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Pasokh Z, Seif M, Ghaem H, Rezaianzadeh A, Johari MG. Age at natural menopause and development of chronic diseases in the female population of Kharameh, Iran: A historical cohort study. Health Sci Rep 2024; 7:e2042. [PMID: 38650726 PMCID: PMC11033488 DOI: 10.1002/hsr2.2042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 03/19/2024] [Accepted: 03/21/2024] [Indexed: 04/25/2024] Open
Abstract
Background and Aims Declines in estradiol levels after menopause have been reported to be associated with several health outcomes. This study aimed to determine the effect of age at natural menopause (ANM) on some of the most common chronic diseases. Methods This historical cohort study was performed on 2636 postmenopausal women aged 40-70 years participating in phase one of the PERSIAN cohort study in Kharameh, Iran, during 2015-2017. The effect of early (<45 years), intermediate (45-53 years), and late menopause (>53 years) on chronic diseases such as hypertension, diabetes, ischemic heart diseases, stroke, thyroid diseases, and depression was assessed using classic logistic regression for diseases with an incidence rate of more than 10% and Firth's logistic regression for diseases with an incidence of less than this amount. Results The mean age of women was 53.48 ± 8.59. Respectively, early and intermediate menopause was associated with ischemic heart disease (odds ratio [OR = 1.61, 95% confidence interval [CI]: 1.08-2.42; p = 0.020), (OR = 1.57, 95% CI: 1.13-2.21; p = 0.008) and thyroid diseases (OR = 3.10, 95% CI: 1.64-6.24; p < 0.001), (OR = 1.83, 95% CI: 1.02-3.57; p = 0.042). furthermore, early menopause was a risk factor for diabetes (OR = 1.46, 95% CI: 1.07-2.00; p = 0.018), depression (OR = 4.79, 95% CI: 2.20-11.79; p = <0.001) and stroke (OR = 3.00, 95% CI: 1.08-9.32; p = 0.034). Conclusions In this study, women with diabetes, ischemic heart diseases, stroke, thyroid disorders, and depression had a younger ANM compared to their healthy counterparts. Therefore, applying appropriate strategies to postpone the age of menopause, can reduce the incidence of these types of chronic diseases.
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Affiliation(s)
- Zahra Pasokh
- Student Research Committee, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Mozhgan Seif
- Non‐Communicable Diseases Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Haleh Ghaem
- Non‐Communicable Diseases Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Abbas Rezaianzadeh
- Colorectal Research Center, Department of Epidemiology, School of HealthShiraz University of Medical SciencesShirazIran
| | - Masoumeh Ghoddusi Johari
- Breast Diseases Research Center, Community Medicine DepartmentShiraz University of Medical SciencesShirazIran
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Lloyd D, House JS, Akhtari FS, Schmitt CP, Fargo DC, Scholl EH, Phillips J, Choksi S, Shah R, Hall JE, Motsinger-Reif AA. Questionnaire-based exposome-wide association studies for common diseases in the Personalized Environment and Genes Study. EXPOSOME 2024; 4:osae002. [PMID: 38450326 PMCID: PMC10914401 DOI: 10.1093/exposome/osae002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 01/01/2024] [Indexed: 03/08/2024]
Abstract
The exposome collectively refers to all exposures, beginning in utero and continuing throughout life, and comprises not only standard environmental exposures such as point source pollution and ozone levels but also exposures from diet, medication, lifestyle factors, stress, and occupation. The exposome interacts with individual genetic and epigenetic characteristics to affect human health and disease, but large-scale studies that characterize the exposome and its relationships with human disease are limited. To address this gap, we used extensive questionnaire data from the diverse North Carolina-based Personalized Environment and Genes Study (PEGS, n = 9, 429) to evaluate exposure associations in relation to common diseases. We performed an exposome-wide association study (ExWAS) to examine single exposure models and their associations with 11 common complex diseases, namely allergic rhinitis, asthma, bone loss, fibroids, high cholesterol, hypertension, iron-deficient anemia, ovarian cysts, lower GI polyps, migraines, and type 2 diabetes. Across diseases, we found associations with lifestyle factors and socioeconomic status as well as asbestos, various dust types, biohazardous material, and textile-related exposures. We also found disease-specific associations such as fishing with lead weights and migraines. To differentiate between a replicated result and a novel finding, we used an AI-based literature search and database tool that allowed us to examine the current literature. We found both replicated findings, especially for lifestyle factors such as sleep and smoking across diseases, and novel findings, especially for occupational exposures and multiple diseases.
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Affiliation(s)
- Dillon Lloyd
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - John S House
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Farida S Akhtari
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Charles P Schmitt
- Division of Translational Toxicology, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - David C Fargo
- Office of the Director, National Institute of Environmental Health Sciences, Durham, NC, USA
| | | | | | | | | | - Janet E Hall
- Clinical Research Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - Alison A Motsinger-Reif
- Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Durham, NC, USA
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Crizzle AM, Wawzonek PA, Bigelow PL. Health Comparisons Between Truck Drivers and the General Population Using the Canadian Community Health Survey. J Occup Environ Med 2024; 66:20-27. [PMID: 37800354 DOI: 10.1097/jom.0000000000002988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023]
Abstract
BACKGROUND This study examined and compared risk factors and health conditions of truck drivers compared with the general Canadian population. METHODS This study used the Canadian Community Health Survey consisting of 991 male truck drivers and 29,958 male respondents of the general population. RESULTS Compared with the general population, truck drivers were older, less educated, had lower incomes, worked more hours, and were more likely to be widowed/separated/divorced. In addition, truck drivers had significantly higher rates of cardiovascular disease and obesity and were more likely to be sedentary, smoke, drive when fatigued, and eat unhealthy compared with the general population. CONCLUSIONS Multicomponent interventions are needed to address the poor lifestyle practices of truckers to reduce the high rates of morbidity.
