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Goh RSJ, Chong B, Jayabaskaran J, Jauhari SM, Chan SP, Kueh MTW, Shankar K, Li H, Chin YH, Kong G, Anand VV, Chan KA, Sukmawati I, Toh SA, Muthiah M, Wang JW, Tse G, Mehta A, Fong A, Baskaran L, Zhong L, Yap J, Yeo KK, Hausenloy DJ, Tan JWC, Chao TF, Li YH, Lim SL, Chan KH, Loh PH, Chai P, Yeo TC, Low AF, Lee CH, Foo R, Tan HC, Yip J, Rao S, Honda S, Yasuda S, Kajiya T, Goto S, Yan BP, Zhou X, Figtree GA, Mamas MA, Kim Y, Jeong YH, Kim MH, Park DW, Park SJ, Richards AM, Chan MY, Lip GY, Chew NW. The burden of cardiovascular disease in Asia from 2025 to 2050: a forecast analysis for East Asia, South Asia, South-East Asia, Central Asia, and high-income Asia Pacific regions. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 49:101138. [PMID: 39100533 PMCID: PMC11296249 DOI: 10.1016/j.lanwpc.2024.101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 05/29/2024] [Accepted: 06/25/2024] [Indexed: 08/06/2024]
Abstract
Background Given the rapidly growing burden of cardiovascular disease (CVD) in Asia, this study forecasts the CVD burden and associated risk factors in Asia from 2025 to 2050. Methods Data from the Global Burden of Disease 2019 study was used to construct regression models predicting prevalence, mortality, and disability-adjusted life years (DALYs) attributed to CVD and risk factors in Asia in the coming decades. Findings Between 2025 and 2050, crude cardiovascular mortality is expected to rise 91.2% despite a 23.0% decrease in the age-standardised cardiovascular mortality rate (ASMR). Ischaemic heart disease (115 deaths per 100,000 population) and stroke (63 deaths per 100,000 population) will remain leading drivers of ASMR in 2050. Central Asia will have the highest ASMR (676 deaths per 100,000 population), more than three-fold that of Asia overall (186 deaths per 100,000 population), while high-income Asia sub-regions will incur an ASMR of 22 deaths per 100,000 in 2050. High systolic blood pressure will contribute the highest ASMR throughout Asia (105 deaths per 100,000 population), except in Central Asia where high fasting plasma glucose will dominate (546 deaths per 100,000 population). Interpretation This forecast forewarns an almost doubling in crude cardiovascular mortality by 2050 in Asia, with marked heterogeneity across sub-regions. Atherosclerotic diseases will continue to dominate, while high systolic blood pressure will be the leading risk factor. Funding This was supported by the NUHS Seed Fund (NUHSRO/2022/058/RO5+6/Seed-Mar/03), National Medical Research Council Research Training Fellowship (MH 095:003/008-303), National University of Singapore Yong Loo Lin School of Medicine's Junior Academic Fellowship Scheme, NUHS Clinician Scientist Program (NCSP2.0/2024/NUHS/NCWS) and the CArdiovascular DiseasE National Collaborative Enterprise (CADENCE) National Clinical Translational Program (MOH-001277-01).
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Affiliation(s)
- Rachel Sze Jen Goh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Bryan Chong
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | | | - Silingga Metta Jauhari
- Department of Biostatistics, Cardiovascular Research Institute, National University Heart Centre (Singapore), NUHS
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Siew Pang Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Biostatistics, Cardiovascular Research Institute, National University Heart Centre (Singapore), NUHS
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Martin Tze Wah Kueh
- Royal College of Surgeons in Ireland and University College Dublin Malaysia Campus, Malaysia
- UCD School of Medicine and Medical Science, UCD Conway Institute of Biomolecular and Biomedical Research, University College Dublin, Dublin, Ireland
| | - Kannan Shankar
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
| | - Henry Li
- University of New South Wales, Australia
| | - Yip Han Chin
- Ministry of Health Holdings, Ministry of Health, Singapore
| | - Gwyneth Kong
- Ministry of Health Holdings, Ministry of Health, Singapore
| | - Vickram Vijay Anand
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - Keith Andrew Chan
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Section of Adult Cardiology, Chong Hua Hospital, Philippines Don Mariano Cui Street, Fuente Osmeña, Cebu City, 6000, Philippines
| | - Indah Sukmawati
- Cardiovascular Department, Siloam Hospitals Lippo Village, Pelita Harapan University, Tangerang, Indonesia
| | - Sue Anne Toh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Medicine, National University Hospital, Singapore
- NOVI Health, Singapore
- Regional Health System Office, National University Health System, Singapore
| | - Mark Muthiah
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Division of Gastroenterology and Hepatology, Department of Medicine, National University Hospital, Singapore
- National University Centre for Organ Transplantation, National University Health System, Singapore
| | - Jiong-Wei Wang
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore
| | - Gary Tse
- Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, 300211, China
- Kent and Medway Medical School, Canterbury, Kent, CT2 7NT, United Kingdom
| | - Anurag Mehta
- Division of Cardiology, Virginia Commonwealth University, Richmond, VA, USA
| | - Alan Fong
- Clinical Research Center, Institute for Clinical Research, Sarawak General Hospital, Kuching, Malaysia
- Department of Cardiology, Sarawak Heart Center, Kota Samarahan, Malaysia
| | - Lohendran Baskaran
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
- CVS.AI, National Heart Research Institute, National Heart Centre Singapore, Singapore, 169609, Singapore
- Cardiovascular Sciences Academic Clinical Program & Cardiovascular Metabolic Disorder Program, Duke National University of Singapore Medical School, Singapore, 169857, Singapore
| | - Liang Zhong
- CVS.AI, National Heart Research Institute, National Heart Centre Singapore, Singapore, 169609, Singapore
- Cardiovascular Sciences Academic Clinical Program & Cardiovascular Metabolic Disorder Program, Duke National University of Singapore Medical School, Singapore, 169857, Singapore
- Department of Biomedical Engineering, National University of Singapore, Singapore, 117583, Singapore
| | - Jonathan Yap
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
| | - Khung Keong Yeo
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
| | - Derek J. Hausenloy
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Duke-NUS Medical School, Cardiovascular and Metabolic Disorders Programme, Singapore, Singapore
- National Heart Centre Singapore, National Heart Research Institute Singapore, Singapore, Singapore
- University College London, The Hatter Cardiovascular Institute, London, UK
| | - Jack Wei Chieh Tan
- Department of Cardiovascular Medicine, National Heart Centre Singapore, and Duke-National University of Singapore, Singapore
| | - Tze-Fan Chao
- Division of Cardiology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Clinical Medicine, and Cardiovascular Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Heng Li
- Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Shir Lynn Lim
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Pre-hospital Emergency Research Centre, Duke-NUS Medical School, Singapore
| | - Koo Hui Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Poay Huan Loh
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
- Department of Cardiology, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Ping Chai
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Tiong Cheng Yeo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Adrian F. Low
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Chi Hang Lee
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Roger Foo
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Huay Cheem Tan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - James Yip
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Sarita Rao
- Department of Cardiology, Apollo Hospital, Indore, India
| | - Satoshi Honda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Satoshi Yasuda
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Takashi Kajiya
- Clinical Research Center, Tenyoukai Central Hospital, 6-7 Izumi-cho, Kagoshima, 892-0822, Japan
| | - Shinya Goto
- Department of Medicine (Cardiology), Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan
| | - Bryan P. Yan
- Department of Medicine & Therapeutics, The Chinese University of Hong Kong
| | - Xin Zhou
- Department of Cardiology, Tianjin Medical University General Hospital, 154, Anshan Road, Heping District, Tianjin, 300052, China
| | | | - Mamas A. Mamas
- Keele Cardiovascular Research Group, School of Medicine, Keele University, United Kingdom
| | - Yongcheol Kim
- Yonsei University College of Medicine and Cardiovascular Center, Yongin Severance Hospital, Yongin, South Korea
| | - Young-Hoon Jeong
- CAU Thrombosis and Biomarker Center, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, South Korea and Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, South Korea
| | - Moo Hyun Kim
- Department of Cardiology, Dong-A University Hospital, Busan, Republic of Korea
| | - Duk-Woo Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Seung-Jung Park
- Division of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - A Mark Richards
- Christchurch Heart Institute, University of Otago, New Zealand
- Cardiovascular Research Institute, National University Heart Centre Singapore, Singapore
| | - Mark Y. Chan
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
| | - Gregory Y.H. Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, United Kingdom
- Danish Center for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - Nicholas W.S. Chew
- Yong Loo Lin School of Medicine, National University Singapore, Singapore
- Department of Cardiology, National University Heart Centre, National University Health System, Singapore
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2
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Wei B, Cheng G, Bi Q, Lu C, Sun Q, Li L, Chen N, Hu M, Lu H, Xu X, Mao G, Wan S, Hu Z, Gu Y, Zheng J, Zhao L, Shen XZ, Liu X, Shi P. Microglia in the hypothalamic paraventricular nucleus sense hemodynamic disturbance and promote sympathetic excitation in hypertension. Immunity 2024:S1074-7613(24)00360-1. [PMID: 39116878 DOI: 10.1016/j.immuni.2024.07.011] [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: 09/06/2023] [Revised: 04/22/2024] [Accepted: 07/16/2024] [Indexed: 08/10/2024]
Abstract
Hypertension is usually accompanied by elevated sympathetic tonicity, but how sympathetic hyperactivity is triggered is not clear. Recent advances revealed that microglia-centered neuroinflammation contributes to sympathetic excitation in hypertension. In this study, we performed a temporospatial analysis of microglia at both morphological and transcriptomic levels and found that microglia in the hypothalamic paraventricular nucleus (PVN), a sympathetic center, were early responders to hypertensive challenges. Vasculature analyses revealed that the PVN was characterized by high capillary density, thin vessel diameter, and complex vascular topology relative to other brain regions. As such, the PVN was susceptible to the penetration of ATP released from the vasculature in response to hemodynamic disturbance after blood pressure increase. Mechanistically, ATP ligation to microglial P2Y12 receptor was responsible for microglial inflammatory activation and the eventual sympathetic overflow. Together, these findings identified a distinct vasculature pattern rendering vulnerability of PVN pre-sympathetic neurons to hypertension-associated microglia-mediated inflammatory insults.
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Affiliation(s)
- Bo Wei
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China; Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Guo Cheng
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China; Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Qianqian Bi
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
| | - Cheng Lu
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China
| | - Qihang Sun
- Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Li Li
- Department of Pharmacy, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Ningting Chen
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China; Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Miner Hu
- Department of Cardiology of the Fourth Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Haoran Lu
- Zhejiang University, University of Edinburgh Institute, Zhejiang University School of Medicine, Haining 314400, China
| | - Xuancheng Xu
- Zhejiang Chinese Medical University, Hangzhou 310013, China; Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Genxiang Mao
- Zhejiang Provincial Key Lab of Geriatrics, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China
| | - Shu Wan
- Brain Center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China
| | - Zhechun Hu
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science & Brain-Machine Integration, Zhejiang University, Hangzhou 310058, China; Department of Neurology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yan Gu
- NHC and CAMS Key Laboratory of Medical Neurobiology, MOE Frontier Science Center for Brain Science & Brain-Machine Integration, Zhejiang University, Hangzhou 310058, China; Department of Neurology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jiaxin Zheng
- Key Laboratory for Biomedical Engineering of Ministrey of Education, Collage of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310013, China
| | - Li Zhao
- Key Laboratory for Biomedical Engineering of Ministrey of Education, Collage of Biomedical Engineering & Instrument Science, Zhejiang University, Hangzhou 310013, China
| | - Xiao Z Shen
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China; Brain Center, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China; Department of Physiology, Zhejiang University School of Medicine, Hangzhou 310058, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310013, China
| | - Xiaoli Liu
- Department of Neurology, Affiliated Zhejiang Hospital, Zhejiang University School of Medicine, Hangzhou 310013, China.
| | - Peng Shi
- Department of Cardiology of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310009, China; Institute of Translational Medicine, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China; State Key Laboratory of Transvascular Implantation Devices, Hangzhou 310013, China.
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3
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Kubo K, Hirata A, Kadota A, Harada A, Nakamura Y, Hayakawa T, Takashima N, Fujiyoshi A, Okami Y, Kita Y, Okayama A, Miura K, Ueshima H, Okamura T. Risk Factors for Heart Failure and Coronary Artery Disease Mortality Based on the National Vital Statistics During a 25-Year Follow-up in Japan - NIPPON DATA90. Circ J 2024:CJ-23-0847. [PMID: 39069479 DOI: 10.1253/circj.cj-23-0847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
BACKGROUND Prevention of heart failure (HF) is a public health issue. Using the National Vital Statistics, we explored risk factors for HF and coronary artery disease (CAD) mortality. METHODS AND RESULTS Altogether, 7,556 Japanese individuals aged ≥30 years in 1990 were followed over 25 years; of these, 139 and 154 died from HF and CAD, respectively. In multivariable Cox proportional hazard analysis, common risk factors for CAD and HF mortality were hypertension (hazard ratio [HR] 1.48 [95% confidence interval {CI} 1.00-2.20] and 2.31 [95% CI 1.48-3.61], respectively), diabetes (HR 2.52 [95% CI 1.63-3.90] and 2.07 [95% CI 1.23-3.50], respectively), and current smoking (HR 2.05 [95% CI 1.27-3.31) and 1.86 [95% CI 1.10-3.15], respectively). Specific risk factors for CAD were male sex, chronic kidney disease, history of cardiovascular disease, and both abnormal T and Q waves, with HRs (95% CIs) of 1.75 (1.05-2.92), 1.78 (1.19-2.66), 2.50 (1.62-3.88), and 11.4 (3.64-36.0), respectively. Specific factors for HF were current drinking (HR 0.43; 95% CI 0.24-0.78) and non-high-density lipoprotein cholesterol (non-HDL-C; HR 0.81; 95% CI 0.67-0.98). There was an inverse association between non-HDL-C and HF in those aged ≥65 years (HR 0.71; 95% CI 0.56-0.90), but not in those aged <65 years. CONCLUSIONS We identified common risk factors for HF and CAD deaths; a history of cardiovascular disease was a specific risk for CAD.
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Affiliation(s)
- Kota Kubo
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Aya Hirata
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
| | - Aya Kadota
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Akiko Harada
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Yasuyuki Nakamura
- NCD Epidemiology Research Center, Shiga University of Medical Science
- Takeda Hospital Medical Examination Center
| | | | - Naoyuki Takashima
- NCD Epidemiology Research Center, Shiga University of Medical Science
- Department of Epidemiology for Community Health and Medicine, Kyoto Prefectural University of Medicine
| | | | - Yukiko Okami
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | | | - Akira Okayama
- Research Center for Prevention of Lifestyle-related Diseases
| | - Katsuyuki Miura
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Hirotsugu Ueshima
- NCD Epidemiology Research Center, Shiga University of Medical Science
| | - Tomonori Okamura
- Department of Preventive Medicine and Public Health, Keio University School of Medicine
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Xue N, Du Y. Nutritional Knowledge, Attitudes, and Needs Among Community Residents of Beijing: A Cross Sectional Study. Int J Gen Med 2024; 17:3319-3327. [PMID: 39081672 PMCID: PMC11288351 DOI: 10.2147/ijgm.s462260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 07/09/2024] [Indexed: 08/02/2024] Open
Abstract
Background Community health education is essential in combating obesity and cardiovascular diseases by addressing nutritional knowledge gaps and promoting healthier dietary habits in China. The aim of this study was to investigate the nutritional knowledge, attitudes, and needs of residents at Beijing Fengtai District. Methods This cross-sectional study was conducted between October 2021 and January 2022, residents from 31 communities of the Fengtai District were given an online questionnaire, which was designed to assess their nutritional knowledge, attitudes, and needs. Results From 420 distributed surveys, a total of 416 participants were enrolled for an effective recovery rate of 99.05%. Among them, 317 participants (76.20%) scored 80% or higher on the nutritional knowledge questionnaire, participants with higher nutritional knowledge scores were more likely to be aged over 60 years (OR = 0.21, 95% CI 0.06-0.76, p = 0.02), female (OR = 0.40, 95% CI 0.22-0.73, p < 0.01) and employed (OR = 2.31, 95% CI 1.04-5.12, p = 0.04). While many community residents expressed a desire to receive guidance on dietary guidance (n = 303, 72.84%) dietary matching (n = 303, 72.84%), and preventive health care (n = 286, 68.75%). Residents were familiar with nutritional care clinics (55.05%) and believed that the nutritional care clinics should be increased (59.86%). In addition, 345 residents (83.41%) wanted nutritional care clinics to provide consultation on nutritious meal planning. Conclusion Beijing residents need additional access to clinical nutritional resources as their needs are not fulfilled despite a relatively strong knowledge of nutrition.
