Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 44
Filtrar
Mais filtros










Base de dados
Intervalo de ano de publicação
1.
J Atheroscler Thromb ; 2020 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-31932552

RESUMO

AIM: N-terminal pro-B-type natriuretic peptide (NT-proBNP), frequently used as a biochemical marker for detecting and monitoring heart failure, is also a risk marker for development of coronary heart disease and total stroke. However, studies that explore subtypes of ischemic stroke with regard to NT-proBNP are scarce. Here, we examined NT-proBNP and its impact upon subtypes of ischemic stroke (lacunar stroke, large-artery occlusive stroke and embolic stroke) among Japanese. METHODS: We measured NT-proBNP and categorized 4,393 participants of the Circulatory Risk in Communities Study into four groups (<55, 55-124, 125-399, and ≥ 400 pg/ml). We used a multivariable Cox proportional hazards model to examine association with risks of stroke and subtypes. RESULTS: During 4.7 years of follow-up, we identified 50 strokes, including 35 ischemic (15 lacunar, 6 largeartery occlusive, 10 embolic strokes) and 14 hemorrhagic strokes. NT-proBNP was associated with stroke risk: the multivariable hazard ratio of total strokes was 7.29 (2.82-18.9) for the highest and 2.78 (1.25-6.16) for the second highest NT-proBNP groups compared with the lowest group. The respective hazard ratios for the highest NT-proBNP group were 9.37 (3.14-28.0) for ischemic stroke and 6.81 (1.11-41.7) for lacunar stroke. Further adjustment for atrial fibrillation did not attenuate these associations. The associations were similarly observed for large-artery occlusive and embolic strokes. CONCLUSION: We found that even moderate serum levels of NT-proBNP were associated with the risk of total and ischemic strokes among Japanese whose NT-proBNP levels were relatively low compared with Westerners.

2.
Psychosom Med ; 82(2): 215-223, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31860529

RESUMO

OBJECTIVE: It has been suggested that urbanization, which has been expanding rapidly for the past several decades, increases the risk of cardiovascular disease (CVD) associated with psychological factors such as anger, but the evidence is limited. We examined the hypothesis that urbanicity modifies the association of anger expression with the risk of CVD. METHODS: A prospective study was conducted in 5936 residents of urban and rural communities aged 40 to 79 years who had completed an annual health checkup including a questionnaire on anger expression between 1995 and 1998. Associations of anger expression with the risk of CVDs were examined using Cox proportional hazards models, after adjusting for classical cardiovascular risk factors. RESULTS: During a median follow-up of 16.6 years, we identified 312 incident CVDs. The means (SDs) of anger expression were 24.7 (5.8) among urban residents and 24.6 (5.7) among rural participants (p = .87). Among urban residents, anger expression was positively associated with the risk of total CVD: the multivariable hazard ratio (95% confidence interval) was 1.27 (1.05-1.54). In contrast, no association was found among rural residents: the corresponding ratio (interval) was 0.96 (0.85-1.09), with a significant interaction between urban and rural residency with anger expression for incident CVD (p = .047). Similar associations were observed with the risk of CVD subtypes, including ischemic stroke and ischemic CVD. CONCLUSIONS: We found a positive association between anger expression and the risk of CVD among urban residents but not rural residents, suggesting that urbanicity enhances the anger-CVD association.

3.
J Anesth ; 2019 Dec 16.
Artigo em Inglês | MEDLINE | ID: mdl-31845014

RESUMO

PURPOSE: Analgesic medication epidemic during pregnancy is an important issue in Western countries. However, no large epidemiological study involving pregnant women with pain and their medication use has been conducted in Japan. This study examined the current situation of medication use for non-cancer pain during the perinatal period in Japan using national cohort data. METHODS: We analyzed 94,649 pregnant women who completed a self-report questionnaire investigating bodily pain and an interview-based medication use survey. Medication use before and during pregnancy and new medication administration/discontinuation during pregnancy were compared between women with and without pain during pregnancy using multivariable covariance analysis. RESULTS: Mild pain was reported by 50.4% of pregnant women in the first trimester (survey 1) and 61.8% in the second/third trimester (survey 2). Moderate-to-severe pain was reported by 15.4% of women in survey 1 and 22.4% in survey 2. In survey 1, 6.2% of women used prescribed analgesics and 1.6% used over-the-counter analgesics. In survey 2, prescribed and over the counter analgesics were used by 12.2% and 0.8% of women, respectively. Other pain-related medications were rarely used (< 1.0%). Pregnant women with moderate-to-severe pain showed a lower proportion of discontinuation of analgesics and a higher proportion of new administration of prescription and transdermal analgesics compared with those without pain. CONCLUSIONS: Although a large proportion of pregnant women experience pain, medication use for pain during pregnancy is low in Japan compared with Western countries (50-60%). Adequate treatment or support may be necessary for pregnant women experiencing pain in Japan.

