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PubMed2006

Association between inflammation and malnutrition as risk factors of cardiovascular disease.

Cardiovascular disease is the leading cause of death among dialysis patients. The relative risk of mortality increases as serum albumin concentration and body mass index decline. While these are generally associated with nutritional status, inflammation causes sarcopenia and decreased albumin concentration by reducing synthesis of proteins and increasing their catabolic rate. While inflammation can arise from atherosclerotic blood vessels, systemic inflammation from any source can alter the vascular endothelium and plasma protein composition in ways that promotes vascular injury. High-density lipoprotein synthesis is decreased and the high-density lipoprotein present is less capable of reducing inflammation. Activation of neutrophils favors lipoprotein oxidation. Surprisingly, while obesity is associated with cytokine production in patients without renal failure, as well as among dialysis patients, increased body mass index, whether reflecting muscle mass or adipose tissue, is associated with a decline in mortality rates.

Adipose Tissue↗
PubMed2002

Altered phosphodiesterase 3-mediated cAMP hydrolysis contributes to a hypermotile phenotype in obese JCR:LA-cp rat aortic vascular smooth muscle cells: implications for diabetes-associated cardiovascular disease.

Cardiovascular diseases represent a significant cause of morbidity and mortality in diabetes. Of the many animal models used in the study of non-insulin-dependent (type 2) diabetes, the JCR:LA-cp rat is unique in that it develops insulin resistance in the presence of obesity and manifests both peripheral and coronary vasculopathies. In this animal model, arterial vascular smooth muscle cells (VSMCs) from homozygous obese (cp/cp) rats, but not from age-matched healthy (+/+ or + /cp, collectively defined +/?) littermates, display an " activated" phenotype in vitro and in vivo and have an elevated level of cAMP phosphodiesterase (PDE) activity. In this report, we confirm that cp/cp rat aortic VSMCs have an elevated level of PDE3 activity and show that only particulate PDE3 (PDE3B) activity is elevated. In marked contrast to results obtained in + /? VSMCs, simultaneous activation of adenylyl cyclase and inhibition of PDE3 activity in cp/cp VSMCs synergistically increased cAMP. Although PDE3 inhibition did not potentiate the antimigratory effects of forskolin on +/? VSMCs, PDE3 inhibition did markedly potentiate the forskolin-induced inhibition of migration of cp/cp-derived VSMCs. Although PDE3 activity was elevated in cp/cp rat aortic VSMCs, levels of expression of cytosolic PDE3 (PDE3A) and PDE3B in +/? and cp/cp VSMCs, as well as activation of these enzymes following activation of the cAMP-protein kinase A signaling cascade, were not different. Our data are consistent with an increased role for PDE3 in regulating cAMP-dependent signaling in cp/cp VSMCs and identify PDE3 as a cellular activity potentially responsible for the phenotype of cp/cp VSMCs.

1-Methyl-3-isobutylxanthine↗
PubMed2004

Increased incidence of carotid artery wall changes and associated variables in hemodialysis patients without symptomatic cardiovascular disease.

Cardiovascular disease (CVD) is still the major cause of the morbidity and mortality in hemodialysis (HD) patients. The characteristics of major arterial changes, atherosclerosis and related risk factors in HD patients remain unclear. We aimed to evaluate the atherosclerotic process in asymptomatic HD patients and healthy volunteers, and to determine the association between the risk factor(s) and the atherosclerotic process in these groups. 92 HD patients (female: 43, male: 49) and 62 age and sex matched healthy volunteers (female: 27, male: 35) were enrolled in this study. Diabetics, smokers, and patients with symptomatic CVD were excluded. The right and left carotid intima-media thicknesses (CIMTs) were measured and plaque structures were studied by B-mode ultrasound. The mean CIMT in patients and control group were 0.79 +/- 0.16 mm and 0.54 +/- 0.09 mm, respectively. Mean CIMT in HD patients was thicker (p < 0.001) and the presence ratio of plaque was higher in patients group (n=38, %61.2 vs n=9, %17.3) (p < 0.001). Calcified type of plaque was more frequent in HD patients than control group. Age (r=0.48, p < 0.001), left ventricular mass (r=0.42, p < 0.05), and homocysteine (r=0.46, p < 0.01), mean hematocrit (r=-0.36, p < 0.05), plasma CRP (r=0.50, p < 0.001), ESR (r=0.43, p < 0.01) and albumin (r= -0.34, p < 0.05) levels were correlated with the CIMT measurements and plaque presence, significantly. -CIMT as an atherosclerotic process indicator is thicker in asymptomatic HD patients than healthy subjects. We concluded that in addition to various classical risk factors, uremic environment may also contribute to acceleration of the atherosclerotic process.

