JoAnn E Manson

Brigham and Women's Hospital, Boston, Massachusetts, United States

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Publications (835)9255.84 Total impact

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    ABSTRACT: Observational data on the association between circulating 25(OH)D and colorectal cancer risk are limited in women. To determine whether prediagnostic levels of 25(OH)D were associated with risk of incident colorectal cancer in the Women's Health Study (WHS), we conducted a nested case-control study using 274 colorectal cases and 274 controls. Each case was matched to a control by age, ethnicity, fasting status at the time of blood collection, time of day when blood was drawn, and month of blood draw. Conditional logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for colorectal cancer by 25(OH)D quartiles. Mean plasma 25(OH)D was lower in cases versus controls (21.9 vs 23.9 ng/mL, p=0.01). In multivariable-adjusted logistic regression models, plasma 25(OH)D was significantly and inversely associated with odds of colorectal cancer (quartile 4 [Q4] versus quartile 1 [Q1]: OR (95% CI): 0.45 (0.25-0.81), ptrend 0.02). Additionally, we observed a somewhat lower risk of colorectal cancer mortality after adjustment for matching variables, randomization treatment and other risk factors (Q4:Q1 OR[95%CI]: 0.40(0.17-0.97); ptrend 0.05). In this cohort of healthy women, we found a significant inverse association between prediagnostic 25(OH)D levels and risk of incident colorectal cancer, and a borderline significant inverse association between prediagnostic 25(OH)D levels and colorectal cancer mortality. These results support a possible association between plasma 25(OH)D and risk of colorectal cancer in women. Received December 29, 2014. Revision received March 17, 2015. Accepted March 23, 2015.
    Cancer Prevention Research 03/2015; DOI:10.1158/1940-6207.CAPR-14-0470 · 5.27 Impact Factor
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    ABSTRACT: : We hypothesized that higher concentrations of LDL particles (LDL-P) and leptin, and lower concentrations of HDL particles (HDL-P), and total and high molecular weight (HMW) adiponectin, would predict incident coronary heart disease (CHD) among severely obese postmenopausal women.
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    ABSTRACT: We examined whether circulating concentrations of sex hormones, including estradiol, testosterone, sex hormone-binding globulin (SHBG), and dehydroepiandrosterone sulfate (DHEAS), were associated with alcohol intake or mediated the alcohol-type 2 diabetes (T2D) association. Among women not using hormone replacement therapy and free of baseline cardiovascular disease, cancer, and diabetes in the Women's Health Study, 359 incident cases of T2D and 359 matched controls were chosen during 10 years of follow-up. Frequent alcohol intake (≥1 drink/day) was positively and significantly associated with higher plasma estradiol concentrations in an age-adjusted model (β = 0.14, 95% confidence interval [CI], 0.03, 0.26), compared to rarely/never alcohol intake. After adjusting for additional known covariates, this alcohol-estradiol association remained significant (β = 0.19, 95% CI, 0.07, 0.30). Testosterone (β = 0.13, 95% CI, -0.05, 0.31), SHBG (β = 0.07, 95% CI, -0.07, 0.20), and DHEAS (β = 0.14, 95% CI, -0.04, 0.31) showed positive associations without statistical significance. Estradiol alone or in combination with SHBG appeared to influence the observed protective association between frequent alcohol consumption and T2D risk, with a 12%-21% reduction in odds ratio in the multivariate-adjusted models. Our cross-sectional analysis showed positive associations between alcohol intake and endogenous estradiol concentrations. Our prospective data suggested that baseline concentrations of estradiol, with or without SHBG, might influence the alcohol-T2D association in postmenopausal women.
