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Zhang C, Zeng Q, Liu X, He Q, Zhang J, Zhao S, Hu H. Association of Blood Selenium Levels with Diabetes and Heart Failure in American General Adults: a Cross-sectional Study of NHANES 2011-2020 pre. Biol Trace Elem Res 2024; 202:3413-3424. [PMID: 37996718 PMCID: PMC11144148 DOI: 10.1007/s12011-023-03933-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 10/23/2023] [Indexed: 11/25/2023]
Abstract
Selenium is an essential trace element closely related to human health; however, the relationship between blood selenium levels, diabetes, and heart failure remains inconclusive. Therefore, this study aimed to explore the relationship between blood selenium levels and the prevalence of diabetes as well as heart failure in American general adults aged 20 years or older. This study utilized data from four survey cycles from NHANES 2011-2020 pre. Blood selenium levels were considered as both a continuous variable and quartiles, and logistic regression was employed to investigate the associations between blood selenium levels with diabetes and heart failure. Nonlinear relationships were examined by restricted cubic spline regression. The analysis included a total of 16311 participants aged 20 years or older. After adjustment for all potential confounder, we found when the blood selenium levels increased by 10 ug/L, the average risk of diabetes increased by 4.2% (95% CI: 1.5%, 7.0%), and the average risk of heart failure decreased by 5.0% (95% CI: 0.1%, 9.8%). In addition, compared with the lowest reference group, blood selenium levels were significantly positively associated with risk of diabetes in participants in the fourth quartile (OR=1.458, 95% CI: 1.173, 1.812), while significantly negatively associated with the risk of heart failure in participants in the second, third and fourth quartiles (Q2, OR=0.677, 95% CI: 0.471, 0.974) (Q3, OR=0.609, 95% CI: 0.426, 0.870) (Q4, OR=0.653, 95% CI: 0.443, 0.961). There was a nonlinear and reverse L-shaped association between blood selenium and diabetes, while a negative dose-response association between blood selenium and heart failure. Furthermore, the association between blood selenium levels and heart failure was more pronounced in participants with poor glycemic control, rather than diabetic patients. High blood selenium levels may be positively related to diabetes, while low blood selenium levels may be associated to heart failure. Appropriate blood selenium levels may help prevent diabetes and heart failure.
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Affiliation(s)
- Chongyang Zhang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Qingjia Zeng
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Xinyao Liu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Qile He
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Jinyao Zhang
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Shanshan Zhao
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China
| | - Hongpu Hu
- Institute of Medical Information/Library, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100020, China.
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Li M, Yin T, Qi J, Shi M, Wang F, Mao Z, Zhang H, Wang L. The Optimal Cut-off Value of Upper Arm Circumference and Calf Circumference for Assessing Sarcopenia Among Chinese Community-Dwelling Older Adults. Clin Interv Aging 2024; 19:1309-1323. [PMID: 39050518 PMCID: PMC11268771 DOI: 10.2147/cia.s468036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Accepted: 06/27/2024] [Indexed: 07/27/2024] Open
Abstract
Objective To explore the cut-off values and health evaluations of upper arm circumference (AC) and calf circumference (CC) on sarcopenia in Chinese community-dwelling older people. Methods In this cross-sectional study, AC, CC, handgrip strength, muscle mass and gait speed were measured in 1537 Chinese community-dwelling older people in Sub-study 1. Correlation analysis, receiver operator characteristic curve (ROC curve) analysis, and consistency analysis were used for determination of AC and CC cut-off values for sarcopenia diagnosis (sarcopenia-AC and CC). Thereafter, 269 participants accepted additional assessments on physical function, body composition and muscle strength in Sub-study 2. T-test or Mann-Whitney U-test was used to explore the differential effects of sarcopenia-AC and CC on health indicators between sarcopenic and non-sarcopenic participants. Results In Sub-study 1, the Area Under ROC (AUC) of AC and CC for sarcopenia screening were greater than 0.700 (P<0.05). The cut-off values, sensitivity and specificity of AC and CC on sarcopenia in males were 25.9 cm (86.0%, 83.6%) and 33.7 cm (90.7%, 81.4%) whereas in females were 26.5 cm (70.8%, 69.7%) and 33.0 cm (86.5%, 69.4%), respectively. In Sub-study 2, the participants with sarcopenia-AC or sarcopenia-CC showed lower muscle strength and lower fat and muscle mass than the ones without (P<0.05). Additionally, males instead of females with sarcopenia-AC or sarcopenia-CC showed worse performance in time-up and go test and 6-Minute Walk Test (P<0.05). However, the 30-second chair stand test was not different between participants with and without sarcopenia-AC or sarcopenia-CC in both sexes. Conclusion We found accurate and Chinese population targeted cut-off values of AC and CC on sarcopenia diagnosis (25.9 cm and 33.7 cm in males; 26.5 cm and 33.0 cm in females) and a good evaluation effect of AC and CC on fat and muscle mass, muscle strength and physical functions in males, not females.
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Affiliation(s)
- Mengli Li
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Tongtong Yin
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Jiaying Qi
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Minhao Shi
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Fangfang Wang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Zhiyu Mao
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
| | - Hui Zhang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
- School of Nursing, Suzhou Vocational Health College, Suzhou, Jiangsu, People’s Republic of China
| | - Li Wang
- School of Nursing, Suzhou Medical College of Soochow University, Suzhou, Jiangsu, People’s Republic of China
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Wen H, Li X, Chen J, Li Y, Yang N, Tan N. Association of oxidative balance score with chronic kidney disease: NHANES 1999-2018. Front Endocrinol (Lausanne) 2024; 15:1396465. [PMID: 38919480 PMCID: PMC11198875 DOI: 10.3389/fendo.2024.1396465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 05/20/2024] [Indexed: 06/27/2024] Open
Abstract
Background The Oxidative Balance Score (OBS), which quantifies the balance between antioxidants and pro-oxidants influenced by diet and lifestyle, is crucial given oxidative stress's significant role in Chronic Kidney Disease (CKD). This study aims to determine the association between OBS and CKD using data from the National Health and Nutrition Examination Survey (NHANES) 1999-2018. Methods We analyzed data from the National Health and Nutrition Examination Survey (NHANES) spanning 1999 to 2018. OBS was constructed from a detailed array of 20 factors, including dietary nutrients and lifestyle behaviors. The relationship between OBS and CKD risk was evaluated using weighted logistic regression models, adjusted for potential confounders, with a generalized additive model (GAM) examining non-linear associations. Subgroup analyses and interaction effects across diverse demographic and clinical groups, along with sensitivity analyses, were performed to validate the findings. Results Among 32,120 participants analyzed, 4,786 were identified with CKD. Fully adjusted weighted logistic regression analysis revealed that each unit increase in OBS was associated with a 2% reduction in CKD prevalence [OR: 0.98 (0.98-0.99), P < 0.001]. Higher OBS quartiles were significantly correlated with a decreased CKD risk [Q4 vs. Q1: OR: 0.82 (0.68-0.98), P = 0.03; P for trend = 0.01]. The GAM and smoothed curve fit indicated a linear relationship between OBS and the risk of CKD. Stratified and sensitivity analyses further substantiated the inverse relationship between OBS and CKD prevalence. Conclusions Our findings from the NHANES data affirm a significant inverse association between OBS and CKD risk in the U.S. population, underscoring the role of optimizing dietary and lifestyle factors in managing CKD risk. These results advocate for incorporating OBS considerations into CKD prevention and treatment strategies.