Adult↗
PubMed1999

Uric acid in hypertension and cardiovascular disease.

Cardiovascular disease, and particularly coronary artery disease, remains the leading cause of mortality worldwide, despite recent substantial declines. Hypertension, long recognized as a risk factor for both stroke and myocardial infarction, is an important target for preventive intervention. However, effective hypotensive therapy produces incomplete cardioprotection, and most events that would have occurred in the natural state continue to occur among controlled hypertensive patients. Further progress in reducing the burden of cardiac disease will depend on early identification of risk in successfully treated hypertensive subjects and the development of preventive interventions that go beyond simple reduction of blood pressure. Recently, elevation of uric acid has been found to be associated with subsequent morbidity and mortality in the general population among patients with congestive heart failure, diabetes and hypertension. A prospective study in a large cohort of well controlled hypertensive subjects has revealed a strong, specific, stepwise, independent association of increasing serum uric acid and cardiac morbidity and mortality. Unanswered, however, is the question of whether uric acid is simply an associated phenomenon, or actually contributes to the occurrence of cardiac events.

Angiotensin Receptor Antagonists↗
PubMedDate not supplied

Is chronic kidney disease a cardiovascular disease risk factor?

Cardiovascular disease (CVD) is prevalent in patients with chronic kidney disease (CKD) and may account for 50% of all deaths. The recent Dialysis Outcomes Quality Initiative (DOQI) publication on the evaluation, classification, and stratification of CKD states that a reduced glomerular filtration rate (GFR) identifies individuals at greater risk for CVD and death. This risk is the result of traditional and nontraditional CVD risk factors. However, the relative contribution of these risk factors in the CKD population remains uncertain. Recently interest in kidney disease (reduced GFR) as an independent nontraditional risk factor for CVD has come to the forefront. Studies examining this potential link have included community-based cohort studies, studies in patients with extensive comorbidity, and reports in kidney transplant recipients. Herein, results from these studies are reviewed. The difference between an independent CVD risk factor and a causal CVD risk factor is discussed, with particular emphasis on the temporal association between exposure (GFR) and outcome (CVD and CVD death).

Cardiovascular Diseases↗
PubMed1990

The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study.

The relationship between corneal arcus (arcus senilis) and mortality from coronary heart disease (CHD) and cardiovascular disease (CVD) is examined in a prospective study of White men (n = 3,930) and women non-hormone users (n = 2,139), ages 30-69, followed for an average of 8.4 years as part of the Lipid Research Clinics Mortality Follow-up Study. After excluding those with clinically manifest CHD at baseline, corneal arcus was strongly associated with CHD and CVD mortality only in hyperlipidemic men ages 30-49 years, for whom the relative risk for CHD and CVD death was 3.7 and 4.0, respectively, after adjusting for age, total cholesterol, HDL cholesterol, and smoking status using a Cox proportional hazards model. Among 30-49 year old males, corneal arcus appears to be a prognostic factor for CHD, independent of its association with hyperlipidemia in this age-group, of about the same magnitude as other common risk factors, underscoring the usefulness of corneal arcus as a prognostic factor to the practicing clinician.

Adult↗
PubMed2000

Trends and disparities in coronary heart disease, stroke, and other cardiovascular diseases in the United States: findings of the national conference on cardiovascular disease prevention.

