Atherogenic lipid profiles in Filipino adolescents with low body mass index and low dietary fat intake

This study reports mean lipid levels and their association with body composition, diet, and activity level in 300 male and 308 female adolescents (14–16 years) living in Cebu City, the Philippines. Participants were selected from the Cebu Longitudinal Health and Nutrition Survey (CLHNS), a 1‐year birth cohort study begun in 1982–83. Lipid profiles suggest high cardiovascular disease (CVD) risk in this sample, despite low intake of dietary fat (22% for both sexes) and an absence of obesity (0.3% of sample). Mean lipid levels for males and females were, respectively, 153.2 mg/dl and 182.5 mg/dl for total cholesterol (TC), 91.9 mg/dl and 104.6 mg/dl for low‐density lipoprotein cholesterol (LDL‐C), 38.3 mg/dl and 41.3 mg/dl for high‐density lipoprotein cholesterol (HDL‐C, geometric mean), and 73.9 mg/dl and 79.6 mg/dl for triglycerides (TG, geometric mean). The atherogenic ratio of TC/HDL‐C was high at 4.16 and 4.55 for males and females. Adjusting for maturational changes, the body mass index (BMI) and skinfold measures were positively associated with most lipids in males. Among females, BMI and skinfolds related positively to LDL‐C and TG, and inversely to HDL‐C. Although males had a higher waist hip ratio (WHR), WHR only predicted lipid profiles in females. Activity level had a beneficial association with lipid profiles in both sexes, while dietary fat intake was positively associated with LDL‐C in males and with HDL‐C in females. In sum, diet, adiposity, and physical activity predict variability in lipid profiles in this adolescent Filipino population. However, the low fat intake and near‐absence of obesity raise questions about the causes of the high apparent risk for future CVD in this young population. Am. J. Hum. Biol. 15:688–696, 2003. © 2003 Wiley‐Liss, Inc.     

Water-soluble dietary fibers and cardiovascular disease

One well-established way to reduce the risk of developing cardiovascular disease (CVD) is to lower serum LDL cholesterol levels by reducing saturated fat intake. However, the importance of other dietary approaches, such as increasing the intake of water-soluble dietary fibers is increasingly recognized. Well-controlled intervention studies have now shown that four major water-soluble fiber types—β-glucan, psyllium, pectin and guar gum—effectively lower serum LDL cholesterol concentrations, without affecting HDL cholesterol or triacylglycerol concentrations. It is estimated that for each additional gram of water-soluble fiber in the diet serum total and LDL cholesterol concentrations decrease by − 0.028 mmol/L and − 0.029 mmol/L, respectively. Despite large differences in molecular structure, no major differences existed between the different types of water-soluble fiber, suggesting a common underlying mechanism. In this respect, it is most likely that water-soluble fibers lower the (re)absorption of in particular bile acids. As a result hepatic conversion of cholesterol into bile acids increases, which will ultimately lead to increased LDL uptake by the liver. Additionally, epidemiological studies suggest that a diet high in water-soluble fiber is inversely associated with the risk of CVD. These findings underlie current dietary recommendations to increase water-soluble fiber intake.     

Lipid Abnormalities and Inflammation in HIV Inflection

Infection with the human immunodeficiency virus (HIV), and subsequent treatment with antiretroviral therapy (ART), is often associated with perturbations in lipid profiles. Furthermore, persistent inflammation, in spite of suppression of viral replication by ART, likely contributes to modifications in lipid composition and function, exacerbating risk for development of cardiovascular disease (CVD). Increased levels of several pro-inflammatory lipid species, including oxidized low-density lipoprotein (LDL) and high-density lipoprotein (HDL), have been measured in HIV-infected persons and are associated with markers of immune activation. The mechanisms linked to this bidirectional relationship in which inflammation increases lipid levels and promotes their modification, and these modified lipid species perpetuate inflammatory processes, require further investigation. Treatment with statins and other lifestyle modifications, including improvement in dietary intake and exercise, are critical to reducing CVD risk. Well-designed clinical trials that take into account the complex relationships among lipids and inflammation within persons infected with HIV need to be considered.     

