American journal of preventive cardiology最新文献

{"title":"Relationships among fibrosis-4, triglyceride-glucose index, and cardiovascular disease: Evidence from the NHANES 2003-2018","authors":"Ziliang Ye,&nbsp;Manyun Long,&nbsp;Lang Li","doi":"10.1016/j.ajpc.2025.101014","DOIUrl":"10.1016/j.ajpc.2025.101014","url":null,"abstract":"<div><h3>Objective</h3><div>The Fibrosis-4 (FIB-4) index is linked to cardiovascular diseases (CVD), but the role of the triglyceride-glucose (TyG) index in this relationship remains unclear. This study evaluates the associations among FIB-4, TyG, and CVD-related outcomes, and explores whether TyG mediates these effects.</div></div><div><h3>Methods</h3><div>This cross-sectional and cohort study analyzed data from NHANES (2003–2018). Logistic regression and Cox proportional hazards models assessed the associations between FIB-4, TyG, CVD, and all-cause mortality (ACM). Restricted cubic spline (RCS) curves examined potential non-linear relationships, and mediation analysis tested TyG’s role in mediating the effect of FIB-4 on CVD and ACM.</div></div><div><h3>Results</h3><div>Among 19,119 participants, 2229 (9.28 %) were diagnosed with CVD. Individuals with FIB-4 levels above the median and elevated TyG levels (above the median) exhibited the highest risk of CVD (odds ratio = 6.02; 95 % CI: 3.60–10.06). Among CVD patients, those with elevated FIB-4 and TyG levels faced a substantially higher risk of ACM (HR = 2.98; 95 % CI: 1.75–5.09). RCS curves revealed a strong positive correlation between FIB-4, TyG, and both CVD and the risk of ACM. Mediation analysis revealed that TyG partially mediated the effect of FIB-4 on CVD incidence (mediation proportion: 31.82 %, P_indir &lt; 0.001), whereas TyG did not mediate the association between FIB-4 and ACM (mediation proportion: 1.28 %, P_indir = 0.91).</div></div><div><h3>Conclusion</h3><div>Elevated FIB-4 levels indirectly increase CVD risk via TyG, and combining both indices improve CVD and mortality prediction. These findings suggest that managing both liver fibrosis and insulin resistance could reduce CVD and mortality risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101014"},"PeriodicalIF":4.3,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144185078","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of life’s essential 8 score with incidence of atrial fibrillation: The Framingham heart study","authors":"Camilo Toro ,&nbsp;Ayelet Shapira Daniels ,&nbsp;Brenton Prescott ,&nbsp;Vanessa Xanthakis ,&nbsp;Matthew Nayor ,&nbsp;Priya Gajjar ,&nbsp;Emelia J Benjamin ,&nbsp;Sarah R Preis","doi":"10.1016/j.ajpc.2025.101018","DOIUrl":"10.1016/j.ajpc.2025.101018","url":null,"abstract":"<div><h3>Background</h3><div>Atrial fibrillation (AF) burden can be reduced by targeting modifiable risk factors. Limited data exist on the association between American Heart Association’s Life’s Essential 8 (LE8) score (higher scores healthier) and AF incidence.</div></div><div><h3>Methods</h3><div>We studied AF-free Framingham Heart Study Offspring and Omni 1 participants aged ≥45 years who attended ≥1 index exam in which LE8 components were assessed. LE8 scores were calculated incorporating body mass index, blood pressure, non-HDL cholesterol, glucose, smoking, physical activity, diet, and sleep. Fine-Gray hazards models, accounting for the competing risk of death, were used to calculate subdistribution hazards ratios (sHR) for the association of LE8 score and its components with 10-year AF incidence.</div></div><div><h3>Results</h3><div>We included 3161 unique participants (<em>n</em> = 4628 index exams, 57 % women, mean age 65±9 years). Participants were classified as having “ideal” (LE8≥80; 16 % [<em>n</em> = 763 exam cycles]), “intermediate” (LE8 50–79; 76 % [<em>n</em> = 3519]), or “poor”(LE8&lt;50; 7 % [<em>n</em> = 346]) cardiovascular health. There were 410 incident AF events (10.4/1000 person-years). Compared with “ideal”, a “poor” LE8 score was associated with higher AF risk (sHR,1.78; 95 %CI, 1.20–2.64; <em>p</em> = 0.004); we did not observe a statistically significant association comparing participants with “intermediate” LE8 scores to those with “low” LE8 scores with regards to AF risk. Higher LE8 scores (healthier; continuous) were associated with lower AF risk (sHR per 1-SD increase increment of LE8 score, 0.80; 95 %CI, 0.72–0.90; <em>p</em> &lt; 0.0001).