Eliseo Guallar
Eliseo Guallar
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Chair and Professor of the Department of Epidemiology
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Professional overview
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Dr. Guallar is an epidemiologist whose research is focused on the study of cardiovascular disease epidemiology and prevention, with an emphasis on evaluating the role of environmental and nutritional exposures in the development of cardiovascular disease. This research has made critically important and novel contributions to our understanding of risk factors for chronic disease both in the US and globally. He has published seminal articles and is a leading figure in an emerging field highlighting the risks of exposure to levels of metals previously considered safe for cardiovascular health. In addition to his work in toxic metals, Dr. Guallar has made important contributions to understanding the effects of certain micronutrients and vitamin supplements on cardiovascular disease risk and outcomes. Publications in this area were influential in changing consumer habits and attitudes towards these products. Much of this research has been funded by the National Institutes of Health, the Agency for Healthcare Research and Quality, the American Heart Association, the CDC, and other funders.
Dr. Guallar was the founding director of the Center for Clinical Epidemiology at the Samsung Medical Center and a lead investigator of the Kangbuk Samsung Cohort Study at the Kangbuk Samsung Hospital since its inception in 2010. Dr. Guallar has published over 500 research papers in peer-reviewed journals. He is also a Deputy Editor for Methods at the Annals of Internal Medicine and a past member and Chair of the Cancer, Heart, and Sleep Study Section at the National Institutes of Health.
Prior to teaching at NYU, Dr. Guallar was a Professor of Epidemiology and Medicine at the Johns Hopkins University Bloomberg School of Public Health and a core faculty member of the Welch Center for Prevention, Epidemiology, and Clinical Research at Johns Hopkins. In the Department of Epidemiology, Dr. Guallar was the Director of the Environmental and Occupational Area of Concentration and the Co-Director of the PhD Program. Dr. Guallar was also an adjunct Professor at the Department of Clinical Research Design and Evaluation of the Samsung Advanced Institute for Health Science and Technology, Sungkyunkwan University, in Seoul, Korea.
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Education
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Diploma of English, Spanish Official School of Languages at Zaragoza (Escuela Oficial de Idiomas de Zaragoza), Zaragoza, SpainMD, University of Zaragoza, Zaragoza, SpainMPH, University of Minnesota, Minneapolis, MNDrPH, Harvard University, Boston, MA
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Honors and awards
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Six Honor Calls in the MD Program, University of Zaragoza School of Medicine (1981)Fellow of Spain’s Program of Training of Graduate Research of the Ministry of Education and Science, University of Zaragoza (1988)Fulbright Scholar, sponsored by Spain’s Ministry of Health and Consumer Affairs (1989)Faculty Innovation Award, Johns Hopkins University Bloomberg School of Public Health (2001)Scientist Development Award, American Heart Association (2002)Fellow of the American Heart Association, Council on Epidemiology and Prevention (2013)Advising, Mentoring, and Teaching Recognition Award 2014 – 2015, Johns Hopkins University Bloomberg School of Public Health (2015)High Impact Research Icon, University of Malaya (2015)
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Publications
Publications
Effect of Anemia on Physical Function and Physical Activity in CKD : The National Health and Nutrition Examination Survey, 1999-2016
AbstractFarag, Y. M., Blasco-Colmenares, E., Zhao, D., Sanon, M., Guallar, E., & Finkelstein, F. O. (n.d.).Publication year
2023Journal title
Kidney360Volume
4Issue
9Page(s)
E1212-E1222AbstractKey PointsIn a large sample representative of the US adult noninstitutionalized population, among participants with CKD stages 3-5, anemia was associated with a significantly lower level of physical activity.The presence of CKD and anemia showed a positive interaction on physical functioning outcomes. Among participants with CKD, physical functioning was worse in patients with anemia compared with those without anemia.BackgroundCKD is a major public health problem worldwide. Anemia, a frequent and treatable complication of CKD, is associated with decreased physical functioning and physical activity. The objective of this study was to evaluate the joint association of CKD and anemia with physical functioning and physical activity in a representative sample of the US population.MethodsCross-sectional study using the National Health and Nutrition Examination Survey (NHANES) 1999-2016 for physical functioning outcomes (N=33,300) and NHANES 2007-2016 for physical activity (N=22,933). The NHANES physical functioning questionnaire included 19 items. The NHANES physical activity questionnaire captured