0098: Erythrocyte membrane phospholipid fatty acids, dairy intakes and cardiovascular risk

IntroductionThe impact of dairy fats on cardiovascular risk has been debated. Circulating Pentadecanoic (15:0) and heptadecanoic (17:0) saturated fatty acids are good biomarkers of dairy product consumption as they are mainly provided by dairy fats. We described the prevalence of cardiovascular risk factors according to erythrocyte membrane phospholipid content in 15:0 and 17:0 fatty acids.Methods402 women and men aged 45-64 were randomly selected in 2005-2007, from the general population of three French areas. Nutritional data were collected through a 3-day food record. Fatty acid content was measured in erythrocyte membrane phospholipids.ResultsErythrocyte membrane contents in 15:0 and 17:0 fatty acids significantly increased with the consumption of dairy products collected during the 3-day food record. Prevalence of hypertension significantly decreased from the lowest to the highest quartile of 15:0 erythrocyte content (48.1%; 33.3%; 29.9%; 25.5%; p=0.005). A similar trend was observed for metabolic syndrome prevalence (39.4%; 28.1%; 25.2%; 21.3%; p=0.029). Prevalence of hypertension, hypertriglyceridaemia, overweight and metabolic syndrome significantly decreased from the lowest to the highest quartile of 17:0 erythrocyte content (44.1%; 36.5%; 28.1%; 25.6%; p=0.020 for hypertension; 30.3%; 15.4%; 16.9%; 16.7%; p=0.017 for hypertriglyceridaemia; 68.1%; 58.7%; 46.6%; 44.4%; p=0.002 for overweight; and 43.2%; 26.9%; 22.5%; 17.8%; p<0.001 for metabolic syndrome). All these relationships remained significant after adjustment for age and gender. The link did not reach significance level for diabetes.ConclusionElevated erythrocyte membrane phospholipid contents in 15:0 and 17:0 saturated fatty acids are associated with a lower prevalence of the metabolic syndrome and several of its components. These results suggest that saturated fat intake should not be systematically associated with high cardiovascular risk and can be considered as part of a balanced diet

Study of the relationship between work and cardiovascular health

Contexte : Travailler implique de faire face à plusieurs types de contraintes liées à l’environnement de travail. Celles-ci peuvent influer sur l’état de santé, et inversement l’état de santé peut entraîner des répercussions sur la vie professionnelle. Dans un premier temps, nous nous sommes intéressés à l’impact des conditions de travail sur la santé cardiovasculaire, plus particulièrement sur la pression artérielle et les pathologies vasculaires périphériques, puis nous avons évalué les conséquences d’un événement coronaire sur la vie professionnelle. Méthodes : Des analyses par régressions linéaires et logistiques ajustées sur les caractéristiques individuelles (sexe, âge, facteurs de risques cardiovasculaires etc.) et les facteurs professionnels (physiques, organisationnels, psychosociaux) ont été conduites afin d’évaluer l’effet des conditions de travail sur l’évolution de la pression artérielle sur 5 ans et sur l’incidence de l’hypertension artérielle à partir de la cohorte prospective VISAT de travailleurs français. Deux revues systématiques de la littérature ont été menées. La première consiste en l’état des lieux de la relation entre conditions de travail et pathologies vasculaires périphériques (varices, maladies veineuses thromboemboliques, artériopathie oblitérante des membres inférieurs, anévrisme et dissection aortique). La seconde a permis d’estimer, à l’aide de méta-analyses, la prévalence du retour au travail après un événement coronaire et de rechercher les déterminants de ce retour. Résultats : Chez les personnes normo-tendues au début de l’étude VISAT, avoir un travail tendu (forte demande psychologique et faible latitude décisionnelle) était associé, après ajustement sur les caractéristiques individuelles, à une augmentation de la pression artérielle systolique 5 ans plus tard. Au contraire, la reconnaissance par l’entourage professionnel du travail effectué était associée à une diminution de la pression artérielle systolique et ce même après la prise en compte de l’exposition à de multiples contraintes professionnelles. Aucune contrainte professionnelle n’influait sur la survenue d’hypertension artérielle. La revue systématique de la littérature portant sur les pathologies vasculaires périphériques a permis de mettre en évidence un potentiel lien entre travailler longtemps debout et les varices, ainsi qu’entre rester assis de façon prolongée et les maladies veineuses thromboemboliques. Enfin, près de 20 % des personnes ayant présenté un événement coronaire ne retournait pas travailler. Le retour au travail semblait moins fréquent en cas de travail manuel ou nécessitant une activité physique professionnelle importante. Conclusion : Vie professionnelle et santé cardiovasculaires sont probablement liées, cependant des études supplémentaires demeurent indispensables afin d’approfondir les connaissances de l’impact des facteurs professionnels et ainsi permettre la mise en place de mesures de prévention sur le lieu de travail et une meilleure prise en charge.Background: Working involves dealing with several types of constraints related to the work environment. These constraints can influence health, and conversely health can have repercussions on working life. First, we studied the impact of occupational factors on cardiovascular health, more specifically on blood pressure and peripheral vascular diseases, then we evaluated the consequences of coronary events on work life. Methods: From the French prospective cohort VISAT, linear and logistic regression analyses adjusted on individual characteristics (sex, age, cardiovascular risk factors, etc.) and occupational factors (physical, organizational, psychosocial) were conducted to assess the effect of working conditions on the 5-year evolution of arterial pressure and on the incidence of high blood pressure. Two systematic reviews were carried out. First, we aimed to summarise of the relationship between working conditions and peripheral vascular pathologies (varicose veins, thromboembolic venous diseases, intermittent claudication, aortic aneurysm, and dissection). Secondly, using meta-analyses, we estimated the prevalence of return to work after a coronary event and investigated the determinants of this return. Results: In people with normal baseline blood pressure, high job strain (high psychological demand and low decision-making latitude) was associated, after adjustment for individual characteristics, with an increase in systolic blood pressure 5 years later. On the contrary, work recognition by peers was associated to a decrease in systolic blood pressure, even after considering the exposure to multiple professional constraints. No professional constraints influenced the occurrence of high blood pressure. The systematic review on peripheral vascular diseases revealed a potential link between prolonged standing at work and varicose veins, as well as between prolonged sitting and venous thromboembolic diseases. Finally, nearly 20% of people who presented with a coronary event did not return to work. Return to work seemed less frequent among manual workers or in jobs with high occupational physical activity. Conclusion: Work life and cardiovascular health are probably linked, however additional studies remain essential to expand the knowledge of the impact of occupational factors, thus allowing the implementation of preventive measures in the workplace and better management

