1
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Rabiaza A, Puddu PE, Menotti A, Humbert X. Marital status and long-term cardiovascular risk in general population-RIFLE project (Italy). Ir J Med Sci 2024:10.1007/s11845-024-03761-y. [PMID: 39012422 DOI: 10.1007/s11845-024-03761-y] [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: 06/06/2024] [Accepted: 07/12/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND The impact of marital status on cardiovascular disease (CVD) remains controversial in the general population. AIM The present investigation sought to delineate the association between marital status and long-term major non-fatal and fatal CVD, along with all-cause mortality within the scope of the RIFLE project (Risk Factors and Life Expectancy). METHODS We examined the incidences of CVD, including cerebrovascular accidents and coronary heart disease (CHD), as well as all-cause mortality. In total, 47,167 individuals (46% female, average age 50 ± 9 years) were included in the analysis. Marital status at inception was categorized into married (inclusive of married or cohabitating) versus unmarried cohorts (including widowed, separated, divorced, or single individuals). RESULTS Compared to their married counterparts, unmarried subjects demonstrated a heightened risk for CVD in both females and males. Throughout a median follow-up span of 7.4 years (interquartile range from 6 to 9 years), married participants, adjusting for standard risk factors, exhibited reduced mortality rates attributed to CHD [hazard ratio (HR) 0.54 (95% confidence interval (CI) 0.33-0.86)) and all causes (HR 0.75 (95% CI 0.62-0.91)] within the aggregate population; this reduction persisted for both CHD-specific [HR 0.39 (95% CI 0.51-0.90)]and all-cause mortality [HR 0.68 (95% CI 0.51-0.90)], independent of traditional risk factors in women. No associations were evident between matrimonial status and any measured outcomes in males. CONCLUSIONS Within primary care settings, marital status should be considered a potential correlate of long-term CHD and overall mortality risks, especially among women.
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Affiliation(s)
- Andry Rabiaza
- Normandie Université, UNICAEN, UFR Santé, General Practice Department, 14000, Caen, France
| | - Paolo E Puddu
- Association for Cardiac Research, 00198, Rome, Italy
| | | | - Xavier Humbert
- Normandie Université, UNICAEN, UFR Santé, General Practice Department, 14000, Caen, France.
- Normandie Univ, UNICAEN, INSERM U1086 ANTICIPE, 14000, Caen, France.
- Normandie Université, UNICAEN, UFR Santé, General Practice Department, 2, rue des Rochambelles, 14000, Caen, France.
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2
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Zhu C, Dreyer RP, Li F, Spatz ES, Caraballo C, Mahajan S, Raparelli V, Leifheit EC, Lu Y, Krumholz HM, Spertus JA, D’Onofrio G, Pilote L, Lichtman JH. Association of marital/partner status with hospital readmission among young adults with acute myocardial infarction. PLoS One 2024; 19:e0287949. [PMID: 38277368 PMCID: PMC10817183 DOI: 10.1371/journal.pone.0287949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2023] [Accepted: 12/22/2023] [Indexed: 01/28/2024] Open
Abstract
INTRODUCTION Despite evidence supporting the benefits of marriage on cardiovascular health, the impact of marital/partner status on the long-term readmission of young acute myocardial infarction (AMI) survivors is less clear. We examined the association between marital/partner status and 1-year all-cause readmission and explored sex differences among young AMI survivors. METHODS Data were from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which enrolled young adults aged 18-55 years with AMI (2008-2012). The primary end point was all-cause readmission within 1 year of hospital discharge, obtained from medical records and patient interviews and adjudicated by a physician panel. We performed Cox proportional hazards models with sequential adjustment for demographic, socioeconomic, clinical, and psychosocial factors. Sex-marital/partner status interaction was also tested. RESULTS Of the 2,979 adults with AMI (2002 women [67.2%]; mean age 48 [interquartile range, 44-52] years), unpartnered individuals were more likely to experience all-cause readmissions compared with married/partnered individuals within the first year after hospital discharge (34.6% versus 27.2%, hazard ratio [HR] = 1.31; 95% confidence interval [CI], 1.15-1.49). The association attenuated but remained significant after adjustment for demographic and socioeconomic factors (adjusted HR, 1.16; 95% CI, 1.01-1.34), and it was not significant after further adjusting for clinical factors and psychosocial factors (adjusted HR, 1.10; 95%CI, 0.94-1.28). A sex-marital/partner status interaction was not significant (p = 0.69). Sensitivity analysis using data with multiple imputation and restricting outcomes to cardiac readmission yielded comparable results. CONCLUSIONS In a cohort of young adults aged 18-55 years, unpartnered status was associated with 1.3-fold increased risk of all-cause readmission within 1 year of AMI discharge. Further adjustment for demographic, socioeconomic, clinical, and psychosocial factors attenuated the association, suggesting that these factors may explain disparities in readmission between married/partnered versus unpartnered young adults. Whereas young women experienced more readmission compared to similar-aged men, the association between marital/partner status and 1-year readmission did not vary by sex.
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Affiliation(s)
- Cenjing Zhu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Rachel P. Dreyer
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States of America
| | - Fan Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States of America
- Center for Methods in Implementation and Preventive Science, Yale University, New Haven, CT, United States of America
| | - Erica S. Spatz
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - César Caraballo
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, United States of America
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Erica C. Leifheit
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Harlan M. Krumholz
- Center for Outcomes Research and Evaluation, Yale School of Medicine, New Haven, CT, United States of America
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, United States of America
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, United States of America
| | - John A. Spertus
- Healthcare Institute for Innovations in Quality, University of Missouri–Kansas City, Kansas City, Missouri, United States of America
- Saint Luke’s Cardiovascular Outcomes Research, Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, United States of America
| | - Gail D’Onofrio
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Louise Pilote
- Center for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
- Department of Medicine and Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Judith H. Lichtman
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, United States of America
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Shibata Y, Kobayashi N, Shirakabe A, Miyauchi Y, Asai K. Comparisons of Patients Living Alone versus Living with Others in Acute Coronary Syndrome. Int J Angiol 2023; 32:179-187. [PMID: 37576535 PMCID: PMC10421695 DOI: 10.1055/s-0043-1767697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
Abstract
We aimed to examine the relationship of living arrangements (i.e., living alone or living with others) with background, clinical severity, preintervention culprit lesion plaque morphology, and clinical outcomes in patients with acute coronary syndrome (ACS). Among 1,683 consecutive patients with ACS, we retrospectively compared patients living alone ( n = 318) versus living with others ( n = 1,362). Optical coherence tomography (OCT) findings, which are high-resolution intracoronary imaging devices, were analyzed in patients with preintervention OCT and compared between patients living alone ( n = 174) versus those living with others ( n = 665). Older (median; 69 vs. 67 y, p = 0.046) and female (31 vs. 17%, p < 0.001) patients more frequently lived alone. Frequency of achieving a time interval of 6 hours or less from ACS onset to admission was lower in patients living alone (56 vs. 63%, p = 0.022). Clinical presentation was more severe in patients living alone (Killip II/III/IV; 27 vs. 22%, p = 0.029). Plaque morphology evaluated by OCT was similar between groups (plaque rapture; 48 vs. 48%, p = 0.171). Kaplan-Meier analyses revealed higher rates of cardiac mortality during 2-year follow-up period in patients living alone [13.9 vs. 8.5%, hazard ratio (HR) 1.604, 95% confidence interval (CI) 1.112-2.313, p = 0.010]. After traditional cardiovascular risk factors and clinical severity upon admission had been adjusted, living alone was an independent predictor of cardiac mortality in ACS patients (HR 1.582, 95% CI 1.056-2.371, p = 0.026). Living alone was independently associated with 2-year cardiacmortality in ACS patients after adjusting for background and presentation and might be unrelated to the development of atherosclerosis.
