Dataset Information

Dyspnoea as a predictor of cause-specific heart/lung disease mortality in Bangladesh: a prospective cohort study.

ABSTRACT: BACKGROUND:The spectrum of mortality outcomes by cause in populations with/without dyspnoea has not been determined. The study aimed to evaluate whether dyspnoea, a symptom, predicts cause-specific mortality differences between groups. The hypothesis was that diseases that result in chronic dyspnoea, those originating from the heart and lungs, would preferentially result in heart and lung disease mortality in those with baseline dyspnoea (relative to no dyspnoea) when followed over time. METHODS:A population-based sample of 11?533 Bangladeshis was recruited and followed for 11-12?years and cause-specific mortality evaluated in those with and without baseline dyspnoea. Dyspnoea was ascertained by trained physicians. The cause of death was determined by verbal autopsy. Kaplan-Meier survival curves, the Fine-Gray competing risk hazards model and logistic regression models were used to determine group differences in cause-specific mortality. RESULTS:Compared to those not reporting dyspnoea at baseline, the adjusted HRs were 6.4 (3.8 to 10.7), 9.3 (3.9 to 22.3), 1.8 (1.2 to 2.8), 2.2 (1.0 to 5.1) and 2.8 (1.3 to 6.2) for greater risk of dying from chronic obstructive pulmonary disease (COPD), asthma, heart disease, tuberculosis and lung cancer, respectively. In contrast, there was a similar risk of dying from stroke, cancer (excluding lung), liver disease, accidents and other (miscellaneous causes) between the dyspnoeic and non-dyspnoeic groups. In addition, the HR was 2.1 (1.7 to 2.5) for greater all-cause mortality in those with baseline dyspnoea versus no dyspnoea. CONCLUSIONS:Dyspnoea, ascertained by a single question with binary response, predicts heart and lung disease mortality. Individuals reporting dyspnoea were twofold to ninefold more likely to die of diseases that involve the heart and/or lungs relative to the non-dyspnoeic individuals. Therefore, in those with chronic dyspnoea, workup to look for the five common dyspnoeic diseases resulting in increased mortality (COPD, asthma, heart disease, tuberculosis and lung cancer), all treatable, should reduce mortality and improve the public health.

SUBMITTER: Pesola GR

PROVIDER: S-EPMC5959743 | biostudies-literature | 2016 Jul

REPOSITORIES: biostudies-literature

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Dyspnoea as a predictor of cause-specific heart/lung disease mortality in Bangladesh: a prospective cohort study.

Pesola Gene R GR Argos Maria M Chinchilli Vernon M VM Chen Yu Y Parvez Faruque F Islam Tariqul T Ahmed Alauddin A Hasan Rabiul R Rakibuz-Zaman Muhammad M Ahsan Habibul H

Journal of epidemiology and community health 20160114 7

<h4>Background</h4>The spectrum of mortality outcomes by cause in populations with/without dyspnoea has not been determined. The study aimed to evaluate whether dyspnoea, a symptom, predicts cause-specific mortality differences between groups. The hypothesis was that diseases that result in chronic dyspnoea, those originating from the heart and lungs, would preferentially result in heart and lung disease mortality in those with baseline dyspnoea (relative to no dyspnoea) when followed over time. ...[more]

