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Verbakel I, Lazar J, Sinha S, Hashim H, Weiss JP, Abrams P, Everaert K. How should we assess the cardiovascular system in patients presenting with bothersome nocturia? ICI-RS 2023. Neurourol Urodyn 2024; 43:1391-1399. [PMID: 37942826 DOI: 10.1002/nau.25331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 10/29/2023] [Indexed: 11/10/2023]
Abstract
AIMS The link between nocturia and cardiovascular disease (CVD) is frequently discussed in literature, yet the precise nature of this relationship remains poorly characterized. The existing literature was reviewed in order to address issues concerning the origin, diagnosis, management, and implications of the co-occurrence of CVD and nocturia. METHODS This review summarizes literature and recommendations regarding the link between CVD and nocturia discussed during a think-tank meeting held at the 2023 International Consultation on Incontinence-Research Society. RESULTS Cardiovascular disorders are often underestimated contributors to nocturia, with various potential mechanisms influencing nighttime urination, such as impact on fluid retention, atrial natriuretic peptide, and glomerular filtration rate. The redistribution of fluid from leg edema in supine position can lead nocturnal polyuria (NP). Additionally, sleep disturbances due to nocturia in itself may lead to CVD through an increase in blood pressure, insulin resistance, and inflammation. Disrupted circadian rhythms (e.g., in sleep pattern and urine production) were identified as critical factors in most etiologies of nocturia, and their contribution is deemed imperative in future research and treatment approaches, particularly in the aging population. NP can be detected through a simple bladder diary and can even be used to distinguish cardiac from noncardiac causes of nocturia. For the treatment of NP, desmopressin can be effective in select patients, however, caution and close monitoring is warranted for those with CVD due to increased risk of side effects. CONCLUSIONS Gaps were identified in the available evidence and clear cut recommendations were put forth for future research. It is essential to gain a deeper understanding of the mechanisms linking nocturia and CVD to develop optimal management strategies.
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Affiliation(s)
- Irina Verbakel
- Department of Urology, ERN Accredited Center, Ghent University Hospital, Gent, Belgium
| | - Jason Lazar
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Sanjay Sinha
- Department of Urology, Apollo Hospital, Hyderabad, Telangana, India
| | - Hashim Hashim
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Jeffrey P Weiss
- Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, New York, USA
| | - Paul Abrams
- Bristol Urological Institute, Southmead Hospital, Bristol, UK
| | - Karel Everaert
- Department of Urology, ERN Accredited Center, Ghent University Hospital, Gent, Belgium
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Folayan A, Cheong MWL, Fatt QK, Su TT. Health insurance status, lifestyle choices and the presence of non-communicable diseases: a systematic review. J Public Health (Oxf) 2024; 46:e91-e105. [PMID: 38084086 PMCID: PMC10901270 DOI: 10.1093/pubmed/fdad247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 10/05/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Although health insurance (HI) has effectively mitigated healthcare financial burdens, its contribution to healthy lifestyle choices and the presence of non-communicable diseases (NCDs) is not well established. We aimed to systematically review the existing evidence on the effect of HI on healthy lifestyle choices and NCDs. METHODS A systematic review was conducted across PubMed, Medline, Embase, Cochrane Library and CINAHLComplet@EBSCOhost from inception until 30 September 2022, capturing studies that reported the effect of HI on healthy lifestyle and NCDs. A narrative synthesis of the studies was done. The review concluded both longitudinal and cross-sectional studies. A critical appraisal checklist for survey-based studies and the National Institutes of Health Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies were used for the quality assessment. RESULT Twenty-four studies met the inclusion criteria. HI was associated with the propensity to engage in physical activities (6/11 studies), consume healthy diets (4/7 studies), not to smoke (5/11 studies) or take alcohol (5/10 studies). Six (of nine) studies showed that HI coverage was associated with a lowered prevalence of NCDs. CONCLUSION This evidence suggests that HI is beneficial. More reports showed that it propitiated a healthy lifestyle and was associated with a reduced prevalence of NCDs.