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Affiliation(s)
- Alexander M Crizzle
- Form the School of Public Health, University of Saskatchewan, Saskatoon, Canada (A.M.C.); and School of Public Health and Health Systems, University of Waterloo, Waterloo, Canada (A.M.C., P.A.W., P.L.B.)
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Gaalema DE, Khadanga S, Pack QR. Clinical challenges facing patient participation in cardiac rehabilitation: cigarette smoking. Expert Rev Cardiovasc Ther 2023; 21:733-745. [PMID: 37938825 DOI: 10.1080/14779072.2023.2282026] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 11/07/2023] [Indexed: 11/10/2023]
Abstract
INTRODUCTION Cardiac rehabilitation (CR) is highly effective at reducing morbidity and mortality. However, CR is underutilized, and adherence remains challenging. In no group is CR attendance more challenging than among patients who smoke. Despite being more likely to be referred to CR, they are less likely to enroll, and much more likely to drop out. CR programs generally do not optimally engage and treat those who smoke, but this population is critical to engage given the high-risk nature of continued smoking in those with cardiovascular disease. AREAS COVERED This review covers four areas relating to CR in those who smoke. First, we review the evidence of the association between smoking and lack of participation in CR. Second, we examine how smoking has historically been identified in this population and propose objective screening measures for all patients. Third, we discuss the optimal treatment of smoking within CR. Fourth, we review select populations within those who smoke (those with lower-socioeconomic status, females) that require additional research and attention. EXPERT OPINION Smoking poses a challenge on multiple fronts, being a significant predictor of future morbidity and mortality, as well as being strongly associated with not completing the secondary prevention program (CR) that could benefit those who smoke the most.
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Affiliation(s)
- Diann E Gaalema
- Department of Psychiatry, University of Vermont, Burlington, VT, United States of America
| | - Sherrie Khadanga
- Cardiac Rehabilitation and Prevention, University of Vermont Medical Center, South Burlington, VT, United States of America
| | - Quinn R Pack
- Department of Healthcare Delivery and Population Sciences, University of Massachusetts Chan Medical School - Baystate, Springfield, MA, United States of America
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Kyprianidou M, Panagiotakos D, Makris KC, Kambanaros M, Christophi CA, Giannakou K. The Lifestyle Profile of Individuals with Cardiovascular and Endocrine Diseases in Cyprus: A Hierarchical, Classification Analysis. Nutrients 2022; 14:nu14081559. [PMID: 35458120 PMCID: PMC9027605 DOI: 10.3390/nu14081559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/01/2022] [Accepted: 04/05/2022] [Indexed: 02/01/2023] Open
Abstract
The study aims to explore the lifestyle profile of adult individuals with cardiovascular and endocrine diseases in Cyprus. Age and sex-specific analyses were applied. A representative sample of the general adult population was recruited during 2018–2019 using stratified sampling among the five government-controlled municipalities of the Republic of Cyprus. Data on Mediterranean diet adherence, quality of sleep, smoking status, physical activity, Body Mass Index, and the presence of cardiovascular and endocrine diseases were collected using a validated questionnaire. Diseases were classified according to the International Classification of Diseases, Tenth Revision (ICD-10). A total of 1140 men and women over 18 years old (range: 18–94) participated in the study. The prevalence of cardiovascular and endocrine diseases among the adult general population of Cyprus was 24.8% and 17.2%, respectively, with a higher prevalence of cardiovascular diseases in men, and a higher prevalence of endocrine diseases in women. Among individuals with cardiovascular disease, 23.3% were aged between 18–44 years old, while the corresponding percentage among endocrine disease individuals was 48%. The prevalence of smoking, physical activity, a low adherence to the Mediterranean diet, poor quality of sleep and obesity among the study population was 35.5%, 48.0%, 32.9%, 39.0% and 13.6%, respectively. Individuals with cardiovascular and endocrine diseases were characterized by poor quality of sleep, inadequate physical activity, and a higher BMI. This is the first study in Cyprus exploring the profile of individuals with cardiovascular and endocrine diseases in Cyprus. Health promotion and educational programs focusing on the importance of sleep quality, healthier dietary habits, physical activity, and lower BMIs among people with cardiovascular and endocrine diseases should be developed.
