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Murkey JA, Gaston SA, Alhasan DM, Payne CW, Jackson WB, Jackson CL. Food security status and cardiometabolic health by sex/gender and race/ethnicity among adults in the United States. BMC Public Health 2024; 24:1220. [PMID: 38698385 PMCID: PMC11065684 DOI: 10.1186/s12889-024-18655-y] [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: 10/03/2023] [Accepted: 04/18/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Minoritized racial/ethnic groups and women in the United States (US) are disproportionately burdened by food insecurity, which likely contributes to disparities in cardiovascular health (CVH). Disparities are projected to widen due to the worsening climate crisis that is straining the agricultural system including food supplies. Nonetheless, studies have not investigated the relationship between food security status and 'ideal' CVH in a large, nationally-representative and racially/ethnically diverse US sample. METHODS AND RESULTS We investigated household food security status in relation to 'ideal' CVH among US adults (N = 157,001) using 2014-2018/2020 National Health Interview Survey data. Food security status was defined as very low, low, marginal, or high. A summed score of 4 health behaviors and 3 clinical factors totaling 7 different measures was dichotomized (yes/no) to assess modified 'ideal' CVH (mICVH). Using Poisson regression with robust variance, we estimated prevalence ratios (PRs) and 95% CIs of mICVH by household food security status. We stratified models by sex/gender and race/ethnicity. Very low food security prevalence was higher among non-Hispanic (NH)-Black (8.0%) compared to Hispanic/Latinx (5.1%), NH-White (3.1%) and NH-Asian (1.7%) adults. The association between very low versus high food security and mICVH was stronger among women (PR = 0.23 [95% CI: 0.17-0.31]) than men (PR = 0.48 [95% CI: 0.35-0.66]). Compared to NH-White adults with high food security, racially/ethnically minoritized groups with very low to high food security were generally less likely (range: [PRvery low = 0.25[95% CI: 0.14-0.44] - [PRhigh = 0.88 [95% CI: 0.79-0.97]) to meet mICVH criteria. CONCLUSIONS Food insecurity was associated with lower mICVH prevalence and racially/ethnically minoritized groups were disproportionately burdened.
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Affiliation(s)
- Jamie A Murkey
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Dana M Alhasan
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA
| | - Christopher W Payne
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, 27703, USA
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, 27703, USA
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, Durham, NC, 27709, USA.
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, 20892, USA.
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Osibogun O, Ogunmoroti O, Turkson-Ocran RA, Okunrintemi V, Kershaw KN, Allen NB, Michos ED. Financial strain is associated with poorer cardiovascular health: The multi-ethnic study of atherosclerosis. Am J Prev Cardiol 2024; 17:100640. [PMID: 38419947 PMCID: PMC10899015 DOI: 10.1016/j.ajpc.2024.100640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/08/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
Objective Psychosocial stress is associated with increased cardiovascular disease (CVD) risk. The relationship between financial strain, a toxic form of psychosocial stress, and ideal cardiovascular health (CVH) is not well established. We examined whether financial strain was associated with poorer CVH in a multi-ethnic cohort free of CVD at baseline. Methods This was a cross-sectional analysis of 6,453 adults aged 45-84 years from the Multi-Ethnic Study of Atherosclerosis. Financial strain was assessed by questionnaire and responses were categorized as yes or no. CVH was measured from 7 metrics (smoking, body mass index, physical activity, diet, total cholesterol, blood glucose and blood pressure). A CVH score of 14 was calculated by assigning points to the categories of each metric (poor = 0 points, intermediate = 1 point, ideal = 2 points). Multinomial logistic regression was used to examine the association of financial strain with the CVH score (inadequate 0-8, average 9-10, and optimal 11-14 points) adjusting for sociodemographic factors, depression and anxiety. Results The mean age (SD) was 62 (10) and 53 % were women. Financial strain was reported by 25 % of participants. Participants who reported financial strain had lower odds of average (OR, 0.82 [95 % CI, 0.71, 0.94]) and optimal (0.73 [0.62, 0.87]) CVH scores. However, in the fully adjusted model, the association was only significant for optimal CVH scores (0.81, [0.68, 0.97]). Conclusion Financial strain was associated with poorer CVH. More research is needed to understand this relationship so the burden of CVD can be decreased, particularly among people experiencing financial hardship.
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Affiliation(s)
- Olatokunbo Osibogun
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Oluseye Ogunmoroti
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Victor Okunrintemi
- Division of Cardiovascular Disease, Houston Methodist Hospital, Houston, TX, USA
| | - Kiarri N. Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Norrina B. Allen
- Division of Cardiovascular Disease, Houston Methodist Hospital, Houston, TX, USA
| | - Erin D. Michos
- The Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Murkey JA, Gaston SA, Payne CW, Jackson WB, Jackson CL. Food security status and cardiometabolic health among pregnant women in the United States. Front Glob Womens Health 2024; 4:1286142. [PMID: 38415184 PMCID: PMC10896860 DOI: 10.3389/fgwh.2023.1286142] [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: 09/01/2023] [Accepted: 12/12/2023] [Indexed: 02/29/2024] Open
Abstract
Introduction Pregnant women and their offspring are particularly vulnerable to food insecurity and its adverse effects during critical periods of fetal development. Racially/ethnically minoritized women in the United States (US) who are pregnant are additionally burdened by food insecurity, which may exacerbate cardiovascular health (CVH) disparities. Despite heightened social vulnerability, few studies have employed an intersectional framework, including race and gender, to assess the food insecurity and CVH relationship. Methods We used 2012-2018 and 2020 National Health Interview Survey data among US pregnant women aged 18-49 years old (N = 1,999) to assess the prevalence of food insecurity status by race/ethnicity and to investigate household food security status in relation to ideal CVH, using a modified ideal CVH (mICVH) metric. We categorized food security status as "very low/low", "marginal", or "high". To assess mICVH, a summary score of 7 clinical characteristics and health behaviors was dichotomized as yes [(7)] vs. no [<7]. Prevalence ratios (PRs) and 95% confidence intervals (CIs) of associations between food security status and mICVH were estimated using Poisson regression with robust variance. Models were adjusted for age, household income, educational attainment, geographic region, marital status, alcohol consumption, survey year, and race/ethnicity (in overall model). Results The mean age ± standard error was 29.0 ± 0.2 years. Among pregnant women, 12.7% reported "very low/low", 10.6% reported "marginal", and 76.7% reported "high" food security. "Very low/low" food security prevalence was higher among NH-Black (16.2%) and Hispanic/Latina (15.2%) pregnant women compared to NH-White (10.3%) and NH-Asian (3.2%) pregnant women. The mICVH prevalence was 11.6% overall and 14.5% for NH-White, 4.1% for NH-Black, 5.0% for Hispanic/Latina, and 26.7% for NH-Asian pregnant women. Among all pregnant women, "very low/low" and "marginal" vs. "high" food security status was associated with a lower prevalence of mICVH {[PRvery low/low = 0.26 (95% CI: 0.08-0.75)]; [PRmarginal = 0.47 (95% CI: 0.23 -0.96)]}. Conclusion Household food insecurity was higher among pregnant women in minoritized racial/ethnic groups and was associated with lower mICVH prevalence. Given the higher burden of food insecurity among minoritized racial/ethnic groups, food security may be an important intervention target to help address disparities in poor CVH among pregnant women.
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Affiliation(s)
- Jamie A Murkey
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, United States
| | - Symielle A Gaston
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, United States
| | - Christopher W Payne
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, United States
| | - W Braxton Jackson
- Social & Scientific Systems, Inc., a DLH Holdings Company, Durham, NC, United States
| | - Chandra L Jackson
- Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC, United States
- Intramural Program, National Institute on Minority Health and Health Disparities, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, United States
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Shao J, Yao B, Yu Z, Xu J, Wu J, Ma Y, Zheng L, Sun Z. Prevalence of ideal cardiovascular health and its relationship with relative handgrip strength in rural northeast China. Front Cardiovasc Med 2023; 10:1124757. [PMID: 37332574 PMCID: PMC10275610 DOI: 10.3389/fcvm.2023.1124757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
Objectives We aimed to investigate ideal cardiovascular health (CVH), its relationship with handgrip strength, and its components in rural China. Methods We conducted a cross-sectional study of 3,203 rural Chinese individuals aged ≥35 years in Liaoning Province, China. Of these, 2,088 participants completed the follow-up survey. Handgrip strength was estimated using a handheld dynamometer and was normalized to body mass. Ideal CVH was assessed using seven health indicators (smoking, body mass index, physical activity, diet, cholesterol, blood pressure, and glucose). Binary logistic regression analyses were performed to assess the correlation between handgrip strength and ideal CVH. Results Women had a higher rate of ideal cardiovascular health (CVH) than men (15.7% vs. 6.8%, P < 0.001). Higher handgrip strength correlated with a higher proportion of ideal CVH (P for trend <0.001). After adjusting for confounding factors, the odds ratios (95% confidence interval) of ideal CVH across increasing handgrip strength tripartite were 1.00 (reference), 2.368 (1.773, 3.164), and 3.642 (2.605, 5.093) in the cross-sectional study and 1.00 (reference), 2.088 (1.074, 4.060), and 3.804 (1.829, 7.913) in the follow-up study (all P < 0.05). Conclusion In rural China, the ideal CVH rate was low, and positively correlated with handgrip strength. Grip strength can be a rough predictor of ideal CVH and can be used to provide guidelines for improving CVH in rural China.
