151
|
McKenzie BL, Santos JA, Geldsetzer P, Davies J, Manne-Goehler J, Gurung MS, Sturua L, Gathecha G, Aryal KK, Tsabedze L, Andall-Brereton G, Bärnighausen T, Atun R, Vollmer S, Woodward M, Jaacks LM, Webster J. Evaluation of sex differences in dietary behaviours and their relationship with cardiovascular risk factors: a cross-sectional study of nationally representative surveys in seven low- and middle-income countries. Nutr J 2020; 19:3. [PMID: 31928531 PMCID: PMC6956488 DOI: 10.1186/s12937-019-0517-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Accepted: 12/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Cardiovascular diseases (CVD) are the leading causes of death for men and women in low-and-middle income countries (LMIC). The nutrition transition to diets high in salt, fat and sugar and low in fruit and vegetables, in parallel with increasing prevalence of diet-related CVD risk factors in LMICs, identifies the need for urgent action to reverse this trend. To aid identification of the most effective interventions it is crucial to understand whether there are sex differences in dietary behaviours related to CVD risk. METHODS From a dataset of 46 nationally representative surveys, we included data from seven countries that had recorded the same dietary behaviour measurements in adults; Bhutan, Eswatini, Georgia, Guyana, Kenya, Nepal and St Vincent and the Grenadines (2013-2017). Three dietary behaviours were investigated: positive salt use behaviour (SUB), meeting fruit and vegetable (F&V) recommendations and use of vegetable oil rather than animal fats in cooking. Generalized linear models were used to investigate the association between dietary behaviours and waist circumference (WC) and undiagnosed and diagnosed hypertension and diabetes. Interaction terms between sex and dietary behaviour were added to test for sex differences. RESULTS Twenty-four thousand three hundred thirty-two participants were included. More females than males reported positive SUB (31.3 vs. 27.2% p-value < 0.001), yet less met F&V recommendations (13.2 vs. 14.8%, p-value< 0.05). The prevalence of reporting all three dietary behaviours in a positive manner was 2.7%, varying by country, but not sex. Poor SUB was associated with a higher prevalence of undiagnosed hypertension for females (13.1% vs. 9.9%, p-value = 0.04), and a higher prevalence of undiagnosed diabetes for males (2.4% vs. 1.5%, p-value = 0.02). Meeting F&V recommendations was associated with a higher prevalence of high WC (24.4% vs 22.6%, p-value = 0.01), but was not associated with undiagnosed or diagnosed hypertension or diabetes. CONCLUSION Interventions to increase F&V intake and positive SUBs in the included countries are urgently needed. Dietary behaviours were not notably different between sexes. However, our findings were limited by the small proportion of the population reporting positive dietary behaviours, and further research is required to understand whether associations with CVD risk factors and interactions by sex would change as the prevalence of positive behaviours increases.
Collapse
Affiliation(s)
- Briar L McKenzie
- The George Institute for Global Health, University of New South Wales, Sydney, Australia.
| | - Joseph Alvin Santos
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Pascal Geldsetzer
- Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, USA
| | - Justine Davies
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- Medical Research Council/Wits University Rural Public Health and Health Transitions Research Unit, Faculty of Health Sciences, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | | | | | - Lela Sturua
- Non-Communicable Disease Department, National Center for Disease Control and Public Health, Petre Shotadze Tbilisi Medical Academy, Tbilisi, Georgia
| | - Gladwell Gathecha
- Division of Non-Communicable Diseases, Kenya Ministry of Health, Nairobi, Kenya
| | | | | | - Glennis Andall-Brereton
- Non-Communicable Diseases, Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago
| | - Till Bärnighausen
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele an Durban, Durban, South Africa
| | - Rifat Atun
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Sebastian Vollmer
- Department of Economics and Centre for Modern Indian Studies, University of Göttingen, Göttingen, Germany
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, University of Oxford, Oxford, UK
- Department of Epidemiology, Johns Hopkins University, Baltimore, USA
| | - Lindsay M Jaacks
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Jacqui Webster
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| |
Collapse
|
152
|
Kim K, Lee CH, Park CB. Chemical sensing platforms for detecting trace-level Alzheimer's core biomarkers. Chem Soc Rev 2020; 49:5446-5472. [DOI: 10.1039/d0cs00107d] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
This review provides an overview of recent advances in optical and electrical detection of Alzheimer's disease biomarkers in clinically relevant fluids.
