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Bellanca CM, Augello E, Di Benedetto G, Burgaletto C, Cantone AF, Cantarella G, Bernardini R, Polosa R. A web-based scoping review assessing the influence of smoking and smoking cessation on antidiabetic drug meabolism: implications for medication efficacy. Front Pharmacol 2024; 15:1406860. [PMID: 38957391 PMCID: PMC11217182 DOI: 10.3389/fphar.2024.1406860] [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: 03/25/2024] [Accepted: 05/20/2024] [Indexed: 07/04/2024] Open
Abstract
Currently 1.3 billion individuals globally engage in smoking, leading to significant morbidity and mortality, particularly among diabetic patients. There is urgent need for a better understanding of how smoking influences antidiabetic treatment efficacy. The review underscores the role of cigarette smoke, particularly polycyclic aromatic hydrocarbons (PAHs), in modulating the metabolic pathways of antidiabetic drugs, primarily through the induction of cytochrome P450 (CYP450) enzymes and uridine diphosphate (UDP)-glucuronosyltransferases (UGTs), thus impacting drug pharmacokinetics and therapeutic outcomes. Furthermore, the review addresses the relatively uncharted territory of how smoking cessation influences diabetes treatment, noting that cessation can lead to significant changes in drug metabolism, necessitating dosage adjustments. Special attention is given to the interaction between smoking cessation aids and antidiabetic medications, a critical area for patient safety and effective diabetes management. This scoping review aims to provide healthcare professionals with the knowledge to better support diabetic patients who smoke or are attempting to quit, ensuring tailored and effective treatment strategies. It also identifies gaps in current research, advocating for more studies to fill these voids, thereby enhancing patient care and treatment outcomes for this at-risk population.
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Affiliation(s)
- Carlo Maria Bellanca
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
- Clinical Toxicology Unit, University Hospital of Catania, Catania, Italy
| | - Egle Augello
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
- Clinical Toxicology Unit, University Hospital of Catania, Catania, Italy
| | - Giulia Di Benedetto
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
- Clinical Toxicology Unit, University Hospital of Catania, Catania, Italy
| | - Chiara Burgaletto
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Anna Flavia Cantone
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Giuseppina Cantarella
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
| | - Renato Bernardini
- Department of Biomedical and Biotechnological Sciences, Section of Pharmacology, University of Catania, Catania, Italy
- Clinical Toxicology Unit, University Hospital of Catania, Catania, Italy
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
- Centre of Excellence for the Acceleration of HArm Reduction (CoEHAR), University of Catania, Catania, Italy
- Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Hospital of Catania, Catania, Italy
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Walicka M, Krysiński A, La Rosa GRM, Sun A, Campagna D, Di Ciaula A, Dugal T, Kengne A, Le Dinh P, Misra A, Polosa R, Raza SA, Russo C, Sammut R, Somasundaram N. Influence of quitting smoking on diabetes-related complications: A scoping review with a systematic search strategy. Diabetes Metab Syndr 2024; 18:103044. [PMID: 38810420 DOI: 10.1016/j.dsx.2024.103044] [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: 03/21/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Smoking in people with diabetes markedly elevates their risk of developing complications and increases the likelihood of cardiovascular mortality. This review is the first to specifically provide evidence-based analysis about the influence of quitting smoking on diabetes-related complications in people with type 2 diabetes. METHOD The present review was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Extension for Scoping Reviews. All human clinical studies assessing the effects of stopping smoking cessation on diabetes-related complications were included. PubMed and Embase were screened until January 2024. References of primary studies and principal peer-reviewed scientific journals in the field were manually screened. RESULTS We identified a total of 1023 studies. Only 26 met the criteria for eligibility. In general quitting smoking is associated with decreased risks of myocardial infarction and ischemic stroke. Regarding microvascular complications, the strongest evidence for the beneficial effects of smoking cessation is observed in diabetic nephropathy. However, the relationship between smoking cessation and retinopathy, neuropathy, diabetic foot complications and diabetic-related erectile dysfunction, is poorly investigated. CONCLUSION Quitting smoking offers significant advantages in managing diabetes-related complications, significantly lowering the risks of myocardial infarction, ischemic stroke, and diabetic nephropathy. This underscores the importance of cessation. Providing evidence-based information on the benefits of stopping smoking for people with type 2 diabetes who smoke, can bolster smoking cessation efforts in the context of diabetes management.