work-related, leisure-time, and sedentary activities. Higher physical functioning scores represent worse function. CKD was classified using Kidney Disease Outcomes Quality Initiative 2002 criteria, and anemia was defined using the World Health Organization criteria.ResultsThe adjusted mean differences (95% confidence interval) in overall physical functioning score comparing participants with anemia with those without anemia among participants with no CKD, CKD stages 1-2, and stages 3-5 were 0.5 (-0.1 to 1.0), 1.5 (0.2 to 2.8), and 3.6 (2.0 to 5.2). Anemia and CKD showed a supra-additive interaction for all physical functioning outcomes among participants in CKD stages 3-5. The prevalence of high physical activity was also lower in participants with anemia compared with those without anemia among participants in CKD stages 3-5 (adjusted prevalence ratio, 0.74; 95% confidence interval, 0.54 to 1.01).ConclusionsCKD and anemia were associated with impairments in physical functioning and reduced physical activity. For physical functioning outcomes, the combined presence of CKD and of anemia showed a stronger effect than what was expected from their independent effects.Effect of Isocaloric, Time-Restricted Eating on Body Weight in Adults With Obesity : A Randomized Controlled Trial
AbstractMaruthur, N. M., Pilla, S. J., White, K., Wu, B., Maw, M. T., Duan, D., Turkson-Ocran, R. A., Zhao, D., Charleston, J., Peterson, C. M., Dougherty, R. J., Schrack, J. A., Appel, L. J., Guallar, E., & Clark, J. M. (n.d.).Publication year
2024Journal title
Annals of internal medicineVolume
177Issue
5Page(s)
549-558AbstractBACKGROUND: Time-restricted eating (TRE) lowers body weight in many studies. Whether TRE induces weight loss independent of reductions in calorie intake, as seen in rodent studies, is unknown. OBJECTIVE: To determine the effect of TRE versus a usual eating pattern (UEP) on body weight in the setting of stable caloric intake. DESIGN: Randomized, isocaloric feeding study. (ClinicalTrials.gov: NCT03527368). SETTING: Clinical research unit. PARTICIPANTS: Adults with obesity and prediabetes or diet-controlled diabetes. INTERVENTION: Participants were randomly assigned 1:1 to TRE (10-hour eating window, 80% of calories before 1 p.m.) or UEP (≤16-hour window, ≥50% of calories after 5 p.m.) for 12 weeks. Both groups had the same nutrient content and were isocaloric with total calories determined at baseline. MEASUREMENTS: Primary outcome was change in body weight at 12 weeks. Secondary outcomes were fasting glucose, homeostatic model assessment for insulin resistance (HOMA-IR), glucose area under the curve by oral glucose tolerance test, and glycated albumin. We used linear mixed models to evaluate the effect of interventions on outcomes. RESULTS: All 41 randomly assigned participants (mean age, 59 years; 93% women; 93% Black race; mean BMI, 36 kg/m2) completed the intervention. Baseline weight was 95.6 kg (95% CI, 89.6 to 101.6 kg) in the TRE group and 103.7 kg (CI, 95.3 to 112.0 kg) in the UEP group. At 12 weeks, weight decreased by 2.3 kg (CI, 1.0 to 3.5 kg) in the TRE group and by 2.6 kg (CI, 1.5 to 3.7 kg) in the UEP group (average difference TRE vs. UEP, 0.3 kg [CI, -1.2 to 1.9 kg]). Change in glycemic measures did not differ between groups. LIMITATION: Small, single-site study; baseline differences in weight by group. CONCLUSION: In the setting of isocaloric eating, TRE did not decrease weight or improve glucose homeostasis relative to a UEP, suggesting that any effects of TRE on weight in prior studies may be due to reductions in caloric intake. PRIMARY FUNDING SOURCE: American Heart Association.Effect of long-term selenium supplementation on mortality : Results from a multiple-dose, randomised controlled trial
AbstractRayman, M. P., Winther, K. H., Pastor-Barriuso, R., Cold, F., Thvilum, M., Stranges, S., Guallar, E., & Cold, S. (n.d.).Publication year
2018Journal title
Free Radical Biology and MedicineVolume
127Page(s)
46-54AbstractBackground: Selenium, an essential trace element, is incorporated into selenoproteins with a wide range of health effects. Selenoproteins may reach repletion at a plasma selenium concentration of ~ 125 µg/L, at which point the concentration of selenoprotein P reaches a plateau; whether sustained concentrations higher than this are beneficial, or indeed detrimental, is unknown. Objective: In a population of relatively low selenium status, we aimed to determine the effect on mortality of long-term selenium supplementation at different dose levels. Design: The Denmark PRECISE study was a single-centre, randomised, double-blinded, placebo-controlled, multi-arm, parallel clinical trial with four groups. Participants were 491 male and female volunteers aged 60–74 years, recruited at Odense University Hospital, Denmark. The trial was initially designed as a 6-month pilot study, but supplemental funding allowed for extension of the study and mortality assessment. Participants were randomly assigned to treatment with 100, 200, or 300 µg selenium/d as selenium-enriched-yeast or placebo-yeast for 5 years from randomization in 1998–1999 and were followed up for mortality for a further 10 years (through March 31, 2015). Results: During 6871 person-years of follow-up, 158 deaths occurred. In an intention-to-treat analysis, the hazard ratio (95% confidence interval) for all-cause mortality comparing 300 µg selenium/d to placebo was 1.62 (0.66, 3.96) after 5 years of treatment and 1.59 (1.02, 2.46) over the entire follow-up period. The 100 and 200 µg/d doses showed non-significant decreases in mortality during the intervention period that disappeared after treatment cessation. Although we lacked power for endpoints other than all-cause mortality, the effects on cancer and cardiovascular mortality appeared similar. Conclusions: A 300 µg/d dose of selenium taken for 5 years in a country with moderately-low selenium status increased all-cause mortality 10 years later. While our study was not initially designed to evaluate mortality and the sample size was limited, our findings indicate that total selenium intake over 300 µg/d and high-dose selenium supplements should be avoided.Effect of selenium supplementation on changes in HbA1c : Results from a multiple-dose, randomized controlled trial
AbstractStranges, S., Rayman, M. P., Winther, K. H., Guallar, E., Cold, S., & Pastor-Barriuso, R. (n.d.).Publication year
2019Journal title
Diabetes, Obesity and MetabolismVolume
21Issue
3Page(s)
541-549AbstractAim: To investigate the effect of selenium supplementation at different dose levels on changes in HbA1c after 6 months and 2 years in a population of low selenium status. Materials and Methods: The Denmark PRECISE study was a single-centre, randomized, double-blinded, placebo-controlled, multi-arm, parallel clinical trial with four groups. In total, 491 volunteers aged 60 to 74 years were randomly assigned to treatment with 100, 200 or 300 μg selenium/day as selenium-enriched yeast or placebo-yeast. HbA1c measurements were available for 489 participants at baseline, 435 at 6 months, and 369 after 2 years of selenium supplementation. Analyses were performed by intention to treat. Results: The mean (SD) age, plasma-selenium concentration, and blood HbA1c at baseline were 66.1 (4.1) years, 86.5 (16.3) ng/g and 36.6 (7.0) mmol/mol, respectively. During the initial 6-month intervention period, mean HbA1c (95% CI) decreased by 1.5 (−2.8 to −0.2) mmol/mol for 100 μg/d of selenium supplementation and by 0.7 (−2.0 to 0.6) mmol/mol for the 200 and 300 μg/d groups compared with placebo (P = 0.16 for homogeneity of changes across the four groups). After 2 years of selenium supplementation, HbA1c had decreased significantly in all treatment groups, with no difference between active treatment and placebo. Conclusions: Selenium supplementation in an elderly European population of low selenium status did not significantly affect HbA1c levels after 2 years. Our findings corroborate a possible U-shaped response of selenium supplementation on glucose metabolism.Effect of supplementation with high-selenium yeast on plasma lipids : A randomized trial
AbstractRayman, M. P., Stranges, S., Griffin, B. A., Pastor-Barriuso, R., & Guallar, E. (n.d.).Publication year
2011Journal title
Annals of internal medicineVolume
154Issue
10Page(s)
656-665AbstractBackground: High selenium status has been linked to elevated blood cholesterol levels in cross-sectional studies. Objective: To investigate the effect of selenium supplementation on plasma lipids. Design: Randomized, placebo-controlled, parallel-group study stratified by age and sex. Participants, research nurses, and persons assessing outcomes were blinded to treatment assignment. (International Standard Randomised Controlled Trial Number Register registration number: ISRCTN25193534) Setting: 4 general practices in the United Kingdom. Participants: 501 volunteers aged 60 to 74 years. Intervention: Participants received selenium, 100 mcg/d (n =127), 200 mcg/d (n = 127), or 300 mcg/d (n =126), as high-selenium yeast or a yeast-based placebo (n = 121) for 6 months. Measurements: Total and high-density lipoprotein (HDL) cholesterol concentrations were measured in nonfasting plasma samples stored from participants in the UK PRECISE (United Kingdom PREvention of Cancer by Intervention with SElenium) Pilot Study at baseline (n =454) and at 6 months (n = 394). Non-HDL cholesterol levels were calculated. Results: Mean plasma selenium concentration was 88.8 ng/g (SD, 19.2) at baseline and increased statistically significantly in the treatment groups. The adjusted difference in change in total cholesterol levels for selenium compared with placebo was -0.22 mmol/L (-8.5 mg/dL) (95% CI, -0.42 to -0.03 mmol/L [-16.2 to -1.2 mg/dL]; P = 0.02) for 100 mcg of selenium per day, -0.25 mmol/L (-9.7 mg/dL) (CI, -0.44 to -0.07 mmol/L [-17.0 to-2.7 mg/dL]; P = 0.008) for 200 mcg of selenium per day, and -0.07 mmol/L (-2.7 mg/dL) (CI, -0.26 to 0.12 mmol/L [-10.1 to 4.6 mg/dL]; P =0.46) for 300 mcg of selenium per day. Similar reductions were observed for non-HDL cholesterol levels. There was no apparent difference in change in HDL cholesterol levels with 100 and 200 mcg of selenium per day, but the difference was an adjusted 0.06 mmol/L (2.3 mg/dL) (CI, 0.00 to 0.11 mmol/L [0.0 to 4.3 mg/dL]; P = 0.045) with 300 mcg of selenium per day. The total-HDL cholesterol ratio decreased