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Konty KJ, Day SE, Larkin M, Thompson HR, D’Agostino EM. Physical fitness disparities among New York City public school youth using standardized methods, 2006-2017. PLoS One 2020; 15:e0227185. [PMID: 32271758 PMCID: PMC7144992 DOI: 10.1371/journal.pone.0227185] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 12/13/2019] [Indexed: 12/23/2022] Open
Abstract
Standardized physical fitness monitoring provides a more accurate proxy for youth health when compared with physical activity. Little is known about the utilization of broad-scale individual-level youth physical fitness testing to explore health disparities. We examined longitudinal trends in population-level fitness for 4th-12th grade New York City youth during 2006/7-2016/17 (average n = 510,293 per year). Analyses were performed in 2019. The primary outcome was whether or not youth achieved sex-/age-specific performance levels (called the Healthy Fitness Zone) on the aerobic capacity, muscular strength and muscular endurance tests using the NYC FITNESSGRAM. The Cooper Institute’s most recent Healthy Fitness Zone criteria were applied to all tests and years. Prevalence estimates were weighted, accounted for school clustering, adjusted for student-level sociodemographics, and run by sociodemographic subgroups and year. The overall prevalence for meeting 3 Healthy Fitness Zones increased from 15.5% (95%CI: 13.9%-17.0%) in 2006/7 to 23.3% (95%CI: 22.2%-24.4%) in 2016/17 for students in grades 4–12. Fitness for all student groups increased over time, although Hispanic and non-Hispanic black girls consistently had the lowest prevalence of meeting 3 Healthy Fitness Zones as compared to all other race/sex subgroups. Also, 9th-12th graders had a lower prevalence of meeting 3 Healthy Fitness Zones as compared to 4th-8th graders. Given forecasted sharp increases in cardiovascular disease prevalence, routine youth fitness surveillance using standardized, criterion referenced methods can identify important fitness disparities and inform interventions.
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Affiliation(s)
- Kevin J. Konty
- NYC Department of Health and Mental Hygiene, Office of School Health, New York City, New York, United States of America
| | - Sophia E. Day
- NYC Department of Health and Mental Hygiene, Office of School Health, New York City, New York, United States of America
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Heath Policy, City University of New York, New York City, New York, United States of America
| | - Michael Larkin
- Learning, Teaching and Assessment, Plainedge School District, Massapequa, NY, United States of America
| | - Hannah R. Thompson
- Department of Community Health Sciences, School of Public Health, University of California Berkley, Berkeley, California, United States of America
| | - Emily M. D’Agostino
- Department of Epidemiology and Biostatistics, Graduate School of Public Health and Heath Policy, City University of New York, New York City, New York, United States of America
- Department of Family Medicine and Community Health, Duke University School of Medicine, Durham, North Carolina, United States of America
- * E-mail:
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Kris-Etherton PM, Petersen KS, Velarde G, Barnard ND, Miller M, Ros E, O'Keefe JH, Williams K, Horn LV, Na M, Shay C, Douglass P, Katz DL, Freeman AM. Barriers, Opportunities, and Challenges in Addressing Disparities in Diet-Related Cardiovascular Disease in the United States. J Am Heart Assoc 2020; 9:e014433. [PMID: 32200727 PMCID: PMC7428614 DOI: 10.1161/jaha.119.014433] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
In the United States, cardiovascular disease (CVD) is the leading cause of death and disability. Suboptimal diet quality is responsible for a greater percentage of CVD-related morbidity and mortality than any other modifiable risk factor. Further troubling are the stark racial/ethnic and socioeconomic disparities in diet quality. This represents a major public health concern that urgently requires a coordinated effort to better characterize the barriers to healthy dietary practices in population groups disproportionally affected by CVD and poor diet quality to inform multifaceted approaches at the government (policy), community environment, sociocultural, and individual levels. This paper reviews the barriers, opportunities, and challenges involved in shifting population behaviors, especially in underserved populations, toward healthy dietary practices. It is imperative that public health policies address the social determinants of nutrition more intensively than previously in order to significantly decrease CVD on a population-wide basis.
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Affiliation(s)
- Penny M Kris-Etherton
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Kristina S Petersen
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Gladys Velarde
- Division of Cardiology Department of Medicine University of Florida Jacksonville FL
| | - Neal D Barnard
- Adjunct Faculty George Washington University School of Medicine Physicians Committee for Responsible Medicine Washington DC
| | - Michael Miller
- Department of Medicine University of Maryland School of Medicine Baltimore MD
| | - Emilio Ros
- Lipid Clinic Endocrinology and Nutrition Service Institut d'Investigacions Biomediques August Pi Sunyer Hospital Clinic University of Barcelona, and Centro de Investigación Biomédica en Red (CIBER) Fisiopatología de la Obesidad y Nutrición Instituto de Salud Carlos III Madrid Spain
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute School of Medicine University of Missouri-Kansas City MO
| | | | - Linda Van Horn
- Department of Preventive Medicine Feinberg School of Medicine Northwestern University Chicago IL
| | - Muzi Na
- Department of Nutritional Sciences The Pennsylvania State University University Park PA
| | - Christina Shay
- Center for Health Metrics and Evaluation American Heart Association American Heart Association Dallas TX
| | - Paul Douglass
- Wellstar Medical Group, Metro Atlanta Cardiovascular Medicine Atlanta GA
| | - David L Katz
- Yale-Griffin Prevention Research Center Derby CT
| | - Andrew M Freeman
- Division of Cardiology Department of Medicine National Jewish Health Denver CO
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54
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Movsisyan NK, Vinciguerra M, Medina-Inojosa JR, Lopez-Jimenez F. Cardiovascular Diseases in Central and Eastern Europe: A Call for More Surveillance and Evidence-Based Health Promotion. Ann Glob Health 2020; 86:21. [PMID: 32166066 PMCID: PMC7059421 DOI: 10.5334/aogh.2713] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Objectives The paper aims to identify the priorities for cardiovascular health promotion research in Central and Eastern Europe (CEE), the region with the highest cardiovascular diseases (CVD) burden in the world. Methods This narrative review covered peer-reviewed publications and online databases using a nonsystematic purposive approach. Results In despite of a steady decrease in CVD burden in the region, the East-West disparities are still significant. There is minimal continuity in the past and current CVD prevention efforts in the region. Many challenges still exist, including an opportunity gap in research funding, surveillance and population-based preventive interventions. A comprehensive approach focusing on multisectoral cooperation, quality and accessibility of healthcare and equity-oriented public policies and supported by well-designed epidemiologic studies is needed to overcome these challenges. Conclusion The current level of effort is not adequate to address the magnitude of the CVD epidemic in CEE. It is imperative to strengthen the epidemiological base concerning cardiovascular health in the region, to foster surveillance and progress in implementation of CVD preventive strategies in the most affected populations of Europe.
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Affiliation(s)
- Narine K. Movsisyan
- International Clinical Research Center, St. Anne’s University Hospital, Brno, CR
| | - Manlio Vinciguerra
- International Clinical Research Center, St. Anne’s University Hospital, Brno, CR
| | - Jose R. Medina-Inojosa
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, US
| | - Francisco Lopez-Jimenez
- Division of Preventive Cardiology, Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, US
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55
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Sidebottom AC, Benson G, Vacquier M, Pereira R, Hayes J, Boersma P, Boucher JL, Lindberg R, Pribyl B, VanWormer JJ. Population-Level Reach of Cardiovascular Disease Prevention Interventions in a Rural Community: Findings from the Heart of New Ulm Project. Popul Health Manag 2020; 24:86-100. [PMID: 31971871 PMCID: PMC7875136 DOI: 10.1089/pop.2019.0196] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
This study examines participation by residents of a rural community in programs implemented as part of The Heart of New Ulm (HONU) Project, a population-based cardiovascular disease (CVD) prevention initiative. The study compares participation rates for the various interventions to assess which were the most engaging in the priority community and identifies factors that differentiate participants vs. nonparticipants. Participation data were merged with electronic health record (EHR) data representing the larger community population to enable an analysis of participation in the context of the entire community. HONU individual-level interventions engaged 44% of adult residents in the community. Participation ranked as follows: (1) heart health screenings (37% of adult residents), (2) a year-long community weight loss intervention (12% of adult residents), (3) community health challenges (10% of adult residents), and (4) a phone coaching program for invited high CVD-risk residents (enrolled 6% of adult residents). Interventions that yielded the highest engagement were those that had significant staffing and recruited participants over several months, often with many opportunities to participate or register. Compared to nonparticipants, HONU participants were significantly older and a higher proportion were female, married, overweight or obese, and had high cholesterol. Participants also had a lower prevalence of smoking and diabetes than nonparticipants. Findings indicate community-based CVD prevention initiatives can be successful in engaging a high proportion of adult community members. Partnering with local health care systems can allow for use of EHR data to identify eligible participants and evaluate reach and engagement of the priority population.
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Affiliation(s)
| | - Gretchen Benson
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Marc Vacquier
- Care Delivery Research, Allina Health, Minneapolis, Minnesota, USA
| | - Raquel Pereira
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Joy Hayes
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | - Peter Boersma
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | | | - Rebecca Lindberg
- Population Health, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota, USA
| | | | - Jeffrey J VanWormer
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Institute, Marshfield, Wisconsin, USA
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Dean CA, Zhang D, Kulchycki KT, Ventline B, Jagirdar R, Milan RA. Social Determinants of Cardiovascular Disease among Michigan Residents: A Call to Action for Population Health Initiatives. J Racial Ethn Health Disparities 2019; 7:144-161. [PMID: 31713223 DOI: 10.1007/s40615-019-00644-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 08/30/2019] [Accepted: 09/24/2019] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Little is known about the cardiovascular health (CVH) and social determinants of cardiovascular diseases (SDCVDs) among Michigan residents by race and ethnicity. Therefore, the objective of this cross-sectional study was to determine the CVH of Michigan residents and to examine the relationship between CVH and SDCVDs by race/ethnicity and age. METHODOLOGY Michigan-level data consisting of 10,889 participants was extracted from the 2017 Behavioral Risk Factor Surveillance System data. Descriptive statistics examined the adjusted proportions of the CVH measures and determined the adjusted mean CVH score for the SDCVDs among racial/ethnic groups by age. Generalized ordinal logistic regression analyses assessed the relationship between residents' CVH and SDCVDs by racial/ethnic status. All analyses were performed using STATA MP14. RESULTS Residents from each racial/ethnic group did not meet the criteria for ideal BMI. The mean CVH score was found to be low for Black (2.65; 95% CI, 2.41-2.89) and Hispanic (2.84; 95% CI, 2.29-3.40) residents ≥ 50 years old with a high school degree or less. Black residents unemployed for more than a year were less likely to have a high CVH score (OR = 0.45; 95% CI, 0.21-80.97) compared with Black residents employed for wages. CONCLUSION Michigan residents' CVH is lacking across multiple dimensions. Multifaceted population health initiatives are warranted to address influential SDCVDs to diminish the CVH disparities identified across racial/ethnic and age groups.
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Affiliation(s)
- Caress A Dean
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA.
| | - Diana Zhang
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Kevin T Kulchycki
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Brittany Ventline
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Rachita Jagirdar
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
| | - Rebecca A Milan
- Department of Public and Environmental Wellness, School of Health Sciences, Oakland University, 433 Meadow Brook Road, Rochester, MI, 48309-4452, USA
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57
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Mosińska P, Martín-Ruiz M, González A, López-Miranda V, Herradón E, Uranga JA, Vera G, Sánchez-Yáñez A, Martín-Fontelles MI, Fichna J, Abalo R. Changes in the diet composition of fatty acids and fiber affect the lower gastrointestinal motility but have no impact on cardiovascular parameters: In vivo and in vitro studies. Neurogastroenterol Motil 2019; 31:e13651. [PMID: 31145538 DOI: 10.1111/nmo.13651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/30/2019] [Accepted: 05/17/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND Food and diet are central issues for proper functioning of the cardiovascular (CV) system and gastrointestinal (GI) tract. We hypothesize that different types of dietary FAs affect CV parameters as well as GI motor function and visceral sensitivity. METHODS Male Wistar rats were fed with control diet (CTRL), diet supplemented with 7% soybean oil (SOY), SOY + 3.5% virgin coconut oil (COCO), and SOY + 3.5% evening primrose oil (EP) for 4 weeks. The content of insoluble fiber in CTRL was higher than in SOY, COCO, or EP. Body weight gain and food/water intake were measured. At day 28, biometric, biochemical, CV parameters, GI motor function (X-ray and colon bead expulsion test), and visceral sensitivity were evaluated. Changes in propulsive colonic activity were determined in vitro. The colon and adipose tissue were histologically studied; the number of mast cells (MCs) in the colon was calculated. RESULTS SOY, COCO, and EP had increased body weight gain but decreased food intake vs CTRL. Water consumption, biometric, biochemical, and CV parameters were comparable between groups. SOY increased the sensitivity to colonic distention. All groups maintained regular propulsive neurogenic contractions; EP delayed colonic motility (P < 0.01). SOY, COCO, and EP displayed decreased size of the cecum, lower number and size of fecal pellets, and higher infiltration of MCs to the colon (P < 0.001). CONCLUSIONS AND INFERENCES Dietary FAs supplementation and lower intake of insoluble fiber can induce changes in the motility of the lower GI tract, in vivo and in vitro, but CV function and visceral sensitivity are not generally affected.