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Affiliation(s)
- Magdalena Walicka
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.
| | - Arkadiusz Krysiński
- Department of Human Epigenetics, Mossakowski Medical Research Institute, Polish Academy of Sciences, Warsaw, Poland; Department of Internal Diseases, Endocrinology and Diabetology, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland
| | | | - Ang Sun
- Department of Biology, and Center for Biotechnology/Sbarro Institute for Cancer Research and Molecular Medicine, Temple University, Philadelphia, USA
| | - Davide Campagna
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy
| | - Agostino Di Ciaula
- Clinica Medica "A. Murri" Department of Precision and Regenerative Medicine and Ionian Area [DiMePre-J], University "Aldo Moro" Medical School, Bari, Italy
| | - Tabinda Dugal
- Department of Endocrinology College of Physicians and Surgeons, Royal Cornwall Hospital NHS Trust, Truro, UK
| | - Andre Kengne
- Non-Communicable Diseases Research Unit, South African Medical Research Council and University of Cape Town, Cape Town, South Africa; Department of Biological and Environmental Science, Faculty of Science, Walter Sisulu University, Mthatha, South Africa
| | - Phuong Le Dinh
- General Practice, Family Medicine and Check-up Department, FV Hospital Ho Chi Minh City, Viet Nam
| | - Anoop Misra
- Diabetes Foundation [India], New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation [N-DOC], New Delhi, India; Fortis C-DOC Centre for Excellence for Diabetes, Metabolic Disease, and Endocrinology, New Delhi, India
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy; Center of Excellence for the acceleration of Harm Reduction [CoEHAR], University of Catania, Vietnam, Italy; Centre for the Prevention and Treatment of Tobacco Addiction (CPCT), University Teaching Hospital "Policlinico-Vittorio Emanuele", University of Catania, Catania, Italy
| | - Syed Abbas Raza
- Shaukat Khanum Cancer Hospital and Research Center, Peshawar, Pakistan
| | - Cristina Russo
- Ashford and Saint Peter's Hospitals NHS Foundation Trust, Chertsey, UK
| | - Roberta Sammut
- Department of Nursing, Faculty of Health Sciences, University of Malta, Msida, Malta
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Okekunle AP, Asowata OJ, Fakunle AG, Akpa OM, Sarfo FS, Akpalu A, Wahab K, Obiako R, Komolafe M, Owolabi L, Osaigbovo GO, Tiwari HK, Akinyemi J, Jenkins C, Arulogun O, Ibinaiye P, Appiah L, Agunloye AM, Adeoye AM, Yaria J, Calys-Tagoe B, Uvere EO, Ogbole G, Agyekum F, Sanni TA, Amusa GA, Ogunronbi M, Olowookere S, Balogun O, Ogunmodede JA, Olalusi OV, Samuel D, Mande A, Rabiu M, Adebayo P, Sunday A, Imoh LC, Oguntade AS, Ajose A, Singh A, Adeegbe OT, Mensah Y, Fawale MB, Abdul S, Ikubor J, Tolulope A, Yahaya IS, Akisanya C, Odo CJ, Efidi R, Chukwuonye II, Shidali V, Adebowale A, Ohagwu KA, Adeleye OO, Iheonye H, Akintunde A, Olabinri E, Akpalu J, Adesina J, Onyeonoro U, Onasanya A, Arnett DK, Lackland D, Akinyemi R, Ovbiagele B, Owolabi M. Secondhand smoke exposure is independently associated with stroke among non-smoking adults in West Africa. J Neurol Sci 2022; 443:120489. [PMID: 36399928 PMCID: PMC9712270 DOI: 10.1016/j.jns.2022.120489] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 10/15/2022] [Accepted: 11/02/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Stroke is a leading cause of disability and mortality worldwide, but little is known about the contribution of secondhand smoke exposure (SHSE) to stroke epidemiology among indigenous Africans. OBJECTIVE To evaluate the association of SHSE with stroke among indigenous Africans. METHODS We analyzed the relationship of SHSE with stroke among 2990 case-control pairs of adults who had never smoked (identified in the SIREN study) using conditional logistic regression at a two-sided P < 0.05. RESULTS Multivariable-adjusted odds ratio and 95% confidence interval; 1.25 (1.04, 1.50; P = 0.02) revealed SHSE was positively associated with stroke independent of stroke subtypes. CONCLUSION Culturally relevant primary prevention strategies targeted at SHSE might be promising in preventing stroke among Africans.
