101
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Tragaki A, Panagiotakos D. Population ageing and cardiovascular health: the case of Greece. Hellenic J Cardiol 2018; 59:360-361. [DOI: 10.1016/j.hjc.2018.01.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Accepted: 01/02/2018] [Indexed: 11/16/2022] Open
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Cardiovascular disease in Greece; the latest evidence on risk factors. Hellenic J Cardiol 2018; 60:271-275. [PMID: 30321654 DOI: 10.1016/j.hjc.2018.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/24/2018] [Accepted: 09/25/2018] [Indexed: 11/21/2022] Open
Abstract
Cardiovascular disease (CVD) is a significant and ever-growing problem in Europe, accounting for nearly 45% of all deaths and leading to significant morbidity. Greece is one of the European Union member states that top the list of deaths due to ischemic heart disease and stroke, a fact that is mainly attributed to unfavorable changes in modifiable risk factors. The aim of this review is to examine the latest evidence on the most important CVD risk factors. According to studies conducted during the last two decades, the prevalence of arterial hypertension, hypercholesterolemia, diabetes mellitus, and obesity remained relatively stable or increased. The decrease in the prevalence of active smokers and the increase in physical activity, during the last few years, are the main favorable risk modifications in the Greek population. Nevertheless, citizens of Greece seem to gradually adopt unhealthy dietary habits by moving away from Mediterranean diet, as issue that is intensified after the outbreak of the Greek debt crisis. Furthermore, the inability of some patients to afford their medications and the possible health care deficiencies as well as the increasing prevalence of depression may make the situation even worse. During the financial crisis, CVD mortality seems to have remained unaffected, but there is evidence that the incidence of cardiovascular events is increasing. More effort is needed to control established and emerging CVD risk factors among the Greek population.
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Baro L, Sharma N, Toor D, Chaliha MS, Kusre G, Baruah SM, Das S. A hospital-based study of socioeconomic status and clinical spectrum of rheumatic heart disease patients of Assam, North-East India. Eur J Prev Cardiol 2018; 25:1303-1306. [DOI: 10.1177/2047487318787333] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective The aim of this study was to assess the impact of socioeconomic factors in increased prevalence of rheumatic heart disease and its clinical spectrum in Assam, North-East India. Method A case–control questionnaire-based study of 100 echocardiography confirmed rheumatic heart disease cases with age- and sex-matched healthy controls from Assam medical college and hospital in Dibrugarh, Assam was conducted. Results There was a trend toward increased risk of rheumatic heart disease and its clinical spectrum with respect to low socioeconomic status. Three parameters were found to be statistically significant in posing increased risk towards rheumatic heart disease: rural dwelling location ( p < 0.0001, odds ratio (OR) 4.1, 95% confidence interval (CI = 2.29−7.45), low monthly income ( p < 0.001, OR=9.5, 95% CI = 4.99−18.1) and education status ( p < 0.05, OR=9.5, 95% CI = 1.866). Out of the severe cases of mitral stenosis, mitral regurgitation and aortic regurgitation, 69.6%, 58.3% and 34% patients were of low socioeconomic status. Conclusion Socioeconomic factors can be of significant importance in increased prevalence of rheumatic heart disease and might also influence the clinical spectrum of the disease. Increased awareness and up-gradation of socioeconomic status might ameliorate the prevalence of rheumatic heart disease.
