المؤلفون: Paulina Kaiser, Alice M. Arnold, Mercedes R. Carnethon, Norrina B. Allen, Joseph A.C. Delaney, Michelle C. Odden, Calvin H. Hirsch

المصدر: Ann Epidemiol

مصطلحات موضوعية: Male, Gerontology, Epidemiology, Cardiovascular health, Disease, 01 natural sciences, Article, Social Networking, 03 medical and health sciences, Social support, 0302 clinical medicine, Risk Factors, Cause of Death, Humans, Medicine, Interpersonal Relations, Survivors, 030212 general & internal medicine, 0101 mathematics, Association (psychology), Aged, Aged, 80 and over, Heart Failure, Social network, business.industry, Mortality rate, 010102 general mathematics, Social Support, medicine.disease, Survival Analysis, United States, Heart failure, Scale (social sciences), Female, business

الوصف: Purpose Although social support has been shown to be associated with survival among persons with cardiovascular disease, little research has focused on whether social support, measured before the onset of heart failure, can enhance survival after diagnosis. The objective of this study was to assess the association between prediagnosis social support and postdiagnosis survival among older adults with heart failure. Methods We obtained the data from the Cardiovascular Health Study, which included noninstitutionalized adults aged 65 years or older from four sites in the United States with primary enrollment in 1989–1990. We used two measures of social support, the Lubben Social Network Scale and the Interpersonal Support Evaluation List. The analytic data set included 529 participants with a social support measure within two years before diagnosis of heart failure. Results After adjustment for demographic covariates, cardiovascular risk factors, and general health status, mortality rates were lower among participants in the highest tertile of social network scores (HR 0.74, 95% CI: 0.59, 0.93) and the middle tertile (HR 0.73 [0.58, 0.90]), compared with the lowest tertile. Results with interpersonal support were null. Conclusions These findings suggest that prediagnosis structural social support may modestly buffer heart failure patients from mortality.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::e201dac2dc0ef72d3d97b6665318b4ff
https://doi.org/10.1016/j.annepidem.2019.12.013

المؤلفون: Lindsay R. Pool, Lauren S. Wakschlag, Liliana Aguayo, Linda Van Horn, Darwin R. Labarthe, Matthew M. Davis, Lifang Hou, Bradley S. Marino, Norrina B. Allen, Donald M. Lloyd-Jones

المصدر: Circulation. 143

مصطلحات موضوعية: Gerontology, business.industry, Physiology (medical), Cardiovascular health, Multidimensional assessment, Physical activity, Medicine, Cardiology and Cardiovascular Medicine, business, Sleep in non-human animals

الوصف: Introduction: The importance of healthy family lifestyles and home environments (e.g. environments that support healthy choices for food, physical activity, and sleep) on health behaviors and obesity risks are well-recognized. Less is known about the association of family factors with cardiovascular health (CVH) in youth. We examined the cross-sectional association of family factors (reported by youth and their parents) with youths’ CVH. Methods: Analyses included data from the Multidimensional Assessment of Preschoolers Study. Parents and youth (11.3± 0.7 years old) reported the frequency of ten family factors (e.g. breakfast intake, monitoring of screen time, etc.). The outcome was a 10-point score of youths’ CVH that included 5 CVH metrics (diet, physical activity, smoking, BMI, and blood pressure) summed using the AHA criteria. Pearson correlations were used to compare youth and parents’ reports of family factors and adjusted multivariable linear regression models to examine the association of both reports with youths’ CVH scores. Results: Study included 177 parent-youth dyads, and 22% of youth had ideal, 74% intermediate, and 5% poor CVH. Correlations between parents and youths’ reports of family factors were moderate. Based on parents’ reports, support of healthy beverage choices (i.e. limit sweet and soda beverages and support low fat dairy intake) associated with youths’ CVH scores (β= -0.10, p Conclusion: Youths’ CVH scores were associated with healthy beverage choices and family support of youths’ physical activity, but not other family factors. These important family factors require further research.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::0a7dc2bcadeac64dc698519384a2669b
https://doi.org/10.1161/circ.143.suppl_1.p034