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Affiliation(s)
- Haibin Wen
- Department of Nephrology, Jiangbin Hospital of Guangxi Zhuang Autonomous Region, Nanning, China
| | - Xianhua Li
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jiangming Chen
- Traditional Chinese Medicine Department, Guilin Maternal and Child Health Hospital, Guilin, China
| | - Yi Li
- General Surgery Day Ward, Department of General Surgery, The Third People’s Hospital of Chengdu and The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Nailong Yang
- Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Ning Tan
- College of Basic Medical Sciences, Guilin Medical University, Guilin, China
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Mszar R, Katz ME, Grandhi GR, Osei AD, Gallo A, Blaha MJ. Subclinical Atherosclerosis to Guide Treatment in Dyslipidemia and Diabetes Mellitus. Curr Atheroscler Rep 2024; 26:217-230. [PMID: 38662272 DOI: 10.1007/s11883-024-01202-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/03/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE OF REVIEW Dyslipidemia and type 2 diabetes mellitus are two common conditions that are associated with an increased risk of atherosclerotic cardiovascular disease (ASCVD). In this review, we aimed to provide an in-depth and contemporary review of non-invasive approaches to assess subclinical atherosclerotic burden, predict cardiovascular risk, and guide appropriate treatment strategies. We focused this paper on two main imaging modalities: coronary artery calcium (CAC) score and computed tomography coronary angiography. RECENT FINDINGS Recent longitudinal studies have provided stronger evidence on the relationship between increased CAC, thoracic aorta calcification, and risk of cardiovascular events among those with primary hypercholesterolemia, highlighting the beneficial role of statin therapy. Interestingly, resilient profiles of individuals not exhibiting atherosclerosis despite dyslipidemia have been described. Non-conventional markers of dyslipidemia have also been associated with increased subclinical atherosclerosis presence and burden, highlighting the contribution of apolipoprotein B-100 (apoB)-rich lipoprotein particles, such as remnant cholesterol and lipoprotein(a), to the residual risk of individuals on-target for low-density lipoprotein cholesterol (LDL-C) goals. Regarding type 2 diabetes mellitus, variability in atherosclerotic burden has also been found, and CAC testing has shown significant predictive value in stratifying cardiovascular risk. Non-invasive assessment of subclinical atherosclerosis can help reveal the continuum of ASCVD risk in those with dyslipidemia and diabetes mellitus and can inform personalized strategies for cardiovascular disease prevention in the primary prevention setting.
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Affiliation(s)
- Reed Mszar
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Miriam E Katz
- School of Medicine, New York Medical College, Valhalla, NY, USA
| | - Gowtham R Grandhi
- Virginia Commonwealth University Health Pauley Heart Center, Richmond, VA, USA
| | - Albert D Osei
- Division of Cardiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Antonio Gallo
- Department of Nutrition, Lipidology and Cardiovascular Prevention Unit, APHP, INSERM UMR1166, Hôpital Pitié-Salpètriêre, Sorbonne Université, Paris, France
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
- Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA.
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Lai Q, Ye L, Luo J, Zhang C, Wu Q, Shao Y. The cross-sectional correlation between the oxidative balance score and cardiometabolic risk factors and its potential correlation with longitudinal mortality in patients with cardiometabolic risk factors. BMC Public Health 2024; 24:1452. [PMID: 38816823 PMCID: PMC11140939 DOI: 10.1186/s12889-024-18967-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 05/27/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND This study analyzes the correlation between oxidative balance score (OBS), cardiometabolic risk factors (CMRFs), and mortality in individuals with CMRFs. METHODS Data were chosen from the National Health and Nutrition Examination Survey. The survey-weighted multivariable logistic regression models were implemented to explore the relationship between OBS and the risk of CMRFs. Then, Cox proportional hazard models were employed to estimate the impact of OBS on mortality in individuals with CMRFs. RESULTS Following multivariate adjustment, the subjects in the highest quartile exhibited a 46% reduction in the risk of CMRFs, a 33% reduction in the risk of diabetes, a 31% reduction in the risk of hypertension, and a 36% reduction in the risk of hyperlipidemia, compared with those in the lowest quartile. Furthermore, each 1-unit increase in OBS was remarkably negatively correlated with the prevalence of CMRFs, diabetes, hypertension, and hyperlipidemia. The correlation between OBS and CMFRs was found to be mediated by serum γ-glutamyltransferase (GGT) and white blood cells (WBC), and the mediation effect of GGT levels and WBC, accounting for 6.90% and 11.51%, respectively. Lastly, the multivariate Cox regression model revealed that elevated OBS, irrespective of whether it was treated as a categorical or continuous variable, exhibited a significant association with decreased mortality from all causes, cardiovascular disease, and cancer. CONCLUSIONS An increased OBS might reflect a lower risk of CMRFs and a favorable prognosis for individuals with CMRFs. Moreover, WBC and GGT may play a potential mediating role between OBS and CMRFs.
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Affiliation(s)
- Qiancheng Lai
- Department of Cardiac Surgery, Sichuan Provincial People's Hospital, University of Electronic Science and Technology of China, Chengdu, China
| | - Liu Ye
- Health Management Center, The First Branch, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Luo
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, NO. 1 Youyi Road, Yuzhong District, Chongqing, China
| | - Cheng Zhang
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, NO. 1 Youyi Road, Yuzhong District, Chongqing, China
| | - Qingchen Wu
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, NO. 1 Youyi Road, Yuzhong District, Chongqing, China
| | - Yue Shao
- Department of Cardiothoracic Surgery, The First Affiliated Hospital of Chongqing Medical University, NO. 1 Youyi Road, Yuzhong District, Chongqing, China.
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Fleischer S, Heinrich S, Meyer G, Mikolajczyk R, Lückmann SL. Sex differences in cardiologic medication provision for adults with coronary heart disease: an analysis of health claims data from 2018 to 2020 in Saxony-Anhalt, Germany. BMC Health Serv Res 2024; 24:288. [PMID: 38448928 PMCID: PMC10916020 DOI: 10.1186/s12913-024-10727-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 02/15/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND Coronary heart diseases (CHDs) have experienced the largest increase worldwide as a cause of death, accounting for 16% of all deaths. In Saxony-Anhalt, a federal state in Germany, both CHD morbidity and acute myocardial infarction mortality rates are particularly high. Several risk factors associated with CHDs have been studied in Saxony-Anhalt, but sex differences in service use and medication have not been investigated. This study therefore aimed to investigate sex differences in the quality and quantity of cardiological care provided to adults with CHD. METHODS This study used health claims data from 2018 to 2020 to analyse the utilisation of healthcare services and adherence to medication-related guideline recommendations in primary and specialist care. The sample included 133,661 individuals with CHD from a major statutory health insurance company (Germany). RESULTS Almost all CHD patients (> 99%) received continuous primary care. Continuous cardiologist utilisation was lower for females than for males, with 15.0% and 22.2%, respectively, and sporadic utilisation showed greater differences, with 33.5% of females and 43.4% of males seeking sporadic cardiologist consultations. Additionally, 43.1% of the identified CHD patients participated in disease management programmes (DMPs). The study also examined the impact of DMP participation and cardiologist care on medication uptake and revealed that sex differences in medication uptake, except for statin use, were mitigated by these factors. Statins were prescribed to 42.9% of the CHD patients eligible for statin prescription in accordance with the QiSA indicator for statin prescription eligibility. However, there were significant sex differences in statin utilisation. Female CHD patients were less likely to use statins (35.2%) than male CHD patients were (50.1%). The difference in statin utilisation persisted after adjustment for DMP participation and cardiologist consultation. CONCLUSIONS This study highlights sex differences in the utilisation of cardiological healthcare services for patients with CHD in the Saxony-Anhalt cohort. These findings underscore the continuing need for interventions to reduce sex inequalities in accessing healthcare and providing health care for patients with CHD. Factors at the health care system, patient, and physician levels should be further investigated to eventually improve statin prescription in people with CHD, especially women.
