1
|
Abohashem S, Nasir K, Munir M, Sayed A, Aldosoky W, Abbasi T, Michos ED, Gulati M, Rana JS. Lack of leisure time physical activity and variations in cardiovascular mortality across US communities: a comprehensive county-level analysis (2011-2019). Br J Sports Med 2024; 58:204-212. [PMID: 38212043 DOI: 10.1136/bjsports-2023-107220] [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] [Accepted: 11/18/2023] [Indexed: 01/13/2024]
Abstract
OBJECTIVES To investigate the associations between county-level proportions of adults not engaging in leisure-time physical activity (no LTPA) and age-adjusted cardiovascular mortality (AACVM) rates in the overall US population and across demographics. METHODS Analysing 2900 US counties from 2011 to 2019, we used the Centers for Disease Control and Prevention (CDC) databases to obtain annual AACVM rates. No LTPA data were sourced from the CDC's Behavioural Risk Factor Surveillance System survey and county-specific rates were calculated using a validated multilevel regression and poststratification modelling approach. Multiple regression models assessed associations with county characteristics such as socioeconomic, environmental, clinical and healthcare access factors. Poisson generalised linear mixed models were employed to calculate incidence rate ratios (IRR) and additional yearly deaths (AYD) per 100 000 persons. RESULTS Of 309.9 million residents in 2900 counties in 2011, 7.38 million (2.4%) cardiovascular deaths occurred by 2019. County attributes such as socioeconomic, environmental and clinical factors accounted for up to 65% (adjusted R2=0.65) of variance in no LTPA rates. No LTPA rates associated with higher AACVM across demographics, notably among middle-aged adults (standardised IRR: 1.06; 95% CI (1.04 to 1.07)), particularly women (1.09; 95% CI (1.07 to 1.12)). The highest AYDs were among elderly non-Hispanic black individuals (AYD=68/100 000). CONCLUSIONS Our study reveals a robust association between the high prevalence of no LTPA and elevated AACVM rates beyond other social determinants. The most at-risk groups were middle-aged women and elderly non-Hispanic black individuals. Further, county-level characteristics accounted for substantial variance in community LTPA rates. These results emphasise the need for targeted public health measures to boost physical activity, especially in high-risk communities, to reduce AACVM.
Collapse
Affiliation(s)
- Shady Abohashem
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital - Harvard Medical School, Boston, Massachusetts, USA
- Epidemiology Department, Harvard University T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Khurram Nasir
- Department of Cardiology Houston Methodist DeBakey Heart, Vascular Center, Houston, Texas, USA
| | - Malak Munir
- Department of Medicine, Ain Shams University, Cairo, Egypt
| | - Ahmed Sayed
- Department of Medicine, Ain Shams University, Cairo, Egypt
| | - Wesam Aldosoky
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital - Harvard Medical School, Boston, Massachusetts, USA
| | - Taimur Abbasi
- Cardiovascular Research Center and Cardiology Division, Massachusetts General Hospital - Harvard Medical School, Boston, Massachusetts, USA
| | - Erin D Michos
- Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Martha Gulati
- Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA
| | - Jamal S Rana
- Department of Cardiology and Division of Research, The Permanente Medical Group, Kaiser Permanente Northern California, Oakland, California, USA
| |
Collapse
|
2
|
Xu D, Xu Y, Zhang B, Wang Y, Han L, Sun J, Sun H. Higher dietary intake of aromatic amino acids was associated with lower risk of cardiovascular disease mortality in adult participants in NHANES III. Nutr Res 2023; 113:39-48. [PMID: 37023498 DOI: 10.1016/j.nutres.2023.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 01/08/2023] [Accepted: 03/07/2023] [Indexed: 03/19/2023]
Abstract
Little is known about the associations between dietary aromatic amino acids (AAAs) intake and mortality from all causes and cardiovascular disease (CVD). Accordingly, we evaluated these associations in the adult population of the United States using data from the Third National Health and Nutrition Examination Survey. This was a cohort study. Dietary intake of AAAs (tyrosine, phenylalanine, and tryptophan) was determined from the total nutrient intake document. We hypothesized that higher dietary AAA intake would lower all-cause and CVD mortality in adults in the United States. First, we categorized participants into quintiles based on their dietary intakes of total AAAs, tyrosine, phenylalanine, and tryptophan. Then, we established 4 Cox proportional-hazards models (models 1-4) and calculated hazard ratios and 95% confidence intervals to estimate the associations between dietary intakes of total AAAs, tyrosine, phenylalanine, and tryptophan and all-cause and CVD mortality. Mortality status was primarily obtained from files linked to the National Death Index records up to December 31, 2015. After multivariate adjustment, the hazard ratios (95% confidence intervals) of CVD mortality in the highest quintiles of dietary total AAAs, tyrosine, phenylalanine, and tryptophan intake (reference: the lowest quintiles) were 0.66 (0.52-0.84), 0.65 (0.51-0.83), 0.66 (0.52-0.85) and 0.64 (0.50-0.82), respectively. In a nationally representative cohort, higher dietary intakes of total AAA and the 3 individual AAAs were independently associated with a lower risk of CVD mortality, and these associations were stronger in non-Hispanic White people than in other people.
Collapse
|
3
|
Lennon JC, Aita SL, Del Bene VA, Rhoads T, Resch ZJ, Eloi JM, Walker KA. Black and White individuals differ in dementia prevalence, risk factors, and symptomatic presentation. Alzheimers Dement 2022; 18:1461-1471. [PMID: 34854531 PMCID: PMC9160212 DOI: 10.1002/alz.12509] [Citation(s) in RCA: 55] [Impact Index Per Article: 27.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 09/23/2021] [Accepted: 09/28/2021] [Indexed: 01/25/2023]
Abstract
INTRODUCTION Although dementia prevalence differs by race, it remains unclear whether cognition and neuropsychiatric symptom severity differ between Black and White individuals with dementia. METHODS Using National Alzheimer's Coordinating Center (NACC) data, we evaluated dementia prevalence in non-Hispanic Black and White participants and compared their clinicodemographic characteristics. We examined race differences in cognition, neuropsychiatric symptoms, and functional abilities in participants with dementia using multivariable linear and logistic regression models. RESULTS We included 5,700 Black and 31,225 White participants across 39 Alzheimer's Disease Research Centers. Of these, 1,528 (27%) Black and 11,267 (36%) White participants had dementia diagnoses. Despite having lower dementia prevalence, risk factors were more prevalent among Black participants. Black participants with dementia showed greater cognitive deficits, neuropsychiatric symptoms/severity, and functional dependence. DISCUSSION Despite lower dementia prevalence, Black participants with dementia had more dementia risk factors, as well as greater cognitive impairment and neuropsychiatric symptom severity than White participants.
Collapse
Affiliation(s)
- Jack C. Lennon
- Department of Psychology, Adler University, Chicago, IL 60602, USA
| | - Stephen L. Aita
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Victor A. Del Bene
- Department of Neurology, University of Alabama at Birmingham School of Medicine, Birmingham, AL 35233, USA
| | - Tasha Rhoads
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Zachary J. Resch
- Department of Psychology, Rosalind Franklin University of Medicine & Science, North Chicago, IL 60064, USA
| | - Janelle M. Eloi
- Department of Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH 03755, USA
| | - Keenan A. Walker
- Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD 21224, USA,Corresponding author: Keenan Walker, Ph.D., BRC BG RM 04B311, 251 Bayview BLVD., Baltimore, MD 21224, , Office Phone: 667-205-2657
| |
Collapse
|
4
|
Laptop-Administered NIH Toolbox and Cogstate Brief Battery in Community-Dwelling Black Adults: Unexpected Pattern of Cognitive Performance between MCI and Healthy Controls. J Int Neuropsychol Soc 2022; 28:239-248. [PMID: 33752763 PMCID: PMC10112283 DOI: 10.1017/s135561772100028x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Black adults are approximately twice as likely to develop Alzheimer's disease (AD) than non-Hispanic Whites and access diagnostic services later in their illness. This dictates the need to develop assessments that are cost-effective, easily administered, and sensitive to preclinical stages of AD, such as mild cognitive impairment (MCI). Two computerized cognitive batteries, NIH Toolbox-Cognition and Cogstate Brief Battery, have been developed. However, utility of these measures for clinical characterization remains only partially determined. We sought to determine the convergent validity of these computerized measures in relation to consensus diagnosis in a sample of MCI and healthy controls (HC). METHOD Participants were community-dwelling Black adults who completed the neuropsychological battery and other Uniform Data Set (UDS) forms from the AD centers program for consensus diagnosis (HC = 61; MCI = 43) and the NIH Toolbox-Cognition and Cogstate batteries. Discriminant function analysis was used to determine which cognitive tests best differentiated the groups. RESULTS NIH Toolbox crystallized measures, Oral Reading and Picture Vocabulary, were the most sensitive in identifying MCI apart from HC. Secondarily, deficits in memory and executive subtests were also predictive. UDS neuropsychological test analyses showed the expected pattern of memory and executive functioning tests differentiating MCI from HC. CONCLUSIONS Contrary to expectation, NIH Toolbox crystallized abilities appeared preferentially sensitive to diagnostic group differences. This study highlights the importance of further research into the validity and clinical utility of computerized neuropsychological tests within ethnic minority populations.
Collapse
|
5
|
Khalid SI, Maasarani S, Shanker RM, Becerra AZ, Omotosho P, Torquati A. Social determinants of health and their impact on rates of postoperative complications among patients undergoing vertical sleeve gastrectomy. Surgery 2021; 171:447-452. [PMID: 34303546 DOI: 10.1016/j.surg.2021.06.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 06/07/2021] [Accepted: 06/11/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Vertical sleeve gastrectomy is one of the most common bariatric procedures worldwide, but the impact of social determinants of health on postoperative outcomes for this procedure has not been well characterized. The objective of this study was to analyze the impact that social determinants of health have on postoperative outcomes after vertical sleeve gastrectomy. METHOD This was a population-based study using the MARINER-15 database, an all-payer claims database. The primary endpoint of this study was the development of any complication, including cardiac complication, acute kidney injury, deep vein thrombosis, wound complication, hematoma, pneumonia, pulmonary embolism, transfusion, or urinary tract infection within 60 days, 30- and 90-day all-cause mortality, or readmission within 30 or 90 days in patients undergoing vertical sleeve gastrectomy procedures. RESULTS Individuals in the social determinants of health cohort had a significantly longer length of stay when compared with those without social determinants of health (3.07 days vs 1.582 days, P < .001). These patients were more likely to develop any complication within 60 days after surgery (hazard ratio 1.20, 95% confidence interval 1.03-1.40) but were less likely to return for readmission within 30 and 90 days (hazard ratio 0.80, 95% confidence interval 0.66-0.96; hazard ratio 0.85 95% confidence interval 0.72-0.99). CONCLUSION Vertical sleeve gastrectomy is an effective treatment for morbid obesity and its associated comorbidities. Although patients with social determinants of health are more likely to develop any of the analyzed postoperative complications within 60 days, they are less likely to return for readmission, highlighting the importance of focused follow-up and other measures to avoid lapses in care and eliminate further barriers to care in this population.
Collapse
Affiliation(s)
- Syed I Khalid
- Department of Surgery, Rush University Medical Center, Chicago, IL; Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL.
| | - Samantha Maasarani
- Department of Plastic Surgery, Cleveland Clinic, Cleveland, OH. https://twitter.com/smaasarani
| | - Rachyl M Shanker
- Department of Surgery, Loyola University Medical Center, Maywood, IL
| | - Adan Z Becerra
- Department of Surgery, Rush University Medical Center, Chicago, IL. https://twitter.com/AdanZBecerra1
| | - Philip Omotosho
- Department of Surgery, Rush University Medical Center, Chicago, IL. https://twitter.com/RushBariatrics
| | - Alfonso Torquati
- Department of Surgery, Rush University Medical Center, Chicago, IL. https://twitter.com/RushSurgery
| |
Collapse
|
6
|
Yan Y, Li S, Liu Y, Bazzano L, He J, Mi J, Chen W. The impact of body weight trajectory from childhood on chronic inflammation in adulthood: The Bogalusa Heart Study. Pediatr Investig 2021; 5:21-27. [PMID: 33778423 PMCID: PMC7984006 DOI: 10.1002/ped4.12248] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 02/17/2021] [Indexed: 12/24/2022] Open
Abstract
IMPORTANCE The impact of long-term burden of excessive body weight, beginning in childhood, on inflammatory status in adulthood has been poorly described. OBJECTIVE To characterize the longitudinal body mass index (BMI) trajectory from childhood and examine its relationship with inflammatory status in adulthood. METHODS We included 1285 adults who had 4-15 repeat measurements of BMI from childhood to adulthood. The area under the curve (AUC) of growth curves was calculated to characterize long-term burden (total AUC) and trends (incremental AUC) of BMI. RESULTS After adjusting for covariates, higher values of BMI in terms of childhood and adulthood, as well as total and incremental AUC, were strongly associated with elevated levels of adult C-reactive protein (CRP) in the four race-sex groups. There were significant differences in linear and nonlinear curve parameters between the normal and high CRP groups for all race-sex groups (P < 0.01). Compared with participants who had consistently low BMI in both childhood and adulthood, participants with high BMI in adulthood had higher CRP levels (P < 0.001), irrespective of their childhood BMI status; participants with high BMI in childhood but low BMI in adulthood had similar adult CRP levels. INTERPRETATION The impact of excessive body weight on inflammation is cumulative and exacerbated over time. The influence of childhood overweight/obesity on inflammatory status in adulthood can be alleviated by reducing adiposity in adulthood.