المؤلفون: Donald M. Lloyd-Jones, Darwin R. Labarthe, Linda Van Horn, Leigha A. MacNeill, Amy Krefman, Bradley S. Marino, Orna Reges, Lifang Hou, Norrina B. Allen, Lauren S. Wakschlag, Xiaoyun Yang, Rachel Flynn, Matthew M. Davis

المصدر: Circulation. 143

مصطلحات موضوعية: Gerontology, business.industry, Physiology (medical), Cardiovascular health, Multidimensional assessment, Medicine, Early childhood, Cardiology and Cardiovascular Medicine, business

الوصف: Background: Cardiovascular health (CVH) declines with age starting in early childhood. Neurodevelopmental health (NDH) measures, such as executive function, in early childhood have been associated with subsequent behavioral and lifestyle outcomes; however, little is known about the association of NDH measures in early life with CVH during childhood. Objective: To assess the association of preschool NDH with CVH in later childhood/early adolescence. Methods: Among participants from the Multidimensional Assessment of Preschoolers Study (MAPS), we defined 3 neurodevelopment domains at baseline (ages 3-7 years): executive functioning, developmental functioning, and emotion and behavior regulation (each as a z-score of its component surveys and direct assessment). At the tween follow-up wave (ages 9-14 years), MAPS participants completed a CVH examination including assessment of physical activity, diet, blood pressure, and BMI defined as favorable vs unfavorable CVH metrics according to AHA recommendations. Multivariate logistic regression models were used to assess the association of each NDH domain with favorable/unfavorable CVH metrics at follow up. Models were adjusted for age, race, gender, and poverty. Results: We included 229 SES-diverse children (46.2% boys; 52% living in poverty at baseline; mean baseline age 4.7 yr; mean follow-up age: 11.3 yr). At follow-up, there were 179 (78.2%) children with favorable CVH and 50 (21.8%) children with unfavorable CVH. Better performance on all 3 NDH domains at baseline was demonstrated among children with favorable CVH at follow-up compared to those with unfavorable CVH, with mean z-score of 0.04 among those with favorable CVH compared to -0.15 among those with unfavorable CVH for executive functioning (p Conclusions: These findings suggest a possible association between neurodevelopmental domains and CVH, although findings were not significant after adjustment. The heterogeneity of the sample may have obscured effects and the moderating role of the environment may elucidate explanatory pathways. More research with larger sample sizes is needed to better understand the impact of early-life NDH with adolescent CVH.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::f3748e7f1e3085a23db086a9ac3236b7
https://doi.org/10.1161/circ.143.suppl_1.p035

المؤلفون: Xiaoyun Yang, Lindsay R. Pool, Marc B. Rosenman, Amanda M. Perak, Donald M. Lloyd-Jones, Matthew M. Davis, Lifang Hou, Amy Krefman, Norrina B. Allen, Darwin R. Labarthe, Bradley S. Marino, Linda Van Horn

المصدر: Circulation. 143

مصطلحات موضوعية: Gerontology, Race (biology), business.industry, Electronic health record, Physiology (medical), Cardiovascular health, Ethnic group, Medicine, Racial/ethnic difference, Early childhood, Cardiology and Cardiovascular Medicine, business, Cardiometabolic disease

