Self-reported anxiety and the risk of clinical events and atherosclerotic progression among patients with Coronary Artery Bypass Grafts (CABG).

Background: Symptoms of anxiety are associated with increased risk of coronary artery disease and potentially poor prognosis among patients with existing coronary artery disease, but whether symptoms of anxiety influence atherosclerotic progression among such patients is uncertain. Accordingly, we evaluated the hypotheses that symptoms of anxiety are associated with adverse clinical outcomes and progression of atherosclerosis among individuals with previous coronary artery bypass graft (CABG) surgery and saphenous vein grafts enrolled in the Post-CABG Trial.

Methods: The Post-CABG Trial randomized patients with a history of CABG surgery to either aggressive or moderate lipid lowering and to either warfarin or placebo.

Early life factors and adult-onset rheumatoid arthritis.

Objective: Early life factors have been associated with risk of developing autoimmune disease in adulthood. We investigated the association of preterm birth and being breastfed with the incidence of rheumatoid arthritis (RA) in 2 large prospective cohorts.

Methods: We studied participants from the Nurses' Health Study (NHS) and the Nurses' Health Study II (NHSII) who provided information on perinatal factors.

Adiposity and incidence of heart failure hospitalization and mortality: a population-based prospective study.

Background: Obesity is associated with heart failure (HF) incidence. We examined the strength of the association of body mass index (BMI) with HF by age and joint associations of BMI and waist circumference (WC).

Methods And Results: Women aged 48 to 83 (n=36873) and men aged 45 to 79 (n=43487) self-reported height, weight, and WC.

Coffee consumption and risk of heart failure in men: an analysis from the Cohort of Swedish Men.

Background: A previous study found that consuming 5 or more cups of coffee per day was associated with increased incidence of heart failure (HF). We sought to evaluate this association in a larger population.

Methods: We measured coffee consumption using food frequency questionnaires among 37,315 men without history of myocardial infarction, diabetes, or HF.

T-wave alternans, air pollution and traffic in high-risk subjects.

Particulate pollution has been linked to risk for cardiac death; possible mechanisms include pollution-related increases in cardiac electrical instability. T-wave alternans (TWA) is a marker of cardiac electrical instability measured as differences in the magnitude between adjacent T waves. In a repeated-measures study of 48 patients aged 43 to 75 years, associations of ambient and home indoor particulate pollution, including black carbon (BC) and reports of traffic exposure, with changes in 0.

Autonomic effects of controlled fine particulate exposure in young healthy adults: effect modification by ozone.

Background: Human controlled-exposure studies have assessed the impact of ambient fine particulate matter on cardiac autonomic function measured by heart rate variability (HRV), but whether these effects are modified by concomitant ozone exposure remains unknown.

Objective: In this study we assessed the impact of O(3) and particulate matter exposure on HRV in humans.

Methods: In a crossover design, 50 subjects (19-48 years of age) were randomized to 2-hr controlled exposures to filtered air (FA), concentrated ambient particles (CAPs), O(3), or combined CAPs and ozone (CAPs + O(3)).

Effects of myostatin deletion in aging mice.

Inhibitors of myostatin, a negative regulator of skeletal muscle mass, are being developed to mitigate aging-related muscle loss. Knock-out (KO) mouse studies suggest myostatin also affects adiposity, glucose handling and cardiac growth. However, the cardiac consequences of inhibiting myostatin remain unclear.

Infectious disease in a warming world: how weather influenced West Nile virus in the United States (2001-2005).

Background: The effects of weather on West Nile virus (WNV) mosquito populations in the United States have been widely reported, but few studies assess their overall impact on transmission to humans.

Objectives: We investigated meteorologic conditions associated with reported human WNV cases in the United States.

Methods: We conducted a case-crossover study to assess 16,298 human WNV cases reported to the Centers for Disease Control and Prevention from 2001 to 2005.

Insights into the mechanisms and mediators of the effects of air pollution exposure on blood pressure and vascular function in healthy humans.