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Affiliation(s)
- Jingan Shao
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
- School of Public Health, China Medical University, Shenyang, China
| | - Bin Yao
- Department of Orthopedics, Shidong Hospital, Shanghai, China
| | - Zhecong Yu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
- Institute for Prevention and Control of Non-Communicable Chronic Diseases, Hangzhou Center for Disease Control and Prevention, Hangzhou, China
| | - Jiahui Xu
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Wu
- School of Nursing, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
- Institute of Health Sciences, China Medical University, Shenyang, China
| | - Liqiang Zheng
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
- Ministry of Education-Shanghai Key Laboratory of Children’s Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaoqing Sun
- Department of Cardiology, Shengjing Hospital of China Medical University, Shenyang, China
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Adherence to the EAT-Lancet sustainable reference diet and cardiometabolic risk profile: cross-sectional results from the ELSA-Brasil cohort study. Eur J Nutr 2023; 62:807-817. [PMID: 36266476 DOI: 10.1007/s00394-022-03032-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 10/05/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE The EAT-Lancet Commission released a reference sustainable diet to improve human health and respect the planetary boundaries. The Planetary Health Diet Index (PHDI) was developed with the purpose of evaluate the adherence to this reference diet. The aim of the present study was to evaluate the association between adherence to the EAT-Lancet diet with cardiometabolic risk profile. METHODS We used the cross-sectional baseline data from 14,155 participants of the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter ongoing cohort study. Dietary data were collected using a 114-item validated food frequency questionnaire. The PHDI was used to assess the adherence to the EAT-Lancet diet. It consists of 16 components and the total score can range from 0 to 150 points. Linear, logistic and quasi-Poisson regression models were built to evaluate the associations between PHDI and the outcomes. RESULTS Individuals with higher adherence to EAT-Lancet diet (PHDI, 5th quintile) had lower values for systolic blood pressure (β - 0.84; 95% CI - 1.66: - 0.01), diastolic blood pressure (β - 0.70; 95% CI - 1.24: - 0.15), total cholesterol (β - 3.15; 95% CI - 5.30: - 1.01), LDL-c (β - 4.10; 95% CI - 5.97: - 2.23), and non-HDL-cholesterol (β - 2.57; 95% CI - 4.62: - 0.52). No association was observed for HDL-c, triglycerides and HOMA-IR. CONCLUSIONS Our results indicate that higher adherence to the EAT-Lancet diet is associated with lower levels of blood pressure, total cholesterol, LDL-c, and non-HDL-c.
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Fang PJ, Kuo PH, Chen WL, Kao TW, Wu LW, Yang HF, Peng TC. Prevalence of Ideal Cardiovascular Health Metrics among Young Asian Adults over 5 Years of Follow-Up. Nutrients 2023; 15:nu15030645. [PMID: 36771352 PMCID: PMC9920953 DOI: 10.3390/nu15030645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 01/13/2023] [Accepted: 01/24/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Ideal cardiovascular health (CVH) metrics play an important role in preventing cardiovascular disease (CVD). However, there is a lack of cohort studies on CVH metrics among young Asian adults. The aims of this study were to describe early changes in CVH among young Asian adults and to investigate the association between CVH metrics and sociodemographic variables. METHODS A total of 10,000 young adults (aged 21-30 years) were recruited between 2000 and 2016. There were two CVH measurements taken from these participants over the study period. One measurement was taken at the beginning, and the other was taken five years later. Subgroup analysis of the changes in CVH metrics was divided by education level and marital status. RESULTS The mean age of the participants was 26.8 years. The initial prevalence of ideal CVH metrics was 52.3% and 86.8% and decreased to 43.8% and 81.2% after five years for males and females, respectively. In the subgroup analysis, males with less than a university education had a smaller ideal CVH metric decrease (6.2%) than males with more than a university education (8.9%), while females with more than a university education had a smaller ideal CVH metric decrease (5.4%) than females with less than a university education (7.3%). Married males had a smaller ideal CVH metric decrease (6.1%) than single males (9.1%), while single females had a smaller ideal CVH metric decrease (5.3%) than married females (6.2%). CONCLUSIONS The prevalence of ideal CVH metrics among young adults gradually decreased as age increased. Higher educational attainment and unmarried status were associated with a greater prevalence of ideal CVH metrics regardless of sex, but early CVH changes differed by sex, education level, and marital status. The prevalence of CVH changes found early among young adults can be used to monitor CVH changes quickly. Effective health promotion programs are needed to maintain CVH metrics among young adults.
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Affiliation(s)
- Pu-Jun Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Ping-Hsuan Kuo
- Department of Internal Medicine, Taipei Veterans General Hospital, Taipei 11217, Taiwan
- Faculty of Medicine, National Yang Ming Chiao Tung University, Taipei 11221, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 11490, Taiwan
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei 11490, Taiwan
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490, Taiwan
- Correspondence:
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Motta ACSV, Bousquet-Santos K, Motoki IHL, Andrade JMDL. Prevalence of ideal cardiovascular health in the Brazilian adult population - National Health Survey 2019. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2023; 32:e2022669. [PMID: 37018816 PMCID: PMC10069666 DOI: 10.1590/s2237-96222023000300006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 12/21/2022] [Indexed: 04/07/2023] Open
Abstract
OBJECTIVE to analyze the prevalence of ideal cardiovascular health (CVH) in the Brazilian adult population based on the 2019 National Health Survey. METHODS this was a population-based cross-sectional study (n = 77,494); prevalence and respective 95% confidence intervals (95%CI) of ideal CVH (seven metrics achieved simultaneously) and by individual metrics (four behavioral and three biological metrics), as defined by the American Heart Association, were estimated. RESULTS only 0.5% (95%CI 0.4;0.6) of the study population presented ideal CVH, with higher prevalence among those with higher level of education (1.3%; 95%CI 0.9;1.6) and residents in urban areas (0.6%; 95%CI 0.5;0.7); the prevalence of behavioral and biological metrics was 0.7% (95%CI 0.6;0.8) and 63.3% (95%CI 62.7;63.9) respectively. CONCLUSION the prevalence of ideal CVH was very low, highlighting the need for public policies aimed at promotion, surveillance and CVH care in the Brazilian adult population.