A workshop was held September 27 through 29, 1999, to address issues relating to national trends in mortality and morbidity from cardiovascular diseases; the apparent slowing of declines in mortality from cardiovascular diseases; levels and trends in risk factors for cardiovascular diseases; disparities in cardiovascular diseases by race/ethnicity, socioeconomic status, and geography; trends in cardiovascular disease preventive and treatment services; and strategies for efforts to reduce cardiovascular diseases overall and to reduce disparities among subpopulations. The conference concluded that coronary heart disease mortality is still declining in the United States as a whole, although perhaps at a slower rate than in the 1980s; that stroke mortality rates have declined little, if at all, since 1990; and that there are striking differences in cardiovascular death rates by race/ethnicity, socioeconomic status, and geography. Trends in risk factors are consistent with a slowing of the decline in mortality; there has been little recent progress in risk factors such as smoking, physical inactivity, and hypertension control. There are increasing levels of obesity and type 2 diabetes, with major differences among subpopulations. There is considerable activity in population-wide prevention, primary prevention for higher risk people, and secondary prevention, but wide disparities exist among groups on the basis of socioeconomic status and geography, pointing to major gaps in efforts to use available, proven approaches to control cardiovascular diseases. Recommendations for strategies to attain the year 2010 health objectives were made.

Cardiovascular Diseases↗
PubMed2005

Cardiovascular disease in patients with chronic obstructive pulmonary disease, Saskatchewan Canada cardiovascular disease in COPD patients.

PURPOSE: To measure prevalence, incidence, and mortality of cardiovascular outcomes among persons with chronic obstructive pulmonary disease (COPD) and to assess the extent these outcomes differ from persons without COPD. METHODS: Retrospective cohort study in longitudinal health care databases maintained by the government of Saskatchewan, Canada. Subjects were persons age 40 years or older who were diagnosed with COPD during 1997-2000 and who received two or more prescriptions for bronchodilators within 6 months of diagnosis. Each subject was matched by age and sex to two controls without COPD or asthma. RESULTS: Of COPD patients (n = 11,493), 54% were male, and 74% were 65 years or older. Prevalence of all cardiovascular diseases was higher in the COPD group than in the comparison group. After adjusting for cardiovascular risk, odds ratios of prevalence were: arrhythmia 1.76 (confidence interval [CI]: 1.64-1.89), angina 1.61 (CI: 1.47-1.76), acute myocardial infarction 1.61 (CI: 1.43-1.81), congestive heart failure 3.84(CI: 3.56-4.14), stroke 1.11 (CI: 1.02-1.21), pulmonary embolism 5.46 (CI: 4.25-7.02). Risk of hospitalization due to each cardiovascular cause was elevated in the COPD group. The risk ratio for cardiovascular mortality was 2.07 (CI: 1.82-2.36) and all cause mortality was 2.82 (CI: 2.61-3.05). CONCLUSIONS: Persons with diagnosed and treated COPD are at increased risk for hospitalizations and deaths due to cardiovascular diseases.

Aged↗
PubMed2005

Systemic effects of periodontitis: epidemiology of periodontal disease and cardiovascular disease.