    Journal of the American College of Nutrition 03/2015; DOI:10.1080/07315724.2014.926163 · 1.68 Impact Factor
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    ABSTRACT: Inflammation may be important in endometrial cancer development. Long-chain ω-3 (n-3) polyunsaturated fatty acids (LCω-3PUFAs) may reduce inflammation and, therefore, reduce cancer risk. Because body mass is associated with both inflammation and endometrial cancer risk, it may modify the association of fat intake on risk. We examined whether intakes of LCω-3PUFAs were associated with endometrial cancer risk overall and stratified by body size and histologic subtype. Women were n = 87,360 participants of the Women's Health Initiative Observational Study and Clinical Trials who were aged 50-79 y, had an intact uterus, and completed a baseline food-frequency questionnaire. After 13 y of follow-up, n = 1253 incident invasive endometrial cancers were identified. Cox regression models were used to estimate HRs and 95% CIs for the association of intakes of individual ω-3 fatty acids and fish with endometrial cancer risk. Intakes of individual LCω-3PUFAs were associated with 15-23% linear reductions in endometrial cancer risk. In women with body mass index (BMI; in kg/m(2)) <25, those in the upper compared with lowest quintiles of total LCω-3PUFA intake (sum of eicosapentaenoic, docosapentaenoic, and docosahexaenoic acids) had significantly reduced endometrial cancer risk (HR: 0.59; 95% CI: 0.40, 0.82; P-trend = 0.001), whereas there was little evidence of an association in overweight or obese women. The reduction in risk observed in normal-weight women was further specific to type I cancers.Conclusions: Long-chain ω-3 intake was associated with reduced endometrial cancer risk only in normal-weight women. Additional studies that used biomarkers of ω-3 intake are needed to more-accurately estimate their effects on endometrial cancer risk. This trial was registered at as NCT00000611. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 03/2015; DOI:10.3945/ajcn.114.098988 · 6.50 Impact Factor
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    ABSTRACT: To evaluate the association between statins and breast cancer stage and mortality in the Women's Health Initiative. The study population included 128,675 postmenopausal women aged 50-79 years, out of which there were 7,883 newly diagnosed cases of in situ (19 %), local (61 %)-, regional (19 %)- and distant (1 %)-stage breast cancer and 401 deaths due to breast cancer after an average of 11.5 (SD = 3.7) years of follow-up. Stage was coded using SEER criteria and was stratified into early (in situ and local)- versus late (regional and distant)-stage disease. Information on statins and other risk factors were collected by self- and interviewer-administered questionnaires. Cause of death was based on medical record review. Multivariable-adjusted hazards ratios (HR) and 95 % confidence intervals (CIs) evaluating the relationship between statin use (at baseline only and in a time-dependent manner) and diagnosis of late-stage breast cancer and breast cancer-specific mortality were computed from Cox proportional hazards analyses after adjusting for appropriate confounders. Statins were used by 10,474 women (8 %) at baseline. In the multivariable-adjusted time-dependent model, use of lipophilic statins was associated with a reduction in diagnosis of late-stage breast cancer (HR 0.80, 95 % CI 0.64-0.98, p = 0.035) which was also significant among women with estrogen receptor-positive disease (HR 0.72, 95 % CI 0.56-0.93, p = 0.012). Breast cancer mortality was marginally lower in statin users compared with nonusers (HR 0.59, 95 % CI 0.32-1.06, p = 0.075). Prior statin use is associated with lower breast cancer stage at diagnosis.
    Cancer Causes and Control 03/2015; DOI:10.1007/s10552-015-0530-7 · 2.96 Impact Factor
  • JoAnn E Manson, Shari S Bassuk
  • Gloria Richard-Davis, JoAnn E Manson
    JAMA Internal Medicine 02/2015; DOI:10.1001/jamainternmed.2014.8099 · 13.25 Impact Factor
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    ABSTRACT: Objective To test the hypothesis that greater chocolate-candy intake is associated with more weight gain in postmenopausal women.MethodsA prospective cohort study involved 107,243 postmenopausal American women aged 50-79 years (mean = 60.7) at enrollment in the Women's Health Initiative, with 3-year follow-up. Chocolate-candy consumption was assessed by food frequency questionnaire, and body weight was measured. Linear mixed models, adjusted for demographic, socio economic, anthropomorphic, and behavioral variables, were used to test our main hypotheses.ResultsCompared with women who ate a 1 oz (∼28 g) serving of chocolate candy <1 per month, those who ate this amount 1 per month to <1 per week, 1 per week to < 3 per week and ≥3 per week showed greater 3-year prospective weight gains (kg) of 0.76 (95% CI: 0.66, 0.85), 0.95 (0.84, 1.06), and 1.40 (1.27, 1.53), respectively, (P for linear trend<0.0001). Each additional 1 oz/day was associated with a greater 3-year weight gain (kg) of 0.92 (0.80, 1.05). The weight gain in each chocolate-candy intake level increased as BMI increased above the normal range (18.5-25 kg/m2), and was inversely associated with age.Conclusions Greater chocolate-candy intake was associated with greater prospective weight gain in this cohort of postmenopausal women.