4.
J Anesth ; 33(6): 636-641, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31511988

RESUMO

PURPOSE: To examine the association between catastrophizing and pain intensity with acute herpes zoster, and the association of treatment-related early changes in depressive symptoms, anxiety, and catastrophizing with postherpetic neuralgia (PHN) development, independent of acute pain intensity. METHODS: We analyzed 44 outpatient participants with acute herpes zoster who completed a 6-month follow-up. Participants completed a self-reported questionnaire with a Visual Analog Scale (VAS), the Pain Catastrophizing Scale (PCS), and the Hospital Anxiety and Depression Scale (HADS) at first visit, and 3 and 6 months, thereafter. We assessed associations between acute pain intensity and analyzed factors using univariate regression analyses. Univariate and bivariate logistic regression models were constructed to assess associations of variables at the first visit and early changes in psychological factors with PHN development. RESULTS: Sex, severe skin rash at first visit, PCS, and HADS depression were associated with acute pain intensity {standardized regression coefficient, 0.46 [95% confidence interval (CI) 0.12-0.74], 0.36 (95% CI 0.07-0.65), 0.33 (95% CI 0.03-0.62), 0.47 (95% CI 0.19-0.74), respectively}. Acute pain intensity and early change in pain intensity were associated with PHN development [odds ratio (OR) 1.08 (95% CI 1.02-1.14) OR 2.38 (95% CI 1.10-5.16), respectively]. Decreased PCS was associated with decreased risk of PHN development, independent of acute pain intensity [OR 0.31 (95% CI: 0.12-0.80)]. CONCLUSION: Catastrophizing was associated with acute pain intensity, and lower pain-related catastrophizing among patients with acute herpes zoster was associated with less risk of PHN development, independent of acute pain intensity.

5.
J Am Heart Assoc ; 8(18): e012657, 2019 Sep 17.
Artigo em Inglês | MEDLINE | ID: mdl-31495291

RESUMO

Background High levels of physical activity have been associated with longer life expectancy free of cardiovascular disease (CVD), but specific types of CVD and sedentary behavior have not been examined. We examined associations of leisure-time moderate-to-vigorous physical activity (LTPA) and television viewing with life expectancy free of 3 types of CVD. Methods and Results We included 13 534 participants from the ARIC (Atherosclerosis Risk in Communities) cohort. We used multistate survival models to estimate associations of LTPA in the past year (no LTPA, less than the median, equal to or greater than the median) and television viewing (often or very often, sometimes, seldom or rarely) with life expectancy at age 50 free of nonfatal coronary heart disease (CHD), stroke, and heart failure (HF). Over 27 years of follow-up, 4519 participants developed one of the 3 nonfatal CVDs and 5475 deaths occurred. Compared with participants who engaged in no LTPA, participants who engaged in LTPA equal to or greater than the median had longer life expectancy free of nonfatal CHD (men: 1.5 years [95% CI, 1.0-2.0]; women: 1.6 years [95% CI, 1.1-2.2]), stroke (men: 1.8 years [95% CI, 1.2-2.3]; women: 1.8 years [95% CI, 1.3-2.3]), and HF (men: 1.6 years [95% CI, 1.1-2.1]; women: 1.7 years [95% CI, 1.2-2.2]). Compared with viewing more television, watching less television was associated with longer life expectancy free of CHD, stroke, and HF (≈0.8 year). Conclusions Higher levels of LTPA and less television viewing were associated with longer life expectancy free of CHD, stroke, and HF. Engaging in LTPA and watching less television may increase the number of years lived free of CHD, stroke, and HF.