Fine particulate matter air pollution plus ozone impairs vascular function and raises diastolic blood pressure. We aimed to determine the mechanism and air pollutant responsible. The effects of pollution on heart rate variability, blood pressure, biomarkers, and brachial flow-mediated dilatation were determined in 2 randomized, double-blind, crossover studies.

Postural changes in blood pressure associated with interactions between candidate genes for chronic respiratory diseases and exposure to particulate matter.

Background: Fine particulate matter [aerodynamic diameter View Article and Find Full Text PDF

Herbal supplement use and blood lead levels of United States adults.

Background: Some herbal supplements may contain lead.

Objective: To examine whether use of specific herbal dietary supplements during the last 30 days is associated with blood lead levels in US men and women.

Design: Cross-sectional analysis.

The eating assessment table-an evidence-based nutrition tool for clinicians: background, description, future of tool.

The complex relationships between health and dietary components and patterns have been intensely studied. Researchers have developed various tools, such as food diaries and food frequency questionnaires, to help understand relationships between dietary components and health, and have developed indexes such as the Alternative Healthy Eating Index, and the revised Dietary Quality Index, to help understand relationships between dietary patterns and health. These tools have greatly enhanced our understanding, but they are too costly and cumbersome to use in routine clinical practice.

Renal function predicts survival in patients with acute ischemic stroke.

Background: Among patients with acute ischemic stroke, impaired kidney function has been shown to increase the mortality risk, but the shape of this relationship has not been evaluated in detail.

Methods: We estimated the glomerular filtration rate (eGFR) at the time of hospitalization in 1,175 consecutive patients hospitalized with acute ischemic stroke at the Beth Israel Deaconess Medical Center and examined the shape of the association between eGFR and all-cause mortality.

Results: There were 508 deaths during a median follow-up of 40.

Consistency with the DASH diet and incidence of heart failure.

Background: The Dietary Approaches to Stop Hypertension (DASH) diet effectively reduces blood pressure. In observational studies, the association between diets consistent with DASH and risk of coronary heart disease and stroke has been examined with varying results. We hypothesized that diets consistent with the DASH diet would be associated with a lower incidence of heart failure (HF).

Relation of heart rate response to exercise with prognosis and atherosclerotic progression after coronary artery bypass grafting.

Impaired heart rate response to exercise is associated with adverse clinical outcomes in healthy adults and those with established coronary artery disease. It is unclear whether this association persists in subjects who have undergone coronary artery bypass grafting (CABG). In this study, 920 subjects enrolled in the Post CABG trial who had undergone CABG with patent saphenous vein grafts at baseline and known to have discontinued beta blockers before exercise were studied.

Candidate genes for respiratory disease associated with markers of inflammation and endothelial dysfunction in elderly men.

Background: Inflammation and endothelial dysfunction are important risk factors for cardiovascular disease (CVD). We hypothesized that candidate genes selected for a study of asthma and chronic obstructive pulmonary disorder (COPD) are associated with markers of systemic inflammation and endothelial dysfunction in an aging population.

Methods: Plasma levels of circulating C-reactive protein (CRP), fibrinogen, intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were obtained from 679 elderly male participants in the Normative Aging Study.

Intervening on risk factors for coronary heart disease: an application of the parametric g-formula.

Estimating the population risk of disease under hypothetical interventions--such as the population risk of coronary heart disease (CHD) were everyone to quit smoking and start exercising or to start exercising if diagnosed with diabetes--may not be possible using standard analytic techniques. The parametric g-formula, which appropriately adjusts for time-varying confounders affected by prior exposures, is especially well suited to estimating effects when the intervention involves multiple factors (joint interventions) or when the intervention involves decisions that depend on the value of evolving time-dependent factors (dynamic interventions). We describe the parametric g-formula, and use it to estimate the effect of various hypothetical lifestyle interventions on the risk of CHD using data from the Nurses' Health Study.