    Obesity 02/2015; DOI:10.1002/oby.20983 · 4.39 Impact Factor
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    ABSTRACT: Although vitamin D is widely used to promote skeletal health, the effects of supplemental vitamin D alone on bone are unclear. Results from large, randomized controlled trials in the general population are sparse. Data on the effects of supplemental omega-3 fatty acids on bone are also lacking. The VITamin D and OmegA-3 TriaL (VITAL) is a, double-blind, placebo-controlled trial assessing the role of the interventions (vitamin D3, 2000 IU/day and omega-3 fatty acid, 1 g/day) in reducing risks of cancer and cardiovascular disease among U.S. men aged ≥ 50 and women aged ≥ 55. To comprehensively test effects of supplemental vitamin D and/or omega-3 on skeletal health, the VITAL: Effects on Fractures ancillary study is testing effects of the interventions on fracture risk. Fracture outcomes are being determined among 25,875 participants enrolled in the parent trial. Study investigators blinded to treatment adjudicate fractures through medical record review, with hip and femur fractures adjudicated using radiological images. In a complementary ancillary, VITAL: Effects on Structure and Architecture is determining the effects of supplemental vitamin D on bone with clinical measurements in 770 participants. Comprehensive assessments of bone health measures are being performed at baseline and 2 years post-randomization. Detailed phenotyping during in-person visits includes measurements of bone density, structure, turnover, microarchitecture, body composition, and physical performance. Results from these studies will clarify the relationship between supplemental vitamin D and bone health outcomes, and inform clinical care and public health guidelines on the use of supplemental vitamin D for the primary prevention of fractures.
    Contemporary Clinical Trials 01/2015; DOI:10.1016/j.cct.2015.01.007 · 1.99 Impact Factor
  • Diabetes Care 01/2015; 38(2):e13-e14. DOI:10.2337/dc14-2093 · 8.57 Impact Factor
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    ABSTRACT: We sought to evaluate the relationship between delayed conception and type 2 diabetes risk, given that there are plausible underlying mechanisms linking the two, including inflammation and insulin resistance. Participants of the Nurses' Health Study II prospective cohort were included if they were free of chronic disease (cardiovascular disease, type 2 diabetes, cancer) at baseline. Biennial questionnaires updated information on infertility status (>12 months attempted pregnancy), lifestyle characteristics and several health-related outcomes. Self-reported cases of diabetes were confirmed using a follow-up questionnaire. Multivariable Cox proportional hazards models were used to compute the HRs and 95% CIs. Incident type 2 diabetes occurred in 5,993 of the 112,106 participants over 24 years of follow-up (1989-2013). A history of infertility was reported in 27,774 (24.8%) women and was associated with a 20% greater risk of developing diabetes, compared with those never reporting infertility (HR 1.20 [95% CI 1.14, 1.28]), after adjusting for age, lifestyle factors, marital status, oral contraceptive use, family history of diabetes and BMI. Compared with women without a history of infertility, the causes of infertility associated with a higher diabetes risk were ovulation disorders (HR 1.43 [95% CI 1.29, 1.58]) and tubal factor (HR 1.34 [95% CI 1.13, 1.58]). Cervical factor (HR 1.06 [95% CI 0.81, 1.40]) and endometriosis (HR 1.06 [95% CI 0.89, 1.27]) were not associated, while male factor infertility was associated with a modestly higher diabetes risk (HR 1.15 [95% CI 1.00, 1.33]). These novel findings suggest a history of infertility, particularly that related to ovulation disorders and tubal blockage, is significantly associated with a higher risk of type 2 diabetes.
