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BACKGROUND/OBJECTIVES: To examine the association between the different definitions of metabolic syndrome (MetS) and the prediction of incident cardiovascular disease (CVD) and mortality events and to determine whether the concept of MetS adds to traditional risk factors among elderly Iranians. SUBJECTS/METHODS: The association between MetS and outcomes was examined in 922 adults aged ≥ 65 years, free of CVD at baseline, using multivariate Cox proportional hazards models. To examine whether MetS could enhance prediction of outcomes beyond that achieved by risk factors; the net reclassification improvement index was used. RESULTS: During a median follow-up of 9.9 years, 207 CVD events and 193 deaths (82 CVD deaths) occurred. World health organization (WHO) and the joint interim statement (JIS) definitions were shown to be the strongest predictors of CVD events. The WHO definition predicted CVD and all-cause mortality events (hazard ratio (HR) = 1.55 (95% confidence interval (CI) = 1.15-2.09) and 2.08 (95% CI = 1.23-3.51), respectively) and the JIS definition showed a risk for CVD mortality (HR=1.65 (95% CI = 1.03-2.65)). Different definitions of MetS did not add to traditional risk factors in the prediction of different outcomes. CONCLUSIONS: The WHO definition was the strongest predictor of CVD and mortality outcomes; however, none of the MetS definitions provided added value to traditional risk factors. European Journal of Clinical Nutrition (2014) 68, 853-858;doi: 10.1038/ejcn.2014.91; published online 28 May 2014, INTRODUCTION Metabolic syndrome (MetS) refers to a clustering of subclinical metabolic abnormalities including central obesity, elevated blood pressure (BP), hyperglycemia, and dyslipidemia, which its association with increased risk of cardiovascular [...]

BACKGROUND/OBJECTIVES: Endothelial dysfunction, which can be manifested by loss of nitric oxide bioavailability, is an increasingly recognized cause of cardiovascular diseases. Previous studies showed that diets affect endothelial function and modify cardiovascular risks. This study aimed to assess the effects of Ramadan fasting, as a diet intervention, on endothelial function. SUBJECTS/METHODS: The study population consisted of 21 male patients (mean age: 52[+ or -]9 years) with cardiovascular risks (coronary artery disease, cerebrovascular or peripheral arterial diseases). The biochemical variables in serum of patients were measured 2 days before and after Ramadan fasting. The levels of asymmetric dimethylarginine (ADMA) and vascular endothelial growth factor (VEGF) were evaluated using the enzyme-linked immunosorbent assay. Nitric oxide (NO) and Malondialdehyde (MDA) levels were measured by the Griess and thiobarbituric acid reaction substances assay, respectively. RESULTS: NO levels in patients after Ramadan fasting were significantly higher compared with the baseline value (85.1 [+ or -]11.54 vs 75.8 [+ or -]10.7 [micro]mol/l) (P < 0.05). Post-Ramadan levels of ADMA decreased significantly in comparison with pre-Ramadan levels (802.6 [+ or -] 60.9 vs 837.6 [+ or -] 51.0 nmol/l) (P < 0.05). In addition, the levels of VEGF and MDA changed during Ramadan fasting, but these changes were not statistically significant (228.1 [+ or -] 27.1 vs 222.7 [+ or -] 22.9 pg/ml and 3.2 [+ or -]0.7 vs 3.6 [+ or -]1.1 [micro]mol/l, respectively). CONCLUSIONS: Ramadan fasting may have beneficial effects on endothelial function and can modulate cardiovascular risks. Further studies are needed to confirm the clinical significance of Ramadan fasting on cardiovascular health. doi:10.1038/ejcn.2014.61;published online 23 April 2014, INTRODUCTION Ramadan is a lunar month during which Muslims are prescribed fasting for moral and spiritual reasons. As more than one billion people worldwide believe in Islam, it is estimated [...]

