

2016-03-01

Older adults have a high prevalence of postload hyperglycemia. Postload glucose has shown more robust associations with cardiovascular disease (CVD) and death than fasting glucose, but data in the oldest old are sparse. Fasting and 2-hour postload glucose were measured in community-dwelling older adults, mean age 78, at the 1996-1997 follow-up visit of the Cardiovascular Health Study. We evaluated their associations with atherosclerotic CVD (ASCVD) and mortality using standard Cox regression and competing-risks analyses and assessed improvement in prediction-model discrimination with the c-statistic. Among 2,394 participants without treated diabetes and available data on glycemic measures, there were 579 ASCVD events and 1,698 deaths during median follow-up of 11.2 years. In fully adjusted models, both fasting and 2-hour glucose were associated with ASCVD (HR per SD, 1.13 [1.03-1.25] and 1.17 [1.07-1.28], respectively) and all-cause mortality (HR 1.12 [1.07-1.18] and 1.14 [1.08-1.20]). After mutual adjustment, however, the associations for fasting glucose with both outcomes were abolished, but those for postload glucose were largely unchanged. Consistent findings were observed for ASCVD in competing-risks models. In adults surviving to advanced old age, postload glucose was associated with ASCVD and mortality independently of fasting glucose, but fasting glucose was not associated with these outcomes independently of postload glucose. These findings affirm the robust association of postload glucose with ASCVD and death late in life. © The Author 2015. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Mortality in patients with psoriasis. A retrospective cohort study.

Science.gov (United States)

Masson, Walter; Rossi, Emiliano; Galimberti, María Laura; Krauss, Juan; Navarro Estrada, José; Galimberti, Ricardo; Cagide, Arturo

2017-06-07

The immune and inflammatory pathways involved in psoriasis could favor the development of atherosclerosis, consequently increasing mortality. The objectives of this study were: 1) to assess the mortality of a population with psoriasis compared to a control group, and 2) to assess the prevalence of cardiovascular risk factors. A retrospective cohort was analyzed from a secondary database (electronic medical record). All patients with a diagnosis of psoriasis at 1-01-2010 were included in the study and compared to a control group of the same health system, selected randomly (1:1). Subjects with a history of cardiovascular disease were excluded from the study. A survival analysis was performed considering death from any cause as an event. Follow-up was extended until 30-06-2015. We included 1,481 subjects with psoriasis and 1,500 controls. Prevalence of cardiovascular risk factors was higher in the group with psoriasis. The average follow-up time was 4.6±1.7 years. Mortality was higher in psoriasis patients compared to controls (15.1 vs. 9.6 events per 1,000 person-year, PPsoriasis was seen to be significantly associated with increased mortality rates compared to the control group in the univariate analysis (HR 1.58, 95% CI 1.16-2.15, P=.004) and after adjusting for cardiovascular risk factors (HR 1.48, 95% CI 1.08-2.3, P=.014). In this population, patients with psoriasis showed a higher prevalence for the onset of cardiovascular risk factors as well as higher mortality rates during follow-up. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Predictive value of casual ECG-based resting heart rate compared with resting heart rate obtained from Holter recording

DEFF Research Database (Denmark)

Carlson, Nicholas; Dixen, Ulrik; Marott, Jacob L

2014-01-01

BACKGROUND: Elevated resting heart rate (RHR) is associated with cardiovascular mortality and morbidity. Assessment of heart rate (HR) from Holter recording may afford a more precise estimate of the effect of RHR on cardiovascular risk, as compared to casual RHR. Comparative analysis was carried ...

Heat-Related Mortality Projections for Cardiovascular and Respiratory Disease Under the Changing Climate in Beijing, China

Science.gov (United States)

Li, Tiantian; Ban, Jie; Horton, Radley M.; Bader, Daniel A.; Huang, Ganlin; Sun, Qinghua; Kinney, Patrick L.

2015-01-01

Because heat-related health effects tend to become more serious at higher temperatures, there is an urgent need to determine the mortality projection of specific heat-sensitive diseases to provide more detailed information regarding the variation of the sensitivity of such diseases. In this study, the specific mortality of cardiovascular and respiratory disease in Beijing was initially projected under five different global-scale General Circulation Models (GCMs) and two Representative Concentration Pathways scenarios (RCPs) in the 2020s, 2050s, and 2080s compared to the 1980s. Multi-model ensembles indicated cardiovascular mortality could increase by an average percentage of 18.4 percent, 47.8 percent, and 69.0 percent in the 2020s, 2050s, and 2080s under RCP 4.5, respectively, and by 16.6 percent, 73.8 percent and 134 percent in different decades respectively, under RCP 8.5 compared to the baseline range. The same increasing pattern was also observed in respiratory mortality. The heat-related deaths under the RCP 8.5 scenario were found to reach a higher number and to increase more rapidly during the 21st century compared to the RCP4.5 scenario, especially in the 2050s and the 2080s. The projection results show potential trends in cause-specific mortality in the context of climate change, and provide support for public health interventions tailored to specific climate-related future health risks.

Forced migration and mortality in the very long term: did perestroika affect death rates also in Finland?

Science.gov (United States)

Saarela, Jan; Finnäs, Fjalar

2009-08-01

In this article, we analyze mortality rates of Finns born in areas that were ceded to the Soviet Union after World War II and from which the entire population was evacuated. These internally displaced persons are observed during the period 1971-2004 and compared with people born in the same region but on the adjacent side of the new border. We find that in the 1970s and 1980s, the forced migrants had mortality rates that were on par with those of people in the comparison group. In the late 1980s, the mortality risk of internally displaced men increased by 20% in relation to the expected time trend. This deviation, which manifests particularly in cardiovascular mortality, coincides with perestroika and the demise of the Soviet Union, which were events that resulted in an intense debate in civil society about restitution of the ceded areas. Because state actors were reluctant to engage, the debate declined after some few years, and after the mid-1990s, the death risk again approached the long-term trend. Our findings indicate that when internally displaced persons must adjust to situations for which appropriate coping behaviors are unknown, psychosocial stress might arise several decades after their evacuation.

Cardiovascular disease, chronic kidney disease, and diabetes mortality burden of cardiometabolic risk factors from 1980 to 2010: a comparative risk assessment

NARCIS (Netherlands)

Danaei, Goodarz; Lu, Yuan; Singh, Gitanjali M.; Carnahan, Emily; Stevens, Gretchen A.; Cowan, Melanie J.; Farzadfar, Farshad; Lin, John K.; Finucane, Mariel M.; Rao, Mayuree; Khang, Young-Ho; Riley, Leanne M.; Mozaffarian, Dariush; Lim, Stephen S.; Ezzati, Majid; Aamodt, Geir; Abdeen, Ziad; Abdella, Nabila A.; Rahim, Hanan F. Abdul; Addo, Juliet; Aekplakorn, Wichai; Afifi, Mustafa M.; Agabiti-Rosei, Enrico; Salinas, Carlos A. Aguilar; Agyemang, Charles; Ali, Mohammed K.; Ali, Mohamed M.; Al-Nsour, Mohannad; Al-Nuaim, Abdul R.; Ambady, Ramachandran; Di Angelantonio, Emanuele; Aro, Pertti; Azizi, Fereidoun; Babu, Bontha V.; Bahalim, Adil N.; Barbagallo, Carlo M.; Barbieri, Marco A.; Barceló, Alberto; Barreto, Sandhi M.; Barros, Henrique; Bautista, Leonelo E.; Benetos, Athanase; Bjerregaard, Peter; Björkelund, Cecilia; Bo, Simona; Bobak, Martin; Bonora, Enzo; Botana, Manuel A.; Bovet, Pascal; Breckenkamp, Juergen

2014-01-01

Background High blood pressure, blood glucose, serum cholesterol, and BMI are risk factors for cardiovascular diseases and some of these factors also increase the risk of chronic kidney disease and diabetes. We estimated mortality from cardiovascular diseases, chronic kidney disease, and diabetes

Vitamin D and Cardiovascular Disease: Potential Role in Health Disparities

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Artaza, Jorge N.; Contreras, Sandra; Garcia, Leah A.; Mehrotra, Rajnish; Gibbons, Gary; Shohet, Ralph; Martins, David; Norris, Keith C.

2012-01-01

Cardiovascular disease (CVD), which includes coronary artery disease and stroke, is the leading cause of mortality in the nation. Excess CVD morbidity and premature mortality in the African American community is one of the most striking examples of racial/ethnic disparities in health outcomes. African Americans also suffer from increased rates of hypovitaminosis D, which has emerged as an independent risk factor for all-cause and cardiovascular mortality. This overview examines the potential role of hypovitaminosis D as a contributor to racial and ethnic disparities in cardiovascular disease (CVD). We review the epidemiology of vitamin D and CVD in African Americans and the emerging biological roles of vitamin D in key CVD signaling pathways that may contribute to the epidemiological findings and provide the foundation for future therapeutic strategies for reducing health disparities. PMID:22102304

Lower mortality rate in elderly patients with community-onset pneumonia on treatment with aspirin.

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Falcone, Marco; Russo, Alessandro; Cangemi, Roberto; Farcomeni, Alessio; Calvieri, Camilla; Barillà, Francesco; Scarpellini, Maria Gabriella; Bertazzoni, Giuliano; Palange, Paolo; Taliani, Gloria; Venditti, Mario; Violi, Francesco

2015-01-06

Pneumonia is complicated by high rate of mortality and cardiovascular events (CVEs). The potential benefit of aspirin, which lowers platelet aggregation by inhibition of thromboxane A2 production, is still unclear. The aim of the study was to assess the impact of aspirin on mortality in patients with pneumonia. Consecutive patients admitted to the University-Hospital Policlinico Umberto I (Rome, Italy) with community-onset pneumonia were recruited and prospectively followed up until discharge or death. The primary end point was the occurrence of death up to 30 days after admission; the secondary end point was the intrahospital incidence of nonfatal myocardial infarction and ischemic stroke. One thousand and five patients (age, 74.7±15.1 years) were included in the study: 390 were receiving aspirin (100 mg/day) at the time of hospitalization, whereas 615 patients were aspirin free. During the follow-up, 16.2% of patients died; among these, 19 (4.9%) were aspirin users and 144 (23.4%; PFiO(2) ratio <300 negatively influenced survival, whereas aspirin therapy was associated with improved survival. Compared to patients receiving aspirin, the propensity score adjusted analysis confirmed that patients not taking aspirin had a hazard ratio of 2.07 (1.08 to 3.98; P=0.029) for total mortality. This study shows that chronic aspirin use is associated with lower mortality rate within 30 days after hospital admission in a large cohort of patients with pneumonia. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

The Finnish Cardiovascular Study (FINCAVAS): characterising patients with high risk of cardiovascular morbidity and mortality

International Nuclear Information System (INIS)

Nieminen, Tuomo; Turjanmaa, Väinö; Kähönen, Mika; Lehtinen, Rami; Viik, Jari; Lehtimäki, Terho; Niemelä, Kari; Nikus, Kjell; Niemi, Mari; Kallio, Janne; Kööbi, Tiit

2006-01-01

The purpose of the Finnish Cardiovascular Study (FINCAVAS) is to construct a risk profile – using genetic, haemodynamic and electrocardiographic (ECG) markers – of individuals at high risk of cardiovascular diseases, events and deaths. All patients scheduled for an exercise stress test at Tampere University Hospital and willing to participate have been and will be recruited between October 2001 and December 2007. The final number of participants is estimated to reach 5,000. Technically successful data on exercise tests using a bicycle ergometer have been collected of 2,212 patients (1,400 men and 812 women) by the end of 2004. In addition to repeated measurement of heart rate and blood pressure, digital high-resolution ECG at 500 Hz is recorded continuously during the entire exercise test, including the resting and recovery phases. About 20% of the patients are examined with coronary angiography. Genetic variations known or suspected to alter cardiovascular function or pathophysiology are analysed to elucidate the effects and interactions of these candidate genes, exercise and commonly used cardiovascular medications. FINCAVAS compiles an extensive set of data on patient history, genetic variation, cardiovascular parameters, ECG markers as well as follow-up data on clinical events, hospitalisations and deaths. The data enables the development of new diagnostic and prognostic tools as well as assessments of the importance of existing markers

The combined impact of adherence to five lifestyle factors on all-cause, cancer and cardiovascular mortality

DEFF Research Database (Denmark)

Petersen, Kristina E N; Johnsen, Nina F; Olsen, Anja

2015-01-01

guidelines into account. The objective of the present prospective cohort study was to investigate the combined impact of adherence to five lifestyle factors (smoking, alcohol intake, physical activity, waist circumference and diet) on all-cause, cancer and cardiovascular mortality based on international...

Physical Activity and Heart Rate Variability in Older Adults: The Cardiovascular Health Study

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Soares-Miranda, Luisa; Sattelmair, Jacob; Chaves, Paulo; Duncan, Glen; Siscovick, David S; Stein, Phyllis K; Mozaffarian, Dariush

2014-01-01

Background Cardiac mortality and electrophysiologic dysfunction both increase with age. Heart rate variability (HRV) provides indices of autonomic function and electrophysiology that are associated with cardiac risk. How habitual physical activity (PA) among older adults prospectively relates to HRV, including nonlinear indices of erratic sinus patterns, is not established. We hypothesized that increasing levels of both total leisure-time activity and walking would be prospectively associated with more favorable time-domain, frequency-domain, and nonlinear HRV measures in older adults. Methods and Results We evaluated serial longitudinal measures of both PA and 24-hour Holter HRV over 5 years among 985 older US adults in the community-based Cardiovascular Health Study. After multivariable adjustment, greater total leisure-time activity, walking distance, and walking pace were each prospectively associated with specific, more favorable HRV indices, including higher 24-hour standard-deviation-of-all-normal-to-normal-intervals (SDNN, p-trend=0.009, 0.02, 0.06, respectively) and ultra-low-frequency-power (p-trend=0.02, 0.008, 0.16, respectively). Greater walking pace was also associated with higher short-term-fractal-scaling-exponent (p-trend=0.003) and lower Poincare ratio (p-trend=0.02), markers of less erratic sinus patterns. Conclusions Greater total leisure-time activity, as well as walking alone, were prospectively associated with more favorable and specific indices of autonomic function in older adults, including several suggestive of more normal circadian fluctuations and less erratic sinoatrial firing. Our results suggest potential mechanisms that might contribute to lower cardiovascular mortality with habitual PA later in life. PMID:24799513

Anabolic steroids and cardiovascular risk: A national population-based cohort study.

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Thiblin, Ingemar; Garmo, Hans; Garle, Mats; Holmberg, Lars; Byberg, Liisa; Michaëlsson, Karl; Gedeborg, Rolf

2015-07-01

Non-therapeutic use of anabolic androgenic steroids (AAS) has been associated with various adverse effects; one of the most serious being direct cardiovascular effects with unknown long-term consequences. Therefore, large studies of the association between AAS and cardiovascular outcomes are warranted. We investigated cardiovascular morbidity and mortality in individuals who tested positive for AAS. Between 2002 and 2009, a total of 2013 men were enrolled in a cohort on the date of their first AAS test. Mortality and morbidity after cohort entry was retrieved from national registries. Of the 2013 individuals, 409 (20%) tested positive for AAS. These men had twice the cardiovascular morbidity and mortality rate as those with negative tests (adjusted hazard ratio (aHR) 2.0; 95% confidence interval (CI) 1.2-3.3). Compared to the Swedish population, all tested men had an increased risk of premature death from all causes (standardized mortality ratio for AAS-positive: 19.3, 95% CI 12.4-30.0; for AAS-negative: 8.3, 95% CI 6.1-11.0). Non-therapeutic exposure to AAS appears to be an independent risk factor for cardiovascular morbidity and premature death. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Longitudinal Study of Hypertensive Subjects With Type 2 Diabetes Mellitus: Overall and Cardiovascular Risk.