Fish consumption, marine omega-3 fatty acids, and incidence of heart failure: a population-based prospective study of middle-aged and elderly men.

Aims: Fatty fish and marine omega-3 fatty acids were associated with lower rates of heart failure (HF) among US elderly, but this has not been confirmed in broader age ranges or other populations where source and type of fish may differ. We therefore conducted a population-based, prospective study of 39 367 middle-aged and older Swedish men.

Methods And Results: Diet was measured using food-frequency questionnaires.

Instrumental variables I: instrumental variables exploit natural variation in nonexperimental data to estimate causal relationships.

The gold standard of study design for treatment evaluation is widely acknowledged to be the randomized controlled trial (RCT). Trials allow for the estimation of causal effect by randomly assigning participants either to an intervention or comparison group; through the assumption of "exchangeability" between groups, comparing the outcomes will yield an estimate of causal effect. In the many cases where RCTs are impractical or unethical, instrumental variable (IV) analysis offers a nonexperimental alternative based on many of the same principles.

Instrumental variables II: instrumental variable application-in 25 variations, the physician prescribing preference generally was strong and reduced covariate imbalance.

Objective: An instrumental variable (IV) is an unconfounded proxy for a study exposure that can be used to estimate a causal effect in the presence of unmeasured confounding. To provide reliably consistent estimates of effect, IVs should be both valid and reasonably strong. Physician prescribing preference (PPP) is an IV that uses variation in doctors' prescribing to predict drug treatment.

Weather and air pollution as triggers of severe headaches.

Background: The roles of weather conditions and air pollution as triggers of headache have been inconsistent in previous, generally small studies.

Methods: We performed a case-crossover study of 7,054 patients seen in a single emergency department between May 2000 and December 2007 with a primary discharge diagnosis of headache. We compared levels of temperature, barometric pressure, humidity, fine particulate matter, black carbon, and nitrogen and sulfur dioxides during the three 24-hour periods preceding presentation with corresponding levels on the remaining occurrences of that day of the week in a given month, using local meteorologic and pollutant monitors.

Air pollution and risk of stroke: underestimation of effect due to misclassification of time of event onset.

Background: Epidemiologic studies linking ambient air pollution to the onset of acute cardiovascular events often rely on date of hospital admission for exposure assessment.

Methods: We investigated the extent of exposure misclassification resulting from assigning exposure to particulate matter based on (1) date of hospital admission, or (2) time of hospital presentation compared with particulate matter exposure based on time of stroke symptom onset. We performed computer simulations to evaluate the impact of this source of exposure misclassification on estimates of air pollution health effects in the context of a time-stratified case-crossover study.

Gender differences in presenting and prodromal stroke symptoms.

Background And Purpose: Prompt recognition of stroke symptoms is critical to timely treatment and women have increased delay to treatment. Women may be more likely to present with atypical symptoms, but this hypothesis has not been extensively evaluated.

Methods: We examined gender differences in the prevalence of presenting and prodromal stroke symptoms among 1107 consecutive patients hospitalized with neurologist-confirmed acute ischemic stroke.

Hematologic parameters, atherosclerotic progression, and prognosis in patients with previous coronary artery bypass grafting (from the Post CABG Trial).

Although inflammatory markers and anemia have both been associated with prognosis in patients with cardiovascular disease, their relation with atherosclerotic progression in patients with previous coronary artery bypass grafting (CABG) is unknown. A total of 1,273 patients enrolled in the Post CABG Trial who had undergone CABG 1 to 11 years before entry were studied. Subjects were randomly assigned to lovastatin in low or high doses and low-dose warfarin or placebo in a factorial design.

Vascular function, inflammation, and variations in cardiac autonomic responses to particulate matter among welders.

Patients with health conditions associated with impaired vascular function and inflammation may be more susceptible to the adverse health effects of fine particulate (particulate matter with a mass median aerodynamic diameter of View Article and Find Full Text PDF