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Affiliation(s)
- Yusaku Shibata
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Nobuaki Kobayashi
- Cardiovascular Center, Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Akihiro Shirakabe
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Yasushi Miyauchi
- Cardiovascular Center, Department of Cardiovascular Medicine, Nippon Medical School Chiba Hokusoh Hospital, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Kuniya Asai
- Division of Intensive Care Unit, Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
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Zhu C, Dreyer RP, Li F, Spatz ES, Caraballo C, Mahajan S, Raparelli V, Leifheit EC, Lu Y, Krumholz HM, Spertus JA, D’Onofrio G, Pilote L, Lichtman JH. Association of Marital/Partner Status with Hospital Readmission Among Young Adults With Acute Myocardial Infarction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.20.23291664. [PMID: 37425864 PMCID: PMC10327186 DOI: 10.1101/2023.06.20.23291664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Introduction Despite evidence supporting the benefits of marriage on cardiovascular health, the impact of marital/partner status on the long-term readmission of young acute myocardial infarction (AMI) survivors is less clear. We aimed to examine the association between marital/partner status and 1-year all-cause readmission, and explore sex differences, among young AMI survivors. Methods Data were from the VIRGO study (Variation in Recovery: Role of Gender on Outcomes of Young AMI Patients), which enrolled young adults aged 18-55 years with AMI (2008-2012). The primary end point was all-cause readmission within 1 year of hospital discharge, obtained from medical record, patient interviews, and adjudicated by a physician panel. We performed Cox proportional hazards models with sequential adjustment for demographic, socioeconomic, clinical and psychosocial factors. Sex-marital/partner status interaction was also tested. Results Of the 2,979 adults with AMI (2002 women [67.2%]; mean age 48 [interquartile range, 44-52] years), unpartnered individuals were more likely to experience all-cause readmissions compared with married/partnered individuals within the first year after hospital discharge (34.6% versus 27.2%, hazard ratio [HR]=1.31; 95% confidence interval [CI], 1.15-1.49). The association attenuated but remained significant after adjustment for demographic and socioeconomic factors (adjusted HR, 1.16; 95%CI, 1.01-1.34), and was not significant after further adjusting for clinical factors and psychosocial factors (adjusted HR, 1.10; 95%CI, 0.94-1.28). Sex-marital/partner status interaction was not significant (p=0.69). Sensitivity analysis using data with multiple imputation, and restricting outcomes to cardiac readmission yielded comparable results. Conclusions In a cohort of young adults aged 18-55 years, unpartnered status was associated with 1.3-fold increased risk of all-cause readmission within 1 year of AMI discharge. Further adjustment for demographic, socioeconomic, clinical and psychosocial factors attenuated the association, suggesting that these factors may explain disparities in readmission between married/partnered versus unpartnered young adults. Whereas young women experienced more readmission compared to similar-aged men, the association between marital/partner status and 1-year readmission did not vary by sex.
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Affiliation(s)
- Cenjing Zhu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Rachel P Dreyer
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
| | - Fan Li
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, USA
- Center for Methods in Implementation and Preventive Science, Yale University, New Haven, CT, USA
| | - Erica S Spatz
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - César Caraballo
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Shiwani Mahajan
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Erica C Leifheit
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
| | - Yuan Lu
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Harlan M Krumholz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, USA
- Department of Cardiology, Yale School of Medicine, New Haven, CT, USA
- Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - John A Spertus
- Healthcare Institute for Innovations in Quality, University of Missouri – Kansas City, Missouri, USA
- Saint Luke’s Cardiovascular Outcomes Research, Saint Luke’s Mid America Heart Institute, Kansas City, Missouri, USA
| | - Gail D’Onofrio
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Louise Pilote
- Center for Outcomes Research and Evaluation, Research Institute, McGill University Health Centre, Montreal, Quebec, Canada
- Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada
| | - Judith H Lichtman
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT, USA
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5
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Humbert X, Rabiaza A, Fedrizzi S, Alexandre J, Menotti A, Touzé E, Laurenzi M, Terradura-Vagnarelli O, Puddu PE. Marital status and long-term cardiovascular risk in general population (Gubbio, Italy). Sci Rep 2023; 13:6723. [PMID: 37185571 PMCID: PMC10130019 DOI: 10.1038/s41598-023-33943-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 04/21/2023] [Indexed: 05/17/2023] Open
Abstract
To investigate whether marital status is associated to long-term major fatal and non-fatal cardiovascular events in men and women from the Gubbio Population Study. The incidence of cardiovascular disease (CVD), including stroke and coronary heart disease (CHD) and CVD death together with all-cause mortality were analyzed. The analysis included 2832 persons (44% men, 54 ± 11 years old). Marital status was defined at entry as married (married or living conjugally) versus unmarried subjects (widowed, separated, divorced or single). Married and unmarried subjects did not differ concerning socio-demographic, anthropometric and biological variables at baseline. Over 191 months median follow-up, the incidence of CHD was lower among married versus unmarried women [HR: 0.63 (95% CI 0.41-0.96)] only; the same was true for CHD mortality [HR: 0.43 (95% CI 0.22-0.84)] and all-cause mortality [HR: 0.75 (95% CI 0.59-0.96)] independently of traditional risk factors (age, SBP, total and HDL cholesterol, cigarette smoke and BMI). In men, marital status was not associated to any of the investigated outcomes. In primary care, marital status should be investigated as it can be associated with long-term CHD and all-cause incidence and mortality risks among women.
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Affiliation(s)
- Xavier Humbert
- Département de medecine generale, Normandie Université, UNICAEN, 14000, Caen, France.
- INSERM U1086 ANTICIPE, Normandie Université, UNICAEN, 14000, Caen, France.