BACKGROUND/OBJECTIVES: Although high or low (no) meat consumption was associated with elevated or reduced mortality from cardiovascular disease, respectively, few studies have investigated the association between moderate meat consumption and cardiovascular disease. We aimed to evaluate the associations between moderate meat consumption and cardiovascular disease mortality. SUBJECTS/METHODS: We conducted a prospective cohort study of 51 683 Japanese (20466 men and 31 217 women) aged 40-79 years living in all of Japan (The Japan Collaborative Cohort Study; JACC Study). Consumptions of meat (beef, pork, poultry, liver and processed meat) were assessed via a food frequency questionnaire administrated at baseline survey. Hazard ratios (HRs) of mortality from cardiovascular disease were estimated from Cox proportional hazards regression models according to quintiles of meat consumption after adjustment for potential confounding variables. RESULTS: During 820076 person-years of follow-up, we documented 2685 deaths due to total cardiovascular disease including 537 ischemic heart diseases and 1209 strokes. The multivariable HRs (95% confidence interval) for the highest versus lowest quintiles of meat consumption (77.6 versus 10.4 g/day) among men were 0.66 (0.45-0.97) for ischemic heart disease, 1.10 (0.84-1.43) for stroke and 1.00 (0.84-1.20) for total cardiovascular disease. The corresponding HRs (59.9 versus 7.5 g/day) among women were 1.22 (0.81-1.83), 0.91 (0.70-1.19) and 1.07 (0.90-1.28). The associations were similar when the consumptions of red meat, poultry, processed meat and liver were examined separately. CONCLUSION: Moderate meat consumption, up to ~100 g/day, was not associated with increased mortality from ischemic heart disease, stroke or total cardiovascular disease among either gender. European Journal of Clinical Nutrition (2012) 66, 687-693; doi: 10.1038/ejcn.2012.6; published online 15 February 2012 Keywords: meat; cardiovascular diseases; ischemic heart disease; stroke; mortality; prospective study, INTRODUCTION Meat is a major protein source for humans. (1) Unlike fish or beans, however, meat in particular red or processed meat is often considered to be unhealthy because of [...]

BACKGROUND: In June 2008, burning peat deposits produced haze and air pollution far in excess of National Ambient Air Quality Standards, encroaching on rural communities of eastern North Carolina. Although [...]

Background. Older women experience disability more commonly than their male peers. This disparity may be due, in part, to sex-based differences in the prevalence or the disabling effects of common medical conditions. The objectives of this analysis were to (a) quantify the extent to which excess disability in women is explained by higher prevalence of selected medical conditions and (b) evaluate whether the same conditions have differing effects on disability in men and women. Methods. We analyzed cross-sectional data from 5,888 community-dwelling older men and women. Disability was defined as difficulty with greater than or equal to one activity of daily living. Thirteen medical conditions were assessed by self-report, testing, or record review. Results. Controlling for age, race, education, and marital status, women were more likely to experience disability (odds ratio = 1.70, 95% confidence interval = 1.36-2.11). Higher prevalence of arthritis and obesity in women explained 30.2% and 12.9%, respectively, of the sex-based difference in disability rates, whereas male prevalent diseases like vascular conditions and emphysema narrowed the disability gap. Women with arthritis, bearing problems, coronary artery disease, congestive heart failure, stroke, and claudication were more likely to exhibit disability compared with men with the same conditions (p < .001). Conclusions. Efforts to lessen sex-based inequality in disability should focus on reducing the prevalence of arthritis and obesity. Future generations may see greater functional disparity if rates of vascular disease and emphysema rise among women. Several conditions were more often associated with disability in women, suggesting additional sex-based differences in the disablement process. Key Words: Comorbidity--Disability--Gender--Function--Disparity. doi: 10.1093/gerona/glq139

Objectives. We assessed changes in cardiovascular disease--related health outcomes and risk factors among American Indians and Alaska Natives by age and gender. Methods. We used cross-sectional data from the 1995 to 1996 and the 2005 to 2006 Behavioral Risk Factor Surveillance System. The respondents were 2548 American Indian and Alaska Native women and men aged 18 years or older in 1995-1996 and 11 104 women and men in 2005-2006. We analyzed the prevalence of type 2 diabetes, obesity, hypertension, cigarette smoking, sedentary behavior, and low vegetable or fruit intake. Results. From 1995-1996 to 2005-2006, the adjusted prevalence of diabetes among American Indians and Alaska Natives increased by 26.9%, from 6.7% to 8.5%, and obesity increased by 25.3%, from 24.9% to 31.2%. Hypertension increased by 5%, from 28.1% to 29.5%. Multiple logistic models showed no meaningful changes in smoking, sedentary behavior, or intake of fruits or vegetables. In 2005-2006, 79% of the population had 1 or more of the 6 risk factors, and 46% had 2 or more. Conclusions. Diabetes, obesity, and hypertension and their associated risk factors should be studied further among urban, rural, and reservation American Indian and Alaska Native populations, and effective primary and secondary prevention efforts are critical. (Am J Public Health. 2010;100:677-683. doi: 10.2105/AJPH.2009.164285)

In this meta-analytic review of 31 laboratory studies, we examined if relatively older adults showed lower or higher cardiovascular reactivity compared with relatively younger adults. Results revealed that age was associated with lower heart rate reactivity but higher systolic blood pressure (SBP) reactivity during emotionally evocative tasks. Consistent with the predictions of dynamic integration theory, the result for SBP was moderated by the degree of task activation. These data are discussed in light of existing self-regulatory models and important future research directions. Key Words: Age--Emotion regulation--Health--Reactivity--Stress. doi: 10.1093/geronb/gbp127

OBJECTIVE: To evaluate the influence of cardiorespiratory fitness (fitness) on the obesity paradox in middle-aged men with known or suspected coronary artery disease. PATIENTS AND METHODS: This study consists of [...]

