1
|
Safdar M, Ullah M, Hamayun S, Wahab A, Khan SU, Abdikakhorovich SA, Haq ZU, Mehreen A, Naeem M, Mustopa AZ, Hasan N. Microbiome miracles and their pioneering advances and future frontiers in cardiovascular disease. Curr Probl Cardiol 2024; 49:102686. [PMID: 38830479 DOI: 10.1016/j.cpcardiol.2024.102686] [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: 05/23/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024]
Abstract
Cardiovascular diseases (CVDs) represent a significant global health challenge, underscoring the need for innovative approaches to prevention and treatment. Recent years have seen a surge in interest in unraveling the complex relationship between the gut microbiome and cardiovascular health. This article delves into current research on the composition, diversity, and impact of the gut microbiome on CVD development. Recent advancements have elucidated the profound influence of the gut microbiome on disease progression, particularly through key mediators like Trimethylamine-N-oxide (TMAO) and other microbial metabolites. Understanding these mechanisms reveals promising therapeutic targets, including interventions aimed at modulating the gut microbiome's interaction with the immune system and its contribution to endothelial dysfunction. Harnessing this understanding, personalized medicine strategies tailored to individuals' gut microbiome profiles offer innovative avenues for reducing cardiovascular risk. As research in this field continues to evolve, there is vast potential for transformative advancements in cardiovascular medicine, paving the way for precision prevention and treatment strategies to address this global health challenge.
Collapse
Affiliation(s)
- Mishal Safdar
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Muneeb Ullah
- College of Pharmacy, Pusan National University, Busandaehak-ro 63 beon-gil 2, Geumjeong-gu, Busan 46241, Republic of Korea; Department of Pharmacy, Kohat University of Science and Technology, Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shah Hamayun
- Department of Cardiology, Pakistan Institute of Medical Sciences (PIMS), Islamabad, 04485 Punjab, Pakistan
| | - Abdul Wahab
- Department of Pharmacy, Kohat University of Science and Technology, Kohat, 26000, Khyber Pakhtunkhwa, Pakistan
| | - Shahid Ullah Khan
- Department of Biochemistry, Women Medical and Dental College, Khyber Medical University, Abbottabad, 22080, Khyber Pakhtunkhwa, Pakistan
| | | | - Zia Ul Haq
- Department of Public Health, Institute of Public Health Sciences, Khyber Medical University, Peshawar 25120, Pakistan
| | - Aqsa Mehreen
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Muhammad Naeem
- Department of Biological Sciences, National University of Medical Sciences (NUMS), Rawalpindi, Punjab, Pakistan
| | - Apon Zaenal Mustopa
- Research Center for Genetic Engineering, National Research, and Innovation Agency (BRIN), Bogor 16911, Indonesia
| | - Nurhasni Hasan
- Faculty of Pharmacy, Universitas Hasanuddin, Jl. Perintis Kemerdekaan Km 10, Makassar 90245, Republic of Indonesia.
| |
Collapse
|
2
|
Liddell A, Brown L, Williams S, Gonzalez-Chica D. General practitioner assessment of lifestyle risk factors for chronic disease: a cross-sectional study in urban, rural and remote South Australia. Aust J Prim Health 2023; 29:613-624. [PMID: 37348844 DOI: 10.1071/py23035] [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: 03/08/2023] [Accepted: 05/25/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND The assessment and management of the SNAP lifestyle risk factors (smoking, nutrition, alcohol intake and physical activity) is fundamental to primary prevention of chronic disease. This study investigates the prevalence of SNAP assessments conducted in South Australian general practice, according to patient risk profiles, and across urban, rural and remote locations. METHODS A cross-sectional population-based survey was conducted in South Australia in 2017. Survey data included information on health characteristics, lifestyle risks and general practitioner (GP) assessments for 2775 participants, aged ≥18years, who visited a GP in the past 12months. The main outcome measure was assessment for two or more (≥2) SNAP risks in this time. Logistic regression models were used to estimate the prevalence of ≥2 SNAP assessments by remoteness area, using the Modified Monash Model (MMM) classifications for urban (MMM), rural (MMM3-4) and remote (MMM5-6), and adjusting for sociodemographic, SNAP lifestyle risks and clinical variables. RESULTS Of the 2775 participants (mean age 49.1±18.7years; 52.7% women), 32% were assessed for ≥2 SNAP in the past 12months. The adjusted prevalence of assessments was higher in rural (43.8%; 95% CI 36.4-51.2%) than urban (29.7%; 95% CI 27.2-32.2%) or remote (34.7%; 95% CI 28.4-41.0%) areas. Depending on rurality, ≥2 SNAP assessments were 2.5-3.4times more likely among participants with existing cardiovascular disease, and two to seven times more likely among participants with three or four SNAP risk factors (P <0.05 in all cases). CONCLUSION Greater attention to GP SNAP assessments is warranted to match the prevalence of SNAP risks across South Australia.
