The association between lipoprotein (a) (Lp(a)) and 10-year first fatal/nonfatal cardiovascular d... more The association between lipoprotein (a) (Lp(a)) and 10-year first fatal/nonfatal cardiovascular disease (CVD) risk in apparently healthy men and women was evaluated. The ATTICA prospective study was conducted during 2001-2012 and included n = 1514 men and n = 1528 women (age >18 years) from the greater Athens area, Greece. Follow-up CVD assessment (2011-2012) was achieved in n = 2020 participants (n = 317 cases); baseline Lp(a) was measured in n = 1890 participants. The recommended threshold of 50 mg/dL was used to define abnormal Lp(a) status. Ten-year CVD-event rate was 14% and 24% in participants with Lp(a) <50 and Lp(a) ≥50 mg/dL, respectively. Multivariate analysis revealed that participants with Lp(a) ≥50 mg/dL versus Lp(a) <50 mg/dL had about 2 times higher CVD risk (hazard ratio (HR) = 2.18, 95% confidence interval (CI) 1.11, 4.28). The sex-based analysis revealed that the independent Lp(a) effect was retained only in men (HR = 2.00, 95% CI 1.19, 2.56); in women, si...
Tea is one of the most-widely consumed beverages in the world with a number of different benefici... more Tea is one of the most-widely consumed beverages in the world with a number of different beneficial health effects, mainly ascribed to the polyphenolic content of the tea catechins. The aim of this study was to examine the consumption of green, black, or no tea, in relation to the previously validated successful ageing index (SAI; higher values “healthier” ageing) in a combined analysis of adults aged >50 years old from the ATTICA (n = 1128 adults from Athens, Greece metropolitan area) and the MEDiterranean Islands Study (MEDIS) (n = 2221 adults from various Greek island and Mani) studies. After adjusting for age, sex, smoking, and coffee consumption, green tea was positively associated with SAI (b ± SE: 0.225 ± 0.055, p < 0.001), while black tea was negatively associated with SAI (unstandardized b coefficient ± Standard error: −0.807 ± 0.054, p < 0.001). Green tea (vs black tea) consumption, had higher odds of a SAI of over 3.58 out of 10 (OR: 1.77, 95% CI: 1.38–2.28). Gre...
The aim of the study was to understand determinants of ageing in relation to future cardiovascula... more The aim of the study was to understand determinants of ageing in relation to future cardiovascular disease (CVD) events at population level, and to explore determinants of healthy ageing and its relation to 10-year CVD incidence among apparently healthy individuals. In the context of the ATTICA study 453 apparently healthy men (45±13 years) and 400 women (44±18 years) with complete psychological evaluation were studied and followed during 2002-2012. Healthy Ageing Index (HAI) (range 0-7) was calculated based on socio-economical, bio-clinical, psychological, and lifestyle characteristics (i.e. dietary habits and physical activity) of the participants during the baseline examination. CVD incidence during the follow-up period was defined according to ICD-10 criteria. Healthy Ageing Index was inversely associated with higher 10-year CVD risk (OR per 1/7 (95% CI): 0.47 (0.28, 0.80). Age and sex-adjusted determinants of healthy ageing were abnormal waist to hip ratio (p<0.001), increas...
Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objec... more Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objective was to explore potential associations between anthropometric indices and the 10-year CVD incidence in Greek adults without previous CVD. During 2001-2, we enrolled 3042 adults without CVD from the general population of Attica, Greece. In 2011-2, the 10-year study follow-up was performed, recording the CVD incidence in 1958 participants with baseline body mass index (BMI) ≥18.5kg/m(2). The study 10-year CVD incidence was 15.8%, exhibiting a gradual increase according to the baseline body mass index (BMI) category. Baseline BMI ≥30kg/m(2) was related with significantly higher 10-year CVD risk compared to BMI <25kg/m(2), even after adjustment for age and other known CVD risk factors. Baseline BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio and waist-to-hip-to-height ratio were independently associated with the 10-year CVD risk in multi-adjusted models. Gender-spe...
Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and ... more Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design A population-based, health and nutrition prospective survey. Methods In the context of the ATTICA Study (2002-2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results After adjustment for multiple established CVD risk factors, both reported ...