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Affiliation(s)
- Maria Kyprianidou
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, 17676 Athens, Greece;
| | - Konstantinos C. Makris
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
| | - Maria Kambanaros
- Department of Allied Health and Human Performance, University of South Australia, Adelaide, SA 5001, Australia;
| | - Costas A. Christophi
- Cyprus International Institute for Environmental and Public Health, Cyprus University of Technology, Limassol 3036, Cyprus; (M.K.); (K.C.M.); (C.A.C.)
| | - Konstantinos Giannakou
- Department of Health Sciences, School of Sciences, European University Cyprus, Nicosia 1516, Cyprus
- Correspondence: ; Tel.: +357-2255-9656
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Peng KG, Yu HL. Characteristic analysis of clinical coronary heart disease and coronary artery disease concerning young and middle-aged male patients. World J Clin Cases 2021; 9:7358-7364. [PMID: 34616802 PMCID: PMC8464452 DOI: 10.12998/wjcc.v9.i25.7358] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 05/15/2021] [Accepted: 07/09/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is a type of coronary atherosclerotic heart disease. In recent years, the incidence of CHD has been increasing annually, with an increasing number of young patients. Severe CHD may cause severe myocardial ischemia or myocardial necrosis, which in turn may cause myocardial infarction and related complications that seriously affect the life and health of the patient.
AIM To examine the coronary arteries and clinical features of young and middle-aged male patients with CHD.
METHODS From February 2019 to January 2020, 110 male CHD patients admitted to our hospital were selected as research subjects and were divided into two groups by age: middle-aged group (n = 55) and young group (n = 55). The coronary arteries and clinical features of the patients were compared.
RESULTS There were no significant differences in dyslipidemia, stroke history, high-density lipoprotein cholesterol, or triacylglycerol (P > 0.05) between the two groups. In the young group, age, diabetes, hypertension, smoking history, body mass index, family history of CHD, drinking history, fibrinogen, low-density lipoprotein cholesterol, total cholesterol, and single-vessel disease were higher than those in the middle-aged group. Correspondingly, serum uric acid, hyperuricemia, myocardial infarction, Gensini score > 50, collateral circulation, multivessel disease, double vessel disease, involvement of the right coronary artery, and involvement of the left main coronary artery were lower in the young group than in the middle-aged group. The middle-aged group mainly suffered from a high Gensini score, implicating multiple arteries, whereas the young group was mainly affected by single-vessel disease. The between-group difference was significant (P < 0.05).
CONCLUSION In CHD attacks, multiple coronary arteries are implicated in middle-aged male patients and single-vessel disease in young male patients.
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Affiliation(s)
- Kai-Ge Peng
- Department of Cardiovascular Medicine, Anqing Municipal Hospital, Anqing 230032, Anhui Province, China
| | - Hui-Lin Yu
- Department of Cardiovascular Medicine, Anqing Municipal Hospital, Anqing 230032, Anhui Province, China
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McKay GJ, Lyner N, Linden GJ, Kee F, Moitry M, Biasch K, Amouyel P, Dallongeville J, Bongard V, Ferrières J, Gey KF, Patterson CC, Woodside JV. Association of low plasma antioxidant levels with all-cause mortality and coronary events in healthy middle-aged men from France and Northern Ireland in the PRIME study. Eur J Nutr 2021; 60:2631-2641. [PMID: 33355688 PMCID: PMC8275518 DOI: 10.1007/s00394-020-02455-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The main underlying risk factors associated with coronary heart disease (CHD) are modifiable and oxidative injury and systemic inflammatory damage represent key aetiological factors associated with the development and progression of CHD and premature mortality. OBJECTIVE To examine associations of plasma antioxidant status with all-cause mortality and fatal or non-fatal cardiovascular events. DESIGN The PRIME study prospectively evaluated 9709 men aged 50-59 years between 1991 and 1993 in Northern Ireland and France who were free of CHD at recruitment and followed annually for deaths and cardiovascular events for 10 years. Serum concentrations of vitamin C, retinol, two forms of vitamin E (α- and γ-tocopherol) and six carotenoids were quantified by high-performance liquid chromatography. Baseline conventional risk factors were considered, as well as socioeconomic differences and lifestyle behaviours including diet, smoking habit, physical activity, and alcohol consumption through Cox regression analyses. RESULTS At 10 years, there were 538 deaths from any cause and 440 fatal or non-fatal cardiovascular events. After adjustment for country, age, systolic blood pressure, diabetes, body mass index, cholesterol, high density lipoprotein cholesterol, triglycerides, height, total physical activity, alcohol consumption and smoking habit, higher levels of all antioxidants were associated with significantly lower risk of all-cause mortality, with the exception of γ-tocopherol. Only retinol was significantly associated with decreased risk of cardiovascular events in a fully adjusted model. CONCLUSIONS Low antioxidant levels contribute to the gradient of all-cause mortality and cardiovascular incidence independent of lifestyle behaviours and traditional cardiovascular and socioeconomic risk factors.
