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Background: Depression, anxiety, and psychotic disorders have been associated with an increased risk of coronary heart disease (CHD). It is unclear whether this association between mental health and CHD is present across a wider range of mental disorders., Methods and Results: Participants were 1 107 524 Swedish men conscripted at a mean age of 18.3 years. Mental disorders were assessed by psychiatric interview on conscription, and data on hospital admissions for mental disorder and CHD were obtained from national registers during 22.6 years of follow-up. An increased risk of incident CHD was evident across a range of mental disorders whether diagnosed at conscription or on later hospital admission. Age-adjusted hazard ratios (95% confidence intervals) according to diagnoses at conscription ranged from 1.30 (1.05, 1.62) (depressive disorders) to 1.90 (1.58, 2.38) (alcohol-related disorders). [corrected]. The equivalent figures according to diagnoses during hospital admission ranged from 1.49 (1.24-1.80) (schizophrenia) to 2.82 (2.53-3.13) (other substance use disorders). Associations were little changed by adjustment for parental socioeconomic status, or body mass index, diabetes mellitus, and blood pressure measured at conscription, but they were partially attenuated by the adjustment for smoking, alcohol intake, and intelligence measured at conscription, and for education and own socioeconomic position., Conclusions: Increased risk of incident CHD is present across a range of mental disorders and is observable when the disorders are diagnosed at a young age.

Objective: Carotid intima-media thickness (IMT) is a known precursor to coronary heart disease (CHD) and other relevant health outcomes such as stroke and cognitive impairment. In addition, higher childhood intelligence has been associated with lower risk of coronary heart disease events in later life, although the mechanisms of effect are unclear. We therefore examined the association between childhood intelligence and atherosclerosis using carotid IMT as a marker of the atherosclerotic process., Approach: Participants were 412 members of the Newcastle Thousand Families Study, a prospective cohort study of all 1142 births in the city of Newcastle in May and June 1947, who took an IQ test and English and arithmetic tests at age 11 years. Study members participated in a medical examination and lifestyle assessment at age 49-51 years during which IMT was measured using ultrasound techniques., Results: Individuals with higher childhood IQ score had a lower mean IMT in middle-age. A standard deviation higher score in childhood overall IQ was associated with a 0.053 mm (95% CI -0.102, -0.004) lower IMT in men and a 0.039 mm (95% CI -0.080, -0.002) lower IMT in women. Similar levels of association were found for the English and arithmetic tests. After adjustment for a range of covariates including education, the size of effect was undiminished in men but increased in women., Conclusions: In the present study, higher childhood IQ scores were associated with a lower degree of atherosclerosis by middle-age., (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)

Background: The health and social impact of drinking in excess of internationally recognized weekly (>21 units in men; >14 units in women) and daily (>4 units in men; >3 units in women) recommendations for 'sensible' alcohol intake are largely unknown., Methods: A prospective cohort study of 1551 men and women aged around 55 years in 1988 when typical alcohol consumption was recalled using a 7-day grid. An average of 3.4 years later (1990/92), study participants were re-surveyed (n = 1259; 84.7% of the target population) when they responded to nurse-administered enquiries regarding minor psychiatric morbidity, self-perceived health, hypertension, accidents, overweight/obesity and financial difficulties. Study members were followed up for mortality experience over 18 years., Results: In fully adjusted analyses, surpassing guidelines for sensible alcohol intake was associated with an increased risk of hypertension [daily guidelines only: P-value(trend): 0.012], financial problems [weekly guidelines: P-value(difference): 0.046] and, to a lesser degree, accidents [weekly guidelines: P-value(difference): 0.065]. There was no association between either indicator of alcohol intake and mortality risk., Conclusions: In the present study, there was some evidence for a detrimental effect on health and social circumstances of exceeding current internationally recognized weekly and daily guidelines for alcohol intake.

Objective: Examine the relation between IQ in early adulthood and later coronary heart disease (CHD) mortality, and assess the extent to which established risk factors measured in middle-age might explain this gradient., Design: Cohort study of 4316 male former Vietnam-era US army personnel with IQ scores (mean age 20.4 years), risk factor data (mean age 38.3 years) and 15 years mortality surveillance., Results: In age-adjusted analyses, lower IQ scores were associated with an increased rate of CHD mortality (hazard ratio per SD decrease in IQ; 95% confidence interval: 1.34; 1.00, 1.79). Adjustment for later chronic disease (1.22; 0.91, 1.64), behavioural (1.29; 0.95, 1.74) and physiological risk factors (1.19; 0.88, 1.62) led to some attenuation of this gradient. This attenuation was particularly pronounced on adding socioeconomic indices to the multivariable model when the IQ-CHD relation was eliminated (1.05; 0.73, 1.52). A similar pattern of association was apparent when cardiovascular disease was the outcome of interest., Conclusion: High IQ may lead to educational success, well remunerated and higher prestige employment, and this pathway may confer cardio-protection.