Background/Objectives: Vitamin D deficiency is associated with cardiovascular disease, osteoporosis, poor muscle strength, falls, fractures and mortality. Although older adults are at a higher risk of vitamin D deficiency, the relationship of serum 25-hydroxyvitamin D (25(OH)D) with all-cause and cardiovascular disease mortality has not been well characterized in the elderly. We hypothesized that low serum 25(OH)D levels predicted mortality in older adults. Subjects/Methods: Serum 25(OH)D as well as all-cause and cardiovascular disease mortality were examined in 1006 adults, aged ≥ 65 years, who participated in the InCHIANTI (Invecchiare in Chianti, Aging in the Chianti Area) study, a population-based, prospective cohort study of aging in Tuscany, Italy. Serum 25(OH)D levels were measured at the time of enrollment in 1998-1999, and participants were followed up for mortality. Results: During 6.5 years of follow-up, 228 (22.7%) participants died, of whom 107 died due to cardiovascular diseases. Compared with participants in the highest quartile of serum 25(OH)D (>26.5 ng/ml) (to convert to nmol/l, multiply by 2.496), those in the lowest quartile ( Conclusions: Older community-dwelling adults with low serum 25(OH)D levels are at higher risk of all-cause and cardiovascular disease mortality. European Journal of Clinical Nutrition (2010) 64, 203-209; doi: 10.1038/ejcn.2009.140; published online 2 December 2009 Keywords: aging; all-cause mortality; cardiovascular disease mortality; vitamin D, Introduction Worldwide, the population of individuals aged ≥ 65 years was 420 million in 2000, and it is expected to increase to 973 million by 2030 (Ferrucci et al, 2008). [...]

Purpose: The goal of this study was to determine the impact of age, gender, and race on the prevalence and severity of hearing loss in elder adults, aged 72-96 years, after accounting for income, education, smoking, and clinical and subclinical cardiovascular disease. Methods: Air-conduction thresholds for standard and extended high-frequency pure-tones were obtained from a cohort of 548 (out of 717) elderly adults (ages 72-96 years) who were recruited during the Year 11 clinical visit (1999-2000) of the Cardiovascular Health Study (CHS) at the Pittsburgh, Pennsylvania site. Participant smoking, income, education, and cardiovascular disease histories were obtained from the CHS database and were included as factors. Results: Hearing loss was more common and more severe for the participants in their 80s than for those in their 70s--the men more than the women and the White participants more than the Black participants. The inclusion of education, income, smoking, and cardiovascular disease (clinical and subclinical) histories as factors did not substantively impact the overall results. Conclusion: Although the data reported in this article were cross-sectional and a cohort phenomenon might have been operational, they suggested that hearing loss is more substantive in the 8th than the 7th decade of life and that race and gender influence this decline in audition. Given the high prevalence in the aging population and the differences across groups, there is a clear need to understand the nature and causes of hearing loss across various groups in order to improve prevention and develop appropriate interventions. KEY WORDS: hearing loss, aging, gender, race, Hearing loss is very common in the general population. Approximately 16% of adults in the United States report some difficulty with hearing, and after arthritis and hypertension, hearing impairment is [...]

Objectives. We assessed the impact of education level on the association between self-rated health and cardiovascular risk factors (blood pressure, glycosylated hemoglobin level, and total cholesterol and triglyceride levels). Methods. We used data from the National Health and Nutrition Examination Survey for the years 2001 through 2004 (4015 men and 4066 women). Multivariate analyses were performed with a logistic regression model. Results. After adjustment for age and ethnicity, among women with high glycosylated hemoglobin levels, the most-educated women had poorer self-rated health compared with the least-educated women (odds ratio [OR] =4.61; 95% confidence interval [CI]=2.90, 7.34 vs OR=2.59; 95% CI=1.60, 4.20, respectively; interaction test, P=0.06). The same was true among women with high cholesterol levels (OR=2.23; 95% CI=1.40, 3.56 vs OR=1.13; 95% CI=0.85, 1.49, respectively; interaction test, P=0.06). Among men, the impact of education level on the association between self-rated health and any cardiovascular risk factors (measured or self-reported) was not significant. Conclusions. The impact of cardiovascular risk factors on self-rated health was higher for highly educated women, which could lead to underestimation of health inequalities between socioeconomic groups when self-rated health is used as an indicator of objective health. (doi:10.2105/AJPH.2008.147934)