PMID: 26767408

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Project description:ObjectiveTo investigate the association of spontaneous abortion with the risk of all cause and cause specific premature mortality (death before the age of 70).DesignProspective cohort study.SettingThe Nurses' Health Study II (1993-2017), United States.Participants101 681 ever gravid female nurses participating in the Nurses' Health Study II.Main outcomes measuresLifetime occurrence of spontaneous abortion in pregnancies lasting less than 6 months, determined by biennial questionnaires. Hazard ratios and 95% confidence intervals for all cause and cause specific premature death according to the occurrence of spontaneous abortion, estimated with time dependent Cox proportional hazards models.ResultsDuring 24 years of follow-up, 2936 premature deaths were recorded, including 1346 deaths from cancer and 269 from cardiovascular disease. Crude all cause mortality rates were comparable for women with and without a history of spontaneous abortion (1.24 per 1000 person years in both groups) but were higher for women experiencing three or more spontaneous abortions (1.47 per 1000 person years) and for women reporting their first spontaneous abortion before the age of 24 (1.69 per 1000 person years). The corresponding age adjusted hazard ratios for all cause premature death during follow-up were 1.02 (95% confidence interval 0.94 to 1.11), 1.39 (1.03 to 1.86), and 1.27 (1.11 to 1.46), respectively. After adjusting for confounding factors and updated dietary and lifestyle factors, the occurrence of spontaneous abortion was associated with a hazard ratio of 1.19 (95% confidence interval 1.08 to 1.30) for premature mortality during follow-up. The association was stronger for recurrent spontaneous abortions (hazard ratio 1.59, 95% confidence interval 1.17 to 2.15 for three or more spontaneous abortions; 1.23, 1.00 to 1.50 for two; and 1.16, 1.05 to 1.28 for one compared with none), and for spontaneous abortions occurring early in a woman's reproductive life (1.32, 1.14 to 1.53 for age ≤23; 1.16, 1.01 to 1.33 for ages 24-29; and 1.12, 0.98 to 1.28 for age ≥30 compared with none). When cause specific mortality was evaluated, the association of spontaneous abortion with premature death was strongest for deaths from cardiovascular disease (1.48, 1.09 to 1.99). Spontaneous abortion was not related to premature death from cancer (1.08, 0.94 to 1.24).ConclusionsSpontaneous abortion was associated with an increased risk of premature mortality, particularly death from cardiovascular disease.

Project description:Bangladesh has achieved remarkable gains in health indicators during the last four decades despite low levels of economic development. However, the persistence of inequities remains disturbing. This success was also accompanied by health and demographic transitions, which in turn brings new challenges for a nation that has yet to come to terms with pre-transition health challenges. It is therefore important to understand the causes of death and their relationship with socioeconomic status (SES).The paper aims to assess the causes of death by SES based on surveillance data from a rural area of Bangladesh, in order to understand the situation and inform policy makers and programme leaders.We analysed population-based mortality data collected from the Chakaria Health and Demographic Surveillance System in Bangladesh. The causes of death were determined by using a Bayesian-based programme for interpreting verbal autopsy findings (InterVA-4). The data included 1,391 deaths in 217,167 person-years of observation between 2010 and 2012. The wealth index constructed using household assets was used to assess the SES, and disease burdens were compared among the wealth quintiles.Analysing cause of death (CoD) revealed that non-communicable diseases (NCDs) were the leading causes of deaths (37%), followed by communicable diseases (CDs) (22%), perinatal and neonatal conditions (11%), and injury and accidents (6%); the cause of remaining 24% of deaths could not be determined. Age-specific mortality showed premature birth, respiratory infections, and drowning were the dominant causes of death for childhood mortality (0-14 years), which was inversely associated with SES (p<0.04). For adult and the elderly (15 years and older), NCDs were the leading cause of death (51%), followed by CDs (23%). For adult and the elderly, NCDs concentrated among the population from higher SES groups (p<0.005), and CDs among the lower SES groups (p<0.001).Epidemiologic transition is taking place with a shift from the dominance of CDs to NCDs. SES inequity in mortality still persists--the poor suffer from CDs in all age groups, whereas those better off suffer more from NCDs than CDs. Policy makers thus need to consider the social distribution of diseases before developing any public health action targeted towards reducing mortality and the extent of disease burden in an equitable manner.