Collapse
Affiliation(s)
- Antoinette Liddell
- Adelaide Rural Clinical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Lucy Brown
- Adelaide Rural Clinical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Susan Williams
- Adelaide Rural Clinical School, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| | - David Gonzalez-Chica
- Adelaide Rural Clinical School and Discipline of General Practice, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5005, Australia
| |
Collapse
|
3
|
Tuot S, Sim JW, Nagashima-Hayashi M, Chhoun P, Teo AKJ, Prem K, Yi S. What are the determinants of antiretroviral therapy adherence among stable people living with HIV? A cross-sectional study in Cambodia. AIDS Res Ther 2023; 20:47. [PMID: 37452342 PMCID: PMC10347818 DOI: 10.1186/s12981-023-00544-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/05/2023] [Indexed: 07/18/2023] Open
Abstract
BACKGROUND Understanding context-specific determinants of antiretroviral therapy (ART) adherence is crucial for developing tailored interventions for improving health outcomes and achieving the UNAIDS' third 95% target. This cross-sectional study explores factors associated with ART adherence among stable people living with HIV on ART in Cambodia. METHODS We used baseline survey data from a quasi-experimental study conducted in 2021. The participants were recruited from 20 ART clinics in nine provinces for face-to-face interviews. A structured questionnaire collected information on sociodemographic characteristics, ART adherence, perceived ART self-efficacy, mental health, quality of life, stigma, and discrimination. We conducted bivariate and multiple logistic regression analyses to identify factors associated with ART adherence. RESULTS Out of the 4101 participants, 86.5% reported adhering to ART in the past two months. The adjusted odds of ART adherence were significantly higher among participants in older age groups than those aged 15-29, participants with elevated cholesterol than those without it, participants who exhibited strong self-efficacy in health responsibility to maintain life than those with poor self-efficacy in health responsibility, participants who scored < 3 on the stigma and discrimination scale than those who scored ≥ 3, participants who scored ≥ 42 on the mental component of the quality-of-life scale than those who scored < 42. The adjusted odds of ART adherence were significantly lower in participants who earned > 301 USD per month than those who earned ≤ 100 USD per month. CONCLUSION The ART adherence rate among stable people living with HIV in this study was comparable to that of the general people living with HIV in Cambodia. The results suggest the need for innovative interventions to further reduce stigma and discrimination and strategies to improve the self-efficacy and mental health of people living with HIV to improve ART adherence.
Collapse
Affiliation(s)
- Sovannary Tuot
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- Faculty of Social Sciences and Humanity, Royal University of Phnom Penh, Phnom Penh, Cambodia
| | - Jian Wei Sim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10- 01, 117549, Singapore, Singapore
| | - Michiko Nagashima-Hayashi
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10- 01, 117549, Singapore, Singapore
| | - Pheak Chhoun
- KHANA Center for Population Health Research, Phnom Penh, Cambodia
| | - Alvin Kuo Jing Teo
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10- 01, 117549, Singapore, Singapore
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Kiesha Prem
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10- 01, 117549, Singapore, Singapore
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK
| | - Siyan Yi
- KHANA Center for Population Health Research, Phnom Penh, Cambodia.
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, 12 Science Drive 2, #10- 01, 117549, Singapore, Singapore.
- Center for Global Health Research, Public Health Program, Touro University California, Vallejo, CA, USA.
| |
Collapse
|
4
|
Yun JY, Yun YH. Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach. Sci Rep 2023; 13:4848. [PMID: 36964273 PMCID: PMC10039031 DOI: 10.1038/s41598-023-31867-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
The association between health-related role limitations in the mental and physical subdomains and clinical status (i.e., chronic disease and comorbid depressive symptoms) is mediated by health-promoting behaviors. To enhance health-promoting behaviors in adults with chronic disease, it is necessary to identify item-level associations among targets of health-related monitoring and management. Therefore, the current study used a network approach to examine associations among health-related role limitations, depressive symptoms, existential well-being, socioeconomic position, and health-promoting behavior in adults with chronic disease. A total of 535 adults (mean ± SD age = 62.9 ± 11.9 years; males, n = 231, females, n = 304) who were regularly visiting an outpatient clinic for chronic disease treatment participated in this cross-sectional study. Data on participant demographics, chronic disease diagnoses, socioeconomic status, health-related role limitations (12-item short form survey scores), depressive symptoms (patient health questionnaire-9 scores), existential well-being (scores for four items of the McGill quality of life questionnaire-Revised), and health-promoting behavior (Healthy Habits Questionnaire scores) were acquired. "Undirected regularized partial correlations" and "directional joint probability distributions" among these variables were calculated using a mixed graphical model (MGM) and directed acyclic graph (DAG). In the MGM, the most influential nodes were emotional well-being, feelings of failure, and health-related limitations affecting usual role and physical activities. According to both the MGM and DAG, the relationship between emotional well-being and feelings of failure mediated the relationships of health-related role limitations with concentration difficulty and suicidal ideation. A positive mindset was dependent on the probability distributions of suicidal ideation, controllability of life, and positive self-image. Both the meaning of life and a positive mindset had direct associations with proactive living. Specifically, proactive living was associated with a balanced diet, regular exercise, volunteering in the community, and nurturing intimacy in social interactions. The meaning and controllability of life in individuals with chronic diseases could mediate the relationships of health-promoting behavior with health-related limitations related to usual role activities, physical activities, and depressive symptoms. Thus, interventions targeting health-promoting behaviors should aim to enhance the meaning and controllability of life (as it pertains to limitations in usual role and physical activities), as well as promote proactive screening and timely psychiatric treatment of depressive symptoms including feelings of failure, concentration difficulties, and suicidal ideation.
