Monthly Archive for: ‘February, 2013’

Four lifestyle factors combined and cardiovascular disease

A healthful diet and lifestyle is related to low CVD risk

A Mediterranean style diet, a high level of physical activity, not smoking and moderate alcohol consumption were all associated with low 10-year risk of CHD and CVD in the European HALE project. A very low risk of these diseases was observed in elderly men who had four compared to those who had none or one healthful diet and lifestyle factor. We estimate that among elderly men who did not adhere to a low-risk lifestyle pattern, 64% of deaths due to CHD and 61% due to CVD might have been prevented based on the observed risk differences.

Interpretation

Among elderly men, the more healthful factors of diet and lifestyle the lower the CVD mortality observed. More than 60% of CVD mortality was associated with lack of adherence to the low-risk pattern. This finding implies that even at advanced ages those who follow a Mediterranean style diet and maintain a healthful lifestyle are less likely to die from CVD.

References

Optimism and cardiovascular disease

High optimism low CVD mortality

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Optimism and cardiovascular mortality
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Optimism was a relatively stable trait over 15 years in the Zutphen Elderly Study. Elderly men with a high level of optimism had only half the risk of 15-year CVD mortality compared to those with a low level of optimism. Similar results were obtained after adjustment for CVD risk factors, lifestyle factors, living arrangements, self-rated health and depressive symptoms.

Interpretation

Optimism was not related to major cardiovascular risk factors. However, a high level of optimism was associated with better coping behavior, goal-directed efforts such as better self-care, vitality, emotional flexibility and seeking social support. Optimism was also related to physical activity, non-smoking, moderate alcohol intake and higher intakes of fruit, vegetables and whole-grain bread. This suggests that a high level of optimism affects the risk of cardiovascular death through positive psycho-social behaviors, more healthy lifestyle and dietary habits.

References

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CVD   Main topics

Country Trends

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Depressive symptoms and cardiovascular disease

Depressive symptoms related to CVD mortality

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Depressive symptoms and CVD
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Elderly men from the FINE study cohorts of Finland, the Netherlands and Italy who manifested a number of depressive symptoms had a 2-fold greater 10-year CVD mortality. The relative risk did not change after excluding cases that died from CVD in the first 5 years of follow-up. The strongest associations were observed with the mortality from stroke and heart failure and the relation with CHD mortality was of borderline statistical significance. Depressive symptoms were not related to risk of other degenerative heart diseases and no differences in risk from depression were observed between northern and southern Europe.

Interpretation

The results of this study provide strong support for the hypothesis that depressive symptoms are a real and causal risk factor for CVD. Its prospective design, established that the depressive symptoms preceded the fatal CVD event. Furthermore, the large sample size and the long follow-up made it possible to exclude subjects who died from CVD in the first five years after baseline, making reversed causality unlikely, that is, that the event caused the depressive symptoms. Adjustment for many confounding variables made it likely that the depressive symptoms had an independent effect.

References

Average saturated fat intake and coronary heart disease rates in the 16 cohorts

Saturated fat was strongly correlated with long-term CHD mortality

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Average saturated fat intake and CHD mortality rates


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The average population intake of saturated fat varied between 3% of energy in Japan and 22% of energy in Eastern Finland in the 1960s. There was also a 6-fold range in 25-year CHD mortality rates among the 16 cohorts. The average saturated fat intake at baseline was strongly correlated with 25-year CHD mortality rates. The higher the saturated fat intake, the higher the CHD mortality rate.

Different sources of saturated fat in different countries

The dietary surveys carried out in the 1960s showed that the most important sources of saturated fat were butter in Finland, hard margarine in The Netherlands and lard in Slavonia (Croatia). Equivalent portions of the foods eaten in 1960s were collected locally for the 16 cohorts in 1987 and were chemically analyzed for fatty acids. This analysis provided more detailed information about the different categories of fatty acids than that carried out in the 1960s.

References

Flavan-3-ols (catechins) and cardiovascular disease

Flavan-3-ol intake related to CHD but not to stroke

An average intake of monomeric flavan-3-ols of 124 mg/d, compared to an average intake of 25 mg/d, was associated with a 51% lower 10-year CHD mortality in the Zutphen Elderly Study. Tea is a rich source of both flavan-3-ols and flavonols. Therefore we analyzed also the intake of tea, flavan-3-ols not from tea and flavonols not from tea in relation to fatal CHD. Tea and flavan-3-ols not from tea were inversely related to fatal CHD but flavonols from other sources than tea were not associated. These results suggest that a high intake of flavan-3-ols is related to a low risk of fatal CHD independent of flavonols. In contrast, flavan-3-ols intake was not associated with 10-year stroke incidence.

Measuring flavan-3-ols (catechins)

Flavan-3-ols are a subclass of flavonoids, an extended class of chemically related compounds ubiquitously present in plant foods. Evidence from controlled experiments in people shows that one of the flavan-3-ols, epicatechin, has favorable effects on endothelial function, blood pressure and insulin resistance. The richest sources of flavan-3-ols are tea, apples and chocolate (cocoa).

References

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CVD   Main topics

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Country Trends

Explore the graphs with trends in CVD risk factors across time and cultures.

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Average serum cholesterol level and CHD death rates in the 16 cohorts

Serum cholesterol levels strongly correlated to long-term CHD mortality

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Average serum cholesterol and CHD mortality rates


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In the 1960s average serum cholesterol levels varied from 160 mg/dl (4 mmol/l) in the Japanese cohorts to 270 mg/dl (7 mmol/l) in Eastern Finland. The baseline serum cholesterol levels of the 16 cohorts were positively correlated with the CHD mortality rates after 5, 10, and 25 years. The higher the average serum cholesterol level at baseline the higher the CHD mortality rates. Cohorts with low serum cholesterol levels at outset, in which average levels rose during 10 years of follow-up had an excess risk of CHD mortality during the subsequent 15 years.

Interpretation

These results indicate that both average serum cholesterol level and change in this level are correlated with CHD mortality rate in the 16 cohorts of the SCS. Individual 25-year risk of CHD death within SCS cohorts was also strongly related to serum cholesterol level (Read more). Because primary and secondary prevention trials have shown that reduction of serum cholesterol levels (with statins) reduced risk of CHD events and death, the totality of evidence is strong that serum cholesterol is causally related to CHD mortality.

References