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  • 1
    Online Resource
    Online Resource
    The association of acculturation with accelerometer-assessed and self-reported physical activity and sedentary behavior: The Hispanic Community Health Study/Study of Latinos
    Elsevier BV ; 2020
    In:  Preventive Medicine Reports Vol. 17 ( 2020-03), p. 101050-
    Details
    In: Preventive Medicine Reports, Elsevier BV, Vol. 17 ( 2020-03), p. 101050-
    Type of Medium: Online Resource
    ISSN: 2211-3355
    URL: Article
    DOI: 10.1016/j.pmedr.2020.101050
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2020
    detail.hit.zdb_id: 2785569-7
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  • 2
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    Are sedentary behavior and physical activity independently associated with cardiometabolic benefits? The Hispanic Community Health Study/Study of Latinos
    Springer Science and Business Media LLC ; 2020
    In:  BMC Public Health Vol. 20, No. 1 ( 2020-12)
    Details
    In: BMC Public Health, Springer Science and Business Media LLC, Vol. 20, No. 1 ( 2020-12)
    Abstract: Whether physical activity can reduce cardiometabolic risk particularly in understudied populations such as US Hispanics/Latinos is of public health interest. We prospectively examined the association of physical activity and cardiometabolic biomarkers in n  = 8049 participants of the Hispanic Community Health Study/Study of Latinos, a community-based cohort study of 16,415 adults aged 18–74 yr who self-identified as Hispanic/Latino from four US urban centers. Methods We assessed physical activity using accelerometry in 2008–2011 at visit 1. We assessed cardiometabolic biomarkers twice: once at visit 1 and collected a second measure in 2014–2017 at visit 2. We used survey linear regression models with changes in cardiometabolic markers as the dependent variables and quartiles of sedentary behavior or whether adults met guidelines for moderate-to-vigorous physical activity as the independent variables. Results In normoglycemic adults without cardiovascular disease, but not in adults with evidence of cardiometabolic disease, those who were in the lowest quartile for sedentary behavior ( 〈  10.08 h/day) had a significant decline in mean LDL-cholesterol of − 3.94 mg/dL (95% CI: − 6.37, − 1.52) compared to adults in the highest quartile (≥13.0 h/day) who exhibited a significant increase in LDL-cholesterol of 0.14 mg/dL (95% CI, − 2.15,2.42) over the six year period ( P   〈  0.02 in fully adjusted models.) There was also a trend toward lower mean increase in HbA1c comparing the lowest with the highest quartile of sedentary behavior. Overall regardless of glycemic level or evidence of cardiometabolic disease, adults who met guidelines for moderate-to-vigorous physical activity at visit 1, had significantly lower mean increases in level of fasting glucose compared to adults not meeting guidelines in fully adjusted models. Conclusions In this cohort of Hispanics/Latinos, being free of cardiometabolic disease and having low levels of sedentary behavior were associated with health benefits. Among all adults regardless of cardiometabolic disease, meeting guidelines for moderate-to-vigorous physical activity was associated with health benefits. Overall these data suggest that an active lifestyle may blunt the association of advancing age with worsening cardiometabolic risk factors.
