Prediction of various insulin resistance indices for the risk of hypertension among military young adults: the CHIEF cohort study, 2014-2020.

BACKGROUND: Non-insulin-based insulin resistance (NI-IR) indices have been reported to have an association with prevalent hypertension, however, no cohort studies to date have compared their prediction of hypertension among young adults. METHODS: A total of 2,448 military men and women, aged 18-39 years, without baseline hypertension in Taiwan were followed for incident hypertension events from 2014 until the end of 2020. All subjects underwent annual health examinations including measurements of blood pressure (BP) in mmHg. Systolic BP (SBP) 130-139/diastolic BP (DBP) < 80, SBP < 130/DBP 80-89, and SBP 130-139/DBP 80-89 were respectively defined as stage I isolated systolic hypertension (ISH), isolated diastolic hypertension (IDH) and combined hypertension (CH). The cut-off levels of stage II hypertension for SBP and DBP were 140-159 and 90-99, respectively. Four NI-IR indices included the ratio of serum triglycerides (TG) to high-density lipoprotein cholesterol (HDL-C), TyG index defined as ln[TG* fasting glucose (FG)/2], Metabolic Score for IR (METS-IR) defined as ln[(2* FG) + TG)* body mass index (BMI)/(ln(HDL-C))], and ZJU index defined as BMI + FG + TG + 3* alanine transaminase/aspartate transaminase (+ 2 if female). Multivariable Cox regression analysis was performed with adjustments for baseline age, sex, body mass index, BP, substance use, family history for early onset cardiovascular diseases or hypertension, low-density lipoprotein cholesterol, kidney function, serum uric acid and physical activity to determine the associations. RESULTS: During a median follow-up of 6.0 years, there were 920 hypertension events (37.6%). Greater TyG, TG/HDL-C and METS-IR indices were associated with a higher risk of stage I IDH (hazard ratios (HRs) and 95% confidence intervals: 1.376 (1.123-1.687), 1.082 (1.039-1.127) and 3.455 (1.921-6.214), respectively), whereas only greater ZJU index was associated with a higher risk of stage II IDH [HRs: 1.011 (1.001-1.021)]. In addition, greater ZJU index was associated with a higher risk of stage II ISH [HR: 1.013 (1.003-1.023)], and greater TyG index was associated with a higher risk of stage II CH [HR: 2.821 (1.244-6.395)]. CONCLUSION: Insulin resistance assessed by various NI-IR indices was associated with a higher risk of hypertension in young adults, while the assessment ability for specific hypertension category may differ by NI-IR indices.

The effect of exercise training intervention for patients with abdominal aortic aneurysm on cardiovascular and cardiorespiratory variables: an updated meta-analysis of randomized controlled trials.

OBJECTIVE: The purpose of this meta-analysis was to evaluate the effect of exercise training intervention in patients with abdominal aortic aneurysm (AAA). METHODS: Eight randomized controlled trials (RCTs) that recruited 588 AAA patients were extracted using 4 databases (PubMed, Embase, Wanfang Data, and Cochrane Library). Physiological and biochemistry parameters that included in this study are high-sensitivity C-reactive protein (hs-CRP), respiratory peak oxygen uptake rate (VO2peak), triglyceride (TG), total cholesterol (TC), anaerobic threshold (AT), the diameter of AAA, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL), and matrix metalloproteinase-9 (MMP-9). Standard mean difference (SMD) was used to assess the between group effect. RESULTS: This meta-analysis was synthesized with findings from RCTs and found that hs-CRP (SMD, - 0.56 mg/dL; 95% CI: - 0.90 to 0.22; P = 0.001), VO2peak (SMD, 0.4 mL/kg/min; 95% CI, 0.21 to 0.60; P < 0.001), TG (SMD, - 0.39 mg/dL; 95% CI: - 0.02 to 0.77; P = 0.04), and AT (SMD, 0.75 mL/kg/min; 95% CI, 0.54 to 0.96; P < 0.001) were significantly improved in the exercise groups, while the size of AAA (SMD, - 0.15; 95% CI: - 0.36 to 0.06; P = 0.15), TC (SMD, 0.16 mg/dL; 95% CI: - 0.10 to 0.42; P = 0.23), HDL/LDL ratio (SMD, - 0.06; 95% CI: - 0.32 to 0.20; P = 0.64), HDL (SMD, - 0.09; 95% CI: - 0.39 to 0.20; P = 0.54), LDL (SMD, 0.08; 95% CI: - 0.21 to 0.38; P = 0.59), and MMP-9 (SMD, - 0.23 mg/dL; 95% CI: - 0.53 to 0.06; P = 0.12) did not differ in the exercise groups compared with the controls. CONCLUSION: Exercise intervention improved some of the CVD risk factors but not all, hs-CRP, VO2peak and AT were significantly improved after exercise intervention, while, changes of MMP-9, the size of AAA, and the overall lipids profile were not. Exercise intervention provides an additional solution for improving cardiorespiratory capacity and health status among AAA patients, and might lead to a delay of AAA progression.

