Publications by authors named "Vittinghoff E"

Article Synopsis
  • Higher FSH levels are linked to bone loss during perimenopause and aging in men, but it was unclear if they independently increase fracture risk.
  • A study analyzed 295 adults from the AGES-Reykjavik cohort to find out if baseline FSH levels could predict hip fractures within 10 years.
  • Results showed that higher FSH levels significantly increased the risk of hip fractures, suggesting FSH might directly affect bone health beyond just being associated with sex hormones.
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Background: Although smoking heightens the risk of AF, it remains unknown if that risk is amenable to modification after smoking cessation.

Objectives: This study sought to evaluate the association between smoking cessation and atrial fibrillation (AF) risk in a large longitudinal cohort.

Methods: After excluding those with prevalent AF and no history of smoking at baseline, we evaluated 146,772 UK Biobank participants with serial smoking assessments.

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  • Pelvic floor yoga is being explored as a possible alternative treatment for urinary incontinence (UI) in women, but solid evidence supporting its effectiveness is still limited.
  • This study compared a 12-week pelvic floor yoga program to a general physical conditioning program to see which was more effective in reducing UI.
  • Results showed both groups experienced a decrease in UI frequency, with pelvic yoga showing slightly better outcomes, but the differences were minimal and not statistically significant for all types of UI.
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Background: Previous literature has explored the relationship between television viewing and cardiovascular disease (CVD) in adults; however, there remains a paucity of longitudinal data describing how young adult television viewing relates to premature CVD events.

Objective: To ascertain the relationship between level and annualized changes in television viewing from young adulthood to middle age and the incidence of premature CVD events before age 60.

Design: The Coronary Artery Risk Development in Young Adults (CARDIA) study, a prospective community-based cohort with over 30 years of follow-up (1985-present).

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There is a strong association between total hip bone mineral density (THBMD) changes after 24 mo of treatment and reduced fracture risk. We examined whether changes in THBMD after 12 and 18 mo of treatment are also associated with fracture risk reduction. We used individual patient data (n = 122 235 participants) from 22 randomized, placebo-controlled, double-blind trials of osteoporosis medications.

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Context: Impaired bone microarchitecture, assessed by high-resolution peripheral quantitative computed tomography (HR-pQCT), may contribute to bone fragility in type 2 diabetes (T2DM) but data on men are lacking.

Objective: To investigate the association between T2DM and HR-pQCT parameters in older men.

Methods: HR-pQCT scans were acquired on 1794 participants in the Osteoporotic Fractures in Men (MrOS) study.

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Background And Objectives: The nature of associations between depressive symptoms and cognition early in the life course remains unclear, and racial differences in these associations are not well characterized. The aim of this study was to examine the relationship between trajectories of depressive symptom over 20 years, beginning in young adulthood, and cognitive functions in middle-age among Black and White adults.

Methods: We used prospective data from participants of the Coronary Artery Risk Development in Young Adults Study.

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Background And Hypothesis: In the United States, women with schizophrenia face challenges in receiving gynecologic care, but little is known about how cervical cancer screening rates vary across time or states in a publicly insured population. We hypothesized that women Medicaid beneficiaries with schizophrenia would be less likely to receive cervical cancer screening across the United States compared with a control population, and that women with schizophrenia and other markers of vulnerability would be least likely to receive screening.

Study Design: This retrospective cohort study used US Medicaid administrative data from across 44 states between 2002 and 2012 and examined differences in cervical cancer screening test rates among 283 950 female Medicaid beneficiaries with schizophrenia and a frequency-matched control group without serious mental illness, matched on age and race/ethnicity.

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Some osteoporosis drug trials have suggested that treatment is more effective in those with low BMD measured by DXA. This study used data from a large set of randomized controlled trials (RCTs) to determine whether the anti-fracture efficacy of treatments differs according to baseline BMD. We used individual patient data from 25 RCTs (103 086 subjects) of osteoporosis medications collected as part of the FNIH-ASBMR SABRE project.

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People with schizophrenia are at increased risk for contracting HIV and face higher mortality rates compared with the general population. Viral suppression is key to HIV care, yet little is known about this metric among people with HIV and schizophrenia. A chart review was conducted among people with HIV/AIDS and schizophrenia living in San Francisco who had received inpatient mental health services between 2010 and 2016.

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Objectives: To explore the relevance of pregnancy intention as a screen for contraceptive needs among postpartum individuals.

Study Design: We surveyed 234 postpartum individuals to assess the alignment between pregnancy intentions in the next year and current desire to prevent pregnancy.

Results: Most individuals (87%) desired pregnancy prevention now, including 73% of individuals who desired or were ambivalent about pregnancy in the next year.

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Article Synopsis
  • A study analyzed randomized controlled trials to investigate the effectiveness of antiosteoporosis medications in individuals aged 70 and older compared to those younger than 70.
  • Results showed that these medications significantly reduced fracture risks in both age groups, with similar effectiveness, although younger participants had a slightly greater reduction in hip fracture risk.
  • Additionally, older adults experienced greater improvements in bone mineral density (BMD) after 24 months of treatment, suggesting these meds are beneficial for both age groups without significant age-related differences in fracture prevention.
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Previous studies relying on alcohol sales, alcohol-related injuries, and surveys have suggested that alcohol consumption increased during the COVID-19 pandemic. We sought to leverage over 1 million Breath Alcohol Concentration (BrAC) measurements from Bluetooth-enabled breathalyzers to conduct an objective and longitudinal assessment of alcohol use during the pandemic. Serial BrAC measurements revealed a decrease in drinking between January 1, 2020 and March 30, 2020, an increase between March 30, 2020 and May 25, 2020, a statistically insignificant decrease between May 25, 2020 and January 1, 2021, and an increase again between January 1, 2021 and June 4, 2021.