    Diabetologia 01/2015; 58(4). DOI:10.1007/s00125-015-3493-z · 6.88 Impact Factor
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    ABSTRACT: Background Homocysteine-lowering nutrients may have preventive/ameliorative roles in depression. Aims To test whether long-term B-vitamin/folate supplementation reduces depression risk. Method Participants were 4331 women (mean age 63.6 years), without prior depression, from the Women's Antioxidant and Folic Acid Cardiovascular Study - a randomised controlled trial of cardiovascular disease prevention among 5442 women. Participants were randomly assigned to receive a combination of folic acid (2.5 mg/d), vitamin B6 (50 mg/d) and vitamin B12 (1 mg/d) or a matching placebo. Average treatment duration was 7 years. The outcome was incident depression, defined as self-reported physician/clinician-diagnosed depression or clinically significant depressive symptoms. Results There were 524 incident cases. There was no difference between active v. placebo groups in depression risk (adjusted relative risk 1.02, 95% CI 0.86-1.21, P = 0.81), despite significant homocysteine level reduction. Conclusions Long-term, high-dose, daily supplementation with folic acid and vitamins B6 and B12 did not reduce overall depression risk in mid-life and older women. Royal College of Psychiatrists.
    The British journal of psychiatry: the journal of mental science 01/2015; DOI:10.1192/bjp.bp.114.148361 · 6.62 Impact Factor
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    ABSTRACT: Although multivitamins are widely used, there are limited prospective studies investigating their association with both long- and short-term risk of cardiovascular disease (CVD). The objective was to investigate how multivitamin use is associated with the long- and short-term risk of CVD. A prospective cohort study was conducted of 37,193 women from the Women's Health Study aged ≥45 y and free of CVD and cancer at baseline who were followed for an average of 16.2 y. At baseline, women self-reported a wide range of lifestyle, clinical, and dietary factors. Women were categorized into 1) no current use and 2) current use of multivitamins. Duration and updated measures over the course of the follow-up to address short-term effects were also considered. Women were followed for major CVD events, including myocardial infarction (MI), stroke, and CVD death. During the follow-up, 1493 incident cases of CVD [defined as myocardial infarction (MI), stroke, and CVD death] occurred. In multivariable analyses, multivitamin use compared with no use was not associated with major CVD events (HR: 1.01; 95% CI: 0.89, 1.15), MI (HR: 1.04; 95% CI: 0.84, 1.27), stroke (HR: 0.99; 95% CI: 0.83, 1.18), or CVD death (HR: 1.10; 95% CI: 0.84, 1.45). A nonsignificant inverse association was observed between baseline multivitamin use and major CVD events among women aged ≥70 y (P-interaction = 0.04) and those consuming <3 servings/d of fruit and vegetables (P-interaction = 0.01). When updating information on multivitamin use during the course of follow-up, no associations were observed for major CVD events (HR: 0.91; 95% CI: 0.82, 1.02), MI (HR: 0.89; 95% CI: 0.74, 1.06), stroke (HR: 0.91; 95% CI: 0.78, 1.06), and CVD death (HR: 0.91; 95% CI: 0.71, 1.16). In this study of middle-aged and elderly women, neither baseline nor time-varying multivitamin use was associated with the long-term risk of major CVD events, MI, stroke, cardiac revascularizations, or CVD death. Additional studies are needed to clarify the role of multivitamins on CVD. © 2015 American Society for Nutrition.
    American Journal of Clinical Nutrition 01/2015; 101(1):144-52. DOI:10.3945/ajcn.114.088310 · 6.50 Impact Factor
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    ABSTRACT: To determine whether statin treatment is associated with increased risk of haemorrhagic stroke (HS) in older women. A secondary objective was to evaluate HS risk in users of combined statin and antiplatelet treatment. Observational study: secondary data analysis from the Women's Health Initiative (WHI) clinical trials. Women were recruited from 40 participating sites. Cohort of 68 132 women followed through 2005 (parent study) and for an additional 5 years in the extension study. Statin use was assessed at baseline and at follow-up visits (1, 3, 6 and 9 years). Women brought medications in original containers for inventory. Strokes were ascertained semiannually and centrally adjudicated. Risk of HS by statin use (time-varying covariate, with the 'no use' category as the referent) was estimated from Cox