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Affiliation(s)
| | - Kelb Bousquet-Santos
- Universidade de Brasília, Colegiado de Bases Biológicas e da Saúde, Brasília, DF, Brazil
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Qureshi F, Bousquet-Santos K, Okuzono SS, Tsao E, Delaney S, Guimond AJ, Boehm JK, Kubzansky LD. The social determinants of ideal cardiovascular health: A global systematic review. Ann Epidemiol 2022; 76:20-38. [PMID: 36191736 PMCID: PMC9930100 DOI: 10.1016/j.annepidem.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022]
Abstract
This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Kelb Bousquet-Santos
- Department of Biological and Health Sciences, University of Brasilia, Campus Universitario - Centro Metropolitano, Ceilandia Campus, Brasilia, FD, Brazil
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Elaine Tsao
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Scott Delaney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
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Gupta RD, Tamanna RJ, Hashan MR, Akonde M, Haider SS, Chakraborty PA, Hossain MB. Prevalence and Associated Factors with Ideal Cardiovascular Health Metrics in Bangladesh: Analysis of the Nationally Representative STEPS 2018 Survey. EPIDEMIOLOGIA (BASEL, SWITZERLAND) 2022; 3:533-543. [PMID: 36547257 PMCID: PMC9778360 DOI: 10.3390/epidemiologia3040040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
This study aims to find out the prevalence of the American Heart Association's (AHA)'s cardiovascular health metrics and associated socio-demographic factors. A secondary analysis of the World Health Organization (WHO) STEPwise approach to surveillance survey 2018 (STEPS 2018) data was conducted. Ideal Cardiovascular Health (ICH) was defined as the presence of 5-7 ideal metrics as defined by the AHA. Design-adjusted multivariable logistic regression was used to determine the associated factors of ICH. In total, 5930 respondents were included in our analysis, and 43.1% of the participants had ICH. The odds of ICH decreased with age [compared to 18-29 years old individuals, 30-49 years: AOR (Adjusted Odds Ratio): 0.4; 95% Confidence Interval (CI): 0.4-0.5; 50-69 years: AOR: 0.7; 95% CI: 0.6-0.8], and higher educational attainment (compared to those who received no formal education, being educated up to primary level: AOR:0.7; 95% CI: 0.6-0.8; being educated up to secondary level: AOR: 0.4; 95% CI: 0.4-0.5; being educated up to college and higher: AOR: 0.4; 95% CI: 0.3-0.5). Compared with female and urban residents, the odds were 30% and 40% less among male and rural residents, respectively. The public health promotion programs of Bangladesh should raise awareness among high-risk groups to prevent cardiovascular diseases.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
- Correspondence: ; Tel.: +1-8036364017
| | - Rownak Jahan Tamanna
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka 1000, Bangladesh
| | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka 1000, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton North, Queensland 4701, Australia
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
| | - Md. Belal Hossain
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
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Santos IS, Lotufo PA, Goulart AC, Brant LCC, Pinto MM, Pereira AC, Barreto SM, Ribeiro ALP, Thomas GN, Lip GYH, Bensenor IM. Cardiovascular Health and Atrial Fibrillation or Flutter: A Cross-Sectional Study from ELSA-Brasil. Arq Bras Cardiol 2022; 119:S0066-782X2022005016205. [PMID: 36169453 PMCID: PMC9750207 DOI: 10.36660/abc.20210970] [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: 11/21/2021] [Revised: 03/13/2022] [Accepted: 06/01/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The association between ideal cardiovascular health (ICVH) status and atrial fibrillation or flutter (AFF) diagnosis has been less studied compared to other cardiovascular diseases. OBJECTIVE To analyze the association between AFF diagnosis and ICVH metrics and scores in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). METHODS This study analyzed data from 13,141 participants with complete data. Electrocardiographic tracings were coded according to the Minnesota Coding System, in a centralized reading center. ICVH metrics (diet, physical activity, body mass index, smoking, blood pressure, fasting plasma glucose, and total cholesterol) and scores were calculated as proposed by the American Heart Association. Crude and adjusted binary logistic regression models were built to analyze the association of ICVH metrics and scores with AFF diagnosis. Significance level was set at 0.05. RESULTS The sample had a median age of 55 years and 54.4% were women. In adjusted models, ICVH scores were not significantly associated with prevalent AFF diagnosis (odds ratio [OR]:0.96; 95% confidence interval [95% CI]:0.80-1.16; p=0.70). Ideal blood pressure (OR:0.33; 95% CI:0.15-0.74; p=0.007) and total cholesterol (OR:1.88; 95% CI:1.19-2.98; p=0.007) profiles were significantly associated with AFF diagnosis. CONCLUSIONS No significant associations were identified between global ICVH scores and AFF diagnosis after multivariable adjustment in our analyses, at least partially due to the antagonistic associations of AFF with blood pressure and total cholesterol ICVH metrics. Our results suggest that estimating the prevention of AFF burden using global ICVH scores may not be adequate, and ICVH metrics should be considered in separate.
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Affiliation(s)
- Itamar S. Santos
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Paulo A. Lotufo
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Alessandra C. Goulart
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Luisa C. C. Brant
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - Marcelo M Pinto
- Programa de Pós-Graduação em Infectologia e Medicina TropicalFaculdade de MedicinaUniversidade Federal de Minas Gerais,Belo HorizonteMGBrasil Programa de Pós-Graduação em Infectologia e Medicina Tropical da Faculdade de Medicina da Universidade Federal de Minas Gerais, Belo Horizonte , MG – Brasil
| | - Alexandre C. Pereira
- Hospital das ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Laboratório de Genética e Cardiologia Molecular do Instituto do Coração do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
| | - Sandhi M. Barreto
- Departamento de Medicina Preventiva e SocialFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Medicina Preventiva e Social da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - Antonio L. P. Ribeiro
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade Federal de Minas GeraisBelo HorizonteMGBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade Federal de Minas Gerais , Belo Horizonte , MG – Brasil
| | - G Neil Thomas
- Institute of Applied Health ResearchCollege of Medical and Dental SciencesUniversity of BirminghamBirminghamReino Unido Institute of Applied Health Research , College of Medical and Dental Sciences , University of Birmingham , Birmingham – Reino Unido
| | - Gregory Y. H. Lip
- Chest Hospital and Aalborg Thrombosis Research UnitDepartment of Clinical MedicineAalborg UniversityLiverpoolReino Unido Liverpool Centre for Cardiovascular Science, University of Liverpool and Liverpool Heart & Chest Hospital and Aalborg Thrombosis Research Unit , Department of Clinical Medicine , Aalborg University , Liverpool – Reino Unido
| | - Isabela M. Bensenor
- Departamento de Clínica MédicaFaculdade de MedicinaUniversidade de São PauloSão PauloSPBrasil Departamento de Clínica Médica da Faculdade de Medicina da Universidade de São Paulo , São Paulo , SP – Brasil
- Centro de Pesquisa Clínica e EpidemiológicaHospital UniversitárioUniversidade de São PauloSão PauloSPBrasil Centro de Pesquisa Clínica e Epidemiológica do Hospital Universitário da Universidade de São Paulo , São Paulo , SP – Brasil
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Tavares GA, Ribeiro JB, Almeida-Santos MA, Sousa ACS, Barreto-Filho JAS. Cardiovascular health control in the family health strategy. Front Cardiovasc Med 2022; 9:933972. [PMID: 36061539 PMCID: PMC9433642 DOI: 10.3389/fcvm.2022.933972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 07/18/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction In Brazil, the Unified Health System (SUS) controls and oversees public health care, and the Family Health Strategy (FHS) is its primary access, with 60% of the population registered in it. The surveillance of risk factors for cardiovascular diseases (CVD) is the responsibility of the FHS. In 2010, the American Heart Association (AHA) proposed the evaluation of seven metrics (smoking, Body Mass Index (BMI), physical activity, diet, total cholesterol, blood pressure and blood glucose) with an aim to monitoring cardiovascular health (CVH). However, the results of the FHS regarding the CVH of the Brazilian population are unascertained. Objective Evaluate the control of CVH among adult patients treated by the FHS in the city of Aracaju, Sergipe, Brazil. Material and methods A cross-sectional study was conducted using the seven metrics recommended by the AHA to evaluate CVH among patients treated by the FHS. The city of Aracaju has a population of 571,149 inhabitants, with 394,267 > 20 years of age; therefore, it was admitted that in a simple random sample, sampling error of 5% with 95% CI, 329 individuals would be needed. Results Among 400 patients, only 32.5% had controlled CVH. In a univariate analysis, the adjusted multivariate analysis found that being female (aOR: 2.07 IC: 1.20 to 3.60 p: 0.006) under 45 years old (aOR: 1.61 IC: 1.15 to 2.28 p: 0.006) and with the habit of following health advice from family members and neighbors (aOR: 1.28 IC: 1.15 to 2.28 p: 0.040) were associated with control of CVH. On the other hand, those ones who had a greater number of children (aOR: 0.91 IC: 0.84 to 0.95 p: 0.020) were associated with less control of CVH. Conclusions The study showed that only 32.5% of patients have controlled CVH. Being a woman, young and following health advice from family members and neighbors have a positive influence in controlling CVH. More children reduced controlling these metrics.
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Affiliation(s)
- Gilberto Andrade Tavares
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
- Department of Medicine Lagarto, Federal University of Sergipe, Aracaju, Brazil
| | - Joathan Borges Ribeiro
- Postgraduate Program in Adult Health Nursing, University of São Paulo, São Paulo, Brazil
- Intensive Care Unit, Hospital Sírio-Libanês, São Paulo, Brazil
| | - Marcos Antonio Almeida-Santos
- Postgraduate Program in Health and Environment, Tiradentes University, Aracaju, Brazil
- São Lucas Clinic and Hospital / Rede D‘Or São Luiz, Aracaju, Brazil
| | - Antônio Carlos Sobral Sousa
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
- São Lucas Clinic and Hospital / Rede D‘Or São Luiz, Aracaju, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Brazil
- Department of Internal Medicine, Federal University of Sergipe, Aracaju, Brazil
| | - José Augusto Soares Barreto-Filho
- Postgraduate Program in Health Sciences, Federal University of Sergipe, Aracaju, Brazil
- São Lucas Clinic and Hospital / Rede D‘Or São Luiz, Aracaju, Brazil
- Division of Cardiology, University Hospital, Federal University of Sergipe, Aracaju, Brazil
- Department of Internal Medicine, Federal University of Sergipe, Aracaju, Brazil
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Freitas RS, Santos IDS, Matos SMAD, Aquino EMLD, Amorim LDAF. Ideal cardiovascular health at ELSA-Brasil: non-additivity effects of gender, race, and schooling by using additive and multiplicative interactions. CAD SAUDE PUBLICA 2022; 38:e00266221. [PMID: 35946616 DOI: 10.1590/0102-311xen266221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 06/13/2022] [Indexed: 11/22/2022] Open
Abstract
This study aims to assess the non-additivity effects of gender, race, and schooling on ideal cardiovascular health among participants of the Brazilian Longitudinal Study of Adult Health - ELSA-Brasil. This is a cross-sectional study using data from the baseline of ELSA-Brasil, conducted from 2008 to 2010. The American Heart Association defined a score of ideal cardiovascular health (ICH) as the sum of indicators for the presence of seven favorable health factors and behaviors: non-smoking, ideal body mass index, physical activity and healthy diet, adequate levels of total cholesterol, normal blood pressure, and absence of diabetes mellitus. Multiplicative and additive interactions between gender, race, and schooling were assessed using the Poisson regression model to discuss intersectionality. The mean cardiovascular health score was 2.49 (SD = 1.31). This study showed a positive interaction between gender and schooling (women with high school and higher education) in both additive and multiplicative scales for the score of ideal cardiovascular health. We observed a trend towards higher mean values of cardiovascular health for increased schooling, with a marked difference among women. The lowest cardiovascular health scores observed reinforce the importance of understanding the psychosocial experiences that influence health attitudes, access to health care, and healthy lifestyle choices, which affect ICH, to reduce inequities in health and propose more adequate public policies that assist and prevent cardiovascular diseases.