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Affiliation(s)
- Ningning Xue
- Emergency Department of Beijing Tiantan Hospital, Capital Medical University, Beijing, 100007, People’s Republic of China
| | - Yue Du
- Emergency Department of Beijing Tiantan Hospital, Capital Medical University, Beijing, 100007, People’s Republic of China
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Chaudhary RS, Srinivasapura Venkateshmurthy N, Dubey M, Jarhyan P, Prabhakaran D, Mohan S. Regional and socio-demographic variation in laboratory-based predictions of 10-year cardiovascular disease risk among adults in north and south India. Indian Heart J 2024:S0019-4832(24)00157-3. [PMID: 39025430 DOI: 10.1016/j.ihj.2024.07.004] [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: 02/05/2024] [Revised: 04/28/2024] [Accepted: 07/12/2024] [Indexed: 07/20/2024] Open
Abstract
OBJECTIVE Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in India. There is no laboratory-based CVD risk data among Indians from different regions and backgrounds. This study estimated laboratory-based 10-year CVD risk across different population sub-groups. METHODS Data from UDAY derived from cross-sectional surveys of rural and urban populations of northern (Haryana) and southern (Andhra Pradesh) India were analysed. World Health Organization/International Society of Hypertension laboratory-based equations calculated 10-year CVD risk among participants without CVD history. Wilcoxon rank sum test analyzed average CVD risk across subgroups. Chi-square test compared population proportions in different CVD risk categories. Regression analysis assessed the association between CVD risk and participant characteristics. RESULTS The mean (SD) age of the participants (n = 8448) was 53.2 (9.2) years. Males in Haryana had increased CVD risk compared to those in Andhra Pradesh (p < 0.01). In both states, female gender was shown to have a protective effect on CVD risk (p < 0.01). Age correlated with increased risk (p < 0.01). Education level did not affect CVD risk however employment status may have. Hypertension, diabetes, hyperlipidemia, smoking, and insufficient exercise were associated with increased CVD risk (p < 0.01). Residence (urban versus rural) and wealth index did not largely affect CVD risk. CONCLUSION Minor differences exist in the distribution of laboratory-based CVD risk across Indian population cohorts. CVD risk was similar in urban wealthy participants and rural poor and working-class communities in northern and southern India. Public health efforts need to target all major segments of the Indian population to curb the CVD epidemic.
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Affiliation(s)
- Richard S Chaudhary
- Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
| | | | - Manisha Dubey
- Centre for Chronic Disease Control, New Delhi, India
| | - Prashant Jarhyan
- Public Health Foundation of India, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India
| | - Dorairaj Prabhakaran
- Public Health Foundation of India, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India; London School of Hygiene and Tropical Medicine, London, UK
| | - Sailesh Mohan
- Public Health Foundation of India, New Delhi, India; Centre for Chronic Disease Control, New Delhi, India; Deakin University, Burwood, VIC, Australia
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6
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Zong Q, He C, Long B, Huang Q, Chen Y, Li Y, Dang Y, Cai C. Targeted Delivery of Nanoparticles to Blood Vessels for the Treatment of Atherosclerosis. Biomedicines 2024; 12:1504. [PMID: 39062077 PMCID: PMC11275173 DOI: 10.3390/biomedicines12071504] [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: 04/25/2024] [Revised: 06/21/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024] Open
Abstract
Atherosclerosis is a common form of cardiovascular disease, which is one of the most prevalent causes of death worldwide, particularly among older individuals. Surgery is the mainstay of treatment for severe stenotic lesions, though the rate of restenosis remains relatively high. Current medication therapy for atherosclerosis has limited efficacy in reversing the formation of atherosclerotic plaques. The search for new drug treatment options is imminent. Some potent medications have shown surprising therapeutic benefits in inhibiting inflammation and endothelial proliferation in plaques. Unfortunately, their use is restricted due to notable dose-dependent systemic side effects or degradation. Nevertheless, with advances in nanotechnology, an increasing number of nano-related medical applications are emerging, such as nano-drug delivery, nano-imaging, nanorobots, and so forth, which allow for restrictions on the use of novel atherosclerotic drugs to be lifted. This paper reviews new perspectives on the targeted delivery of nanoparticles to blood vessels for the treatment of atherosclerosis in both systemic and local drug delivery. In systemic drug delivery, nanoparticles inhibit drug degradation and reduce systemic toxicity through passive and active pathways. To further enhance the precise release of drugs, the localized delivery of nanoparticles can also be accomplished through blood vessel wall injection or using endovascular interventional devices coated with nanoparticles. Overall, nanotechnology holds boundless potential for the diagnosis and treatment of atherosclerotic diseases in the future.
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Affiliation(s)
- Qiushuo Zong
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Q.Z.); (Y.C.); (Y.L.)
| | - Chengyi He
- Department of Vascular Surgery, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, China;
| | - Binbin Long
- Department of General Surgery, Taihe Hospital Affiliated to Hubei University of Medicine, Shiyan 442099, China;
| | - Qingyun Huang
- Department of Cardiothoracic Surgery, The First Hospital of Putian Affiliated to Fujian Medical University, Putian 351106, China;
| | - Yunfei Chen
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Q.Z.); (Y.C.); (Y.L.)
| | - Yiqing Li
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Q.Z.); (Y.C.); (Y.L.)
| | - Yiping Dang
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Q.Z.); (Y.C.); (Y.L.)
| | - Chuanqi Cai
- Department of Vascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (Q.Z.); (Y.C.); (Y.L.)
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7
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Ushcatz I, Zhao HJ, Tadrous M, Aoki V, Chang AY, Dlova N, Merilleno ASP, Drucker AM. Association of Countries' Atopic Dermatitis Burden and Sociodemographic Index with Topical Calcineurin Inhibitor Utilization. Dermatitis 2024. [PMID: 38959123 DOI: 10.1089/derm.2024.0107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2024]
Abstract
Background: There is limited knowledge on international trends in topical calcineurin inhibitor (TCI) utilization. Objective: To describe international TCI utilization trends from 2012 to 2019 and evaluate the relationship of country-level economic status, geographic location, and atopic dermatitis (AD) disease burden with drug utilization. Methods: We used IQVIA MIDAS® pharmaceutical quarterly sales data to attain country-level purchasing of TCIs in grams from 2012 to 2019. A multivariable linear regression estimated the association between countries' sociodemographic index (SDI), AD disability-adjusted life year (DALY) rates, and geographic location with TCI utilization. Results: A total of 68 countries were included in our analysis. From 2012 to 2019, overall TCI utilization increased by 66% but remained 11.2 times higher in high-sociodemographic compared with low-middle/low-sociodemographic countries. SDI and geographic location were associated with greater TCI utilization in multivariable analyses, whereas AD DALY rates were not. High-SDI countries used 21,476 grams (95% confidence interval [CI]: 11,915 to 31,036) and high-middle SDI countries used 9,403 grams (95% CI: -393 to 19,200) more TCIs per 100,000 people compared with low-middle/low-SDI countries, respectively. Northern hemisphere countries used 8,588 grams more TCIs per 100,000 people (95% CI: 612 to 16,564). Conclusions: We demonstrated greater TCI utilization among high-SDI compared with lower SDI countries.
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Affiliation(s)
- Inna Ushcatz
- From the Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Heather J Zhao
- From the Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Canada
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Mina Tadrous
- From the Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Canada
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - Valeria Aoki
- Department of Dermatology, University of Sao Paulo School of Medicine, Sao Paulo, Brazil
| | - Aileen Y Chang
- Department of Dermatology, University of California School of Medicine, San Francisco, California, USA
- Department of Dermatology, Zuckerberg San Francisco General Hospital and Trauma Center, San Francisco, California, USA
| | - Ncoza Dlova
- School of Clinical Medicine and Dermatology Department, University of KwaZulu-Natal, Durban, South Africa
| | | | - Aaron M Drucker
- From the Women's College Research Institute and Department of Medicine, Women's College Hospital, Toronto, Canada
- Division of Dermatology, Department of Medicine, University of Toronto, Toronto, Canada
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8
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Manla Y, Bader F. Heart Failure Burden in Asia: The Full Picture. JACC. ASIA 2024; 4:569-570. [PMID: 39101111 PMCID: PMC11291340 DOI: 10.1016/j.jacasi.2024.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/06/2024]
Affiliation(s)
- Yosef Manla
- Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
| | - Feras Bader
- Heart, Vascular and Thoracic Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates
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9
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Lim GH, Neelakantan N, Lee YQ, Park SH, Kor ZH, van Dam RM, Chong MFF, Chia A. Dietary Patterns and Cardiovascular Diseases in Asia: A Systematic Review and Meta-Analysis. Adv Nutr 2024; 15:100249. [PMID: 39009489 PMCID: PMC11294752 DOI: 10.1016/j.advnut.2024.100249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2024] [Revised: 04/29/2024] [Accepted: 05/23/2024] [Indexed: 07/17/2024] Open
Abstract
With emerging Asian-derived diet quality indices and data-driven dietary patterns available, we aimed to synthesize the various dietary patterns and quantify its association with cardiovascular diseases (CVDs) among Asian populations. We systematically searched PubMed, Embase, Scopus, and Web of Science for observational studies in South, Southeast, and East Asia. Dietary patterns were grouped "high-quality," which included high intakes of three or more of the following food groups: 1) fruits and vegetables, 2) whole grains, 3) healthy protein sources (legumes and nuts, fish and seafood, low-fat dairy, and lean meat and poultry), and 4) liquid plant oils. High-quality patterns were further subcategorized based on their derivation methods: non-Asian indices, Asian indices, data-driven patterns, and plant-based indices. Dietary patterns were grouped "low-quality," which included high intakes of two or more of the following: 5) ultraprocessed food, 6) beverages and foods with added sugars, 7) foods high in salt, and 8) alcoholic beverages. Data-driven dietary patterns characterized by animal food sources were labeled "animal-based," and studies using dietary diversity scores were labeled "diet diversity indices." Dietary patterns that could not be meaningfully categorized were summarized narratively. Study-specific effect estimates were pooled using a random-effects model. Forty-one studies were included in this review. Higher adherence to high-quality dietary patterns in the top compared with bottom tertile defined by non-Asian indices (RR: 0.78; 95% CI: 0.69, 0.88; GRADE: moderate), Asian indices (RR: 0.84; 95% CI: 0.79, 0.90; GRADE: low), and data-driven patterns (RR: 0.81; 95% CI: 0.74, 0.89; GRADE: moderate) were associated with lower CVD risk. Plant-based, low-quality, animal-based, and diet diversity indices dietary patterns were not associated with CVD. Associations of Asian diet quality indices and CVD risk were weaker than those with non-Asian indices, highlighting the need for current Asian diet quality criteria to be updated to better capture the impact of diet on CVD. The systematic review and meta-analysis was registered at PROSPERO as CRD42021244318.
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Affiliation(s)
- Gladys Huiyun Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Nithya Neelakantan
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Epidemiology, Fay W. Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Yu Qi Lee
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Su Hyun Park
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Zhi Heng Kor
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
| | - Rob M van Dam
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Department of Nutrition and Exercise Sciences and Epidemiology, Milken Institute School of Public Health, The George Washington University, Washington, DC, United States; Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, United States
| | - Mary Foong-Fong Chong
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore; Singapore Institute for Clinical Sciences, Agency for Science, Technology and Research (A∗STAR), Singapore
| | - Airu Chia
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore.
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10
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Kumar D, Bardooli F, Chen WJ, Huang D, Sankardas MA, Ahmed WH, Liew HB, Gwon HC, Van Dorn B, Holmes T, Thompson A, Zhang S. Risk factors for mortality in post-myocardial infarction patients: insights from the improve SCA bridge study. Egypt Heart J 2024; 76:72. [PMID: 38849606 PMCID: PMC11161447 DOI: 10.1186/s43044-024-00505-2] [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: 10/20/2023] [Accepted: 06/01/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND Underutilization of implantable cardioverter defibrillators (ICD) to prevent sudden cardiac death (SCD) in post-myocardial infarction (MI) patients remains an issue across several geographies. A better understanding of risk factors for SCD in post-MI patients from regions with low ICD adoption rates will help identify those who will benefit from an ICD. This analysis assessed risk factors for all-cause and cardiovascular-related mortality in post-MI patients from the Improve Sudden Cardiac Arrest (SCA) Bridge Trial. RESULTS For the entire cohort, the overall 1-year mortality rate was 5.9% (88/1491) and 3.4% (51/1491) for all-cause and cardiovascular mortality, respectively, with 76.5% of all cardiac deaths being from SCD. A multivariate model determined increased age, reduced left ventricular ejection fraction (LVEF), increased time from myocardial infarction to hospital admission, being female, being from Southeast Asia (SEA), and having coronary artery disease to be significant risk factors for all-cause mortality. The risk factors for cardiovascular-related mortality revealed increased age, reduced LVEF, and being from SEA as significant risk factors. CONCLUSIONS We show several characteristics as being predictors of cardiovascular-related mortality in post-MI patients from the Improve SCA Bridge study. Patients who experience an MI and present with these characteristics would benefit from a referral to an electrophysiologist for further SCD risk stratification and management and possible subsequent ICD implantation to reduce unnecessary death.
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Affiliation(s)
- Dileep Kumar
- Mohammed Bin Khalifa Specialist Cardiac Centre, Awali, Bahrain.
- Phoenix Hospital, Abu Dhabi, United Arab Emirates.
| | - Fawaz Bardooli
- Mohammed Bin Khalifa Specialist Cardiac Centre, Awali, Bahrain
| | | | - Dejia Huang
- National Taiwan University Hospital, Taipei, Taiwan
| | | | | | - Houng-Bang Liew
- Queen Elizabeth Hospital II Clinical Research Centre, Sabah, Malaysia
| | - Hyeon-Cheol Gwon
- Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | | | | | | | - Shu Zhang
- Fu Wai Hospital Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing, Mainland, China
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11
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Li W, Xing A, Xu W, Guo L, Gao X, Zhou S, Drouin-Chartier JP, Wu S, Chen Z. Life's Essential 8 in Relation to Cardiovascular Disease and Mortality in Individuals With Diabetes. JACC. ASIA 2024; 4:456-464. [PMID: 39100706 PMCID: PMC11291351 DOI: 10.1016/j.jacasi.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 08/06/2024]
Abstract
Background Evidence regarding the potential health effects of Life's Essential 8 (LE8) score among individuals with type 2 diabetes (T2D) is limited. Objectives The purpose of this study was to examine the associations of LE8 score with risk of cardiovascular disease (CVD) and mortality among individuals with T2D. Methods We prospectively followed 19,915 Chinese participants with T2D at baseline or diagnosed during follow-up (Kailuan Study: 2006-2020), who were free of CVD at diagnosis of diabetes. Diet, lifestyle, and health conditions were repeatedly assessed every 2 years. The LE8 score (range 0-100), was calculated based on 8 components: diet quality, physical activity, smoking status, sleep health, body mass index, blood lipids, blood glucose, and blood pressure. We used time-varying cox models to model the associations. Results During a median follow-up of 11.5 years in participants with T2D, there were 3,295 incident CVD cases and 3,123 deaths. Higher LE8 score was associated with lower risk of CVD incidence and total mortality among participants with diabetes. The multivariate-adjusted HRs for the highest quintile of LE8 score compared with the lowest quintile were 0.56 (95% CI: 0.53-0.59) for CVD, 0.57 (95% CI: 0.53-0.62) for heart disease, 0.53 (95% CI: 0.49-0.57) for stroke, and 0.73 (95% CI: 0.69-0.78) for total mortality (all P trend <0.001). Furthermore, compared with participants with stable or decreased LE8 score after diabetes diagnosis, those with increased LE8 score had 17% to 42% lower risk of CVD, heart disease, stroke, and mortality. Conclusions A higher LE8 score was associated with a substantially lower risk of CVD incidence and total mortality among adults with T2D.