A Bayesian proportional hazards mixture cure model for interval-censored data.

The proportional hazards mixture cure model is a popular analysis method for survival data where a subgroup of patients are cured. When the data are interval-censored, the estimation of this model is challenging due to its complex data structure. In this article, we propose a computationally efficient semiparametric Bayesian approach, facilitated by spline approximation and Poisson data augmentation, for model estimation and inference with interval-censored data and a cure rate. The spline approximation and Poisson data augmentation greatly simplify the MCMC algorithm and enhance the convergence of the MCMC chains. The empirical properties of the proposed method are examined through extensive simulation studies and also compared with the R package "GORCure". The use of the proposed method is illustrated through analyzing a data set from the Aerobics Center Longitudinal Study.

Associations of cardiorespiratory fitness and body mass index with incident restrictive spirometry pattern.

OBJECTIVES: Restrictive spirometry pattern (RSP) suggests an impairment of lung function associated with a significantly increased risk of premature mortality. We evaluated the independent and joint associations of cardiorespiratory fitness (CRF) and body mass index with incident RSP. METHODS: Data from the Aerobics Centre Longitudinal Study included 12 360 participants (18-82 years). CRF was assessed by maximal treadmill test and categorised into five groups. Body mass index was categorised into normal weight (<25.0 kg/m2), overweight (25.0-29.9 kg/m2) or obesity (≥30.0 kg/m2). RSP was defined as the simultaneous occurrence of forced expiratory volume in 1 s/force vital capacity ≥lower limit of normal and forced vital capacity

Association between cardiorespiratory fitness and low back pain is anxiety-dependent: A prospective cohort study among adults and older adults.

To investigate the relationship between low back pain and cardiorespiratory fitness (CRF) among participants with and without self-report anxiety. Participants were 13,080 individuals (86.6% men; 44.7 ± 9.3 years). CRF was quantified as maximal treadmill test duration and was grouped for analysis as low (lowest 20% of treadmill test duration), moderate (middle 40%), and high (upper 40%). Cox regression analysis was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) between low back pain and CRF according to the presence/absence of self-report anxiety. During an average of 5.7 ± 5.1 years of follow-up, 2,965 cases of low back pain were identified. Participants with self-report anxiety and low CRF had 3.7 times (HR: 3.7; 95%CI: 1.7-8.2) more risk for having low back pain when compared with participants with self-report anxiety and high CRF. Additionally, among participants with self-reported anxiety, moderate CRF was associated with an 70% greater risk of having low back pain than those with high CRF (HR: 1.7; 95%CI: 1.1-3.2). For participants without self-reported anxiety, no association was found between the risk of having low back pain and CRF. According to the results identified in the present study, participants with self-reported anxiety who had low and moderate CRF had higher risks of low back pain than those with high CRF.

