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Regassa LD, Tola A, Ayele Y. Prevalence of Cardiovascular Disease and Associated Factors Among Type 2 Diabetes Patients in Selected Hospitals of Harari Region, Eastern Ethiopia. Front Public Health 2021; 8:532719. [PMID: 33614562 PMCID: PMC7892600 DOI: 10.3389/fpubh.2020.532719] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 12/21/2020] [Indexed: 12/28/2022] Open
Abstract
Background: Cardiovascular disease (CVD) is the most prevalent complication and the leading cause of death among patients with diabetes mellitus (DM). Type 2 diabetes mellitus (T2DM) patients have a 2- to 4-fold increased risk of CVD. There is a scarcity of data about the magnitude of CVD among patients with diabetes in Ethiopia. This study aimed to assess the prevalence and associated factors of CVD among T2DM patients at selected hospitals of Harari regional state of Ethiopia. Methods: This hospital-based retrospective data review was conducted among T2DM patients on follow-up in the diabetes clinics of selected hospitals of Harari regional state. The records of T2DM patients who have been diagnosed between January 1, 2013, and December 31, 2017, were reviewed from March to April 2018. Data were collected by using structured checklists from all necessary documents of T2DM patients. Statistical analysis was done using STATA 14.1. Bivariate and multivariate logistic regressions were used to identify factors associated with CVD. Result: The records of 454 T2DM patients were extracted from three government hospitals in Harari regional state. Their age was ranging from 15 to 86 years with a mean age (±SD) of 45.39 (14.76). The overall prevalence of CVD among T2DM patients was 42.51%, composed of hypertensive heart diseases (38.99%), heart failure (6.83%), and stroke (2.20%). The final multivariate logistic regression model revealed that age older than 60 years [adjusted odds ratio (AOR) = 3.22; 95% CI: 1.71-6.09], being physically inactive (AOR = 1.45; 95 CI: 1.06-2.38), drinking alcohol (AOR = 2.39; 95% CI: 1.17-6.06), hypertension (AOR = 2.41; 95% CI: 1.52-3.83), body mass index >24.9 kg/m2 (AOR = 1.81; 95% CI: 1.07-3.07), and experiencing microvascular diabetic complications (AOR = 3.62; 95% CI: 2.01-6.53) were significantly associated with the odds of having CVD. Conclusion: The prevalence of CVD was high and associated with advanced age, physical inactivity, drinking alcohol, higher body mass index, hypertension, and having microvascular complications. Health care workers should educate T2DM patients about healthy lifestyles like physical activity, weight reduction, blood pressure control, and alcohol secession, which can reduce the risk of CVD.
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Affiliation(s)
- Lemma Demissie Regassa
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Assefa Tola
- Department of Epidemiology and Biostatistics, School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yohanes Ayele
- Department of Clinical Pharmacy, School of Pharmacy, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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Alam MT, Echeverria SE, DuPont-Reyes MJ, Vasquez E, Murillo R, Gonzalez T, Rodriguez F. Educational Attainment and Prevalence of Cardiovascular Health (Life's Simple 7) in Asian Americans. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18041480. [PMID: 33557415 PMCID: PMC7914420 DOI: 10.3390/ijerph18041480] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/25/2021] [Accepted: 02/02/2021] [Indexed: 11/16/2022]
Abstract
Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.
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Affiliation(s)
- Md Towfiqul Alam
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
- Correspondence:
| | - Sandra E. Echeverria
- Department of Public Health Education, University of North Carolina at Greensboro, Greensboro, NC 27412, USA;
| | - Melissa J. DuPont-Reyes
- Department of Epidemiology & Biostatistics, Texas A&M University, College Station, TX 77843, USA;
| | - Elizabeth Vasquez
- Department of Epidemiology & Biostatistics, University at Albany, Albany, NY 12144, USA;
| | - Rosenda Murillo
- Department of Psychological, Health, & Learning Sciences, University of Houston, Houston, TX 77204, USA;
| | - Tailisha Gonzalez
- Department of Community Health, CUNY Graduate School of Public Health & Health Policy, New York, NY 10027, USA;
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine, Stanford University, Quarry Road, Falk CVRC, Stanford, CA 94305, USA;
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Ogunmoroti O, Osibogun O, McClelland RL, Lazo M, Mathews L, Okunrintemi V, Oni ET, Burke GL, Michos ED. Alcohol type and ideal cardiovascular health among adults of the Multi-Ethnic Study of Atherosclerosis. Drug Alcohol Depend 2021; 218:108358. [PMID: 33162252 PMCID: PMC7750284 DOI: 10.1016/j.drugalcdep.2020.108358] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND Light to moderate alcohol consumption is associated with favorable cardiovascular health (CVH). However, the association between alcohol type and ideal CVH has not been well-established. We examined the relationship between alcohol type and ideal CVH as measured by the American Heart Association's seven CVH metrics. METHODS We analyzed data from 6,389 men and women aged 45-84 years from a multi-ethnic cohort free of cardiovascular disease. Alcohol type (wine, beer and liquor) was categorized as never, former, 0 but drink other alcohol types, >0 but <1 drink/day, 1-2 drinks/day and >2 drinks/day. A CVH score ranging from 0 to 14 points was created from the seven CVH metrics (Inadequate score, 0-8; average, 9-10; optimal, 11-14). We used multinomial logistic regression to examine the association between alcohol type and CVH, adjusting for age, sex, race/ethnicity, education, income, health insurance, field site and total calorie intake. RESULTS The mean (SD) age of participants was 62 (10) years and 53 % were women. Participants who consumed 1-2 drinks/day of wine had higher odds of optimal CVH scores compared to those who never drank wine [adjusted prevalence odds ratio (POR) 1.64 (1.12-2.40)]. In comparison to participants who never drank beer, those who consumed >2 drinks/day of beer had lower odds of optimal CVH scores [0.31 (0.14-0.69)]. Additionally, those who consumed >2 drinks/day of liquor had lower odds of optimal scores compared to those who never drank liquor [0.32 (0.16-0.65)]. CONCLUSION Moderate consumption of wine was associated with favorable CVH. However, heavy consumption of beer or liquor was associated with poorer CVH.
