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  • 1
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    Abstract 154: Sex-specific Genome Wide Association Study Of Early-onset Ischemic Stroke
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Stroke Vol. 53, No. Suppl_1 ( 2022-02)
    Details
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 53, No. Suppl_1 ( 2022-02)
    Abstract: Introduction: Genetic studies of early-onset disease have been an effective strategy to identify novel pathways and drug targets generalizable also to later-onset disease. Few studies have investigated the sex-specific genetic associations with early-onset ischemic stroke even though several features of ischemic stroke differ between males and females. We hypothesized that stratifying the GWAS by sex would reveal novel stroke loci. Methods: We performed a transethnic ischemic stroke GWAS of 3,056 female cases and 4,462 male cases 〈 60 years-old and 16,192 and 16,048 sex-matched controls, respectively, from the Early Onset Stroke Genetics Consortium. Results: We identified a significant association in women with a locus in close proximity to TMX1 , a transmembrane platelet protein that inhibits platelet function. Additionally, we identified 2 other suggestive (P 〈 5 x 10 -6 ) loci in females (see Table), i.e., at APOH , which encodes beta2-glycoprotein I, an established GWAS locus for lipoprotein(a), and LRFN2 which has been previously reported to associate with obesity-related measures and type II diabetes. We observed suggestive evidence for association in males with MMP3/MMP12 , a known stroke susceptibility locus. Conclusions: Despite a very modest sample size, sex-specific analyses identified suggestive associations at biologically important novel loci in females and a known stroke locus in males. Further studies of sex-specific associations in both early- and later-onset ischemic stroke are needed.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.53.suppl_1.154
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1467823-8
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  • 2
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    Abstract MP60: Blood Pressure Variability And Risk Of Heart Failure In Postmenopausal Women. Results From The Women's Health Initiative.
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 143, No. Suppl_1 ( 2021-05-25)
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    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 143, No. Suppl_1 ( 2021-05-25)
    Abstract: Introduction: Little is known about the relationships between visit-to-visit BPV and HF sub-phenotypes, HF with preserved ejection fraction (HFpEF) and HF with reduced ejection fraction (HFrEF). The aim of this analysis was to investigate the relationship of visit-to-visit systolic and diastolic BPV and risk of HF subtypes HFrEF and HFpEF in a large cohort of postmenopausal women. Hypothesis: We hypothesized that greater systolic and diastolic BPV would be associated with a higher risk for HFrEF and HFpEF. Methods: This study consisted of 23,918 postmenopausal women aged 50-79 enrolled in the Women’s Health Initiative Hormone Therapy Trials. Blood pressure (BP) was measured at baseline (1993-1998) and then annually through 2005 by trained clinical staff. Variability was defined as the standard deviation of the mean BP across visits (SDm). The outcome was first HF hospitalization, which was adjudicated by physician review of medical records. Cox regression models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for HF endpoints with adjustments for demographic, medical history, lifestyle factors, antihypertensive medication use, mean systolic and diastolic BPs, and time-varying coronary events interim to HF hospitalization. Results: During a mean follow-up of 15.8 years, 913 incident cases of HFpEF and 421 cases of HFrEF were identified. In fully adjusted models, women in the highest quartile of SDm for systolic blood pressure were at higher risk of HFpEF [HR (95% CI): 1.61, 95% confidence interval: 1.12, 2.31)], but not HFrEF [1.18 (0.70,1.96)] compared to women in the lowest quartile of SDm. Higher SDm for diastolic blood pressure was not related to HFpEF [1.19 (0.85,1.65)] or HFrEF [1.56 (0.89,2.74)] . Conclusions: Greater systolic BPV was associated with a higher risk of HFpEF independent of mean blood pressure and coronary events interim to HF hospitalization. These findings suggest that control of BPV may be a relevant target for the prevention of HFpEF in postmenopausal women.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.143.suppl_1.MP60
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 3
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    Abstract P188: Anxiety Is Associated With Six-year Blood Pressure Change And Incident Hypertension: Findings From The Hispanic Community Health Study/ Study Of Latinos