Simultaneous variable selection in regression analysis of multivariate interval-censored data.

Multivariate interval-censored data arise when each subject under study can potentially experience multiple events and the onset time of each event is not observed exactly but is known to lie in a certain time interval formed by adjacent examination times with changed statuses of the event. This type of incomplete and complex data structure poses a substantial challenge in practical data analysis. In addition, many potential risk factors exist in numerous studies. Thus, conducting variable selection for event-specific covariates simultaneously becomes useful in identifying important variables and assessing their effects on the events of interest. In this paper, we develop a variable selection technique for multivariate interval-censored data under a general class of semiparametric transformation frailty models. The minimum information criterion (MIC) method is embedded in the optimization step of the proposed expectation-maximization (EM) algorithm to obtain the parameter estimator. The proposed EM algorithm greatly reduces the computational burden in maximizing the observed likelihood function, and the MIC naturally avoids selecting the optimal tuning parameter as needed in many other popular penalties, making the proposed algorithm promising and reliable. The proposed method is evaluated through extensive simulation studies and illustrated by an analysis of patient data from the Aerobics Center Longitudinal Study.

Resistance exercise, alone and in combination with aerobic exercise, and obesity in Dallas, Texas, US: A prospective cohort study.

BACKGROUND: Obesity is a significant and growing public health problem in high-income countries. Little is known about the relationship between resistance exercise (RE), alone and in combination with aerobic exercise (AE), and the risk of developing obesity. The purpose of this prospective cohort study was to examine the associations between different amounts and frequencies of RE, independent of AE, and incident obesity. METHODS AND FINDINGS: Participants were 11,938 healthy adults ages 18-89 years with a BMI < 30 kg/m2 at baseline who completed at least 2 clinical examinations during 1987-2005 as part of the Aerobics Center Longitudinal Study. Self-reported RE participation in minutes/week and days/week was collected from a standardized questionnaire. Incident obesity was defined as a BMI ≥ 30 kg/m2 at follow-up. Incident obesity was also defined by waist circumference (WC) > 102/88 cm for men/women and percent body fat (PBF) ≥ 25%/30% for men/women at follow-up in participants who were not obese by WC (n = 9,490) or PBF (n = 8,733) at baseline. During the average 6-year follow-up, 874 (7%), 726 (8%), and 1,683 (19%) developed obesity defined by BMI, WC, or PBF, respectively. Compared with no RE, 60-119 min/wk of RE was associated with 30%, 41%, and 31% reduced risk of obesity defined by BMI (hazard ratio [95% CI], 0.70 [0.54-0.92], p = 0.008), WC (0.59 [0.44-0.81], p < 0.001), and PBF (0.69 [0.57-0.83], p < 0.001), respectively, after adjusting for confounders including age, sex, examination year, smoking status, heavy alcohol consumption, hypertension, hypercholesterolemia, diabetes, and AE. Compared with not meeting the RE guidelines of ≥2 d/wk, meeting the RE guidelines was associated with 18%, 30%, and 30% reduced risk of obesity defined by BMI (hazard ratio [95% CI], 0.82 [0.69-0.97], p = 0.02), WC (0.70 [0.57-0.85], p < 0.001), and PBF (0.70 [0.62-0.79], p < 0.001), respectively. Compared with meeting neither guideline, meeting both the AE and RE guidelines was associated with the smallest hazard ratios for obesity. Limitations of this study include limited generalizability as participants were predominantly white men from middle to upper socioeconomic strata, use of self-reported RE, and lack of detailed diet data for the majority of participants. CONCLUSIONS: In this study, we observed that RE was associated with a significantly reduced risk of obesity even after considering AE. However, meeting both the RE and AE guidelines was associated with the lowest risk of obesity.

The association of fitness and fatness with intermediate hyperglycemia incidence in women: A cohort study.