Collapse
Affiliation(s)
- Kayoung Kim
- Department of Materials Science and Engineering
- Korea Advanced Institute of Science and Technology (KAIST)
- Daejeon 305-701
- Republic of Korea
| | - Chang Heon Lee
- Department of Materials Science and Engineering
- Korea Advanced Institute of Science and Technology (KAIST)
- Daejeon 305-701
- Republic of Korea
| | - Chan Beum Park
- Department of Materials Science and Engineering
- Korea Advanced Institute of Science and Technology (KAIST)
- Daejeon 305-701
- Republic of Korea
| |
Collapse
|
153
|
Vautrin E, Jean ABP, Fourny M, Marlière S, Vanzetto G, Bouvaist H, Debaty G, Belle L, Danchin N, Labarère J. Sex differences in coronary artery lesions and in‐hospital outcomes for patients with ST‐segment elevation myocardial infarction under the age of 45. Catheter Cardiovasc Interv 2019; 96:1222-1230. [DOI: 10.1002/ccd.28627] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 11/08/2019] [Accepted: 11/17/2019] [Indexed: 12/19/2022]
Affiliation(s)
- Estelle Vautrin
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | | | - Magali Fourny
- Quality of Care Unit Grenoble Alpes University Hospital Grenoble France
| | - Stéphanie Marlière
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Gérald Vanzetto
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Hélène Bouvaist
- Department of Cardiology Grenoble Alpes University Hospital Grenoble France
| | - Guillaume Debaty
- TIMC, UMR 5525, CNRS Université Grenoble Alpes Grenoble France
- Department of Emergency Medicine Grenoble Alpes University Hospital Grenoble France
| | - Loïc Belle
- Department of Cardiology Annecy‐Genevois Hospital, Réseau nord alpin des urgences (RENAU) Annecy France
| | - Nicolas Danchin
- Department of Cardiology Hôpital Européen Georges Pompidou, Assistance Publique‐Hôpitaux de Paris Paris France
| | - José Labarère
- Quality of Care Unit Grenoble Alpes University Hospital Grenoble France
- TIMC, UMR 5525, CNRS Université Grenoble Alpes Grenoble France
- CIC 1406, INSERM Grenoble Alpes University Hospital Grenoble France
| |
Collapse
|
154
|
Kitazawa M, Fujihara K, Osawa T, Yamamoto M, Yamada MH, Kaneko M, Matsubayashi Y, Yamada T, Yamanaka N, Seida H, Sone H. Risk of coronary artery disease according to glucose abnormality status and prior coronary artery disease in Japanese men. Metabolism 2019; 101:153991. [PMID: 31666194 DOI: 10.1016/j.metabol.2019.153991] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 09/18/2019] [Accepted: 09/21/2019] [Indexed: 01/09/2023]
Abstract
OBJECTIVE Although glucose abnormality status (GAS), prior coronary artery disease (CAD), and other traditional risk factors affect the incidence of subsequent CAD, their impact in the same cohort has been scantly studied. RESEARCH DESIGN AND METHODS We analyzed data from a nationwide claims database in Japan that was accumulated during 2008-2016 involving 138,162 men aged 18-72 years. Participants were classified as having normoglycemia, borderline glycemia, or diabetes mellitus (DM) with prior CAD (CAD+) or without prior CAD (CAD-). Cox regression model identified variables related to the incidence of CAD. RESULTS Among CAD-, management of traditional risks differed from those with and without subsequent CAD events. On the other hand, such differences were weaker in borderline glycemia and DM CAD+, and the influence of traditional risk factors on subsequent CAD was not observed. Cox regression model showed that borderline glycemia and DM confer approximately 1.2- and 2.8-fold excess risks of CAD, respectively, compared with CAD- with normoglycemia. CAD+ confers approximately a 5- to 8-fold increased risk. The impacts of DM and prior CAD additively reached a hazard ratio (HR) of 15.74 (95% confidence interval [CI]: 11.82-21.00). However, the HR in those with borderline glycemia and CAD+ was 7.20 (95% CI: 5.01-10.34), which was not different from those with normoglycemia and CAD+. CONCLUSION Control status of traditional risk factors and impact on subsequent CAD differ among categories of glycemic status with and without prior CAD. Individualizing treatment strategies is needed in consideration of risk factors, such as GAS and CAD+.