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Alizadeh G, Gholipour K, Azami-Aghdash S, Dehnavieh R, JafarAbadi MA, Azmin M, Khodayari-Zarnaq R. Social, Economic, Technological, and Environmental Factors Affecting Cardiovascular Diseases: A Systematic Review and Thematic Analysis. Int J Prev Med 2022; 13:78. [PMID: 35706860 PMCID: PMC9188896 DOI: 10.4103/ijpvm.ijpvm_105_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 07/27/2020] [Indexed: 11/04/2022] Open
Abstract
Background Today, cardiovascular disease (CVD) is the leading cause of mortality in both sexes. There are several risk factors for heart diseases; some controllable, others not. However, socioeconomic, technological, and environmental factors can impact CVD as well as exclusive risk factors. Accurate identification and assessment of these factors are often difficult. In the present systematic review, we aimed to explore factors affecting CVD. Methods Multiple databases (MEDLINE, Scopus, ISI Web of Science, and Cochrane) and gray literature were searched. The included studies described at least one determinant of CVD. The framework method was applied to analyze the qualitative data. Results A total of 64 studies from 26 countries were included. The contextual determinants of CVD were categorized into 45 determinants, 15 factors, and 4 main social, economic, technological, and environmental categories. The 15 potentially reversible factors were identified as sociodemographic, violence, smoking, occupation, positive childhood experience, social inequalities, psychological distress, eating habits, neighborhood, family income, rapid technology, environmental pollution, living environments, noise, and disaster. Conclusions Devolution and more efficient health policies are required to achieve further sustained reduction in CVD mortality, increase life expectancy, and reduce its associated risk factors. Policymakers should fully address the value of social, economic, technological, and environmental factors. In fact, a prevention agenda should be developed and updated collaboratively in terms of the determinant factors.
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Affiliation(s)
- Gisoo Alizadeh
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Kamal Gholipour
- Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Azami-Aghdash
- Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Reza Dehnavieh
- Health Services Management Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Asghari JafarAbadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mehrdad Azmin
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rahim Khodayari-Zarnaq
- Department of Health policy and Management, Iranian Center of Excellence in Health Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran.,Tabriz Health Services Management Research Center, Health Management and Safety Promotion Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
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14
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Pengpid S, Peltzer K. National Cross-Sectional Data on Ideal Cardiovascular Health Among Adults in Mongolia in 2019. Glob Heart 2022; 17:34. [PMID: 35837357 PMCID: PMC9165669 DOI: 10.5334/gh.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20-69 years) in Mongolia. Method Cross-sectional data were analyzed from 4,516 individuals (20-69 years, mean age = 42.3 years) who participated in the Mongolia STEPS survey in 2019, who had complete measurement of CVH metrics and no history of cardiovascular disease. Ideal CVH measures included non-smoking, healthy diet, physical activity, fasting blood glucose <100 mg/dL, body mass index (<23 kg/m2), total cholesterol <200 mg/dL, and blood pressure <120/<80 mmHg). Results The prevalence of five to seven ideal CVH metrics was 27.7% in 2019. Most Mongolians had ideal total cholesterol (77.4%), ideal smoking (67.8%), ideal fasting glucose (73.8%) and ideal physical activity (66.0%), while a lower prevalence was found for ideal blood pressure (42.4%), ideal body mass index (31.4%), and ideal healthy diet (1.8%). The prevalence of poor smoking, poor fruit/vegetable intake, poor fasting glucose, poor blood pressure, and poor total cholesterol was higher in men than in women, while poor physical activity was higher in women than in men, and poor BMI did not differ by sex. In the adjusted logistic regression analysis, older age, male sex, and belonging to the Khalkh ethnic group were negatively associated, and a higher number of adult household members was positively associated with meeting the ideal 5-7 CVH metrics. Conclusions The proportion of meeting 5-7 ideal CVH metrics was moderate among adults in Mongolia. Primary and secondary prevention programmes should be strengthened to improve CVH in Mongolia, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, TH
- Department of Research Administration and Development, University of Limpopo, Polokwane, ZA
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, TW
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15
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Pengpid S, Peltzer K. Prevalence and associated factors of ideal cardiovascular health: A cross-sectional national population-based study of adults in the Marshall Islands. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/148425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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16
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Pengpid S, Peltzer K. National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019. Sci Rep 2022; 12:5660. [PMID: 35383251 PMCID: PMC8983656 DOI: 10.1038/s41598-022-09688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) across three cross-sectional surveys in 2007, 2014 and 2019 in Bhutan. Cross-sectional data were analysed from 9712 individuals (20–69 years, mean age = 37.6 years) who participated in the 2007, 2014 or 2019 Bhutan STEPS surveys, had complete measurement of CVH metrics, and had no history of a cardiovascular disease in 2014 and 2019. Ideal CVH measures included non-smoking, healthy diet, physical activity, body mass index (< 23 kg/m2), blood pressure < 120/ < 80 mmHg, total cholesterol < 200 mg/dL, and fasting blood glucose < 100 mg/dL). The prevalence of five to seven ideal CVH metrics increased from 11.6% in 2007 to 37.9% in 2019. Trend analyses showed that ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal fasting glucose increased from 2007 to 2019, while ideal fruit and vegetable intake, ideal smoking, and ideal body mass index decreased from 2007 to 2019. Five to seven ideal CVH metrics, 0–7 ideal CVH metrics, and 0–14 poor, intermediate, and ideal CVH metrics increased from 2007 to 2019. In the adjusted logistic regression analysis, older age decreased the odds of having 5–7 ideal CVH metrics in all three study years. Male sex increased the odds, and employment decreased the odds of 5–7 ideal CVH metrics in 2007, and urban residence increased the odds of 5–7 ideal CVH metrics in 2014 and decreased the odds in 2019. The proportion of meeting 5–7 ideal CVH metrics increased in Bhutan. Primary and secondary prevention programmes must be strengthened to improve CVH in Bhutan, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public, Health Mahidol University, Bangkok, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Ferreira NV, Lotufo PA, Marchioni DML, Barreto SM, Viana MC, Caramelli P, Bensenor IJM, Suemoto CK. Association Between Adherence to the MIND Diet and Cognitive Performance is Affected by Income: The ELSA-Brasil Study. Alzheimer Dis Assoc Disord 2022; 36:133-139. [PMID: 35090161 DOI: 10.1097/wad.0000000000000491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/06/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND The relationship between the Mediterranean-DASH Diet Intervention for Neurodegenerative Delay (MIND) diet and cognition has not been widely investigated in low- to middle-income countries. We investigated the relationship between MIND diet and cognition in the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline data. METHODS We included 11,788 participants. MIND diet adherence was based on the intake of 15 components according to a food frequency questionnaire. We analyzed the association between MIND diet adherence and global cognition, memory, and executive function using adjusted linear regression. We examined the interaction between income and MIND diet adherence on cognition and presented income stratified analyses. RESULTS MIND diet adherence was not associated with cognition in the whole sample. Income was an effect modifier of MIND adherence on global cognition (P=0.03) and executive function (P<0.001). For participants with high income, greater adherence was associated with better executive function [β=0.015, 95% confidence interval (CI)=0.002; 0.028, P=0.025]; while for participants with low income, greater adherence was associated with lower global cognition (β=-0.020, 95% CI=-0.036; -0.005, P=0.010) and executive function (β=-0.023, 95% CI=-0.039; -0.007, P=0.004). Adherence to the MIND diet was higher among participants with high income (P<0.001). CONCLUSION For high-income participants, greater adherence was associated with better cognitive performance; for low-income participants, greater adherence was associated with lower cognitive performance.