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Affiliation(s)
- Wenjuan Li
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Aijun Xing
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Wenqi Xu
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Lu Guo
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, Hebei, China
| | - Xiang Gao
- Department of Nutrition and Food Hygiene, School of Public Health, Institute of Nutrition, Fudan University, Shanghai, China
| | - Shenghua Zhou
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jean-Philippe Drouin-Chartier
- Nutrition, Health and Society (NUTRISS) Research Center, Institute of Nutrition and Functional Foods (INAF), Laval University, Quebec City, Quebec, Canada
- Faculty of pharmacy, Laval University, Quebec City, Quebec, Canada
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, Hebei, China
| | - Zhangling Chen
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Key Laboratory of Cardiometabolic Medicine in Hunan Province, Changsha, Hunan, China
- FuRong Laboratory, Changsha, Hunan, China
- Department of Epidemiology, Erasmus Medical Center, University Medical Center Rotterdam, Rotterdam, the Netherlands
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12
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Su K, Kim Y, Park Y. Prevalence of Metabolic Syndrome Based on Activity Type and Dietary Habits in Extremely Low-Income Individuals. Nutrients 2024; 16:1677. [PMID: 38892609 PMCID: PMC11175098 DOI: 10.3390/nu16111677] [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: 05/08/2024] [Revised: 05/22/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
A high prevalence of metabolic syndrome (MS) and cardiovascular disease among low-income individuals has often been reported. However, there is still a lack of research on the relationship between basic livelihood security (BLS) and MS. This study investigated the prevalence of MS according to activity type, dietary habits, and the nutrient intake characteristics of individuals receiving BLS. Data from 14,803 men and 20,299 women were analyzed to assess the association between receiving BLS and MS. The associations between MS and various factors were analyzed separately in men and women by logistic regression analysis. In this cohort, 5.9% of men and 6.8% of women received BLS; of these, 46.9% and 47.7% had MS, respectively. High caloric intake, low-frequency breakfast consumption, and no nutritional education were associated with MS in both men and women. Among those with a low-frequency walking habit and strength training activity type, MS increased by 1.58 and 1.57 times in men and by 1.47 and 2.16 times in women, respectively. Men who were sedentary for 8 h or more had an increased risk of MS, but there was no association between these in women. BLS nutritional intake characteristics were high in carbohydrates and fat and low in dietary fiber and vitamin C (p < 0.05). In conclusion, establishing a healthy eating pattern through nutritional education and increasing walking and strength training may reduce the risk of MS.
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Affiliation(s)
- Kunxia Su
- Department of Sports, Henan University of Chinese Medicine, Zhengzhou 450046, China;
| | - Yonghwan Kim
- Department of Physical Education, Gangneung-Wonju National University, Gangneung 25457, Republic of Korea
| | - Yoonjung Park
- Laboratory of Integrated Physiology, Department of Health and Human Performance, University of Houston, Houston, TX 77204, USA
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13
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Tran K, Shon H, Phan J, Cheng T, Kim GS, Jamal A, Srinivasan M, Palaniappan LP, Nguyen L, Huang RJ. Leading causes of death in Vietnamese Americans: An ecological study based on national death records from 2005-2020. PLoS One 2024; 19:e0303195. [PMID: 38787829 PMCID: PMC11125458 DOI: 10.1371/journal.pone.0303195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/21/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Disaggregated data is a cornerstone of precision health. Vietnamese Americans (VietAms) are the fourth-largest Asian subgroup in the United States (US), and demonstrate a unique burden of disease and mortality. However, most prior studies have aggregated VietAms under the broader Asian American category for analytic purposes. This study examined the leading causes of death among VietAms compared to aggregated Asian Americans and non-Hispanic Whites (NHWs) during the period 2005-2020. METHODS Decedent data, including underlying cause of death, were obtained from the National Center for Health Statistics national mortality file from 2005 to 2020. Population denominator estimates were obtained from the American Community Survey one-year population estimates. Outcome measures included proportional mortality, age-adjusted mortality rates per 100,000 (AMR), and annual percent change (APC) in mortality over time. Data were stratified by sex and nativity status. Due to large differences in age structure, we report native- and foreign-born VietAms separately. FINDINGS We identified 74,524 VietAm decedents over the study period (71,305 foreign-born, 3,219 native-born). Among foreign-born VietAms, the three leading causes of death were cancer (26.6%), heart disease (18.0%), and cerebrovascular disease (9.0%). Among native-born VietAms the three leading causes were accidents (19.0%), self-harm (12.0%), and cancer (10.4%). For every leading cause of death, VietAms exhibited lower mortality compared to both aggregated Asians and NHWs. Over the course of the study period, VietAms witnessed an increase in mortality in every leading cause. This effect was mostly driven by foreign-born, male VietAms. CONCLUSIONS AND RELEVANCE While VietAms have lower overall mortality from leading causes of death compared to aggregated Asians and NHWs, these advantages have eroded markedly between 2005 and 2020. These data emphasize the importance of racial disaggregation in the reporting of public health measures.
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Affiliation(s)
- Khoa Tran
- Department of Humanities, New York University, Abu Dhabi, United Arab Emirates
| | - HyeYuong Shon
- Department of Psychology, University of California, Berkeley, CA, United States of America
| | - Jonathan Phan
- Department of Bioengineering, University of California, Los Angeles, CA, United States of America
| | - Tina Cheng
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Gloria S. Kim
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Armaan Jamal
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States of America
| | - Malathi Srinivasan
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Latha P. Palaniappan
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Cardiovascular Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Linda Nguyen
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Robert J. Huang
- Center for Asian Health Research and Education, Stanford University School of Medicine, Stanford, CA, United States of America
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, CA, United States of America
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14
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Zhang J, Xu P, Liu R, Gyu JM, Cao P, Kang C. Osteoporosis and coronary heart disease: a bi-directional Mendelian randomization study. Front Endocrinol (Lausanne) 2024; 15:1362428. [PMID: 38841298 PMCID: PMC11150617 DOI: 10.3389/fendo.2024.1362428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Background Osteoporosis (OP) and cardiovascular disease (CVD) are major global public health issues, especially exacerbated by the challenges of an aging population. As these problems intensify, the associated burden on global health is expected to increase significantly. Despite extensive epidemiological investigations into the potential association between OP and CVD, establishing a clear causal relationship remains elusive. Methods Instrumental variables were selected from summary statistics of the IEU GWAS database. Five different components of BMD (heel BMD, LS BMD, FA BMD, FN BMD, and TB BMD) were used as OP phenotypes. CHD, MI, and stroke were selected to represent CVD. Multiple analysis methods were used to evaluate the causal relationship between CVD and OP comprehensively. In addition, sensitivity analyses(Cochran's Q test, MR-Egger intercept test, and "leave one out" analysis) were performed to verify the reliability of the results. Results The MR showed a significant causal relationship between CHD on heel BMD and TB BMD; in the reverse analysis, there was no evidence that OP has a significant causal effect on CVD. The reliability of the results was confirmed through sensitivity analysis. Conclusion The study results revealed that CHD was causally associated with Heel BMD and TB BMD, while in the reverse MR analysis, the causal relationship between OP and CVD was not supported. This result posits CHD as a potential etiological factor for OP and prompts that routine bone density assessment at traditional sites (forearm, femoral neck, lumbar spine) using DAX may inadequately discern underlying osteoporosis issues in CHD patients. The recommendation is to synergistically incorporate heel ultrasound or DAX for total body bone density examinations, ensuring clinical diagnostics are both precise and reliable. Moreover, these findings provide valuable insights for public health, contributing to the development of pertinent prevention and treatment strategies.
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Affiliation(s)
- Junsheng Zhang
- Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Pai Xu
- Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Rongcan Liu
- Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Jin Min Gyu
- Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
| | - Peng Cao
- Burn & Trauma Treatment Center, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Chan Kang
- Department of Orthopedic Surgery, Chungnam National University School of Medicine, Daejeon, Republic of Korea
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15
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Zhuang Y, Pan X, Chen Y, Song J. Unraveling genetic causality between metformin and myocardial infarction on the basis of Mendelian randomization. Front Endocrinol (Lausanne) 2024; 15:1376464. [PMID: 38765955 PMCID: PMC11099286 DOI: 10.3389/fendo.2024.1376464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Accepted: 04/17/2024] [Indexed: 05/22/2024] Open
Abstract
Background In recent years, several studies have explored the effect of metformin on myocardial infarction (MI), but whether metformin has an improvement effect in patients with MI is controversial. This study was aimed to investigate the causal relationship between metformin and MI using Mendelian randomization (MR) analysis. Methods The genome-wide significant (P<5×10-8) single-nucleotide polymorphisms (SNPs) in patients with metformin and patients with MI were screened from the Open genome-wide association study (GWAS) project as instrumental variables (IVs). The study outcomes mainly included MI, old MI, acute MI, acute transmural MI of inferior wall, and acute transmural MI of anterior wall. The inverse variance weighted (IVW) method was applied to assess the main causal effect, and weighted median, simple mode, weighted mode methods, and MR-Egger regression were auxiliary applied for supplementary proof. The causal relationship between metformin and MI was assessed using odds ratios (OR) and 95% confidence intervals (95% CI). A leave-one-out method was used to explore the effect of individual SNPs on the results of IVW analyses, and a funnel plot was used to analyze the potential bias of the study results, thus ensuring the robustness of the results. Results In total, 16, 84, 39, 26, and 34 SNPs were selected as IVs to assess the genetic association between metformin and outcomes of MI, old MI, acute MI, acute transmural MI of inferior wall, and acute transmural MI of anterior wall, respectively. Treatment with metformin does not affect the risk of acute transmural MI of anterior wall at the genetic level (P>0.05; OR for inverse variance weighted was 1.010). In the cases of MI, old MI, acute MI, and acute transmural MI of inferior wall, metformin may even be a risk factor for patients (P<0.05; ORs for inverse variance weighted were 1.078, 1.026, 1.022 and 1.018 respectively). There was no horizontal pleiotropy or heterogeneity among IVs. The results were stable when removing the SNPs one by one. Conclusion Metformin is not protective against the risk of myocardial infarction in patients and may even be a risk factor for MI, old MI, acute MI, and acute transmural MI of inferior wall.
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Affiliation(s)
- Yongru Zhuang
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
- Department of Pharmacy, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Xiaojun Pan
- Department of Pharmacy, Wuxi No.5 People’s Hospital, Wuxi, China
| | - Ya Chen
- Department of Endocrinology, Affiliated Hospital of Jiangnan University, Wuxi, China
| | - Jinfang Song
- Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou, China
- Department of Pharmacy, Affiliated Hospital of Jiangnan University, Wuxi, China
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16
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Harikrishnan S, Rath PC, Bang V, McDonagh T, Ogola E, Silva H, Rajbanshi BG, Pathirana A, Ng GA, Biga C, Lüscher TF, Daggubati R, Adivi S, Roy D, Banerjee PS, Das MK. Heart failure, the global pandemic: A call to action consensus statement from the global presidential conclave at the platinum jubilee conference of cardiological society of India 2023. Indian Heart J 2024; 76:147-153. [PMID: 38609052 DOI: 10.1016/j.ihj.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 03/26/2024] [Accepted: 04/08/2024] [Indexed: 04/14/2024] Open
Abstract
Heart failure (HF) is emerging as a major public health problem both in high- and low - income countries. The mortality and morbidity due to HF is substantially higher in low-middle income countries (LMICs). Accessibility, availability and affordability issues affect the guideline directed therapy implementation in HF care in those countries. This call to action urges all those concerned to initiate preventive strategies as early as possible, so that we can reduce HF-related morbidity and mortality. The most important step is to have better prevention and treatment strategies for diseases such as hypertension, ischemic heart disease (IHD), type-2 diabetes, and rheumatic heart disease (RHD) which predispose to the development of HF. Setting up dedicated HF-clinics manned by HF Nurses, can help in streamlining HF care. Subsidized in-patient care, financial assistance for device therapy, use of generic medicines (including polypill strategy) will be helpful, along with the use of digital technologies.
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Affiliation(s)
| | - Prathap Chandra Rath
- Apollo Health City, Jubilee Hills, Hyderabad, President, Cardiological Society of India (CSI), India
| | - Vijay Bang
- Lilavati Hospital, Bandra West, Mumbai, Immediate Past-President, CSI, India
| | | | - Elijah Ogola
- University of Nairobi (Kenya), President Pan African Society of Cardiology, Kenya
| | - Hugo Silva
- Hospital General de Agudos Dr. Cosme Argerich, Buenos Aires, Treasurer, Argentinian Cardiac Society, Argentina
| | - Bijoy G Rajbanshi
- Nepal Mediciti, Lalitpur, Past-President, Cardiac Society of Nepal, Nepal
| | - Anidu Pathirana
- National Hospital of SriLanka, Past-President SriLanka Heart Association, Sri Lanka
| | - G Andre Ng
- University of Leicester, President-Elect, British Cardiovascular Society, United Kingdom
| | - Cathleen Biga
- President and CEO of Cardiovascular Management of Illinois, Vice President, American College of Cardiology, USA
| | - Thomas F Lüscher
- Royal Brompton Hospital Imperial College London, London, President-Elect European Society of Cardiology, United Kingdom
| | - Ramesh Daggubati
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Shirley Adivi
- West Virginia University School of Medicine, Morgantown, WV, USA
| | - Debabrata Roy
- Rabindranath Tagore Institute of Cardiac Sciences, Kolkata, Hon. General Secretary, CSI, India
| | - P S Banerjee
- Manipal Hospital, Kolkata, Past-President, CSI, India
| | - M K Das
- B.M. Birla Heart Research Centre, Kolkata, Past-President CSI, India
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17
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Zhang RS, Weber BN, Araiza-Garaygordobil D, Garshick MS. Colchicine for the Prevention of Cardiovascular Disease: Potential Global Implementation. Curr Cardiol Rep 2024; 26:423-434. [PMID: 38573553 PMCID: PMC11196186 DOI: 10.1007/s11886-024-02049-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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/19/2024] [Indexed: 04/05/2024]
Abstract
PURPOSE OF REVIEW Targeting traditional cardiovascular risk factors is effective in reducing recurrent cardiovascular events, yet the presence of residual cardiovascular risk due to underlying systemic inflammation is a largely unaddressed opportunity. This review aims to comprehensively assess the evolving role of colchicine as a therapeutic approach targeting residual inflammatory risk in the context of those with coronary artery disease (CAD). RECENT FINDINGS Inflammation plays a significant role in promoting atherosclerosis, and targeting anti-inflammatory pathways has the potential to decrease cardiovascular events. Low-dose colchicine (0.5 mg/day orally), when added to guideline-directed medical care for CAD, safely decreases major adverse cardiovascular events (MACE) by 31% in stable atherosclerosis patients and 23% in those after recent myocardial infarctions. Meta-analyses of recent randomized control trials further support both the efficacy and safety of colchicine, particularly when added to other standard cardiovascular therapies, including statin therapy. The European Society of Cardiology and other national guidelines endorse the use of low-dose colchicine in patients across the spectrum of CAD. Recently, colchicine was FDA-approved in the United States as the first anti-inflammatory therapy for the reduction of cardiovascular events. In a period of a rising incidence of CAD across the globe, colchicine represents a unique opportunity to decrease MACE due to its large magnitude of benefits and general affordability. However, challenges with drug interactions must be addressed, especially in those regions where HIV, hepatitis, and tuberculosis are prevalent. Colchicine is safe and effective at reducing cardiovascular events across a broad spectrum of coronary syndromes. The ability to simultaneously target traditional risk factors and mitigate residual inflammatory risk marks a substantial advancement in cardiovascular prevention strategies, heralding a new era in the global battle against CAD.