Collapse
Affiliation(s)
- Masaru Kitazawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Kazuya Fujihara
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan.
| | - Taeko Osawa
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Masahiko Yamamoto
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Mayuko Harada Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan; Division of Diabetes and Endocrinology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Masanori Kaneko
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Yasuhiro Matsubayashi
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | - Takaho Yamada
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| | | | | | - Hirohito Sone
- Department of Internal Medicine, Niigata University Faculty of Medicine, Niigata, Japan
| |
Collapse
|
155
|
Govender RD, Al-Shamsi S, Soteriades ES, Regmi D. Incidence and risk factors for recurrent cardiovascular disease in middle-eastern adults: a retrospective study. BMC Cardiovasc Disord 2019; 19:253. [PMID: 31711429 PMCID: PMC6849175 DOI: 10.1186/s12872-019-1231-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Accepted: 10/21/2019] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Individuals with established cardiovascular disease (CVD) and risk factors such as age, smoking, hypertension, and diabetes mellitus are at an increased risk of recurrent cardiovascular events and death. The incidence rate of recurrent CVD events varies between countries and populations. The United Arab Emirates (UAE) has one of the highest age-standardized death rates for CVD worldwide. The aim of our study was to estimate the incidence rates and determine the predictors of recurrent CVD events among UAE nationals. METHODS We investigated an outpatient-based cohort of patients with a history of CVD visiting Tawam Hospital between April 1, 2008 and December 31, 2008. They were followed-up until July 31, 2018. Univariable and multivariable Cox proportional hazards regression models were used to determine the association between major CVD risk factors and the risk of CVD recurrence. RESULTS A total of 216 patients (167 males, 49 females) with a history of CVD were included. They were followed for a median (interquartile range) of 8.1 (5.5-9.3) years, with a total of 1184 patient-years of follow-up. The overall incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. The 8-year cumulative incidence was 73.7%. Age, female sex, and diabetes mellitus were significant predictors of recurrent CVD events, where females had a 1.96 times higher risk of recurrent CVD events than males. CONCLUSION Significant predictors of recurrent CVD events are older age, female sex, and diabetes mellitus. The incidence rate of recurrent CVD events was 92.1 per 1000 patient-years. Preventive measures, based on international guidelines for CVD management, may improve CVD morbidity and mortality in the UAE population.
Collapse
Affiliation(s)
- Romona D Govender
- College of Medicine and Health Sciences, Department of Family Medicine, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates.
| | - Saif Al-Shamsi
- College of Medicine and Health Sciences, Department of Internal Medicine, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Elpidoforos S Soteriades
- College of Medicine and Health Sciences, Institute of Public Health, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Dybesh Regmi
- College of Medicine and Health Sciences, Department of Family Medicine, United Arab Emirates University, P.O. Box 17666, Al Ain, United Arab Emirates
| |
Collapse
|
156
|
Heraty E, Griffin BL, Vest KM. Faculty insights regarding incorporation of gender- and sex-related differences in the PharmD curriculum: Phase 2. CURRENTS IN PHARMACY TEACHING & LEARNING 2019; 11:1167-1171. [PMID: 31783964 DOI: 10.1016/j.cptl.2019.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 05/03/2019] [Accepted: 07/24/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND While pharmacists should be aware of gender and sex-related differences in treatment related decisions, this is not a required doctor of pharmacy curricular component. A regional pilot study demonstrated that approximately half of pharmacy practice faculty discussed these differences in their content area. The aim of this study was to evaluate the extent of inclusion of gender and sex-related differences on a national level in doctor of pharmacy curricula and to determine if faculty are comfortable teaching the topic. METHODS An electronic message with a link to an online survey was distributed to 7250 faculty members at 139 colleges of pharmacy. The survey remained open for three weeks and potential participants received weekly email reminders. The survey was voluntary, and responses were de-identified. RESULTS Overall, 641 faculty participated in the survey (8.8% response rate). Most respondents indicated that they do not teach about gender or sex-related differences (54.9%). Of those faculty reporting teaching gender and/or sex-related differences, 28% indicated that it was addressed in one clinical topic, while some (7.7%) indicated that the content was included in up to five topics. Half of faculty (53.6%) indicated that they believe this topic is somewhat important. CONCLUSIONS Results of this study suggest that gender and sex-related differences are not adequately addressed in current pharmacy curricula.
