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1.
The association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults: systematic review and meta-analysis.
Wei, J, Hou, R, Zhang, X, Xu, H, Xie, L, Chandrasekar, EK, Ying, M, Goodman, M
The British journal of psychiatry : the journal of mental science. 2019;(2):449-455
Abstract
BACKGROUND Late-life depression has become an important public health problem. Available evidence suggests that late-life depression is associated with all-cause and cardiovascular mortality among older adults living in the community, although the associations have not been comprehensively reviewed and quantified.AimTo estimate the pooled association of late-life depression with all-cause and cardiovascular mortality among community-dwelling older adults. METHOD We conducted a systematic review and meta-analysis of prospective cohort studies that examine the associations of late-life depression with all-cause and cardiovascular mortality in community settings. RESULTS A total of 61 prospective cohort studies from 53 cohorts with 198 589 participants were included in the systematic review and meta-analysis. A total of 49 cohorts reported all-cause mortality and 15 cohorts reported cardiovascular mortality. Late-life depression was associated with increased risk of all-cause (risk ratio 1.34; 95% CI 1.27, 1.42) and cardiovascular mortality (risk ratio 1.31; 95% CI 1.20, 1.43). There was heterogeneity in results across studies and the magnitude of associations differed by age, gender, study location, follow-up duration and methods used to assess depression. The associations existed in different subgroups by age, gender, regions of studies, follow-up periods and assessment methods of late-life depression. CONCLUSION Late-life depression is associated with higher risk of both all-cause and cardiovascular mortality among community-dwelling elderly people. Future studies need to test the effectiveness of preventing depression among older adults as a way of reducing mortality in this population. Optimal treatment of late-life depression and its impact on mortality require further investigation.Declaration of interestNone.
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2.
Lipoprotein(a): An independent, genetic, and causal factor for cardiovascular disease and acute myocardial infarction.
Enas, EA, Varkey, B, Dharmarajan, TS, Pare, G, Bahl, VK
Indian heart journal. 2019;(2):99-112
Abstract
Lipoprotein(a) [Lp(a)] is a circulating lipoprotein, and its level is largely determined by variation in the Lp(a) gene (LPA) locus encoding apo(a). Genetic variation in the LPA gene that increases Lp(a) level also increases coronary artery disease (CAD) risk, suggesting that Lp(a) is a causal factor for CAD risk. Lp(a) is the preferential lipoprotein carrier for oxidized phospholipids (OxPL), a proatherogenic and proinflammatory biomarker. Lp(a) adversely affects endothelial function, inflammation, oxidative stress, fibrinolysis, and plaque stability, leading to accelerated atherothrombosis and premature CAD. The INTER-HEART Study has established the usefulness of Lp(a) in assessing the risk of acute myocardial infarction in ethnically diverse populations with South Asians having the highest risk and population attributable risk. The 2018 Cholesterol Clinical Practice Guideline have recognized elevated Lp(a) as an atherosclerotic cardiovascular disease risk enhancer for initiating or intensifying statin therapy.
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3.
The association between obesity and cardiovascular disease mortality in different strata of socioeconomic position: evidence from pooled Norwegian health surveys.
Kjøllesdal, M, Degerud, E, Næss, Ø
European journal of public health. 2019;(6):1160-1166
Abstract
BACKGROUND Socioeconomic position (SEP) is related to both obesity and cardiovascular disease (CVD). There is little evidence on whether SEP modifies the relation between obesity and CVD. The aim of the study was to investigate whether the association between obesity and CVD mortality is stronger among people with disadvantaged than among people with advantaged life course SEP. METHODS Data from Norwegian population-based cardiovascular health surveys (1985-2003), including body mass index and CVD risk factors (cholesterol, blood pressure, smoking, current treatment for hypertension) were linked to socioeconomic indicators from register and census data (1960-90), and to the Cause of Death Registry (up until 2014). The total number of participants was 398 297. RESULTS In comparison with normal weight, the age-adjusted hazard ratios and 95% confidence intervals of CVD mortality among obese participants were 2.39 (2.07-2.75) and 2.08 (1.70-2.53) among men and women with high SEP, respectively and 1.88 (1.60-2.21) and 1.75 (1.43-2.14) among men and women with low SEP. Adjustment for CVD risk factors attenuated the results in a similar manner in all SEP groups, and among both women and men. CONCLUSION Obesity was consistently associated with a higher risk of CVD mortality, with only minor variation according to SEP. This means that preventing or treating obesity is, for the purpose of reducing CVD risk, equally important for an individual with high or low SEP.