Collapse
Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
| |
Collapse
|
5
|
Chatzinikolaou A, Tzikas S, Lavdaniti M. Assessment of Quality of Life in Patients With Cardiovascular Disease Using the SF-36, MacNew, and EQ-5D-5L Questionnaires. Cureus 2021; 13:e17982. [PMID: 34667665 PMCID: PMC8517455 DOI: 10.7759/cureus.17982] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 11/05/2022] Open
Abstract
Background Cardiovascular disease (CVD) is responsible for 18 million annual deaths worldwide. CVD affects patients' Quality of Life (QoL) mainly in physical, emotional and social dimension. Aim To assess the QoL of patients with CVD in Northern Greece, using three different instruments. Methods The study was conducted in one large hospital located in a major Greek city. A convenience sample of 80 patients participated. A questionnaire including Short Form-36 Health Survey (SF-36), EuroQoL 5-dimensions 5-levels (EQ-5D-5L), MacNew, demographic, and clinical characteristics was used to collect data. Results The mean age of the patients was 63.31±14.07. Analysis revealed statistically significant main effects of age on the physical limitations, emotional limitations, social functioning, and pain. Also, the analysis showed significant main effects of education on the MacNew Physical, MacNew Social, and the EQ-5D-5L index (p< 0.05). Participants who had graduated primary school had significantly lower quality of life scores than higher education graduates in the MacNew physical (p< 0.02). Furthermore, in the SF-36 pain subscale, the heart failure group had a significantly lower quality of life than the other heart diseases (p= 0.03). Conclusion Quality of life is affected by factors such as age, type of heart disease, therapy, and comorbidities. Health care providers should be knowledgeable of the factors that affect the quality of life sectors (physical, emotional, and social life) of patients with CVD in order to meet their needs and have the most suitable treatment.
Collapse
Affiliation(s)
| | - Stergios Tzikas
- Third Department of Cardiology, Ippokratio General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GRC
| | - Maria Lavdaniti
- Nursing Department, International Hellenic University, Thessaloniki, GRC
| |
Collapse
|
6
|
Lima TRD, Silva DAS, Giehl MWC, D'Orsi E, González-Chica DA. Clusters of Cardiometabolic Risk Factors and Their Association with Atherosclerosis and Chronic Inflammation among Adults and Elderly in Florianópolis, Southern Brazil. Arq Bras Cardiol 2021; 117:39-48. [PMID: 34320066 PMCID: PMC8294721 DOI: 10.36660/abc.20200230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Accepted: 07/29/2020] [Indexed: 11/18/2022] Open
Abstract
Fundamento O aumento significativo de doenças cardiovasculares em países em desenvolvimento alerta sobre seu impacto em populações carentes. Objetivo Identificar a relação de agrupamentos de componentes da síndrome metabólica (SM) com aterosclerose e inflamação crônica em adultos e idosos. Métodos Análise transversal usando dados de dois estudos populacionais de tipo coorte realizados em Florianópolis, sul do Brasil (EpiFloripa Adult Cohort Study, n = 862, 39,9±11,5 anos; EpiFloripa Aging Cohort Study, n = 1197, 69,7±7,1 anos). Pressão arterial (PA), circunferência da cintura (CC), e níveis plasmáticos de lipídio e glicose foram analisados como fatores individuais ou como agrupamentos de componentes da SM (como número de componentes presentes em um indivíduo ou como combinações). Os desfechos incluíram espessura intima-media carotídea (EIMC), placas ateroscleróticas, e níveis de proteína C reativa (CRP). Regressão linear múltipla e regressão logística, ajustadas quanto aos fatores de confusão, foram usadas para análise. O nível de significância adotado foi de 5%. Resultados Indivíduos com PA e CC elevadas, dislipidemia e hiperglicemia (61,5%) apresentaram maiores valores de EIMC e PCR que aqueles que não apresentaram componentes de SM. CC elevada foi um determinante comum de inflamação sistêmica, ao passo que a coexistência de PA elevada e CC elevada (agrupamentos de dois ou três fatores) associou-se com maior EIMC (β entre +3,2 e +6,1 x 10-2 mm; p < 0,05) e PCR (EXPβ entre 2,18 e 2,77; p < 0,05). Conclusão A coexistência de PA e CC elevadas associou-se com maiores valores de EIMC e níveis de PCR. A obesidade central, isolada ou em combinação com outros fatores de risco, teve efeito sobre a inflamação sistêmica.
