Ideal Cardiovascular Health Metrics Are Associated with Disability Independently of Vascular Conditions.

BACKGROUND:Vascular risk factors may be associated with disability independently of vascular events. We examined whether the American Heart Association's 7 ideal cardiovascular health (CVH) metrics were independently associated with disability in a nationally representative cohort. METHODS:Adults age ≥20 years from the National Health and Nutrition Examination Survey 2005-2012 were included. Ideal CVH was calculated as a composite of 7 measures, each scored 0-2. Primary predictors were number of ideal CVH metrics and score of CVH metrics. The outcome was a dichotomous score from 20 activities of daily living (ADL) and instrumental ADLs. Unadjusted and adjusted weighted logistic models estimated associations between ideal CVH and disability. The data were analyzed in 2015. RESULTS:Among 22692 participants, mean age was 46.9 years. Cardiac disease and stroke were present in 6.6% and 2.8%; 90.3% had poor physical activity and 89.9% poor diet. Among 3975 individuals with full CVH data, in fully adjusted models, OR for disability was 0.90 (95% CI 0.83-0.98) per point increase in ideal CVH score, and 0.84 (0.73-0.97) per additional number of ideal CVH metrics. CONCLUSIONS:CVH metrics were strongly and significantly associated with reduced odds of disability independently of vascular and non-vascular conditions. Poorer CVH may cause subclinical vascular disease resulting in disability

A Rare Sequela of Acute Disseminated Encephalomyelitis

Acute disseminated encephalomyelitis is a demyelinating disease, typically occurring in children following a febrile infection or a vaccination. Primary and secondary immune responses contribute to inflammation and subsequent demyelination, but the exact pathogenesis is still unknown. Diagnosis of acute disseminated encephalomyelitis is strongly suggested by temporal relationship between an infection or an immunization and the onset of neurological symptoms. Biopsy is definitive. In general, the disease is self-limiting and the prognostic outcome is favorable with anti-inflammatory and immunosuppressive agents. Locked-in syndrome describes patients who are awake and conscious but have no means of producing limb, speech, or facial movements. Locked-in syndrome is a rare complication of acute disseminated encephalomyelitis. We present a case of incomplete locked-in syndrome occurring in a 34-year-old male secondary to acute disseminated encephalomyelitis. Our case is unique, as acute disseminated encephalomyelitis occurred in a 34-year-old which was poorly responsive to immunosuppression resulting in severe disability

The association between ideal cardiovascular indicators and disability in unadjusted and adjusted models^†.

<p>The association between ideal cardiovascular indicators and disability in unadjusted and adjusted models<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0150282#t003fn001" target="_blank">^†</a>.</p

Definitions of the 7 ideal cardiovascular health factors.

<p>Definitions of the 7 ideal cardiovascular health factors.</p

Baseline demographics of study population^*.

<p>Baseline demographics of study population^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0150282#t002fn001" target="_blank">*</a>}.</p

Interactions between ideal cardiovascular health indicators and covariates^*.

<p>Interactions between ideal cardiovascular health indicators and covariates^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0150282#t004fn002" target="_blank">*</a>}.</p