Showing papers by "Barbara V. Howard published in 2023"
4 citations
TL;DR: In this paper , the authors used liquid chromatography-mass spectrometry (LCS) to measure 1542 lipid species in 3699 fasting plasma samples at 2 visits (1905 at baseline, 1794 at follow-up, ~5.5 years apart) from American Indians in the Strong Heart Family Study.
Abstract: BACKGROUND: Dyslipidemia is an important risk factor for hypertension and cardiovascular disease. Standard lipid panel cannot reflect the complexity of blood lipidome. The associations of individual lipid species with hypertension remain to be determined in large-scale epidemiological studies, especially in a longitudinal setting. METHODS: Using liquid chromatography-mass spectrometry, we repeatedly measured 1542 lipid species in 3699 fasting plasma samples at 2 visits (1905 at baseline, 1794 at follow-up, ~5.5 years apart) from 1905 unique American Indians in the Strong Heart Family Study. We first identified baseline lipids associated with prevalent and incident hypertension, followed by replication of top hits in Europeans. We then conducted repeated measurement analysis to examine the associations of changes in lipid species with changes in systolic blood pressure, diastolic blood pressure, and mean arterial pressure. Network analysis was performed to identify lipid networks associated with the risk of hypertension. RESULTS: Baseline levels of multiple lipid species, for example, glycerophospholipids, cholesterol esters, sphingomyelins, glycerolipids, and fatty acids, were significantly associated with both prevalent and incident hypertension in American Indians. Some lipids were confirmed in Europeans. Longitudinal changes in multiple lipid species, for example, acylcarnitines, phosphatidylcholines, fatty acids, and triacylglycerols, were significantly associated with changes in blood pressure measurements. Network analysis identified distinct lipidomic patterns associated with the risk of hypertension. CONCLUSIONS: Baseline plasma lipid species and their longitudinal changes are significantly associated with hypertension development in American Indians. Our findings shed light on the role of dyslipidemia in hypertension and may offer potential opportunities for risk stratification and early prediction of hypertension.
TL;DR: In this paper , biomarkers for saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid densities were developed to study their associations with cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) in Women's Health Initiative (WHI) cohorts.
Abstract: A substantial observational literature relating specific fatty acid classes to chronic disease risk may be limited by its reliance on self-reported dietary data. We aimed to develop biomarkers for saturated (SFA), monounsaturated (MUFA), and polyunsaturated (PUFA) fatty acid densities, and to study their associations with cardiovascular disease (CVD), cancer, and type 2 diabetes (T2D) in Women’s Health Initiative (WHI) cohorts. Biomarker equations were based primarily on serum and urine metabolomics profiles from an embedded WHI human feeding study (n = 153). Calibration equations were based on biomarker values in a WHI nutritional biomarker study (n = 436). Calibrated intakes were assessed in relation to disease incidence in larger WHI cohorts (n = 81,894). Participants were postmenopausal women, aged 50–79 when enrolled at 40 United States Clinical Centers (1993–1998), with a follow-up period of ∼20 y. Biomarker equations meeting criteria were developed for SFA, MUFA, and PUFA densities. That for SFA density depended somewhat weakly on metabolite profiles. On the basis of our metabolomics platforms, biomarkers were insensitive to trans fatty acid intake. Calibration equations meeting criteria were developed for SFA and PUFA density, but not for MUFA density. With or without biomarker calibration, SFA density was associated positively with risk of CVD, cancer, and T2D, but with small hazard ratios, and CVD associations were not statistically significant after controlling for other dietary variables, including trans fatty acid and fiber intake. Following this same control, PUFA density was not significantly associated with CVD risk, but there were positive associations for some cancers and T2D, with or without biomarker calibration. Higher SFA and PUFA diets were associated with null or somewhat higher risk for clinical outcomes considered in this population of postmenopausal United States women. Further research is needed to develop even stronger biomarkers for these fatty acid densities and their major components. This study is registered with clinicaltrials.gov identifier: NCT00000611.
TL;DR: The Strong Heart Study (SHS) as discussed by the authors showed that sociodemographic factors such as age, gender, education, and employment influence health care access and usage patterns in Native communities.
Abstract:
Introduction:
Previous research has shown that health care access and usage patterns among Native Americans are often difficult to measure.
Hypothesis:
We hypothesize that sociodemographic factors such as age, gender, education, and employment influence health care access and usage patterns in Native communities in the Strong Heart Study (SHS).
Methods:
The SHS is a prospective population-based epidemiological study of cardiovascular disease and its associated risk factors in American Indians (AI). Between 1997 and 1999, surviving participants (N=2,382) of the original cohort were invited to a third exam, in which health care access and usage information were collected, along with other clinical and sociodemographic measurements. Multivariate logistic regression was used to find influencing factors of health care choices.
Results:
The majority of study participants (79%, 1,877/2,382) reported Indian Health Services (IHS) as their primary source of care, and close to one-third (29%, 689/2,358) reported having no additional coverage. Figure 1 showed travel time, waiting time after arriving at the clinics, and waiting time of a walk-in visit in IHS, tribal health service, and private practice. As participants aging or obtaining more years of education, they were less likely to use public (IHS or tribal) health service vs. private practice with odds ratio (95% confidence interval) 0.97 (0.95-0.99, p<0.01) and 0.89 (0.84-0.93, p<0.01) respectively, adjusting for gender and employment status.
Conclusions:
SHS participants primarily utilize IHS compared to other health services. Average waiting time is longer for IHS facilities (vs. private practice or tribal health facilities) with 35% (622/1,760) participants waiting for > 60 minutes to be seen in regular appointments, and with 53% (814/1,540) participants waiting for > 60 minutes in a walk-in visit. Age and education influence access to and selection of health care services for AI. This report provides baseline information for future health care access study in SHS.
TL;DR: In this paper , the authors found that participants who accumulated at least 3126 steps/d had a 28% to 35% lower risk of death compared with those who accumulated fewer steps per day.
Abstract: Key Points Question Is objectively measured ambulatory activity (ie, steps per day) associated with risk of death among young and middle-aged American Indian individuals who reside in rural communities? Findings In this cohort study of 2204 American Indian individuals aged 14 to 65 years, there were 449 deaths during a mean 17-year follow-up. Participants who accumulated at least 3126 steps/d had a 28% to 35% lower risk of death compared with those who accumulated fewer steps per day. Meaning These findings suggest that physical inactivity may be associated with mortality among young and middle-aged American Indian individuals and that physical activity outreach programs that target inactive individuals are needed.