Maternal hypertension after a low-birth-weight delivery differs by race/ethnicity: Evidence from the National Health and Nutrition Examination Survey (NHANES) 1999-2006

Studies have suggested an increase in maternal morbidity and mortality due to cardiovascular diseases in women with a prior low-birth-weight (LBW, <2,500 grams) delivery. This study evaluated blood pressure and hypertension in women who reported a prior preterm or small-for-gestational-age (SGA) LBW delivery in the National Health and Nutrition Examination Survey 1999-2006 (n = 6,307). This study also aimed to explore if race/ethnicity, menopause status, and years since last pregnancy modified the above associations. A total of 3,239 white, 1,350 black, and 1,718 Hispanics were assessed. Linear regression models were used to evaluate blood pressure by birth characteristics (preterm-LBW, SGA-LBW, and birthweight ≥2,500). Logistic regression models estimated the odds ratios (OR) of hypertension among women who reported a preterm-LBW or SGA-LBW delivery compared with women who reported an infant with birthweight ≥2,500 at delivery. Overall, there was a positive association between a preterm-LBW delivery and hypertension (adjusted OR = 1.39, 95% confidence interval (CI) 1.02-1.90). Prior SGA-LBW also increased the odds of hypertension, but the estimate did not reach statistical significance (adjusted OR = 1.21, 95% CI 0.76-1.92). Race/ethnicity modified the above associations. Only black women had increased risk of hypertension following SGA-LBW delivery (adjusted OR = 2.09, 95% CI 1.12-3.90). Black women were at marginally increased risk of hypertension after delivery of a preterm-LBW (adjusted OR = 1.49, 95% CI 0.93-2.38). Whites and Hispanics had increased, but not statistically significant, risk of hypertension after a preterm-LBW (whites: adjusted OR = 1.39, 95% CI 0.92-2.10; Hispanics: adjusted OR = 1.22, 95% CI 0.62-2.38). Stratified analysis indicated that the associations were stronger among women who were premenopausal and whose last pregnancy were more recent. The current study suggests that in a representative United States population, women with a history of preterm- or SGA-LBW deliveries have increased odds of hypertension and this risk appears to be higher for black women and younger women. © 2014 Xu et al

Evidence from the National Health and Nutrition Examination Survey (NHANES) 1999-2006

Abstract Studies have suggested an increase in maternal morbidity and mortality due to cardiovascular diseases in women with a prior low-birth-weight (LBW, ,2,500 grams) delivery. This study evaluated blood pressure and hypertension in women who reported a prior preterm or small-for-gestational-age (SGA) LBW delivery in the National Health and Nutrition Examination Survey 1999Survey -2006. This study also aimed to explore if race/ethnicity, menopause status, and years since last pregnancy modified the above associations. A total of 3,239 white, 1,350 black, and 1,718 Hispanics were assessed. Linear regression models were used to evaluate blood pressure by birth characteristics (preterm-LBW, SGA-LBW, and birthweight $2,500). Logistic regression models estimated the odds ratios (OR) of hypertension among women who reported a preterm-LBW or SGA-LBW delivery compared with women who reported an infant with birthweight$2,500 at delivery. Overall, there was a positive association between a preterm-LBW delivery and hypertension (adjusted OR = 1.39, 95% confidence interval (CI) 1.02-1.90). Prior SGA-LBW also increased the odds of hypertension, but the estimate did not reach statistical significance (adjusted OR = 1.21, 95% CI 0.76-1.92). Race/ethnicity modified the above associations. Only black women had increased risk of hypertension following SGA-LBW delivery (adjusted OR = 2.09, 95% CI 1.12-3.90). Black women were at marginally increased risk of hypertension after delivery of a preterm-LBW (adjusted OR = 1.49, 95% CI 0.93-2.38). Whites and Hispanics had increased, but not statistically significant, risk of hypertension after a preterm-LBW (whites: adjusted OR = 1.39, 95% CI 0.92-2.10; Hispanics: adjusted OR = 1.22, 95% CI 0.62-2.38). Stratified analysis indicated that the associations were stronger among women who were premenopausal and whose last pregnancy were more recent. The current study suggests that in a representative United States population, women with a history of preterm-or SGA-LBW deliveries have increased odds of hypertension and this risk appears to be higher for black women and younger women

Femoral Artery Atherosclerosis Is Associated With Physical Function Across the Spectrum of the Ankle-Brachial Index: The San Diego Population Study.