Collapse
Affiliation(s)
| | | | | | - Eleonora D'Orsi
- Universidade Federal de Santa Catarina, Florianópolis, SC - Brasil
| | | |
Collapse
|
7
|
Leach MJ, Gillam M, Gonzalez-Chica DA, Walsh S, Muyambi K, Jones M. Health care need and health disparities: Findings from the Regional South Australia Health (RESONATE) survey. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:905-917. [PMID: 32767700 DOI: 10.1111/hsc.13124] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Revised: 05/05/2020] [Accepted: 07/10/2020] [Indexed: 06/11/2023]
Abstract
Regional South Australia has some of the highest rates of psychological distress, chronic disease and multimorbidity of any Australian State or Territory. Yet, the healthcare needs of this population are still not completely understood. To better understand the healthcare needs of regional South Australians, we invited adults living in the region to complete the 44-item consumer utilisation, expectations and experiences of healthcare instrument (CONVERSATIONS), online or in hard-copy. The survey was conducted between April 2017 and March 2018. A multi-modal recruitment campaign was utilised to promote the survey. We examined associations between study outcomes and remoteness area, and drew comparisons between our findings and other surveys reporting pertinent outcomes in the urban SA population. The questionnaire was completed by 3,926 adults (52.5% females; 37.6% aged 60 + years). Among the 264 distinct health conditions reported by participants, the most prevalent were hypertension (31.6%), depression (25.7%), anxiety (23.5%) and hypercholesterolaemia (22.9%). The lifetime prevalence of these conditions among participants exceeded rates reported in urban SA. The largest regional-urban health disparities were observed for eczema/dermatitis, skin cancer, other cancer types and cataracts, where prevalence rates were 2075%, 400%, 373% and 324% higher, respectively, than that reported in urban SA. Participants also reported higher levels of multimorbidity (37.7% higher) relative to urban South Australians. By contrast, participants appeared to be exposed to fewer lifestyle risk behaviours (e.g. smoking, alcohol, inadequate fruit or vegetable intake) than their urban counterparts. In summary, there was a high level of healthcare need, and considerable health disparity among participants when compared with urban settings (particularly for skin and eye conditions). These findings highlight the need for a more targeted approach to delivering health services and health promotion activities in regional areas.
Collapse
Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Marianne Gillam
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | | | - Sandra Walsh
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Kuda Muyambi
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| | - Martin Jones
- Department of Rural Health, University of South Australia, Whyalla Norrie, Australia
| |
Collapse
|
8
|
Soh SE, Morello R, Ayton D, Ahern S, Scarborough R, Zammit C, Brand M, Stirling RG, Zalcberg J. Measurement properties of the 12-item Short Form Health Survey version 2 in Australians with lung cancer: a Rasch analysis. Health Qual Life Outcomes 2021; 19:157. [PMID: 34059079 PMCID: PMC8165769 DOI: 10.1186/s12955-021-01794-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Accepted: 05/21/2021] [Indexed: 12/24/2022] Open
Abstract
Background The 12-item Short-Form Health Survey version 2 (SF-12v2), a widely used, generic patient-reported measure of health status that provides summary scores of physical and mental health. No study to date has examined the measurement properties of the SF-12v2 in patients with lung cancer using Rasch analysis. The aim of this study was to extend the psychometric evaluations of the SF-12 within the lung cancer population to ensure its validity and reliability to assess the health status in this population. Methods Participants in the Victorian Lung Cancer Registry (VLCR) who completed the SF-12v2 between 2012 and 2016 were included in this study. The structural validity of the SF-12v2 was assessed using Rasch analysis. Overall fit to the Rasch measurement model was examined as well as five key measurement properties: uni-dimensionality, response thresholds, internal consistency, measurement invariance and targeting. Results A total of 342 participants completed the SF-12v2 three months following their lung cancer diagnosis. The SF-12 Physical Component Score (PCS-12) did not fit the overall Rasch measurement model (χ2 107.0; p < 0.001). Three items deviated significantly from the Rasch model (item fit residual beyond ± 2.5) with signs of dependency between item responses and disordered thresholds. Nevertheless, the PCS-12 was uni-dimensional with good internal consistency (person separation index [PSI] 0.83) and reasonable targeting. In contrast, the SF-12 Mental Component Score (MCS-12) had good overall model fit (χ2 35.1; p = 0.07), reasonable targeting and good internal consistency (PSI 0.81). Conclusions Rasch analysis suggests that there is general support for the reliability of the SF-12v2 as a measure of physical and mental health in people with lung cancer. However, the appropriateness of some items (e.g. pain) in the PCS-12 is questionable and further refinement of the scale including changing the response options may be required to improve the ability of the SF-12v2 to more appropriately assess the health status of this population. Supplementary Information The online version contains supplementary material available at 10.1186/s12955-021-01794-w.