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Affiliation(s)
- Lokajeet Baro
- Assam Medical College and Hospital, Dibrugarh, India
| | - Neha Sharma
- Amity Institute of Virology and Immunology, Amity University, India
| | - Devinder Toor
- Amity Institute of Virology and Immunology, Amity University, India
| | | | - Giriraj Kusre
- Assam Medical College and Hospital, Dibrugarh, India
| | | | - Sangeeta Das
- Assam Medical College and Hospital, Dibrugarh, India
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104
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Kareem H, Shetty PN, Devasia T, Karkala YR, Paramasivam G, Guddattu V, Singh A, Chauhan S. Impact of socioeconomic status on adverse cardiac events after coronary angioplasty: a cohort study. HEART ASIA 2018; 10:e010960. [PMID: 29942357 DOI: 10.1136/heartasia-2017-010960] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Revised: 04/11/2018] [Accepted: 05/09/2018] [Indexed: 12/29/2022]
Abstract
Background Socioeconomic status (SES) has been associated with adverse cardiovascular events in coronary atherosclerotic disease. However, it is unclear how SES impacts adverse cardiac events in patients treated with percutaneous coronary intervention (PCI). Methods We determined SES based on educational, economic and occupational parameters for 630 consecutive patients who underwent PCI at our centre between 01 June 2015 and 01 June 2016. The patients were divided into low and high SES groups, and they were followed up for 12 months. Patients were matched at baseline for demographic and procedural characteristics; multivariate analysis was used to adjust for baseline and procedural variables. Postprocedure compliance to medications was analysed. At 12 months, the primary composite end point of major adverse cardiac events (MACE) - consisting of death, non-fatal myocardial infarction, target lesion revascularisation, target vessel revascularisation - was compared between the groups. Results The high SES group had a higher prevalence of diabetes mellitus (p=0.03; OR 0.74%, 95% CI 0.53% to 1.03%) and a stronger family history of ischaemic heart disease (p=0.003; OR 0.53%, 95% CI 0.33% to 0.84%). Low SES was associated with lower compliance with medication (p=0.01; OR 2.22%, 95% CI 1.19% to 4.15%). At 12 months, the primary composite end point of MACE was found to be higher in the low SES group (p=0.01); higher MACE was primarily driven by cardiac mortality (p<0.001). Low SES was found to be an independent predictor of MACE (HR 1.84%, 95% CI 1.16% to 2.96%). Conclusion Low SES was associated with a higher incidence of major adverse cardiac events in patients undergoing PCI and was an independent predictor of MACE at 12 months.
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Affiliation(s)
- Hashir Kareem
- Department of Cardiology, Kasturba Medical College and Hospital, Manipal University, Manipal, India
| | - Prasad Narayana Shetty
- Department of Cardiology, Kasturba Medical College and Hospital, Manipal University, Manipal, India
| | - Tom Devasia
- Department of Cardiology, Kasturba Medical College and Hospital, Manipal University, Manipal, India
| | - Yeshwanth Rao Karkala
- Department of Pharmacology, Melaka Manipal Medical College, Manipal University, Manipal, India
| | - Ganesh Paramasivam
- Department of Cardiology, Kasturba Medical College and Hospital, Manipal University, Manipal, India
| | - Vasudev Guddattu
- Department of Statistics Prasanna school of Public Health, Manipal University, Manipal, India
| | - Ajit Singh
- Department of Cardiology, Kasturba Medical College and Hospital, Manipal University, Manipal, India
| | - Sheetal Chauhan
- Department of Pharmacology, Melaka Manipal Medical College, Manipal University, Manipal, India
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McCartney DL, Stevenson AJ, Walker RM, Gibson J, Morris SW, Campbell A, Murray AD, Whalley HC, Porteous DJ, McIntosh AM, Evans KL, Deary IJ, Marioni RE. Investigating the relationship between DNA methylation age acceleration and risk factors for Alzheimer's disease. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2018; 10:429-437. [PMID: 30167451 PMCID: PMC6111045 DOI: 10.1016/j.dadm.2018.05.006] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Introduction The “epigenetic clock” is a DNA methylation–based estimate of biological age and is correlated with chronological age—the greatest risk factor for Alzheimer's disease (AD). Genetic and environmental risk factors exist for AD, several of which are potentially modifiable. In this study, we assess the relationship between the epigenetic clock and AD risk factors. Methods Multilevel models were used to assess the relationship between age acceleration (the residual of biological age regressed onto chronological age) and AD risk factors relating to cognitive reserve, lifestyle, disease, and genetics in the Generation Scotland study (n = 5100). Results We report significant associations between age acceleration and body mass index, total cholesterol to high-density lipoprotein cholesterol ratios, socioeconomic status, high blood pressure, and smoking behavior (Bonferroni-adjusted P < .05). Discussion Associations are present between environmental risk factors for AD and age acceleration. Measures to modify such risk factors might improve the risk profile for AD and the rate of biological ageing. Future longitudinal analyses are therefore warranted.