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Affiliation(s)
- Robert S Zhang
- Leon H. Charney Division of Cardiology and Center for the Prevention of Cardiovascular Disease, New York University Grossman School of Medicine, New York, NY, 10016, USA
| | - Brittany N Weber
- Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Michael S Garshick
- Leon H. Charney Division of Cardiology and Center for the Prevention of Cardiovascular Disease, New York University Grossman School of Medicine, New York, NY, 10016, USA.
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18
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Birhanu MM, Zengin A, Joshi R, Evans RG, Kalyanram K, Kartik K, Riddell MA, Suresh O, Srikanth VK, Arabshahi S, Thomas N, Thrift AG. Risk factors for incident cardiovascular events and their population attributable fractions in rural India: The Rishi Valley Prospective Cohort Study. Trop Med Int Health 2024; 29:377-389. [PMID: 38403844 DOI: 10.1111/tmi.13981] [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] [Indexed: 02/27/2024]
Abstract
OBJECTIVE We prospectively determined incident cardiovascular events and their association with risk factors in rural India. METHODS We followed up with 7935 adults from the Rishi Valley Prospective Cohort Study to identify incident cardiovascular events. Using Cox proportional hazards regression, we estimated hazard ratios (HRs) with 95% confidence intervals (95% CI) for associations between potential risk factors and cardiovascular events. Population attributable fractions (PAFs) for risk factors were estimated using R ('averisk' package). RESULTS Of the 4809 participants without prior cardiovascular disease, 57.7% were women and baseline mean age was 45.3 years. At follow-up (median of 4.9 years, 23,180 person-years [PYs]), 202 participants developed cardiovascular events, equating to an incidence of 8.7 cardiovascular events/1000 PYs. Incidence was greater in those with hypertension (hazard ratio [HR] [95% CI] 1.73 [1.21-2.49], adjusted PAF 18%), diabetes (1.96 [1.15-3.36], 4%) or central obesity (1.77 [1.23, 2.54], 9%) which together accounted for 31% of the PAF. Non-traditional risk factors such as night sleeping hours and number of children accounted for 16% of the PAF. CONCLUSIONS Both traditional and non-traditional cardiovascular risk factors are important contributors to incident cardiovascular events in rural India. Interventions targeted to these factors could assist in reducing the incidence of cardiovascular events.
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Affiliation(s)
- Mulugeta Molla Birhanu
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Rohina Joshi
- School of Population Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
- George Institute for Global Health, New Delhi, India
| | - Roger G Evans
- Cardiovascular Disease Program, Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia
- Pre-clinical Critical Care Unit, Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Kartik Kalyanram
- Rishi Valley Rural Health Centre, Chittoor, Andhra Pradesh, India
| | - Kamakshi Kartik
- Rishi Valley Rural Health Centre, Chittoor, Andhra Pradesh, India
| | - Michaela A Riddell
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Oduru Suresh
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
- Rishi Valley Rural Health Centre, Chittoor, Andhra Pradesh, India
| | - Velandai K Srikanth
- Department of Medicine, Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- National Centre for Healthy Ageing, Melbourne, Victoria, Australia
| | - Simin Arabshahi
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Nihal Thomas
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College, Vellore, Tamil Nadu, India
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
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19
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Jin DL, Kim KH, Chung ES, Yoon SJ. Trends in Regional Disparities in Cardiovascular Surgery and Mortality in Korea: A National Cross-sectional Study. J Prev Med Public Health 2024; 57:260-268. [PMID: 38857891 PMCID: PMC11164609 DOI: 10.3961/jpmph.24.057] [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: 01/30/2024] [Revised: 03/25/2024] [Accepted: 04/01/2024] [Indexed: 06/12/2024] Open
Abstract
OBJECTIVES Regional disparities in cardiovascular care in Korea have led to uneven patient outcomes. Despite the growing need for and access to procedures, few studies have linked regional service availability to mortality rates. This study analyzed regional variation in the utilization of major cardiovascular procedures and their associations with short-term mortality to provide better evidence regarding the relationship between healthcare resource distribution and patient survival. METHODS A cross-sectional study was conducted using nationwide claims data for patients who underwent coronary artery bypass grafting (CABG), percutaneous coronary intervention (PCI), stent insertion, or aortic aneurysm resection in 2022. Regional variation was assessed by the relevance index (RI). The associations between the regional RI and 30-day mortality were analyzed. RESULTS The RI was lowest for aortic aneurysm resection (mean, 26.2; standard deviation, 26.1), indicating the most uneven regional distribution among the surgical procedures. Patients undergoing this procedure in regions with higher RIs showed significantly lower 30-day mortality (adjusted odds ratio [aOR], 0.73; 95% confidence interval, 0.55 to 0.96; p=0.026) versus those with lower RIs. This suggests that cardiovascular surgery regional availability, as measured by RI, has an impact on mortality rates for certain complex surgical procedures. The RI was not associated with significant mortality differences for more widely available procedures like CABG (aOR, 0.96), PCI (aOR, 1.00), or stent insertion (aOR, 0.91). CONCLUSIONS Significant regional variation and underutilization of cardiovascular surgery were found, with reduced access linked to worse mortality for complex procedures. Disparities should be addressed through collaboration among hospitals and policy efforts to improve outcomes.
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Affiliation(s)
- Dal-Lae Jin
- Department of Public Health, Graduate School of Korea University, Seoul, Korea
- Transdisciplinary Major in Learning Health Systems, Graduate School of Korea University, Seoul, Korea
| | - Kyoung-Hoon Kim
- Department of Health Administration, College of Nursing and Health, Kongju National University, Gongju, Korea
| | - Euy Suk Chung
- Department of Thoracic and Cardiovascular Surgery, Kangbuk Samsung Hospital, Seoul, Korea
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Korea
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20
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Sia CH, Simon O, Loh PH, Poh KK. Atherosclerotic cardiovascular disease landscape in Singapore. Front Cardiovasc Med 2024; 11:1342698. [PMID: 38720921 PMCID: PMC11076755 DOI: 10.3389/fcvm.2024.1342698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide, accounting for over one-third of all deaths in Singapore. An analysis of age-standardized mortality rates (ASMR) for CVD in Singapore revealed a deceleration in the initial rapid decline in ASMR. A decrease in smoking prevalence may have contributed to the initial rapid decline in ASMR. Furthermore, other major risk factors, such as diabetes mellitus, hypertension, elevated low-density lipoprotein levels, and obesity, are steadily rising. Singapore's CVD economic burden is estimated to be 8.1 billion USD (11.5 billion SGD). The burden of CVD can only be reduced using individual and population-based approaches. Prevention programs must also be developed based on an understanding of risk trends. Therefore, this article attempts to capture the burden of CVD, trends in risk factor control, preventive care, disparities, and current unmet needs, particularly in atherosclerotic cardiovascular disease management in Singapore.
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Affiliation(s)
- Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Oliver Simon
- Medical Affairs, Novartis (Singapore) Ltd Pte, Singapore, Singapore
| | - Poay-Huan Loh
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Division of Cardiology, Department of Medicine, Ng Teng Fong General Hospital, Singapore, Singapore
| | - Kian Keong Poh
- Department of Cardiology, National University Heart Centre Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
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21
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Ma M, He L, Wang H, Tang M, Zhu D, Sikanha L, Darapiseth S, Lu J, Xia Y, Wang Z, Wu X, Zhu Q, Duo L, Pan X, Pang L. Prevalence and Clustering of Cardiovascular Disease Risk Factors among Adults Along the Lancang-Mekong River: A Cross-Sectional Study from Low- and Middle-Income Countries. Glob Heart 2024; 19:35. [PMID: 38638126 PMCID: PMC11025572 DOI: 10.5334/gh.1319] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 03/20/2024] [Indexed: 04/20/2024] Open
Abstract
Background Progress in cardiovascular health is increasingly concentrated in high-income countries, while the burden of cardiovascular disease (CVD) is high in low- and middle-income countries, a clear health inequity that must be urgently addressed. Objective This study aims to evaluate the prevalence and clustering of CVD risk factors in the three Lancang-Mekong regions. Methods We conducted a population-based cross-sectional survey from January 2021 to March 2023 in China, Laos, and Cambodia. We compared the prevalence and clustering of CVD risk factors-including hypertension, dyslipidemia, diabetes mellitus, overweight/obesity, current smoking status, current drinking status, inadequate vegetable and fruit intake, and insufficient physical activity-across the three regions, further stratifying the data by gender and age. Multivariate logistic regression models were performed to explore factors influencing the aggregation of CVD risk factors (≥2, ≥3, ≥4). Results A total of 11,005 adults were included in the study. Hypertension emerged as the primary metabolic risk factor in Laos (36.8%) and Cambodia (23.5%), whereas overweight/obesity was the primary risk factor in China (37.6%). In terms of behavioral risk factors, participants in all three regions showed insufficient vegetable and fruit intake. The prevalence of individuals without CVD risk factors was 10% in China, 1.9% in Laos, and 5.2% in Cambodia. Meanwhile, the prevalence of two or more risk factors was 64.6% in China, 79.2% in Laos, and 76.0% in Cambodia. Multivariate logistic regression models revealed that the propensity for CVD risk factors clustering was higher in men and increased with age in all three countries. Conclusions CVD risk factors and multiple clustering are pressing health threats among adults in low- and middle-income areas along the Lancang-Mekong River Basin. This study highlights the urgent need for proactive tailored strategies to control CVD risk factors.
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Affiliation(s)
- Min Ma
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
- Kunming Medical University, Kunming, China
| | - Liping He
- Kunming Medical University, Kunming, China
| | | | - Mingjing Tang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Da Zhu
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Labee Sikanha
- Saimangkorm International Hospital, Oudomxay province, Lao PDR
| | | | - Jiang Lu
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Yu Xia
- Kunming Medical University, Kunming, China
| | | | - Xia Wu
- Kunming Medical University, Kunming, China
| | - Qiuyan Zhu
- Yunnan Center for Disease Control and Prevention, Kunming, China
| | - Lin Duo
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
| | - Xiangbin Pan
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
- Department of Structure Heart Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Linhong Pang
- Affiliated Cardiovascular Hospital of Kunming Medical University, Fuwai Yunnan Cardiovascular Hospital, Kunming, China
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22
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Nelson AJ, Azzopardi R, Lam CS, Nicholls SJ. Reply: Low Asian Enrollment in Cardiometabolic Studies and the Importance of Trial Context. JACC. ASIA 2024; 4:343. [PMID: 38660104 PMCID: PMC11035946 DOI: 10.1016/j.jacasi.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 04/26/2024]
Affiliation(s)
- Adam J. Nelson
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
| | - Robert Azzopardi
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
| | - Carolyn S.P. Lam
- National Heart Centre and SingHealth Duke-NUS Cardiovascular Sciences, Singapore
| | - Stephen J. Nicholls
- Victorian Heart Institute, Monash University, Melbourne, Victoria, Australia
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23
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Gao Z, Wang Y, Yu K, Dai Z, Song T, Zhang J, Huang C, Zhang H, Yang H. Cardiac Multi-Frequency Vibration Signal Sensor Module and Feature Extraction Method Based on Vibration Modeling. SENSORS (BASEL, SWITZERLAND) 2024; 24:2235. [PMID: 38610445 PMCID: PMC11014338 DOI: 10.3390/s24072235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/20/2024] [Accepted: 03/29/2024] [Indexed: 04/14/2024]
Abstract
Cardiovascular diseases pose a long-term risk to human health. This study focuses on the rich-spectrum mechanical vibrations generated during cardiac activity. By combining Fourier series theory, we propose a multi-frequency vibration model for the heart, decomposing cardiac vibration into frequency bands and establishing a systematic interpretation for detecting multi-frequency cardiac vibrations. Based on this, we develop a small multi-frequency vibration sensor module based on flexible polyvinylidene fluoride (PVDF) films, which is capable of synchronously collecting ultra-low-frequency seismocardiography (ULF-SCG), seismocardiography (SCG), and phonocardiography (PCG) signals with high sensitivity. Comparative experiments validate the sensor's performance and we further develop an algorithm framework for feature extraction based on 1D-CNN models, achieving continuous recognition of multiple vibration features. Testing shows that the recognition coefficient of determination (R2), mean absolute error (MAE), and root mean square error (RMSE) of the 8 features are 0.95, 2.18 ms, and 4.89 ms, respectively, with an average prediction speed of 60.18 us/point, meeting the re-quirements for online monitoring while ensuring accuracy in extracting multiple feature points. Finally, integrating the vibration model, sensor, and feature extraction algorithm, we propose a dynamic monitoring system for multi-frequency cardiac vibration, which can be applied to portable monitoring devices for daily dynamic cardiac monitoring, providing a new approach for the early diagnosis and prevention of cardiovascular diseases.
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Affiliation(s)
- Zhixing Gao
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Yuqi Wang
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Kang Yu
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
| | - Zhiwei Dai
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
| | - Tingting Song
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
| | - Jun Zhang
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Chengjun Huang
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Haiying Zhang
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
| | - Hao Yang
- Institute of Microelectronics of the Chinese Academy of Sciences, Beijing 100029, China; (Z.G.); (Y.W.); (K.Y.); (Z.D.); (J.Z.); (C.H.); (H.Z.)
- University of Chinese Academy of Sciences, Beijing 100049, China
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24
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Jalali M, Bahadoran Z, Mirmiran P, Khalili D, Symonds ME, Azizi F, Faghih S. Higher ultra-processed food intake is associated with an increased incidence risk of cardiovascular disease: the Tehran lipid and glucose study. Nutr Metab (Lond) 2024; 21:14. [PMID: 38504359 PMCID: PMC10949749 DOI: 10.1186/s12986-024-00788-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/13/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) is a major cause of death worldwide, although limited data are currently available regarding the impact of consuming ultra-processed food (UPF) on its incidence. Given the increased consumption of UPF in Iran, we aimed to investigate the association between UPF intake and CVD risk. METHODS Individuals without CVD (n = 2050) aged ≥ 30 years old were recruited from the Tehran Lipid and Glucose Study (TLGS). Dietary data were collected using a validated food frequency questionnaire (FFQ) and UPF intakes were assessed based on the Nova food classification. Multivariable Cox proportional hazard models adjusted for potential confounders were used to estimate the hazard ratio (HR) and 95% confidence intervals (95% CI) for the risk of CVD across tertiles of UPF intake. RESULTS A 10.1% incidence of CVD occurred over a median follow-up of 10.6 years, with a 22% increase in CVD risk per each 50 g/day UPF intake. Participants with the highest intake of UPF had a 68% greater incidence of CVD compared to those with the lowest intake (HR = 1.68, 95% CI=1.14-2.48) after controlling for potential confounders. Regarding sub-groups of UPF, participants in the 3rd tertile compared to the reference had a significantly increased risk of CVD (HR = 1.56, 95% CI=1.04-2.34). Nevertheless, intake of bread, fast food, sweetened beverages, sweets and desserts, high-fat dairy products, and other UPFs were not associated with greater CVD risk. CONCLUSION Our findings support the hypothesis that the incidence of CVD is enhanced with the higher consumption of UPF in a representative sample of the Iranian population.
