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  • 1
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    Online Resource
    Ideal Cardiovascular Health Predicts Functional Status Independently of Vascular Events: The Northern Manhattan Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Journal of the American Heart Association Vol. 4, No. 2 ( 2015-01-30)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 4, No. 2 ( 2015-01-30)
    Abstract: We hypothesized that the American Heart Association's metric of ideal cardiovascular health ( CVH ) predicts improved long‐term functional status after adjusting for incident stroke and myocardial infarction. Methods and Results In the prospective, multiethnic Northern Manhattan Study, stroke‐free individuals in northern Manhattan aged ≥40 years had annual assessments of the primary outcome of functional status with the Barthel index ( BI ), for a median of 13 years. Ideal CVH was calculated as a composite of 7 measures, each scored on a scale of 0 to 2. Primary predictors were (1) number of ideal CVH metrics, and (2) total score of all CVH metrics. Of 3219 participants, mean age was 69 years ( SD 10), 63% were female, 21% were white, 25% were non‐Hispanic black, and 54% were Hispanic. Twenty percent had 0 to 1 ideal CVH metrics, 32% had 2, 30% had 3, 14% had 4, and 4% had 5 to 7. Both number of ideal CVH categories and higher CVH metric scores were associated with higher mean BI scores at 5 and 10 years. 0047 Gradients persisted when results were adjusted for incident stroke and myocardial infarction, when mobility and nonmobility domains of the BI were analyzed separately, and when BI was analyzed dichotomously. At 10 years, in a fully adjusted model, differences in mean BI score were lower for poor versus ideal physical activity (3.48 points, P 〈 0.0001) and fasting glucose (4.58 points, P 〈 0.0001). Conclusions Ideal CVH predicts functional status, even after accounting for incident vascular events. Vascular functional impairment is an important outcome that can be reduced by optimizing vascular health.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.114.001322
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2653953-6
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  • 2
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    Cardiovascular Health Status Among Caribbean Hispanics Living in Northern Manhattan and Ecuadorian Natives/Mestizos in Rural Coastal Ecuador: A Comparative Study
    Springer Science and Business Media LLC ; 2013
    In:  Journal of Community Health Vol. 38, No. 4 ( 2013-8), p. 634-641
    Details
    In: Journal of Community Health, Springer Science and Business Media LLC, Vol. 38, No. 4 ( 2013-8), p. 634-641
    Type of Medium: Online Resource
    ISSN: 0094-5145 , 1573-3610
    URL: Article
    DOI: 10.1007/s10900-013-9658-0
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2013
    detail.hit.zdb_id: 2016765-9
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  • 3
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    Fibroblast Growth Factor 23 and Cause-Specific Mortality in the General Population: The Northern Manhattan Study
    The Endocrine Society ; 2016
    In:  The Journal of Clinical Endocrinology & Metabolism Vol. 101, No. 10 ( 2016-10), p. 3779-3786
    Details
    In: The Journal of Clinical Endocrinology & Metabolism, The Endocrine Society, Vol. 101, No. 10 ( 2016-10), p. 3779-3786
    Type of Medium: Online Resource
    ISSN: 0021-972X , 1945-7197
    URL: Article
    DOI: 10.1210/jc.2016-2215
    RVK:
    XA 10000
    Language: English
    Publisher: The Endocrine Society
    Publication Date: 2016
    detail.hit.zdb_id: 2026217-6
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  • 4
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    Subclinical Cerebrovascular Disease Increases the Risk of Incident Stroke and Mortality: The Northern Manhattan Study
    Ovid Technologies (Wolters Kluwer Health) ; 2017
    In:  Journal of the American Heart Association Vol. 6, No. 9 ( 2017-09-22)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 9 ( 2017-09-22)