Higher nut consumption has been associated with lower risk of coronary heart disease (CHD) events in several epidemiologic studies. The study examined the association between intake of nuts and incident cardiovascular disease (CVD) in a cohort of women with type 2 diabetes. For the primary analysis, there were 6309 women with type 2 diabetes who completed a validated FFQ every 2-4 y between 1980 and 2002 and were without CVD or cancer at study entry. Major CVD events included incident myocardial infarction (MI), revascularization, and stroke. During 54,656 person-years of follow-up, there were 452 CHD events (including MI and revascularization) and 182 incident stroke cases. Frequent nut and peanut butter consumption was inversely associated with total CVD risk in age-adjusted analyses. After adjustment for conventional CVD risk factors, consumption of at least 5 servings/wk of nuts or peanut butter [serving size, 28 g (1 ounce) for nuts and 16 g (1 tablespoon) for peanut butter] was significantly associated with a lower risk of CVD (relative risk = 0.56; 95% CI: 0.36-0.89). Furthermore, when we evaluated plasma lipid and inflammatory biomarkers, we observed that increasing nut consumption was significantly associated with a more favorable plasma lipid profile, including lower LDL cholesterol, non-HDL cholesterol, total cholesterol, and apolipoprotein-B-100 concentrations. However, we did not observe significant associations for HDL cholesterol or inflammatory markers. These data suggest that frequent nut and peanut butter consumption is associated with a significantly lower CVD risk in women with type 2 diabetes.

BACKGROUND: Cadmium exposure has been associated with increased all-cause, cancer, and cardiovascular disease mortality. However, studies investigating this association have included participants with considerably higher levels of cadmium than those [...]

Background. To determine socioeconomic status (SES) gradients in the different dimensions of health among elderly Costa Ricans. Hypothesis: SES disparities in adult health are minimal in Costa Rican society. Methods. Data from the Costa Rican Study on Longevity and Healthy Aging study: 8,000 elderly Costa Ricans to determine mortality in the period 2000-2007 and a subsample of 3,000 to determine prevalence of several health conditions and biomarkers from anthropometry and blood and urine specimens. Results. The ultimate health indicator, mortality, as well as the metabolic syndrome, reveals that better educated and wealthier individuals are worse off. In contrast, quality of life-related measures such as functional and cognitive disabilities, physical frailty, and depression all clearly worsen with lower SES. Overall self-reported health (SRH) also shows a strong positive SES gradient. Traditional cardiovascular risk factors such as diabetes and cholesterol are not significantly related to SES, but hypertension and obesity are worse among high-SES individuals. Reflecting mixed SES gradients in behaviors, smoking and lack of exercise are more common among low SES, but high calorie diets are more common among high SES. Conclusions. Negative modern behaviors among high-SES groups may be reversing cardiovascular risks across SES groups, hence reversing mortality risks. But negative SES gradients in healthy years of life persist. Key Words: Aging--Biological markers--Costa Rica--Health--Mortality--Socioeconomic status.

There is evidence for differences in the response to the treatment of cardiovascular disease in men and women. In addition, there are conflicting results regarding the effectiveness of pharmacologically induced protection or ischemic preconditioning in females. We investigated whether the ability of [Met.sup.5]-enkephalin (ME) to reduce cell death after oxygen-glucose deprivation (OGD) is influenced by the presence of 17[beta]-estradiol ([E.sub.2]) in a nitric oxide (NO)- and estrogen receptor-dependent manner. On postnatal day 7 to 8, routine cardiomyocytes from wild-type or inducible NO synthase (iNOS) knockout mice were separated by sex, isolated by collagenase digestion, cultured for 24 h, and subjected to 90 rain OGD and 180 min reoxygenation at 37[degrees]C (n = 4 to 5 replicates). Cell cultures were incubated in [E.sub.2] for 15 min or 24 h before OGD. ME was used to increase cell survival. Cell death was assessed by propidium iodide. More than 300 cells were examined for each treatment. Data are presented as means [+ or -] SE. As a result, in both sexes, ME-induced cell survival was lost in the presence of [E.sub.2], and the ability of ME to improve cell survival was restored after treatment with the estrogen receptor antagonist ICI-182780. Furthermore, iNOS was necessary for ME to increase cell survival following OGD in vitro. We conclude that ME-induced reduction in cell death is abolished by [E.sub.2] in a sex-independent manner via activation of estrogen receptors, and this interaction is dependent on iNOS. viability; sex hormone; hypoxia