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Affiliation(s)
- Mohammad Jalali
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Zahra Bahadoran
- Nutrition and Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran.
| | - Parvin Mirmiran
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, No. 24, Shahid-Erabi St., Yeman St., Velenjak, Tehran, Iran
| | - Davood Khalili
- Department of Epidemiology and Biostatistics, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael E Symonds
- Centre for Perinatal Research, Academic Unit of Population and Lifespan Sciences, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shiva Faghih
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Ave, Shiraz, Iran.
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25
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Nazir A, Heryaman H, Juli C, Ugusman A, Martha JW, Moeliono MA, Atik N. Resistance Training in Cardiovascular Diseases: A Review on Its Effectiveness in Controlling Risk Factors. Integr Blood Press Control 2024; 17:21-37. [PMID: 38523733 PMCID: PMC10959113 DOI: 10.2147/ibpc.s449086] [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: 11/09/2023] [Accepted: 03/06/2024] [Indexed: 03/26/2024] Open
Abstract
Cardiovascular Disease (CVD), a term encompassing various disorders affecting the heart and blood vessels, includes coronary artery disease (CAD). CAD is primarily due to the development of atherosclerotic plaques that disrupt blood flow, oxygenation, and nutrient delivery to the myocardium. Risk factors contributing to CAD progression include smoking, hypertension, diabetes mellitus (DM), dyslipidaemia, and obesity. While aerobic exercise (AE) has shown promising results in controlling CVD risk factors, the impact of resistance training (RT) has not been extensively investigated. This review aims to describe the effects of RT on CVD risk factors based on studies retrieved from PubMed and Google Scholar databases. Both isometric and isotonic RT have been found to decrease systolic blood pressure (SBP), diastolic blood pressure, or mean arterial pressure, with SBP showing a more significant reduction. Hypertensive patients engaging in RT alongside a calorie-restricted diet demonstrated significant improvements in blood pressure. RT is associated with increased nitric oxide bioavailability, sympathetic modulation, and enhanced endothelial function. In type-2 DM patients, 8-12 weeks of RT led to improvements in fasting blood glucose levels, insulin secretion, metabolic syndrome risk, and glucose transporter numbers. Combining AE with RT had a more significant impact in reducing insulin resistance and enhancing blood glucose compared to performing exercises separately. It also significantly decreased total cholesterol, triglycerides, and low-density lipoprotein levels while increasing high-density lipoprotein within 12 weeks of application. However, improvements are considered insignificant when lipid levels are already low to normal at baseline. The administration of RT resulted in weight loss and improved body mass index, with more pronounced effects seen when combining AE with RT and a calorie-restricted diet. Considering these results, the administration of RT, either alone or in combination with AE, proves beneficial in rehabilitating CAD patients by improving various risk factors.
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Affiliation(s)
- Arnengsih Nazir
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Henhen Heryaman
- Doctoral Program, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Cep Juli
- Department of Neurology, Dr. Hasan Sadikin General Hospital/Faculty of Medicine Padjadjaran University, Bandung, WJ, Indonesia
| | - Azizah Ugusman
- Department of Physiology, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Marina Annette Moeliono
- Department of Physical and Rehabilitation Medicine, Dr. Hasan Sadikin General Hospital/Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
| | - Nur Atik
- Department of Biomedical Sciences, Faculty of Medicine, Padjadjaran University, Bandung, WJ, Indonesia
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26
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Haybar H, Hadi H, Purrahman D, Mahmoudian-Sani MR, Saki N. Emerging roles of HOTAIR lncRNA in the pathogenesis and prognosis of cardiovascular diseases. Biomark Med 2024; 18:203-219. [PMID: 38411079 DOI: 10.2217/bmm-2023-0368] [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] [Indexed: 02/28/2024] Open
Abstract
Highlights HOTAIR, a long noncoding RNA, plays a role in the regulation of proteins involved in the pathogenesis of cardiovascular disease. Furthermore, it has been identified as a biomarker of this type of disease. Several factors and cells contribute to atherosclerosis, a progressive disease. However, the prognosis of HOTAIR in this disease varies depending on the path in which it plays a role. For this condition, there is no single prognosis to consider.
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Affiliation(s)
- Habib Haybar
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hakimeh Hadi
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Daryush Purrahman
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Reza Mahmoudian-Sani
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmaldin Saki
- Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Muharram FR, Multazam CECZ, Mustofa A, Socha W, Andrianto, Martini S, Aminde L, Yi-Li C. The 30 Years of Shifting in The Indonesian Cardiovascular Burden-Analysis of The Global Burden of Disease Study. J Epidemiol Glob Health 2024; 14:193-212. [PMID: 38324147 PMCID: PMC11043320 DOI: 10.1007/s44197-024-00187-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
IMPORTANCE Cardiovascular disease (CVD) remains the leading cause of mortality and morbidity. Compared with disease burden rates in 1990, significant reductions in Disability-Adjusted Life Years (DALYs) burden rates for CVD have been recorded. However, general DALYs rates have not changed in Indonesia in the past 30 years. Thus, assessing Indonesian CVD burdens will be an essential first step in determining primary disease interventions. OBJECTIVE To determine the national and province-level burden of CVD from 1990 to 2019 in Indonesia. DESIGN, SETTING, AND PARTICIPANTS A retrospective observational study was conducted using data from the Global Burden of Disease (GBD) 2019, provided by the Institute of Health Metrics and Evaluation (IHME), to analyze trends in the burden of CVD, including mortality, morbidity, and prevalence characteristics of 12 underlying CVDs. EXPOSURES Residence in Indonesia. MAIN OUTCOMES AND MEASURES Mortality, incidence, prevalence, death, and DALYs of CVD. RESULTS CVD deaths have doubled from 278 million in 1990 to 651 million in 2019. All CVDs recorded increased death rates, except for rheumatic heart disease (RHD) (- 69%) and congenital heart disease (CHD) (- 37%). Based on underlying diseases, stroke and ischemic heart disease (IHD) are still the leading causes of mortality and morbidity in Indonesia, whereas stroke and peripheral artery disease (PAD) are the most prevalent CVDs. Indonesia has the second worst CVD DALYs rates compared to ASEAN countries after Laos. At provincial levels, the highest CVD DALY rates were recorded in Bangka Belitung, South Kalimantan, and Yogyakarta. In terms of DALYs rate changes, they were recorded in West Nusa Tenggara (24%), South Kalimantan (18%), and Central Java (11%). Regarding sex, only RHD, and PAD burdens were dominated by females. CONCLUSIONS CVD mortality, morbidity, and prevalence rates increased in Indonesia from 1990 to 2019, especially for stroke and ischemic heart disease. The burden is exceptionally high, even when compared to other Southeast Asian countries and the global downward trend. GBD has many limitations. However, these data could provide policymakers with a broad view of CVD conditions in Indonesia.
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Affiliation(s)
| | | | - Ali Mustofa
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University, Soetomo General Hospital, Surabaya, Indonesia
| | - Wigaviola Socha
- Cardiology and Respiratory Department, Imperial College London, London, UK
| | - Andrianto
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, Airlangga University, Soetomo General Hospital, Surabaya, Indonesia
| | - Santi Martini
- Faculty of Public Health, Airlangga University, Surabaya, Indonesia.
| | - Leopold Aminde
- Population Health and Research Methods Department, School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Chung Yi-Li
- Institute of Public Health, National Cheng Kung University, Tainan City, Taiwan
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Turnbull I, Camm CF, Halsey J, Du H, Bennett DA, Chen Y, Yu C, Sun D, Liu X, Li L, Chen Z, Clarke R. Correlates and consequences of atrial fibrillation in a prospective study of 25 000 participants in the China Kadoorie Biobank. EUROPEAN HEART JOURNAL OPEN 2024; 4:oeae021. [PMID: 38572088 PMCID: PMC10989653 DOI: 10.1093/ehjopen/oeae021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 02/08/2024] [Accepted: 02/15/2024] [Indexed: 04/05/2024]
Abstract
Aims The prevalence of atrial fibrillation (AF) is positively correlated with prior cardiovascular diseases (CVD) and CVD risk factors but is lower in Chinese than Europeans despite their higher burden of CVD. We examined the prevalence and prognosis of AF and other electrocardiogram (ECG) abnormalities in the China Kadoorie Biobank. Methods and results A random sample of 25 239 adults (mean age 59.5 years, 62% women) had a 12-lead ECG recorded and interpreted using a Mortara VERITAS™ algorithm in 2013-14. Participants were followed up for 5 years for incident stroke, ischaemic heart disease, heart failure (HF), and all CVD, overall and by CHA2DS2-VASc scores, age, sex, and area. Overall, 1.2% had AF, 13.6% had left ventricular hypertrophy (LVH), and 28.1% had ischaemia (two-thirds of AF cases also had ischaemia or LVH). The prevalence of AF increased with age, prior CVD, and levels of CHA₂DS₂-VASc scores (0.5%, 1.3%, 2.1%, 2.9%, and 4.4% for scores <2, 2, 3, 4, and ≥5, respectively). Atrial fibrillation was associated with two-fold higher hazard ratios (HR) for CVD (2.15; 95% CI, 1.71-2.69) and stroke (1.88; 1.44-2.47) and a four-fold higher HR for HF (3.79; 2.21-6.49). The 5-year cumulative incidence of CVD was comparable for AF, prior CVD, and CHA₂DS₂-VASc scores ≥ 2 (36.7% vs. 36.2% vs. 37.7%, respectively) but was two-fold greater than for ischaemia (19.4%), LVH (18.0%), or normal ECG (14.1%), respectively. Conclusion The findings highlight the importance of screening for AF together with estimation of CHA₂DS₂-VASc scores for prevention of CVD in Chinese adults.
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Affiliation(s)
- Iain Turnbull
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Christian Fielder Camm
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Jim Halsey
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Huaidong Du
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Derrick A Bennett
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Yiping Chen
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Dianyianji Sun
- Department of Epidemiology and Biostatistics, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
| | - Xiaohong Liu
- Medical Records Archive, Pengzhou Traditional Medicine Hospital, Penzhou, China
| | - Liming Li
- Department of Epidemiology and Biostatistics, Peking University, Beijing, China
- Department of Epidemiology and Biostatistics, Peking University Center for Public Health and Epidemic Preparedness and Response, Beijing, China
- Key Laboratory of Epidemiology of Major Diseases, Peking University, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
| | - Robert Clarke
- Clinical Trial Service Unit, Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF, UK
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Abdul-Rahman T, Bliss ZSB, Lizano-Jubert I, Muñoz MJS, Garg N, Pachchipulusu VK, Ashinze P, Miteu GD, Baig R, Omar DA, Badawy MM, Bukhari SMA, Wireko AA, Aborode AT, Atallah O, Mahmoud HA, Aldosoky W, Abohashem S. Beyond symptoms: Unlocking the potential of coronary calcium scoring in the prevention and treatment of coronary artery disease. Curr Probl Cardiol 2024; 49:102378. [PMID: 38185434 DOI: 10.1016/j.cpcardiol.2024.102378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/04/2024] [Indexed: 01/09/2024]
Abstract
Coronary Artery Disease (CAD) represents a persistent global health menace, particularly prevalent in Eastern European nations. Often asymptomatic until its advanced stages, CAD can precipitate life-threatening events like myocardial infarction or stroke. While conventional risk factors provide some insight into CAD risk, their predictive accuracy is suboptimal. Amidst this, Coronary Calcium Scoring (CCS), facilitated by non-invasive computed tomography (CT), emerges as a superior diagnostic modality. By quantifying calcium deposits in coronary arteries, CCS serves as a robust indicator of atherosclerotic burden, thus refining risk stratification and guiding therapeutic interventions. Despite certain limitations, CCS stands as an instrumental tool in CAD management and in thwarting adverse cardiovascular incidents. This review delves into the pivotal role of CCS in CAD diagnosis and treatment, elucidates the involvement of calcium in atherosclerotic plaque formation, and outlines the principles and indications of utilizing CCS for predicting major cardiovascular events.
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Affiliation(s)
| | | | | | | | - Neil Garg
- Rowan-Virtua School of Osteopathic Medicine, Stratford, New Jersey, United States
| | | | - Patrick Ashinze
- Department of Medical Services, Saint Francis Catholic Hospital, Okpara Inland, Delta, Nigeria
| | - Goshen David Miteu
- Department of Biomedical Science, School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States
| | - Rusab Baig
- Shadan Institute of Medical Sciences, Hyderabad, India
| | | | | | | | | | | | - Oday Atallah
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany
| | | | - Wesam Aldosoky
- Massachusetts General Hospital and Harvard Medical School, Boston, United States
| | - Shady Abohashem
- Massachusetts General Hospital and Harvard Medical School, Boston, United States.
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Cha J, Choi SY, Rha SW, Choi BG, Byun JK, Hyun S, Lee MW, Kang J, Chu W, Park EJ, Kang DO, Choi CU, Kim SW, Jeong MH, Park S. Long-term air pollution exposure is associated with higher incidence of ST-elevation myocardial infarction and in-hospital cardiogenic shock. Sci Rep 2024; 14:4976. [PMID: 38424210 PMCID: PMC10904831 DOI: 10.1038/s41598-024-55682-6] [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: 10/27/2023] [Accepted: 02/26/2024] [Indexed: 03/02/2024] Open
Abstract
Previous studies have reported the association between myocardial infarction (MI) and air pollution (AP). However, limited information is available regarding the long-term effects of AP on the relative incidence rates of ST-elevation MI (STEMI) and Non-ST-elevation MI (NSTEMI). We investigated the association between long-term exposure to AP and the incidence of STEMI. Between January 2006 and December 2015, a total of 45,619 eligible patients with Acute Myocardial Infarction (AMI) were enrolled in the Korea Acute MI Registry (KAMIR) and KAMIR-National Institutes of Health. Mixed-effect regression models were used to examine the association between the annual average ambient AP before MI onset and the incidence of STEMI, and to evaluate the association of AP with the incidence of in-hospital cardiogenic shock. After mixed-effect regression model analysis, particulate matter (PM) 10 µm or less in diameter (PM10) was associated with increased incidence of STEMI compared with NSTEMI (odds ratio [OR] 1.009, 95% Confidence Interval [CI] 1.002-1.016; p = 0.012). For in-hospital cardiogenic shock complication, PM10 and SO2 were associated with increased risk, PM10 (OR 1.033, 95% CI 1.018-1.050; p < 0.001), SO2 (OR 1.104, 95% CI 1.006-1.212; p = 0.037), respectively. Policy-level strategies and clinical efforts to reduce AP exposure are necessary to prevent the incidence of STEMI and severe cardiovascular complications.
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Affiliation(s)
- Jinah Cha
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, 02841, Republic of Korea
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Se Yeon Choi
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Seung-Woon Rha
- BK21 Graduate Program, Department of Biomedical Sciences, Korea University College of Medicine, Seoul, 02841, Republic of Korea.
| | - Byoung Geol Choi
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Jae Kyeong Byun
- Cardiovascular Research Institution, Korea University College of Medicine, Seoul, 02841, Republic of Korea
| | - Sujin Hyun
- Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Seoul, 02841, Republic of Korea
| | - Min Woo Lee
- Research Institute of Health Science, Korea University, Seoul, 02841, Republic of Korea
| | - Jaeho Kang
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Wonsang Chu
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Eun Jin Park
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Dong Oh Kang
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Cheol Ung Choi
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea
| | - Suhng Wook Kim
- School of Health and Environmental Science, College of Health Sciences, Korea University, Seoul, 02841, Republic of Korea
| | - Myung Ho Jeong
- Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju, 61469, Republic of Korea
| | - Soohyung Park
- Department of Cardiology, Cardiovascular Center, Guro Hospital, Korea University College of Medicine, Seoul, 08308, Republic of Korea.