الوصف: Introduction: Racial/ethnic differences in CVH beginning at age 8 have been identified and linked with the development of cardiometabolic disease in adulthood; however, there is scarce research on CVH in very childhood. Our objective was to use a large, diverse pediatric EHR consortium to identify racial/ethnic patterns of clinical CVH from ages 2-12 years. Methods: We used ambulatory visit data spanning 2010-2018 from children aged 2-12 years within CAPriCORN - an EHR repository that combines medical records throughout the city of Chicago. The 4 clinical CVH metrics - BMI, blood pressure, cholesterol, and glucose - were categorized as ideal or non-ideal using available values of weight, height, blood pressure, laboratory readings, and ICD diagnosis codes. Multiple measurements within a given integer age were averaged by individual. Frequency of ideal and non-ideal status for each CVH metric was plotted by age in years and stratified by race/ethnicity (Figure). Results: There were 162,621 children included (47% female) with a median of 2 visits during follow-up. The race/ethnicity distribution was 4% Asian/Pacific Islander (API), 26% non-Hispanic Black (NHB), 44% non-Hispanic white (NHW), 18% Hispanic, and 8% other/unknown. Sustained decrease in ideal BMI occurred across race/ethnicity groups; however, proportion in ideal was consistently lower for NHB and Hispanic children. Ideal BP appeared to increase across childhood with few racial differences. Ideal cholesterol levels were constant across childhood, but the proportion of NHW children in ideal was lower than NHB and Hispanic children. Almost all individuals had ideal glucose levels throughout early childhood. Conclusions: Early childhood declines in CVH appeared to be driven by changes in ideal BMI. Racial/ethnic differences in ideal BMI and cholesterol were present by age 2 and were mostly sustained through age 12. Selection bias may account for some of these findings; consistent monitoring in early childhood is needed to better understand observed differences.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::0b89200f131ca3eda9ff82b8a5934f30
https://doi.org/10.1161/circ.143.suppl_1.p033

المؤلفون: Donald M. Lloyd-Jones, Hongyan Ning, Cora E. Lewis, Norrina B. Allen, David R. Jacobs, Amanda M. Perak, Linda Van Horn, Sadiya S. Khan, Joshua D. Bundy

المصدر: Circulation. 142

مصطلحات موضوعية: Gerontology, business.industry, Physiology (medical), Coronary risk, Cardiovascular health, Medicine, Young adult, Cardiology and Cardiovascular Medicine, business, Late adolescence

الوصف: Introduction: Mid-life cardiovascular health (CVH) is strongly associated with risks of later-life CVD and mortality across race and sex groups. Adolescent and young-adult CVH are associated with risk of subclinical CVD, but data are lacking regarding CVD events or mortality. Hypotheses: (1) CVH in late adolescence/young adulthood (18-30y) is associated with risks of premature CVD and mortality; (2) Event rates are uniformly low across sociodemographic subgroups with high baseline CVH. Methods: CVH (defined by AHA’s 7 metrics) was measured at baseline and total CVH scores were categorized as high (12-14 pts), moderate (8-11) or low (0-7). CVD events and cause-specific mortality were adjudicated over 32y of follow-up. We estimated adjusted associations of baseline CVH with outcomes using Cox models and calculated population attributable fractions (PAFs; adjusted for competing risk of death as applicable) and event rates by CVH category. Results: See Table . Among 4836 participants, mean age was 24.9y (SD 3.6), 44.1% were aged 18-24y, 54.8% were female, and 50.5% were black. Baseline CVH was high in 28.8%, moderate in 65.0%, and low in 6.3%. In total, 306 CVD events and 431 deaths occurred. CVH was significantly associated with all outcomes, with similar patterns by age, sex, and race. PAFs for moderate/low (vs high) CVH ranged from 0.42 (all-cause mortality) to 0.63 (CVD) to 0.81 (CVD mortality) overall; PAFs were not significantly different across sociodemographic subgroups. Among individuals with high CVH, event rates were low across all sociodemographic subgroups (e.g., CVD rates/1000 person-yrs: age 18-24y 0.64, 25-30y 0.65, women 0.36, men 1.04, black 0.90, white 0.50). Conclusions: High CVH at age 18-30y was associated with low rates of premature CVD and mortality. Preservation of high CVH to at least age 18y may reduce CVD and mortality burdens and disparities, and adolescent/young-adult CVH may be a valid intermediate outcome for early-life determinants of risk.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::e369e59fc16a27080434ce8f79331694
https://doi.org/10.1161/circ.142.suppl_3.195

المؤلفون: Andrew E. Moran, Emily M. Bucholz, Sarah D. de Ferranti, Neel M. Butala, Norrina B. Allen