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Affiliation(s)
- Naomi V Ferreira
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Adventist University of São Paulo, Engenheiro Coelho, SP
| | - Paulo A Lotufo
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Department of Internal Medicine, Faculdade de Medicina
| | - Dirce M L Marchioni
- Nutrition Department, University of Sao Paulo Medical School, School of Public Health
| | | | - Maria C Viana
- Section of Psychiatric Epidemiology (CEPEP), Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Research Group, Medical Clinics Department, Medical School, Federal University of Minas Gerais, Belo Horizonte, MG, Brazil
| | - Isabela J M Bensenor
- Center for Clinical and Epidemiological Research, Hospital Universitário
- Department of Internal Medicine, Faculdade de Medicina
| | - Claudia K Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo
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He YM, Chen WL, Kao TW, Wu LW, Yang HF, Peng TC. Association Between Ideal Cardiovascular Health and Vegetarian Dietary Patterns Among Community-Dwelling Individuals. Front Nutr 2022; 9:761982. [PMID: 35369052 PMCID: PMC8971747 DOI: 10.3389/fnut.2022.761982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundVegetarians have been shown to have better metabolic profiles than non-vegetarians, and vegetarianism has potential beneficial effects on cardiovascular disease. However, there is a lack of studies on vegetarians that examine both metabolic profiles and lifestyle habits, such as physical activity, smoking habits, and dietary patterns, which are equally important in the context of cardiovascular disease. We explored whether a vegetarian diet is associated with both metabolic traits and lifestyle habits by assessing cardiovascular health (CVH) metrics.MethodsThis was a cross-sectional study conducted in a Taiwanese population. Data collected between 2000 and 2016 were extracted from the MJ Health database. Participants aged 40 years and older without cardiovascular disease were included. CVH metrics included smoking habits, blood pressure, total cholesterol, serum glucose, body mass index, physical activity, and healthy diet score. Vegetarian participants were full-time vegetarians who did not consume meat or fish. All the data were assessed from self-report questionnaires, physical examinations, and blood analyses following standard protocol. Multiple logistic regression analysis was used to evaluate the association between vegetarianism and CVH metrics.ResultsOf 46,287 eligible participants, 1,896 (4.1%) were vegetarian. Overall, vegetarians had better CVH metrics (OR = 2.09, 95% CI = 1.84–2.37) but lower healthy diet scores (OR = 0.41, 95% CI = 0.33–0.51) after adjustment. No difference in physical activity (OR = 0.86, 95% CI = 0.73–1.02) was identified between vegetarians and non-vegetarians. Additionally, vegetarians had higher whole grain intake (OR = 2.76, 95% CI = 2.28–3.35) and lower sugar-sweetened beverage consumption (OR = 1.36, 95% CI = 1.18–1.58).ConclusionsOur results suggested that vegetarians had better overall ideal CVH metrics but lower ideal healthy diet scores than non-vegetarians, which was likely due to the lack of fish consumption in this population group. When assessing CVH metrics and healthy diet scores for vegetarians, metrics and scores chosen should be suitable for use with vegetarian populations.
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Affiliation(s)
- Yu-Min He
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Tung-Wei Kao
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - Li-Wei Wu
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Hui-Fang Yang
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
| | - Tao-Chun Peng
- Division of Family Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- Division of Geriatric Medicine, Department of Family and Community Medicine, National Defense Medical Center, Tri-Service General Hospital, Taipei, Taiwan
- *Correspondence: Tao-Chun Peng
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Zhu Y, Guo P, Zou Z, Li X, Cao M, Ma J, Jing J. Status of Cardiovascular Health in Chinese Children and Adolescents. JACC: ASIA 2022; 2:87-100. [PMID: 36340258 PMCID: PMC9627810 DOI: 10.1016/j.jacasi.2021.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/15/2021] [Accepted: 09/19/2021] [Indexed: 01/14/2023]
Abstract
Background The American Heart Association defined “ideal cardiovascular health (CVH)” in pediatric populations to promote primordial prevention in cardiovascular diseases. Little is known about CVH and associated sociodemographic factors among Chinese children and adolescents. Objectives This study aimed to evaluate CVH and the associations with sociodemographic characteristics in Chinese children and adolescents. Methods This cross-sectional study analyzed baseline data of 15,583 participants aged 7 to 17 years from a Chinese national intervention program against obesity (2013-2014). CVH status was estimated according to 4 health behaviors (nonsmoking, body mass index, physical activity, and diet) and 3 health factors (total cholesterol, blood pressure, and fasting plasma glucose), using revised American Heart Association criteria. Multinomial logistic regression was used to assess the association between sociodemographic characteristics and the number of ideal CVH metrics. Results The prevalence of ideal CVH status was 1.7% (males: 1.9%; females: 1.6%) in the study population. The prevalence of ideal CVH behaviors and ideal health factors was 3.1% (males 3.3%; females: 3.0%) and 53.6% (males: 52.4%; females: 54.9%), respectively. Ideal fasting plasma glucose was the most prevalent component (males: 94.4%; females: 97.4%), whereas ideal physical activity (males: 34.6%; females: 23.9%) and diet (males: 28.3%; females: 30.1%) were the least prevalent. Female sex, younger age, undeveloped economy, residence in the southern region, and no family history of cardiovascular diseases were associated with more ideal CVH metrics. Conclusions Ideal CVH status in Chinese children and adolescents is alarmingly rare. Physical activity and diet are key to promotion of CVH. Effective interventions are needed to promote CVH and reduce health disparities in early life.
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Acevedo M, Varleta P, Casas-Cordero C, Berríos A, Navarrete C, López R. Prevalence and determinants of ideal cardiovascular health in a latin women cohort: a cross-sectional study. LANCET REGIONAL HEALTH. AMERICAS 2021; 4:100071. [PMID: 36776705 PMCID: PMC9904128 DOI: 10.1016/j.lana.2021.100071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 08/19/2021] [Accepted: 08/25/2021] [Indexed: 06/18/2023]
Abstract
BACKGROUND Ideal cardiovascular health (CVH) sought to reduce cardiovascular (CV) morbidity and mortality. In Chile, CV mortality in women is high. The study's main aim was to determine the prevalence of ideal CVH, and the factors and behaviors associated with ideal CVH in women from Santiago de Chile. METHODS Cross-sectional study in women between 35 - 70 years old who were selected through a probabilistic, multistage, and geographically stratified sampling. The study included a survey on demographic and CV risk factors and anthropometric, blood pressure, and biochemical measurements. Three categories were used to characterize low (0-2), intermediate (3-4), and high (5-7) levels of AHA's Ideal CVH index. We assessed the prevalence of ideal CVH by age, education level, and socioeconomic status and determined the independent associations of different variables with ideal CVH. FINDINGS 620 women, mean age 51± 4 years old, were recruited. Ideal CVH prevalence was 14.3%; none of the women presented an ideal healthy diet, and only 22.6% reached an ideal BMI. The best predictors of ideal CVH were a high education level (OR= 2.85; 1.43 to 5.92; p < 0.01), having less than two alcoholic drinks per day (OR= 4.09; 1.60 to 13.77; p< 0.01), and having a pregnancy history without preeclampsia and/or gestational diabetes (OR=1.94; 1.07 to 3.71; p=0.04). INTERPRETATION This study demonstrates a low ideal CVH prevalence in Chilean women. Education level was a significant factor associated with ideal CVH. But also, women-specific risk factors, such as a history of preeclampsia/gestational diabetes, and alcohol consumption, were important factors related to CVH. FUNDING This study was supported by grants from Fundación SOCHICAR de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular, the American Heart Association and an unrestricted grant by TEVA Pharmaceuticals.
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Affiliation(s)
- Mónica Acevedo
- Fundación SOCHICAR de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
- Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Paola Varleta
- Fundación SOCHICAR de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
- Unidad de Prevención Cardiovascular y Rehabilitación Cardíaca, Centro Cardiovascular, Hospital DIPRECA, Santiago, Chile
| | | | - Amalia Berríos
- Fundación SOCHICAR de la Sociedad Chilena de Cardiología y Cirugía Cardiovascular, Santiago, Chile
| | - Carlos Navarrete
- Departamento de Matemáticas, Facultad de Ciencias, Universidad de La Serena, La Serena, Chile
| | - Rosario López
- Servicio de Kinesiología, Red UC CHRISTUS, Hospital Clínico Pontificia Universidad Católica de Chile, Santiago, Chile
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Seron P, Lanas F. The urgent need of public policies for promoting cardiovascular health in Latin-American women. LANCET REGIONAL HEALTH. AMERICAS 2021; 4:100114. [PMID: 36776711 PMCID: PMC9903792 DOI: 10.1016/j.lana.2021.100114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Pamela Seron
- Internal Medicine Department, Medicine Faculty, Universidad de La Frontera.,Corresponding author: Internal Medicine Department, Medicine Faculty, Universidad de La Frontera, Temuco, Chile. Claro Solar #115, Temuco Chile. Phone: 56-45-2325765
| | - Fernando Lanas
- Internal Medicine Department, Medicine Faculty, Universidad de La Frontera
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Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis. PLoS One 2021; 16:e0255959. [PMID: 34379696 PMCID: PMC8357101 DOI: 10.1371/journal.pone.0255959] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/28/2021] [Indexed: 01/22/2023] Open
Abstract
Background In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. Methods A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. Results This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. Conclusions To the best of our knowledge, this is the first systematic review on the relationship between participants’ socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.