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Affiliation(s)
- Akinkunmi Paul Okekunle
- Department of Medicine, University of Ibadan, Nigeria; Department of Food and Nutrition, Seoul National University, Republic of Korea.
| | | | - Adekunle G Fakunle
- Department of Medicine, University of Ibadan, Nigeria; Department of Public Health, Osun State University, Osogbo, Nigeria
| | - Onoja Matthew Akpa
- Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria; Institute of Cardiovascular Diseases, University of Ibadan, Nigeria
| | - Fred S Sarfo
- Kwame Nkrumah University of Science and Technology, Ghana
| | - Albert Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | - Kolawole Wahab
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | - Reginald Obiako
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | - Lukman Owolabi
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | | | - Joshua Akinyemi
- Department of Epidemiology and Medical Statistics, University of Ibadan, Nigeria
| | | | - Oyedunni Arulogun
- Department of Health Promotion and Education, University of Ibadan, Nigeria
| | - Philip Ibinaiye
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | - Lambert Appiah
- Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Abiodun M Adeoye
- Department of Medicine, University of Ibadan, Nigeria; Institute of Cardiovascular Diseases, University of Ibadan, Nigeria; Center for Genomic and Precision Medicine, University of Ibadan, Nigeria
| | - Joseph Yaria
- Department of Medicine, University of Ibadan, Nigeria
| | | | | | - Godwin Ogbole
- Department of Radiology, University of Ibadan, Nigeria
| | - Francis Agyekum
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | | | | | | | - Olayemi Balogun
- Department of Medicine, Ahmadu Bello University, Zaria, Nigeria
| | | | | | - Diala Samuel
- Department of Medicine, University of Ibadan, Nigeria
| | - Aliyu Mande
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | - Musbahu Rabiu
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Adeniyi Sunday
- Department of Medicine, University of Ilorin, Ilorin, Nigeria
| | | | - Ayodipupo S Oguntade
- Department of Medicine, University of Ibadan, Nigeria; Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Big Data Institute, Oxford Population Health, University of Oxford, UK
| | - Abiodun Ajose
- Department of Medicine, University of Ibadan, Nigeria
| | - Arti Singh
- Kwame Nkrumah University of Science and Technology, Ghana
| | | | - Yaw Mensah
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | | | - Joyce Ikubor
- Delta State University Teaching Hospital, Oghara, Delta State, Nigeria
| | | | - Isah S Yahaya
- Department of Medicine, Aminu Kano Teaching Hospital, Kano, Nigeria
| | | | - Chidi J Odo
- Department of Radiology, University of Ibadan, Nigeria
| | - Richard Efidi
- Department of Radiology, University College Hospital, Ibadan, Nigeria
| | | | | | | | | | | | - Henry Iheonye
- Department of Medicine, Federal Medical Centre, Lokoja, Nigeria
| | - Adeseye Akintunde
- Ladoke Akintola University of Technology/Teaching Hospital, Ogbomosho, Nigeria
| | | | - Josephine Akpalu
- Department of Medicine, University of Ghana Medical School, Accra, Ghana
| | | | | | | | | | - Daniel Lackland
- Department of Neurology, Medical University of South Carolina, USA
| | - Rufus Akinyemi
- Federal Medical Centre, Abeokuta, Nigeria; Center for Genomic and Precision Medicine, University of Ibadan, Nigeria; Institute for Advanced Medical Research and Training, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Bruce Ovbiagele
- Weill Institute for Neurosciences, University of California San Francisco, USA
| | - Mayowa Owolabi
- Department of Medicine, University of Ibadan, Nigeria; Center for Genomic and Precision Medicine, University of Ibadan, Nigeria.