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Narang M, Saxena A, Kaur R, Gopa HR, West NEJ. Variability in research culture across busy catheterisation labs in the Asia-Pacific region. ASIAINTERVENTION 2024; 10:26-33. [PMID: 38425813 PMCID: PMC10900241 DOI: 10.4244/aij-d-23-00005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 07/11/2023] [Indexed: 03/02/2024]
Abstract
Background Information related to research culture in the busy catheterisation (cath) labs across the Asia-Pacific (APAC) region is sparse. Aims The aims of this study were to examine the variability in research culture in busy cath labs in the APAC region and to propose a roadmap for hospitals to develop in-house research capabilities in conjunction with industry and academia. Methods Data related to research practices in the APAC region were collected from busy cath labs (at least 250 angioplasty/year) and analysed. Results were shared with research experts to understand the challenges in institutional research and create a roadmap for hospitals to develop research capabilities. Results A total of 220 respondents from 62 cath labs (88.6%) across 13 APAC countries participated in the survey. A wide variation was noted in research culture across APAC countries. Well-established infrastructure was reported in Australia, New Zealand, South Korea, Singapore, and Japan. Large multicentre trials were common in South Korea, while routine follow-ups were common in Japan. Linking medical records across hospitals/states was considered challenging. Research exposure and training were limited in the APAC region. The experts suggested a roadmap, including creating a conducive regulatory environment, forming synergistic goals, training programs for the professionals involved in research, and leveraging best practices, for improving the research culture in APAC. Conclusions Clinical research in cardiology has grown significantly in the APAC region, with a huge research potential in China and India. Implementing measures to improve research training and involvement of the industry will boost the research culture in the APAC region.
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Affiliation(s)
- Manish Narang
- Department of Medical Affairs, Abbott Vascular, Abbott Healthcare Pvt Ltd, New Delhi, India
| | - Aseem Saxena
- Department of Medical Affairs, Abbott Vascular, Abbott Healthcare Pvt Ltd, New Delhi, India
| | - Ramneek Kaur
- Department of Medical Affairs, Abbott Vascular, Abbott Healthcare Pvt Ltd, New Delhi, India
| | | | - Nick E J West
- Global Medical Affairs, Abbott Vascular, Santa Clara, CA, USA
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Poon DMC, Tan GM, Chan K, Chan MTY, Chan TW, Kan RWM, Lam MHC, Leung CLH, Wong KCW, Kam KKH, Ng CF, Chiu PKF. Addressing the risk and management of cardiometabolic complications in prostate cancer patients on androgen deprivation therapy and androgen receptor axis-targeted therapy: consensus statements from the Hong Kong Urological Association and the Hong Kong Society of Uro-Oncology. Front Oncol 2024; 14:1345322. [PMID: 38357197 PMCID: PMC10864500 DOI: 10.3389/fonc.2024.1345322] [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: 11/27/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background Androgen deprivation therapy (ADT) is the foundational treatment for metastatic prostate cancer (PCa). Androgen receptor (AR) axis-targeted therapies are a new standard of care for advanced PCa. Although these agents have significantly improved patient survival, the suppression of testosterone is associated with an increased risk of cardiometabolic syndrome. This highlights the urgency of multidisciplinary efforts to address the cardiometabolic risk of anticancer treatment in men with PCa. Methods Two professional organizations invited five urologists, five clinical oncologists, and two cardiologists to form a consensus panel. They reviewed the relevant literature obtained by searching PubMed for the publication period from April 2013 to April 2023, to address three discussion areas: (i) baseline assessment and screening for risk factors in PCa patients before the initiation of ADT and AR axis-targeted therapies; (ii) follow-up and management of cardiometabolic complications; and (iii) selection of ADT agents among high-risk patients. The panel convened four meetings to discuss and draft consensus statements using a modified Delphi method. Each drafted statement was anonymously voted on by every panelist. Results The panel reached a consensus on 18 statements based on recent evidence and expert insights. Conclusion These consensus statements serve as a practical recommendation for clinicians in Hong Kong, and possibly the Asia-Pacific region, in the management of cardiometabolic toxicities of ADT or AR axis-targeted therapies in men with PCa.
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Affiliation(s)
- Darren M. C. Poon
- Department of Clinical Oncology, State Key Laboratory of Translational Oncology, Sir YK Pao Centre for Cancer, Hong Kong Cancer Institute, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Comprehensive Oncology Centre, Hong Kong Sanatorium and Hospital, Hong Kong, Hong Kong SAR, China
| | - Guang-Ming Tan
- Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kuen Chan
- Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, Hong Kong SAR, China
| | - Marco T. Y. Chan
- Division of Urology, Department of Surgery, Tuen Mun Hospital, Hong Kong, Hong Kong SAR, China
| | - Tim-Wai Chan
- Department of Clinical Oncology, Queen Elizabeth Hospital, Hong Kong, Hong Kong SAR, China
| | | | - Martin H. C. Lam
- Hong Kong Integrated Oncology Centre, Hong Kong, Hong Kong SAR, China
| | | | - Kenneth C. W. Wong
- Department of Clinical Oncology, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kevin K. H. Kam
- Division of Cardiology, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Peter K. F. Chiu
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Homroy S, Chopra R, Singh PK, Dhiman A, Chand M, Talwar B. Role of encapsulation on the bioavailability of omega-3 fatty acids. Compr Rev Food Sci Food Saf 2024; 23:e13272. [PMID: 38284597 DOI: 10.1111/1541-4337.13272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Revised: 10/21/2023] [Accepted: 10/29/2023] [Indexed: 01/30/2024]
Abstract
Omega-3 fatty acids (omega-3 FAs) have been widely recognized for their therapeutic advantages, including anti-inflammatory and cardioprotective properties. They have shown promise in enhancing regulatory function, promotingdevelopment and mitigating the progression of diabetes and cancer. The scientific communities, along with industries, are actively endorsing initiatives aimed at increasing the daily intake of lipids rich in omega-3 FAs. Nevertheless, incorporating polyunsaturated FAs (PUFAs) into food products poses several challenges due to their susceptibility to oxidation when exposed to oxygen, high temperatures, and moisture. This oxidative deterioration results in undesirable flavours and a loss of nutritional value. Various methods, including physical blending, interesterification, and encapsulation, have been utilized as ways to enhance the stability of edible oils rich in PUFA against oxidation. Encapsulation has emerged as a proven strategy for enhancing the oxidative stability and functional properties of omega-3 FA-rich oils. Multiple encapsulation methods have been developed to stabilize and improve the delivery of omega-3 FAs in food products. The selection of an appropriate encapsulation method depends on the desired application of the encapsulated oil. In addition, encapsulation enhances the bioavailability of omega-3 FAs by promoting increased absorption of the encapsulated form in the intestinal epithelium. This review discusses the techniques and principles of omega-3 FA-rich oil encapsulation and its role in improving stability and bioavailability. Furthermore, it also investigates the potential health benefits of these encapsulated oils. This review explores the variations in bioavailability based on encapsulation techniques and processing, offering vital insights for nutrition and product development.
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Affiliation(s)
- Snigdha Homroy
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
| | - Rajni Chopra
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
| | - Priyanka Kumari Singh
- Department of Food and Nutrition & Food Technology, Institute of Home Economics, University of Delhi, Delhi, India
| | - Aishwarya Dhiman
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
| | - Monika Chand
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
| | - Binanshu Talwar
- Department of Food Science and Technology, National Institute of Food Technology Entrepreneurship and Management, Kundli, Haryana, India
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Liu T, Zhao X, Huang M, Yang Y, Chen Z, He X, Li X, Jiang W. Hypertension doctors' awareness and practice of medication adherence in hypertensive patients: a questionnaire-based survey. PeerJ 2023; 11:e16384. [PMID: 38047018 PMCID: PMC10693237 DOI: 10.7717/peerj.16384] [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: 11/17/2022] [Accepted: 10/10/2023] [Indexed: 12/05/2023] Open
Abstract
Background Poor adherence to antihypertensive drugs is a major cause of unsatisfactory blood pressure control. Hypertension doctors play an integral role in improving medication adherence in hypertensive patients. Although most existing studies have recognized the status quo and influencing factors of medication adherence, little attention has been paid to hypertension doctors' awareness and practice in hypertension management. Therefore, in this study, we aimed to investigate hypertension doctors' awareness and practice of medication adherence in hypertensive patients. Methods This is a cross-sectional survey. A self-reported questionnaire was developed and sent to hypertension doctors in Hunan province, China, between May 1, 2022 and July 1, 2022. Univariate and generalized linear models were used to identify the factors influencing hypertension doctors' awareness and practice. The correlation between awareness and practice was determined using Spearman's correlation coefficient. Results In total, 236 valid questionnaires were collected (valid response rate, 73.5%). Of the respondents, 44.1% were chief physicians and 64.4% were females. Approximately half of the respondents were ≥40 years old and had over 14 years of working experience. Most respondents (87.7%) did not have hypertension, but 54.2% had a family history of hypertension. The average awareness and practice scores were 29.8 ± 8.8 and 39.4 ± 7.1, respectively, out of 50, with higher scores indicating higher levels of awareness or practice. More hypertension consultations and more antihypertensive prescriptions issued were associated with better awareness and practice among respondents (ps < 0.05). Respondents with higher education and professional titles had higher awareness (ps < 0.05). Moreover, respondents with 6-13 years of work experience had better practice than those with <5 years of work experience (p = 0.017). There was a significant correlation between hypertension doctors' awareness and practice of medication adherence in hypertensive patients (R = 0.682, p < 0.001). These findings indicate that misconceptions persist in hypertension doctors' awareness and practice of patient medication adherence. Conclusion Hypertension doctors lack sufficient and correct awareness and practice of medication adherence in hypertensive patients.
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Affiliation(s)
- Tao Liu
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiexiong Zhao
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Miao Huang
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Yang
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Zhi Chen
- Department of Cardiovascular Medicine, Xingsha hospital, Changsha, Hunan, China
| | - Xin He
- Department of Cardiovascular Medicine, The People’s Hospital of Liuyang, Changsha, Hunan, China
| | - Xiaogang Li
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weihong Jiang
- Department of Cardiovascular Medicine, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
- Hypertension Research Center of Hunan Province, Hunan, China (Mainland)
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Lee GB, Nam GE, Kim W, Han B, Cho KH, Kim SM, Choi YS, Kim DH, Park Y, Jung J, Han K, Kim Y. Association Between Premature Menopause and Cardiovascular Diseases and All-Cause Mortality in Korean Women. J Am Heart Assoc 2023; 12:e030117. [PMID: 37947103 PMCID: PMC10727283 DOI: 10.1161/jaha.123.030117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Accepted: 09/26/2023] [Indexed: 11/12/2023]
Abstract
Background Mortality from cardiovascular diseases in Asian populations is considerable. Menopause is a risk-enhancing factor for cardiovascular disease, but it is unclear whether menopause is an independent risk factor for cardiovascular disease and mortality in Asian women. Methods and Results A total of 1 159 405 postmenopausal women, who had participated in the health examinations of the Korean National Health Insurance Service in 2009, were analyzed, and their reproductive histories were taken. A multivariable Cox proportional hazard model assessed the hazard ratios (HRs) of myocardial infarction (MI), ischemic stroke, and all-cause mortality, according to the history of premature menopause and age at menopause. After an average 10-year follow-up, there were 31 606, 45 052, and 77 680 new cases of MI, ischemic stroke, and all-cause mortality, respectively. The women with premature menopause exhibited increased risks of MI (HR, 1.40 [95% CI, 1.31-1.50]), ischemic stroke (HR, 1.24 [95% CI, 1.17-1.31]), and all-cause mortality (HR, 1.19 [95% CI, 1.14-1.24]) when compared with women with menopause aged ≥50 years. The highest risk was evident with menopause between the ages of 30 and 34 years (HR for MI, 1.52 [95% CI, 1.30-1.78]; HR for ischemic stroke, 1.29 [95% CI, 1.12-1.48]; HR for all-cause mortality, 1.33 [95% CI, 1.20-1.47]) when compared with women with menopause aged ≥50 years. Conclusions Earlier age at menopause was associated with increased risks for MI, ischemic stroke, and all-cause mortality. Future guidelines and risk assessment tools should consider menopause as an independent risk factor of cardiovascular disease in Korean women.
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Affiliation(s)
- Gyu Bae Lee
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Ga Eun Nam
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Wonsock Kim
- Department of Family MedicineUijeongbu Eulji Medical CenterUijeongbuKorea
| | - Byoungduck Han
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Kyung Hwan Cho
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Seon Mee Kim
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Youn Seon Choi
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Do Hoon Kim
- Department of Family MedicineKorea University College of MedicineSeoulKorea
| | - Yong‐Gyu Park
- Department of Medical StatisticsCatholic University College of MedicineSeoulKorea
| | - Jin‐Hyung Jung
- Samsung Biomedical Research Institute, Sungkyunkwan University School of MedicineSuwonKorea
| | - Kyungdo Han
- Department of Statistics and Actuarial ScienceSoongsil UniversitySeoulKorea
| | - Yang‐Hyun Kim
- Department of Family MedicineKorea University College of MedicineSeoulKorea
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Nguyen TPL, Rokhman MR, Stiensma I, Hanifa RS, Ong TD, Postma MJ, van der Schans J. Cost-effectiveness of non-communicable disease prevention in Southeast Asia: a scoping review. Front Public Health 2023; 11:1206213. [PMID: 38026322 PMCID: PMC10666286 DOI: 10.3389/fpubh.2023.1206213] [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: 04/15/2023] [Accepted: 09/25/2023] [Indexed: 12/01/2023] Open
Abstract
Background Cost-effectiveness analyses (CEAs) on prevention of non-communicable diseases (NCDs) are necessary to guide decision makers to allocate scarce healthcare resource, especially in Southeast Asia (SEA), where many low- and middle-income countries (LMICs) are in the process of scaling-up preventive interventions. This scoping review aims to summarize the cost-effectiveness evidence of primary, secondary, or tertiary prevention of type 2 diabetes mellitus (T2DM) and cardiovascular diseases (CVDs) as well as of major NCDs risk factors in SEA. Methods A scoping review was done following the PRISMA checklist for Scoping Reviews. Systematic searches were performed on Cochrane Library, EconLit, PubMed, and Web of Science to identify CEAs which focused on primary, secondary, or tertiary prevention of T2DM, CVDs and major NCDs risk factors with the focus on primary health-care facilities and clinics and conducted in SEA LMICs. Risks of bias of included studies was assessed using the Consensus of Health Economic Criteria list. Results This study included 42 CEAs. The interventions ranged from screening and targeting specific groups for T2DM and CVDs to smoking cessation programs, discouragement of smoking or unhealthy diet through taxation, or health education. Most CEAs were model-based and compared to a do-nothing scenario. In CEAs related to tobacco use prevention, the cost-effectiveness of tax increase was confirmed in all related CEAs. Unhealthy diet prevention, mass media campaigns, salt-reduction strategies, and tax increases on sugar-sweetened beverages were shown to be cost-effective in several settings. CVD prevention and treatment of hypertension were found to be the most cost-effective interventions. Regarding T2DM prevention, all assessed screening strategies were cost-effective or even cost-saving, and a few strategies to prevent T2DM complications were found to be cost-effective in certain settings. Conclusion This review shows that the cost-effectiveness of preventive strategies in SEA against T2DM, CVDs, and their major NCDs risk factors are heterogenous in both methodology as well as outcome. This review combined with the WHO "best buys" could guide LMICs in SEA in possible interventions to be considered for implementation and upscaling. However, updated and country-specific information is needed to further assess the prioritization of the different healthcare interventions. Systematic review registration https://osf.io, identifier: 10.17605/OSF.IO/NPEHT.