Collapse
Affiliation(s)
- Yinkun Yan
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Shengxu Li
- Children’s Minnesota Research InstituteChildren’s Hospitals and Clinics of MinnesotaMinneapolisMNUSA
| | - Yang Liu
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
- Department of CardiologyThe First Affiliated Hospital of Soochow UniversitySuzhouChina
| | - Lydia Bazzano
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Jiang He
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| | - Jie Mi
- Department of Non‐communicable Disease ManagementBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Wei Chen
- Department of EpidemiologyTulane University School of Public Health and Tropical MedicineNew OrleansLAUSA
| |
Collapse
|
7
|
Characteristics and resolution of hypertension in obese African American bariatric cohort. Sci Rep 2021; 11:1683. [PMID: 33462353 PMCID: PMC7814052 DOI: 10.1038/s41598-021-81360-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 12/15/2020] [Indexed: 01/08/2023] Open
Abstract
Weight reduction continues to be first-line therapy in the treatment of hypertension (HTN). However, the long-term effect of bariatric malabsorptive surgical techniques such as Roux-en-Y Gastric Bypass (RYGB) surgery in the management of hypertension (HTN) is less clear. African Americans (AA) are disproportionately affected by obesity and hypertension and have inconsistent outcomes after bariatric surgery (BS). Despite a plethora of bariatric literature, data about characteristics of a predominantly AA bariatric hypertensive cohort including hypertension in obese (HIO) are scarce and underreported. The aims of this study were, (1) to describe the preoperative clinical characteristics of HIO with respect to HTN status and age, and (2) to identify predictors of HTN resolution one year after RYGB surgery in an AA bariatric cohort enrolled at the Howard University Center for Wellness and Weight Loss Surgery (HUCWWS). In the review of 169 AA bariatric patients, the average BMI was 48.50 kg/m2 and the average age was 43.86 years. Obese hypertensive patients were older (46 years vs. 37.89 years; p < .0001); had higher prevalence of diabetes mellitus (DM, 43.09% vs. 10.87%; p < .0001) and dyslipidemia (38.2% vs. 13.04%; p 0.002). Hypertensive AA who were taking ≥ 2 antihypertensive medications prior to RYGB were 18 times less likely to experience HTN resolution compared to hypertensive AA taking 0–1 medications, who showed full or partial response. Also, HIO was less likely to resolve after RYGB surgery in patients who needed ≥ 2 antihypertensive medications prior to surgical intervention.
Collapse
|
8
|
Hyacinth HI, Franceschini N, Seals SR, Irvin MR, Chaudhary N, Naik RP, Alonso A, Carty CL, Burke GL, Zakai NA, Winkler CA, David VA, Kopp JB, Judd SE, Adams RJ, Gee BE, Longstreth WT, Egede L, Lackland DT, Greenberg CS, Taylor H, Manson JE, Key NS, Derebail VK, Kshirsagar AV, Folsom AR, Konety SH, Howard V, Allison M, Wilson JG, Correa A, Zhi D, Arnett DK, Howard G, Reiner AP, Cushman M, Safford MM. Association of Sickle Cell Trait With Incidence of Coronary Heart Disease Among African American Individuals. JAMA Netw Open 2021; 4:e2030435. [PMID: 33399855 PMCID: PMC7786247 DOI: 10.1001/jamanetworkopen.2020.30435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 10/21/2020] [Indexed: 12/20/2022] Open
Abstract
IMPORTANCE The incidence of and mortality from coronary heart disease (CHD) are substantially higher among African American individuals compared with non-Hispanic White individuals, even after adjusting for traditional factors associated with CHD. The unexplained excess risk might be due to genetic factors related to African ancestry that are associated with a higher risk of CHD, such as the heterozygous state for the sickle cell variant or sickle cell trait (SCT). OBJECTIVE To evaluate whether there is an association between SCT and the incidence of myocardial infarction (MI) or composite CHD outcomes in African American individuals. DESIGN, SETTING, AND PARTICIPANTS This cohort study included 5 large, prospective, population-based cohorts of African American individuals in the Women's Health Initiative (WHI) study, the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, the Multi-Ethnic Study of Atherosclerosis (MESA), the Jackson Heart Study (JHS), and the Atherosclerosis Risk in Communities (ARIC) study. The follow-up periods included in this study were 1993 and 1998 to 2014 for the WHI study, 2003 to 2014 for the REGARDS study, 2002 to 2016 for the MESA, 2002 to 2015 for the JHS, and 1987 to 2016 for the ARIC study. Data analysis began in October 2013 and was completed in October 2020. EXPOSURES Sickle cell trait status was evaluated by either direct genotyping or high-quality imputation of rs334 (the sickle cell variant). Participants with sickle cell disease and those with a history of CHD were excluded from the analyses. MAIN OUTCOMES AND MEASURES Incident MI, defined as adjudicated nonfatal or fatal MI, and incident CHD, defined as adjudicated nonfatal MI, fatal MI, coronary revascularization procedures, or death due to CHD. Cox proportional hazards regression models were used to estimate the hazard ratio for incident MI or CHD comparing SCT carriers with noncarriers. Models were adjusted for age, sex (except for the WHI study), study site or region of residence, hypertension status or systolic blood pressure, type 1 or 2 diabetes, serum high-density lipoprotein level, total cholesterol level, and global ancestry (estimated from principal components analysis). RESULTS A total of 23 197 African American men (29.8%) and women (70.2%) were included in the combined sample, of whom 1781 had SCT (7.7% prevalence). Mean (SD) ages at baseline were 61.2 (6.9) years in the WHI study (n = 5904), 64.0 (9.3) years in the REGARDS study (n = 10 714), 62.0 (10.0) years in the MESA (n = 1556), 50.3 (12.0) years in the JHS (n = 2175), and 53.2 (5.8) years in the ARIC study (n = 2848). There were no significant differences in the distribution of traditional factors associated with cardiovascular disease by SCT status within cohorts. A combined total of 1034 participants (76 with SCT) had incident MI, and 1714 (137 with SCT) had the composite CHD outcome. The meta-analyzed crude incidence rate of MI did not differ by SCT status and was 3.8 per 1000 person-years (95% CI, 3.3-4.5 per 1000 person-years) among those with SCT and 3.6 per 1000 person-years (95% CI, 2.7-5.1 per 1000 person-years) among those without SCT. For the composite CHD outcome, these rates were 7.3 per 1000 person-years (95% CI, 5.5-9.7 per 1000 person-years) among those with SCT and 6.0 per 1000 person-years (95% CI, 4.9-7.4 per 1000 person-years) among those without SCT. Meta-analysis of the 5 study results showed that SCT status was not significantly associated with MI (hazard ratio, 1.03; 95% CI, 0.81-1.32) or the composite CHD outcome (hazard ratio, 1.16; 95% CI, 0.92-1.47). CONCLUSIONS AND RELEVANCE In this cohort study, there was not an association between SCT and increased risk of MI or CHD in African American individuals. These disorders may not be associated with sickle cell trait-related sudden death in this population.
Collapse
Affiliation(s)
- Hyacinth I. Hyacinth
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Nora Franceschini
- Department of Epidemiology, University of North Carolina, Chapel Hill
| | - Samantha R. Seals
- Department of Mathematics and Statistics, University of West Florida, Pensacola
| | | | - Ninad Chaudhary
- School of Public Health, University of Alabama at Birmingham, Birmingham
| | - Rakhi P. Naik
- Division of Hematology, Department of Medicine, The Johns Hopkins University, Baltimore, Maryland
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Cara L. Carty
- Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Gregory L. Burke
- Department of Public Health Sciences, Wake Forest University, Winston-Salem, North Carolina
| | - Neil A. Zakai
- Department of Medicine and Pathology and Laboratory Medicine, University of Vermont, Burlington
| | - Cheryl A. Winkler
- Basic Science Laboratory, National Cancer Institute and Frederick National Laboratory, Leidos Biomedical Research, Frederick, Maryland
| | - Victor A. David
- Basic Science Laboratory, National Cancer Institute and Frederick National Laboratory, Leidos Biomedical Research, Frederick, Maryland
| | - Jeffrey B. Kopp
- National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland
| | - Suzanne E. Judd
- School of Public Health, University of Alabama at Birmingham, Birmingham
| | - Robert J. Adams
- Stroke Center, Department of Neurology, Medical University of South Carolina, Charleston
| | - Beatrice E. Gee
- Aflac Cancer and Blood Disorder Center, Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - W. T. Longstreth
- Department of Neurology, University of Washington, Seattle
- Department of Epidemiology, University of Washington, Seattle
| | - Leonard Egede
- Division of General Internal Medicine, Medical College of Wisconsin, Milwaukee
| | - Daniel T. Lackland
- Stroke Center, Department of Neurology, Medical University of South Carolina, Charleston
| | - Charles S. Greenberg
- Division of Hematology-Oncology, Medical University of South Carolina, Charleston
| | - Herman Taylor
- Cardiovascular Research Institute, Morehouse School of Medicine, Atlanta, Georgia
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Nigel S. Key
- Division of Hematology/Oncology, University of North Carolina at Chapel Hill, Chapel Hill
| | - Vimal K. Derebail
- University of North Carolina Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Abhijit V. Kshirsagar
- University of North Carolina Kidney Center, University of North Carolina at Chapel Hill, Chapel Hill
| | - Aaron R. Folsom
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis
| | - Suma H. Konety
- Division of Cardiology, University of Minnesota Medical Center, Minneapolis
| | - Virginia Howard
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham
| | - Matthew Allison
- Department of Family Medicine and Public Health, University of California San Diego, San Diego
| | - James G. Wilson
- Department of Physiology and Biophysics, University of Mississippi Medical Center, Jackson
| | - Adolfo Correa
- Jackson Heart Study, University of Mississippi Medical Center, Jackson
| | - Degui Zhi
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham
| | | | - George Howard
- Department of Biostatistics, School of Public Health, University of Alabama at Birmingham, Birmingham
| | | | - Mary Cushman
- Department of Medicine and Pathology and Laboratory Medicine, University of Vermont, Burlington
| | - Monika M. Safford
- Division of General Internal Medicine, Weill Cornell Medicine, New York, New York
| |
Collapse
|
9
|
Qi J, Hu H, Yaghjyan L, An L, Kalim HA, Cooke EO, Cheng TYD. Association of Adipose Tissue Distribution With Type 2 Diabetes in Breast Cancer Patients. Breast Cancer (Auckl) 2020; 14:1178223420972369. [PMID: 33281450 PMCID: PMC7691945 DOI: 10.1177/1178223420972369] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 10/12/2020] [Indexed: 01/02/2023] Open
Abstract
PURPOSE We examined the association of adipose tissue distribution with type 2 diabetes (T2D) in breast cancer patients. METHODS Participants (N = 238) diagnosed with breast cancer at 20-75 years old who received breast cancer treatment at a major hospital from January 1, 2012, to December 31, 2017, with at least one completed and identifiable abdominal or pelvic computed tomography (CT) scan and data regarding race and ethnicity were included. Thirty-two breast cancer patients were identified as T2D patients after their breast cancer diagnoses. The adipose tissue distribution (visceral fat area [VFA], subcutaneous fat area [SFA], and the ratio of VFA to SFA [VFA/SFA]) was quantified on CT images of the third lumbar vertebra. T2D status was retrieved from patients' electronic medical records. The association of adipose tissue distribution with T2D in women with breast cancer was examined using multivariable logistic regression. RESULTS Participants with T2D had significantly smaller SFA compared to those without T2D (odds ratio [OR] = 0.88, 95% confidence interval [95% CI] = 0.81-0.96, per 10 cm2 SFA). A positive association of VFA/SFA ratio with T2D was observed (OR = 19.57, 95% CI = 3.26-117.42, per unit VFA/SFA), although the estimate was imprecise. CONCLUSIONS The amount of subcutaneous adipose tissue was inversely associated with T2D, and the ratio of the amount of visceral adipose tissue to the amount of subcutaneous adipose tissue was positively associated with T2D in breast cancer patients.