The purpose of this study was to examine the associations of cardiorespiratory fitness, general adiposity, and central adiposity with incident intermediate hyperglycemia (IH) in women. We conducted a prospective cohort study of 1534 women aged 20-79 years old who had an annual health check-up with no history of major chronic diseases. At baseline, fitness was assessed by a Balke graded exercise test, and the estimated metabolic equivalents were used to create quartile groups. Women were also grouped based on their body mass index (<25 kg/m2, 25-29.9 kg/m2, and ≥ 30 kg/m2) and waist-to-height ratio (≥0.50 or < 0.50). Cox proportional hazards models were conducted to assess the association of fitness and fatness variables with incident IH defined as fasting glucose of 5.6-6.9 mmol/L. Overall, 18.1% (n = 277) of the women developed IH during an average follow-up of 5.06 years. Fitness, body mass index, and waist-to-height ratio at baseline were the independent predictors of the IH incidence in separate age-adjusted models; yet when all three variables were included in the same model along with confounding variables, only fitness remained significant and demonstrated a clear inverse association with incident IH (P-for-trend <0.001). Health promotion efforts should focus on improving fitness for the prevention of IH in women.

Association between type 2 diabetes and non-exercise estimated cardiorespiratory fitness among adults: evidences from a middle-income country.

OBJECTIVE: The objective of this study is to assess the association between type 2 diabetes (T2D) and cardiorespiratory fitness (CRF) estimated through a non-exercise model in a large representative group of Brazilian adults. STUDY DESIGN: The study design of this study is a cross-sectional population-based study. METHODS: The presence of T2D was assessed through self-report in 42,631 individuals aged 20-59 years. The CRF was predicted from a non-exercise equation containing the following data: sex, age, body mass index, and physical activity level. The corresponding metabolic equivalent (MET) value was used to classify participants into the following four groups based on the cutpoints: <6, 6-9, 10-11, and ≥12 METs. Crude and multivariable-adjusted logistic regressions were carried out to determine the association between CRF and the presence of diabetes. RESULTS: Significant linear trends were observed in diabetes across different categories of CRF in men. In women, however, linear trends were not observed in T2D across '10-11' and '≥12' categories. A 1-MET increase in estimated CRF was associated with 29% lower odds of diabetes in men and 14% in women after adjusting all the potential confounders (P < 0.001). CONCLUSIONS: The presence of T2D was inversely associated with every CRF level in men and with 6-9 METs when comparing with <6 METs in women, through a non-exercise model in Brazilian adults. This finding suggests that a practical, viable, and low-cost measurement of CRF could be applied in lower income countries to assess the relationship between CRF and T2D. However, new non-exercise models are needed to better detect T2D in women.

Association between change in maternal physical activity during pregnancy and infant size, in a sample overweight or obese women.

Physical activity (PA) naturally declines during pregnancy and its effects on infant size are unclear, especially in overweight or obese pregnancies, a low-active subpopulation that tends deliver heavier infants. The objective of this study was to evaluate changes in prenatal PA and infant birthweight in a group of overweight or obese pregnant women. We employed a prospective analysis using data from a randomized controlled exercise trial (2001 to 2006) in sedentary, overweight or obese pregnant women in Michigan. Women with complete data on peak oxygen consumption, daily PA (via pedometers) and birthweight were included in the analyses. Change in PA was estimated via repeated measures analyses, and then its influence on infant birthweight was assessed via linear regression. Eighty-nine pregnant women were included and considered low-active (6,579.91 ± 2379.17 steps/day). PA declined from months 4 to 8 (-399.73 ± 371.38 steps∙day-1∙month-1). Analyses showed that the decline in PA (ß = -0.28 g, 95%CI: -0.70, 0.25 g, p = .35) was not associated with birthweight. The findings of this study demonstrated that the decline in maternal PA during mid- to late-pregnancy, in overweight or obese women, was unrelated to infant birthweight. Future investigations should employ rigorous measurements of PA and infant anthropometry in this subpopulation.