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Affiliation(s)
- Paula Mosińska
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Marta Martín-Ruiz
- Departamento de Biología, Facultad de Ciencias, Universidad Autónoma de Madrid, Madrid, Spain
| | - Antonio González
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Visitación López-Miranda
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.,Unidad Asociada al Instituto de Química Medica (IQM) del Consejo Superior de Investigaciones Científicas (CSIC), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Esperanza Herradón
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.,Unidad Asociada al Instituto de Química Medica (IQM) del Consejo Superior de Investigaciones Científicas (CSIC), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - José A Uranga
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Gema Vera
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.,Unidad Asociada al Instituto de Química Medica (IQM) del Consejo Superior de Investigaciones Científicas (CSIC), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Adrián Sánchez-Yáñez
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Mª Isabel Martín-Fontelles
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.,Unidad Asociada al Instituto de Química Medica (IQM) del Consejo Superior de Investigaciones Científicas (CSIC), Universidad Rey Juan Carlos, Alcorcón, Spain
| | - Jakub Fichna
- Department of Biochemistry, Faculty of Medicine, Medical University of Lodz, Lodz, Poland
| | - Raquel Abalo
- Departamento de Ciencias Básicas de la Salud, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Alcorcón, Spain.,Unidad Asociada al Instituto de Química Medica (IQM) del Consejo Superior de Investigaciones Científicas (CSIC), Universidad Rey Juan Carlos, Alcorcón, Spain
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58
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Hand GA. A Scoping Review of Positive Lifestyle and Wellness Interventions to Inform the Development of a Comprehensive Health Promotion Program: "HealthPro." A Commentary to Schuette and Colleagues (2018). Am J Lifestyle Med 2019; 13:351-353. [PMID: 31285715 PMCID: PMC6600615 DOI: 10.1177/1559827619840637] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Song M, Li N, Yao Y, Wang K, Yang J, Cui Q, Geng B, Chen J, Wang Y, Cheng W, Zhou Y. Longitudinal association between serum uric acid levels and multiterritorial atherosclerosis. J Cell Mol Med 2019; 23:4970-4979. [PMID: 31240862 PMCID: PMC6652300 DOI: 10.1111/jcmm.14337] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 03/12/2019] [Accepted: 03/29/2019] [Indexed: 01/19/2023] Open
Abstract
Multiterritorial atherosclerosis has dramatically increased annual risk of adverse cardiovascular events than atherosclerotic disease with single-artery affected. Serum uric acid (SUA) is an important predictor of stroke and atherosclerosis; however, which is supported by few direct evidence based on cohort studies. A prospective cohort study including 2644 North Chinese adults aged ≥40 years was performed in 2010-2012 to investigate the association between SUA and multiterritorial vascular stenosis. Hyperuricaemia was defined as SUA levels >6 and >7 mg/dL for males and females, respectively. All participants underwent twice transcranial Doppler (TCD) and bilateral carotid duplex ultrasound to evaluate intracranial artery stenosis (ICAS) and extracranial arterial stenosis (ECAS) and peripheral arterial disease (PAD) was determined by ankle-brachial index (ABI) on January 2010 and January 2012 based on regular health check-ups. The cumulative incidence of vascular stenosis was significantly higher in subjects with hyperuricaemia than in those without hyperuricaemia (54.1% vs. 34.7%, P < 0.001). The adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for new on-set vascular stenosis due to hyperuricaemia and a 1-mg/dL change in SUA level were 1.75 (1.32-2.31) and 1.29 (1.21-1.38), respectively. Furthermore, in the gender-stratified analysis, the association between SUA levels and ICAS was statistically significant in males (OR: 2.02; 95% CI: 1.18-3.46), but not females (OR: 0.85, 95% CI: 0.41-1.76, P for interaction: 0.026).
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Affiliation(s)
- Meiyue Song
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Na Li
- Department of Health Care, China-Japan Friendship Hospital, Ministry of Health, Beijing, China
| | - Yan Yao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Kaile Wang
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Jichun Yang
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Qinghua Cui
- Department of Physiology and Pathophysiology, Peking University Health Science Center, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Jianxin Chen
- Beijing University of Chinese Medicine and China-Japan Friendship Hospital, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Wenli Cheng
- Department of Hypertension, Beijing Anzhen Hospital and Capital Medical University, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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Onion DK, Prior RE, Record NB, Record SS, Cayer GR, Amos CI, Pearson TA. Assessment of Mortality and Smoking Rates Before and After Reduction in Community-wide Prevention Programs in Rural Maine. JAMA Netw Open 2019; 2:e195877. [PMID: 31199453 PMCID: PMC6575143 DOI: 10.1001/jamanetworkopen.2019.5877] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
IMPORTANCE It is unclear whether effective population-wide interventions that reduce risk factors and improve health result in sustained benefits to a community's health. If benefits do persist after a program is ended, interventions could be brief rather than maintained long term. OBJECTIVE To measure mortality and smoking rates in a rural community over decades before, during, and after prevention program reductions. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study compared smoking and mortality rates in a rural Maine county with other Maine counties over time by 5-year intervals. Multiple changes occurred between 2001 and 2015 in the physiological and behavioral risk factor reduction programs offered in the county. They included reductions in leadership, staff, institutional resources, data monitoring, and the programs themselves. Data were analyzed from May 2018 to March 2019. INTERVENTION Previous multifaceted interventions and outcome monitoring were withdrawn or diminished in the past decade. MAIN OUTCOMES AND MEASURES Smoking and age-adjusted mortality rates vs household income. RESULTS Reduced mortality rates in Franklin County in 1986 to 2005 reverted to those predicted by household incomes, relative to other Maine counties, by 2006 to 2015 (1986-1990 T score = -2.86 [P = .01] and 2001-2005 T score = -3.00 [P = .01] to 2006 to 2010 T score = -0.43 [P = .67] and 2011-2015 T score = -0.72 [P = .48]). Analysis of County Health Rankings data from 2010 to 2018 also showed that Franklin County's outcomes have reverted to no better than predicted by socioeconomic status. The county's T scores increased from -3.62 (P = .003) in 2010 to -0.41 (P = .69) in 2015 to 0.13 (P = .90) in 2018. Statewide association of income with mortality by analyses of variance showed that the R2 values have increased from the decades preceding 2000 (1976-1980, R2 = 0.21; P = .08; 1986-1990, R2 = 0.32; P = .02) to 2006 to 2010 (R2 = 0.73; P < .001) and 2011 to 2015 (R2 = 0.70; P < .001). CONCLUSIONS AND RELEVANCE This study suggests that gains associated with population health interventions may be lost when the interventions are reduced. Adjusting outcome measures for socioeconomic status may allow quicker and more sensitive monitoring of intervention adequacy and success. The increasing trend of age-adjusted mortality in Maine and nationally to correlate inversely with incomes may warrant further community interventions, especially for poorer populations.
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Affiliation(s)
- Daniel K. Onion
- Maine-Dartmouth Family Medicine Residency, MaineGeneral Medical Center, Augusta
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
| | | | | | | | | | - Christopher I. Amos
- Department of Community and Family Medicine, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire
- Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Thomas A. Pearson
- College of Medicine and Public Health and Health Professions, University of Florida, Gainesville
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Magriplis E, Sialvera TE, Papadopoulou A, Efstathiou SP, Trautwein EA, Goumas G, Dimakopoulos I, Papavasiliou K, Koutsouri A, Zampelas A. Effectiveness and easiness of adherence to behavioural guidelines for diet and lifestyle changes for cholesterol‐lowering: the Increasing Adherence of Consumers to Diet & Lifestyle Changes to Lower (
LDL
) Cholesterol (
ACT
) randomised controlled trial. J Hum Nutr Diet 2019; 32:607-618. [DOI: 10.1111/jhn.12667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Affiliation(s)
- E. Magriplis
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - T. E. Sialvera
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - A. Papadopoulou
- Center for Cardiovascular Disease Prevention Hygeias Melathron Infirmary Athens Greece
| | - S. P. Efstathiou
- Center for Cardiovascular Disease Prevention Hygeias Melathron Infirmary Athens Greece
| | | | - G. Goumas
- Department of Cardiology Euroclinic Athens Greece
| | - I. Dimakopoulos
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | - K. Papavasiliou
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
| | | | - A. Zampelas
- Department of Food Science and Human Nutrition School of Food, Biotechnology and Development Agricultural University of Athens Athens Greece
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Grabovac I, Smith L, Stefanac S, Haider S, Cao C, Waldhoer T, Jackson SE, Yang L. Health Care Providers' Advice on Lifestyle Modification in the US Population: Results from the NHANES 2011-2016. Am J Med 2019; 132:489-497.e1. [PMID: 30521796 DOI: 10.1016/j.amjmed.2018.11.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 11/09/2018] [Accepted: 11/09/2018] [Indexed: 11/24/2022]
Abstract
OBJECTIVE Health care providers are encouraged to prescribe lifestyle modifications for preventing and managing obesity and associated chronic conditions. However, the pattern of lifestyle advice provision is unknown. We investigate the prevalence of advised lifestyle modification according to weight status and chronic conditions in a US nationally representative sample. METHODS Adults ages 20-64years (n = 11,467) from the National Health and Nutrition Examination Survey between 2011 and 2016 were analyzed, with weight status and chronic conditions (high blood pressure, high blood cholesterol, osteoarthritis, coronary heart disease, and type 2 diabetes mellitus). Lifestyle modification advice by health care providers included: increase physical activity/exercise, reduce dietary fat/calories, control/lose weight, and all of the above. RESULTS High blood pressure (32.7%) and cholesterol (29.3%) were highly prevalent compared with osteoarthritis (7.4%), type 2 diabetes (5.7%), and coronary heart disease (3.7%). Those with type 2 diabetes received considerably more frequent advice (56.5%; 95% confidence interval [CI], 52.4%-60.6%) than those with high blood pressure (31.4%; 95% CI, 29.3%-33.6%) and cholesterol (27.0%; 95% CI, 24.9%-29.3%). Prevalence of lifestyle advice exhibited substantial increases with graded body mass index and comorbidity (all P < .001). After adjusting for comorbid conditions, advice was more commonly reported among women, those overweight/obese, nonwhite, or insured. A remarkably low proportion of overweight (21.4; 95% CI, 18.7%-24.3%) and obese (44.2%; 95% CI, 41.0%-47.4%) adults free of chronic conditions reported receiving any lifestyle advice. CONCLUSIONS Prevalence of lifestyle modification advised by health care providers is generally low among US adults with chronic conditions, and worryingly low among those without chronic conditions, however overweight or obese. Prescribed lifestyle modification is a missing opportunity in implementing sustainable strategies to reduce chronic condition burden.