- Département de medecine generale, Pôle de formation et de recherche en sante, 2, rue des Rochambelles, 14000, Caen, France.
| | - Andry Rabiaza
- Département de medecine generale, Normandie Université, UNICAEN, 14000, Caen, France
| | - Sophie Fedrizzi
- EA 4650, Signalisation, électrophysiologie et imagerie des lesions d'ischémie reperfusion myocardique, UNICAEN, 14000, Caen, France
- Service de Pharmacologie, Normandie Université, UNICAEN, CHU Caen Normandie, 14000, Caen, France
| | - Joachim Alexandre
- INSERM U1086 ANTICIPE, Normandie Université, UNICAEN, 14000, Caen, France
- Service de Pharmacologie, Normandie Université, UNICAEN, CHU Caen Normandie, 14000, Caen, France
| | | | - Emmanuel Touzé
- Service de Neurologie, Normandie Université, UNICAEN, CHU Caen Normandie, 14000, Caen, France
- INSERM U1237 PhIND, Normandie Université, UNICAEN, 14000, Caen, France
| | - Martino Laurenzi
- Centro Studi Epidemiologici di Gubbio (CeSEG), 06024, Gubbio, Perugia, Italy
| | | | - Paolo E Puddu
- EA 4650, Signalisation, électrophysiologie et imagerie des lesions d'ischémie reperfusion myocardique, UNICAEN, 14000, Caen, France
- Association for Cardiac Research, 00198, Rome, Italy
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Wei Z, Yang J, Qian H, Yang Y. Impact of Marital Status on Management and Outcomes of Patients With Acute Myocardial Infarction: Insights From the China Acute Myocardial Infarction Registry. J Am Heart Assoc 2022; 11:e025671. [PMID: 36444834 PMCID: PMC9851450 DOI: 10.1161/jaha.122.025671] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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
Background Acute myocardial infarction (AMI) is one of the leading causes of mortality worldwide, whereas social support is a known predictor of the prognosis after AMI. As a common factor influencing social support, the impact of marital status on care quality, in-hospital mortality, and long-term prognosis of patients with AMI remains largely unknown. Methods and Results The present study analyzed data from the CAMI (China Acute Myocardial Infarction) registry involving 19 912 patients with AMI admitted at 108 hospitals in China between January 2013 and September 2014 and aimed to evaluate marital status-based differences in acute management, medical therapies, and short-term and long-term outcomes. The primary end point was 2-year all-cause death. The secondary end points included in-hospital death and 2-year major adverse cardiac and cerebrovascular events (a composite of all-cause death, myocardial infarction, or stroke). After multivariable adjustment, 1210 (6.1%) unmarried patients received less reperfusion treatment in patients with both ST-segment-elevation myocardial infarction and non-ST-segment-elevation myocardial infarction (adjusted odds ratio [OR], 0.520 [95% CI, 0.437-0.618]; P<0.0001; adjusted OR, 0.489 [95% CI, 0.364-0.656]; P<0.0001). Being unmarried was not associated with poorer in-hospital outcome but with long-term all-cause mortality and major adverse cardiac and cerebrovascular events in both ST-segment-elevation myocardial infarction (adjusted hazard ratio [HR], 1.225 [95% CI, 1.031-1.456]; P=0.0209; adjusted HR, 1.277 [95% CI, 1.089-1.498]; P=0.0027) and non-ST-segment-elevation myocardial infarction (adjusted HR, 1.302 [95% CI, 1.036-1.638]; P=0.0239; adjusted HR, 1.368 [95% CI, 1.105-1.694]; P=0.0040) populations. Conclusions The present study suggests that being unmarried is independently related to less reperfusion received, but could not explain the higher in-hospital mortality rate after covariate adjustment. Being unmarried is associated with a substantially increased risk of adverse events over at least the first 24 months after AMI. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT01874691.
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Affiliation(s)
- Zhi‐Yao Wei
- Department of Cardiology, Center for Coronary Heart Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Jin‐Gang Yang
- Department of Cardiology, Center for Coronary Heart Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Hai‐Yan Qian
- Department of Cardiology, Center for Coronary Heart Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Yue‐Jin Yang
- Department of Cardiology, Center for Coronary Heart Disease, Fu Wai Hospital, National Center for Cardiovascular Diseases of China, State Key Laboratory of Cardiovascular DiseaseChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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Blood Chromium Levels and Their Association with Cardiovascular Diseases, Diabetes, and Depression: National Health and Nutrition Examination Survey (NHANES) 2015-2016. Nutrients 2022; 14:nu14132687. [PMID: 35807870 PMCID: PMC9268404 DOI: 10.3390/nu14132687] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 06/21/2022] [Accepted: 06/24/2022] [Indexed: 02/01/2023] Open
Abstract
Currently, there is no global consensus about the essentiality of dietary chromium. To provide evidence to this debate, an examination of blood chromium levels and common chronic health conditions was undertaken. Using a subsample from the 2015−2016 US National Health and Nutrition Examination Survey (n = 2894; 40 years+), chi-square and binary logistic regression analyses were conducted to examine blood chromium levels (0.7−28.0 vs. <0.7 µg/L) and their associations with cardiovascular diseases (CVDs; self-report), diabetes mellitus (DM; glycohemoglobin ≥5.7%), and depression (Patient Health Questionnaire-9 score ≥5), while controlling for socio-demographic (age/sex/income/education/relationship status) and health-related (red blood cell folate/medications/co-morbidities/body mass index (BMI)/substance use) factors. The sample was almost evenly distributed between men and women (n = 1391, 48.1% (men); n = 1503, 51.9% (women)). The prevalence estimates of low blood chromium levels tended to be higher among those with CVDs (47.4−47.6%) and DM (50.0−51.6%). Comparisons between those with low vs. normal blood chromium levels indicate men have increased odds of CVDs (adjusted odds ratio (aOR) = 1.86, 95% confidence interval (CI): 1.22−2.85, p < 0.001) and DM (aOR = 1.93, 95% CI: 1.32−2.83, p < 0.001) and lower odds of depression (aOR = 0.42, 95% CI: 0.22−0.77, p < 0.05). Dietary chromium may be important in the prevention and management of CVDs and DM for men. Continued exploration of chromium’s role in chronic diseases, including differences by biological factors, is needed.
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8
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Malaeb D, Hallit S, Dia N, Cherri S, Maatouk I, Nawas G, Salameh P, Hosseini H. Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study. F1000Res 2021; 10:793. [PMID: 34504688 PMCID: PMC8383125 DOI: 10.12688/f1000research.54236.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/20/2021] [Indexed: 01/04/2023] Open
Abstract
Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4 to 5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic and socioeconomic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA
2DS
2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Data was collected through a survey that was distributed to all eligible patients. Results: A total of 524 patients were enrolled in the study with a mean age (± SD) of 58.75 ± 13.59 years with hypertension (78.4%) being the most predominant disease. The results showed that obesity (Beta=0.61, p-value =0.011), retirement and unemployment compared to employment (Beta=1.44 and 1.44, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.38, p-value =0.001) were significantly associated with higher CHA
2DS
2-VASc scores whereas high versus low socio-economic status (Beta=-1.03, p=0.009) and high school education versus primary education level (Beta=-0.49, p-value=0.025) were significantly associated with lower CHA
2DS
2-VASc scores. Conclusions: The study highlights that
the
CHA
2DS
2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.