A varying-coefficient generalized odds rate model with time-varying exposure: An application to fitness and cardiovascular disease mortality.

Varying-coefficient models have become a common tool to determine whether and how the association between an exposure and an outcome changes over a continuous measure. These models are complicated when the exposure itself is time-varying and subjected to measurement error. For example, it is well known that longitudinal physical fitness has an impact on cardiovascular disease (CVD) mortality. It is not known, however, how the effect of longitudinal physical fitness on CVD mortality varies with age. In this paper, we propose a varying-coefficient generalized odds rate model that allows flexible estimation of age-modified effects of longitudinal physical fitness on CVD mortality. In our model, the longitudinal physical fitness is measured with error and modeled using a mixed-effects model, and its associated age-varying coefficient function is represented by cubic B-splines. An expectation-maximization algorithm is developed to estimate the parameters in the joint models of longitudinal physical fitness and CVD mortality. A modified pseudoadaptive Gaussian-Hermite quadrature method is adopted to compute the integrals with respect to random effects involved in the E-step. The performance of the proposed method is evaluated through extensive simulation studies and is further illustrated with an application to cohort data from the Aerobic Center Longitudinal Study.

Sedentary behaviour is associated with diabetes mellitus in adults: findings of a cross-sectional analysis from the Brazilian National Health System.

BACKGROUND: Sedentary behaviour (SB) may contribute to the development of several chronic diseases, such as hypertension, diabetes mellitus (DM) and all-cause mortality. The aim of this study is to investigate the association between different domains of SB with diabetes among adult users of the Brazilian National Health System (NHS). METHODS: Cross-sectional study from the primary care system of the Brazilian NHS in the city of Bauru, Brazil. SB, physical activity (PA), DM and other chronic diseases were assessed by face-to-face interviews and medical records. As potential confounders in the adjusted model, we used gender, age, economic status, smoking status, hypertension, hypercholesterolaemia and PA. RESULTS: The study was composed of 147 men and 410 women. The fully adjusted model showed that Brazilian adults spending ≥3 h per day in television viewing (OR = 1.61 [95% CI: 1.11-2.33]) and overall SB (OR = 1.60 [95% CI: 1.09-2.36]) had increased prevalence of DM compared to those spending <3 h per day. CONCLUSIONS: TV viewing and overall SB was associated with higher prevalence of DM in Brazilian adults from the NHS, even after controlling for potential confounders including PA.

The effect of moderate-intensity exercise on nightly variability in objectively measured sleep parameters among older women.

Objective/Background: Exercise training has been demonstrated to beneficially influence mean-level measures of sleep; however, few studies have examined the impact of an exercise intervention on night-to-night variability in sleep. This study investigated whether four months of moderate-intensity exercise impacted night-to-night variability in sleep among older women. Methods: Participants (n = 49) were randomized to one of two moderate-intensity walking programs with different doses of energy expenditure: low-dose (n = 23: 8 kcal/kg of body weight per week) or high-dose (n = 26: 14 kcal/kg of body weight per week). Sleep parameters were assessed objectively via actigraphy at baseline, mid- (2 months), and postintervention (4 months). Nightly variability in each of the sleep parameters was calculated using the seven-day standard deviation (SD) and a coefficient of variation (SD/mean x 100%). Cardiorespiratory fitness (VO2peak) was measured at baseline and postintervention using a graded treadmill test. Results: Both measures of nightly variability demonstrated a borderline to significantly lower amount of night-to-night variability in wake time after sleep onset (WASO) and number of awakenings at postintervention in comparison to baseline (p ≤ 0.05). Higher VO2peak levels at baseline were associated with less time in bed and lower total sleep time variability throughout the exercise intervention (p < 0.05). Conclusion: Overall, participation in moderate-intensity exercise was observed to reduce the amount of nightly variability for WASO and number of awakenings over time in older women.

Impact of sports participation on mortality rates among Brazilian adults.