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Affiliation(s)
- Steffen Fleischer
- Martin-Luther-University Halle Wittenberg, Medical Faculty, Institute of Nursing and Health Science, Magdeburger Str. 8, 06108, Halle (Saale) , Germany.
| | | | - Gabriele Meyer
- Martin-Luther-University Halle Wittenberg, Medical Faculty, Institute of Nursing and Health Science, Magdeburger Str. 8, 06108, Halle (Saale) , Germany
| | - Rafael Mikolajczyk
- Martin-Luther-University Halle Wittenberg, Medical Faculty, Institute of Medical Epidemiology Biometrics and Informatics, Halle (Saale) , Germany
| | - Sara Lena Lückmann
- Martin-Luther-University Halle Wittenberg, Medical Faculty, Institute of Medical Epidemiology Biometrics and Informatics, Halle (Saale) , Germany
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Martin SS, Aday AW, Almarzooq ZI, Anderson CAM, Arora P, Avery CL, Baker-Smith CM, Barone Gibbs B, Beaton AZ, Boehme AK, Commodore-Mensah Y, Currie ME, Elkind MSV, Evenson KR, Generoso G, Heard DG, Hiremath S, Johansen MC, Kalani R, Kazi DS, Ko D, Liu J, Magnani JW, Michos ED, Mussolino ME, Navaneethan SD, Parikh NI, Perman SM, Poudel R, Rezk-Hanna M, Roth GA, Shah NS, St-Onge MP, Thacker EL, Tsao CW, Urbut SM, Van Spall HGC, Voeks JH, Wang NY, Wong ND, Wong SS, Yaffe K, Palaniappan LP. 2024 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association. Circulation 2024; 149:e347-e913. [PMID: 38264914 DOI: 10.1161/cir.0000000000001209] [Citation(s) in RCA: 124] [Impact Index Per Article: 124.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2024]
Abstract
BACKGROUND The American Heart Association (AHA), in conjunction with the National Institutes of Health, annually reports the most up-to-date statistics related to heart disease, stroke, and cardiovascular risk factors, including core health behaviors (smoking, physical activity, nutrition, sleep, and obesity) and health factors (cholesterol, blood pressure, glucose control, and metabolic syndrome) that contribute to cardiovascular health. The AHA Heart Disease and Stroke Statistical Update presents the latest data on a range of major clinical heart and circulatory disease conditions (including stroke, brain health, complications of pregnancy, kidney disease, congenital heart disease, rhythm disorders, sudden cardiac arrest, subclinical atherosclerosis, coronary heart disease, cardiomyopathy, heart failure, valvular disease, venous thromboembolism, and peripheral artery disease) and the associated outcomes (including quality of care, procedures, and economic costs). METHODS The AHA, through its Epidemiology and Prevention Statistics Committee, continuously monitors and evaluates sources of data on heart disease and stroke in the United States and globally to provide the most current information available in the annual Statistical Update with review of published literature through the year before writing. The 2024 AHA Statistical Update is the product of a full year's worth of effort in 2023 by dedicated volunteer clinicians and scientists, committed government professionals, and AHA staff members. The AHA strives to further understand and help heal health problems inflicted by structural racism, a public health crisis that can significantly damage physical and mental health and perpetuate disparities in access to health care, education, income, housing, and several other factors vital to healthy lives. This year's edition includes additional global data, as well as data on the monitoring and benefits of cardiovascular health in the population, with an enhanced focus on health equity across several key domains. RESULTS Each of the chapters in the Statistical Update focuses on a different topic related to heart disease and stroke statistics. CONCLUSIONS The Statistical Update represents a critical resource for the lay public, policymakers, media professionals, clinicians, health care administrators, researchers, health advocates, and others seeking the best available data on these factors and conditions.
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Shetty NS, Gaonkar M, Patel N, Knowles JW, Natarajan P, Arora G, Arora P. Trends of Lipid Concentrations, Awareness, Evaluation, and Treatment in Severe Dyslipidemia in US Adults. Mayo Clin Proc 2024; 99:271-282. [PMID: 38189687 PMCID: PMC10873035 DOI: 10.1016/j.mayocp.2023.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 09/22/2023] [Indexed: 01/09/2024]
Abstract
OBJECTIVE To evaluate the contemporary trends of lipid concentrations, cholesterol evaluation, hypercholesterolemia awareness, and statin use among individuals with severe dyslipidemia (low-density lipoprotein cholesterol [LDL-C] level ≥190 mg/dL) between 2011 and 2020. PATIENTS AND METHODS This serial cross-sectional analysis included nonpregnant adults ≥20 years of age from the National Health and Nutrition Examination Survey between 2011 and 2020. Age-adjusted weighted trends of LDL-C, triglycerides, cholesterol evaluation in the past 5 years, hypercholesterolemia awareness, and documented statin use among individuals with severe dyslipidemia were estimated. RESULTS Among 24,722 participants included, the prevalence of severe dyslipidemia was 5.4% (SE: 0.2%) which was stable across the study period (Ptrend=.78). Among individuals with severe dyslipidemia (mean age: 55.3 [SE: 0.7] years; 52.2% females; 68.8% non-Hispanic White), LDL-C (224.3 [SE: 4.2] mg/dL in 2011-2012 to 224.2 [SE: 4.6] mg/dL in 2017-2020; Ptrend =.83), and triglyceride (123.3 [SE: 1.1] mg/dL in 2011-2012 to 101.8 [SE: 1.1] mg/dL in 2017-2020; Ptrend=.13), levels remained stable from 2011 to 2020. The rates of cholesterol evaluation in the past 5 years (72.0% [SE: 5.7%] in 2011-2012 to 78.0% [SE: 4.8%] in 2017-2020; Ptrend=.91), hypercholesterolemia awareness (48.1% [SE: 5.5%] in 2011-2012 to 51.9% [SE: 5.8%] in 2017- 2020; Ptrend=.77), and documented statin use (34.7% [SE: 4.5%] in 2011-2012 to 33.4% [SE: 4.0%] in 2017-2020; Ptrend=.28) remained stagnant in individuals with severe dyslipidemia between 2011 and 2020. CONCLUSION Among individuals with severe dyslipidemia, cholesterol evaluation and hypercholesterolemia awareness rates were stable at ∼75% and ∼50% in the past decade. Only ∼34% of individuals with severe dyslipidemia took statins between 2011 and 2020, which likely contributed to the stable LDL-C levels noted across the study period. Further investigations into the determinants of statin use and adherence to statins are needed.
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Affiliation(s)
- Naman S Shetty
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mokshad Gaonkar
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirav Patel
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Joshua W Knowles
- Department of Medicine, Division of Cardiovascular Medicine, School of Medicine, Stanford University, Stanford, CA, USA; Department of Medicine, Diabetes Research Center, Cardiovascular Institute and Prevention Research Center, Stanford, CA, USA
| | - Pradeep Natarajan
- Cardiology Division, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA; Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA; Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA.
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Hussein HM, Yang MK, Ramezani S, Sharma R, Lodhi OUH, Owens-Pochinka Y, Lu J, Elbokl A. Racial Impact on Inpatient Stroke Quality of Care in Two Community Hospitals. J Clin Med 2023; 12:7654. [PMID: 38137723 PMCID: PMC10743521 DOI: 10.3390/jcm12247654] [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: 10/29/2023] [Revised: 12/08/2023] [Accepted: 12/09/2023] [Indexed: 12/24/2023] Open
Abstract
INTRODUCTION This analysis was conducted as a part of a quality improvement project aiming at identifying racial disparity in inpatient stroke quality of care. METHODS The Get With The Guidelines (GWTG) database was used to identify all patients discharged with any stroke diagnosis between January and December 2021. An additional chart review was conducted to ensure the accuracy of racial/ethnic categorization. The sample was dichotomized into white vs. non-white groups and compared with univariate analysis. RESULTS The study sample comprised 1408 encounters (1347 patients) with Mean age of 71 ± 15 years, 51% women, 82% white patients, 15% non-white patients, 72% acute ischemic stroke (AIS); 15% transient ischemic attack (TIA), 9% intracerebral hemorrhage (ICH), 3% subarachnoid hemorrhage (SAH), and 1% stroke not otherwise specified. Non-white patients were younger and had fewer concomitant diagnoses, a lower proportion of TIA, and a higher proportion of ICH (p = 0.004). In the AIS cohort, compared to white patients, non-white patients had less frequent ambulance (p = 0.009), arrived at the hospital later than white patients (7.7 h longer; p < 0.001), had more severe strokes, and had less frequent IV thrombolysis utilization (7% vs. 13%; p = 0.042). Similarly, in the TIA cohort, non-white patients' utilization of EMS was lower than that of white patients, and their hospital arrival was delayed. In the ICH cohort, non-white patients were younger and had a lower frequency of atrial fibrillation and a non-significant trend toward higher disease severity. The SAH cohort had only eight non-white patients, six of whom were transferred to a higher level of hospital care within a few hours of arrival. Importantly, the hospital-based quality metrics, such as door-to-CT time, door-to-needle time, and the Joint Commission stroke quality metrics, were similar between the two groups. CONCLUSIONS There is a racial disparity in the pre-hospital phase of the stroke chain of survival of non-white patients, impacting IV thrombolysis utilization. The younger age and worse lipid profile and hemoglobin A1c of non-white patients suggest the need for better preventative care starting at a young age.