Collapse
Affiliation(s)
- Jia Qi
- School of Population and Public Health,
The University of British Columbia, Vancouver, BC, Canada
| | - Hui Hu
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Lusine Yaghjyan
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Lejun An
- Department of Hypertension, Chinese
Medicine Hospital of the Xinjiang University of Medicine, Urumqi, China
| | - Harris A Kalim
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| | - Erinn O Cooke
- Department of Radiology, College of
Medicine, University of Florida, Gainesville, FL, USA
| | - Ting-Yuan David Cheng
- Department of Epidemiology, College of
Public Health and Health Professions & College of Medicine, University of
Florida, Gainesville, FL, USA
| |
Collapse
|
10
|
Budden T, Dimmock JA, Smith B, Beauchamp M, Rosenberg M, Jackson B. Overweight and obese men's experiences in a sport-based weight loss intervention for men. PSYCHOLOGY OF SPORT AND EXERCISE 2020; 50:101750. [PMID: 32834779 PMCID: PMC7324325 DOI: 10.1016/j.psychsport.2020.101750] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 06/03/2020] [Accepted: 06/22/2020] [Indexed: 05/14/2023]
Abstract
In Western countries, such as Australia and the UK, a significantly greater proportion of men (relative to women) are overweight and obese, yet relatively few weight loss interventions have been developed that sufficiently target men. This lack of male-focused programming may be in part because 'traditional' weight loss programs are unappealing for what is considered a 'hard-to-reach' population. One program that appears to have such appeal for men is the MAN v FAT Football (MVFF) program, based out of the United Kingdom, which is designed for men with a body mass index of (or greater than) 27.5. MVFF encourages men's participation in a community-based weight loss program that incentivizes weight loss through participation in a football league, and since 2016 MVFF has supported the weight loss efforts of several thousand men. Using MVFF as an exemplar, our aim was to derive insight into how men experience a male-only competitive, sport-based weight loss program. We recruited twenty-seven players (Mage = 41.13, SD = 9.93), and ten coaches (Mage = 31.8, SD = 11.55) from program locations throughout the United Kingdom. Using semi-structured interviews and thematic analysis, we identified several appraisal aspects of the program that players and coaches considered important, including the appeal of sport, competition on a level playing field, being part of a team, camaraderie, accountability, men sharing issues with other men, gender-sensitized environment, likeminded and similar men, and perceptions that traditional weight loss programs are tailored towards women. Player experiences (i.e., competence and enjoyment) and functional supports in the program (e.g., player handbook, weight loss coach) were reported to drive outcomes of effective weight loss and program retention. Interventions aiming to target men may be more successful working with rather than against formulations of identity such as masculinities, and this can be achieved by tailoring program content (e.g., messaging), settings (e.g., among men sharing similar characteristics such as body-type or goals), and mode of delivery (e.g., through organized sports, and leveraging competition to drive healthy behaviours).
Collapse
Affiliation(s)
- Timothy Budden
- School of Human Sciences, The University of Western Australia, Australia
- Corresponding author.
| | - James A. Dimmock
- Department of Psychology, College of Healthcare Sciences, James Cook University, Australia
| | - Brett Smith
- Department of Sport and Exercise Sciences, Durham University, United Kingdom
| | - Mark Beauchamp
- School of Kinesiology, University of British Columbia, Canada
| | - Michael Rosenberg
- School of Human Sciences, The University of Western Australia, Australia
| | - Ben Jackson
- School of Human Sciences, The University of Western Australia, Australia
| |
Collapse
|
11
|
Johnson LA, Large SE, Izurieta Munoz H, Hall JR, O'Bryant SE. Vascular Depression and Cognition in Mexican Americans. Dement Geriatr Cogn Disord 2019; 47:68-78. [PMID: 30861514 DOI: 10.1159/000494272] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 10/02/2018] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Mexican Americans are at increased risk of developing mild cognitive impairment (MCI) and Alzheimer's disease compared to non-Hispanic whites. This study sought to examine the relationship between vascular risk, depression, and cognition in Mexican American elders. METHODS Data from 470 (390 normal controls, 80 MCI patients) Mexican Americans enrolled in the Health and Aging Brain among Latino Elders (HABLE) study were used. The cardiovascular risk was assessed by the Framingham Risk Score. Cognition was assessed with a neuropsychological battery, and depression was assessed based on scores from the Geriatric Depression Scale (GDS). ANOVAs were utilized to determine the differences in neuropsychological scores of normal controls with and without depression and CVD risk (low vs. high). Follow-up logistic regression was conducted to determine MCI risk. RESULTS The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance in Mexican Americans. Depressed women with high CVD risk were more likely to have executive dysfunction, language deficits, and poorer global cognition than nondepressed women with a high CVD risk. In Mexican American men, those with a high vascular risk and depression were more likely to have executive dysfunction and poorer immediate memory than the nondepressed high-risk group. Higher GDS scores (OR = 1.10; 95% CI 1.02-1.10, p = 0.001) and higher vascular risk scores (OR = 1.05; 95% CI 1.02-1.10, p = 0.001) significantly predicted MCI status in Mexican Americans. CONCLUSION The results of this study indicated that comorbid depression and a high CVD risk were associated with poorer cognitive performance and increased risk of MCI in Mexican Americans.
Collapse
Affiliation(s)
- Leigh Ann Johnson
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA,
| | - Stephanie Ellen Large
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Haydee Izurieta Munoz
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - James Richard Hall
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| | - Sid E O'Bryant
- Department of Pharmacology and Neuroscience, University of North Texas Health Science Center, Fort Worth, Texas, USA
| |
Collapse
|
12
|
Man REK, Gan AHW, Fenwick EK, Gan ATL, Gupta P, Sabanayagam C, Tan N, Wong KH, Wong TY, Cheng CY, Lamoureux EL. Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease. Popul Health Metr 2019; 17:17. [PMID: 31806040 PMCID: PMC6896313 DOI: 10.1186/s12963-019-0197-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 11/06/2019] [Indexed: 01/08/2023] Open
Abstract
Background To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.
Collapse
Affiliation(s)
- Ryan E K Man
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alvin Hong Wei Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Eva K Fenwick
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Alfred Tau Liang Gan
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Preeti Gupta
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore
| | - Charumathi Sabanayagam
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore
| | - Nicholas Tan
- National University of Singapore, Singapore, Singapore
| | - Kah Hie Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,National University of Singapore, Singapore, Singapore
| | - Tien Yin Wong
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ching-Yu Cheng
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore.,Duke-NUS Medical School, Singapore, Singapore.,Singapore National Eye Centre, Singapore, Singapore.,National University of Singapore, Singapore, Singapore
| | - Ecosse L Lamoureux
- Singapore Eye Research Institute, Singapore National Eye Centre, 20 College Rd, The Academia, Discovery Tower Level 6, Singapore, 169856, Singapore. .,Duke-NUS Medical School, Singapore, Singapore. .,National University of Singapore, Singapore, Singapore.
| |
Collapse
|
13
|
Siahpush M, Robbins RE, Ramos AK, Michaud TL, Clarke MA, King KM. Does Difference in Physical Activity Between Blacks and Whites Vary by Sex, Income, Education, and Region of Residence? Results from 2008 to 2017 National Health Interview Surveys. J Racial Ethn Health Disparities 2019; 6:883-891. [PMID: 31004290 DOI: 10.1007/s40615-019-00586-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 03/21/2019] [Accepted: 03/25/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To examine how the effect of race (Black versus White) on meeting physical activity (PA) guidelines varies by sex, income, education, and region of residence. METHODS We pooled data from 10 consecutive years (2008 to 2017) of the National Health Interview Survey. We used logistic regression to assess the extent to which the effect of race on meeting the U.S. federal guidelines for PA varies by sex, income, education, and region, after controlling for several health-related variables. The analysis sample size was 225,600 (102,348 men and 123,252 women). RESULTS Race and most of the other covariates interacted with sex in their effect on meeting PA guidelines; therefore, separate models for men and women were estimated. In each model, race interacted with income and region, but not with education. Among men, Blacks were more likely to meet PA guidelines than Whites in nearly all income categories and regions. The race effect was weakest among the poor and in the Northeast region. Among women, Blacks were generally less likely than Whites to meet the guidelines and the race effect was largest among the poor and in the Northeast region. CONCLUSION This study showed that the difference between Blacks and Whites in the extent to which they adhere to federal PA guidelines varies by sex, income, and region of residence. Black women whole live below the poverty threshold are less likely than other demographic groups to meet the PA guidelines. Targeted interventions to promote PA among this population group are warranted.
Collapse
Affiliation(s)
- Mohammad Siahpush
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center; 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA.
| | - Regina E Robbins
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center; 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA
| | - Athena K Ramos
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center; 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA
| | - Tzeyu L Michaud
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center; 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA
| | - Martina A Clarke
- Department of Internal Medicine, College of Medicine, University of Nebraska Medical Center; 982265 Nebraska Medical Center, Omaha, NE, 68198-2265, USA
| | - Keyonna M King
- Department of Health Promotion, College of Public Health, University of Nebraska Medical Center; 984365 Nebraska Medical Center, Omaha, NE, 68198-4365, USA
| |
Collapse
|
14
|
Zou H, Yin P, Liu L, Liu W, Zhang Z, Yang Y, Li W, Zong Q, Yu X. Body-Weight Fluctuation Was Associated With Increased Risk for Cardiovascular Disease, All-Cause and Cardiovascular Mortality: A Systematic Review and Meta-Analysis. Front Endocrinol (Lausanne) 2019; 10:728. [PMID: 31787929 PMCID: PMC6856014 DOI: 10.3389/fendo.2019.00728] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 10/09/2019] [Indexed: 01/05/2023] Open
Abstract
Background: The aim of this study was to evaluate associations between body-weight fluctuation and risk of mortality and cardiovascular diseases (CVD). Methods: PubMed, EMBASE databases and Cochrane Library were searched for cohort studies published up to May 20, 2019, reporting on associations of body-weight fluctuation and mortality from all causes, CVD and cancer, as well as morbidity of CVD and hypertension. Summary relative risks (RRs) were estimated using a random-effects model. Results: Twenty-five eligible publications from 23 studies with 441,199 participants were included. Body-weight fluctuation was associated with increased risk for all-cause mortality (RR, 1.41; 95% confidence interval (CI): 1.27-1.57), CVD mortality (RR, 1.36; 95% CI 1.22-1.52), and morbidity of CVD (RR, 1.49, 95% CI 1.26-1.76) and hypertension (RR, 1.35, 95% CI 1.14-1.61). However, there was no significant association between weight fluctuation and cancer mortality (RR, 1.01; 95% CI 0.90-1.13). No evidence of publication bias was observed (all P > 0.05) except for studies on all-cause mortality (Egger's test, P = 0.001; Begg's test, P = 0.014). Conclusions: Body-weight fluctuation was associated with higher mortality due to all causes and CVD and a higher morbidity of CVD and hypertension.
Collapse
Affiliation(s)
- Huajie Zou
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ping Yin
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liegang Liu
- Hubei Key Laboratory of Food Nutrition and Safety, Department of Nutrition and Food Hygiene, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Ministry of Education Key Lab of Environment and Health, School of Public Health, Tongji Medical College, Wuhan, China
| | - Wenhua Liu
- Medical Translation Center, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zeqing Zhang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Yang
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenjun Li
- Computer Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Qunchuan Zong
- Department of Orthopedics, The Affiliated Hospital of Qinghai University, Medical College of Qinghai University, Xining, China
| | - Xuefeng Yu
- Division of Endocrinology, Department of Internal Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- *Correspondence: Xuefeng Yu
| |
Collapse
|
15
|
Long-term outcomes after repair of symptomatic abdominal aortic aneurysms. J Vasc Surg 2018; 68:1360-1366. [DOI: 10.1016/j.jvs.2018.02.036] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 02/20/2018] [Indexed: 11/20/2022]
|
16
|
Flores YN, Zhang ZF, Bastani R, Leng M, Crespi CM, Ramírez-Palacios P, Stevens H, Salmerón J. Risk factors for liver disease among adults of Mexican descent in the United States and Mexico. World J Gastroenterol 2018; 24:4281-4290. [PMID: 30310261 PMCID: PMC6175761 DOI: 10.3748/wjg.v24.i37.4281] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/01/2018] [Accepted: 08/24/2018] [Indexed: 02/06/2023] Open
Abstract
AIM To compare the prevalence of chronic liver disease (CLD) risk factors in a representative sample of Mexican-Americans born in the United States (US) or Mexico, to a sample of adults in Mexico.
METHODS Data for Mexican-Americans in the US were obtained from the 1999-2014 National Health and Nutrition Examination Survey (NHANES), which includes persons of Mexican origin living in the US (n = 4274). The NHANES sample was restricted to Mexican-American participants who were 20 years and older, born in the US or Mexico, not pregnant or breastfeeding, and with medical insurance. The data in Mexico were obtained from the 2004-2013 Health Worker Cohort Study in Cuernavaca, Mexico (n = 9485). The following known risk factors for liver disease/cancer were evaluated: elevated aminotransferase levels (elevated alanine aminotransferase was defined as > 40 IU/L for males and females; elevated aspartate aminotransferase was defined as > 40 IU/L for males and females), infection with hepatitis B or hepatitis C, metabolic syndrome, high total cholesterol, diabetes, obesity, abdominal obesity, and heavy alcohol use. The main independent variables for this study classified individuals by country of residence (i.e., Mexico vs the US) and place of birth (i.e., US-born vs Mexico-born). Regression analyses were used to investigate CLD risk factors.
