Occupational, leisure-time physical activity reduced risk for HF
Wang Y. J Am Coll Cardiol. 2010;56:1140-1148.
New data from a study featuring more than 55,000 Finnish men and women suggested that moderate and high levels of occupational or leisure-time physical activity may reduce the risk for HF.
The study cohorts included 28,334 men and 29,874 women from Finland, who were free of HF at baseline and between the ages of 25 and 74 years. Researchers utilized baseline measurement of different types of physical activity to predict incident HF and followed patients for a mean of 18.4 years.
During follow-up, HF developed in 1,868 (6.6%) men and 1,640 (5.5%) women. After adjusting for multivariates, including age, smoking, BMI and systolic BP, the HRs for HF were as follows for the three occupational activity levels in men: light, 1.00; moderate, 0.90; and active 0.83 (P=.005 for trend). For women, the HRs for the occupational activity levels were 1.00 for light, 0.80 for moderate and 0.92 for active (P=.007).
Similarly, HRs for HF during leisure time activity also decreased with the progression from low (men, 1.00; women, 1.00) to moderate (men, 0.83; women, 0.84) to high (men, 0.65; women, 0.75) activity levels (P<.001 for both men and women trends).
Study limitations included the self-report of physical activity, and that physical activity was recorded only once at baseline.
“This study confirms that moderate or high levels of occupational or leisure-time physical activity have a negative association with the risk of HF among men and women,” the researchers concluded.
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Single CRP threshold may lead to inequalities in statin eligibility
Shah T. Circ Cardiovasc Genet. 2010;doi:10.1161/CIRCGENETICS.110.957431.
A single C-reactive protein threshold of 2 mg/L for CV risk prediction could result in inequality for statin eligibility due to differences in C-reactive protein concentrations in populations of diverse ancestry, according to new data appearing in Circulation: Cardiovascular Genetics.
“Eligibility for rosuvastatin (Crestor, AstraZeneca) treatment for CVD prevention includes a CRP concentration greater than 2 mg/L,” researchers wrote. “Most observational studies of CRP and CVD have been in Europeans. We evaluated the influence of ancestry on population CRP concentration to assess the implications for statin targeting in non-Europeans.”
The systematic review and meta-analysis featured 221,287 people from 89 studies. The geometric mean CRP was 2.6 mg/L in blacks (n=18,585), 2.51 mg/L in Hispanics (n=5,049), 2.34 mg/L in South Asians (n=1,053), 2.03 mg/L in whites (n=104,949) and 1.01 mg/L in East Asians (n=39,521).
According to researchers, differences in CRP levels were not explained by study design or CRP assay and remained even after adjustment for age and BMI. Furthermore, by age 60 years, 39% of East Asians, 55% of whites, 57% of South Asians, 62.5% of blacks and 63% of Hispanics were estimated to have CRP values exceeding 2 mg/L.
“We found substantial differences in CRP concentration across diverse ancestral groups that could have major impact on eligibility for rosuvastatin treatment based on CRP cut-point value of 2 mg/L,” researchers concluded. “A one-size-fits-all threshold value of CRP for risk prediction or statin targeting could diminish the opportunity to receive a statin in individuals from certain ethnic backgrounds while increasing this opportunity among others. This policy could lead to inequalities in statin eligibility that do not closely relate to underlying levels of risk.”