Background: There is a suggestion that acute dehydration in childhood may lead to elevated blood pressure. We examined if episodes of diarrhoea in childhood, a recognized proxy for acute dehydration, were related to measured blood pressure and coronary heart disease in older adults., Methods: Data were pooled from two prospective UK cohort studies (participants born 1920-39) in which episodes of diarrhoea were ascertained from health visitor records from birth until 5 years of age. Blood pressure and coronary heart disease were assessed during medical examination in men and women over 64 years of age. In total, 5203 men and women had data on diarrhoea in early life, adult blood pressure and a range of covariates; 4181 of these also had data on coronary heart disease status., Results: The prevalence of diarrhoea in infancy (3.3%) and between 1 and 5 years (1.1%) was low. There was no relation of diarrhoea from either period (age- and sex-adjusted results for diarrhoea in infancy presented here) with measured blood pressure [coefficient for systolic; 95% CI (confidence interval): 0.44; -2.88-3.76] or coronary heart disease (Odds ratio, OR; 95% CI: 0.91; 0.54-1.54) in adulthood. There was a similar lack of association when hypertension was the outcome of interest. These observations were unchanged after adjustment for a range of covariates., Conclusions: In the largest study to date to examine the relation, there was no evidence that diarrhoea in early life had an influence on measured blood pressure, hypertension or coronary heart disease in older adults.

Aims: Matrix metalloproteinase-1 (MMP-1), a proteolytic enzyme able to degrade types I and III collagens, is present in atherosclerotic lesions but absent from the normal blood vessel wall. The recent observation that, in a transgenic mouse model, MMP-1 gene expression slows the development and progression of atherosclerotic plaques suggests that it may play a role in human atherogenesis. We investigated whether coronary heart disease was associated with a functional polymorphism in the human MMP-1 gene. In addition, we examined a polymorphism in the human MMP-3 gene that was previously reported to be associated with progression of coronary atherosclerosis., Methods and Results: We genotyped 471 Caucasian men and women, aged 66-75 years, from Sheffield, UK, for the 1G/2G polymorphism in the MMP-1 gene and the 5A/6A polymorphism in the MMP-3 gene and ascertained the prevalence of coronary heart disease. People homozygous for the more transcriptionally active 2G allele of the MMP-1 gene had a reduced risk of coronary heart disease (OR 0.5, 95% CI 0.3 to 0.9) compared to people homozygous for the less transcriptionally active 1G allele. Heterozygotes had an intermediate risk (OR 0.7, 95% CI, 0.5 to 1.1). We found no association between the 5A/6A polymorphism in the MMP-3 gene and risk of coronary heart disease., Conclusion: Sequence variants at the MMP-1 genomic locus may influence risk of coronary heart disease in humans.

Objectives: To determine whether vitamin C status, as measured by dietary intake and plasma ascorbic acid concentration, is related to mortality from stroke and coronary heart disease in people aged 65 and over., Design: A 20 year follow up study of a cohort of randomly selected elderly people living in the community who had taken part in the 1973-4 Department of Health and Social Security nutritional survey and for whom dietary and other data had been recorded., Setting: Eight areas in Britain (five in England, two in Scotland, and one in Wales)., Subjects: 730 men and women who had completed a seven day dietary record and who had no history or symptoms of stroke, cerebral arteriosclerosis, or coronary heart disease when examined by a geriatrician in 1973-4., Results: Mortality from stroke was highest in those with the lowest vitamin C status. Those in the highest third of the distribution of vitamin C intake had a relative risk of 0.5 (95% confidence interval 0.3 to 0.8) compared with those in the lowest third, after adjustment for age, sex, and established cardiovascular risk factors. The relation between vitamin C intake and stroke was independent of social class and other dietary variables. A similar gradient in risk was present for plasma ascorbic acid concentrations. No association was found between vitamin C status and risk of death from coronary heart disease., Conclusion: In elderly people vitamin C concentration, whether measured by dietary intake or plasma concentration of ascorbic acid, is strongly related to subsequent risk of death from stroke but not from coronary heart disease.