Some epidemiological studies undertaken in Western countries have demonstrated that high intake of fruit and vegetables results in decreased risk of cardiovascular disease (CVD). The objective of this study was to examine the hypothesis that high intake of fruit and vegetables lowers CVD mortality in a population-based cohort of Japanese subjects. In 1992, fruit and vegetable intake was assessed in 13,355 men and 15,724 women in Takayama, Gifu, Japan using a validated FFQ. During the follow-up (1992-99), 200 men and 184 women died from CVD. For women, the highest quartile of vegetable intake compared with the lowest was marginally significant and inversely associated with CVD mortality after adjusting for total energy, age, and nondietary and dietary covariates (hazard ratio (HR) = 0.62; 95% CI, 0.36-1.08; P-trend = 0.007]. An inverse trend with borderline significance was also observed in fruit intake, excluding CVD deaths in the first 2 y of this study, after adjusting for the above-mentioned covariates (HR = 0.83; 95% CI, 0.51-1.34; P-trend = 0.10). In men, CVD death was not associated with fruit (HR = 1.16; 95% CI, 0.77-1.74; P-trend = 0.61) and vegetable (HR = 0.81, 95% CI: 0.49-1.34; P-trend = 0.47) intake. These data suggest that higher intake of vegetables is associated with reduced risk of death from CVD for women.

Important sex differences in cardiovascular disease outcomes exist, including conditions of hypertrophic cardiomyopathy and cardiac ischemia. Studies of sex differences in the extent to which load-independent (primary) hypertrophy modulates the response to ischemia-reperfusion (I/R) damage have not been characterized. We have previously described a model of primary genetic cardiac hypertrophy, the hypertrophic heart rat (HHR). In this study the sex differences in HHR cardiac function and responses to I/R [compared to control normal heart rat (NHR)] were investigated ex vivo. The ventricular weight index was markedly increased in HHR female (7.82 [+ or -] 0.49 vs. 4.80 [+ or -] 0.10 mg/g; P < 0.05) and male (5.76 [+ or -] 0.22 vs. 4.62 [+ or -] 0.07 mg/g; P < 0.05) hearts. Female hearts of both strains exhibited a reduced basal contractility compared with strain-matched males [maximum first derivative of pressure (dP/[dt.sub.max]): NHR, 4,036 [+ or -] 171 vs. 4,258 [+ or -] 152 mmHg/s; and HHR, 3,974 [+ or -] 160 vs. 4,540 [+ or -] 259 mmHg/s; P < 0.05]. HHR hearts were more susceptible to I/R (I = 25 min, and R = 30 min) injury than NHR hearts (decreased functional recovery, and increased lactate dehydrogenase efflux). Female NHR hearts exhibited a significantly greater recovery (dP/[dt.sub.max]) post-I/R relative to male NHR (95.0 [+ or -] 12.2% vs. 60.5 [+ or -] 9.4%), a resistance to postischemic dysfunction not evident in female HHR (29.0 [+ or -] 5.6% vs. 25.9 [+ or -] 6.3%). Ventricular fibrillation was suppressed, and expression levels of Akt and ERKI/2 were selectively elevated in female NHR hearts. Thus the occurrence of load-independent primary cardiac hypertrophy undermines the intrinsic resistance of female hearts to I/R insult, with the observed abrogation of endogenous cardioprotective signaling pathways consistent with a potential mechanistic role in this loss of protection. sex differences; intracellular signaling; cardiac function; ischemiareperfusion

We analyzed cardiovascular disease mortality risks associated with obesity using participant-level meta-analysis of data from the Black Pooling Project for Black and White individuals. The adjusted relative risks (ARRs) were stronger among White participants than among Black participants for coronary heart disease AAR = 1.21 (95% confidence interval [CI]=1.07, 1.36) versus 0.87 (95% CI=0.69, 1.09), respectively, and cardiovascular disease ARR=1.18 (95% CI=1.07, 1.29) versus 0.91 (95% CI=0.77, 1.05), repectively. The results suggest that obesity is an independent risk factor in White people, and additional study of body size and disease progression is necessary in the assessment of racial disparities. (Am J Public Health. 2008;98:63-66. doi:10. 2105/AJPH.2006.093781)

