Association of the Duration of Ideal Cardiovascular Health Through Adulthood With Cardiometabolic Outcomes and Mortality in the Framingham Offspring Study

Corlin, Laura; Short, Meghan I.; Vasan, Ramachandran S.; Xanthakis, Vanessa

doi:10.1001/jamacardio.2020.0109

Cited by 75 publications

(78 citation statements)

References 36 publications

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“…The impact of this polymorphism on BP throughout adulthood and the potential modifying effect of riboflavin are important findings, considering that this polymorphism is linked with an increased risk of stroke [ 12 – 14 ], and recent evidence shows that living longer in better cardiovascular health during mid-life is associated with lower risk of disease and mortality later in life [ 27 ]. Control of BP is highly effective in reducing cardiovascular mortality [ 5 , 23 , 24 ], with each 2 mmHg lower systolic BP associated with a 10% lower risk of stroke [ 4 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

Ward

Hughes

Strain

et al. 2020

BMC Med

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Background Genome-wide and clinical studies have linked the 677C→T polymorphism in the gene encoding methylenetetrahydrofolate reductase (MTHFR) with hypertension, whilst limited evidence shows that intervention with riboflavin (i.e. the MTHFR co-factor) can lower blood pressure (BP) in hypertensive patients with the variant MTHFR 677TT genotype. We investigated the impact of this common polymorphism on BP throughout adulthood and hypothesised that riboflavin status would modulate the genetic risk of hypertension. Methods Observational data on 6076 adults of 18–102 years were drawn from the Joint Irish Nutrigenomics Organisation project, comprising the Trinity-Ulster Department of Agriculture (TUDA; volunteer sample) and the National Adult Nutrition Survey (NANS; population-based sample) cohorts. Participants were recruited from the Republic of Ireland and Northern Ireland (UK) in 2008–2012 using standardised methods. Results The variant MTHFR 677TT genotype was identified in 12% of adults. From 18 to 70 years, this genotype was associated with an increased risk of hypertension (i.e. systolic BP ≥ 140 and/or a diastolic BP ≥ 90 mmHg): odds ratio (OR) 1.42, 95% confidence interval (CI) 1.07 to 1.90; P = 0.016, after adjustment for antihypertensive drug use and other significant factors, namely, age, male sex, BMI, alcohol and total cholesterol. Low or deficient biomarker status of riboflavin (observed in 30.2% and 30.0% of participants, respectively) exacerbated the genetic risk of hypertension, with a 3-fold increased risk for the TT genotype in combination with deficient riboflavin status (OR 3.00, 95% CI, 1.34–6.68; P = 0.007) relative to the CC genotype combined with normal riboflavin status. Up to 65 years, we observed poorer BP control rates on antihypertensive treatment in participants with the TT genotype (30%) compared to those without this variant, CT (37%) and CC (45%) genotypes (P < 0.027). Conclusions The MTHFR 677TT genotype is associated with higher BP independently of homocysteine and predisposes adults to an increased risk of hypertension and poorer BP control with antihypertensive treatment, whilst better riboflavin status is associated with a reduced genetic risk. Riboflavin intervention may thus offer a personalised approach to prevent the onset of hypertension in adults with the TT genotype; however, this requires confirmation in a randomised trial in non-hypertensive adults.

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Section: Discussionmentioning

confidence: 99%

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

Ward

Hughes

Strain

et al. 2020

BMC Med

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“…There have been a lot of research reports that adherence to healthy lifestyle may substantially lower the burden of cardiovascular diseases [49][50][51][52] . Maintaining ICH from early adulthood results in higher health-related quality of life in middle age 10,53 . Even for patients with diabetes and hypertension, maintaining ICH is bene cial to reduce the risk of cardiovascular disease 51,54 .…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have indicated the inverse association between the number of ICH metrics and the risks of hypertension 9,10 , type 2 diabetes mellitus 11,12 , CVDevents (stroke, heart failure, myocardial infarction, and fatal coronary disease) [13][14][15][16][17][18][19][20] , CVD mortality 21,22 , all-cause mortality 10,23 and concer 24,25 . However, most of the previous studies were conducted in western countries and Chinese urban areas [26][27][28] , much fewer in Chinese rural areas, which may not completely re ect the characteristics of Chinese rural population.…”

Section: Introductionmentioning

confidence: 99%

Gender-specific Prevalence and Influencing Factors of Ideal Cardiovascular Health in Chinese Rural Population: The Henan Rural Cohort Study