</div></div><div><h3>Conclusions</h3><div>Lower LE8 scores were associated with greater risk of developing AF. Future studies of the role of LE8 in reducing AF burden in the overall population are warranted.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"23 ","pages":"Article 101018"},"PeriodicalIF":4.3,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The interactions of Lipoprotein(a) with common cardiovascular risk factors in cardiovascular disease risk: evidence based on the UK Biobank","authors":"Linjun Ao ,&nbsp;Raymond Noordam ,&nbsp;J Wouter Jukema ,&nbsp;Diana van Heemst ,&nbsp;Ko Willems van Dijk","doi":"10.1016/j.ajpc.2025.101008","DOIUrl":"10.1016/j.ajpc.2025.101008","url":null,"abstract":"<div><h3>Background</h3><div><strong>:</strong> Although Lipoprotein(a) (Lp(a)) is associated with cardiovascular disease, it is unclear whether the associated risk is similar in the presence of other concomitant risk factors. Here, we aimed to investigate the interactions between Lp(a) and common cardiovascular risk factors on coronary artery disease (CAD), calcific aortic valve stenosis (CAVS) and ischemic stroke (IS).</div></div><div><h3>Methods</h3><div><strong>:</strong> We included 127,958 unrelated European-ancestry participants from UK Biobank (54.7 % women) with data available on Lp(a) and without a baseline history of CAD, CAVS and IS. Multivariable-adjusted Cox proportional hazards interaction models were used to study whether the associations of Lp(a) with outcomes varied based on the level of total cholesterol (Total-C), low-density lipoprotein-cholesterol (LDL-C), triglycerides (TG) and other cardiovascular risk factors.</div></div><div><h3>Results</h3><div><strong>:</strong> Higher Lp(a) levels were associated with higher risks of CAD, CAVS and IS. Per 10 mg/dL increase in Lp(a), hazard ratios [95 % confidence interval] were 1.05 [1.04, 1.06], 1.06 [1.04, 1.09], and 1.01 [0.99, 1.03] for CAD, CAVS and IS, respectively. For CAD, interactions were observed between Lp(a) and Total-C (<em>P_interaction</em>=0.001), LDL-C (<em>P_interaction</em>=4e-4) and TG (<em>P_interaction</em>=0.026). In more detail, participants with Lp(a) ≥ 50 mg/dL in the highest quartile of Total-C, LDL-C and TG showed evidence of additive interaction in CAD, with relative excess risk due to interaction (RERI) of 0.42 (0.17, 0.67), 0.44 (0.18, 0.71), and 0.39 (0.12, 0.67), respectively. No such interactions were observed in CAVS and IS.</div></div><div><h3>Conclusions</h3><div>Lp(a)-associated CAD risk seems to particularly affect those having levels of Total-C, LDL-C and TG above the thresholds from clinical guidelines.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101008"},"PeriodicalIF":4.3,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The aspirin heart disease prevention conundrum","authors":"H. Robert Superko,&nbsp;John Sninsky,&nbsp;Brenda Garrett","doi":"10.1016/j.ajpc.2025.101013","DOIUrl":"10.1016/j.ajpc.2025.101013","url":null,"abstract":"<div><div>The use of daily aspirin in a primary prevention population to reduce cardiovascular disease event risk is a conundrum because the reduction in cardiovascular event risk is balanced by an equal increase in the risk of a serious gastrointestinal bleed. This conundrum can be partially clarified by genetic testing for <em>LPA</em> polymorphisms. A genetic polymorphism in the apolipoprotein (a) component of lipoprotein (a) has been identified that could help identify patients who may benefit the most from daily aspirin in regard to coronary heart disease event reduction. Recent clinical trials have demonstrated that carriers of the <em>LPA</em> variant (rs3798220) have a significantly greater risk for a coronary heart disease event compared to non-carriers. However, in carriers of the <em>LPA</em> variant randomized to aspirin, the incidence of major coronary heart disease events was reduced to the same level as subjects who did not have the <em>LPA</em> variant. This provides a clinically available tool that may allow identification of a subset of primary prevention patients who derive more cardiovascular risk reduction from daily aspirin than the risk of a serious gastrointestinal bleed. This provides an inexpensive treatment options for patients with the <em>LPA</em> variant.