Association Between Behavior-Dependent Cardiovascular Risk Factors and Asymptomatic Carotid Atherosclerosis in a General Population (original) (raw)

Effects of Timing and Extent of Smoking, Type of Cigarettes, and Concomitant Risk Factors on the Association Between Smoking and Subclinical Atherosclerosis

Stroke, 2009

Background and Purpose-The purpose of this study was to evaluate the effects of timing and extent of smoking, type of cigarettes, and concomitant vascular risk factors (VRFs) on the association between smoking and carotid intima-media thickness (C-IMT) in a lipid clinic population. Methods-1804 patients (869 men, age 21 to 85 year) participated in the study. Smoking habits were recorded and C-IMTs were measured by B-mode ultrasound. The associations of C-IMT with smoking status (never, former, and current) and with the cigarettes' content of tar, nicotine, and carbon monoxide (alone or combined to define "light" or "regular" cigarettes) as well as the interactions between smoking status, gender, and VRFs were evaluated before and after adjustment for confounders.

Lifestyle behaviour and lifetime incidence of heart diseases

International Journal of Cardiology, 2015

Objectives: Investigate the relationship of some behavioural characteristics of a male population with lifetime incidence of heart diseases. Material and methods: In the Italian Rural Areas of the Seven Countries Study of Cardiovascular Diseases, 1677 heart disease-free men aged 40-59 years were followed up during 50 years for lifetime incidence of heart disease up to the age of 90 years. They were classified as coronary heart disease (CHD) and heart diseases of uncertain etiology (HDUE). Baseline cigarette smoking habits (non-smokers and ex-smokers, moderate smokers, heavy smokers), physical activity (sedentary, moderate, vigorous) and eating habits (non-Mediterranean Diet, Prudent Diet and Mediterranean Diet) were related to incidence of heart disease. Results: Incidence of CHD and HDUE up to the age of 90 years was 28.8 and 17.7%, respectively. Univariate and multivariate analyses showed strong association of behavioural characteristics with CHD incidence, but not with HDUE incidence. Cox proportional hazard rates for CHD were 1.45 (95% confidence intervals, CI: 1.11-1.90) for heavy smokers versus non-smokers; 0.67 (CI 0.50-0.89) for vigorous activity versus sedentary habits and 0.62 (CI 0.47-0.83) for Mediterranean Diet versus non-Mediterranean Diet. Combining CHD cases with HDUE cases made the predictive picture similar to that of CHD. When some basic risk factors were added to the model results remained substantially unaltered, despite the existence of some correlations of behaviours with risk factors. Conclusions: Behavioural factors including cigarette smoking, physical activity and diet are strong predictors of lifetime incidence of common heart diseases even adding other traditional risk factors.

Lifestyle Modification in the Prevention of Atherosclerotic Cardiovascular Disease

Neth Heart J (2022) 30:3–14, 2020

Abstract Lifestyle management is the cornerstone of both primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) and the importance of lifestyle management is emphasised by all major guidelines. Despite this, actual implementation of lifestyle management is poor. Lifestyle modification includes smoking cessation, weight loss, dietary change, increasing physical inactivity, and stress management. This review summarises evidence-based opportunities and challenges for healthcare professionals to promote healthy lifestyles at an individual level for the prevention of ASCVD.

Risk Factors for Subclinical Carotid Atherosclerosis Among Current Smokers

Preventive Cardiology, 2010

This study characterized the determinants of carotid atherosclerosis in a large, contemporary sample of current smokers. Associations between risk factors, carotid intima-media thickness (CIMT) and carotid plaque presence were determined by multivariable regression. Subjects included 1,504 current smokers (58% female) who were a median (interquartile range) of 44.7 (38-53) years old and smoked 25 (15-40) pack-years; 55% had plaque. Pack-years, age, male sex, non-white race, body-mass index, systolic blood pressure, small low-density lipoproteins (LDL), and total high-density lipoproteins were independently associated with CIMT (model R 2 =0.434, p<0.001). Pack-years (OR 1.14 per 10 pack-years, p=0.001), age (OR 1.75 per 10 years, p<0.001), body-mass index (OR 0.91 per 5 kg/m 2 , p =0.035), and small LDL (OR 1.11 per 100 nmol/L, p<0.001), were independently associated with carotid plaque presence (model X 2 =210.7, p<0.001). The association between pack-years and carotid plaque was stronger in women (OR 1.09 per 10 pack-years, p interaction =0.018).