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Safar, Michel E; Gnakaméné, Jean-Barthélémy; Bahous, Sola Aoun; Yannoutsos, Alexandra; Thomas, Frédérique

2017-06-01

Despite adequate glycemic and blood pressure control, treated type 2 diabetic hypertensive subjects have a significantly elevated overall/cardiovascular risk. We studied 244 816 normotensive and 99 720 hypertensive subjects (including 7480 type 2 diabetics) attending medical checkups between 1992 and 2011. We sought to identify significant differences in overall/cardiovascular risk between hypertension with and without diabetes mellitus. Mean follow-up was 12.7 years; 14 050 all-cause deaths were reported. From normotensive to hypertensive populations, a significant progression in overall/cardiovascular mortality was observed. Mortality was significantly greater among diabetic than nondiabetic hypertensive subjects (all-cause mortality, 14.05% versus 7.43%; and cardiovascular mortality, 1.28% versus 0.7%). No interaction was observed between hemodynamic measurements and overall/cardiovascular risk, suggesting that blood pressure factors, even during drug therapy, could not explain the differences in mortality rates between diabetic and nondiabetic hypertensive patients. Using cross-sectional regression models, a significant association was observed between higher education levels, lower levels of anxiety and depression, and reduced overall mortality in diabetic hypertensive subjects, while impaired renal function, a history of stroke and myocardial infarction, and increased alcohol and tobacco consumption were significantly associated with increased mortality. Blood pressure and glycemic control alone cannot reverse overall/cardiovascular risk in diabetics with hypertension. Together with cardiovascular measures, overall prevention should include recommendations to reduce alcohol and tobacco consumption and improve stress, education levels, and physical activity. © 2017 American Heart Association, Inc.

Cardiovascular morbidity and early mortality cluster in parents of type 1 diabetic patients with diabetic nephropathy

DEFF Research Database (Denmark)

Tarnow, L; Rossing, P; Nielsen, F S

2000-01-01

OBJECTIVE: A familial predisposition was proposed to be a determinant of the increased morbidity and mortality from cardiovascular disease in type 1 diabetic patients with diabetic nephropathy. The insertion allele of an insertion/deletion polymorphism in the ACE (ACE/ID) gene seems to protect ag...

What is the association of hypothyroidism with risks of cardiovascular events and mortality? A meta-analysis of 55 cohort studies involving 1,898,314 participants.

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Ning, Yu; Cheng, Yun J; Liu, Li J; Sara, Jaskanwal D S; Cao, Zhi Y; Zheng, Wei P; Zhang, Tian S; Han, Hui J; Yang, Zhen Y; Zhang, Yi; Wang, Fei L; Pan, Rui Y; Huang, Jie L; Wu, Ling L; Zhang, Ming; Wei, Yong X

2017-02-02

Whether hypothyroidism is an independent risk factor for cardiovascular events is still disputed. We aimed to assess the association between hypothyroidism and risks of cardiovascular events and mortality. We searched PubMed and Embase from inception to 29 February 2016. Cohort studies were included with no restriction of hypothyroid states. Priori main outcomes were ischemic heart disease (IHD), cardiac mortality, cardiovascular mortality, and all-cause mortality. Fifty-five cohort studies involving 1,898,314 participants were identified. Patients with hypothyroidism, compared with euthyroidism, experienced higher risks of IHD (relative risk (RR): 1.13; 95% confidence interval (CI): 1.01-1.26), myocardial infarction (MI) (RR: 1.15; 95% CI: 1.05-1.25), cardiac mortality (RR: 1.96; 95% CI: 1.38-2.80), and all-cause mortality (RR: 1.25; 95% CI: 1.13-1.39); subclinical hypothyroidism (SCH; especially with thyrotropin level ≥10 mIU/L) was also associated with higher risks of IHD and cardiac mortality. Moreover, cardiac patients with hypothyroidism, compared with those with euthyroidism, experienced higher risks of cardiac mortality (RR: 2.22; 95% CI: 1.28-3.83) and all-cause mortality (RR: 1.51; 95% CI: 1.26-1.81). Hypothyroidism is a risk factor for IHD and cardiac mortality. Hypothyroidism is associated with higher risks of cardiac mortality and all-cause mortality compared with euthyroidism in the general public or in patients with cardiac disease.

Osteoprotegerin and mortality in type 2 diabetic patients

DEFF Research Database (Denmark)

Reinhard, Henrik; Lajer, Maria Stenkil; Gall, Mari-Anne

2010-01-01

aimed to investigate the prognostic value of OPG in relation to all-cause and cardiovascular mortality in a cohort of type 2 diabetic patients. RESEARCH DESIGN AND METHODS In a prospective observational follow-up study, 283 type 2 diabetic patients (172 men; aged 53.9 ± 8.8 years) were followed...... predictor of all-cause mortality in type 2 diabetic patients. The effect of OPG on all-cause mortality was independent of conventional cardiovascular risk factors, UAER, and NT-proBNP levels....... for a median of 16.8 years (range 0.2-23.0). Baseline plasma OPG concentrations were determined by immunoassay. RESULTS During follow-up, 193 (68%) patients died. High versus low levels of OPG predicted all-cause mortality (covariate-adjusted for urinary albumin excretion rate [UAER], estimated glomerular...

Does mortality vary between Asian subgroups in New Zealand: an application of hierarchical Bayesian modelling.

Directory of Open Access Journals (Sweden)

Santosh Jatrana

Full Text Available The aim of this paper was to see whether all-cause and cause-specific mortality rates vary between Asian ethnic subgroups, and whether overseas born Asian subgroup mortality rate ratios varied by nativity and duration of residence. We used hierarchical Bayesian methods to allow for sparse data in the analysis of linked census-mortality data for 25-75 year old New Zealanders. We found directly standardised posterior all-cause and cardiovascular mortality rates were highest for the Indian ethnic group, significantly so when compared with those of Chinese ethnicity. In contrast, cancer mortality rates were lowest for ethnic Indians. Asian overseas born subgroups have about 70% of the mortality rate of their New Zealand born Asian counterparts, a result that showed little variation by Asian subgroup or cause of death. Within the overseas born population, all-cause mortality rates for migrants living 0-9 years in New Zealand were about 60% of the mortality rate of those living more than 25 years in New Zealand regardless of ethnicity. The corresponding figure for cardiovascular mortality rates was 50%. However, while Chinese cancer mortality rates increased with duration of residence, Indian and Other Asian cancer mortality rates did not. Future research on the mechanisms of worsening of health with increased time spent in the host country is required to improve the understanding of the process, and would assist the policy-makers and health planners.

Mortality and cardiovascular risk associated with different insulin secretagogues compared with metformin in type 2 diabetes, with or without a previous myocardial infarction: a nationwide study

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Schramm, Tina Ken; Gislason, Gunnar Hilmar; Vaag, Allan

2011-01-01

Aims The impact of insulin secretagogues (ISs) on long-term major clinical outcomes in type 2 diabetes remains unclear. We examined mortality and cardiovascular risk associated with all available ISs compared with metformin in a nationwide study. Methods and results All Danish residents >20 years......, initiating single-agent ISs or metformin between 1997 and 2006 were followed for up to 9 years (median 3.3 years) by individual-level linkage of nationwide registers. All-cause mortality, cardiovascular mortality, and the composite of myocardial infarction (MI), stroke, and cardiovascular mortality...... associated with individual ISs were investigated in patients with or without previous MI by multivariable Cox proportional-hazard analyses including propensity analyses. A total of 107 806 subjects were included, of whom 9607 had previous MI. Compared with metformin, glimepiride (hazard ratios and 95...

Prognostic value of ambulatory heart rate revisited in 6928 subjects from 6 populations

DEFF Research Database (Denmark)

Hansen, Tine Willum; Thijs, Lutgarde; Staessen, Jan A.

2008-01-01

The evidence relating mortality and morbidity to heart rate remains inconsistent. We performed 24-hour ambulatory blood pressure monitoring in 6928 subjects (not on beta-blockers; mean age: 56.2 years; 46.5% women) enrolled in prospective population studies in Denmark, Belgium, Japan, Sweden......, Uruguay, and China. We computed standardized hazard ratios for heart rate, while stratifying for cohort, and adjusting for blood pressure and other cardiovascular risk factors. Over 9.6 years (median), 850, 325, and 493 deaths accrued for total, cardiovascular, and noncardiovascular mortality......, respectively. The incidence of fatal combined with nonfatal end points was 805, 363, 439, and 324 for cardiovascular, stroke, cardiac, and coronary events, respectively. Twenty-four-hour heart rate predicted total (hazard ratio: 1.15) and noncardiovascular (hazard ratio: 1.18) mortality but not cardiovascular...

Ten-year blood pressure trajectories, cardiovascular mortality, and life years lost in 2 extinction cohorts: the Minnesota Business and Professional Men Study and the Zutphen Study.

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Tielemans, Susanne M A J; Geleijnse, Johanna M; Menotti, Alessandro; Boshuizen, Hendriek C; Soedamah-Muthu, Sabita S; Jacobs, David R; Blackburn, Henry; Kromhout, Daan

2015-03-09

Blood pressure (BP) trajectories derived from measurements repeated over years have low measurement error and may improve cardiovascular disease prediction compared to single, average, and usual BP (single BP adjusted for regression dilution). We characterized 10-year BP trajectories and examined their association with cardiovascular mortality, all-cause mortality, and life years lost. Data from 2 prospective and nearly extinct cohorts of middle-aged men—the Minnesota Business and Professional Men Study (n=261) and the Zutphen Study (n=632)—were used. BP was measured annually during 1947-1957 in Minnesota and 1960-1970 in Zutphen. BP trajectories were identified by latent mixture modeling. Cox proportional hazards and linear regression models examined BP trajectories with cardiovascular mortality, all-cause mortality, and life years lost. Associations were adjusted for age, serum cholesterol, smoking, and diabetes mellitus. Mean initial age was about 50 years in both cohorts. After 10 years of BP measurements, men were followed until death on average 20 years later. All Minnesota men and 98% of Zutphen men died. Four BP trajectories were identified, in which mean systolic BP increased by 5 to 49 mm Hg in Minnesota and 5 to 20 mm Hg in Zutphen between age 50 and 60. The third systolic BP trajectories were associated with 2 to 4 times higher cardiovascular mortality risk, 2 times higher all-cause mortality risk, and 4 to 8 life years lost, compared to the first trajectory. Ten-year BP trajectories were the strongest predictors, among different BP measures, of cardiovascular mortality, all-cause mortality, and life years lost in Minnesota. However, average BP was the strongest predictor in Zutphen. © 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.

Increased risk for cardiovascular mortality among malnourished end-stage renal disease patients.

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Fung, Frank; Sherrard, Donald J; Gillen, Daniel L; Wong, Craig; Kestenbaum, Bryan; Seliger, Steven; Ball, Adrianne; Stehman-Breen, Catherine

2002-08-01

Studies have shown that protein-energy malnutrition (PEM) is a strong predictor of total mortality among patients with end-stage renal disease (ESRD). The aim of this study is to assess the relationship between nutritional indices and cardiovascular (CV) mortality among patients with ESRD by using data from the US Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave I (DMMS-1). Demographic and medical data were abstracted from 5,058 patients who participated in the USRDS DMMS-1. Nutritional measurements of interest included subjective assessment of malnutrition, serum albumin level, body mass index (BMI), and cholesterol level. The USRDS provided follow-up data on mortality through July 1998. The Cox proportional hazard model was used to estimate the risk for CV death associated with nutritional markers. The risk for CV death was 39% greater for each 1-g/dL (10-g/L) decrement in serum albumin level (95% confidence interval [CI], 1.20 to 1.60; P history of CVD at the study start. Both PEM at baseline and worsening PEM over time are associated with a greater risk for CV death. This finding persists among dialysis patients without preexisting CVD at baseline. Copyright 2002 by the National Kidney Foundation, Inc.

Vitamin D, calcium, and cardiovascular mortality: a perspective from a plenary lecture given at the annual meeting of the American Association of Clinical Endocrinologists.

Science.gov (United States)

Miller, Paul D

2011-01-01

To examine data showing associations between serum 25-hydroxyvitamin D levels and calcium intake and cardiovascular mortality. The articles reviewed include those published from 1992-2011 derived from search engines (PubMed, Scopus, Medscape) using the following search terms: vitamin D, calcium, cardiovascular events, cardiovascular mortality, all-cause mortality, vascular calcification, chronic kidney disease, renal stones, and hypercalciuria. Because these articles were not weighted (graded) on the level of evidence, this review reflects my own perspective on the data and how they should be applied to clinical management. For skeletal health, vitamin D and calcium are both needed to ensure proper skeletal growth (modeling) and repair (remodeling). Nutritional deficiencies of either vitamin D or calcium may lead to a spectrum of metabolic bone disorders. Excessive consumption of either nutrient has been linked to a variety of medical disorders, such as hypercalcemia or renal stones. There have also been associations between vitamin D or calcium intake and cardiovascular disease. However, neither of these associations have established evidence nor known causality for increasing cardiovascular risk or all-cause mortality in patients with creatinine clearances greater than 60 mL/min. In patients with more severe chronic kidney disease, stronger data link excess calcium (or phosphorus) intake and increase in vascular calcification, but not mortality. The safe upper limit for vitamin D intake is at least 4000 IU daily and probably 10 000 IU daily; for calcium, the safe upper limit is between 2000 and 3000 mg daily. While no solid scientific evidence validates that serum vitamin D levels between 15 and 70 ng/mL are associated with increased cardiovascular disease risk, stronger but inconsistent evidence shows an association between calcium supplementation greater than 500 mg daily and an increase in cardiovascular disease risk. Most professional societies suggest that

Is there evidence showing that salt intake reduction reduces cardiovascular morbidity and mortality risk?

Directory of Open Access Journals (Sweden)

Fernando Lanas

2012-02-01

Full Text Available A recent systematic review of Cochrane collaboration about the effect of reducing dietary salt concluded that “there is still insufficient power to exclude clinically important effects of reduced dietary salt on mortality or cardiovascular morbidity in normotensive or hypertensive populations”. This conclusion has generated an important debate, because the estimation that salt reduction can prevent 24% of strokes and 18% of myocardial infarctions has decided the health authorities of several nations to implement salt consumption reduction programs. The review of ecological studies and clinical trials allow to conclude that a reduction in salt consumption reduces blood pressure and methodological well conducted cohort studies has shown that cardiovascular events risk decreases progressively with lower levels of blood pressure. Combining this two finding we can assume that population should benefice from a decrease on salt consumption although there are no studies that shown a reduction in cardiovascular events in population with high sodium intake when dietary salt is reduced.

Suicide mortality rates in Louisiana, 1999-2010.

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Straif-Bourgeois, Susanne; Ratard, Raoult

2012-01-01

This report is a descriptive study on suicide deaths in Louisiana occurring in the years 1999 to 2010. Mortality data was collected from death certificates from this 12-year period to describe suicide mortality by year, race, sex, age group, and methods of suicide. Data were also compared to national data. Rates and methods used to commit suicide vary greatly according to sex, race, and age. The highest rates were observed in white males, followed by black males, white females, and black females. Older white males had the highest suicide rates. The influence of age was modulated by the sex and race categories. Firearm was the most common method used in all four categories. Other less common methods were hanging/strangulation/suffocation (HSS) and drugs/alcohol. Although no parish-level data were systematically analyzed, a comparison of suicide rates post-Katrina versus pre-Katrina was done for Orleans Parish, the rest of the Greater New Orleans area, and a comparison group. It appears that rates observed among whites, particularly males, were higher after Katrina. Data based on mortality do not give a comprehensive picture of the burden of suicide, and their interpretation should be done with caution.

Bone mineral density at the hip predicts mortality in elderly men.

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Trivedi, D P; Khaw, K T

2001-01-01

Low bone density as assessed by calcaneal ultrasound has been associated with mortality in elderly men and women. We examined the relationship between bone density measured at the hip and all cause and cardiovascular mortality in elderly men. Men aged 65-76 years from the general community were recruited from general practices in Cambridge between 1991 and 1995. At baseline survey, data collection included health questionnaires, measures of anthropometry and cardiovascular risk factors, as well as bone mineral density (BMD) measured using dual energy X-ray absorptiometry. All men have been followed up for vital status up to December 1999. BMD was significantly inversely related to mortality from all causes and cardiovascular disease, with decreasing rates with increasing bone density quartile, and an approximate halving of risk between the bottom and top quartile (p risk (95% CI 0.66-0.91) for all-cause mortality and 0.76 relative risk (95% CI 0.62-0.93) for cardiovascular disease mortality. The association remained significant after adjusting for age, body mass index, cigarette smoking status, serum cholesterol, systolic blood pressure, past history of heart attack, stroke or cancer and other lifestyle factors which included use of alcohol, physical activity and general health status. Low bone density at the hip is thus a strong and independent predictor of all-cause and cardiovascular mortality in older men.