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Affiliation(s)
- Gareth J McKay
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK.
| | - Natalie Lyner
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Gerry J Linden
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Frank Kee
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | | | | | | | | | | | | | - K Fred Gey
- The MONICA Reference Centre for Vitamins, Department of Biochemistry and Molecular Biology, University of Bern, Bern, Switzerland
| | - Chris C Patterson
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
| | - Jayne V Woodside
- Centre for Public Health, Royal Victoria Hospital, Queen's University Belfast, Belfast, BT12 6BA, UK
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Are Perceptions of Health Dependant on Social Class? Studying Soft Power and Symbolic Violence in a Health Promotion Program among Young Men at Vocational Schools. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147517. [PMID: 34299968 PMCID: PMC8307088 DOI: 10.3390/ijerph18147517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 11/30/2022]
Abstract
Health behaviour among young people has a social gradient, and tends to be skewed in terms of gender as well. Young men in vocational educational settings are an example where the inequality in health is apparent. Addressing this problem requires an understanding of health behaviour and its determinants in the target group in order to be able to develop interventions that can address the problem. The aim of the paper is to investigate to what extent a multicomponent intervention based on the Whole School Approach, targeting the risk behaviours, smoking, eating and physical activity that have an impact on health behaviour among male students in a disadvantaged educational setting. The paper uses self-reported longitudinal data on risk behaviours from the “Gearing up the Body” 1-year intervention program that was implemented among students at a Danish vocational school. For the analysis, we created a score model to categorise students and behaviour. Analyses suggest that interventions had only a modest impact and what evidence there is shows that the interventions reduced the health behaviour scores by 0.03 points. More specifically, we find that symbolic violence reduces the health behaviour score of the healthy types by 0.20 points, whereas soft power increases the health behaviour of the unhealthy type by 0.05 points. An explanation for the disappointing results of the “Gearing up the Body” program is tension between different understanding of what is “right” and “wrong” health behaviour. We find that the ideas of soft power and symbolic violence can contribute to a better understanding of why health and health behaviour is understood differently among vocational students. Thus, the finding demonstrates that one needs to apply a participatory approach rather than a normative approach addressing the health behaviour of disadvantaged individuals.
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Yousefzadeh G, Najafipour H, Baneshi M, Ahmadi Gohari M, Shahouzehi B, Farokhi M, Mirzazadeh A. Prevalence and 5-year incidence rate of dyslipidemia and its association with other coronary artery disease risk factors in Iran: Results of the Kerman coronary artery disease risk factors study (Phase 2). JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2021; 26:99. [PMID: 34899937 PMCID: PMC8607185 DOI: 10.4103/jrms.jrms_748_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 01/04/2021] [Accepted: 05/31/2021] [Indexed: 11/04/2022]
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Ongosi AN, Wilunda C, Musumari PM, Techasrivichien T, Wang CW, Ono-Kihara M, Serrem C, Kihara M, Nakayama T. Prevalence and Risk Factors of Elevated Blood Pressure and Elevated Blood Glucose among Residents of Kajiado County, Kenya: A Population-Based Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17196957. [PMID: 32977566 PMCID: PMC7579460 DOI: 10.3390/ijerph17196957] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/03/2020] [Accepted: 09/19/2020] [Indexed: 12/15/2022]
Abstract
Kenya is experiencing a rising burden of non-communicable diseases (NCDs), yet data to inform effective interventions are limited. We investigated the prevalence of elevated blood pressure, elevated blood glucose and their determinants in a rapidly urbanizing area in Kenya. Data on socio-demographics, dietary and behavioural risk factors, anthropometric measurements, blood pressure, blood glucose, plasma lipids and urinary biomarkers were collected from 221 men and 372 women (25-64 years). Multivariable logistic regression models assessed correlates of elevated blood pressure (EBP) and elevated blood glucose (EBG). Participants' mean age was 38.0. ± 11.1 years. The prevalence rates of pre-hypertension and hypertension were 49.0% and 31.6% in men and 43.7% and 20.1% in women, respectively, while those of pre-diabetes and diabetes were 8.4% and 8.0% in men and 11.6% and 7.4% in women, respectively. The prevalence of Body Mass Index (BMI) ≥ 25 kg/m2 was higher in women (60.2%) than in men (39.7%). However, both the risk of EBP and EBG were stronger among men than among women. The high prevalence rates of EBP, EBG and overweight/obesity coupled with low physical activity and low fruit and vegetable intake predispose this population to a higher NCD risk. Interventions to mitigate this risk considering the sex differences are urgently required.
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Affiliation(s)
- Anita Nyaboke Ongosi
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-Ku, Kyoto 606-8501, Japan;
- Correspondence: ; Tel.: +81-090-6660-5961
| | - Calistus Wilunda
- African Population and Health Research Centre, Manga Close, Nairobi P.O. Box 10787-00100, Kenya;
| | - Patou Masika Musumari
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
- International Institute of Socio-Epidemiology, Kitagosho-cho, Sakyo-ku, Kyoto 606-8336, Japan
| | - Teeranee Techasrivichien
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
- International Institute of Socio-Epidemiology, Kitagosho-cho, Sakyo-ku, Kyoto 606-8336, Japan
| | - Chia-Wen Wang
- Population Health Research Centre, College of Public Health, National Taiwan University, Taipei 100, Taiwan;
| | - Masako Ono-Kihara
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
| | - Charlotte Serrem
- Department of Consumer Science, School of Agriculture and Biotechnology, University of Eldoret, Eldoret P.O. Box 1125-30100, Kenya;
| | - Masahiro Kihara
- Interdisciplinary Unit for Global Health, Centre for the Promotion of Interdisciplinary Education and Research, Kyoto University, Yoshida hon-machi, Sakyo-ku, Kyoto 606-8501, Japan; (P.M.M.); (T.T.); (M.O.-K.); (M.K.)