Collapse
Affiliation(s)
- Sze-Ee Soh
- Department of Physiotherapy, Monash University, Melbourne, VIC, Australia. .,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Renata Morello
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Darshini Ayton
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Susannah Ahern
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ri Scarborough
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Claire Zammit
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Margaret Brand
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robert G Stirling
- Department of Respiratory Medicine, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Medicine, Monash University, Melbourne, VIC, Australia
| | - John Zalcberg
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
9
|
Chowdhury EK, Nelson MR, Ernst ME, Margolis KL, Beilin LJ, Johnston CI, Woods RL, Murray AM, Wolfe R, Storey E, Shah RC, Lockery JE, Tonkin AM, Newman AB, Williamson JD, Abhayaratna WP, Stocks NP, Fitzgerald SM, Orchard SG, Trevaks RE, Donnan GA, Grimm R, McNeil JJ, Reid CM. Factors Associated With Treatment and Control of Hypertension in a Healthy Elderly Population Free of Cardiovascular Disease: A Cross-sectional Study. Am J Hypertens 2020; 33:350-361. [PMID: 31807750 DOI: 10.1093/ajh/hpz192] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 11/01/2019] [Accepted: 12/04/2019] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Despite readily available treatments, control of blood pressure (BP) with population aging remains suboptimal. Further, there are gaps in the understanding of the management of high BP in the aged. We explored antihypertensive treatment and control among elderly hypertensive participants free from overt cardiovascular disease (CVD), and identified factors related to both "untreated" and "treated but uncontrolled" high BP. METHODS We analyzed baseline data from 19,114 individuals aged ≥65 years enrolled from Australia and United States (US) in the ASPirin in Reducing Events in the Elderly study. Hypertension was defined as an average systolic/diastolic BP ≥140/90 mm Hg and/or the use of any BP lowering medication. "Controlled hypertension" was defined if participants were receiving antihypertensive medication and BP <140 and 90 mm Hg. Descriptive analyses were used to summarize hypertension control rates; logistic regression was used to investigate relationships with treatment and BP control. RESULTS Overall, 74% (14,213/19,114) of participants were hypertensive; and of these 29% (4,151/14,213) were untreated. Among those treated participants, 53% (5,330/10,062) had BP ≥140/90 mm Hg. Participants who were untreated were more likely to be men, have higher educational status, and be in good physical health, and less likely to have significant comorbidities. The factors related to "treated but uncontrolled" BP included older age, male, Black race (vs. White), using antihypertensive monotherapy (vs. multiple) and residing in Australia (vs. US). CONCLUSIONS High levels of "untreated" and "treated but uncontrolled" BP occur in healthy elderly people without CVD, suggesting there are opportunities for better BP control in the primary prevention of CVD in this population. CLINICAL TRIALS REGISTRATION NCT01038583.
Collapse
Affiliation(s)
- Enayet K Chowdhury
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Mark R Nelson
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Michael E Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, The University of Iowa, Iowa City, IA, USA
- Department of Family Medicine, Carver College of Medicine, The University of Iowa, Iowa City , IA, USA
| | | | - Lawrence J Beilin
- School of Medicine, Royal Perth Hospital, University of Western Australia, Perth, WA, Australia
| | | | - Robyn L Woods
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute (HHRI), Hennepin Healthcare, Minneapolis, MN, USA
- Division of Geriatrics, Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis, MN, USA
| | - Rory Wolfe
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Elsdon Storey
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jessica E Lockery
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Andrew M Tonkin
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Jeff D Williamson
- Sticht Center on Healthy Aging and Alzheimer’s Prevention, Section on Gerontology and Geriatric Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Walter P Abhayaratna
- College of Health and Medicine, The Australian National University, Canberra, ACT, Australia
| | - Nigel P Stocks
- Discipline of General Practice, University of Adelaide, Adelaide, SA, Australia
| | - Sharyn M Fitzgerald
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Suzanne G Orchard
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Ruth E Trevaks
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Geoffrey A Donnan
- Florey Institute of Neuroscience and Mental Health, University of Melbourne, Victoria, Australia
| | - Richard Grimm
- Division of Geriatrics, Department of Medicine, Hennepin Healthcare and University of Minnesota, Minneapolis, MN, USA
| | - John J McNeil
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Christopher M Reid
- Department of Epidemiology & Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | | |
Collapse
|
10
|
Gonzalez-Chica DA, Bowden J, Miller C, Longo M, Nelson M, Reid C, Stocks N. Patient-reported GP health assessments rather than individual cardiovascular risk burden are associated with the engagement in lifestyle changes: population-based survey in South Australia. BMC FAMILY PRACTICE 2019; 20:173. [PMID: 31836016 PMCID: PMC6911269 DOI: 10.1186/s12875-019-1066-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Accepted: 12/05/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Little is known about whether a more comprehensive health assessment, performed by a general practitioner (GP) during a clinical encounter, could influence patients' lifestyle. We aimed to investigate whether health assessments, performed by GPs, are more important than the presence of cardiovascular disease (CVD) or cardiometabolic risk factors (obesity, diabetes, hypertension, dyslipidaemia) for engagement in lifestyle change. METHODS Cross-sectional, population-based survey conducted in South Australia (September-December 2017) using face-to-face interviews and self-reported data of 2977 individuals aged 15+ years. The main outcome was engagement in four lifestyle changes: 1) increasing fruit/vegetable intake, 2) increasing physical activity level, 3) reducing alcohol consumption, and 4) attempts to stop smoking. Health assessments performed by a GP in the last 12 months included clinical/laboratory investigations (weight/waist circumference, blood pressure, glucose levels, lipid levels) and questions about lifestyle/wellbeing (current diet, physical activity, smoking status, alcohol intake, mental health, sleeping problems). Results were restricted to individuals aged 35+ years because of the low prevalence of CVD or their risk factors among younger participants. Logistic regression was used in all associations, adjusted for sociodemographic, lifestyle, mental health, and clinical variables. RESULTS Of the 2384 investigated adults (mean age 57.3 ± 13.9 years; 51.9% females), 10.2% had CVD and 49.1% at least one cardiometabolic risk factor. Clinical/laboratory assessments performed by the GP were 2-3 times more frequent than assessments of lifestyle, mental health status, or sleeping problems, especially among those with CVD. Individuals with CVD or a cardiometabolic risk factor were no more likely to be increasing their fruit/vegetable consumption (33.6%), physical activity level (40.9%), reducing alcohol consumption (31.1%), or trying to quit smoking (34.0%) than 'healthy' participants. However, lifestyle changes were between 30 and 100% more likely when GPs performed three or more health assessments (either clinical/laboratory or questions about lifestyle/wellbeing) than when individuals did not visit the GP or when GPs performed no any assessment during these clinical encounters (p < 0.05 in all cases). CONCLUSION More frequent and comprehensive CVD-related assessments by GPs were more important in promoting a healthier lifestyle than the presence of CVD or cardiometabolic risk factors by themselves.