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Affiliation(s)
- Haitham M. Hussein
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Mai-Kau Yang
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Solmaz Ramezani
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Rishi Sharma
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Omair ul haq Lodhi
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Yaroslav Owens-Pochinka
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Jinci Lu
- Department of Neurology, University of Minnesota, MMC 295, 420 Delaware Street SE, Minneapolis, MN 55455, USA (S.R.); (R.S.); (O.u.h.L.); (Y.O.-P.); (J.L.)
| | - Ahmed Elbokl
- Institute of Health Informatics, University of Minnesota, Minneapolis, MN 55455, USA;
- Department of Neurology, Ain Shams University, Cairo 11517, Egypt
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Liu M, Aggarwal R, Zheng Z, Yeh RW, Kazi DS, Joynt Maddox KE, Wadhera RK. Cardiovascular Health of Middle-Aged U.S. Adults by Income Level, 1999 to March 2020 : A Serial Cross-Sectional Study. Ann Intern Med 2023; 176:1595-1605. [PMID: 37983825 DOI: 10.7326/m23-2109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2023] Open
Abstract
BACKGROUND Although cardiovascular mortality has increased among middle-aged U.S. adults since 2011, how the burden of cardiovascular risk factors has changed for this population by income level over the past 2 decades is unknown. OBJECTIVE To evaluate trends in the prevalence, treatment, and control of cardiovascular risk factors among low-income and higher-income middle-aged adults and how social determinants contribute to recent associations between income and cardiovascular health. DESIGN Serial cross-sectional study. SETTING NHANES (National Health and Nutrition Examination Survey), 1999 to March 2020. PARTICIPANTS Middle-aged adults (aged 40 to 64 years). MEASUREMENTS Age-standardized prevalence of hypertension, diabetes, hyperlipidemia, obesity, and cigarette use; treatment rates for hypertension, diabetes, and hyperlipidemia; and rates of blood pressure, glycemic, and cholesterol control. RESULTS The study population included 20 761 middle-aged adults. The prevalence of hypertension, diabetes, and cigarette use was consistently higher among low-income adults between 1999 and March 2020. Low-income adults had an increase in hypertension over the study period (37.2% [95% CI, 33.5% to 40.9%] to 44.7% [CI, 39.8% to 49.5%]) but no changes in diabetes or obesity. In contrast, higher-income adults did not have a change in hypertension but had increases in diabetes (7.8% [CI, 5.0% to 10.6%] to 14.9% [CI, 12.4% to 17.3%]) and obesity (33.0% [CI, 26.7% to 39.4%] to 44.0% [CI, 40.2% to 47.7%]). Cigarette use was high and stagnant among low-income adults (33.2% [CI, 28.4% to 38.0%] to 33.9% [CI, 29.6% to 38.3%]) but decreased among their higher-income counterparts (18.6% [CI, 13.5% to 23.7%] to 11.5% [CI, 8.7% to 14.3%]). Treatment and control rates for hypertension were unchanged in both groups (>80%), whereas diabetes treatment rates improved only among the higher-income group (58.4% [CI, 44.4% to 72.5%] to 77.4% [CI, 67.6% to 87.1%]). Income-based disparities in hypertension, diabetes, and cigarette use persisted in more recent years even after adjustment for insurance coverage, health care access, and food insecurity. LIMITATION Sample size limitations could preclude detection of small changes in treatment and control rates. CONCLUSION Over 2 decades in the United States, hypertension increased in low-income middle-aged adults, whereas diabetes and obesity increased in their higher-income counterparts. Income-based disparities in hypertension, diabetes, and smoking persisted even after adjustment for other social determinants of health. PRIMARY FUNDING SOURCE National Institutes of Health.
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Affiliation(s)
- Michael Liu
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (M.L., R.W.Y., D.S.K., R.K.W.)
| | - Rahul Aggarwal
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and Heart and Vascular Center, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts (R.A.)
| | - Zhaonian Zheng
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts (Z.Z.)
| | - Robert W Yeh
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (M.L., R.W.Y., D.S.K., R.K.W.)
| | - Dhruv S Kazi
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (M.L., R.W.Y., D.S.K., R.K.W.)
| | - Karen E Joynt Maddox
- Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri (K.E.J.M.)
| | - Rishi K Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center, and Harvard Medical School, Boston, Massachusetts (M.L., R.W.Y., D.S.K., R.K.W.)
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11
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Yin J, Li S, Li J, Gong R, Jia Z, Liu J, Jin Z, Yang J, Liu Y. Association of serum oleic acid level with depression in American adults: a cross-sectional study. BMC Psychiatry 2023; 23:845. [PMID: 37974120 PMCID: PMC10652490 DOI: 10.1186/s12888-023-05271-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 10/11/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND As the most abundant fatty acid in plasma, oleic acid has been found to be associated with multiple neurological diseases; however, results from studies of the relationship between oleic acid and depression are inconsistent. METHODS This cross-sectional study analyzed 4,459 adults from the National Health and Nutrition Examination Survey 2011-2014. The following covariates were adjusted in multivariable logistic regression models: age, sex, race/ethnicity, education level, marital status, body mass index, physical activity, smoking status, alcohol status, metabolic syndrome, omega-3 polyunsaturated fatty acids, and total cholesterol. RESULTS Serum oleic acid levels were positively associated with depression. After adjusting for all covariates, for every 1 mmol/L increase in oleic acid levels, the prevalence of depression increased by 40% (unadjusted OR: 1.35, 95%CI: 1.16-1.57; adjusted OR: 1.40, 95% CI: 1.03-1.90). CONCLUSIONS Our study suggests that oleic acid may play a role in depression. Further research is needed to investigate the potential benefits of changing oleic acid levels for the treatment and prevention of depression.
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Affiliation(s)
- Jiahui Yin
- College of Traditional Chinese Medicine, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Siyuan Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinling Li
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China
| | | | - Zhixia Jia
- First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China
| | - Junjun Liu
- Nanjing Meishan Hospital, Nanjing, China
| | - Zhi Jin
- Department of Neurology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Jiguo Yang
- College of Acupuncture and Massage, Shandong University of Traditional Chinese Medicine, Jinan, China.
| | - Yuanxiang Liu
- Department of Neurology, Shandong University of Traditional Chinese Medicine Affiliated Hospital, Jinan, China.
