American journal of preventive cardiology最新文献

{"title":"Extreme heat triggers first-time acute myocardial infarction: Evidence from a case-crossover study in Tianjin, China","authors":"Zinuo Wang ,&nbsp;Rui Hu ,&nbsp;Jinglin Li ,&nbsp;Jingting Chen ,&nbsp;Yifan Liu ,&nbsp;Hongyue Sun ,&nbsp;Yishu Yang ,&nbsp;Yiqing Wang ,&nbsp;Suqin Han ,&nbsp;Yuming Guo ,&nbsp;Congchao Lu ,&nbsp;Shilu Tong ,&nbsp;Nai-jun Tang ,&nbsp;Xi Chen","doi":"10.1016/j.ajpc.2025.101344","DOIUrl":"10.1016/j.ajpc.2025.101344","url":null,"abstract":"<div><h3>Objective</h3><div>To assess whether extreme high temperatures (EHT) and heat waves (HW) are associated with acute myocardial infarction (AMI) risk, and to determine whether these effects differ between first-time and recurrent events.</div></div><div><h3>Methods</h3><div>We performed a time-stratified case-crossover study of 7573 AMI admissions in Tianjin, China (2021–2023). Meteorological exposures were derived from ground-based monitoring and satellite products. Conditional logistic regression with distributed lag nonlinear models quantified immediate and delayed associations between temperature and AMI, stratified by event type (first-time vs recurrent). Effect modification was examined by age, sex, and ST-segment elevation.</div></div><div><h3>Results</h3><div>Both EHT and HW were associated with increased AMI risk, with effects concentrated among first-time events. The strongest single-day associations for first-time AMI were observed 4–5 days after exposure (peaking at lag 4 for EHT_90TH: OR = 1.1594; 95 % CI: 1.0622–1.2655), while cumulative risks peaked across lag windows of 4–6 days (peaking at lag 0–6 for EHT_90TH: OR = 1.1564; 95 % CI: 1.0558–1.2665). Among first-time AMI, higher risks were seen in men, individuals &lt;65 years, and those with non-ST-segment elevation myocardial infarction.</div></div><div><h3>Conclusions</h3><div>Short-term exposure to extreme heat significantly increases the risk of first-time AMI, but not recurrent events. Risk persists for several days after exposure, particularly among younger adults, men, and NSTEMI patients. These findings highlight the need for targeted heat-health messaging, early recognition of symptoms, and preventive strategies tailored to individuals at risk of a first AMI in the era of climate change.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101344"},"PeriodicalIF":5.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable device–measured physical activity and risk of MAFLD in adolescents","authors":"Ruli Wang ,&nbsp;Congwei You ,&nbsp;Zijuan Dong ,&nbsp;Qingqing Zheng ,&nbsp;Xiaowei Zheng ,&nbsp;Liangbin Zhou ,&nbsp;Xiaolei Wang ,&nbsp;Le Zhang ,&nbsp;Haoyang Zhang","doi":"10.1016/j.ajpc.2025.101345","DOIUrl":"10.1016/j.ajpc.2025.101345","url":null,"abstract":"<div><h3>Background</h3><div>While physical activity is known to affect the risk of MAFLD in adults, evidence in adolescents is limited and often based on self-reported questionnaires. We therefore used wearable device–based measurements to investigate the association between physical activity and MAFLD in adolescents.</div></div><div><h3>Methods</h3><div>Data were obtained from the National Health and Nutrition Examination Survey (NHANES) database for adolescents aged 12–19 years during the 2003–2006 and 2011–2014 cycle. Physical activity was measured using wearable accelerometers, averaged across all valid wearing days. Weighted multivariate logistic regressions were applied to assess associations between physical activity (overall, daytime, and nighttime) and MAFLD.</div></div><div><h3>Result</h3><div>Among 5705 adolescents, higher physical activity levels were strongly associated with lower odds of MAFLD in the 2003–2006 cycle, with a clear dose–response trend across quartiles (<em>P</em> for trend &lt; 0.001). Participants in the highest physical activity (Q4) had 60 % lower odds overall, 58 % lower odds for daytime, and 43 % lower odds for nighttime activity, compared with those with lowest physical activity (Q1). The association between higher physical activity and lower MAFLD risk was generally observed across sex, age, and income subgroups. In contrast, no significant association between physical activity and MAFLD risk was observed in the 2011–2014 cycle.