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Affiliation(s)
- Adeola Folayan
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Malaysia
| | | | - Quek Kia Fatt
- Global Public Health, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Malaysia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, 47500 Bandar Sunway, Malaysia
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Park YS, Joo HJ, Jang YS, Jeon H, Park EC, Shin J. Socioeconomic Status and Dementia Risk Among Intensive Care Unit Survivors: Using National Health Insurance Cohort in Korea. J Alzheimers Dis 2024; 97:273-281. [PMID: 38143351 DOI: 10.3233/jad-230715] [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] [Indexed: 12/26/2023]
Abstract
BACKGROUND In aging populations, more elderly patients are going to the intensive care unit (ICU) and surviving. However, the specific factors influencing the occurrence of post-intensive care syndrome in the elderly remain uncertain. OBJECTIVE To investigate the association between socioeconomic status (SES) and risk of developing dementia within two years following critical care. METHODS This study included participants from the Korean National Health Insurance Service Cohort Database who had not been diagnosed with dementia and had been hospitalized in the ICU from 2003 to 2019. Dementia was determined using specific diagnostic codes (G30, G31) and prescription of certain medications (rivastigmine, galantamine, memantine, or donepezil). SES was categorized into low (medical aid beneficiaries) and non-low (National Health Insurance) groups. Through a 1:3 propensity score matching based on sex, age, Charlson comorbidity index, and primary diagnosis, the study included 16,780 patients. We used Cox proportional hazard models to estimate adjusted hazard ratios (HR) of dementia. RESULTS Patients with low SES were higher risk of developing dementia within 2 years after receiving critical care than those who were in non-low SES (HR: 1.23, 95% CI: 1.04-1.46). Specifically, patients with low SES and those in the high-income group exhibited the highest incidence rates of developing dementia within two years after receiving critical care, with rates of 3.61 (95% CI: 3.13-4.17) for low SES and 2.58 (95% CI: 2.20-3.03) for high income, respectively. CONCLUSIONS After discharge from critical care, compared to the non-low SES group, the low SES group was associated with an increased risk of developing dementia.
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Affiliation(s)
- Yu Shin Park
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hye Jin Joo
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Gachon University College of Medicine, Seoul, Republic of Korea
| | - Yun Seo Jang
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
| | - Hajae Jeon
- Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Eun-Cheol Park
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jaeyong Shin
- Institute of Health Services Research, Yonsei University, Seoul, Republic of Korea
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
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Kähönen E, Korpimäki S, Juonala M, Kähönen M, Lehtimäki T, Hutri-Kähönen N, Raitakari OT, Kivimäki M, Vahtera J. Neighbourhood deprivation in childhood and adulthood and risk of arterial stiffness: the Cardiovascular Risk in Young Finns study. Blood Press 2023; 32:2220037. [PMID: 37300298 DOI: 10.1080/08037051.2023.2220037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 05/09/2023] [Accepted: 05/25/2023] [Indexed: 06/12/2023]
Abstract
Purpose: Individual socioeconomic status is associated with increased arterial stiffness, but limited data are available on the relations of neighbourhood deprivation with this vascular measure. We prospectively examined whether neighbourhood deprivation in childhood and adulthood predicts arterial stiffness indicated by pulse wave velocity (PWV).Materials and methods: The study population comprised 1,761 participants aged 3-18 years at baseline (1980) from the longitudinal Cardiovascular Risk in Young Finns cohort study. PWV was measured in 2007 by whole-body impedance cardiography at ages 30-45 years. Cumulative lifetime neighbourhood deprivation was assessed using data from socioeconomic circumstances in participants' lifetime residential neighbourhoods, categorised as low versus high deprivation.Results: High deprivation in childhood and adulthood was associated with higher PWV in adulthood after adjustment for age, sex, and place of birth (mean difference = 0.57 m/s, 95%CI = 0.26-0.88, P for trend = 0.0004). This association was attenuated but remained statistically significant after further adjustment for childhood parental socioeconomic status and adulthood individual socioeconomic status (mean difference = 0.37 m/s, 95%CI = 0.05-0.70, P for trend 0.048). Also, low individual socioeconomic status in adulthood was associated with higher PWV when adjusted for age, sex, place of birth, parental socioeconomic status in childhood, and lifetime neighbourhood deprivation (mean difference = 0.54 m/s, 95%CI = 0.23-0.84, P for trend 0.0001).Conclusion: These findings suggest that lifetime neighbourhood deprivation and low adulthood socioeconomic status are independent risk factors for increased arterial stiffness in adulthood.
