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Article ; Online: Commentary: Early insights about genetics and sex differences from 1968.

Barrett-Connor, Elizabeth

2016 Volume 45, Issue 3, Page(s) 666–667

Language	English
Publishing date	2016-06
Publishing country	England
Document type	Journal Article
ZDB-ID	187909-1
ISSN	1464-3685 ; 0300-5771
ISSN (online)	1464-3685
ISSN	0300-5771
DOI	10.1093/ije/dyw166
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Zs.A 893: Show issues

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Article ; Online: Menopause, atherosclerosis, and coronary artery disease.

Barrett-Connor, Elizabeth

Current opinion in pharmacology

2013 Volume 13, Issue 2, Page(s) 186–191

Abstract: Women have coronary heart disease (CHD) later than men. This review describes studies of CHD risk factors or outcomes based on studies of premenopausal women followed through the menopause transition, and prospective cohort studies of younger or older ... ...

Abstract	Women have coronary heart disease (CHD) later than men. This review describes studies of CHD risk factors or outcomes based on studies of premenopausal women followed through the menopause transition, and prospective cohort studies of younger or older women with CHD risk markers or disease outcomes in the context of their menopause history. Major early reports from both types of studies are included in order to put more recent work in context. Most attention has been paid to the Healthy Women Study (HWS), Study of Women's Health across the Nation (SWAN), the Nurses' Health Study (NHS), and the Rancho Bernardo Study (RBS) because they continue to produce recent publications designed to distinguish the effect of age from the effect of menopause. Understanding these differences has important implications for women's cardiovascular health, but remains incomplete. Transition studies have relatively short (<10 years) follow-up and exclude women with surgical menopause. Cohort studies suggest that women with oophorectomy are at greater risk for CHD than intact women, pointing to a greater risk from testosterone deficiency than from estradiol levels.
MeSH term(s)	Atherosclerosis/epidemiology ; Atherosclerosis/etiology ; Atrial Fibrillation/epidemiology ; Coronary Artery Disease/epidemiology ; Coronary Artery Disease/etiology ; Depression/epidemiology ; Humans ; Menopause ; Sleep Wake Disorders/epidemiology
Language	English
Publishing date	2013-01-23
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	2037057-X
ISSN	1471-4973 ; 1471-4892
ISSN (online)	1471-4973
ISSN	1471-4892
DOI	10.1016/j.coph.2013.01.005
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Zs.A 5608: Show issues

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Article ; Online: The Rancho Bernardo Study: 40 years studying why women have less heart disease than men and how diabetes modifies women's usual cardiac protection.

Barrett-Connor, Elizabeth

Global heart

2013 Volume 8, Issue 2

Abstract: Forty years ago, few cohort studies of cardiovascular disease (CVD) included women and fewer still included diabetes or glycemia as a risk factor. I describe here the Rancho Bernardo Study (RBS), a single-site, >40-year cohort study of sex differences in ...

Abstract	Forty years ago, few cohort studies of cardiovascular disease (CVD) included women and fewer still included diabetes or glycemia as a risk factor. I describe here the Rancho Bernardo Study (RBS), a single-site, >40-year cohort study of sex differences in heart disease and how diabetes modifies women's natural cardioprotection. More than 6000 participants were followed for morbidity and mortality, with nearly 3000 survivors (and death certificates for >85% of decedents). In RBS more than half of diabetes was undiagnosed without an oral glucose tolerance test (OGTT); more women than men had isolated post-challenge hyperglycemia (IPH) as their only glucose evidence of diabetes; men had more diabetes than women, with higher fasting but lower post-challenge glucose levels than women; women with diabetes had more classical CVD risk factors than men; excess risk-factor clustering partially explained how diabetes eradicates female cardioprotection. Post-challenge glucose was a stronger CVD risk factor than fasting glucose. Endogenous insulin was not an independent CVD risk factor in women or men. Men with higher testosterone levels developed less diabetes and had fewer metabolic syndrome components. In men higher total testosterone levels predicted a reduced risk of all-cause and CVD but not cancer mortality. In women both extremes of bioavailable testosterone predicted fatal coronary heart disease but not all-cause mortality. Summary point estimates from large systematic reviews of individual data have replicated most RBS findings. Ongoing research can further clarify how diabetes modifies women's cardioprotection from mid-life to old age.
Language	English
Publishing date	2013-11-04
Publishing country	England
Document type	Journal Article
ZDB-ID	2629633-0
ISSN	2211-8179 ; 2211-8160
ISSN (online)	2211-8179
ISSN	2211-8160
DOI	10.1016/j.gheart.2012.12.002
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Article ; Online: Gender differences and disparities in all-cause and coronary heart disease mortality: epidemiological aspects.

