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Background: The impact of assisted reproductive technology (ART) on the cardiovascular system is unclear., Methods: We conducted a retrospective longitudinal cohort study of 1,001,593 pregnancies conceived naturally or through ART from 2008 to 2019 in Québec to assess the association of ART with cardiovascular disease in families. The exposure measure was ART. The outcome included severe maternal cardiovascular morbidity, congenital heart defects in offspring, and long-term risk of cardiovascular hospitalisation in mothers, fathers, and offspring during 11 years of follow-up. We estimated the association between ART and cardiovascular outcomes with the use of adjusted log-binomial regression (risk ratio, 95% confidence interval [CI]) and Cox proportional hazards regression models (hazard ratio [HR])., Results: Compared with natural conception, ART was associated with 2.04 times the risk of severe cardiovascular morbidity in mothers (95% CI 1.86-2.23) and 1.38 times the risk of congenital heart defects in offspring (95% CI 1.26-1.50). ART was not associated with the risk of maternal cardiovascular hospitalisation following pregnancy (HR 1.03, 95% CI 0.88-1.21). However, ART was associated with an increased risk of paternal cardiovascular hospitalisation (HR 1.24, 95% CI 1.11-1.38) and offspring cardiovascular hospitalisation (HR 1.27, 95% CI 1.01-1.61), mainly due to an increased risk of hypertension., Conclusions: ART is associated with only a small increase in the risk of cardiovascular complications in families. Parents and offspring may be reassured that ART likely has no major impact on the cardiovascular system., (Copyright © 2023 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.)

Introduction: Several meta-analyses have examined the efficacy of smoking cessation therapies in the general population. However, little is known about the efficacy of these therapies in cardiac patients. Therefore, a meta-analysis of randomized controlled trials (RCTs) was performed to determine the efficacy of behavioural therapy and pharmacotherapy for smoking cessation in cardiac patients., Methods: The medical literature was systematically reviewed to identify smoking cessation RCTs in cardiac patients. Only RCTs that reported smoking abstinence at six or 12 months were included. Smoking abstinence was examined based on the 'most rigorous criterion', defined as the most conservative outcome reported in any given RCT., Results: Eleven behavioural therapy RCTs that enrolled 2105 patients and four pharmacotherapy RCTs that enrolled 1542 patients were identified. RCTs differed in the type of behavioural therapy administered as well as the total length and duration of the intervention. RCTs differed in the type of pharmacotherapy administered (one nicotine patch RCT, one nicotine gum RCT and two bupropion RCTs). Behavioural therapy was associated with a significantly higher proportion of smoking abstinence than usual care (OR 1.97 [95% CI 1.37 to 2.85]). Pharmacotherapies were more efficacious than placebo (pooled OR 1.72 [95% CI 1.15 to 2.57])., Conclusions: Both behavioural therapy and pharmacotherapy are more efficacious than usual care for smoking cessation in cardiac patients. The present meta-analysis highlights the need for head-to-head RCTs to identify which smoking cessation therapy is preferred in cardiac patients as well as RCTs examining the efficacy of combined behavioural and pharmacotherapies.

Background: There are few data on the prevalence of cardiometabolic risk factors in population-based samples of overweight and obese youth., Objectives: To compare the prevalence of individual and multiple cardiometabolic risk factors across body mass index (BMI) categories in a population-based sample of youth., Methods: In 1999, a school-based survey of a provincially representative sample of youth nine, 13 and 16 years of age was conducted in Quebec (1778 boys, 1835 girls). Overweight was defined as BMI in the 85th percentile or higher and lower than the 95th percentile of the Centers for Disease Control and Prevention 2000 growth charts, and obesity was defined as BMI in the 95th percentile or higher. Levels of total cholesterol, low-density lipoprotein cholesterol, apolipoprotein B, high-density lipoprotein cholesterol, triglycerides, insulin, glucose, C-reactive protein and systolic blood pressure were categorized as desirable, borderline or unfavourable., Results: The proportions of overweight and obese participants were 14% and 10% in boys, and 14% and 7% in girls, respectively. With the exception of total cholesterol and low-density lipoprotein cholesterol in girls, and glucose in both sexes, the prevalence of all investigated risk factors (borderline or unfavourable) was significantly higher among overweight and obese participants. Almost one-third of obese participants had unfavourable levels of at least two of seven risk factors (apolipoprotein B, high-density lipoprotein cholesterol, triglycerides, insulin, glucose, C-reactive protein and systolic blood pressure) compared with 3% of normal weight participants (adjusted OR 15 and 18 in boys and girls, respectively). Thirty-four per cent of obese youth did not have unfavourable levels of any risk factor., Conclusion: There is marked heterogeneity in the association between excess weight and cardiometabolic risk factors. Nonetheless, the present study highlights a high prevalence of multiple risk factors in a population-based sample of overweight and obese youth.

Background: Although atherosclerosis begins in childhood, there are no recent Canadian data on cardiovascular risk factors in provincially or nationally representative samples of youth., Objective: To describe the design and methods of the 1999 Québec Child and Adolescent Health and Social Survey, which assessed the prevalence and distribution of risk factors in a representative sample of Québec youth., Methods: School-based, multistage, cluster sampling survey of youth aged nine, 13 and 16 years. Measures included height, weight, subscapular and tricipital skinfolds, blood pressure (measured with the Dinamap), a fasting blood draw for assessment of lipoproteins and glucose, an age-adapted youth questionnaire on lifestyles and a parent questionnaire., Results: One thousand two hundred sixty-seven, 1186 and 1160 subjects aged nine, 13 and 16 years, respectively, responded to the questionnaire and had height, weight, skinfold thickness and blood pressure measured (response proportions of 83%, 79% and 78% respectively); 783, 818 and 874 subjects of the same age agreed to the blood draw (response proportions of 52%, 55% and 59%, respectively). Comparisons of characteristics of participants and nonparticipants in the blood draw showed few differences. The mean relative difference between lipoprotein and glucose values obtained at the study laboratory and a reference method varied from -0.3% to 6.1%. Design effects for means and proportions varied from 1.0 to 1.8., Conclusion: Despite its complexity, this survey was able to achieve a high level of precision for multiple measures. It will provide the most complete data on cardiovascular risk factors ever collected among children and adolescents in Canada.