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Affiliation(s)
- Igor Grabovac
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Lee Smith
- Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Compass House, Cambridge, UK
| | - Sinisa Stefanac
- Institute of Outcomes Research, Center for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Austria; Ludwig Boltzmann Cluster Arthritis and Rehabilitation, Vienna, Austria.
| | - Sandra Haider
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Austria
| | - Chao Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, StLouis, Mo
| | - Thomas Waldhoer
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria
| | - Sarah E Jackson
- Department of Behavioral Science and Health, University College London, UK
| | - Lin Yang
- Department of Epidemiology, Center for Public Health, Medical University of Vienna, Austria; Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Holy Cross Centre, Calgary, Alberta, Canada; Preventive Oncology & Community Health Sciences, Cumming School of Medicine, University of Calgary, Alberta, Canada
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Kazemi MK, Alimohammadzadeh K, Maher A. Short-and Long–Term Follow–up in the Elderly Patients With ST–Elevation Myocardial Infarction Receiving Primary Angioplasty or Thrombolytic Therapy. INTERNATIONAL JOURNAL OF CARDIOVASCULAR PRACTICE 2019. [DOI: 10.21859/ijcp-403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Melero-Alegria JI, Cascon M, Romero A, Vara PP, Barreiro-Perez M, Vicente-Palacios V, Perez-Escanilla F, Hernandez-Hernandez J, Garde B, Cascon S, Martin-Garcia A, Diaz-Pelaez E, de Dios JM, Uribarri A, Jimenez-Candil J, Cruz-Gonzalez I, Blazquez B, Hernandez JM, Sanchez-Pablo C, Santolino I, Ledesma MC, Muriel P, Dorado-Diaz PI, Sanchez PL. SALMANTICOR study. Rationale and design of a population-based study to identify structural heart disease abnormalities: a spatial and machine learning analysis. BMJ Open 2019; 9:e024605. [PMID: 30765403 PMCID: PMC6398793 DOI: 10.1136/bmjopen-2018-024605] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 10/06/2018] [Accepted: 12/18/2018] [Indexed: 01/03/2023] Open
Abstract
INTRODUCTION This study aims to obtain data on the prevalence and incidence of structural heart disease in a population setting and, to analyse and present those data on the application of spatial and machine learning methods that, although known to geography and statistics, need to become used for healthcare research and for political commitment to obtain resources and support effective public health programme implementation. METHODS AND ANALYSIS We will perform a cross-sectional survey of randomly selected residents of Salamanca (Spain). 2400 individuals stratified by age and sex and by place of residence (rural and urban) will be studied. The variables to analyse will be obtained from the clinical history, different surveys including social status, Mediterranean diet, functional capacity, ECG, echocardiogram, VASERA and biochemical as well as genetic analysis. ETHICS AND DISSEMINATION The study has been approved by the ethical committee of the healthcare community. All study participants will sign an informed consent for participation in the study. The results of this study will allow the understanding of the relationship between the different influencing factors and their relative importance weights in the development of structural heart disease. For the first time, a detailed cardiovascular map showing the spatial distribution and a predictive machine learning system of different structural heart diseases and associated risk factors will be created and will be used as a regional policy to establish effective public health programmes to fight heart disease. At least 10 publications in the first-quartile scientific journals are planned. TRIAL REGISTRATION NUMBER NCT03429452.
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Affiliation(s)
- Jose Ignacio Melero-Alegria
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Cascon
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Pedro Pablo Vara
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Manuel Barreiro-Perez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Victor Vicente-Palacios
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Jesus Hernandez-Hernandez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Beatriz Garde
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Sara Cascon
- Robleda Primary Care Center, Salamanca, Spain
| | - Ana Martin-Garcia
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Elena Diaz-Pelaez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | - Aitor Uribarri
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Javier Jimenez-Candil
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Ignacio Cruz-Gonzalez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Clara Sanchez-Pablo
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | | | | | - Paz Muriel
- Miguel Armijo Primary Care Centre, Salamanca, Spain
| | - P Ignacio Dorado-Diaz
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
| | - Pedro L Sanchez
- Department of Cardiology, Hospital Universitario de Salamanca, Instituto de Investigación Biomédica de Salamanca (IBSAL), Facultad de Medicina, Universidad de Salamanca, and CIBERCV, Salamanca, Spain
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Gonzalez-Cantero A, Gonzalez-Cantero J, Sanchez-Moya AI, Perez-Hortet C, Arias-Santiago S, Schoendorff-Ortega C, Gonzalez-Calvin JL. Subclinical atherosclerosis in psoriasis. Usefulness of femoral artery ultrasound for the diagnosis, and analysis of its relationship with insulin resistance. PLoS One 2019; 14:e0211808. [PMID: 30735527 PMCID: PMC6368294 DOI: 10.1371/journal.pone.0211808] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2018] [Accepted: 01/20/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Psoriasis is associated with an increased risk of cardiovascular disease (CVD) at younger ages that is not identifiable by traditional risk factors. Screening for subclinical atherosclerosis with ultrasound has only been investigated in carotid arteries. Femoral artery ultrasound has never been considered for this purpose. The link between psoriasis and accelerated atherosclerosis has not yet been established. OBJECTIVE To study the usefulness of femoral artery ultrasound for the detection of subclinical atherosclerosis in psoriasis. We also investigated its possible relationship with changes in insulin resistance. METHODS We conducted a cross-sectional study in 140 participants, 70 patients with moderate-to-severe psoriasis and 70 healthy controls, matched 1:1 for age, sex, and BMI. Femoral and carotid atherosclerotic plaques were evaluated by ultrasonography. Insulin resistance was assessed by the homeostasis model assessment method (HOMA-IR). RESULTS Femoral atherosclerotic plaque prevalence was significantly higher in patients with psoriasis (44.64%) than in controls (19.07%) (p<0.005), but no significant difference was found in carotid plaque prevalence (p<0.3). Femoral plaques were significantly more prevalent than carotid plaques (21.42%) among patients with psoriasis (p<0.001). In the regression analysis, insulin resistance was the most influential determinant of atherosclerosis in psoriasis and C-reactive protein the most significant predictor of insulin resistance. CONCLUSIONS Ultrasound screening for femoral atherosclerotic plaques improves the detection of subclinical atherosclerosis in patients with psoriasis, whereas the study of carotid arteries is not sufficiently accurate. Insulin resistance appears to play a greater role in the development of atherosclerosis in these patients in comparison to other classical CVD risk factors.
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Medenwald D, Kluttig A, Lacruz ME, Schumann J. Serum dietary fatty acids and coronary heart disease risk - A nested case-control-study within the CARLA cohort. Nutr Metab Cardiovasc Dis 2019; 29:152-158. [PMID: 30642791 DOI: 10.1016/j.numecd.2018.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 10/10/2018] [Accepted: 10/11/2018] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND AIMS Diet is known to play a decisive role in the development of coronary heart disease (CHD). One factor believed to decrease lifetime risk of CHD is the consumption of omega-3 fatty acids. Yet, conclusive evidence regarding the potential cardioprotective effects of fatty acids is far from being reached. The present study aimed to provide further evidence on the association of serum fatty acid profiles with CHD risk. METHODS AND RESULTS The CARdio-vascular Disease, Living and Ageing in Halle study (CARLA study) is an observational cohort study comprising an older adult's general population with a high level of cardiovascular risk factors. In a matched case-control design the serum fatty acid concentrations of 73 subjects with an incident fatal or nonfatal CHD event were compared to 146 controls matched for sex and age. Our data show that the participants of the CARLA study are underserved in unsaturated fatty acids with respect to current dietary recommendations. In addition, the ratio of omega-6 to omega-3 fatty acids was determined to be 8:1 which underlines the consumption of a Western-style diet enriched in omega-6 fatty acids. There were no significant differences in fatty acid patterns between cases and controls. Thus, no clear association of particular serum fatty acid levels with cardiovascular risk was found. CONCLUSION Our results support the conclusion that in populations with a homogenous low level of omega-3 polyunsaturated fatty acids consumption, serum fatty acid levels are not associated with CHD risk.
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Affiliation(s)
- D Medenwald
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - A Kluttig
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - M E Lacruz
- Institute of Medical Epidemiology, Biostatistics and Informatics, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - J Schumann
- Clinic for Anesthesiology and Surgical Intensive Care, University Hospital Halle (Saale), Halle (Saale), Germany.
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Benson G, Sidebottom AC, Sillah A, Vock DM, Vacquier MC, Miedema MD, VanWormer JJ. Population-level changes in lifestyle risk factors for cardiovascular disease in the Heart of New Ulm Project. Prev Med Rep 2019; 13:332-340. [PMID: 30792949 PMCID: PMC6369314 DOI: 10.1016/j.pmedr.2019.01.018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 01/22/2019] [Accepted: 01/27/2019] [Indexed: 11/30/2022] Open
Abstract
Lifestyle significantly influences development of cardiovascular disease (CVD), but limited data exists demonstrating lifestyle improvements in community-based interventions. This study aims to document how lifestyle risk factors changed at the population level in the context of Heart of New Ulm (HONU), a community-based CVD prevention initiative in Minnesota. HONU intervened across worksites, healthcare and the community/environment to reduce CVD risk factors. HONU collected behavioral measures including smoking, physical activity, fruit/vegetable consumption, alcohol use and stress at heart health screenings from 2009 to 2014. All screenings were documented in the electronic health record (EHR). Changes at the community level for the target population (age 40–79) were estimated using weights created from EHR data and modeled using generalized estimating equation models. Screening participants were similar to the larger patient population with regard to age, race, and marital status, but were slightly healthier in regards to BMI, LDL cholesterol, blood pressure, and less likely to smoke. Community-level improvements were significant for physical activity (62.8% to 70.5%, p < 0.001) and 5+ daily fruit/vegetable servings (16.9% to 28.1%, p < 0.001), with no significant change in smoking, stress, alcohol or BMI. By leveraging local EHR data and integrating it with patient-reported outcomes, improvements in nutrition and physical activity were identified in the HONU population, but limited changes were noted for smoking, alcohol consumption and stress. Systematically documenting behaviors in the EHR will help healthcare systems impact the health of the communities they serve, both at the individual and population level.
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Affiliation(s)
- Gretchen Benson
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States of America
| | - Abbey C Sidebottom
- Allina Health, 2925 Chicago Avenue, Minneapolis, MN, United States of America
| | - Arthur Sillah
- School of Public Health, University of Washington, Seattle, WA, United States of America
| | - David M Vock
- Division of Biostatistics, University of Minnesota School of Public Health, A460 Mayo Building, MMC303, 420 Delaware Street SE, Minneapolis, MN, United States of America
| | - Marc C Vacquier
- Allina Health, 2925 Chicago Avenue, Minneapolis, MN, United States of America
| | - Michael D Miedema
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States of America.,Minneapolis Heart Institute, 920 East 28th Street, Suite 600, Minneapolis, MN, United States of America
| | - Jeffrey J VanWormer
- Center for Clinical Epidemiology & Population Health, Marshfield Clinic Research Institute, 1000 North Oak Ave, Marshfield, WI, United States of America
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Direito A, Rawstorn J, Mair J, Daryabeygi-Khotbehsara R, Maddison R, Tai ES. Multifactorial e- and mHealth interventions for cardiovascular disease primary prevention: Protocol for a systematic review and meta-analysis of randomised controlled trials. Digit Health 2019; 5:2055207619890480. [PMID: 31803491 PMCID: PMC6876157 DOI: 10.1177/2055207619890480] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 10/27/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE Cardiovascular diseases (CVD) are a leading cause of mortality and disease burden. Preventative interventions to augment the population-level adoption of health lifestyle behaviours that reduce CVD risk are a priority. Face-to-face interventions afford individualisation and are effective for improving health-related behaviours and outcomes, but they are costly and resource intensive. Electronic and mobile health (e- and mHealth) approaches aimed at modifying lifestyle risk factors may be an effective and scalable approach to reach many individuals while preserving individualisation. This systematic review aims to (a) determine the effectiveness of multifactorial e- and mHealth interventions on CVD risk and on lifestyle-related cardiometabolic risk factors and self-management behaviours among adults without CVD; and (b) describe the evidence on adverse events and on the cost-effectiveness of these interventions. METHODS Methods were detailed prior to the start of the review in order to improve conduct and prevent inconsistent decision making throughout the review. This protocol was prepared following the PRISMA-P 2015 statement. MEDLINE, CINAHL, Embase, PsycINFO, Web of Science, Cochrane Public Health Group Specialised Register and CENTRAL electronic databases will be searched between 1991 and September 2019. Eligibility criteria are: (a) population: community-dwelling adults; (b) intervention/comparison: randomised controlled trials comparing e- or mHealth CVD risk preventative interventions with usual care; and (c) outcomes: modifiable CVD risk factors. Selection of study reports will involve two authors independently screening titles and abstracts, followed by a full-text review of potentially eligible reports. Two authors will independently undertake data extraction and assess risk of bias. Where appropriate, meta-analysis of outcome data will be performed. DISCUSSION This protocol describes the pre-specified methods for a systematic review that will provide quantitative and narrative syntheses of current multifactorial e- and mHealth CVD preventative interventions. A systematic review and meta-analysis will be conducted following the methods outlined in the Cochrane Handbook for Systematic Reviews of Interventions and reported according to PRISMA guidelines.
