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Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.

ABSTRACT: Background Measures of subclinical atherosclerosis are predictors of future cardiovascular outcomes as well as of physical and cognitive functioning. The menopausal transition is associated with accelerated progression of atherosclerosis in women. The prospective association between a healthy lifestyle during the midlife and subclinical atherosclerosis is unclear. Methods and Results Self-reported data on smoking, diet, and physical activity from 1143 women in the Study of Women's Health Across the Nation were used to construct a 10-year average Healthy Lifestyle Score ( HLS ) during the midlife. Markers of subclinical atherosclerosis were measured 14 years after baseline and included common carotid artery intima-media thickness ( CCA - IMT ), adventitial diameter ( CCA - AD ), and carotid plaque. The associations of average HLS with CCA - IMT and CCA - AD were estimated using linear models; the association of average HLS with carotid plaque was estimated using cumulative logit models. Average HLS was associated with smaller CCA - IMT and CCA - AD in the fully adjusted models ( P=0.0031 and <0.001, respectively). Compared with participants in the lowest HLS level, those in the highest level had 0.024 mm smaller CCA - IMT (95% confidence interval: -0.048, 0.000), which equals 17% of the SD of CCA - IMT , and 0.16 mm smaller CCA - AD (95% confidence interval: -0.27, -0.04), which equals 24% of the SD of CCA - AD . Among the 3 components of the HLS , abstinence from smoking had the strongest association with subclinical atherosclerosis. Conclusions Healthy lifestyle during the menopausal transition is associated with less subclinical atherosclerosis, highlighting the growing recognition that the midlife is a critical window for cardiovascular prevention in women.

SUBMITTER: Wang D

PROVIDER: S-EPMC6405552 | biostudies-literature | 2018 Dec

REPOSITORIES: biostudies-literature

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Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.

Wang Dongqing D Jackson Elizabeth A EA Karvonen-Gutierrez Carrie A CA Elliott Michael R MR Harlow Siobán D SD Hood Michelle M MM Derby Carol A CA Sternfeld Barbara B Janssen Imke I Crawford Sybil L SL Huang Mei-Hua MH El Khoudary Samar R SR Chae Claudia U CU Baylin Ana A

Journal of the American Heart Association 20181201 23

Background Measures of subclinical atherosclerosis are predictors of future cardiovascular outcomes as well as of physical and cognitive functioning. The menopausal transition is associated with accelerated progression of atherosclerosis in women. The prospective association between a healthy lifestyle during the midlife and subclinical atherosclerosis is unclear. Methods and Results Self-reported data on smoking, diet, and physical activity from 1143 women in the Study of Women's Health Across ...[more]

PMID: 30482079

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Project description:BackgroundThe potential impacts of beverage intake during the midlife on future subclinical atherosclerosis among women are unclear. The aim of this study was to evaluate the prospective associations between the intakes of eight beverage groups and subclinical carotid atherosclerosis in midlife women.MethodsData came from the Study of Women's Health Across the Nation, a multicenter, multiethnic, and prospective cohort study. A total of 1,235 midlife women had measures of subclinical carotid atherosclerosis and repeatedly beverage intake data collected using a validated food frequency questionnaire. Beverages were aggregated into eight groups, including coffee, tea, sugar-sweetened beverages, artificially sweetened beverages, fruit juices, whole milk, milk with lower fat content, and alcoholic beverages. The associations of beverage intake with common carotid artery intima-media thickness (CCA-IMT) and adventitial diameter (CCA-AD) were estimated using linear models; the associations with carotid plaque were estimated using log-binomial models.ResultsCoffee intake was associated with CCA-IMT in an inverted J-shaped pattern. After adjusting for covariates, women with >0 to <1 cup/day and 1 to <2 cups/day of coffee intake had a 0.031 mm (95% CI: 0.012, 0.051) and a 0.027 mm (95% CI: 0.005, 0.049) larger CCA-IMT, respectively, than coffee non-drinkers. Women who consumed ≥2 cups/day of coffee did not have significantly different CCA-IMT than non-drinkers. There was an inverse linear association between moderate alcoholic beverages intake and CCA-IMT (P-trend = 0.014). Whole milk intake had inverted U-shaped associations with CCA-IMT and carotid plaque. No significant associations were found between other beverage groups and subclinical atherosclerosis.ConclusionsIn midlife women, occasional coffee intake may be associated with more subclinical atherosclerosis while moderate alcoholic beverages intake may be associated with less subclinical atherosclerosis. Future work should focus on the determination of the optimal beverage intake profile for maximum cardiovascular benefits in midlife women.