| | - Takeo Nakayama
- Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe-cho, Sakyo-Ku, Kyoto 606-8501, Japan;
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Rezaei M, Fakhri N, Pasdar Y, Moradinazar M, Najafi F. Modeling the risk factors for dyslipidemia and blood lipid indices: Ravansar cohort study. Lipids Health Dis 2020; 19:176. [PMID: 32723339 PMCID: PMC7388539 DOI: 10.1186/s12944-020-01354-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Accepted: 07/23/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Lipid disorder is one of the most important risk factors for chronic diseases. Identifying the factors affecting the development of lipid disorders helps reduce chronic diseases, especially Chronic Heart Disease (CHD). The aim of this study was to model the risk factors for dyslipidemia and blood lipid indices. METHODS This study was conducted based on the data collected in the initial phase of Ravansar cohort study (2014-16). At the beginning, all the 453 available variables were examined in 33 stages of sensitivity analysis by perceptron Artificial Neural Network (ANN) data mining model. In each stage, the variables that were more important in the diagnosis of dyslipidemia were identified. The relationship among the variables was investigated using stepwise regression. The data obtained were analyzed in SPSS software version 25, at 0.05 level of significance. RESULTS Forty percent of the subjects were diagnosed with lipid disorder. ANN identified 12 predictor variables for dyslipidemia related to nutrition and physical status. Alkaline phosphatase, Fat Free Mass (FFM) index, and Hemoglobin (HGB) had a significant relationship with all the seven blood lipid markers. The Waist Hip Ratio was the most effective variable that showed a stronger correlation with cholesterol and Low-Density Lipid (LDL). The FFM index had the greatest effect on triglyceride, High-Density Lipid (HDL), cholesterol/HDL, triglyceride/HDL, and LDL/HDL. The greatest coefficients of determination pertained to the triglyceride/HDL (0.203) and cholesterol/HDL (0.188) model with nine variables and the LDL/HDL (0.180) model with eight variables. CONCLUSION According to the results, alkaline phosphatase, FFM index, and HGB were three common predictor variables for all the blood lipid markers. Specialists should focus on controlling these factors in order to gain greater control over blood lipid markers.
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Affiliation(s)
- Mansour Rezaei
- Professor of Biostatistics, Biostatistics Department, Social Development and Health Promotion Research Center, Kermanshah University of medical sciences, Kermanshah, Iran
| | - Negin Fakhri
- Master of Biostatistics, Student's research committee, Faculty of Health, Kermanshah University of medical sciences, Kermanshah, Iran.
| | - Yahya Pasdar
- Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mehdi Moradinazar
- Social Development and Health Promotion Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Professor of Epidemiology, Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
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12
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Moradinazar M, Pasdar Y, Najafi F, Shahsavari S, Shakiba E, Hamzeh B, Fakhri N. Association between dyslipidemia and blood lipids concentration with smoking habits in the Kurdish population of Iran. BMC Public Health 2020; 20:673. [PMID: 32404075 PMCID: PMC7218585 DOI: 10.1186/s12889-020-08809-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 04/29/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Smoking is the most preventable cause of most chronic diseases such as cardiovascular disease (CVD). Dyslipidemia is also an important risk factor for CVD. Yet, research has provided contradicting findings regarding the association between smoking and blood lipids. This paper examines the relationship between dyslipidemia and smoking based on the results of a cross-sectional sample of a Kurdish population in western Iran. METHODS This population-based study was derived from the recruitment phase of Ravansar Non-Communicable Disease (RaNCD) cohort study. Logistic regression model adjusted by confounding variables was used to determine the relationship between smoking and blood lipid components. In addition, dose-response relationship between blood lipids and the number of smoked cigarettes was evaluated. RESULTS For the purpose of this study, 7586 participants were examined. The lifetime prevalence of smoking was 19.9%, and 11.8% were current smokers. The prevalence of dyslipidemia in current smokers (54.9%) was higher than former smokers (43.9%) and in turn former smokers higher than non-smokers (38.0%). Current smokers had greater risk of abnormal HDL cholesterol [OR (95% CI), 2.28(1.98 -2.62)] and triglyceride [OR (95% CI), 1.37(1.15 -1.67)] compared to non-smokers. There was no significant difference in total cholesterol and LDL cholesterol between the two groups. A dose-response relationship was found between the number of cigarettes smoked and HDL-C and TG but no relationship was observed in terms of total cholesterol and LDL-C. CONCLUSIONS As compared to non-smokers, current smokers and former smokers had abnormal HDL-C and triglyceride and abnormal total cholesterol and triglyceride, respectively. After quitting smoking, heavy smokers showed a more normal HDL-C and total cholesterol levels than the people who tended to smoke a lower number of cigarettes per day.