RESULTS After adjusting for socio-demographic characteristics, Mexican-American males were more likely to be obese, diabetic, heavy/binge drinkers or have abdominal obesity than males in Mexico. The adjusted multivariate results for females also indicate that Mexican-American females were significantly more likely to be obese, diabetic, be heavy/binge drinkers or have abdominal obesity than Mexican females. The prevalence ratios and prevalence differences mirror the multivariate analysis findings for the aforementioned risk factors, showing a greater risk among US-born as compared to Mexico-born Mexican-Americans.
CONCLUSION In this study, Mexican-Americans in the US had more risk factors for CLD than their counterparts in Mexico. These findings can be used to design and implement more effective health promotion policies and programs to address the specific factors that put Mexicans at higher risk of developing CLD in both countries.
Collapse
Affiliation(s)
- Yvonne N Flores
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
- UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA 90095, United States
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
| | - Zuo-Feng Zhang
- UCLA Department of Epidemiology, Fielding School of Public Health, Los Angeles, CA 90095, United States
| | - Roshan Bastani
- UCLA Department of Health Policy and Management and Kaiser Permanente Center for Health Equity, Fielding School of Public Health, Los Angeles, CA 90095, United States
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
| | - Mei Leng
- UCLA Division of General Internal Medicine and Health Services Research, Los Angeles, CA 90095, United States
| | - Catherine M Crespi
- UCLA Cancer Prevention and Control Research Center, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, Los Angeles, CA 90095, United States
- UCLA Department of Biostatistics, Fielding School of Public Health, Los Angeles, CA 90095, United States
| | - Paula Ramírez-Palacios
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
| | - Heather Stevens
- University of Washington, School of Medicine, Seattle, WA 98195, United States
| | - Jorge Salmerón
- Unidad de Investigación Epidemiológica y en Servicios de Salud, Delegación Morelos, Instituto Mexicano del Seguro Social, Cuernavaca, Morelos 62000, México
- Universidad Nacional Autónoma de México, Academic Epidemiology Research Unit, Avenida Universidad 3000, Ciudad Universitaria, Coyoacán, Mexico City 04510, México
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos 62100, México
| |
Collapse
|
17
|
Corbie-Smith G, Wiley-Cene C, Bess K, Young T, Dave G, Ellis K, Hoover SM, Lin FC, Wynn M, McFarlin S, Ede J. Heart Matters: a study protocol for a community based randomized trial aimed at reducing cardiovascular risk in a rural, African American community. BMC Public Health 2018; 18:938. [PMID: 30064398 PMCID: PMC6069773 DOI: 10.1186/s12889-018-5802-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 07/04/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND African Americans living in the rural south have the highest prevalence of cardiovascular disease (CVD) risk in the United States. Given this geographic and racial disparity, intervention implementation needs to be evaluated for effectiveness and feasibility with African Americans in the rural south. METHODS The trial developed out of a community-based participatory research partnership, Project GRACE, and community partners who are collaborators throughout the study. Heart Matters is a randomized stepped wedge trial that will assess the effectiveness of a 12-month behavioral change intervention adapted from PREMIER, an evidence-based treatment targeting multiple CVD risk factors. 140 participants will be recruited through 8 community- or faith-based organizations to participate in the intervention. Through matched pair randomization, organizations will be randomized to begin immediately after baseline data collection (Arm 1) or delayed 6 months (Arm 2). Data collection will occur at baseline, 6, 12, and 18 months. The primary outcome is change in body weight. In addition to assessing effectiveness, the study will also evaluate process and feasibility outcomes through quantitative and qualitative data collection. DISCUSSION This study will contribute to CVD prevention research and likely have a positive impact on the rural, African American community where the trial occurs. Our study is unique in its use of community partnerships to develop, implement, and evaluate the intervention. We expect that this approach will enhance the feasibility of the trial, as well as future dissemination and sustainability of the intervention. TRIAL REGISTRATION Clinical Trials, NCT02707432 . Registered 13 March 2016.
Collapse
Affiliation(s)
| | | | - Kiana Bess
- University of North Carolina School of Medicine, Chapel Hill, USA
| | - Tiffany Young
- University of North Carolina School of Medicine, Chapel Hill, USA
| | - Gaurav Dave
- University of North Carolina School of Medicine, Chapel Hill, USA
| | - Katrina Ellis
- University of North Carolina School of Medicine, Chapel Hill, USA
| | | | - Feng-Chang Lin
- University of North Carolina School of Medicine, Chapel Hill, USA
| | - Mysha Wynn
- Project Momentum, Inc., Rocky Mount, USA
| | | | - Jamie Ede
- University of North Carolina School of Medicine, Chapel Hill, USA
| |
Collapse
|
18
|
Tettey NS. Overcoming initial barriers in implementing faith-based health education programs: Insights from HeartSmarts. COGENT MEDICINE 2018. [DOI: 10.1080/2331205x.2018.1478478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- Naa-Solo Tettey
- Assistant Professor of Public Health, William Paterson University, Wayne, NJ, USA
| |
Collapse
|
19
|
Perception of Physical Fitness and Exercise Self-Efficacy and Its Contribution to the Relationship between Body Dissatisfaction and Physical Fitness in Female Minority Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15061187. [PMID: 29882789 PMCID: PMC6025461 DOI: 10.3390/ijerph15061187] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 11/17/2022]
Abstract
Body Dissatisfaction (BD) and low physical self-concept and exercise efficacy have been linked to poor physical fitness levels and adverse health outcomes in children. The purpose of this study was to examine the relationship between BD, physical fitness, exercise self-efficacy, and self-Perception of Physical Fitness (PFP) in Latina and Black female children. Twenty-eight Latina and Black children enrolled in an elementary afterschool program, aged 8–12, completed surveys evaluating body dissatisfaction, exercise efficacy, PFP, and measures of physical fitness. Subjects exhibited moderate but significant inverse relationships between BD and PFP in strength (r = −0.459), agility (r = −0.382), aerobic fitness (r = −0.354), and flexibility (r = −0.461) (p < 0.05 for all). There was a significant negative correlation between exercise efficacy and BD (r = −4.2; p < 0.05). Power (r = 0.51) and flexibility (r = 0.42) were the only physical fitness measures significantly and positively related to children’s PFP (p < 0.05). A significant medium inverse relationship was also found between BD and aerobic fitness scores (r = −0.381; p < 0.05). However, after controlling for exercise efficacy or perception of physical fitness, the relationship between BD and aerobic fitness was not significant (p > 0.05). Findings suggest that positive PFP and positive performance in several physical fitness measures are associated with lower levels of BD in minority female children. Furthermore, evidence suggests exercise efficacy and PFP can mediate the relationship body image and aerobic fitness. These findings suggest that PFP, more so than measured physical fitness, was associated with lower levels of BD in minority female children. These results have important implications for programs designed to improve physical fitness and mental health in minority children.
Collapse
|
20
|
Magno FCCM, Sousa PAMD, Rodrigues MP, Pereira LLP, Oliveira JEPD, Rosado EL, Carneiro JRI. Long term maintenance of glucose and lipid concentrations after Roux-en-Y gastric bypass. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2018; 62:346-351. [PMID: 29791656 PMCID: PMC10118783 DOI: 10.20945/2359-3997000000047] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 02/17/2018] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Roux-en-Y gastric bypass (RYGB) reduces body weight and the comorbidities associated with obesity. The aim of this study was to evaluate whether glucose and lipid profiles were maintained during a 5-year follow-up period after RYGB. SUBJECTS AND METHODS Anthropometric and laboratory data from 323 patients who had undergone this operation were analyzed. Differences in laboratory variables between the baseline and 12, 24, 36, 48 and 60 months postoperatively (PO) were assessed using a one-way ANOVA test to compare the three groups. Delta significance using one-way ANOVA was performed to assess anthropometric variable in the postoperative period (p < 0.05). RESULTS 77 patients (24%) were included in Group 1 (G1), 101 (32%) in Group 2 (G2), and 141 (44%) in Group 3 (G3). The majority of patients, 71.7% in G1, 82.8% in G2, and 70% in G3, showed high triglycerides (TG) before surgery. A decrease in weight loss was observed in all groups followed by an increase in body weight in G2 and G3 at 36, 48 and 60 months. Laboratory results for G1, G2 and G3 showed no significant differences between groups at baseline and during the post-operative period. CONCLUSION Our results suggest that weight regain after RYGB has no significant impact on the long-term evolution of the lipid profile and glycemia.
Collapse
|
21
|
González HM, Tarraf W, Harrison K, Windham BG, Tingle J, Alonso A, Griswold M, Heiss G, Knopman D, Mosley TH. Midlife cardiovascular health and 20-year cognitive decline: Atherosclerosis Risk in Communities Study results. Alzheimers Dement 2018; 14:579-589. [PMID: 29268079 PMCID: PMC5938099 DOI: 10.1016/j.jalz.2017.11.002] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2017] [Revised: 11/03/2017] [Accepted: 11/13/2017] [Indexed: 12/29/2022]
Abstract
INTRODUCTION The aim was to examine associations between midlife cardiovascular health (CVH) and 20-year cognitive decline among blacks and whites. METHODS Midlife CVH metrics (American Heart Association's Life's Simple 7) were calculated and examined in relation to midlife and 20-year change in cognitive function among 13,270 whites and blacks from the Atherosclerosis Risk in Communities Cohort Study. We used linear mixed models to estimate adjusted associations of midlife CVH with midlife cognitive status and change. RESULTS Higher midlife (Life's Simple 7) scores and individual metrics, particularly blood pressure and glucose, were associated with better midlife cognition and reduced 20-year decline. Midlife CVH 20-year neuroprotection was more pronounced among whites than blacks. DISCUSSION Better midlife CVH was associated with higher midlife and reduced decline in cognitive function 20 years later. However, the benefits of midlife CVH on cognition were stronger for whites than for blacks. Our findings suggest that improved midlife CVH may promote enduring cognitive health.
Collapse
Affiliation(s)
- Hector M González
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Research Center, University of California San Diego, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology, Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Kimystian Harrison
- School of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA
| | - B Gwen Windham
- Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Jonathan Tingle
- Department of Data Science, JD Bower School of Population Health, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael Griswold
- Department of Data Science, JD Bower School of Population Health, The University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Thomas H Mosley
- Department of Medicine, The University of Mississippi Medical Center, Jackson, MS, USA; Memory Impairment and Neurodegenerative Dementia (MIND) Center, The University of Mississippi Medical Center, Jackson, MS, USA.
| |
Collapse
|
22
|
Noble JM, Schupf N, Manly JJ, Andrews H, Tang MX, Mayeux R. Secular Trends in the Incidence of Dementia in a Multi-Ethnic Community. J Alzheimers Dis 2018; 60:1065-1075. [PMID: 28984588 DOI: 10.3233/jad-170300] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Determination of secular trends in cognitive aging is important for prioritization of resources, services, and research in aging populations. Prior studies have identified declining dementia incidence associated with changes in cardiovascular risk factors and increased educational attainment. However, few studies have examined these factors in multi-ethnic cohorts. OBJECTIVE To identify secular trends in the incidence rate of dementia in an elderly population. METHODS Participants in this study were drawn from the Washington Heights-Inwood Columbia Aging Project, a multi-ethnic cohort study of northern Manhattan residents aged 65 years and older. Cox proportional hazards models were used to examine differences in the incidence of dementia in cohorts recruited in 1992 and 1999, with age at dementia or age at last follow-up visit as the "time-to-event" variable. RESULTS Overall, there was a 41% reduction in the hazard ratio for dementia among participants in the 1999 cohort compared with those in the 1992 cohort, adjusting for age, sex, race, and baseline memory complaints (HR = 0.59). The reduction in incidence was greatest among non-Hispanic Whites and African-Americans and lowest among Hispanic participants (HRs = 0.60, 0.52 and 0.64, respectively), and was associated with increases in level of educational attainment, especially among African-Americans. Reduction in incidence of dementia was also greater among persons 75 years or older than among younger participants (HR = 0.52 versus HR = 0.69). CONCLUSIONS Our results support previous findings that secular trends in dementia incidence are changing, including in aging minority populations.