Mortality and treatment patterns among patients hospitalized with acute cardiovascular conditions during dates of national cardiology meetings.

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Jena, Anupam B; Prasad, Vinay; Goldman, Dana P; Romley, John

2015-02-01

Thousands of physicians attend scientific meetings annually. Although hospital physician staffing and composition may be affected by meetings, patient outcomes and treatment patterns during meeting dates are unknown. To analyze mortality and treatment differences among patients admitted with acute cardiovascular conditions during dates of national cardiology meetings compared with nonmeeting dates. Retrospective analysis of 30-day mortality among Medicare beneficiaries hospitalized with acute myocardial infarction (AMI), heart failure, or cardiac arrest from 2002 through 2011 during dates of 2 national cardiology meetings compared with identical nonmeeting days in the 3 weeks before and after conferences (AMI, 8570 hospitalizations during 82 meeting days and 57,471 during 492 nonmeeting days; heart failure, 19,282 during meeting days and 11,4591 during nonmeeting days; cardiac arrest, 1564 during meeting days and 9580 during nonmeeting days). Multivariable analyses were conducted separately for major teaching hospitals and nonteaching hospitals and for low- and high-risk patients. Differences in treatment utilization were assessed. Hospitalization during cardiology meeting dates. Thirty-day mortality, procedure rates, charges, length of stay. Patient characteristics were similar between meeting and nonmeeting dates. In teaching hospitals, adjusted 30-day mortality was lower among high-risk patients with heart failure or cardiac arrest admitted during meeting vs nonmeeting dates (heart failure, 17.5% [95% CI, 13.7%-21.2%] vs 24.8% [95% CI, 22.9%-26.6%]; P cardiology meetings. High-risk patients with heart failure and cardiac arrest hospitalized in teaching hospitals had lower 30-day mortality when admitted during dates of national cardiology meetings. High-risk patients with AMI admitted to teaching hospitals during meetings were less likely to receive PCI, without any mortality effect.

Mortality and causes of death among Croatian male Olympic medalists.

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Radonić, Vedran; Kozmar, Damir; Počanić, Darko; Jerkić, Helena; Bohaček, Ivan; Letilović, Tomislav

2017-08-31

To compare the overall and disease-specific mortality of Croatian male athletes who won one or more Olympic medals representing Yugoslavia from 1948 to 1988 or Croatia from 1992 to 2016, and the general Croatian male population standardized by age and time period. All 233 Croatian male Olympic medalists were included in the study. Information on life duration and cause of death for the Olympic medalists who died before January 1, 2017, was acquired from their families and acquaintances. We asked the families and acquaintances to present medical documentation for the deceased. Data about the overall and disease-specific mortality of the Croatian male population standardized by age and time period were obtained from the Croatian Bureau of Statistics (CBS). Overall and disease-specific standard mortality ratios (SMR) with 95% confidence intervals (CI) were calculated to compare the mortality rates of athletes and general population. Among 233 Olympic medalists, 57 died before the study endpoint. The main causes of death were cardiovascular diseases (33.3%), neoplasms (26.3%), and external causes (17.6%). The overall mortality of the Olympic medalists was significantly lower than that of general population (SMR 0.73, 95% CI 0.56-0.94, P=0.013). Regarding specific causes of death, athletes' mortality from cardiovascular diseases was significantly reduced (SMR 0.61, 95% CI 0.38-0.93, P=0.021). Croatian male Olympic medalists benefit from lower overall and cardiovascular mortality rates in comparison to the general Croatian male population.

Effect of the 2008 economic crisis on the cardiovascular mortality of the Irish population: an ecological 12-year study of a heart-broken Celtic Tiger.

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Osman, M; Osman, A

2017-08-08

Ireland has endured a substantial financial crisis in 2008 and we sought to explore the effect of economic recession on Irish cardiovascular mortality. We found an increase by 17.2% in CVA-deaths during the financial crisis years (95% CI 11.1% to 23.6%). In males, we found a notable rise in the annual IHD rate by 7.56% (95% CI 4.73% to 10.46%), in annual MI rate by 2.96% (95% CI 0.16% to 5.84%), and in annual CVA death rate by 20.07% (95% CI 16.13% to 24.14%). In females our findings indicated an increased rate of CVA-related deaths during the economic crisis by 15.54% (95% CI 6.67% to 25.16%). Irish CVA-related deaths increased during the economic crisis for males and females alike. Male IHD-related deaths have also risen indicating a potential differential effect for financial hardships on male gender mortality.

An evaluation of the 25 by 25 goal for premature cardiovascular disease mortality in Taiwan: an age-period-cohort analysis, population attributable fraction and national population-based study.

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Su, Shih-Yung; Lee, Wen-Chung; Chen, Tzu-Ting; Wang, Hao-Chien; Su, Ta-Chen; Jeng, Jiann-Shing; Tu, Yu-Kang; Liao, Shu-Fen; Lu, Tzu-Pin; Chien, Kuo-Liong

2017-01-01

The aim of the 25 by 25 goal is to reduce mortality from premature non-communicable diseases by 25% before 2025. Studies have evaluated the 25 by 25 goal in many countries, but not in Taiwan. The aim of this study was to estimate the 25 by 25 goal for premature mortality from cardiovascular diseases in Taiwan. We applied the age-period-cohort model to project the incidence of premature death from cardiovascular disease from 2015 to 2024 and used the population attributable fraction to estimate the contributions of targeted risk factors. The probability of death was used to estimate the percent change. The percent change in business-as-usual trend during 2010-2024 was only a 6% (range 1.7-10.7%) lower risk of premature mortality from cardiovascular disease among men. The greatest reduction in the risk of mortality occurred with a 30% reduction in the prevalence of smoking; however, there was only a 14.5% (10.6-18.3%) decrease in percent change and in the corresponding number of men (3706: range 3543-3868) who were prevented from dying. More than a 25% reduction in the percent change of premature cardiovascular disease mortality among women was achieved without control of any risk factor. To reach a 25% reduction in men before 2025, there needs to be a 70% reduction in the prevalence of smoking to reduce mortality by 26.2% (22.9-29.3%). Cigarette smoking is the primary target in the prevention of cardiovascular disease. Through the stringent control of smoking, the goal of a 25% reduction in premature mortality from cardiovascular disease may be achieved before 2025 in Taiwan.

A Typology for Charting Socioeconomic Mortality Gradients: "Go Southwest".

Science.gov (United States)

Blakely, Tony; Disney, George; Atkinson, June; Teng, Andrea; Mackenbach, Johan P

2017-07-01

Holistic depiction of time-trends in average mortality rates, and absolute and relative inequalities, is challenging. We outline a typology for situations with falling average mortality rates (m↓; e.g., cardiovascular disease), rates stable over time (m-; e.g., some cancers), and increasing average mortality rates (m↑; e.g., suicide in some contexts). If we consider inequality trends on both the absolute (a) and relative (r) scales, there are 13 possible combination of m, a, and r trends over time. They can be mapped to graphs with relative inequality (log relative index of inequality [RII]; r) on the y axis, log average mortality rate on the x axis (m), and absolute inequality (slope index of inequality; SII; a) as contour lines. We illustrate this by plotting adult mortality trends: (1) by household income from 1981 to 2011 for New Zealand, and (2) by education for European countries. Types range from the "best" m↓a↓r↓ (average, absolute, and relative inequalities all decreasing; southwest movement in graphs) to the "worst" m↑a↑r↑ (northeast). Mortality typologies in New Zealand (all-cause, cardiovascular disease, nonlung cancer, and unintentional injury) were all m↓r↑ (northwest), but variable with respect to absolute inequality. Most European typologies were m↓r↑ types (northwest; e.g., Finland), but with notable exceptions of m-a↑r↑ (north; e.g., Hungary) and "best" or southwest m↓a↓r↓ for Spain (Barcelona) females. Our typology and corresponding graphs provide a convenient way to summarize and understand past trends in inequalities in mortality, and hold potential for projecting future trends and target setting.

The inter-arm systolic blood pressure difference and risk of cardiovascular mortality: A meta-analysis of cohort studies.

Science.gov (United States)

Zhou, Ming; Gao, Zhen; Chen, Fei; Xu, Haijun; Dong, Xiao; Ma, Li

2016-01-01

The inter-arm systolic blood pressure difference (SBPD) is recommended to be in relation to potential cardiovascular disease (CVD). Previous studies yielded controversial results about the association between an inter-arm SBPD ≥ 10 mmHg or ≥15 mmHg and the risk of cardiovascular mortality. Therefore, we conducted this meta-analysis to investigate this association. We searched PubMed and Embase databases through December 31, 2014, and examined the references of retrieved articles to identify relevant cohort studies. We utilized Newcastle-Ottawa scale to assess the quality of included studies and calculated the summary risk estimates in a fixed/random-effect model. All data analyses were conducted using STATA version 11.0. A total of seven studies were identified. Compared with participants with an inter-arm SBPD arm SBPD ≥ 10 mmHg was 1.58 (95% CI: 1.3-1.93), and the pooled HR of cardiovascular mortality of participants with an inter-arm SBPD ≥ 15 mmHg versus those with an inter-arm SBPD arm SBPD may define a subpopulation at high risk of CVD events.

Nonlinear association of BMI with all-cause and cardiovascular mortality in type 2 diabetes mellitus: a systematic review and meta-analysis of 414,587 participants in prospective studies.

Science.gov (United States)

Zaccardi, Francesco; Dhalwani, Nafeesa N; Papamargaritis, Dimitris; Webb, David R; Murphy, Gavin J; Davies, Melanie J; Khunti, Kamlesh

2017-02-01

The relationship between BMI and mortality has been extensively investigated in the general population; however, it is less clear in people with type 2 diabetes. We aimed to assess the association of BMI with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus. We searched electronic databases up to 1 March 2016 for prospective studies reporting associations for three or more BMI groups with all-cause and cardiovascular mortality in individuals with type 2 diabetes mellitus. Study-specific associations between BMI and the most-adjusted RR were estimated using restricted cubic splines and a generalised least squares method before pooling study estimates with a multivariate random-effects meta-analysis. We included 21 studies including 24 cohorts, 414,587 participants, 61,889 all-cause and 4470 cardiovascular incident deaths; follow-up ranged from 2.7 to 15.9 years. There was a strong nonlinear relationship between BMI and all-cause mortality in both men and women, with the lowest estimated risk from 31-35 kg/m 2 and 28-31 kg/m 2 (p value for nonlinearity 1) respectively. The risk of mortality at higher BMI values increased significantly only in women, whilst lower values were associated with higher mortality in both sexes. Limited data for cardiovascular mortality were available, with a possible inverse linear association with BMI (higher risk for BMI type 2 diabetes, BMI is nonlinearly associated with all-cause mortality with lowest risk in the overweight group in both men and women. Further research is needed to clarify the relationship with cardiovascular mortality and assess causality and sex differences.

Size-dependent mortality rate profiles.

Science.gov (United States)

Roa-Ureta, Ruben H

2016-08-07

Knowledge of mortality rates is crucial to the understanding of population dynamics in populations of free-living fish and invertebrates in marine and freshwater environments, and consequently to sustainable resource management. There is a well developed theory of population dynamics based on age distributions that allow direct estimation of mortality rates. However, for most cases the aging of individuals is difficult or age distributions are not available for other reasons. The body size distribution is a widely available alternative although the theory underlying the formation of its shape is more complicated than in the case of age distributions. A solid theory of the time evolution of a population structured by any physiological variable has been developed in 1960s and 1970s by adapting the Hamilton-Jacobi formulation of classical mechanics, and equations to estimate the body size-distributed mortality profile have been derived for simple cases. Here I extend those results with regards to the size-distributed mortality profile to complex cases of non-stationary populations, individuals growing according to a generalised growth model and seasonally patterned recruitment pulses. I apply resulting methods to two cases in the marine environment, a benthic crustacean population that was growing during the period of observation and whose individuals grow with negative acceleration, and a sea urchin coastal population that is undergoing a stable cycle of two equilibrium points in population size whose individuals grow with varying acceleration that switches sign along the size range. The extension is very general and substantially widens the applicability of the theory. Copyright © 2016 Elsevier Ltd. All rights reserved.

Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts.

Directory of Open Access Journals (Sweden)

Emmanuel Stamatakis

Full Text Available There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts.The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education.In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89 and cancer (HR = 0.60, 95% CI 0.43-0.85 mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity.Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

Long-Term PM2.5 Exposure and Respiratory, Cancer, and Cardiovascular Mortality in Older US Adults.

Science.gov (United States)

Pun, Vivian C; Kazemiparkouhi, Fatemeh; Manjourides, Justin; Suh, Helen H

2017-10-15

The impact of chronic exposure to fine particulate matter (particulate matter with an aerodynamic diameter less than or equal to 2.5 μm (PM2.5)) on respiratory disease and lung cancer mortality is poorly understood. In a cohort of 18.9 million Medicare beneficiaries (4.2 million deaths) living across the conterminous United States between 2000 and 2008, we examined the association between chronic PM2.5 exposure and cause-specific mortality. We evaluated confounding through adjustment for neighborhood behavioral covariates and decomposition of PM2.5 into 2 spatiotemporal scales. We found significantly positive associations of 12-month moving average PM2.5 exposures (per 10-μg/m3 increase) with respiratory, chronic obstructive pulmonary disease, and pneumonia mortality, with risk ratios ranging from 1.10 to 1.24. We also found significant PM2.5-associated elevated risks for cardiovascular and lung cancer mortality. Risk ratios generally increased with longer moving averages; for example, an elevation in 60-month moving average PM2.5 exposures was linked to 1.33 times the lung cancer mortality risk (95% confidence interval: 1.24, 1.40), as compared with 1.13 (95% confidence interval: 1.11, 1.15) for 12-month moving average exposures. Observed associations were robust in multivariable models, although evidence of unmeasured confounding remained. In this large cohort of US elderly, we provide important new evidence that long-term PM2.5 exposure is significantly related to increased mortality from respiratory disease, lung cancer, and cardiovascular disease. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Healthy lifestyle factors and risk of cardiovascular events and mortality in treatment-resistant hypertension: the Reasons for Geographic and Racial Differences in Stroke study.

Science.gov (United States)

Diaz, Keith M; Booth, John N; Calhoun, David A; Irvin, Marguerite R; Howard, George; Safford, Monika M; Muntner, Paul; Shimbo, Daichi

2014-09-01

Few data exist on whether healthy lifestyle factors are associated with better prognosis among individuals with apparent treatment-resistant hypertension, a high-risk phenotype of hypertension. The purpose of this study was to assess the association of healthy lifestyle factors with cardiovascular events, all-cause mortality, and cardiovascular mortality among individuals with apparent treatment-resistant hypertension. We studied participants (n=2043) from the population-based Reasons for Geographic and Racial Differences in Stroke (REGARDS) study with apparent treatment-resistant hypertension (blood pressure ≥140/90 mm Hg despite the use of 3 antihypertensive medication classes or the use of ≥4 classes of antihypertensive medication regardless of blood pressure control). Six healthy lifestyle factors adapted from guidelines for the management of hypertension (normal waist circumference, physical activity ≥4 times/week, nonsmoking, moderate alcohol consumption, high Dietary Approaches to Stop Hypertension diet score, and low sodium-to-potassium intake ratio) were examined. A greater number of healthy lifestyle factors were associated with lower risk for cardiovascular events (n=360) during a mean follow-up of 4.5 years. Multivariable-adjusted hazard ratios [HR (95% confidence interval)] for cardiovascular events comparing individuals with 2, 3, and 4 to 6 versus 0 to 1 healthy lifestyle factors were 0.91 (0.68-1.21), 0.80 (0.57-1.14), and 0.63 (0.41-0.95), respectively (P-trend=0.020). Physical activity and nonsmoking were individual healthy lifestyle factors significantly associated with lower risk for cardiovascular events. Similar associations were observed between healthy lifestyle factors and risk for all-cause and cardiovascular mortality. In conclusion, healthy lifestyle factors, particularly physical activity and nonsmoking, are associated with a lower risk for cardiovascular events and mortality among individuals with apparent treatment

The Association of Reproductive Hormone Levels and All-Cause, Cancer, and Cardiovascular Disease Mortality in Men

DEFF Research Database (Denmark)

Agergaard Holmboe, Stine; Vradi, Eleni; Jensen, Tina Kold

2015-01-01

, 50, 60 or 70 years at baseline. MAIN OUTCOME MEASURES: All-cause mortality, cardiovascular disease (CVD) mortality and cancer mortality. RESULTS: 1,533 men died during the follow-up period; 428 from CVD and 480 from cancer. Cox proportional hazard models revealed that men in highest LH quartile had...... an increased all-cause mortality compared to lowest quartile (HR=1.32, 95%CI: 1.14 to 1.53). Likewise, increased quartiles of LH/T and estradiol increased the risk of all-cause mortality (HR=1.23, 95%CI: 1.06 to 1.43, HR=1.23, 95%CI: 1.06 to 1.43). No association to testosterone levels was found. Higher LH...... levels were associated with increased cancer mortality (HR=1.42, 95%CI: 1.10 to 1.84) independently of smoking status. Lower CVD mortality was seen for men with testosterone in the highest quartile compared to lowest (HR=0.72, 95%CI: 0.53 to 0.98). Furthermore, negative trends were seen for SHBG and free...