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23
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Oliveira RS, Schneider BC, Callo-Quinte G, Oliveira IO, Gonçalves H, Wehrmeister FC, Menezes AMB. Prevalence of ideal cardiovascular health in young adults: A birth cohort from southern Brazil. Am Heart J 2021; 235:65-73. [PMID: 33508220 DOI: 10.1016/j.ahj.2021.01.014] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 01/21/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Ideal cardiovascular health (ICH) aims at primordial prevention of cardiovascular diseases in the population. However, there is a lack of research describing ICH in youth from middle-income countries. The aims of this study were to describe the prevalence of ICH at 18- and 22-year-old and to investigate the influence of socioeconomic status. METHODS The sample consisted of participants from the Pelotas 1993 birth-cohort followed-up at 18- (n = 4,106) and 22-year-old (n = 3,810). Ideal metrics were created for diet, smoking, body mass index, physical activity, blood pressure, total cholesterol, and blood glucose. The presence of 4 or more ideal metrics was defined as ICH. Socioeconomic status was obtained using wealth quintiles calculated with factor analysis based on analysis based on the ownership of household and education. The impact of socioeconomic status on ICH metrics was statistically measured using the slope index of inequality. RESULTS The prevalence of ICH was 84.5% (95% confidence interval [CI] = 82.7-86.2%) and 84.1% (82.3-85.8%) at 18-year-old and decreased to 61.1% (58.4-63.7%) and 68.7% (66.2-71.2%) at 22-years old, for male and female, respectively. Socioeconomic status influenced ICH and its components differently in males and females. Wealthiest females had ICH prevalence 19 percentage points (pp) (11-27 pp) higher compared to the poorest, whereas poorest males had ICH prevalence 12 pp (1-21 pp) higher compared to the wealthiest. Longitudinal decreases in ICH components were mostly present in the poorest females. CONCLUSIONS In middle-income countries, the prevalence of ICH is high at 18-year-old and decreases in a 4-year follow-up. Socioeconomic status influences differently individuals' ICH between sexes. Efforts are needed to maintain ICH in youth and different strategies may be required between the social status.
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Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi. Glob Heart 2021; 16:24. [PMID: 34040937 PMCID: PMC8064282 DOI: 10.5334/gh.986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index <25 kg/m2, healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL). Objective: This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi. Methods: National cross-sectional survey data of 3,441 persons aged 18–69 years with complete ICH measurements in Malawi in 2017 were analysed. Results: Almost one in ten (7.4%) of respondents had 0–2 ICH metric), 21.2% 3–4 ICH metrics, and 71.5% 5–7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50–69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17–0.36) and urban residence (AOR: 0.56, 95% CI: 0.40–0.78) were negatively associated with meeting 5–7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5–7 ICH metrics. Conclusion: The proportion of meeting 5–7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi. Highlights
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25
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Pinhati R, Ferreira R, Carminatti M, Colugnati F, de Paula R, Sanders-Pinheiro H. Adherence to antihypertensive medication after referral to secondary healthcare: A prospective cohort study. Int J Clin Pract 2021; 75:e13801. [PMID: 33113587 DOI: 10.1111/ijcp.13801] [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] [Received: 08/07/2020] [Accepted: 10/23/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Nonadherence (NAd) to antihypertensive medication is associated with lack of blood pressure control and worsened long-term outcomes. Increased access to a programme for high-risk cardiovascular patients has the potential to reduce NAd and improve clinical outcomes. We evaluated implementation NAd prevalence and risk factors among severely hypertensive patients after 12-month-long access to secondary healthcare centres. METHODS The Morisky Green Levine Scale (MGLS) was used to analyse antihypertensive medication NAd in a prospective cohort of 485 patients. Logistic regression models evaluated the influence of ecological model factors on NAd. RESULTS The majority of patients were female, had low health literacy, a low family income and a mean age of 61.8 ± 12.5 years. Prevalence of NAd fell from 57.1% at programme entry to 28.3% (P < .001) at the end of the study. After access to a secondary healthcare centre, we observed better blood pressure control, an increase in the number of pills/day and a higher number of antihypertensive medications. Predictive variables of NAd were age (OR 1.027; CI 1.003-1.051; P = .023), low health literacy (OR 1.987; CI 1.009-3.913; P = .047), systolic blood pressure (OR 1.010; CI 1.003-1.021; P = .049), dosages ≥ 2 times/day (OR 1.941; CI 1.091-3.451; P = .024) and patient satisfaction with the healthcare team (OR 0.711; IC 0.516-0.980; P = .037). CONCLUSIONS Greater access to health services is associated with a reduction in NAd to antihypertensive medication and better blood pressure control. NAd was correlated with modifiable variables such as treatment complexity and, for the first time, team satisfaction, suggesting that implementation of similar programmes may limit NAd in similar patient groups.
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Affiliation(s)
- Renata Pinhati
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Renato Ferreira
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Moisés Carminatti
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Fernando Colugnati
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Rogério de Paula
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
| | - Helady Sanders-Pinheiro
- Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
- Renal Transplant Unit, Nephrology Division, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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26
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Zhang M, Shi Y, Shi O, Zhao Z, Zhang X, Li C, Huang Z, Zhao L, Wang L, Li Y, Li X. Geographical variations in cardiovascular health in China: A nationwide population-based survey of 74,726 adults. LANCET REGIONAL HEALTH-WESTERN PACIFIC 2020; 3:100033. [PMID: 34327384 PMCID: PMC8315622 DOI: 10.1016/j.lanwpc.2020.100033] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 08/26/2020] [Accepted: 09/09/2020] [Indexed: 12/18/2022]
Abstract
Background Cardiovascular disease is the leading cause of death in China. The aim of this study was to evaluate the levels of cardiovascular health among Chinese adults and to understand the geographic pattern of cardiovascular health. Methods In 2015, a total of 74,726 respondents aged ≥ 20 years with no history of cardiovascular disease were randomly sampled from 298 counties/districts of 31 provinces in mainland China and were interviewed. Seven metrics, including smoking, body mass index, physical activity, diet, total cholesterol, blood pressure, and fasting glucose, were determined. Ideal cardiovascular health was defined as the simultaneous presence of all metrics at the ideal level. A score ranging from 0 to 14 was calculated as the sum of all seven metrics for each province. Scores for cardiovascular health behaviors (smoking, body mass index, physical activity and diet) and those for cardiovascular health factors (smoking, total cholesterol, blood pressure, and fasting glucose) were also calculated. Findings The mean age was 44.4 ± 15.9 years, and 49.3% were women. The age-sex-standardized prevalence of ideal cardiovascular health was universally poor, ranging from 0.02% [95% confidence interval (CI): 0%, 0.05%] in Tibet to 2.76% (95% CI: 0.45%, 5.07%) in Heilongjiang. Ideal diet (7.1%) was the least common factor of the seven metrics in each province and varied considerably across provinces. Other component metrics of ideal cardiovascular health were also spatially patterned. In all provinces, women had higher scores than men for cardiovascular health, health behaviors and health factors. Differences in cardiovascular health and health behavior scores between urban and rural areas were associated with levels of socio-economic development. Interpretation Strategies for addressing poor cardiovascular health require geographic targeting and localized consideration. Funding This research was supported by National Key R&D Program, the Shenzhen Strategic Emerging Industry Development Special Fund, and the Fund of "Sanming" Project of Medicine in Shenzhen.
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Affiliation(s)
- Mei Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yu Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Oumin Shi
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China
| | - Zhenping Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Xiao Zhang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Chun Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Zhengjing Huang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Liyun Zhao
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Limin Wang
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
| | - Yichong Li
- Fuwai Hospital Chinese Academy of Medical Sciences, Shenzhen, 12# Langshan Rd, Nanshan District, Shenzhen 518057, Guangdong Province, China.,Department of Clinical Research and Epidemiology, Shenzhen Institute for Cardiovascular Disease, Shenzhen 518057, Guangdong Province, China
| | - Xinhua Li
- National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 27# Nanwei Rd, Xicheng District, Beijing 100050, China
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27
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Moreira TCL, Polizel JL, Santos IDS, Silva Filho DF, Bensenor I, Lotufo PA, Mauad T. Green Spaces, Land Cover, Street Trees and Hypertension in the Megacity of São Paulo. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17030725. [PMID: 31979152 PMCID: PMC7038323 DOI: 10.3390/ijerph17030725] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 01/16/2020] [Accepted: 01/17/2020] [Indexed: 12/31/2022]
Abstract
Proximity to green spaces has been shown to be beneficial to several cardiovascular outcomes in urban spaces. Few studies, however, have analyzed the relationship between these outcomes and green space or land cover uses in low-medium income megacities, where the consequences of rapid and inordinate urbanization impose several health hazards. This study used a subgroup of the dataset from The Brazilian Longitudinal Study of Adult Health ELSA-BRASIL (n= 3418) to identify the correlation between the medical diagnosis of hypertension and green spaces in the megacity of São Paulo. Land cover classification was performed based on the random forest algorithm using geometrically corrected aerial photography (orthophoto). Three different indicators of exposure to green spaces were used: number of street trees, land cover and number of parks within 1 km. We used logistic regression models to obtain the association of the metrics exposure and health outcomes. The number of street trees in the regional governments (OR = 0.937 and number of parks within 1 km (OR = 0.876) were inversely associated with a diagnosis of hypertension. Sixty-three percent of the population had no parks within 1 km of their residence. Our data indicate the need to encourage large-scale street tree planting and increase the number of qualified parks in megacities.