    Abstract: The effects of white matter hyperintensity volume and subclinical brain infarcts on the risk of incident stroke, its ischemic subtypes, and mortality require further study in diverse samples. Methods and Results Stroke‐free participants in the Northern Manhattan Study underwent magnetic resonance imaging (N=1287; mean age 71±9 years, 60% women, 15% non‐Hispanic white, 17% non‐Hispanic black, 68% Hispanic) and were followed for a median of 8 years (interquartile range: 6–9 years). Cox models estimated proportional hazards of incident stroke of all types, ischemic stroke (and its subtypes), and mortality and stratified by race/ethnicity. In total 72 participants (6%) had incident strokes and 244 died (19%). In fully adjusted models, those with larger white matter hyperintensity volume had greater risk of all stroke types (hazard ratio [HR]: 1.4; 95% CI , 1.1–1.9), ischemic stroke ( HR : 1.3; 95% CI , 1.0–1.8), and cryptogenic stroke ( HR : 2.2; 95% CI , 1.1–4.4). White and black but not Hispanic participants had increased stroke risk ( P 〈 0.05 for heterogeneity for all and ischemic stroke). Those with subclinical brain infarct had greater risk for all stroke types ( HR : 1.9; 95% CI , 1.1–3.3), ischemic stroke ( HR : 2.2; 95% CI , 1.3–3.8), lacunar ( HR : 4.0; 95% CI , 1.3–12.3), and cryptogenic stroke ( HR : 3.6; 95% CI , 1.0–12.7), without significant heterogeneity across race/ethnic groups. Greater white matter hyperintensity volume increased both vascular ( HR : 1.3; 95% CI , 1.1–1.7) and nonvascular ( HR : 1.2; 95% CI , 1.0–1.5) mortality among Hispanic and white but not black participants ( P =0.040 for heterogeneity). Subclinical brain infarct was associated with increased vascular mortality among Hispanic participants only ( HR : 2.9; 95% CI , 1.4–5.8). Conclusions In this urban US sample, subclinical cerebrovascular lesions increased the risk of clinical stroke and vascular mortality and varied by race/ethnicity and lesion type.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.116.004069
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2017
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  • 5
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    Ideal Cardiovascular Health and Biomarkers of Subclinical Brain Aging: The Northern Manhattan Study
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of the American Heart Association Vol. 7, No. 16 ( 2018-08-21)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 7, No. 16 ( 2018-08-21)
    Abstract: The American Heart Association Life's Simple 7 metric defines ideal cardiovascular health (CVH) on 7 factors: smoking, diet, physical activity, body mass index, blood sugar, blood pressure, and cholesterol. This metric has been used to define optimal brain health, but data relative to subclinical imaging biomarkers of brain aging are lacking. This study examines the association between Life's Simple 7 with white matter hyperintensity volume, silent brain infarcts, and cerebral volume. Methods and Results A subsample of stroke‐free participants from the population‐based Northern Manhattan Study underwent brain magnetic resonance imaging an average of 7 years after baseline. Linear and logistic regression models were constructed to estimate associations between the number of ideal CVH metrics achieved with imaging biomarkers of brain aging, adjusting for sociodemographics. Among 1031 participants (mean age at magnetic resonance imaging=72±8, 40% men, 19% black, 16% white, and 65% Hispanic), no one had ideal status in all 7 factors, 1% had ideal status in 6 factors, 18% in 4 to 5 factors, 30% in 3 factors, 33% in 2 factors, and 18% in 0 to 1 factors. The number of ideal CVH factors achieved was inversely associated with white matter hyperintensity volume (beta per factor=−0.047; P =0.04) and silent brain infarct (odds ratio per factor=0.84; 95% confidence interval=0.72–0.97) and positively associated with cerebral volume (beta per factor=0.300; P =0.002). Conclusions An increasing ideal CVH score was associated with less white matter hyperintensity volume and silent brain infarcts and greater cerebral volumes, supporting the Life's Simple 7 metric as a useful measure to quantify optimal brain health. Monitoring and promoting achievement of Life's Simple 7 ideal CVH factors may improve subclinical and clinical brain health outcomes.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.118.009544
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
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  • 6
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    Ideal Cardiovascular Health and Cognitive Aging in the Northern Manhattan Study
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Journal of the American Heart Association Vol. 5, No. 3 ( 2016-03-09)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 5, No. 3 ( 2016-03-09)