progressively with increasing selenium dose (overall P = 0.01). Limitation: The duration of supplementation was limited, as was the age range of the participants. Conclusion: Selenium supplementation seemed to have modestly beneficial effects on plasma lipid levels in this sample of persons with relatively low selenium status. The clinical significance of the findings is unclear and should not be used to justify the use of selenium supplementation as additional or alternative therapy for dyslipidemia. This is particularly true for persons with higher selenium status, given the limitations of the trial and the potential additional risk in other metabolic dimensions. Primary Funding Source: The Cancer Research Campaign (now Cancer Research UK) and the University of Surrey.Effects of education on aging-related cortical thinning among cognitively normal individuals
AbstractKim, J. P., Seo, S. W., Shin, H. Y., Ye, B. S., Yang, J. J., Kim, C., Kang, M., Jeon, S., Kim, H. J., Cho, H., Kim, J. H., Lee, J. M., Kim, S. T., Na, D. L., & Guallar, E. (n.d.).Publication year
2015Journal title
NeurologyVolume
85Issue
9Page(s)
806-812AbstractObjectives: We aimed to investigate the relationship between education and cortical thickness in cognitively normal individuals to determine whether education attenuated the association of advanced aging and cortical thinning. Methods: A total of 1,959 participants, in whom education levels were available, were included in the final analysis. Cortical thickness was measured on high-resolution MRIs using a surface-based method. Multiple linear regression analysis was performed for education level and cortical thickness, after controlling for possible confounders. Results: High levels of education were correlated with increased mean cortical thickness throughout the entire cortex (p 0.003). This association persisted after controlling for vascular risk factors. Statistical maps of cortical thickness showed that the high levels of education were correlated with increased cortical thickness in the bilateral premotor areas, anterior cingulate cortices, perisylvian areas, right superior parietal lobule, left lingual gyrus, and occipital pole. There were also interactive effects of age and education on the mean cortical thickness (p 0.019). Conclusions: Our findings suggest the protective effect of education on cortical thinning in cognitively normal older individuals, regardless of vascular risk factors. This effect was found only in the older participants, suggesting that the protective effects of education on cortical thickness might be achieved by increased resistance to structural loss from aging rather than by simply providing a fixed advantage in the brain.Effects of nutritional supplements and dietary interventions on cardiovascular outcomes
AbstractKhan, S. U., Khan, M. U., Riaz, H., Valavoor, S., Zhao, D., Vaughan, L., Okunrintemi, V., Riaz, I. B., Khan, M. S., Kaluski, E., Murad, M. H., Blaha, M. J., Guallar, E., & Michos, E. D. (n.d.).Publication year
2019Journal title
Annals of internal medicineVolume
171Issue
3Page(s)
190-198AbstractBackground: The role of nutritional supplements and dietary interventions in preventing mortality and cardiovascular disease (CVD) outcomes is unclear. Purpose: To examine evidence about the effects of nutritional supplements and dietary interventions on mortality and cardiovascular outcomes in adults. Data Sources: PubMed, CINAHL, and the Cochrane Library from inception until March 2019; ClinicalTrials.gov (10 March 2019); journal Web sites; and reference lists. Study Selection: English-language, randomized controlled trials (RCTs) and meta-analyses of RCTs that assessed the effects of nutritional supplements or dietary interventions on all-cause mortality or cardiovascular outcomes, such as death, myocardial infarction, stroke, and coronary heart disease. Data Extraction: Two independent investigators abstracted data, assessed the quality of evidence, and rated the certainty of evidence. Data Synthesis: Nine systematic reviews and 4 new RCTs were selected that encompassed a total of 277 trials, 24 interventions, and 992 129 participants. A total of 105 meta-analyses were generated. There was moderate-certainty evidence that reduced salt intake decreased the risk for all-cause mortality in normotensive participants (risk ratio [RR], 0.90 [95% CI, 0.85 to 0.95]) and cardiovascular mortality in hypertensive participants (RR, 0.67 [CI, 0.46 to 0.99]). Low-certainty evidence showed that omega-3 long-chain polyunsaturated fatty acid (LC-PUFA) was associated with reduced risk for myocardial infarction (RR, 0.92 [CI, 0.85 to 0.99]) and coronary heart disease (RR, 0.93 [CI, 0.89 to 0.98]). Folic acid was associated with lower risk for stroke (RR, 0.80 [CI, 0.67 to 0.96]; low certainty), whereas calcium plus Vitamin D increased the risk for stroke (RR, 1.17 [CI, 1.05 to 1.30]; moderate certainty). Other nutritional supplements, such as vitamin B6, Vitamin A, multivitamins, antioxidants, and iron and dietary interventions, such as reduced fat intake, had no significant effect on mortality or cardiovascular disease outcomes (very low- to moderate-certainty evidence). Limitations: Suboptimal quality and certainty of evidence. Conclusion: Reduced salt intake, omega-3 LC-PUFA use, and folate supplementation could reduce risk for some cardiovascular outcomes in adults. Combined calcium plus Vitamin D might increase risk for stroke.Effects of vitamin c supplementation on blood pressure : A meta-analysis of randomized controlled trials