6.
J Am Coll Cardiol ; 74(10): 1290-1300, 2019 Sep 10.
Artigo em Inglês | MEDLINE | ID: mdl-31488265

RESUMO

BACKGROUND: Spontaneous coronary artery dissection (SCAD) is an increasingly recognized cause of myocardial infarction (MI) in younger women, often treated conservatively due to revascularization risks. Revascularization outcomes are largely unknown in SCAD presenting with ST-segment elevation myocardial infarction (STEMI). OBJECTIVES: The purpose of this study was to compare revascularization strategies and outcomes of STEMI-SCAD with STEMI atherosclerosis (STEMI-ATH). METHODS: Consecutive STEMI patients were retrospectively analyzed (2003 to 2017) at 2 regional STEMI programs (Minneapolis Heart Institute and Cedars-Sinai Smidt Heart Institute) with 3-year outcomes. RESULTS: Among 5,208 STEMI patients, SCAD was present in 53 (1%; 93% female). SCAD prevalence was 19% in female STEMI patients age ≤50 years. Compared with STEMI-ATH, STEMI-SCAD patients were younger (age 49 ± 10 years vs. 63 ± 13 years), were more often female (93% vs. 27%), and had more frequent cardiogenic shock (19% vs. 9%); all p ≤ 0.03. In STEMI-SCAD, the culprit artery was more commonly left main (13% vs. 1%) or left anterior descending (47% vs. 38%); both p = 0.003. Acute revascularization was lower in STEMI-SCAD (70% vs. 97%); p < 0.001. In STEMI-SCAD, acute revascularization included percutaneous coronary intervention (PCI), n = 33 (62%), or bypass grafting, n = 4 (8%); PCI success was 91%. Those with revascularization were more likely to have shock, left main culprit, proximal dissection, and initial TIMI (Thrombolysis In Myocardial Infarction) flow grade 0 to 1. The 3-year survival was 98% for STEMI-SCAD versus 84% for STEMI-ATH; p < 0.001. CONCLUSIONS: STEMI-SCAD represents an important STEMI subset, particularly among younger women, characterized by significantly greater frequency of left main or left anterior descending culprit and cardiogenic shock than STEMI-ATH. Primary PCI is successful in most STEMI-SCAD patients, with low 3-year mortality.

7.
J Anesth ; 33(4): 523-530, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31278448

RESUMO

PURPOSE: Pain symptom, such as that caused by musculoskeletal disorders, is a major cause of occupational disability. As nicotine intake from smoking increases pain sensitivity, smokers may experience stronger pain and be more likely to experience pain-related disability than non-smokers. The study aim was to examine whether smoking was associated with pain-related occupational disability via pain intensity. METHODS: Participants were 1189 workers with pain aged 20-74 years in Japan. Participants completed a self-report questionnaire, which included a question to measure pain-related occupational disability with ordinal-option: (1) without pain-related disability, (2) pain-related presenteeism, and (3) pain-related absenteeism. An ordinal logistic regression model was used to calculate multivariable-adjusted proportional odds ratios (OR) with 95% confidence intervals (CI) for the prevalence of pain-related occupational disability according to smoking status. A multiple mediation analysis was also conducted to assess whether pain sensitivity mediated the association between smoking and pain-related occupational disability. Adjusted variables were demographic variables, socioeconomic status, work-related psychosocial factors, general psychological factors, and pain duration. RESULTS: Current smoking and pain were associated with pain-related occupational disability compared with non-smoking and pain (multivariable OR 1.78; 95% CI 1.26-2.52). Greater pain intensity partially mediated the association of current smoking and pain with pain-related occupational disability. The mediation rate (indirect/total effect) was 25%. CONCLUSION: Smoking and pain were associated with pain-related occupational disability, partially through greater pain intensity, among Japanese workers.