Mothers' dietary patterns during pregnancy and risk of asthma symptoms in children at 3 years

There is increasing evidence that dietary factors in early life play a role in the aetiology of childhood asthma. Our objective in this analysis was to assess whether maternal dietary patterns during pregnancy, as measured by a validated food frequency questionnaire, influenced general practitioner diagnosis of asthma by the age of 3 years in the Life-ways cohort of children. General Practice follow-up records were available for 631 of 1001 singleton children, twins having been excluded (63% follow-up rate). Overall 10.4% of children had diagnosed asthma, a prevalence rate comparable with other studies. In logistic regression models, based on quartiles of intake, which adjusted for maternal lifestyle and socio-economic circumstances, relatively higher maternal fruit and vegetable intake and oily fish consumption were associated with lower risk of children developing asthma, whilst those with relatively higher spreadable fat intake had a higher risk of asthma. These findings warrant further investigation as they imply an important role for maternal diet in childhood asthma, though the confounding effect of other social and lifestyle factors should be assessed as the children get older.     

Missed opportunities for the prevention of cardiovascular disease among British hypertensives in primary care.

BACKGROUND: High-risk strategies for the prevention of cardiovascular disease (CVD) among hypertensive patients require knowledge of the prevalence and interaction of modifiable risk factors to ensure effective targeting of interventions. Comparatively little is known of risk-factor profiles and their modification among hypertensives in primary care. AIM: The present study was designed to explore relationships between patients' knowledge of CVD risk factors, their perception of personal risk and health behaviours, and their use of lifestyle interventions. METHOD: A cross-sectional survey of 2676 men and women with mild to moderate hypertension (diastolic blood pressure 95-115 mmHg), and their general practitioners, recruited from 1044 general practices throughout the UK, was conducted. RESULTS: Levels of modifiable risk factors were high, although there was considerable variation by age and sex; most (98.5%) patients had at least one additional CVD risk factor. A lower standard of living was associated with a higher prevalence of 'unhealthy' behaviours. Out of those with a current lifestyle problem, 85% of obese patients, 59% of smokers, 47% of excess drinkers, 49% of those with dietary risk factors and 32% of inactive patients claimed to have adopted healthier behaviours within the past 3 months. Older subjects and those with a lower standard of living were less likely to acknowledge risks, and those who did were less likely to report improving their lifestyles. While 71% of patients recalled receiving lifestyle advice, the coverage and targeting of specific interventions was generally poor. Overall, 60% of the sample had received advice on weight control, 47% on diet, 38% on exercise, 38% on smoking and 36% on alcohol. Women and older people were less likely to be given relevant counseling, and there was no evidence of targeting with respect to subjects' social class, level of hypertension or duration of diagnosis. CONCLUSION: Lifestyle interventions are welcomed and are viewed as helpful by patients receiving them. Potential health gains among high-risk hypertensives are being lost because of poor targeting and coverage of those at greatest risk.     

Relations among night work,dietary habits,biological measures,and health status

A cross-sectional study was conducted to investigate dietary intake, behavioral habits, and clinical and metabolic differences in night workers compared to day workers and to evaluate the metabolic differences associated with diet and body habits that occur between these two groups. Dietary habits, biological parameters, and health status were collected in 1,200 night workers and in an equal number of day workers, matched for gender, age, and socioeconomic status. Our findings demonstrated that night workers had poorer dietary habits and metabolic profile compared to day workers with a similar overall health status. These differences were associated with a higher prevalence of some cardiovascular risk factors such as smoking and obesity.     

Difference in body weight between American and Italian women with polycystic ovary syndrome: influence of the diet

BACKGROUND: The study aim was to determine differences in body mass in two populations of women (USA and Italy) with polycystic ovary syndrome (PCOS), and to assess the effect of diet on body mass and cardiovascular risk factors. METHODS: Pools of women with PCOS from the USA (n = 343) and Italy (n = 301), seen between 1993 and 2001, were available for assessment. From these populations, 20 women who were seen consecutively in 2001 at each site had detailed analyses of diet and cardiovascular risk factors. RESULTS: In the entire group, American women had a significantly higher body mass compared with Italian women (P < 0.01). Also, the 20 women consecutively evaluated in the USA had a significantly higher mean (+/- SD) body mass index (40.3 +/- 1.0 kg/m(2)) than in Italy (29.7 +/- 1.0 kg/m(2)). US women had worse insulin resistance, lower levels of high-density lipoprotein-cholesterol (HDL-C) (P < 0.01) and higher levels of triglycerides (P < 0.01). Dietary analysis in the two groups indicated that the total daily calorific intake was similar (USA 2277 +/- 109; Italy 2325 +/- 68 Kcal), with no appreciable differences in dietary content of protein, carbohydrate and fat. However, the dietary saturated fat content was significantly higher in US women (31.9 +/- 3 versus 18.2 +/- 2 g/day, P < 0.01). Saturated fat intake correlated negatively with HDL-C (P < 0.01). CONCLUSIONS: Among women with PCOS, body mass was significantly higher in US women compared with Italian women. However, total calorie intake and dietary constituents were similar, except for a higher saturated fat in US women. It is hypothesized that diet alone does not explain differences in body mass; genetic and lifestyle factors likely contribute. An increased saturated fat intake may worsen the cardiovascular risk profile.     