AbstractJuraschek, S. P., Guallar, E., Appel, L. J., & Miller, E. R. (n.d.).Publication year
2012Journal title
American Journal of Clinical NutritionVolume
95Issue
5Page(s)
1079-1088AbstractBackground: In observational studies, increased vitamin C intake, vitamin C supplementation, and higher blood concentrations of vitamin C are associated with lower blood pressure (BP). However, evidence for blood pressure-lowering effects of vitamin C in clinical trials is inconsistent. Objective: The objective was to conduct a systematic review and meta-analysis of clinical trials that examined the effects of vitamin C supplementation on BP. Design: We searched Medline, EMBASE, and Central databases from 1966 to 2011. Prespecified inclusion criteria were as follows: 1) use of a randomized controlled trial design; 2) trial reported effects on systolic BP (SBP) or diastolic BP (DBP) or both; 3) trial used oral vitamin C and concurrent control groups; and 4) trial had a minimum duration of 2 wk. BP effects were pooled by random-effects models, with trials weighted by inverse variance. Results: Twenty-nine trials met eligibility criteria for the primary analysis. The median dose was 500 mg/d, the median duration was 8 wk, and trial sizes ranged from 10 to 120 participants. The pooled changes in SBP and DBP were -3.84 mm Hg (95% CI: -5.29, -2.38 mm Hg; P < 0.01) and -1.48 mm Hg (95% CI: -2.86, -0.10 mm Hg; P = 0.04), respectively. In trials in hypertensive participants, corresponding reductions in SBP and DBP were -4.85 mm Hg (P < 0.01) and -1.67 mm Hg (P = 0.17). After the inclusion of 9 trials with imputed BP effects, BP effects were attenuated but remained significant. Conclusions: In short-term trials, vitamin C supplementation reduced SBP and DBP. Long-term trials on the effects of vitamin C supplementation on BP and clinical events are needed.Efficacy and safety of statin monotherapy in older adults : A meta-analysis
AbstractRoberts, C. G., Guallar, E., & Rodriguez, A. (n.d.).Publication year
2007Journal title
Journals of Gerontology - Series A Biological Sciences and Medical SciencesVolume
62Issue
8Page(s)
879-887AbstractBackground. Statin therapy significantly reduces cardiovascular events. Older patients, however, are less likely to be prescribed statins than younger patients due to concern over lack of indication, lower predictive value of cholesterol levels, and increased risk of adverse events. To determine the effect of statins on all-cause mortality and on major cardiovascular events, including stroke, we performed a meta-analysis of statin trials that included older adult participants. Methods. Mortality, cardiovascular events, and adverse event outcomes were extracted from published randomized, placebo-controlled clinical trials of persons aged 60 years and older. Results. Data on 51,351 patients were evaluated. Statins reduced all-cause mortality by 15% (95% confidence interval, 7%-22%), coronary heart disease (CHD) death by 23% (15%-29%), fatal or nonfatal myocardial infarction (MI) by 26% (22%-30%), and fatal or nonfatal stroke by 24% (10%-35%). The relative risk of cancer comparing statins to placebo was 1.06 (0.95-1.18). Adverse event data were not consistently reported. Conclusions. Statin therapy significantly reduced all-cause and CHD mortality, as well as risk of stroke and MI. Statin therapy should be offered to older patients at high risk of atherosclerotic disease events.Efficacy of a tailored moisturizer for reducing chemotherapy-induced skin dryness in breast cancer patients : A randomized controlled clinical trial
AbstractKang, D., Kim, N., Im, Y. H., Park, Y. H., Kim, J. Y., Park, H., Kim, E., Zhao, D., Guallar, E., Ahn, J. S., & Cho, J. (n.d.).Publication year
2022Journal title
Journal of the American Academy of DermatologyVolume
87Issue
4Page(s)
858-860Abstract~Efficacy of an educational material on second primary cancer screening practice for cancer survivors : A randomized controlled trial
AbstractShin, D. W., Cho, J., Kim, Y. W., Oh, J. H., Kim, S. W., Chung, K. W., Lee, W. Y., Lee, J. E., Guallar, E., & Lee, W. C. (n.d.).Publication year
2012Journal title
PloS oneVolume
7Issue