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Background: Alcohol consumption is associated with a higher increased risk of atrial fibrillation (AF), but the acute effects on cardiac electrophysiology in humans remain poorly understood. The HOw ALcohol InDuces Atrial TachYarrhythmias (HOLIDAY) Trial revealed that alcohol shortened pulmonary vein atrial effective refractory periods, but more global electrophysiologic changes gleaned from the surface ECG have not yet been reported.

Methods: This was a secondary analysis of the HOLIDAY Trial.

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Context: Prolonged bisphosphonate (BP) treatment for osteoporosis prevents hip and other fractures but causes atypical femoral fractures (AFF).

Objective: To establish the relationship between patterns of BP use and the risk of AFF and hip fractures. Other potential risk factors for AFF were also examined.

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Background: Cannabis use is increasing worldwide. While prior studies have reported an association between cannabis use and a higher risk of atrial fibrillation (AF), most were cross-sectional and generally relied on diagnostic coding to identify cannabis users, which may not be representative of the typical recreational cannabis user.

Objective: The purpose of this study was to examine the association between recreational cannabis use and lifetime AF risk.

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Background: People living with HIV have increased risk of cardiovascular disease, but few studies focus on women with HIV (WWH) and few account for the use of multiple substances.

Setting: We recruited WWH from San Francisco shelters, free meal programs, street encampments, and a safety net HIV clinic.

Methods: Between 2016 and 2019, participants completed 6 monthly interviews, specimen collection, and a transthoracic echocardiogram.

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Introduction: Few studies have longitudinally examined TV viewing trajectories and cardiovascular disease risk factors. The objective of this study was to determine the association between level and annualized changes in young adult TV viewing and the incidence of cardiovascular disease risk factors from young adulthood to middle age.

Methods: In 2023, prospective community-based cohort data of 4,318 Coronary Artery Risk Development in Young Adults study participants (1990-1991 to 2015-2016) were analyzed.

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Importance: Modifiable risk factors are hypothesized to account for 30% to 40% of dementia; yet, few trials have demonstrated that risk-reduction interventions, especially multidomain, are efficacious.

Objective: To determine if a personalized, multidomain risk reduction intervention improves cognition and dementia risk profile among older adults.

Design, Setting, And Participants: The Systematic Multi-Domain Alzheimer Risk Reduction Trial was a randomized clinical trial with a 2-year personalized, risk-reduction intervention.

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Article Synopsis
  • Chronic sleep disruption may enhance the risk of atrial fibrillation (AF), but it's not clear if poor sleep quality directly triggers it.
  • A study analyzed data from 419 patients daily, linking worse sleep quality to a 15% increase in self-reported AF episodes the following day.
  • While poor sleep was associated with longer AF episodes, no significant tie was found between poor sleep and mobile ECG-confirmed AF events, suggesting sleep quality could be a modifiable risk factor for AF.
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Objective: The aim of this study was to determine whether urine biomarkers of kidney health are associated with subclinical cardiovascular disease among men with and without HIV.

Design: A cross-sectional study within the Multicenter AIDS Cohort Study (MACS) among 504 men with and without HIV infection who underwent cardiac computed tomography scans and had urine biomarkers measured within the preceding 2 years.

Methods: Our primary predictors were four urine biomarkers of endothelial (albuminuria), proximal tubule dysfunction (alpha-1-microglobulin [A1 M] and injury (kidney injury molecule-1 [KIM-1]) and tubulointerstitial fibrosis (pro-collagen-III N-terminal peptide [PIIINP]).

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Stimulant use among unstably housed individuals is associated with increased risks of psychiatric co-morbidity, violence, HIV transmission, and overdose. Due to a lack of highly effective treatments, evidence-based policies targeting the prevention of stimulant use disorder are of critical importance. However, little empirical evidence exists on risks associated with initiating or returning to stimulant use among at-risk populations.

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Background: While substance use is known to influence cardiovascular health, most prior studies only consider one substance at a time. We examined associations between the concurrent use of multiple substances and left ventricular mass index (LVMI) in unhoused and unstably housed women.

Methods: Between 2016 and 2019, we conducted a cohort study of unstably housed women in which measurements included an interview, serum/urine collection, vital sign assessment, and a single transthoracic echocardiogram at baseline.

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Background: People with HIV (PWH) generally have worse ambulatory levels of kidney injury biomarkers and excess risk of acute kidney injury (AKI) compared to persons without HIV. We evaluated whether ambulatory measures of subclinical kidney injury among PWH are associated with subsequent AKI.

Methods: In the Predictors of Acute Renal Injury Study (PARIS), which enrolled 468 PWH from April 2016 to August 2019, we measured 10 urine biomarkers of kidney health (albumin, a1m, b2M, NGAL, IL18, KIM-1, EGF, UMOD, MCP-1, YKL40) at baseline and annually during follow-up.

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Article Synopsis
  • High-power, short duration (HPSD) radiofrequency ablation (RFA) is being compared to standard power, standard duration (SPSD) RFA for pulmonary vein isolation in patients with atrial fibrillation.
  • In a study of 60 patients, HPSD resulted in a significantly shorter time to achieve isolation and less time spent in the left atrium compared to SPSD.
  • While HPSD showed better outcomes in terms of reduced recurrent atrial arrhythmias after 12 months, it also hinted at a greater risk of asymptomatic cerebral emboli compared to SPSD.
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