Collapse
Affiliation(s)
- David Alejandro Gonzalez-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Helen Mayo North, Sturt Road, Level 1, Room 113. South Australia, Adelaide, 5005 Australia
- Adelaide Rural Clinical School, The University of Adelaide, Adelaide, SA Australia
| | - Jacqueline Bowden
- Population Health Research Group, South Australian Health & Medical Research Institute, Adelaide, SA Australia
| | - Caroline Miller
- Population Health and Clinical Monitoring, Drug Policy & Population Health, Drug & Alcohol Services South Australia, Adelaide, SA Australia
| | - Marie Longo
- Population Health and Clinical Monitoring, Drug Policy & Population Health, Drug & Alcohol Services South Australia, Adelaide, SA Australia
| | - Mark Nelson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania Australia
| | - Christopher Reid
- School of Public Health, Curtin University, Perth, Western Australia Australia
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Helen Mayo North, Sturt Road, Level 1, Room 113. South Australia, Adelaide, 5005 Australia
| |
Collapse
|
11
|
Stocks NP, González-Chica DA, Woods RL, Lockery JE, Wolfe RSJ, Murray AM, Kirpach B, Shah RC, Nelson MR, Reid CM, Ernst ME, McNeil JJ. Quality of Life for 19,114 participants in the ASPREE (ASPirin in Reducing Events in the Elderly) study and their association with sociodemographic and modifiable lifestyle risk factors. Qual Life Res 2019; 28:935-946. [PMID: 30411180 PMCID: PMC6924574 DOI: 10.1007/s11136-018-2040-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2018] [Indexed: 01/21/2023]
Abstract
PURPOSE To explore the relationship between sociodemographic and lifestyle variables with health-related quality of life (HRQoL) of a large cohort of 'healthy' older individuals. METHODS The sample included individuals aged 65+ years from Australia (N = 16,703) and the USA (N = 2411) enrolled in the ASPirin in Reducing Events in the Elderly (ASPREE) multicentre placebo-controlled trial study and free of cardiovascular disease, dementia, serious physical disabilities or 'fatal' illnesses. The associations with the physical (PCS) and mental component scores (MCS) of HRQoL (SF-12 questionnaire) were explored using multiple linear regression models from data collected at baseline (2010-2014). RESULTS The adjusted PCS mean was slightly higher in the USA (49.5 ± 9.1) than Australia (48.2 ± 11.6; p < 0.001), but MCS was similar in both samples (55.7 ± 7.5 and 55.7 ± 9.6, respectively; p = 0.603). Males, younger participants, better educated, more active individuals, or those currently drinking 1-2 alcoholic drinks/day showed a better HRQoL (results more evident for PCS than MCS), while current heavy smokers had the lowest physical HRQoL in both countries. Neither age, walking time, nor alcohol intake was associated with MCS in either cohort. CONCLUSIONS Baseline HRQoL of ASPREE participants was higher than that reported in population-based studies of older individuals, but the associations between sociodemographic and lifestyle variables were consistent with the published literature. As the cohort ages and develops chronic diseases, ASPREE will be able to document HRQoL changes.
Collapse
Affiliation(s)
- Nigel P Stocks
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Level 1, Helen Mayo North, Frome Road, North Tce Campus, Adelaide, SA, 5005, Australia.