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12
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Yuan S, Song C, He J, Zhang R, Bian X, Song W, Dou K. Trends in cardiovascular risk factors control among US adults by glycemic statuses, 2007-2018. Eur J Prev Cardiol 2023; 30:1513-1523. [PMID: 36929777 DOI: 10.1093/eurjpc/zwad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Revised: 03/08/2023] [Accepted: 03/14/2023] [Indexed: 03/18/2023]
Abstract
AIMS Understanding the national trends in cardiovascular risk factors control of individuals with prediabetes and diabetes is critical for diabetes prevention and management. Our study aims to estimate how cardiovascular risk factors changed in US adults with different glycemic statuses between 2007-2008 and 2017-2018. METHODS AND RESULTS This was a serial cross-sectional study based on the National Health and Nutrition Examination Surveys (between 2007-2008 and 2017-2018 cycle). Non-pregnant American participants aged 20 years or older were included. Cardiovascular risk factors including weight, blood pressure, plasma cholesterol, and smoking by glycemic statuses were estimated. A total of 33 040 American adults were included. From 2007-2008 to 2017-2018, the age-adjusted proportions of individuals who reached weight control (body mass index <30 kg/m2) of both normoglycemia group and prediabetes group had a significant decrease over the study period, while the trend in participants with diabetes was not significant (mean difference: -5.34%, 95% confidence interval: -15.28%, 4.59%; P for trend = 0.298). The age-adjusted means of total cholesterol of all three groups decreased during the study decade (P for trend < 0.010), with participants with diabetes maintaining the lowest level. Individuals with high total cholesterol were more likely to receive statin therapy in the diabetes group. Notably, prediabetes participants had the highest level of total cholesterol and low-density lipoprotein cholesterol and were less likely to achieve lipid control with statin therapy. Sensitivity analysis with the second definition of prediabetes and diabetes resulted in a consistent trend. CONCLUSIONS In this nationally representative cross-sectional study, we systematically estimated the cardiovascular risk factors control in American adults and found poor weight control in the normoglycemia and prediabetes group. Despite the significant decrease trend of plasma total cholesterol in all groups, the high cholesterol level in the prediabetes group deserves special concern.
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Affiliation(s)
- Sheng Yuan
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Chenxi Song
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Jining He
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Rui Zhang
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Xiaohui Bian
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Weihua Song
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
| | - Kefei Dou
- Cardiometabolic Medicine Center, Department of Cardiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 167, Beilishi Road, Xicheng District, Beijing 100037, China
- State Key Laboratory of Cardiovascular Disease, Shilongxi Road, Mentougou District, Beijing 102308, China
- National Clinical Research Center for Cardiovascular Diseases, Shilongxi Road, Mentougou District, Beijing 102308, China
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13
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Chen X, Hou C, Yao L, Li J, Gui M, Wang M, Zhou X, Lu B, Fu D. Dietary inflammation index is associated with dyslipidemia: evidence from national health and nutrition examination survey, 1999-2019. Lipids Health Dis 2023; 22:149. [PMID: 37689717 PMCID: PMC10492364 DOI: 10.1186/s12944-023-01914-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 09/02/2023] [Indexed: 09/11/2023] Open
Abstract
BACKGROUND AND AIMS This study aimed to investigate the association between the Dietary Inflammatory Index (DII) and dyslipidemia, as well as to evaluate the mortality risk associated with DII in participants with dyslipidemia. METHODS Data from the National Health and Nutrition Examination Survey database were divided into dyslipidemia and non-dyslipidemia groups. The association between DII and dyslipidemia was investigated using the weighted chi-square test, weighted t-test, and weighted logistic regression. Weighted Cox proportional hazards models were used to estimate the hazard ratios and 95% confidence intervals for all-cause and cardiovascular disease-related mortality within the dyslipidemia group. RESULTS A total of 17,820 participants, including 4,839 without and 12,981 with dyslipidemia were analyzed in this study. The results showed that DII was higher in the dyslipidemia group compared to the non-dyslipidemia group (1.42 ± 0.03 vs. 1.23 ± 0.04, P < 0.01). However, for energy, protein, carbohydrates, total fat, saturated fat, and iron, DII was lower in participants with dyslipidemia. Logistic regression analysis revealed a strong positive association between DII and dyslipidemia. The odds ratios for dyslipidemia from Q1 to Q4 were 1.00 (reference), 1.12 (0.96-1.31), 1.23 (1.04-1.44), and 1.33 (1.11-1.59), respectively. In participants with dyslipidemia, a high DII was associated with high all-cause and cardiovascular mortality. CONCLUSION DII was closely associated with dyslipidemia. A pro-inflammatory diet may play a role in unfavorable consequences and is linked to both all-cause mortality and cardiovascular death in patients with dyslipidemia. Participants with dyslipidemia should pay attention to their anti-inflammatory dietary patterns.
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Affiliation(s)
- Xiaozhe Chen
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunlei Hou
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Lei Yao
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianhua Li
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingtai Gui
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Mingzhu Wang
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xunjie Zhou
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Bo Lu
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
| | - Deyu Fu
- Department of Cardiology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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Jiang S, Wang Y, Wang Z, Zhang L, Jin F, Li B. The association of serum Klotho concentrations with hyperlipidemia prevalence and lipid levels among US adults: a cross-sectional study. BMC Public Health 2023; 23:1645. [PMID: 37641103 PMCID: PMC10463308 DOI: 10.1186/s12889-023-16566-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 08/20/2023] [Indexed: 08/31/2023] Open
Abstract
BACKGROUND Klotho has anti-oxidative and anti-inflammatory properties. However, little is known about whether high Klotho concentrations were associated with reduced hyperlipidemia risk and improved plasma lipid levels. METHODS Participants with complete data on serum Klotho and plasma lipid concentrations from the 2007-2016 National Health and Nutrition Examination Survey were included. Weighted regression models were fitted to explore the association of Klotho concentrations with hyperlipidemia risk and plasma lipid levels while restricted cubic spline models were applied to explore the dose-response relationship. Additionally, we assessed the mediating effects of C-reaction protein (CRP) on the foregoing association. RESULTS Individuals in the fourth and fifth quintile of serum Klotho had an adjusted odds ratio (OR) of 0.77 (95%CI: 0.65, 0.93) and 0.67 (95%CI: 0.65, 0.93) for hyperlipidemia. Doubling of serum Klotho concentrations was associated with decreased hyperlipidemia risk (OR = 0.81; 95%CI: 0.68, 0.95) and triglyceride levels (13.25 mg/dL; 95%CI: 4.02, 22.47), with a monotonic dose-response relationship. Individuals in the fourth and fifth quintile of serum Klotho had a 0.07 (95%CI: 0.002, 0.13), 0.08 (95%CI: 0.02, 0.15) and 0.05 (95%CI: -0.03, 0.12) mg/dL decreased CRP levels, with a marginally significant trend (Ptrend = 0.05). CONCLUSIONS Higher Klotho concentrations were associated with reduced hyperlipidemia risk and triglyceride levels. Klotho supplementation maybe a promising method to intervene and prevent hyperlipidemia, but the underlying mechanism should be further explored.
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Affiliation(s)
- Shunli Jiang
- Department of Public Health, Jining Medical University, Rencheng District, #33 Jianshe RoadShan Dong, Jining, 272000, China.
| | - Yongxin Wang
- Department of Neurosurgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Zengliang Wang
- Department of Neurosurgery Center, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lu Zhang
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, China
| | - Feng Jin
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, China.
| | - Bo Li
- Department of Neurosurgery, Affiliated Hospital of Jining Medical University, Jining, China.