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Affiliation(s)
- Erika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Satu Korpimäki
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Markus Juonala
- Department of Medicine, Division of Medicine, University of Turku, Turku University Hospital, Turku, Finland
| | - Mika Kähönen
- Department of Clinical Physiology and Nuclear Medicine, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
- Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
| | - Terho Lehtimäki
- Finnish Cardiovascular Research Center-Tampere, Tampere University, Tampere, Finland
- Fimlab Laboratories, Tampere, Finland
- Department of Clinical Chemistry, Faculty of Medicine and Health Technology, Tampere University and Tampere University Hospital, Tampere, Finland
| | - Nina Hutri-Kähönen
- Tampere Centre for Skills Training and Simulation, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli T Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Mika Kivimäki
- Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
- UCL Brain Sciences, University College London, London, United Kingdom
| | - Jussi Vahtera
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
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Lim WH, Kim HL, Joh HS, Seo JB, Kim SH, Zo JH, Kim MA. The Prognostic Value of Arterial Stiffness According to Socioeconomic Status. J Clin Med 2023; 12:6943. [PMID: 37959408 PMCID: PMC10647441 DOI: 10.3390/jcm12216943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 10/31/2023] [Accepted: 11/04/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Individuals of low socioeconomic status (SES) often exhibit increased cardiovascular risk factors and a worse prognosis. We conducted this study to ascertain whether brachial-ankle pulse wave velocity (baPWV), a straightforward and reliable measure of arterial stiffness, can hold prognostic value for people with low SES. METHODS We retrospectively analyzed a total of 1266 subjects (mean age 64.6 ± 11.6 years; 47.2% female) without documented cardiovascular disease who had undergone baPWV measurement. The subjects included 633 National Health Insurance Beneficiaries (NHIB) and 633 Medical Aid Beneficiaries (MAB), matched for major clinical features through a 1:1 propensity score matching method. Major adverse cardiovascular events (MACE), such as death, non-fatal myocardial infarction, non-fatal ischemic stroke, coronary revascularization, and heart failure necessitating admission, were assessed during the clinical follow-up. RESULTS During a median follow-up period of 4.2 years (interquartile range, 2.2-5.7 years), there were 77 MACE cases (6.1%). In multivariable Cox regression analyses, baPWV was identified as a significant predictor of MACE in both groups, regardless of the use of three different baPWV criteria (median value, Asian consensus recommendation, and cut-off value obtained by receiver operating characteristic [ROC] curve analysis). In both groups, the baPWV value obtained using ROC curve analysis emerged as the best predictor of MACE. This predictive value was stronger in the NHIB group (hazard ratio, 5.80; 95% confidence interval, 2.30-14.65; p < 0.001) than in the MAB group (hazard ratio, 3.30; 95% confidence interval, 1.57-6.92; p = 0.002). CONCLUSIONS baPWV was associated with future MACE incidence in both NHIB and MAB groups. Since baPWV is simple and cost-effective to measure, it could be efficiently used as a risk stratification tool for individuals with low SES.
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Affiliation(s)
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul 07061, Republic of Korea; (W.-H.L.); (H.S.J.); (J.-B.S.); (S.-H.K.); (J.-H.Z.); (M.-A.K.)