Barrett-Connor, Elizabeth

Best practice & research. Clinical endocrinology & metabolism

2013 Volume 27, Issue 4, Page(s) 481–500

Abstract: This overview is primarily concerned with large recent prospective cohort studies of adult populations, not patients, because the latter studies are confounded by differences in medical and surgical management for men vs. women. When early papers are ... ...

Abstract	This overview is primarily concerned with large recent prospective cohort studies of adult populations, not patients, because the latter studies are confounded by differences in medical and surgical management for men vs. women. When early papers are uniquely informative they are also included. Because the focus is on epidemiology, details of age, sex, sample size, and source as well as study methods are provided. Usually the primary outcomes were all-cause or coronary heart disease (CHD) mortality using baseline data from midlife or older adults. Fifty years ago few prospective cohort studies of all-cause or CHD mortality included women. Most epidemiologic studies that included community-dwelling adults did not include both sexes and still do not report men and women separately. Few studies consider both sex (biology) and gender (behavior and environment) differences. Lifespan studies describing survival after live birth are not considered here. The important effects of prenatal and early childhood biologic and behavioral factors on adult mortality are beyond the scope of this review. Clinical trials are not discussed. Overall, presumptive evidence for causality was equivalent for psychosocial and biological exposures, and these attributes were often associated with each other. Inconsistencies or gaps were particularly obvious for studies of sex or gender differences in age and optimal measures of body size for CHD outcomes, and in the striking interface of diabetes and people with the metabolic syndrome, most of whom have unrecognized diabetes.
MeSH term(s)	Adult ; Aged ; Cohort Studies ; Coronary Disease/ethnology ; Coronary Disease/mortality ; Diabetes Mellitus/epidemiology ; Diabetes Mellitus/mortality ; Europe/epidemiology ; Female ; Gender Identity ; Humans ; Male ; Metabolic Syndrome/epidemiology ; Middle Aged ; Motor Activity ; Obesity/complications ; Sex Factors ; Smoking/adverse effects ; Socioeconomic Factors ; Stress, Psychological ; Testosterone/blood ; United States/epidemiology
Chemical Substances	Testosterone (3XMK78S47O)
Language	English
Publishing date	2013-07-08
Publishing country	Netherlands
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Review
ZDB-ID	2052339-7
ISSN	1878-1594 ; 1532-1908 ; 1521-690X
ISSN (online)	1878-1594 ; 1532-1908
ISSN	1521-690X
DOI	10.1016/j.beem.2013.05.013
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Article ; Online: ACP Journal Club. Review: Intensive-dose statin therapy increases incident diabetes compared with moderate-dose therapy.

Barrett-Connor, Elizabeth

Annals of internal medicine

2011 Volume 155, Issue 8, Page(s) JC4–7

Language	English
Publishing date	2011-10-18
Publishing country	United States
Document type	Comment ; Journal Article
ZDB-ID	336-0
ISSN	1539-3704 ; 0003-4819
ISSN (online)	1539-3704
ISSN	0003-4819
DOI	10.7326/0003-4819-155-8-201110180-02007
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Article ; Online: Different impacts of hypertension and diabetes mellitus on all-cause and cardiovascular mortality in community-dwelling older adults: the Rancho Bernardo Study.

Oh, Jee-Young / Allison, Matthew A / Barrett-Connor, Elizabeth

Journal of hypertension

2017 Volume 35, Issue 1, Page(s) 55–62

Abstract: Objectives: Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading ...