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Affiliation(s)
- Daniel L McCartney
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Anna J Stevenson
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Rosie M Walker
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Jude Gibson
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland
| | - Stewart W Morris
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Archie Campbell
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland
| | - Alison D Murray
- Aberdeen Biomedical Imaging Centre, University of Aberdeen, Aberdeen, Scotland
| | - Heather C Whalley
- Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland
| | - David J Porteous
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland
| | - Andrew M McIntosh
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland.,Division of Psychiatry, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, Scotland.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland
| | - Kathryn L Evans
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland
| | - Ian J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland.,Department of Psychology, University of Edinburgh, Edinburgh, Scotland
| | - Riccardo E Marioni
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland.,Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, Scotland
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106
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The impact of financial crisis on coronary artery disease burden in Greece. Hellenic J Cardiol 2018; 60:185-188. [PMID: 29601956 DOI: 10.1016/j.hjc.2018.03.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2017] [Revised: 02/23/2018] [Accepted: 03/16/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Economic crisis poses an immense threat to public health worldwide and has been linked to cardiovascular morbidity and mortality. Greece is facing a distinctive recession over the recent years. However, the exact impact on coronary artery disease (CAD) burden has not been adequately addressed. METHODS Demographic, clinical, and angiographic data of 3895 hospitalized patients were retrospectively studied. Patients were classified into two groups: those before crisis (2006-2007, n = 1228) and those during crisis (2011-2015, n = 2667). RESULTS All data before and during crisis were compared. During crisis, patients presented with less acute coronary syndrome (ACS - 45.5% vs. 39.9%, p < 0.001). Subsequently, there were more patients without CAD (23.7% vs. 35.1%, p < 0.001) or one-vessel disease (20.5% vs. 23%, p < 0.001). The prevalence of traditional risk factors decreased significantly or remained stable except obesity (26.3% vs. 31.4%, p = 0.002). A significant increase in the examined females (23.6% vs. 26.7%, p = 0.04) was also observed. CONCLUSIONS The burden of CAD in Greece was partially affected during the financial crisis. Even though the incidence of ACS was decreased, more women and more patients with no- or single-vessel disease were referred for cardiac catheterization. In addition, the prevalence of traditional risk factors for CAD did not increase except obesity confirming the "obesity paradox." It seems that the impact of traditional risk factors for CAD is not an immediate process and is somewhat related to living conditions or other exogenous and social factors.
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107
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Control of cardiovascular risk factors and its determinants in the general population- findings from the STAAB cohort study. BMC Cardiovasc Disord 2017; 17:276. [PMID: 29096615 PMCID: PMC5669014 DOI: 10.1186/s12872-017-0708-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2017] [Accepted: 10/24/2017] [Indexed: 01/30/2023] Open
Abstract
Background While data from primary care suggest an insufficient control of vascular risk factors, little is known about vascular risk factor control in the general population. We therefore aimed to investigate the adoption of adequate risk factor control and its determinants in the general population free of cardiovascular disease (CVD). Methods Data from the Characteristics and Course of Heart Failure Stages A-B and Determinants of Progression (STAAB) Cohort Study, a population-based study of inhabitants aged 30 to 79 years from the general population of Würzburg (Germany), were used. Proportions of participants without established CVD meeting targets for risk factor control recommended by 2016 ESC guideline were identified. Determinants of the accumulation of insufficiently controlled vascular risk factors (three or more) were assessed. Results Between December 2013 and April 2015, 1379 participants without CVD were included; mean age was 53.1 ± 11.9 years and 52.9% were female; 30.8% were physically inactive, 55.2% overweight, 19.3% current smokers. Hypertension, dyslipidemia, and diabetes mellitus were prevalent in 31.8%, 57.6%, and 3.9%, respectively. Treatment goals were not reached despite medication in 52.7% of hypertensive, in 37.3% of hyperlipidemic and in 44.0% of diabetic subjects. Insufficiently controlled risk was associated with male sex (OR 1.94, 95%CI 1.44–2.61), higher age (OR for 30–39 years vs. 70–79 years 4.01, 95%CI 1.94–8.31) and lower level of education (OR for primary vs. tertiary 2.15, 95%CI 1.48–3.11). Conclusions In the general population, prevalence of vascular risk factors was high. We found insufficient identification and control of vascular risk factors and a considerable potential to improve adherence to cardiovascular guidelines for primary prevention. Further studies are needed to identify and overcome patient- and physician-related barriers impeding successful control of vascular risk factors in the general population. Electronic supplementary material The online version of this article (10.1186/s12872-017-0708-x) contains supplementary material, which is available to authorized users.