proportional hazard regression models adjusted for age (model 1); risk factors for HS (model 2); and possible confounders by indication (model 3). Prespecified subgroup analyses were conducted by use of antiplatelet medications. Final models included 67 882 women (mean age, 63±7 years). Over a mean follow-up of 12 years, incidence rates of HS were 6.4/10 000 person-years among statin users and 5.0/10 000 person-years among non-users (p=0.11). The unadjusted risk of HS in statin users was 1.21 (CI 0.96 to 1.53); after adjusting for age and HS risk factors the HR was 0.98 (CI 0.76 to 1.26). Risk of HS was higher among women on statins and antiplatelet agents versus women on antiplatelet medications alone (HR=1.59; CI 1.03 to 2.47); p for interaction=0.011. This retrospective analysis did not show an association between statin use and HS risk among older women. HS risk was higher among women taking statins with antiplatelet agents. These findings warrant further investigation, given potential implications for clinical decision-making. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to
    BMJ Open 01/2015; 5(2):e007075. DOI:10.1136/bmjopen-2014-007075 · 2.06 Impact Factor
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    ABSTRACT: Coronary heart disease (CHD) is a leading cause of morbidity and mortality in African Americans. However, there is a paucity of studies assessing genetic determinants of CHD in African Americans. We examined the association of published variants in CHD loci with incident CHD, attempted to fine map these loci, and characterize novel variants influencing CHD risk in African Americans. Up to 8,201 African Americans (including 546 first CHD events) were genotyped using the MetaboChip array in the Atherosclerosis Risk in Communities (ARIC) study and Women's Health Initiative (WHI). We tested associations using Cox proportional hazard models in sex- and study-stratified analyses and combined results using meta-analysis. Among 44 validated CHD loci available in the array, we replicated and fine-mapped the SORT1 locus, and showed same direction of effects as reported in studies of individuals of European ancestry for SNPs in 22 additional published loci. We also identified a SNP achieving array wide significance (MYC: rs2070583, allele frequency 0.02, P = 8.1×10-8), but the association did not replicate in an additional 8,059 African Americans (577 events) from the WHI, HealthABC and GeneSTAR studies, and in a meta-analysis of 5 cohort studies of European ancestry (24,024 individuals including 1,570 cases of MI and 2,406 cases of CHD) from the CHARGE Consortium. Our findings suggest that some CHD loci previously identified in individuals of European ancestry may be relevant to incident CHD in African Americans.
    PLoS ONE 12/2014; 9(12):e113203. DOI:10.1371/journal.pone.0113203 · 3.53 Impact Factor
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    ABSTRACT: Context: Vasomotor symptoms (VMS) are common. Whether VMS are associated with fracture incidence or bone mineral density (BMD) levels is unknown. Objective: This study aimed to examine associations of baseline VMS with fracture incidence and BMD. Design: This was a prospective observational study with mean (SD) followup of 8.2 (1.7) years (1993-2005). Setting: Forty United States clinical centers. Participants: We examined data from Women's Health Initiative Clinical Trial participants (n = 23 573) age 50-79 years not using menopausal hormone therapy, and 4,867 participants of the BMD sub-study. Interventions: None. Main Outcome Measures: We measured baseline VMS, incident adjudicated fractures, and BMD (baseline, annual visits 1, 3, 6, and 9). Results: After adjustment for baseline age, body mass index, race/ethnicity, smoking, and education, the hazard ratio for hip fracture among women with baseline moderate/severe VMS (vs no VMS) was 1.78 (95% confidence interval [CI], 1.20-2.64; P = .01). There was no association between VMS and vertebral fracture. VMS severity was inversely associated with BMD during followup (P = .004 for femoral neck, P = .045 for lumbar spine). In repeated measures models, compared with women who reported no VMS, women with moderate/severe VMS had 0.015 g/cm(2) lower femoral neck BMD (95% CI, -0.025--0.005) and 0.016 g/cm(2) lower lumbar spine BMD (95% CI, -0.032--0.004). Conclusions: Women with moderate/severe VMS have lower BMD and increased hip fracture rates. Elucidation of the biological mechanisms underlying these associations may inform the design of preventive strategies for at-risk women prior to occurrence of fracture.