There have been 42 published studies describing associations between oral conditions and cardiovascular diseases. In the absence of randomized controlled trials, the 16 longitudinal studies represent the highest level of evidence available. However, two databases produced eight of the 16 studies. There also is extensive variability in definitions of the oral exposure that include salivary flow, reported periodontal disease, number of teeth, oral organisms, antibodies to oral organisms, Total Dental Index, Community Periodontal Index of Treatment Needs, plaque scores, probing depth, attachment loss, and bone level. Variability also exists in the cardiovascular outcomes that include atherosclerosis measures and events, such as hospitalization for coronary heart disease (CHD), chronic CHD, fatal CHD, total stroke, ischemic stroke, and revascularization procedures. One of the criticisms of this research is that the exposure has not been represented by measures of infection. To begin to address this concern, we present new data showing that patterns of high and low levels of eight periodontal pathogens and antibody levels against those organisms are related to clinical periodontal disease as well as other characteristics of the individuals, such as age, race, gender, diabetic status, atherosclerosis, and CHD. As others before us, we conclude that the cumulative evidence presented above supports, but does not prove, a causal association between periodontal infection and atherosclerotic cardiovascular disease or its sequelae. A number of legitimate concerns have arisen about the nature of the relationship and, indeed, the appropriate definitions for periodontal disease when it is thought to be an exposure for systemic diseases. There is still much work needed to identify which aspects of the exposure are related to which aspects of the outcome. Principal component analyses illustrate the complexity of the interactions among risk factors, exposures, and outcomes. These analyses provide an initial clustering that describes and suggests the presence of specific syndromes.

Antibodies, Bacterial↗
PubMedDate not supplied

[Drinking water hardness and chronic degenerative diseases. II. Cardiovascular diseases].

Since the 1950s a causal relation between water hardness and cardiovascular diseases (CVD) in humans has been hypothesized. In order to evaluate the influence of calcium and magnesium, the minerals responsible for the hardness of drinking water, on human health, a review of all the articles published on the subject from 1980 up to today has been carried out. Many but not all geographic correlation studies showed an inverse association between water hardness and mortality for CVD. Most case-control and one cohort studies showed an inverse relation, statistically significant, between mortality from CVD and water levels of magnesium, but not calcium. Consumption of water containing high concentrations of magnesium seems to reduce of about 30-35% the mortality for CVD, but not the incidence. This inverse association is supported by clinical and experimental findings and is biologically plausible and in line with Hill's criteria for a cause-effect relationship.

Adult↗
PubMed2003

Dyslipidemia in patients with type 2 diabetes. relationships between lipids, kidney disease and cardiovascular disease.

Type 2 diabetes mellitus is a leading cause of morbidity and mortality. Cardiovascular disease (CVD) is the most prevalent complication and primarily accounts for the excess morbidity and mortality in diabetic patients, but microvascular complications, such as kidney disease and retinopathy, are frequent and contribute to the total disease burden. Lipid abnormalities in patients with type 2 diabetes are a major problem and associated with the increased risk of CVD. The most common pattern of dyslipidemia in these patients consists of elevated levels of triglycerides and low levels of high-density lipoprotein cholesterol. Low-density lipoprotein levels in these patients are often similar to that of the nondiabetic population, although there may be important qualitative differences in the pattern that contribute to the increased risk of CVD. Abnormal levels of urinary albumin occur in 30-40% of patients with type 2 diabetes and the presence of kidney disease enhances the mortality from CVD. Microalbuminuria, an early marker of diabetic nephropathy, is an independent risk factor for CVD. The increased levels of urinary albumin secretion may represent a more generalized vascular damage than renal microvascular injury alone. This Review focuses on the significance of diabetic dyslipidemia and microalbuminuria to CVD risk as well as to kidney complications. We also discuss the role of aggressive therapy to ameliorate vascular injury in the diabetic patient and reduce or prevent the cardiovascular and renal consequences of the disease.

Cardiovascular Diseases↗
PubMed2006

Apolipoprotein E, cholesterol metabolism, diabetes, and the convergence of risk factors for Alzheimer's disease and cardiovascular disease.

