Effectiveness of sodium-glucose co-transporter-2 inhibitors on ischaemic heart disease.

AIM: To compare the cardiovascular risks between users and non-users of sodium-glucose co-transporter-2 (SGLT2) inhibitors based on electronic medical record data from a large integrated healthcare system in South Louisiana. MATERIALS AND METHODS: Demographic, anthropometric, laboratory and medication prescription information for patients with type 2 diabetes who were new users of SGLT2 inhibitors, either as initial treatments or as add-on treatments, were obtained from electronic health records. Mediation analysis was performed to evaluate the association of use of SGLT2 inhibitors and changes of metabolic risk factors with the risk of incident ischaemic heart disease. RESULTS: A total of 5338 new users of SGLT2 inhibitors were matched with 13 821 non-users. During a mean follow-up of 3.26 years, 2302 incident cases of ischaemic heart disease were defined. After adjusting for multiple confounding factors, patients using SGLT2 inhibitors had a lower risk of incident ischaemic heart disease compared to patients not using SGLT2 inhibitors (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.54-0.73). Patients using SGLT2 inhibitors also had a lower risk of incident ischaemic heart disease within 6 months (HR 0.36, 95% CI 0.25-0.44), 12 months (HR 0.40, 95% CI 0.32-0.49), 24 months (HR 0.53, 95% CI 0.43-0.60) and 36 months (HR 0.65, 95% CI 0.54-0.73), respectively. Reductions in systolic blood pressure partly mediated lowering risk of ischaemic heart disease among patients using SGLT2 inhibitors. CONCLUSIONS: The real-world data in the present study show the contribution of SGLT2 inhibitors to reducing risk of ischaemic heart disease, and their benefits beyond glucose-lowering.

Step Tracking with Goals Increases Children's Weight Loss in Behavioral Intervention.

BACKGROUND: This study examined the influence of step goals with pedometers to improve children's weight loss, physical activity, and psychosocial health during obesity treatment. METHODS: Overweight and obese children ages 8-17 years (n = 105) participated in a 10-week family-based weight management intervention, including physical activity, nutrition, and behavioral modification. A quasi-experimental design was used to group eight cohorts into three conditions: no pedometer (n = 24), pedometer only (n = 25), and pedometer with step goals (i.e., 500 steps/day weekly increase above baseline; n = 56). Height and weight were measured at baseline and week 10 and used to calculate BMI. Analysis of covariance was performed to examine difference by condition for change in weight, BMI, and BMI z-score, controlling for age and baseline value. Differences in steps per day and psychosocial health were compared between the two pedometer conditions. RESULTS: Participants were 12.4 ± 2.5 years of age, including 70% girls and 64% African Americans. The pedometer with goals condition significantly reduced BMI (p = 0.02) and BMI z-score (p = 0.01) compared with the no-pedometer group. The pedometer with goals condition significantly increased steps per day (+1185 ± 425 steps/day) compared with the pedometer-only condition (-162 ± 620 steps/day; p < 0.05). Both pedometer groups similarly increased in subjective health and quality of life. CONCLUSIONS: Providing children with pedometers and individualized step goals was an effective approach to produce weight loss. Further work is needed to increase the strength of interventions to achieve clinically meaningful weight reduction for children with obesity.

Coffee consumption and the risk of heart failure in Finnish men and women.

OBJECTIVES: To evaluate the association of coffee consumption with the risk of heart failure (HF) in the Finnish population. DESIGN: Prospective population-based cohort study. SETTING: This study, which is a part of FINRISK study, was carried out in Finland. SUBJECTS: Study cohorts included 59,490 Finnish participants aged 25-74 years who were free of HF at baseline. MAIN OUTCOME MEASURES: HF (2020 men and 1807 women) during a mean follow-up of 19.2 years. RESULTS: Multivariable-adjusted (age, study year, body mass index, smoking, education, alcohol consumption, tea consumption, physical activity, systolic blood pressure, history of myocardial infarction, history of valvular heart disease, history of diabetes and total cholesterol) HRs (with 95% CI) of HF associated with the amount of coffee consumption daily (0, 1-2, 3-4, 5-6, 7-9 and ≥10 cups) were 1.00, 0.91 (0.71 to 1.16), 0.88 (0.70 to 1.10), 0.91 (0.73 to 1.13), 0.96 (0.76 to 1.22) and 1.02 (0.80 to 1.30) (p(trend) = 0.485) for men and 1.00, 0.73 (0.56 to 0.97), 0.77 (0.60 to 0.98), 0.68 (0.53 to 0.88), 0.80 (0.61 to 1.04) and 0.88 (0.65 to 1.19) (p(trend) = 0.007) for women, respectively. Stratification by age, smoking status, alcohol consumption, history of type 2 diabetes mellitus and body mass index gave similar results. CONCLUSION: Coffee consumption does not increase the risk of HF in Finnish men and women. In women, an inverse association was observed between low to moderate coffee consumption and the risk of HF.