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Alfhili MA, Alotaibi GA, Alfaifi M, Almoghrabi Y, Alsughayyir J. Association of Platelet-Monocyte Ratio with Dyslipidemia in Saudi Arabia: A Large, Population-Based Study. Life (Basel) 2023; 13:1685. [PMID: 37629542 PMCID: PMC10455526 DOI: 10.3390/life13081685] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 07/27/2023] [Accepted: 07/28/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Abnormal lipid metabolism predisposes to cardiovascular disease. However, dyslipidemia is often asymptomatic leading to its underdiagnosis. Therefore, it is of utmost importance to identify biomarkers that reflect an abnormal lipid profile and trigger the specific investigation of lipid metabolism. The platelet-monocyte ratio (PMR) is a severely understudied index whose association with disturbed lipid markers remains unknown. METHODS A cross-sectional study of the association between PMR and comprehensive lipid profile including total cholesterol (TC), low-density lipoprotein (LDL), high-density lipoprotein (HDL), triglycerides (TG), TC/HDL, LDL/HDL, and TG/HDL in 14,269 Saudi subjects was designed. Prevalence, risk measures, association, and the diagnostic performance (i.e., area under the curve (AUC)) were evaluated. RESULTS Median PMR was significantly elevated in subjects with high TC (p < 0.01), TG, TC/HDL, LDL/HDL, TG/HDL, and LDL and reduced in those with low HDL (all p < 0.0001) compared to normal subjects. The increase in PMR was abolished when only males with high TC were considered. Except for TC and LDL, all other abnormal markers were significantly more prevalent when PMR was lower (higher for HDL) than a certain cutoff specific for each parameter. Moreover, the odds of having PMR readings above or below the selected cutoffs are significantly higher with all lipid abnormalities. PMR was also weakly but significantly and differentially correlated with all forms of dyslipidemia (p < 0.0001). Notably, the highest diagnostic accuracy of PMR was observed for reduced HDL (AUC = 0.608, p < 0.0001) and elevated TG/HDL (AUC = 0.596, p < 0.0001). CONCLUSIONS PMR is a novel, inexpensive, and readily available index that is associated with all forms of dyslipidemia, suggesting its potential use in related disorders.
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Affiliation(s)
- Mohammad A. Alfhili
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Ghada A. Alotaibi
- Chair of Medical and Molecular Genetics Research, Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia;
| | - Mohammed Alfaifi
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia;
| | - Yousef Almoghrabi
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah 21589, Saudi Arabia;
- Department of Research and Development, Al Borg Diagnostics, Jeddah 23523, Saudi Arabia
| | - Jawaher Alsughayyir
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 12372, Saudi Arabia;
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Kovach CP, Mesenbring EC, Gupta P, Glorioso TJ, Ho PM, Waldo SW, Schwartz GG. Projected Outcomes of Optimized Statin and Ezetimibe Therapy in US Military Veterans with Coronary Artery Disease. JAMA Netw Open 2023; 6:e2329066. [PMID: 37638630 PMCID: PMC10463102 DOI: 10.1001/jamanetworkopen.2023.29066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 07/07/2023] [Indexed: 08/29/2023] Open
Abstract
Importance Many patients with coronary artery disease (CAD) do not achieve the guideline-directed goals for low-density lipoprotein cholesterol (LDL-C) levels. Objective To estimate reductions in the rates of adverse events associated with CAD in a large US military veteran population that may be achieved through use of optimized statin therapy alone or with ezetimibe compared with the prevailing lipid-lowering therapy (LLT). Design, Setting, and Participants In this observational cohort study, US military veterans with CAD were identified by coronary angiography between June 2015 and September 2020 across 82 US Department of Veterans Affairs health care facilities. Exposures The exposures were observed LLT, LLT with an optimized statin regimen, and LLT with optimized statin and ezetimibe. Main Outcomes and Measures Observed rates of death, myocardial infarction, stroke, and coronary revascularization, and potential reductions in those outcomes with optimized LLT based on expected further reductions in LDL-C levels and application of formulas from The Cholesterol Treatment Trialists' Collaboration. Results The analysis cohort comprised 111 954 veterans (mean [SD] age, 68.4 [8.8] years; 109 390 men [97.7%]; 91 589 White patients [81.8%]; 17 592 Black patients [15.7%]). The median (IQR) observation period for this study was 3.4 (2.1-4.0) years. At the time of index angiography, 66 877 patients (59.7%) were treated with statin therapy, and 623 patients (0.6%) were treated with ezetimibe. At 6 months, the number of patients with statin prescriptions increased to 74 400 (68.7%), but the number of patients with high-intensity statin prescriptions was only 57 297 (52.9%). At 6 months, ezetimibe use remained low (n = 1168 [1.1%]), and LDL-C levels were 70 mg/dL or more in 56 405 patients (52.1%). At 4 years, observed incidences of death, myocardial infarction, stroke, and coronary revascularization were 21.6% (95% CI, 21.3%-21.8%), 5.0% (95% CI, 4.9%-5.2%), 2.2% (95% CI, 2.1%-2.3%), and 15.4% (95% CI, 15.2%-15.7%), respectively. With optimized statin treatment, projected absolute reductions in these incidences were 1.3% (95% CI, 0.9%-1.7%), 0.8% (95% CI, 0.7%-1.0%), 0.2% (95% CI, 0.1%-0.3%), and 2.3% (95% CI, 2.0%-2.7%), respectively. With optimized statin and ezetimibe treatment, projected absolute reductions were 1.8% (95% CI, 1.2%-2.4%), 1.1% (95% CI, 0.9%-1.3%), 0.3% (95% CI, 0.2%-0.4%), and 3.1% (95% CI, 2.6%-3.6%), respectively. Conclusions and Relevance In this cohort study of veterans with CAD, suboptimal LLT was prevalent in the clinical setting. Optimization of statin therapy was projected to produce clinically relevant reductions in the risks of death and cardiovascular events. Despite a lesser lipid-lowering efficacy of ezetimibe, its widespread use on a population level in conjunction with optimized statin therapy may be associated with further meaningful reductions in cardiovascular risk.
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Affiliation(s)
- Christopher P. Kovach
- Division of Cardiology, Department of Medicine, University of Washington, Seattle
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
| | - Elise C. Mesenbring
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
- Denver Research Institute, Aurora, Colorado
| | - Prerna Gupta
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora
| | - Thomas J. Glorioso
- Clinical Assessment, Reporting, and Tracking Program, Office of Quality and Patient Safety, Veterans Health Administration, Washington, DC
| | - P. Michael Ho
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
| | - Stephen W. Waldo
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
- Clinical Assessment, Reporting, and Tracking Program, Office of Quality and Patient Safety, Veterans Health Administration, Washington, DC
| | - Gregory G. Schwartz
- Division of Cardiology, Department of Medicine, University of Colorado, Aurora
- Rocky Mountain Regional VA Medical Center, Aurora, Colorado
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Yokoyama S. Continuous and Marked Increase of Japanese HDL Associates Paradoxically with their Nutritional Shift. J Atheroscler Thromb 2023; 30:919-933. [PMID: 36384911 PMCID: PMC10406630 DOI: 10.5551/jat.63894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 09/28/2022] [Indexed: 08/04/2023] Open
Abstract
AIMS Plasma HDL has evidently increased for decades among Japanese, exclusively in HDL particles containing apoA-I but not A-II. Its metabolic background is yet to be elucidated. METHODS Trends in plasma lipoproteins were analyzed by examining data on total cholesterol, triglyceride and HDL-cholesterol, which are available in the public database of the National Health and Nutrition Examination Survey of Japan (NHNESJ) and in the clinical data of SRL Co., from 1989 to 2019, estimating cholesterol (C) in non-HDL, VLDL, LDL, and sub-fractions of LDL using the equations by Sampson et al. Food intake and supply data in NHNSJ and in the UN Food and Agriculture Organization were also analyzed in relation to the lipoprotein analysis. RESULTS HDL-C levels showed a steady increase in men and women throughout the period as per the data retrieved in NHNSJ and SRL data. It is noted to be higher in women than men (from 46.8 to 52.7, and from 58.4 to 68.3 in mg/dl, respectively). Triglyceride and VLDL-C were higher in men but sex difference was not apparent in non-HDL-C and LDL-C levels, while these parameters slightly decreased in both sexes. The increase in HDL was most prominent in women in the age of 50 - 59 (from 57.0 to 73.4). The age-dependent HDL trend was reversed among women during the study period, as increasing instead of decreasing. This increase in HDL was found to coincide with lowered fish/meat ratio in food intake among Japanese. CONCLUSION Marked increase in plasma HDL among Japanese is age- and sex-dependent and exhibited an apparent paradoxical association with lowered fish/meat ratio in their diet. Further investigation is required to elucidate the background for these findings.
