Diastolic dysfunction is associated with sedentary leisure time physical activity and smoking in females only

Figures & data

Table I. Characteristics of male (♂) and female (♀) participants related to diastolic dysfunction with preserved systolic function (DD-PSF).

Variables (units) (n ♂/n ♀)		Regular diastolic function (421/480)	DD-PSF (79/58)	p
Age (years)	♂	48.7 (11.0)	63.1 (11.0)	< 0.001
	♀	48.4 (10.6)	65.3 (10.6)	< 0.001
BMI (kg m^2)	♂	26.8 (3.4)	28.2 (3.7)	0.005
	♀	26.8 (5.1)	28.2 (5.6)	0.002
SBP (mm Hg)	♂	125.9 (14.2)	133.5 (15.3)	< 0.001
	♀	121.6 (13.4)	130.4 (14.6)	< 0.001
DBP (mm Hg)	♂	72.5 (9.6)	77.6 (10.4)	< 0.001
	♀	69.4 (9.5)	71.5 (10.4)	0.147
Heart rate (beats/minute)	♂	62.4 (8.6)	65.4 (9.2)	0.009
	♀	64.2 (8.5)	66.5 (9.2)	0.070
Total cholesterol (mmol/L)	♂	4.6 (0.9)	4.4 (1.0)	0.093
	♀	4.5 (0.9)	4.3 (1.0)	0.023
HDL (mmol/L)	♂	1.2 (0.3)	1.1 (0.3)	0.239
	♀	1.3 (0.3)	1.2 (0.4)	0.002
LDL (mmol/L)	♂	3.5 (0.9)	3.3 (1.0)	0.165
	♀	3.2 (0.8)	3.1 (0.9)	0.249
TG (g/L)	♂	1.4 (0.9)	1.6 (0.9)	0.044
	♀	1.2 (0.6)	1.5 (0.6)	0.001
Hypertension (%)	♂	58 (13.8)	38 (48.1)	0.002
	♀	59 (12.3)	38 (65.5)	< 0.001
Diabetes (%)	♂	20 (4.8)	18 (22.8)	0.025
	♀	23 (4.8)	15 (25.9)	0.006
Obesity (%)	♂	74 (17.6)	22 (27.8)	< 0.001
	♀	101 (21.0)	26 (45.6)	< 0.001
History of CVD (%)	♂	19 (4.5)	10 (12.7)	0.473
	♀	16 (3.4)	8 (13.8)	0.339
Sedentary LTPA (%)	♂	254 (60.9)	53 (67.9)	0.287
	♀	330 (69.0)	51 (87.9)	0.018
Sedentary WTPA (%)	♂	237 (67.1)	27 (67.5)	0.688
	♀	282 (75.2)	16 (69.6)	0.697
Smokers (%)	♂	70 (16.7)	15 (19.0)	0.514
	♀	94 (19.7)	11 (19.0)	0.093
Education < HS (%)	♂	154 (37.4)	57 (73.1)	0.615
	♀	130 (27.4)	33 (61.1)	0.964
LVH (%)	♂	27 (7.3)	42 (39.4)	< 0.001
	♀	30 (8.4)	31 (34.5)	< 0.001
EF	♂	73.7 (8.5)	72.4 (9.1)	0.241
	♀	74.2 (7.3)	73.6 (8.5)	0.671
E/A ratio	♂	1.3 (0.3)	0.9 (0.3)	< 0.001
	♀	1.4 (0.3)	1.0 (0.3)	< 0.001
IVRT (ms)	♂	90.6 (14.6)	121.3 (15.7)	< 0.001
	♀	88.5 (14.3)	121.4 (15.6)	< 0.001

Notes: Means were adjusted for age difference using general linear models (GLM). Data are presented in means (SD) or numbers (%). Abbreviations: DD-PSF = diastolic dysfunction with preserved systolic function; BMI = body mass index; SBP = systolic blood pressure; DBP = diastolic blood pressure; HDL = high-density lipoprotein; LDL = low-density lipoprotein; TG = triglycerides; CVD = cardiovascular disease; Sedentary LTPA = i.e. leisure time physical activity where strenuous activity did not regularly occur; Sedentary WTPA = daily work with little muscle activity; education < HS i.e. not more than high school exam; LVH = left ventricular hypertrophy; EF = ejection fraction; E/A–ratio = early filling to atrial filling ratio; IVRT = isovolumetric relaxation time.