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101013"},"PeriodicalIF":4.3,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144154583","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Carotid intima-media thickness, cardiovascular disease, and risk factors in 29,000 UK Biobank adults","authors":"Sayan Mitra ,&nbsp;Raaj Kishore Biswas ,&nbsp;Petra Hooijenga ,&nbsp;Sophie Cassidy ,&nbsp;Andrea Nova ,&nbsp;Isabella De Ciutiis ,&nbsp;Tian Wang ,&nbsp;Cynthia M Kroeger ,&nbsp;Emmanuel Stamatakis ,&nbsp;Andrius Masedunskas ,&nbsp;Raffaele De Caterina ,&nbsp;Maria L Cagigas ,&nbsp;Luigi Fontana","doi":"10.1016/j.ajpc.2025.101011","DOIUrl":"10.1016/j.ajpc.2025.101011","url":null,"abstract":"<div><h3>Importance</h3><div>Atherosclerotic cardiovascular disease remains the leading cause of global morbidity and mortality. Identifying early markers of subclinical atherosclerosis is critical for predicting major adverse cardiovascular events (MACE) and improving prevention strategies. Carotid intima-media thickness (cIMT) is a well-established surrogate marker of atherosclerosis, but the impact of cardiometabolic risk factor burden on cIMT and future MACE risk is not fully understood.</div></div><div><h3>Objective</h3><div>To assess the association between cIMT and the risk of MACE, and to evaluate the relationship between a composite cardiometabolic-risk biomarker index and cIMT as well as future MACE risk.</div></div><div><h3>Design</h3><div>Prospective cohort study using data from the UK Biobank, with a median follow-up of 4.3 years.</div></div><div><h3>Setting</h3><div>Population-based study of 29,292 participants from the UK Biobank.</div></div><div><h3>Participants</h3><div>Men and women aged 40 to 69 years (n=29,292) free from cardiovascular disease at baseline. Exclusions were made for those with prior coronary heart disease, myocardial infarction, and heart failure.</div></div><div><h3>Exposures</h3><div>Carotid intima-media thickness (cIMT) measured at baseline. A composite cardiometabolic-risk biomarker index (CRBI) was developed using HbA1c, total cholesterol ratio, and blood pressure.</div></div><div><h3>Main Outcomes and Measures</h3><div>The primary outcomes were the risk of MACE, including coronary heart disease (CHD), myocardial infarction (MI), and heart failure (HF). The association between cIMT, CRBI, and the risk of these events was evaluated using hazard ratios (HRs) and adjusted for confounders.</div></div><div><h3>Results</h3><div>Higher cIMT values (&gt;800 µm) were predictive of increased risk for CHD (HR: 2.15 at 800 µm; 95 % CI: 1.07-4.31) and MI (HR: 2.46 at 800 µm; 95 % CI: 0.93-6.53). The cumulative burden of cardiometabolic risk factors, as measured by the CRBI score, was significantly associated with increased cIMT (β=44.38 µm for very high CRBI score; 95 % CI: 38.25-50.51; <em>p</em> &lt; 0.001) and future MI risk (HR: 10.43 for very high CRBI score; 95 % CI: 3.18-34.24). Lifestyle factors such as smoking and physical activity were also correlated with higher cIMT, particularly in males.</div></div><div><h3>Conclusions</h3><div>Carotid intima-media thickness is a strong predictor of coronary heart disease and myocardial infarction. The cumulative cardiometabolic-risk biomarker index offers additional predictive value for subclinical atherosclerosis and future cardiovascular events. These findings underscore the importance of comprehensive cardiometabolic health in CVD prevention strategies.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101011"},"PeriodicalIF":4.3,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144167562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance of PREVENT and pooled cohort equations for predicting 10-Year ASCVD risk in the UK Biobank","authors":"Matthew Ambrosio ,&nbsp;Pamela L. Alebna ,&nbsp;Terence Lee ,&nbsp;Alec Friedman ,&nbsp;Nicholas WS Chew ,&nbsp;Carolyn Burns ,&nbsp;Phillip Duncan ,&nbsp;W. Gregory Hundley ,&nbsp;Le Kang ,&nbsp;Anurag Mehta","doi":"10.1016/j.ajpc.2025.101009","DOIUrl":"10.1016/j.ajpc.2025.101009","url":null,"abstract":"<div><h3>Background</h3><div>The Pooled Cohort Equations (PCE) were created in 2013 to assess ASCVD risk in primary prevention. In 2023 the American Heart Association published the PREVENT equations to assess the risk of cardiovascular disease in primary prevention. The comparative performance of PCE and PREVENT for predicting 10-year ASCVD risk has not been evaluated in an external large-scale epidemiologic cohort.