Abstract	Objectives: Although the prevalence rates of hypertension (HTN) and diabetes mellitus are slowing in some high-income countries, HTN and diabetes mellitus remain as the two major risk factors for atherosclerotic cardiovascular disease (CVD), the leading cause of death in the United States and worldwide. We aimed to observe the association of HTN and diabetes mellitus with all-cause and CVD mortality in older white adults. Methods: All community-dwelling Rancho Bernardo Study participants who were at least 55 years old and had carefully measured blood pressure and plasma glucose from 75-g oral glucose tolerance test at the baseline visit (1984-1987, n = 2186) were followed up until death or the last clinic visit in 2013 (median 14.3 years, interquartile range 8.4-21.3). Results: In unadjusted analyses, diabetes mellitus was associated with all-cause mortality [hazard ratio 1.40, 95% confidence interval (CI) 1.23-1.60] and CVD mortality (hazard ratio 1.67, 95% CI 1.39-2.00); HTN with all-cause mortality [hazard ratio 1.93 (1.73-2.15)] and CVD mortality [hazard ratio 2.45 (2.10-2.93)]. After adjustment for cardiovascular risk factors, including age, BMI, triglycerides, HDL-cholesterol, smoking, exercise, and alcohol consumption, diabetes mellitus was associated with CVD mortality only (hazard ratio 1.25, P = 0.0213). Conversely, HTN was associated with both all-cause (hazard ratio 1.34, P < 0.0001) and CVD mortality (hazard ratio 1.40, P = 0.0003). Having both diabetes mellitus and HTN was associated with all-cause (hazard ratio 1.38, P = 0.0002) and CVD mortality (hazard ratio 1.70, P < 0.0001). Conclusion: We report the novel finding that HTN is more strongly associated with all-cause and CVD mortality than diabetes mellitus. Having both confers a modest increase in the hazards for these types of mortality.
MeSH term(s)	Aged ; Aged, 80 and over ; California/epidemiology ; Cardiovascular Diseases/mortality ; Diabetes Mellitus/epidemiology ; Female ; Humans ; Hypertension/epidemiology ; Male ; Middle Aged ; Residence Characteristics
Language	English
Publishing date	2017-01
Publishing country	England
Document type	Journal Article
ZDB-ID	605532-1
ISSN	1473-5598 ; 0263-6352 ; 0952-1178
ISSN (online)	1473-5598
ISSN	0263-6352 ; 0952-1178
DOI	10.1097/HJH.0000000000001145
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Zs.A 1885: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 614: Show issues

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Article ; Online: ARB users exhibit a lower fracture incidence than ACE inhibitor users among older hypertensive men.

Kwok, Timothy / Leung, Jason / Barrett-Connor, Elizabeth

Age and ageing

2017 Volume 46, Issue 1, Page(s) 57–64

Abstract: Introduction: Angiotensin II, a major effector protein of the renin angiotensin system (RAS), induces bone loss under certain conditions. Drugs that block the RAS may therefore reduce bone loss and fracture incidence. The fracture incidence in older ... ...

Abstract	Introduction: Angiotensin II, a major effector protein of the renin angiotensin system (RAS), induces bone loss under certain conditions. Drugs that block the RAS may therefore reduce bone loss and fracture incidence. The fracture incidence in older hypertensive men with long-term use of angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) were compared with the incidence in users of calcium channel blockers (CCBs) and non-users. Methods: A total of 5,994 US men aged 65 years or older who had bone mineral density measured at baseline in the Osteoporotic Fractures in Men Study (MrOS) were followed for fracture incidence for an average of 6.8 years. Men with follow-up dual-energy X-ray absorptiometry bone mineral density data and who reported hypertension at any visit, or use of antihypertensive medications at any visit among those with non-missing mediation data were included in the study (N = 2,573). Results: Six hundred and nineteen men had taken ACE inhibitors, while 182 took ARBs for at least 4 years. Using Cox regression for the incidence of non-vertebral fractures, we found that long-term users of ACE inhibitors and ARBs each had a significantly lower fracture incidence than non-users. The hazard ratio of non-vertebral fractures was three times lower in ARB users than ACE inhibitor users (Hazard ratio (95% confidence interval): 0.194 (0.079–0.474) versus 0.620 (0.453–0.850), P = 0.0168). There was a trend of greater fracture risk reduction with longer duration of ARB use, but not for ACE inhibitor use. Conclusions: In older hypertensive men, ARBs use was associated with lower incidence of non-vertebral fracture than ACE inhibitors or CCBs.
MeSH term(s)	Absorptiometry, Photon ; Age Factors ; Aged ; Angiotensin II Type 1 Receptor Blockers/therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; Antihypertensive Agents/therapeutic use ; Blood Pressure/drug effects ; Bone Density/drug effects ; Calcium Channel Blockers/therapeutic use ; Humans ; Hypertension/diagnosis ; Hypertension/drug therapy ; Hypertension/epidemiology ; Hypertension/physiopathology ; Incidence ; Logistic Models ; Male ; Multivariate Analysis ; Osteoporotic Fractures/diagnostic imaging ; Osteoporotic Fractures/epidemiology ; Osteoporotic Fractures/prevention & control ; Propensity Score ; Proportional Hazards Models ; Prospective Studies ; Protective Factors ; Renin-Angiotensin System/drug effects ; Risk Factors ; Sex Factors ; Time Factors ; United States/epidemiology
Chemical Substances	Angiotensin II Type 1 Receptor Blockers ; Angiotensin-Converting Enzyme Inhibitors ; Antihypertensive Agents ; Calcium Channel Blockers
Language	English
Publishing date	2017-02-08
Publishing country	England
Document type	Comparative Study ; Journal Article ; Observational Study ; Research Support, N.I.H., Extramural
ZDB-ID	186788-x
ISSN	1468-2834 ; 0002-0729
ISSN (online)	1468-2834
ISSN	0002-0729
DOI	10.1093/ageing/afw150
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Zs.A 877: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 448: Show issues