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 143, No. Suppl_1 ( 2021-05-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 143, No. Suppl_1 ( 2021-05-25)
    Abstract: Introduction: Prior research on the association of anxiety with hypertension has yielded mixed results. Despite the high burden of both conditions in Hispanics/Latinos, little is known about their association in this population. This study examined the longitudinal relationship of trait anxiety with changes in BP and incidence of hypertension. Hypothesis: Higher trait anxiety at Visit 1 (V1) will be associated with greater increases in BP and incident hypertension over 6 years. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multi-center prospective community-based study of 16,415 diverse Hispanics/Latinos ages 18-74 at V1 (2008-11). Data included 11,048 participants with complete information on BP, trait anxiety, and other variables at V1 and V2 (2014-17). Trait anxiety was measured at V1 using the 10-item Spielberger Trait Anxiety Scale, which was dichotomized into low and high using a cut-point of 20 points, the top quartile in the HCHS/SOL cohort. BP was measured using a standardized protocol and validated automated device. Hypertension was defined as systolic BP ≥ 140 or diastolic BP ≥ 90 mm Hg or self-reported antihypertensive medication use. Linear regressions were used to examine the association of anxiety with BP change; to account for medication use, 9 mmHg and 6 mmHg were added to systolic and diastolic BP of treated participants, respectively. The association of anxiety with incident hypertension at V2 was examined using Poisson regression among those without hypertension at V1 ( N = 7,878). Estimates were adjusted for complex survey design, sociodemographic factors, baseline BP, antidepressant/anxiolytic medication use, and health conditions. Results: Mean baseline age was 45.8 years and 60% were women. Mean change was 3.13 ( SE = 15.67) in systolic and 0.21 ( SE = 9.73) in diastolic BP. Individuals with high, compared to those with low, trait anxiety had greater increases in systolic ( B = 1.10, 95% CI = 0.28-1.93, p = 0.009) and diastolic BP ( B = 0.69, 95% CI = 0.11-1.27, p = 0.02) over 6 years, after adjusting for covariates. Individuals with high, relative to those with low, trait anxiety had an 18% higher risk of hypertension (RR = 1.18, 95% CI = 1.03-1.34, p = 0.012). Conclusions: Elevated trait anxiety is associated with small increases in BP over 6 years and an 18% higher risk of hypertension among diverse Hispanics/Latino adults. Research on the mechanisms underlying these relationships among Hispanics/Latinos is warranted to develop effective interventions to prevent and treat hypertension in this population.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.143.suppl_1.P188
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 4
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    Abstract 030: The Association Of Hypnotics With Incident Cardiovascular Disease And Mortality Among Post-menopausal Women With Sleep Disturbances
    Ovid Technologies (Wolters Kluwer Health) ; 2021
    In:  Circulation Vol. 143, No. Suppl_1 ( 2021-05-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 143, No. Suppl_1 ( 2021-05-25)
    Abstract: Background: Chronic insomnia is common in post-menopausal women and is associated with higher cardiovascular disease (CVD) risk. Hypnotics are a second-line therapy after cognitive behavioral therapy for management of chronic insomnia. Among the hypnotics, nonbenzodiazepine GABA agonists (Z-drugs) are commonly prescribed. However, it is unclear whether Z-drug use and other hypnotic use is associated with risk of incident CVD and mortality in older people with sleep disturbances. Objectives: Among post-menopausal women with sleep disturbances, to evaluate the association of Z-drug use compared with use of other prescription hypnotics, and with non-use of any prescription hypnotics with CVD and mortality. Methods: The population studied were post-menopausal women from the Women’s Health Initiative (WHI) Observational Study and Clinical Trials who, at baseline, scored 〉 =9 with the WHI Insomnia Rating Scale (N=40,728). Hypnotic use was ascertained from prescription medications scanned into the Medi-Span database at baseline and first follow-up clinic visit. Frequency of use was ascertained from self-report. Participants were categorized as users of Z-drugs, users of other prescription hypnotics or non-users. Outcomes were composite CVD (congestive heart failure, stroke, and fatal/non-fatal myocardial infarction) and mortality, centrally adjudicated with review of medical records and death certificates. Hazard