Cardiovascular disease: screening and management of the a-symptomatic high-risk post-menopausal woman

Menopause-related oestrogen deficiency increases the risk of cardiovascular disease (CVD). The presence of abdominal obesity, dyslipidemia, hypertension, fasting hyperglycaemia or impaired glucose tolerance further aggravates the CVD risk imposed by menopause. A detailed personal history should be recorded, covering PCOS, gestational diabetes mellitus, alcohol intake and smoking, as well as a family history of cardiovascular disease. Screening of the a-symptomatic post-menopausal woman should include fasting lipid profile, plasma glucose and liver, renal and thyroid function tests. Serum low-density lipoprotein cholesterol (LDL-c)>130 mg/dL is associated with an increased risk of CVD. Levels of triglycerides (TG)>or=150 mg/dL and high-density lipoprotein cholesterol (HDL-c)相似文献   

Saturated fats and cardiovascular health: Current evidence and controversies

A diet high in saturated fatty acids (SFA) is a suspected contributor to atherosclerotic cardiovascular disease (ASCVD) risk, in large part because of an effect to raise the low-density lipoprotein cholesterol (LDL-C) concentration. Most dietary guidance from health authorities advocates limiting intake of SFA, particularly for people with clinical ASCVD, dyslipidemia, or diabetes mellitus. However, recent reviews have highlighted controversies regarding SFA intake and cardiovascular health. This brief editorial commentary includes a discussion of the evidence regarding SFA intake and cardiovascular health, outlines gaps in the available evidence, and proposes tentative conclusions based on what is known today about SFA consumption and ASCVD risk. Results from observational studies demonstrate that dietary patterns with lower average intakes of SFA are associated with favorable cardiovascular outcomes. Additionally, although the number of randomized controlled trials testing the effects of reducing SFA intake on ASCVD outcomes is limited, the available evidence supports the view that replacing SFA with unsaturated fatty acids, particularly polyunsaturated fatty acids, may reduce ASCVD risk. Beyond raising LDL-C and atherogenic lipoprotein particle concentrations, higher intakes of SFA may influence pathways affecting inflammation, cardiac rhythm, hemostasis, apolipoprotein CIII production, and high-density lipoprotein function. However, the impacts of these effects on ASCVD risk remain uncertain. In the authors’ view, the totality of the evidence supports the current recommendation to limit SFA intake to <10% of total daily energy for the general healthy population and further (e.g., to 5-6% of total daily energy) for patients with hypercholesterolemia.     

Results of a multifactor cardiovascular risk reduction program in the czech republic: The healthy dubec project

Czech cardiovascular disease (CVD) morbidity and mortality rates are among the highest in the world. A 2-year community-based project was designed to increase CVD awareness and knowledge and behavior change skills, thus stimulating change in CVD-related behaviors. Dubec, a Czech town located just outside Prague, was the study community. Risk-factor surveys were conducted before and after the intervention (1992 and 1994). The intervention combined communitywide health education and intensive medical treatment of individuals at high risk for CVD. At baseline, 55% of the eligible population (n = 1,119) participated in the survey; however, the dropout rate in 1994 was high (46%). After taking those factors associated with dropout into consideration, regression analyses revealed significant increases in CVD knowledge, reductions in blood pressure, non-high-density lipoprotein cholesterol (non-HDL-C), and dietary intake of fat in both the high-risk CVD group and the community sample. In addition, the community sample had significant reductions in total cholesterol and a positive shift in their attitudes about changing CVD risk. There were no significant changes in percentage of smokers, body mass index (BMI), or dietary intake of high-fiber foods. This study demonstrates the feasibility of addressing CVD risk-related behaviors in Central Europe and supports additional efforts to address this significant public health problem. This program was supported by the U.S. Agency for International Development (US AID) under the Partnerships in Health Care Program (EUR 00037-G-00-2026-00). The authors wish to acknowledge the considerable support of Julia Terry, US AID program officer for the Central and Eastern European Partnerships.     