Etude des relations entre monde du travail et santé cardiovasculaire

Contexte : Travailler implique de faire face à plusieurs types de contraintes liées à l'environnement de travail. Celles-ci peuvent influer sur l'état de santé, et inversement l'état de santé peut entraîner des répercussions sur la vie professionnelle. Dans un premier temps, nous nous sommes intéressés à l'impact des conditions de travail sur la santé cardiovasculaire, plus particulièrement sur la pression artérielle et les pathologies vasculaires périphériques, puis nous avons évalué les conséquences d'un événement coronaire sur la vie professionnelle. Méthodes : Des analyses par régressions linéaires et logistiques ajustées sur les caractéristiques individuelles (sexe, âge, facteurs de risques cardiovasculaires etc.) et les facteurs professionnels (physiques, organisationnels, psychosociaux) ont été conduites afin d'évaluer l'effet des conditions de travail sur l'évolution de la pression artérielle sur 5 ans et sur l'incidence de l'hypertension artérielle à partir de la cohorte prospective VISAT de travailleurs français. Deux revues systématiques de la littérature ont été menées. La première consiste en l'état des lieux de la relation entre conditions de travail et pathologies vasculaires périphériques (varices, maladies veineuses thromboemboliques, artériopathie oblitérante des membres inférieurs, anévrisme et dissection aortique). La seconde a permis d'estimer, à l'aide de méta-analyses, la prévalence du retour au travail après un événement coronaire et de rechercher les déterminants de ce retour. Résultats : Chez les personnes normo-tendues au début de l'étude VISAT, avoir un travail tendu (forte demande psychologique et faible latitude décisionnelle) était associé, après ajustement sur les caractéristiques individuelles, à une augmentation de la pression artérielle systolique 5 ans plus tard. Au contraire, la reconnaissance par l'entourage professionnel du travail effectué était associée à une diminution de la pression artérielle systolique et ce même après la prise en compte de l'exposition à de multiples contraintes professionnelles. Aucune contrainte professionnelle n'influait sur la survenue d'hypertension artérielle. La revue systématique de la littérature portant sur les pathologies vasculaires périphériques a permis de mettre en évidence un potentiel lien entre travailler longtemps debout et les varices, ainsi qu'entre rester assis de façon prolongée et les maladies veineuses thromboemboliques. Enfin, près de 20 % des personnes ayant présenté un événement coronaire ne retournait pas travailler. Le retour au travail semblait moins fréquent en cas de travail manuel ou nécessitant une activité physique professionnelle importante. Conclusion : Vie professionnelle et santé cardiovasculaires sont probablement liées, cependant des études supplémentaires demeurent indispensables afin d'approfondir les connaissances de l'impact des facteurs professionnels et ainsi permettre la mise en place de mesures de prévention sur le lieu de travail et une meilleure prise en charge.Background: Working involves dealing with several types of constraints related to the work environment. These constraints can influence health, and conversely health can have repercussions on working life. First, we studied the impact of occupational factors on cardiovascular health, more specifically on blood pressure and peripheral vascular diseases, then we evaluated the consequences of coronary events on work life. Methods: From the French prospective cohort VISAT, linear and logistic regression analyses adjusted on individual characteristics (sex, age, cardiovascular risk factors, etc.) and occupational factors (physical, organizational, psychosocial) were conducted to assess the effect of working conditions on the 5-year evolution of arterial pressure and on the incidence of high blood pressure. Two systematic reviews were carried out. First, we aimed to summarise of the relationship between working conditions and peripheral vascular pathologies (varicose veins, thromboembolic venous diseases, intermittent claudication, aortic aneurysm, and dissection). Secondly, using meta-analyses, we estimated the prevalence of return to work after a coronary event and investigated the determinants of this return. Results: In people with normal baseline blood pressure, high job strain (high psychological demand and low decision-making latitude) was associated, after adjustment for individual characteristics, with an increase in systolic blood pressure 5 years later. On the contrary, work recognition by peers was associated to a decrease in systolic blood pressure, even after considering the exposure to multiple professional constraints. No professional constraints influenced the occurrence of high blood pressure. The systematic review on peripheral vascular diseases revealed a potential link between prolonged standing at work and varicose veins, as well as between prolonged sitting and venous thromboembolic diseases. Finally, nearly 20% of people who presented with a coronary event did not return to work. Return to work seemed less frequent among manual workers or in jobs with high occupational physical activity. Conclusion: Work life and cardiovascular health are probably linked, however additional studies remain essential to expand the knowledge of the impact of occupational factors, thus allowing the implementation of preventive measures in the workplace and better management