8.
Biopsychosoc Med ; 13: 17, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31360219

RESUMO

Background: Menstrual pain causes low quality of life among women of reproductive age, and often interferes with daily activities. Perceived injustice is a cognition linked to adverse symptoms. The aims of this study were to develop a Japanese version of the Injustice Experience Questionnaire-chronic (IEQ-chr-J), and to examine if perceived injustice is associated with pain intensity and impairment from menstruation. Methods: We investigated 130 Japanese women (aged 20-45 years) with menstrual pain in the past 3 months using online self-administered questionnaires. We examined the psychometric properties of the IEQ-chr-J including: structural validity; internal consistency; and test-retest reliability (intra-class correlation coefficients; ICC). Concurrent validity was examined by correlations among the IEQ-chr-J, the Pain Catastrophizing Scale (PCS), the Hospital Anxiety and Depression Scale (HADS), a numerical rating scale (NRS) for maximum/average menstrual pain, and the Brief Pain Inventory (BPI) pain interference domain. We used multivariable regression analysis to investigate the association between perceived injustice and severity of menstrual pain, after excluding 10 hormone drug users. Results: The IEQ-chr-J showed sufficient validity and reliability (Cronbach's α = 0.96, ICC 0.75, [95% confidence interval (CI): 0.61-0.88]. Pearson's correlation coefficients for the IEQ-chr-J, PCS, HADS anxiety, HADS depression, NRS, and BPI pain interference ranged from 0.27-0.65. The IEQ-chr-J was correlated with impairment due to menstrual pain (ICC 0.36, 95% CI: 0.14-0.58), an independent diagnosis of endometriosis, anxiety, and depression, but not with maximum or average pain intensity. Conclusions: The IEQ-chr-J has acceptable psychometric properties, and perceived injustice is associated with impairment from menstrual pain.

9.
Sci Rep ; 9(1): 10690, 2019 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-31337809

RESUMO

The aim of this prospective study was to investigate the associations of knee and low back pain with dementia development. Participants were 14,627 older people with no history of stroke, cancer, injuries, depression, Parkinson's disease, or dementia who did not require support for daily living completed self-administered questionnaires with 3-years follow-up. A Cox regression model was used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for dementia development. Stratified analyses by age and regular walking were conducted. Dementia risk was higher in participants aged 65-79 years with knee pain and without low back pain than in those without knee and low back pain [HR: 1.73 (95% CI: 1.11-2.68)]. Dementia risk was lower in participants ≥80 years with low back pain but no knee pain than in those without low back or knee pain [HR: 0.50 (95% CI: 0.31-0.80)]. Participants with knee pain who did not walk regularly had the highest dementia risk [HR: 1.71 (95% CI: 1.26-2.33)]. Knee pain may increase dementia risk among individuals aged 65-79 years, and may further increase risk in non-regular walkers. Low back pain may be a marker of maintained cognitive function despite age for individuals ≥80 years.

12.
J Atheroscler Thromb ; 26(9): 775-782, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-30700678

RESUMO

AIM: Previous studies suggested a positive association between eczema and cardiovascular disease (CVD), probably through enhanced systemic inflammation. However, several studies reported null findings about eczema and CVD, so the evidence is still controversial. METHODS: We asked 85,099 participants (35,489 men and 49,610 women), aged 40 to 79 years, without a history of CVD or cancer at baseline between 1988 and 1990, to complete a lifestyle questionnaire, including information eczema frequency (seldom, sometimes or often). RESULTS: During the 6,389,818 person-years of follow-up, there were 1,174 deaths from coronary heart disease (CHD), 979 from heart failure, 366 from cardiac arrhythmia, 2,454 from total stroke, 1,357 from ischemic stroke, 1,013 from hemorrhagic stroke, and 201 from aortic aneurysm or dissection. The multivariable-adjusted model showed that individuals who "sometimes" or "often" had eczema had 0.82 (95%confidence interval (CI): 0.69-0.97) or 1.26 (95%CI: 1.01-1.56) times the risk of mortality from CHD, respectively, compared to those who "seldom" did. Individuals who "often" had 1.30 (95%CI: 1.05-1.61) times the risk of mortality from CHD, compared to those who "seldom or sometimes" did. There was no association of eczema with mortality from other CVD, or no interaction between eczema and sex or age, in relation to any CVD mortality risk. CONCLUSIONS: Self-reported frequent eczema was associated with increased risk of mortality from CHD, but not other major CVD, in a Japanese general population. Since steroid usage was not considered, future studies should include it as a potential confounding factor.


Assuntos
Doenças Cardiovasculares/mortalidade , Eczema/complicações , Estilo de Vida , Autorrelato , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/patologia , Feminino , Seguimentos , Humanos , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco , Inquéritos e Questionários , Taxa de Sobrevida
13.
Pain Pract ; 19(5): 476-483, 2019 06.
Artigo em Inglês | MEDLINE | ID: mdl-30659740