Mortality of marine planktonic copepods : global rates and patterns

DEFF Research Database (Denmark)

Hirst, A.G.; Kiørboe, Thomas

2002-01-01

Using life history theory we make predictions of mortality rates in marine epi-pelagic copepods from field estimates of adult fecundity, development times and adult sex ratios. Predicted mortality increases with temperature in both broadcast and sac spawning copepods, and declines with body weight...... in broadcast spawners, while mortality in sac spawners is invariant with body size. Although the magnitude of copepod mortality does lie close to the overall general pattern for pelagic animals, copepod mortality scaling is much weaker, implying that small copepods are avoiding some mortality agent....../s that other pelagic animals of a similar size do not, We compile direct in situ estimates of copepod mortality and compare these with our indirect predictions; we find the predictions generally match the field measurements well with respect to average rates and patterns. Finally, by comparing in situ adult...

Change in the structures, dynamics and disease-related mortality rates of the population of Qatari nationals: 2007-2011.

Science.gov (United States)

Al-Thani, Mohamed H; Sadoun, Eman; Al-Thani, Al-Anoud; Khalifa, Shamseldin A; Sayegh, Suzan; Badawi, Alaa

2014-12-01

Developing effective public health policies and strategies for interventions necessitates an assessment of the structure, dynamics, disease rates and causes of death in a population. Lately, Qatar has undertaken development resurgence in health and economy that resulted in improving the standard of health services and health status of the entire Qatari population (i.e., Qatari nationals and non-Qatari residents). No study has attempted to evaluate the population structure/dynamics and recent changes in disease-related mortality rates among Qatari nationals. The present study examines the population structure/dynamics and the related changes in the cause-specific mortality rates and disease prevalence in the Qatari nationals. This is a retrospective, analytic descriptive analysis covering a period of 5years (2007-2011) and utilizes a range of data sources from the State of Qatar including the population structure, disease-related mortality rates, and the prevalence of a range of chronic and infectious diseases. Factors reflecting population dynamics such as crude death (CDR), crude birth (CBR), total fertility (TFR) and infant mortality (IMR) rates were also calculated. The Qatari nationals is an expansive population with an annual growth rate of ∼4% and a stable male:female ratio. The CDR declined by 15% within the study period, whereas the CBR was almost stable. The total disease-specific death rate, however, was decreased among the Qatari nationals by 23% due to the decline in mortality rates attributed to diseases of the blood and immune system (43%), nervous system (44%) and cardiovascular system (41%). There was a high prevalence of a range of chronic diseases, whereas very low frequencies of the infectious diseases within the study population. Public health strategies, approaches and programs developed to reduce disease burden and the related death, should be tailored to target the population of Qatari nationals which exhibits characteristics that vary from

Hipertrofia ventricular e mortalidade cardiovascular em pacientes de hemodiálise de baixo nível educacional Hipertrofia ventricular y mortalidad cardiovascular en pacientes de hemodiálisis de bajo nivel educativo Ventricular hypertrophy and cardiovascular mortality in hemodialysis patients with low educational level

Directory of Open Access Journals (Sweden)

Rosana dos Santos e Silva Martin

2012-01-01

escolaridad tienen hipertrofia ventricular más intensa. OBJETIVO: Ampliar estudio previo y verificar si la hipertrofia ventricular izquierda puede justificar la asociación entre escolaridad y mortalidad cardiovascular de pacientes en hemodiálisis. MÉTODOS: Fueron evaluados 113 pacientes entre enero de 2005 y marzo de 2008 y seguidos hasta octubre de 2010. Fueron trazadas curvas de sobrevida comparando la mortalidad cardiovascular, y por todas las causas de los pacientes con escolaridad de hasta tres años (mediana de la escolaridad y pacientes con escolaridad igual o superior a cuatro años. Fueron construidos modelos múltiples de Cox ajustados para las variables de confusión. RESULTADOS: Se observó asociación entre nivel de escolaridad e hipertrofia ventricular. La diferencia estadística de mortalidad de origen cardiovascular y por todas las causas entre los diferentes niveles de escolaridad ocurrió a los cinco años y medio de seguimiento. En el modelo de Cox, la hipertrofia ventricular y la proteína-C reactiva se asociaron a la mortalidad por todas las causas y de origen cardiovascular. La etiología de la insuficiencia renal se asoció a la mortalidad por todas las causas y la creatinina se asoció a la mortalidad de origen cardiovascular. La asociación entre escolaridad y mortalidad perdió significación estadística en el modelo ajustado. CONCLUSÓN: Los resultados del presente trabajo confirman estudio previo y demuestran, además, que la mayor mortalidad cardiovascular observada en los pacientes con menor escolaridad puede ser explicada por factores de riesgo de orden bioquímico y de morfología cardíaca.BACKGROUND: Left ventricular hypertrophy is a strong predictor of mortality in chronic kidney patients. A previous study of our group has shown that chronic kidney patients with low educational level has more severe ventricular hypertrophy. OBJECTIVE: To extend a previous study and to assess whether left ventricular hypertrophy can explain the

Body mass index and risk of perioperative cardiovascular adverse events and mortality in 34,744 Danish patients undergoing hip or knee replacement

DEFF Research Database (Denmark)

Thornqvist, Catharina; Gislason, Gunnar H; Køber, Lars

2014-01-01

underwent elective primary hip or knee replacement surgery between 2005 and 2011. We used multivariable Cox regression models to calculate the 30-day risks of MACE and mortality associated with 5 BMI groups (underweight (BMI ...BACKGROUND AND PURPOSE: Obesity is a risk factor for osteoarthritis in the lower limb, yet the cardiovascular risks associated with obesity in hip or knee replacement surgery are unknown. We examined associations between body mass index (BMI) and the risk of a major adverse cardiovascular event...... (MACE: ischemic stroke, acute myocardial infarction, or cardiovascular death) or the risk of all-cause mortality in a nationwide Danish cohort of patients who underwent primary hip or knee replacement surgery. METHODS: Using Danish nationwide registries, we identified 34,744 patients aged ≥ 20 years who...

Six-year change in high-sensitivity C-reactive protein and risk of diabetes, cardiovascular disease, and mortality.

Science.gov (United States)

Parrinello, Christina M; Lutsey, Pamela L; Ballantyne, Christie M; Folsom, Aaron R; Pankow, James S; Selvin, Elizabeth

2015-08-01

Single measurements of elevated high-sensitivity C-reactive protein (hs-CRP) are associated with increased risk of diabetes, cardiovascular disease, and mortality. Large increases or sustained elevations in hs-CRP may be associated with even greater risk of these outcomes. The objective of this study was to characterize the association of 6-year change in hs-CRP with incident diabetes, incident cardiovascular events (heart disease, stroke, and heart failure), and mortality. We included 10,160 ARIC participants with hs-CRP measured at visits 2 (1990-1992) and 4 (1996-1998). Change in hs-CRP was categorized as sustained low/moderate (<3 mg/L at both visits), decreased (≥3 mg/L at visit 2 and <3 mg/L at visit 4), increased (<3 mg/L at visit 2 and ≥3 mg/L at visit 4), and sustained elevated (≥3 mg/L at both visits). Cox proportional hazards models were used to assess the association of 6-year change in hs-CRP with incident diabetes, cardiovascular events, and death during ~15 years after visit 4. Compared with persons with sustained low/moderate hs-CRP, those with increased or sustained elevated hs-CRP had an increased risk of incident diabetes (hazard ratios [95% CIs] 1.56 [1.38-1.76] and 1.39 [1.25-1.56], respectively), whereas those with deceased hs-CRP did not. Persons with sustained elevated hs-CRP had an increased risk of coronary heart disease, ischemic stroke, heart failure, and mortality (hazard ratios [95% CIs] 1.51 [1.23-1.85], 1.70 [1.32-2.20], 1.60 [1.35-1.89], and 1.52 [1.37-1.69], respectively) compared with those with sustained low/moderate hs-CRP. Associations for sustained elevated hs-CRP were greater than for those with increased hs-CRP over 6 years. Large increases or sustained elevations in hs-CRP over a 6-year period were associated with a subsequent increased risk of diabetes, and persons with sustained elevations in hs-CRP were at the highest risk for cardiovascular disease and mortality. Two measurements of hs-CRP are better than one for

Cardiovascular mortality, all-cause mortality, and diabetes incidence after lifestyle intervention for people with impaired glucose tolerance in the Da Qing Diabetes Prevention Study: a 23-year follow-up study.

Science.gov (United States)

Li, Guangwei; Zhang, Ping; Wang, Jinping; An, Yali; Gong, Qiuhong; Gregg, Edward W; Yang, Wenying; Zhang, Bo; Shuai, Ying; Hong, Jing; Engelgau, Michael M; Li, Hui; Roglic, Gojka; Hu, Yinghua; Bennett, Peter H

2014-06-01

Lifestyle interventions among people with impaired glucose tolerance reduce the incidence of diabetes, but their effect on all-cause and cardiovascular disease mortality is unclear. We assessed the long-term effect of lifestyle intervention on long-term outcomes among adults with impaired glucose tolerance who participated in the Da Qing Diabetes Prevention Study. The study was a cluster randomised trial in which 33 clinics in Da Qing, China-serving 577 adults with impaired glucose tolerance-were randomised (1:1:1:1) to a control group or lifestyle intervention groups (diet or exercise or both). Patients were enrolled in 1986 and the intervention phase lasted for 6 years. In 2009, we followed up participants to assess the primary outcomes of cardiovascular mortality, all-cause mortality, and incidence of diabetes in the intention-to-treat population. Of the 577 patients, 439 were assigned to the intervention group and 138 were assigned to the control group (one refused baseline examination). 542 (94%) of 576 participants had complete data for mortality and 568 (99%) contributed data to the analysis. 174 participants died during the 23 years of follow-up (121 in the intervention group vs 53 in the control group). Cumulative incidence of cardiovascular disease mortality was 11.9% (95% CI 8.8-15.0) in the intervention group versus 19.6% (12.9-26.3) in the control group (hazard ratio [HR] 0.59, 95% CI 0.36-0.96; p=0.033). All-cause mortality was 28.1% (95% CI 23.9-32.4) versus 38.4% (30.3-46.5; HR 0.71, 95% CI 0.51-0.99; p=0.049). Incidence of diabetes was 72.6% (68.4-76.8) versus 89.9% (84.9-94.9; HR 0.55, 95% CI 0.40-0.76; p=0.001). A 6-year lifestyle intervention programme for Chinese people with impaired glucose tolerance can reduce incidence of cardiovascular and all-cause mortality and diabetes. These findings emphasise the long-term clinical benefits of lifestyle intervention for patients with impaired glucose tolerance and provide further justification for

Effects of Liraglutide on Heart Rate and Heart Rate Variability

DEFF Research Database (Denmark)

Kumarathurai, Preman; Anholm, Christian; Larsen, Bjørn Strøier

2017-01-01

OBJECTIVE: Reduced heart rate variability (HRV) and increased heart rate (HR) have been associated with cardiovascular mortality. Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) increase HR, and studies have suggested that they may reduce HRV. We examined the effect of the GLP-1 RA...

Cardiovascular disease - risk benefits of clean fuel technology and policy. A statistical analysis

Energy Technology Data Exchange (ETDEWEB)

Gallagher, Paul; Fischer, Amelia [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States); Lazarus, William; Bachewe, Fantu [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Shapouri, Hosein; Conway, Roger [Office of Energy Policy and New Uses, 400 Independence Avenue, SW (Rm.4059 So. Bldg), United States Department of Agriculture, Washington, DC 20250 (United States)

2010-02-15

The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels. (author)

Cardiovascular disease-risk benefits of clean fuel technology and policy: A statistical analysis

Energy Technology Data Exchange (ETDEWEB)

Gallagher, Paul, E-mail: paulg@iastate.ed [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States); Lazarus, William [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Shapouri, Hosein; Conway, Roger [Office of Energy Policy and New Uses, 400 Independence Avenue, SW (Rm.4059 So. Bldg), United States Department of Agriculture, Washington, DC 20250 (United States); Bachewe, Fantu [Applied Economics Department, 253 COB, University of Minnesota, St. Paul, MN 55455 (United States); Fischer, Amelia [Economics Department, 481 Heady Hall, Iowa State University, Ames Iowa 50011 (United States)

2010-02-15

The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels.

Cardiovascular disease-risk benefits of clean fuel technology and policy: A statistical analysis

International Nuclear Information System (INIS)

Gallagher, Paul; Lazarus, William; Shapouri, Hosein; Conway, Roger; Bachewe, Fantu; Fischer, Amelia

2010-01-01

The hypothesis of this study is that there is a statistical relationship between the cardiovascular disease mortality rate and the intensity of fuel consumption (measured in gallons/square mile) at a particular location. We estimate cross-sectional regressions of the mortality rate due to cardiovascular disease against the intensity of fuel consumption using local data for the entire US, before the US Clean Air Act (CAA) in 1974 and after the most recent policy revisions in 2004. The cardiovascular disease rate improvement estimate suggests that up to 60 cardiovascular disease deaths per 100,000 residents are avoided in the largest urban areas with highest fuel consumption per square mile. In New York City, for instance, the mortality reduction may be worth about $30.3 billion annually. Across the US, the estimated Value of Statistical Life (VSL) benefit is $202.7 billion annually. There are likely three inseparable reasons that contributed importantly to this welfare improvement. First, the CAA regulations banned leaded gasoline, and mandated reduction in specific chemicals and smog components. Second, technologies such as the Catalytic Converter (CC) for the automobile and the low particulate diesel engine were adopted. Third, biofuels have had important roles, making the adoption of clean air technology possible and substituting for high emission fuels.

Cardiovascular disease, risk factors and heart rate variability in the elderly general population: Design and objectives of the CARdiovascular disease, Living and Ageing in Halle (CARLA Study

Directory of Open Access Journals (Sweden)

Kuss Oliver

2005-11-01

Full Text Available Abstract Background The increasing burden of cardiovascular diseases (CVD in the ageing population of industrialized nations requires an intensive search for means of reducing this epidemic. In order to improve prevention, detection, therapy and prognosis of cardiovascular diseases on the population level in Eastern Germany, it is necessary to examine reasons for the East-West gradient of CVD morbidity and mortality, potential causal mechanisms and prognostic factors in the elderly. Psychosocial and nutritional factors have previously been discussed as possible causes for the unexplained part of the East-West gradient. A reduced heart rate variability appears to be associated with cardiovascular disease as well as with psychosocial and other cardiovascular risk factors and decreases with age. Nevertheless, there is a lack of population-based data to examine the role of heart rate variability and its interaction with psychosocial and nutritional factors regarding the effect on cardiovascular disease in the ageing population. There also is a paucity of epidemiological data describing the health situation in Eastern Germany. Therefore, we conduct a population-based study to examine the distribution of CVD, heart rate variability and CVD risk factors and their associations in an elderly East German population. This paper describes the design and objectives of the CARLA Study. Methods/design For this study, a random sample of 45–80 year-old inhabitants of the city of Halle (Saale in Eastern Germany was drawn from the population registry. By the end of the baseline examination (2002–2005, 1750 study participants will have been examined. A multi-step recruitment strategy aims at achieving a 70 % response rate. Detailed information is collected on own and family medical history, socioeconomic, psychosocial, behavioural and biomedical factors. Medical examinations include anthropometric measures, blood pressure of arm and ankle, a 10-second and a 20

Rates of cardiovascular disease following smoking cessation in patients with HIV infection

DEFF Research Database (Denmark)

Petoumenos, K; Worm, S; Reiss, P

2011-01-01

The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection.......The aim of the study was to estimate the rates of cardiovascular disease (CVD) events after stopping smoking in patients with HIV infection....