Collapse
Affiliation(s)
- James M Noble
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,G.H. Sergievsky Center, Columbia University, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,G.H. Sergievsky Center, Columbia University, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA.,Department of Epidemiology, Columbia University Medical Center, New York, NY, USA
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,G.H. Sergievsky Center, Columbia University, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Howard Andrews
- Department of Biostatistics, Mailman School of Public Health, Columbia University Medical Center, New York, NY, USA
| | - Ming-Xin Tang
- G.H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA.,G.H. Sergievsky Center, Columbia University, New York, NY, USA.,Department of Neurology, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
23
|
Arauz A, Marquez-Romero JM, Barboza MA, Serrano F, Artigas C, Murillo-Bonilla LM, Cantú-Brito C, Ruiz-Sandoval JL, Barinagarrementeria F. Mexican-National Institute of Neurology and Neurosurgery-Stroke Registry: Results of a 25-Year Hospital-Based Study. Front Neurol 2018; 9:207. [PMID: 29670570 PMCID: PMC5893807 DOI: 10.3389/fneur.2018.00207] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Accepted: 03/16/2018] [Indexed: 11/16/2022] Open
Abstract
Background and purpose Stroke has been scarcely studied in Latin America (LA). The Mexican Institute of Neurology Stroke Registry was established in 1990 as a prospective computer-based database to register data obtained from patients admitted with stroke. Using this data, we attempted to define the profile of risk factors and outcomes. Methods The demographic data, stroke description, ancillary tests, vascular risk factors, and modified Rankin scale (mRs) were registered. Ischemic stroke subtyping was based on the Trial of Org 10,172 of the Acute Stroke Treatment classification. We followed-up patients using multiple overlapping methods. Primary outcomes included mRs, recurrence, and death at 30 days and at the end of follow-up. Results We included 4,481 patients with a median follow-up of 27 months, (17,281 person-years follow-up). The mean age was 52.8 ± 18 years. There were 2,229 males (50%) included in the study. CI was present in 64.9%, intracerebral hemorrhage (ICH) in 25.6%, and cerebral venous thrombosis (CVT) in 6.3%. Hypertension was the major risk factor (46.5%). The most common cause of CI was atherosclerosis (27%). ICH was mainly hypertensive (58%), and 60% of CVT were puerperal. Overall, the mortality rate was 24.5%. The recurrence rate was 16.9%. Poor outcome (mRs ≥ 3) was found in 56.2% of patients. The best outcomes were observed in CVT patients (74.5% mRs ≤ 2), whereas 72.1% ICH patients had mRs ≥3. Conclusion This is one of the largest hospital-based registries in LA and shows significant differences with other previously published registries, including a younger age, relatively less hypertension, and larger proportion of CVT. Poor functional outcome was common. This study adds to the understanding of geographic differences in stroke characteristics and outcomes.
Collapse
Affiliation(s)
- Antonio Arauz
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | | | - Miguel A Barboza
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Fabiola Serrano
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | - Carol Artigas
- Stroke Clinic, Instituto Nacional de Neurología y Neurocirugía, Mexico City, Mexico
| | | | - Carlos Cantú-Brito
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico
| | | | | |
Collapse
|
24
|
Assari S, Thomas A, Caldwell CH, Mincy RB. Blacks' Diminished Health Return of Family Structure and Socioeconomic Status; 15 Years of Follow-up of a National Urban Sample of Youth. J Urban Health 2018; 95:21-35. [PMID: 29230628 PMCID: PMC5862702 DOI: 10.1007/s11524-017-0217-3] [Citation(s) in RCA: 138] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The protective effect of family structure and socioeconomic status (SES) on physical and mental health is well established. There are reports, however, documenting a smaller return of SES among Blacks compared to Whites, also known as Blacks' diminished return. Using a national sample, this study investigated race by gender differences in the effects of family structure and family SES on subsequent body mass index (BMI) over a 15-year period. This 15-year longitudinal study used data from the Fragile Families and Child Wellbeing Study (FFCWS), in-home survey. This study followed 1781 youth from birth to age 15. The sample was composed of White males (n = 241, 13.5%), White females (n = 224, 12.6%), Black males (n = 667, 37.5%), and Black females (n = 649, 36.4%). Family structure and family SES (maternal education and income to need ratio) at birth were the independent variables. BMI at age 15 was the outcome. Race and gender were the moderators. Linear regression models were run in the pooled sample, in addition to race by gender groups. In the pooled sample, married parents, more maternal education, and income to need ratio were all protective against high BMI of youth at 15 years of age. Race interacted with family structure, maternal education, and income to need ratio on BMI, indicating smaller effects for Blacks compared to Whites. Gender did not interact with SES indicators on BMI. Race by gender stratified regressions showed the most consistent associations between family SES and future BMI for White females followed by White males. Family structure, maternal education, and income to need ratio were not associated with lower BMI in Black males or females. The health gain received from family economic resources over time is smaller for male and female Black youth than for male and female White youth. Equalizing access to economic resources may not be enough to eliminate health disparities in obesity. Policies should address qualitative differences in the lives of Whites and Blacks which result in diminished health returns with similar SES resources. Policies should address structural and societal barriers that hold Blacks against translation of their SES resources to health outcomes.
Collapse
Affiliation(s)
- Shervin Assari
- Department of Psychiatry, University of Michigan, 4250 Plymouth Road, SPC 5763, Ann Arbor, MI, 48109-2700, USA.
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA.
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA.
| | - Alvin Thomas
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Palo Alto University, Palo Alto, CA, USA
| | - Cleopatra H Caldwell
- Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI, USA
- Department of Health Behavior and Health Education, University of Michigan, Ann Arbor, MI, USA
| | - Ronald B Mincy
- Center for Research on Fathers, Children, and Family Well-Being, New York, NY, USA
- Columbia Population Research Center (CPRC), New York, NY, USA
- Columbia School of Social Work, New York, NY, USA
| |
Collapse
|
25
|
Hirsch JR, Waits G, Li Y, Soliman EZ. Racial Differences in Heart Age and Impact on Mortality. J Natl Med Assoc 2017; 110:169-175. [PMID: 29580451 DOI: 10.1016/j.jnma.2017.08.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 08/11/2017] [Accepted: 08/15/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Heart age is an estimate of the age of a person's cardiovascular system given their cardiovascular disease (CVD) risk factors. The difference between a person's chronological age and heart age (excess heart age) represents their added CVD risk. OBJECTIVE To examine racial differences in excess heart age and whether race impacts the association between excess heart age and CVD mortality. METHODS This analysis included 5110 participants (2449 non-Hispanic white, 1287 non-Hispanic black, and 1374 Mexican-American) from the NHANES III who were free of CVD. Heart age was calculated using the sex-specific non-laboratory-based Framingham risk prediction functions. Multivariable Cox proportional-hazards regression models were used to evaluate the relationship (overall and by race) between excess heart age and CVD mortality. RESULTS Mean excess heart age was greatest in non-Hispanic blacks (13.0 years), followed by Mexican-Americans (10.5 years), and non-Hispanic whites (8.5 years); p < 0.001 for pairwise differences. Over a mean follow-up of 13.0 years, 394 CVD deaths occurred. Each 10 years of excess heart age was associated with 65% increased risk of CVD mortality (HR, 95% CI: 1.65, 1.53-1.78). This association was stronger in non-Hispanic whites (1.83, 1.63-2.02) compared to non-Hispanic blacks (1.50, 1.29-1.72) and Mexican American (1.60, 1.33-1.87), interaction p = 0.065. CONCLUSIONS Compared to non-Hispanic whites, non-Hispanic blacks and Mexican Americans have more excess heart age, but the risk of CVD death for the same level of excess heart age appears more pronounced in non-Hispanic whites. Further investigation is needed to show the usefulness of these findings in directing future efforts and resource allocation for reduction of health disparities between ethnic groups.
Collapse
Affiliation(s)
| | - George Waits
- Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Yabing Li
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, USA
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston Salem, NC, USA; Department of Internal Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston Salem, NC, USA.
| |
Collapse
|
26
|
Huynh-Hohnbaum ALT, Marshall L, Villa VM, Lee G. Self-Management of Heart Disease in Older Adults. Home Health Care Serv Q 2017; 34:159-72. [PMID: 26566582 DOI: 10.1080/01621424.2015.1092909] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The American Heart Association estimates that 81% of people who die of coronary heart disease are 65 years old or older. The leading risk health behaviors include physical inactivity, poor diet, smoking, and binge drinking. Using the 2011-2012 California Health Interview Survey (CHIS), this study looked at how self-management, which includes a plan developed by a medical professional and the confidence to manage one's disease, may decrease negative risk behaviors in older adults. The presence of a plan and increased self-efficacy decreased engagement in negative dietary behaviors and low physical activity. Implications for strategies that address heart disease and self-management are discussed.
Collapse
Affiliation(s)
- Anh-Luu T Huynh-Hohnbaum
- a School of Social Work , California State University , Los Angeles, Los Angeles , California , USA
| | - Lia Marshall
- b Luskin School of Public Affairs , University of California , Los Angeles, Los Angeles , California , USA
| | - Valentine M Villa
- c School of Social Work, and Applied Gerontology Institute , California State University , Los Angeles, Los Angeles , California , USA
| | - Gi Lee
- a School of Social Work , California State University , Los Angeles, Los Angeles , California , USA
| |
Collapse
|
27
|
Tettey NS, Duran PA, Andersen HS, Boutin-Foster C. Evaluation of HeartSmarts, a Faith-Based Cardiovascular Health Education Program. JOURNAL OF RELIGION AND HEALTH 2017; 56:320-328. [PMID: 27709319 DOI: 10.1007/s10943-016-0309-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
In order to effectively address cardiovascular disease among African Americans, evidence-based health information must be disseminated within a context aligned with the values and beliefs of the population. Faith-based organizations play a critical role in meeting the religious and spiritual needs of many African Americans. Additionally, faith-based organizations can be effective in health promotion. A manual was created by incorporating biblical scriptures relating to health messages drawn from existing health manuals oriented toward African Americans. Lay health educators active in their churches participated in a 12-week training to learn the basics of cardiovascular disease and methods for delivering the program to their congregations' members. After the completion of the training, these lay health educators recruited participants from their respective churches and administered their own 12-week HeartSmarts program. Measurements of participants' systolic and diastolic blood pressure (mmHg), height (in.), weight (lbs.), and waist circumference (in.) were taken, and cardiovascular disease knowledge assessments (based on 20 open-ended questions) were administered at the start and end of the 12-week programs. Fourteen predominantly African American churches in NYC participated. Of the 221 participants, 199 completed the program. There were significant reductions in pretest and posttest total participant averages for systolic BP (4.48 mmHg, p < 0.001), diastolic BP (3.38 mmHg, p < 0.001), weight (3lbs., p = 0.001), and BMI (0.46, p = 0.001). Cardiovascular disease health assessment scores had an average increase of 12.74 correct responses (p < 0.001). The HeartSmarts program may be an effective ecumenical and cultural model for disseminating health messages and reducing cardiovascular risk among African Americans.
Collapse
Affiliation(s)
- Naa-Solo Tettey
- Ronald O. Perelman Heart Institute, New York-Presbyterian Hospital, Perelman Heart Institute/Weill Cornell Medical Center, 525 E. 68th Street, Greenberg Pavilion 4th Floor Atrium, New York, 10065, NY, USA.