Cardiovascular disease (CVD) remains the leading cause of death in the developed world. In the United States alone, cardiovascular disease accounts for nearly 40% of deaths, at an estimated annual cost of at least US $430 billion. Notable, racial/ethnic differences in morbidity and mortality have been observed; in the United States, African Americans have the highest age-adjusted death rate from CVD, followed by Whites, Hispanics, and Asians. The underlying basis for the observed racial/ethnic disparities in CVD morbidity and mortality is likely multifactoriaL Although hyperlipidemia screening and treatment has proven to be one of the most effective strategies for reducing CVD burden in the US population, it often fails to identify a substantial proportion of persons at high risk for CVD-related events. Elevations in markers of inflammation and thrombosis such as high sensitivity C-reactive protein, soluble intercellular adhesion molecule, homocysteine, and fibrinogen are also associated with increased CVD risk. However, data relating markers of inflammation and hemostasis to CVD principally come from White populations; little data are available across racial/ethnic groups. A range of barriers exist related to ethnic minority subject participation in research studies in the United States. If we are to better understand the racial differences in cardiovascular risk, these barriers must be overcome. Key words: C-reactive protein (CRP), soluble intercellular adhesion molecule (sICAM), homocysteine, fibrinogen doi: 10.1301/nr.2007.dec.S234-S238

There is increasing interest in the idea that social participation (operationalised as taking part in formal groups and associations) is an important determinant of health and survival. However, although a large body of literature exists which supports the notion that social contact is associated with good health, few studies have examined whether participation in specific groups and associations is related to specific risk factors, which are ill turn linked to a major cause of death. In this paper, we focus on risk markers (BMI, waist--hip ratio, blood pressure, resting heart rate, anxiety and depression) for cardiovascular disease (CVD), which contributes around a third to all cause mortality in the UK. Using survey data (n = 2334 individuals) from the West of Scotland Twenty-07 Study, we examine, separately by sex, cross-sectional associations between participation in groups and associations and CVD risk markers. There is no consistent patterning in the results. For some types of groups, there is a relationship between participation and risk factors in one sex but not the other, or better functioning on one health measure but worse in another. The most consistent results are found for psychological distress where, with the exception of church-related activities, participation in groups and associations is related to less distress (although more strongly in men than in women). Our findings do not therefore lend unequivocal support to the notion of social participation having a strong relationship with CVD risk factors at a cross-sectional level. Keywords: UK; Social participation; Cardiovascular risk factor; Gender; Social capital; Health

Children with high blood pressure are more likely to become adults with hypertension, recognized as a cardiovascular risk factor. The importance of the early recognition of the seeds of hypertension is discussed and some of the steps taken by the U. S. government in this direction are highlighted.

Ethnic minority and low-income populations have the highest rates of cardiovascular disease and the lowest rates of leisure-time physical activity. Because physical activity reduces the risk of premature death and disability from cardiovascular disease, researching correlates to such activity in these populations is an important aspect of health promotion in the US. To identify environmental, policy, and cultural barriers to physical activity in women, The Women's Cardiovascular Health Network Project conducted focus groups with White, African American, Latina, and American Indian women aged 20-50 years. The focus groups were audiotaped, transcribed, and analyzed with QSR NUD*IST qualitative software using a set of codes developed a priori by the research team. Family priorities were a main barrier to physical activity in all the groups. Having multiple roles as wife, mother, daughter, and as an active community member was mentioned as time-consuming and difficult, leaving little time or energy for exercise. Cultural barriers, which varied among the groups, included acculturation issues, lack of community support, and lack of past experience with exercise. Physical activity interventions suggested involved work programs, family-friendly programs, increased social support, and the availability of safer places to exercise such as parks, well-lit walking trails, and recreation centers. Many of the barriers were common to all groups (e.g., family priority) while some were unique (e.g., lack of community support). Assessing and addressing the issues raised should be considered when planning physical activity interventions for these populations. KEYWORDS. Policy, environment, physical activity, women, exercise

Ethnic minority and low-income populations have some of the highest rates of cardiovascular disease (CVD) and the highest rates of physical inactivity, an independent risk factor for CVD. Ethnic minority and low-income women are especially at risk. Because programs designed to increase physical activity have the potential to reduce CVD rates in specific populations, research in this area is expanding. As part of the Women's Cardiovascular Health Network funded by the Centers for Disease Control and Prevention, the goal of this multi-site project is to identify factors, particularly environmental, policy, and cultural factors, that may influence physical activity among ethnic minority and low-income women ages 20-50 years. To achieve this goal, 42 focus groups were conducted in various locations throughout the United States with African American, American Indian, Latina and White women. Groups represented both urban and rural living environments. This article explains the basis for this project and the methodology used. Other articles in this series explain the results from the focus groups in detail. KEYWORDS. Physical activity, women' s health, exercise, determinants

Research has been conducted on the hypercholestestrolemic HIV-infected chidren who take protease inhibitors. The hypothesis that high cholesterol level may lead to heart disease in childhood has been tested and the results demonstrate tnat the risk for heart disease in protease inhibitotreated children in minimal.