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Affiliation(s)
- Tiana C. L. Moreira
- Faculdade de Medicina, Departamento de Patologia, Universidade de São Paulo, São Paulo 01246-903, Brazil;
- Harvard T. H. CHAN School of Public Health, Environmental Health Department, Boston, MA 02215, USA
- Correspondence:
| | - Jefferson L. Polizel
- Escola Superior de Agricultura “Luiz de Queiroz”, Universidade de São Paulo, Piracicaba 13418-900, Brazil; (J.L.P.); (D.F.S.F.)
| | - Itamar de Souza Santos
- Centro de Pesquisa Clínica, Hospital Universitário, Universidade de São Paulo, São Paulo 05508-000, Brazil; (I.d.S.S.); (I.B.); (P.A.L.)
- Faculdade de Medicina, Departamento de Clínica Médica, Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Demóstenes F. Silva Filho
- Escola Superior de Agricultura “Luiz de Queiroz”, Universidade de São Paulo, Piracicaba 13418-900, Brazil; (J.L.P.); (D.F.S.F.)
| | - Isabela Bensenor
- Centro de Pesquisa Clínica, Hospital Universitário, Universidade de São Paulo, São Paulo 05508-000, Brazil; (I.d.S.S.); (I.B.); (P.A.L.)
- Faculdade de Medicina, Departamento de Clínica Médica, Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Paulo A. Lotufo
- Centro de Pesquisa Clínica, Hospital Universitário, Universidade de São Paulo, São Paulo 05508-000, Brazil; (I.d.S.S.); (I.B.); (P.A.L.)
- Faculdade de Medicina, Departamento de Clínica Médica, Universidade de São Paulo, São Paulo 01246-903, Brazil
| | - Thais Mauad
- Faculdade de Medicina, Departamento de Patologia, Universidade de São Paulo, São Paulo 01246-903, Brazil;
- Instituto de Estudos Avançados, Universidade de São Paulo, São Paulo 05508-060, Brazil
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28
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Brunoni AR, Szlejf C, Suemoto CK, Santos IS, Goulart AC, Viana MC, Koyanagi A, Barreto SM, Moreno AB, Carvalho AF, Lange S, Griep RH, Lotufo PA, Benseñor IM. Association between ideal cardiovascular health and depression incidence: a longitudinal analysis of ELSA-Brasil. Acta Psychiatr Scand 2019; 140:552-562. [PMID: 31587258 DOI: 10.1111/acps.13109] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE We investigated whether ideal cardiovascular health (ICH), a metric proposed by the American Heart Association, predicts depression development. METHODS Cohort analysis from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil). Adults with no current depression and other common mental disorders, cardiovascular diseases, and antidepressant drug use at baseline had their ICH (composite score of smoking, dietary habits, body mass index, blood pressure, fasting glucose, cholesterol, and physical activity) assessed and classified into poor, intermediate, and optimal. Depression was assessed using the Clinical Interview Schedule-Revised (CIS-R). Poisson regression models, adjusted for sociodemographic factors and alcohol consumption, were employed. Stratified analyses were performed for age and sex. RESULTS We included 9214 participants (mean age 52 ± 9 years, 48.6% women). Overall depression incidence at 3.8-year follow-up was 1.5%. Intermediate and poor ICH significantly increased the risk rate (RR) of developing depression (2.48 [95%CI 1.06-5.78] and 3 [1.28-7.03], respectively) at a 3.8-year follow-up. Higher ICH scores decreased the rate of depression development (RR = 0.84 [0.73-0.96] per metric). Stratified analyses were significant for women and adults < 55 years old. CONCLUSIONS Poor cardiovascular health tripled depression risk at follow-up in otherwise healthy adults. Ameliorating cardiovascular health might decrease depression risk development.
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Affiliation(s)
- A R Brunoni
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Laboratory of Neurosciences (LIM-27), Department and Institute of Psychiatry, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - C Szlejf
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - C K Suemoto
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil
| | - I S Santos
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - A C Goulart
- Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - M C Viana
- Center of Psychiatric Epidemiology (CEPEP), Department of Social Medicine, Postgraduate Program in Public Health, Federal University of Espírito Santo, Vitória, Brazil
| | - A Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,ICREA, Barcelona, Spain
| | - S M Barreto
- School of Medicine & Clinical Hospital, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - A B Moreno
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health Sergio Arouca, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - A F Carvalho
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada.,Institute for Mental Health Policy Research, Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - S Lange
- Institute for Mental Health Policy Research, Centre for Addiction & Mental Health (CAMH), Toronto, ON, Canada
| | - R H Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - P A Lotufo
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
| | - I M Benseñor
- Department of Internal Medicine, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.,Center for Clinical and Epidemiological Research, Hospital Universitário, Universidade de São Paulo, São Paulo, Brazil
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29
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Rocco PTP, Bensenor IM, Griep RH, Barreto SM, Moreno AB, Alencar AP, Lotufo PA, Santos IS. Work-Family Conflict and Ideal Cardiovascular Health Score in the ELSA-Brasil Baseline Assessment. J Am Heart Assoc 2019; 8:e012701. [PMID: 31597505 PMCID: PMC6818030 DOI: 10.1161/jaha.119.012701] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background There are few data about the association between work‐related stress and the American Heart Association ideal cardiovascular health (CVH) metrics. We studied the association between work‐family conflict (WFC) and ideal CVH scores in the ELSA‐Brasil (Brazilian Longitudinal Study of Adult Health) baseline study. Methods and Results We analyzed data of active workers (5424 men and 5967 women), aged 35 to 74 years, from 2008 to 2010. Ideal CVH scores were calculated based on the lifestyle and health metrics proposed by the American Heart Association, using data from questionnaires and clinical and laboratory examinations from the ELSA‐Brasil study baseline. The WFC questionnaire was based on the Frone model, validated for Brazilian Portuguese. WFC domains (time and strain‐based work interference with family, family interference with work, and lack of time for personal care and leisure) and frequency (never to rarely, sometimes, or frequently) were self‐reported. Main models were adjusted for age, sex, race, educational level, income, and study site. Positive relative predicted score differences (rPSDs) indicate higher predicted scores. We found lower lifestyle ideal CVH scores among men (rPSD, −5.7%; P=0.002) and women (rPSD, −10.2%; P<0.001) with frequent lack of time for personal care and leisure. We found lower lifestyle ideal CVH scores among women with frequent strain‐based work interference with family (rPSD, −5.1%; P=0.002), and family interference with work (rPSD, −8.6%; P=0.001). We found higher health ideal CVH scores among men with frequent WFC, which may be attributable to reverse causation. Conclusions We found significant associations between WFC and ideal CVH scores. These associations were heterogeneous according to sex.
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Affiliation(s)
- Priscila T P Rocco
- Centro de Pesquisa Clínica e Epidemiológica Hospital Universitário da Universidade de São Paulo São Paulo Brazil.,Programa de Pós-Graduaçãoem Ciências Médicas Universidade de São Paulo São Paulo Brazil
| | - Isabela M Bensenor
- Centro de Pesquisa Clínica e Epidemiológica Hospital Universitário da Universidade de São Paulo São Paulo Brazil.,Departamento de Clínica Médica Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Rosane H Griep
- Laboratório de Educação em Ambiente e Saúde Instituto Oswaldo Cruz Fundação Oswaldo Cruz Rio de Janeiro Brazil
| | - Sandhi M Barreto
- Departamento de Medicina Preventiva e Social Faculdade de Medicina da Universidade Federal de Minas Gerais Belo Horizonte Brazil
| | - Arlinda B Moreno
- Departamento de Epidemiologia e Métodos Quantitativos em Saúde da Escola Nacional de Saúde Pública Sérgio Arouca Fundação Oswaldo Cruz Rio de Janeiro Brazil
| | - Airlane P Alencar
- Departamento de Estatística Instituto de Matemática e Estatística Universidade de São Paulo São Paulo Brazil
| | - Paulo A Lotufo
- Centro de Pesquisa Clínica e Epidemiológica Hospital Universitário da Universidade de São Paulo São Paulo Brazil.,Departamento de Clínica Médica Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
| | - Itamar S Santos
- Centro de Pesquisa Clínica e Epidemiológica Hospital Universitário da Universidade de São Paulo São Paulo Brazil.,Departamento de Clínica Médica Faculdade de Medicina da Universidade de São Paulo São Paulo Brazil
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González-Rivas JP, Mechanick JI, Ugel E, Marulanda MI, Duran M, Nieto-Martínez R. Cardiovascular Health in a National Sample of Venezuelan Subjects Assessed According to the AHA Score: The EVESCAM. Glob Heart 2019; 14:285-293. [PMID: 31327753 DOI: 10.1016/j.gheart.2019.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 04/18/2019] [Accepted: 06/20/2019] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Cardiovascular health status of the Venezuelan population has not been evaluated. The American Heart Association recommends the Cardiovascular Health Score (CHS) to assess cardiovascular health. OBJECTIVES This study sought to determine the prevalence of CHS categories in a nationally representative sample of Venezuelan adults. METHODS EVESCAM (Venezuelan Study of Cardio-Metabolic Health) was a national population-based, cross-sectional, randomized cluster sampling study performed from July 1, 2014 to January 31, 2017, which assessed 3,454 adults, age ≥20 years, with a response rate of 77.3%. The American Heart Association's CHS evaluates 4 behaviors (smoking, body mass index, physical activity, and diet) and 3 risk factors (total cholesterol, blood pressure, and blood glucose), assigning 1 point to those meting an ideal behavior or factor or 0 points if are not. Subjects were categorized as having ideal (5 to 7 points), intermediate (3 to 4), or poor (<3) cardiovascular health. Weighted prevalence by age, sex, and regions are presented. RESULTS A total of 2,992 participants completed the data. Mean age and CHS were 41.4 ± 15.8 years and 4.3 ± 1.1 points, respectively. The prevalence of ideal CHS was 37.9% (95% confidence interval: 35.0 to 40.7); two-thirds presented with intermediate to poor CHS. Ideal CHS was most prevalent in women, in the youngest participants, and in those with higher education degree and living in a rural area. The prevalence of 7 components was 0.13%. Subjects evaluated since mid-2016 had a higher prevalence of ideal CHS (≈47%) than those evaluated before it (≈32%) (p < 0.001). CONCLUSIONS A high prevalence of ideal CHS was observed in Venezuelan adults compared with other reports; however, a large proportion remain with high risk for cardiovascular disease.