High fat diets and sedentary lifestyles are becoming major concerns for Western countries. They have led to a growing incidence of obesity, dyslipidemia, high blood pressure, and a condition known as the insulin-resistance syndrome or metabolic syndrome. These health conditions are well known to develop along with, or be precursors to atherosclerosis, cardiovascular disease, and diabetes. Recent studies have found that most of these disorders can also be linked to an increased risk of Alzheimer's disease (AD). To complicate matters, possession of one or more apolipoprotein E epsilon4 (APOE epsilon4) alleles further increases the risk or severity of many of these conditions, including AD. ApoE has roles in cholesterol metabolism and Abeta clearance, both of which are thought to be significant in AD pathogenesis. The apparent inadequacies of ApoE epsilon4 in these roles may explain the increased risk of AD in subjects carrying one or more APOE epsilon4 alleles. This review describes some of the physiological and biochemical changes that the above conditions cause, and how they are related to the risk of AD. A diversity of topics is covered, including cholesterol metabolism, glucose regulation, diabetes, insulin, ApoE function, amyloid precursor protein metabolism, and in particular their relevance to AD. It can be seen that abnormal lipid, cholesterol and glucose metabolism are consistently indicated as central in the pathophysiology, and possibly the pathogenesis of AD. As diagnosis of mild cognitive impairment and early AD are becoming more reliable, and as evidence is accumulating that health conditions such as diabetes, obesity, and coronary artery disease are risk factors for AD, appropriate changes to diets and lifestyles will likely reduce AD risk, and also improve the prognosis for people already suffering from such conditions.

Alzheimer Disease↗
PubMed2005

Piecing together the evidence on anemia: the link between chronic kidney disease and cardiovascular disease.

Chronic kidney disease (CKD) is now accepted as an independent cardiovascular disease (CVD)-risk state, regardless of its underlying cause. Anemia is a common feature of CKD, particularly in end-stage renal disease. Anemia is also independently associated with poorer outcomes in a wide variety of CVD states, including congestive heart failure and coronary artery disease. Anemia appears to act as an independent mortality multiplier when hemoglobin levels drop below 12 g/dL. With the independent and profound contribution of both CKD and anemia to cardiovascular mortality and morbidity, understanding the pathophysiologic links among these disease states is important. In addition, it is hoped that treatments currently under active investigation and geared specifically to attenuate the cardiovascular risk associated with anemia and CKD, such as erythropoietin therapy, will improve outcomes. This article reviews the evidence for an association among CKD, anemia, and CVD.

Anemia↗
PubMed1994

Homozygous Tangier disease and cardiovascular disease.

Decreased levels of plasma high density lipoprotein (HDL) cholesterol have been associated with premature cardiovascular disease (CVD). Tangier disease is an autosomal co-dominant disorder in which homozygotes have a marked deficiency of HDL cholesterol and apolipoprotein (apo) A-I levels (both < 10 mg/dl), decreased low density lipoprotein (LDL) cholesterol levels (about 40% of normal), and mild hypertriglyceridemia. Homozygotes develop cholesterol ester deposition in tonsils (orange tonsils), liver, spleen, gastrointestinal tract, lymph nodes, bone marrow, and Schwann cells. Our purpose was to assess the prevalence of CVD in Tangier disease. We reviewed published clinical information on 51 cases of homozygous Tangier disease, report 3 new cases and provide autopsy information on 3 cases. Mean (+/- S.D.) lipid values of all cases were as follows: total cholesterol 68 +/- 30 mg/dl (32% of normal), triglycerides 201 +/- 118 mg/dl (162% of normal), HDL cholesterol 3 +/- 3 mg/dl (6% of normal) and LDL cholesterol 50 +/- 38 mg/dl (37% of normal). The most common clinical finding in these subjects (n = 54) was peripheral neuropathy which was observed in 54% of cases versus < 1% of control subjects (n = 3130). CVD was observed in 20% of Tangier patients versus 5% of controls (P < 0.05), and in those that were between 35 and 65 years of age, 44% (11 of 25) had evidence of CVD (either angina, myocardial infarction or stroke) versus 6.5% in 1533 male controls and 3.2% in 1597 female controls in this age group (P < 0.01). In 9 patients who died, 2 died prior to age 20 of probable infectious diseases, 3 of documented coronary heart disease at ages 48, 64, and 72, 2 of stroke at ages 56 and 69, one of valvular heart disease, and 1 of cancer. In three autopsy cases, significant diffuse atherosclerosis was observed in one at age 64, moderate atherosclerosis and cerebral infarction in another at age 56, but no atherosclerosis was noted in the third case who died of lymphoma at age 62. In one patient with established coronary heart disease, none of the lipid lowering agents used (niacin, gemfibrozil, estrogen or lovastatin) raised HDL cholesterol levels above 5 mg/dl. However, these agents did have significant effects on lowering triglyceride and LDL cholesterol levels. Our data indicate that there may be heterogeneity in these patients with regard to CVD risk, that peripheral neuropathy is a major problem in many patients, and that CVD is a significant clinical problem in middle aged and elderly Tangier homozygotes.(ABSTRACT TRUNCATED AT 400 WORDS)

