Usefulness of Desirable Lifestyle Factors to Attenuate the Risk of Heart Failure Among Offspring Whose Parents had Myocardial Infarction Before Age 55 Years
Division of Aging, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.The American journal of cardiology (Impact Factor: 3.28). 04/2012; 110(3):326-30. DOI: 10.1016/j.amjcard.2012.03.028
Heart failure (HF) is one of the leading causes of hospitalization and death in the United States and throughout Europe. Although a higher risk for HF with antecedent myocardial infarction (MI) has been reported in offspring whose parents had MIs before age 55 years, it is unclear whether adherence to healthful behaviors can mitigate that risk. The aim of the present study was therefore to prospectively examine if adherence to healthy weight, regular exercise, moderate alcohol consumption, and abstinence from smoking can attenuate such increased HF risk. Information on parental history of MI and lifestyle factors was collected using questionnaires. Subjects adhering to ≥3 healthy lifestyle factors were classified as having good versus poor lifestyle scores. Incident HF was assessed via yearly follow-up questionnaires and validated in a subsample. During an average follow up of 21.7 ± 6.5 years, 1,323 new HF cases (6.6%), of which 190 (14.4%) were preceded by MI, occurred. Compared to subjects with good lifestyle scores and no parental histories of premature MI, multivariate adjusted hazard ratios for incident HF with antecedent MI were 3.21 (95% confidence interval 1.74 to 5.91) for subjects with good lifestyle score and parental histories of premature MI, 1.52 (95% confidence interval 1.12 to 2.07) for those with poor lifestyle score and no parental histories of premature MI, and 4.60 (95% confidence interval 2.55 to 8.30) for those with poor lifestyle scores and parental histories of premature MI. In conclusion, our data suggest that even in subjects at higher risk for HF because of genetic predisposition, adherence to healthful lifestyle factors may attenuate such an elevated HF risk.
Chapter: Survival Analysis[Show abstract] [Hide abstract]
ABSTRACT: This chapter takes up the topic of survival analysis, one of the most frequently employed statistical techniques in medical research. This is the statistical tool we use when we follow cases over time to see whether they experience a particular event. Because the event in question is often death, the period of time from inception of risk for the event until the occurrence of the event has come to be called survival time. And the technique has come to be known as survival analysis. However, in fields other than medicine it is also referred to as failure-time analysis, reliability analysis, duration analysis, or event history analysis (Allison 2010). The event in question need not just be death. In fact, any time we are interested in studying the length of time until occurrence of an event and how characteristics of cases affect that time, survival analysis is relevant. The event in question could be the development of prostate cancer (Pettaway et al. 2011), recurrence of prostate cancer after radical prostatectomy (O’Brien et al. 2010), the occurrence of heart failure (Khawaja et al. 2012), death within 90 days of radical cystectomy (Morgan et al. 2011), the development of incident dementia (Lieb et al. 2009), and so on.Converting Data into Evidence, 01/2013: pages 137-159; , ISBN: 978-1-4614-7791-4
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