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Affiliation(s)
- Thi-Phuong-Lan Nguyen
- Faculty of Public Health, Thai Nguyen University of Medicine and Pharmacy, Thái Nguyên, Vietnam
| | - M. Rifqi Rokhman
- Unit of Global Health, Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands
- Faculty of Pharmacy, Universitas Gadjah Mada, Groningen, Indonesia
| | - Imre Stiensma
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Rachmadianti Sukma Hanifa
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - The Due Ong
- Department of Health Financing and Health Technology Assessment, Health Strategy and Policy Institute, Hanoi, Vietnam
| | - Maarten J. Postma
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Centre of Excellence in Higher Education for Pharmaceutical Care Innovation, Universitas Padjadjaran, Bandung, Indonesia
- Department of Economics, Econometrics, and Finance, University of Groningen, Groningen, Netherlands
| | - Jurjen van der Schans
- Unit of Global Health, Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
- Department of Economics, Econometrics and Finance, Faculty of Economics and Business, University of Groningen, Groningen, Netherlands
- Faculty of Management Sciences, Open University, Heerlen, Netherlands
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Pasdar Y, Moradi F, Cheshmeh S, Sedighi M, Saber A, Moradi S, Bonyani M, Najafi F. Major dietary patterns and dietary inflammatory index in relation to dyslipidemia using cross-sectional results from the RaNCD cohort study. Sci Rep 2023; 13:19075. [PMID: 37925569 PMCID: PMC10625524 DOI: 10.1038/s41598-023-46447-8] [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: 02/08/2023] [Accepted: 11/01/2023] [Indexed: 11/06/2023] Open
Abstract
Dyslipidemia can increase the risk of heart attack and stroke due to the restriction of blood flow through the blood vessels. Dietary modification is an appropriate approach to reducing this phenomenon. This cross-sectional study aimed to evaluate major dietary patterns and the dietary inflammatory index (DII) in relation to dyslipidemia. 5954 participants in the Ravansar non-communicable diseases (RaNCD) cohort study were eligible for this study. Dyslipidemia was diagnosed based on the lipid profile under consideration of the RaNCD physician. Dietary patterns were assessed by principal component analysis. The three identified dietary patterns included (1) plant-based pattern; (2) high protein and sugar pattern; and (3) energy-dense dense pattern. DII was also calculated based on the dietary information from a validated semi-quantitative food frequency questionnaire (FFQ). We found that higher adherence to DII was significantly associated with increased odds of dyslipidemia after adjusting for age, sex, and physical activity (OR: 1.24; CI 95% 1.09-1.42). Additionally, higher adherence to the high protein and sugar diet and an energy-dense diet was significantly associated with higher odds for dyslipidemia (OR: 1.31; CI 95% 1.16-1.49) and (OR: 1.28; CI 95% 1.12-1.46). Nevertheless, according to our results, following plant-based diet had no association with dyslipidemia in both crude and adjusted models. Our findings revealed that greater adherence to DII, a high-protein, high-sugar diet, and an energy-dense diet can have undesirable effects on dyslipidemia.
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Affiliation(s)
- Yahya Pasdar
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Fardin Moradi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sahar Cheshmeh
- Molecular and Experimental Nutritional Medicine Department, University of Potsdam, Nuthetal, Germany
| | - Mohammad Sedighi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Amir Saber
- Department of Nutrition Sciences, Research Center for Environmental Determinants of Health (RCEDH), Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shima Moradi
- Student Research Committee, School of Nutritional Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Mitra Bonyani
- Medical Education Development Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health (RCEDH), Kermanshah University of Medical Sciences, Kermanshah, Iran
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Wahid A, Wen J, Yang Q, Zhang Z, Zhao X, Tang X. Serum HMGB1 is a biomarker for acute myocardial infarction with or without heart failure. Clin Transl Sci 2023; 16:2299-2309. [PMID: 37775976 PMCID: PMC10651663 DOI: 10.1111/cts.13630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/25/2023] [Accepted: 08/23/2023] [Indexed: 10/01/2023] Open
Abstract
This study measured serum high mobility group box 1 (HMGB1) levels in patients with acute myocardial infarction (AMI) and/or heart failure (HF) and evaluated their relationship with peripheral inflammatory biomarkers and cardiac biomarkers, which have not been reported before. Of the patients, 55 had AMI without HF (AMI-HF ), 42 had AMI with HF (AMI+HF ), and 60 had HF without AMI (HF-AMI ) compared with 50 healthy controls. Blood samples were collected to assess serum HMGB1 levels and blood test-related inflammatory biomarkers (e.g., erythrocyte sedimentation rate [ESR], hs-CRP, uric acid, and white blood cell count) and cardiac biomarkers (e.g., MYO, cTnI, CKMB, CK, NT-proBNP, LDH, aspartate aminotransferase [AST], and alanine aminotransferase [ALT]). Compared to healthy controls, three groups of patients, especially those with AMI+HF , had significantly higher levels of serum HMGB1. All tested inflammatory biomarkers (except uric acid) were significantly positively correlated with HMGB1 in patients with AMI patients but not in patients with non-AMI. In addition, all tested cardiac biomarkers (except NT-proBNP in AMI-HF ) were significantly higher in patients with AMI than in control individuals. The levels of MYO, cTnI, CKMB, CK, AST, and ALT were not significantly changed in patients with HF-AMI compared to control individuals, but were still much lower than those in patients with AMI (except ALT). In all patients, the levels of NT-proBNP, and cTnI were significantly correlated with HMGB1 levels. Except for MYO, LDH, AST, and ALT, all cardiac biomarkers in AMI-HF and AMI+HF showed a significant correlation with HMGB1. Among risk factors, hypertension, diabetes, previous heart disease, and reduced left ventricular ejection fraction showed a significant correlation with HMGB1 in all disease groups.
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Affiliation(s)
- Abdul Wahid
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Juan Wen
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Qiong Yang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Zhihui Zhang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Xiexiong Zhao
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
| | - Xiaohong Tang
- Department of Cardiology of the Third Xiang‐Ya HospitalCentral South UniversityChangshaHunanChina
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Bhattacharya S, Kalra S. ADA-EASD Consensus Report on the Management of Hyperglycaemia in Type 2 Diabetes in an Afro-Asian Context: Broadening the Perspective. TOUCHREVIEWS IN ENDOCRINOLOGY 2023; 19:4-6. [PMID: 38187081 PMCID: PMC10769473 DOI: 10.17925/ee.2023.19.2.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 03/16/2023] [Indexed: 01/09/2024]
Abstract
The American Diabetes Association and the European Association for the Study of Diabetes consensus statement 2022 effectively captures the changing paradigm of modern diabetes care. As emphasized in the guidelines, a person-centered decision cycle focusing on preventing complications and improving quality of life is the driving principle behind modern diabetes management. Other notable features of the document are its emphasis on self-management education, therapeutic behaviour, sleep hygiene, nonalcoholic fatty liver disease and weight loss. Focus on individualization of care, social determinants of health, and ethnic variations are pertinent from an Afro-Asian perspective. The "language matters" section is a welcome addition that will help to overcome several barriers in diabetes care.
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Affiliation(s)
| | - Sanjay Kalra
- Department of Endocrinology, Bharti Hospital, Karnal, India
- University Center for Research & Development, Chandigarh University, Mohali, Punjab, India
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Ciofani JL, Han D, Allahwala UK, Woolf B, Gill D, Bhindi R. Lipids, Blood Pressure, and Diabetes Mellitus on Risk of Cardiovascular Diseases in East Asians: A Mendelian Randomization Study. Am J Cardiol 2023; 205:329-337. [PMID: 37633070 PMCID: PMC7615095 DOI: 10.1016/j.amjcard.2023.08.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
Elevated blood pressure, dyslipidemia, and impaired glycemic control are well-established cardiovascular risk factors in Europeans, but there are comparatively few studies focused on East Asian populations. This study evaluated the potential causal relations between traditional cardiovascular risk factors and disease risk in East Asians through a 2-sample Mendelian randomization approach. We collected summary statistics for blood pressure parameters, lipid subsets, and type 2 diabetes mellitus liability from large genome-wide association study meta-analyses conducted in East Asians and Europeans. These were paired with summary statistics for ischemic heart disease (IHD), ischemic stroke (IS), peripheral vascular disease, heart failure (HF) and atrial fibrillation (AF). We performed univariable Mendelian randomization analyses for each exposure-outcome pair, followed by multivariable analyses for the available lipid subsets. The genetically predicted risk factors associated with IHD and AF were similar between East Asians and Europeans. However, in East Asians only genetically predicted elevated blood pressure was significantly associated with IS (odds ratio 1.05, 95% confidence interval 1.04 to 1.06, p <0.0001) and HF (odds ratio 1.05, 95% confidence interval 1.04 to 1.06, p <0.0001), whereas nearly all genetically predicted risk factors were significantly associated with IS and HF in Europeans. In conclusion, this study provides supportive evidence for similar causal relations between traditional cardiovascular risk factors and IHD and AF in both East Asian and European ancestry populations. However, the identified risk factors for IS and HF differed between East Asians and Europeans, potentially highlighting distinct disease etiologies between these populations.
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Affiliation(s)
- Jonathan L Ciofani
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Daniel Han
- Medical Research Council Laboratory of Molecular Biology, Cambridge, United Kingdom; Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Usaid K Allahwala
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin Woolf
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; School of Psychological Science, University of Bristol, Bristol, United Kingdom; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Chief Scientific Advisor Office, Novo Nordisk, Copenhagen, Denmark
| | - Ravinay Bhindi
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Wong LP, Alias H, Tan KM, Wong PF, Murugan DD, Hu Z, Lin Y. Exploring the perspectives of pharmaceutical experts and healthcare practitioners on senolytic drugs for vascular aging-related disorder: a qualitative study. Front Pharmacol 2023; 14:1254470. [PMID: 37869747 PMCID: PMC10587464 DOI: 10.3389/fphar.2023.1254470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 09/25/2023] [Indexed: 10/24/2023] Open
Abstract
Objective: The field of targeting cellular senescence with drug candidates to address age-related comorbidities has witnessed a notable surge of interest and research and development. This study aimed to gather valuable insights from pharmaceutical experts and healthcare practitioners regarding the potential and challenges of translating senolytic drugs for treatment of vascular aging-related disorders. Methods: This study employed a qualitative approach by conducting in-depth interviews with healthcare practitioners and pharmaceutical experts. Participants were selected through purposeful sampling. Thematic analysis was used to identify themes from the interview transcripts. Results: A total of six individuals were interviewed, with three being pharmaceutical experts and the remaining three healthcare practitioners. The significant global burden of cardiovascular diseases presents a potentially large market size that offer an opportunity for the development and marketability of novel senolytic drugs. The pharmaceutical sector demonstrates a positive inclination towards the commercialization of new senolytic drugs targeting vascular aging-related disorders. However potential important concerns have been raised, and these include increasing specificity toward senescent cells to prevent off-site targeting, thus ensuring the safety and efficacy of these drugs. In addition, novel senolytic therapy for vascular aging-related disorders may encounter competition from existing drugs that treat or manage risk factors of cardiovascular diseases. Healthcare practitioners are also in favor of recommending the novel senolytic drugs for vascular aging-related disorders but cautioned that its high cost may hinder its acceptance among patients. Besides sharing the same outcome-related concerns as with the pharmaceutical experts, healthcare practitioners anticipated a lack of awareness among the general public regarding the concept of targeting cellular senescence to delay vascular aging-related disorders, and this knowledge gap extends to healthcare practitioner themselves as well. Conclusion: Senolytic therapy for vascular aging-related disorders holds great promise, provided that crucial concerns surrounding its outcomes and commercial hurdles are effectively addressed.
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Affiliation(s)
- Li Ping Wong
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Haridah Alias
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Kit Mun Tan
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Pooi Fong Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Dharmani Devi Murugan
- Department of Pharmacology, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Zhijian Hu
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
| | - Yulan Lin
- Department of Epidemiology and Health Statistics, The School of Public Health, Fujian Medical University, Fuzhou, Fujian, China
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Momayyezi M, Sefidkar R, Fallahzadeh H. Agreement between ten-years cardiovascular disease risk assessment tools: An application to Iranian population in Shahedieh Cohort Study. Heliyon 2023; 9:e20396. [PMID: 37810856 PMCID: PMC10556586 DOI: 10.1016/j.heliyon.2023.e20396] [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: 05/17/2023] [Revised: 09/20/2023] [Accepted: 09/21/2023] [Indexed: 10/10/2023] Open
Abstract
Background and aim Cardiovascular risk-prediction models are efficient primary prevention tools to detect high-risk individuals. The study aims to use three tools to estimate the 10-year risk of developing cardiovascular disease (CVD) and investigate their agreement in an Iranian adult population. Methods The current cross-sectional study was carried out on 8569 adults between 35 and 70 who participated in the first phase of the Shahedieh cohort study in Yazd, Iran, and were free of CVDs (cardiac ischemia or myocardial infarction or stroke). World Health Organization/International Society of Hypertension (WHO/ISH) chart, Laboratory-Based (LB) and Non-Laboratory-Based (NLB) Framingham Risk Score (FRS) were used to predict the 10-year risk of developing CVD. The agreement across tools was determined by Kappa. Results WHO/ISH chart indicated the highest prevalence of low CVD risk for males (96.10%) and females (96.50%), while NLB Framingham had the highest prevalence of high CVD risk for males (19.40%) and females (5.30%). In total, there was substantial agreement between both FRS models (Kappa = o.70), while there was a slight agreement between WHO/ISH and both FRS tools. For under 60 years males and females, substantial agreements were observed between FRS methods (kappa = 0.73 and kappa = 0.68). For males and females over 60 years, this agreement was moderate and substantial, respectively (kappa = 0.54 and kappa = 0.64). WHO/ISH and LB Framingham model had substantial agreement for over 60 years females (kappa = 0.61). Conclusions Framingham models classified more participants in the high-risk category than WHO/ISH. Due to the lethality of CVDs, categorizing individuals based on FRS can ensure that most of the real high-risk people are detected. Remarkable agreement between FRS methods in all sex-age groups suggested using the NLB Framingham model as a primary screening tool, especially in a shortage of resources condition.
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Affiliation(s)
- Mahdieh Momayyezi
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Reyhane Sefidkar
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Hossein Fallahzadeh
- Center for Healthcare Data Modeling, Departments of Biostatistics and Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Muneeb M, Nuzhat N, Khan Niazi A, Khan AH, Chatha Z, Kazmi T, Farhat S. Assessment of the Dimensions of Coronary Arteries for the Manifestation of Coronary Artery Disease. Cureus 2023; 15:e46606. [PMID: 37937019 PMCID: PMC10625989 DOI: 10.7759/cureus.46606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/06/2023] [Indexed: 11/09/2023] Open
Abstract
INTRODUCTION The size of the coronary artery influences the effective outcome of therapeutic measures like coronary artery bypass graft (CABG) surgery, percutaneous coronary interventions (PCI), and diagnosis of coronary artery disease. Patients' age, gender, BMI, anatomical variations, and increased left ventricular size all have an effect on coronary artery parameters. OBJECTIVE This study aims to compare the average size of the coronary arteries of the Pakistani population in both sexes for manifestation of coronary artery disease. METHODOLOGY For the analysis of the coronary arteries, 100 patients of both sexes, male and female, were taken. X-ray angiography was performed for two-dimensional images of coronary arteries. For diameter measurement, images were visualized on quantitative coronary angiography (QCA) in different views (caudal and cranial views). The diameters of the left main coronary artery (left main stem/LMS), left anterior descending (LAD), left circumflex (LCx), and right coronary artery (RCA) were measured on angiograms. Data about the dimensions of the coronary artery was gathered through quantitative angiography. Data analysis was done through SPSS version 26 (IBM Corp., Armonk, NY). RESULTS There is a notable distinction in the average diameters among the proximal LAD (3.12), mid-LAD (2.40), and distal LAD (1.29). A statistically significant difference is evident among mid-LCx, distal LCx, and proximal LCx (p-value < 0.001). Likewise, the average diameter of the distal RCA (1.89) was smaller when compared to the mid-RCA (3.19) and proximal RCA (3.78). However, there was no significant difference in the average diameter among mid-LMS, distal LMS, and proximal LMS (p-value = 0.09). CONCLUSION The average diameter of distal RCA was smaller when compared to mid-RCA and proximal RCA. The average size of proximal LAD and proximal LCx was comparatively larger than mid- and distal LAD and LCx. The findings of current research will be beneficial for the diagnosis and management of coronary artery disease patients.