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Affiliation(s)
- Diana Malaeb
- School of pharmacy, Lebanese International University, Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
| | - Nada Dia
- School of pharmacy, Lebanese International University, Beirut, Lebanon
| | - Sarah Cherri
- School of pharmacy, Lebanese International University, Beirut, Lebanon
| | - Imad Maatouk
- School of pharmacy, Lebanese International University, Beirut, Lebanon
| | - George Nawas
- College of Pharmacy, Xavier University of Louisiana, Louisiana, USA
| | - Pascale Salameh
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hassan Hosseini
- Henri Mondor Hospital, Paris, France.,Life Sciences and Health Department, Paris-Est Créteil University, Paris, France
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Alansari W, Mohammed A, Aljohani R, Bakhashwain S, Manlangit JJS, Al-Husayni F, Anajreah N, Almehmadi F, Zagzoog A, AlQubbany A. The Quality of Life in Patients With Implantable Cardiac Devices: A Single-Center Cross-Sectional Study. Cureus 2021; 13:e18542. [PMID: 34765337 PMCID: PMC8575321 DOI: 10.7759/cureus.18542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2021] [Indexed: 11/05/2022] Open
Abstract
Background Cardiovascular diseases (CVDs) and their complications are one of the most common causes of death worldwide. Implantable cardiac assistive devices (CADs) play a significant role in preventing dreadful outcomes, and the complication rate of these implanting procedures is minimal. These cardiac devices require some adaptation and could affect the patients' quality of life psychosocially and financially. This study is aimed to identify the impact of implantable cardiac assistive devices on patients' quality of life in the National Guard Hospital, Jeddah, Saudi Arabia. Methods This is an observational cross-sectional questionnaire-based study. It was conducted on patients who underwent cardiac assistive device implantation in National Guard Hospital. The patients were interviewed face-to-face and were requested to fill the Implanted Device Adjustment Scale (IDAS). Descriptive statistics were carried out. Chi-square test for independence was conducted to examine the associations between qualitative variables with the level of significance was taken as p-value <0.05. Results There was a statistically significant association between IDAS score and gender (p=0.03), monthly income (p=0.009), and type of cardiac implantation device (p=0.041). Females with an implantable cardiac defibrillator (ICD) and individuals with low socioeconomic status reported alongside divorced participants have higher IDAS scores, which correlates to worse adjustment. However, most of our patients scored 21-50 in IDAS score, which indicates a mild psychosocial effect after the cardiac assistive device implantation. Conclusion This study confirmed that most individuals adjust positively to implanted devices. It showed a significant association of gender, type of device, monthly income, and duration. Attention must be drawn to females and divorced patients in regards to psychological and emotional support.
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Affiliation(s)
- Wasna Alansari
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Asmaa Mohammed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Rahaf Aljohani
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Shahad Bakhashwain
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Juan Jr S Manlangit
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Faisal Al-Husayni
- Internal Medicine, King Abdullah International Medical Research Center, Jeddah, SAU.,Internal Medicine, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Nesreen Anajreah
- Nursing, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Fahad Almehmadi
- Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Amin Zagzoog
- Cardiology, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
| | - Atif AlQubbany
- Cardiology, King Faisal Cardiac Center, National Guard Hospital, King Abdulaziz Medical City, Jeddah, SAU
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10
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Correlates of Delayed Initial Contact to Emergency Services among Patients with Suspected ST-Elevation Myocardial Infarction. Cardiol Res Pract 2021; 2021:8483817. [PMID: 34567802 PMCID: PMC8457972 DOI: 10.1155/2021/8483817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/26/2021] [Indexed: 11/25/2022] Open
Abstract
Background Early diagnosis and treatment of a patient displaying symptoms of myocardial ischemia is paramount in preventing detrimental tissue damage, arrhythmias, and death. Patient-related hospital delay is the greatest considerable cause of total delay in treatment for acute myocardial infarction. Objective To identify patient characteristics contributing to prehospital delay and ultimately developing health interventions to prevent future delay and improve health outcomes. Methods A retrospective chart review of 287 patients diagnosed with ST-elevation myocardial infarction (STEMI) was evaluated to examine correlates of patient-related delays to care. Results Stepwise logistic regression modeling with forward selection (likelihood ratio) was performed to identify predictors of first medical contact (FMC) within 120 minutes of symptom onset and door-to-balloon (DTB) time within 90 minutes. Distance from the hospital, being unmarried, self-medicating, disability, and hemodynamic stability emerged as variables that were found to be predictive of FMC within the first 120 minutes after symptom onset. Similarly, patient characteristics of gender and disability and having an initial nondiagnostic electrocardiogram emerged as significant predictors of DTB within 90 minutes. Conclusions Individual attention to high-risk patients and public education campaigns using printed materials, public lectures, and entertainment mediums are likely needed to disseminate information to improve prevention strategies. Future research should focus on identifying the strengths of prehospital predictors and finding other variables that can be established as forecasters of delay. Interventions to enhance survival in acute STEMI should continue as to provide substantial advances in overall health outcomes.
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11
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Malaeb D, Hallit S, Dia N, Cherri S, Maatouk I, Nawas G, Salameh P, Hosseini H. Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study. F1000Res 2021; 10:793. [PMID: 34504688 DOI: 10.12688/f1000research.54236.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4-5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA 2DS 2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Results: A total of 524 patients were enrolled in the study with a mean age of 58.75 (± SD) ± 13.59 years with hypertension (78.38%) being the most predominant disease. The results showed that obesity (Beta=0.610, p-value =0.011), retirement and unemployment compared to employment (Beta=1.440 and 1.440, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.380, p-value =0.001) were significantly associated with higher CHA 2DS 2-VASc scores whereas high versus low socio-economic status (Beta=-1.030, p=0.009) and high school education versus primary education level (Beta=-0.490, p-value=0.025) were significantly associated with lower CHA 2DS 2-VASc scores. Conclusions: The study highlights that the CHA 2DS 2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.
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Affiliation(s)
- Diana Malaeb
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est Créteil University, Paris, France
| | - Nada Dia
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - Sarah Cherri
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - Imad Maatouk
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - George Nawas
- College of Pharmacy, Xavier University of Louisiana, Louisiana, USA
| | - Pascale Salameh
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hassan Hosseini
- Henri Mondor Hospital, Paris, France.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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12
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Sex differences of the association between marital status and coronary artery disease in patients experiencing chest pain: The Korean Women's Chest Pain Registry. Menopause 2020; 27:788-793. [DOI: 10.1097/gme.0000000000001533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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13
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Takagi H, Hari Y, Nakashima K, Kuno T, Ando T. Marriage and mortality after acute coronary syndrome. Eur J Prev Cardiol 2019; 27:2374-2384. [PMID: 31690097 DOI: 10.1177/2047487319881832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Hisato Takagi
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Japan
| | - Yosuke Hari
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Japan
| | - Kouki Nakashima
- Department of Cardiovascular Surgery, Shizuoka Medical Center, Japan.,Department of Cardiovascular Surgery, Kitasato University School of Medicine, Japan
| | - Toshiki Kuno
- Department of Medicine, Mount Sinai Beth Israel Medical Center, USA
| | - Tomo Ando
- Division of Interventional Cardiology, New York Presbyterian Hospital/Columbia University Medical Center, USA
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14
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Mbouemboue OP, Ngoufack TJO. High Blood Pressure Prevalence, Awareness, Control, and Associated Factors in a Low-Resource African Setting. Front Cardiovasc Med 2019; 6:119. [PMID: 31544107 PMCID: PMC6728810 DOI: 10.3389/fcvm.2019.00119] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/05/2019] [Indexed: 01/13/2023] Open
Abstract
Background and Objectives: Recent and contextualized data are needed to improve hypertension management known as a major cardiovascular disease risk factor regardless of the geographical area. This study aimed at assessing the prevalence of hypertension, awareness of hypertensive status, treatment, and control of hypertension as well as assessing the factors associated with risk of hypertension and awareness of hypertensive status in the population of Ngaoundere. Methods: This was a community based cross sectional study carried out from February to December 2016. A three-stage sampling method was used for recruitment of participants. Demographic, clinical, and biological data were collected and analyzed using Statistical Package for Social Sciences version 20.0. Statistical significance was set at P < 0.05. Results: In total, 948 participants were included in the study. The overall prevalence of hypertension was 46.94% (n = 445). Fraction of hypertensive participants who were aware of their status was 36.85% (n = 164). Among them, 39 (23.78%) were getting treatment and the control rate of treated hypertensives was 30.56%. Age, marital status, family history of hypertension, overweight, and high serum triglyceride level were identified as independent predicting factors of hypertension, whereas female gender, age, personal history of stroke or diabetes, family history of hypertension or heart failure, overweight, and abdominal obesity were those of hypertension awareness. Conclusion: The present study revealed high prevalence, extremely low awareness, treatment, and control rates of hypertension in Ngaoundere community setting.