BackgroundThe ankle-brachial index (ABI) is inadequate to detect early-stage atherosclerotic disease, when interventions to prevent functional decline may be the most effective. We determined associations of femoral artery atherosclerosis with physical functioning, across the spectrum of the ABI, and within the normal ABI range.Methods and resultsIn 2007-2011, 1103 multiethnic men and women participated in the San Diego Population Study, and completed all components of the summary performance score. Using Doppler ultrasound, superficial and common femoral intima media thickness and plaques were ascertained. Logistic regression was used to assess associations of femoral atherosclerosis with the summary performance score and its individual components. Models were adjusted for demographics, lifestyle factors, comorbidities, lipids, and kidney function. In adjusted models, among participants with a normal-range ABI (1.00-1.30), the highest tertile of superficial intima media thickness was associated with lower odds of a perfect summary performance score of 12 (odds ratio=0.56 [0.36, 0.87], P=0.009), and lower odds of a 4-m walk score of 4 (0.34 [0.16, 0.73], P=0.006) and chair rise score of 4 (0.56 [0.34, 0.94], P=0.03). Plaque presence (0.53 [0.29, 0.99], P=0.04) and greater total plaque burden (0.61 [0.43, 0.87], P=0.006) were associated with worse 4-m walk performance in the normal-range ABI group. Higher superficial intima media thickness was associated with lower summary performance score in all individuals (P=0.02).ConclusionsFindings suggest that use of femoral artery atherosclerosis measures may be effective in individuals with a normal-range ABI, especially, for example, those with diabetes mellitus or a family history of peripheral artery disease, when detection can lead to earlier intervention to prevent functional declines and improve quality of life

History of Adverse Pregnancy Outcomes, Blood Pressure, and Subclinical Vascular Measures in Late Midlife: SWAN (Study of Women’s Health Across the Nation)

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/142563/1/jah32800_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/142563/2/jah32800.pd

The quantity and quality of cardiovascular fat at mid‐life and future cognitive performance among women: The SWAN cardiovascular fat ancillary study

IntroductionCardiovascular fat is a novel risk factor that may link to dementia. Fat volume and radiodensity are measurements of fat quantity and quality, respectively. Importantly, high fat radiodensity could indicate healthy or adverse metabolic processes.MethodsThe associations of cardiovascular fat (including epicardial, paracardial, and thoracic perivascular adipose tissue [PVAT]) quantity and quality assessed at mean age of 51 with subsequent cognitive performance measured repeatedly over 16 years of follow-up were examined using mixed models among 531 women.ResultsHigher thoracic PVAT volume was associated with a higher future episodic memory (β[standard error (SE)]&nbsp;=&nbsp;0.08 [0.04], P&nbsp;=&nbsp;0.033), while higher thoracic PVAT radiodensity with lower future episodic (β[SE]&nbsp;=&nbsp;-0.06 [0.03], P&nbsp;=&nbsp;0.045) and working (β[SE]&nbsp;=&nbsp;-0.24 [0.08], P&nbsp;=&nbsp;0.003) memories. The latter association is prominent at higher volume of thoracic PVAT.DiscussionMid-life thoracic PVAT may have a distinct contribution to future cognition possibly due to its distinct adipose tissue type (brown fat) and anatomical proximity to the brain circulation.HighlightsHigher mid-life thoracic perivascular adipose tissue (thoracic PVAT) volume is related to a better future episodic memory in women. Higher mid-life thoracic PVAT radiodensity is related to worse future working and episodic memories. Negative association of high thoracic PVAT radiodensity with working memory is prominent at higher thoracic PVAT volume. Mid-life thoracic PVAT is linked to future memory loss, an early sign of Alzheimer's disease. Mid-life women's epicardial and paracardial fat are not related to future cognition