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Wang* R, Qiang* Y, Gao* X, Yang Q, Li B. Prevalence of non-communicable diseases and its association
with tobacco smoking cessation intention among current
smokers in Shanghai, China. Tob Induc Dis 2022; 20:106. [DOI: 10.18332/tid/155828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 09/29/2022] [Accepted: 10/17/2022] [Indexed: 11/29/2022] Open
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Chen Q, Ma X, Geng Y, Liao J, Ma L. Association between smoking and hypertension under different PM 2.5 and green space exposure: A nationwide cross-sectional study. Front Public Health 2022; 10:1026648. [PMID: 36466446 PMCID: PMC9712966 DOI: 10.3389/fpubh.2022.1026648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 10/24/2022] [Indexed: 11/19/2022] Open
Abstract
Background Smoking has been widely reported to have a significant relationship with hypertension, but the past description of this relationship has not been uniform. In addition, there has been a lack of research to discuss the impact of environmental exposure on the relationship between smoking and hypertension. Therefore, this study estimates the association between smoking and hypertension in middle aged and elderly people in China under different PM2.5 (fine particulate matter) concentrations and the green space exposure conditions. Methods Individual sample data from the China Health and Retirement Longitudinal Study in 2018 and the long-term average exposure concentration of fine particles and green space exposure for all participants were used with a multilevel binary logistic mixed effects model. Adjustments were made for sociodemographic characteristics and other health behaviors including drinking, physical activity, and social activity. The normalized difference vegetation index (NDVI) and PM2.5 concentration stratification were assigned with the median of the population exposure concentration as the dividing line, and the dual environmental factor stratification was assigned in combination with the two types of environmental exposure. The analysis was also stratified using age groups. Results A total of 10,600 participants over the age of 45 were included in the study. The effects of smoking on hypertension were diverse under different environmental exposure conditions. There was a significant relationship between smoking behavior and hypertension in the Low-NDVI group, and the effect value of this relationship was significantly different from that in the High-NDVI group. Furthermore, for respondents exposed to low green spaces and high PM2.5 environments at the same time (Low-NDVI/High-PM2.5 group), their smoking behavior may lead to an increase in the risk of hypertension. In addition, the risk of hypertension caused by smoking in the middle-aged (45-64) was significant under low green space exposure, but the effect difference between the different age groups was not significant. Conclusions The relationship between smoking and hypertension was different under different environmental exposure conditions. Exposure to low green spaces may strengthen the association between smoking and hypertension risk. When participants were exposed to both low green spaces and high PM2.5 concentrations, the risk of hypertension caused by smoking was significantly higher than that of those who were exposed to high green spaces and low PM2.5 concentrations.
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Affiliation(s)
- Qihao Chen
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Xuxi Ma
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Yan Geng
- Department of Global Health, School of Public Health, Wuhan University, Wuhan, China
| | - Jingling Liao
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College, Wuhan University of Science and Technology, Wuhan, China
| | - Lu Ma
- Department of Biostatistics, School of Public Health, Wuhan University, Wuhan, China,*Correspondence: Lu Ma
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Nascimento BR, Brant LCC, Naback ADN, Veloso GA, Polanczyk CA, Ribeiro ALP, Malta DC, Ferreira AVL, Oliveira GMMD. Carga de Doenças Cardiovasculares Atribuível aos Fatores de Risco nos Países de Língua Portuguesa: Dados do Estudo “Global Burden of Disease 2019”. Arq Bras Cardiol 2022; 118:1028-1048. [PMID: 35703642 PMCID: PMC9345142 DOI: 10.36660/abc.20210680] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 12/08/2021] [Indexed: 12/26/2022] Open
Abstract
Fundamento: O impacto dos fatores de risco (FR) sobre a morbimortalidade por doença cardiovascular (DCV) na maioria dos países de língua portuguesa (PLP) é pouco conhecido. Objetivo: Analisar a morbimortalidade por DCV atribuível aos FR e sua variação nos PLP de 1990 a 2019, a partir de estimativas do estudo Global Burden of Disease (GBD) 2019. Métodos: Avaliamos as mudanças nos FR ocorridas no período, as taxas de mortalidade e os anos de vida perdidos por incapacidade (DALYs), padronizados por idade, entre 1990 e 2019. Realizou-se a correlação entre a variação percentual das taxas de mortalidade e o índice sociodemográfico (SDI) de cada PLP pelo método de Spearman. O valor p<0,05 foi considerado estatisticamente significativo. Resultados: A pressão arterial sistólica (PAS) elevada foi o principal fator de risco para mortalidade e DALY por DCV para todos os PLP. A mortalidade por DCV mostrou uma tendência de redução em 2019, maior em Portugal (-66,6%, IC95% -71,0 - -61,2) e no Brasil (-49,8%, IC95% -52,5 - -47,1). Observou-se tendência à correlação inversa entre SDI e a variação percentual da mortalidade, que foi significativa para os riscos dietéticos (r=-0,70, p=0,036), colesterol LDL elevado (r=-0,77, p=0,015) e PAS elevada (r=-0,74, p=0,023). Conclusões: Além da PAS, os FR dietéticos e metabólicos justificaram uma maior variação da carga de DCV, correlacionada com o SDI nos PLP, sugerindo a necessidade de adoção de políticas de saúde adaptadas à realidade de cada país, visando a redução de seu impacto sobre a população.