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Affiliation(s)
- Olivier Pancha Mbouemboue
- Department of Biomedical Sciences, Faculty of Science, University of Ngaoundere, Ngaoundere, Cameroon
- General Medicine Service, Ngaoundere Regional Hospital, Ngaoundere, Cameroon
| | - Tsougmo Jacques Olivier Ngoufack
- Department of Biomedical Sciences, Faculty of Science, University of Ngaoundere, Ngaoundere, Cameroon
- Hypertension and Diabetes Unit, Ngaoundere Regional Hospital, Ngaoundere, Cameroon
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15
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Marcus G, Litovchik I, Pereg D, Beigel R, Sholmo N, Iakobishvili Z, Goldenberg I, Fuchs S, Minha S. Impact of Marital Status on the Outcome of Acute Coronary Syndrome: Results From the Acute Coronary Syndrome Israeli Survey. J Am Heart Assoc 2019; 8:e011664. [PMID: 31266391 PMCID: PMC6662115 DOI: 10.1161/jaha.118.011664] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background Marriage is one of the common forms of social support. Conflicting evidence exists about the impact of marital status on the outcomes of patients with acute coronary syndrome (ACS). It is further not clear if sex disparity exists in the outcome of married and nonmarried patients with ACS. Methods and Results Data from the ACS Israeli Survey, collected between 2004 and 2016, were used to compare baseline characteristics, clinical indexes, and outcomes of married and nonmarried patients with ACS. Cox regression analysis and propensity score matching were used to explore if marital status was independently associated with long‐term outcome. Of 7233 patients included with reported marital status, 5643 (78%) were married. Married patients were younger (62.69±12.07 versus 68.47±14.84 years; P<0.001), more frequently men (83.1% versus 54.8%; P<0.001), and less likely to be hypertensive (61.1% versus 69.3%; P<0.001). All‐cause mortality incidence at 30 days and at 1 year was lower in married patients (3.1% versus 7.6% [P<0.001]; and 7.1% versus 15.3% [P<0.001], respectively). After adjusting for multiple covariates, the hazard ratio for 5‐year all‐cause mortality for married patients was 0.74 (95% CI, 0.62–0.88). Similar results were observed after propensity score matching. Kaplan‐Meier estimates for all‐cause mortality at 5 years demonstrated the best prognosis for married men and the worst for nonmarried women. Conclusions Marriage is independently associated with better short‐ and long‐term outcomes across the spectrum of ACS. Attempts to intensify secondary prevention measures should focus on nonmarried patients and especially nonmarried women.
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Affiliation(s)
- Gil Marcus
- 1 Department of Cardiology Assaf-Harofeh Medical Center Zerifin Israel.,2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel
| | - Ilya Litovchik
- 1 Department of Cardiology Assaf-Harofeh Medical Center Zerifin Israel.,2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel
| | - David Pereg
- 2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel.,3 Department of Cardiology Meir Medical Center Kfar Saba Israel
| | - Roy Beigel
- 2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel.,4 Leviev Heart Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Nir Sholmo
- 2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel.,4 Leviev Heart Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Zaza Iakobishvili
- 2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel.,5 Department of Community Cardiology Clalit Health Services Tel-Aviv District Israel
| | - Ilan Goldenberg
- 2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel.,4 Leviev Heart Center Sheba Medical Center Tel Hashomer Ramat Gan Israel
| | - Shmuel Fuchs
- 1 Department of Cardiology Assaf-Harofeh Medical Center Zerifin Israel.,2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel
| | - Sa'ar Minha
- 1 Department of Cardiology Assaf-Harofeh Medical Center Zerifin Israel.,2 Sackler School of Medicine Tel-Aviv University Ramat-Aviv Israel
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16
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Pellegrini C, Rheude T, Mahr L, Trenkwalder T, Mayr NP, Michel J, Schunkert H, Kasel AM, Joner M, Hengstenberg C, Kastrati A, Husser O, Kessler T. Influence of marital status in patients undergoing transcatheter aortic valve implantation. J Thorac Dis 2019; 11:1888-1895. [PMID: 31285881 DOI: 10.21037/jtd.2019.05.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Background Marital status has been described to affect outcome in cardiovascular diseases, however its impact on patients undergoing transcatheter aortic valve implantation (TAVI) is unknown. We therefore aimed to assess the impact of marital status in patients undergoing TAVI. Methods Between 2011 and 2015, 779 patients undergoing transfemoral TAVI with known marital status were included in the analysis. The primary endpoint of the study was the composite of cardiac death and readmission for congestive heart failure (CHF) at one year. Results Mean age was 80.7±5.9 years, 47.8% were female and median logistic EuroScore was 12.7% (8.13-19.39%). Forty-three point three percent of patients were not married. Compared to married patients, unmarried patients were older (82.4±5.5 vs. 79.5±5.8 years; P<0.001), more often female (73.3% vs. 28.3%; P<0.001), presented with a higher logistic EuroScore [13.1% (9.5-21.5%) vs. 11.7% (7.0-18.5%); P<0.001], and more symptomatic with New York Heart Association functional class III/IV (69.7% vs. 60.6%; P=0.009). At one year the incidence of the primary endpoint was higher in unmarried patients (18.7% vs. 12.0%; P=0.011) which was mainly driven by more admissions for CHF (14.1% vs. 7.8%; P=0.007). After multivariable adjustment, marital status was borderline significant regarding CHF (HR 0.61, 95% CI: 0.37-1.02; P=0.06) but not the primary endpoint. Conclusions Unmarried patients undergoing TAVI showed a higher incidence of cardiac death or CHF at one year. Hence, marital status should be taken into account in patients with aortic stenosis subjected to TAVI. Whether closer monitoring and intensified medical follow-up improves outcomes remains to be investigated in future studies.