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Xu M, Wang W, Chen R, Zhou L, Hu H, Qiao G, Wang L, Liu X, Wang Q, Ai Y, Ren H, Hu P. Individual and combined associations of estimated pulse wave velocity and systemic inflammation response index with risk of stroke in middle-aged and older Chinese adults: a prospective cohort study. Front Cardiovasc Med 2023; 10:1158098. [PMID: 38028467 PMCID: PMC10655141 DOI: 10.3389/fcvm.2023.1158098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 10/19/2023] [Indexed: 12/01/2023] Open
Abstract
Background and aims Estimated pulse wave velocity (ePWV) and systemic inflammatory response index (SIRI) have been recently investigated as a marker of arterial stiffness and a novel systemic inflammatory indicator. This study aims to examine the independent and combined association of ePWV and SIRI with incident stroke and its subtypes. Methods Data of the Dongfeng-Tongji cohort study was analyzed for 9,154 middle-aged and older adults, who were free of cardiovascular disease and cancer and were followed up to document incident stroke. But their association with incident stroke events and its subtypes have not been well studied. Multivariable adjusted Cox regression models were used to determine the independent and combined association of ePWV and SIRI with incident stroke events. Results Over a 7.22-year follow-up, the cohort documented 491 stroke cases (387 ischemic stroke and 104 hemorrhagic stroke). The multivariate adjusted model showed that with each one-unit increase in the level of ePWV, the corresponding hazard ratios (HRs) (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.53 (95% CI, 1.23-1.90), 1.42 (95% CI, 1.11-1.83), and 1.92 (95% CI, 1.21-3.03), respectively. Similarly, with each one-unit increase in log-transformed levels of SIRI, the corresponding HRs (95% CI) for total stroke, ischemic stroke, and hemorrhagic stroke were 1.23 (95% CI,1.04-1.47), 1.16 (95% CI, 0.96-1.41), and 1.52 (95% CI, 1.05-2.20), respectively. There appeared to be a combined effect of ePWV and SIRI on stroke; Participants with high levels of both ePWV and SIRI had a higher risk of total stroke and hemorrhagic stroke, with multiple adjusted HR of 2.43 (95% CI, 1.09-5.42). Additionally, the incorporation of ePWV in addition to traditional cardiovascular risk factors significantly improved the predictive accuracy for total stroke with C statistic increased from 0.684 (95% CI, 0.661-0.707) to 0.687 (95% CI, 0.664-0.710; x2 = 6.65; p for difference = 0.010), and (suggestively) for ischemic stroke with C statistic increased from 0.684 (95% CI, 0.659-0.71) to 0.691(95% CI, 0.666-0.717; x2 = 3.13, p for difference = 0.077), respectively. Conclusions The presence of both high ePWV and SIRI individually, as well as together, was found to be associated with an increased incidence of stroke. The combined stroke risk assessment using these two indicators could potentially improve non-invasive assessment and treatment strategies for high-risk patients, as these indicators are easily accessible in clinical practice.
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Affiliation(s)
- Man Xu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqiang Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, United Kingdom
| | - Li Zhou
- Academy of Nutrition and Health, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Hui Hu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Guiyuan Qiao
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ling Wang
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | | | - Qiuhong Wang
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yating Ai
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Hairong Ren
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Ping Hu
- Key Laboratory of Environment and Health (HUST), Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Yoo KH, Cho Y, Oh J, Lee J, Ko BS, Kang H, Lim TH, Lee SH. Association of Socioeconomic Status With Long-Term Outcome in Survivors After Out-of-Hospital Cardiac Arrest: Nationwide Population-Based Longitudinal Study. JMIR Public Health Surveill 2023; 9:e47156. [PMID: 37432716 PMCID: PMC10369165 DOI: 10.2196/47156] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 04/12/2023] [Accepted: 06/14/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Out-of-hospital cardiac arrest (OHCA) is a major public health problem and a leading cause of death worldwide. Previous studies have focused on improving the survival of people who have had OHCA by analyzing short-term survival outcomes, such as the return of spontaneous circulation, 30-day survival, and survival to discharge. Research has been conducted on prehospital prognostic factors to improve the survival of patients with OHCA, among which the association between socioeconomic status (SES) and survival has been reported. SES could affect bystander cardiopulmonary resuscitation rates and whether