RESUMO

OBJECTIVES: There have been no community-based studies investigating the association between sleep duration and postherpetic neuralgia (PHN) development. The aim of the current study was to examine the association of sleep with herpes zoster (HZ) incidence and PHN. METHODS: In total, 12,329 residents (ages 50 to 103 years) of Shozu County, Japan, participated in our study from December 2009 to November 2010 and were followed up for 3 years. At baseline, the participants completed self-administered health questionnaires, including those on usual sleep duration. Three dermatologists diagnosed HZ on the basis of clinical symptoms and virus identification testing by polymerase chain reaction and serological tests, and evaluated pain using a modified Zoster Brief Pain Inventory survey form via telephone. We used a Cox proportional hazard regression model to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HZ and PHN. We also performed mediation analysis to examine whether hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity. RESULTS: During follow-up, 400 cases of HZ were identified. Of these, 55 participants developed PHN. Sleep duration was not associated with HZ incidence. Sleep shortage increased the risk for PHN (HR 2.02 [95% CI: 1.06 to 3.85]). Hyperesthesia and acute pain intensity mediated the association between sleep shortage and chronic pain intensity (indirect/total effect ratio = 50% mediation). CONCLUSIONS: Sleep shortage was associated with increased risk for PHN, and hyperesthesia and acute pain intensity appeared to mediate this association. Sleep shortage may be a novel risk factor for PHN.


Assuntos
Neuralgia Pós-Herpética/epidemiologia , Sono , Dor Aguda/epidemiologia , Dor Aguda/etiologia , Idoso , Idoso de 80 Anos ou mais , Feminino , Herpes Zoster/complicações , Humanos , Hiperestesia/epidemiologia , Hiperestesia/etiologia , Incidência , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Neuralgia Pós-Herpética/etiologia , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo
14.
Heart Lung Circ ; 28(4): 615-622, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29685716

RESUMO

BACKGROUND: Although many studies have investigated the association of blood homocysteine with major cardiovascular diseases such as coronary heart disease and stroke, research on its association with atrial fibrillation (AF) is scarce. METHODS: We analysed data from Atherosclerosis Risk in Communities (ARIC) Study (n=492, age 45-64 years) and Multi-Ethnic Study of Atherosclerosis (MESA) (n=6,641, age 45-84 years). RESULTS: During the 10,106 and 67,613 person-years of follow-up, we identified 85 and 351 AF events in ARIC and MESA, respectively. An age-, sex-, and race-adjusted model showed dose-response relations between plasma homocysteine concentrations and AF incidence in both ARIC and MESA. Further adjustments for other AF risk factors did not change the associations. In the fully adjusted model, a meta-analysis of both studies showed a significant association between homocysteine and AF [hazard ratio (95% confidence interval) per 1 unit increment in log2(homocysteine), 1.27 (1.01-1.61)]. Individuals with higher levels of all three B vitamins (vitamin B6 and B12, and folate) had a lower risk of AF, but those associations were not statistically significant. In the full ARIC cohort [n=12,686 (2079 AF events)], there was no association between the C677T methylenetetrahydrofolate reductase (MTHFR) mutation and AF. CONCLUSIONS: In the prospective population-based ARIC and MESA cohorts, elevated homocysteine was modestly associated with an increased risk of incident AF, but the C677T MTHFR mutation was not associated with AF risk, suggesting that homocysteine may be a novel risk marker for AF rather than a causal risk factor.


Assuntos
Aterosclerose/sangue , Fibrilação Atrial/etnologia , Grupos Étnicos , Homocisteína/sangue , Vigilância da População/métodos , Medição de Risco/métodos , Idoso , Idoso de 80 Anos ou mais , Aterosclerose/complicações , Aterosclerose/etnologia , Fibrilação Atrial/sangue , Fibrilação Atrial/etiologia , Biomarcadores/sangue , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Fatores de Risco
15.
J Epidemiol ; 29(3): 83-91, 2019 Mar 05.
Artigo em Inglês | MEDLINE | ID: mdl-30584233

RESUMO

The Circulatory Risk in Communities Study (CIRCS) is an ongoing community-based epidemiological study of lifestyle-related disease involving dynamic prospective cohorts of approximately 12,000 adults from five communities of Japan: Ikawa, Ishizawa and Kita-Utetsu (Akita Prefecture), Minami-Takayasu (Osaka Prefecture), Noichi (Kochi Prefecture), and Kyowa (Ibaraki Prefecture). One of the most notable features of CIRCS is that it is not only an observational cohort study to identify risk factors for cardiovascular diseases (CVD), such as stroke, coronary heart disease, and sudden cardiac death, but it also involves prevention programs for CVD. Using basic, clinical, epidemiological, and statistical techniques, CIRCS has clarified characteristics of CVD and the related risk factors to develop specific methodologies towards CVD prevention in Japanese middle-aged or older adults for more than half a century.