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Article ; Online: Metabolic Syndrome and Sexual Function in Postmenopausal Women.

Trompeter, Susan E / Bettencourt, Ricki / Barrett-Connor, Elizabeth

The American journal of medicine

2016 Volume 129, Issue 12, Page(s) 1270–1277.e1

Abstract: Background: Limited literature suggests that sexual dysfunction in women covaries with the metabolic syndrome. This study examined the association of sexual function with metabolic syndrome and cardiovascular disease in healthy older women.: Methods: ...

Abstract	Background: Limited literature suggests that sexual dysfunction in women covaries with the metabolic syndrome. This study examined the association of sexual function with metabolic syndrome and cardiovascular disease in healthy older women. Methods: There were 376 postmenopausal, community-dwelling women from the Rancho Bernardo Study (mean baseline age = 73 years) that completed a clinic visit during 1999-2002 and returned the Female Sexual Function Index (FSFI) questionnaire mailed in 2002. Results: Thirty-nine percent reported being sexually active; 41.5% met a diagnosis of metabolic syndrome. The number of metabolic syndrome components was strongly associated with decreased sexual activity, desire, and low sexual satisfaction. Waist girth, diabetes, and hypertension were associated with decreased sexual activity. Elevated triglycerides were associated with low desire. Among the cardiovascular endpoints, heart attack, coronary artery bypass, and angina were associated with decreased sexual activity, but not with sexual desire or satisfaction. Past diagnosis of heart failure, poor circulation, and stroke were not associated with sexual function. Sexually active women with metabolic syndrome met criteria for sexual dysfunction in desire, arousal, orgasm, and satisfaction domains. The FSFI Total Score did not differ significantly between sexually active and inactive women. Conclusions: Metabolic syndrome was associated with decreased sexual activity, desire, and satisfaction in all women and with sexual dysfunction in most domains in sexually active women. Coronary artery disease was more prevalent in women with low sexual activity.
MeSH term(s)	Aged ; Aged, 80 and over ; Body Mass Index ; California/epidemiology ; Cardiovascular Diseases/epidemiology ; Comorbidity ; Female ; Health Status ; Humans ; Libido/physiology ; Marital Status ; Metabolic Syndrome/diagnosis ; Metabolic Syndrome/epidemiology ; Middle Aged ; Postmenopause/physiology ; Postmenopause/psychology ; Prevalence ; Sexual Behavior/physiology ; Sexual Behavior/statistics & numerical data ; Sexual Dysfunction, Physiological/epidemiology ; Sexual Dysfunctions, Psychological/epidemiology ; Waist Circumference
Language	English
Publishing date	2016-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	80015-6
ISSN	1555-7162 ; 1873-2178 ; 0002-9343 ; 1548-2766
ISSN (online)	1555-7162 ; 1873-2178
ISSN	0002-9343 ; 1548-2766
DOI	10.1016/j.amjmed.2016.03.039
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Ua VI Zs.289: Show issues

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Article ; Online: Sex differences in the association of physical function and cognitive function with life satisfaction in older age: The Rancho Bernardo Study.