Adult↗
PubMed1985

The relationship between parental history of vascular disease and cardiovascular disease risk factors in children: the Bogalusa Heart Study.

The relationship between parental history of vascular disease (heart attack, stroke, diabetes mellitus, and hypertension) and risk factor variables for cardiovascular disease was assessed in 3,312 offspring aged 5-17 years during the 1981-1982 school year in the biracial community of Bogalusa, Louisiana. Risk factors studied included systolic blood pressure, diastolic blood pressure, serum total cholesterol, triglycerides, and individual lipoprotein cholesterol (beta-, low density lipoprotein (LDL) cholesterol; pre-beta, very low density lipoprotein (VLDL) cholesterol; and alpha-, high density lipoprotein (HDL) cholesterol). Risk factors were adjusted for age, race, sex, and height (blood pressure only) prior to testing parental history effects. Univariate comparisons between risk factors in children and vascular disease in parents resulted in statistically significant increases in systolic and diastolic pressures associated with the presence of maternal or paternal hypertension (p less than 0.001). Paternal heart attack was also associated with elevations in diastolic pressure (p less than 0.01) of children. Maternal diabetes mellitus was associated with an increase in serum total cholesterol (p less than 0.05). Paternal diabetes mellitus and maternal heart attack (for female progeny only) were associated with increases in mean triglyceride levels of children. VLDL cholesterol results were similar to those for triglycerides. For HDL cholesterol, paternal diabetes mellitus was associated with a small decrease in mean levels (p less than 0.05). Dramatic increases to the highest decile of risk were found in association with the following parental disease combinations: paternal heart attack-paternal diabetes for serum total cholesterol (p less than 0.0001), maternal heart attack-paternal diabetes (p less than 0.001) and paternal stroke-maternal diabetes (p less than 0.0001) for LDL cholesterol. Multivariate analysis detected no significant effects of single parental vascular disease. However, paternal heart attack in combination with either diabetes mellitus or hypertension was statistically significant in their relationship to the risk factors overall.

Adolescent↗
PubMed2003

[The relation between peripheral arterial occlusive disease and cardiovascular diseases in elderly population: a cross-section study in Wanshoulu area, Beijing].

OBJECTIVE: To investigate the prevalence of cardiovascular diseases (CVD) in the elderly with peripheral arterial occlusive disease (PAOD) and the prevalence of PAOD in the elderly with high cardiovascular factors. METHODS: A questionnaire survey was conducted, physical examination and electrocardiography were undertaken, blood pressure at the ankle artery and brachial artery was taken, and peripheral blood was drawn to determine the triglyceride, cholesterol, high density lipoprotein, low density lipoprotein, and fasting blood glucose among 2,124 persons aged 60 approximately 95 (mean age 68.54 +/- 5.43), 943 males and 1,183 females, in Wanshoulu area, Beijing. PAOD was defined as an ankle-arm index (AAI) < or = 0.9. RESULTS: (1) The prevalence rate of PAOD was 15.91% (16.42% after being standardized). (2) The prevalence rates of essential hypertension, hyperlipidemia, coronary heart disease, and diabetes mellitus in the elderly population with PAOD were 55.8%, 54.3%, 41.0%, and 25.4% respectively, among which the prevalence rates of hypertension, coronary heart disease, and diabetes were significantly higher in the population with PAOD than in the population without PAOD (P < 0.01, P < 0.05, and P < 0.05 respectively), The prevalence rates of hypertension in the female PAOD population and the prevalence rate of coronary heart disease in the male PAOD population were significantly higher than those in the populations without PAOD respectively (P < 0.001 and P < 0.01). The prevalence rate of CVD in the population with PAOD was 1.36 approximately 1.63 times higher than that in the population without PAOD. (3) The prevalence rate of PAOD was 17.55% in the elderly population with single CVD risk factor (U = 3.8661, P < 0.001), 20.33% in those with double risk factors, and 22.14% in those with triple factors (chi(2) = 7.240 8, P < 0.05) respectively. CONCLUSION: The prevalence of PAOD in Wanshoulu area is similar to that in the developed countries, suggesting that PAOD is also one of the common diseases in elderly population in China. The prevalence of CVD in the population with PAOD is significantly higher than that in the population without PAOD. The PAOD prevalence increases along with the increase of cardiovascular risk factors. PAOD in elderly population.