Liu

Luo

et al. 2020

Preprint

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Abstract Background: The American Heart Association define a new concept of ideal cardiovascular health (ICH), which was widely used. However, the prevalence of ICH according to the definition of Chinese rural population is unclear. The study aimed to estimate prevalence and influencing factors of ICH in rural areas of China.Methods: This study included 35081 participants (13711 men and 21370 women)aged 18 to 79 years from “the Henan Rural Cohort study”. The cardiovascular health (CVH) metrics, the ICH scores, the ideal health behaviors (IHB) scores and ideal health factors (IHF)scores were evaluated in Chinese rural adults. Each CVH metrics divided into ideal and non-ideal including diet, physical activity, smoking, BMI, blood pressure, total cholesterol and fasting plasma glucose. The influencing factors of ideal CVH (ICH scores≥5), ideal HB (IHB scores>3) and ideal HF (IHF scores>3) were explored by logistic regression analysis.Results: The age-standardized mean scores of the ICH was 4.30(3.62 in men and4.69 in women). Prevalence of ICH metrics about ideal physical activity was the highest (91.37%), while about ideal diet was lowest (0.48%).The age-standardized prevalence of population who with 7 scores of ICH was 0.10% (0.07% in men and 0.11% in women). The age-standardized prevalence of Ideal CVH (ICH scores≥5) was 48.86% (28.26% in men and 60.70% in women). The age-standardized prevalence of 4 of IHB scores and 4 of IHF scores were 0.16% (0.17% in men and 0.16% in women) and 33.26% (10.06% in men and 46.60% in women), respectively. Further, apart from IHB scores, age had an inverse relationship with the ICH scores and IHF scores in total populations and women. Much older, men, low family income, current drinking and abdominal obesity were independently associated with ICH in Chinese rural adults.Conclusions: The percentage of ideal cardiovascular health is extremely low in rural China. There is an increasing need for primordial prevention of unhealthy lifestyles and monitoring high risk factors to promote cardiovascular health in rural China.Clinical Trial Registration The Henan Rural Cohort Study has been registered at Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699). Date of registration: 2015-07-06.http://www.chictr.org.cn/showproj.aspx?proj=11375

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“…The EQ-5D utility scores were calculated based on the recently available Chinese value set for the EQ-5D-5L instrument [19]. 3,4,5). Scores ranged from −0.200 to 1.000, with one representing full health, 0 representing death, and a score <0 representing a health status worse than death.…”

Section: Eq-5d-5lmentioning

confidence: 99%

The Association Between Ideal Cardiovascular Health and Health-Related Quality of Life in Adults: A Population-Based Cross-Sectional Study

Wu¹,

Liu²,

Liao³

et al. 2021

Int J Public Health

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Objectives: The study aimed to explore the association between Ideal cardiovascular health (ICH) and health-related quality of life (HRQoL) using the European Quality of Life Five Dimension Five Level Scale (EQ-5D-5L) among rural population.Methods: This study included 20,683 participants aged 18–79 years from “the Henan Rural Cohort study”. Generalized linear and Tobit regression models were employed to explore the associations of ICH with EQ-5D-5L utility scores and visual analogue scale (VAS) scores, respectively.Results: The mean EQ-5D-5L utility scores and VAS scores were 0.962 ± 0.095 and 79.52 ± 14.02, respectively. Comparing with poor CVH participants (EQ-5D-5L utility scores and VAS scores: 0.954 ± 0.111 and 78.44 ± 14.29), people with intermediate and ideal CVH had higher EQ-5D-5L utility scores (0.969 ± 0.079 and 0.959 ± 0.099) and VAS scores (80.43 ± 13.65 and 79.28 ± 14.14). ICH scores were positively correlated with EQ-5D-5L utility scores (0.007 (0.004, 0.009)) and VAS scores (0.295 (0.143, 0.446)), respectively.Conclusions: Higher ICH scores is positive associated with better HRQoL in rural population, which suggests that improvement of cardiovascular health may help to enhance HRQoL among rural population.

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Association of the Duration of Ideal Cardiovascular Health Through Adulthood With Cardiometabolic Outcomes and Mortality in the Framingham Offspring Study

Cited by 75 publications

References 36 publications

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

Impact of the common MTHFR 677C→T polymorphism on blood pressure in adulthood and role of riboflavin in modifying the genetic risk of hypertension: evidence from the JINGO project

Gender-specific Prevalence and Influencing Factors of Ideal Cardiovascular Health in Chinese Rural Population: The Henan Rural Cohort Study

The Association Between Ideal Cardiovascular Health and Health-Related Quality of Life in Adults: A Population-Based Cross-Sectional Study

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