Incidence and mortality rates of colorectal cancer in Malaysia.

Science.gov (United States)

Abu Hassan, Muhammad Radzi; Ismail, Ibtisam; Mohd Suan, Mohd Azri; Ahmad, Faizah; Wan Khazim, Wan Khamizar; Othman, Zabedah; Mat Said, Rosaida; Tan, Wei Leong; Mohammed, Siti Rahmah Noor Syahireen; Soelar, Shahrul Aiman; Nik Mustapha, Nik Raihan

2016-01-01

This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC) patients in Malaysia by sex and ethnicity. The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR) was calculated as the proportion of CRC cases (incidence) and deaths (mortality) from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35), followed by the Malay (18.95), and Indian (17.55) ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively). The 2011 (44.7%) CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46) than females (8.05). CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

Variability in the measurement of hospital-wide mortality rates.

Science.gov (United States)

Shahian, David M; Wolf, Robert E; Iezzoni, Lisa I; Kirle, Leslie; Normand, Sharon-Lise T

2010-12-23

Several countries use hospital-wide mortality rates to evaluate the quality of hospital care, although the usefulness of this metric has been questioned. Massachusetts policymakers recently requested an assessment of methods to calculate this aggregate mortality metric for use as a measure of hospital quality. The Massachusetts Division of Health Care Finance and Policy provided four vendors with identical information on 2,528,624 discharges from Massachusetts acute care hospitals from October 1, 2004, through September 30, 2007. Vendors applied their risk-adjustment algorithms and provided predicted probabilities of in-hospital death for each discharge and for hospital-level observed and expected mortality rates. We compared the numbers and characteristics of discharges and hospitals included by each of the four methods. We also compared hospitals' standardized mortality ratios and classification of hospitals with mortality rates that were higher or lower than expected, according to each method. The proportions of discharges that were included by each method ranged from 28% to 95%, and the severity of patients' diagnoses varied widely. Because of their discharge-selection criteria, two methods calculated in-hospital mortality rates (4.0% and 5.9%) that were twice the state average (2.1%). Pairwise associations (Pearson correlation coefficients) of discharge-level predicted mortality probabilities ranged from 0.46 to 0.70. Hospital-performance categorizations varied substantially and were sometimes completely discordant. In 2006, a total of 12 of 28 hospitals that had higher-than-expected hospital-wide mortality when classified by one method had lower-than-expected mortality when classified by one or more of the other methods. Four common methods for calculating hospital-wide mortality produced substantially different results. This may have resulted from a lack of standardized national eligibility and exclusion criteria, different statistical methods, or

Age-Specific Trends in Incidence, Mortality, and Comorbidities of Heart Failure in Denmark, 1995 to 2012

DEFF Research Database (Denmark)

Christiansen, Mia N.; Køber, Lars; Weeke, Peter

2017-01-01

on additional adjustment for diabetes mellitus, ischemic heart disease, and hypertension. Standardized 1-year mortality rates declined for middle-aged patients with heart failure but remained constant for younger (...Background: The cumulative burden and importance of cardiovascular risk factors have changed over the past decades. Specifically, obesity rates have increased among younger people, whereas cardiovascular health has improved in the elderly. Little is known regarding how these changes have impacted...... the incidence and the mortality rates of heart failure. Therefore, we aimed to investigate the age-specific trends in the incidence and 1-year mortality rates following a first-time diagnosis of heart failure in Denmark between 1995 and 2012. Methods: We included all Danish individuals >18 years of age...

Music therapy-induced changes in salivary cortisol level are predictive of cardiovascular mortality in patients under maintenance hemodialysis.

Science.gov (United States)

Hou, Yi-Chou; Lin, Yen-Ju; Lu, Kuo-Cheng; Chiang, Han-Sun; Chang, Chia-Chi; Yang, Li-King

2017-01-01

Music therapy has been applied in hemodialysis (HD) patients for relieving mental stress. Whether the stress-relieving effect by music therapy is predictive of clinical outcome in HD patients is still unclear. We recruited a convenience sample of 99 patients on maintenance HD and randomly assigned them to the experimental (n=49) or control (n=50) group. The experimental group received relaxing music therapy for 1 week, whereas the control group received no music therapy. In the experimental group, we compared cardiovascular mortality in the patients with and without cortisol changes. The salivary cortisol level was lowered after 1 week of music therapy in the experimental group (-2.41±3.08 vs 1.66±2.11 pg/mL, P 0.6 pg/mL (83.8% vs 63.6%, P predict cardiovascular mortality in patients under maintenance HD.

Long-term cardiovascular mortality after procedure-related or spontaneous myocardial infarction in patients with non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II, ICTUS, and RITA-3 trials (FIR).

Science.gov (United States)

Damman, Peter; Wallentin, Lars; Fox, Keith A A; Windhausen, Fons; Hirsch, Alexander; Clayton, Tim; Pocock, Stuart J; Lagerqvist, Bo; Tijssen, Jan G P; de Winter, Robbert J

2012-01-31

The present study was designed to investigate the long-term prognostic impact of procedure-related and spontaneous myocardial infarction (MI) on cardiovascular mortality in patients with non-ST-elevation acute coronary syndrome. Five-year follow-up after procedure-related or spontaneous MI was investigated in the individual patient pooled data set of the FRISC-II (Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Randomized Intervention Trial of Unstable Angina 3) non-ST-elevation acute coronary syndrome trials. The principal outcome was cardiovascular death up to 5 years of follow-up. Cumulative event rates were estimated by the Kaplan-Meier method; hazard ratios were calculated with time-dependent Cox proportional hazards models. Adjustments were made for the variables associated with long-term outcomes. Among the 5467 patients, 212 experienced a procedure-related MI within 6 months after enrollment. A spontaneous MI occurred in 236 patients within 6 months. The cumulative cardiovascular death rate was 5.2% in patients who had a procedure-related MI, comparable to that for patients without a procedure-related MI (hazard ratio 0.66; 95% confidence interval, 0.36-1.20, P=0.17). In patients who had a spontaneous MI within 6 months, the cumulative cardiovascular death rate was 22.2%, higher than for patients without a spontaneous MI (hazard ratio 4.52; 95% confidence interval, 3.37-6.06, P<0.001). These hazard ratios did not change materially after risk adjustments. Five-year follow-up of patients with non-ST-elevation acute coronary syndrome from the 3 trials showed no association between a procedure-related MI and long-term cardiovascular mortality. In contrast, there was a substantial increase in long-term mortality after a spontaneous MI.

[Spatial analysis of mortality from cardiovascular diseases in Madrid City, Spain].

Science.gov (United States)

Gómez-Barroso, Diana; Prieto-Flores, María-Eugenia; Mellado San Gabino, Ana; Moreno Jiménez, Antonio

2015-01-01

Cardiovascular disease is the leading cause of death worldwide, but its spatial distribution is not homogeneous. The objective of this study is to analyze the spatial pattern of mortality from these diseases for men and women, in the populated urban area (AUP) of the municipality of Madrid, and to identify spatial aggregations. An ecological study was carried out by census tract, for men and women in 2010. Standardized Mortality Ratio (SMR), Relative Risk Smoothing (RRS) and Posterior Probability (PP) were calculated to consider the spatial pattern of the disease. To identify spatial clusters the Moran index (Moran I) and the Local Index of Spatial Autocorrelation (LISA) were used. The results were mapped. SMR higher than 1.1 was observed mainly in central areas among men and in peripheral areas among women. The PP that RRS was higher than 1 surpassed 0.8 in the center and in the periphery, in both men and women. Moran's I was 0.04 for men and 0.03 for women (p AUP. The LISA method showed similar patterns to those previously observed.

Spatial variation of multiple air pollutants and their potential contributions to all-cause, respiratory, and cardiovascular mortality across China in 2015-2016

Science.gov (United States)

Chen, Huan; Lin, Yun; Su, Qiong; Cheng, Liqiu

2017-11-01

Association of serious air pollution with adverse health effects in China has become a matter of public concern. However, many of studies that focused on a single air pollutant or a single city in China have rarely reflected the overall potential contribution of air pollution to unfavorable health outcomes. Therefore, our study estimated the spatial variation of particulate matter (PM2.5 and PM10) and gaseous pollutants (SO2, NO2, CO, and O3). Moreover, an additive approach was conducted to evaluate their overall potential contributions to mortality across China in 2015-2016 using the exposure-response coefficients. The results showed that cities with relatively high PM2.5 and PM10 concentrations were mainly distributed in the North China Plain (NCP). The average annual PM2.5 and PM10 concentrations in the NCP was 75.0 ± 14.7 and 131.2 ± 21.6 μg m-3. The potential contributions of six air pollutants ranged from 6.5% (95% confidence interval (CI): 5.4-7.5%) to 25.7% (95% CI: 22.2-28.9%) in all-cause mortality, from 6.5% (95% CI: 4.7-8.3%) to 24.9% (95% CI: 18.6-30.9%) in respiratory mortality, and from 7.0% (95% CI: 5.3-8.6%) to 29.5% (95% CI: 24.3-34.5%) in cardiovascular mortality. Many cities with high potential contributions of the multiple air pollutants were in the NCP. NCP had the average potential contribution of 20.0% (95% CI: 17.2-22.6%) in all-cause mortality, 19.5% (95% CI: 14.5-24.3%) in respiratory mortality, and 23.0% (95% CI: 18.8-27.0%) in cardiovascular mortality. Besides, the Taklimakan Desert (TD) also had high potential contribution of 19.9% (95% CI: 17.1-22.4%) in all-cause mortality, 19.5% (95% CI: 14.3-24.3%) in respiratory mortality, and 23.5% (95% CI: 19.2-27.5%) in cardiovascular mortality.

Widespread increase of tree mortality rates in the Western United States

Science.gov (United States)

van Mantgem, P.J.; Stephenson, N.L.; Byrne, J.C.; Daniels, L.D.; Franklin, J.F.; Fule, P.Z.; Harmon, M.E.; Larson, A.J.; Smith, Joseph M.; Taylor, A.H.; Veblen, T.T.

2009-01-01

Persistent changes in tree mortality rates can alter forest structure, composition, and ecosystem services such as carbon sequestration. Our analyses of longitudinal data from unmanaged old forests in the western United States showed that background (noncatastrophic) mortality rates have increased rapidly in recent decades, with doubling periods ranging from 17 to 29 years among regions. Increases were also pervasive across elevations, tree sizes, dominant genera, and past fire histories. Forest density and basal area declined slightly, which suggests that increasing mortality was not caused by endogenous increases in competition. Because mortality increased in small trees, the overall increase in mortality rates cannot be attributed solely to aging of large trees. Regional warming and consequent increases in water deficits are likely contributors to the increases in tree mortality rates.

Influence of Exposure Error and Effect Modification by Socioeconomic Status on the Association of Acute Cardiovascular Mortality with Particulate Matter in Phoenix

Science.gov (United States)

Using ZIP code-level mortality data, the association of cardiovascular mortality with PM2.5 and PM10-2.5,measured at a central monitoring site, was determined for three populations at different distances from the monitoring site but with similar numbers of d...

Population-wide weight loss and regain in relation to diabetes burden and cardiovascular mortality in Cuba 1980-2010: repeated cross sectional surveys and ecological comparison of secular trends.

Science.gov (United States)

Franco, Manuel; Bilal, Usama; Orduñez, Pedro; Benet, Mikhail; Morejón, Alain; Caballero, Benjamín; Kennelly, Joan F; Cooper, Richard S

2013-04-09

To evaluate the associations between population-wide loss and gain in weight with diabetes prevalence, incidence, and mortality, as well as cardiovascular and cancer mortality trends, in Cuba over a 30 year interval. Repeated cross sectional surveys and ecological comparison of secular trends. Cuba and the province of Cienfuegos, from 1980 to 2010. Measurements in Cienfuegos included a representative sample of 1657, 1351, 1667, and 1492 adults in 1991, 1995, 2001, and 2010, respectively. National surveys included a representative sample of 14 304, 22 851, and 8031 participants in 1995, 2001, and 2010, respectively. Changes in smoking, daily energy intake, physical activity, and body weight were tracked from 1980 to 2010 using national and regional surveys. Data for diabetes prevalence and incidence were obtained from national population based registries. Mortality trends were modelled using national vital statistics. Rapid declines in diabetes and heart disease accompanied an average population-wide loss of 5.5 kg in weight, driven by an economic crisis in the mid-1990s. A rebound in population weight followed in 1995 (33.5% prevalence of overweight and obesity) and exceeded pre-crisis levels by 2010 (52.9% prevalence). The population-wide increase in weight was immediately followed by a 116% increase in diabetes prevalence and 140% increase in diabetes incidence. Six years into the weight rebound phase, diabetes mortality increased by 49% (from 9.3 deaths per 10 000 people in 2002 to 13.9 deaths per 10 000 people in 2010). A deceleration in the rate of decline in mortality from coronary heart disease was also observed. In relation to the Cuban experience in 1980-2010, there is an association at the population level between weight reduction and death from diabetes and cardiovascular disease; the opposite effect on the diabetes and cardiovascular burden was seen on population-wide weight gain.

Evaluation of cardiac surgery mortality rates: 30-day mortality or longer follow-up?

NARCIS (Netherlands)

Siregar, Sabrina; Groenwold, Rolf H. H.; de Mol, Bas A. J. M.; Speekenbrink, Ron G. H.; Versteegh, Michel I. M.; Brandon Bravo Bruinsma, George J.; Bots, Michiel L.; van der Graaf, Yolanda; van Herwerden, Lex A.

2013-01-01

The aim of our study was to investigate early mortality after cardiac surgery and to determine the most adequate follow-up period for the evaluation of mortality rates. Information on all adult cardiac surgery procedures in 10 of 16 cardiothoracic centres in Netherlands from 2007 until 2010 was

Current status of cardiovascular surgery in Japan 2013 and 2014: A report based on the Japan Cardiovascular Surgery Database. 2: Congenital heart surgery.

Science.gov (United States)

Hirata, Yasutaka; Hirahara, Norimichi; Murakami, Arata; Motomura, Noboru; Miyata, Hiroaki; Takamoto, Shinichi

2018-01-01

We analyzed the mortality and morbidity of congenital heart surgery in Japan using the Japan Cardiovascular Surgery Database (JCVSD). Data regarding congenital heart surgery performed between January 2013 and December 2014 were obtained from JCVSD. The 20 most frequent procedures were selected and the mortality rates and major morbidities were analyzed. The mortality rates of atrial septal defect repair and ventricular septal defect repair were less than 1%, and the mortality rates of tetralogy of Fallot repair, complete atrioventricular septal defect repair, bidirectional Glenn, and total cavopulmonary connection were less than 2%. The mortality rates of the Norwood procedure and total anomalous pulmonary venous connection repair were more than 10%. The rates of unplanned reoperation, pacemaker implantation, chylothorax, deep sternal infection, phrenic nerve injury, and neurological deficit were shown for each procedure. Using JCVSD, the national data for congenital heart surgery, including postoperative complications, were analyzed. Further improvements of the database and feedback for clinical practice are required.

RSR' pattern and the risk of mortality in men and women free of cardiovascular disease.

Science.gov (United States)

O'Neal, Wesley T; Qureshi, Waqas; Li, Yabing; Soliman, Elsayed Z

2015-01-01

This study included 6,398 participants (mean age 55 ± 0.34 years; 54% female; 49% white; 22% black; 24% Mexican; 4.3% other) free of clinical cardiovascular disease (CVD) and major ECG abnormalities. Cox regression was used to examine the association between the RSR' (incomplete right bundle branch block (RBBB) or right ventricular conduction delay) pattern and CVD and all-cause mortalities. The RSR' pattern was not associated with an increased risk of CVD (HR=1.10; 95%CI=0.63, 1.91) mortality or all-cause (HR=0.95; 95%CI=0.66, 1.35) mortality. The results were similar when the RSR' pattern was further separated into incomplete RBBB and right ventricular conduction delay. In conclusion, the RSR' pattern is a benign finding in older adults free of clinical CVD. Copyright © 2015 Elsevier Inc. All rights reserved.