Age Distribution↗
PubMed2005

[Rho/Rho kinase signal transduction pathway in cardiovascular disease and cardiovascular remodeling].

The small guanosine triphosphatase Rho and its target, Rho kinase, play important roles in both blood pressure regulation and vascular smooth muscle contraction. Rho is activated by agonists of receptors coupled to cell membrane G protein, such as angiotensin II and phenylephrine. Once Rho is activated, it translocates to the cell membrane where it, in turn, activates Rho kinase. Activated Rho kinase phosphorylates myosin light chain phosphatase, which is then inhibited. This sequence stimulates vascular smooth muscle contraction, stress fiber formation,and cell migration. In this way, Rho and Rho kinase activation have important effects on several cardiovascular diseases. Currently available substances that specifically inhibit this signaling pathway could offer clinical benefits in several cardiovascular, as well as noncardiovascular diseases, such as arterial hypertension, pulmonary hypertension, cerebral or coronary spasm, post-angioplasty restenosis, and erectile dysfunction.

Cardiovascular Diseases↗
PubMed2004

Longitudinal changes in diet from childhood into adulthood with respect to risk of cardiovascular diseases: The Cardiovascular Risk in Young Finns Study.

OBJECTIVE: To assess nutrient intakes relevant in the prevention of cardiovascular diseases (CVD) among young adults in Finland and to find past and present determinants of quality of diet. DESIGN: Prospective study, 21 years of follow-up. SETTING: The Cardiovascular Risk in Young Finns Study, Finland. SUBJECTS: At baseline in 1980: 3569 children aged 3-18 y participated (83% of those invited), and every second of them (1780) were selected to the dietary study. At follow-ups in 1986 and 2001: 1200 and 1037 of the original sample, respectively, participated. METHODS: Food consumption was assessed using 48-h dietary recall. Intakes in 2001 were compared with those obtained in 1980 and 1986. Nutrients selected for further examination were those implicated in the risk of CVD: saturated, monounsaturated, polyunsaturated and n-3 fatty acids, fibre and salt. An index describing the quality of adulthood diet was constructed. Multivariate logistic regression was used to identify independent childhood and adulthood determinants of the quality index. RESULTS: The average intakes showed substantial changes since 1980. Intakes of fat and saturated fat had decreased, while the consumption of vegetables and fruit had increased. However, a great disparity was present between the recommended levels and actual intakes for many of the nutrients, particularly salt, saturated fat and fibre. Intake of fat and consumption of vegetables in childhood and physical activity in adulthood were important health behavioural determinants of the cardiovascular quality of the adult diet. Socio-demographic factors, including education of the subject and their parents, had no significant associations with diet. CONCLUSIONS: While intakes of energy and nutrients have changed favourably in Finnish young adults between 1980 and 2001 with regard to the risk of CVD, they are still far from recommended levels. Childhood diet is a significant determinant of adult diet even after 21 y. SPONSORSHIP: This study was supported by the Academy of Finland (grant 77841) and Juho Vainio Foundation.

Adolescent↗