Depressed mood and dietary fish intake: direct relationship or indirect relationship as a result of diet and lifestyle?

Previous studies have suggested an association between depressed mood and the dietary intake of fish. In all cases, however, dietary fish intake has been considered at the exclusion of all other aspects of the diet. This analysis investigates associations between depressed mood and dietary fish intake, while also concurrently investigating intake of a number of other dietary components. The analysis is conducted on data from 10,602 men from Northern Ireland and France screened for inclusion into the PRIME cohort study. Depressed mood was assessed using a self-report questionnaire based on the Welsh Pure Depression sub-scale of the Minnesota Multiphasic Personality Inventory, diet was assessed using a Food Frequency Questionnaire, and limited demographics were also measured. Using regression, depressed mood is initially inversely associated with dietary fish intake. On inclusion of all other dietary variables, the strength of this relationship reduces but remains, and significant associations with a number of other foods are also found. On additional inclusion of all demographic variables, the strength of the above relationships again reduces, and associations with various measures of socio-economic status and education are also significant. These findings suggest that depressed mood is associated with fish intake both directly, and indirectly as part of a diet that is associated with depression and as part of a lifestyle that is associated with depression. Additional support for these conclusions is also provided in the pattern of associations between depressed mood and diet in the two countries. The relative contributions of fish intake to depressed mood both directly and indirectly are yet to be determined. However, while diet is not measured and until lifestyle can be adequately measured, the potential roles of diet and lifestyle in the association between depressed mood and dietary fish intake should not be ignored.     

Aerobic exercise, lipoproteins, and cardiovascular disease: benefits and possible risks.

Aerobic exercise has been shown to reduce the risk of cardiovascular disease (CVD). This reduction is proportional to the intensity of the exercise. The reduction in CVD risk is at least partially mediated by changes in circulating lipoproteins resulting from adaptive changes in enzymes involved in their metabolism. Specifically, aerobic exercise is associated with reductions in low density lipoprotein (LDL), total cholesterol and triacylglycerol (TAG), and increases in high density lipoprotein (HDL). Exposure to oxygen can oxidatively damage LDL. Oxidized LDL is a risk factor for atherosclerosis. Although aerobic exercise can cause oxidative damage, there are adaptive changes resulting from chronic exercise that result in lower rather than higher levels of oxidized LDL.     

Dietary trans fatty acids and its metabolic implications

Fats are important nutrients in our diet, they have wide chemical properties that drive diverse metabolic effects. The trans fatty acids (TFA) are common compounds found in industrialized food, and recent research has shown they should be avoided due to their increased risk of cardiovascular disease (CVD). Some of the mechanisms involved include: reduction of c-HDL concentration, increase of low density lipoprotein, Lp (a), triglycerides; disturbance in prostaglandin balance and they may also promote insulin resistance. Obese subjects are prone to increased CVD risk associated with a state of chronic inflammation that can be worsened by TFA intake. The US population consumes approximately 5.3 g TFA per day (2.6% of their total energy intake and 7.4% of their fat energy). Recently, WHO recommendations suggest the intake of TFA should be lower than 1% of energy per day. Current fast food industry products have to decrease the amount of TFA content, and the experience from different countries shows that the elimination of trans fatty acids is a cost effective and feasible public health intervention.     

Nutrition education in postmenopausal women: changes in dietary and cardiovascular indices

OBJECTIVE: The aim of the current study was to examine whether a diet rich in dairy products followed by a nutrition education program for the prevention of osteoporosis could have any adverse effect on certain cardiovascular disease (CVD) risk factors over a 5-month intervention period. METHODS: A total sample of 82 women (55-65 years old) was randomized to a dietary intervention group (IG: n=42), attending biweekly nutrition education program and provided with low-fat, fortified dairy products and to a control group (CG: n=40). Changes in dietary, biochemical and clinical indices related to CVD were determined at the end of the 5-month intervention period. RESULTS: The IG was found to have a higher decrease in the percentage of energy intake derived from total fat and a higher increase in the intake of calcium, phosphorus, magnesium and potassium compared to the CG (p<0.05). Furthermore, the IG subjects were found to have a lower increase in BMI (0.7+/-0.1 versus 1.4+/-0.2 Kg/m(2), p=0.011) and systolic blood pressure (SBP) (2.5+/-2.9 versus 7.8+/-2.2 mmHg, p=0.040) and a higher decrease in serum total cholesterol (-5.2+/-3.3 versus 6.9+/-5.1 mg/dl, p=0.042) and LDL-cholesterol levels (-20.0+/-2.6 versus -12.4+/-4.2 mg/dl, p=0.034) compared to the CG. CONCLUSIONS: The findings of the current study indicate that a dietary intervention aiming to minimize the risk for osteoporosis did not have any adverse effects on CVD risk factors. On the contrary, it has induced favourable changes in BMI, serum lipids and SBP.     

