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  • 1
    Online Resource
    Online Resource
    Serum fibroblast growth factor-23 and incident hypertension : the Atherosclerosis Risk in Communities (ARIC) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Journal of Hypertension Vol. 34, No. 7 ( 2016-07), p. 1266-1272
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 34, No. 7 ( 2016-07), p. 1266-1272
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/HJH.0000000000000936
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2017684-3
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  • 2
    Online Resource
    Online Resource
    Cardiovascular disease mortality among women with endometrial cancer in the Iowa Women’s Health Study
    Springer Science and Business Media LLC ; 2017
    In:  Cancer Causes & Control Vol. 28, No. 10 ( 2017-10), p. 1043-1051
    Details
    In: Cancer Causes & Control, Springer Science and Business Media LLC, Vol. 28, No. 10 ( 2017-10), p. 1043-1051
    Type of Medium: Online Resource
    ISSN: 0957-5243 , 1573-7225
    URL: Article
    DOI: 10.1007/s10552-017-0953-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2017
    detail.hit.zdb_id: 1496544-6
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  • 3
    Online Resource
    Online Resource
    Abstract P050: Serum Fibroblast Growth Factor 23 and Incident Hypertension: The Atherosclerosis Risk in Communities Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 129, No. suppl_1 ( 2014-03-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Background: Elevated serum fibroblast growth factor-23 (FGF23), an endogenous hormone, is associated with endothelial dysfunction, chronic kidney disease, arterial wall stiffness, and inflammation. These factors may contribute to an increased risk of hypertension. To date, the association of FGF23 with incident hypertension has not been examined. Hypothesis: Elevated serum FGF23 will be positively associated with risk of incident hypertension. Methods: The ARIC study measured intact FGF23 in stored serum from 7,948 middle-aged men and women without hypertension at baseline (1990-92). Participants were examined during two follow-up visits, in 1993-95 and 1996-98. Incident hypertension was determined by measured blood pressure (DBP 90 mm Hg, or SBP140 mm Hg) and/or hypertension medication use during the follow-up exams. Multivariate Cox proportional hazards regression models and complementary log-log models were used to adjust for potential confounding variables. Results: During a median follow-up of 5.9 years, 27% (2,152/7,948) participants developed hypertension. A nonlinear association between serum FGF23 and incident hypertension was observed; only the highest decile of serum FGF23 was positively associated with incident hypertension (Table). After adjustment for demographics, the hazard ratio for incident hypertension was 1.37 (95% CI: 1.17, 1.60) for the highest decile of FGF23 compared to the lowest quintile. After adjustment for behaviors and adiposity the HR was 1.25 (95% CI: 1.07, 1.46). The association was further attenuated in the final model after adjusting for renal function (HR: 1.20, 95% CI: 1.03, 1.41). Complementary log-log models that accounted for interval censoring did not alter results. Conclusions: High levels ( 60.6 pg/mL) of FGF23 are associated with a modestly increased risk of incident hypertension in the general population. Next steps include replication of these findings in other cohorts, and examining the association with a longer follow-up period.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.p050
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 4
    Online Resource
    Online Resource
    Three-year variability in plasma concentrations of the soluble receptor for advanced glycation end products (sRAGE)
    Elsevier BV ; 2014
    In:  Clinical Biochemistry Vol. 47, No. 1-2 ( 2014-01), p. 132-134
    Details
    In: Clinical Biochemistry, Elsevier BV, Vol. 47, No. 1-2 ( 2014-01), p. 132-134
    Type of Medium: Online Resource
    ISSN: 0009-9120
    URL: Article
    DOI: 10.1016/j.clinbiochem.2013.11.005
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
    detail.hit.zdb_id: 1496880-0
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  • 5
    Online Resource
    Online Resource
    Abstract P177: Hypertension is Considerably More Prevalent, Yet Decreasing Over Time According to the New Guidelines
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation Vol. 139, No. Suppl_1 ( 2019-03-05)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 139, No. Suppl_1 ( 2019-03-05)
