Vitamin D status and functional performance in peripheral artery disease.

The clinical implications of low vitamin D in peripheral artery disease (PAD) are unknown. We hypothesized that among individuals with PAD, lower levels of 25-hydroxyvitamin D would be associated with poorer functional performance, more adverse calf muscle characteristics, and poorer peripheral nerve function. Participants were 402 men and women with PAD who underwent measurement of 25-hydroxyvitamin D (DiaSorin radioimmunoassay) along with 6-minute walk testing, measurement of walking velocity at usual and fastest pace, computed tomography-measured calf muscle density, and peripheral nerve conduction velocity (NCV).

Association of QRS duration with left ventricular structure and function and risk of heart failure in middle-aged and older adults: the Multi-Ethnic Study of Atherosclerosis (MESA).

Aims: Prolonged QRS duration (QRSd) on the electrocardiogram (ECG) has been associated with cardiac structural and functional abnormalities by echocardiography and an increased risk of heart failure (HF). Data are sparse on these relationships in middle-aged and elderly individuals free of baseline cardiovascular disease with respect to cardiac magnetic resonance imaging (MRI). We sought to determine whether QRSd is associated with incident HF and measures of cardiac structure and function by cardiac MRI.

Plaque Characteristics in the Superficial Femoral Artery Correlate with Walking Impairment Questionnaire Scores in Peripheral Arterial Disease: The Walking and Leg Circulation Study (WALCS) III.

Purpose: We studied associations of magnetic resonance imaging (MRI)-measured plaque area and relative percent lumen reduction in the proximal superficial femoral artery with Walking Impairment Questionnaire (WIQ) scores and quality of life in people with lower extremity peripheral arterial disease (PAD).

Methods: Four-hundred forty-two participants with PAD underwent cross-sectional imaging of the proximal superficial femoral artery with MRI, and completed the WIQ and the Short-Form-12 mental and physical functioning questionnaires. Questionnaires were scored on a 0-100 scale (100=best).

Clinical correlates of size and number of collateral vessels in peripheral artery disease.

We studied associations of the number and size of magnetic resonance angiography (MRA)-assessed lower extremity collateral vessels with the ankle-brachial index (ABI), severity of superficial femoral artery (SFA) plaque, and leg symptoms in participants with peripheral artery disease (PAD). A total of 303 participants with PAD underwent time-resolved MRA at the thigh station. Collaterals were categorized by number (Category 1: 0-3 collaterals; Category 2: 4-7 collaterals; Category 3: ≥ 8 collateral vessels) and size (Grade 1: ≤ 5 small collaterals; Grade 2: > 5 small vessels; Grade 3: ≤ 5 large collaterals; Grade 4: > 5 large collaterals).

Genetic ancestry-smoking interactions and lung function in African Americans: a cohort study.

Background: Smoking tobacco reduces lung function. African Americans have both lower lung function and decreased metabolism of tobacco smoke compared to European Americans. African ancestry is also associated with lower pulmonary function in African Americans.

Multi-ethnic analysis of lipid-associated loci: the NHLBI CARe project.

Background: Whereas it is well established that plasma lipid levels have substantial heritability within populations, it remains unclear how many of the genetic determinants reported in previous studies (largely performed in European American cohorts) are relevant in different ethnicities.

Methodology/principal Findings: We tested a set of ∼50,000 polymorphisms from ∼2,000 candidate genes and genetic loci from genome-wide association studies (GWAS) for association with low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) in 25,000 European Americans and 9,000 African Americans in the National Heart, Lung, and Blood Institute (NHLBI) Candidate Gene Association Resource (CARe). We replicated associations for a number of genes in one or both ethnicities and identified a novel lipid-associated variant in a locus harboring ICAM1.

The Walking Impairment Questionnaire stair-climbing score predicts mortality in men and women with peripheral arterial disease.

Objective: The Walking Impairment Questionnaire (WIQ) measures self-reported walking distance, walking speed, and stair-climbing ability in men and women with lower extremity peripheral arterial disease (PAD). We determined whether poorer WIQ scores are associated with higher all-cause and cardiovascular disease (CVD) mortality in individuals with and without PAD.

Methods: We identified 1048 men and women with and without PAD from Chicago-area medical centers.

Fasting insulin level is positively associated with incidence of hypertension among American young adults: a 20-year follow-up study.

Objective: Although hyperinsulinemia, a surrogate of insulin resistance, may play a role in the pathogenesis of hypertension (HTN), the longitudinal association between fasting insulin level and HTN development is still controversial. We examined the relation between fasting insulin and incidence of HTN in a large prospective cohort.

Research Design And Methods: A prospective cohort of 3,413 Americans, aged 18-30 years, without HTN in 1985 (baseline) were enrolled.

Metabolic syndrome, diabetes, and incidence and progression of coronary calcium: the Multiethnic Study of Atherosclerosis study.