The role of Mediterranean type of diet on the development of cancer and cardiovascular disease,in the elderly: A systematic review

Background

The proportion of elderly worlwide is increasing. This increase in life expectancy, is staggering posing tremendous challenges in disease burden, especially, in chronic diseases such as obesity, diabetes, hypertension, hypercholesterolemia, cancer and cardiovascular disease (CVD). Limited studies investigate the effect of Mediterranean diet on cardiovascular risk and cancer in older populations. In this review, findings from observational studies are summarized to evaluate the effect of Mediterranean diet on cancer and cardiovascular disease risk in elderly people.

Methods

Published results from observational studies that assessed food habits on cancer and cardiovascular disease risk in elderly were retreived and summarized.

Results

In all studies diet had an effect on cardiovascular disease risk. The Mediterranean diet, a high-qulaity diet and increased fruit and vegetable consumption were all found to be cardioprotective.

Conclusion

The systematically reviewed studies reveal that a high adherence to a Mediterranean type of diet or “prudent diet” is associated with reduced risk of CVD and some types of cancer, even in the elderly. Also dietary intervention strategies can prevent morbidity, premature mortality and improve quality of life in older persons worldwide.     

LDL,LDL receptors,and PCSK9 as modulators of the risk for type 2 diabetes: a focus on white adipose tissue

Type 2 diabetes (T2D) and cardiovascular disease (CVD) share many risk factors such as obesity, unhealthy lifestyle, and metabolic syndrome, whose accumulation over years leads to disease onset. However, while lowering plasma low-density lipoprotein cholesterol (LDLC) is cardio-protective, novel evidence have recognised a role for common LDLC-lowering variants (e.g. in HMGCR, PCSK9, and LDLR) and widely used hypocholesterolemic drugs that mimic the effects of some of these variants (statins) in higher risk for T2D. As these conditions decrease plasma LDLC by increasing tissue-uptake of LDL, a role for LDL receptor (LDLR) pathway was proposed. While underlying mechanisms remain to be fully elucidated, work from our lab reported that native LDL directly provoke the dysfunction of human white adipose tissue (WAT) and the activation of WAT NLRP3 (Nucleotide-binding domain and Leucine-rich repeat Receptor, containing a Pyrin domain 3) inflammasome, which play a major role in the etiology of T2D. However, while elevated plasma numbers of apolipoprotein B (apoB)-containing lipoproteins (measured as apoB, mostly as LDL) is associated with WAT dysfunction and related risk factors for T2D in our cohort, this relation was strengthened in regression analysis by lower plasma proprotein convertase subtilisin/kexin type 9 (PCSK9). This supports a central role for upregulated pathway of LDLR and/or other receptors regulated by PCSK9 such as cluster of differentiation 36 (CD36) in LDL-induced anomalies. Targeting receptor-mediated uptake of LDL into WAT may reduce WAT inflammation, WAT dysfunction, and related risk for T2D without increasing the risk for CVD.     

What is a good marker for serum cholesterol to identify high-risk patients at general health checks?