</div></div><div><h3>Methods</h3><div>The study population includes participants of the UK Biobank who were free of clinical cardiovascular disease. 10-year ASCVD risk was calculated using the PCE and PREVENT equations. Harrel’s C-Statistics and delta C-Statistics were calculated for males and females to evaluate risk discrimination. Predicted 10-year risks were divided into deciles as well as risk groups for each equation and stratified by sex to compare predicted risk versus observed risk within each risk group, with calibration slopes calculated by decile. Sensitivity and specificity were also analyzed to assess statin eligibility.</div></div><div><h3>Results</h3><div>The final cohort was 368,125 individuals ages 40–73 (mean age 56.2, 54.7 % female, 94.0 % white). The C-statistics for PCE were 0.729 (0.722–0.736) for females and 0.688 (0.683–0.693) for males; C-Statistics for PREVENT were 0.728 (0.721–0.735) for females and 0.687 (0.682–0.692) for males, with delta C-Statistics being 0.001 (<em>p</em> = 0.87) for females and 0.001 (<em>p</em> = 0.82) for males. Predicted risks were closer to observed risks for PREVENT as compared to PCE, and PREVENT tended to estimate lower risk (mean risk of 4.6 % compared to 8.3 % for PCE). PREVENT demonstrated higher specificity but lower sensitivity than PCE using the current 7.5 % risk threshold for statin eligibility, and a Youden index of 4.5 % risk was found for PREVENT.</div></div><div><h3>Conclusions</h3><div>There is no significant difference in 10-year ASCVD risk discrimination between PCE and PREVENT equations. However, the PREVENT equations demonstrate better calibration in the UK Biobank.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101009"},"PeriodicalIF":4.3,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144131337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Machine learning applied to wearable fitness tracker data and the risk of hospitalizations and cardiovascular events","authors":"John Kundrick,&nbsp;Aditi Naniwadekar,&nbsp;Virginia Singla,&nbsp;Krishna Kancharla,&nbsp;Aditya Bhonsale,&nbsp;Andrew Voigt,&nbsp;Alaa Shalaby,&nbsp;N.A. Mark Estes,&nbsp;Sandeep K Jain,&nbsp;Samir Saba","doi":"10.1016/j.ajpc.2025.101006","DOIUrl":"10.1016/j.ajpc.2025.101006","url":null,"abstract":"<div><div>Background: Wearable fitness trackers generate extensive physiological and activity data, offering potential to monitor health and predict outcomes. Machine learning (ML) techniques applied to these data may enable early identification of adverse health conditions, such as hospitalizations and development of cardiovascular diseases (CVD). This study aimed to evaluate ML models' ability to forecast the incidence of (1) hospitalizations from any cause and (2) of new diagnosis of CVD, including a composite of heart failure (HF), coronary artery disease or myocardial infarction (CAD-MI), cardiomyopathy (CMP), and atrial fibrillation (AF). Method and Results: Data from 14,157 participants in the All of Us study that included both Fitbit and electronic health record (EHR) information were censored on the date preceding events and analyzed using various ML classifiers for extracted feature data. Performance metrics included accuracy, area under the receiver operating characteristic (AUROC) curve, and F1 scores. Our overall study population was young (median age 54 years), with good representation of women (67%). For hospitalizations, a Random Forest classifier achieved the best performance (AUROC=0.95, accuracy=0.99, F1 score=0.92). For the CVD events, the best prediction model was gradient boosting (AUROC=0.80, accuracy=0.71, F1 score=0.15).</div><div>Conclusion: ML models applied to Fitbit data demonstrate promise in predicting clinical outcomes with strong performance for predicting all-cause hospitalizations and modest performance for predicting incident CVD. Wearable technology could play a role in risk assessment and patient management.