Reduced Cardiovascular Mortality 10 Years after Supplementation with Selenium and Coenzyme Q10 for Four Years: Follow-Up Results of a Prospective Randomized Double-Blind Placebo-Controlled Trial in Elderly Citizens.

Directory of Open Access Journals (Sweden)

Urban Alehagen

Full Text Available Selenium and coenzyme Q10 are important antioxidants in the body. As the intake of selenium is low in Europe, and the endogenous production of coenzyme Q10 decreases as age increases, an intervention trial using selenium and coenzyme Q10 for four years was performed. As previously reported, the intervention was accompanied by reduced cardiovascular mortality. The objective of the present study was to analyze cardiovascular mortality for up to 10 years after intervention, to evaluate if mortality differed in subgroups differentiated by gender, diabetes, ischemic heart disease (IHD, and functional class.Four-hundred forty-three healthy elderly individuals were included from a rural municipality in Sweden. All cardiovascular mortality was registered, and no participant was lost to the follow-up. Based on death certificates and autopsy results mortality was registered.Significantly reduced cardiovascular mortality could be seen in those on selenium and coenzyme Q10 intervention. A multivariate Cox regression analysis demonstrated a reduced cardiovascular mortality risk in the active treatment group (HR: 0.51; 95%CI 0.36-0.74; P = 0.0003. The reduced mortality could be seen to persist during the 10-year period. Subgroup analysis showed positive effects in both genders. An equally positive risk reduction could be seen in those with ischemic heart disease (HR: 0.51; 95%CI 0.27-0.97; P = 0.04, but also in the different functional classes.In a 10-year follow-up of a group of healthy elderly participants given four years of intervention with selenium and coenzyme Q10, significantly reduced cardiovascular mortality was observed. The protective action was not confined to the intervention period, but persisted during the follow-up period. The mechanism explaining the persistency remains to be elucidated. Since this was a small study, the observations should be regarded as hypothesis-generating.

Incidence and mortality rates of colorectal cancer in Malaysia

Directory of Open Access Journals (Sweden)

Muhammad Radzi Abu Hassan

2016-03-01

Full Text Available OBJECTIVES This is the first study that estimates the incidence and mortality rate for colorectal cancer (CRC patients in Malaysia by sex and ethnicity. METHODS The 4,501 patients were selected from National Cancer Patient Registry-Colorectal Cancer data. Patient survival status was cross-checked with the National Registration Department. The age-standardised rate (ASR was calculated as the proportion of CRC cases (incidence and deaths (mortality from 2008 to 2013, weighted by the age structure of the population, as determined by the Department of Statistics Malaysia and the World Health Organization world standard population distribution. RESULTS The overall incidence rate for CRC was 21.32 cases per 100,000. Those of Chinese ethnicity had the highest CRC incidence (27.35, followed by the Malay (18.95, and Indian (17.55 ethnicities. The ASR incidence rate of CRC was 1.33 times higher among males than females (24.16 and 18.14 per 100,000, respectively. The 2011 (44.7% CRC deaths were recorded. The overall ASR of mortality was 9.79 cases, with 11.85 among the Chinese, followed by 9.56 among the Malays and 7.08 among the Indians. The ASR of mortality was 1.42 times higher among males (11.46 than females (8.05. CONCLUSIONS CRC incidence and mortality is higher in males than females. Individuals of Chinese ethnicity have the highest incidence of CRC, followed by the Malay and Indian ethnicities. The same trends were observed for the age-standardised mortality rate.

Epicardial, pericardial and total cardiac fat and cardiovascular disease in type 2 diabetic patients with elevated urinary albumin excretion rate

DEFF Research Database (Denmark)

Christensen, Regitse H.; Von Scholten, Bernt J.; Hansen, Christian S.

2017-01-01

of 200 patients with type 2 diabetes and elevated urinary albumin excretion rate (UAER). Methods Cardiac adipose tissue was measured from baseline echocardiography. The composite endpoint comprised incident cardiovascular disease and all-cause mortality. Coronary artery calcium, carotid intima media.......7, p = 0.017) models. Cardiac adipose tissue (p = 0.033) was associated with baseline coronary artery calcium (model 1) and interleukin-8 (models 1-3, all p type 2 diabetes patients without coronary artery disease, high cardiac adipose tissue levels were associated...

Increase in waist circumference over 6 years predicts subsequent cardiovascular disease and total mortality in nordic women

DEFF Research Database (Denmark)

Klingberg, Sofia; Mehlig, Kirsten; Lanfer, Anne

2015-01-01

-shaped association. Associations between increase in WC and outcomes were restricted to women with normal weight at baseline and to ever-smokers. CONCLUSIONS: In contrast to changes in HC which did not predict mortality and CVD, a 6-year increase in WC is strongly predictive, particularly among initially lean women...... and cardiovascular disease (CVD) mortality in women but that gain or loss in HC was unrelated to these outcomes. This study examines whether a 6-year change in waist circumference (WC) predicts mortality and CVD in the same study sample. METHODS: Baseline WC and 6-year change in WC as predictors of mortality and CVD...... were analyzed in 2,492 women from the Danish MONICA study and the Prospective Population Study of Women in Gothenburg, Sweden. RESULTS: Increase in WC was significantly associated with increased subsequent mortality and CVD adjusting for BMI and other covariates, with some evidence of a J...

Determinants of self-rated health: could health status explain the association between self-rated health and mortality?

Science.gov (United States)

Murata, Chiyoe; Kondo, Takaaki; Tamakoshi, Koji; Yatsuya, Hiroshi; Toyoshima, Hideaki

2006-01-01

The purpose of this study was to investigate factors related to self-rated health and to mortality among 2490 community-living elderly. Respondents were followed for 7.3 years for all-cause mortality. To compare the relative impact of each variable, we employed logistic regression analysis for self-rated health and Cox hazard analysis for mortality. Cox analysis stratified by gender, follow-up periods, age group, and functional status was also employed. Series of analysis found that factors associated with self-rated health and with mortality were not identical. Psychological factors such as perceived isolation at home or 'ikigai (one aspect of psychological well-being)' were associated with self-rated health only. Age, functional status, and social relations were associated both with self-rated health and mortality after controlling for possible confounders. Illnesses and functional status accounted for 35-40% of variances in the fair/poor self-rated health. Differences by gender and functional status were observed in the factors related to self-rated health. Overall, self-rated health effect on mortality was stronger for people with no functional impairment, for shorter follow-up period, and for young-old age group. Although, illnesses and functional status were major determinants of self-rated health, economical, psychological, and social factors were also related to self-rated health.

Cardiovascular impact in patients undergoing maintenance hemodialysis: Clinical management considerations.

Science.gov (United States)

Chirakarnjanakorn, Srisakul; Navaneethan, Sankar D; Francis, Gary S; Tang, W H Wilson

2017-04-01

Patients undergoing maintenance hemodialysis develop both structural and functional cardiovascular abnormalities. Despite improvement of dialysis technology, cardiovascular mortality of this population remains high. The pathophysiological mechanisms of these changes are complex and not well understood. It has been postulated that several non-traditional, uremic-related risk factors, especially the long-term uremic state, which may affect the cardiovascular system. There are many cardiovascular changes that occur in chronic kidney disease including left ventricular hypertrophy, myocardial fibrosis, microvascular disease, accelerated atherosclerosis and arteriosclerosis. These structural and functional changes in patients receiving chronic dialysis make them more susceptible to myocardial ischemia. Hemodialysis itself may adversely affect the cardiovascular system due to non-physiologic fluid removal, leading to hemodynamic instability and initiation of systemic inflammation. In the past decade there has been growing awareness that pathophysiological mechanisms cause cardiovascular dysfunction in patients on chronic dialysis, and there are now pharmacological and non-pharmacological therapies that may improve the poor quality of life and high mortality rate that these patients experience. Copyright © 2017 Elsevier B.V. All rights reserved.

Serbia within the European context: An analysis of premature mortality

Directory of Open Access Journals (Sweden)

Marinkovic Jelena

2009-08-01

Full Text Available Abstract Background Based on the global predictions majority of deaths will be collectively caused by cancer, cardiovascular diseases, and traffic accidents over the coming 25 years. In planning future national health policy actions, inter – regional assessments play an important role. The purpose of the study was to analyze similarities and differences in premature mortality between Serbia, EURO A, EURO B, and EURO C regions in 2000. Methods Mortality and premature mortality patterns were analysed according to cause of death, by gender and seven age intervals. The study results are presented in relative (% and absolute terms (age-specific and age-standardized death rates per 100,000 population, and age-standardized rates of years of life lost – YLL per 1,000. Direct standardization of rates was undertaken using the standard population of Europe. The inter-regional comparison was based on a calculation of differences in YLL structures and with a ratio of age-standardized YLL rates per 1,000. A multivariate generalized linear model was used to explore mortality of Serbia and Europe sub-regions with ln age-specific death rates. The dissimilarity was achieved with a p ≤ 0.05. Results According to the mortality pattern, Serbia was similar to EURO B, but with a lower average YLL per death case. YLL patterns indicated similarities between Serbia and EURO A, while SRR YLL had similarities between Serbia and EURO B. Compared to all Europe sub-regions, Serbia had a major excess of premature mortality in neoplasms and diabetes mellitus. Serbia had lost more years of life than EURO A due to cardiovascular, genitourinary diseases, and intentional injuries. Yet, Serbia was not as burdened with communicable diseases and injuries as were EURO B and EURO C. Conclusion With a premature mortality pattern, Serbia is placed in the middle position of the Europe triangle. The main excess of YLL in Serbia was due to cardiovascular, malignant diseases, and

Cardiovascular mortality in Hispanics compared to non-Hispanic whites: a systematic review and meta-analysis of the Hispanic paradox.

Science.gov (United States)

Cortes-Bergoderi, Mery; Goel, Kashish; Murad, Mohammad Hassan; Allison, Thomas; Somers, Virend K; Erwin, Patricia J; Sochor, Ondrej; Lopez-Jimenez, Francisco

2013-12-01

Hispanics, the largest minority in the U.S., have a higher prevalence of several cardiovascular (CV) risk factors than non-Hispanic whites (NHW). However, some studies have shown a paradoxical lower rate of CV events among Hispanics than NHW. To perform a systematic review and a meta-analysis of cohort studies comparing CV mortality and all-cause mortality between Hispanic and NHW populations in the U.S. We searched EMBASE, MEDLINE, Web of Science, and Scopus databases from 1950 through May 2013, using terms related to Hispanic ethnicity, CV diseases and cohort studies. We pooled risk estimates using the least and most adjusted models of each publication. We found 341 publications of which 17 fulfilled the inclusion criteria; data represent 22,340,554 Hispanics and 88,824,618 NHW, collected from 1950 to 2009. Twelve of the studies stratified the analysis by gender, and one study stratified people by place of birth (e.g. U.S.-born, Mexican-born, and Central/South American-born). There was a statistically significant association between Hispanic ethnicity and lower CV mortality (OR 0.67; 95% CI, 0.57-0.78; pvalue value 0.06. These results confirm the existence of a Hispanic paradox regarding CV mortality. Further studies are needed to identify the mechanisms mediating this protective CV effect in Hispanics. © 2013.

Effect of lowering blood pressure on cardiovascular events and mortality in patients on dialysis : a systematic review and meta-analysis of randomised controlled trials

NARCIS (Netherlands)

Heerspink, HiddoJ Lambers; Ninomiya, Toshiharu; Zoungas, Sophia; de Zeeuw, Dick; Grobbee, Diederick E.; Jardine, Meg J.; Gallagher, Martin; Roberts, Matthew A.; Cass, Alan; Neal, Bruce; Perkovic, Vlado

2009-01-01

Background Patients undergoing dialysis have a substantially increased risk of cardiovascular mortality and morbidity. Although several trials have shown the cardiovascular benefits of lowering blood pressure in the general population, there is uncertainty about the efficacy and tolerability of

Cardiovascular events and mortality in patients with adrenal incidentalomas that are either non-secreting or associated with intermediate phenotype or subclinical Cushing's syndrome: a 15-year retrospective study.

Science.gov (United States)

Di Dalmazi, Guido; Vicennati, Valentina; Garelli, Silvia; Casadio, Elena; Rinaldi, Eleonora; Giampalma, Emanuela; Mosconi, Cristina; Golfieri, Rita; Paccapelo, Alexandro; Pagotto, Uberto; Pasquali, Renato

2014-05-01

associated independently with a change (from baseline to the end of follow-up) in cortisol concentrations post DST (hazard ratio 1·13, 95% CI 1·05-1·21; p=0·001). Survival rates for all-cause mortality were lower in patients with either stable intermediate phenotype adrenal incidentalomas or subclinical Cushing's syndrome compared with those with stable non-secreting masses (57·0% vs 91·2%; p=0·005). Factors associated with mortality were age (hazard ratio 1·06, 95% CI 1·01-1·12; p=0·03) and mean concentrations of cortisol post DST (1·10, 1·01-1·19; p=0·04). Compared with patients with stable non-secreting adrenal incidentalomas, unadjusted survival for cardiovascular-specific mortality was lower in patients with either a stable intermediate phenotype or subclinical Cushing's syndrome (97·5% vs 78·4%; p=0·02) and in those with worsened secreting patterns (97·5% vs 60·0%; p=0·01). Cancer mortality did not differ between groups. Even when clinical signs of overt hypercortisolism are not present, patients with adrenal incidentalomas and mild hypercortisolism have an increased risk of cardiovascular events and mortality. None. Copyright © 2014 Elsevier Ltd. All rights reserved.

Long-Term Exposure to Fine Particulate Matter: Association with Nonaccidental and Cardiovascular Mortality in the Agricultural Health Study Cohort

OpenAIRE

Weichenthal, Scott; Villeneuve, Paul J.; Burnett, Richard T.; van Donkelaar, Aaron; Martin, Randall V.; Jones, Rena R.; DellaValle, Curt T.; Sandler, Dale P.; Ward, Mary H.; Hoppin, Jane A.

2014-01-01

Background: Few studies have examined the relationship between long-term exposure to ambient fine particulate matter (PM2.5) and nonaccidental mortality in rural populations. Objective: We examined the relationship between PM2.5 and nonaccidental and cardiovascular mortality in the U.S. Agricultural Health Study cohort. Methods: The cohort (n = 83,378) included farmers, their spouses, and commercial pesticide applicators residing primarily in Iowa and North Carolina. Deaths occurring between ...

Cardiovascular Reactivity and Heart Rate Variability in Panic Disorder

National Research Council Canada - National Science Library

Santiago, Helen T

1999-01-01

.... Because previous studies of cardiovascular reactivity and heart rate variability have been inconclusive, these factors were re-examined in panickers and controls during physiological challenge...

Dietary restriction of rodents decreases aging rate without affecting initial mortality rate -- a meta-analysis.

Science.gov (United States)

Simons, Mirre J P; Koch, Wouter; Verhulst, Simon

2013-06-01

Dietary restriction (DR) extends lifespan in multiple species from various taxa. This effect can arise via two distinct but not mutually exclusive ways: a change in aging rate and/or vulnerability to the aging process (i.e. initial mortality rate). When DR affects vulnerability, this lowers mortality instantly, whereas a change in aging rate will gradually lower mortality risk over time. Unraveling how DR extends lifespan is of interest because it may guide toward understanding the mechanism(s) mediating lifespan extension and also has practical implications for the application of DR. We reanalyzed published survival data from 82 pairs of survival curves from DR experiments in rats and mice by fitting Gompertz and also Gompertz-Makeham models. The addition of the Makeham parameter has been reported to improve the estimation of Gompertz parameters. Both models separate initial mortality rate (vulnerability) from an age-dependent increase in mortality (aging rate). We subjected the obtained Gompertz parameters to a meta-analysis. We find that DR reduced aging rate without affecting vulnerability. The latter contrasts with the conclusion of a recent analysis of a largely overlapping data set, and we show how the earlier finding is due to a statistical artifact. Our analysis indicates that the biology underlying the life-extending effect of DR in rodents likely involves attenuated accumulation of damage, which contrasts with the acute effect of DR on mortality reported for Drosophila. Moreover, our findings show that the often-reported correlation between aging rate and vulnerability does not constrain changing aging rate without affecting vulnerability simultaneously. © 2013 John Wiley & Sons Ltd and the Anatomical Society.