المصدر: Circulation. 142

مصطلحات موضوعية: Gerontology, Race ethnicity, medicine.medical_specialty, Ideal (set theory), business.industry, Physiology (medical), Cardiovascular health, Epidemiology, Medicine, Cardiology and Cardiovascular Medicine, business

الوصف: Introduction: Ideal cardiovascular health (CVH) in adulthood is rare; however, the relationship between CVH and age has not been fully delineated. The aim of this study was to characterize the association of age with ideal CVH and individual CVH metrics across the lifespan and to compare these associations across gender, race, and income subgroups. Methods: We studied participants aged 12-80 years from NHANES 2005-2016 (n=42,367). Ideal CVH was defined using the AHA’s Simple 7 criteria (range 0-14) based on smoking status, body mass index, physical activity, diet quality, total cholesterol, plasma glucose, and blood pressure. Cubic models were used to model the association of mean CVH with age. The percentage of participants with ideal (≥5) and poor (≤2) CVH were plotted by age. Results: Mean CVH declined with increasing age starting in early adolescence and reaching a nadir by age 60 before stabilizing ( Figure 1 ). At age 20, only 45% of adults had ideal CVH; >50% of adults had poor CVH by age 53. Women had higher mean CVH than men at younger ages but lower mean CVH at age ≥60 ( Figure 2 ). Mean CVH scores were highest for non-Hispanic whites and higher income adults, and lowest for non-Hispanic blacks and low-income adults across all ages. Mean CVH decreased to poor levels ~30 years earlier for non-Hispanic blacks compared with non-Hispanic whites, and ~35 years earlier younger for low-income compared with higher-income adults. Conclusions: The proportion of the population with ideal CVH decreases within increasing age beginning in early adolescence and persists through adulthood. Race/ethnicity and income disparities in CVH are evident early in life and became more profound at older ages.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::6299bed5bab45de1002faa9678582512
https://doi.org/10.1161/circ.142.suppl_3.194

المؤلفون: Samuel S. Gidding, Bonnie Spring, Kirsten Bibbins-Domingo, Tené T. Lewis, Deborah F. Tate, Holly C. Gooding, Kathleen Mullan Harris, Michael A. Grandner, Maureen Monaghan, Trudy L. Burns, Andrew E. Moran, Janet M. Catov, Nicole Redmond, Jennifer G. Robinson, Norrina B. Allen, Michaela Kiernan, Karen A. Matthews, Fida Bacha, Heather M Johnson

المصدر: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease

مصطلحات موضوعية: young adults, Adult, Persistence (psychology), Gerontology, cardiovascular disease risk factors, Epidemiology, primary prevention, Ethnic group, Health Promotion, Disease, 030204 cardiovascular system & hematology, Behavioral Medicine, 03 medical and health sciences, 0302 clinical medicine, Risk Factors, Cardiovascular Disease, Primary prevention, Contemporary Review, medicine, Humans, 030212 general & internal medicine, Young adult, Contemporary Reviews, Life History Traits, Lung, cardiovascular disease prevention, business.industry, Age Factors, medicine.anatomical_structure, Cardiovascular Diseases, Heart Disease Risk Factors, Evidence-Based Practice, Public Health, Cardiology and Cardiovascular Medicine, business

الوصف: Improvements in cardiovascular disease (CVD) rates among young adults in the past 2 decades have been offset by increasing racial/ethnic and gender disparities, persistence of unhealthy lifestyle habits, overweight and obesity, and other CVD risk factors. To enhance the promotion of cardiovascular health among young adults 18 to 39 years old, the medical and broader public health community must understand the biological, interpersonal, and behavioral features of this life stage. Therefore, the National Heart, Lung, and Blood Institute, with support from the Office of Behavioral and Social Science Research, convened a 2‐day workshop in Bethesda, Maryland, in September 2017 to identify research challenges and opportunities related to the cardiovascular health of young adults. The current generation of young adults live in an environment undergoing substantial economic, social, and technological transformations, differentiating them from prior research cohorts of young adults. Although the accumulation of clinical and behavioral risk factors for CVD begins early in life, and research suggests early risk is an important determinant of future events, few trials have studied prevention and treatment of CVD in participants