    Type of Medium: Online Resource
    ISSN: 1471-2458
    URL: Article
    DOI: 10.1186/s12889-020-09497-5
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2020
    detail.hit.zdb_id: 2041338-5
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  • 3
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    Abstract P380: Steps Per Day and Step Intensity are Associated With a Lower Risk of Diabetes. The Hispanic Community Health Study / Study of Latinos (HCHS/SOL)
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 141, No. Suppl_1 ( 2020-03-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 141, No. Suppl_1 ( 2020-03-03)
    Abstract: Introduction: Physical activity has been associated with a lower risk of diabetes but less is known about the association of steps per day (steps/d) and step intensity with incident diabetes. Hypothesis: We hypothesized an inverse association between both number of steps/d and time spent at a stepping rate corresponding to purposeful steps ( 〉 40 steps/min) with the risk of incident diabetes. Methods: We included 7247 participants free of diabetes at baseline in the prospective HCHS/SOL cohort of Latinos sampled from four communities in the United States. Steps/d and minutes per day (min/d) at a stepping rate 〉 40 steps/min were assessed at baseline with the Actical accelerometer (2008-2011), and incident diabetes was ascertained at a follow-up visit (2014-2017). The association of steps with incidence rates (per 1,000 person-years) of diabetes and incidence rate ratios (IRR) was estimated using Poisson regression, accounting for the sampling design and adjusted for age, ethnicity, gender, education, smoking status, alcohol intake, and accelerometer wear time. Results: The average age at baseline was 38 years (range 18 - 74 years) and 52% were female. Over a median of 5.9 years, 850 participants (9%) developed diabetes. The median step count was 7360 steps/d and the median minutes per day at a stepping rate of 〉 40 steps/min was 55 minutes. For each 1,000 step/d increment, the risk of diabetes was 5% lower (Table, IRR= 0.95(95% confidence interval (CI) 0.88, 1.02)). Compared to adults who engaged in 2,000 steps/d, those who engaged in 5,000 and 10,000 steps/d had a 13% and 26% lower risk of diabetes. The risk of diabetes was 5% lower (IRR=0.95 (95% CI 0.89, 1.00)) per 10 minute increase in time spent at a stepping rate 〉 40 steps/min. Compared to adults who spent 10 min/d at 〉 40 step/min, those who spent 30, 60, and 120 min/d had a 10%, 20%, and 32% lower risk of diabetes. Conclusion: The number of steps per day and time spent at a stepping rate that corresponds to purposeful steps are inversely associated with the risk of developing diabetes among adults.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.141.suppl_1.P380
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 4
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    Online Resource
    Abstract P182: Diet Quality and Longitudinal Change in Kidney Function: Findings From the Hispanic Community Health Study/Study of Latinos (hchs/sol)
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 141, No. Suppl_1 ( 2020-03-03)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 141, No. Suppl_1 ( 2020-03-03)
    Abstract: Introduction: Recent studies suggest an association between healthy diet and incident chronic kidney disease (CKD), but these included few Hispanics/Latinos. We examined the relationship of diet quality with change in kidney function in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Given the bidirectional relationship between CKD and cardiovascular disease (CVD), we assessed prevalent CVD as a potential effect modifier. Methods: Data from HCHS/SOL Visits 1 (2008-2011) and 2 (2014-2017) were used. The Alternative Healthy Eating Index (AHEI-2010), a measure of diet quality, was calculated from two 24-hour dietary recalls administered at Visit 1 and analyzed as quintiles (lowest to highest quality). Kidney function was assessed using CKD-EPI creat glomerular filtration rate estimating equation (eGFR), and urine albumin-to-creatinine ratio (UACR). Annualized change was computed as the difference in eGFR or UACR between visits divided by follow-up time in years. CVD was defined at Visit 1 as self-reported coronary heart disease, cerebrovascular events, peripheral artery disease or heart failure. Of 16415 HCHS/SOL participants, data from 9336 and 9209 persons with complete information on dietary intake, and change in eGFR and UACR, respectively, were analyzed using linear regression. Interaction between AHEI-2010 and CVD was explored. Analyses accounted for complex sampling design. Results: Average age was 41 years, 52% were women, and 22% had prevalent CVD. On average, eGFR declined by 0.67 mL/min/1.73 m 2 / year, and UACR increased by 2.0 mg/g/year. A significant interaction between diet quality and CVD was seen (p 〈 0.01). Lower AHEI-2010 quintiles were associated with greater decline in eGFR in a dose-response manner in persons without CVD (P-trend 〈 0.01, Table). The association between diet quality and eGFR was stronger in those with CVD. AHEI-2010 was not associated with change in UACR. Conclusion: These findings have important implications for CKD prevention, especially for those with CVD.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.141.suppl_1.P182