| | - David A González-Chica
- Discipline of General Practice, Adelaide Medical School, The University of Adelaide, Level 1, Helen Mayo North, Frome Road, North Tce Campus, Adelaide, SA, 5005, Australia
| | - Robyn L Woods
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Jessica E Lockery
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rory S J Wolfe
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Brenda Kirpach
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin County Medical Center, Minneapolis, MN, USA
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Mark R Nelson
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, Australia
| | - Christopher M Reid
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Public Health, Curtin University, Perth, WA, Australia
| | - Michael E Ernst
- Department of Pharmacy Practice and Science, College of Pharmacy, Department of Family Medicine, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - John J McNeil
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| |
Collapse
|
12
|
Arena R, Ozemek C, Laddu D, Campbell T, Rouleau CR, Standley R, Bond S, Abril EP, Hills AP, Lavie CJ. Applying Precision Medicine to Healthy Living for the Prevention and Treatment of Cardiovascular Disease. Curr Probl Cardiol 2018; 43:448-483. [DOI: 10.1016/j.cpcardiol.2018.06.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
|
13
|
Caceres VDM, Stocks N, Adams R, Haag DG, Peres KG, Peres MA, González-Chica DA. Physical activity moderates the deleterious relationship between cardiovascular disease, or its risk factors, and quality of life: Findings from two population-based cohort studies in Southern Brazil and South Australia. PLoS One 2018; 13:e0198769. [PMID: 29879229 PMCID: PMC5991645 DOI: 10.1371/journal.pone.0198769] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 05/24/2018] [Indexed: 11/22/2022] Open
Abstract
Background Few studies have investigated the relationship between physical activity (PA) of low intensity and duration with quality of life (QoL) among individuals at risk or with cardiovascular disease (CVD). Objectives To investigate whether PA of different intensity and duration moderates the relationship between CVD and its risk factors (obesity, hypertension, diabetes, dyslipidaemia) and QoL in adults. Methods Population-based cross-sectional studies using data from the EpiFloripa Cohort Study (Southern Brazil; n = 1,220, 38.8±12.0 years, 48.2% males) and the North West Adelaide Health Study (NWAHS, South Australia; n = 1,661, 43.7±11.1 years, 49.7% males). The physical and psychological domains of QoL were assessed using the WHOQOL-Bref (EpiFloripa) or the SF-36 (NWAHS) questionnaires. The diagnosis of CVD and its risk factors were self-reported. PA was self-reported and quantified by its intensity [“walking” or moderate/vigorous (MVPA)] and duration (none, 1–150, ≥150 min/week). Both studies were analysed separately, and results were adjusted for sociodemographic variables. Results Participants at risk or with CVD from both studies showed a lower QoL than ‘healthy’ individuals with a stronger relationship for the physical domain. PA duration showed a direct-trend relationship with QoL, but the associations were stronger for MVPA in both studies. However, when stratified by health status, the magnitude of the association between “walking” duration and a higher physical QoL was greater among those at risk or with CVD compared to ‘healthy’ individuals. Conversely, among Australians with CVD, MVPA was associated with a better physical QoL only when its duration was ≥150 min/week. All associations were stronger in the NWAHS than in the Brazilian study. Conclusions “Walking” was more prevalent than MVPA and was consistently associated with a better physical QoL among those at risk or with CVD. These findings should be considered in the design of public health interventions designed to increase PA and improve QoL.
Collapse
Affiliation(s)
- Viviane de Menezes Caceres
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- Postgraduate Program in Rehabilitation Sciences, Department of Health Sciences, Federal University of Santa Catarina, Araranguá, Santa Catarina, Brazil
| | - Nigel Stocks
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert Adams
- The Health Observatory, Adelaide Medical School, The University of Adelaide, Adelaide, Australia
| | - Dandara Gabriela Haag
- School of Public Health, The University of Adelaide, Adelaide, South Australia, Australia
| | - Karen Glazer Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Marco Aurélio Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - David Alejandro González-Chica
- Discipline of General Practice, Adelaide Medical School, NHMRC Centre of Research Excellence to Reduce Inequality in Heart Disease, The University of Adelaide, Adelaide, South Australia, Australia
- * E-mail:
| |
Collapse
|
14
|
Kazemi Shishavan M, Asghari Jafarabadi M, Aminisani N, Shahbazi M, Alizadeh M. The association between self-care and quality of life in hypertensive patients: findings from the Azar cohort study in the North West of Iran. Health Promot Perspect 2018; 8:139-146. [PMID: 29744310 PMCID: PMC5935818 DOI: 10.15171/hpp.2018.18] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 02/28/2018] [Indexed: 12/26/2022] Open
Abstract
Background: Hypertension affects the quality of life of patients and their caregivers. The aim of this study was to assess the knowledge and self-care behaviors and health-related quality of life (HRQOL) among hypertensive people. Methods: All people aged 35 years and older with hypertension were invited to participate in this study. Information on self-care behavior for hypertension (H-scale), and health-related quality of life (WHOHRQOL-BRFF) were completed by trained interviewer. Data analysis was done using SPSS 16. Results: The median age of hypertensive patients was 62.5(25th to 75th percentile: 55 to 72 years), the correlation between quality of life and overall self-care scores was not significant(r =-0.048, P =0.520). Physical activity was the only significant predictor for quality of life,showing that the quality of life of hypertensive people increased by 3.371 units per day of being physically active in the cohort study (β =0.223, P<0.01). The only significant predictor of quality of life among the elderly was medication use (β =-0.572, P<0.001). Quality of life of participants decreased 3.456 units per day as a result of medication adherence. Conclusion: No association was observed between self-care and HRQOL total score in hypertensive patients in the study. Among the self-care domains, only medication adherence and physical activity had significant association with social health. There was a reverse association between smoking and HRQOL.