3AbstractBackground: Cancer surivors have limited knowledge about second primary cancer (SPC) screening and suboptimal rates of completion of screening practices for SPC. Our objective was to test the efficacy of an educational material on the knowledge, attitudes, and screening practices for SPC among cancer survivors. Methods: Randomized, controlled trial among 326 cancer survivors from 6 oncology care outpatient clinics in Korea. Patients were randomized to an intervention or an attention control group. The intervention was a photo-novel, culturally tailored to increase knowledge about SPC screening. Knowledge and attitudes regarding SPC screening were assessed two weeks after the intervention, and screening practices were assessed after one year. Results: At two weeks post-intervention, the average knowledge score was significantly higher in the intervention compared to the control group (0.81 vs. 0.75, P&0.01), with no significant difference in their attitude scores (2.64 vs. 2.57, P = 0.18). After 1 year of follow-up, the completion rate of all appropriate cancer screening was 47.2% in both intervention and control groups. Conclusion: While the educatinal material was effective for increasing knowledge of SPC screening, it did not promote cancer screening practice among cancer survivors. More effective interventions are needed to increase SPC screening rates in this population. Trial Registration: ClinicalTrial.gov NCT00948337.EGFR Mutation Testing in Patients with Advanced Non-Small Cell Lung Cancer : A Comprehensive Evaluation of Real-World Practice in an East Asian Tertiary Hospital
AbstractChoi, Y. L., Sun, J. M., Cho, J., Rampal, S., Han, J., Parasuraman, B., Guallar, E., Lee, G., Lee, J., & Shim, Y. M. (n.d.).Publication year
2013Journal title
PloS oneVolume
8Issue
2AbstractIntroduction: Guidelines for management of non-small cell lung cancer (NSCLC) strongly recommend EGFR mutation testing. These recommendations are particularly relevant in Asians that have higher EGFR mutation prevalence. This study aims to explore current testing practices, logistics of testing, types of EGFR mutation, and prevalence of EGFR mutations in patients with advanced NSCLC in a large comprehensive cancer center in Korea. Methods: Our retrospective cohort included 1,503 NSCLC patients aged ≥18 years, with stage IIIB/IV disease, who attended the Samsung Medical Center in Seoul, Korea, from January 2007 through July 2010. Trained oncology nurses reviewed and abstracted data from electronic medical records. Results: This cohort had a mean age (SD) of 59.6 (11.1) years, 62.7% were males, and 52.9% never-smokers. The most common NSCLC histological types were adenocarcinoma (70.5%) and squamous cell carcinoma (18.0%). Overall, 39.5% of patients were tested for EGFR mutations. The proportion of patients undergoing EGFR testing during January 2007 through July 2008, August 2008 through September 2009, and October 2009 through July 2010 were 23.3%, 38.3%, and 63.5%, respectively (PEgg consumption and coronary artery calcification in asymptomatic men and women
AbstractChoi, Y., Chang, Y., Lee, J. E., Chun, S., Cho, J., Sung, E., Suh, B. S., Rampal, S., Zhao, D., Zhang, Y., Pastor-Barriuso, R., Lima, J. A., Shin, H., Ryu, S., & Guallar, E. (n.d.).Publication year
2015Journal title
AtherosclerosisVolume
241Issue
2Page(s)
305-312AbstractObjective: The association of egg consumption with subclinical coronary atherosclerosis remains unknown. Our aim was to examine the association between egg consumption and prevalence of coronary artery calcium (CAC). Methods: Cross-sectional study of 23,417 asymptomatic adult men and women without a history of cardiovascular disease (CVD) or hypercholesterolemia, who underwent a health screening examination including cardiac computed tomography for CAC scoring and completed a validated food frequency questionnaire at the Kangbuk Samsung Hospital Total Healthcare Centers, South Korea (March 2011-April 2013). Results: The prevalence of detectable CAC (CAC score>0) was 11.2%. In multivariable-adjusted models, CAC score ratio (95% confidence interval [CI]) comparing participants eating≥7 eggs/wk to those eatingEl placebo en ensayos clínicos con medicamentos
AbstractGarcía-Alonso, F., Guallar, E., Bakke, O. M., & Carné, X. (n.d.).Publication year
1997Journal title
Medicina ClinicaVolume
109Issue
20Page(s)
797-801Abstract~El placebo en ensayos clinicos con medicamentos
AbstractGuallar, E., Laporte, J. R., Garcia Alonso, F., Guallar, E., Bakke, O., & Carne, X. (n.d.).Publication year
1998Journal title
Medicina ClinicaVolume
111Issue
14Page(s)
558Abstract~Endogenous Sex Hormones and Endothelial Function in Postmenopausal Women and Men : The Multi-Ethnic Study of Atherosclerosis
AbstractMathews, L., Subramanya, V., Zhao, D., Ouyang, P., Vaidya, D., Guallar, E., Yeboah, J., Herrington, D., Hays, A. G., Budoff, M. J., & Michos, E. D. (n.d.).Publication year
2019Journal title
Journal of Women's HealthVolume
28Issue
7Page(s)
900-909AbstractBackground: The relationship of endogenous sex hormones (SH) with vascular endothelial function and with cardiovascular disease (CVD) is incompletely understood. We examined the associations between SH and endothelial function measured by brachial artery flow-mediated dilation (FMD). Materials and Methods: We included 1368 postmenopausal women and 1707 men, free of clinical CVD, participating in MESA Visit 1 (2000-2002). Serum SH [total testosterone, SH binding globulin (SHBG), dehydroepiandrosterone (DHEA), estradiol] were measured; free testosterone was calculated. The percent FMD difference (%FMD) was measured by high-resolution ultrasound. Using multivariable-adjusted linear regression, we tested the cross-sectional associations of SH (log transformed, compared per one SD increment) with %FMD. Results: The mean age of women and men were 64.2 and 61.4 years, respectively. Among women, after adjusting for demographics, CVD risk factors, and hormone therapy, higher SHBG was associated with greater %FMD [β = 0.215% (95% CI 0.026-0.405)], whereas higher free testosterone was associated with a smaller %FMD [-0.209% (-0.402, -0.017)]. Estradiol and DHEA were not associated with %FMD in women after multivariable adjustment. There was an age interaction, with higher free testosterone and lower SHBG associated with worse FMD in womenEndogenous Sex Hormones and Incident Cardiovascular Disease in Post-Menopausal Women