Objectives: This study sought to examine and compare the incidence and progression of coronary artery calcium (CAC) among persons with metabolic syndrome (MetS) and diabetes mellitus (DM) versus those with neither condition.

Background: MetS and DM are associated with subclinical atherosclerosis as evidenced by CAC.

Methods: The MESA (Multiethnic Study of Atherosclerosis) included 6,814 African American, Asian, Caucasian, and Hispanic adults 45 to 84 years of age, who were free of cardiovascular disease at baseline.

Folate intake and incidence of hypertension among American young adults: a 20-y follow-up study.

Background: Laboratory studies suggest that folate intake may decrease blood pressure (BP) through increasing nitric oxide synthesis in endothelial cells and/or reducing plasma homocysteine concentrations. However, human studies, particularly longitudinal data, are limited.

Objective: Our objective was to investigate whether dietary folate intake is associated with the 20-y incidence of hypertension.

Calf muscle characteristics, strength measures, and mortality in peripheral arterial disease: a longitudinal study.

Objectives: This study analyzed whether lower calf muscle density and poorer upper and lower extremity strength are associated with higher mortality rates in men and women with peripheral arterial disease (PAD).

Background: Men and women with lower extremity PAD have lower calf muscle density and reduced lower extremity strength compared with individuals without PAD.

Methods: At baseline, participants underwent measurement of calf muscle density with computed tomography in addition to knee extension power and isometric knee extension, plantar flexion, and hand grip strength measures.

Association of sex hormones and sex hormone-binding globulin with depressive symptoms in postmenopausal women: the Multiethnic Study of Atherosclerosis.

Objective: Sex hormones are thought to play an important role in the pathophysiology of depressive disorders in women. This study assessed the associations of total testosterone (T), bioavailable T, estradiol, dehydroepiandrosterone, and sex hormone-binding globulin (SHBG) with depressive symptoms stratified on postmenopausal stage to determine whether the associations were strongest for early postmenopausal women.

Methods: Women (N = 1,824) free of depressive symptoms at baseline (2000-2002) in the Multiethnic Study of Atherosclerosis were categorized into tertiles of years postmenopause: T1, 0 to 10 years; T2, 11 to 20 years; and T3, 21 to 58 years.

Higher body mass index is associated with more adverse changes in calf muscle characteristics in peripheral arterial disease.

Objective: This study investigated whether higher body mass index (BMI) is associated with more adverse lower extremity muscle characteristics at baseline and more adverse changes in muscle over time among participants with lower extremity peripheral arterial disease (PAD).

Methods: This was a longitudinal, observational study of 425 men and women with PAD and 261 without PAD. Computed tomography was used to measure calf muscle characteristics at baseline and every 2 years.

Associations of noninvasive measures of arterial compliance and ankle-brachial index: the Multi-Ethnic Study of Atherosclerosis (MESA).

Background: The association between measures of arterial compliance and peripheral arterial disease (PAD) is unclear. Early changes in arterial wall compliance could be a useful marker of patients at high risk for developing lower extremity atherosclerosis.

Methods: We used linear and logistic regression models on baseline data from 2,803 female and 2,558 male participants in the Multi-Ethnic Study of Atherosclerosis (MESA) to study associations between tonometry-derived baseline measures of arterial compliance (large artery compliance (C1) and small artery compliance (C2)) and the baseline ankle-brachial index (ABI), as well as change in the ABI over ~3 years of follow-up.

Healthy lifestyle through young adulthood and the presence of low cardiovascular disease risk profile in middle age: the Coronary Artery Risk Development in (Young) Adults (CARDIA) study.

Background: A low cardiovascular disease risk profile (untreated cholesterol <200 mg/dL, untreated blood pressure <120/<80 mm Hg, never smoking, and no history of diabetes mellitus or myocardial infarction) in middle age is associated with markedly better health outcomes in older age, but few middle-aged adults have this low risk profile. We examined whether adopting a healthy lifestyle throughout young adulthood is associated with the presence of the low cardiovascular disease risk profile in middle age.

Methods And Results: The Coronary Artery Risk Development in (Young) Adults (CARDIA) study sample consisted of 3154 black and white participants 18 to 30 years of age at year 0 (1985-1986) who attended the year 0, 7, and 20 examinations.

A long way from home: comparing mental health measures between foreign and U.S.-born Latinos in the Multi-Ethnic Study of Atherosclerosis (MESA).

Background: Studies exploring the relationship between foreign-born status and mental health among Latinos in the United States have varied in their conclusions. We examined 2000-2002 MESA data on Latinos and compared responses between immigrants and non-immigrants on the Center for Epidemiologic Studies Depression (CES-D) scale and the Spielberger anxiety and anger scales.

Methods: We used logistic and linear regression to examine whether immigrant status was associated with these psychological outcomes in Latinos-overall, Mexicans-only and Other-Latinos (non-Mexicans).