Association Between a Social-Business Eating Pattern and Early Asymptomatic Atherosclerosis

Journal of the American College of Cardiology, 2016

BACKGROUND The importance of a healthy diet in relation to cardiovascular health promotion is widely recognized. Identifying specific dietary patterns related to early atherosclerosis would contribute greatly to inform effective primary prevention strategies. OBJECTIVES This study sought to quantify the association between specific dietary patterns and presence and extent of subclinical atherosclerosis in a population of asymptomatic middle-aged adults. METHODS The PESA (Progression of Early Subclinical Atherosclerosis) study enrolled 4,082 asymptomatic participants 40 to 54 years of age (mean age 45.8 years; 63% male) to evaluate the presence of subclinical atherosclerosis in multiple vascular territories. A fundamental objective of this cohort study was to evaluate the lifestyle related determinants, including diet, on atherosclerosis onset and development. We conducted a cross-sectional analysis of baseline data, including detailed information on dietary habits obtained as part of the overall lifestyle and risk factor assessment, as well as a complete vascular imaging study that was performed blinded to the clinical information. RESULTS Most PESA participants follow a Mediterranean (40% of participants) or a Western (41%) dietary pattern. A new pattern, identified among 19% of participants, was labeled as a social-business eating pattern, characterized by a high consumption of red meat, pre-made foods, snacks, alcohol, and sugar-sweetened beverages and frequent eatingout behavior. Participants following this pattern presented a significantly worse cardiovascular risk profile and, after adjustment for risk factors, increased odds of presenting subclinical atherosclerosis (odds ratio: 1.31; 95% confidence interval: 1.06 to 1.63) compared with participants following a Mediterranean diet. CONCLUSIONS A new social-business eating pattern, characterized by high consumption of red and processed meat, alcohol, and sugar-sweetened beverages, and by frequent snacking and eating out as part of an overall unhealthy lifestyle , is associated with an increased prevalence, burden, and multisite presence of subclinical atherosclerosis.

Cigarette smoking and the development and progression of aortic atherosclerosis. A 9-year population-based follow-up study in women

Circulation, 1993

Cigarette smoking has been recognized as an important risk factor for cardiovascular disease in men and women. Whether the increased risk results from an atherogenic effect of smoking is still debated. We examined the relation between cigarette smoking and atherosclerotic changes in the abdominal aorta. The association between cigarette smoking and atherosclerotic changes in the abdominal aorta was examined in a population-based cohort of 758 women, initially aged 45 to 64 years. All women were examined radiographically for calcified deposits in the abdominal aorta, which have been shown to represent intimal atherosclerosis. After 9 years of follow-up, atherosclerotic changes, indicating development or progression of plaques, could be demonstrated in 37% of women. A direct association was found between atherosclerotic change and number of cigarettes smoked per day. Compared with women who had never smoked, the relative risks of those who smoked 1 to 9, 10 to 19, and 20 or more cigarettes per day were 1.4 (95% confidence interval, 1.0 to 2.0), 2.0 (1.6 to 2.5), and 2.3 (1.8 to 3.0), respectively, after adjustment for age and other cardiovascular risk factors. Associations of atherosclerotic change with inhaling habit and duration of smoking were borderline significant after number of cigarettes smoked per day was taken into account. Among former smokers, the risk decreased with increasing duration of stopping but a significant excess risk was still observed after 5 to 10 years since quitting (relative risk, 1.6; 95% confidence interval, 1.1 to 2.2). These follow-up data support the evidence for an effect of cigarette smoking on atherosclerosis. The findings suggest that the rate of atherosclerotic change may be reduced by cessation of smoking, but a residual effect appears to be present for at least 10 years.