Factor V Leiden, prothrombin G20210A, and risk of sudden coronary death in apparently healthy persons.
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Biomedical subjects
Trivellore E Raghunathan
Publications and source records attributed to Trivellore E Raghunathan.
Cell membrane trans-fatty acids and the risk of primary cardiac arrest.
BACKGROUND: The relation of trans-fatty acid intake to life-threatening arrhythmias and primary cardiac arrest is unknown. METHODS AND RESULTS: We investigated the association of trans-fatty acid intake, assessed through a biomarker, with the risk of primary cardiac arrest in a population-based case-control study. Cases, aged 25 to 74 years, were out-of-hospital cardiac arrest patients attended by paramedics in Seattle, Washington from 1988 to 1999 (n=179). Controls, matched to cases by age and sex, were randomly identified from the community (n=285). Participants were free of previous clinically diagnosed heart disease. Blood was obtained at the time of cardiac arrest (cases) or at the time of an interview (controls) to assess trans-fatty acid intake. Higher total trans-fatty acids in red blood cell membranes was associated with a modest increase in the risk of primary cardiac arrest after adjustment for medical and lifestyle risk factors (odds ratio for interquintile range, 1.5; 95% CI, 1.0 to 2.1). However, trans isomers of oleic acid were not associated with risk (odds ratio for interquintile range, 0.8; 95% CI, 0.5 to 1.2), whereas higher levels of trans isomers of linoleic acid were associated with 3-fold increase in risk (odds ratio for interquintile range, 3.1; 95% CI, 1.7 to 5.4). CONCLUSIONS: These findings suggest that dietary intake of total trans-fatty acids is associated with modest increase and trans isomers of linoleic acid with a larger increase in the risk of primary cardiac arrest. These associations need to be confirmed in future studies that distinguish between trans isomers of linoleic acid and trans isomers of oleic acid.
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Life course socioeconomic conditions and adult psychosocial functioning.
BACKGROUND: Various psychosocial factors have been linked to adult physical health and are also associated with socioeconomic position in adulthood. We evaluated the effect of socioeconomic conditions over the life course on measures of psychosocial functioning in adulthood. METHODS: Life course socioeconomic position was assessed by retrospective recall of parents' education and occupation when the respondent was age 10, and the respondents' education, occupation, and income in 2585 men from eastern Finland aged 42, 48, 54, and 60 years. Measures of psychosocial functioning were derived from scales measuring cynical hostility, hopelessness, and depressive symptoms. RESULTS: Men with both parents who had less than a primary school education or who both had unskilled manual jobs had higher age-adjusted levels of cynical hostility, hopelessness, and depressive symptoms in adulthood. Mutually adjusted analyses showed that parents' education and the respondents' education, occupation, and income all had statistically independent effects on adult levels of cynical hostility and hopelessness. For instance, men for whom neither parent had completed primary education had a 0.15 standard deviation (P = 0.006) higher cynical hostility score, and a 0.20 standard deviation (P = 0.00018) higher hopelessness score, after adjustment for education, occupation and income. In contrast, depressive symptoms in adulthood were only associated with the respondent's occupation and income. CONCLUSIONS: Childhood socioeconomic position was associated with adult psychosocial functioning, but these effects were specific to some aspects of adult psychosocial functioning--cynical hostility and hopelessness, but not depressive symptoms. Adult occupation and income were associated with all measures of psychosocial functioning. In addition to the impact of adult socioeconomic position, some aspects of poor psychosocial functioning in adulthood may also have socioeconomic roots early in life.
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Relationship of blood pressure measures with coronary artery calcification.
BACKGROUND: Increased blood pressure level is a major risk factor for coronary artery disease. Previous studies of relationships of blood pressure level and hypertension status with coronary artery calcification (CAC), a measure of subclinical atherosclerosis, were restricted to participants who were physician- or self-referred, high risk, selected on hypertension status, or young adults. MATERIAL/METHODS: 803 asymptomatic individuals at least age 40 years were studied from a community. Blood pressure level was measured and blood pressure diagnostic category (i.e. hypertension vs. normotension) was determined by considering reported history of physician-diagnosed hypertension, use of antihypertensive medication, and measured blood pressure levels. CAC was measured non-invasively with electron beam computed tomography. Tobit regression models allowed simultaneous modeling of presence and quantity of CAC. RESULTS: In men, age, having ever smoked, having hypertension, LDL-C level, and body mass index were significantly and positively associated with presence and quantity of CAC. In women, age, systolic blood pressure level, use of lipid lowering medications, and waist-to-hip ratio were significantly and positively associated with presence and quantity of CAC. Relationships of measures of blood pressure with CAC were modified by age, but no other risk factors, in both sexes. CONCLUSIONS: Our results indicated that measures of blood pressure make a relatively large contribution to predictions of CAC at younger ages. CAC quantification, especially among younger individuals, may allow for early assessment of the presence and extent of target organ disease.
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