    Abstract: Introduction: New High Blood Pressure (BP) Guidelines released by the American Heart Association (AHA) and the American College of Cardiology redefined hypertension, imparting implications for monitoring cardiovascular health (CVH). The impact on reclassification of patients according to electronic health record (EHR) data as a result of changes in criteria for BP cut points has not yet been described. Hypothesis: We hypothesized that more stringent cut points for hypertension would increase the prevalence of United States (US) adults with poor CVH for BP. Methods: We analyzed outpatient visit data recorded in The Guideline Advantage©, a repository of EHRs of patients from eight diverse healthcare systems in the US from 2012-2015. For each year, the first non-missing BP measurement for each patient was categorized into poor (hypertensive), intermediate (pre-hypertensive), and ideal (normotensive) for CVH, first in accordance with AHA’s Life Simple 7 guidelines, and then in accordance with the new guidelines. We compared overall trends with trends stratified by race and sex, in distributions of poor and intermediate categories, and in the proportion eligible for pharmacological treatment (BP ≥ 130/80). Results: A total of 172,209 unique patients contributed 348,933 BP measurements, and most were female (58.63%) and white (75.09%). Although the prevalence of poor CVH for BP was consistently 3-fold higher under the new guidelines and the difference in prevalence was significant (p 〈 0.0001), it decreased over time for the both the old (9.4% to 8.7%) and new (27.8% to 26.4%) guidelines. Over time, the proportion classified as hypertensive decreased (12.4% to 10.4 vs. 33.9% to 30.3%) for males and increased for non-whites (10.2% to 13.9% vs. 27.1% to 35.3%) from the old and new guidelines, respectively, but remained stable for females and whites. Similarly, the annual difference in the proportion of intermediate CVH for BP was significant (p 〈 0.0001); however, pre-hypertension prevalence slightly increased under the old (57.9% to 58.5%) and new (39.5% to 40.7%) guidelines. Among untreated adults eligible for pharmacological intervention, the proportion remained relatively unchanged over time; in 2015, patients lacking treatment yet meeting treatment criteria was 23% and 7.3% under the new and old guidelines, respectively, resulting in a difference of 15.7% (p 〈 0.0001). Whites (66.8%) and females (50.6%), compared with non-whites and males, respectively, comprised the majority. Conclusions: Prevalence of poor CVH for BP among US adults substantially increases in the outpatient setting when categorizing measures with the new guidelines. Active participation by clinicians and public health practitioners are needed to address the higher prevalence of and disparities in both hypertension and treatment prescription identified with the old versus new guidelines.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.139.suppl_1.P177
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 1466401-X
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  • 6
    Online Resource
    Online Resource
    Abstract MP25: Is Surgical Menopause Associated With Future Cardiovascular Risk Factors Independent Of Antecedent Levels? The Cardia Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 129, No. suppl_1 ( 2014-03-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Objective: The aim of this study was to compare changes in selected CVD risk factors prior to and after natural or surgical (hysterectomy with or without bilateral oophorectomy) menopause. Methods: Data were obtained from women aged 18 to 30 years at baseline without hysterectomy enrolled in the Coronary Artery Risk Development in Young Adults (CARDIA) study and followed for 25 years. Piecewise linear mixed effects models were used to examine changes in waist circumference (WC) and HDL-cholesterol (HDL-c) from baseline to index visit (first visit after the date of natural or surgical menopause) and after index visit to the end of observation. Results: During follow up, 639 women reached natural menopause (NM), 304 reported hysterectomy with one or both ovaries conserved (HO) and 153 reported hysterectomy with bilateral oophorectomy (HBO). Baseline mean values of WC were 73.9, 76.4, 75.9 cm, p=0.005 for NM, HO, and HBO respectively while those for HDL-c were 57.6, 54.6, 54.2 mg/dL, p=0.001. After adjustment for race, education, field center, traditional CVD risk factors, lipid-lowering medication, age at and time since menopause, the mean values of WC at the index visit were 88.8, 92.4, 92.0 cm, p=0.001 for NM, HO, and HBO respectively while those for HDL-c were 61.5, 57.0, 57.8 mg/dL, p=0.006. Compared to women with natural menopause, surgically menopausal women (regardless of ovarian status) had higher annual rate of change for WC (0.74 vs. 0.63 cm, p=0.002) as well as lower rate of change for HDL-c (0.15 vs. 0.30 mg/dL, p=0.001) from baseline to index visit. No statistically significant differences in the annual rate of change after index visit to the end of follow up were observed between these two groups for either WC or HDL-c. Conclusion: While surgical menopause is commonly believed to worsen CVD risk, in this population-based sample, we found that women who undergo hysterectomy with or without bilateral oophorectomy had more adverse values for central adiposity and lipids at baseline compared to women with natural menopause. However, antecedent risk factor levels were strongly associated with postmenopausal levels in all women.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.mp25