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Affiliation(s)
- Mehdi Moradinazar
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Yahya Pasdar
- Nutritional Sciences Department, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Farid Najafi
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Soodeh Shahsavari
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ebrahim Shakiba
- Behavioral Disease Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Behrooz Hamzeh
- Research Center for Environmental Determinants of Health, School of Public Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Negin Fakhri
- Student’s research committee, Faculty of Health, Kermanshah University of medical sciences, Kermanshah, Iran
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Kıraç CO, Akşan S, Kaya A. Konya ilinde sağlıklı bireylerin demografik özelliklerine ve antropometrik ölçümlerine göre lipid düzeylerinin değerlendirilmesi. CUKUROVA MEDICAL JOURNAL 2019. [DOI: 10.17826/cumj.512944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ahmad K, Chen EW, Nazir U, Cotts W, Andrade A, Trivedi AN, Erqou S, Wu W. Regional Variation in the Association of Poverty and Heart Failure Mortality in the 3135 Counties of the United States. J Am Heart Assoc 2019; 8:e012422. [PMID: 31480884 PMCID: PMC6818020 DOI: 10.1161/jaha.119.012422] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 07/05/2019] [Indexed: 12/30/2022]
Abstract
Background There is significant geographical variation in heart failure (HF) mortality across the United States. County socioeconomic factors that influence these outcomes are unknown. We studied the association between county socioeconomic factors and HF mortality and compared it with coronary heart disease (CHD) mortality. Methods and Results This is a cross-sectional analysis of socioeconomic factors and mortality in HF and CHD across 3135 US counties from 2010 to 2015. County-level poverty, education, income, unemployment, health insurance status, and cause-specific mortality rates were collected from the Centers for Disease Control and Prevention and US Census Bureau databases. Poverty had the strongest correlation with both HF and CHD mortality, disproportionately higher for HF (r=0.48) than CHD (r=0.24). HF mortality increased by 5.2 deaths/100 000 for each percentage increase in county poverty prevalence in a frequency-weighted, demographic-adjusted, multivariate regression model. The greatest attenuation in the poverty regression coefficient (66.4%) was seen after adjustment for prevalence of diabetes mellitus and obesity. Subgroup analysis by census region showed that this relationship was the strongest in the South and weakest in the Northeast (6.1 versus 1.4 deaths/100 000 per 1% increase in county poverty in a demographics-adjusted model). Conclusions County poverty is the strongest socioeconomic factor associated with HF and CHD mortality, an association that is stronger with HF than with CHD and varied by census region. Over half of the association was explained by differences in the prevalence of diabetes mellitus and obesity across the counties. Health policies targeting improvement in these risk factors may address and possibly minimize health disparities caused by socioeconomic factors.
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Affiliation(s)
- Khansa Ahmad
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Edward W. Chen
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Umair Nazir
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - William Cotts
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Ambar Andrade
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Amal N. Trivedi
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Sebhat Erqou
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
| | - Wen‐Chih Wu
- Division of Cardiology, Providence Veterans Affairs Medical Center and the Warren Alpert Medical School at Brown UniversityProvidenceRI
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DO BIOMARKERS VARY BY SOCIAL CLASS, EDUCATION AND REGION AND IS MIGRATION IMPORTANT? EVIDENCE FROM A COHORT OF BRITISH ADULTS. J Biosoc Sci 2018; 51:95-117. [DOI: 10.1017/s0021932017000700] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SummaryThe aim of this study was to test whether Body Mass Index (BMI), waist circumference, systolic and diastolic blood pressure, Forced Expiratory Volume (FEV1) and Peak Expiratory Flow (PEF) vary in relation to social class at birth and adulthood, educational level and region of residence, and also with inter-generational social, educational and regional mobility/migration. The study used 5702 adults (2894 males and 2718 females) from the longitudinal British National Child Development Study (all children born in England, Scotland and Wales during the first week in March 1958 with follow-up throughout childhood and adulthood, most recently at 55 years of age). In both sexes BMI and waist circumference tended to increase from social classes I+II to IV+V and higher social class was associated with higher mean FEV1 and PEF. Better-educated adults tended to have lower BMI and waist circumference, and higher mean FEV1 and PEF. Women from Wales had the highest mean BMI and waist circumference but the lowest mean PEF, while women in Scotland had the highest mean systolic blood pressure and the lowest mean FEV1. For men only, FEV1 and PEF showed regional variation and the lowest mean FEV1 was in Wales and the lowest PEF in Yorkshire & Humberside. Inter-generational social mobility was not found to be associated with any of the biomarkers, while educational mobility was related only to FEV1 and PEF. In both sexes, in unadjusted regression analysis regional migrant cohort members tended to have a lower mean BMI than sedentes. Regional male migrants also tended to have a lower waist circumference and a higher FEV1 and PEF than sedentes.
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Gaalema DE, Elliott RJ, Morford ZH, Higgins ST, Ades PA. Effect of Socioeconomic Status on Propensity to Change Risk Behaviors Following Myocardial Infarction: Implications for Healthy Lifestyle Medicine. Prog Cardiovasc Dis 2017; 60:159-168. [PMID: 28063785 PMCID: PMC5498261 DOI: 10.1016/j.pcad.2017.01.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 01/02/2017] [Indexed: 01/04/2023]
Abstract
Failure to change risk behaviors following myocardial infarction (MI) increases the likelihood of recurrent MI and death. Lower-socioeconomic status (SES) patients are more likely to engage in high-risk behaviors prior to MI. Less well known is whether propensity to change risk behaviors after MI also varies inversely with SES. We performed a systematized literature review addressing changes in risk behaviors following MI as a function of SES. 2160 abstracts were reviewed and 44 met eligibility criteria. Behaviors included smoking cessation, cardiac rehabilitation (CR), medication adherence, diet, and physical activity (PA). For each behavior, lower-SES patients were less likely to change after MI. Overall, lower-SES patients were 2 to 4 times less likely to make needed behavior changes (OR's 0.25-0.56). Lower-SES populations are less successful at changing risk behaviors post-MI. Increasing their participation in CR/secondary prevention programs, which address multiple risk behaviors, including increasing PA and exercise, should be a priority of healthy lifestyle medicine (HLM).
