BACKGROUND
Dysfunction of the autonomic nervous system increases cardiovascular risk, but its contribution to cancer outcomes is less well-characterized.
OBJECTIVES
The aim of this study was to evaluate associations between physiological measures reflective of autonomic function and all-site and site-specific cancer mortality in healthy adults.
METHODS
The study included 75,308 participants (26.8% women) in the Cooper Center Longitudinal Study who completed a preventive medicine examination with a treadmill test between 1971 and 2018. Gompertz mortality models estimated associations between autonomic markers-resting heart rate, heart rate reserve, systolic blood pressure response to exercise, and heart rate recovery-and cancer mortality through 2019. Analyses were sex-stratified when significant interactions were present. Models adjusted for age, clinical and lifestyle factors, and cardiorespiratory fitness.
RESULTS
Over a median follow-up of 21.9 years, 3,855 cancer deaths occurred. Lower heart rate reserve (HR per 10% lower: 1.05; 95% CI: 1.02-1.07) and heart rate recovery at 5 minutes (HR per 10 beats/min lower: 1.06; 95% CI: 1.03-1.09) were associated with higher all-site cancer mortality. Sex-specific associations were observed for certain markers: A higher resting heart rate was related to higher cancer mortality in men (HR per 10 beats/min: 1.04; 95% CI: 1.01-1.08), but not in women, whereas systolic blood pressure response associations were stronger in women. Associations with site-specific cancer mortality were particularly pronounced for lung cancer.
CONCLUSIONS
In apparently healthy adults, multiple noninvasive markers of autonomic function were associated with cancer mortality, independent of cardiorespiratory fitness.
Clare Meernik, David Leonard, Kerem Shuval et al.· JACC: Advances· 0 citations
OBJECTIVE
To investigate the relationship between depressive symptoms and risk for COVID-19 hospitalization and death in a United States general population-based sample.
METHODS
We studied participants enrolled into observational NIH-funded cohorts from 1971-2010 with ongoing follow-up through 2023. Pre-pandemic Centers for Epidemiologic Studies Depression (CES-D) 10-item scale scores ≥10 defined elevated depressive symptoms. Questionnaires, medical records, and death certificates classified incident COVID-19 as severe (hospitalized/fatal) or non-severe from April 2020 through February 2023.
RESULTS
Of 33,565 participants, 633 (1.9%) had incident severe COVID-19 over a mean (SD) follow-up of 453 (207) days. Elevated pre-pandemic depressive symptoms were present in 4,922 (16.3%) of participants. Elevated pre-pandemic depressive symptoms increased the hazard of severe COVID-19 in fully-adjusted (aHR=1.27; 95%CI: 1.03-1.57) models. In sex-stratified models (p-interaction=0.03), elevated depressive symptoms increased the hazard in women (aHR=1.49; 95%CI: 1.17-1.90) but not in men (aHR=0.96; 95%CI: 0.67-1.39).
CONCLUSIONS
Pre-pandemic depressive symptoms were associated with increased risk of severe COVID-19 among women in a large US general population-based study of adults, and associations in men were neither confirmed nor ruled out. These results support current CDC recommendations that depression be considered an underlying medical condition associated with higher risk for severe COVID-19 and suggest that increased clinical focus on risk mitigation for COVID-19 and other acute respiratory infections among patients with depressive symptoms is warranted.
E. Oelsner, Yi-Fei Sun, P. Balte et al.· Biopsychosocial science and...· 0 citations
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