    Journal of Clinical Endocrinology &amp Metabolism 12/2014; 100(2):jc20143062. DOI:10.1210/jc.2014-3062 · 6.31 Impact Factor
  • Elizabeth R Bertone-Johnson, JoAnn E Manson
    Menopause (New York, N.Y.) 12/2014; 22(1). DOI:10.1097/GME.0000000000000385 · 3.08 Impact Factor
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    ABSTRACT: Positive associations between dog ownership and physical activity in older adults have been previously reported. The objective of this study was to examine cross-sectional associations between dog ownership and physical activity measures in a well-characterized, diverse sample of postmenopausal women. Analyses included 36,984 dog owners (mean age: 61.5years), and 115,645 non-dog owners (mean age: 63.9years) enrolled in a clinical trial or the observational study of the Women's Health Initiative between 1993 and 1998. Logistic regression models were used to test for associations between dog ownership and physical activity, adjusted for potential confounders. Owning a dog was associated with a higher likelihood of walking ≥150min/wk (Odds Ratio, 1.14; 95% Confidence Interval, 1.10-1.17) and a lower likelihood of being sedentary ≥8h/day (Odds Ratio, 0.86; 95% Confidence Interval, 0.83-0.89) as compared to not owning a dog. However, dog owners were less likely to meet ≥7.5MET-h/wk of total physical activity as compared to non-dog owners (Odds Ratio, 1.03; 95% Confidence Interval, 1.00-1.07). Dog ownership is associated with increased physical activity in older women, particularly among women living alone. Health promotion efforts aimed at older adults should highlight the benefits of regular dog walking for both dog owners and non-dog owners. Copyright © 2014 Elsevier Inc. All rights reserved.
    Preventive Medicine 11/2014; 70C:33-38. DOI:10.1016/j.ypmed.2014.10.030 · 2.93 Impact Factor
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    ABSTRACT: This study aims to evaluate the effects of low-dose estradiol (E2) or venlafaxine on menopause-related quality of life and associated symptoms in healthy perimenopausal and postmenopausal women with hot flashes. A double-blind, placebo-controlled, randomized trial of low-dose oral 17β-E2 0.5 mg/day and venlafaxine XR 75 mg/day, versus identical placebo, was conducted among 339 women (aged 40-62 y) experiencing two or more vasomotor symptoms (VMS) per day (mean [SD], 8.07 [5.29]) who were recruited at three clinical sites from November 2011 to October 2012. The primary trial outcome, as reported previously, was frequency of VMS at 8 weeks. Here, we report on secondary endpoints of total and domain scores from the Menopause-Specific Quality of Life Questionnaire (MENQOL) and from measures of pain (Pain, Enjoyment in life, and General activity scale), depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Questionnaire-7), and perceived stress (Perceived Stress Scale). Treatment with both E2 and venlafaxine resulted in significantly greater improvement in quality of life, as measured by total MENQOL scores, compared with placebo (E2: mean difference at 8 wk, -0.4; 95% CI, -0.7 to -0.2; P < 0.001; venlafaxine: mean difference at 8 wk, -0.2; 95% CI, -0.5 to 0.0; P = 0.04). Quality-of-life domain analyses revealed that E2 had beneficial treatment effects on all domains of the MENQOL except for the psychosocial domain, whereas venlafaxine benefits were observed only in the psychosocial domain. Neither E2 nor venlafaxine improved pain, anxiety, or depressive symptoms, although baseline symptom levels were low. Modest benefits were observed for perceived stress with venlafaxine. Both low-dose E2 and venlafaxine are effective pharmacologic agents for improving menopause-related quality of life in healthy women with VMS.
    Menopause (New York, N.Y.) 11/2014; DOI:10.1097/GME.0000000000000364 · 3.08 Impact Factor
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    ABSTRACT: -Vitamin D supplementation may be an inexpensive intervention to reduce heart failure (HF) incidence. However, there are insufficient data to support this hypothesis. This study evaluates whether vitamin D plus calcium (CaD) supplementation is associated with lower rates of HF in post-menopausal women and whether the effects differ between those at high versus low risk for HF.