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Affiliation(s)
- Diann E Gaalema
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT; Department of Psychiatry, University of Vermont, Burlington, VT; Department of Psychological Science, University of Vermont, Burlington, VT.
| | - Rebecca J Elliott
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT; Department of Psychiatry, University of Vermont, Burlington, VT
| | - Zachary H Morford
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT; Department of Psychiatry, University of Vermont, Burlington, VT; Department of Psychological Science, University of Vermont, Burlington, VT
| | - Stephen T Higgins
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT; Department of Psychiatry, University of Vermont, Burlington, VT; Department of Psychological Science, University of Vermont, Burlington, VT
| | - Philip A Ades
- Vermont Center on Behavior and Health, University of Vermont, Burlington, VT; Department of Medicine, Division of Cardiology, University of Vermont Medical Center, Burlington, VT
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Hughes J, Kabir Z, Kee F, Bennett K. Cardiovascular risk factors-using repeated cross-sectional surveys to assess time trends in socioeconomic inequalities in neighbouring countries. BMJ Open 2017; 7:e013442. [PMID: 28373251 PMCID: PMC5387991 DOI: 10.1136/bmjopen-2016-013442] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
OBJECTIVES This study compares trends in socioeconomic inequalities related to key cardiovascular risk factors in neighbouring countries Northern Ireland (NI) and the Republic of Ireland (RoI). DESIGN Repeated cross-sectional studies. SETTING Population based. PARTICIPANTS 3500-4000 in national surveys in NI and 5000-9000 in RoI, aged 20-69 years. MEASURES Educational attainment was used as a socioeconomic indicator by which the magnitude and direction of trends in inequalities for smoking, diabetes, obesity and physical inactivity in NI and RoI were examined between 1997/1998 and 2007/2011. Gender-specific relative and absolute inequalities were calculated using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII) for both countries. RESULTS In both countries, the prevalence of diabetes and obesity increased whereas levels of smoking and physical inactivity decreased over time. In NI relative inequalities increased for obesity (RII 1.1 in males and 2.1 in females in 2010/2011) and smoking (RII 4.5 in males and 4.2 in females in 2010/2011) for both genders and absolute inequalities increased for all risk factors in men and increased for diabetes and obesity in women. In RoI greater inequality was observed in women, particularly for smoking (RII 2.8 in 2007) and obesity (RII 8.2 in 2002) and in men for diabetes (RII 3.2 in 2002). CONCLUSIONS Interventions to reduce inequalities in risk factors, particularly smoking, obesity and diabetes are encouraged across both countries.
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Affiliation(s)
- John Hughes
- UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
| | - Zubair Kabir
- Department of Epidemiology & Public Health University College Cork, Cork, Ireland
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, Queen's University, Belfast, UK
| | - Kathleen Bennett
- Population Health Sciences Division, RCSI St Stephen's Green, Dublin, Ireland
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Korda RJ, Soga K, Joshy G, Calabria B, Attia J, Wong D, Banks E. Socioeconomic variation in incidence of primary and secondary major cardiovascular disease events: an Australian population-based prospective cohort study. Int J Equity Health 2016; 15:189. [PMID: 27871298 PMCID: PMC5117581 DOI: 10.1186/s12939-016-0471-0] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 11/02/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) disproportionately affects disadvantaged people, but reliable quantitative evidence on socioeconomic variation in CVD incidence in Australia is lacking. This study aimed to quantify socioeconomic variation in rates of primary and secondary CVD events in mid-age and older Australians. METHODS Baseline data (2006-2009) from the 45 and Up Study, an Australian cohort involving 267,153 men and women aged ≥ 45, were linked to hospital and death data (to December 2013). Outcomes comprised first event - death or hospital admission - for major CVD combined, as well as myocardial infarction and stroke, in those with and without prior CVD (secondary and primary events, respectively). Cox regression estimated hazard ratios (HRs) for each outcome in relation to education (and income and area-level disadvantage), separately by age group (45-64, 65-79, and ≥ 80 years), adjusting for age and sex, and additional sociodemographic factors. RESULTS There were 18,207 primary major CVD events over 1,144,845 years of follow-up (15.9/1000 person-years), and 20,048 secondary events over 260,357 years (77.0/1000 person-years). For both primary and secondary events, incidence increased with decreasing education, with the absolute difference between education groups largest for secondary events. Age-sex adjusted hazard ratios were highest in the 45-64 years group: for major CVDs, HR (no qualifications vs university degree) = 1.62 (95% CI: 1.49-1.77) for primary events, and HR = 1.49 (1.34-1.65) for secondary events; myocardial infarction HR = 2.31 (1.87-2.85) and HR = 2.57 (1.90-3.47) respectively; stroke HR = 1.48 (1.16-1.87) and HR = 1.97 (1.42-2.74) respectively. Similar but attenuated results were seen in older age groups, and with income. For area-level disadvantage, CVD gradients were weak and non-significant in older people (> 64 years). CONCLUSIONS Individual-level data are important for quantifying socioeconomic variation in CVD incidence, which is shown to be substantial among both those with and without prior CVD. Findings reinforce the opportunity for, and importance of, primary and secondary prevention and treatment in reducing socioeconomic variation in CVD and consequently the overall burden of CVD morbidity and mortality in Australia.
