Bisphenol: Urinary Concentration and Risk of Future Coronary Artery Disease

Urinary Bisphenol: A Concentration and Risk of Future Coronary Artery Disease in Apparently Healthy Men and Women

1. David Melzer1*; 
2. Nicholas J. Osborne2; 
3. William E. Henley3;
4. Ricardo Cipelli4; 
5. Anita Young5; 
6. Cathryn Money5; 
7. Paul McCormack5;
8. Robert Luben6; 
9. Kay-Tee Khaw6; 
10. Nicholas J. Wareham7;
11. Tamara S. Galloway4

+Author Affiliations

1. ¹ Peninsula Medical School, University of Exeter, Exeter, United Kingdom;
2. ² Peninsula College of Medicine & Dentistry, University of Exeter, Exeter, United Kingdom;
3. ³ University of Plymouth, Plymouth, United Kingdom;
4. ⁴ University of Exeter, Exeter, United Kingdom;
5. ⁵ Brixham Environmental Laboratory, Brixham, United Kingdom;
6. ⁶ University of Cambridge, Cambridge, United Kingdom;
7. ⁷ Medical Research Council Epidemiology Centre, London, United Kingdom

1. ↵* Corresponding author; email: david.melzer@pms.ac.uk

Abstract

Background—The endocrine disrupting chemical Bisphenol A (BPA) is widely used in food and beverage packaging. Higher urinary BPA concentrations (uBPA) were cross-sectionally associated with heart disease in NHANES 2003/04 and NHANES 2005/6, independent of traditional risk factors.

Methods and Results—We included 758 incident coronary artery disease (CAD) cases and 861 controls followed for 10.8 yrs from the European Prospective Investigation of Cancer - Norfolk UK. Respondents aged 40-74 yrs and free of CAD, stroke or diabetes provided baseline spot urine samples. uBPA concentrations (median value 1.3 ng/ml) were low. Per standard deviation (4.56ng/ml) increases in uBPA concentration were associated with incident CAD in age, sex and urinary creatinine adjusted models (n=1919, OR=1.13 95% CI 1.02 to 1.24, p=0.017). With CAD risk factor adjustment (including education, occupational social class, BMI category, systolic blood pressure, lipid concentrations and exercise) the estimate was similar but narrowly missed two-sided significance (n=1744 OR=1.11 95% CI: 1.00 to 1.23, p=0.058). Sensitivity analyses with the fully adjusted model, excluding early CAD (<3 year follow up); those with BMI>30; abnormal renal function; or adjusting additionally for vitamin C; C-reactive protein; or alcohol consumption, all produced similar estimates and all showed associations at p≤0.05.

Conclusions—Associations between higher BPA exposure (reflected in higher urinary concentrations) and incident CAD during over ten years of follow-up showed similar trends to previously reported cross-sectional findings in the more highly exposed NHANES respondents. Further work is needed to accurately estimate the prospective exposure response curve and to establish the underlying mechanisms.

Career in the Networked Economy

LinkedIn Founder Reid Hoffman: How to Build Your Career in the Networked Economy

By SAM GUSTIN | @samgustin | February 21, 2012 |

Reid Hoffman knows a thing or two about networking. Not only did he launch one of the most successful Internet companies of the past decade, LinkedIn, the social network for professionals, but he’s developed a formidable network of his own, one that’s given him the opportunity to invest such high-flying Internet start-ups as Facebook and Zynga. Hoffman stopped by TIME’s office in New York City to discuss his new book, The Start-Up of You, which offers insight into how to further your career in the digital, networked economy.

Read other related stories about this:

• The real way to build a social network Fortune
• Facebook (Eye)PO: Early Investor Reid Hoffman on Mission Vs. Payday AllThingsD

Related Topics: entrepreneurs, jobs, LinkedIn, networking, Reid Hoffman, workplace, Management & Leadership, Technology & Media

Avoiding Avoidable Care

COST CONTROL REQUIRES CULTURE CHANGE

Until recently, the main framework for thinking about reform has been one of shortages and disparities. That has begun to shift as patients and providers become more aware of the problem of unnecessary or avoidable care. Efforts to improve care and control costs will not be successful unless policymakers, payers, providers, and patients address the problem of avoidable care.

Considerable uncertainty remains. How much care in the US is avoidable? Can we quantify its consequences, in terms of financial impact and harms? What factors drive overutilization and inappropriate medical services, how can we to curb this, and do physicians have an ethical duty to do so?

Organized by the Lown Cardiovascular Research Foundation and the New America Foundation, and co-hosted by the Institute of Medicine, the Conference on Avoiding Avoidable Care will propose solutions to the problem of avoidable care in all areas of medicine, and facilitate the transformation of the American health care culture from one focused on volume and quantity to one centered on value and quality. Dr. Harvey Fineberg, President of the Institute of Medicine, will deliver the keynote address.

Click here to learn more about the Conference.

The Conference is by invitation only, and if you are interested in attending, pleasecontact us.

Ecercise

February 15, 2012, 12:01 AM

How 1-Minute Intervals Can Improve Your Health

By GRETCHEN REYNOLDS

John P. Kelly/Getty ImagesCan brief bursts of exercise improve your health?

While many of us wonder just how much exercise we really need in order to gain health and fitness, a group of scientists in Canada are turning that issue on its head and asking, how little exercise do we need?

The emerging and engaging answer appears to be, a lot less than most of us think — provided we’re willing to work a bit.

In proof of that idea, researchers at McMaster University in Hamilton, Ontario, recently gathered several groups of volunteers. One consisted of sedentary but generally healthy middle-aged men and women. Another was composed of middle-aged and older patients who’d been diagnosed with cardiovascular disease./.../

Inovare

Braile Biomédica launches transapical valve

Washington, DC - Brazilian developers of the Inovare transapical aortic valve are encouraged by the early experience with the device despite a 50% two-year mortality rate.

Here at CRT 2012, the Cardiovascular Research Technologies conference, Dr Valter Lima (Hospital São Francisco, Porto Alegre, Brazil) presented data from 93 of the 150 or so patients who have been implanted with the Inovare transcatheter aortic valve, a bovine pericardium and cobalt-chromium valve developed by Braile Biomédica.

In this initial experience with the device, 93% of the procedures—all transapical implants—were successful. Success was defined as achieving a mean valve gradient under 20 mm Hg with aortic regurgitation less than a grade 2+. The average mean valve gradient for all the patients was reduced from 43 mm Hg to 11 mm Hg after one year.

There were three deaths within 30 days. Mortality was 17% at one year and 50% at two years for the 79 patients for whom data are available. Lima explained the relatively high mortality is due to the small sample size and the severe illness of the patients. "It's self-defensive to say, but I think they were 'too-sick' patients," he said. "But still, 17% at the end of 12 months I think is acceptable. And, of course we need more data."

Lima explained that 76% of the patients treated so far were considered at high risk for valve surgery while the rest were completely inoperable. Also, 10 of the procedures so far were "valve-in-valve" implants for stenotic or regurgitant prosthetic valves. The patients' average STS score was 31.

Based on these results, Inovare earned regulatory approval in Brazil in November. It is currently available only for transapical implants, with 22F as the smallest size. The company is also developing an 18F transfemoral version, Lima said./.../