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 5
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    Online Resource
    Abstract P115: Relationship between Cardiovascular Risk Factors and Psychological Distress among Hispanic/Latinos: The Hispanic Community Health Study/ Study of Latinos
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Circulation Vol. 127, No. suppl_12 ( 2013-03-26)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 127, No. suppl_12 ( 2013-03-26)
    Abstract: Background: Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress. Minimal research has been conducted exploring the relationship between psychological distress and CVD risk among Hispanic/ Latinos (H/L) of different background groups. The aim of this study was to investigate which CVD risk factors were most strongly correlated with psychological distress. Methods: The multi-site prospective population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of H/L adults (n = 16,415) ages 18-74 in four US communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified two-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010 US Population Census. Analyses involve 15,464 participants with complete data. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale and 10 item Spielberger Trait Anxiety Scale), socio-demographics (i.e., age, education, health insurance, gender, and H/L background), acculturation (i.e., years in the U.S., country of birth, and language), and CVD risk factors [i.e., dyslipidemia (HDL cholesterol 〈 40, LDL cholesterol ≥ 160,or triglycerides ≥ 200), body mass index (BMI), current cigarette smoking, diabetes (i.e., fasting time 〉 8 hr AND fasting glucose ≥ 126, or fasting time ≤ 8 hr AND fasting glucose ≥ 200, or post-OGTT glucose ≥ 200, or A1C≥ 6.5 or on medication), and hypertension (blood pressure ≥140/90 or on mediations)] were measured during the HCHS/SOL baseline exam. Associations between CVD risk factors and psychological distress were assessed using multiple linear regression models with depression and anxiety as dependent variables, accounting for the complex survey design and sampling weights, and controlling for socio-demographic and acculturation covariates. Results: Current smoking, diabetes, and BMI were significantly associated with depression and anxiety symptoms, after adjusting for covariates. Mean depressive symptomatology was 1.66 higher among smokers, .58 higher among diabetics, and increased by .04 for every one unit increase in BMI; mean anxiety symptomatology was 1.31 higher among smokers, .58 higher among diabetics, and increased by .05 for every one unit increase in BMI, adjusting for other factors. Dyslipidemia and hypertension were not associated with depression or anxiety. Discussion: Results demonstrate that certain CVD risk factors (i.e., smoking, diabetes, and BMI) were associated with psychological distress. Among the multiple CVD risk factors, current smoking was the strongest correlate; indicating its importance in CVD risk reduction among patients with depressive symptomatology.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.127.suppl_12.AP115
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 1466401-X
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  • 6
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    Online Resource
    Associations between dietary fatty acid patterns and cognitive function in the Hispanic Community Health Study/Study of Latinos
    Cambridge University Press (CUP) ; 2023
    In:  British Journal of Nutrition Vol. 129, No. 7 ( 2023-04-14), p. 1202-1212
    Details
    In: British Journal of Nutrition, Cambridge University Press (CUP), Vol. 129, No. 7 ( 2023-04-14), p. 1202-1212
    Abstract: Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56·2 years and proportion female 55·2 %). The National Cancer Institute method was used to estimate dietary intake from two 24-h recalls. We derived DFA patterns using principal component analysis with twenty-six fatty acid and total plant and animal MUFA input variables. Global cognitive function was calculated as the average z -score of four neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake and CVD. DFA patterns were characterised by the consumption of long-chain SFA, animal-based MUFA and trans -fatty acids (factor 1); short to medium-chain SFA (factor 2); very-long-chain n -3 PUFA (factor 3); very-long-chain SFA and plant-based MUFA and PUFA (factor 4). Factor 2 was associated with greater scores for global cognitive function ( β = 0·037 ( sd 0·012)) and the Digit Symbol Substitution (DSS) ( β = 0·56 ( sd 0·17)), Brief Spanish English Verbal Learning-Sum (B-SEVLT) ( β = 0·23 ( sd 0·11)) and B-SEVLT-Recall ( β = 0·11 ( sd 0·05)) tests ( P 〈 0·05 for all). Factors 1 ( β = 0·04 ( sd 0·01)) and 4 ( β = 0·70 ( sd 0·18)) were associated with the DSS test ( P 〈 0·05 for all). The consumption of short to medium-chain SFA may be associated with higher cognitive function among US-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.