Although significant advances have been made in the area of cardiovascular disease, few studies have targeted ethnic groups. There is a large and growing Arab-American (AA) population living in Southeast Michigan, whose risk of cardiovascular disease may be on the increase. The objective of this study was to evaluate the prevalence of cardiovascular disease risk factors and associated behavioral factors in an AA community with a large population of emigrants, subjected to significant lifestyle changes. Three hundred and fifty-two AA living in Southeast Michigan, mostly from the Middle East, were screened to determine their eating and smoking habits, body mass index (BMI) body fat analysis, blood pressure, and complete lipid profiling. Overweight was defined as a BMI greater than or equal to the 85th percentile value for age- and sex-specific reference data from the third National Health and Nutrition Examination Survey (NHANES III). Correlation analysis was used to examine factors associated with being overweight, with adjustment for age and sex. Blood cholesterol concentrations were compared with published data for Arabs from the Middle Eastern countries. The overall prevalence of being overweight in subjects aged 35 and older was significantly higher than NHANES III reference data (Men, 27.7% (95% confidence interval, 21.8-34.5); women, 33.7% (95% confidence interval, 27.9-40.1)). A mean cholesterol concentration of 210 [+ or -] 4 mg/dl was observed in those over the age of 40. The mean high-density lipoprotein (HDL)-cholesterol levels for men and women were 38 and 48 mg/dl, respectively. Greater than 54.6% of all subjects had a total cholesterol:HDL ratio >4.5. Although being overweight and obesity were prevalent in this population, the mean BMI for men was 25.7 [+ or -] 0.34, compared with 27 [+ or -] 0.58 for women. Increased BMI was significantly correlated (P < 0.01) with increased blood pressure, increased glucose levels, increased total cholesterol and decreased HDL-cholesterol levels (P < 0.01). Elevation in risk factors to cardiovascular disease is prevalent in this population and indicates a need for programs targeting primary prevention of obesity in men and women. These results, which could be attributed in part to lifestyle changes typical of most emigrant populations, suggest an increase in the risk for developing cardiovascular disease. In addition, this study provides a basis for future intervention to improve the health of this population.

Background: The Amsterdam Growth and Health Longitudinal Study (AGAHLS) is a 20y observational study concerning biological, psychological and lifestyle risk factors for cardiovascular disease and osteoporosis. In the AGAHLS two cohorts can be distinguished: the so-called Multi-Measurement Group (MMG), which received eight repeated measurements, and a Bi-Measurement Group (BMG), which received two measurements, one at the beginning and one at the end of the 20 y period. Objective: In health-related longitudinal research, the outcomes of the study may be influenced by the measurements themselves and the health information provided. It was hypothesized that the repeated measurements and the health information given to the MMG would result in a more healthy dietary intake in comparison to the BMG. Design: The MMG consisted of 164 subjects and the BMG consisted of 90 subjects. At the start of the study, subjects were teenagers of 13-y-old. The hypothesis was tested with use of regression analysis, analysing group differences in mean individual change scores. Results: Only the MMG showed a significantly larger decrease in the intake of mono- and disaccharides compared to the BMG. Conclusions: The effect of the repeated measurements and the health information provided on dietary intake was relatively small, since it was only one out of the 14 nutrients that differed between the MMG and the BMG. Descriptors: dietary intake; health information; longitudinal study; CVD risk factors; adolescents and young adults, Introduction It has been suggested that dietary intake can be influenced by education about healthy dietary habits in patients (Lisspers et al, 1999; Slaby et al, 1998) as well as [...]

The growth of research on cardiovascular disease in women has primarily resulted from a greater number of single-sex research trials, rather than an increase in female enrollment in studies of both men and women. Women represented 54% of subjects in federally funded studies of cardiovascular disease, but only 38% of subjects in studies involving both genders.