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108
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Abstract
Zusammenfassung. Trotz aller Kontroversen ist die Empfehlung der Kontrolle der Zufuhr an gesättigten Fetten und Cholesterin bei gleichzeitiger Optimierung der Zufuhr an einfach- und mehrfach ungesättigten Fetten immer noch gültig, sollte aber nicht unabhängig von anderen beeinflussbaren Determinanten betrachtet werden. Diese Empfehlungen können am einfachsten durch Beachtung des gesamten Essmusters erreicht werden, das eigentlich einem semi-vegetarischen Essmuster mit geringer Energiedichte entspricht. Es gilt, regelmässig alle Komponenten des «Foodoms» mit der Ernährung aufzunehmen.
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Affiliation(s)
- Paolo M Suter
- 1 Klinik und Poliklinik für Innere Medizin, Universitätsspital Zürich
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109
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Özdaş S, Olt S, Şirik M. The Role of Sleeve Gastrectomy on Preventing Type 2 Diabetes Mellitus. Open Access Maced J Med Sci 2017; 5:316-318. [PMID: 28698749 PMCID: PMC5503729 DOI: 10.3889/oamjms.2017.074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/22/2017] [Accepted: 06/05/2017] [Indexed: 12/30/2022] Open
Abstract
AIM: To investigate the effect of bariatric surgery on HbA1c and serum cortisol levels in morbidly obese patients without type 2 diabetes mellitus. MATERIALS AND METHODS: Twenty-nine patients who underwent sleeve gastrectomy and whose body mass index was> 40 were included in the present study. Patients’ files were reviewed retrospectively. Those with diabetes mellitus and those with age <18 were excluded from the study. Pre-operative and 1-year post operative data were documented. The obtained data were analysed by SPSS statistical program. RESULTS: The mean age of the patients was 27.4 ± 8.4. 5 of the patients were male, and 24 were female. The mean body mass index of the patients was 44 ± 2.3. 1 patient [3.4%] had hypertension. Four patients [13.7%] had gastroesophageal reflux disease. The number of smokers was 7 [24.1%], and the number of alcohol users was 3 [10.3%]. There was a statistically significant decrease in HbA1c, body mass index values after operation [p value <0.01], but cortisol was not different [p value = 0.72]. CONCLUSION: In this present study we found that bariatric surgery caused a significant decrease in HbA1c levels in non-diabetic patients, suggesting that bariatric surgery may prevent Type 2 Diabetes Mellitus in obese patients.
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Affiliation(s)
- Sabri Özdaş
- Adıyaman University Medical Faculty, Department of General Surgery, Adıyaman, Turkey
| | - Serdar Olt
- Adıyaman University Medical Faculty, Department of Internal Medicine, Adıyaman, Turkey
| | - Mehmet Şirik
- Adıyaman University Medical Faculty, Department of Radiology, Adıyaman, Turkey
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110
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Tousoulis D. Socioeconomic status and cardiac disease in Europe: A modern-day problem in the era of economic crisis. Hellenic J Cardiol 2017; 58:1-3. [PMID: 28396053 DOI: 10.1016/j.hjc.2017.03.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Accepted: 03/30/2017] [Indexed: 11/25/2022] Open
Affiliation(s)
- Dimitris Tousoulis
- 1(st) Cardiology Department, National and Kapodistrian University of Athens University Medical School, Hippokration Hospital, Athens, Greece.
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