| | - Pedro A Duran
- Weill Cornell Medical College in New York, New York, NY, USA
| | - Holly S Andersen
- Ronald O. Perelman Heart Institute, New York-Presbyterian Hospital, Perelman Heart Institute/Weill Cornell Medical Center, 525 E. 68th Street, Greenberg Pavilion 4th Floor Atrium, New York, 10065, NY, USA
| | - Carla Boutin-Foster
- Comprehensive Center of Excellence in Disparities Research and Community Engagement (CEDREC), Weill Cornell Medical College, New York, NY, USA
| |
Collapse
|
28
|
Yao Y, Suo T, Andersson R, Cao Y, Wang C, Lu J, Chui E. Dietary fibre for the prevention of recurrent colorectal adenomas and carcinomas. Cochrane Database Syst Rev 2017; 1:CD003430. [PMID: 28064440 PMCID: PMC6465195 DOI: 10.1002/14651858.cd003430.pub2] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
BACKGROUND This is an update of the Cochrane review published in 2002.Colorectal cancer (CRC) is a major cause of morbidity and mortality in industrialised countries. Experimental evidence has supported the hypothesis that dietary fibre may protect against the development of CRC, although epidemiologic data have been inconclusive. OBJECTIVES To assess the effect of dietary fibre on the recurrence of colorectal adenomatous polyps in people with a known history of adenomatous polyps and on the incidence of CRC compared to placebo. Further, to identify the reported incidence of adverse effects, such as abdominal pain or diarrhoea, that resulted from the fibre intervention. SEARCH METHODS We identified randomised controlled trials (RCTs) from Cochrane Colorectal Cancer's Specialised Register, CENTRAL, MEDLINE and Embase (search date, 4 April 2016). We also searched ClinicalTrials.gov and WHO International Trials Registry Platform on October 2016. SELECTION CRITERIA We included RCTs or quasi-RCTs. The population were those having a history of adenomatous polyps, but no previous history of CRC, and repeated visualisation of the colon/rectum after at least two-years' follow-up. Dietary fibre was the intervention. The primary outcomes were the number of participants with: 1. at least one adenoma, 2. more than one adenoma, 3. at least one adenoma greater than or equal to 1 cm, or 4. a new diagnosis of CRC. The secondary outcome was the number of adverse events. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data, assessed trial quality and resolved discrepancies by consensus. We used risk ratios (RR) and risk difference (RD) with 95% confidence intervals (CI) to measure the effect. If statistical significance was reached, we reported the number needed to treat for an additional beneficial outcome (NNTB) or harmful outcome (NNTH). We combined the study data using the fixed-effect model if it was clinically, methodologically, and statistically reasonable. MAIN RESULTS We included seven studies, of which five studies with 4798 participants provided data for analyses in this review. The mean ages of the participants ranged from 56 to 66 years. All participants had a history of adenomas, which had been removed to achieve a polyp-free colon at baseline. The interventions were wheat bran fibre, ispaghula husk, or a comprehensive dietary intervention with high fibre whole food sources alone or in combination. The comparators were low-fibre (2 to 3 g per day), placebo, or a regular diet. The combined data showed no statistically significant difference between the intervention and control groups for the number of participants with at least one adenoma (5 RCTs, n = 3641, RR 1.04, 95% CI 0.95 to 1.13, low-quality evidence), more than one adenoma (2 RCTs, n = 2542, RR 1.06, 95% CI 0.94 to 1.20, low-quality evidence), or at least one adenoma 1 cm or greater (4 RCTs, n = 3224, RR 0.99, 95% CI 0.82 to 1.20, low-quality evidence) at three to four years. The results on the number of participants diagnosed with colorectal cancer favoured the control group over the dietary fibre group (2 RCTS, n = 2794, RR 2.70, 95% CI 1.07 to 6.85, low-quality evidence). After 8 years of comprehensive dietary intervention, no statistically significant difference was found in the number of participants with at least one recurrent adenoma (1 RCT, n = 1905, RR 0.97, 95% CI 0.78 to 1.20), or with more than one adenoma (1 RCT, n = 1905, RR 0.89, 95% CI 0.64 to 1.24). More participants given ispaghula husk group had at least one recurrent adenoma than the control group (1 RCT, n = 376, RR 1.45, 95% CI 1.01 to 2.08). Other analyses by types of fibre intervention were not statistically significant. The overall dropout rate was over 16% in these trials with no reasons given for these losses. Sensitivity analysis incorporating these missing data shows that none of the results can be considered as robust; when the large numbers of participants lost to follow-up were assumed to have had an event or not, the results changed sufficiently to alter the conclusions that we would draw. Therefore, the reliability of the findings may have been compromised by these missing data (attrition bias) and should be interpreted with caution. AUTHORS' CONCLUSIONS There is a lack of evidence from existing RCTs to suggest that increased dietary fibre intake will reduce the recurrence of adenomatous polyps in those with a history of adenomatous polyps within a two to eight year period. However, these results may be unreliable and should be interpreted cautiously, not only because of the high rate of loss to follow-up, but also because adenomatous polyp is a surrogate outcome for the unobserved true endpoint CRC. Longer-term trials with higher dietary fibre levels are needed to enable confident conclusion.
Collapse
Affiliation(s)
- Yibo Yao
- Longhua Hospital, Shanghai Traditional Chinese Medicine UniversityDepartment of Anorectal Surgery725 South Wanping Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Tao Suo
- Zhongshan Hospital, Fudan UniversityDepartment of General Surgery, Institute of General Surgery180 Fenglin Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Roland Andersson
- Faculty of Medicine, Lund UniversityDepartment of Surgery, Clinical SciencesLund University HospitalLundSwedenSE‐221 85
| | - Yongqing Cao
- Longhua Hospital, Shanghai Traditional Chinese Medicine UniversityDepartment of Anorectal Surgery725 South Wanping Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Chen Wang
- Longhua Hospital, Shanghai Traditional Chinese Medicine UniversityDepartment of Anorectal Surgery725 South Wanping Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Jingen Lu
- Longhua Hospital, Shanghai Traditional Chinese Medicine UniversityDepartment of Anorectal Surgery725 South Wanping Road, Xuhui DistrictShanghaiShanghaiChina200032
| | - Evelyne Chui
- Systematic Review Solutions Ltd5‐6 West Tashan RoadYan TaiChina264000
| | | |
Collapse
|
29
|
Patt MR, Yanek LR, Moy TF, Becker DM. Sociodemographic, Behavioral, and Psychological Correlates of Current Overweight and Obesity in Older, Urban African American Women. HEALTH EDUCATION & BEHAVIOR 2016; 31:57S-68S. [PMID: 15296692 DOI: 10.1177/1090198104266036] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
To better understand obesity and overweight among urban African American women, the authors examined sociodemographic, behavioral, and psychological factors within body mass index (BMI) categories. A total of 496 women were recruited for cardiovascular risk factor screening from 20 urban African American churches. Study participants had a mean age of 52.8 years, 13.5 years of education, and an average BMI of 32 kg/m2. Bivariate analyses showed increased overall energy intake and decreased physical performance on a walk test, and general well-being declined as the BMI class increased; obese women had the lowest physical performance and well-being levels and the highest energy intake levels. There was no difference by BMI category, however, in social variables such as educational attainment, employment, marital status, or household income. This study suggests that although women with increasing BMI have some physical and well-being concerns, the major social variables are not differentially distributed by BMI in this sample of women.
Collapse
Affiliation(s)
- Madhavi Reddy Patt
- Center for Health Promotion, Johns Hopkins University School of Medicine, Division of Internal Medicine, Baltimore, MD 21205, USA
| | | | | | | |
Collapse
|
30
|
Jurkowski JM, Rivera Y, Hammel J. Health Perceptions of Latinos With Intellectual Disabilities: The Results of a Qualitative Pilot Study. Health Promot Pract 2016; 10:144-55. [DOI: 10.1177/1524839907309045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
A pilot study among Latinos with intellectual disabilities (ID) was conducted. Focus groups and Photovoice methodology were employed to explore participants' health perceptions and beliefs. Three focus groups were conducted for a total of 15 participants. An additional member check focus group was conducted to verify results of the analysis. Photovoice methodology was employed with four Latinos with ID to explore health beliefs and perceptions of the influence of the social and physical environment. Participants' perceptions of health focused on social and mental aspects of health. Latinos with ID believed that social relationships are important to health. They believed in a connection among social, mental, and physical well-being and health. Cultural beliefs related to the role of God and traditional therapies were identified. Latinos with ID reported that they believed that health was influenced by behaviors and that diet and physical activity were beneficial, but this did not necessarily translate into regular practice.
Collapse
Affiliation(s)
- Janine M. Jurkowski
- Department of Health Policy, Management & Behavior at the University at Albany School of Public Health in Rensselaer, New York
| | | | - Joy Hammel
- Departments of Occupational Therapy and Disability and
Human Development, Joint Doctoral Program in Disability Studies, University
of Illinois at Chicago in Chicago, Illinois
| |
Collapse
|
31
|
Woudberg NJ, Goedecke JH, Lecour S. Protection from Cardiovascular Disease Due to Increased High-Density Lipoprotein Cholesterol in African Black Populations: Myth or Reality? Ethn Dis 2016; 26:553-560. [PMID: 27773983 PMCID: PMC5072485 DOI: 10.18865/ed.26.4.553] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
The burden of cardiovascular disease (CVD) in sub-Saharan Africa has increased over the last decade. Despite this, African Black populations present with relatively low incidences of coronary heart disease and ischemic heart disease, which may be attributed to their lower total cholesterol, triglycerides and low-density lipoprotein cholesterol concentrations, compared with White populations. Commensurate with these lower lipid levels, it was believed that high-density lipoprotein cholesterol (HDL-C) concentrations would be higher in Black populations compared with their White counterparts. This is based on data from previous studies of African and African American populations; however, recent studies conducted in Africa found similar or lower HDL-C concentrations in Black compared with White individuals. Current research, therefore, suggests that HDL-C may not be a good indicator of cardiovascular risk and future research should focus on HDL quality (vs quantity), by measuring HDL functionality and subclass.
Collapse
Affiliation(s)
- Nicholas J. Woudberg
- Hatter Institute for Cardiovascular Research in Africa and South African Medical Research Council Inter-University Cape Heart Group, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Julia H. Goedecke
- Non-Communicable Disease Research Unit, South African Medical Research Council
| | - Sandrine Lecour
- Hatter Institute for Cardiovascular Research in Africa and South African Medical Research Council Inter-University Cape Heart Group, Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
32
|
Turk MT, Elci OU, Resick LK, Kalarchian MA. Wise Choices: Nutrition and Exercise for Older Adults: A Community-Based Health Promotion Intervention. FAMILY & COMMUNITY HEALTH 2016; 39:263-272. [PMID: 27536931 DOI: 10.1097/fch.0000000000000116] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Effective interventions for older adults are needed to address lifestyle behaviors linked to chronic illnesses. We implemented a 12-week group behavioral intervention for 118 racially diverse older adults at 6 community-based senior centers to improve eating and physical activity. Assessments were completed pre- and postintervention, with 85.6% retention. We documented increases in fruit, vegetable, and whole grain intake; pace of walking; number of city blocks walked; daily steps walked; functional mobility; and self-rated general health (P < .05). Findings indicate that a relatively low-intensity lifestyle intervention can effectively be implemented for community-dwelling older adults. Further development of this approach is warranted.
Collapse
Affiliation(s)
- Melanie T Turk
- Duquesne University School of Nursing, Pittsburgh, Pennsylvania (Drs Turk, Resick, and Kalarchian); and Westat Biostatistics and Data Management Core, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania (Dr Elci)
| | | | | | | |
Collapse
|
33
|
Winkleby MA, Cubbin C. Changing Patterns in Health Behaviors and Risk Factors Related to Chronic Diseases, 1990–2000. Am J Health Promot 2016; 19:19-27. [PMID: 15460097 DOI: 10.4278/0890-1171-19.1.19] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Purpose. Assess changes in chronic disease-related health behaviors and risk factors from 1990 to 2000, by race/ethnicity, age, and gender. Design. Stratified cross-sectional design. Setting. United States. Subjects. 16,948 black, 11,956 Hispanic, and 158,707 white women and men, ages 18 to 74. Measures. Cigarette smoking, obesity, sedentary behavior, low vegetable or fruit intake. From the Behavioral Risk Factor Surveillance System. Results. Young women and men, ages 18 to 24, had poor health profiles and experienced adverse changes from 1990 to 2000. After the variables were adjusted for education and income, these young people had the highest prevalence of smoking (34%–36% current smokers among white women and men), the largest increases in smoking (10%–12% increase among white women and men; 9% increase among Hispanic women), and large increases in obesity (4%–9% increase, all gender and racial/ethnic groups). Young women and men from each racial/ethnic group also had high levels of sedentary behavior (approximately 20%–30%) and low vegetable or fruit intake (approximately 35%–50%). In contrast, older Hispanic women and men and older black men, ages 65 to 74, showed some of the most positive changes. They had the largest decreases in smoking (Hispanic women), largest decreases in sedentary behavior (Hispanic women and black men), and largest increases in vegetable or fruit intake (Hispanic women and men, and black men). Conclusion. The poor and worsening health profile of young women and men is a particular concern, as they will soon enter the ages of high chronic disease burden.
Collapse
Affiliation(s)
- Marilyn A Winkleby
- Stanford Prevention Research Center, Stanford University School of Medicine, 211 Quarry Road, Room N229, Stanford, CA 94305-5705, USA.
| | | |
Collapse
|
34
|
Tettey NS, Duran PA, Andersen HS, Washington N, Boutin-Foster C. "It's Like Backing up Science with Scripture": Lessons Learned from the Implementation of HeartSmarts, a Faith-Based Cardiovascular Disease Health Education Program. JOURNAL OF RELIGION AND HEALTH 2016; 55:1078-1088. [PMID: 26857287 DOI: 10.1007/s10943-016-0196-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
African-Americans are disproportionately impacted by cardiovascular disease (CVD). Faith-based institutions provide a non-traditional route for health education targeted at African-Americans. This paper describes HeartSmarts, a faith-based CVD education program. Evidence-based literature was used to develop a curriculum, which was tailored by integrating biblical scripture representing aspects of health behaviors. Eighteen church peer-educators were recruited to participate in a 12-week training. They then disseminated the faith-based curriculum to members of their congregations. There were 199 participants of which 137 provided feedback via open-ended surveys indicating that HeartSmarts was well accepted and effective for disseminating CVD health messages while engaging spirituality.