</div></div><div><h3>Conclusion</h3><div>Our results suggest that higher levels of physical activity, especially during the daytime, may protect against MAFLD in adolescents. Our findings offer partial evidence for the role of circadian activity patterns in MAFLD risk and underscore the need for future studies to validate these associations.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101345"},"PeriodicalIF":5.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypertension-attributable stroke burden in younger vs older people: analysis of GBD 2021 and NHANES databases","authors":"Fanqi Li ,&nbsp;Jiasong Li ,&nbsp;Siyuan Tan ,&nbsp;Murong Xie ,&nbsp;Haixiong Wang ,&nbsp;Qiming Liu","doi":"10.1016/j.ajpc.2025.101343","DOIUrl":"10.1016/j.ajpc.2025.101343","url":null,"abstract":"<div><h3>Background</h3><div>Hypertension is a leading global cause of stroke. Cardiovascular diseases are occurring at progressively younger ages. This study aims to compare the younger and older age groups burden of stroke attributable to hypertension.</div></div><div><h3>Methods</h3><div>Analyses were conducted using two databases: the Global Burden of Disease (GBD) study and the U.S. National Health and Nutrition Examination Survey (NHANES). For GBD study, stroke mortality attributable to hypertension was extracted. Age-period-cohort model was used to assess differences in annual mortality reduction rates across age groups. Estimated Annual Percentage Change (EAPC) was calculated to quantify the temporal trend in age-standardized mortality. Health inequalities were assessed using the concentration index. For NHANES, analyses were restricted to participants age≥25 years with hypertension. Among these participants, proportions of uncontrolled hypertension and hypertension unawareness were calculated, with sampling weights applied to ensure nationally representative estimates.</div></div><div><h3>Results</h3><div>Hypertension was the dominant risk factor for stroke-related deaths, contributing to 50.5 % of global mortality. Age-period-cohort model revealed a key age-specific pattern: annual mortality rate reductions were slower in adults aged 25–54 years than in those aged≥55. EAPC values further confirmed this trend, with slower annual death rate declines in adults aged 25–54 years (-1.37 %) versus those aged ≥55 years (-1.74 %). NHANES data showed worse hypertension control and awareness in younger hypertensive populations: uncontrolled hypertension rose from 79.6 % (2013–2014) to 88.9 % (2021–2023) in 25–54-year-olds, while remaining relative stable (71.2–71.8 %) in older groups. Hypertension unawareness increased from 35 % to 48 % in younger adults over the same period, consistently higher than in older hypertensive populations. Concentration index indicated widening health inequalities, becoming increasingly concentrated in lower socioeconomic status countries. More importantly, this concentration trend was more pronounced among younger adults (25–54 years) than in older groups across all study years.</div></div><div><h3>Conclusions</h3><div>Hypertension drives most stroke deaths. Younger adults experience slower mortality improvements, worse hypertension control and awareness, and more severe health inequalities compared to older adults. Therefore, age-specific interventions are urgently needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101343"},"PeriodicalIF":5.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Blood pressure indices for predicting incident cardiovascular disease: A 13-year follow-up study in Japanese population","authors":"Takahiro Ichikawa ,&nbsp;Hiroshi Okada ,&nbsp;Hanako Nakajima ,&nbsp;Emi Ushigome ,&nbsp;Masahide Hamaguchi ,&nbsp;Kazushiro Kurogi ,&nbsp;Hiroaki Murata ,&nbsp;Eri Tsuda ,&nbsp;Naoki Yoshida ,&nbsp;Masato Ito ,&nbsp;Michiaki Fukui","doi":"10.1016/j.ajpc.2025.101341","DOIUrl":"10.1016/j.ajpc.2025.101341","url":null,"abstract":"<div><h3>Background</h3><div>Several blood pressure (BP) indices have been associated with incident cardiovascular disease (CVD); however, evidence comparing their long-term prognostic value in Asian populations is limited. We investigated the association between multiple BP indices and CVD risk over a 13-year follow-up period in a large Japanese population.