Objective: To analyze the possible dose-response association between components of sports participation (intensity, volume and previous engagement) and 4-year mortality rates among Brazilian adults. Methods: 679 males and females (mean age among men = 66.7 ± 9.3 years old and mean age among women = 64.8 ± 8.9 years old) composed the study sample. Sports participation was assessed using Baecke's questionnaire, which considers intensity, duration and previous engagement. Medical records were used to identify the cause of the death. Cox regression analysis was performed to determine the independent associations of exercise components and mortality. Results: Participants that reported exercising at moderate-vigorous intensity (Moderate/vigorous: 4.1% versus None/light: 10.3% [p-value = 0.012]; HR = 0.42 [0.1 to 0.94)] and for more than four months (≥4 months: 5.3% versus <4 months: 10.2% [p-value = 0.038]; HR = 0.47 [0.24 to 0.94]) had lower mortality risk. The percentage of survival according to all-cause mortality was significantly higher for participants engaged in sports at moderate-vigorous intensity (p-value = 0.014), as well as for those engaged in sports for periods superior than four months (p-value = 0.036). Conclusion: We found higher percentage of survival among adults engaged in sports at moderate-vigorous intensity and with at least four months of previous engagement.

The Effect of Structured Exercise on Sleep During the Corresponding Night Among Older Women in an Exercise Program.

This study investigated the acute effect of exercise on sleep outcomes among healthy older women by comparing days with structured exercise versus days without structured exercise during 4 months of exercise training. Participants (n = 51) in this study had wrist-worn actigraphic sleep data available following at least 3 days with structured exercise and 3 days without structured exercise at mid-intervention and at the end of intervention. The exercise intervention was treadmill walking. Multilevel models were used to examine whether structured exercise impacted sleep outcomes during the corresponding night. Overall, 1,362 nights of data were included in the analyses. In unadjusted and adjusted models, bedtimes were significantly earlier on evenings following an acute bout of structured exercise than on evenings without structured exercise. No other sleep parameters differed between exercise and nonexercise days. Understanding the effects of exercise on sleep in this understudied population may help to improve their overall sleep quality.

Association of TV Viewing and All-Cause Mortality in Older Adults With Hypertension: A 6-Year Longitudinal Study.

The purpose of this study was to examine the longitudinal association between television (TV) viewing and all-cause mortality in older adults with hypertension. Sedentary behavior, physical activity, hypertension, and other chronic diseases were assessed by face-to-face interviews and confirmed by medical history. Mortality was reported by relatives and confirmed in medical records of the National Health System. The fully adjusted model showed a direct association between high TV viewing time and all-cause mortality; hazard ratio: 1.65 (95% confidence interval [1.02-2.68]). Women with high TV viewing were more likely to die than men. Higher TV viewing time was associated with all-cause mortality among those with diabetes and hypertension; hazard ratio: 3.54 (95% confidence interval [1.64-7.66]). The findings from this longitudinal study show that higher TV viewing time is associated with higher risk for all-cause mortality among older adults with hypertension, independently of physical activity, and other potential confounders.

Physical activity and fitness for the prevention of hypertension.

PURPOSE OF REVIEW: The aim of this review is to evaluate the most recent literature about the role of physical activity, exercise, and fitness in hypertension prevention. RECENT FINDINGS: Strong evidence indicates that performing moderate-to-vigorous physical activity, particularly aerobic exercise, and improving cardiorespiratory fitness (CRF) reduce blood pressure (BP) levels and lower hypertension incidence. Although evidence is limited, performing resistance exercise or improving muscular strength appears to be associated with a lower incidence of hypertension. Furthermore, reducing sedentary time or replacing sedentary time with physical activity might lower BP. SUMMARY: To lower the risk of hypertension, promoting physical activity and improving fitness, especially CRF, should be encouraged. More research is needed to determine the effects of sedentary behavior, resistance exercise, and muscle strength on the development of hypertension across diverse populations and settings. Future studies should focus on dose-response relationships of exercise and physical activity with the development of hypertension to determine the minimal and optimal amount of exercise and physical activity for hypertension prevention.

