Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women\u27s Health Initiative Study Findings

Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women\u27s Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611

Risk factor burden, heart failure, and survival in women of different ethnic groups insights from the women's health initiative

BACKGROUND: The higher risk of heart failure (HF) in African-American and Hispanic women compared with white women is related to the higher burden of risk factors (RFs) in minorities. However, it is unclear if there are differences in the association between the number of RFs for HF and the risk of development of HF and death within racial/ethnic groups. METHODS AND RESULTS: In the WHI (Women's Health Initiative; 1993-2010), African-American (n=11996), white (n=18479), and Hispanic (n=5096) women with 1, 2, or 3+ baseline RFs were compared with women with 0 RF within their respective racial/ethnic groups to assess risk of developing HF or all-cause mortality before and after HF, using survival analyses. After adjusting for age, socioeconomic status, and hormone therapy, the subdistribution hazard ratio (95% confidence interval) of developing HF increased as number of RFs increased (P<0.0001, interaction of race/ethnicity and RF number P=0.18)-African-Americans 1 RF: 1.80 (1.01-3.20), 2 RFs: 3.19 (1.84-5.54), 3+ RFs: 7.31 (4.26-12.56); Whites 1 RF: 1.27 (1.04-1.54), 2 RFs: 1.95 (1.60-2.36), 3+ RFs: 4.07 (3.36-4.93); Hispanics 1 RF: 1.72 (0.68-4.34), 2 RFs: 3.87 (1.60-9.37), 3+ RFs: 8.80 (3.62-21.42). Risk of death before developing HF increased with subsequent RFs (P<0.0001) but differed by racial/ethnic group (interaction P=0.001). The number of RFs was not associated with the risk of death after developing HF in any group (P=0.25; interaction P=0.48). CONCLUSIONS: Among diverse racial/ethnic groups, an increase in the number of baseline RFs was associated with higher risk of HF and death before HF but was not associated with death after HF. Early RF prevention may reduce the burden of HF across multiple racial/ethnic groups

Social isolation and incident heart failure hospitalization in older women: Women\u27s health initiative study findings

Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44 174 postmenopausal women of diverse race and ethnicity from the WHI (Women\u27s Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0 years, we analyzed data from 36 457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611

Haematological, Biochemical and Antioxidant Changes in Wistar Rats Exposed to Dichlorvos Based Insecticide Formulation Used in Southeast Nigeria

The indiscriminate use of pesticide is a treat to non-target organisms. This study evaluates the haematological and biochemical changes induced by inhalation of local Nigerian dichlorvos insecticide on rats. The rats were randomly assigned to a control group which received only food and water and a test group which, in addition to food and water, was exposed to the pesticide for a period of 4 h daily for 28 days, after which exposure was discontinued for seven days. Five animals were sacrificed from each group on days 1, 7, 14, 21, 28 and 35, and blood was collected by cardiac puncture for haematological, biochemical and antioxidant analysis. Results obtained showed lowered values of red blood cell count (RBC), packed cell volume (PCV), haemoglobin, mean cell haemoglobin (MCH) and mean cell haemoglobin concentration (MCHC) (p &lt; 0.05) with increased white blood cell count (WBC) and platelet counts after day 14 when compared to the control group. Liver enzymes aspartate amino transaminase (AST) and alanine amino transaminase (ALT) were higher in the exposed rats compared to the control group (p &lt; 0.05). Urea and creatinine concentrations increased significantly after day 1 and at day 28, while superoxide dismutase (SOD), gluthathione (GSH) and catalase (CAT) activity increased significantly compared to the control after day 1, day 14 and day 21, respectively. The RBC, PCV and haemoglobin values of all exposed rats were restored to normal following withdrawal of the pesticide, though AST, ALT, urea, creatinine and, glutathione values remained significantly high compared to the control. Inhalation of the local insecticide is toxic to the blood, liver and kidney of laboratory rats and may be deleterious to human health following long-term exposure

Yam and Moringa oliefera Seed Blend in Lipid Profile Disorders, Kidney and Liver Toxicities, in Alloxan Induced Diabetic Rats

Background and Aim: Diabetes mellitus is a chronic and very prevalent metabolic disease condition characterized by the abnormally high blood sugar level that eventually gives rise to diabetic complications affecting human and animals. Insulin deficiency increases free fatty acid influx and triglyceride levels into the blood, with reciprocal decrease in high-density lipoprotein (HDL) level. Numerous plants have in the past been screened for antidiabetic effects. Plants with medicinal property had served as anti-diabetic In this study; three yam varieties namely Dioscorea alata, Dioscorea cayennessis and Dioscorea rotundata sourced from Wuruku Market, Benue State Nigeria were evaluated for possible anti-diabetic effects. Methods: The collected Moringa seeds were processed into flour. Moringa oleifera seed 45 male albino rats assigned into 9 groups of 5 rats each were used for the study. Eight groups were induced with alloxan monohydrate and were confirmed to be diabetic after two days before treatment with Dioscorea alata control (100%) at 90% + 10% commercial feed, DA90%MRGA10% at (90%) +10% commercial feed, Dioscorea rotundata control (100%) at 90+10% commercial feed, DR90%MRGA10%, at (90%) +10% commercial feed, Dioscorea cayennesis control (100%) at 90% + 10% commercial. DC90%MRGA10% at (90%) +10%commercial feed, Moringa seed meal (100%) at 90% + 10% commercial feed, and 100% commercial feed. Both GRP8 (non-diabetic group) and GRP 9 (diabetic untreated group), were feed with rat Chow only. At the end of 28dys, the rats were sacrificed and the kidney, liver toxicities and lipid profile disorders were all investigated. Results: Result generated showed that diabetes caused liver, kidney toxicity and lipid disorder as evidence in the diabetic untreated groups (GRP9).Groups that received yam/moringa seed meal had significantly decreased (P&lt;0.05) triglycerides (TG), cholesterol (Chol), high density lipoprotein-cholesterol (HDL-C) and VLDL and Serum Liver level of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), Total protein, Albumin, Creatinine and Urea when compared with diabetic untreated group. Conclusion: A combination of Moringa seed flour and some yam species may be of value in the management of diabetes mellitus and its associated complications

