CV health and cognitive aging

Ideal Cardiovascular Health and Cognitive Aging in the Northern Manhattan Study
J Am Heart Assoc. 2016
Hannah Gardener, ScD, et al.

Conclusions: The number of ideal CVH metrics was associated with less decline in the domains of Processing Speed and, to a lesser extent, of Executive Function and Episodic Memory.
Ideal CVH promotion benefits brain health and cognitive aging.

journalistic version:

Executive functions program


Depression & stroke risk 2 years after mood improves

Changes in Depressive Symptoms and Incidence of First Stroke Among Middle‐Aged and Older US Adults
Paola Gilsanz, et al.
Conclusions: persistently high depressive symptoms were associated with increased stroke risk. Risk remained elevated even if depressive symptoms remitted over a 2‐year period, suggesting cumulative etiologic mechanisms linking depression and stroke.

journalistic version:
Long-Term Depression May Boost Stroke Risk Long After Mood Improves
May 14, 2015

Psychological Distress Across the Life Course and Cardiometabolic Risk

Psychological Distress Across the Life Course and Cardiometabolic Risk
Findings From the 1958 British Birth Cohort Study
Ashley Winning, ScD, MPH, et al.
J Am Coll Cardiol. 2015;66(14):1577-1586.

Background  Research suggests cardiovascular and metabolic diseases are influenced by psychological distress in adulthood; however, this research is often limited to adult populations and/or a snapshot measure of distress. Given emerging recognition that cardiometabolic diseases have childhood origins, an important question is whether psychological distress earlier in life influences disease development.

Objectives  This study sought to assess whether life course patterns of psychological distress assessed from childhood through adulthood predict biomarkers of cardiometabolic risk in adulthood and whether effects of sustained distress differ from more limited exposure.

Methods  The sample (n = 6,714) consists of members of the 1958 British Birth Cohort Study who completed repeated measures of psychological distress and a biomedical survey at age 45 years. Psychological distress profiles over the life course (no distress, childhood only, adulthood only, or persistent distress) were identified from 6 assessments between ages 7 and 42 years. Cardiometabolic risk was assessed by combining information on 9 biomarkers of immune, cardiovascular, and metabolic system function. Covariate adjusted linear regression models were used to assess associations between distress profiles and cardiometabolic risk.

Results  Compared with those with no distress, cardiometabolic risk was higher among people with psychological distress in childhood only (β = 0.11, SE = 0.03, p = 0.0002), in adulthood only (β = 0.09, SE = 0.03, p = 0.007), and persistent across the life course (β = 0.26, SE = 0.04, p < 0.0001).

Conclusions  Psychological distress at any point in the life course is associated with higher cardiometabolic risk. This is the first study to suggest that even if distress appears to remit by adulthood, heightened risk of cardiometabolic disease remains. Findings suggest early emotional development may be a target for primordial prevention and for promoting lifelong cardiovascular health.

journalistic version

Type A personality: a construct of the tobacco industry

The Secret History Behind The Science Of Stress
July 07, 2014

both Selye’s work and much of the work around Type A, were profoundly influenced by cigarette manufacturers who were interested in promoting the concept of stress because it allowed them to muddy the waters by arguing that it was stress and not cigarettes that was to blame for heart disease and cancer.

PETTIGREW: In the case of Selye, tobacco industry lawyers vetted papers. They vetted the content of the paper. They agreed the wording of papers. Tobacco industry lawyers actually influenced the content of his writings. They suggested to him things that he should comment on.

“What’s never really been appreciated is that the tobacco industry was a major funder and stimulant of research on stress,” he says. “Specifically Selye’s work, but also research on Type A behavior. Type A personality is to a large extent a construct of the tobacco industry.”

from Schwartz’s Principles of Surgery, 10e (July 2014) > Chapter 46: Anesthesia for the Surgical Patient
Major Risk Factors for Coronary Artery Disease:

  • hypercholesterolemia
  • hyperlipidemia
  • hypertension
  • smoking
  • diabetes mellitus
  • hyperhomocysteinemia
  • advanced age
  • male sex
  • obesity
  • sedentary lifestyle

Myocardial stunning

Patchett: In Bad Relationships, ‘There Comes A Day When You Gotta Go’
January 23, 2014

I never had any procrastination issues and a lot of my writer friends had procrastination issues, deadline issues, and they were really tortured by magazine writing.