    Type of Medium: Online Resource
    ISSN: 0007-1145 , 1475-2662
    URL: Article
    DOI: 10.1017/S0007114521003275
    Language: English
    Publisher: Cambridge University Press (CUP)
    Publication Date: 2023
    detail.hit.zdb_id: 2016047-1
    SSG: 12
    SSG: 21
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  • 7
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    Online Resource
    Abstract 32: Physical Activity Fragmentation and Mortality in Hispanics/Latinos: The Hispanic Community Health Study / Study of Latinos (HCHS/SoL)
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Circulation Vol. 147, No. Suppl_1 ( 2023-02-28)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 147, No. Suppl_1 ( 2023-02-28)
    Abstract: Background: Physical activity (PA) fragmentation, an emerging concept of PA patterns, indicates the frequency of transitioning from an active to a sedentary state. Whether PA fragmentation provides prognostic information beyond conventional PA measures is unclear, especially in Hispanics/Latinos. Aim: To examine the association between PA fragmentation and mortality in Hispanics/Latinos. Methods: We included 9,856 participants (mean age 41.7 [SE 0.27] years; 52.1% women) from HCHS/SOL with baseline PA evaluation from an Actical accelerometer (≥3 days with ≥10 hr/day of wear). We defined sedentary as 〈 10 counts/min and active as ≥10 counts/min. PA fragmentation was calculated using the active-to-sedentary transition probability (ASTP), defined as the reciprocal of the average active bout duration on a minute-level basis across valid days. We used daily mean total log activity counts (TLAC) as a measure of total PA volume. We modeled the residuals of ASTP regressed on TLAC (total-PA-adjusted ASTP) to investigate ASTP independently of total PA. Deaths were identified from annual follow-up contacts until December 31, 2018. We explored multivariable Cox regression models accounting for the multi-stage sampling design. Results: There were 242 deaths (2.5%) over a mean of 7.1 years. ASTP was associated with mortality in all models ( Table ). Each 0.10-unit increase of ASTP at baseline was associated with a 38% higher mortality risk after accounting for demographic, clinical, and lifestyle factors. Similarly, the highest ASTP tertile indicated a 2-times greater risk of death compared to the lowest tertile. The results were largely similar when we modeled using total-PA-adjusted ASTP. Higher TLAC was also associated with reduced mortality. Similar results were observed after excluding early deaths (first 2 years). Conclusion: PA fragmentation was robustly associated with mortality, independent of total PA volume. Our findings support PA fragmentation as an emerging novel measure that is informative beyond total PA.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.147.suppl_1.32
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 1466401-X
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  • 8
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    Online Resource
    Abstract P071: Association of Baseline Depressive Symptoms With 6-Year Incidence of Diabetes in the Hispanic Community Health Study/Study of Latinos
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Circulation Vol. 137, No. suppl_1 ( 2018-03-20)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 137, No. suppl_1 ( 2018-03-20)
    Abstract: Background: Among Hispanics/Latinos, there is substantial heterogeneity in the prevalence of depressive symptoms and diabetes by background. This study aimed to examine the association between depressive symptoms and incident diabetes among Hispanic/Latino adults of diverse backgrounds. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a prospective, community-based study of 16,415 self-identified Hispanic/Latino adults aged 18-74 years at Visit 1 (2008-2011) and 10,914 who have also completed the Visit 2 examination by August 2017. This analysis includes 8,804 participants who were free from diabetes at baseline and attended both Visits. Baseline depressive symptoms were assessed using the CES-D 10-item depression scale and divided into quartiles. Incident diabetes was defined by fasting glucose ≥126mg/dL, 2-hour postload glucose 140-199mg/dL, HbA1c ≥6.5%, or self-report. Accounting for HCHS/SOL complex survey design, we used Poisson regression models to estimate diabetes incidence density ratios (Table). Results: Baseline BMI was associated with both depressive symptoms and incident diabetes. Overall, 876 participants developed diabetes. In analyses stratified by Hispanic/Latino background, the association between baseline depressive symptoms and incident diabetes was significant for South Americans, Central Americans, and Mexicans. No significant associations between depressive symptoms and diabetes were seen among Hispanics/Latinos of Dominican, Cuban, or Puerto Rican backgrounds. Conclusions: These findings suggest that the association between depressive symptoms and incident diabetes in Hispanics/Latinos may differ by their background, with South and Central Americans at the highest risk. This difference may be partly explained by variation in participants’ understanding of CES-D questions by Hispanic/Latino background. Future research is needed to understand these novel findings fully and explore their implications for practice and policy.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.137.suppl_1.p071