AbstractZhao, D., Guallar, E., Ouyang, P., Subramanya, V., Vaidya, D., Ndumele, C. E., Lima, J. A., Allison, M. A., Shah, S. J., Bertoni, A. G., Budoff, M. J., Post, W. S., & Michos, E. D. (n.d.).Publication year
2018Journal title
Journal of the American College of CardiologyVolume
71Issue
22Page(s)
2555-2566AbstractBackground: Higher androgen and lower estrogen levels are associated with cardiovascular disease (CVD) risk factors in women. However, studies on sex hormones and incident CVD events in women have yielded conflicting results. Objectives: The authors assessed the associations of sex hormone levels with incident CVD, coronary heart disease (CHD), and heart failure (HF) events among women without CVD at baseline. Methods: The authors studied 2,834 post-menopausal women participating in the MESA (Multi-Ethnic Study of Atherosclerosis) with testosterone, estradiol, dehydroepiandrosterone, and sex hormone binding globulin (SHBG) levels measured at baseline (2000 to 2002). They used Cox hazard models to evaluate associations of sex hormones with each outcome, adjusting for demographics, CVD risk factors, and hormone therapy use. Results: The mean age was 64.9 ± 8.9 years. During 12.1 years of follow-up, 283 CVD, 171 CHD, and 103 HF incident events occurred. In multivariable-adjusted models, the hazard ratio (95% confidence interval [CI]) associated with 1 SD greater log-transformed sex hormone level for the respective outcomes of CVD, CHD, and HF were as follows: total testosterone: 1.14 (95% CI: 1.01 to 1.29), 1.20 (95% CI: 1.03 to 1.40), 1.09 (95% CI: 0.90 to 1.34); estradiol: 0.94 (95% CI: 0.80 to 1.11), 0.77 (95% CI: 0.63 to 0.95), 0.78 (95% CI: 0.60 to 1.02); and testosterone/estradiol ratio: 1.19 (95% CI: 1.02 to 1.40), 1.45 (95% CI: 1.19 to 1.78), 1.31 (95% CI: 1.01 to 1.70). Dehydroepiandrosterone and SHBG levels were not associated with these outcomes. Conclusions: Among post-menopausal women, a higher testosterone/estradiol ratio was associated with an elevated risk for incident CVD, CHD, and HF events, higher levels of testosterone associated with increased CVD and CHD, whereas higher estradiol levels were associated with a lower CHD risk. Sex hormone levels after menopause are associated with women's increased CVD risk later in life.Endogenous sex steroid hormones and measures of chronic kidney disease (CKD) in a nationally representative sample of men
AbstractYi, S., Selvin, E., Rohrmann, S., Basaria, S., Menke, A., Rifai, N., Guallar, E., Platz, E. A., & Astor, B. (n.d.).Publication year
2009Journal title
Clinical EndocrinologyVolume
71Issue
2Page(s)
246-252AbstractContext Sex steroid hormones may play a role in the pathogenesis of chronic kidney disease (CKD). Objective To determine whether sex steroid hormone concentrations are associated with kidney function or kidney damage in men in the general US population. We hypothesized that lower serum testosterone and E2 concentrations are associated with CKD. Design patients and measurements Serum sex steroid hormones were measured by electrochemiluminescence immunoassays for 1470 men who attended the morning session of Phase I of the Third National Health and Nutrition Examination Survey (NHANES III). We used two measures of CKD, estimated glomerular filtration rate (eGFR) < 60 ml/min/1·73 m2 calculated using serum creatinine or cystatin C levels and the abbreviated Modification of Diet in Renal Disease Study formulae and urinary albumin : creatinine ratio (UACR) ≥ 17 mg/g. Results Mean free testosterone concentration was higher in men with an eGFR < 60 ml/min/1·73 m2 than in men with a higher eGFR. In multivariable adjusted models, the odds of an eGFR < 60 ml/min/1·73 m2 or UACR ≥ 17 mg/g did not differ across tertiles of hormones with the exception of free E2; those in the highest vs. lowest tertile had an elevated odds of decreased eGFR (OR: 3·04, 95% CI (1·22, 7·57); P-trend = 0·02). Conclusions In a nationally representative sample of US adult men, higher free E2 concentration was significantly associated with an eGFR < 60 ml/min/1·73 m 2 as assessed by serum creatinine or cystatin C even after multivariable adjustment. These findings are in contrast to the hypothesis that oestrogens may protect against CKD, though reverse causation cannot be ruled out. Longitudinal investigation of the role of oestrogens in kidney haemodynamics, function, and pathophysiology is warranted.Enough is enough : In response
AbstractGuallar, E., Stranges, S., Mulrow, C., Appel, L. J., & Miller, E. R. (n.d.).Publication year
2014Journal title
Annals of internal medicineVolume
160Issue
11Page(s)
809-810Abstract~Enough is enough : Stop wasting money on vitamin and mineral supplements.