</div></div><div><h3>Methods</h3><div>Data from a health check-up program conducted by the Panasonic Corporation covering 166 operational sites from 2008 to 2021, including 163,956 participants not receiving anti-hypertensive drugs, were analyzed. The primary outcome was the incidence of three-point major adverse cardiac events (MACE), including cardiovascular death, nonfatal coronary artery disease, and nonfatal stroke. Cox proportional hazards models and time-dependent receiver operating characteristic (ROC) analyses were used to evaluate the associations between the four BP indices (systolic BP [SBP], diastolic BP [DBP], pulse pressure [PP], and mean arterial pressure [MAP]) and incident MACE.</div></div><div><h3>Results</h3><div>After adjusting for confounders, all four BP indices were found to be independently associated with incident MACE. Among them, MAP demonstrated the highest area under the ROC curve for predicting MACE. In the gender-stratified analyses, the findings in males were broadly consistent with the overall results, whereas the predictive advantage of MAP was attenuated in females. Similarly, in analyses restricted to participants aged ≥50 years, the superiority of the MAP was less evident.</div></div><div><h3>Conclusions</h3><div>MAP was the strongest predictor of incident CVD in the Japanese population. These findings underscore the importance of BP phenotyping and suggest that gender and age may modify the utility of MAP in cardiovascular risk stratification.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101341"},"PeriodicalIF":5.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex and gender differences in the associations between psychosocial stressors at work and coronary heart disease incidence: An 18-year longitudinal study of 5192 Canadian workers","authors":"Azita Zahiriharsini ,&nbsp;Mahée Gilbert-Ouimet ,&nbsp;Mathilde Lavigne-Robichaud ,&nbsp;Xavier Trudel ,&nbsp;Denis Talbot ,&nbsp;Peter Smith ,&nbsp;Caty Blanchette ,&nbsp;Alain Milot ,&nbsp;Chantal Brisson","doi":"10.1016/j.ajpc.2025.101340","DOIUrl":"10.1016/j.ajpc.2025.101340","url":null,"abstract":"<div><h3>Background</h3><div>Psychosocial stressors at work (PSW) are modifiable occupational stressors associated with an increased coronary heart disease (CHD) incidence. While systematic reviews suggest differences between women and men, there has been limited examinations of potential effect modifiers. This study aimed to explore the effect modifications of characteristics related to sex (biological) and gender (sociocultural) in the associations between PSW and CHD incidence over an 18-year follow-up.</div></div><div><h3>Methods</h3><div>This study relied on a prospective cohort of 5192 white-collar workers (50 % women) from 19 public and semi-public enterprises in Quebec, Canada. PSW, defined according to the job strain and effort-reward imbalance (ERI) models, were assessed using self-administered, validated questionnaires. Incident CHD cases were identified from medico-administrative databases using validated algorithms. Cox proportional hazard models were used to estimate hazard ratios (HR) and 95 % confidence intervals (CI) for the associations between PSW and CHD incidence, stratified by sex, and characteristics related to sex (age) and gender (education level, occupational position, and children load).</div></div><div><h3>Results</h3><div>Associations between PSW and CHD incidence differed by sex. In men, being exposed to both job strain and ERI was associated with a 2-fold increased CHD risk (HR: 2.01, 95 % CI: 1.52–2.65), rising to a 2.80-fold risk among those aged 60 and older (HR: 2.80, 95 % CI: 1.90–4.13). Amplified associations were also observed in men with lower education (HR: 3.23, 95 % CI: 1.73–6.03) and a low children load (HR: 2.48, 95 % CI: 1.74–3.54). In women, the association between ERI and CHD was stronger, although it remained marginally non-significant, among those under 60 years-old (HR: 1.57, 95 % CI: 0.96–2.57), with a lower education level (HR: 1.84, 95 % CI: 0.95–3.56) and with an intermediate to high children load (HR: 1.72, 95 % CI: 0.96–3.10).