One-Year Impact of COVID-19 Lockdown-Related Factors on Cardiovascular Risk and Mental Health: A Population-Based Cohort Study

Lockdown measures have obvious psychological impacts, which could, in turn, increase cardiovascular risk. We assessed the association between lockdown-related factors and the worsening of cardiovascular risk, incident anxiety and depression during 12 months&rsquo; follow-up. During lockdown (April&ndash;May 2020), 534 subjects, aged 50&ndash;89 years, were included in the PSYCOV-CV study (NCT04397835) and followed for up to 12 months post-lockdown. We found that participants with symptoms of depression during lockdown were more likely to report increased cardiovascular drug treatment (Odds-Ratio (OR) = 5.08 (1.78&ndash;14.5), p = 0.002), decreased physical activity (OR = 1.76 (1.10&ndash;2.82), p = 0.019) and weight gain (OR = 1.85 (1.08&ndash;3.17), p = 0.024) after lockdown. Moreover, changes in sleep patterns (OR = 2.35 (1.13&ndash;4.88), p = 0.022) or living in a rural area during lockdown (OR = 1.70 (0.96&ndash;3.03, p = 0.069) were associated with higher incident depression, whereas a better relationship with one&rsquo;s partner during lockdown was associated with less incident depression (OR = 0.56 (0.29&ndash;1.08), p = 0.084). Finally, we found that continuing to work during lockdown in a role requiring in-person contact with the public (such as cashiers, nurses or physicians) was associated with more incident anxiety after lockdown (OR = 3.38 (1.12&ndash;10.2), p = 0.031). Interestingly, decreased consumption of alcohol during lockdown was associated with less incident anxiety (OR = 0.30 (0.10&ndash;0.90), p = 0.032). Our study, conducted in a representative sample of an age group at increased risk of both cardiovascular disease and severe COVID-19, increases the understanding of modifiable factors associated with the health impacts of lockdown measures

Exposure to environmental occupational constraints and all-cause mortality: Results for men and women from a 20-year follow-up prospective cohort, the VISAT study. Be aware of shift-night workers!