    Abstract: The American Heart Association defined target levels for 7 cardiovascular health ( CVH ) factors: smoking, body mass index, physical activity, diet, blood pressure, cholesterol, and glucose. We hypothesized that a greater number of American Heart Association ideal CVH metrics would be associated with less decline in cognitive performance in our multiethnic population. Methods and Results A subsample from the population‐based Northern Manhattan Study underwent repeated neuropsychological testing (mean interval 6±2 years). Domain‐specific Z scores were derived by using factor analysis for the domains of Episodic Memory, Semantic Memory, Executive Function, and Processing Speed, based on initial performance and decline over time. Linear regression models were constructed to examine the relationship between the number of ideal CVH metrics at enrollment with later cognitive performance and decline, adjusting for sociodemographics and magnetic resonance imaging brain markers. Among 1033 participants (mean age at initial cognitive assessment 72±8 years, 39% male, 19% black, 16% white, 65% Hispanic; n=722 with repeat testing), 3% had 0 ideal factors, 15% had 1 factor, 33% had 2 factors, 30% had 3 factors, 14% had 4 factors, 4% had 5 factors, 1% had 6 factors, and 0% had 7 factors. An increasing number of ideal CVH factors was associated with better processing speed at initial assessment and less decline. The association was driven by nonsmoking and glucose. Among those with better cognitive performance at initial assessment, positive associations were observed between the number of ideal CVH factors and less decline in the domains of Executive Function and Episodic Memory. Conclusions The number of ideal CVH metrics was associated with less decline in the domains of Processing Speed and, to a lesser extent, of Executive Function and Episodic Memory. Ideal CVH promotion benefits brain health and cognitive aging.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.115.002731
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
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  • 7
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    Association between Sleep Duration and the Mini-Mental Score: The Northern Manhattan Study
    American Academy of Sleep Medicine (AASM) ; 2013
    In:  Journal of Clinical Sleep Medicine Vol. 09, No. 07 ( 2013-07-15), p. 669-673
    Details
    In: Journal of Clinical Sleep Medicine, American Academy of Sleep Medicine (AASM), Vol. 09, No. 07 ( 2013-07-15), p. 669-673
    Type of Medium: Online Resource
    ISSN: 1550-9389 , 1550-9397
    URL: Article
    DOI: 10.5664/jcsm.2834
    Language: English
    Publisher: American Academy of Sleep Medicine (AASM)
    Publication Date: 2013
    detail.hit.zdb_id: 2210082-9
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  • 8
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    Table_1.DOCX
    Frontiers Media SA ; 2022
    In:  Frontiers in Cardiovascular Medicine Vol. 9 ( 2022-1-24)
    Details
    In: Frontiers in Cardiovascular Medicine, Frontiers Media SA, Vol. 9 ( 2022-1-24)
    Abstract: Low Gray-Scale Median (GSM) index is an ultrasonographic parameter of soft, lipid rich plaque morphology that has been associated with stroke and cardiovascular disease (CVD). We sought to explore the contribution of the modifiable and not-modifiable cardiovascular risk factors (RFs) to vulnerable plaque morphology measured by the low GSM index. A total of 1,030 stroke-free community dwelling individuals with carotid plaques present (mean age, 71.8 ± 9.1; 58% women; 56% Hispanic, 20% Non-Hispanic Black, 22% Non-Hispanic White) were assessed for minimum GSM (min GSM) using high-resolution B-mode carotid ultrasound. Multiple linear regression models were used to evaluate the association between RFs and minGSM after adjusting for sociodemographic characteristics. Within an individual, median plaque number was 2 (IQR: 1–3) and mean plaque number 2.3 (SD: 1.4). Mean minGSM was 78.4 ± 28.7 (IQR: 56–96), 76.3 ± 28.8 in men and 80 ± 28.5 in women; 78.7 ± 29.3 in Hispanics participants, 78.5 ± 27.2 in Non-Hispanic Black participants, and 78.2 ± 29 in Non-Hispanic white participants. In multivariable adjusted model, male sex (β = −5.78, p = 0.007), obesity BMI (β = −6.92, p = 0.01), and greater levels of fasting glucose (β = −8.02, p = 0.02) and LDL dyslipidemia (β = −6.64, p = 0.005) were positively associated with lower minGSM, while presence of glucose lowering medication resulted in a significant inverse association (β = 7.68, p = 0.04). Interaction (with p for interaction & lt;0.1) and stratification analyses showed that effect of age on minGSM was stronger in men (β = −0.44, p = 0.03) than in women (β = −0.20, p = 0.18), and in individuals not taking glucose lowering medication (β = −0.33, p = 0.009). Our study has demonstrated an important contribution of glycemic and lipid metabolism to vulnerable, low density or echolucent plaque morphology, especially among men and suggested that use of glucose lowering medication was associated with more fibrose-stable plaque phenotype (greater GSM). Further research is needed to evaluate effects of medical therapies in individuals with vulnerable, low density, non-stenotic carotid plaques and how these effects translate to prevention of cerebrovascular disease.