</div></div><div><h3>Conclusions</h3><div>This study reinforces the importance of considering sex- and gender-related characteristics — such as age, education, and caregiving responsibilities — when examining the associations between PSW and CHD incidence. However, the findings observed among women require replication in larger prospective cohorts.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101340"},"PeriodicalIF":5.9,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predictive value of different long-term (10-year) blood pressure parameters variability in cardiovascular disease: A prospective cohort study","authors":"Yixiu Chen ,&nbsp;Hongmin Liu ,&nbsp;Mo Zhang ,&nbsp;Zhihui Liu ,&nbsp;Qian Liu ,&nbsp;Shihe Liu ,&nbsp;Wenchao Yao ,&nbsp;Yajing Liang ,&nbsp;Yicheng Liao ,&nbsp;Yufeng Bian ,&nbsp;Renjie Fu ,&nbsp;Shuohua Chen ,&nbsp;Shouling Wu ,&nbsp;Yuntao Wu","doi":"10.1016/j.ajpc.2025.101336","DOIUrl":"10.1016/j.ajpc.2025.101336","url":null,"abstract":"<div><h3>Background and Objective</h3><div>We aimed to compare the predictive value of long-term variability in systolic blood pressure (SBP), diastolic blood pressure (DBP), and pulse pressure (PP) over a 10-year period for cardiovascular diseases (CVDs).</div></div><div><h3>Methods</h3><div>A prospective cohort of 44,938 participants were categorized into four groups based on the quartiles of variability of SBP, DBP, and PP. Cox proportional hazards regression models were applied to assess the impact of SBP, DBP, and PP variability on CVDs. The predictive value of SBP, DBP, and PP variability for CVDs and specific cardiovascular outcomes was evaluated based on the China-PAR model.</div></div><div><h3>Results</h3><div>During a mean follow-up period of 5.04 years, compared to the Q1, the HR and 95 %CI of CVDs was 1.28 (1.11,1.48) in the Q4 of SBP, 1.33 (1.17,1.51) in the Q4 of DBP, and 1.25 (1.06,1.47) in the Q4 of PP (all <em>P</em> &lt; 0.01). When incorporated into the China-PAR model, the <em>C-index</em> for SBP, DBP, and PP variability in predicting CVDs were 0.6866, 0.6787, and 0.6822, with SBP variability offering the strongest predictive improvement to the China-PAR model. Subgroup analysis revealed a significant interaction between age and SBP, DBP, and PP variability (<em>P</em> &lt; 0.01).</div></div><div><h3>Conclusion</h3><div>Increases in SBP, DBP, and PP variability independently elevate the risk of CVDs and its subtypes, regardless of absolute blood pressure levels. Furthermore, SBP, DBP, and PP variability can improve the predictive value of the China-PAR model for CVDs risk, with SBP variability demonstrating the strongest predictive capacity.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101336"},"PeriodicalIF":5.9,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465797","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using the American heart association's new 'cardiovascular-kidney-metabolic syndrome' metrics to assess life expectancy in us adults: A life table analysis","authors":"Zhendong Cheng ,&nbsp;Wenqing Xu ,&nbsp;Jianping Luo ,&nbsp;Xianghui Zeng ,&nbsp;Qingfeng Zeng ,&nbsp;Gang Cao ,&nbsp;Guosheng Liu ,&nbsp;Chunqing Xiao","doi":"10.1016/j.ajpc.2025.101339","DOIUrl":"10.1016/j.ajpc.2025.101339","url":null,"abstract":"<div><h3>Background</h3><div>Cardiac, kidney, and metabolic diseases are associated with a short life expectancy. However, the potential impact of the cardiovascular-kidney-metabolic (CKM) syndrome, recently introduced by the American Heart Association (AHA), on life expectancy at different stages has not yet been described.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the association between CKM syndrome and life expectancy among adults in the United States.</div></div><div><h3>Methods</h3><div>9043 participants (age≥20 years) were included in this study who participated in the National Health and Nutrition Examination Survey from 2007–2018. The life table method was used to estimate life expectancy at each CKM syndrome stage. The Arriaga decomposition method estimated cause-specific contribution to differences in life expectancy between stages 0–1 CKM syndrome and stage 4 CKM syndrome participants.