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Affiliation(s)
- Juan P González-Rivas
- Foundation for Clinical, Public Health and Epidemiology Research in Venezuela (FISPEVen), Caracas, Venezuela.
| | - Jeffrey I Mechanick
- Divisions of Cardiology Icahn School of Medicine at Mount Sinai, New York, NY, USA; Division of Endocrinology, Diabetes and Bone Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eunice Ugel
- Foundation for Clinical, Public Health and Epidemiology Research in Venezuela (FISPEVen), Caracas, Venezuela; Public Health Research Unit, Department of Social and Preventive Medicine, School of Medicine, University Centro-Occidental "Lisandro Alvarado", Barquisimeto, Venezuela
| | - María Inés Marulanda
- Foundation for Clinical, Public Health and Epidemiology Research in Venezuela (FISPEVen), Caracas, Venezuela; Endocrine Associates of Florida, Research Department, Orlando, Florida, USA
| | - Maritza Duran
- Foundation for Clinical, Public Health and Epidemiology Research in Venezuela (FISPEVen), Caracas, Venezuela; Internal Medicine Department, Avila Clinic, Caracas, Venezuela
| | - Ramfis Nieto-Martínez
- South Florida Veterans Affairs Foundation for Research & Education and Geriatric Research, Education, and Clinical Center (GRECC), Miami VA Healthcare System, Miami, FL, USA; Department of Global Health and Population. Harvard TH Chan School of Public Health, Harvard University, Boston, Massachusetts, USA; Department of Physiology, School of Medicine, University Centro-Occidental "Lisandro Alvarado" Barquisimeto, Cardio-metabolic Unit 7, Barquisimeto, Venezuela
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31
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Poorer cardiovascular health is associated with psychiatric comorbidity: results from the ELSA-Brasil Study. Int J Cardiol 2019; 274:358-365. [DOI: 10.1016/j.ijcard.2018.06.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/05/2018] [Accepted: 06/11/2018] [Indexed: 02/08/2023]
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Chilunga FP, Boateng D, Henneman P, Beune E, Requena-Méndez A, Meeks K, Smeeth L, Addo J, Bahendeka S, Danquah I, Schulze MB, Klipstein-Grobusch K, Mannens MMAM, Agyemang C. Perceived discrimination and stressful life events are associated with cardiovascular risk score in migrant and non-migrant populations: The RODAM study. Int J Cardiol 2018; 286:169-174. [PMID: 30638750 DOI: 10.1016/j.ijcard.2018.12.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Revised: 11/28/2018] [Accepted: 12/19/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND Psychosocial stress could be an underlying factor for emerging risk of cardiovascular diseases (CVD) in Africans. We assessed the association between psychosocial stress and estimated CVD risk among non-migrant Ghanaians and migrant Ghanaians living in Europe. METHODS Data from the Research on Obesity and Diabetes among African Migrants (RODAM) study, involving 2315 migrant and 1549 non-migrants aged 40-70 years were used for this study. Psychosocial stress included self-reported stress at work and home, recent negative life events and perceived discrimination. CVD risk was estimated using the pooled cohort equations with estimates ≥7.5% over 10 years defining high CVD risk. Adjusted Odds Ratios (AOR) and 95% confidence intervals (95% CI) were calculated by logistic regression with adjustments for socioeconomic status. RESULTS Prevalence for migrant and non-migrants were; 72.5% and 84.9% for psychosocial stress and 35.9% and 27.4% for high estimated CVD risk. Stress at work and home was not associated with a high estimated CVD risk in either group. Recent negative life events were associated with a high estimated CVD risk in non-migrants only (AOR 1.29, 95%CI 1.02-1.68, p = 0.048). Higher levels of perceived discrimination were associated with a high estimated CVD risk in migrants only (AOR 2.74, 95%CI 1.95-3.86, p < 0.001). CONCLUSIONS Among migrant populations, higher levels of perceived discrimination were associated with a high estimated CVD risk, and this was also true for recent negative life events among non-migrant populations. Further research is needed to identify context specific mechanisms that underlie associations between psychological characteristics and CVD risk.
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Affiliation(s)
- Felix P Chilunga
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands.
| | - Daniel Boateng
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Peter Henneman
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Erik Beune
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Ana Requena-Méndez
- ISGlobal, Barcelona Ctr. Int. Health Res. (CRESIB), Hospital Clínic-Universitat de Barcelona, Spain
| | - Karlijn Meeks
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands
| | - Liam Smeeth
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Juliet Addo
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | | | - Ina Danquah
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany; Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universitaet zu Berlin, Berlin Institute of Health, Institute for Social Medicine, Epidemiology and Health Economics, Germany
| | - Matthias B Schulze
- Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke, Arthur-Scheunert-Allee 114-116, 14558 Nuthetal, Germany
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, the Netherlands; Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Marcel M A M Mannens
- Department of Clinical Genetics, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, the Netherlands
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Peng Y, Cao S, Yao Z, Wang Z. Prevalence of the cardiovascular health status in adults: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis 2018; 28:1197-1207. [PMID: 30360955 DOI: 10.1016/j.numecd.2018.08.002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/20/2018] [Accepted: 08/09/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND AND AIMS The American Heart Association has outlined seven cardiovascular health (CVH) metrics, including smoking, body mass index, physical activity, dietary pattern, total cholesterol, and fasting plasma glucose, to define and monitor CVH status. Our study was to evaluate the global CVH in adults. METHODS AND RESULTS We searched PubMed, Embase, Cochrane Central Register of Controlled Trials, and reference lists of relevant articles for studies published between 1 January 2010 and 30 June 2018. Included studies should report the proportions of ideal status for the seven CVH metrics and/or provide the prevalence of overall poor (having 0-2 ideal metrics) or ideal (having 5-7 ideal metrics) CVH status in adults. 88 articles were identified: 75 for the prevalence of ideal CVH metrics, 58 for the proportion of overall poor CVH status, and 55 for the proportion of overall ideal CVH status. Smoking had the highest prevalence of ideal status (69.1%) while dietary pattern has the lowest (12.1%). 32.2% and 19.6% of participants had overall poor and ideal CVH, respectively. Females and young adults had better CVH status when compared to males and older adults. There existed regional variations in ideal CVH metrics and overall CVH status. The overall CVH status had improved over study time. CONCLUSION The prevalence of ideal status was low for some metrics, such as dietary pattern, and the overall CVH status was still unsatisfactory. We should continue to measure the CVH status and carry out lifestyle interventions to improve the CVH status in the whole population.
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Affiliation(s)
- Y Peng
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia.
| | - S Cao
- Centre for Longitudinal and Life Course Research, School of Public Health, The University of Queensland, Herston, Australia
| | - Z Yao
- Department of Epidemiology and Health Statistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Z Wang
- Centre for Chronic Disease, School of Clinical Medicine, The University of Queensland, Herston, Australia
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Wang H, Wang S, Sun Y. Does sociodemographic characteristics affect ideal cardiovascular health score in Chinese population? Int J Cardiol 2018; 264:179. [DOI: 10.1016/j.ijcard.2018.01.083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2018] [Accepted: 01/18/2018] [Indexed: 10/16/2022]
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35
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Machado LB, Lotufo PA, Bensenor IM, Santos IS. Education and cardiovascular health in different populations. Int J Cardiol 2018; 264:180. [DOI: 10.1016/j.ijcard.2018.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Accepted: 04/05/2018] [Indexed: 10/16/2022]
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