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Affiliation(s)
- Shinji Yokoyama
- Food and Nutritional Sciences, Chubu University, Kasugai, Japan
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Aggarwal R, Chiu N, Libby P, Boden WE, Bhatt DL. Low-Density Lipoprotein Cholesterol Levels in Adults With Coronary Artery Disease in the US, January 2015 to March 2020. JAMA 2023; 330:80-82. [PMID: 37395777 PMCID: PMC10318472 DOI: 10.1001/jama.2023.8646] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/03/2023] [Indexed: 07/04/2023]
Abstract
This study uses National Health and Nutrition Examination Survey data to examine lipid control among adults in the US with coronary artery disease from January 2015 to March 2020.
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Affiliation(s)
- Rahul Aggarwal
- Brigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
| | - Nicholas Chiu
- Department of Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - Peter Libby
- Brigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School, Boston, Massachusetts
| | - William E. Boden
- VA Boston Healthcare System, Boston University School of Medicine, Boston, Massachusetts
| | - Deepak L. Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, New York
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19
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Huang H, Liu J, Liang X, Fang L, Yang C, Ke K, Bai H, Xu W, Li W, Meng F, Chen C. Trends in the prevalence of elevated cardiovascular risk and the control of its risk factors Among US adults, 2001-2020. Front Cardiovasc Med 2023; 10:1153926. [PMID: 37456815 PMCID: PMC10347386 DOI: 10.3389/fcvm.2023.1153926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023] Open
Abstract
Background An accurate assessment of current trends in cardiovascular risks could inform public health policy. This study aims to determine 20-year trends in the prevalence of elevated cardiovascular risk and its risk factors' control among US adults. Methods In this serial cross-sectional analysis of 23,594 adults, aged 40-79 years, without clinical atherosclerotic cardiovascular disease (ASCVD) in the National Health and Nutrition Examination Survey from 2001 to 2020, we calculated the prevalence of elevated cardiovascular risk (10-year ASCVD risk ≥ 7.5%) for all participants and subgroups with their risk factors controlled for diabetes, hypertension, or dyslipidemia. Results The age- and sex-adjusted prevalence of elevated cardiovascular risk slightly decreased from 41.5% (95% CI, 39.7-43.3%) in 2001-2004 to 38.6% (95% CI, 36.1-41.1%) in 2017-2020 (P for trend = 0.169) while the respective sex-adjusted prevalence significantly increased from 34.4% (95% CI, 32.8-36.0%) to 39.5% (95% CI, 37.0-42.0%; P for trend <0.001). Sex and race continued to show disparities in cardiovascular risk. Furthermore, a worsening disparity in age- and sex-adjusted prevalence of elevated cardiovascular risk between young and old and a narrowing gap among different education and poverty index levels (all P trend for interaction <0.05). Differential decomposition analysis found that demographic changes (primarily population aging) led to an 8.8% increase in the prevalence of elevated cardiovascular risk from 2001 to 2004 to 2017-2020, while risk factor control led to a 3.8% decrease. The rate of individuals receiving treatment for diabetes, hypertension, or dyslipidemia increased significantly between 2001 and 2020 (all P for trend <0.05). The rate of participants with hypertension who achieved blood pressure under 130/80 mmHg and those with dyslipidemia who achieved a non-high-density lipoprotein cholesterol level under 130 mg/dl increased significantly (all P for trend <0.001). Conclusions There is a slight reduction in the prevalence of age- and sex-adjusted elevated cardiovascular risk among US adults without clinical ASCVD between 2001 and 2020, while the sex-adjusted prevalence significantly increased. The decrease in elevated cardiovascular risk prevalence was mainly attributed to risk factor control, while demographic changes contributed to an increase.
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Affiliation(s)
- Haitao Huang
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jianhong Liu
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Xiao Liang
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Lingyan Fang
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Chenhui Yang
- Key Laboratory of Environment and Health, Ministries of Education and Environmental Protection, And State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Kangling Ke
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Hemanyun Bai
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Weize Xu
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Weiyan Li
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
- The First Clinical College, Guangdong Medical University, Zhanjiang, China
| | - Fanji Meng
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Can Chen
- Department of Cardiology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
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20
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Shetty NS, Patel N, Gaonkar M, Kalra R, Li P, Pavela G, Arora G, Arora P. Trends of cardiovascular health in Asian American individuals: A national health and nutrition examination survey study. Am J Prev Cardiol 2023; 14:100509. [PMID: 37334161 PMCID: PMC10273280 DOI: 10.1016/j.ajpc.2023.100509] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 05/18/2023] [Accepted: 05/21/2023] [Indexed: 06/20/2023] Open
Abstract
Objective Oversampling of Asian American individuals in the National Health and Nutrition Examination Survey (NHANES) provides a unique opportunity to assess the population-level cardiovascular health (CVH) in the fastest-growing racial group in the US. Methods The Life's Essential 8 (LE8) score and its components were calculated in self-reported Asian American individuals ≥20 years of age and free of cardiovascular disease in the NHANES cycles from 2011-March 2020. Multivariable adjusted linear and logistic regression models were used for analysis. Results Among 2,059 Asian American individuals, the weighted mean LE8 score was 69.1 (0.4) with US-born [69.0 (0.8)] and foreign-born individuals [69.1 (0.4)] having similar CVH. From 2011 to March 2020, CVH in the overall population [69.7 (0.8) to 68.1 (0.8); Ptrend: 0.009] and foreign-born individuals [69.7 (0.8) to 67.7 (0.8); Ptrend: 0.005] declined. Decreasing trends were noted in the body mass index score irrespective of stratification and in the blood pressure scores in the overall population and foreign-born Asian American individuals. Compared with US-born individuals, the odds of ideal levels of smoking [ORadj:<5 years: 2.23 (95%CI: 1.45-3.44); 5-15 years: 1.97 (95%CI: 1.27-3.05); 15-30 years: 1.61 (95%CI: 1.11-2.34); ≥30 years: 1.69(95%CI:1.20-2.36)] and diet [ORadj: <5 years: 1.87 (95%CI: 1.26-2.79); 5-15 years: 2.00 (95%CI: 1.38-2.89); 15-30 years: 1.74 (95%CI: 1.14-2.68)] were higher in foreign-born individuals. Foreign-born individuals had lower odds of ideal physical activity levels [ORadj: 5-15 years: 0.55 (95%CI: 0.39-0.79); 15-30 years: 0.68 (95%CI: 0.49-0.95)] and ideal cholesterol levels [ORadj: 5-15 years: 0.59 (95%CI: 0.42-0.82); 15-30 years: 0.54 (95%CI :0.38-0.76); ≥30 years: 0.52 (95%CI: 0.38-0.76)]. Conclusion The CVH in Asian American individuals declined from 2011 to March 2020. The odds of ideal CVH decreased with increasing duration of stay in the US, with foreign-born individuals residing in the US for ≥30 years having ∼28% lower odds of ideal CVH compared with US-born individuals.