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Affiliation(s)
- Oluseye Ogunmoroti
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
| | - Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL
| | | | - Mariana Lazo
- Division of General Internal Medicine, Johns Hopkins School of Medicine and Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health
| | - Lena Mathews
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Victor Okunrintemi
- Department of Internal Medicine, East Carolina University, Greenville, NC
| | - Ebenezer T. Oni
- Division of Cardiology, Albert Einstein Medical Center, Philadelphia, PA
| | - Gregory L. Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Erin D. Michos
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD
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Elkind MSV, Lisabeth L, Howard VJ, Kleindorfer D, Howard G. Approaches to Studying Determinants of Racial-Ethnic Disparities in Stroke and Its Sequelae. Stroke 2020; 51:3406-3416. [PMID: 33104476 DOI: 10.1161/strokeaha.120.030424] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Disparities are differences in health outcomes among groups that originate from sources including historically experienced social injustice and broadly defined environmental exposures. Large health disparities exist, defined by many factors including race/ethnicity, sex, age, geography, and socioeconomic status. Studying disparities relies on measures of disease burden. Traditional measures, such as mortality, may be less applicable to neurological disorders, which often lead to substantial morbidity and lower quality of life, without necessarily causing death. Measures such as disability-adjusted life-years or healthy life expectancy may be more appropriate for assessing neurological disease and permit comparisons across diseases and communities. There are many approaches that can be used to study disparities. Analyses of population-based observational studies, patient registries, and administrative data all contribute to the understanding of disparities in humans. Animal and other experimental designs, including clinical trials, may be used to identify mechanisms and strategies to reduce disparities. All of these approaches have strengths and weaknesses. Ultimately, understanding and mitigating disparities will require use of all of these methods. Crucially, a focus on not only improving outcomes among all individuals in society but minimizing or eliminating differences between those with better outcomes and those who have historically been disadvantaged should drive the ongoing investigations into disparities. This review is focused on epidemiological approaches to examining the depth and determinants of racial-ethnic disparities in the United States related to stroke, stroke care, and stroke outcomes.
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Affiliation(s)
- Mitchell S V Elkind
- Department of Neurology, Vagelos College of Physicians and Surgeons (M.S.V.E.), Columbia University, New York, NY.,Department of Epidemiology, Mailman School of Public Health (M.S.V.E.), Columbia University, New York, NY
| | - Lynda Lisabeth
- Department of Epidemiology, School of Public Health (L.L.), University of Michigan, Ann Arbor
| | - Virginia J Howard
- Department of Epidemiology, School of Public Health (V.J.H.), University of Alabama at Birmingham
| | - Dawn Kleindorfer
- Department of Neurology (D.K.), University of Michigan, Ann Arbor
| | - George Howard
- Department of Biostatistics, UAB School of Public Health (G.H.), University of Alabama at Birmingham
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Lakshmanan S, Kinninger A, Golub I, Dahal S, Birudaraju D, Ahmad K, Ghanem AK, Rezvanizadeh V, Roy SK, Budoff MJ. 20-Year trend of high prevalence of zero coronary artery calcium in beach cities of Southern California: A blue zone? Am J Prev Cardiol 2020; 4:100098. [PMID: 34327474 PMCID: PMC8315595 DOI: 10.1016/j.ajpc.2020.100098] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 10/06/2020] [Accepted: 10/10/2020] [Indexed: 12/14/2022] Open
Abstract
Background Blue zones are longevity hotspots around the world characterized by highest concentrations of healthy centenarians. Certified blue zone communities are designed by implementation of environmental and policy changes that promote healthy behaviors. Objective To examine the trends of prevalence of zero CAC, a marker of ideal cardiovascular and overall health status and burden of cardiovascular risk factors in Beach Cities/certified blue zones of Southern California and rest of California. Methods This is a population-based cohort study of persons aged 50 years or older in California, who underwent CAC screening between 2000 and 2019. A total of 3864 participants from Beach Cities of Southern California were identified by Zip Codes and compared with 35,537 participants from rest of California. We compared trends of prevalence of zero CAC and cardiovascular risk factors between the two groups, in 5-year intervals. Results Among 39,401 participants (mean age, 58.1 years; 36% women), 13,374 (34%) had zero CAC. The prevalence of CAC = 0 was significantly higher in Beach Cities compared to the rest of California (p < 0.001). Across the study period, the prevalence of cardiac risk factors including obesity, smoking, diabetes and hypertension remain significantly lower in Beach Cities. (p < 0.001) Conclusions This study, shows for the first time, that higher prevalence of zero CAC in Beach Cities of California, adds validity to excellent prognosis and longevity in these areas. The impact of policy implementation and environmental changes on lifestyle patterns, cardiovascular health and healthy ageing needs to be evaluated.
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Affiliation(s)
- Suvasini Lakshmanan
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - April Kinninger
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Ilana Golub
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Suraj Dahal
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Divya Birudaraju
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Khadije Ahmad
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Ahmad K Ghanem
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Vahid Rezvanizadeh
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Sion K Roy
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
| | - Matthew J Budoff
- Lundquist Institute of Biomedical Innovation and Research at Harbor UCLA Medical Center, Torrance, CA, USA
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