Assuntos
Doenças Cardiovasculares/epidemiologia , Estilo de Vida , Características de Residência/estatística & dados numéricos , Adulto , Idoso , Doenças Cardiovasculares/prevenção & controle , Estudos Epidemiológicos , Feminino , Humanos , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fatores de Risco
16.
J Phys Act Health ; 15(12): 895-899, 2018 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-30463480

RESUMO

BACKGROUND: There is no research on the association of television (TV) watching with atrial fibrillation (AF). METHODS: From 1987 to 1989, the authors obtained information on the frequency of TV watching in 14,458 participants, aged 45-64 years, without a history of AF. The authors used the Cox proportional hazards model to estimate hazard ratios and their 95% confidence intervals of AF according to the frequency of TV watching ("never or seldom," "sometimes," "often," or "very often"). RESULTS: During the 294,553 person-years of follow-up, the authors identified 2,476 AF events. Adjustment for other potential confounding factors, including physical activity, did not change the associations, in which "very often" watching TV carried 1.28 (95% confidence interval, 1.09-1.50) times AF risk compared with "never or seldom" watching TV (P for trend = .002). Even among individuals who met a recommended level of physical activity, watching TV "very often" carried 1.36 (1.02-1.82) times AF risk, compared with watching TV "never or seldom." CONCLUSION: Greater frequency of TV watching was independently associated with increased risk of AF even after adjusting for physical activity. Moreover, a recommended level of physical activity did not eliminate the increased risk of frequent TV watching for AF. Avoiding frequent TV watching might be beneficial for AF prevention.


Assuntos
Aterosclerose/epidemiologia , Fibrilação Atrial/epidemiologia , Exercício/fisiologia , Recreação/fisiologia , Tempo de Tela , Comportamento Sedentário , Pressão Sanguínea/fisiologia , Índice de Massa Corporal , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos de Riscos Proporcionais , Estudos Prospectivos , Fatores de Risco , Televisão/estatística & dados numéricos
17.
J Anesth ; 32(3): 360-367, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29582154

RESUMO

PURPOSE: The aim of this study was to examine the association between body mass index and chronic pain. METHODS: The outcome was chronic pain prevalence by body mass index (BMI). BMIs of less than 18.5, 18.5-25.0, 25.0-30.0, and 30.0 or over kg/m2 were defined as underweight, normal weight, overweight, and obese. SUBJECTS: We used data from 4993 participants (2464 men and 2529 women aged 20-79 years) of the Pain Associated Cross-sectional Epidemiological survey in Japan. Sex-stratified multivariable-adjusted odds ratios were calculated with 95% confidence intervals using a logistic regression model including age, smoking, exercise, sleep time, monthly household expenditure, and presence of severe depression. We analyzed all ages and age subgroups, 20-49 and 50-79 years. RESULTS: The prevalence of chronic pain was higher among underweight, overweight, and obese male respondents than those reporting normal weight, with multivariable odds ratios of 1.52 (1.03-2.25), 1.55 (1.26-1.91), and 1.71 (1.12-2.60). According to underweight, only older men showed higher prevalence of chronic pain than normal weight men with odd ratios, 2.19 (1.14-4.20). Being overweight and obese were also associated with chronic pain in women; multivariable odds ratios were 1.48 (1.14-1.93) and 2.09 (1.20-3.64). Being underweight was not associated with chronic pain. CONCLUSION: There was a U-shaped association between BMI and chronic pain prevalence among men ≥ 50 years, and a dose-response association among women. Our finding suggests that underweight should be considered in older men suffering chronic pain.