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Ntaganda E, Mugeni R, Harerimana E, Ngoga G, Dusabeyezu S, Uwinkindi F, Utumatwishima JN, Mutimura E, Davila-Roman VG, Schechtman K, Nishimwe A, Twizeyimana L, Brown AL, Cade WT, Bushaku M, de Las Fuentes L, Reeds D, Twagirumukiza M. High rates of undiagnosed and uncontrolled hypertension upon a screening campaign in rural Rwanda: a cross-sectional study. BMC Cardiovasc Disord 2022; 22:197. [PMID: 35473501 PMCID: PMC9044706 DOI: 10.1186/s12872-022-02606-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/28/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Hypertension remains the major risk factor for cardiovascular diseases (CVDs) worldwide with a prevalence and mortality in low- and middle-income countries (LMICs) among the highest. The early detection of hypertension risk factors is a crucial pillar for CVD prevention. DESIGN AND METHOD This cross-sectional study included 4284 subjects, mean age 46 ± 16SD, 56.4% females and mean BMI 26.6 ± 3.7 SD. Data were collected through a screening campaign in rural area of Kirehe District, Eastern of Rwanda, with the objective to characterize and examine the prevalence of elevated blood pressure (BP) and other CVD risk factors. An adapted tool from the World Health Organization STEPwise Approach was used for data collection. Elevated BP was defined as ≥ 140/90 mm/Hg and elevated blood glucose as blood glucose ≥ 100 mg/dL after a 6-h fast. RESULTS Of the sampled population, 21.2% (n = 910) had an elevated BP at screening; BP was elevated among individuals not previously known to have HTN in 18.7% (n = 752). Among individuals with a prior diagnosis of HTN, 62.2% (n = 158 of 254) BP was uncontrolled. Age, weight, smoking, alcohol history and waist circumference were associated with BP in both univariate analyses and multivariate analysis. CONCLUSION High rates of elevated BP identified through a health screening campaign in this Rwandan district were surprising given the rural characteristics of the district and relatively low population age. These data highlight the need to implement an adequate strategy for the prevention, diagnosis, and control of HTN that includes rural areas of Rwanda as part of a multicomponent strategy for CVD prevention.
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Affiliation(s)
- Evariste Ntaganda
- Rwanda Biomedical Center (RBC), Rwanda Ministry of Health, Kigali, Rwanda
| | - Regine Mugeni
- Rwamagana Provincial Hospital, Rwamagana, Eastern Province, Rwanda.
| | | | - Gedeon Ngoga
- Partners in Health (PIH)/Inshuti Mu Buzima, Rwinkwavu, Rwanda
| | | | - Francois Uwinkindi
- Rwanda Biomedical Center (RBC), Rwanda Ministry of Health, Kigali, Rwanda
| | | | - Eugene Mutimura
- National Council for Science and Technology (NCST), Kigali, Rwanda
| | - Victor G Davila-Roman
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Kenneth Schechtman
- Division of Biostatistics, Washington University in St. Louis, St. Louis, MO, USA
| | - Aurore Nishimwe
- Regional Alliance for Sustainable Development (RASD Rwanda), Kigali, Rwanda
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | - Angela L Brown
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - W Todd Cade
- Duke University School of Medicine, Durham, NC, 27710, USA
| | - Marcus Bushaku
- Regional Alliance for Sustainable Development (RASD Rwanda), Kigali, Rwanda
| | - Lisa de Las Fuentes
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Dominic Reeds
- Cardiovascular Division, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Marc Twagirumukiza
- School of Medicine and Pharmacy, College of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
- Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
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8
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Wang X, Carcel C, Woodward M, Schutte AE. Blood Pressure and Stroke: A Review of Sex- and Ethnic/Racial-Specific Attributes to the Epidemiology, Pathophysiology, and Management of Raised Blood Pressure. Stroke 2022; 53:1114-1133. [PMID: 35344416 DOI: 10.1161/strokeaha.121.035852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Raised blood pressure (BP) is the leading cause of death and disability worldwide, and its particular strong association with stroke is well established. Although systolic BP increases with age in both sexes, raised BP is more prevalent in males in early adulthood, overtaken by females at middle age, consistently across all ethnicities/races. However, there are clear regional differences on when females overtake males. Higher BP among males is observed until the seventh decade of life in high-income countries, compared with almost 3 decades earlier in low- and middle-income countries. Females and males tend to have different cardiovascular disease risk profiles, and many lifestyles also influence BP and cardiovascular disease in a sex-specific manner. Although no hypertension guidelines distinguish between sexes in BP thresholds to define or treat