Effects of an intensive behavioral weight loss intervention consisting of caloric restriction with or without physical activity on common carotid artery remodeling in severely obese adults

Obesity increases cardiovascular disease risk and adversely affects vascular structure and function. Few studies have evaluated the vascular effects of non-surgical weight reduction in the severely obese. We hypothesized that weight loss and improvements in cardiometabolic factors would reduce common carotid artery intima-media thickness (CIMT) and inter-adventitial diameter (AD) in severely obese adults

Carotid Intima-Media Thickness (CIMT): A Reproducibility Study

Carotid Intima-Media Thickness (CIMT): A Reproducibility Study Mindy Columbus, Brian Wagner, Emma Barinas-Mitchell Implementation of newer ultrasound technology for measuring subclinical atherosclerosis may increase the validity of measurement of carotid artery intima-media thickness (CIMT) cross-sectionally, but may prove to be a challenge for obtaining valid and reproducible progression data in existing follow-up studies. In the Department of Epidemiology Ultrasound Research Lab (URL), participants of the ERA JUMP study are returning for a five year follow-up visit for CIMT measurements to determine progression rates of subclinical atherosclerosis. A Toshiba 140A scanner was used for the baseline measurements and the maintenance service will end soon. There is a newer scanner available for use in the laboratory, and the question is whether the follow-up images that will be taken on this scanner, a Siemens Sonoline® Antares scanner, will provide comparable results to the baseline measurements in order to predict valid progression and not introduce error due to differences in machines. A reproducibility study was conducted to determine whether a Siemens Sonoline® Antares Doppler ultrasound scanner could be used in place of a Toshiba 140A Doppler ultrasound scanner to conduct follow-up visit measurements in the ERA JUMP study. A five year progression rate of ~0.04 mm (0.043) was estimated based on the literature. An average difference of 0.03 mm in CIMT between machines was determined a priori as an acceptable difference as we wanted to detect a difference between machines that was less than the estimated progression rate in order to assess reliability. The study recruited and evaluated 20 volunteers (85% women, age range: 24-77 years) who were scanned on each machine during the same visit by the same technician for between machine reliability. The mean CIMT values for this study population ranged from 0.488 to 1.039 mm. Reproducibility was evaluated on mean CIMT with Spearman and intraclass correlations and by the absolute value of the difference between replicate values. The mean difference in mean CIMT between the machines was -0.045 and the mean absolute difference was 0.052 mm. The mean difference in CIMT values between machines ranged from 0.077 to -0.256 mm, with 95% (19/20) of the differences being negative. This demonstrates systematic bias as the images read on the Toshiba machine were thicker (higher) than the Antares machine. This is likely due to the fact that the Antares scanner produces a crisper and clearer image than the Toshiba scanner demonstrating the advancement of digital technology with the newer scanner. Although the correlation for the mean CIMT between machines was high and agreed well, according to the Spearman correlation (r=0.93,

Potential Protective Effects of Equol (Soy Isoflavone Metabolite) on Coronary Heart Diseases—From Molecular Mechanisms to Studies in Humans

Equol, a soy isoflavone-derived metabolite of the gut microbiome, may be the key cardioprotective component of soy isoflavones. Systematic reviews have reported that soy isoflavones have no to very small effects on traditional cardiovascular disease risk factors. However, the potential mechanistic mode of action of equol on non-traditional cardiovascular risk factors has not been systematically reviewed. We searched the PubMed through to July 2021 by using terms for equol and each of the following markers: inflammation, oxidation, endothelial function, vasodilation, atherosclerosis, arterial stiffness, and coronary heart disease. Of the 231 records identified, 69 articles met the inclusion criteria and were summarized. Our review suggests that equol is more lipophilic, bioavailable, and generally more potent compared to soy isoflavones. Cell culture, animal, and human studies show that equol possesses antioxidative, anti-inflammatory, and vasodilatory properties and improves arterial stiffness and atherosclerosis. Many of these actions are mediated through the estrogen receptor β. Overall, equol may have a greater cardioprotective benefit than soy isoflavones. Clinical studies of equol are warranted because equol is available as a dietary supplement