Collapse
Affiliation(s)
- Erin Heraty
- Midwestern University Chicago College of Pharmacy, 555 31st Street, Downers Grove, IL 60515, United States.
| | - Brooke L Griffin
- Midwestern University Chicago College of Pharmacy, 555 31st Street, Downers Grove, IL 60515, United States.
| | - Kathleen M Vest
- Midwestern University Chicago College of Pharmacy, 555 31st Street, Downers Grove, IL 60515, United States.
| |
Collapse
|
157
|
Conroy M, Sellors J, Effingham M, Littlejohns TJ, Boultwood C, Gillions L, Sudlow CLM, Collins R, Allen NE. The advantages of UK Biobank's open-access strategy for health research. J Intern Med 2019; 286:389-397. [PMID: 31283063 PMCID: PMC6790705 DOI: 10.1111/joim.12955] [Citation(s) in RCA: 61] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Ready access to health research studies is becoming more important as researchers, and their funders, seek to maximize the opportunities for scientific innovation and health improvements. Large-scale population-based prospective studies are particularly useful for multidisciplinary research into the causes, treatment and prevention of many different diseases. UK Biobank has been established as an open-access resource for public health research, with the intention of making the data as widely available as possible in an equitable and transparent manner. Access to UK Biobank's unique breadth of phenotypic and genetic data has attracted researchers worldwide from across academia and industry. As a consequence, it has enabled scientists to perform world-leading collaborative research. Moreover, open access to an already deeply characterized cohort has encouraged both public and private sector investment in further enhancements to make UK Biobank an unparalleled resource for public health research and an exemplar for the development of open-access approaches for other studies.
Collapse
Affiliation(s)
- M Conroy
- UK Biobank, Cheadle, Stockport, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - T J Littlejohns
- UK Biobank, Cheadle, Stockport, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - C L M Sudlow
- UK Biobank, Cheadle, Stockport, UK.,Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK
| | - R Collins
- UK Biobank, Cheadle, Stockport, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - N E Allen
- UK Biobank, Cheadle, Stockport, UK.,Clinical Trial Service Unit and Epidemiological Studies Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| |
Collapse
|
158
|
Huebschmann AG, Huxley RR, Kohrt WM, Zeitler P, Regensteiner JG, Reusch JEB. Sex differences in the burden of type 2 diabetes and cardiovascular risk across the life course. Diabetologia 2019; 62:1761-1772. [PMID: 31451872 PMCID: PMC7008947 DOI: 10.1007/s00125-019-4939-5] [Citation(s) in RCA: 176] [Impact Index Per Article: 35.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 05/29/2019] [Indexed: 12/11/2022]
Abstract
By 2017 estimates, diabetes mellitus affects 425 million people globally; approximately 90-95% of these have type 2 diabetes. This narrative review highlights two domains of sex differences related to the burden of type 2 diabetes across the life span: sex differences in the prevalence and incidence of type 2 diabetes, and sex differences in the cardiovascular burden conferred by type 2 diabetes. In the presence of type 2 diabetes, the difference in the absolute rates of cardiovascular disease (CVD) between men and women lessens, albeit remaining higher in men. Large-scale observational studies suggest that type 2 diabetes confers 25-50% greater excess risk of incident CVD in women compared with men. Physiological and behavioural mechanisms that may underpin both the observed sex differences in the prevalence of type 2 diabetes and the associated cardiovascular burden are discussed in this review. Gender differences in social behavioural norms and disparities in provider-level treatment patterns are also highlighted, but not described in detail. We conclude by discussing research gaps in this area that are worthy of further investigation.
Collapse
Affiliation(s)
- Amy G Huebschmann
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | - Rachel R Huxley
- College of Science, Health and Engineering, La Trobe University, Melbourne, VIC, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, NSW, Australia
| | - Wendy M Kohrt
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of Geriatric Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - Philip Zeitler
- Division of Pediatric Endocrinology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Judith G Regensteiner
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA
- Division of General Internal Medicine, University of Colorado School of Medicine, Aurora, CO, USA
- Division of Cardiology, University of Colorado School of Medicine (CU-SOM), Aurora, CO, USA
| | - Jane E B Reusch
- Center for Women's Health Research, University of Colorado School of Medicine, MS C263, 12348 E. Montview Boulevard, Aurora, CO, 80045, USA.
- Department of Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA.