To better understand the metabolic syndrome (MS) spectrum through principal components analysis a... more To better understand the metabolic syndrome (MS) spectrum through principal components analysis and further evaluate the role of the Mediterranean diet on MS presence. During 2001-2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III) definition. Adherence to the Mediterranean diet was assessed using the MedDietScore (range 0-55). Five principal components were derived, explaining 73.8% of the total variation, characterized by the: a) body weight and lipid profile, b) blood pressure, c) lipid profile, d) glucose profile, e) inflammatory factors. All component...
BACKGROUND: Epidemiological studies suggest a non-monotonic effect of alcohol consumption on card... more BACKGROUND: Epidemiological studies suggest a non-monotonic effect of alcohol consumption on cardiovascular risk, while there is strong evidence concerning the involvement of homocysteine levels on thrombosis. The aim of this work was to evaluate the association between usual ethanol consumption and homocysteine levels, in cardiovascular disease free adults. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 women, without any evidence of cardiovascular disease, stratified by age - gender (census 2001), from the greater area of Athens, Greece. Among the variables ascertained we measured the daily ethanol consumption and plasma homocysteine concentrations. RESULTS: Data analysis revealed a J-shape association between ethanol intake (none, <12 gr, 12 - 24 gr, 25 - 48 gr, >48 gr per day) and total homocysteine levels (mean +/- standard deviation) among males (13 +/- 3 vs. 11 +/- 3 vs. 14 +/- 4 vs. 18 +/- 5 vs. 19 +/- 3 mumol/L, respectively, p &l...
Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē
The purpose of this study was to evaluate changes in the prevalence of cardiovascular disease (CV... more The purpose of this study was to evaluate changes in the prevalence of cardiovascular disease (CVD) risk factors in a population-based sample of Greek adults. From May 2001 to December 2002, 1514 men and 1528 women (age >18 y), living in the Attica region of Greece, were enrolled in the ATTICA cohort study. In 2006, the 5-year follow up was performed (941 of the 3042 participants, 31%, were lost to follow up). The prevalence of hypertension, hypercholesterolemia, diabetes, obesity, smoking and physical inactivity, was assessed in both examinations through established procedures. Development of CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) during the followup period was defined according to the WHO-ICD-10 criteria. During 2001-2006 there were 88 male and 102 female cases with hypertension per 1000 individuals, 237 male and 177 female cases with hypercholesterolemia per 1000 individuals, 58 male and 53 female cases with diabetes per 1000 individuals. ...
Introduction: Health attitudes and beliefs have long been associated with lower risk of various d... more Introduction: Health attitudes and beliefs have long been associated with lower risk of various diseases, better compliance to medication and less likelihood of relapsing. The aim of this work was to study health beliefs and attitudes of hypertensive subjects in relation to the management of cardiovascular disease (CVD) risk factors. Methods: The Hellenic Atherosclerosis Society ran a project where during 2006-2012, 10,141 individuals (39 ± 15 years, 47% men, i.e., 0.01% of the Greek population), from all areas of the country, were voluntarily enrolled and participated into a face-toface interview that gathered information about their beliefs and attitudes on diet, smoking and physical activity, as well as management of CVD disorders. Results: Self-reported prevalence of hypertension was 16.7% in men and 13.2% in women. Hypertensive subjects had lower educational level than non-hypertensive (11 ± 5 vs. 13 ± 4.5 years of school, p<0.001). Hypertensive participants as compared to n...
The association between lipoprotein (a) (Lp(a)) and 10-year first fatal/nonfatal cardiovascular d... more The association between lipoprotein (a) (Lp(a)) and 10-year first fatal/nonfatal cardiovascular disease (CVD) risk in apparently healthy men and women was evaluated. The ATTICA prospective study was conducted during 2001-2012 and included n = 1514 men and n = 1528 women (age >18 years) from the greater Athens area, Greece. Follow-up CVD assessment (2011-2012) was achieved in n = 2020 participants (n = 317 cases); baseline Lp(a) was measured in n = 1890 participants. The recommended threshold of 50 mg/dL was used to define abnormal Lp(a) status. Ten-year CVD-event rate was 14% and 24% in participants with Lp(a) <50 and Lp(a) ≥50 mg/dL, respectively. Multivariate analysis revealed that participants with Lp(a) ≥50 mg/dL versus Lp(a) <50 mg/dL had about 2 times higher CVD risk (hazard ratio (HR) = 2.18, 95% confidence interval (CI) 1.11, 4.28). The sex-based analysis revealed that the independent Lp(a) effect was retained only in men (HR = 2.00, 95% CI 1.19, 2.56); in women, si...