Importance of Assessing Cardiorespiratory Fitness in Clinical Practice: A Case for Fitness as a Clinical Vital Sign: A Scientific Statement From the American Heart Association.

Mounting evidence has firmly established that low levels of cardiorespiratory fitness (CRF) are associated with a high risk of cardiovascular disease, all-cause mortality, and mortality rates attributable to various cancers. A growing body of epidemiological and clinical evidence demonstrates not only that CRF is a potentially stronger predictor of mortality than established risk factors such as smoking, hypertension, high cholesterol, and type 2 diabetes mellitus, but that the addition of CRF to traditional risk factors significantly improves the reclassification of risk for adverse outcomes. The purpose of this statement is to review current knowledge related to the association between CRF and health outcomes, increase awareness of the added value of CRF to improve risk prediction, and suggest future directions in research. Although the statement is not intended to be a comprehensive review, critical references that address important advances in the field are highlighted. The underlying premise of this statement is that the addition of CRF for risk classification presents health professionals with unique opportunities to improve patient management and to encourage lifestyle-based strategies designed to reduce cardiovascular risk. These opportunities must be realized to optimize the prevention and treatment of cardiovascular disease and hence meet the American Heart Association's 2020 goals.

Exercise and the cardiovascular system: clinical science and cardiovascular outcomes.

Substantial evidence has established the value of high levels of physical activity, exercise training (ET), and overall cardiorespiratory fitness in the prevention and treatment of cardiovascular diseases. This article reviews some basics of exercise physiology and the acute and chronic responses of ET, as well as the effect of physical activity and cardiorespiratory fitness on cardiovascular diseases. This review also surveys data from epidemiological and ET studies in the primary and secondary prevention of cardiovascular diseases, particularly coronary heart disease and heart failure. These data strongly support the routine prescription of ET to all patients and referrals for patients with cardiovascular diseases, especially coronary heart disease and heart failure, to specific cardiac rehabilitation and ET programs.

Is There a Dose-Response Relationship between Tea Consumption and All-Cause, CVD, and Cancer Mortality?

BACKGROUND: A small change in tea consumption at population level could have large impact on public health. However, the health benefits of tea intake among Americans are inconclusive. OBJECTIVE: To evaluate the association between tea consumption and all-causes, cardiovascular disease (CVD) and cancer mortality in the Aerobics Center Longitudinal study (ACLS). METHODS: 11808 participants (20-82 years) initially free of CVD and cancers enrolled in the ACLS and were followed for mortality. Participants provided baseline self-report of tea consumption (cups/day). During a median follow-up of 16 years, 842 participants died. Of others, 250 died from CVD, and 345 died from cancer, respectively. A Cox proportional hazard model was used to produce hazard ratio (HR) and 95% confidence interval (CI). RESULTS: Compared with participants consuming no tea, tea drinkers had a survival advantage ( Log-2 = 10.2, df = 3, P = 0.017); however, the multivariate hazard ratios (HRs) of all-cause mortality for those drinking 1-7, 8-14, and >14 cups/week were 0.95 (95% CI, 0.81-1.12), 1.00 (95% CI, 0.82-1.22), and 0.98 (95% CI, 0.76-1.25), respectively (P for linear trend = 0.83). The multivariate HR were 1.16 (95% CI, 0.86-1.56), 1.22 (95% CI, 0.85-1.76), and 0.94 (95% CI, 0.56-1.54) for CVD mortality (P for linear trend = 0.47), and 0.97 (95% CI, 0.75-1.25), 0.85 (95% CI, 0.60-1.16), and 0.94 (95% CI, 0.64-1.38) for cancer mortality (P for trend = 0.62). CONCLUSIONS: There were week or null relationships between tea consumption and mortality due to all-cause, CVD disease or cancer were observed in ACLS.