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 1466401-X
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  • 9
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    Abstract P320: Discordance of Framingham Risk Score and Reynolds Risk Score to Global Vascular Risk Score: Results from the Hispanic Community Health Study/Study of Latinos
    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: The Framingham Risk Score (FRS) is a coronary heart disease (CHD) risk model established using an ethnically homogeneous population that predicts 10-year hard CHD events, myocardial infarction (MI) and coronary death. The Reynolds Risk Score (RRS) and Global Vascular Risk Score (GVRS) are validated CHD risk models that, in addition to hard CHD events, predict stroke and other CHD outcomes. In addition to major CHD risk factors, RRS adds systemic inflammation and family history of MI as GVRS adds behavioral and anthropometric measures. This study aims to compare agreement of RRS and GVRS with FRS among Hispanic/Latino adults and to describe discordance in RRS and GVRS with FRS categories, by socio-demographic characteristics. Methods: HCHS/SOL is a population-based cohort study of Hispanics/Latinos in four US communities. The analytic sample includes 6,058 non-diabetic participants 45-74 years of age with no past history of CHD and stroke who underwent comprehensive baseline examination. 10-year hard CHD risk score was calculated; participants were categorized as low ( 〈 10%), moderate (10- 〈 20%), and high (≥20%) risk. Kappa scores were calculated to compare agreement of RRS and GVRS with FRS. Socio-demographic characteristics of concordance and discordance were characterized overall; multinomial logistic regression models was used to examine age-sex-adjusted likelihood of in discordance by these factors. Results: Mean age of the participants was 55 (SE=0.15) years, 54.3% were women, 41% had family history of CHD, and 90% were foreign born. Overall, 4,805 (74%) had low FRS, 1,143 (24%) had moderate FRS, and 110 (2%) had high FRS. There was poor agreement between RRS and FRS (Kappa=0.16, P 〈 0.01) and fair agreement between GVRS and FRS (Kappa=0.36, P 〈 0.01). In age-sex-adjusted analyses, RRS and GVRS were both more likely to classify persons of moderate and high risk who are between the ages of 60-74; GVRS classified more moderate and high risk women than the FRS. RRS and GVRS discordance with FRS was not associated with nativity and length of time in US. Conclusion: Significant discordance was observed between RRS and GVRS compared to FRS. Among Hispanic/Latino adults, use of RRS or GVRS may be more inclusive in classifying older age adults and women at high 10-year CHD risk.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.129.suppl_1.p320
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1466401-X
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  • 10
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    Abstract P064: Associations Between Signs and Symptoms of Androgen Excess With Prediabetes and Diabetes in Hispanic/Latina Women of Reproductive Age in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)
    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: Androgen excess is a characteristic of polycystic ovary syndrome (PCOS). Signs and symptoms of androgen excess are associated with cardiometabolic risk factors and diabetes, however the characterization is incomplete among premenopausal women and high risk groups such as Hispanic/Latina women. Methods: HCHS/SOL is a community-based cohort study of 16,415 self-identified Hispanic/Latino adults from diverse backgrounds in the US at the baseline visit (2008-2011; 3,801 women age 18-44 years). This preliminary cross-sectional analysis is from 994 reproductive-aged women who attended the ongoing visit 2 (Oct. 2014-Sept. 2017) by Sept. 2016. Signs and symptoms of androgen excess included menstrual cycle irregularities, self-reported PCOS, and oral contraceptive use to regulate menstrual cycles or acne. Impaired fasting glucose (prediabetes) was defined as fasting glucose 100-125 mg/dL (excluding diabetes), and diabetes as fasting glucose ≥126 mg/dL, glucose post oral glucose tolerance test ≥200 mg/dL, or hemoglobin A1c ≥6.5%. Design-based estimates are presented and adjusted for site, age, Hispanic/Latina background, education, smoking status, and body mass index. Results: The mean age was 34 years. The prevalence of any sign or symptom of androgen excess was 28%, of which 19% self-reported having PCOS. Signs and symptoms of androgen excess was not significantly associated with the odds of prediabetes or diabetes (see table). Women self-reporting PCOS or oral contraceptive use to regulate cycles or acne had a higher odds of diabetes compared to those that did not, although not statistically significant. Conclusion: In this sample of Hispanic/Latina women, the association between signs and symptoms of androgen excess and the odds of prediabetes or diabetes were not statistically significant. Future analyses will include the whole cohort of reproductive-aged women that will improve statistical power and be critical to further characterize these relationships.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.135.suppl_1.p064
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
    detail.hit.zdb_id: 1466401-X
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