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Head of Westport, MA, United States

Rosenbloom J.I.,Cardiovascular Epidemiology Research Unit | Rosenbloom J.I.,Harvard University | Mukamal K.J.,Beth Israel Deaconess Medical Center | Mukamal K.J.,Harvard University | And 3 more authors.
Circulation | Year: 2012

Background-The relationship between residential proximity to roadway and long-term survival after acute myocardial infarction (AMI) is unknown. We investigated the association between distance from residence and major roadway and 10-year all-cause mortality after AMI in the Determinants of Myocardial Infarction Onset Study (Onset Study), hypothesizing that living closer to a major roadway at the time of AMI would be associated with increased risk of mortality. Methods and Results-The Onset Study enrolled 3886 individuals hospitalized for AMI in 64 centers across the United States from 1989 to 1996. Institutionalized patients, those providing only post office boxes, and those whose addresses could not be geocoded were excluded, leaving 3547 patients eligible for analysis. Addresses were geocoded, and distance to the nearest major roadway was assigned. Cox regression was used to calculate hazard ratios, with adjustment for personal characteristics (age, sex, race, education, marital status, distance to nearest acute care hospital), clinical characteristics (smoking, body mass index, comorbidities, medications), and neighborhood-level characteristics derived from US Census block group data (household income, education, urbanicity). There were 1071 deaths after 10 years of follow-up. In the fully adjusted model, compared with living <1000 m, hazard ratios (95% confidence interval) for living ≤100 m were 1.27 (1.01-1.60), for 100 to ≤200 m were 1.19 (0.93-1.60), and for 200 to ≤1000 m were 1.13 (0.99 -1.30) (Ptrend-0.016). Conclusions-In this multicenter study, living close to a major roadway at the time of AMI was associated with increased risk of all-cause 10-year mortality; this relationship persisted after adjustment for individual and neighborhood-level covariates. © 2012 American Heart Association, Inc.

Wang Y.,Brown University | Eliot M.N.,Brown University | Kuchel G.A.,University of Connecticut | Coull B.A.,Harvard University | And 3 more authors.
Journal of Occupational and Environmental Medicine | Year: 2014

Objective: Long-termexposure to traffic-related air pollution has been linked to increased risk of obesity and diabetes and may be associated with higher serum levels of the adipokine leptin, but this hypothesis has not been previously evaluated in humans. Methods: In a cohort of older adults, we estimated the association between serum leptin concentrations and two markers of long-term exposure to traffic pollution, adjusting for participant characteristics, temporal trends, socioeconomic factors, and medical history. Results: An interquartile range increase (0.11 μg/m3) in annual mean residential black carbon was associated with 12% (95% confidence interval: 3%, 22%) higher leptin levels. Leptin levels were not associated with residential distance to major roadway. Conclusions: If confirmed, these findings support the emerging evidence suggesting that certain sources of traffic pollutionmay be associated with adverse cardiometabolic effects. Copyright © 2014 by American College of Occupational and Environmental Medicine.

Mostofsky E.,Cardiovascular Epidemiology Research Unit | Mostofsky E.,Harvard University | Burger M.R.,Medical Center Heart Institute | Schlaug G.,Beth Israel Deaconess Medical Center | And 5 more authors.
Stroke | Year: 2010

Background and Purpose-: Previous research suggests that regular heavy alcohol consumption increases the risk for ischemic stroke, whereas frequent light to moderate alcohol intake may decrease the risk. However, the risk of ischemic stroke associated with transient exposure to alcohol remains unclear. In this study, we used a case-crossover approach to test the hypothesis that alcohol consumption affects the acute risk of ischemic stroke, to determine the length of time between alcohol intake and the onset of symptoms (induction time), and to examine whether the risk varies by the type of alcohol. Methods-: In this multicenter study, we interviewed 390 patients (209 men, 181 women) between January 2001 and November 2006 (median 3 days after stroke). Alcohol consumption in the hour before stroke symptoms was compared with its expected frequency based on the usual frequency of alcohol consumption over the prior year. Results-: Of the 390 patients, 248 (64%) reported alcohol consumption in the prior year, 104 within 24 hours and 14 within 1 hour of stroke onset. The relative risk of stroke in the hour after consuming alcohol was 2.3 (95% CI, 1.4 to 4.0; P=0.002). The relative risks were similar for different types of alcoholic beverages and when the sample was restricted to those who were not simultaneously exposed to other potential triggers. Conclusions-: The risk of stroke onset is transiently elevated in the hour after alcohol ingestion. © 2010 American Heart Association, Inc.

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