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Affiliation(s)
- Artur Direito
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jonathan Rawstorn
- Institute for Physical Activity and Nutrition, Deakin University, Australia
| | | | | | - Ralph Maddison
- Institute for Physical Activity and Nutrition, Deakin University, Australia
| | - E Shyong Tai
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman MEP, Labarthe DR. Reprint of: Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:3012-3026. [PMID: 30522634 DOI: 10.1016/j.jacc.2018.10.023] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 02/08/2023]
Abstract
Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.
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Affiliation(s)
| | - Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hayami K Koga
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily H Feig
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Martin E P Seligman
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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Guo YC, Zhou Y, Gao X, Yao Y, Geng B, Cui QH, Yang JC, Hu HP. Association between Nonalcoholic Fatty Liver Disease and Carotid Artery Disease in a Community-Based Chinese Population: A Cross-Sectional Study. Chin Med J (Engl) 2018; 131:2269-2276. [PMID: 30246712 PMCID: PMC6166459 DOI: 10.4103/0366-6999.241797] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases with a high prevalence in the general population. The association between NAFLD and cardiovascular disease has been well addressed in previous studies. However, whether NAFLD is associated with carotid artery disease in a community-based Chinese population remained unclear. The aim of this study was to investigate the association between NAFLD and carotid artery disease. Methods: A total of 2612 participants (1091 men and 1521 women) aged 40 years and older from Jidong of Tangshan city (China) were selected for this study. NAFLD was diagnosed by abdominal ultrasonography. The presence of carotid stenosis or plaque was evaluated by carotid artery ultrasonography. Logistic regression was used to analyze the association between NAFLD and carotid artery disease. Results: Participants with NAFLD have a higher prevalence of carotid stenosis (12.9% vs. 4.6%) and carotid plaque (21.9% vs. 15.0%) than those without NAFLD. After adjusting for age, gender, smoking status, income, physical activity, diabetes, hypertension, triglyceride, waist-hip ratio, and high-density lipoprotein, NAFLD is significantly associated with carotid stenosis (odds ratio [OR]: 2.06, 95% confidence interval [CI]: 1.45–2.91), but the association between NAFLD and carotid plaque is not statistically significant (OR: 1.10, 95% CI: 0.8–1.40). Conclusion: A significant association between NAFLD and carotid stenosis is found in a Chinese population.
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Affiliation(s)
- Yu-Chen Guo
- Department of Health Information Management, Institute of Medical Information, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Yong Zhou
- Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Xing Gao
- Department of Health Information Management, Institute of Medical Information, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100020, China
| | - Yan Yao
- Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing 100037, China
| | - Qing-Hua Cui
- Department of Biomedical Informatics, School of Basic Medical Sciences, Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing 100191, China
| | - Ji-Chun Yang
- Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing 100191, China
| | - Hong-Pu Hu
- Department of Health Information Management, Institute of Medical Information, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100020, China
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Guo Y, Hu H, Liu Y, Leng Y, Gao X, Cui Q, Chen J, Geng B, Zhou Y. Gender differences in the relationship between alcohol consumption and insomnia in the northern Chinese population. PLoS One 2018; 13:e0207392. [PMID: 30521547 PMCID: PMC6283629 DOI: 10.1371/journal.pone.0207392] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 10/30/2018] [Indexed: 01/01/2023] Open
Abstract
Background Insomnia is one of the main symptoms of sleep disorders. Previous studies have suggested that alcohol intake is associated with several adverse health outcomes. The association between alcohol consumption and insomnia has been addressed in several studies with different results. However, whether gender may modify the association between alcohol consumption and insomnia is not clear. This study will focus on gender differences in the relationship between alcohol consumption and insomnia. Methods The final study includes 8081 subjects aged between 18 and 65 years from the Jidong cohort. The data on alcohol consumption is collected by questionnaires, and insomnia problems are assessed using the entire 8-item Athens Insomnia Scale (AIS-8). Logistic analysis is used to evaluate the association between alcohol consumption and insomnia. Results Among the 8081 participants in this study, 2618 (32.4%) are alcohol drinkers, including 2424 males and 194 females. The prevalence of insomnia is 9.6% in the male and 10.6% in the female. The adjusted odds ratios (ORs) with 95% confidence interval (CI) of mild-to-moderate drinkers and heavy drinkers for insomnia are 1.27 (1.02–1.58) and 1.02 (0.79–1.32), respectively. Heavy alcohol consumption is significantly correlated with insomnia in the female, after controlling for potential confounding factors (OR: 2.11, 95% CI: 1.28–3.49, p for interaction = 0.002). Conclusion A significant association between alcohol consumption and insomnia is found in females, but not in males from the northern Chinese population.
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Affiliation(s)
- Yuchen Guo
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hongpu Hu
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Yingping Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Yue Leng
- Department of Psychiatry, University of California, San Francisco, California, United States of America
| | - Xing Gao
- Department of Health Information Management, Institute of Medical Information, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Qinghua Cui
- Department of Biomedical Informatics, School of Basic Medical Sciences, Key Laboratory of Molecular Cardiovascular Science of the Ministry of Education Center for Non-coding RNA Medicine, Peking University Health Science Center, Beijing, China
| | - Jianxin Chen
- Beijing University of Chinese Medicine, Beijing, China
| | - Bin Geng
- Hypertension Center, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, State Key Laboratory of Cardiovascular Disease, Beijing, China
| | - Yong Zhou
- Sanbo Brain Institute, Sanbo Brain Hospital, Capital Medical University, Beijing, China
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72
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Cardiovascular health and cognitive function among Mexican older adults: cross-sectional results from the WHO Study on Global Ageing and Adult Health. Int Psychogeriatr 2018; 30:1827-1836. [PMID: 29667567 PMCID: PMC6193870 DOI: 10.1017/s1041610218000297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
UNLABELLED ABSTRACTObjectives:To assess the association between cardiovascular health and cognitive function among Mexican older adults. DESIGN Nationally representative cross-sectional survey. SETTING Households in Mexico. PARTICIPANTS Individuals aged 50 years and older (n = 1,492) from the Mexico-SAGE project Wave 1. MEASUREMENTS A continuous and a categorical index of cardiovascular health was calculated based on exercise, smoking, body mass index, and blood pressure ranging from 0 to 4. Cognitive function was obtained by averaging the standardized scores (z scores) of five psychometric tests. Associations were conducted using linear regression. RESULTS The continuous index of cardiovascular health was not associated with cognitive function. Using the categorical index, participants with the best levels of cardiovascular (score of 4) health performed better on global cognitive function than groups with lower cardiovascular health (scores of 0, 0.41 SD; 1, 0.39 SD; and 2, 0.56 SD). The association was moderated by age, reaching significance only among those 50-64 years old. CONCLUSIONS If longitudinal research confirms these findings, results would suggest that dementia-related policies in Mexico need to focus on achieving optimal levels of cardiovascular health, especially in midlife.
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A controlled trial of mobile short message service among participants in a rural cardiovascular disease prevention program. Prev Med Rep 2018; 13:126-131. [PMID: 30568871 PMCID: PMC6299144 DOI: 10.1016/j.pmedr.2018.11.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 11/20/2018] [Accepted: 11/29/2018] [Indexed: 12/16/2022] Open
Abstract
The statewide Colorado Healthy Heart Solutions (CHHS) program provides cardiovascular disease (CVD) risk factor screening and education to the medically underserved and has been shown to improve CVD risk profiles. We aimed to enhance its effectiveness through addition of a mobile health (mHealth) intervention using SMS messaging (termed Cardio SMS). We conducted a prospective, non-randomized controlled pilot trial of this intervention implemented at 5 rural program sites (number of participants N = 204) compared with a contemporaneous propensity-score matched control group from 14 CHHS sites not receiving the intervention (N = 408) between 2012 and 2014. All participants were free of CVD at baseline, and follow-up time was 12-months. The primary outcome was program engagement, defined as the number of completed interactions with the program during the entire follow-up period. Secondary outcomes were program retention, defined as any interaction during the last two months of the study; change in self-reported healthy behaviors (physical activity, weight loss, smoking cessation, fat intake); and change in CVD risk factors. There were trends for differences between groups across multiple outcomes, but most did not reach statistical significance, except for a greater decrease in self-reported fat intake in the intervention vs. control groups (26.3% vs 10.6%, P = 0.001). In addition, a subset of surveyed participants who viewed the SMS messages as motivating showed greater program retention (P = 0.03). Given the relative ease and scalability of SMS interventions in rural underserved communities, further study of SMS as part of multicomponent strategies for CVD prevention is warranted.
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74
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Senecal C, Widmer RJ, Johnson MP, Lerman LO, Lerman A. Digital health intervention as an adjunct to a workplace health program in hypertension. ACTA ACUST UNITED AC 2018; 12:695-702. [DOI: 10.1016/j.jash.2018.05.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 05/01/2018] [Accepted: 05/18/2018] [Indexed: 01/21/2023]
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75
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Kubzansky LD, Huffman JC, Boehm JK, Hernandez R, Kim ES, Koga HK, Feig EH, Lloyd-Jones DM, Seligman MEP, Labarthe DR. Positive Psychological Well-Being and Cardiovascular Disease: JACC Health Promotion Series. J Am Coll Cardiol 2018; 72:1382-1396. [PMID: 30213332 PMCID: PMC6289282 DOI: 10.1016/j.jacc.2018.07.042] [Citation(s) in RCA: 218] [Impact Index Per Article: 36.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 07/30/2018] [Accepted: 07/30/2018] [Indexed: 02/07/2023]
Abstract
Facets of positive psychological well-being, such as optimism, have been identified as positive health assets because they are prospectively associated with the 7 metrics of cardiovascular health (CVH) and improved outcomes related to cardiovascular disease. Connections between psychological well-being and cardiovascular conditions may be mediated through biological, behavioral, and psychosocial pathways. Individual-level interventions, such as mindfulness-based programs and positive psychological interventions, have shown promise for modifying psychological well-being. Further, workplaces are using well-being-focused interventions to promote employee CVH, and these interventions represent a potential model for expanding psychological well-being programs to communities and societies. Given the relevance of psychological well-being to promoting CVH, this review outlines clinical recommendations to assess and promote well-being in encounters with patients. Finally, a research agenda is proposed. Additional prospective observational studies are needed to understand mechanisms underlying the connection between psychological well-being and cardiovascular outcomes. Moreover, rigorous intervention trials are needed to assess whether psychological well-being-promoting programs can improve cardiovascular outcomes.