Project description:BackgroundThe menopause has adverse effects on cardiometabolic profiles that are linked to an increased risk of atherosclerosis in women. A healthy diet during the menopausal transition may counteract the menopause-induced atherosclerotic risk.ObjectiveThis prospective cohort study aimed to examine the associations between empirically derived dietary patterns and subclinical carotid atherosclerosis in midlife women.MethodsA total of 1246 midlife women (average age at baseline: 46.3 y) from the Study of Women's Health Across the Nation who completed dietary assessments and had a carotid ultrasound scan were included. Dietary data were collected at 3 time points, during 1996-1997, 2001-2003, and 2005-2007. Measures of carotid atherosclerosis included common carotid artery intima-media thickness (CCA-IMT), adventitial diameter (AD), and carotid plaque index collected during 2009-2013. Three statistical methods, including principal component analysis (PCA), reduced rank regression (RRR), and partial least squares regression (PLS), were used to identify dietary patterns.ResultsA Western dietary pattern was identified from each method and a Prudent dietary pattern from PCA. High adherence to the Western pattern was associated with higher CCA-IMT. Women in the fourth quartile of the Western pattern identified by PCA, RRR, and PLS had 0.042 mm (95% CI: 0.011, 0.073), 0.033 mm (95% CI: 0.0086, 0.057), and 0.049 mm (95% CI: 0.025, 0.074), respectively, larger CCA-IMT than women in the first quartile; these differences correspond to 30%, 24%, and 35% of the sample SD, respectively. The Prudent pattern was not significantly associated with CCA-IMT. No significant associations were found between the identified dietary patterns and AD or carotid plaque.ConclusionsThe positive association between the Western diet and CCA-IMT was robust under different dietary pattern derivation methods. The adoption of a diet low in red meat, processed meat, deep-fried products, and sugar-sweetened beverages among midlife women is associated with a lower future risk of atherosclerosis.

Project description:IntroductionMidlife, which encompasses the menopause transition in women, can be a time of disrupted sleep and accelerated atherosclerosis accumulation. Short or poor sleep quality has been associated with cardiovascular disease (CVD) risk; few studies have investigated relations among midlife women. We tested whether shorter actigraphy sleep time or poorer subjective sleep quality was associated with carotid atherosclerosis among midlife women.Aims and methodsTwo hundred fifty-six peri- and postmenopausal women aged 40-60 years completed 3 days of wrist actigraphy, hot flash monitoring, questionnaires (Pittsburgh Sleep Quality Index [PSQI], Berlin), a blood draw, and carotid ultrasound [intima media thickness (IMT), plaque]. Associations of objective (actigraphy) and subjective (PSQI) sleep with IMT/plaque were tested in regression models (covariates: age, race, education, body mass index, blood pressure, lipids, insulin resistance, medications, snoring, depressive symptoms, sleep hot flashes, and estradiol).ResultsShorter objective sleep time was associated with higher odds of carotid plaque (for each hour shorter sleep, plaque score ? 2, odds ratio (OR) [95% confidence interval, CI] = 1.58 [1.11-2.27], p = .01; plaque score = 1, OR [95% CI] = 0.95 [0.68-1.32], p = .75, vs. no plaque, multivariable). Poorer subjective sleep quality was associated with higher mean IMT [?, b (standard error, SE) = 0.004 (0.002), p = .03], maximal IMT [b (SE) = 0.009 (0.003), p = .005], and plaque [plaque score ? 2, OR (95% CI) = 1.23 (1.09-1.40), p = .001; score = 1, OR (95% CI) = 1.06 (0.93-1.21), p = .37, vs. no plaque] in multivariable models. Findings persisted additionally adjusting for sleep hot flashes and estradiol.ConclusionsShorter actigraphy-assessed sleep time and poorer subjective sleep quality were associated with increased carotid atherosclerosis among midlife women. Associations persisted adjusting for CVD risk factors, hot flashes, and estradiol.

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Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.

Publications

Healthy Lifestyle During the Midlife Is Prospectively Associated With Less Subclinical Carotid Atherosclerosis: The Study of Women's Health Across the Nation.

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