Objective: Unfavourable dietary habits might explain a part of the increased cardiovascular morbidity and mortality among the lower socioeconomic groups. The aim of the study was to describe differences in dietary intake in older subjects by socioeconomic status, as indicated by educational level. Design: A cross-sectional analysis of socioeconomic status in relation to dietary intake. Setting: The Rotterdam Study. Subjects: 2213 men and 3193 women, aged 55y and over living between 1990 and 1993 in a district of Rotterdam, The Netherlands. Methods: Dietary data were assessed with a semiquantitative food frequency questionnaire, containing 170 food items in 13 food groups. Results: In general, the dietary differences between socioeconomic groups were small. Lower educated subjects had a higher intake of almost all macronutrients compared with higher educated subjects. The total energy intake of men/women with the lowest educational level differed from those with the highest education in the following respect: 9.60/7.54 vs 8.94/7.17 MJ/day. Furthermore, fat composition was more adverse in the lower educated strata; in lower educated subjects, relatively more energy was derived from saturated fat (14.5/14.6 vs 13.8/13.8 energy%), the ratio of polyunsaturated saturated fat was lower (for men: 0.50 vs 0.55) and the intake of cholesterol higher (271/220 vs 240/204 mg/day). These differences could be explained by a higher intake of visible fat (46/37 vs 44/34g/day) and more meat consumption (130/100 vs 116/86g/day). In addition, the composition of these products differed: the higher educated used relatively more lean meat and low-fat milk products. Furthermore, the intake of fibre was lower among the lower educated (1.88/2.17 vs 2.03/2.29 g/MJ). Among lower educated groups there were more abstainers (15.5/31.5 vs 12.3/26.9%) and the type of alcoholic beverages also differed between the groups. Intake of antioxidant vitamins from food alone did not differ between educational groups. Conclusions: In Dutch elderly people, there are socioeconomic differences in dietary intake. Although these differences are small, these findings support the role of diet in the explanation of socioeconomic inequalities in cardiovascular health. Sponsorship: Erasmus Centre for Research on Aging, Erasmus University Rotterdam. Descriptors: socioeconomic factors; diet; aged, Introduction Socioeconomic status has been shown to be inversely related to cardiovascular morbidity and mortality in several countries, including The Netherlands (Mackenbach, 1992; Kaplan & Keil, 1993). To detech high [...]

Objective: To evaluate the habitual diet of a rural and urban population in Cameroon, Central Africa. Setting: An urban area-Cite Verte Housing District, Yaounde (1058 subjects); and a rural area-three villages in Evodoula, Cameroon (746 subjects). Subjects: Cameroonian men and women of African origin (1058 urban, and 746 rural), aged 24-74y. Methods: The habitual diet was estimated with an interviewer-administered food frequency questionnaire. Main outcome measures: Macro- and micronutrient intake. Results: The intake of energy, fat and alcohol was higher in rural men and women than in urban subjects. In rural women, the intake of carbohydrates and protein was also higher. The intakes of fibre, iron, carotene, zinc, potassium, and of the vitamins C, D and E were all higher in rural men and women than in their urban counterparts. The intake of retinol was lower in rural subjects than in urban subjects. Eight of the 10 foods eaten in the highest amount and contributing must to energy intake differed between the rural and urban population. Conclusion: The habitual diet in rural Cameroon contains more fat and alcohol than the diet in urban Cameroon. The high physical activity in the rural area may explain the lower levels of the cardiovascular risk factors in this area compared to those of the urban dwellers. Sponsorship: This work was supported by a grant from the European Union (contract no. TS3*CT92-0142) and by the Conseil Regional d&apos;Ile de France and INSERM. Descriptors: habitual diet; Africa; Cameroon; urban; rural European Journal of Clinical Nutrition (2000) 54, 150-154, Introduction From many epidemiological studies it is clear that the habitual diet is an important contributor to the burden of chronic diseases such as cardiovascular disease, diabetes and cancer, in [...]

We examined potential age and gender differences in cardiovascular reactivity during acute psychosocial stress in 133 normotensive participants using a cross-sectional design. Results revealed that age predicted increased systolic blood pressure (SBP) reactivity during stress (p < .001). The greater SBP reactivity found in older individuals appeared due to an age-associated increase in both cardiac output and total peripheral resistance during stress as statistically controlling for these changes rendered the age and SBP reactivity effect nonsignificant. Similar analyses revealed that the age-related increase in cardiac output reactivity appeared to be driven by increased cardiac sympathetic control of myocardial contractility as measured by pre-ejection period. Older individuals also had greater vagal withdrawal during stress compared to younger individuals as indexed by respiratory sinus arrhythmia (p < .01). These results were comparable for men and women, and could not be explained by task-specific affective responses, task performance, or demographic factors. Implications for the study of age, cardiovascular reactivity, and health are discussed.