Ratigan, Amanda / Kritz-Silverstein, Donna / Barrett-Connor, Elizabeth

Maturitas

2016 Volume 89, Page(s) 29–35

Abstract: Objectives: This study examines the cross-sectional associations of cognitive and physical function with life satisfaction in middle-class, community-dwelling adults aged 60 and older.: Study design: Participants were 632 women and 410 men who had ... ...

Abstract	Objectives: This study examines the cross-sectional associations of cognitive and physical function with life satisfaction in middle-class, community-dwelling adults aged 60 and older. Study design: Participants were 632 women and 410 men who had cognitive function tests (CFT) and physical function tasks (PFT) assessed at a clinic visit between 1988 and 1992, and who responded in 1992 to a mailed survey that included life satisfaction measures. Cognitive impairment was defined as ≤24 on MMSE, ≥132 on Trails B, ≤12 on Category Fluency, ≤13 on Buschke long-term recall, and ≤7 on Heaton immediate recall. Physical impairment was defined as participants' self-reported difficulty (yes/no) in performing 10 physical functions. Multiple linear regression examined associations between life satisfaction and impairment on ≥1 CFT or difficulty with ≥1 PFT. Main outcome measures: The Satisfaction with Life Scale (SWLS; range:0-26) and Life Satisfaction Index-Z (LSI-Z; range:5-35). Results: Participants' average age was 73.4 years (range=60-94). Categorically defined cognitive impairment was present in 40% of men and 47% of women. Additionally, 30% of men and 43% of women reported difficulty performing any PFT. Adjusting for age and impairment on ≥1 CFT, difficulty performing ≥1 PFT was associated with lower LSI-Z and SWLS scores in men (β=-1.73, -1.26, respectively, p<0.05) and women (β=-1.79, -1.93, respectively, p<0.01). However, impairment on ≥ 1 CFT was not associated with LSI-Z or SWLS score after adjusting for age and difficulty with ≥1 PFT. Conclusions: Limited cognitive function was more common than limited physical function; however, limited physical function was more predictive of lower life satisfaction. Interventions to increase or maintain mobility among older adults may improve overall life satisfaction.
MeSH term(s)	Aged ; Aged, 80 and over ; Aging/physiology ; Aging/psychology ; Cognition ; Cognition Disorders/epidemiology ; Cross-Sectional Studies ; Female ; Health Surveys ; Humans ; Linear Models ; Male ; Middle Aged ; Personal Satisfaction ; Physical Fitness ; Sex Factors
Language	English
Publishing date	2016-07
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	80460-5
ISSN	1873-4111 ; 0378-5122
ISSN (online)	1873-4111
ISSN	0378-5122
DOI	10.1016/j.maturitas.2016.04.007
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Zs.MO 575: Show issues

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Article ; Online: Women and heart disease: neglected directions for future research.

Barrett-Connor, Elizabeth

Journal of cardiovascular translational research

2009 Volume 2, Issue 3, Page(s) 256–257

Abstract: Before age 65, women have less heart disease than men. For many years, estrogen was the most popular explanation for this female advantage, and observational studies through the 1980s showed a lower risk of heart attacks in postmenopausal women taking " ... ...

Abstract	Before age 65, women have less heart disease than men. For many years, estrogen was the most popular explanation for this female advantage, and observational studies through the 1980s showed a lower risk of heart attacks in postmenopausal women taking "replacement" estrogen. But the Women's Health Initiative (WHI), the first placebo-controlled trials of hormone therapy with the size and statistical power necessary to study clinical cardiovascular outcomes, did not confirm the hormone-healthy heart hypothesis. Now, at least 5 years later, the most unexpected WHI result may be how resilient the estrogen hypothesis has been. Where, beyond estrogen therapy, should we go from here to explain the striking sex differences in heart disease rates? A broader spectrum of research about the female cardiovascular advantage and its translation is needed.
MeSH term(s)	Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/prevention & control ; Estrogen Replacement Therapy ; Evidence-Based Medicine ; Female ; Humans ; Male ; Prognosis ; Program Development ; Risk Assessment ; Risk Factors ; Sex Factors ; Translational Medical Research/organization & administration ; Women's Health ; Women's Health Services/organization & administration
Language	English
Publishing date	2009-07-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	2422411-X
ISSN	1937-5395 ; 1937-5387
ISSN (online)	1937-5395
ISSN	1937-5387
DOI	10.1007/s12265-009-9110-0
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