ratios were estimated from Cox proportional hazards regression models adjusted for demographic, medical history, and sleep measures. To address potential confounding by indication, we also adjusted for propensity to be prescribed hypnotics. Results: At the first follow-up visit 1.1% (424 of 38,979) of participants were users of Z-drugs, 4.2% (1,653 of 38,979) were users of other prescription hypnotics, 3.1% (1,187 of 38,979) had discontinued prescription hypnotic use, and 91.6% (35,715 of 38,979) were non-users at both baseline and first follow-up visit. The mean age of our cohort was 63.6 years (SD = 7.2) and mean follow-up time after the initial follow-up visit was 14.0 years (SD = 6.3). Z-drug use was significantly associated with an increased risk of composite CVD (HR= 1.35, 95%CI: 1.02-1.79) and all-cause mortality (HR= 1.38, 95%CI: 1.13-1.69). Use of other prescription hypnotics and casual use ( 〈 =2 times a week) of any hypnotic were not associated with either cardiovascular disease or mortality. Conclusion: Use of Z-drugs three or more times a week was associated with an increased risk of death and cardiovascular disease in post-menopausal women being treated for insomnia. Additional research is needed to evaluate association between frequency of hypnotic use and these outcomes and to investigate possible mechanisms.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.143.suppl_1.030
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
    detail.hit.zdb_id: 1466401-X
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  • 5
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    Abstract 10664: Association of Unfavorable Social Determinants of Health With Stroke/TIA and Vascular Risk Factors: Results From the Hispanic Community Health Study/Study of Latinos
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
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    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Introduction: Social Determinants of Health (SDOH) contribute to the development of diseases and disproportionally affect minoritized groups. There is a paucity of information describing the relationship between SDOH, stroke/TIA and vascular risk factors (VRFs) in Hispanics/Latinos. Hypothesis: Unfavorable SDOH are associated with self-reported stroke/TIA and with increased VRFs. Methods: Cross-sectional data from cohort study of Hispanic Community Health Study/Study of Latinos (2014-2017). SDOH were assessed using questionnaires and previously validated scales. VRFs were hypertension, diabetes mellitus, hypercholesterolemia, smoking, at-risk alcohol use, and obesity. We investigated the association between the SDOH (individually and as count) and stroke/TIA using weighted complex survey multivariable logistic and linear regression analyses. Results: For individuals with stroke/TIA (weighted n=388), the mean age (58.9, 95% CI=56.4-61.5) differed from those without stroke/TIA (weighted n=11,210; 46.8, 95% CI=46.3-47.4). In bivariate analysis, income 〈 $20,000, education less than high school, no health insurance, perceived discrimination, not retired and not currently employed, upper tertile for chronic stress, and lower tertiles for social support and language- and social-based acculturation were associated with stroke/TIA and used in further analysis. Participants were grouped into 5 categories based on the distribution of SDOH (≤1, 2, 3, 4 and ≥5 SDOH). Increasing number of SDOH was directly associated with the odds of each individual VRFs investigated (except for at-risk alcohol) and VRF count (β=0.11, 95% CI=0.09-0.14). After adjustment for confounders, the odds of stroke/TIA increased 2.3 times in individuals with three SDOH (95% CI 1.6-3.2) and 2.7 times (95% CI 1.9-3.7) for those with ≥5 SDOH, compared to those with ≤1 SDOH. In final model, income, discrimination, social support, chronic stress, and employment status were individually associated with higher odds of stroke/TIA. Conclusions: Increased number of SDOH increased odds for stroke/TIA and VRFs. The association between SDOH and stroke/TIA remained significant after adjustment for VRFs, suggesting the participation of additional mechanisms of disease.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.10664
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 6
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    Abstract 064: Prevalence Of Stroke Symptoms Among Hispanic/Latino Adults In The Hispanic Community Health Study/study Of Latinos (HCHS/SOL)
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 145, No. Suppl_1 ( 2022-03)
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    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 145, No. Suppl_1 ( 2022-03)