hypertension, observational evidence suggests that in terms of stroke risk, females would benefit from lower BP thresholds to the magnitude of 10 to 20 mm Hg. More randomized evidence is needed to determine if females have greater cardiovascular benefits from lowering BP and whether optimal BP is lower in females. Since 1990, the number of people with hypertension worldwide has doubled, with most of the increase occurring in low- and-middle-income countries where the greatest population growth was also seen. Sub-Saharan Africa, Oceania, and South Asia have the lowest detection, treatment, and control rates. High BP has a more significant effect on the burden of stroke among Black and Asian individuals than Whites, possibly attributable to differences in lifestyle, socioeconomic status, and health system resources. Although pharmacological therapy is recommended differently in local guidelines, recommendations on lifestyle modification are often very similar (salt restriction, increased potassium intake, reducing weight and alcohol, smoking cessation). This overall enhanced understanding of the sex- and ethnic/racial-specific attributes to BP motivates further scientific discovery to develop more effective prevention and treatment strategies to prevent stroke in high-risk populations.
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Affiliation(s)
- Xia Wang
- The George Institute for Global Health (X.W., C.C., M.W., A.E.S.), University of New South Wales, Sydney, Australia
| | - Cheryl Carcel
- The George Institute for Global Health (X.W., C.C., M.W., A.E.S.), University of New South Wales, Sydney, Australia.,Sydney School of Public Health, Sydney Medical School, The University of Sydney, New South Wales, Australia (C.C.)
| | - Mark Woodward
- The George Institute for Global Health (X.W., C.C., M.W., A.E.S.), University of New South Wales, Sydney, Australia.,The George Institute for Global Health, School of Public Health, Imperial College London, United Kingdom (M.W.)
| | - Aletta E Schutte
- The George Institute for Global Health (X.W., C.C., M.W., A.E.S.), University of New South Wales, Sydney, Australia.,School of Population Health (A.E.S.), University of New South Wales, Sydney, Australia.,Hypertension in Africa Research Team, Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa (A.E.S.)
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Bai J, Shi F, Ma Y, Yang D, Yu C, Cao J. The Global Burden of Type 2 Diabetes Attributable to Tobacco: A Secondary Analysis From the Global Burden of Disease Study 2019. Front Endocrinol (Lausanne) 2022; 13:905367. [PMID: 35937829 PMCID: PMC9355706 DOI: 10.3389/fendo.2022.905367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Growing epidemiological studies have reported the relationship between tobacco and health loss among patients with type 2 diabetes (T2D). This study aimed to explore the secular trend and spatial distribution of the T2D burden attributable to tobacco on a global scale to better understand regional disparities and judge the gap between current conditions and expectations. METHODS As a secondary analysis, we extracted data of tobacco-attributable T2D burden from the 2019 Global Burden of Disease Study (GBD). Joinpoint regression was adopted to determine the secular trend of age-standardized rates (ASR), with average annual percentage change (AAPC). Gaussian process regression (GPR) was used to explore the average expected relationship between ASRs and the socio-demographic index (SDI). Spatial autocorrelation was used to indicate if there is clustering of age-standardized DALY rate (ASDR) with Moran's I value. Multi-scale geographically weighted regression (MGWR) was to investigate the spatial distribution and scales of influencing factors in ASDR attributable to tobacco, with the regression coefficients for each influencing factor among 204 countries. RESULTS Tobacco posed a challenge to global T2D health, particularly for the elderly and men from lower SDI regions. For women, mortality attributable to secondhand smoke was higher than smoking. A downward trend in age-standardized mortality rate (ASMR) of T2D attributable to tobacco was observed (AAPCs= -0.24; 95% CI -0.30 to -0.18), while the ASDR increased globally since 1990 (AAPCs= 0.19; 0.11 to 0.27). Oceania, Southern Sub-Saharan Africa, and Southeast Asia had the highest ASMRs and ASDRs, exceeding expectations based on the SDI. Also, "high-high" clusters were mainly observed in South Africa and Southeast Asian countries, which means a high-ASDR country is surrounded by high-ASDR neighborhoods in the above areas. According to MGWR model, smoking prevalence was the most sensitive influencing factor, with regression coefficients from 0.15 to 1.80. CONCLUSION The tobacco-attributable burden of T2D should be considered as an important health issue, especially in low-middle and middle-SDI regions. Meanwhile, secondhand smoke posed a greater risk to women. Regional disparities existed, with hot spots mainly concentrated in South Africa and Southeast Asian countries.