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Affiliation(s)
- Costanza Pellegrini
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Tobias Rheude
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Lukas Mahr
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Teresa Trenkwalder
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - N Patrick Mayr
- Institut für Anästhesiologie, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Jonathan Michel
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Heribert Schunkert
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - A Markus Kasel
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany
| | - Michael Joner
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Christian Hengstenberg
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany.,Klinische Abteilung für Kardiologie, Universitätsklinik für Innere Medizin II, Medizinische Universität Wien, Vienna, Austria
| | - Adnan Kastrati
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
| | - Oliver Husser
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Klinik für Innere Medizin I, Kardiologie, St. Johannes-Hospital Dortmund, Dortmund, Germany
| | - Thorsten Kessler
- Klinik für Herz- und Kreislauferkrankungen, Deutsches Herzzentrum München, Technische Universität München, Munich, Germany.,Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany
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17
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Wong CW, Kwok CS, Narain A, Gulati M, Mihalidou AS, Wu P, Alasnag M, Myint PK, Mamas MA. Marital status and risk of cardiovascular diseases: a systematic review and meta-analysis. Heart 2018; 104:1937-1948. [PMID: 29921571 DOI: 10.1136/heartjnl-2018-313005] [Citation(s) in RCA: 107] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Revised: 04/18/2018] [Accepted: 04/19/2018] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND The influence of marital status on the incidence of cardiovascular disease (CVD) and prognosis after CVD is inconclusive. We systematically reviewed the literature to determine how marital status influences CVD and prognosis after CVD. METHODS A search of MEDLINE and Embase in January 2018 without language restriction was performed to identify studies that evaluated the association between marital status and risk of CVD. Search terms related to both marital status and CVD were used and included studies had to be prospective in design. The outcomes of interest were CVD, coronary heart disease (CHD) or stroke incidence and mortality. We performed random effects meta-analysis stratified by the types of population by calculating odds ratios (OR) and 95% confidence intervals (95% CI). RESULTS Our analysis included 34 studies with more than two million participants. Compared with married participants, being unmarried (never married, divorced or widowed) was associated with increased odds of CVD (OR 1.42; 95% CI 1.00 to 2.01), CHD (OR 1.16,95% CI 1.04 to 1.28), CHD death (OR 1.43,95% CI 1.28 to 1.60) and stroke death (OR 1.55,95% 1.16 to 2.08). Being divorced was associated with increased odds of CHD (P<0.001) for both men and women while widowers were more likely to develop a stroke (P<0.001). Single men and women with myocardial infarction had increased mortality (OR 1.42, 95% CI 1.14 to 1.76) compared with married participants. CONCLUSIONS Marital status appears to influence CVD and prognosis after CVD. These findings may suggest that marital status should be considered in the risk assessment for CVD and outcomes of CVD based on marital status merits further investigation.
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Affiliation(s)
- Chun Wai Wong
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK
| | - Chun Shing Kwok
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK
| | - Aditya Narain
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK
| | - Martha Gulati
- University of Arizona College of Medicine-Phoenix, Phoenix, Arizona, USA
| | - Anastasia S Mihalidou
- Department of Cardiology and Kolling Institute, Royal North Shore Hospital, St Leonards and Macquarie University, Sydney, New South Wales, Australia
| | - Pensee Wu
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele, Keele, UK.,Academic Department of Obstetrics and Gynaecology, Royal Stoke Hospital, Stoke-on-Trent, UK
| | - Mirvat Alasnag
- Department of Cardiology, King Fahd Armed Forces Hospital, Jeddah, Saudi Arabia
| | - Phyo Kyaw Myint
- Institute of Applied Health Sciences, University of Aberdeen, Aberdeen, UK
| | - Mamas A Mamas
- Keele Cardiovascular Research Group, Institute for Applied Clinical Science and Centre for Prognosis Research, Institute of Primary Care and Health Sciences, University of Keele and Academic Department of Cardiology, Royal Stoke Hospital, Stoke-on-Trent, UK
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18
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Schultz WM, Hayek SS, Samman Tahhan A, Ko YA, Sandesara P, Awad M, Mohammed KH, Patel K, Yuan M, Zheng S, Topel ML, Hartsfield J, Bhimani R, Varghese T, Kim JH, Shaw L, Wilson P, Vaccarino V, Quyyumi AA. Marital Status and Outcomes in Patients With Cardiovascular Disease. J Am Heart Assoc 2017; 6:e005890. [PMID: 29263033 PMCID: PMC5778993 DOI: 10.1161/jaha.117.005890] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 11/21/2017] [Indexed: 12/19/2022]
Abstract
BACKGROUND Being unmarried is associated with decreased survival in the general population. Whether married, divorced, separated, widowed, or never-married status affects outcomes in patients with cardiovascular disease has not been well characterized. METHODS AND RESULTS A prospective cohort (inception period 2003-2015) of 6051 patients (mean age 63 years, 64% male, 23% black) undergoing cardiac catheterization for suspected or confirmed coronary artery disease was followed for a median of 3.7 years (interquartile range: 1.7-6.7 years). Marital status was stratified as married (n=4088) versus unmarried (n=1963), which included those who were never married (n=451), divorced or separated (n=842), or widowed (n=670). The relationship between marital status and primary outcome of cardiovascular death and myocardial infarction was examined using Cox regression models adjusted for clinical characteristics. There were 1085 (18%) deaths from all causes, 688 (11%) cardiovascular-related deaths, and 272 (4.5%) incident myocardial infarction events. Compared with married participants, being unmarried was associated with higher risk of all-cause mortality (hazard ratio [HR]: 1.24; 95% confidence interval [CI], 1.06-1.47), cardiovascular death (HR: 1.45; 95% CI, 1.18-1.78), and cardiovascular death or myocardial infarction (HR: 1.52; 95% CI, 1.27-1.83). Compared with married participants, the increase in cardiovascular death or myocardial infarction was similar for the participants who were divorced or separated (HR: 1.41; 95% CI, 1.10-1.81), widowed (HR: 1.71; 95% CI, 1.32-2.20), or never married (HR: 1.40; 95% CI, 0.97-2.03). The findings persisted after adjustment for medications and other socioeconomic factors. CONCLUSIONS Marital status is independently associated with cardiovascular outcomes in patients with or at high risk of cardiovascular disease, with higher mortality in the unmarried population. The mechanisms responsible for this increased risk require further study.