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Affiliation(s)
- Naman S. Shetty
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Nirav Patel
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mokshad Gaonkar
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rajat Kalra
- Cardiovascular Division, University of Minnesota, Minneapolis, MN, United States of America
| | - Peng Li
- School of Nursing, School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory Pavela
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
- Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL, USA
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Aggarwal R, Yeh RW, Joynt Maddox KE, Wadhera RK. Cardiovascular Risk Factor Prevalence, Treatment, and Control in US Adults Aged 20 to 44 Years, 2009 to March 2020. JAMA 2023; 329:899-909. [PMID: 36871237 PMCID: PMC9986841 DOI: 10.1001/jama.2023.2307] [Citation(s) in RCA: 66] [Impact Index Per Article: 66.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/10/2023] [Indexed: 03/06/2023]
Abstract
Importance Declines in cardiovascular mortality have stagnated in the US over the past decade, in part related to worsening risk factor control in older adults. Little is known about how the prevalence, treatment, and control of cardiovascular risk factors have changed among young adults aged 20 to 44 years. Objective To determine if the prevalence of cardiovascular risk factors (hypertension, diabetes, hyperlipidemia, obesity, and tobacco use), treatment rates, and control changed among adults aged 20 to 44 years from 2009 through March 2020, overall and by sex and race and ethnicity. Design, Setting, and Participants Serial cross-sectional analysis of adults aged 20 to 44 years in the US participating in the National Health and Nutrition Examination Survey (2009-2010 to 2017-March 2020). Main Outcomes and Measures National trends in the prevalence of hypertension, diabetes, hyperlipidemia, obesity, and smoking history; treatment rates for hypertension and diabetes; and blood pressure and glycemic control in those receiving treatment. Results Among 12 924 US adults aged 20 to 44 years (mean age, 31.8 years; 50.6% women), the prevalence of hypertension was 9.3% (95% CI, 8.1%-10.5%) in 2009-2010 and 11.5% (95% CI, 9.6%-13.4%) in 2017-2020. The prevalence of diabetes (from 3.0% [95% CI, 2.2%-3.7%] to 4.1% [95% CI, 3.5%-4.7%]) and obesity (from 32.7% [95% CI, 30.1%-35.3%] to 40.9% [95% CI, 37.5%-44.3%]) increased from 2009-2010 to 2017-2020, while the prevalence of hyperlipidemia decreased (from 40.5% [95% CI, 38.6%-42.3%] to 36.1% [95% CI, 33.5%-38.7%]). Black adults had high rates of hypertension across the study period (2009-2010: 16.2% [95% CI, 14.0%-18.4%]; 2017-2020: 20.1% [95% CI, 16.8%-23.3%]), and significant increases in hypertension were observed among Mexican American adults (from 6.5% [95% CI, 5.0%-8.0%] to 9.5% [95% CI, 7.3%-11.7%]) and other Hispanic adults (from 4.4% [95% CI, 2.1%-6.8%] to 10.5% [95% CI, 6.8%-14.3%]), while Mexican American adults had a significant rise in diabetes (from 4.3% [95% CI, 2.3%-6.2%] to 7.5% [95% CI, 5.4%-9.6%]). The percentage of young adults treated for hypertension who achieved blood pressure control did not significantly change (from 65.0% [95% CI, 55.8%-74.2%] in 2009-2010 to 74.8% [95% CI, 67.5%-82.1%] in 2017-2020], while glycemic control among young adults receiving treatment for diabetes remained suboptimal throughout the study period (2009-2010: 45.5% [95% CI, 27.7%-63.3%]) to 2017-2020: 56.6% [95% CI, 39.2%-73.9%]). Conclusions and Relevance In the US, diabetes and obesity increased among young adults from 2009 to March 2020, while hypertension did not change and hyperlipidemia declined. There was variation in trends by race and ethnicity.
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Affiliation(s)
- Rahul Aggarwal
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
- Heart and Vascular Center, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts
| | - Robert W. Yeh
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Karen E. Joynt Maddox
- Cardiovascular Division, Washington University School of Medicine, St Louis, Missouri
- Associate Editor, JAMA
| | - Rishi K. Wadhera
- Richard A. and Susan F. Smith Center for Outcomes Research, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
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Kim Y, Park S, Oh K, Choi H, Jeong EK. Changes in the management of hypertension, diabetes mellitus, and hypercholesterolemia in Korean adults before and during the COVID-19 pandemic: data from the 2010-2020 Korea National Health and Nutrition Examination Survey. Epidemiol Health 2023; 45:e2023014. [PMID: 36731473 PMCID: PMC10581891 DOI: 10.4178/epih.e2023014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 11/28/2022] [Indexed: 02/04/2023] Open
Abstract
OBJECTIVES This study aimed to analyze the changes in chronic disease management indicators, including hypertension, diabetes mellitus, and hypercholesteremia, from 2010-2020 and before (2019) and during (2020) the coronavirus disease 2019 (COVID-19) pandemic. METHODS This study included 58,504 individuals aged ≥30 years who participated in the Korea National Health and Nutrition Examination Survey 2010-2020. Trends in the prevalence, awareness, treatment, and control of chronic diseases and the difference in those between before and during the COVID-19 pandemic were analyzed using the SAS program PROC SURVEYREG. RESULTS From 2010-2020, the awareness, treatment, and control in adults aged ≥30 years for hypertension and hypercholesterolemia continuously improved, whereas no significant change in the management indicators of diabetes mellitus was observed. The prevalence of hypertension, diabetes mellitus, and hypercholesterolemia in men increased from before to during the COVID- 19 pandemic. However, there was no significant change in the management indicators of hypertension and diabetes mellitus in men and women, and the awareness, treatment, and control rates for hypercholesterolemia increased by 5.5%p, 6.9%p, and 4.1%p respectively. CONCLUSIONS In 2020, the first year of the COVID-19 pandemic, the prevalence of hypertension, diabetes mellitus, and hypercholesterolemia increased, but the management indicators of the chronic diseases did not significantly deteriorate. Considering the ongoing COVID-19 pandemic, it is necessary to monitor changes in chronic disease management indicators and to develop efficient and accessible chronic disease prevention and management programs.
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Affiliation(s)
- Yoonjung Kim
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Suyeon Park
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Kyungwon Oh
- Division of Health and Nutrition Survey and Analysis, Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Hongseok Choi
- Bureau of Chronic Disease Prevention and Control, Korea Disease Control and Prevention Agency, Cheongju, Korea
| | - Eun Kyeong Jeong
- Public Health Care Headquarters, Seoul National University Bundang Hospital, Seongnam, Korea
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23
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Dong W, Yang Z. Trends in lipid profile and lipid control among survivors of stroke or myocardial infarction among US adults, 2001-2018. Front Endocrinol (Lausanne) 2023; 14:1128878. [PMID: 36967759 PMCID: PMC10031105 DOI: 10.3389/fendo.2023.1128878] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND We aim to analyze the change in lipid profile and lipid control among survivors of stroke and/or myocardial infarction among US adults from 2001-2018. METHODS In total, 3,736 survivors of stroke and/or myocardial infarction from the 2001-2018 National Health and Nutrition Examination Surveys were included in this study, representing a weighted total population of 110,005,898. Trends for lipid concentration and lipid control rate over time were detected via general linear regression analysis and lipid control was compared by sex and race via survey-weighted logistic regression analysis. RESULTS The total cholesterol, LDL, and triglyceride concentrations were significantly decreased in survivors from the 2001-2002 survey cycle to the 2017-2018 survey cycle (p for trend < 0.01). Lipid control was defined as total cholesterol < 200 mg/dL. Among survivors, the lipid control rate increased from 56.2% (95% CI: 43.9%, 67.7%) in the 2001-2002 survey cycle to 73.2% (95% CI: 64.8%, 80.2%) in the 2017-2018 survey cycle (p for trend < 0.01). Women had a higher lipid concentration and were more likely have poor lipid control compared to men. Non-Hispanic White survivors possessed better lipid control than other races survivors. CONCLUSIONS Lipid concentrations decreased and lipid control improved in stroke and/or myocardial infarction survivors from 2001 to 2018, with heterogeneity observed according to sex and race.
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Affiliation(s)
- Weiwei Dong
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Zhiyong Yang
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Zhiyong Yang,
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Pagidipati NJ, Peterson ED. Can System Solutions Be Scaled to Control High Blood Pressure and Lipids? JAMA Cardiol 2023; 8:21-22. [PMID: 36350615 DOI: 10.1001/jamacardio.2022.4015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Neha J Pagidipati
- Duke Clinical Research Institute, Duke University, Durham, North Carolina
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