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado School of Medicine, Aurora, CO, USA.
| |
Collapse
|
159
|
|
160
|
Woodward M. Rationale and tutorial for analysing and reporting sex differences in cardiovascular associations. Heart 2019; 105:1701-1708. [PMID: 31371439 PMCID: PMC6855792 DOI: 10.1136/heartjnl-2019-315299] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 06/05/2019] [Accepted: 06/24/2019] [Indexed: 12/30/2022] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death in women and men. Yet biological and social factors differ between the sexes, while the importance of CVD in women may be underestimated due to the higher age-specific rates in men and the historical bias towards the male model of CVD. Consequently, sex differences in risk factor associations with CVD occur, but these are not always recognised. This article argues that sex disaggregation should be the norm in CVD research, for both humanitarian and clinical reasons. A tutorial on how to design and analyse sex comparisons is provided, including ways of reducing bias and increasing efficiency. This is presented both in the context of analysing individual participant data from a single study and a meta-analysis of sex-specific summary data. Worked examples are provided for both types of research. Fifteen key recommendations are included, which should be considered when undertaking sex comparisons of CVD associations. Paramount among these is the need to estimate sex differences, as ratios of relative risks or differences in risk differences, rather than merely test them for statistical significance. Conversely, when there is no evidence of statistical or clinical significance of a sex difference, the conclusions from the research should not be sex-specific.
Collapse
Affiliation(s)
- Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia.,The George Institute for Global Health, University of Oxford, Oxford, UK.,Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| |
Collapse
|
161
|
Bai MF, Wang X. Risk factors associated with coronary heart disease in women: a systematic review. Herz 2019; 45:52-57. [DOI: 10.1007/s00059-019-4835-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2018] [Revised: 06/12/2019] [Accepted: 06/21/2019] [Indexed: 12/20/2022]
|
162
|
Thompson K, Peters S, Woodward M, Carcel C, Norton R. Reporting sex and gender in medical research. Lancet 2019; 393:2038. [PMID: 31106752 DOI: 10.1016/s0140-6736(19)31041-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 03/21/2019] [Indexed: 01/02/2023]
Affiliation(s)
- Kelly Thompson
- The George Institute for Global Health, University of New South Wales, Sydney, 2042, Australia.
| | - Sanne Peters
- The George Institute for Global Health, University of Oxford, Oxford, UK; Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, 2042, Australia; The George Institute for Global Health, University of Oxford, Oxford, UK; Department of Epidemiology, Johns Hopkins University, Baltimore, MD, USA
| | - Cheryl Carcel
- The George Institute for Global Health, University of New South Wales, Sydney, 2042, Australia; The George Institute for Global Health, University of Oxford, Oxford, UK; Sydney School of Public Health, Sydney Medical School, University of Sydney, Sydney, Australia
| | - Robyn Norton
- The George Institute for Global Health, University of New South Wales, Sydney, 2042, Australia; The George Institute for Global Health, University of Oxford, Oxford, UK
| |
Collapse
|
163
|
Beale AL, Kaye DM, Marques FZ. The role of the gut microbiome in sex differences in arterial pressure. Biol Sex Differ 2019; 10:22. [PMID: 31023366 PMCID: PMC6485140 DOI: 10.1186/s13293-019-0236-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/08/2019] [Indexed: 01/22/2023] Open
Abstract
There has been intense interest in the role of the gut microbiome in human health and a broad range of diseases in recent years. In the context of cardiovascular disease, gut dysbiosis (defined as a change in the gut microbiome and the gut-epithelial barrier) has been linked to disturbances in blood pressure (BP) regulation. These findings build upon our understanding of the complex pathophysiology of essential hypertension. There are clear sex differences in the epidemiology of hypertension, with distinct trends in BP across the life-course in men and women. To date, a role for the gut microbiome in contributing to the sex differences in BP is yet to be clearly established. The purpose of this review is to summarise the current literature regarding how the gut microbiome differs between men and women and to investigate whether sex-determined differences in the gut microbiome influence the response to factors such as diet, obesity and inflammation. Finally, we will explore evidence for the possible interaction between sex-specific factors, including sex hormones and pregnancy, with the gut in the context of hypertension pathophysiology.
