Age- and sex- specific all-cause mortality risk greatest in metabolic syndrome combinations with elevated blood pressure from 7 U.S. cohorts

Background The association between metabolic syndrome (MetS) and all-cause mortality is well established but it is unclear if there are differences in mortality risk among the 32 possible MetS combinations. Hence, the purpose of this study is to evaluate the associations between different MetS combinations and its individual components with all-cause mortality, and to examine differences in the association by age and sex. Methods A merged sample of 82,717 adults from 7 U.S. cohorts was used. Results In our sample, MetS was present in 32% of men, 34% of women, 28% of younger adults (18–65 years) and 62% of older adults (>65 years) with 14,989 deaths over 14.6 ± 7.4 years of follow-up. Risk of all-cause mortality was higher in younger individuals with a greater number of MetS factors present, but in older adults having all 5 MetS factors was the only combination significantly associated with mortality. Regardless of age or sex, elevated blood pressure was the MetS factor most consistently present in MetS combinations that were significantly and most strongly associated with mortality. In fact, elevated blood pressure in the absence of other risk factors was significantly associated with mortality in men (HR, 95% CI = 1.56, 1.33–1.84), women (HR = 1.62, 1.44–1.81) and younger adults (HR = 1.61, 1.45–1.79). Conversely, waist circumference, glucose and triglycerides in isolation were not associated with mortality (p>0.05). Conclusion In a large U.S. population, different combinations of MetS components vary substantially in their associations with all-cause mortality. Men, women and younger individuals with MetS combinations including elevated blood pressure had stronger associations with greater mortality risk, with minimal associations between MetS and mortality risk in older adults. Thus, we suggest that future algorithms may wish to consider differential weighting of these common metabolic risk factors, particularly in younger populations.York University Librarie

Trends in medication use by body mass index and age between 1988 and 2012 in the United States.

Whether the increase in prescription medication use over time differs by age and obesity status is unclear.National Health and Nutrition Examination Survey (NHANES) between 1988 and 2012 was analyzed (n = 57,543).Increased medication use over time was seen in older individuals of all body mass index (BMI) classes, with the most prominent increase in those with obesity (p0.05).Older individuals of all BMI classes may be driving the increase in medication use over time. However, the rise in the likelihood of taking cardiometabolic medications over time was generally not different between those with or without obesity in men with some increases seen in older women. Further research may be required to assess accessibility and barriers to medication use among certain demographics

Do Moderate to Vigorous Intensity Accelerometer Count Thresholds Correspond to Relative Moderate to Vigorous Intensity Physical Activity?

OBJECTIVESː We aim to predict %VO2max at absolute accelerometer thresholds, and estimate and compare durations of objective physical activity (PA) among body mass index (BMI) categories using thresholds that account for cardiorespiratory fitness. METHODSː 828 adults (53.5% male, age= 33.9±0.3 years) from NHANES 2003-2004 were analyzed. MET values at absolute thresholds were converted to %VO2max, and accelerometer counts corresponding to 40 or 60% VO2max were determined using 4 energy expenditure prediction equations. RESULTSː Absolute thresholds under-estimated PA intensity for all adults; however, individuals with overweight and obesity work at significantly higher %VO2max at the absolute thresholds, and require significantly lower accelerometer counts to reach relative moderate and vigorous PA intensities compared to normal weight due to lower fitness (PThe accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author

Odd ratios for prevalent medication class by age and time in men and women.

<p>The reference groups are older individuals (men and women separately) in the year 1988. For simplicity, only 3 of 7 years are shown. Models adjusted for ethnicity and education. *: Significantly different within age and sex group in 1988.</p

Odd ratios for prevalent antihypertensive and antidiabetics use in women by BMI, age and time.

<p>Both young and older women with obesity are more likely to be taking these medications over time, with the effect of time being significantly larger in older women. Models adjusted for ethnicity and education. Underweight sample was removed from the analyses. *: Significantly different from the reference group. †: Significantly different within the BMI category in 1988. ‡: Significantly different from the normal weight within the time period.</p

Baseline characteristics of US adults by NHANES surveys.

<p>Baseline characteristics of US adults by NHANES surveys.</p