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Affiliation(s)
- William M Schultz
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Salim S Hayek
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Ayman Samman Tahhan
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Yi-An Ko
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health Emory University, Atlanta, GA
| | - Pratik Sandesara
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Mosaab Awad
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Kareem H Mohammed
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Keyur Patel
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Michael Yuan
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA
| | - Shuai Zheng
- Department of Biomedical Informatics, Emory University School of Medicine, Atlanta, GA
| | - Matthew L Topel
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Joy Hartsfield
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Ravila Bhimani
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Tina Varghese
- Department of Medicine, Emory University School of Medicine, Atlanta, GA
| | - Jonathan H Kim
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Leslee Shaw
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Peter Wilson
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
| | - Viola Vaccarino
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
- Department of Epidemiology, Rollins School of Public Health Emory University, Atlanta, GA
- American Institutes for Research, Washington, DC
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute Emory University School of Medicine, Atlanta, GA
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Manfredini R, De Giorgi A, Tiseo R, Boari B, Cappadona R, Salmi R, Gallerani M, Signani F, Manfredini F, Mikhailidis DP, Fabbian F. Marital Status, Cardiovascular Diseases, and Cardiovascular Risk Factors: A Review of the Evidence. J Womens Health (Larchmt) 2017; 26:624-632. [PMID: 28128671 DOI: 10.1089/jwh.2016.6103] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND There is evidence showing that marital status (MS) and marital disruption (i.e., separation, divorce, and being widowed) are associated with poor physical health outcomes, including for all-cause mortality. We checked for the available evidence on the association between MS and cardiovascular (CV) diseases, outcomes, and CV risk factors. METHODS A search across the PubMed database of all articles, including the term "marital status" in their title, was performed. All articles were then manually checked for the presence of the following terms or topic: CV diseases, acute myocardial infarction, acute coronary syndrome, coronary artery disease, cardiac arrest, heart failure, heart diseases, and CV mortality. Moreover, other search terms were: CV risk factors, hypertension, cholesterol, obesity, smoking, alcohol, fitness and/or physical activity, and health. Systematic reviews, meta-analyses, controlled trials, cohort studies, and case-control studies were potentially considered pertinent for inclusion. Case reports, comments, discussion letters, abstracts of scientific conferences, articles in other than English language, and conference abstracts or proceedings were excluded. RESULTS In total, 817 references containing the title words "marital status" were found. After elimination of articles dealing with other topics, 70 records were considered pertinent. Twenty-two were eliminated for several reasons, such as old articles, no abstract, full text unavailable, other than English language, comments, and letters. Out of the remaining 48 articles, 13 were suitable for the discussion, and 35 (accounting for 1,245,967 subjects) were included in this study. CONCLUSIONS Most studies showed better outcomes for married persons, and men who were single generally had the poorest results. Moreover, being married was associated with lower risk factors and better health status, even in the presence of many confounding effects.
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Affiliation(s)
- Roberto Manfredini
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | - Alfredo De Giorgi
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | - Ruana Tiseo
- 2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | | | | | | | | | | | - Fabio Manfredini
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
| | | | - Fabio Fabbian
- 1 University of Ferrara , Ferrara, Italy .,2 Azienda Ospedaliera-Universitaria (AOU) , Ferrara, Italy
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20
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Li CS, Lee JH, Chang LY, Liu CC, Chan YL, Wen C, Chiu ML, Tsai MK, Tsai SP, Wai JPM, Tsao CK, Wu X, Wen CP. Physical activity to overcome the adversity of widowhood: Benefits beyond physical health. Medicine (Baltimore) 2016; 95:e4413. [PMID: 27512856 PMCID: PMC4985311 DOI: 10.1097/md.0000000000004413] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 06/23/2016] [Accepted: 06/24/2016] [Indexed: 11/25/2022] Open
Abstract
Widowhood has been increasingly encountered because of increasing longevity of women, often characterized by social stigmatization and poor physical and mental health. However, applied research to overcome its adversity has been quite limited. The goal of this study is to explore the role of physical activity in improving the health of widows.A cohort of 446,582 adults in Taiwan who successively participated in a comprehensive medical screening program starting in 1994, including 232,788 women, was followed up for mortality until 2008. Each individual provided detailed health history, and extensive lab tests results.The number of widows increased with time trend. Every other woman above age 65 was a widow (44%). Widows were less active, more obese, and smoked and drank more, had sleep problems, were more depressed with taking sedatives or psychoactive drugs, leading to more suicides. In the global development of health policies by World Health Organization (WHO), physical activity is one of the main factors to reverse poor health. The poor health of inactive widow was mitigated when becoming fully active in this study. Exercise not only reduced the observed 18% increase in all-cause mortality, but also gained 4 years and as much as 14% mortality advantage over the married but inactive. More importantly, becoming physically active energized their mental status, improved sleep quality and quantity, reduced depressions and the need for psychoactive drugs, and increased socialization circles.Widows, a rapidly growing and socially stigmatized group, suffered from social and financial inequality and tended to develop poorer health. Sustained physical activity could be one of the ways for them to overcome and reverse some of the physical and mental adversities of widowhood, and improve their quality and quantity of life.
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Affiliation(s)
- Chu-Shiu Li
- Department of Risk Management and Insurance, National Kaohsiung First University of Science and Technology, Kaohsiung
- Department of International Business, Asia University, Taichung
| | - June Han Lee
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan
| | | | - Chwen-Chi Liu
- Department of Risk Management and Insurance, Feng Chia University, Taichung, Taiwan
| | - Yan-Lan Chan
- Department of International Business, Asia University, Taichung
| | - Christopher Wen
- Department of Radiological Sciences, University of California at Irvine, Irvine, CA
| | - Mu-Lin Chiu
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan
- Department of Public Health, China Medical University, Liaoning
| | - Min Kuang Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan
| | - Shan Pou Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan
| | | | | | - Xifeng Wu
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Chi Pang Wen
- China Medical University Hospital, Taichung and Institute of Population Health Sciences, National Health Research Institutes, Zhunan
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21
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Abu-Saad K, Chetrit A, Eilat-Adar S, Alpert G, Atamna A, Gillon-Keren M, Rogowski O, Ziv A, Kalter-Leibovici O. Blood pressure level and hypertension awareness and control differ by marital status, sex, and ethnicity: a population-based study. Am J Hypertens 2014; 27:1511-20. [PMID: 24795402 DOI: 10.1093/ajh/hpu081] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Population-based studies about factors associated with blood pressure (BP) levels and hypertension awareness and control are lacking in Israel. We aimed to identify covariables of BP level (across the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) categories) and hypertension awareness and control. METHODS Participants (n = 763; aged 25-74 years) were randomly selected from the population registry and stratified by sex, age, and ethnicity (Arab or Jewish). Sociodemographic, lifestyle, chronic morbidity, drug therapy, and measured anthropometric and BP data were collected. Hypertension was defined as physician diagnosis, antihypertension drug therapy, or systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg. RESULTS Standardized hypertension prevalence was 32.5%. Age and body mass index were positively associated with being in a higher JNC-7 category. In multivariable analysis, the association between gender and JNC-7 category depended upon marital status. Of those with hypertension (n = 315), 66.0% were aware of their status, and 26.0% exhibited adequate BP control. Using "aware-and-controlled" as the outcome reference category, the odds ratio (OR) of being aware and uncontrolled was 1.9 (95% confidence interval (CI) = 1.3-2.9) for 10-year age increment. The OR of being unaware and uncontrolled was 5.6 (95% CI = 2.0-15.8) for Arabs vs. Jews, 5.6 (95% CI = 1.4-22.3) for single/divorced vs. married participants, 3.9 (95% CI = 1.7-9.2) for those with <3 visits to the family physician per year, and 0.1 (95% CI = 0.02-0.4) for those with self-reported cardiovascular disease. CONCLUSIONS Sociodemographic factors and primary healthcare service utilization are associated with hypertension awareness and control. Specially focused outreach may be needed to improve hypertension awareness among Arabs, certain subgroups not traditionally considered to be at high risk, and those who have less contact with the healthcare system.