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::eb52b169284a5034ff749d80c51fa1e2
https://doi.org/10.1161/jaha.120.016115

المؤلفون: Mercedes R. Carnethon, Amy Krefman, Kristen L. Knutson, Charles Hansell, Amanda M. Perak, Megan E. McCabe, Mandy Wong, Norrina B. Allen, Wakschlag Lauren

المصدر: Circulation. 141

مصطلحات موضوعية: Gerontology, business.industry, Multidimensional assessment, Disease, Intra individual, medicine.disease, Obesity, Sleep in non-human animals, Physiology (medical), Diabetes mellitus, medicine, Cardiology and Cardiovascular Medicine, Association (psychology), business, Sleep duration

الوصف: Background: Average nightly sleep duration is associated with cardiometabolic health; both short- and long-sleep are associated with obesity, diabetes, hypertension and cardiovascular disease. An equally important measure of cardiometabolic health is an individual’s daily variability (DV) in sleep timing and duration. Greater intra-individual DV is associated with less favorable cardiometabolic health in adults, but less is known about the association of DV with cardiometabolic health in youth. We hypothesize that DV in sleep timing and duration is associated with less favorable body mass index (BMI), systolic blood pressure and waist girth among youth. Methods: Boys and girls aged 9-13 years old who wore the Actigraph GT-3X BT on their non-dominant wrist for a minimum of 4 days and had available measures of cardiometabolic health were included in the analysis (N=91). Validated algorithms from ActiLife software were used to determine daily total sleep time, sleep efficiency, sleep onset and time out of bed. We calculated DV in sleep onset, time out of bed and duration as the coefficient of variation (CV = standard deviation/overall mean). Average sleep measures were calculated across the days worn. We modeled the association of each sleep measure with metabolic outcomes using multivariable linear regression. Results: On average, participants slept for 7.23 (SD=1.4) hours per night, BMI percentile (BMI%) was 63.0 (SD=30.9), waist girth was 66.7 cm (SD=10.8) and systolic blood pressure percentile (SBP%) was 41.4 (SD= 21.4). Higher DV in sleep onset was associated with significantly higher BMI% and positively associated with SBP%. There was no association of average sleep measures with any outcomes. Findings were consistent by sex and age. Conclusions: Daily variability in time to sleep in youth was associated with higher BMI% and a modest association with SBP%. Future studies should test whether promoting consistent bedtimes can improve cardiometabolic health.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::f33068802fb35f748012c0b7d66f2fba
https://doi.org/10.1161/circ.141.suppl_1.mp22

المؤلفون: Joshua D. Bundy, Sadiya S. Khan, Hongyan Ning, Norrina B. Allen, Donald M. Lloyd-Jones, John T. Wilkins

المصدر: Circulation. 141

مصطلحات موضوعية: Health span, Gerontology, business.industry, Physiology (medical), Cardiovascular health, Medicine, Cardiology and Cardiovascular Medicine, business, Span (engineering), U s population, Loss of life

الوصف: Introduction: Individuals who maintain optimal cardiovascular health (CVH) live a longer, healthier life without cardiovascular disease (CVD). In order to quantify the population burden of sub-optimal CVH, we estimated potential loss of health- and life-span in a nationally representative sample of middle-aged US black and white adults. Methods: We first calculated individual-level composite CVH scores (range 0-14 points), including all 7 AHA-defined CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, glucose, and cholesterol) using data from middle-aged participants (40-49 years) from 3 population-based cohorts. We categorized participants into low (0-6), moderate (7-9), and high (10-14) CVH and used Irwin’s restricted means to estimate years lived free of and with CVD. Next, we determined the contemporary prevalence of low, moderate, and high CVH in middle-aged black and white adults (40-59 years) pooled from 3 NHANES survey cycles (2011-2016). Finally, we generated estimates of CVD-free and overall years of life lost in moderate and low CVH compared to high CVH subgroups, weighted to the US population accounting for the NHANES complex survey design. Results: Of 12,906 participants in the pooled cohort, 23% were black and 56% women. Low and moderate CVH were associated with 4.41±0.02 and 1.86±0.01 fewer healthy years lived without CVD and 2.43±0.02 and 1.09±0.01 fewer overall years of life, respectively. This resulted in a greater proportion of life lived with CVD across all race-sex groups (FIGURE). When weighted to the US population, we estimate that approximately 230.8 (203.5, 258.0) and 97.1 (95% CI 85.6, 108.6) million healthy life years will be lost due to low and moderate CVH, respectively, in middle-aged adults. Conclusions: The projected loss of healthy CVD-free years and total life years due to low and moderate CVH is substantial. Maintenance of optimal CVH into mid-life may represent a significant opportunity to extend healthspan and mitigate disparities in the US population.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::9d2976ea4ae9dd2a6047a3832f6f0915
https://doi.org/10.1161/circ.141.suppl_1.p102