    Type of Medium: Online Resource
    ISSN: 2297-055X
    URL: Article
    URL: Article
    DOI: 10.3389/fcvm.2022.793755
    DOI: 10.3389/fcvm.2022.793755.s001
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2022
    detail.hit.zdb_id: 2781496-8
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  • 9
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    Sleep duration is associated with white matter hyperintensity volume in older adults: the Northern Manhattan Study
    Wiley ; 2014
    In:  Journal of Sleep Research Vol. 23, No. 5 ( 2014-10), p. 524-530
    Details
    In: Journal of Sleep Research, Wiley, Vol. 23, No. 5 ( 2014-10), p. 524-530
    Abstract: Self‐reports of long or short sleep durations have indicated an association with cardiovascular morbidity and mortality, but there are limited data evaluating their association with white matter hyperintensity volume ( WMHV ), a marker of cerebral small vessel disease. We conducted a cross‐sectional analysis of self‐reported sleep duration to test for a correlation with white matter hyperintensities, measured by quantitative magnetic resonance imaging ( MRI ), in the Northern Manhattan Study. We used multivariable linear regression models to assess associations between both short ( 〈 6 h) and long (≥9 h) sleep durations and log‐transformed WMHV , adjusting for demographic, behavioural and vascular risk factors. A total of 1244 participants, mean age 70 ± 9 years, 61% women and 68% Hispanics were analysed with magnetic resonance brain imaging and self‐reported sleep duration. Short sleep was reported by 23% ( n  =   293) and long sleep by 10% ( n  =   121) of the sample. Long sleep ( β  = 0.178; P  =   0.035), but not short sleep ( β  = −0.053; P  =   0.357), was associated with greater log‐ WMHV in fully adjusted models. We observed an interaction between sleep duration, diabetes mellitus and log‐ WMHV ( P  =   0.07). In fully adjusted models, stratified analysis showed that long sleep duration was associated with greater WMHV only in those with diabetes ( β  = 0.78; P  =   0.0314), but not in those without diabetes ( β  = 0.022; P  =   0.2), whereas short sleep was not associated with white matter hyperintensities in those with or without diabetes. In conclusion, long sleep duration was associated with a greater burden of white matter lesions in this stroke‐free urban sample. The association was seen mainly among those with diabetes mellitus.
    Type of Medium: Online Resource
    ISSN: 0962-1105 , 1365-2869
    URL: Issue
    URL: Article
    DOI: 10.1111/jsr.2014.23.issue-5
    DOI: 10.1111/jsr.12177
    Language: English
    Publisher: Wiley
    Publication Date: 2014
    detail.hit.zdb_id: 2007459-1
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  • 10
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    Infectious Burden and Cognitive Decline in the Northern Manhattan Study
    Wiley ; 2015
    In:  Journal of the American Geriatrics Society Vol. 63, No. 8 ( 2015-08), p. 1540-1545
    Details
    In: Journal of the American Geriatrics Society, Wiley, Vol. 63, No. 8 ( 2015-08), p. 1540-1545
    Abstract: To determine whether infectious burden ( IB ) is associated with worse performance and decline on a battery of neuropsychological tests. Design Prospective cohort study (Northern Manhattan Study ( NOMAS )). Setting Community. Participants A subsample of 588 stroke‐free NOMAS participants with IB and cognitive data (mean age 71 ± 8, 62% female, 14% white, 16% black, 70% Hispanic) and 419 with repeat cognitive testing. Measurements Samples used for IB data were collected at baseline. Two waves of neurocognitive assessments occurred during follow‐up. Participants underwent a neuropsychological battery and had repeated testing (mean time span 6 ± 2 years). Using factor analysis–derived domain‐specific Z scores for language, memory, executive function, and processing speed, associations between a quantitative stroke risk‐weighted IB index ( IBI ), based on five common infections ( Chlamydia pneumoniae , Helicobacter pylori , cytomegalovirus, herpes simplex viruses 1 and 2), and cognitive performance and decline in each domain was examined. Results Adjusting for demographic characteristics, socioeconomic status, crystallized cognitive abilities, and vascular risk factors, the IBI was inversely associated with executive function at baseline (beta = −0.10, P  = .01) but not with baseline language, memory, or processing speed performance in adjusted analyses. The IBI was associated with cognitive decline in the memory domain, adjusting for demographic and vascular risk factors ( P  = .02). Conclusion A quantitative stroke risk‐weighted measure of IB explained variability in baseline executive function performance and associated with decline in memory. Past exposure to common infections may contribute to vascular cognitive impairment and warrants further study.
    Type of Medium: Online Resource
    ISSN: 0002-8614 , 1532-5415
    URL: Issue
    URL: Article
    DOI: 10.1111/jgs.2015.63.issue-8
    DOI: 10.1111/jgs.13557
    Language: English
    Publisher: Wiley
    Publication Date: 2015
    detail.hit.zdb_id: 2040494-3
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