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Affiliation(s)
| | - Jeff C Huffman
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
| | - Rosalba Hernandez
- School of Social Work, University of Illinois at Urbana-Champaign, Champaign, Illinois
| | - Eric S Kim
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Hayami K Koga
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Emily H Feig
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts; Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
| | - Donald M Lloyd-Jones
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Martin E P Seligman
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Darwin R Labarthe
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
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76
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Bayley A, Stahl D, Ashworth M, Cook DG, Whincup PH, Treasure J, Greenough A, Ridge K, Winkley K, Ismail K. Response bias to a randomised controlled trial of a lifestyle intervention in people at high risk of cardiovascular disease: a cross-sectional analysis. BMC Public Health 2018; 18:1092. [PMID: 30180833 PMCID: PMC6124010 DOI: 10.1186/s12889-018-5939-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Accepted: 08/07/2018] [Indexed: 11/23/2022] Open
Abstract
Background Research evaluating lifestyle interventions for prevention of cardiovascular disease (CVD) may not reach those most at risk. We compared the response rate to a randomised controlled trial (RCT) of a lifestyle intervention by CVD risk, ethnicity and level of deprivation. Methods Primary care patients with a QRisk2 score ≥ 20% were invited to participate in a RCT of an intensive lifestyle intervention versus usual care. This cross-sectional analysis compares anonymised data of responders and non-responders with multiple logistic regression, using adjusted odds ratios (AORs) for QRisk2 score, ethnicity, Index of Multiple Deprivation (IMD 2010) quintile, age and sex. Results From 60 general practices, 8902 patients were invited and 1489 responded. The mean age was 67.3 years and 21.0% were female. Of all patients invited, 69.9% were of white ethnic background, 13.9% ethnic minority backgrounds and 16.2% had no ethnicity data recorded in their medical records. Likelihood of response decreased as QRisk2 score increased (AOR 0.82 per 5 percentage points, 95% CI 0.77–0.88). Black African or Caribbean patients (AOR 0.67; 95% CI 0.45–0.98) and those with missing ethnicity data (AOR 0.55; 95% CI 0.46–0.66) were less likely to respond compared to participants of white ethnicity, but there was no difference in the response rates between south Asian and white ethnicity (AOR 1.08; 95% CI 0.84–1.38). Patients residing in the fourth (AOR 0.70; 95% CI 0.56–0.87) and fifth (AOR 0.52; 95% CI 0.40–0.68) most deprived IMD quintile were less likely to respond compared to the least deprived quintile. Conclusions Evaluations of interventions intended for those at high risk of CVD may fail to reach those at highest risk. Hard to reach patient groups may require different recruitment strategies to maximise participation in future trials. Improvements in primary care ethnicity data recording is required to aid understanding of how successfully study samples represent the target population. Trial registration ISRCTN, ISRCTN84864870. Registered 15 May 2012, 10.1186/ISRCTN84864870. Electronic supplementary material The online version of this article (10.1186/s12889-018-5939-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Adam Bayley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College Londonz, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Daniel Stahl
- Department of Biostatistics, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Mark Ashworth
- Department of Primary Care and Public Health Sciences, King's College London, Addison House, Guy's Campus, London, SE1 1UL, UK
| | - Derek G Cook
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Peter H Whincup
- Population Health Research Institute, St George's, University of London, Cranmer Terrace, London, SW17 0RE, UK
| | - Janet Treasure
- Department of Health Services and Population Research, Institute of Psychiatry, King's College London, 16 De Crespigny Park, London, SE5 8AF, UK
| | - Anne Greenough
- Division of Asthma, Allergy and Lung Biology, King's College London, Guy's Hospital, London, SE1 9RT, UK.,MRC & Asthma UK Centre for Allergic Mechanisms in Asthma, London, UK.,Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Katie Ridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College Londonz, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Kirsty Winkley
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College Londonz, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - Khalida Ismail
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College Londonz, 10 Cutcombe Road, London, SE5 9RJ, UK.
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77
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Affiliation(s)
- Darwin Labarthe
- Department of Preventive Medicine (D.L., D.M.L.-J.), Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Donald M. Lloyd-Jones
- Department of Preventive Medicine (D.L., D.M.L.-J.), Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
- Department of Medicine (D.M.L.-J.), Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL
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Yang X, Lv H, Hidru TH, Wu J, Liu H, Wang Y, Liu K, Xia Y, Zhou Y, Jiang Y. Relation of serum uric acid to asymptomatic proximal extracranial artery stenosis in a middle-aged Chinese population: a community-based cross-sectional study. BMJ Open 2018; 8:e020681. [PMID: 30139894 PMCID: PMC6112387 DOI: 10.1136/bmjopen-2017-020681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Serum uric acid (SUA) has been associated with cardiovascular diseases, including atherosclerosis and carotid artery stenosis. However, data on the relationship between SUA level and proximal extracranial artery stenosis (PEAS) are limited. Therefore, this study investigates the association between SUA levels and the risk of PEAS in asymptomatic Chinese population. SETTING This community-based cross-sectional study was conducted in Jidong Community Hospital, Tangshan, Hebei, China between July 2013 and August 2014. PARTICIPANTS The study examined 3325 asymptomatic participants (40-60 years) to evaluate the risk of PEAS. RESULTS For the participants stratified into quartiles based on gender-specific SUA levels, the prevalence of PEAS increased from Q1 to Q4 from 12.3% to 29.8% in the vertebral artery (VA), and from 2.8% to 5.8% in the common carotid artery. The proportion of PEAS relative to the detected number of arterial stenosis was lower in Q1 than in Q2-Q4. The multivariable ORs and 95% CI of PEAS in the second through fourth compared with the lowest quartiles for arterial stenosis were 1.278 (0.980 to 1.665), 1.117 (0.851 to 1.468) and 1.375 (1.033 to 1.830) (ptrend=0.0399); and for VA stenosis, 1.285 (0.966 to 1.709), 1.085 (0.808 to 1.457) and 1.439 (1.061 to 1.952) (ptrend=0.0235). CONCLUSION Elevated SUA concentration is significantly associated with PEAS in an asymptomatic middle-aged Chinese population, and vertebral arteries appeared to be the most vulnerable vessels.
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Affiliation(s)
- Xiaolei Yang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Haichen Lv
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Tesfaldet Habtemariam Hidru
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Jing Wu
- Department of Technology, Beijing Recdata Technology Co., Ltd, Beijing, China
| | - Henghui Liu
- Department of Technology, Beijing Recdata Technology Co., Ltd, Beijing, China
| | - Youxin Wang
- Beijing Municipal Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China
| | - Kejia Liu
- Department of Technology, Beijing Recdata Technology Co., Ltd, Beijing, China
| | - Yunlong Xia
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yong Zhou
- Department of Cardiology, Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vascular Diseases, Beijing, China
| | - Yinong Jiang
- Department of Cardiology, Institute of Cardiovascular Diseases, First Affiliated Hospital of Dalian Medical University, Dalian, China
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Jiang Y, Mao F, Li Y, Liu J, Zhang Y, Jiang Y, Zhao D, Chen W, Nicholas S, Huo Y, Ge J, Wang L, Zhou M. Construction of China cardiovascular health index. BMC Public Health 2018; 18:937. [PMID: 30064389 PMCID: PMC6069793 DOI: 10.1186/s12889-018-5647-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 05/31/2018] [Indexed: 11/24/2022] Open
Abstract
Background Cardiovascular disease (CVD) is not only the primary cause of death in developed western countries, but also its disease burden is increasing in China. The purpose of constructing population cardiovascular health index is to monitor, compare and evaluate disease burden, influencing factors and prevention and control levels of Chinese population cardiovascular disease in order to provide evidence to improve population cardiovascular health. Methods This study collected multi-source data and constructed China Cardiovascular Health Index (CHI) using literature review, questionnaire surveys, Delphi method and Analytical Hierarchy Process (AHP) model. Results China CHI system included 52 indices of 5 dimensions, which were prevalence status of CVD, exposure of risk factors, prevention and control of risk factors, treatment situation and public health policy and service ability. The weights of 5 dimensions from high to low were successively prevention and control of risk factors 0.3656, prevalence status of CVD 0.2070, treatment situation 0.1812, public health policy and service ability 0.1458, and exposure of risk factors 0.1004. Conclusion China CHI is a comprehensive evaluation system raised to effectively control the prevalence of CVD. In the future, we should strengthen and improve CVD monitoring and big data usage, to ensure these indices to reflect the practical situations and to become utility of controlling CVD.
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Affiliation(s)
- Yingying Jiang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Fan Mao
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Yichong Li
- Peking University Clinical Research Institute, Beijing, China
| | - Jing Liu
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Yan Zhang
- Peking University First Hospital, Beijing, China
| | - Yong Jiang
- Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong Zhao
- Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
| | - Weiwei Chen
- National Center for Cardiovascular Disease, Beijing, China
| | - Stephen Nicholas
- School of Management and School of Economics, Tianjin Normal University, West Bin Shui Avenue, Tianjin, 300074, People's Republic of China.,Guangdong Research Institute for International Strategies, Guangdong University of Foreign Studies, 2 Baiyun North Avenue, Baiyun, Guangzhou, Guangdong, 510420, People's Republic of China.,School of International Business, Beijing Foreign Studies University, 19 North Xisanhuan Avenue Haidian, Beijing, 100089, People's Republic of China.,University of Newcastle, Newcastle, NSW, 2308, Australia
| | - Yong Huo
- Peking University First Hospital, Beijing, China
| | - Junbo Ge
- Zhongshan Hospital, Fudan University, Shanghai, China
| | - Linhong Wang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China
| | - Maigeng Zhou
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27 Nanwei Road, Xicheng District, Beijing, 100050, China.
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Sidebottom AC, Sillah A, Vock DM, Miedema MD, Pereira R, Benson G, Lindberg R, Boucher JL, Knickelbine T, VanWormer JJ. Assessing the impact of the heart of New Ulm Project on cardiovascular disease risk factors: A population-based program to reduce cardiovascular disease. Prev Med 2018; 112:216-221. [PMID: 29634974 DOI: 10.1016/j.ypmed.2018.04.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Revised: 03/19/2018] [Accepted: 04/06/2018] [Indexed: 12/11/2022]
Abstract
The Heart of New Ulm Project (HONU), is a population-based project designed to reduce modifiable cardiovascular disease (CVD) risk factors in the rural community of New Ulm, MN. HONU interventions address multiple levels of the social-ecological model. The community is served by one health system, enabling the use of electronic health record (EHR) data for surveillance. The purpose of this study was to assess if trends in CVD risk factors and healthcare utilization differed between a cohort of New Ulm residents age 40-79 and matched controls selected from a similar community, using EHR data from baseline (2008-2009) through three follow up time periods (2010-2011, 2012-2013, 2014-2015). Matching, using covariate balance sparse technique, yielded a sample of 4077 New Ulm residents and 4077 controls. We used mixed effects longitudinal models to examine trends over time between the two groups. Blood pressure, total cholesterol, low-density lipoprotein-cholesterol, and triglycerides showed better management in New Ulm over time compared to the controls. The proportion of residents in New Ulm with controlled blood pressure increased by 6.2 percentage points compared to an increase of 2 points in controls (p < 0.0001). As the cohort aged, 10-year ASCVD risk scores increased less in New Ulm (5.1) than the comparison community (5.9). The intervention and control community did not differ with regard to inpatient stays, smoking, or glucose. Findings suggest efficacy for the HONU project interventions for some outcomes.
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Affiliation(s)
| | - Arthur Sillah
- Allina Health, 2925 Chicago Avenue, Minneapolis, MN, United States
| | - David M Vock
- Division of Biostatistics, University of Minnesota School of Public Health, A460 Mayo Building, MMC303, 420 Delaware Street SE. Minneapolis, MN, United States
| | - Michael D Miedema
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States; Minneapolis Heart Institute, 920 East 28th Street, Suite 300, Minneapolis, MN, United States
| | - Raquel Pereira
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States
| | - Gretchen Benson
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States
| | - Rebecca Lindberg
- Minneapolis Heart Institute Foundation, 920 East 28th Street, Suite 100, Minneapolis, MN, United States
| | - Jackie L Boucher
- Children's HeartLink, 5075 Arcadia Ave, Edina, MN, United States
| | - Thomas Knickelbine
- Minneapolis Heart Institute, 920 East 28th Street, Suite 300, Minneapolis, MN, United States
| | - Jeffrey J VanWormer
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research Foundation, 1000 North Oak Ave, Marshfield, WI, United States
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Amraei M, Ghorbani A, Seifinejad Y, Mousavi SF, Mohamadpour M, Shirzadpour E. The effect of hydroalcoholic extract of Teucrium polium L. on the inflammatory markers and lipid profile in hypercholesterolemic rats. J Inflamm Res 2018; 11:265-272. [PMID: 29950880 PMCID: PMC6014391 DOI: 10.2147/jir.s165172] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Background Cardiovascular diseases are among the most common causes of mortality worldwide. Therefore, it is necessary to control the risk factors of these patients. Since the level of inflammatory markers and lipid profiles has increased in cardiovascular diseases and due to the increasing role of plants in the treatment of diseases, the current study aimed to investigate the effect of hydroalcoholic extract of Teucrium polium on inflammatory markers and lipid profile in hypercholesterolemic rats. Materials and methods A total of 24 adult male Wistar rats were randomly divided into four groups of six each and treated with oral administration for 8 weeks. The control group received normal diet, the sham group received high-cholesterol diet and experimental groups 1 and 2 received high-cholesterol diet in the 8 weeks and doses of 85 and 170 mg/kg, respectively, of the T. polium hydroalcoholic extract (TPHAE) in the second 4 weeks. At the beginning and the end of the study, rats were examined for biochemical parameters. The mean level of variables for each group was presented as mean ± standard error of mean. Results The results of this study showed that, after administration of TPHAE, there was a significant decrease in the mean of inflammatory markers in all groups compared to sham group (P<0.001). Also, administration of the extract significantly reduced the serum levels of triglyceride, cholesterol and LDL-cholesterol and significantly increased the serum HDL-cholesterol levels. In addition, the 170 mg/kg dose of TPHAE was the most effective in reducing serum levels of inflammatory and lipid markers. Conclusion Treatment with TPHAE caused dose-dependent decrease in serum levels of inflammatory markers and lipid profile in hypercholesterolemic rats. Therefore, it can be applied as a natural product for the management of cardiovascular diseases.