Table II. Associations between sedentary leisure time physical activity (LTPA) and left ventricular diastolic dysfunction with preserved systolic function (DD-PSF), adjusted for lifestyle and cardiovascular risk factors in males and females.

	LTPA
	Active Reference	OR	Sedentary (95% CI)	p
Covariates
Males	n = 188	n = 307
Age	1.0	1.37	(0.77–2.45)	0.287
Age, active smoker	1.0	1.37	(0.77–2.46)	0.284
Age, BMI	1.0	1.16	(0.64–2.11)	0.616
Age, BMI, HT	1.0	1.07	(0.58–1.96)	0.826
Age, BMI, HT, DM, CVD,	1.0	1.04	(0.56–1.94)	0.907
heart rate, active smoker
Females	n = 155	n = 381
Age	1.0	3.04	(1.21–7.63)	0.018
Age, active smoker	1.0	3.15	(1.25–7.94)	0.015
Age, BMI	1.0	3.19	(1.18–8.64)	0.022
Age, BMI, HT	1.0	3.05	(1.09–8.55)	0.034
Age, BMI, HT, DM, CVD	1.0	2.91	(1.02–8.27)	0.046
heart rate, active smoker

Note: Data presented as odds ratio (OR) and 95% confidence interval (CI) with DD-PSF as dependent variable.

Abbreviations: BMI = body mass index; HT = hypertension; DM = diabetes; CVD = cardiovascular disease.

Table III. Associations between smoking and left ventricular diastolic dysfunction with preserved systolic function (DD-PSF), adjusted for lifestyle and cardiovascular risk factors in males and females.

	Smoking status
	Non-/previous smoker Reference	OR	Active smoker (95% CI)	p
Covariates
Males	n = 414	n = 85
Age	1.0	1.26	(0.62–2.55)	0.514
Age, sedentary LTPA	1.0	1.21	(0.59–2.48)	0.604
Age, BMI	1.0	1.33	(0.65–2.72)	0.430
Age, BMI, HT	1.0	1.39	(0.65–2.74)	0.427
Age, BMI, HT, DM, CVD	1.0	1.18	(0.56–2.52)	0.662
heart rate, sedentary LTPA
Females	n = 431	n = 105
Age	1.0	2.03	(0.89–4.65)	0.093
Age, sedentary LTPA	1.0	2.14	(0.93–4.97)	0.075
Age, BMI	1.0	2.93	(1.23–6.99)	0.015
Age, BMI, HT	1.0	3.35	(1.36–8.27)	0.009
Age, BMI, HT, DM, CVD	1.0	3.42	(1,35–8.64)	0.009
heart rate, sedentary LTPA

Note: Data presented as odds ratio (OR) and 95% confidence interval (CI) with DD-PSF as dependent variable.

Abbreviations: BMI = body mass index; HT = hypertension; DM = diabetes; CVD = cardiovascular disease; LTPA = leisure time physical activity.

Figure 1. Prevalence of left ventricular diastolic dysfunction with preserved systolic function related to age and sex.

Table IV. The probability of diastolic dysfunction with preserved systolic function in males (♂) and females (♀).

Risk factor/condition		n1	PPV	n2	NPV
Sedentary LTPA	♂	39	17.9	456	84.4
	♀	27	37.0	509	90.6
Active smoker	♂	85	17.6	414	84.5
	♀	105	10.5	431	89.1
Hypertension	♂	96	39.6	404	89.9
	♀	97	39.2	441	95.5
Obesity	♂	96	22.9	404	85.9
	♀	127	20.5	410	92.4
Diabetes	♂	38	47.4	462	86.8
	♀	38	39.5	500	91.4
Sedentary LTPA & hypertension	♂	5	40.0	490	84.5
	♀	14	64.3	522	90.6
Sedentary LTPA & hypertension	♂	4	50.0	496	89.2
& Obesity	♀	9	77.8	529	90.4
Active smoker & hypertension	♂	16	37.5	483	84.9
	♀	12	50.0	524	90.1

Abbreviations: PPV = positive predictive value; NPV = negative predictive value; n1 = number of cases identified with the studied risk factor/condition; n2 = number of cases where the risk factor/condition is absent; sedentary LTPA; leisure time physical activity (walking = cycling = gardening etc.) less than two hours a week.