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 7
    Online Resource
    Online Resource
    Abstract P317: Area Traffic Density Contributes to the Risk of Gestational Diabetes in a Sample of Central Ohio Pregnancies
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Circulation Vol. 135, No. suppl_1 ( 2017-03-07)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 135, No. suppl_1 ( 2017-03-07)
    Abstract: Background: The prevalence of gestational diabetes mellitus (GDM) in the US and the state of Ohio is approximately 9.0%. GDM is associated with increased risks for mother and child, including macrosomia, preterm birth, preeclampsia, and development of type 2 diabetes. In addition to known risk factors, the role of exposure to environmental pollutants in development of GDM warrants further investigation. Because exposure to traffic-related pollutants has been shown to influence the development of type 2 diabetes, we assessed the contribution of exposure to high traffic to the development of GDM during pregnancy among women without prior diabetes history. Methods: A population of 275 pregnant women in Ohio reported perceived exposure to high traffic areas and health behaviors. Clinical information and addresses were obtained through their electronic health records. Using ArcMap TM 10.2.2 (ESRI), addresses were geocoded to assess individual exposures, and linked with area exposures and demographic indicators at the level of the census block group from EJScreen (EPA). A woman was classified as “near” a major roadway if one fell within a 500m buffer of her home. Distance to nearest major roadway was also calculated. Logistic regression was used to examine the association between quintiles of traffic exposure at the census block group level, self-reported proximity, individual-level proximity, health behaviors, and demographic factors with development of GDM. Because assessment of individual-level exposures may be difficult to use in clinical and large scale population settings, a model was also fit using only data publically available from EJScreen and self-report. Results: The prevalence of GDM was 8.0% (22/275) and distribution of demographics factors were similar between those with and without GDM. After adjustment for potential confounders, quintile of traffic exposure was significantly associated with development of GDM (p=.036). Compared to those residing in block groups in the lowest quintile, the odds of GDM for those in the second quintile were 8.1 times greater [95% CI 1.2, 56.3] and for those in fourth quintile were 10.4 times greater [95% CI 1.6, 67.6] . Addition of individual-level proximity factors did not significantly improve the model (p=.08). Conclusions: This study suggests that living in an area with high traffic density contributes to the risk of developing GDM. For both the clinical practitioner and public health researcher it is difficult or impractical to obtain individual level environmental exposure data. From our analysis, the individually calculated exposure proxies did not significantly improve the fit of the model. We suggest examining ways to combine self-report measures with existing environmental data, such as EJScreen, to identify populations at elevated risk.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.135.suppl_1.p317
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1466401-X
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  • 8
    Online Resource
    Online Resource
    Abstract P061: Blood Pressure Control in the Outpatient Setting Among Patients with Diabetes: The Guideline Advantage
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Circulation Vol. 135, No. suppl_1 ( 2017-03-07)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 135, No. suppl_1 ( 2017-03-07)
    Abstract: Introduction: Blood pressure (BP) screening and control is often suboptimal in patients with diabetes, a population in whom cardiovascular disease (CVD) is the leading cause of morbidity and mortality. Hypertension in the context of diabetes uniquely increases risk for CVD incidence and mortality. The aim of this study was to describe the burden of uncontrolled BP among patients with diabetes seen in the outpatient setting and factors associated with BP control using data from a large, electronic health record (EHR) data registry. Methods: Outpatient EHR data were analyzed from The Guideline Advantage™ (TGA), a joint quality improvement initiative of the American Heart Association, American Diabetes Association, and American Cancer Society. Data were compiled from patients aged ≥18 years seen at 〉 70 individual clinics across the U.S. “Uncontrolled BP” was defined as measured BP ≥140/90mmHg at the most recent outpatient visit with or without a clinical diagnosis of hypertension. Logistic regression was used to examine factors associated BP control status. Results: We observed 1,710,702 BP measurements among 216,947 unique patients. The population was 42% male (n= 91,062) with a mean age of 49 years; 19% (n=41,714) of patients had BP ≥140/90 mmHg at their most recent outpatient visit and 8% of the population had a history