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4.
Pregnancy As a Predictor of Maternal Cardiovascular Disease: The Era of CardioObstetrics.
Wu, P, Mamas, MA, Gulati, M
Journal of women's health (2002). 2019;(8):1037-1050
Abstract
Globally, cardiovascular disease (CVD) is the most common cause of mortality in women accounting for one in three deaths. There remains an under recognition of CVD as well as a lack of awareness of risk in women. Promotion of CVD prevention is essential, but the current risk assessment tools do not incorporate any sex-specific cardiovascular risk factors. There is increasing recognition of sex-specific risk factors that appear during pregnancy that are associated with CVD. These adverse pregnancy outcomes (APOs) include preeclampsia, gestational hypertension, preterm birth, gestational diabetes, delivery of a small-for-gestational-age infant, miscarriage, and high parity number. Although the underlying biological mechanism for these association remains to be elucidated, current international guidelines are beginning to recommend the inclusion of APOs in the assessment of CVD risk in women. This review summarizes the evidence for the association between APOs and future CVD. It also highlights the importance of considering APOs in the cardiovascular risk assessment, specifically in young women, allowing for targeted lifestyle-modifying interventions with the potential to alter their risk trajectory and improve their long-term cardiovascular health.
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5.
Dietary total antioxidant capacity and mortality from all causes, cardiovascular disease and cancer: a systematic review and dose-response meta-analysis of prospective cohort studies.
Parohan, M, Anjom-Shoae, J, Nasiri, M, Khodadost, M, Khatibi, SR, Sadeghi, O
European journal of nutrition. 2019;(6):2175-2189
Abstract
PURPOSE No conclusive information is available about the association between dietary total antioxidant capacity (DTAC) and risk of mortality. Current meta-analysis of prospective cohort studies was done to summarize available findings on the association between DTAC and risk of death from all-cause, cancer and cardiovascular diseases (CVDs). METHODS Online databases were searched to detect relevant publications up to January 2018, using relevant keywords. To pool data, either fixed-effects or random-effects model was used. Furthermore, linear and non-linear dose-response analyses were also done. RESULTS In total, five prospective studies were included in the current systematic review and meta-analysis. In a follow-up period of 4.3-16.5 years, there were 38,449 deaths from all-cause, 4470 from cancer and 2841 from CVDs among 226,297 individuals. A significant inverse association was found between DTAC and all-cause mortality (combined effect size: 0.62, 95% CI 0.60-0.64). Such finding was also seen for cancer (combined effect size: 0.81, 95% CI 0.75-0.88) and CVD (combined effect size: 0.71, 95% CI 0.63-0.82) mortality. Findings from linear dose-response meta-analysis revealed that a 5 mmol/day increment in DTAC based on ferric reducing antioxidant power (FRAP) and oxygen radical absorbance capacity (ORAC) was associated with 7% and 15% lower risk of all-cause mortality, respectively. Based on findings from non-linear dose-response meta-analysis, a significant reduction in risk of all-cause mortality was seen when increasing FRAP from 2 to 12 mmol/day (P-nonlinearity = 0.002) and ORAC from 5 to 11 mmol/day (P-nonlinearity < 0.001). CONCLUSIONS Adherence to diet with high total antioxidant capacity was associated with decreased risk of death from all-cause, cancer and CVDs.
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6.
Risk factors for cardiovascular disease in heterozygous familial hypercholesterolemia: A systematic review and meta-analysis.