Collapse
Affiliation(s)
- Anna L Beale
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia.,Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - David M Kaye
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia.,Central Clinical School, Faculty of Medicine Nursing and Health Sciences, Monash University, Melbourne, Australia.,Heart Centre, Alfred Hospital, Melbourne, Australia
| | - Francine Z Marques
- Heart Failure Research Group, Baker Heart and Diabetes Institute, Melbourne, VIC, 3004, Australia. .,School of Biological Sciences, Faculty of Science, Monash University, Melbourne, Australia.
| |
Collapse
|
164
|
Woodward M. Cardiovascular Disease and the Female Disadvantage. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E1165. [PMID: 30939754 PMCID: PMC6479531 DOI: 10.3390/ijerph16071165] [Citation(s) in RCA: 152] [Impact Index Per Article: 30.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 03/17/2019] [Accepted: 03/26/2019] [Indexed: 12/28/2022]
Abstract
Age-standardised rates of cardiovascular disease (CVD) are substantially higher in men than women. This explains why CVD has traditionally been seen as a "man's problem". However, CVD is the leading cause of death in women, worldwide, and is one of the most common causes of disability-adjusted life-years lost. In general, this is under-recognised and, in several ways, women are disadvantaged in terms of CVD. Both in primary and secondary prevention, there is evidence that women are undertreated, compared to men. Women often experience heart disease in a different way compared to men, and lack of recognition of this has been shown to have adverse consequences. Female patients of male cardiac physicians have been found to have worse outcomes than their male counterparts, with no such gender differential for female cardiologists. Clinical trials in CVD primarily recruit male patients, yet, it is well recognised that some drugs act differently in women and men. Diabetes and smoking, and perhaps other risk factors, confer a greater proportional excess cardiovascular risk to women than to men, whilst adverse pregnancies and factors concerned with the female reproductive cycle give women added vulnerability to CVD. However, women's health research is skewed towards mother and child health, an area where, arguably, the greatest public health gains have already been made, and breast cancer. Hence there is a need to redefine what is meant by "women's health" to encompass the whole lifecycle, with a stronger emphasis on CVD and other non-communicable diseases. Sex-specific analyses of research data should be the norm, whenever feasible.
Collapse
Affiliation(s)
- Mark Woodward
- The George Institute for Global Health, University of Oxford, Oxford OX1 2BQ, UK.
- The George Institute for Global Health, University of New South Wales, Sydney, NSW 2050, Australia.
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD 21287, USA.
| |
Collapse
|
165
|
Peffer K, den Heijer M, de Kort WLAM, Verbeek ALM, Atsma F. Cardiovascular risk in 159 934 frequent blood donors while addressing the healthy donor effect. Heart 2019; 105:1260-1265. [PMID: 30872386 DOI: 10.1136/heartjnl-2018-314138] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/30/2019] [Accepted: 02/08/2019] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE To investigate whether regular blood donation decreases cardiovascular risk. METHODS All 159 934 Dutch whole-blood donors with an active donation career of at least 10 years were categorised into sex-specific donation tertiles based on the number of donations during this 10-year qualification period. Cardiovascular endpoints were based on hospital discharge diagnoses and death certificates from Dutch Hospital Data and Statistics Netherlands and occurring after the 10-year qualification period. Cox regression was used to estimate the age-adjusted and starting year-adjusted hazard rate ratio (HRR). RESULTS Female high-frequency blood donors had a reduced cardiovascular morbidity (HRR=0.91, 95% CI 0.85 to 0.98) compared with low-frequency blood donors. No effect was observed in men (HRR=1.00, 95% CI 0.95 to 1.05). To rule out a residual healthy donor effect (HDE), additional sensitivity analyses using a 5-year qualification period were conducted. The results supported the absence of a residual HDE. CONCLUSIONS This study showed a protective effect of long-term, high-frequency blood donation against cardiovascular disease. This effect was only observed in women and not in men.
Collapse
Affiliation(s)
- Karlijn Peffer
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands
| | - Martin den Heijer
- Department of Internal Medicine, VU University Medical Centre, Amsterdam, The Netherlands
| | - Wim L A M de Kort
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Department of Public Health, Academic Medical Center Amsterdam UMC - Location AMC, University of Amsterdam, Amsterdam, The Netherlands
| | - André L M Verbeek
- Department for Health Evidence, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Femke Atsma
- Department of Donor Medicine Research - Donor Studies, Sanquin Research, Amsterdam, The Netherlands.,Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare, Radboud University Medical Center, Nijmegen, The Netherlands
| |
Collapse
|
166
|
Kmietowicz Z. Risk factors for MI are more potent in women, finds study. BMJ 2018; 363:k4708. [PMID: 30404869 DOI: 10.1136/bmj.k4708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|