Project description:OBJECTIVE:To determine the association between recommended physical activity according to the 2018 physical activity guidelines for Americans and all cause and cause specific mortality using a nationally representative sample of US adults. DESIGN:Population based cohort study. SETTING:National Health Interview Survey (1997-2014) with linkage to the National Death Index records to 31 December 2015. PARTICIPANTS:479 856 adults aged 18 years or older. EXPOSURES:Participant self-reports of the amount of leisure time spent in aerobic physical activity and muscle strengthening activity each week were combined and categorised into four groups: insufficient activity, aerobic activity only, muscle strengthening only, and both aerobic and muscle strengthening activities according to the physical activity guidelines. MAIN OUTCOME MEASURES:All cause mortality and cause specific mortality (cardiovascular disease, cancer, chronic lower respiratory tract diseases, accidents and injuries, Alzheimer's disease, diabetes mellitus, influenza and pneumonia, and nephritis, nephrotic syndrome, or nephrosis) obtained from the National Death Index records. RESULTS:During a median follow-up of 8.75 years, 59 819 adults died from all causes, 13 509 from cardiovascular disease, 14 375 from cancer, 3188 from chronic lower respiratory tract diseases, 2477 from accidents and injuries, 1470 from Alzheimer's disease, 1803 from diabetes mellitus, 1135 from influenza and pneumonia, and 1129 from nephritis, nephrotic syndrome, or nephrosis. Compared with those who did not meet the physical activity guidelines (n=268 193), those who engaged in recommended muscle strengthening activity (n=21 428; hazard ratio 0.89, 95% confidence interval 0.85 to 0.94) or aerobic activity (n=113 851; 0.71, 0.69 to 0.72) were found to be at reduced risk of all cause mortality; and even larger survival benefits were found in those engaged in both activities (n=76 384; 0.60, 0.57 to 0.62). In addition, similar patterns were reported for cause specific mortality from cardiovascular disease, cancer, and chronic lower respiratory tract diseases. CONCLUSIONS:Adults who engage in leisure time aerobic and muscle strengthening activities at levels recommended by the 2018 physical activity guidelines for Americans show greatly reduced risk of all cause and cause specific mortality. These data suggest that the physical activity levels recommended in the guidelines are associated with important survival benefits.

Project description:Background Dietary recommendations regarding protein intake have been focused on the amount of protein. However, such recommendations without considering specific protein sources may be simplistic and insufficient. Methods and Results We included 102 521 postmenopausal women enrolled in the Women's Health Initiative between 1993 and 1998, and followed them through February 2017. During 1 876 205 person-years of follow-up, 25 976 deaths occurred. Comparing the highest with the lowest quintile, plant protein intake was inversely associated with all-cause mortality (hazard ratio [HR], 0.91 [0.86, 0.96]), cardiovascular disease mortality (HR, 0.88 [0.79, 0.97]), and dementia mortality (HR, 0.79 [0.67, 0.94]). Among major protein sources, comparing the highest with the lowest quintile of consumption, processed red meat (HR, 1.06 [1.01, 1.10]) or eggs (HR, 1.14 [1.10, 1.19]) was associated with higher risk of all-cause mortality. Unprocessed red meat (HR, 1.12 [1.02, 1.23]), eggs (HR, 1.24 [1.14, 1.34]), or dairy products (HR, 1.11 [1.02, 1.22]) was associated with higher risk of cardiovascular disease mortality. Egg consumption was associated with higher risk of cancer mortality (HR, 1.10 [1.02, 1.19]). Processed red meat consumption was associated with higher risk of dementia mortality (HR, 1.20 [1.05, 1.32]), while consumption of poultry (HR, 0.85 [0.75, 0.97]) or eggs (HR, 0.86 [0.75, 0.98]) was associated with lower risk of dementia mortality. In substitution analysis, substituting of animal protein with plant protein was associated with a lower risk of all-cause mortality, cardiovascular disease mortality, and dementia mortality, and substitution of total red meat, eggs, or dairy products with nuts was associated with a lower risk of all-cause mortality. Conclusions Different dietary protein sources have varying associations with all-cause mortality, cardiovascular disease mortality, and dementia mortality. Our findings support the need for consideration of protein sources in future dietary guidelines.

Dataset Information

Dyspnoea as a predictor of cause-specific heart/lung disease mortality in Bangladesh: a prospective cohort study.

Publications

Dyspnoea as a predictor of cause-specific heart/lung disease mortality in Bangladesh: a prospective cohort study.

Similar Datasets

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