Tea is one of the most-widely consumed beverages in the world with a number of different benefici... more Tea is one of the most-widely consumed beverages in the world with a number of different beneficial health effects, mainly ascribed to the polyphenolic content of the tea catechins. The aim of this study was to examine the consumption of green, black, or no tea, in relation to the previously validated successful ageing index (SAI; higher values “healthier” ageing) in a combined analysis of adults aged >50 years old from the ATTICA (n = 1128 adults from Athens, Greece metropolitan area) and the MEDiterranean Islands Study (MEDIS) (n = 2221 adults from various Greek island and Mani) studies. After adjusting for age, sex, smoking, and coffee consumption, green tea was positively associated with SAI (b ± SE: 0.225 ± 0.055, p < 0.001), while black tea was negatively associated with SAI (unstandardized b coefficient ± Standard error: −0.807 ± 0.054, p < 0.001). Green tea (vs black tea) consumption, had higher odds of a SAI of over 3.58 out of 10 (OR: 1.77, 95% CI: 1.38–2.28). Gre...
The aim of the study was to understand determinants of ageing in relation to future cardiovascula... more The aim of the study was to understand determinants of ageing in relation to future cardiovascular disease (CVD) events at population level, and to explore determinants of healthy ageing and its relation to 10-year CVD incidence among apparently healthy individuals. In the context of the ATTICA study 453 apparently healthy men (45±13 years) and 400 women (44±18 years) with complete psychological evaluation were studied and followed during 2002-2012. Healthy Ageing Index (HAI) (range 0-7) was calculated based on socio-economical, bio-clinical, psychological, and lifestyle characteristics (i.e. dietary habits and physical activity) of the participants during the baseline examination. CVD incidence during the follow-up period was defined according to ICD-10 criteria. Healthy Ageing Index was inversely associated with higher 10-year CVD risk (OR per 1/7 (95% CI): 0.47 (0.28, 0.80). Age and sex-adjusted determinants of healthy ageing were abnormal waist to hip ratio (p<0.001), increas...
Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objec... more Body fat accumulation is implicated in the development of cardiovascular disease (CVD). Our objective was to explore potential associations between anthropometric indices and the 10-year CVD incidence in Greek adults without previous CVD. During 2001-2, we enrolled 3042 adults without CVD from the general population of Attica, Greece. In 2011-2, the 10-year study follow-up was performed, recording the CVD incidence in 1958 participants with baseline body mass index (BMI) ≥18.5kg/m(2). The study 10-year CVD incidence was 15.8%, exhibiting a gradual increase according to the baseline body mass index (BMI) category. Baseline BMI ≥30kg/m(2) was related with significantly higher 10-year CVD risk compared to BMI <25kg/m(2), even after adjustment for age and other known CVD risk factors. Baseline BMI, waist circumference, waist-to-hip ratio, waist-to-height ratio and waist-to-hip-to-height ratio were independently associated with the 10-year CVD risk in multi-adjusted models. Gender-spe...
Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and ... more Background Chronic stress frequently manifests with anxiety and/or depressive symptomatology and may have detrimental cardiometabolic effects over time. As such, recognising the potential links between stress-related psychological disorders and cardiovascular disease (CVD) is becoming increasingly important in cardiovascular epidemiology research. The primary aim of this study was to explore prospectively potential associations between clinically relevant depressive symptomatology and anxiety levels and the 10-year CVD incidence among apparently healthy Greek adults. Design A population-based, health and nutrition prospective survey. Methods In the context of the ATTICA Study (2002-2012), 853 adult participants without previous CVD history (453 men (45 ± 13 years) and 400 women (44 ± 18 years)) underwent psychological evaluations through validated, self-reporting depression and anxiety questionnaires. Results After adjustment for multiple established CVD risk factors, both reported ...