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Affiliation(s)
- Mansour Amraei
- Department of Physiology, Faculty of Medicine, Ilam University of Medical sciences, Ilam, Iran
| | - Ayub Ghorbani
- Department of Physiology, Faculty of Medicine, Ilam University of Medical sciences, Ilam, Iran
| | - Yaser Seifinejad
- Department of Physiology, Faculty of Medicine, Ilam University of Medical sciences, Ilam, Iran
| | | | - Mahmoud Mohamadpour
- Department of Biochemistry, Faculty of Medicine, Ilam University of Medical sciences, Ilam, Iran
| | - Ehsan Shirzadpour
- Department of Biochemistry, Faculty of Medicine, Ilam University of Medical sciences, Ilam, Iran
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82
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Nash R, Elmer S, Thomas K, Osborne R, MacIntyre K, Shelley B, Murray L, Harpur S, Webb D. HealthLit4Kids study protocol; crossing boundaries for positive health literacy outcomes. BMC Public Health 2018; 18:690. [PMID: 29866099 PMCID: PMC5987446 DOI: 10.1186/s12889-018-5558-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Accepted: 05/10/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Health attitudes and behaviours formed during childhood greatly influence adult health patterns. This paper describes the research and development protocol for a school-based health literacy program. The program, entitled HealthLit4Kids, provides teachers with the resources and supports them to explore the concept of health literacy within their school community, through classroom activities and family and community engagement. METHODS HealthLit4Kids is a sequential mixed methods design involving convenience sampling and pre and post intervention measures from multiple sources. Data sources include individual teacher health literacy knowledge, skills and experience; health literacy responsiveness of the school environment (HeLLO Tas); focus groups (parents and teachers); teacher reflections; workshop data and evaluations; and children's health literacy artefacts and descriptions. The HealthLit4Kids protocol draws explicitly on the eight Ophelia principles: outcomes focused, equity driven, co-designed, needs-diagnostic, driven by local wisdom, sustainable, responsive, systematically applied. By influencing on two levels: (1) whole school community; and (2) individual classroom, the HealthLit4Kids program ensures a holistic approach to health literacy, raised awareness of its importance and provides a deeper exploration of health literacy in the school environment. The school-wide health literacy assessment and resultant action plan generates the annual health literacy targets for each participating school. DISCUSSION Health promotion cannot be meaningfully achieved in isolation from health literacy. Whilst health promotion activities are common in the school environment, health literacy is not a familiar concept. HealthLit4Kids recognizes that a one-size fits all approach seldom works to address health literacy. Long-term health outcomes are reliant on embedded, locally owned and co-designed programs which respond to local health and health literacy needs.
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Affiliation(s)
- Rose Nash
- School of Medicine, College of Health and Medicine, University of Tasmania, Private Bag 34, Hobart, TAS, 7000, Australia.
| | - Shandell Elmer
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Katy Thomas
- School of Education, College of Arts, Law and Education (CALE), University of Tasmania, Private Bag 66, Hobart, 7001, Tasmania, Australia
| | - Richard Osborne
- Health Systems Improvement Unit, WHO Collaboration Centre for Health Literacy, School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Kate MacIntyre
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Public Health Services, Department of Health and Human Services, Hobart, Tasmania, Australia
| | - Becky Shelley
- Peter Underwood Centre for Educational Attainment, Academic Division, University of Tasmania, Hobart, Tasmania, Australia
| | - Linda Murray
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
| | - Siobhan Harpur
- School of Medicine, College of Health & Medicine, University of Tasmania, Hobart, Tasmania, Australia
- Public Health Services, Department of Health and Human Services, Hobart, Tasmania, Australia
| | - Diane Webb
- Public Health Services, Department of Health and Human Services, Launceston, Tasmania, Australia
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83
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Rodríguez Lucci F, Schvartz E, Lagos R, Fernández Cisneros L, Pujol Lereis V, Ameriso SF. Detection of Subclinical Atherosclerosis in Subclavian Arteries of Subjects with Vascular Risk Factors and Normal Carotid Ultrasound. J Stroke Cerebrovasc Dis 2018; 27:2418-2422. [PMID: 29803598 DOI: 10.1016/j.jstrokecerebrovasdis.2018.04.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 03/30/2018] [Accepted: 04/23/2018] [Indexed: 10/16/2022] Open
Abstract
BACKGROUND AND PURPOSE Most risk scores that use imaging methods to determine the presence of subclinical atherosclerosis assess the carotid and coronary arteries. The value of assessing subclavian arteries to improve the predictive capacity of traditional imaging studies is not known. MATERIALS AND METHODS We studied subjects without cardiac, cerebral, or peripheral vascular symptoms and normal carotid ultrasound. They had at least 1 traditional vascular risk factor. We assessed prevalence of atherosclerotic plaques in the right subclavian artery. RESULTS We studied 625 subjects aged 54 ± 12. Most participants had 1 vascular risk factor. Using the Framingham Heart Study score, 62% were categorized as low risk, 29% intermediate risk, and 9% high risk. A total of 169 subjects (27%) had atheromatous plaques in the right subclavian artery. The prevalence of this finding was greater in women than in men (64% versus 36%, P < .00001) and was greater in subjects older than 54 years than in younger individuals (72% versus 28%, P < .00001). Plaques in the subclavian artery were present in 27% of subjects with high risk, 34% with intermediate risk, and 24% with low risk. CONCLUSIONS Plaques in subclavian arteries are often detected in asymptomatic subjects with vascular risk factors and normal carotid arteries even with low vascular risk scores. Study of the subclavian arteries appears as a simple strategy for the detection of subclinical atherosclerosis. Its role for improving cardiovascular risk scales and predicting coronary and cerebrovascular events needs to be further explored.
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Affiliation(s)
- Federico Rodríguez Lucci
- Departament of Neurology, Vascular Neurology Division, Institute of Neurological Research, FLENI, Buenos Aires, Argentina.
| | - Elena Schvartz
- Vascular Ultrasound Department, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
| | - Roberto Lagos
- Vascular Ultrasound Department, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
| | - Lucia Fernández Cisneros
- Vascular Ultrasound Department, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
| | - Virginia Pujol Lereis
- Departament of Neurology, Vascular Neurology Division, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
| | - Sebastian F Ameriso
- Departament of Neurology, Vascular Neurology Division, Institute of Neurological Research, FLENI, Buenos Aires, Argentina
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Schultz WM, Kelli HM, Lisko JC, Varghese T, Shen J, Sandesara P, Quyyumi AA, Taylor HA, Gulati M, Harold JG, Mieres JH, Ferdinand KC, Mensah GA, Sperling LS. Socioeconomic Status and Cardiovascular Outcomes: Challenges and Interventions. Circulation 2018; 137:2166-2178. [PMID: 29760227 PMCID: PMC5958918 DOI: 10.1161/circulationaha.117.029652] [Citation(s) in RCA: 725] [Impact Index Per Article: 120.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Socioeconomic status (SES) has a measurable and significant effect on cardiovascular health. Biological, behavioral, and psychosocial risk factors prevalent in disadvantaged individuals accentuate the link between SES and cardiovascular disease (CVD). Four measures have been consistently associated with CVD in high-income countries: income level, educational attainment, employment status, and neighborhood socioeconomic factors. In addition, disparities based on sex have been shown in several studies. Interventions targeting patients with low SES have predominantly focused on modification of traditional CVD risk factors. Promising approaches are emerging that can be implemented on an individual, community, or population basis to reduce disparities in outcomes. Structured physical activity has demonstrated effectiveness in low-SES populations, and geomapping may be used to identify targets for large-scale programs. Task shifting, the redistribution of healthcare management from physician to nonphysician providers in an effort to improve access to health care, may have a role in select areas. Integration of SES into the traditional CVD risk prediction models may allow improved management of individuals with high risk, but cultural and regional differences in SES make generalized implementation challenging. Future research is required to better understand the underlying mechanisms of CVD risk that affect individuals of low SES and to determine effective interventions for patients with high risk. We review the current state of knowledge on the impact of SES on the incidence, treatment, and outcomes of CVD in high-income societies and suggest future research directions aimed at the elimination of these adverse factors, and the integration of measures of SES into the customization of cardiovascular treatment.
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Affiliation(s)
| | - Heval M Kelli
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | | | | | - Jia Shen
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | - Pratik Sandesara
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | - Arshed A Quyyumi
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
| | | | - Martha Gulati
- University of Arizona-Phoenix College of Medicine (M.G.)
| | - John G Harold
- Cedars-Sinai Heart Institute, Cedars-Sinai Medical Center, Los Angeles, CA (J.G.H.)
| | | | | | - George A Mensah
- Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (G.A.M.)
| | - Laurence S Sperling
- Emory Clinical Cardiovascular Research Institute (H.M.K., J.S., P.S., A.A.Q., L.S.S.), Emory University School of Medicine, Atlanta, GA
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85
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Sigala F, Oikonomou E, Antonopoulos AS, Galyfos G, Tousoulis D. Coronary versus carotid artery plaques. Similarities and differences regarding biomarkers morphology and prognosis. Curr Opin Pharmacol 2018; 39:9-18. [DOI: 10.1016/j.coph.2017.11.010] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 11/14/2017] [Accepted: 11/20/2017] [Indexed: 01/09/2023]
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86
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Vrany EA, Hawkins MAW, Wu W, Stewart JC. Depressive symptoms and weight loss behaviors in U.S. adults. Eat Behav 2018; 29:107-113. [PMID: 29631125 DOI: 10.1016/j.eatbeh.2018.03.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 02/28/2018] [Accepted: 03/22/2018] [Indexed: 10/17/2022]
Abstract
OBJECTIVE We sought to determine whether depressive symptoms are associated with attempting to lose weight and engaging in weight loss behaviors in a large, diverse sample of adults representative of the U.S. METHODS Respondents were 23,106 adults, free of cardiovascular disease and diabetes, who participated in the 2005-2014 years of the National Health and Nutrition Examination Survey (NHANES). Depressive symptoms were measured using the Patient Health Questionnaire-9 (PHQ-9), and weight loss variables were obtained from a Weight History Questionnaire. RESULTS PHQ-9 total was not associated with attempting to lose weight in the past year (OR = 1.03, 95%CI = 1.00-1.06, p = 0.074; n = 23,106). Among respondents who attempted to lose weight (n = 9582), PHQ-9 total was associated with a lower odds of exercising (OR = 0.84, 95%CI = 0.79-0.89, p < 0.001) and a greater odds of skipping meals (OR = 1.31, 95%CI = 1.22-1.41, p < 0.001), eating diet foods/products (OR = 1.16, 95%CI = 1.08-1.24, p < 0.001), eating less food (OR = 1.09, 95%CI = 1.04-1.15, p < 0.001), taking non-prescription supplements (OR = 1.31, 95%CI = 1.23-1.41, p < 0.001), taking prescription diet pills (OR = 1.28, 95%CI = 1.10-1.49, p = 0.001), and taking laxatives/vomiting (OR = 1.55, 95%CI = 1.28-1.88, p < 0.001). CONCLUSIONS Although depressive symptoms were not associated with attempting to lose weight in the past year, adults who attempted to lose weight tended to employ potentially ineffective/unhealthy weight loss behaviors and avoid effective behaviors. This pattern of behaviors may be another mechanism that explains the excess risk of obesity in depressed adults and may be a modifiable target for future interventions. Given the cross-sectional nature of this study, reverse causality is a possibility. Future studies should investigate the prospective associations between depressive symptoms and weight loss behaviors.
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Affiliation(s)
- Elizabeth A Vrany
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, OK, United States
| | - Wei Wu
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States
| | - Jesse C Stewart
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN, United States.