Collapse
Affiliation(s)
- Naa-Solo Tettey
- Ronald O. Perelman Heart Institute, New York-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Greenberg Pavilion 4th Floor Atrium, New York, NY, 10065, USA.
| | | | - Holly S Andersen
- Ronald O. Perelman Heart Institute, New York-Presbyterian Hospital/Weill Cornell Medical Center, 525 E. 68th Street, Greenberg Pavilion 4th Floor Atrium, New York, NY, 10065, USA
| | | | - Carla Boutin-Foster
- Center of Excellence in Disparities Research and Community Engagement (CEDREC), Weill Cornell Medical College, New York, NY, USA
| |
Collapse
|
35
|
Abstract
PURPOSE To review the current literature on the prevalence of cataract in Hispanic females living in the United States. METHODS Review relevant literature on cataract, eye disease, and health practices of Hispanics living in the U.S. RESULTS Females comprise 64.5% of blind persons worldwide. Internationally, female gender is associated with lower awareness of cataract and other diseases of the eye and women are less likely to have cataract surgery than men in low- and middle-income countries. CONCLUSION Hispanic women receive disparate care compared to their male counterparts. The etiology of this is likely multifactorial but possible contributors include genetics, gender roles, and personal healthcare decisions. Interventions to address this disparity should be targeted, efficient, and sustainable.
Collapse
Affiliation(s)
- David J Herren
- a Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA
| | - Sahar Kohanim
- a Department of Ophthalmology and Visual Sciences , Vanderbilt University Medical Center , Nashville , TN , USA
| |
Collapse
|
36
|
Juergens CP, Dabin B, French JK, Kritharides L, Hyun K, Kilian J, Chew DPB, Brieger D. English as a second language and outcomes of patients presenting with acute coronary syndromes: results from the CONCORDANCE registry. Med J Aust 2016; 204:239. [DOI: 10.5694/mja15.00812] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Accepted: 12/09/2015] [Indexed: 11/17/2022]
Affiliation(s)
- Craig P Juergens
- Liverpool Hospital, Sydney, NSW
- South Western Sydney Clinical School, University of NSW, Sydney, NSW
| | | | - John K French
- Liverpool Hospital, Sydney, NSW
- South Western Sydney Clinical School, University of NSW, Sydney, NSW
| | | | - Karice Hyun
- The George Institute for Global Health, Sydney, NSW
| | | | | | | |
Collapse
|
37
|
Downer B, Raji MA, Markides KS. Relationship between metabolic and vascular conditions and cognitive decline among older Mexican Americans. Int J Geriatr Psychiatry 2016; 31:213-21. [PMID: 26032435 PMCID: PMC4663174 DOI: 10.1002/gps.4313] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/06/2015] [Accepted: 05/07/2015] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Metabolic and vascular conditions have been independently associated with dementia and cognitive decline among older adults, but research on the combined effects that these conditions have on cognitive decline, especially among older Mexican Americans, is lacking. The purpose of this study was to examine the relationship between metabolic and vascular conditions and cognitive decline among older Mexican Americans. METHODS The final sample included 2767 participants of the Hispanic Established Populations for the Epidemiologic Study of the Elderly. Linear mixed-effects regression was used to model cognitive decline across six examinations (1993-2007) according to the number (zero, one, two, and three to four) of metabolic and vascular conditions (hypertension, diabetes, stroke, and heart attack). RESULTS Of the 2767 participants included in the final sample, 777 had zero conditions, 1314 had one condition, 553 had two conditions, and 123 had three to four conditions. Participants with two or three to four conditions had significantly greater cognitive decline compared with participants with zero or one condition. Stroke had the largest effect size on cognitive decline based on the proportion of variance that stroke accounted for in the linear mixed-effects model. CONCLUSION Mexican American older adults with multiple metabolic and vascular conditions exhibit greater cognitive decline than those with zero or one condition. Public health interventions designed to reduce the prevalence of chronic metabolic and vascular conditions, in particular stroke, may limit the severity of cognitive decline among older Mexican Americans.
Collapse
Affiliation(s)
- Brian Downer
- Sealy Center on Aging, University of Texas Medical Branch, Galveston, TX, USA
| | - Mukaila A. Raji
- Internal Medicine – Geriatrics, University of Texas Medical Branch, Galveston, TX, USA
| | - Kyriakos S. Markides
- Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston, TX, USA
| |
Collapse
|
38
|
Mehta LS, Beckie TM, DeVon HA, Grines CL, Krumholz HM, Johnson MN, Lindley KJ, Vaccarino V, Wang TY, Watson KE, Wenger NK. Acute Myocardial Infarction in Women: A Scientific Statement From the American Heart Association. Circulation 2016; 133:916-47. [PMID: 26811316 DOI: 10.1161/cir.0000000000000351] [Citation(s) in RCA: 742] [Impact Index Per Article: 92.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Cardiovascular disease is the leading cause of mortality in American women. Since 1984, the annual cardiovascular disease mortality rate has remained greater for women than men; however, over the last decade, there have been marked reductions in cardiovascular disease mortality in women. The dramatic decline in mortality rates for women is attributed partly to an increase in awareness, a greater focus on women and cardiovascular disease risk, and the increased application of evidence-based treatments for established coronary heart disease. This is the first scientific statement from the American Heart Association on acute myocardial infarction in women. Sex-specific differences exist in the presentation, pathophysiological mechanisms, and outcomes in patients with acute myocardial infarction. This statement provides a comprehensive review of the current evidence of the clinical presentation, pathophysiology, treatment, and outcomes of women with acute myocardial infarction.
Collapse
|
39
|
Carballido-Gamio J, Bonaretti S, Saeed I, Harnish R, Recker R, Burghardt AJ, Keyak JH, Harris T, Khosla S, Lang TF. Automatic multi-parametric quantification of the proximal femur with quantitative computed tomography. Quant Imaging Med Surg 2015; 5:552-68. [PMID: 26435919 DOI: 10.3978/j.issn.2223-4292.2015.08.02] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
BACKGROUND Quantitative computed tomography (QCT) imaging is the basis for multiple assessments of bone quality in the proximal femur, including volumetric bone mineral density (vBMD), tissue volume, estimation of bone strength using finite element modeling (FEM), cortical bone thickness, and computational-anatomy-based morphometry assessments. METHODS Here, we present an automatic framework to perform a multi-parametric QCT quantification of the proximal femur. In this framework, the proximal femur is cropped from the bilateral hip scans, segmented using a multi-atlas based segmentation approach, and then assigned volumes of interest through the registration of a proximal femoral template. The proximal femur is then subjected to compartmental vBMD, compartmental tissue volume, FEM bone strength, compartmental surface-based cortical bone thickness, compartmental surface-based vBMD, local surface-based cortical bone thickness, and local surface-based cortical vBMD computations. Consequently, the template registrations together with vBMD and surface-based cortical bone parametric maps enable computational anatomy studies. The accuracy of the segmentation was validated against manual segmentations of 80 scans from two clinical facilities, while the multi-parametric reproducibility was evaluated using repeat scans with repositioning from 22 subjects obtained on CT imaging systems from two manufacturers. RESULTS Accuracy results yielded a mean dice similarity coefficient of 0.976±0.006, and a modified Haussdorf distance of 0.219±0.071 mm. Reproducibility of QCT-derived parameters yielded root mean square coefficients of variation (CVRMS) between 0.89-1.66% for compartmental vBMD; 0.20-1.82% for compartmental tissue volume; 3.51-3.59% for FEM bone strength; 1.89-2.69% for compartmental surface-based cortical bone thickness; and 1.08-2.19% for compartmental surface-based cortical vBMD. For local surface-based assessments, mean CVRMS were between 3.45-3.91% and 2.74-3.15% for cortical bone thickness and vBMD, respectively. CONCLUSIONS The automatic framework presented here enables accurate and reproducible QCT multi-parametric analyses of the proximal femur. Our subjects were elderly, with scans obtained across multiple clinical sites and manufacturers, thus documenting its value for clinical trials and other multi-site studies.
Collapse
Affiliation(s)
- Julio Carballido-Gamio
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Serena Bonaretti
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Isra Saeed
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Roy Harnish
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Robert Recker
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Andrew J Burghardt
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Joyce H Keyak
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Tamara Harris
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Sundeep Khosla
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Thomas F Lang
- 1 Department of Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, CA, USA ; 2 Department of Endocrinology, Creighton University, Omaha, NE, USA ; 3 Department of Radiological Sciences, Department of Mechanical and Aerospace Engineering, Department of Biomedical Engineering, and Chao Family Comprehensive Cancer Center, University of California, Irvine, Irvine, CA, USA ; 4 Intramural Research Program, National Institute on Aging, Bethesda, Maryland, USA ; 5 Division of Endocrinology, Diabetes, Metabolism and Nutrition, Department of Internal Medicine, College of Medicine, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
40
|
Ethnic Differences in Cardiovascular Disease Risk Factors: A Systematic Review of North American Evidence. Can J Cardiol 2015; 31:1169-79. [DOI: 10.1016/j.cjca.2015.06.017] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Revised: 06/17/2015] [Accepted: 06/17/2015] [Indexed: 02/06/2023] Open
|
41
|
Takeshita J, Gelfand JM, Li P, Pinto L, Yu X, Rao P, Viswanathan HN, Doshi JA. Psoriasis in the US Medicare Population: Prevalence, Treatment, and Factors Associated with Biologic Use. J Invest Dermatol 2015. [PMID: 26214380 PMCID: PMC4549797 DOI: 10.1038/jid.2015.296] [Citation(s) in RCA: 93] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Psoriasis is a common chronic inflammatory disorder, primarily of the skin. Despite an aging population, knowledge of the epidemiology of psoriasis and its treatments among the elderly is limited. We examined the prevalence of psoriasis and its treatments, with a focus on biologics and identification of factors associated with biologic use, using a nationally representative sample of Medicare beneficiaries in 2011. On the basis of several psoriasis identification algorithms, the claims-based prevalence for psoriasis in the United States ranged from 0.51 to 1.23%. Treatments used for moderate-to-severe psoriasis (phototherapy, oral systemic, or biologic therapies) were received by 27.3% of the total psoriasis sample, of whom 37.2% used biologics. Patients without a Medicare Part D low-income subsidy (LIS) had 70% lower odds of having received biologics than those with LIS (odds ratio 0.30; 95% confidence interval, 0.19-0.46). Similarly, the odds of having received biologics were 69% lower among black patients compared with white patients (0.31; 0.16-0.60). This analysis identified potential financial and racial barriers to receipt of biologic therapies and underscores the need for additional studies to further define the epidemiology and treatment of psoriasis among the elderly.
Collapse
Affiliation(s)
- Junko Takeshita
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA.
| | - Joel M Gelfand
- Department of Dermatology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Department of Epidemiology and Biostatistics, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Penxiang Li
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Xinyan Yu
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Preethi Rao
- Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Health Care Management and Economics, The Wharton School at University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | | | - Jalpa A Doshi
- Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA; Leonard Davis Institute of Health Economics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
42
|
|
43
|
Karris MY, Haubrich RH. Antiretroviral therapy in the elite controller: justified or premature? J Infect Dis 2014; 211:1689-91. [PMID: 25512628 DOI: 10.1093/infdis/jiu812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 12/11/2014] [Indexed: 11/12/2022] Open
Affiliation(s)
- Maile Y Karris
- Department of Internal Medicine, University of California, San Diego
| | | |
Collapse
|
44
|
Hunt KJ, Kistner-Griffin E, Spruill I, Teklehaimanot AA, Garvey WT, Sale M, Fernandes J. Cardiovascular risk in Gullah African Americans with high familial risk of type 2 diabetes mellitus: project SuGAR. South Med J 2014; 107:607-14. [PMID: 25279862 DOI: 10.14423/smj.0000000000000172] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES To determine the prevalence of cardiovascular disease, levels of cardiovascular risk factors, and extent of preventive care in Gullah African Americans with a high familial risk of type 2 diabetes mellitus. METHODS Between 1995 and 2003, 1321 Gullah African Americans with a high prevalence of diabetes mellitus from the South Carolina Sea Islands consented to and enrolled in the Sea Islands Genetic African American Registry (Project SuGAR). A cross-sectional analysis of cardiometabolic risk, preventive care, and self-reported cardiovascular disease was conducted. RESULTS Cardiometabolic risk factor levels were high and vascular disease was prevalent. Among the subjects with diabetes mellitus, the mean disease duration was 10.5 years; approximately one-third reported reduced vision or blindness; and >80% reported numbness, pain, or burning in their feet. Preventive diabetes care was limited, with <60%, <25%, and <40% seeing an ophthalmologist, podiatrist, and dentist, respectively, within the past year. Only 54.4% of women and 39.3% of men reported daily glucose monitoring. CONCLUSIONS As the largest existing study of Gullah individuals, our study offers insight into not only the level of cardiovascular risk in this population but also the pathophysiological mechanisms central to ancestral differences in cardiometabolic risk in the broader African American population.