Collapse
Affiliation(s)
| | - Mohammad Asghari Jafarabadi
- Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.,Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nayyereh Aminisani
- Department of Statistics and Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mohammad Shahbazi
- School of Public Health, Professor Jackson State University, Jackson, Mississippi, USA
| | - Mahasti Alizadeh
- Social Determinants of Health Research Center, Department of Community and Family Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| |
Collapse
|
15
|
Gan W, Liu Y, Luo KH, Liang SS, Wang H, Li M, Zhang YX, Huang HJ. The prevalence change of hyperlipidemia and hyperglycemia and the effectiveness of yearly physical examinations: an eight-year study in Southwest China. Lipids Health Dis 2018; 17:70. [PMID: 29618361 PMCID: PMC5885305 DOI: 10.1186/s12944-018-0724-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 03/25/2018] [Indexed: 02/08/2023] Open
Abstract
Background The aim of this study was to investigate the prevalence changes of hyperlipidemia and hyperglycemia from 2009 to 2016 and the effectiveness of yearly physical examinations to hyperlipidemia and hyperglycemia prevention in Chengdu. Methods A total of 794 residents (499 males) who have undergone annual health check-ups for 8 consecutive years (from 2009 to 2016) in Chengdu, a city in southwest China were selected as the follow-up group, 7226 residents in 2009 and 75,068 residents in 2016 who underwent health examinations in the same hospital were chosen to be the contemporary control group. The concentration of fasting serum triglyceride(TG), total cholesterol(TC), low density lipoprotein cholesterol(LDL-C), high density lipoprotein cholesterol (HDL-C) and glucose were measured and compared among these groups. Results There was a clear rise in the prevalence of hypercholesterolemia and hyperglycemia from 2009 to 2016 (p < 0.05). The follow-up group didn’t show difference in levels of serum lipids and glucose compared with the general population after an 8-years’ consecutive physical examination (p > 0.05), the follow-up cohort in the 8th year exhibited significant increases in serum total cholesterol and glucose compared with the 1st year (p < 0.05). Conclusion The prevalence of hypercholesterolemia and hyperglycemia were increased significantly from 2009 to 2016. Annual physical examination didn’t show a positive effect in the prevention of hypercholesterolemia and hyperglycemia. Health education should be improved to ensure the fulfillment of the preventive objective of yearly physical examination.
Collapse
Affiliation(s)
- Wei Gan
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Ying Liu
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Kai-Hong Luo
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Shan-Shan Liang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Hui Wang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Meng Li
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Yan-Xing Zhang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China
| | - Heng-Jian Huang
- Department of Laboratory Medicine, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Wuhou district Chengdu, Sichuan, 610041, China.
| |
Collapse
|
16
|
Zhang J, Fang L, Qiu L, Huang L, Zhu W, Yu Y. Comparison of the ability to identify arterial stiffness between two new anthropometric indices and classical obesity indices in Chinese adults. Atherosclerosis 2017; 263:263-271. [PMID: 28704699 DOI: 10.1016/j.atherosclerosis.2017.06.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 06/11/2017] [Accepted: 06/15/2017] [Indexed: 02/08/2023]
Abstract
BACKGROUND AND AIMS The association between anthropometric indices of body composition and arterial stiffness is inconclusive. The objective of this study was to examine the predictive ability of two new obesity indices: a body shape index (ABSI), and a body roundness index (BRI), for the identification of arterial stiffness among Chinese adults, as well as to compare the relative strength of association between the anthropometric indices and arterial stiffness. METHODS A total of 10,197 subjects were recruited in this cross-sectional study. We tested the association between anthropometric indices (body mass index [BMI], waist circumference [WC], waist-height-ratio [WHtR], ABSI and BRI) and brachial-ankle pulse wave velocity (PWV). Receiver operating characteristic curve and area under curve (AUC) were employed to evaluate the predictive value of the anthropometric indices for identification of arterial stiffness. RESULTS After adjusting for confounding variables, BRI (linear regression: 0.112; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.173 for male) exhibited a more powerful predictive ability of arterial stiffness than ABSI (linear regression: 0.110; AUC: 0.674; OR: 1.315 for female and linear regression: 0.058; AUC: 0.610; OR: 1.150 for male) and WC (linear regression: 0.078; AUC: 0.699; logistic regression: negative for female and linear regression: negative; AUC: 0.593; logistic regression: negative for male) while having a similar predictive value to that of WHtR (linear regression: 0.113; AUC: 0.726; OR: 1.228 for female and linear regression: 0.047; AUC: 0.631; OR: 1.185 for male) among both sexes. BMI (linear and logistic regression: negative; AUC: 0.660 for female and 0.568 for male) had the lowest predictive power in both sex categories. The optimal cut-off of WHtR for detecting arterial stiffness was 0.49 in females and 0.53 in males, that of BRI was 3.19 in females and 3.89 in males. CONCLUSIONS WHtR, ABSI and BRI were significantly associated with arterial stiffness. BRI and WHtR, rather than ABSI, showed superior predictive abilities for arterial stiffness in both sexes.
Collapse
Affiliation(s)
- Jia Zhang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lizheng Fang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lifeng Qiu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Lijuan Huang
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Wenhua Zhu
- Department of General Practice, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yunsong Yu
- Department of Infectious Disease and Hepatopathy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.
| |
Collapse
|