Cardiovascular Safety of Febuxostat or Allopurinol in Patients with Gout.

Science.gov (United States)

White, William B; Saag, Kenneth G; Becker, Michael A; Borer, Jeffrey S; Gorelick, Philip B; Whelton, Andrew; Hunt, Barbara; Castillo, Majin; Gunawardhana, Lhanoo

2018-03-29

Cardiovascular risk is increased in patients with gout. We compared cardiovascular outcomes associated with febuxostat, a nonpurine xanthine oxidase inhibitor, with those associated with allopurinol, a purine base analogue xanthine oxidase inhibitor, in patients with gout and cardiovascular disease. We conducted a multicenter, double-blind, noninferiority trial involving patients with gout and cardiovascular disease; patients were randomly assigned to receive febuxostat or allopurinol and were stratified according to kidney function. The trial had a prespecified noninferiority margin of 1.3 for the hazard ratio for the primary end point (a composite of cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, or unstable angina with urgent revascularization). In total, 6190 patients underwent randomization, received febuxostat or allopurinol, and were followed for a median of 32 months (maximum, 85 months). The trial regimen was discontinued in 56.6% of patients, and 45.0% discontinued follow-up. In the modified intention-to-treat analysis, a primary end-point event occurred in 335 patients (10.8%) in the febuxostat group and in 321 patients (10.4%) in the allopurinol group (hazard ratio, 1.03; upper limit of the one-sided 98.5% confidence interval [CI], 1.23; P=0.002 for noninferiority). All-cause and cardiovascular mortality were higher in the febuxostat group than in the allopurinol group (hazard ratio for death from any cause, 1.22 [95% CI, 1.01 to 1.47]; hazard ratio for cardiovascular death, 1.34 [95% CI, 1.03 to 1.73]). The results with regard to the primary end point and all-cause and cardiovascular mortality in the analysis of events that occurred while patients were being treated were similar to the results in the modified intention-to-treat analysis. In patients with gout and major cardiovascular coexisting conditions, febuxostat was noninferior to allopurinol with respect to rates of adverse cardiovascular events. All-cause mortality and

Risk of Cardiovascular Morbidity and Mortality in Relation to Temperature

Science.gov (United States)

Mathes, Robert; Ito, Kazuhiko; Matte, Thomas

2013-01-01

Objective To examine the effects of temperature on cardiovascular-related (CVD) morbidity and mortality among New York City (NYC) residents. Introduction Extreme temperatures are consistently shown to have an effect on CVD-related mortality [1, 2]. A large multi-city study of mortality demonstrated a cold-day and hot-day weather effect on CVD-related deaths, with the larger impact occurring on the coldest days [3]. In contrast, the association between weather and CVD-related morbidity is less clear [4, 5]. The purpose of this study is to characterize the effect of temperature on CVD-related emergency department (ED) visits, hospitalizations, and mortality on a large, heterogeneous population. Additionally, we conducted a sensitivity analysis to determine the impact of air pollutants, specifically fine particulates (PM2.5) and ozone (O3), along with temperature, on CVD outcomes. Methods We analyzed daily weather conditions, ED visits classified as CVD-related based on chief complaint text, hospitalizations, and natural cause deaths that occurred in NYC between 2002 and 2006. ED visits were obtained from data reported daily to the city health department for syndromic surveillance. Inpatient admissions were obtained from the Statewide Planning and Research Cooperative System, a data reporting system developed by New York State. Mortality data were obtained from the NYC Office of Vital Statistics. Data for PM2.5 and O3 were obtained from all available air quality monitors within the five boroughs of NYC. To estimate risk of CVD morbidity and mortality, we used generalized linear models using a Poisson distribution to calculate relative risks (RR) and 95% confidence intervals (CI). A non-linear distributed lag was used to model mean temperature in order to allow for its effect on the same day and on subsequent days. Models were fit separately for cold season (October through March) and warm season (April through September) given season may modify the effect on CVD

Coffee consumption after myocardial infarction and risk of cardiovascular mortality: a prospective analysis in the Alpha Omega Cohort

NARCIS (Netherlands)

Van Dongen, Laura H; Mölenberg, Famke Jm; Soedamah-Muthu, S.S.; Kromhout, Daan; Geleijnse, Johanna M

2017-01-01

Background: Consumption of coffee, one of the most popular beverages around the world, has been associated with a lower risk of cardiovascular and all-cause mortality in population-based studies. However, little is known about these associations in patient populations. Objective: This prospective

Coffee consumption after myocardial infarction and risk of cardiovascular mortality: a prospective analysis in the Alpha Omega Cohort.

Science.gov (United States)

van Dongen, Laura H; Mölenberg, Famke Jm; Soedamah-Muthu, Sabita S; Kromhout, Daan; Geleijnse, Johanna M

2017-10-01

Background: Consumption of coffee, one of the most popular beverages around the world, has been associated with a lower risk of cardiovascular and all-cause mortality in population-based studies. However, little is known about these associations in patient populations. Objective: This prospective study aimed to examine the consumption of caffeinated and decaffeinated coffee in relation to cardiovascular disease (CVD) mortality, ischemic heart disease (IHD) mortality, and all-cause mortality in patients with a prior myocardial infarction (MI). Design: We included 4365 Dutch patients from the Alpha Omega Cohort who were aged 60-80 y (21% female) and had experienced an MI coffee consumption over the past month was collected with a 203-item validated food-frequency questionnaire. Causes of death were monitored until 1 January 2013. HRs for mortality in categories of coffee consumption were obtained from multivariable Cox proportional hazard models, adjusting for lifestyle and dietary factors. Results: Most patients (96%) drank coffee, and the median total coffee intake was 375 mL/d (∼3 cups/d). During a median follow-up of 7.1 y, a total of 945 deaths occurred, including 396 CVD-related and 266 IHD-related deaths. Coffee consumption was inversely associated with CVD mortality, with HRs of 0.69 (95% CI: 0.54, 0.89) for >2-4 cups/d and 0.72 (0.55, 0.95) for >4 cups/d, compared with 0-2 cups/d. Corresponding HRs were 0.77 (95% CI: 0.57, 1.05) and 0.68 (95% CI: 0.48, 0.95) for IHD mortality and 0.84 (95% CI: 0.71, 1.00) and 0.82 (95% CI: 0.68, 0.98) for all-cause mortality, respectively. Similar associations were found for decaffeinated coffee and for coffee with additives. Conclusion: Drinking coffee, either caffeinated or decaffeinated, may lower the risk of CVD and IHD mortality in patients with a prior MI. This study was registered at clinicaltrials.gov as NCT03192410. © 2017 American Society for Nutrition.

Geographic distribution of dementia mortality: elevated mortality rates for black and white Americans by place of birth.

Science.gov (United States)

Glymour, M Maria; Kosheleva, Anna; Wadley, Virginia G; Weiss, Christopher; Manly, Jennifer J

2011-01-01

We hypothesized that patterns of elevated stroke mortality among those born in the United States Stroke Belt (SB) states also prevailed for mortality related to all-cause dementia or Alzheimer Disease. Cause-specific mortality (contributing cause of death, including underlying cause cases) rates in 2000 for United States-born African Americans and whites aged 65 to 89 years were calculated by linking national mortality records with population data based on race, sex, age, and birth state or state of residence in 2000. Birth in a SB state (NC, SC, GA, TN, AR, MS, or AL) was cross-classified against SB residence at the 2000 Census. Compared with those who were not born in the SB, odds of all-cause dementia mortality were significantly elevated by 29% for African Americans and 19% for whites born in the SB. These patterns prevailed among individuals who no longer lived in the SB at death. Patterns were similar for Alzheimer Disease-related mortality. Some non-SB states were also associated with significant elevations in dementia-related mortality. Dementia mortality rates follow geographic patterns similar to stroke mortality, with elevated rates among those born in the SB. This suggests important roles for geographically patterned childhood exposures in establishing cognitive reserve.

Association between periodontitis and mortality in stages 3-5 chronic kidney disease: NHANES III and linked mortality study.

Science.gov (United States)

Sharma, Praveen; Dietrich, Thomas; Ferro, Charles J; Cockwell, Paul; Chapple, Iain L C

2016-02-01

Periodontitis may add to the systemic inflammatory burden in individuals with chronic kidney disease (CKD), thereby contributing to an increased mortality rate. This study aimed to determine the association between periodontitis and mortality rate (all-cause and cardiovascular disease-related) in individuals with stage 3-5 CKD, hitherto referred to as "CKD". Survival analysis was carried out using the Third National Health and Nutrition Examination Survey (NHANES III) and linked mortality data. Cox proportional hazards regression was employed to assess the association between periodontitis and mortality, in individuals with CKD. This association was compared with the association between mortality and traditional risk factors in CKD mortality (diabetes, hypertension and smoking). Of the 13,784 participants eligible for analysis in NHANES III, 861 (6%) had CKD. The median follow-up for this cohort was 14.3 years. Adjusting for confounders, the 10-year all-cause mortality rate for individuals with CKD increased from 32% (95% CI: 29-35%) to 41% (36-47%) with the addition of periodontitis. For diabetes, the 10-year all-cause mortality rate increased to 43% (38-49%). There is a strong, association between periodontitis and increased mortality in individuals with CKD. Sources of chronic systemic inflammation (including periodontitis) may be important contributors to mortality in patients with CKD. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Impact of obesity on cardiovascular disease.

LENUS (Irish Health Repository)

Zalesin, Kerstyn C

2012-02-01

Obesity promotes a cascade of secondary pathologies including diabetes, insulin resistance, dyslipidemia, inflammation, thrombosis, hypertension, the metabolic syndrome, and OSA, which collectively heighten the risk for cardiovascular disease. Obesity may also be an independent moderator of cardiac risk apart from these comorbid conditions. Rates of obesity and cardiac disease continue to rise in a parallel and exponential manner. Because obesity is potentially one of the most modifiable mediators of cardiovascular morbidity and mortality, effective treatment and prevention interventions should have a profound and favorable impact on public health.

Estimating Maternal Mortality Rate Using Sisterhood Methods in ...

African Journals Online (AJOL)

... maternal and child morbidity and mortality, which could serve as a surveillance strategy to identify the magnitude of the problem and to mobilize resources to areas where the problems are most prominent for adequate control. KEY WORDS: Maternal Mortality Rate, Sisterhood Method. Highland Medical Research Journal ...

Infant Mortality in Novo Hamburgo: Associated Factors and Cardiovascular Causes

Directory of Open Access Journals (Sweden)

Camila de Andrade Brum

2015-04-01

Full Text Available Background: Infant mortality has decreased in Brazil, but remains high as compared to that of other developing countries. In 2010, the Rio Grande do Sul state had the lowest infant mortality rate in Brazil. However, the municipality of Novo Hamburgo had the highest infant mortality rate in the Porto Alegre metropolitan region. Objective: To describe the causes of infant mortality in the municipality of Novo Hamburgo from 2007 to 2010, identifying which causes were related to heart diseases and if they were diagnosed in the prenatal period, and to assess the access to healthcare services. Methods: This study assessed infants of the municipality of Novo Hamburgo, who died, and whose data were collected from the infant death investigation records. Results: Of the 157 deaths in that period, 35.3% were reducible through diagnosis and early treatment, 25% were reducible through partnership with other sectors, 19.2% were non-preventable, 11.5% were reducible by means of appropriate pregnancy monitoring, 5.1% were reducible through appropriate delivery care, and 3.8% were ill defined. The major cause of death related to heart disease (13.4%, which was significantly associated with the variables ‘age at death’, ‘gestational age’ and ‘birth weight’. Regarding access to healthcare services, 60.9% of the pregnant women had a maximum of six prenatal visits. Conclusion: It is mandatory to enhance prenatal care and newborn care at hospitals and basic healthcare units to prevent infant mortality.

Infant Mortality in Novo Hamburgo: Associated Factors and Cardiovascular Causes

Energy Technology Data Exchange (ETDEWEB)

Brum, Camila de Andrade [Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, RS (Brazil); Stein, Airton Tetelbom [Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS (Brazil); Grupo Hospitalar Conceição (GHC), Porto Alegre, RS (Brazil); Universidade Luterana do Brasil (ULBRA), Porto Alegre, RS (Brazil); Pellanda, Lucia Campos, E-mail: luciapell.pesquisa@cardiologia.org.br [Instituto de Cardiologia/Fundação Universitária de Cardiologia (IC/FUC), Porto Alegre, RS (Brazil); Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS (Brazil)

2015-04-15

Infant mortality has decreased in Brazil, but remains high as compared to that of other developing countries. In 2010, the Rio Grande do Sul state had the lowest infant mortality rate in Brazil. However, the municipality of Novo Hamburgo had the highest infant mortality rate in the Porto Alegre metropolitan region. To describe the causes of infant mortality in the municipality of Novo Hamburgo from 2007 to 2010, identifying which causes were related to heart diseases and if they were diagnosed in the prenatal period, and to assess the access to healthcare services. This study assessed infants of the municipality of Novo Hamburgo, who died, and whose data were collected from the infant death investigation records. Of the 157 deaths in that period, 35.3% were reducible through diagnosis and early treatment, 25% were reducible through partnership with other sectors, 19.2% were non-preventable, 11.5% were reducible by means of appropriate pregnancy monitoring, 5.1% were reducible through appropriate delivery care, and 3.8% were ill defined. The major cause of death related to heart disease (13.4%), which was significantly associated with the variables ‘age at death’, ‘gestational age’ and ‘birth weight’. Regarding access to healthcare services, 60.9% of the pregnant women had a maximum of six prenatal visits. It is mandatory to enhance prenatal care and newborn care at hospitals and basic healthcare units to prevent infant mortality.

Infant Mortality in Novo Hamburgo: Associated Factors and Cardiovascular Causes

International Nuclear Information System (INIS)

Brum, Camila de Andrade; Stein, Airton Tetelbom; Pellanda, Lucia Campos

2015-01-01

Infant mortality has decreased in Brazil, but remains high as compared to that of other developing countries. In 2010, the Rio Grande do Sul state had the lowest infant mortality rate in Brazil. However, the municipality of Novo Hamburgo had the highest infant mortality rate in the Porto Alegre metropolitan region. To describe the causes of infant mortality in the municipality of Novo Hamburgo from 2007 to 2010, identifying which causes were related to heart diseases and if they were diagnosed in the prenatal period, and to assess the access to healthcare services. This study assessed infants of the municipality of Novo Hamburgo, who died, and whose data were collected from the infant death investigation records. Of the 157 deaths in that period, 35.3% were reducible through diagnosis and early treatment, 25% were reducible through partnership with other sectors, 19.2% were non-preventable, 11.5% were reducible by means of appropriate pregnancy monitoring, 5.1% were reducible through appropriate delivery care, and 3.8% were ill defined. The major cause of death related to heart disease (13.4%), which was significantly associated with the variables ‘age at death’, ‘gestational age’ and ‘birth weight’. Regarding access to healthcare services, 60.9% of the pregnant women had a maximum of six prenatal visits. It is mandatory to enhance prenatal care and newborn care at hospitals and basic healthcare units to prevent infant mortality

Trends in 30-day mortality rate and case mix for paediatric cardiac surgery in the UK between 2000 and 2010.

Science.gov (United States)

Brown, Katherine L; Crowe, Sonya; Franklin, Rodney; McLean, Andrew; Cunningham, David; Barron, David; Tsang, Victor; Pagel, Christina; Utley, Martin

2015-01-01

To explore changes over time in the 30-day mortality rate for paediatric cardiac surgery and to understand the role of attendant changes in the case mix. Included were: all mandatory submissions to the National Institute of Cardiovascular Outcomes Research (NICOR) relating to UK cardiac surgery in patients aged case mix indicators, in 10 consecutive time periods, from 2000 to 2010. Comparisons were made between two 5-year eras of: 30-day mortality, period prevalence and mean age for 30 groups of specific operations. 30-day mortality for an episode of surgical management. Our analysis includes 36 641 surgical episodes with an increase from 2283 episodes in 2000 to 3939 in 2009 (pcase mix became more complex in terms of the percentage of patients case mix complexity, and compares well with international benchmarks. Definitive repair is now more likely at a younger age for selected infants with congenital heart defects.

Coffee consumption after myocardial infarction and risk of cardiovascular mortality : A prospective analysis in the Alpha Omega Cohort

NARCIS (Netherlands)

van Dongen, Laura H.; Molenberg, Famke J. M.; Soedamah-Muthu, Sabita S.; Kromhout, Daan; Geleijnse, Johanna M.

2017-01-01

Background: Consumption of coffee, one of the most popular beverages around the world, has been associated with a lower risk of cardiovascular and all-cause mortality in population-based studies. However, little is known about these associations in patient populations.  Objective: This prospective

Evaluation of a consumer-oriented internet health care report card: the risk of quality ratings based on mortality data.

Science.gov (United States)

Krumholz, Harlan M; Rathore, Saif S; Chen, Jersey; Wang, Yongfei; Radford, Martha J

2002-03-13

Health care "report cards" have attracted significant consumer interest, particularly publicly available Internet health care quality rating systems. However, the ability of these ratings to discriminate between hospitals is not known. To determine whether hospital ratings for acute myocardial infarction (AMI) mortality from a prominent Internet hospital rating system accurately discriminate between hospitals' performance based on process of care and outcomes. Data from the Cooperative Cardiovascular Project, a retrospective systematic medical record review of 141 914 Medicare fee-for-service beneficiaries 65 years or older hospitalized with AMI at 3363 US acute care hospitals during a 4- to 8-month period between January 1994 and February 1996 were compared with ratings obtained from HealthGrades.com (1-star: worse outcomes than predicted, 5-star: better outcomes than predicted) based on 1994-1997 Medicare data. Quality indicators of AMI care, including use of acute reperfusion therapy, aspirin, beta-blockers, angiotensin-converting enzyme inhibitors; 30-day mortality. Patients treated at higher-rated hospitals were significantly more likely to receive aspirin (admission: 75.4% 5-star vs 66.4% 1-star, P for trend =.001; discharge: 79.7% 5-star vs 68.0% 1-star, P =.001) and beta-blockers (admission: 54.8% 5-star vs 35.7% 1-star, P =.001; discharge: 63.3% 5-star vs 52.1% 1-star, P =.001), but not angiotensin-converting enzyme inhibitors (59.6% 5-star vs 57.4% 1-star, P =.40). Acute reperfusion therapy rates were highest for patients treated at 2-star hospitals (60.6%) and lowest for 5-star hospitals (53.6% 5-star, P =.008). Risk-standardized 30-day mortality rates were lower for patients treated at higher-rated than lower-rated hospitals (21.9% 1-star vs 15.9% 5-star, P =.001). However, there was marked heterogeneity within rating groups and substantial overlap of individual hospitals across rating strata for mortality and process of care; only 3.1% of comparisons

Long-term mortality after parathyroidectomy among chronic kidney disease patients with secondary hyperparathyroidism: a systematic review and meta-analysis.

Science.gov (United States)

Chen, Lin; Wang, Kongbo; Yu, Shanlan; Lai, Liping; Zhang, Xiaoping; Yuan, Jingjing; Duan, Weifeng

2016-08-01

Parathyroidectomy (PTx) and medical treatments are both recommended for reducing serum intact parathyroid hormone (iPTH) and curing secondary hyperparathyroidism (sHPT) in patients with chronic kidney disease (CKD), but their therapeutic effects on long-term mortality are not well-known. Thus, we aim to assess such therapeutic effect of PTx. Electronic literatures published on Pubmed, Embase, and Cochrane Central Register of Controlled Trials in any language until 27 November 2015 were systematically searched. All literatures that compared outcomes (survival rate or mortality rate) between PTx-treated and medically-treated CKD patients with sHPT were included. Finally, 13 cohort studies involving 22053 patients were included. Data were extracted from all included literatures in a standard form. The outcomes of all-cause and cardiovascular mortalities were assessed using DerSimonian and Laird's random effects model. We find PTx-treated versus medically-treated patients had a 28% reduction in all-cause mortality and a 37% reduction in cardiovascular mortality. Thus, PTx versus medical treatments might reduce the risks of all-cause and cardiovascular mortalities in CKD patients with sHPT. Further studies with prospective and large-sample clinical trials are needed to find out the real effect of PTx and to assess whether mortality rates differ among patterns of PTx.

Acute Effects of Nitrogen Dioxide on Cardiovascular Mortality in Beijing: An Exploration of Spatial Heterogeneity and the District-specific Predictors

Science.gov (United States)

Luo, Kai; Li, Runkui; Li, Wenjing; Wang, Zongshuang; Ma, Xinming; Zhang, Ruiming; Fang, Xin; Wu, Zhenglai; Cao, Yang; Xu, Qun

2016-12-01

The exploration of spatial variation and predictors of the effects of nitrogen dioxide (NO2) on fatal health outcomes is still sparse. In a multilevel case-crossover study in Beijing, China, we used mixed Cox proportional hazard model to examine the citywide effects and conditional logistic regression to evaluate the district-specific effects of NO2 on cardiovascular mortality. District-specific predictors that could be related to the spatial pattern of NO2 effects were examined by robust regression models. We found that a 10 μg/m3 increase in daily mean NO2 concentration was associated with a 1.89% [95% confidence interval (CI): 1.33-2.45%], 2.07% (95% CI: 1.23-2.91%) and 1.95% (95% CI: 1.16-2.72%) increase in daily total cardiovascular (lag03), cerebrovascular (lag03) and ischemic heart disease (lag02) mortality, respectively. For spatial variation of NO2 effects across 16 districts, significant effects were only observed in 5, 4 and 2 districts for the above three outcomes, respectively. Generally, NO2 was likely having greater adverse effects on districts with larger population, higher consumption of coal and more civilian vehicles. Our results suggested independent and spatially varied effects of NO2 on total and subcategory cardiovascular mortalities. The identification of districts with higher risk can provide important insights for reducing NO2 related health hazards.

Association between domains of physical activity and all-cause, cardiovascular and cancer mortality.

Science.gov (United States)

Autenrieth, Christine S; Baumert, Jens; Baumeister, Sebastian E; Fischer, Beate; Peters, Annette; Döring, Angela; Thorand, Barbara

2011-02-01

Few studies have investigated the independent effects of domain-specific physical activity on mortality. We sought to investigate the association of physical activity performed in different domains of daily living on all-cause, cardiovascular (CVD) and cancer mortality. Using a prospective cohort design, 4,672 men and women, aged 25-74 years, who participated in the baseline examination of the MONICA/KORA Augsburg Survey 1989/1990 were classified according to their activity level (no, light, moderate, vigorous). Domains of self-reported physical activity (work, transportation, household, leisure time) and total activity were assessed by the validated MOSPA (MONICA Optional Study on Physical Activity) questionnaire. After a median follow-up of 17.8 years, a total of 995 deaths occurred, with 452 from CVD and 326 from cancer. For all-cause mortality, hazard ratios and 95% confidence interval (HR, 95% CI) of the highly active versus the inactive reference group were 0.69 (0.48-1.00) for work, 0.48 (0.36-0.65) for leisure time, and 0.73 (0.59-0.90) for total activity after multivariable adjustments. Reduced risks of CVD mortality were observed for high levels of work (0.54, 0.31-0.93), household (0.80, 0.54-1.19), leisure time (0.50, 0.31-0.79) and total activity (0.75, 0.55-1.03). Leisure time (0.36, 0.23-0.59) and total activity (0.62, 0.43-0.88) were associated with reduced risks of cancer mortality. Light household activity was related to lower all-cause (0.82, 0.71-0.95) and CVD (0.72, 0.58-0.89) mortality. No clear effects were found for transportation activities. Our findings suggest that work, household, leisure time and total physical activity, but not transportation activity, may protect from premature mortality.

Remarkable rates of lightning strike mortality in Malawi.

Science.gov (United States)

Mulder, Monique Borgerhoff; Msalu, Lameck; Caro, Tim; Salerno, Jonathan

2012-01-01

Livingstone's second mission site on the shore of Lake Malawi suffers very high rates of consequential lightning strikes. Comprehensive interviewing of victims and their relatives in seven Traditional Authorities in Nkhata Bay District, Malawi revealed that the annual rate of consequential strikes was 419/million, more than six times higher than that in other developing countries; the rate of deaths from lightning was 84/million/year, 5.4 times greater than the highest ever recorded. These remarkable figures reveal that lightning constitutes a significant stochastic source of mortality with potential life history consequences, but it should not deflect attention away from the more prominent causes of mortality in this rural area.

Influence of eye diseases on the mortality rate of the population

Directory of Open Access Journals (Sweden)

Andrey V. Zolotarev

2018-03-01

Full Text Available Evaluating of the correlation between quality of life, life expectancy and mortality rate is an important problem of modern ophthalmology. Many researchers note that eye pathology, which leads to a visual acuity decrease and blindness, has a significant impact on the mortality rate of the population. This review of literature is dedicated to studies examining the impact of eye diseases on the mortality rate of the population.

Projection of temperature-related mortality due to cardiovascular disease in beijing under different climate change, population, and adaptation scenarios.

Science.gov (United States)

Zhang, Boya; Li, Guoxing; Ma, Yue; Pan, Xiaochuan

2018-04-01

Human health faces unprecedented challenges caused by climate change. Thus, studies of the effect of temperature change on total mortality have been conducted in numerous countries. However, few of those studies focused on temperature-related mortality due to cardiovascular disease (CVD) or considered future population changes and adaptation to climate change. We present herein a projection of temperature-related mortality due to CVD under different climate change, population, and adaptation scenarios in Beijing, a megacity in China. To this end, 19 global circulation models (GCMs), 3 representative concentration pathways (RCPs), 3 socioeconomic pathways, together with generalized linear models and distributed lag non-linear models, were used to project future temperature-related CVD mortality during periods centered around the years 2050 and 2070. The number of temperature-related CVD deaths in Beijing is projected to increase by 3.5-10.2% under different RCP scenarios compared with that during the baseline period. Using the same GCM, the future daily maximum temperatures projected using the RCP2.6, RCP4.5, and RCP8.5 scenarios showed a gradually increasing trend. When population change is considered, the annual rate of increase in temperature-related CVD deaths was up to fivefold greater than that under no-population-change scenarios. The decrease in the number of cold-related deaths did not compensate for the increase in that of heat-related deaths, leading to a general increase in the number of temperature-related deaths due to CVD in Beijing. In addition, adaptation to climate change may enhance rather than ameliorate the effect of climate change, as the increase in cold-related CVD mortality greater than the decrease in heat-related CVD mortality in the adaptation scenarios will result in an increase in the total number of temperature-related CVD mortalities. Copyright © 2018 Elsevier Inc. All rights reserved.

Studies Comparing Ambulatory Blood Pressure and Home Blood Pressure on Cardiovascular Disease and Mortality Outcomes: A Systematic Review

Science.gov (United States)

Shimbo, Daichi; Abdalla, Marwah; Falzon, Louise; Townsend, Raymond R.; Muntner, Paul

2015-01-01

Ambulatory blood pressure monitoring (ABPM) is more commonly recommended for assessing out-of-clinic blood pressure than home blood pressure monitoring (HBPM). We conducted a systematic review to examine whether ABPM or HBPM is more strongly associated with cardiovascular disease events and/or mortality. Of 1,007 abstracts published through July 20, 2015, nine articles, reporting results from seven cohorts, were identified. After adjustment for blood pressure on HBPM, blood pressure on ABPM was associated with an increased risk of outcomes in two of four cohorts for systolic blood pressure and two of three cohorts for diastolic blood pressure. After adjustment for blood pressure on ABPM, systolic blood pressure on HBPM was associated with outcomes in zero of three cohorts; an association was present in one of two cohorts for diastolic blood pressure on HBPM. There is a lack of strong empiric evidence supporting ABPM or HBPM over the other approach for predicting cardiovascular events or mortality. PMID:26822864

Low dose irradiation reduces cancer mortality rates

International Nuclear Information System (INIS)

Luckey, T.D.

2000-01-01

Low doses of ionizing radiation stimulate development, growth, memory, sensual acuity, fecundity, and immunity (Luckey, T.D., ''Radiation Hormesis'', CRC Press, 1991). Increased immune competence reduces cancer mortality rates and provides increased average lifespan in animals. Decreased cancer mortality rates in atom bomb victims who received low dose irradiation makes it desirable to examine populations exposed to low dose irradiation. Studies with over 300,000 workers and 7 million person-years provide a valid comparison of radiation exposed and control unclear workers (Luckey, T.D., Nurture with Ionizing Radiation, Nutrition and Cancer, 34:1-11, 1999). Careful selection of controls eliminated any ''healthy worker effect''. The person-year corrected average indicated the cancer mortality rate of exposed workers was only 51% that of control workers. Lung cancer mortality rates showed a highly significant negative correlation with radon concentrations in 272,000 U.S. homes (Cohen, B.L., Health Physics 68:157-174, 1995). In contrast, radon concentrations showed no effect on lung cancer rates in miners from different countries (Lubin, J.H. Am. J. Epidemiology 140:323-332, 1994). This provides evidence that excessive lung cancer in miners is caused by particulates (the major factor) or toxic gases. The relative risk for cancer mortality was 3.7% in 10,000 Taiwanese exposed to low level of radiation from 60 Co in their steel supported homes (Luan, Y.C. et al., Am. Nuclear Soc. Trans. Boston, 1999). This remarkable finding needs further study. A major mechanism for reduced cancer mortality rates is increased immune competence; this includes both cell and humoral components. Low dose irradiation increases circulating lymphocytes. Macrophage and ''natural killer'' cells can destroy altered (cancer) cells before the mass becomes too large. Low dose irradiation also kills suppressor T-cells; this allows helper T-cells to activate killer cells and antibody producing cells

Mortality of mothers from cardiovascular and non-cardiovascular causes following pregnancy complications in first delivery

DEFF Research Database (Denmark)

Lykke, Jacob Alexander; Langhoff-Roos, Jens; Lockwood, Charles J

2010-01-01

cardiovascular and non-cardiovascular causes following preterm delivery, small-for-gestational-age offspring and hypertensive disorders of pregnancy. We found that preterm delivery and small-for-gestational-age were both associated with subsequent death of mothers from cardiovascular and non...... cardiovascular and non-cardiovascular causes, while hypertensive disorders of pregnancy are markers of early death of mothers from cardiovascular causes....

Pioglitazone and cause-specific risk of mortality in patients with type 2 diabetes: extended analysis from a European multidatabase cohort study.

Science.gov (United States)

Strongman, Helen; Christopher, Solomon; Majak, Maila; Williams, Rachael; Bahmanyar, Shahram; Linder, Marie; Heintjes, Edith M; Bennett, Dimitri; Korhonen, Pasi; Hoti, Fabian

2018-01-01

Describe and compare the risk of cardiovascular and non-cardiovascular mortality in patients whose antidiabetic therapy is modified to include pioglitazone compared with an alternative antidiabetic medication at the same stage of disease progression. This exploratory linked database cohort analysis used pooled health and mortality data from three European countries: Finland, Sweden and the UK. Propensity score together with exact matching was used to match 31 133 patients with type 2 diabetes first prescribed pioglitazone from 2000 to 2011, to 31 133 patients never prescribed pioglitazone. Exact matching variables were treatment stage, history of diabetes, diabetes complications and cardiovascular disease, and year of cohort entry. Mean follow-up time was 2.60 (SD 2.00) and 2.69 (SD 2.31) years in the pioglitazone and non-pioglitazone-exposed groups, respectively. Crude cause-specific mortality rates were ascertained. Association with pioglitazone use was estimated using Cox proportional hazards models adjusted a priori for country, age, sex, the propensity score quintile and time-dependent variables representing use of antidiabetic drugs. Stepwise testing identified no additional confounders to include in adjusted models. The crude mortality rate was lower in the pioglitazone-exposed group than the non-exposed group for both cardiovascular and non-cardiovascular mortality. Adjusted HRs comparing pioglitazone to alternative antidiabetic exposure were 0.58 (95% CI 0.52 to 0.63) and 0.63 (95% CI 0.58 to 0.68) for cardiovascular and non-cardiovascular mortality, respectively. A protective effect associated with pioglitazone was also found for all specific cardiovascular causes. This analysis suggests that pioglitazone is associated with a decrease in both cardiovascular and non-cardiovascular mortality. Results should be interpreted with caution due to the potential for residual confounding in this exploratory analysis. Further studies, specifically designed to test