AbstractGuallar, E., Stranges, S., Mulrow, C., Appel, L. J., & Miller, E. R. (n.d.).Publication year
2013Journal title
Annals of internal medicineVolume
159Issue
12Page(s)
850-851Abstract~Entropy of cardiac repolarization predicts ventricular arrhythmias and mortality in patients receiving an implantable cardioverter-defibrillator for primary prevention of sudden death
AbstractDemazumder, D., Limpitikul, W. B., Dorante, M., Dey, S., Mukhopadhyay, B., Zhang, Y., Randall Moorman, J., Cheng, A., Berger, R. D., Guallar, E., Jones, S. R., & Tomaselli, G. F. (n.d.).Publication year
2016Journal title
EuropaceVolume
18Issue
12Page(s)
1818-1828AbstractAims: The need for a readily available, inexpensive, non-invasive method for improved risk stratification of heart failure (HF) patients is paramount. Prior studies have proposed that distinct fluctuation patterns underlying the variability of physiological signals have unique prognostic value. We tested this hypothesis in an extensively phenotyped cohort of HF patients using EntropyXQT, a novel non-linear measure of cardiac repolarization dynamics. Methods and results: In a prospective, multicentre, observational study of 852 patients in sinus rhythm undergoing clinically indicated primary prevention implantable cardioverter-defibrillator (ICD) implantation (2003-10), exposures included demographics, history, physical examination, medications, laboratory results, serum biomarkers, ejection fraction, conventional electrocardiographic (ECG) analyses of heart rate and QT variability, and EntropyXQT. The primary outcome was first 'appropriate' ICD shock for ventricular arrhythmias. The secondary outcome was composite events (appropriate ICD shock and all-cause mortality). After exclusions, the cohort (n = 816) had a mean age of 60±13 years, 28% women, 36% African Americans, 56% ischaemic cardiomyopathy, and 29±16% Seattle HF risk score (SHFS) 5-year predicted mortality. Over 45±24 months, there were 134 appropriate shocks and 166 deaths. After adjusting for 30 exposures, the hazard ratios (comparing the 5th to 1st quintile of EntropyXQT) for primary and secondary outcomes were 3.29 (95% CI 1.74-6.21) and 2.28 (1.53-3.41), respectively. Addition of EntropyXQT to a model comprised of the exposures or SHFS significantly increased net reclassification and the ROC curve area. Conclusions: EntropyXQT measured during ICD implantation strongly and independently predicts appropriate shock and all-cause mortality over follow-up. EntropyXQT complements conventional risk predictors and has the potential for broad clinical application.Environmental metals and cardiovascular disease
AbstractTellez-Plaza, M., Guallar, E., & Navas-Acien, A. (n.d.).Publication year
2018Journal title
BMJ (Online)Volume
362AbstractMetals are an important but neglected source of CV risk.Erratum : A dose-response meta-analysis of chronic arsenic exposure and incident cardiovascular disease First (Int J Epidemiol (2017) 46: 6 (1924-1939) DOI: 10.1093/ije/dyx202)
AbstractMoon, K. A., Oberoi, S., Barchowsky, A., Chen, Y., Guallar, E., Nachman, K. E., Rahman, M., Sohel, N., D'Ippoliti, D., Wade, T. J., James, K. A., Farzan, S. F., Karagas, M. R., Ahsan, H., & Navas-Acien, A. (n.d.).Publication year
2018Journal title
International Journal of EpidemiologyVolume
47Issue
3Page(s)
1013AbstractThere was an error in the statistical code used to generate the results presented in this article. The error affected the calculation of the second spline term and the prediction of relative risks in the restricted cubic spline models used for non-linear dose-response analyses in Table 2 and Figure 2 of the manuscript. Corrections have been made to Table 2, Figure 2 and where necessary in the text (page 1931, right column; page 1932, right column) to reflect the correct results. These changes do not affect the conclusions of the manuscript, which remain unchanged.Erratum : Long-Term Air Pollution Exposure and Mitochondrial DNA Copy Number: An Analysis of UK Biobank Data (Environ Health Perspect, (2023), 131, 5, 057703, 10.1289/EHP11946)
AbstractHong, Y. S., Battle, S. L., Puiu, D., Shi, W., Pankratz, N., Zhao, D., Arking, D. E., & Guallar, E. (n.d.).Publication year
2025Journal title
Environmental health perspectivesVolume
133Issue
5AbstractIn the second paragraph of the Introduction, the definition of particulate matters was incorrectly described as >10 lm in aerodynamic diameter for PM10 when it should have been ≤10 lm. Additionally, ≤2:5 lg should have been ≤2:5 lm. The corresponding sentence should have been described as follows: “We therefore evaluated the association between long-term exposure to air pollution [particulate matter ≤10 lm (PM10) and ≤2:5 lm in aerodynamic diameter (PM2:5), black carbon, and nitrogen dioxide (NO2)] with mtDNA-CN in over 45,000 adults from the UK Biobank study.” The authors regret the error.Erratum : Risk factors control for primary prevention of cardiovascular disease in men: Evidence from the Aragon Workers Health Study (AWHS) (PLoS ONE (2018) 13:2 0e0193541) DOI: 10.1371/journal.pone.0193541)
AbstractAguilar-Palacio, I., Malo, S., Feja, C., Lallana, M., León-Latre, M., Casasnovas, J. A., Rabanaque, M., & Guallar, E. (n.d.).Publication year
2020Journal title
PloS oneVolume
15Issue
2AbstractIn the Funding section, the information provided is incomplete. The complete, correct Funding section is: This work was supported by the Instituto de Salud Carlos III and Fondo Europeo de Desarrollo Regional (FEDER). PI13/01668 (http://www.isciii.es).