OHCA is witnessed, and low cardiopulmonary resuscitation education rates are associated with low SES. It has been reported that areas with high SES have shorter hospital transfer times and more public defibrillators per person. Previous studies have shown the impact of SES disparities on the short-term survival of patients with OHCA. However, understanding the impact of SES on the long-term prognosis of OHCA survivors remains limited. As long-term outcomes are more indicative of a patient's ongoing health care needs and the burden on public health than short-term outcomes, understanding the long-term prognosis of OHCA survivors is important. OBJECTIVE This study aimed to identify whether SES influenced the long-term outcomes of OHCA. METHODS Using health claims data obtained from the National Health Insurance (NHI) service in Korea, we included OHCA survivors who were hospitalized between January 2005 and December 2015. The patients were divided into 2 groups: NHI and Medical Aid (MA) groups, with the MA group defined as having a low SES. Cumulative mortality was estimated using the Kaplan-Meier method, and a Cox proportional hazards model was used to evaluate the impact of SES on long-term mortality. A subgroup analysis was performed based on whether cardiac procedures were performed. RESULTS We followed 4873 OHCA survivors for up to 14 years (median of 3.3 years). The Kaplan-Meier survival curve showed that the MA group had a significantly decreased long-term survival rate compared to the NHI group. With an adjusted hazard ratio (aHR) of 1.52 (95% CI 1.35-1.72), low SES was associated with increased long-term mortality. The overall mortality rate of the patients who underwent cardiac procedures in the MA group was significantly higher than that of the NHI group (aHR 1.72, 95% CI 1.05-2.82). The overall mortality rate of patients without cardiac procedures was also increased in the MA group compared to the NHI group (aHR 1.39, 95% CI 1.23-1.58). CONCLUSIONS OHCA survivors with low SES had an increased risk of poor long-term outcomes compared with those with higher SES. OHCA survivors with low SES who have undergone cardiac procedures need considerable care for long-term survival.
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Affiliation(s)
- Kyung Hun Yoo
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
| | - Yongil Cho
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Jaehoon Oh
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Juncheol Lee
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Byuk Sung Ko
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Hyunggoo Kang
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Tae Ho Lim
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
- Department of Emergency Medicine, College of Medicine, Hanyang University, Seoul, Republic of Korea
| | - Sang Hwan Lee
- Department of Emergency Medicine, Hanyang University Hospital, Seoul, Republic of Korea
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Impact of estimated pulse wave velocity and socioeconomic status on the risk of stroke in men: a prospective cohort study. J Hypertens 2022; 40:1165-1169. [PMID: 35239548 DOI: 10.1097/hjh.0000000000003118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE High pulse wave velocity (PWV) and low socioeconomic status (SES) are each associated with increased risk of stroke, but clarification of the interplay between PWV, SES and the risk of stroke appears to be warranted to identify vulnerable populations at high risk of stroke. We conducted a prospective study that examined the independent and joint associations of PWV and SES with the risk of stroke in the general population. METHODS The current study included 2666 men aged 42-61 years, who were enrolled in the Kuopio Ischaemic Heart Disease Study cohort. Estimated PWV (ePWV), a proxy of carotid-femoral PWV, was calculated from an equation based on age and mean blood pressure. SES was assessed using self-reported questionnaires and classified as tertiles, whereas ePWV was categorized as high (≥10 m/s) and low (<10 m/s). RESULTS Individuals with high ePWV had a 48% higher risk of stroke after adjusting for confounding factors, whereas individuals with low SES had a similar 35% increased risk of stroke, compared with those high SES. Results of the joint associations of ePWV and SES with stroke showed high ePWV-high SES and high ePWV-low SES to be each associated with an increased risk of stroke: hazard ratios 1.53, 95% confidence intervals (CIs) (1.12-2.08) and hazard ratio 1.63, 95% CI (1.21-2.20), respectively, but low ePWV-low SES was not associated with a heightened risk of stroke (hazard ratio 1.12, 95% CI 0.87-1.44) compared with the low ePWV-high SES group. CONCLUSION ePWV and SES are each independently associated with stroke risk. The association between elevated ePWV and the heightened risk of stroke is regardless of low or high SES.