So I think for the most part they really admired the fact that I could just kind of get in there workman-like, knock it out, and go home and go back to fiction.

… not only did he not die, he got better a couple of months after we got married. It turned out that it was a misdiagnosis, and that the heart muscle tissue had been stunned, had been paralyzed because the virus was still active, and that he didn’t have dead muscle tissue in the heart; and he was completely fine, he was over it, nothing ever happened.

Red meat consumption and mortality

Red meat consumption and mortality: results from 2 prospective cohort studies.
Arch Intern Med. 2012 Apr 9;172(7):555-63.
Pan A, et al.

Red meat consumption has been associated with an increased risk of chronic diseases. However, its relationship with mortality remains uncertain.

We prospectively observed 37 698 men from the Health Professionals Follow-up Study (1986-2008) and 83 644 women from the Nurses’ Health Study (1980-2008) who were free of cardiovascular disease (CVD) and cancer at baseline. Diet was assessed by validated food frequency questionnaires and updated every 4 years.

We documented 23 926 deaths (including 5910 CVD and 9464 cancer deaths) during 2.96 million person-years of follow-up. After multivariate adjustment for major lifestyle and dietary risk factors, the pooled hazard ratio (HR) (95% CI) of total mortality for a 1-serving-per-day increase was 1.13 (1.07-1.20) for unprocessed red meat and 1.20 (1.15-1.24) for processed red meat. The corresponding HRs (95% CIs) were 1.18 (1.13-1.23) and 1.21 (1.13-1.31) for CVD mortality and 1.10 (1.06-1.14) and 1.16 (1.09-1.23) for cancer mortality.
We estimated that substitutions of 1 serving per day of other foods (including fish, poultry, nuts, legumes, low-fat dairy, and whole grains) for 1 serving per day of red meat were associated with a 7% to 19% lower mortality risk. We also estimated that 9.3% of deaths in men and 7.6% in women in these cohorts could be prevented at the end of follow-up if all the individuals consumed fewer than 0.5 servings per day (approximately 42 g/d) of red meat.

Red meat consumption is associated with an increased risk of total, CVD, and cancer mortality.
Substitution of other healthy protein sources for red meat is associated with a lower mortality risk.

Comment in:
Additional ways to diminish the deleterious effects of red meat. [Arch Intern Med. 2012]

Higher red meat consumption is associated with increased risk of all-cause, cardiovascular, and cancer mortality. [Evid Based Nurs. 2012]

Holy Cow! What’s good for you is good for our planet: comment on “Red Meat Consumption and Mortality”. [Arch Intern Med. 2012]

journalistic version:
Death By Bacon? Study Finds Eating Meat Is Risky
March 12, 2012

BP in Relation to Coffee Consumption

Blood Pressure in Relation to Coffee and Caffeine Consumption
Current Hypertension Reports, August 2014, 16:468
Idris Guessous, Chin B. Eap, Murielle Bochud

The relationship between blood pressure (BP) and coffee is of major interest given its widespread consumption and the public health burden of high BP.
Yet, there is no specific recommendation regarding coffee intake in existing hypertension guidelines.
The lack of a definitive understanding of the BP-coffee relationship is partially attributable to issues that we discuss in this review, issues such as acute vs. chronic effects, genetic and smoking effect modifications, and coffee vs. caffeine effects.

We also present evidence from meta-analyses of studies on the association of BP with coffee intake.
The scope of this review is limited to the latest advances published with a specific focus on caffeine, acknowledging that caffeine is only one among numerous components in coffee that may influence BP.

Finally, considering the state of the research, we propose a mechanism by which the CYP1A2 gene and enzyme influence BP via inhibition of the adenosine receptor differentially in smokers and non-smokers.

this article cites:
Association of Coffee Drinking with Total and Cause-Specific Mortality
Neal D. Freedman, Ph.D., et al.
N Engl J Med, May 17, 2012; 366:1891-1904