Gastroprotective effects of methanol extract of Eremomastax speciosa leaf harvested in Southern part of Nigeria in rat

Gastric ulcer is one of the common cause of hospital consultation with an increasing prevalence worldwide and it is traditionally managed with herbal medicine in the developing countries. This study investigated the gastroprotective effects of methanol extract of Eremomastax speciosa leaf in rats. Cold maceration in 80% methanol was adopted during extract preparation while gas chromatography mass spectroscopy (GC-MS) was employed in the phytochemical analysis. The doses of 25, 50 and 100 mg/kg E. speciosa were used on ethanol-and indomethacin-induced gastric ulcer models in rats. The shay rat method was used to determine the effects of ESE on gastric acidity while the anticholinergic and antihistaminic activities were investigated on isolated rabbit jejunum ex vivo. The GC-MS analysis identified six bioactive compounds. Both ESE and cimetidine significantly (p < 0.05) reduced the severity of indomethacin- and ethanol-induced gastric injuries and gastric acid contents in Shay rats. The extract elicited concentration-dependent relaxation of isolated rabbit jejunum and reduced the contraction induced by both acetylcholine and histamine in the same tissue. The findings showed that ESE protected the rats against chemical-induced gastric ulcer through anticholinergic and antihistaminic mechanisms

Temporal trends in utilization and outcomes of transcatheter aortic valve replacement in different races: an analysis of the national inpatient sample.

AIM: We sought to determine the racial and ethnical disparities in the delivery of TAVR and to evaluate the in-hospital outcomes and utilization of TAVR stratified by patient ethnicity. METHOD: Using a national inpatient sample database between 2011 and 2015, we identified all adult patients who had TAVR. Races were identified and white race was set as control. Multiple logistic regression analysis was performed for the primary outcome of in-hospital mortality. RESULTS: Out of 58 174 patients who underwent TAVR, 50 809 (87.3%) were white, 2327 (4.0%) were black, 2311 (4.0%) were Hispanic, 640 (1.1%) Asian, 105 (0.2%) Native American and 1982 (3.4%) of other ethnicities. We found a statistically significant linear uptrend in the utilization of TAVR in patients of all races between the years 2011 and 2015. White, black, Hispanic and Native American patients had a downward linear trend for mortality during the studied years (P ≤ 0.005 for all). Black patients had lower in-hospital mortality [2.8 vs. 3.6%, odds ratio (OR) = 0.62; 95% confidence interval (CI) 0.44, 0.81 P < 0.001] compared with white patients, whereas Hispanic patients and Native Americans had higher in-hospital mortality compared with white patients (4.5% OR 1.26; 95% CI 1.01, 1.56 P = 0.041), (9.5% OR 4.44; 95% CI 2.25, 8.77 P < 0.001), respectively. CONCLUSION: Overall, TAVR utilization is associated with lower mortality. There is a rising trend in utilization of TAVR in the black population with a significantly favorable mortality trend compared with the white population

Social Isolation and Incident Heart Failure Hospitalization in Older Women: Women's Health Initiative Study Findings.

Background The association of social isolation or lack of social network ties in older adults is unknown. This knowledge gap is important since the risk of heart failure (HF) and social isolation increase with age. The study examines whether social isolation is associated with incident HF in older women, and examines depressive symptoms as a potential mediator and age and race and ethnicity as effect modifiers. Methods and Results This study included 44&nbsp;174 postmenopausal women of diverse race and ethnicity from the WHI (Women's Health Initiative) study who underwent annual assessment for HF adjudication from baseline enrollment (1993-1998) through 2018. We conducted a mediation analysis to examine depressive symptoms as a potential mediator and further examined effect modification by age and race and ethnicity. Incident HF requiring hospitalization was the main outcome. Social isolation was a composite variable based on marital/partner status, religious ties, and community ties. Depressive symptoms were assessed using CES-D (Center for Epidemiology Studies-Depression). Over a median follow-up of 15.0&nbsp;years, we analyzed data from 36&nbsp;457 women, and 2364 (6.5%) incident HF cases occurred; 2510 (6.9%) participants were socially isolated. In multivariable analyses adjusted for sociodemographic, behavioral, clinical, and general health/functioning; socially isolated women had a higher risk of incident HF than nonisolated women (HR, 1.23; 95% CI, 1.08-1.41). Adding depressive symptoms in the model did not change this association (HR, 1.22; 95% CI, 1.07-1.40). Neither race and ethnicity nor age moderated the association between social isolation and incident HF. Conclusions Socially isolated older women are at increased risk for developing HF, independent of traditional HF risk factors. Registration URL: http://www.clinicaltrials.gov; Unique identifier: NCT00000611