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Affiliation(s)
- Muhammad Muneeb
- Interventional Cardiology, Shalamar Medical and Dental College, Lahore, PAK
| | - Nasia Nuzhat
- Applied Physics, University of Engineering and Technology, Lahore, PAK
| | | | - Ammar H Khan
- Cardiovascular Surgery, Imran Idrees Hospital, Sialkot, PAK
| | - Zanib Chatha
- Interventional Cardiology, Shalamar Medical and Dental College, Lahore, PAK
| | - Tahseen Kazmi
- Community Medicine, Central Park Medical College, Lahore, PAK
| | - Saira Farhat
- Community Medicine, Central Park Medical College, Lahore, PAK
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Jiang MC, Ding HY, Huang YH, Cheng CK, Lau CW, Xia Y, Yao XQ, Wang L, Huang Y. Thioridazine protects against disturbed flow-induced atherosclerosis by inhibiting RhoA/YAP-mediated endothelial inflammation. Acta Pharmacol Sin 2023; 44:1977-1988. [PMID: 37217602 PMCID: PMC10545737 DOI: 10.1038/s41401-023-01102-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 04/27/2023] [Indexed: 05/24/2023] Open
Abstract
Atherosclerotic diseases remain the leading cause of adult mortality and impose heavy burdens on health systems globally. Our previous study found that disturbed flow enhanced YAP activity to provoke endothelial activation and atherosclerosis, and targeting YAP alleviated endothelial inflammation and atherogenesis. Therefore, we established a luciferase reporter assay-based drug screening platform to seek out new YAP inhibitors for anti-atherosclerotic treatment. By screening the FDA-approved drug library, we identified that an anti-psychotic drug thioridazine markedly suppressed YAP activity in human endothelial cells. Thioridazine inhibited disturbed flow-induced endothelial inflammatory response in vivo and in vitro. We verified that the anti-inflammatory effects of thioridazine were mediated by inhibition of YAP. Thioridazine regulated YAP activity via restraining RhoA. Moreover, administration of thioridazine attenuated partial carotid ligation- and western diet-induced atherosclerosis in two mouse models. Overall, this work opens up the possibility of repurposing thioridazine for intervention of atherosclerotic diseases. This study also shed light on the underlying mechanisms that thioridazine inhibited endothelial activation and atherogenesis via repression of RhoA-YAP axis. As a new YAP inhibitor, thioridazine might need further investigation and development for the treatment of atherosclerotic diseases in clinical practice.
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Affiliation(s)
- Min-Chun Jiang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Huan-Yu Ding
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yu-Hong Huang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Chak Kwong Cheng
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Chi Wai Lau
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Yin Xia
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Xiao-Qiang Yao
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China
| | - Li Wang
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Yu Huang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China.
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Chen Q, Wu W, Wang K, Han Z, Yang C. Methods for detecting of cardiac troponin I biomarkers for myocardial infarction using biosensors: a narrative review of recent research. J Thorac Dis 2023; 15:5112-5121. [PMID: 37868839 PMCID: PMC10586976 DOI: 10.21037/jtd-23-1263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 09/14/2023] [Indexed: 10/24/2023]
Abstract
Background and Objective In cardiovascular diseases (CVDs), acute myocardial infarction (AMI) is considered one of the leading causes of human death, and its diagnosis mainly relies on the detection of the cardiac biomarker troponin I. Traditional detection methods have certain limitations, which has prompted the development of methods with higher sensitivity and specificity. In recent years, biosensors, as an emerging technology, have been widely applied in the clinical medicine and biodetection fields. We retrieved and reviewed relevant articles published over the past 3 years and subsequently summarized the research progress of different types of biosensors in detecting cardiac troponin I and the challenges faced in achieving simple, specific, and portable point-of-care testing (POCT) technology for bedside rapid detection. The aim of this review is to serve as reference for the early diagnosis and treatment of CVDs. Methods This study searched for relevant literature published from 2019 to 2022 in the PubMed database of the National Center for Biotechnology Information (NCBI). The keywords used were as follows: "cardiac troponin I", "biosensor", "point-of-care testing", "electrochemical detection", and "surface-enhanced Raman spectroscopy". Key Content and Findings The review found that biosensor technology has high specificity and sensitivity in the detection of cardiac troponin I and is simpler and more convenient than is traditional laboratory testing. Its vigorous development can facilitate the diagnosis of AMI earlier and faster. Conclusions This study reviewed the progress of cardiac troponin I detection based on biosensing strategies. We found that cardiac troponin I detection methods based on biosensing strategies have their own advantages and disadvantages in clinical applications, and their sensitivity has been constantly improved. In the future, the detection of cardiac troponin I using biosensing technology will be simpler, faster, more sensitive, and portable.
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Affiliation(s)
- Qingzhuo Chen
- Department of Cardiology, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Wuxi, China
| | - Wenxin Wu
- Department of Laboratory Medicine, Jiangnan University Medical Center, Wuxi, China
| | - Ke Wang
- National Key Laboratory of Radiopharmaceuticals, Jiangsu Key Laboratory of Molecular Nuclear Medicine, Jiangsu Institute of Nuclear Medicine, National Health Commission, Wuxi, China
- Department of Radiopharmaceuticals, School of Pharmacy, Nanjing Medical University, Nanjing, China
| | - Zhijun Han
- Department of Clinical Research Center, Jiangnan University Medical Center, Wuxi, China
| | - Chengjian Yang
- Department of Cardiology, The Affiliated Wuxi No. 2 People’s Hospital of Nanjing Medical University, Wuxi, China
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Sadeghi R, Haji Aghajani M, Parandin R, Taherpour N, Ahmadzadeh K, Sarveazad A. Leuko-Glycemic Index in the Prognosis of Acute Myocardial Infarction; a Cohort Study on Coronary Angiography and Angioplasty Registry. ARCHIVES OF ACADEMIC EMERGENCY MEDICINE 2023; 11:e63. [PMID: 37840868 PMCID: PMC10568944 DOI: 10.22037/aaem.v11i1.2085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
Introduction The leuko-glycemic index (LGI), a combined index of patient leukocyte counts and blood glucose levels, has been shown to predict the prognosis of myocardial infarction (MI) patients. Our study aims to investigate the performance of LGI in prediction of outcomes in a population of diabetic and non-diabetic MI patients. Methods This observational registry-based cohort study was performed on acute myocardial infarction (AMI) patients. Participants were sub-grouped according to their diabetes status and the calculated optimal LGI cut-off value. The outcomes of the study were the length of hospital stay, and in-hospital and 30-day mortality. Results A total of 296 AMI (112 diabetic and 184 non-diabetic) patients were included in the study. The optimal cut-off value of LGI in the diabetic and non-diabetic groups was calculated as 2970.4 mg/dl.mm3 and 2249.4 mg/dl.mm3, respectively. High LGI was associated with increased hospital admission duration in non-diabetic patients (p = 0.017). The area under the curve (AUC) of LGI for prediction of in-hospital mortality was 0.93 (95% CI: 0.87 to 1.00) in the diabetic group and 0.92 (95% CI: 0.85 to 0.99) in the non-diabetic group. LGI had a sensitivity and specificity of 90.00%, and 93.14% in prediction of in-hospital mortality in the diabetic group compared to 77.77% and 90.85% in the non-diabetic group. We observed 4 post-discharge mortalities in our patient group. Conclusion Our study demonstrated that higher LGI predicts in-hospital mortality in both diabetic and non-diabetic patients, while the length of hospital stay was only predicted by LGI levels in non-diabetic patients.
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Affiliation(s)
- Roxana Sadeghi
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Haji Aghajani
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Reza Parandin
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Niloufar Taherpour
- Prevention of Cardiovascular Disease Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Koohyar Ahmadzadeh
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Arash Sarveazad
- Colorectal Research Center, Iran University of Medical Sciences, Tehran, Iran
- Nursing Care Research Center, Iran University of Medical Sciences, Tehran, Iran
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Cai J, Chong CCY, Cheng CY, Lim CC, Sabanayagam C. Circulating Metabolites and Cardiovascular Disease in Asians with Chronic Kidney Disease. Cardiorenal Med 2023; 13:301-309. [PMID: 37669626 PMCID: PMC10664326 DOI: 10.1159/000533741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 08/03/2023] [Indexed: 09/07/2023] Open
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a growing public health problem, with significant burden of cardiovascular disease and mortality. The risk of cardiovascular disease in CKD is elevated beyond that predicted by traditional cardiovascular risk factors, suggesting that other factors may account for this increased risk. Through metabolic profiling, this study aimed to investigate the associations between serum metabolites and prevalent cardiovascular disease in Asian patients with CKD to provide insights into the complex interactions between metabolism, cardiovascular disease and CKD. METHODS This was a single-center cross-sectional study of 1,122 individuals from three ethnic cohorts in the population-based Singapore Epidemiology of Eye Disease (SEED) study (153 Chinese, 262 Indians, and 707 Malays) aged 40-80 years with CKD (estimated glomerular filtration rate <60 mL/min/1.73 m2). Nuclear magnetic resonance spectroscopy was used to quantify 228 metabolites from the participants' serum or plasma. Prevalent cardiovascular disease was defined as self-reported myocardial infarction, angina, or stroke. Multivariate logistic regression identified metabolites independently associated with cardiovascular disease in each ethnic cohort. Metabolites with the same direction of association with cardiovascular disease in all three cohorts were selected and subjected to meta-analysis. RESULTS Cardiovascular disease was present in 275 (24.5%). Participants with cardiovascular disease tend to be male; of older age; with hypertension, hyperlipidemia, and diabetes; with lower systolic and diastolic blood pressure (BP); lower high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol than those without cardiovascular disease. After adjusting for age, sex, systolic BP, diabetes, total cholesterol, and HDL cholesterol, 10 lipoprotein subclass ratios and 6 other metabolites were significantly associated with prevalent cardiovascular disease in at least one cohort. Meta-analysis with Bonferroni correction for multiple comparisons found that lower tyrosine, leucine, and valine concentrations and lower cholesteryl esters to total lipid ratio in intermediate-density lipoprotein (IDL) were associated with cardiovascular disease. CONCLUSION In Chinese, Indian, and Malay participants with CKD, prevalent cardiovascular disease was associated with tyrosine, leucine, valine, and cholesteryl esters to total lipid ratios in IDL. Increased cardiovascular risk in CKD patients may be contributed by altered amino acid and lipoprotein metabolism. The presence of CKD and ethnic differences may affect interactions between metabolites in health and disease, hence greater understanding will allow us to better risk stratify patients, and also individualize care with consideration of ethnic disparities.
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Affiliation(s)
- Jiashen Cai
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
- Medicine Academic Clinical Programme, SingHealth Duke-NUS, Singapore, Singapore
| | | | - Ching Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, SingHealth Duke-NUS, Singapore, Singapore
| | - Cynthia Ciwei Lim
- Department of Renal Medicine, Singapore General Hospital, Singapore, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore
- Ophthalmology and Visual Sciences Academic Clinical Programme, SingHealth Duke-NUS, Singapore, Singapore
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Tern PJW, Vaswani A, Yeo KK. Identifying and Solving Gaps in Pre- and In-Hospital Acute Myocardial Infarction Care in Asia-Pacific Countries. Korean Circ J 2023; 53:594-605. [PMID: 37653695 PMCID: PMC10475691 DOI: 10.4070/kcj.2023.0169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 06/25/2023] [Indexed: 09/02/2023] Open
Abstract
Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.
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Affiliation(s)
- Paul Jie Wen Tern
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Amar Vaswani
- Department of Cardiology, National Heart Centre Singapore, Singapore
| | - Khung Keong Yeo
- Department of Cardiology, National Heart Centre Singapore, Singapore.
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Davies C, Morgan AE, Mc Auley MT. Computationally Modelling Cholesterol Metabolism and Atherosclerosis. BIOLOGY 2023; 12:1133. [PMID: 37627017 PMCID: PMC10452179 DOI: 10.3390/biology12081133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Revised: 08/09/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death globally. The underlying pathological driver of CVD is atherosclerosis. The primary risk factor for atherosclerosis is elevated low-density lipoprotein cholesterol (LDL-C). Dysregulation of cholesterol metabolism is synonymous with a rise in LDL-C. Due to the complexity of cholesterol metabolism and atherosclerosis mathematical models are routinely used to explore their non-trivial dynamics. Mathematical modelling has generated a wealth of useful biological insights, which have deepened our understanding of these processes. To date however, no model has been developed which fully captures how whole-body cholesterol metabolism intersects with atherosclerosis. The main reason for this is one of scale. Whole body cholesterol metabolism is defined by macroscale physiological processes, while atherosclerosis operates mainly at a microscale. This work describes how a model of cholesterol metabolism was combined with a model of atherosclerotic plaque formation. This new model is capable of reproducing the output from its parent models. Using the new model, we demonstrate how this system can be utilized to identify interventions that lower LDL-C and abrogate plaque formation.
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Affiliation(s)
- Callum Davies
- Department of Physical, Mathematical and Engineering Sciences, University of Chester, Chester CH1 4BJ, UK;
| | - Amy E. Morgan
- School of Health & Sport Sciences, Liverpool Hope University, Liverpool L16 9JD, UK;
| | - Mark T. Mc Auley
- Department of Physical, Mathematical and Engineering Sciences, University of Chester, Chester CH1 4BJ, UK;
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Lertsakulbunlue S, Mungthin M, Rangsin R, Kantiwong A, Sakboonyarat B. Trends in baseline triglyceride-glucose index and association with predicted 10-year cardiovascular disease risk among type 2 diabetes patients in Thailand. Sci Rep 2023; 13:12960. [PMID: 37563268 PMCID: PMC10415402 DOI: 10.1038/s41598-023-40299-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 08/08/2023] [Indexed: 08/12/2023] Open
Abstract
Triglyceride-glucose (TyG) index is an independent risk factor for cardiovascular diseases (CVD). Our study determined the trends of the TyG index and its relationship to predicted CVD risk among patients with type 2 diabetes (T2D). A serial cross-sectional study was conducted including 63,815 participants with T2D aged 30-74 years without a history of CVD. The predicted CVD risk was based on the Framingham Heart Study (FHS). The receiver operating characteristic (ROC) curve was utilized for identifying the cutoff point of TyG index to predict intermediate-to-high CVD risk. The relationship between TyG index and predicted CVD risk was tested using linear and logistic regression. Decreasing trends of TyG index were observed between 2014 and 2018 (p < 0.001). ROC curve analysis of the TyG index indicated an AUC of 0.57 (95% CI 0.56-0.57, p < 0.001) in predicting intermediate-to-high predicted CVD risk, with a cutoff value of TyG index > 9.2 (sensitivity of 55.7%, specificity of 46.8%). An independent relationship between the TyG index and predicted CVD risk was observed. High TyG index was independently associated with intermediate-to-high predicted CVD risk. From our study, the TyG index was positively related to predicted 10-year CVD risk. However, the predictive ability of the TyG index in predicting the intermediate-to-high predicted 10-year CVD risk among patients with T2D remained questionable.
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Affiliation(s)
| | - Mathirut Mungthin
- Department of Parasitology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Ram Rangsin
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Anupong Kantiwong
- Department of Pharmacology, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand
| | - Boonsub Sakboonyarat
- Department of Military and Community Medicine, Phramongkutklao College of Medicine, Bangkok, 10400, Thailand.
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