    Abstract: Introduction: In the U.S., Hispanic/Latino adults experience a higher incidence of stroke overall and at younger ages than non-Hispanic White adults. However, given the diversity of U.S. Hispanic/Latinos, understanding heterogeneity in stroke symptom recognition by background is critical to prevention. Methods: The primary outcome was self-reported stroke symptoms over the past year using the validated and telephone-administered Questionnaire for Verifying Stroke Free Status of 8,235 stroke free HCHS/SOL participants in 2017 (mean age=49 + 0.25). Stroke risk factors were collected at baseline (2008-2011) using standardized measurements and validated questionnaires. Stroke risk factors were defined as clinical factors (blood pressure, diabetes, anthropometrics, family history of cardiovascular disease [CVD], smoking, and alcohol consumption), medication use (aspirin, statin, and antihypertensive medication use), and self-reported sociodemographic factors (heritage, sex, education, and years in the mainland US). The prevalence of stroke symptoms and 95% confidence intervals (CI) were estimated overall, by heritage group and by stroke risk factors. Multivariable logistic regression models estimated associations (odds ratio [OR] , 95% CI) between heritage group and stroke risk factors with stroke symptoms, accounting for the complex study design and adjusting for age, sex, and sociodemographic factors. Results: Overall, 15% (n=1,448) reported experiencing 〉 1 stroke symptom in the past year. The most common stroke symptoms reported were sudden numbness (8%) followed by sudden weakness (6%). The prevalence of 〉 1 stroke symptom among those aged 〈 50 years was 13% and 21% among those 〉 50. The prevalence was also highest among those of mixed heritage (20%), followed by Puerto Rican heritage (19%), and was lowest among those of Dominican heritage (10%). In age and sex-adjusted models, reporting 〉 1 stroke symptom was significantly lower among those of Dominican heritage (OR=0.51, 95%CI: 0.40-0.67) and Cuban heritage (OR=0.64, 95%CI: 0.53-0.78) compared to Mexican heritage, while those of mixed heritage exhibited a higher odds (OR=1.58, 95%CI: 1.16-2.15); estimates were unchanged after adjusting for clinical factors and medication. History of diabetes (OR=1.40, 95%CI: 1.17-1.60), CVD (OR=1.94, CI: 1.67-2.26), and current smoking (OR=1.50, 95%CI: 1.28-1.75) were significantly associated with greater odds of reporting 〉 1 stroke symptom, while odds were lower for males than females (OR=0.78, 95%CI: 0.68-0.89). Conclusions: This is the first study to assess the prevalence of stroke symptoms among U.S. Hispanic/Latino adults and demonstrates a high burden of stroke symptoms in this relatively young population. The prevalence varied across heritage groups and stroke risk factors indicating a need for stroke recognition education and targeted screening.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.145.suppl_1.064
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
    detail.hit.zdb_id: 1466401-X
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  • 7
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    Abstract P508: Association of Egg and Dietary Cholesterol Intake With Incident Cardiovascular Disease and All-cause Mortality
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Circulation Vol. 141, No. Suppl_1 ( 2020-03-03)
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    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 141, No. Suppl_1 ( 2020-03-03)
    Abstract: Introduction: The association of egg or dietary cholesterol intake with risk of cardiovascular disease (CVD) and overall mortality remains a topic of active debate. Hypothesis: Higher egg or dietary cholesterol intake is associated with elevated risk of CVD and all-cause mortality. Methods: We analyzed data from 96,755 women aged 50-79 years who were free of CVD and cancer at baseline (1993-1998)(Women’s Health Initiative). Baseline dietary data were collected using a validated food frequency questionnaire. Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals of CVD or mortality ascertained through February, 2018. Results: After multivariable adjustment (model 1 in Figure ), higher intakes of egg and dietary cholesterol both were associated with increased risk of CVD (HRs: 1.09 [1.06-1.13] for ½ eggs/day and 1.13 [1.09-1.17] for cholesterol intake of 100 mg/1000 Kcal/day) and all-cause mortality (HRs: 1.10 [1.07-1.12] for egg and 1.16 [1.12-1.19] for cholesterol intake). These associations persisted with further adjustment for other major food groups (e.g. red/processed meat) or nutrients (e.g. saturated fat), or for several potential intermediators (model 2 in Figure ). For both egg and cholesterol intakes, the positive associations with CVD were limited to obese individuals and the associations with all-cause mortality were more pronounced in individuals with diabetes (all P -interaction≤0.002). Among 9451 participants with blood cholesterol measurements, egg or cholesterol intake remained associated with increased CVD and mortality, and the associations were not altered by further adjustment for LDL and HDL cholesterol despite the expected associations of both lipid measures with CVD and mortality ( Figure ). Conclusions: A higher intake of eggs or dietary cholesterol was associated with higher risk of CVD in obese women and overall mortality predominantly in women diagnosed with diabetes. These associations appeared not attributable to blood cholesterol.