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Wu Y, Liu Q, Ma Y, Han X, Zhao X, Zhao H, Song M, Sun J, Wang X, Wu S. Effect of parental arterial stiffness in offspring: the Kailuan study. J Hypertens 2022; 40:102-107. [PMID: 34420014 DOI: 10.1097/hjh.0000000000002984] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The aim of this study was to examine effect of parental arterial stiffness in offspring. METHODS The individuals who participated in the second or subsequent follow-up and had parent-offspring relationship and completed measurements of brachial-ankle pulse wave velocity (baPWV) from the Kailuan study were recruited. The individuals were divided into groups by the 10-year intervals and sex. Arterial stiffness was defined as the 75th percentiles in each age category. Multivariable generalized estimating equations was used to analyse the effect of parental baPWV and blood pressure in offspring. Multivariable logistic regression using generalized estimating equations was used to analyse the effect of parental arterial stiffness in offspring. RESULTS A total of 4514 parents and offspring who met the inclusion criteria, including 1785 paternal offspring and 625 maternal offspring was recruited. Mean age of paternal offspring and maternal offspring were 36.26 (SD 7.86) and 36.42 (SD 7.57) years, while their mean baPWV were 1294.40 (SD 225.32) and 1270.74 (SD 241.42) cm/s, respectively. In multivariate linear regression analyses, after adjusted for the covariate risk factors, an increase of 1 cm/s in the paternal and maternal baPWV of resulted in an increase of 0.05 and 0.30 cm/s in offspring, respectively. In multivariate logistic regression analyses, the risk of arterial stiffness in the offspring of paternal and maternal arterial stiffness increased by 50 and 77%, respectively. CONCLUSION Paternal and maternal baPWV are linear positively correlated with baPWV in offspring. Parental arterial stiffness is a risk factor for arterial stiffness of offspring and is independent of traditional risk factors of offspring arterial stiffness.
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Affiliation(s)
- Yuntao Wu
- Department of Cardiology, Kailuan General Hospital
| | - Qian Liu
- Graduate School North China University of Science and Technology, Tangshan
| | - Yihan Ma
- Graduate School North China University of Science and Technology, Tangshan
| | - Xu Han
- Graduate School North China University of Science and Technology, Tangshan
| | | | - Haiyan Zhao
- Department of Cardiology, Kailuan General Hospital
| | - Mingzhu Song
- Department of Cardiology, Kailuan General Hospital
| | - Junyan Sun
- Department of Cardiology, Kailuan General Hospital
| | - Xingyu Wang
- Beijing Hypertension League Institute, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital
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Kim HL, Chung J, Lim WH, Seo JB, Kim SH, Zo JH, Kim MA. Association between household income and pulse pressure: data from the Korean National Health and Nutrition Examination Survey. Blood Press 2021; 30:258-264. [PMID: 34013800 DOI: 10.1080/08037051.2021.1928478] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE There has been limited evidence for the association between socioeconomic status (SES) and arterial stiffness. This study was performed to investigate the association between household income and brachial pulse pressure (PP) in the general Korean population. MATERIALS AND METHODS This study was based on data acquired in the 2018 Korea National Health and Nutrition Examination Survey (2018 KNHANES). A total of 13004 subjects at the age of 20 years or older analysed. The information on monthly household income was obtained through the questionnaire, and was stratified into 5 groups for each quintile. Brachial blood pressure (BP) was measured 3 times, and the average of the second and third measured BPs were used. PP was calculated as the difference between systolic and diastolic BPs. RESULTS A lower household income was associated with a higher prevalence of cardiovascular risk factors. As household income increased, PP decreased proportionally (p < .001). In multiple linear regression analysis, household income (per quintile) was independently associated with PP even after controlling for potential confounders (β = -.125, p < .001). Multiple binary logistic regression analysis showed that the increased household income level was significantly associated lower probability having higher PP (≥ 43.5 mmHg) even after controlling for multiple covariates (the lowest vs. the highest household income; odds ratio, 0.48; 95% confidence interval, .41-.55; p < .001). CONCLUSION Low household income was associated with higher PP. This provides additional evidence for the association between low SES and high arterial stiffness.
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Affiliation(s)
- Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jaehoon Chung
- Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Korea
| | - Woo-Hyun Lim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Jae-Bin Seo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Sang-Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Joo-Hee Zo
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Myung-A Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
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