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Affiliation(s)
- Jianjun Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Fang Shi
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Yudiyang Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Donghui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
| | - Chuanhua Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
- Global Health Institute, Wuhan University, Wuhan, China
- *Correspondence: Chuanhua Yu, ; Jinhong Cao,
| | - Jinhong Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Wuhan University, Wuhan, China
- *Correspondence: Chuanhua Yu, ; Jinhong Cao,
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Bhatt G, Goel S, Grover S, Kaur N, Singh S. A cross sectional study to assess tobacco use and its correlates among patients attending non-communicable disease clinics of a Northern Jurisdiction in India. J Family Med Prim Care 2021; 10:2915-2922. [PMID: 34660424 PMCID: PMC8483119 DOI: 10.4103/jfmpc.jfmpc_2471_20] [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: 12/16/2020] [Revised: 02/21/2021] [Accepted: 04/09/2021] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Non-Communicable Diseases (NCDs) continue to rise unabated globally and the existing evidence has unequivocally established the relationship between tobacco use and NCDs. In 2010 the Government of India (GOI) introduced NCD clinics under the National Program for Prevention and Control of Cancer, Diabetes, Cardio Vascular Diseases and Stroke (NPCDCS) with the purpose of preventing and combating the NCD epidemic. This study was undertaken with an objective to comprehensively determine tobacco use and its correlates among patients attending these NCD clinics. METHODS A descriptive cross-sectional study was carried out among 1172 patients attending NCD clinics at district level, in Punjab, India between May to October 2018. Using systematic sampling every fourth patient was interviewed and equal numbers of visits were made to both the clinics. RESULTS Overall, the current tobacco use in any form was reported to be 10.2% among the study respondents. Majority of the tobacco users were males (23.3%), in 40-49 year age group, (18.7%), residing in urban area (15%), educated up to secondary school (18%) and non-government occupation bracket (27.4%) and hypertension disease category (41.6%). More SLT users had thought of quitting in past in comparison to smokers (46.6% vs 40%) and had higher quit attempts in past (42.5% vs 38.3%). In the binary logistic regression analysis, odds of tobacco use increased with increasing age, three times higher among participants who were employed (OR 3.75; CI 1.41-10.02),6 times higher in COPD disease category (OR 6.88; CI 2.1-20.59). CONCLUSION Higher tobacco use among the NCD clinic attendees with increasing age predisposes them to develop grave complications. This calls for the need to administer intensive behaviour change interventions for tobacco cessation at the existing NCD clinics. This could further strengthen existing health systems and thereby improving health outcomes followed by achieving Sustainable Development Goals.
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Affiliation(s)
- Garima Bhatt
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Sonu Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, Punjab, India
| | - Nirlep Kaur
- Department of Health and Family Welfare, State Tobacco Control Cell, Punjab, India
| | - Sandeep Singh
- Department of Health and Family Welfare, State NCD Control Cell, Punjab, India
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Noubiap JJ, Nyaga UF. A review of the epidemiology of atrial fibrillation in sub-Saharan Africa. J Cardiovasc Electrophysiol 2019; 30:3006-3016. [PMID: 31596016 DOI: 10.1111/jce.14222] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/05/2019] [Accepted: 09/09/2019] [Indexed: 01/05/2023]
Abstract
This systematic review summarizes the data on the prevalence, risk factors, complications, and management of atrial fibrillation (AF) in sub-Saharan Africa (SSA). Bibliographic databases were searched from inception to 31 May 2019, to identify all published studies providing data on AF in populations living in SSA. A total of 72 studies were included. The community-based prevalence of AF was 4.3% and 0.7% in individuals aged ≥40 years and aged ≥70 years, respectively. The prevalence of AF ranged between 6.7% and 34.8% in patients with ischemic stroke, between 9.5% and 46.8% in those with rheumatic heart disease (RHD), between 5% and 31.5% in patients with dilated cardiomyopathy. The main risk factors for AF were hypertension, affecting at least one-third of patients with AF, and valvular heart disease (12.3%-44.4%) and cardiomyopathy (~20%). Complications of AF included heart failure in about two thirds and stroke in 10% to 15% of cases. The use of anticoagulation for stroke prevention was suboptimal. Rate control was the most frequent therapeutic strategy, used in approximately 65% to 95% of AF patients, with approximately 80% of them achieving rate control. The management of AF was associated with exorbitant cost. In conclusion, AF seems to have a higher prevalence in the general population than previously thought and is mostly associated with hypertension, cardiomyopathy, and RHD in SSA. It is associated with a high incidence of heart failure and stroke. The management of AF is suboptimal in SSA, especially with a low uptake of oral anticoagulation.