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Sarkar C, Webster C, Gallacher J. Neighbourhood walkability and incidence of hypertension: Findings from the study of 429,334 UK Biobank participants. Int J Hyg Environ Health 2018; 221:458-468. [PMID: 29398408 DOI: 10.1016/j.ijheh.2018.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 01/04/2018] [Accepted: 01/17/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND With an estimated one billion hypertension cases worldwide, the role of the built environment in its prevention and control is still uncertain. The present study aims to examine the associations between neighbourhood walkability and hypertension in a large and diverse population-based cohort. MATERIALS AND METHODS We examined the association between neighbourhood walkability and blood pressure outcomes for N = 429,334 participants drawn from the UK Biobank and aged 38-73 years. Neighbourhood walkability was objectively modelled from detailed building footprint-level data within multi-scale functional neighbourhoods (1.0-, 1.5- and 2.0-kilometer street catchments of geocoded dwelling). A series of linear and modified Poisson regression models were employed to examine the association between walkability and outcomes of diastolic blood pressure (DBP in mmHg), systolic blood pressure (SBP in mmHg) and prevalent hypertension adjusting for socio-demographic, lifestyle and related physical environmental covariates. We also examined the relationship between walkability and change in blood pressure for a sub-sample of participants with follow-up data and tested for interaction effects of age, sex, employment status, neighbourhood SES, residential density and green exposure. RESULTS Neighbourhood walkability within one-kilometer street catchment was beneficially associated with all the three blood pressure outcomes, independent of all other factors. Each interquartile increment in walkability was associated with the lower blood pressure outcomes of DBP (β = -0.358, 95% CI: -0.42, -0.29 mmHg), SBP (β = -0.833, 95% CI: -0.95, -0.72 mmHg) as well as reduced hypertension risk (RR = 0.970, 95% CI: 0.96, 0.98). The results remained consistent across spatial and temporal scales and were sensitive to sub-groups, with pronounced protective effects among female participants, those aged between 50 and 60 years, in employment, residing in deprived, high density and greener areas. CONCLUSION This large population-based cohort found evidence of protective association between neighbourhood walkability and blood pressure outcomes. Given the enduring public health impact of community design on individual behaviour and lifestyle, of particular interest, are the targetted upstream-level interventions in city design aimed at optimizing walkability. Further long term studies are required to assess its sustained effects upon hypertension prevention and control.
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Affiliation(s)
- Chinmoy Sarkar
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China.
| | - Chris Webster
- Healthy High Density Cities Lab, HKUrbanLab, The University of Hong Kong, Knowles Building, Pokfulam Road, Hong Kong, Hong Kong Special Administrative Region, China
| | - John Gallacher
- Department of Psychiatry, Oxford University, Warneford Hospital, Oxford OX3 7JX, United Kingdom
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88
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Tomaselli G, Roach WH, Piña IL, Oster ME, Dietz WH, Horton K, Borden WB, Brownell K, Gibbons RJ, Otten JJ, Lee CS, Hill C, Heidenreich PA, Siscovick DS, Whitsel LP. Government continues to have an important role in promoting cardiovascular health. Am Heart J 2018; 198:160-165. [PMID: 29653638 DOI: 10.1016/j.ahj.2017.11.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 11/03/2017] [Indexed: 12/14/2022]
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Uzhova I, Woolhead C, Timon CM, O'Sullivan A, Brennan L, Peñalvo JL, Gibney ER. Generic Meal Patterns Identified by Latent Class Analysis: Insights from NANS (National Adult Nutrition Survey). Nutrients 2018; 10:nu10030310. [PMID: 29509665 PMCID: PMC5872728 DOI: 10.3390/nu10030310] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 02/22/2018] [Accepted: 03/01/2018] [Indexed: 01/11/2023] Open
Abstract
Nutritional data reduction methods are widely applied in nutrition epidemiology in order to classify individuals into meaningful groups with similar dietary patterns. To date, none of the existing studies have applied latent class analysis to examine dietary patterns which include meal types consumed throughout a day. We investigated main meal patterns followed on weekend and weekdays, and evaluated their associations with cardio-metabolic biomarkers. The analyses were performed within the NANS (National Adult Nutrition Survey) a cross-sectional national food consumption survey of 1500 nationally representative Irish adults. A total number of seven dietary patterns were identified using latent class analysis. The typical meal pattern followed by the majority of the population was characterized by consumption of cereal or toast for breakfast, skipping or consuming a sandwich for light meal, and meat or fish with potatoes, pasta or vegetables for the main meal. Eating patterns differed on weekends, and those participants who consumed meat and eggs for breakfast instead of breakfast cereal and skipped light meal were more likely to have an unhealthier dietary pattern, a higher diastolic blood pressure, and increased serum ferritin. The application of data reduction techniques to simplify the multifaceted nature of dietary data is a useful approach to derive patterns, which might shed further light on the typical dietary patterns followed by populations.
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Affiliation(s)
- Irina Uzhova
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III (CNIC), 28029 Madrid, Spain.
| | - Clara Woolhead
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Belfield, Ireland.
| | - Claire M Timon
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Belfield, Ireland.
| | - Aifric O'Sullivan
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Belfield, Ireland.
| | - Lorraine Brennan
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Belfield, Ireland.
| | - José L Peñalvo
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA.
| | - Eileen R Gibney
- UCD Institute of Food and Health, School of Agriculture and Food Science, University College Dublin, D04 V1W8 Belfield, Ireland.
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90
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Deka P, Pozehl B, Williams MA, Yates B. Adherence to recommended exercise guidelines in patients with heart failure. Heart Fail Rev 2018; 22:41-53. [PMID: 27671166 DOI: 10.1007/s10741-016-9584-1] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Exercise training has been shown to be beneficial in patients with heart failure, and its effectiveness is connected to adherence to the exercise program. Nonetheless, adherence to exercise in these patients remains a concern. Heart failure patients can be considered adherent to an exercise program if they meet 80 % of the recommended dose. We summarize exercise recommendations for patients with heart failure, identify exercise prescription methodologies used in studies that have reported exercise adherence, identify strategies and tools used to improve adherence and examine whether these strategies were developed using a theoretical platform with the primary aim to change behavior and improve adherence to exercise. Factors which may also impact adherence such as exercise setting, intensity and length of participation, gender, race, New York Heart Association functional class and heart failure with preserved and reduced ejection fraction were also investigated. Finally, recommendations for future studies for improving adherence to exercise in patients with heart failure are provided.
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Affiliation(s)
- Pallav Deka
- College of Nursing, University of Nebraska Medical Center, Commerce Court 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA.
| | - Bunny Pozehl
- College of Nursing, University of Nebraska Medical Center, Commerce Court 1230 O Street, Suite 131, Lincoln, NE, 68588-0220, USA
| | - Mark A Williams
- Divison of Cardiology, Creighton University School of Medicine, Omaha, NE, USA
| | - Bernice Yates
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
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91
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D'Agostino EM, Patel HH, Hansen E, Mathew MS, Nardi M, Messiah SE. Longitudinal analysis of cardiovascular disease risk profile in neighbourhood poverty subgroups: 5-year results from an afterschool fitness programme in the USA. J Epidemiol Community Health 2018; 72:193-201. [PMID: 29175865 DOI: 10.1136/jech-2017-209333] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 09/01/2017] [Accepted: 11/13/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND The WHO calls for affordable population-based prevention strategies for reducing the global burden of cardiovascular disease (CVD) on morbidity and mortality; however, effective, sustainable and accessible community-based approaches for CVD prevention in at-risk youth have yet to be identified. We examined the effects of implementing a daily park-based afterschool fitness programme on youth CVD risk profiles over 5 years and across area poverty subgroups. METHODS The study included 2264 youth (mean age 9.4 years, 54% male, 50% Hispanic, 47% non-Hispanic black, 70% high/very high area poverty) in Miami, Florida, USA. We used three-level repeated measures mixed models to determine the longitudinal effects of programme participation on modifiable CVD outcomes (2010-2016). RESULTS Duration of programme participation was significantly associated with CVD risk profile improvements, including body mass index (BMI) z-score, diastolic/systolic blood pressure, skinfold thicknesses, waist-hip ratio, sit-ups, push-ups, Progressive Aerobic Cardiovascular Endurance Run (PACER) score, 400 m run time, probability of developing systolic/diastolic hypertension and overweight/obesity in high/very high poverty neighbourhoods (P<0.001). Diastolic blood pressure decreased 3.4 percentile points (95% CI -5.85 to -0.85), 8.1 percentile points (95% CI -11.98 to -4.26), 6.1 percentile points (95% CI -11.49 to -0.66), 7.6 percentile points (95% CI -15.33 to -0.15) and 11.4 percentile points (95% CI -25.32 to 2.61) for 1-5 years, respectively, in high/very high poverty areas. In contrast, significant improvements were found only for PACER score and waist-hip ratio in low/mid poverty areas. CONCLUSION This analysis presents compelling evidence demonstrating that park-based afterschool programmes can successfully maintain or improve at-risk youth CVD profiles over multiple years.
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Affiliation(s)
- Emily M D'Agostino
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Hersila H Patel
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Eric Hansen
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - M Sunil Mathew
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Maria Nardi
- Health and Fitness Division, Miami-Dade County Department of Parks, Recreation and Open Spaces, Miami, Florida, USA
| | - Sarah E Messiah
- Department of Pediatrics, University of Miami Miller School of Medicine, Miami, Florida, USA
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, Florida, USA
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92
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Alonso-Perales MDM, Lasheras B, Beitia G, Beltrán I, Marcos B, Núñez-Córdoba JM. Barriers to promote cardiovascular health in community pharmacies: a systematic review. Health Promot Int 2018; 32:535-548. [PMID: 26511943 DOI: 10.1093/heapro/dav098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Community pharmacists play an important role in the provision of health promotion services, and community pharmacies are considered as a potentially ideal site for cardiovascular health promotion. Information based on a systematic review of barriers to promoting cardiovascular health in community pharmacy is currently lacking. We have sought to identify the most important barriers to cardiovascular health promotion in the community pharmacy. We have systematically searched PubMed and International Pharmaceutical Abstracts for a period of 15 years from 1 April 1998 to 1 April 2013, contacted subject experts and hand-searched bibliographies. We have included peer-reviewed articles, with English abstracts in the analysis, if they reported community pharmacists' perceptions of the barriers to cardiovascular health promotion activities in a community pharmacy setting. Two reviewers have independently extracted study characteristics and data. We identified 24 studies that satisfy the eligibility criteria. The main barriers to cardiovascular health promotion in the community pharmacy included pharmacist-related factors; practice site factors; financial factors; legal factors; and patient-related factors. This review will help to provide reliable evidence for health promotion practitioners of the barriers to promoting cardiovascular health in the community pharmacy setting. This knowledge is valuable for the improvement of cardiovascular health promotion in this setting and guiding future research.
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Affiliation(s)
| | - Berta Lasheras
- Department of Pharmacology and Pharmacy Practice, Pharmacy School, University of Navarra, Pamplona, Spain
| | - Guadalupe Beitia
- Department of Pharmacology and Pharmacy Practice, Pharmacy School, University of Navarra, Pamplona, Spain
| | - Idoia Beltrán
- Department of Pharmacology and Pharmacy Practice, Pharmacy School, University of Navarra, Pamplona, Spain
| | - Beatriz Marcos
- Department of Pharmacology and Pharmacy Practice, Pharmacy School, University of Navarra, Pamplona, Spain
| | - Jorge M Núñez-Córdoba
- Division of Biostatistics, Research Support Service, Central Clinical Trials Unit, University of Navarra Clinic, Pamplona, Spain.,Department of Preventive Medicine and Public Health, Medical School, University of Navarra, Pamplona, Spain.,Epidemiology and Public Health Area. Navarra Institute for Health Research (IdiSNA), Spain
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93
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Pilkerton CS, Singh SS, Bias TK, Frisbee SJ. Healthcare resource availability and cardiovascular health in the USA. BMJ Open 2017; 7:e016758. [PMID: 29247082 PMCID: PMC5735408 DOI: 10.1136/bmjopen-2017-016758] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 10/05/2017] [Accepted: 10/06/2017] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES Cardiovascular disease (CVD) remains the leading cause of death in the USA. Reducing the population-level burden of CVD disease will require a better understanding and support of cardiovascular health (CVH) in individuals and entire communities. The objectives for this study were to examine associations between community-level healthcare resources (HCrRes) and CVH in individuals and entire communities. SETTING This study consisted of a retrospective, cross-sectional study design, using multivariable epidemiological analyses. PARTICIPANTS All participants in the 2011 Behavioral Risk Factor Surveillance System (BRFSS) survey were examined for eligibility. CVH, defined using the American Heart Association CVH Index (CVHI), was determined using self-reported responses to 2011 BRFSS questions. Data for determining HCrRes were obtained from the Area Health Resource File. Regression analysis was performed to examine associations between healthcare resources and CVHI in communities (linear regression) and individuals (Poisson regression). RESULTS Mean CVHI was 3.3±0.005 and was poorer in the Southeast and Appalachian regions of the USA. Supply of primary care physicians and physician assistants were positively associated with individual and community-level CVHI, while CVD specialist supply was negatively associated with CVHI. Individuals benefiting most from increased supply of primary care providers were: middle aged; female; had non-Hispanic other race/ethnicity; those with household income <$25 000/year; and those in non-urban communities with insurance coverage. CONCLUSIONS Our results support the importance of primary care provider supply for both individual and community CVHI, though not all sociodemographic groups benefited equally from additional primary care providers. Further research should investigate policies and factors that can effectively increase primary care provider supply and influence where they practice.