Factors associated with development of prolonged QRS duration over 20 years in healthy young adults: the Coronary Artery Risk Development in Young Adults study.

Background: Data describing factors associated with the development of a prolonged QRS duration (QRSd) from young adulthood to middle age are sparse.

Methods: We analyzed 12-lead electrocardiograms (ECGs) from the Coronary Artery Risk Development in Young Adults study over 20 years. We performed logistic regression to examine the associations of baseline (year 0) or average (years 0-20) risk factors with incident prolonged QRSd (QRS >100 milliseconds).

Incident obesity and cardiovascular risk factors between young adulthood and middle age by religious involvement: the Coronary Artery Risk Development in Young Adults (CARDIA) study.

Background: Religious involvement has been associated with improved health outcomes but greater obesity in older adults. No longitudinal study of young adults has examined the prospective association of religious involvement with incident cardiovascular risk factors (RFs) and subclinical disease (subCVD).

Methods: We included 2433 participants of the CARDIA study, aged 20 to 32 in 1987 when religiosity was assessed, who were followed for 18 years.

Lower extremity nerve function, calf skeletal muscle characteristics, and functional performance in peripheral arterial disease.

Objectives: To determine whether poor lower extremity nerve function is associated with less-favorable calf muscle characteristics and greater functional impairment in people with and without peripheral arterial disease (PAD).

Design: Cross-sectional.

Setting: Three Chicago-area medical centers.

The effect of including cystatin C or creatinine in a cardiovascular risk model for asymptomatic individuals: the multi-ethnic study of atherosclerosis.

The authors studied the incremental value of adding serum cystatin C or creatinine to the Framingham risk score variables (FRSVs) for the prediction of incident cardiovascular disease (CVD) among 6,653 adults without clinical CVD utilizing the Multi-Ethnic Study of Atherosclerosis (2000-2008). CVD events included coronary heart disease, heart failure, stroke, and peripheral arterial disease. Variables were transformed to yield optimal prediction of 6-year CVD events in sex-stratified models with FRSVs alone, FRSVs + cystatin C, and FRSVs + creatinine.

Association of health professional shortage areas and cardiovascular risk factor prevalence, awareness, and control in the Multi-Ethnic Study of Atherosclerosis (MESA).

BACKGROUND- Individuals living in primary care health professional shortage areas (PC-HPSA), often have difficulty obtaining medical care; however, no previous studies have examined association of pc-hpsa residence with prevalence of cardiovascular disease risk factors. METHODS AND RESULTS- To examine this question, the authors used data from the Multi-Ethnic Study of Atherosclerosis baseline examination (2000-2002). Outcomes included the prevalence of diabetes, hypertension, hyperlipidemia, smoking, and obesity as well as the awareness and control of diabetes, hypertension, and hyperlipidemia.

The association of pericardial fat with coronary artery plaque index at MR imaging: The Multi-Ethnic Study of Atherosclerosis (MESA).

Purpose: To determine the relationship of pericardial fat, which secretes proinflammatory markers that have been implicated in coronary atherosclerosis, with atherosclerotic plaque in an asymptomatic population-based cohort.

Materials And Methods: In this institutional review board-approved study, all participants supplied written informed consent. One hundred eighty-three participants (89 women, 94 men; mean age, 61 years ± 9 [standard deviation]) from the community-based Multi-Ethnic Study of Atherosclerosis (MESA) were included.

Correlates of heart rate recovery over 20 years in a healthy population sample.

Introduction: Slow HR recovery (HRR) from a graded exercise treadmill test (GXT) is a marker of impaired parasympathetic reactivation that is associated with elevated mortality. Our objective was to test whether demographic, behavioral, or CHD risk factors during young adulthood were associated with the development of slow HRR.

Methods: Participants from the Coronary Artery Risk Development in Young Adults study underwent symptom-limited maximal GXT using a modified Balke protocol at baseline (1985-1986) and 20-yr follow-up (2005-2006) examinations.

Superficial femoral artery plaque and functional performance in peripheral arterial disease: walking and leg circulation study (WALCS III).

Objectives: We studied associations of magnetic resonance imaging measurements of plaque area and relative percent lumen reduction in the proximal superficial femoral artery with functional performance among participants with peripheral arterial disease.

Background: The clinical significance of directly imaged plaque characteristics in lower extremity arteries is not well established.

Methods: A total of 454 participants with an ankle brachial index <1.

Association of lipoprotein-associated phospholipase A(2) and endothelial function in the Multi-Ethnic Study of Atherosclerosis (MESA).

Mechanisms underlying the role of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) in atherosclerotic development are not completely understood. We evaluated the relationship of Lp-PLA(2) with endothelial dysfunction, an early manifestation of atherosclerosis, in a cohort without known clinical cardiovascular disease. A total of 2809 participants in the Multi-Ethnic Study of Atherosclerosis underwent plasma Lp-PLA(2) mass and activity measurement and brachial artery flow-mediated vasodilation testing.