Conventional measurement of lipid concentrations includes total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), high-density lipoprotein-cholesterol (HDL-C), and triglycerides (TG). Several guidelines for cardiovascular diseases recommend using LDL-C as the primary target of therapy in conjunction with assessing risk factors for cardiovascular diseases (CVD); however, emerging findings have revealed that lowering LDL-C to the goal with statins is not enough to prevent primary and secondary CVD. Thus, we need new parameters to better integrate residual risks into CVD risk stratification. Recently, non-HDL-C, apolipoprotein B (apoB), and LDL-C/HDL-C have been suggested. Non-HDL-C, indicating the cholesterol contents of all atherogenic lipoproteins and retaining continuity with the concept of cholesterol, is quickly computed by subtracting HDL-C from TC, needs no additional costs, and includes atherogenic TG-rich lipoproteins, called remnant lipoproteins. In addition, non-HDL-C has been shown to be an excellent predictor of CVD, free from dietary variations. ApoB, the number of atherogenic lipoproteins, is also a valuable parameter with slightly better performance than non-HDL-C in epidemiological studies, but it costs more and takes longer than conventional lipid examinations. Several lipid parameters, such as TC/HDL-C, non-HDL-C/HDL-C, LDL-C/HDL-C, are also available in clinical practice and epidemiological study; however, we should note that LDL-C/HDL-C is not reliable in cases of high TG. Thus, in general health checks, we should first pay attention to the absolute values of LDL-C, HDL-C, and TG for the diagnosis and subsequently use non-HDL-C, apoB, and other parameters, considering the pathophysiological condition, convenience, and costs.     

Does calcium intake affect cardiovascular risk factors and/or events?

Dietary intervention is an important approach in the prevention of cardiovascular disease. Over the last decade, some studies have suggested that a calcium-rich diet could help to control body weight, with anti-obesity effects. The potential mechanism underlying the impact of calcium on body fat has been investigated, but it is not fully understood. Recent evidence has also suggested that a calcium-rich diet could have beneficial effects on other cardiovascular risk factors, such as insulin resistance, dyslipidemia, hypertension and inflammatory states. In a series of studies, it was observed that a high intake of milk and/or dairy products (the main sources of dietary calcium) is associated with a reduction in the relative risk of cardiovascular disease. However, a few studies suggest that supplemental calcium (mainly calcium carbonate or citrate) may be associated with an increased risk of cardiovascular events. This review will discuss the available evidence regarding the relationship between calcium intake (dietary and supplemental) and different cardiovascular risk factors and/or events.     

A systematic review and appraisal of methods of developing and validating lifestyle cardiovascular disease risk factors questionnaires

BackgroundWell developed and validated lifestyle cardiovascular disease (CVD) risk factors questionnaires is the key to obtaining accurate information to enable planning of CVD prevention program which is a necessity in developing countries. We conducted this review to assess methods and processes used for development and content validation of lifestyle CVD risk factors questionnaires and possibly develop an evidence based guideline for development and content validation of lifestyle CVD risk factors questionnaires.Materials/methodsRelevant databases at the Stellenbosch University library were searched for studies conducted between 2008 and 2012, in English language and among humans. Using the following databases; pubmed, cinahl, psyc info and proquest. Search terms used were CVD risk factors, questionnaires, smoking, alcohol, physical activity and diet.ResultsMethods identified for development of lifestyle CVD risk factors were; review of literature either systematic or traditional, involvement of expert and /or target population using focus group discussion/interview, clinical experience of authors and deductive reasoning of authors. For validation, methods used were; the involvement of expert panel, the use of target population and factor analysis.ConclusionCombination of methods produces questionnaires with good content validity and other psychometric properties which we consider good.     

Cardiovascular Risk: Gender Differences in Lifestyle Behaviors and Coping Strategies

Background

Although cardiovascular disease (CVD) does not occur until mid to late life for most adults, the presence of risk factors, such as high blood pressure (BP) and cholesterol, has increased dramatically in young adults.

Purpose

The present study examined the relationships between gender and coping strategies, lifestyle behaviors, and cardiovascular risks.

Method

The sample consisted of 297 (71% female) university students. Participants completed a survey to assess demographics, lifestyle behaviors, and coping strategies, and a physiological assessment including lipid and blood pressure (BP) measurements. Data collection occurred from January 2007 to May 2008.

Results

Analyses revealed that age, ethnicity, greater body mass index (BMI), greater use of social support, and less frequent exercise were associated with higher cholesterol, while gender, age, greater BMI, and less frequent exercise were associated with higher systolic BP. There were two significant interactions: one between gender and avoidant coping and the other between gender and exercise on systolic BP, such that for men greater use of avoidant coping or exercise was associated with lower systolic BP.

Conclusion

Understanding how young adults manage their demands and cope with stress sets the stage for understanding the developmental process of CVD. Both coping strategies and lifestyle behaviors must be considered in appraising gender-related cardiovascular risk at an early age before the disease process has begun.