Abdominal obesity and mortality: The Pennington Center Longitudinal Study

The purpose of this study was to determine the association between visceral adipose tissue (VAT) and all-cause mortality. The sample included 1089 white men and women 18–84 years of age from the Pennington Center Longitudinal Study, a prospective cohort of participants assessed between 1995 and 2008, and followed for mortality until 31 December 2009. Abdominal VAT was measured at the L4–L5 vertebral level using computed tomography. There were 27 deaths during an average of 9.1 years of follow-up. Abdominal VAT was significantly associated with mortality after adjustment for age, sex and year of examination (hazards ratio (HR) 1.46; 95% confidence interval 1.05–2.05). The association was stronger after the inclusion of abdominal subcutaneous adipose tissue (SAT), smoking status, alcohol consumption and leisure-time physical activity as additional covariates (HR 1.74; 1.17–2.59). Limiting the sample to participants who were free of stroke, heart disease and cancer at baseline reduced the strength of the relationship slightly (HR 1.62; 1.07–2.47). Abdominal SAT was not associated with mortality, either alone or in combination with VAT and other covariates. The results support the assertion that abdominal VAT is an important therapeutic target for obesity reduction efforts.     

Anger Proneness,Gender, and the Risk of Heart Failure

BackgroundEvidence regarding the association of anger proneness with incidence of heart failure is lacking.Methods and ResultsAnger proneness was ascertained among 13,171 black and white participants of the Atherosclerosis Risk in Communities (ARIC) study cohort with the use of the Spielberger Trait Anger Scale. Incident heart failure events, defined as occurrence of ICD-9-CM code 428.x, were ascertained from participants' medical records during follow-up in the years 1990–2010. Relative hazard of heart failure across categories of trait anger was estimated with the use of Cox proportional hazard models. Study participants (mean age 56.9 [SD 5.7] years) experienced 1,985 incident HF events during 18.5 (SD 4.9) years of follow-up. Incidence of HF was greater among those with high, as compared to those with low or moderate trait anger, with higher incidence observed for men than for women. The relative hazard of incident HF was modestly high among those with high trait anger, compared with those with low or moderate trait anger (age-adjusted hazard ratio for men: 1.44 (95% confidence interval [CI] 1.23–1.69). Adjustment for comorbidities and depressive symptoms attenuated the estimated age-adjusted relative hazard in men to 1.26 (95% CI 1.00–1.60).ConclusionsAssessment of anger proneness may be necessary in successful prevention and clinical management of heart failure, especially in men.