</div></div><div><h3>Results</h3><div>During a mean 6.8 years of follow-up, a total of 842 deaths occurred, of which 218 individuals died of cardiovascular disease (CVD). Estimated life expectancy at age 50 years was 37.5 (95 % CI, 34.7–40.4), 32.6 (95 % CI, 32–33.6), 27.1 (95 % CI, 26.4–28.1), and 25.1 (95 % CI, 24.2–26.1) for participants in stages 0–1, 2, 3, and 4 CKM syndrome, respectively. At age 50, 26.7 % of the life expectancy reduction in individuals with stage 4 CKM syndrome was attributable to the increased risk of CVD mortality compared to those with stage 0–1 CKM syndrome.</div></div><div><h3>Conclusion</h3><div>The higher stage of CKM syndrome is associated with shorter life expectancy. Due to the enormous health damage caused by CKM syndrome, more effective prevention and treatment should be explored as a high public health priority.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101339"},"PeriodicalIF":5.9,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of PREVENT with the pooled cohort equation for estimating atherosclerotic cardiovascular disease risk among patients with rheumatoid arthritis","authors":"Ilana M. Usiskin ,&nbsp;Brittany N. Weber ,&nbsp;Ying Qi ,&nbsp;Katherine Zhong ,&nbsp;Mary Jeffway ,&nbsp;Michael E. Weinblatt ,&nbsp;Nancy Shadick ,&nbsp;Jorge Plutzky ,&nbsp;Katherine P. Liao","doi":"10.1016/j.ajpc.2025.101338","DOIUrl":"10.1016/j.ajpc.2025.101338","url":null,"abstract":"<div><h3>Objective</h3><div>To determine the performance of the PREVENT equation for estimating atherosclerotic cardiovascular disease (ASCVD) risk in rheumatoid arthritis (RA) compared to the American College of Cardiology/American Heart Association ASCVD risk estimator, i.e., the pooled cohort equation (PCE).</div></div><div><h3>Methods</h3><div>We studied patients from an RA longitudinal registry with annual blood samples. After identifying the earliest sample for each patient (index date), we excluded patients with prevalent cardiovascular disease (CVD) or on statin/lipid lowering therapy through the index date. Medical records were reviewed for ASCVD events including coronary heart disease and stroke up to 10 years after index date. PREVENT-ASCVD and PCE were calculated, and patients were categorized into low, borderline, intermediate, and high ASCVD risk categories. Discrimination and calibration of PREVENT and PCE for ASCVD events were determined.</div></div><div><h3>Results</h3><div>We studied 267 RA patients mean age 57 years, 83 % female; 27 patients (10.1 %) had an ASCVD event. The AUC for PREVENT was 0.71 and 0.70 for PCE. Compared to observed ASCVD events, PREVENT underestimated ASCVD risk, to a larger degree compared to PCE; PREVENT either classified patients in the same risk category or reclassified to lower risk categories compared to PCE; 28 % of patients would have a definitive recommendation for statin initiation with PCE vs 14 % with PREVENT.</div></div><div><h3>Conclusion</h3><div>Among a cohort of RA patients, PREVENT and PCE underestimated 10-year ASCVD risk compared to observed ASCVD events, with overall lower risk estimates in PREVENT compared to PCE. Adoption of PREVENT may lead to less aggressive primary CV prevention in RA.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101338"},"PeriodicalIF":5.9,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Obesity-attributable risk of cardiovascular disease (CVD) in the United States: a Bayesian network analysis","authors":"Sunny Sheth ,&nbsp;Samantha Clark ,&nbsp;Anthony Fabricatore ,&nbsp;Mads Faurby ,&nbsp;Azadeh Houshmand-Oeregaard ,&nbsp;Joshua Toliver ,&nbsp;Warren Stevens","doi":"10.1016/j.ajpc.2025.101337","DOIUrl":"10.1016/j.ajpc.2025.101337","url":null,"abstract":"<div><h3>Background</h3><div>Obesity and related complications present clinical and financial burdens for patients and health care systems. Quantification of the impact of obesity on cardiovascular disease (CVD) would aid in disease management. This study aimed to apply Bayesian networks to nationally representative data to analyze the relationship between obesity and CVD.