    Circulation Heart Failure 11/2014; DOI:10.1161/CIRCHEARTFAILURE.114.001738 · 5.95 Impact Factor

Publication Stats

70k Citations
9,255.84 Total Impact Points


  • 1991–2015
    • Brigham and Women's Hospital
      • • Division of Preventive Medicine
      • • Department of Medicine
      Boston, Massachusetts, United States
  • 1990–2015
    • Harvard Medical School
      • Department of Medicine
      Boston, Massachusetts, United States
  • 2014
    • University of Minnesota Duluth
      Duluth, Minnesota, United States
  • 1994–2014
    • Harvard University
      • Department of Nutrition
      Cambridge, Massachusetts, United States
  • 2013
    • University of Balamand
      • Faculty of Health Sciences
      Amiun, Liban-Nord, Lebanon
    • University of Washington Seattle
      Seattle, Washington, United States
    • University of Alabama at Birmingham
      • Department of Epidemiology
      Birmingham, AL, United States
    • University of Auckland
      Окленд, Auckland, New Zealand
    • McGill University
      • Department of Oncology
      Montréal, Quebec, Canada
    • Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center
      Torrance, California, United States
    • The Ohio State University
      Columbus, Ohio, United States
  • 2005–2013
    • University of Massachusetts Amherst
      • • Division of Biostatistics and Epidemiology
      • • Department of Public Health
      Amherst Center, Massachusetts, United States
    • German Institute of Human Nutrition
      • Department of Epidemiology
      Potsdam, Brandenburg, Germany
    • University of Pittsburgh
      • Division of General Internal Medicine
      Pittsburgh, PA, United States
  • 2012
    • Yale-New Haven Hospital
      New Haven, Connecticut, United States
  • 2004–2012
    • Fred Hutchinson Cancer Research Center
      • • Cancer Prevention Program
      • • Division of Public Health Sciences
      Seattle, Washington, United States
    • Columbia University
      New York, New York, United States
    • Wake Forest School of Medicine
      • Division of Public Health Sciences
      Winston-Salem, North Carolina, United States
  • 2011
    • HealthPartners Institute for Education and Research
      Bloomington, Minnesota, United States
    • University of California, San Francisco
      • Department of Obstetrics, Gynecology and Reproductive Sciences
      San Francisco, CA, United States
  • 2008–2011
    • Albert Einstein College of Medicine
      • Department of Epidemiology & Population Health
      New York City, New York, United States
    • University of East Anglia
      • Norwich Medical School
      Norwich, England, United Kingdom
    • Northwestern University
      • Feinberg School of Medicine
      Evanston, IL, United States
  • 2010
    • Medical University of South Carolina
      • Department of Medicine
      Charleston, South Carolina, United States
    • Kaiser Permanente
      Oakland, California, United States
  • 2009
    • John Wayne Cancer Institute
      Santa Monica, California, United States
  • 2002–2009
    • Partners HealthCare
      Boston, Massachusetts, United States
    • University of Zurich
      • Internal Medicine Unit
      Zürich, ZH, Switzerland
    • Dana-Farber Cancer Institute
      • Department of Medical Oncology
      Boston, MA, United States
    • Boston University
      Boston, Massachusetts, United States
  • 2000–2009
    • Massachusetts Department of Public Health
      Boston, Massachusetts, United States
    • University of Alaska Anchorage
      Anchorage, Alaska, United States
  • 2005–2008
    • Beth Israel Deaconess Medical Center
      • • Division of Endocrinology, Diabetes and Metabolism
      • • Division of General Medicine and Primary Care
      Boston, Massachusetts, United States
  • 2007
    • Isfahan University of Medical Sciences
      • Epidemiology and Biostatistics Department
      Eşfahān, Ostan-e Esfahan, Iran
    • University of California, Los Angeles
      • Department of Epidemiology
      Los Angeles, CA, United States
  • 2006–2007
    • George Washington University
      • Department of Medicine
      Washington, D. C., DC, United States
    • University at Buffalo, The State University of New York
      • Department of Social and Preventive Medicine
      Buffalo, NY, United States
    • Ben-Gurion University of the Negev
      Be'er Sheva`, Southern District, Israel
    • Tufts Medical Center
      • Division of Endocrinology, Diabetes and Metabolism
      Boston, Massachusetts, United States
  • 2005–2007
    • Florida Atlantic University
      • Department of Biomedical Science
      Boca Raton, Florida, United States
  • 2004–2006
    • Massachusetts General Hospital
      • Department of Medicine
      Boston, Massachusetts, United States
  • 2004–2005
    • University of California, San Diego
      • Department of Family and Preventive Medicine
      San Diego, CA, United States
    • Simmons College
      • Program in Nutrition and Dietetics
      Boston, Massachusetts, United States
  • 2003
    • Vancouver General Hospital
      Vancouver, British Columbia, Canada
    • University of Iowa
      Iowa City, Iowa, United States
    • Boston Children's Hospital
      Boston, Massachusetts, United States
  • 1996
    • William Penn University
      Filadelfia, Pennsylvania, United States