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Affiliation(s)
- Kathleen Abu-Saad
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel;
| | - Angela Chetrit
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Sigal Eilat-Adar
- Zinman College for Physical Education and Sports, Wingate Institute, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
| | - Gershon Alpert
- Clalit Health Services, Shomron Administration, Hadera, Israel
| | - Ahmed Atamna
- Clalit Health Services, Shomron Administration, Hadera, Israel
| | - Michal Gillon-Keren
- Institute of Endocrinology and Diabetes, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Ori Rogowski
- Sackler Faculty of Medicine, Tel-Aviv University, Israel; Internal Medicine Department C, Soraski Medical Center, Tel Aviv, Israel
| | - Arnona Ziv
- Computer and Information Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel
| | - Ofra Kalter-Leibovici
- Cardiovascular Epidemiology Unit, Gertner Institute for Epidemiology and Health Policy Research, Ramat Gan, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Israel
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22
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Long-term prognostic significance of living alone and other risk factors in patients with acute myocardial infarction. Ir J Med Sci 2014; 184:153-8. [PMID: 24535193 DOI: 10.1007/s11845-014-1079-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Accepted: 02/03/2014] [Indexed: 10/25/2022]
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23
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Quinones PA, Kirchberger I, Heier M, Kuch B, Trentinaglia I, Mielck A, Peters A, von Scheidt W, Meisinger C. Marital status shows a strong protective effect on long-term mortality among first acute myocardial infarction-survivors with diagnosed hyperlipidemia--findings from the MONICA/KORA myocardial infarction registry. BMC Public Health 2014; 14:98. [PMID: 24479754 PMCID: PMC3937149 DOI: 10.1186/1471-2458-14-98] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 01/25/2014] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Reduction of long term mortality by marital status is well established in general populations. However, effects have been shown to change over time and differ considerably by cause of death. This study examined the effects of marital status on long term mortality after the first acute myocardial infarction. METHODS Data were retrieved from the population-based MONICA (Monitoring trends and determinants on cardiovascular diseases)/KORA (Cooperative Health Research in the Region of Augsburg)-myocardial infarction registry which assesses cases from the city of Augsburg and 2 adjacent districts located in southern Bavaria, Germany. A total of 3,766 men and women aged 28 to 74 years who were alive 28 days after their first myocardial infarction were included. Hazard ratios (HR) for the effects of marital status on mortality after one to 10 years of follow-up are presented. RESULTS The study population included 2,854 (75.8%) married individuals. During a median follow-up of 5.3 years, with an inter-quartile range of 3.3 to 7.6 years, 533 (14.15%) deaths occurred. Among married and unmarried individuals 388 (13.6%) and 145 (15.9%) deaths occurred, respectively. Overall marital status showed an insignificant protective HR of 0.76 (95% confidence interval (CI) 0.47-1.22). Stratified analyses revealed strong protective effects only among men and women younger than 60 who were diagnosed with hyperlipidemia. HRs ranged from 0.27 (95% CI 0.13-0.59) for a two-year survival to 0.43 (95% CI 0.27-0.68) for a 10-year survival. Substitution of marital status with co-habitation status confirmed the strata-specific effect [HR: 0.52 (95% CI 0.31-0.86)]. CONCLUSIONS Marital status has a strong protective effect among first myocardial infarction survivors with diagnosed hyperlipidemia, which diminishes with increasing age. Treatments, recommended lifestyle changes or other attributes specific to hyperlipidema may be underlying factors, mediated by the social support of spouses. Underlying causes should be examined in further studies.
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Affiliation(s)
- Philip Andrew Quinones
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Inge Kirchberger
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Margit Heier
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine I, Central Hospital of Augsburg, Augsburg, Germany
- Department of Internal Medicine/Cardiology, Hospital of Nördlingen, Nördlingen, Germany
| | - Ines Trentinaglia
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Andreas Mielck
- Institute of Health Economics and Health Care Management, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Annette Peters
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Wolfgang von Scheidt
- Department of Internal Medicine I, Central Hospital of Augsburg, Augsburg, Germany
| | - Christa Meisinger
- Institute of Epidemiology II, Helmholtz-Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
- KORA Myocardial Infarction Registry, Central Hospital of Augsburg, Augsburg, Germany
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Donnelly TT, Al Suwaidi JM, Alqahtani A, Assad N, Qader NA, Byrne C, Singh R, Fung TS. Study exploring depression and cardiovascular diseases amongst Arabic speaking patients living in the State of Qatar: Rationale and methodology. Glob Cardiol Sci Pract 2013; 2012:56-66. [PMID: 24688991 PMCID: PMC3963714 DOI: 10.5339/gcsp.2012.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2012] [Accepted: 12/02/2012] [Indexed: 11/24/2022] Open
Abstract
In Qatar, cardiovascular diseases are the leading cause of death. Studies show that depression is associated with an increased morbidity and mortality among cardiovascular patients. Thus, early detection of, and intervention for, depression among cardiovascular patients can reduce cardiovascular morbidity and mortality, and save health care costs. To date there is no study in the Gulf region exploring depression among cardiovascular patients. The goals of our three-phase research program are to (1) understand the mental health issues, specifically depression, as experienced by cardiovascular patients living in the State of Qatar; (2) identify and implement strategies that would prevent depression and assist patients to deal with depression; and (3) evaluate, facilitate, and sustain strategies that are effective at reducing depression and foster its treatment among cardiovascular patients. This paper describe phase I of the research program. Using both quantitative and qualitative research methodologies, we will investigate (1) the prevalence and severity of depression among patients who have confirmed diagnosis of cardiovascular diseases (2) how contextual factors such as social, cultural, and economic factors contribute to the risk of depression and its management among cardiovascular patients, and (3) formulate effective intervention strategies that are expected to increase awareness, prevention of and treatment for depression among cardiovascular patients, thus reducing cardiovascular diseases morbidity and mortality in Qatar.
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25
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Barbash IM, Gaglia MA, Torguson R, Minha S, Satler LF, Pichard AD, Waksman R. Effect of marital status on the outcome of patients undergoing elective or urgent coronary revascularization. Am Heart J 2013; 166:729-36. [PMID: 24093854 DOI: 10.1016/j.ahj.2013.07.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Accepted: 07/01/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Marriage confers various health advantages in the general population. However, the added value of marriage among patients who undergo percutaneous coronary intervention (PCI) beyond the standard cardiovascular risk factors is not clear. This study aimed to assess the effects of marital status on outcomes of patients undergoing elective or urgent PCI. METHODS Clinical observational analysis of consecutive patients undergoing elective or urgent PCI from 1993 to 2011 was performed. Patients were stratified by marital status, comparing married to unmarried patients. Clinical outcome up to 12 months was obtained by telephone contact or office visit. A total of 11,216 patients were included in the present analysis; 55% were married and 45% unmarried. RESULTS Significant differences in baseline characteristics were noted, including a lower prevalence of hypertension (86% vs 88%), diabetes (34% vs 38%), and smoking (19% vs 25%) among married vs unmarried patients, respectively (P < .001). However, married patients had a higher prevalence of hypercholesterolemia and family history of coronary artery disease. Early and late major adverse cardiac event rates were significantly lower for married vs unmarried patients up to 1 year (13.3% vs 8.2%, P < .001). Married status was independently associated with improved outcome in multivariable analysis (hazard ratio 0.7, 95% CI 0.6-0.9). CONCLUSIONS Married patients who undergo urgent or elective PCI have superior short- and long-term outcomes up to 1 year when compared with unmarried patients. These benefits persist after adjustment for multiple traditional cardiovascular risk factors.
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