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Affiliation(s)
- Jean Jacques Noubiap
- Centre for Heart Rhythm Disorders, South Australian Health and Medical Research Institute (SAHMRI), University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia
| | - Ulrich Flore Nyaga
- Department of Internal Medicine and Specialties, Faculty of Medicine and Biomedical Sciences, Yaoundé, Cameroon
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Mapesi H, Paris DH. Non-Communicable Diseases on the Rise in Sub-Saharan Africa, the Underappreciated Threat of a Dual Disease Burden. PRAXIS 2019; 108:997-1005. [PMID: 31771492 DOI: 10.1024/1661-8157/a003354] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
In sub-Saharan Africa, the burden of non-communicable diseases (NCDs) remains under appreciated, but emerging evidence suggests it to be substantial. NCDs such as arterial hypertension, heart diseases, diabetes mellitus and chronic kidney diseases are especially relevant, and put additional strain on the already challenged health systems in this region. Moreover, NCDs appear to be associated with higher mortality and morbidity rates and are more common in younger population groups, in people from sub-Saharan Africa when compared to more developed countries. In this review, we summarize the current literature on the burden of NCDs in sub-Saharan Africa, and highlight the clinical implications of the most relevant etiologies, i.e. arterial hypertension, heart diseases, diabetes mellitus and chronic kidney diseases.
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Affiliation(s)
- Herry Mapesi
- Ifakara Health Institute, Ifakara branch, Ifakara,Tanzania
- Swiss Tropical and Public Health Institute, Basel
- University of Basel, Basel
| | - Daniel Henry Paris
- Swiss Tropical and Public Health Institute, Basel
- University of Basel, Basel
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Roderick P, Turner V, Readshaw A, Dogar O, Siddiqi K. The global prevalence of tobacco use in type 2 diabetes mellitus patients: A systematic review and meta-analysis. Diabetes Res Clin Pract 2019; 154:52-65. [PMID: 31202865 DOI: 10.1016/j.diabres.2019.05.035] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 01/03/2023]
Abstract
BACKGROUND A multi-layered association between tobacco use and type 2 diabetes mellitus (T2DM) is well established. However, global epidemiological patterns of tobacco use among T2DM patients are not well documented; this review thus aims to estimate the overall global burden of tobacco use in T2DM. METHODS A systematic review of studies published from Jan 1, 1990 to October 5, 2017 was undertaken, comprising: a comprehensive literature search on multiple electronic databases; quality assessment of studies; data extraction for the primary (prevalence of tobacco use in T2DM patients) and secondary outcomes (patterns of tobacco use in T2DM patients); and a meta-analysis. The review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. A protocol for this review is available on PROSPERO (CRD42016038793). FINDINGS 74 studies were included in the review, reporting data from 3.2 million participants across 33 countries. Global mean prevalence of tobacco use in T2DM was 20·81% (95% CI 18·93-22·76), and was higher in the WHO East Asia and Pacific and South Asia regions, compared to the Americas, Middle East and North Africa, Europe and Central Asia. In studies which compared prevalence of tobacco use in patients to non-patients, patients with T2DM were 26% less likely to use tobacco (pooled OR = 0·74 (CI 0·61-0·88). INTERPRETATION Tobacco is used by one in five T2DM patients globally, but usage is less likely in patients than in non-patients. Global patterns of use demonstrated by this review have implications for both prevention and The understanding of diabetes burden, and the success of tobacco cessation strategies.
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Affiliation(s)
| | | | - Anne Readshaw
- Department of Health Sciences, University of York, United Kingdom
| | - Omara Dogar
- Department of Health Sciences, University of York, United Kingdom
| | - Kamran Siddiqi
- Department of Health Sciences, University of York, United Kingdom
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