</div></div><div><h3>Methods</h3><div>Self-reported medical history, risk factor status, and physiological measurements were longitudinally adapted from the National Health and Nutrition Examination Survey (1999–2018). Respondents were required to have weight history and ≥1 CVD outcome, including myocardial infarction, stroke, heart failure, or overall CVD. The cohort was restricted to respondents ≥35 years to ensure recent weight measurements were sufficiently captured. Population attributable fractions were estimated via the traditional approach (assessing direct effects of exposures on outcomes) and Bayesian networks (assessing indirect effects of interdependent relationships) for each CVD outcome.</div></div><div><h3>Results</h3><div>Obesity was reported in 31 %-32 % of respondents with any CVD outcome (n = 29,388–29,529). CVD outcomes attributed to obesity through the traditional approach were estimated to be &lt;4 %. Using Bayesian networks, estimates of myocardial infarction, stroke, heart failure, and CVD cases attributable to obesity were 21 %, 16 %, 38 %, and 19 %, respectively. For all Bayesian networks, &gt;80 % of the total effect of obesity was attributable to its effect on intermediate medical conditions.</div></div><div><h3>Conclusions</h3><div>These data highlight obesity as a significant CVD risk factor. This work has provided valuable insight into the relationship between obesity and CVD-related outcomes, indicating a need for greater clinical attention to obesity to lessen the burden of downstream complications.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101337"},"PeriodicalIF":5.9,"publicationDate":"2025-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145466650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex differences in macro- and microvascular reactivity – a systematic review and meta-analysis","authors":"Ádám Fekete ,&nbsp;Dániel Horváth ,&nbsp;Patrik Kreuter ,&nbsp;Petrana Martinekova ,&nbsp;Eszter Ágnes Szalai ,&nbsp;Gergely Agócs ,&nbsp;Péter Sótonyi ,&nbsp;Gábor Varga ,&nbsp;Péter Hegyi ,&nbsp;Beáta Kerémi ,&nbsp;János Vág","doi":"10.1016/j.ajpc.2025.101335","DOIUrl":"10.1016/j.ajpc.2025.101335","url":null,"abstract":"<div><h3>Introduction</h3><div>Sex differences in cardiovascular disease are well recognized, but underlying vascular mechanisms remain unclear. This meta-analysis investigates whether young adult healthy males and females differ in macro- and microvascular reactivity, via flow-mediated dilation (FMD) and post-occlusive reactive hyperemia (PORH).</div></div><div><h3>Methods</h3><div>A systematic search of MEDLINE, Embase, and Central identified eligible studies meeting the criteria: FMD or PORH test assessment; Ultrasound or Laser Doppler was used on the brachial artery or the skin; including both sexes under the mean age of &lt;40 years and a mean BMI of &lt;30. We performed a quantitative analysis for baseline artery diameter (BAD), FMD, wall shear rate (WSR), relative change in blood flow on the brachial artery (ΔBF) and microcirculation (microΔBF), and time-to-peak (TTP). Random-effects model was used for synthesis with sex as a predictor and age and BMI as moderators.</div></div><div><h3>Results</h3><div>A total of 51 eligible articles comprising 2426 subjects were included. Without adjustment for age and BMI (studies: 48), females had smaller BAD and TTP but higher FMD and WSR compared with males. No significant differences were found for ΔBF or microΔBF. After adjustment for age and BMI and inclusion of studies using forearm occlusion (studies: 23), FMD differences between sexes were no longer significant.</div></div><div><h3>Conclusion</h3><div>While WSR was consistently higher in young females than in males, there was no clear evidence that females exhibit higher FMD after forearm occlusion. Likewise, greater vascular reactivity in microcirculation could not be statistically confirmed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"24 ","pages":"Article 101335"},"PeriodicalIF":5.9,"publicationDate":"2025-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145417561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}