International audienceOBJECTIVE: To determine the predictive value of the large panel of occupational constraints (OC) on all-cause mortality with a 20-year follow-up, in general population of workers. METHODS: In VISAT prospective cohort study, 3,138 workers (1,605 men; 1,533 women) were recruited during the periodic work health visits conducted by occupational physicians. OC (physical, organizational, psychological and employment categories) were collected through self-questionnaires. Exposure durations of each OC were divided by tertile distribution. Cox-regression models were performed to analyze the associations between all-cause mortality and each OC first separately and simultaneously in a single model. RESULTS: The mortality rates were higher among exposed participants to most of OC compared to those unexposed. Being exposed and longer exposure increased the risks of all-cause mortality for exposures to carrying heavy loads, loud noise, working more than 48 h/week, starting its first job before 18 years old although these risks became non-significant after adjustments for cardiovascular risk factors. Shift work and night work confirmed a high risk of mortality whatever the adjustments and notably when the other occupational exposures were taking into account, with, respectively: HR: 1.38 (1.01-1.91) and 1.44 (1.06-1.95). After adjustments being exposed more than 13 years to a work requiring getting-up before 5:00 a.m. and more than 16 years in rotating shift work significantly increased the risk of mortality by one and a half. CONCLUSION: The links between each OC and all-cause mortality and the role of individual factors were stressed. For night-shift workers, it is urgent to implement preventive strategies at the workplace

COMPARAISON DE LA PRISE EN CHARGE THÉRAPEUTIQUE DU SYNDROME CORONAIRE AIGU EN 2006 ET 2016 EN FRANCE ET ANALYSE DE SON IMPACT SUR LA LÉTALITÉ À 1 AN

Objectif – L’objectif du travail était de comparer la prise en charge thérapeutique des syndromes coronaires aigus (SCA) en 2016 par rapport à 2006 et d’estimer l’impact de cette évolution sur la létalité à 1 an par le calcul de la fraction préventive (FP).Méthodes – L’enquête portait sur des patients pris en charge en 2006 et 2016 pour un SCA incident dans les trois régions surveillées par les registres français des SCA. La FP des traitements a été estimée. Résultats – L’étude comprenait 2 023 patients en 2006 et 1 173 en 2016. À la phase aiguë, les taux d’angioplasties, de prescription d’antiagrégants de nouvelle génération et de statines ont augmenté en 10 ans. Après un épisode STEMI (ST-Segment Elevation Myocardial Infarction), la FP des angioplasties avec pose de stent actif est passée de 10% à 59% (+49%), et celle des antiagrégants a progressé de 86% à 98% (+12%). Après un épisode NSTEMI (Non-ST-Segment Elevation Myocardial Infarction), la FP des angioplasties avec stent actif a progressé pendant la période de 19% à 45% (+26%), et celle des antiagrégants de 62% à 95% (+33%). En sortie d’hospitalisation, les taux de prescription, déjà élevés en 2006, ont peu progressé, à l’exception de la rééducation fonctionnelle (+14% après un SCA STEMI). La FP des antiagrégants a augmenté de 57% à 78% en 2016 par rapport à 2006, après un SCA STEMI, en raison de leurs effets bénéfiques sur la létalité. La létalité à 1 an est restée stable, autour de 11%. Conclusion – Les taux de prescriptions des principaux traitements ont augmenté en 2016 par rapport à 2006, sans bénéfice notable sur la létalité à 1 an

Lower limb venous and arterial peripheral diseases and work conditions: systematic review

Objectives:The individual peripheral vascular disease risk factors are well documented, but the role of work conditions remains equivocal. This systematic review aims to assess relationships between lower limb peripheral venous diseases (lower limb varicose veins (LLVV), venous thromboembolism (VTE) comprising deep vein thrombosis and pulmonary embolism), peripheral arterial disease (intermittent claudication, aortic dissection, aortic aneurysm) and occupational constraints among working adults.Methods: Several databases were systematically searched until February 2019 for observational studies and clinical trials. Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was used for article selection. Quality assessment and risk of bias were evaluated using Strengthening the Reporting of Observational Studies in Epidemiology and Newcastle-Ottawa scales.Results:Among the 720 screened articles, 37 remained after full-text evaluation. Among the 21 studies on LLVV, prolonged standing was significantly associated to a higher risk of varicose veins with a threshold probably around >3 to 4 hours/day but exposure duration in years was not sufficiently considered. Seated immobility was often observed in workers, with no sufficient evidence to prove that prolonged sitting at work is related to VTE. Carrying heavy loads, stress at work and exposure to high temperatures have emerged more recently notably in relation to varicose veins but need to be better explored. Only three studies discussed the potential role of work on peripheral arterial disease development.Conclusions: Although some observational studies showed that prolonged standing can be related to varicose veins and that seated immobility at work could be linked to VTE, very little is known about peripheral arterial disease and occupational constraints. Clinical trials to determine preventive strategies at work are needed