These results are consistent with deficits in hippocampal function and structure in abuse-related PTSD.

Abstract. Coronary heart disease (CHD) is a major cause of morbidity and mortality in patients with chronic kidney disease or anemia. The purpose of this study was to examine whether the association between renal function and risk of CHD is modified by hemoglobin (Hgb) status. Analyses were based on data from the Atherosclerosis Risk in Communities study, a community-based study of risk factors for CHD in middle-aged people. People with known CHD at baseline were excluded from the analysis. Participants were followed for 9 yr for the occurrence of CHD. Anemia was defined as Hgb Ͻ13 g/dl in men and Ͻ12 g/dl in women. Cox proportional hazards models were used to assess the relative risk (RR) of CHD occurrence according to Hgb status, after adjusting for other risk factors (demographics, lipids, diabetes, hypertension, smoking, body mass index, and carotid intima-media thickness). A total of 13,329 participants were included. The interaction between Hgb concentration and serum creatinine (Scr) was significant (P ϭ 0.02). Among people with anemia, a Scr Ն1.2 mg/dl in women or Ն1.5 mg/dl in men was associated with a higher risk of CHD (RR, 2.74; 95% confidence interval, 1.42 to 5.28) than those with normal Scr. In contrast, among those without anemia, this association was not noted (RR, 1.20; 95% confidence interval, 0.86 to 1.67). In conclusion, this study indicates that high Scr is associated with almost a threefold risk of CHD among middle-aged people with anemia, whereas no increased risk is found in people with high Scr in the absence of anemia.Cardiovascular disease (CVD) mortality rates in ESRD are approximately 15 times higher than in the general population (1). Many studies examining the association between ESRD and cardiovascular mortality (2,3) have found that ESRD is an independent predictor of cardiovascular death. However, it is unclear whether moderate renal insufficiency is also associated with cardiovascular events. Previous studies conducted in patients at high risk of CVD have suggested that mild renal insufficiency may be an independent risk factor for cardiovascular events (4 -8). However, in analyses of population-based cohorts (9,10), there was no independent association between moderate renal insufficiency and cardiovascular mortality or nonfatal cardiovascular events after adjustment for traditional risk factors.Anemia is a frequent complication of chronic kidney disease (CKD) and is primarily due to failure of erythropoietin production to respond to decreased hemoglobin (Hgb) concentration (11,12). In chronic anemia, long-lasting flow/volume overload and increased cardiac work lead to progressive cardiac enlargement and left ventricular hypertrophy (13). The risk of coronary heart disease (CHD) increases when the anemia is not treated, and recent studies have indicated that anemia in patients with CKD may predispose to ischemic heart disease, heart failure, and premature death (14 -16). Therefore, the risk of CHD may be distinctly higher in people with renal insufficiency and concomitant ane...

Asthma has been associated with atherosclerotic disease in several studies with some evidence that this association may be limited to women. However, most previous studies have failed to account for the heterogeneity of asthma subtypes. We previously reported increased carotid intima medial thickness among women with adult-onset asthma. In this study, we examine the association of adult and child-onset asthma with incident coronary heart disease (CHD) and stroke. Subjects were classified according to self-report of physician diagnosed asthma and age of asthma onset. We used Cox proportional hazards models to test the association of adult and child-onset asthma with incident CHD and stroke, testing for gender interaction. Subanalysis was also performed using only neversmokers. Women with adult-onset asthma experienced a 2-fold increase in incident CHD and stroke which was independent of other risk factors including smoking, body mass index, and physical activity and persisted when the analysis was restricted to never-smokers. No significant association was found among women with child-onset asthma or among men. In conclusion, adult-onset asthma may be a significant risk factor for CHD and stroke among women but not men. Keywords ASTHMA; CORONARY DISEASE; STROKE; SEX FACTORSAsthma has been associated with vascular disease, carotid atherosclerosis, coronary heart disease (CHD), or stroke in at least nine studies. 1-9 Among studies that present results stratified by gender, there is a suggestion that the association may be stronger among or entirely limited to women. 1-4 However, asthma is not a single disease but rather a collection of distinct underlying subtypes, with somewhat differing etiologies. 10,11 Child and adult-onset asthma differ in regards to asthma triggers 11 , gender distribution 11 , and systemic inflammation. 12 We previously reported an association between carotid intima medial thickness and adult-onset Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Conflicts of NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript asthma among women in the Atherosclerosis Risk in Communities (ARIC) study. 4 This association was not observed among women with child-onset asthma or among men with either adult or child-onset asthma. In this study, we examined the association of asthma age of onset phenotypes with incidence of CHD and stroke according to gender within the ARIC cohort. Methods Study populationThe Atherosclerosis Risk in Communities (ARIC) Study is a prospective study of the etiology of atherosclerotic, cardiovascular, and cerebrova...

Context Although depression is associated with increased cardiovascular morbidity and mortality, there is virtually no information on whether it also increases the risk in young populations. Objectives We sought to determine the association of unipolar and bipolar depression and a history of attempted suicide with mortality due to ischemic heart disease (IHD) and cardiovascular disease (CVD) in young US adults and to examine potential sex differences. Design Longitudinal epidemiologic study. Setting Nationally representative sample of US adults. Participants A total of 7641 US adults aged 17 to 39 years from the 1988–1994 Third National Health and Nutrition Examination Survey. Main Outcome Measures Cardiovascular disease and IHD mortality. Unipolar/bipolar depression and a history of attempted suicide were assessed via the Diagnostic Interview Schedule. Results After a median follow-up of 14.9 years, a total of 51 subjects (0.67%) died of CVD causes and 28 (0.37%) died of IHD. Depression (538 individuals [7.04%]) and history of attempted suicide (419 [5.48%]) were each associated with an increased risk of IHD death, with adjusted hazard ratios of 3.70 (95% CI, 1.32–10.35) for depression and 7.12 (2.67–18.98) for a history of attempted suicide. Women with depression or a history of attempted suicide had a 3-fold adjusted risk of CVD (adjusted hazard ratio, 3.20 [95% CI, 1.12–9.17]) and a 14-fold adjusted risk of IHD (14.57 [2.65–80.10]). Corresponding figures for men were 2.37 (0.85–6.58) and 3.52 (1.05–11.76). Conclusion In adults younger than 40 years, depression and history of attempted suicide are significant independent predictors of premature CVD and IHD mortality in both sexes.

Objective: Although there have been case reports suggesting a relationship between treatment with the acne medication isotretinoin and the development of depression and suicide, this topic remains controversial. In order for isotretinoin to cause depression, it must have an effect on the brain; however, the effects of isotretinoin on brain functioning in acne patients have not been established. The purpose of this study was to assess the effects of isotretinoin on brain functioning in acne patients. Results: Isotretinoin but not antibiotic treatment was associated with decreased brain metabolism in the orbitofrontal cortex (-21% change versus 2% change for antibiotic), a brain area known to mediate symptoms of depression. There were no differences in the severity of depressive symptoms between the isotretinoin and antibiotic treatment groups before or after treatment. Conclusions:This study suggests that isotretinoin treatment is associated with changes in brain functioning.