of diabetes (n= 18,242). Patients with diabetes had 1.15 times the odds of BP ≥140/90 mmHg at their most recent outpatient visit [aOR(95% CI): 1.15 (1.11-1.20)]. Amo ng patients with a diabetes history, the following factors were associated with uncontrolled BP: race/ethnicity [(aOR: 2.81 (2.48-3.19) for non-Hispanic blacks compared to non-Hispanic whites, 1.44 (1.31-1.57) for multiracial patients versus non-Hispanic whites] , sex [aOR: 1.28 (1.25-1.31)] for males compared to females], age [aOR per 10-year increase in age: 1.22 (1.21-1.23)] , and time since diabetes diagnosis [aOR per 1-year increase in time since diagnosis: 0.99(0.98-1.00)]. Conclusions: Uncontrolled BP disproportionately impacts diabetes patients in the outpatient setting. Among these patients, BP control status differed by race/ethnicity, sex, and age. Additionally, patients were more likely to have uncontrolled BP ≥140/90 mmHg closer to the time of their diabetes diagnoses (i.e. time since diagnosis was inversely associated with BP control status). Additional investigation to identify underlying patient- and provider-level factors contributing to these observed differences will be particularly important moving forward for accountable care organizations to meet metrics for equitable quality care delivery across patient subgroups.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.135.suppl_1.p061
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1466401-X
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  • 9
    Online Resource
    Online Resource
    Abstract MP13: N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Risk of Hypertension in the Atherosclerosis Risk in Communities (ARIC) Study
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 129, No. suppl_1 ( 2014-03-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 129, No. suppl_1 ( 2014-03-25)
    Abstract: Introduction: Increased plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration reflects cardiac overload and is used to diagnose and stage congestive heart failure. While NT-proBNP exhibits beneficial effects on the cardiovascular system via vasodilatation and diuresis, increased amounts of circulating NT-proBNP also promote release of norepinephrine, which is known to affect blood pressure. Cross-sectional studies report positive associations of NT-pro-BNP with blood pressure, but the prospective association of increased NT-proBNP with risk of hypertension is not well characterized. Thus, the study aim was to evaluate the association of NT-proBNP with incident hypertension in the community-based ARIC Study. Methods: We conducted a prospective cohort analysis of 3,849 participants aged 53-75 years with measured NT-proBNP at ARIC Visit 4 (1996-98) and normal blood pressure; participants with a history of hypertension (medication use or measured BP ≥140/90 mmHg), cardiovascular disease, or heart failure at baseline were excluded. Incident hypertension was defined based on diagnosis or antihypertensive medication use reported during annual follow-up. Results: During a median follow-up of 9 years, there were 2,157 new hypertension cases. There was a significant independent positive association between NT-proBNP levels and risk of hypertension. A 10% increased risk of hypertension was observed per log-unit increase in NT-proBNP (Table). This association was similar among individuals who were normotensive and pre-hypertensive at baseline [HR (95 % CI): 1.08 (1.01-1.15) and 1.11 (1.00-1.24), respectively]. Participants in the highest quartile for NT-proBNP were at 26% increased risk compared to those in the lowest quartile. Conclusions: NT-proBNP is positively associated with incident hypertension in this community-based cohort of middle-aged and older adults. In spite of the vasodilatory effects of increased NT-proBNP, elevated levels predict the development of hypertension.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.mp13
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 10
    Online Resource
    Online Resource
    Age Moderates the Short-Term Effects of Transdermal 17β-Estradiol on Endothelium-Dependent Vascular Function in Postmenopausal Women
    Ovid Technologies (Wolters Kluwer Health) ; 2007
    In:  Arteriosclerosis, Thrombosis, and Vascular Biology Vol. 27, No. 8 ( 2007-08), p. 1782-1787
    Details
    In: Arteriosclerosis, Thrombosis, and Vascular Biology, Ovid Technologies (Wolters Kluwer Health), Vol. 27, No. 8 ( 2007-08), p. 1782-1787
    Abstract: We sought to evaluate whether age and coronary heart disease moderate the effects of 17β-estradiol on vascular endothelial function. For younger postmenopausal women, short-term estradiol transdermal patch exposure was associated with improved flow mediated dilation. Benefits of estrogen supplementation on vascular endothelial function may be dependent on postmenopausal age.
    Type of Medium: Online Resource
    ISSN: 1079-5642 , 1524-4636
    URL: Article
    DOI: 10.1161/ATVBAHA.107.145383
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2007
    detail.hit.zdb_id: 1494427-3
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