المؤلفون: Nour Makarem, Norrina B. Allen, Marwah Abdalla, Tali Elfassy, Mercedes R. Carnethon, Amanda C. McClain, Susan Redline, Brooke Aggarwal, Charles A German, Jason Fanning

المصدر: Circulation. 141

مصطلحات موضوعية: Gerontology, business.industry, Physiology (medical), Cardiovascular health, Physical activity, Ethnic group, Medicine, Sedentary behavior, Cardiology and Cardiovascular Medicine, business, Sleep in non-human animals

الوصف: Introduction: Sleep, sedentary behavior, and physical activity are each independently associated with cardiovascular health (CVH). However, many studies have investigated these relationships in isolation even though a change in any one given behavior will affect the time spent in the others. It is unknown how reallocating time in sedentary behavior with sleep or physical activity effects overall CVH in a diverse cohort of men and women at risk of cardiovascular disease (CVD). Hypothesis: Reallocating 30 minutes of sedentary time with sleep, light (LIPA), or moderate to vigorous physical activity (MVPA) is associated with more favorable overall CVH due to improvements in risk factors for CVD. Methods: Data for this analysis were taken from the Multi-Ethnic Study on Atherosclerosis (MESA) Sleep Ancillary Study. Eligible participants (n= 1718) wore Actiwatch accelerometers for 24 hours a day, and had at least 3 days of valid accelerometry. Time spent in sleep, sedentary behavior, LIPA, and MVPA was determined based on an established algorithm. The American Heart Association’s life simple 7 was used to represent the CVH score after excluding the physical activity component, with higher scores indicating more favorable CVH. All components were ascertained from MESA exam 5. Isotemporal substitution modeling was conducted to examine the effect of substituting 30 minutes of sedentary time for an equivalent amount of sleep, LIPA, or MVPA. Results: The mean age of participants was 68.3, 54.0% were female and 38.6% were white. The mean CVH score was 5.9 (95%CI: 5.8-6.0). On average, participants spent 499.3 minutes/day in sedentary time, 415.3 minutes/day in LIPA, 26.0 minutes/day in MVPA, and 388.2 minutes/day sleeping. Reallocating 30 minutes of sedentary time to sleep, LIPA, and MVPA was associated with a significantly higher CVH score [β(SE): 0.077(0.023), 0.039(0.017), and 0.485(0.065) respectively]. Reallocating 30 minutes of sedentary time to sleep was associated with lower BMI. Reallocating 30 minutes of sedentary time to LIPA was associated with higher diastolic blood pressure and total cholesterol, and lower BMI. Reallocating 30 minutes of sedentary time to MVPA was associated with lower systolic and diastolic blood pressure, and lower BMI. Conclusions: Our study demonstrates that sleep, LIPA, and MVPA are all positively associated with more favorable overall CVH and several key CVD risk factors. These findings underscore the importance of lifestyle modifications in improving CVH.

URL الوصول: https://explore.openaire.eu/search/publication?articleId=doi_________::f2b093f789ea5ea38b77cc635e719f0b
https://doi.org/10.1161/circ.141.suppl_1.mp16