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101006"},"PeriodicalIF":4.3,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144108103","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cost-effectiveness of cardiovascular risk assessment and management among adults with hypertension in China: A modelling study","authors":"Siqi Lin ,&nbsp;Liming Lin ,&nbsp;Wenyao Peng ,&nbsp;Xuan Liu ,&nbsp;Xi Li ,&nbsp;Jiapeng Lu ,&nbsp;Shouling Wu","doi":"10.1016/j.ajpc.2025.101007","DOIUrl":"10.1016/j.ajpc.2025.101007","url":null,"abstract":"<div><h3>Objective</h3><div>Blood pressure reduction alone is insufficient for significant cardiovascular risk improvement in patients with hypertension. Cardiovascular risk assessment and management are recommended to prevent and control cardiovascular diseases (CVD), but their cost-effectiveness in real-world Chinese settings is unclear. This study evaluated the benefits and cost-effectiveness of two strategies based on cardiovascular risk in Chinese hypertensive patients aged ≥35 years: statin treatment and lifestyle management + statin treatment.</div></div><div><h3>Methods</h3><div>A decision-analytic Markov cohort model was constructed to estimate health benefits and incremental cost-effectiveness ratios between two interventions and no intervention over 10-year and lifetime horizons. Parameters including stroke/myocardial infarction (MI) incidence, all-cause mortality, costs, and health utilities were extracted from the Kailuan study, published literature, or public datasets. Sensitivity analyses assessed the influence of parameter uncertainty on the results of base-case analysis.</div></div><div><h3>Results</h3><div>Statin treatment alone in hypertensive patients with high cardiovascular risk was projected to avert 847,350 stroke cases, 1412,250 MI cases and 564,900 all-cause deaths over a 10-year time horizon. Lifestyle management combined with statin treatment could prevent more cardiovascular and death events and was highly cost-effective ($1219.76/quality-adjusted life-year vs. gross domestic product per capita $12,680.83). Over a lifetime horizon, it was highly cost-effective regardless of the age when the combined intervention was started, with earlier initiation yielding greater benefits in preventing cardiovascular events. Sensitivity analyses confirmed robust results.</div></div><div><h3>Conclusion</h3><div>Cardiovascular risk assessment and combined management in hypertensive individuals aged ≥35 years would generate substantial health gains and represent a highly cost-effective CVD prevention strategy in China.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101007"},"PeriodicalIF":4.3,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144071183","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Causal relationship between physical activity, sleep duration, sedentary behavior, and hypertension: A Mendelian randomisation study","authors":"Chunmei Wang ,&nbsp;Jianting Zeng ,&nbsp;Hongduan Liu ,&nbsp;Li Zhang","doi":"10.1016/j.ajpc.2025.101005","DOIUrl":"10.1016/j.ajpc.2025.101005","url":null,"abstract":"<div><h3>Background</h3><div>Lifestyle behaviors may be an important means of preventing hypertension. The causal relationship between physical activity, sleep duration, sedentary behavior, and hypertension remains unclear. The aim of this study was to examine these associations by using Mendelian randomization (MR) analysis.</div></div><div><h3>Materials and methods</h3><div>Single nucleotide polymorphisms associated with sedentary behavior patterns (including length of mobile phone use, time spent driving, time spent watching television, and time spent playing computer games), duration of walks, sleep duration, and moderate-to-vigorous intensity physical activity (MVPA) at genome-wide significance (<em>P</em> &lt; 5 × 10^–8) were selected as instrumental variables (IVs) from a genome-wide association study. These IVs represented exposure factors in the subsequent analysis. Summary statistics for hypertension were obtained from the FinnGen Biobank study. In MR analysis, inverse-variance weighting (IVW), weighted median, and MR-Egger regression were employed for causal inference. In addition, multivariate MR analysis was applied to explore the potential confounding effects of smoking and education on the causal relationships between exposure factors and hypertension. A mediation analysis was conducted to assess whether body mass index (BMI) and waist-hip ratio (WHR) mediated the associations between exposure factors and hypertension.