Assuntos
Dor Crônica/epidemiologia , Obesidade/epidemiologia , Sobrepeso/epidemiologia , Magreza/epidemiologia , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Feminino , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Obesidade/complicações , Razão de Chances , Prevalência , Inquéritos e Questionários , Adulto Jovem
18.
J Thromb Thrombolysis ; 45(3): 353-359, 2018 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-29468488

RESUMO

TV viewing is associated with risk of arterial vascular diseases, but has not been evaluated in relation to venous thromboembolism (VTE) risk in Western populations. In 1987-1989, the Atherosclerosis Risk in Communities Study obtained information on the frequency of TV viewing in participants aged 45-64 and followed them prospectively. In individuals free of prebaseline VTE (n = 15, 158), we used a Cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident VTE according to frequency of TV viewing ("Never or seldom", "Sometimes", "Often" or "Very often"). During the 299,767 person-years of follow-up, we identified 691 VTE events. In a multivariable-adjusted model, the frequency of TV viewing showed a positive dose-response relation with VTE incidence (P for trend = 0.036), in which "very often" viewing TV carried 1.71 (95% CI 1.26-2.32) times the risk of VTE compared with "never or seldom" viewing TV. This association to some degree was mediated by obesity (25% mediation, 95% CI 10.7-27.5). Even among individuals who met a recommended level of physical activity, viewing TV "very often" carried 1.80 (1.04-3.09) times the risk of VTE, compared to viewing TV "never or seldom". Greater frequency of TV viewing was independently associated with increased risk of VTE, partially mediated by obesity. Achieving a recommended physical activity level did not eliminate the increased VTE risk associated with frequent TV viewing. Avoiding frequent TV viewing as well as increasing physical activity and controlling body weight might be beneficial for VTE prevention.


Assuntos
Televisão , Tromboembolia Venosa/etiologia , Aterosclerose/etiologia , Humanos , Incidência , Pessoa de Meia-Idade , Obesidade , Fatores de Risco
19.
Atherosclerosis ; 268: 225-230, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29079449

RESUMO

BACKGROUND AND AIMS: No prospective study has investigated whether individuals with respiratory impairments, including chronic obstructive pulmonary disease (COPD) and restrictive lung disease (RLD), are at increased risk of abdominal aortic aneurysm (AAA). We aimed to prospectively investigate whether those respiratory impairments are associated with increased AAA risk. METHODS: In 1987-1989, the Atherosclerosis Risk in Communities (ARIC) study followed 14,269 participants aged 45-64 years, without a history of AAA surgery, through 2011. Participants were classified into four groups, "COPD" [forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC)

Assuntos
Aneurisma da Aorta Abdominal/epidemiologia , Pulmão/fisiopatologia , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Feminino , Volume Expiratório Forçado , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Medição de Risco , Fatores de Risco , Espirometria , Fatores de Tempo , Estados Unidos/epidemiologia , Capacidade Vital
20.
Atherosclerosis ; 268: 63-67, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-29182987

RESUMO

BACKGROUND AND AIMS: No prospective study has investigated whether elevated lipoprotein(a) concentrations are associated with an increased risk of abdominal aortic aneurysm (AAA). We aimed to prospectively investigate this association. METHODS: In 1987-1989, the Atherosclerosis Risk in Communities study measured plasma lipoprotein(a) in 13,683 participants aged 45-64 years, without a history of AAA surgery. We followed them for incident, clinical AAA events through 2011. RESULTS: During the 272,914 person-years of follow-up, over a median of 22.6 years, we documented 505 incident AAA events. The age-, sex-, and race-adjusted model showed that individuals in the highest quintile of plasma lipoprotein(a) had an increased risk of AAA. Further adjustment for the other potential confounding factors, including other plasma lipids (high- and low-density lipoprotein cholesterol and triglyceride concentrations), attenuated the association, but individuals in the highest versus lowest quintile of plasma lipoprotein(a) still had a significantly increased risk of AAA [hazard ratio (95% confidence interval): 1.57 (1.19-2.08)]. Interaction testing suggested no difference in the associations for whites and African Americans (p for interaction = 0.96). A restricted cubic spline analysis demonstrated a positive dose-response relation of plasma lipoprotein(a) with AAA, with a steep increase in AAA risk above the 75th percentile (p for overall association = 0.0086, p for non-linear association = 0.097). CONCLUSIONS: In this population-based cohort study, elevated lipoprotein(a) concentrations were independently associated with an increased risk of AAA. The association reflected a threshold of increased AAA risk at high lipoprotein(a) concentrations, rather than a steady monotonic association.


Assuntos
Aneurisma da Aorta Abdominal/sangue , Lipoproteína(a)/sangue , Aneurisma da Aorta Abdominal/diagnóstico , Aneurisma da Aorta Abdominal/epidemiologia , Biomarcadores/sangue , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Medição de Risco , Fatores de Risco , Fatores de Tempo , Estados Unidos/epidemiologia , Regulação para Cima
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA