0000000000133139

AUTHOR

Sudhir Kurl

Exercise cardiac power and the risk of myocardial infarction and fatal coronary heart disease events in men.

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Association between ideal cardiovascular health and risk of sudden cardiac death and all-cause mortality among middle-aged men in Finland

Background Strong associations have been demonstrated between the American Heart Association’s cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. Methods and results We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0–2 (poor), 3–4 (intermediate) and 5–7 (ideal). Mult…

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Leisure-time cross-country skiing and the risk of venous thromboembolism: A prospective cohort study

[No abstract]

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Global electrical heterogeneity as a predictor of cardiovascular mortality in men and women

Aims The aim of this study was to investigate the contribution of depolarization and repolarization abnormalities, specially abnormalities in global electrical heterogeneity of heart in cardiovascular disease (CVD) and all-cause mortality. Methods and results Eight hundred and forty men and 911 women, average age of 63 years participated in this study with average follow-up was 14 years. Six electrocardiogram/vector electrocardiogram (ECG/VECG) markers QRS-duration, QTc-interval, QRST-angle, sum of absolute QRST integral (SAI QRST), T-wave roundness, and TV1-amplitude were estimated from VECG measurements. Hazard ratios (HRs) for CVD events (164 deaths) and all-cause mortality (383 deaths) …

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Handgrip strength is inversely associated with fatal cardiovascular and all-cause mortality events

Purpose: We aimed to assess the associations of handgrip strength (HS) with cardiovascular and all-cause mortality and whether adding data on HS to cardiovascular disease (CVD) risk factors is associated with improvement in CVD mortality prediction. Design: Handgrip strength was assessed in a population-based sample of 861 participants aged 61–74 years at baseline. Relative HS was obtained by dividing the absolute value by body weight. Results: During a median (interquartile range) follow-up of 17.3 (12.6–18.4) years, 116 fatal coronary heart diseases (CHDs), 195 fatal CVDs and 412 all-cause mortality events occurred. On adjustment for several risk factors, the hazard ratios (95% confidence…

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Ideal cardiovascular health and risk of acute myocardial infarction among Finnish men

Background and aims: Acute myocardial infarction (AMI) is associated with high mortality globally and remains a public health burden. We sought to investigate the relation between the American Heart Association’s cardiovascular health metrics (CVH) and the risk of AMI among middle-aged Finnish men. Methods: We used the ongoing population-based Kuopio Ischaemic Heart Disease cohort study comprising men aged 40 to 62 years at baseline. The CVH metrics was computed among 2584 participants at baseline with health scores ranging from 0 to 7. This was categorized into three groups of CVH metrics as poor (0-2), intermediate (3-4) and ideal (≥5). Multivariate Cox regression models were used to esti…

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Cardiorespiratory fitness is not associated with risk of venous thromboembolism: a cohort study

Objectives. The inverse and independent association between cardiorespiratory fitness (CRF) and arterial thrombotic disease is well established. However, the potential association between CRF and venous thromboembolism (VTE) is not well known. We aimed to assess the prospective association of CRF with the risk of VTE. Design. Cardiorespiratory fitness, as measured by maximal oxygen uptake (VO2max), was assessed using a respiratory gas exchange analyser in 2,249 men aged 42-61 years without a history of VTE at baseline in the Kuopio Ischemic Heart Disease prospective cohort. Cox-regression models were used to calculate hazard ratios (HR) with 95% confidence interval (CI) for VTE. We correcte…

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Leisure‐time cross‐country skiing is associated with lower incidence of type 2 diabetes : A prospective cohort study

Aims. Cross‐country skiing is associated with reduction in risk of adverse vascular outcomes, but its association with type 2 diabetes is uncertain. We aimed to assess the associations between leisure‐time cross‐country skiing habits and incident type 2 diabetes. Methods. We analyzed data of 2,483 middle‐aged men with no history of diabetes at baseline in the KIHD prospective study. The frequency, average duration, and intensity of leisure cross‐country skiing were assessed at baseline using a 12‐month physical activity questionnaire. Hazard ratios (HRs) (95% CIs) for type 2 diabetes were estimated. Results. During a median follow‐up of 21.6 years, 539 men developed type 2 diabetes. Type 2 …

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Leisure-time cross-country skiing and risk of atrial fibrillation and stroke:a prospective cohort study

[No Abstract]

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Leisure-time cross-country skiing is associated with lower incidence of hypertension:A prospective cohort study

Abstract Objective: The prospective relationship between cross-country skiing and hypertension is uncertain. We aimed to assess the associations of leisure time cross-country skiing habits with incident hypertension in a general population. Methods: The frequency, average duration, and intensity of leisure cross-country skiing were assessed at baseline using a 12-month physical activity questionnaire in the Kuopio Ischemic Heart Disease prospective study of 1809 middle-aged men without hypertension. Hazard ratios [95% confidence intervals (CIs)] were calculated. Results: New onset diagnosis of hypertension was observed in 279 participants during a median (interquartile range) follow-up of 2…

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American Heart Association’s Cardiovascular Health Metrics and Risk of Cardiovascular Disease Mortality Among a Middle-aged Male Scandinavian Population

Background: The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population. Methods: We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42–60 years). CVH scores were computed among 2607 participants at baseline and categorized as optimum (0–4), average (5–9), or inadequate (10–14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 9…

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Leisure-time cross-country skiing is associated with lower incidence of type 2 diabetes:A prospective cohort study

Background Cross-country skiing is associated with reduction in risk of adverse vascular outcomes, but its association with type 2 diabetes is uncertain. We aimed to assess the associations between leisure-time cross-country skiing habits and incident type 2 diabetes. Methods We analysed the data of 2483 middle-aged men with no history of diabetes at baseline in the Kuopio Ischemic Heart Disease prospective study. The frequency, average duration, and intensity of leisure cross-country skiing were assessed at baseline using a 12-month physical activity questionnaire. Hazard ratios (HRs) (95% CIs) for type 2 diabetes were estimated. Results During a median follow-up of 21.6 years, 539 men dev…

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Effect of Cardiorespiratory Fitness on Risk of Sudden Cardiac Death in Overweight/Obese Men Aged 42 to 60 Years

The purpose of this study was to examine the subject and combined associations of cardiorespiratory fitness (fitness) and body mass index (BMI) with the risk of sudden cardiac death (SCD) in middle-aged men. This prospective study was based on a population sample of 2,357 men aged 42 to 60 years, who were followed up in the Kuopio Ischemic Heart Disease cohort study. Fitness was directly measured by peak oxygen uptake (VO2peak) during progressive exercise testing to volitional fatigue. Participants were divided into 4 groups (fit-normal weight, unfit-normal weight, fit-overweight/obese, and unfit-overweight/obese) based on the median values of fitness and BMI. A total of 253 (10.7%) SCDs oc…

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Association between ideal cardiovascular health and risk of sudden cardiac death and all-cause mortality among middle-aged men in Finland.

Abstract Background Strong associations have been demonstrated between the American Heart Association’s cardiovascular health (CVH) metrics and various cardiovascular outcomes, but the association with sudden cardiac death (SCD) is uncertain. We examined the associations between these CVH metrics and the risks of SCD and all-cause mortality among men in Finland. Methods and results We used the prospective population-based Kuopio Ischaemic Heart Disease cohort study, which consists of men between 42 and 60 years of age at baseline. CVH metrics were computed for 2577 men with CVH scores at baseline ranging from 0 to 7, categorized into CVH scores of 0–2 (poor), 3–4 (intermediate) and 5–7 (ide…

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Joint effect of blood pressure and C-reactive protein and the risk of sudden cardiac death : a prospective cohort study

Background Both blood pressure and C-reactive protein (CRP) are each independently related to mortality risk. However, the combined effect of systolic blood pressure (SBP) and CRP on sudden cardiac death (SCD) risk has not been studied. Patients and methods We studied the joint impact of SBP and CRP and the risk of SCD in the Kuopio Ischemic Heart Disease prospective cohort study of 1953 men aged 42–61 years with no history of ischemic heart disease. Baseline investigations were conducted between March 1984 and December 1989. SBP and CRP were measured. SBP was divided based on median values to low and high (median cutoffs 132 mmHg) and CRP as low and high (median cut-off 1.30 mg/L). Hazard …

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Cross-country skiing and the risk of acute myocardial infarction: A prospective cohort study

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Exercise cardiac power and the risk of heart failure in men: A population-based follow-up study.

Little is known about exercise cardiac power (ECP), defined as the ratio of directly measured maximal oxygen uptake with peak systolic blood pressure during exercise, on heart failure (HF) risk. We examined the association of ECP and the risk of HF.This was a population-based cohort study of 2351 men from eastern Finland. The average time to follow-up was 25 years. Participants participated at baseline in an exercise stress test. A total of 313 cases of HF occurred.Men with low ECP (9.84 mL/mmHg, the lowest quartile) had a 2.37-fold (95% confidence interval (95%CI): 1.68-3.35, p0.0001) hazards ratio of HF as compared with men with high ECP (13.92 mL/mmHg, the highest quartile), after adjust…

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Relative peak exercise oxygen pulse is related to sudden cardiac death, cardiovascular and all-cause mortality in middle-aged men

Background Preliminary evidence suggests that peak exercise oxygen pulse – peak oxygen uptake/heart rate-, a variable obtained during maximal cardiopulmonary exercise testing and a surrogate of stroke volume, is a predictor of mortality. We aimed to assess the associations of peak exercise oxygen pulse with sudden cardiac death, fatal coronary heart disease and cardiovascular disease and all-cause mortality. Design A prospective study. Methods Peak exercise oxygen pulse was assessed in a maximal cycling test at baseline in 2227 middle-aged men of the Kuopio Ischaemic Heart Disease cohort study using expired gas variables and electrocardiograms. Relative peak exercise oxygen pulse was obtain…

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Association between estimated pulse wave velocity and the risk of cardiovascular outcomes in men.

[No Abstract]

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Impact of Cardiorespiratory Fitness on Survival in Men with Low Socioeconomic Status

Abstract Aims Although both low socioeconomic status (SES) and poor cardiorespiratory fitness (CRF) are associated with increased chronic disease and heightened mortality, it remains unclear whether moderate-to-high levels of CRF are associated with survival benefits in low SES populations. This study evaluated the hypothesis that SES and CRF predict all-cause mortality and cardiovascular disease mortality and that moderate-to-high levels of CRF may attenuate the association between low SES and increased mortality. Methods This study included 2368 men, who were followed in the Kuopio Ischaemic Heart Disease Study cohort. CRF was directly measured by peak oxygen uptake during progressive exe…

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Exercise cardiac power and the risk of heart failure in men : A population-based follow-up study

Background Little is known about exercise cardiac power (ECP), defined as the ratio of directly measured maximal oxygen uptake with peak systolic blood pressure during exercise on heart failure (HF) risk. We examined the association of ECP and the risk of HF. Methods This was a population-based cohort study of 2351 men from eastern Finland. The average time to follow-up was 25 years. Participants participated at baseline in an exercise stress test. A total of 313 cases of HF occurred. Results Men with low ECP (13.92 mL/mmHg, highest quartile), after adjusting for age. Low ECP was associated with a 1.96-fold risk (95%CI: 1.38 − 2.78, p < 0.001) of HF after additional adjustment for conventio…

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The Duke treadmill score with bicycle ergometer: Exercise capacity is the most important predictor of cardiovascular mortality

Background The Duke treadmill score, a widely used treadmill testing tool, is a weighted index combining exercise time or capacity, maximum ST-segment deviation and exercise-induced angina. No previous studies have investigated whether the Duke treadmill score and its individual components based on bicycle exercise testing predict cardiovascular death. Design Two populations with a standard bicycle testing were used: 3936 patients referred for exercise testing (2371 men, age 56 ± 13 years) from the Finnish Cardiovascular Study (FINCAVAS) and a population-based sample of 2683 men (age 53 ± 5.1 years) from the Kuopio Ischaemic Heart Disease study (KIHD). Methods Cox regression was applied for…

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Cardiorespiratory Fitness and the Risk of Serious Ventricular Arrhythmias: A Prospective Cohort Study.

Cardiorespiratory fitness (CRF) is an established risk factor for cardiovascular disease outcomes. However, the relationship of CRF with risk of ventricular arrhythmias (VAs) is unknown. We aimed to assess the prospective association of CRF with the risk of serious VAs. Cardiorespiratory fitness, as measured by maximal oxygen uptake, was assessed using a respiratory gas exchange analyzer in 2299 middle-aged men in the Kuopio Ischemic Heart Disease prospective cohort. We corrected for within-person variability in CRF levels using data from repeated measurements 11 years apart. During median follow-up of 25.3 years (interquartile range, 18.7-27.2 years), 73 serious VAs were recorded. The age-…

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American heart association’s cardiovascular health metrics and risk of cardiovascular disease mortality among a middle-aged male Scandinavian population

Background: The burden of cardiovascular disease (CVD) prompted the American Heart Association to develop a cardiovascular health (CVH) metric as a measure to assess the cardiovascular status of the population. We aimed to assess the association between CVH scores and the risk of CVD mortality among a middle-aged Finnish population. Methods: We employed the prospective population-based Kuopio Ischemic Heart Disease cohort study comprising of middle-aged men (42–60 years). CVH scores were computed among 2607 participants at baseline and categorized as optimum (0–4), average (5–9), or inadequate (10–14) CVH. Multivariate cox regression models were used to estimate the hazard ratios (HR) and 9…

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