Among young adults, the association of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) High Blood Pressure Clinical Practice Guidelines with risk of cardiovascular disease (CVD) later in life is uncertain.OBJECTIVE To determine the association of blood pressure categories before age 40 years with risk of CVD later in life.

ObjectiveTo determine the risk of developing dementia in relation to duration of smoking cessation by using a nationwide health claims database.MethodsThis cohort study included 46,140 men aged 60 years or older from Korean National Health Insurance System – National Health Screening Cohort, a population‐based national health screening program from 2002 to 2013. The changes in smoking habit from a questionnaire during the first (2002 and 2003) and second (2004 and 2005) health examination periods, participants were divided into continual smokers, short‐term (less than 4 years) quitters, long‐term (4 years or more) quitters, and never smokers. Participants were followed‐up for 8 years from January 1, 2006 for the development of overall dementia, Alzheimer's disease, and vascular dementia.ResultsCompared to continual smokers, long‐term quitters and never smokers had decreased risk of overall dementia (hazard ratio, HR 0.86 95% CI, confidence interval 0.75–0.99 and HR: 0.81; 95% CI: 0.71–0.91, respectively). Never smokers had decreased risk of Alzheimer's disease (HR: 0.82; 95% CI: 0.70–0.96) compared to continual smokers. Finally, both long‐term quitters (HR: 0.68; 95% CI: 0.48–0.96) and never smokers (HR: 0.71; 95% CI: 0.54–0.95) had decreased risk of vascular dementia compared to continual smokers.InterpretationSmoking was associated with increased risk of dementia. Smokers who quit for a prolonged period of time may benefit from reduced risk of dementia. Therefore, smokers should be encouraged to quit in order to reduce the risk of developing dementia, especially in the elderly population who are already at risk.

BackgroundBody mass index and waist circumference (WC) are commonly used metrics that reflect general obesity and abdominal obesity. However, the impact of general and abdominal obesity discrepancies on the risk for major adverse cardiac events (MACE) is less explored.Methods and ResultsThe study population was derived from the Korean National Health Insurance Service‐Health Screening Cohort. Among 315 982 participants aged 40 years or older who underwent health examinations between 2008 and 2009, body mass index and WC were used to determine the obesity status. The participants were followed from January 1, 2010 for MACE until December 31, 2015. Cox proportional hazards models were used to evaluate the association of obesity and the risk of MACE. Compared with men who were not obese, those with abdominal obesity without general obesity (adjusted hazard ratio (aHR) 1.29, 95% CI 1.16–1.43), and general and abdominal obesity (aHR 1.20, 95% CI 1.12–1.29) had elevated risk of MACE, while those with general obesity without abdominal obesity (aHR 1.06, 95% CI 0.98–1.16) did not. Similarly, women with abdominal obesity without general obesity (aHR 1.13, 95% CI 1.03–1.24) and those with general and abdominal obesity (aHR 1.15, 95% CI 1.06–1.25) had increased risk of MACE, while those with general obesity without abdominal obesity (aHR 1.07, 95% CI 0.88–1.30) did not.ConclusionsAbdominal obesity without general obesity was associated with an elevated risk of major cardiovascular outcomes while general obesity without abdominal obesity did not. Concurrent determination of body mass index and WC may be beneficial for the accurate determination of future cardiovascular risk.

Purpose COVID-19 is characterized by dysfunctional immune responses and metabolic derangements, which in some, lead to multi-organ failure and death. Statins are foundational lipid-lowering therapeutics for cardiovascular disease and also possess beneficial immune-modulating properties. Because of these immune-modulating properties, some have suggested their use in COVID-19. We sought to investigate the association between statin use and mortality in patients hospitalized with COVID-19. Methods Five thousand three hundred seventy-five COVID-19 patients admitted to Mount Sinai Health System hospitals in New York between February 27, 2020, and December 3, 2020, were included in this analysis. Statin use was classified as either non-user, low-to-moderate-intensity user, or high-intensity user. Multivariate Cox proportional hazards models were used to evaluate in-hospital mortality rate. Considered covariates were age, sex, race, and comorbidities. Results Compared to non-statin users, both low-to-moderate-intensity (adjusted hazard ratio; aHR 0.62, 95% confidential intervals; CI 0.51–0.76) and high-intensity statin users (aHR 0.53, 95% CI 0.43–0.65) had a reduced risk of death. Subgroup analysis of 723 coronary artery disease patients showed decreased mortality among high-intensity statin users compared to non-users (aHR 0.51, 95% CI 0.36–0.71). Conclusions Statin use in patients hospitalized with COVID-19 was associated with a reduced in-hospital mortality. The protective effect of statin was greater in those with coronary artery disease. These data support continued use of statin therapy in hospitalized patients with COVID-19. Clinical trials are needed to prospectively determine if statin use is effective in lowering the mortality in COVID-19 and other viral infections. Supplementary Information The online version contains supplementary material available at 10.1007/s10557-021-07263-2.