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Affiliation(s)
- Courtney S Pilkerton
- Department of Family Medicine, School of Medicine, West Virginia University, Morgantown, West Virgina, USA
| | - Sarah S Singh
- Department of Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Thomas K Bias
- Department of Health Policy, Management & Leadership, School of Public Health, West Virginia University, Morgantown, West Virginia, USA
| | - Stephanie J Frisbee
- Departments of Pathology & Laboratory Medicine, and Epidemiology & Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada
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Zhang D, Pan X, Li S, Liang D, Hou Z, Li Y, Shi L. Impact of the National Essential Public Health Services Policy on Hypertension Control in China. Am J Hypertens 2017; 31:115-123. [PMID: 28985269 DOI: 10.1093/ajh/hpx139] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Accepted: 07/26/2017] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hypertension remains a severe challenge to population health worldwide. This study assessed the impact of a nationwide program in China-Essential Public Health Services (EPHS) on improvement of hypertension treatment and control. METHODS A cohort of hypertensive patients was identified from the 2011-2013 China Health and Retirement Longitudinal Study. Hypertension was defined based on: (i) an average systolic blood pressure of ≥140 mm Hg, and/or an average diastolic blood pressure of ≥90 mm Hg; and/or (ii) currently taking antihypertensive medications. Outcomes assessed included the rate of hypertension control, medication use, and blood pressure monitoring at a doctor's office. The key independent variable was defined as whether one received services from the EPHS-covered physical examination by 2013. Probit regression models with a difference-in-difference approach were performed for each of the 3 outcomes. Data were analyzed in 2017. RESULTS Among the 4,958 hypertensive patients, 404 (8.1%) received the EPHS-covered service by 2013. Coverage by the EPHS program was associated with an increase of 7.9% in hypertension control rate (SE = 2.9%, P = 0.020), an increase of 10.3% in the rate of medication use (SE = 2.5%, P < 0.001), and an increase of 10.5% in the rate of blood pressure monitoring (SE = 2.5%, P < 0.001). Results also showed that the EPHS program helped mitigate the geographic disparities in access to health services such as blood pressure monitoring. CONCLUSIONS The National EPHS program improved the treatment and control among hypertension patients. Expanding its program reach could further benefit the cardiovascular health of the population.
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Affiliation(s)
- Donglan Zhang
- Department of Health Policy and Management, College of Public Health, University of Georgia, USA
| | - Xi Pan
- Department of Sociology, Texas State University, USA
| | - Shukai Li
- Institute of Medical Humanity, Peking University, China
| | - Di Liang
- Department of Health Policy and Management, Fielding School of Public Health, University of California, USA
| | - Zhiyuan Hou
- Department of Social Medicine, School of Public Health, Fudan University, China
| | - Yan Li
- Center for Health Innovation, The New York Academy of Medicine, USA
- Department of Population Health Science and Policy, The Icahn School of Medicine at Mount Sinai, USA
| | - Lu Shi
- Department of Public Health Sciences, Clemson University, USA
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Litt JS, Lambert JR, Glueck DH. Gardening and age-related weight gain: Results from a cross-sectional survey of Denver residents. Prev Med Rep 2017; 8:221-225. [PMID: 29159017 PMCID: PMC5683668 DOI: 10.1016/j.pmedr.2017.10.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 10/21/2017] [Accepted: 10/30/2017] [Indexed: 01/26/2023] Open
Abstract
This study examined whether gardening modifies the association between age and body mass index (BMI). We used data from the Neighborhood Environments and Health Survey, which was conducted in Denver (N = 469) between 2006 and 2007. We fit two general linear mixed models. The base model had BMI in kg/m2 as the outcome, and age, an indicator variable for non-gardening status and the age-by-non-gardening status interaction as predictors. The adjusted model included as covariates the potential confounders of education, ethnicity and self-reported health. We assessed self-selection bias and confounding. BMI was 27.18 kg/m2 for non-gardeners, 25.62 kg/m2 for home gardeners, and 24.17 kg/m2 for community gardeners. In the base model, a statistically significant association was observed between age and BMI for non-gardeners but not for the combined community and home gardening group (F = 9.27, ndf = 1, ddf = 441, p = 0.0025). In the adjusted model, the association between age and BMI in non-gardeners was not statistically significant (F = 1.72, ndf = 1, ddf = 431, p = 0.1908). Gardeners differed on social and demographic factors when compared to non-gardeners. The results from the base model are consistent with the hypothesis that gardening might offset age-related weight gain. However, the cross-sectional design does not permit differentiation of true causal effects from the possible effects of bias and confounding. As a follow-up study, to remove bias and confounding, we are conducting a randomized clinical trial of community gardening in Denver.
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Affiliation(s)
- Jill S. Litt
- Environmental Studies Program, University of Colorado Boulder, 4001 Discovery Drive, Boulder, CO 80303, United States
| | - Jeffrey Richard Lambert
- Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place, Aurora, CO 80045, United States
| | - Deborah H. Glueck
- Department of Biostatistics and Informatics, Colorado School of Public Health, 13001 E. 17th Place, Aurora, CO 80045, United States
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96
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Adherence to a Mediterranean diet is associated with the presence and extension of atherosclerotic plaques in middle-aged asymptomatic adults: The Aragon Workers' Health Study. J Clin Lipidol 2017; 11:1372-1382.e4. [DOI: 10.1016/j.jacl.2017.08.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/13/2017] [Accepted: 08/15/2017] [Indexed: 12/29/2022]
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97
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Carnethon MR, Pu J, Howard G, Albert MA, Anderson CAM, Bertoni AG, Mujahid MS, Palaniappan L, Taylor HA, Willis M, Yancy CW. Cardiovascular Health in African Americans: A Scientific Statement From the American Heart Association. Circulation 2017; 136:e393-e423. [PMID: 29061565 DOI: 10.1161/cir.0000000000000534] [Citation(s) in RCA: 679] [Impact Index Per Article: 97.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management. METHOD The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention. RESULTS The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment. CONCLUSIONS The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines.
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98
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Uzhova I, Fuster V, Fernández-Ortiz A, Ordovás JM, Sanz J, Fernández-Friera L, López-Melgar B, Mendiguren JM, Ibáñez B, Bueno H, Peñalvo JL. The Importance of Breakfast in Atherosclerosis Disease: Insights From the PESA Study. J Am Coll Cardiol 2017; 70:1833-1842. [PMID: 28982495 DOI: 10.1016/j.jacc.2017.08.027] [Citation(s) in RCA: 71] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 08/16/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Daily habits, including the number and quality of eating occasions, are potential targets for primary prevention strategies with large health impacts. Skipping breakfast is considered a frequent and unhealthy habit associated with an increased cardiovascular (CV) risk. OBJECTIVES The study sought to explore the association between different breakfast patterns and CV risk factors and the presence, distribution, and extension of subclinical atherosclerosis. METHODS Cross-sectional analysis was performed within the PESA (Progression of Early Subclinical Atherosclerosis) study, a prospective cohort of asymptomatic (free of CV events at baseline) adults 40 to 54 years of age. Lifestyle and multivascular imaging data along with clinical covariates were collected from 4,052 participants. Multivariate logistic regression models were used in the analysis. RESULTS Three patterns of breakfast consumption were studied: high-energy breakfast, when contributing to >20% of total daily energy intake (27% of the population); low-energy breakfast, when contributing between 5% and 20% of total daily energy intake (70% of the population); and skipping breakfast, when consuming <5% of total daily energy (3% of the population). Independent of the presence of traditional and dietary CV risk factors, and compared with high-energy breakfast, habitual skipping breakfast was associated with a higher prevalence of noncoronary (odds ratio: 1.55; 95% confidence interval: 0.97 to 2.46) and generalized (odds ratio: 2.57; 95% confidence interval: 1.54 to 4.31) atherosclerosis. CONCLUSION Skipping breakfast is associated with an increased odds of prevalent noncoronary and generalized atherosclerosis independently of the presence of conventional CV risk factors. (Progression of Early Subclinical Atherosclerosis [PESA]; NCT01410318).
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Affiliation(s)
- Irina Uzhova
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain
| | - Valentín Fuster
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Antonio Fernández-Ortiz
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; CIBER de Enfermedades CardioVasculares, Madrid, Spain; Universidad Complutense, Madrid, Spain; Cardiovascular Institute, IDISSC, Hospital Clínico San Carlos, Madrid, Spain
| | - José M Ordovás
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; U.S. Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, Massachusetts; IMDEA Food Institute, CEI UAM + CSIC, Madrid, Spain
| | - Javier Sanz
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Icahn School of Medicine at Mount Sinai, New York, New York
| | - Leticia Fernández-Friera
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; CIBER de Enfermedades CardioVasculares, Madrid, Spain; HM Hospitales-Centro Integral de Enfermedades Cardiovasculares, Madrid, Spain
| | - Beatriz López-Melgar
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; HM Hospitales-Centro Integral de Enfermedades Cardiovasculares, Madrid, Spain
| | | | - Borja Ibáñez
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; CIBER de Enfermedades CardioVasculares, Madrid, Spain; IIS-Fundación Jiménez Díaz Hospital, Universidad Autónoma, Madrid, Spain
| | - Héctor Bueno
- Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Universidad Complutense, Madrid, Spain; i+12 Research Institute and Cardiology Department, Hospital 12 de Octubre, Madrid, Spain
| | - José L Peñalvo
- Friedman School of Nutrition Science and Policy, Tufts University, Boston, Massachusetts.
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99
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Abstract
Whereas primary prevention seeks to forestall development of disease in individuals with elevated risk, primordial prevention seeks to preempt the development of risk factors. Health behaviors-characterized as "lifestyle" factors-are key interventional targets in primordial prevention of cardiovascular disease. Appropriate dietary intake, including limiting salt and saturated fat consumption, can reduce the risk of developing hypertension and dyslipidemias. Regular physical activity is associated with lower blood pressure and healthier lipid profiles. Diet and exercise are critical to maintaining weight conducive to cardiovascular health. Behavioral factors such as stress management, sleep duration, portion control, and meal timing may play a role in weight management and offer additional routes of intervention. Any smoking elevates cardiovascular risk. Although lifestyle modification programs can be instrumental in reaching public health goals, maintaining cardiovascular health should not be a matter solely of willpower. Ideally, structural and social forces should make healthy lifestyles the default option.
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Affiliation(s)
- Steven A Claas
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Donna K Arnett
- Dean's Office, College of Public Health, University of Kentucky, Lexington, KY, USA.
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100
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Machado JC, Cotta RMM, Moreira TR, da Silva LS. [Analysis of three health education strategies for patients with arterial hypertension]. CIENCIA & SAUDE COLETIVA 2017; 21:611-20. [PMID: 26910168 DOI: 10.1590/1413-81232015212.20112014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2014] [Accepted: 06/21/2015] [Indexed: 11/22/2022] Open
Abstract
The scope of this article is to compare the effect of three health and nutrition education strategies on adherence to the non-pharmacological treatment of systemic arterial hypertension (SAH), using anthropometric, biochemical, clinical and dietetic parameters. It is a longitudinal intervention study of the comparative and quantitative approach community test. The sample was comprised of 212 individuals diagnosed with SAH, who met the inclusion/exclusion criteria. Participants were allocated into three groups, in order to evaluate different methods of intervention, carried out on a monthly basis, for twelve months. The Kolmogorov-Smirnov, ANOVA and Kruskal-Wallis tests were performed for the analyses. Educational interventions in Group 1 and 2 provided the best results on adherence to the non-pharmacological treatment of SAH. In the comparative analysis of different groups, the reduction of glucose showed statistical significant difference, with Group 2 showing the best evolution. Group 1 and 2 had better results on adherence to non-pharmacological treatment of SAH. It is important to stress that in health service practices there is a challenge to promote health education able to intervene on the issue of adherence to the treatment of SAH.
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Affiliation(s)
- Juliana Costa Machado
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, MG, Brasil,
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