To better understand the metabolic syndrome (MS) spectrum through principal components analysis a... more To better understand the metabolic syndrome (MS) spectrum through principal components analysis and further evaluate the role of the Mediterranean diet on MS presence. During 2001-2002, 1514 men and 1528 women (>18y) without any clinical evidence of CVD or any other chronic disease, at baseline, living in greater Athens area, Greece, were enrolled. In 2011-2012, the 10-year follow-up was performed in 2583 participants (15% of the participants were lost to follow-up). Incidence of fatal or non-fatal CVD was defined according to WHO-ICD-10 criteria. MS was defined by the National Cholesterol Education Program Adult Treatment panel III (revised NCEP ATP III) definition. Adherence to the Mediterranean diet was assessed using the MedDietScore (range 0-55). Five principal components were derived, explaining 73.8% of the total variation, characterized by the: a) body weight and lipid profile, b) blood pressure, c) lipid profile, d) glucose profile, e) inflammatory factors. All component...
BACKGROUND: Epidemiological studies suggest a non-monotonic effect of alcohol consumption on card... more BACKGROUND: Epidemiological studies suggest a non-monotonic effect of alcohol consumption on cardiovascular risk, while there is strong evidence concerning the involvement of homocysteine levels on thrombosis. The aim of this work was to evaluate the association between usual ethanol consumption and homocysteine levels, in cardiovascular disease free adults. METHODS: From May 2001 to December 2002 we randomly enrolled 1514 adult men and 1528 women, without any evidence of cardiovascular disease, stratified by age - gender (census 2001), from the greater area of Athens, Greece. Among the variables ascertained we measured the daily ethanol consumption and plasma homocysteine concentrations. RESULTS: Data analysis revealed a J-shape association between ethanol intake (none, <12 gr, 12 - 24 gr, 25 - 48 gr, >48 gr per day) and total homocysteine levels (mean +/- standard deviation) among males (13 +/- 3 vs. 11 +/- 3 vs. 14 +/- 4 vs. 18 +/- 5 vs. 19 +/- 3 mumol/L, respectively, p &l...
Hellenic journal of cardiology : HJC = Hellēnikē kardiologikē epitheōrēsē
The purpose of this study was to evaluate changes in the prevalence of cardiovascular disease (CV... more The purpose of this study was to evaluate changes in the prevalence of cardiovascular disease (CVD) risk factors in a population-based sample of Greek adults. From May 2001 to December 2002, 1514 men and 1528 women (age >18 y), living in the Attica region of Greece, were enrolled in the ATTICA cohort study. In 2006, the 5-year follow up was performed (941 of the 3042 participants, 31%, were lost to follow up). The prevalence of hypertension, hypercholesterolemia, diabetes, obesity, smoking and physical inactivity, was assessed in both examinations through established procedures. Development of CVD (coronary heart disease, acute coronary syndromes, stroke, or other CVD) during the followup period was defined according to the WHO-ICD-10 criteria. During 2001-2006 there were 88 male and 102 female cases with hypertension per 1000 individuals, 237 male and 177 female cases with hypercholesterolemia per 1000 individuals, 58 male and 53 female cases with diabetes per 1000 individuals. ...
Introduction: Health attitudes and beliefs have long been associated with lower risk of various d... more Introduction: Health attitudes and beliefs have long been associated with lower risk of various diseases, better compliance to medication and less likelihood of relapsing. The aim of this work was to study health beliefs and attitudes of hypertensive subjects in relation to the management of cardiovascular disease (CVD) risk factors. Methods: The Hellenic Atherosclerosis Society ran a project where during 2006-2012, 10,141 individuals (39 ± 15 years, 47% men, i.e., 0.01% of the Greek population), from all areas of the country, were voluntarily enrolled and participated into a face-toface interview that gathered information about their beliefs and attitudes on diet, smoking and physical activity, as well as management of CVD disorders. Results: Self-reported prevalence of hypertension was 16.7% in men and 13.2% in women. Hypertensive subjects had lower educational level than non-hypertensive (11 ± 5 vs. 13 ± 4.5 years of school, p<0.001). Hypertensive participants as compared to n...
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Papers by christina chrysohoou