- Award ID(s):
- NSF-PAR ID:
- Date Published:
- Journal Name:
- Journal of Hypertension
- Page Range / eLocation ID:
- 2173 to 2182
- Medium: X
- Sponsoring Org:
- National Science Foundation
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null (Ed.)Background: Both lifestyle and genetic factors confer risk for cardiovascular diseases, type 2 diabetes, and dyslipidemia. However, the interactions between these 2 groups of risk factors were not comprehensively understood due to previous poor estimation of genetic risk. Here we set out to develop enhanced polygenic risk scores (PRS) and systematically investigate multiplicative and additive interactions between PRS and lifestyle for coronary artery disease, atrial fibrillation, type 2 diabetes, total cholesterol, triglyceride, and LDL-cholesterol. Methods: Our study included 276 096 unrelated White British participants from the UK Biobank. We investigated several PRS methods (P+T, LDpred, PRS continuous shrinkage, and AnnoPred) and showed that AnnoPred achieved consistently improved prediction accuracy for all 6 diseases/traits. With enhanced PRS and combined lifestyle status categorized by smoking, body mass index, physical activity, and diet, we investigated both multiplicative and additive interactions between PRS and lifestyle using regression models. Results: We observed that healthy lifestyle reduced disease incidence by similar multiplicative magnitude across different PRS groups. The absolute risk reduction from lifestyle adherence was, however, significantly greater in individuals with higher PRS. Specifically, for type 2 diabetes, the absolute risk reduction from lifestyle adherence was 12.4% (95% CI, 10.0%–14.9%) in the top 1% PRS versus 2.8% (95% CI, 2.3%–3.3%) in the bottom PRS decile, leading to a ratio of >4.4. We also observed a significant interaction effect between PRS and lifestyle on triglyceride level. Conclusions: By leveraging functional annotations, AnnoPred outperforms state-of-the-art methods on quantifying genetic risk through PRS. Our analyses based on enhanced PRS suggest that individuals with high genetic risk may derive similar relative but greater absolute benefit from lifestyle adherence.more » « less
Abstract Hearing loss has been associated with individual cardiovascular disease (CVD) risk factors and, to a lesser extent, CVD risk metrics. However, these relationships are understudied in clinical populations. We conducted a retrospective study of electronic health records to evaluate the relationship between hearing loss and CVD risk burden. Hearing loss was defined as puretone average (PTA 0.5,1,2,4 ) > 20 dB hearing level (HL). Optimal CVD risk was defined as nondiabetic, nonsmoking, systolic blood pressure (SBP) < 120 and diastolic (D)BP < 80 mm Hg, and total cholesterol < 180 mg/dL. Major CVD risk factors were diabetes, smoking, hypertension, and total cholesterol ≥ 240 mg/dL or statin use. We identified 6332 patients (mean age = 62.96 years; 45.5% male); 64.0% had hearing loss. Sex-stratified logistic regression adjusted for age, noise exposure, hearing aid use, and body mass index examined associations between hearing loss and CVD risk. For males, diabetes, hypertension, smoking, and ≥ 2 major CVD risk factors were associated with hearing loss. For females, diabetes, smoking, and ≥ 2 major CVD risk factors were significant risk factors. Compared to those with no CVD risk factors, there is a higher likelihood of hearing loss in patients with ≥ 2 major CVD risk factors. Future research to better understand sex dependence in the hearing loss-hypertension relationship is indicated.more » « less
Social support positively affects health through pathways such as shaping intrapersonal emotional and psychological well‐being. Lower testosterone often interrelates with psychological and behavioral orientations that are beneficial to participation in emotionally supportive relationships. Yet, little research has considered the ways in which testosterone may contribute to health outcomes related to emotional support.
We draw on testosterone, social support data, and cardiovascular disease (CVD)‐relevant indicators (inflammatory markers; blood pressure [BP]) from older men (
n= 366) enrolled in the National Health and Nutrition Examination Survey, a US nationally representative study. We test whether men's testosterone moderates associations between emotional social support and markers related to CVD risk. Results
For men with relatively lower testosterone, higher levels of social support predicted lower white blood cell (WBC) counts, consistent with reduced inflammation. In contrast, men with higher testosterone exhibited elevated WBC counts with greater support. In a diverging pattern, men with lower testosterone had higher systolic and diastolic BP with higher support, whereas the slopes for systolic and diastolic BP, respectively, were comparatively flatter for men with higher levels of testosterone.
We suggest that our findings are theoretically consistent with the idea that testosterone helps shape intrapersonal and interpersonal experiences and perceptions of men's emotional support networks, thereby affecting the health implications of that support. The somewhat divergent results for WBC count vs BP highlight the need for inclusion of other neuroendocrine markers alongside testosterone as well as refined measures of perceived and received support.
Cardiovascular risk factors in midlife have been linked to late life risk for Alzheimer's disease and related dementias (ADRD). The relation of vascular risk factors on cognitive decline within midlife has been less studied.
Using data from the Study of Women's Health Across the Nation, we examined associations of midlife hypertension, elevated lipid levels, diabetes, fasting glucose, central adiposity, and Framingham heart age with rates of cognitive decline in women who completed multiple cognitive assessments of processing speed, and working and verbal memory during midlife.
Diabetes, elevated fasting glucose, central obesity, and heart age greater than chronological age were associated with rate of decline in processing speed during midlife. Vascular risk factors were not related to rate of decline in working or verbal memory.
Midlife may be a critical period for intervening on cardiovascular risk factors to prevent or delay later life cognitive impairment and ADRD.