Akioyamen, LE, Genest, J, Chu, A, Inibhunu, H, Ko, DT, Tu, JV
Journal of clinical lipidology. 2019;(1):15-30
Abstract
BACKGROUND Current data from individual studies present conflicting evidence about the relationship between risk factors and cardiovascular disease (CVD) in heterozygous familial hypercholesterolemia (FH). OBJECTIVES We conducted a systematic review and meta-analysis to quantify the association between various CVD risk factors and CVD in FH. METHODS We searched MEDLINE, EMBASE, Global Health, the Cochrane Library, and PubMed for English-language studies reporting adjusted-associations between cardiovascular, behavioral, or clinical risk factors and CVD with ≥ 100 participants. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) for selected risk factors with random-effects meta-analysis, from which we derived attributable risk estimates. RESULTS We identified 27 studies representing 41,831 unique participants and 6629 CVD events. Age (OR: 1.07; 95% CI: 1.03, 1.10), male sex (OR: 1.95; 95% CI: 1.68, 2.23), hypertension (OR: 2.11; 95% CI: 1.64, 2.58), diabetes (OR: 1.95; 95% CI: 1.33, 2.57), body mass index (OR: 1.04; 95% CI: 1.03, 1.05), smoking (OR: 1.71; 95% CI: 1.30, 2.12), elevated lipoprotein(a) (OR: 1.90; 95% CI: 1.10, 2.71), low high-density lipoprotein cholesterol (OR: 1.39; 95% CI: 1.24, 1.53), and a family history of CVD (OR: 1.83, 95% CI: 1.58, 2.07) were found to be significant CVD risk factors in FH. Smoking, hypertension, and diabetes accounted for more than a quarter of CVD risk in FH individuals, whereas low-density lipoprotein cholesterol > 4.0 mmol/L accounted for 1 in 3 CVD cases. Meta-regression analyses found associations between low-density lipoprotein cholesterol (P = .045) and total cholesterol (P < .001) and CVD. Results were broadly consistent in sensitivity analyses. CONCLUSION Several clinical risk factors are significantly and independently associated with CVD risk in patients with FH and should be targeted for modification. These data can also inform the selection of variables for prediction models to aid in risk stratifying patients.
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7.
Implications of Cardio-Respiratory Fitness on the Performance of Exercise Tests.
Jelinek, M, Hossack, K
Heart, lung & circulation. 2019;(4):e64-e66
Abstract
In 2016, the American Heart Association (AHA) produced a position paper on cardiorespiratory fitness (CRF) which defined CRF as the most important cardiac risk factor in the assessment of prognosis in a wide variety of clinical states [1]. The aim of the paper was to improve patient management and to encourage life-style based strategies designed to improve cardiovascular risk. The authors showed that: In this Brief Communication, we expand on how CRF can be assessed and reported in exercise testing.
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8.
Effect of daily intake of a low-alcohol orange beverage on cardiovascular risk factors in hypercholesterolemic humans.
Cerrillo, I, Escudero-López, B, Ortega, A, Martín, F, Fernández-Pachón, MS
Food research international (Ottawa, Ont.). 2019;:168-174
Abstract
Oxidative stress, inflammation status, endothelial dysfunction, and imbalanced lipid metabolism play a major role in cardiovascular disease. Bioactive compounds and moderate alcohol consumption have been associated with decreased cardiovascular risk. This study aimed to evaluate the effect on cardiovascular risk factors of a low-alcohol beverage derived from the alcoholic fermentation of orange juice. Eighteen individuals with moderately high cholesterol levels were randomly assigned to an experimental group (n = 9) who drank 500 mL/day of the orange beverage for 2 weeks or a control group (n = 9) who drank no orange beverage. Blood samples were drawn at the beginning and end of the study period. Consumption of the beverage significantly decreased plasma levels of total cholesterol (-15.6%), LDL-cholesterol (-17.8%), LDL-cholesterol/HDL-cholesterol ratio (-21.4%), catalase (-25.5%), TBARS (-42.6%), and sVCAM-1 (-5.8%). This orange beverage would have a potential capacity to improve cardiovascular risk in hypercholesterolemic humans, supporting its future consideration as a functional beverage.
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9.
Lipid Management for the Prevention of Atherosclerotic Cardiovascular Disease.
Michos, ED, McEvoy, JW, Blumenthal, RS
The New England journal of medicine. 2019;(16):1557-1567
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10.
The Impact of Obesity on the Association between Vitamin D Deficiency and Cardiovascular Disease.
Paschou, SA, Kosmopoulos, M, Nikas, IP, Spartalis, M, Kassi, E, Goulis, DG, Lambrinoudaki, I, Siasos, G
Nutrients. 2019;(10)
Abstract
The aim of this article is to review the literature regarding the relationship between vitamin D deficiency and cardiovascular disease (CVD) and its modification in the presence of obesity. Despite the strong association between vitamin D status and cardiovascular outcomes, vitamin D supplementation trials in the general population have failed to decrease the incidence of cardiovascular events and mortality. A comprehensive study of the published literature and a comparison with experimental data lead to the conclusion that obesity, due to its high prevalence and strong association with both vitamin D deficiency and CVD, may act as a critical confounder, which is responsible for the different results on this association. Adoption of a vitamin D preventive supplementation strategy for CVD is unlikely to yield any benefit to the general population. However, it might be particularly useful in obese adults with increased risk for CVD.