Collapse
Affiliation(s)
- Kelly J Hunt
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Emily Kistner-Griffin
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Ida Spruill
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Abeba A Teklehaimanot
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - W Timothy Garvey
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Michèle Sale
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| | - Jyotika Fernandes
- From the Department of Public Health Sciences and the College of Nursing, Medical University of South Carolina, Charleston, and the Health Equity and Rural Outreach Innovation Center, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina, the Department of Nutrition Sciences, University of Alabama at Birmingham, and the Center for Public Health Genomics, University of Virginia, Charlottesville
| |
Collapse
|
45
|
Loucks EB, Gilman SE, Howe CJ, Kawachi I, Kubzansky LD, Rudd RE, Martin LT, Nandi A, Wilhelm A, Buka SL. Education and coronary heart disease risk: potential mechanisms such as literacy, perceived constraints, and depressive symptoms. HEALTH EDUCATION & BEHAVIOR 2014; 42:370-9. [PMID: 25431228 DOI: 10.1177/1090198114560020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Education is inversely associated with coronary heart disease (CHD) risk; however the mechanisms are poorly understood. The study objectives were to evaluate the extent to which rarely measured factors (literacy, time preference, sense of control) and more commonly measured factors (income, depressive symptomatology, body mass index) in the education-CHD literature explain the associations between education and CHD risk. METHOD The study sample included 346 participants, aged 38 to 47 years (59.5% women), of the New England Family Study birth cohort. Ten-year CHD risk was calculated using the validated Framingham risk algorithm that utilizes diabetes, smoking, blood pressure, total cholesterol, high-density lipoprotein cholesterol, age, and gender. Multivariable regression and mediation analyses were performed. RESULTS Regression analyses adjusting for age, race/ethnicity, and childhood confounders (e.g., parental socioeconomic status, intelligence) demonstrated that relative to those with greater than or equal to college education, men and women with less than high school had 73.7% (95% confidence interval [CI; 29.5, 133.0]) and 48.2% (95% CI [17.5, 86.8]) higher 10-year CHD risk, respectively. Mediation analyses demonstrated significant indirect effects for reading comprehension in women (7.2%; 95% CI [0.7, 19.4]) and men (7.2%; 95% CI [0.8, 19.1]), and depressive symptoms (11.8%; 95% CI [2.5, 26.6]) and perceived constraint (6.7%, 95% CI [0.7, 19.1]) in women. CONCLUSIONS Evidence suggested that reading comprehension in women and men, and depressive symptoms and perceived constraint in women, may mediate some of the association between education and CHD risk. If these mediated effects are interpreted causally, interventions targeting reading, depressive symptoms, and perceived constraint could reduce educational inequalities in CHD.
Collapse
Affiliation(s)
- Eric B Loucks
- Brown University School of Public Health, Providence, RI, USA
| | - Stephen E Gilman
- Harvard School of Public Health, Boston, MA, USA Massachusetts General Hospital, Boston, MA, USA
| | - Chanelle J Howe
- Brown University School of Public Health, Providence, RI, USA
| | | | | | - Rima E Rudd
- Harvard School of Public Health, Boston, MA, USA
| | | | | | - Aude Wilhelm
- Brown University School of Public Health, Providence, RI, USA
| | - Stephen L Buka
- Brown University School of Public Health, Providence, RI, USA
| |
Collapse
|
46
|
Dalbeni A, Delva P, Minuz P. Could vitamin D supplements be a new therapy for heart failure? Possible pathogenic mechanisms from data of intervention studies. Am J Cardiovasc Drugs 2014; 14:357-66. [PMID: 24934697 DOI: 10.1007/s40256-014-0080-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Vitamin D deficiency may play a role in the pathogenesis of chronic heart failure (HF), but whether giving patients supplements to raise vitamin D into the normal range improves their survival is not clear. It has been demonstrated that vitamin D deficiency is common in patients with HF, especially the elderly, in obese and in dark skinned people, and that low vitamin D levels are associated with adverse outcome. The epidemiological data have been confirmed by experimental data, which show that knockout mice for the vitamin D receptor developed myocardial hypertrophy and dysfunction. Data from interventional studies are scarce and discordant, and more research is urgently needed to confirm whether add-on supplementation therapy with vitamin D has a role in the management of patients with chronic HF.
Collapse
|
47
|
López L, Peralta CA, Lee A, Zeki Al Hazzouri A, Haan MN. Impact of acculturation on cardiovascular risk factors among elderly Mexican Americans. Ann Epidemiol 2014; 24:714-9. [PMID: 25172232 DOI: 10.1016/j.annepidem.2014.07.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 07/10/2014] [Accepted: 07/24/2014] [Indexed: 12/01/2022]
Abstract
PURPOSE Higher levels of acculturation among Latinos have been shown to be associated with a higher prevalence of cardiovascular (CV) risk factors in some studies of middle-age persons. The association of acculturation and prevalence of CV risk factors in elderly Latinos is less well established. METHODS Acculturation was measured using the validated bidimensional Acculturation Rating Scale for Mexican Americans-II. We conducted a cross-sectional analysis of the association of acculturation with prevalence of CV risk factors among 1789 elderly men and women from the Sacramento Area Latino Study on Aging using multivariate linear and logistic regression. We tested for the interaction of acculturation with risk factors by nativity status. RESULTS Median age was 69.8 years. Higher acculturation was associated with lower systolic blood pressure, lower low-density lipoprotein, higher high-density lipoprotein, and lower prevalence of CV disease after age and sex adjustment. Higher acculturation remained associated with lower level of low-density lipoprotein and higher level of high-density lipoprotein after full adjustment. Nativity status did not affect these results. CONCLUSIONS Contrary to other reports in middle-aged persons, higher levels of acculturation were associated with better lipid profiles and no significant differences in other CV risk factors by acculturation level in elderly Latinos.
Collapse
Affiliation(s)
- Lenny López
- Mongan Institute for Health Policy, Massachusetts General Hospital, Boston; Disparities Solutions Center, Massachusetts General Hospital, Boston; Department of General Medicine, Massachusetts General Hospital and Brigham and Women's Hospital, Boston.
| | - Carmen A Peralta
- Division of Nephrology, Department of Medicine, San Francisco VA Medical Center, University of California San Francisco, San Francisco
| | - Anne Lee
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco
| | - Adina Zeki Al Hazzouri
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco
| | - Mary N Haan
- Department of Epidemiology & Biostatistics, School of Medicine, University of California San Francisco, San Francisco
| |
Collapse
|
48
|
Johnson LA, Cushing B, Rohlfing G, Edwards M, Davenloo H, D'Agostino D, Hall JR, O'Bryant SE. The Hachinski ischemic scale and cognition: the influence of ethnicity. Age Ageing 2014; 43:364-9. [PMID: 24321843 DOI: 10.1093/ageing/aft189] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE cardiovascular burden is considered a risk factor for the development of cognitive dysfunction and dementia. While this link is well established in the literature, implementing this work in primary care settings remains a challenge. The goal of this study is to examine the utility of the Hachinski Ischemic Scale (HIS) in identifying cognitive dysfunction and diagnosis of mild cognitive impairment (MCI) in an ethnically diverse sample. METHODS data were analysed on 517 participants (211 Mexican Americans and 306 non-Hispanic Whites) recruited from Project FRONTIER, a study of rural health. Neuropsychological measures were utilised to assess for cognitive functioning. RESULTS among non-Hispanic Whites, HIS scores were significantly related to poorer performance on tasks of global cognition [B (SE) = -0.13 (0.06), P = 0.02], immediate memory [B (SE) = -0.85 (0.26), P < 0.001], attention [B (SE) = -1.6 (0.36), P < 0.001] and executive functioning [B (SE) = 0.46 (0.12), P < 0.001], and significantly predicted diagnosis of MCI [odds ratio (OR) = 1.4; 95% confidence interval (CI) = 1.2-1.6]. For Mexican Americans, HIS scores were significantly related to immediate memory [B (SE) = -0.78 (0.28), P = 0.01], attention [B (SE) = -0.74 (0.36), P = 0.04] and executive functioning [B (SE) = 0.37 (0.14), P = 0.01]; however, HIS scores were not significantly related to diagnosis of MCI in Mexican Americans (OR = 1.2, 95% CI = 0.96-1.4, P = 0.116). CONCLUSION HIS scores were related to cognitive functioning; however, these results differed by ethnicity. It is possible that these findings indicate that vascular factors may increase risk for MCI among non-Hispanic Whites but not for Mexican Americans. These findings are consistent with past research that suggests risk factors for MCI may differ by ethnicity.
Collapse
Affiliation(s)
- Leigh A Johnson
- Department of Internal Medicine, University of North Texas Health Sciences Center, Fort Worth, TX, USA
| | | | | | | | | | | | | | | |
Collapse
|
49
|
Vimalananda VG, Biggs ML, Rosenzweig JL, Carnethon MR, Meigs JB, Thacker EL, Siscovick DS, Mukamal KJ. The influence of sex on cardiovascular outcomes associated with diabetes among older black and white adults. J Diabetes Complications 2014; 28:316-22. [PMID: 24461547 PMCID: PMC4004690 DOI: 10.1016/j.jdiacomp.2013.12.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 12/17/2013] [Accepted: 12/18/2013] [Indexed: 01/05/2023]
Abstract
AIMS It is unknown whether sex differences in the association of diabetes with cardiovascular outcomes vary by race. We examined sex differences in the associations of diabetes with incident congestive heart failure (CHF) and coronary heart disease (CHD) between older black and white adults. METHODS We analyzed data from the Cardiovascular Health Study (CHS), a prospective cohort study of community-dwelling individuals aged ≥65 from four US counties. We included 4817 participants (476 black women, 279 black men, 2447 white women and 1625 white men). We estimated event rates and multivariate-adjusted hazard ratios for incident CHF, CHD, and all-cause mortality by Cox regression and competing risk analyses. RESULTS Over a median follow-up of 12.5years, diabetes was more strongly associated with CHF among black women (HR, 2.42 [95% CI, 1.70-3.40]) than black men (1.39 [0.83-2.34]); this finding did not reach statistical significance (P for interaction=0.08). Female sex conferred a higher risk for a composite outcome of CHF and CHD among black participants (2.44 [1.82-3.26]) vs. (1.44 [0.97-2.12]), P for interaction=0.03). There were no significant sex differences in the HRs associated with diabetes for CHF among whites, or for CHD or all-cause mortality among blacks or whites. The three-way interaction between sex, race, and diabetes on risk of cardiovascular outcomes was not significant (P=0.07). CONCLUSIONS Overall, sex did not modify the cardiovascular risk associated with diabetes among older black or white adults. However, our results suggest that a possible sex interaction among older blacks merits further study.
Collapse
Affiliation(s)
- Varsha G Vimalananda
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
| | - Mary L Biggs
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, WA, USA
| | - James L Rosenzweig
- Section of Endocrinology, Diabetes and Nutrition, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - James B Meigs
- General Medicine Division, Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Evan L Thacker
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA
| | - David S Siscovick
- Cardiovascular Health Research Unit, Departments of Medicine and Epidemiology, University of Washington, Seattle, WA, USA
| | - Kenneth J Mukamal
- General Medicine Division, Department of Medicine, Harvard Medical School, Boston, MA, USA
| |
Collapse
|
50
|
Eldeirawi K, Koenig MD, Persky V, Chavez N. Nativity and serum concentrations of antioxidants in Mexican American children: a cross-sectional study. Nutrients 2014; 6:1598-607. [PMID: 24743050 PMCID: PMC4011053 DOI: 10.3390/nu6041598] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Revised: 03/18/2014] [Accepted: 03/31/2014] [Indexed: 11/17/2022] Open
Abstract
There is limited research on the effect of immigration on biological markers of nutrition among children of Mexican origin in the United States. The purpose of this cross-sectional study was to examine data from the Third National Health and Nutrition Examination Survey (NHANES III) (1988–1994), on a national and representative sample of 1559 Mexican American children, 4–16 years of age, and assess the associations of country of birth with serum concentrations of carotenoids, vitamin A, and vitamin E. In multiple regression analyses, Mexico-born Mexican American children had significantly higher serum concentrations of α-carotene, β-carotene, β-cryptoxanthin, lutein/zeaxanthin, vitamin A, and vitamin E than their counterparts who were born in the United States after adjustment for age, sex, poverty income ratio, level of education of family reference person, body mass index, total serum cholesterol, serum cotinine, total energy intake, and vitamin/mineral consumption. Our findings confirm evidence for a negative effect of immigration/acculturation on dietary quality in this population. These findings also suggest that immigrant Mexican families should be encouraged to maintain their consumption of fruits and vegetables. Prospective studies are needed to further assess the effects of immigration/acculturation on diet and other health outcomes in children of Mexican origin and immigrants.
Collapse
Affiliation(s)
- Kamal Eldeirawi
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago 845 S. Damen Ave. Room 1054 (MC 802), Chicago, IL 60612, USA.
| | - Mary Dawn Koenig
- Department of Women, Children and Family Health Science, College of Nursing, University of Illinois at Chicago 845 S. Damen Ave., Room 814 (MC802), Chicago, IL 60612, USA.
| | - Victoria Persky
- Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago1603 W. Taylor St., 877 SPH-PI (MC 923), Chicago, IL 60612, USA.
| | - Noel Chavez
- Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago 1603 W. Taylor St., 659 SPH-PI (MC 923), Chicago, IL 60612, USA.
| |
Collapse
|