</div></div><div><h3>Results</h3><div>The IVW analysis indicated that increased time spent watching television was associated with an increased risk of hypertension (OR: 1.831; 95 %CI: 1.482–2.262; <em>P</em> = 1.99E-08). The multivariate MR analysis demonstrated that the effect of television viewing time on hypertension remained significant after adjusting for smoking. However, after adjusting for education level, no significant association was observed between television viewing time and hypertension. Mediation analysis revealed that BMI and WHR mediated the causal relationship between television viewing time and hypertension. Genetically predicted other sedentary behavior factors, duration of walks, sleep duration, and MVPA were not significantly associated with hypertension.</div></div><div><h3>Conclusion</h3><div>In conclusion, this MR study revealed that a lifestyle of increased time spent watching television may contribute to an elevated risk of hypertension.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101005"},"PeriodicalIF":4.3,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143948623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between arterial stiffness and MASLD in US young adults: base on NHANES 2005-2018","authors":"Qing-zhong Li ,&nbsp;Jia-xin Tan ,&nbsp;Quan-Zhi Qin ,&nbsp;Guo-tian Ruan ,&nbsp;Teng Deng ,&nbsp;Yi-zhen Gong","doi":"10.1016/j.ajpc.2025.101003","DOIUrl":"10.1016/j.ajpc.2025.101003","url":null,"abstract":"<div><h3>Background</h3><div>Metabolic dysfunction-associated steatotic liver disease (MASLD) impacts &gt;30 % of the world's population, imposing significant societal and familial burdens. Arterial stiffness is a known risk factor for various metabolic disorders, and early-onset MASLD may be linked to heightened arterial stiffness. However, studies investigating the link between arterial stiffness and MASLD are limited.</div></div><div><h3>Methods</h3><div>This study utilized data from the NHANES database, focusing on young adults aged 20 to 45 years, spanning from 2005 to 2018. The Fatty Liver Index (FLI) was used to diagnose MASLD, and the estimated Pulse Wave Velocity (ePWV) was utilized to assess arterial stiffness. The association between MASLD and arterial stiffness was analyzed using weighted multiple logistic regression models and restricted cubic splines. Sensitivity analyses were performed to evaluate the stability of the observed relationship.</div></div><div><h3>Results</h3><div>The study included 5 522 participants, with 3 415 serving as controls and 2 107 diagnosed with MASLD. The two groups differed significantly in age, income, and comorbidities, including hypertension and diabetes. The mean ePWV was 6.79 (<em>SD</em> = 0.71) in the MASLD group and 6.33 (<em>SD</em> = 0.57) in the control group, respectively. Adjusted weighted logistic regression models revealed that individuals in the high ePWV group (ePWV ≥ 6.559) had a 2.39-fold increased risk of onset compared to those in the low ePWV group (ePWV &lt; 6.559), with statistical significance (<em>P</em> &lt; 0.05). Restricted cubic splines (RCS) also demonstrated a positive linear correlation between ePWV and MASLD. Sensitivity analysis validated the strong correlation between ePWV and MASLD, while subgroup analysis demonstrated a positive association between ePWV and MASLD across most subgroups (OR &gt; 1).</div></div><div><h3>Conclusion</h3><div>The study indicates a strong association between arterial stiffness, as measured by ePWV, and MASLD in young adults. The results suggest that targeting arterial stiffness could aid in preventing and managing MASLD.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 101003"},"PeriodicalIF":4.3,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143906591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}