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.141.suppl_1.P508
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
    detail.hit.zdb_id: 1466401-X
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  • 8
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    Abstract T P153: Women and Men with Ischemic Stroke in SiGN Have Different Subtype Distributions and Risk Factors
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Stroke Vol. 45, No. suppl_1 ( 2014-02)
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    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 45, No. suppl_1 ( 2014-02)
    Abstract: Introduction: The relative distribution of stroke risk factors, as well as ischemic stroke subtypes, in women compared with men is not well described. Hypothesis: We hypothesized that the distribution of ischemic stroke risk factors and subtypes would differ by sex, with a later onset in women and greater proportion of comorbidities. Methods: The NINDS Stroke Genetics Network (SiGN) consortium was established to evaluate genetic risk factors for ischemic stroke. A total of 23 separate studies performed Causative Classification of Stroke (CCS) typing using standardized criteria on ischemic stroke cases and contributed data on risk factors. We compared the distribution of ischemic stroke risk factors and CCS phenotypes between men and women with ischemic stroke. Results: Of the 16,228 ischemic strokes in SiGN, 8005 (49.3%) occurred in women. Median age at stroke was older in female than male stroke cases (73 vs. 66 years) (p= 〈 0.0001). Among stroke cases, women were more likely than men cases to have hypertension or atrial fibrillation and less likely to have diabetes or coronary artery disease, or to smoke (p 〈 0.003 for all). The distribution of stroke subtypes also differed by sex, with women less likely than men to have large artery infarction and small artery occlusion, and more likely to have cardioembolic stroke and undetermined stroke due to incomplete work-up (p values all 〈 0.0001; see Table). Results were similar when the distribution of stroke subtypes was examined for those 〈 70 years and ≥70 years, except for cardioembolic stroke remaining more common only among women ≥70. Conclusions: In this large group of carefully phenotyped ischemic strokes, the distribution of ischemic stroke subtypes and risk factor profiles differ significantly by sex. Evaluation of the causes of these differences may highlight areas for improved prevention and risk reduction in both genders.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
    URL: Article
    DOI: 10.1161/str.45.suppl_1.tp153
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
    detail.hit.zdb_id: 1467823-8
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  • 9
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    Multiancestry genome-wide association study of 520,000 subjects identifies 32 loci associated with stroke and stroke subtypes
    Springer Science and Business Media LLC ; 2018
    In:  Nature Genetics Vol. 50, No. 4 ( 2018-04), p. 524-537
    Details
    In: Nature Genetics, Springer Science and Business Media LLC, Vol. 50, No. 4 ( 2018-04), p. 524-537
    Type of Medium: Online Resource
    ISSN: 1061-4036 , 1546-1718
    URL: Article
    DOI: 10.1038/s41588-018-0058-3
    RVK:
    XA 10000
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2018
    detail.hit.zdb_id: 1494946-5
    SSG: 12
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  • 10
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    Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis
    Oxford University Press (OUP) ; 2012
    In:  International Journal of Epidemiology Vol. 41, No. 5 ( 2012-10-01), p. 1419-1433
    Details
    In: International Journal of Epidemiology, Oxford University Press (OUP), Vol. 41, No. 5 ( 2012-10-01), p. 1419-1433
    Type of Medium: Online Resource
    ISSN: 1464-3685 , 0300-5771
    URL: Article
    DOI: 10.1093/ije/dys086
    RVK:
    XF 4100
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2012
    detail.hit.zdb_id: 1494592-7
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