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Affiliation(s)
- Rosemary J Korda
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.
| | - Kay Soga
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Grace Joshy
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Bianca Calabria
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,National Drug and Alcohol Research Centre, UNSW Australia, Sydney, NSW, Australia
| | - John Attia
- Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, The University of Newcastle and Hunter Medical Research Institute, Newcastle, NSW, Australia
| | - Deborah Wong
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, ACT, Australia.,The Sax Institute, Sydney, NSW, Australia
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The Association between Educational Level and Cardiovascular and Cerebrovascular Diseases within the EPICOR Study: New Evidence for an Old Inequality Problem. PLoS One 2016; 11:e0164130. [PMID: 27711245 PMCID: PMC5053474 DOI: 10.1371/journal.pone.0164130] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Accepted: 09/19/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND A consistent association has been reported between low socioeconomic status (SES) and cardiovascular events (CE), whereas the association between SES and cerebrovascular events (CBVD) is less clear. The aim of this study was to investigate the association between SES (measured using education) and CE/CBVD in a cohort study, as well as to investigate lifestyle and clinical risk factors, to help to clarify the mechanisms by which SES influences CE/CBVD. MATERIAL AND METHODS We searched for diagnoses of CE and CBVD in the clinical records of 47,749 members of the EPICOR cohort (average follow-up time: 11 years). SES was determined by the relative index of inequality (RII). RESULTS A total of 1,156 CE and 468 CBVD were found in the clinical records. An increased risk of CE was observed in the crude Cox model for the third tertile of RII compared to the first tertile (hazard ratio [HR] = 1.39; 95% confidence interval [CI] 1.21-1.61). The increased risk persisted after adjustment for lifestyle risk factors (HR = 1.19; 95%CI 1.02-1.38), clinical risk factors (HR = 1.35; 95%CI 1.17-1.56), and after full adjustment (HR = 1.17; 95%CI 1.01-1.37). Structural equation model showed that lifestyle rather than clinical risk factors are involved in the mechanisms by which education influences CE. No significant association was found between education and CBVD. A strong relationship was observed between education and diabetes at baseline. CONCLUSION The most important burden of inequality in CE incidence in Italy is due to lifestyle risk factors.
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Latifi SM, Moradi L, Shahbazian H, Aleali AM. A study of the prevalence of dyslipidemia among the adult population of Ahvaz, Iran. Diabetes Metab Syndr 2016; 10:190-193. [PMID: 27377682 DOI: 10.1016/j.dsx.2016.06.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 06/05/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Hypercholesterolemia is one of the main causes of the disease burden in developed and developing countries. The present study is planned to access the prevalence of dyslipidemia and its risk factors among the general population of Ahvaz over 20 years of age. METHOD In this descriptive-analytic study, using multi-stage cluster method, out of the 25 existing health centers in the city of Ahvaz (four health centers in the Eastern Ahvaz and two centers in the west were chosen based on the population they covered). The blood samples of the participants were taken after 12h of fasting for measure FBS, TG, Chol, HDLand LDL level their heights, and weights were measured using the standard methods. Interviewing the participants, the research questionnaires were filled by the trained health workers. RESULTS Out of 2505 participants, 1155 samples (%46.1) were male with mean age of 42.9±14.5years and 1350 samples (%53.9) were women with the mean age of 39.9±12.6 years. The prevalence of dyslipidemia among the individuals over 20 years of age in Ahvaz was %80.9 (%75.9 in male and %85.1 in female). Age and BMI were positively correlated with increase in the risk of dyslipidemia. Women had a higher risk of dyslipidemia CONCLUSION: This study showed that more than %80 over 20 years old Ahvazian population had dyslipidemia(female more than male). Age and BMI are positively correlated with increasing dyslipidemia in my population.
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Affiliation(s)
- Seyed Mahmoud Latifi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Leila Moradi
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Hajieh Shahbazian
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Armaghan Moravej Aleali
- Health Research Institute, Diabetes Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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The Predictive Value of Depressive Symptoms for All-Cause Mortality: Findings From the PRIME Belfast Study Examining the Role of Inflammation and Cardiovascular Risk Markers. Psychosom Med 2016; 78:401-11. [PMID: 26761713 DOI: 10.1097/psy.0000000000000289] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To improve understanding about the potential underlying biological mechanisms in the link between depression and all-cause mortality and to investigate the role that inflammatory and other cardiovascular risk factors may play in the relationship between depressive symptoms and mortality. METHODS Depression and blood-based biological markers were assessed in the Belfast PRIME prospective cohort study (N = 2389 men, aged 50-59 years) in which participants were followed up for 18 years. Depression was measured using the 10-item Welsh Pure Depression Inventory. Inflammation markers (C-reactive protein [CRP], neopterin, interleukin [IL]-1 receptor antagonist [IL-1Ra], and IL-18) and cardiovascular-specific risk factors (N-terminal pro-b-type natriuretic peptide, midregion pro-atrial natriuretic peptide, midregion pro-adrenomedullin, C-terminal pro-endothelin-1 [CT-proET]) were obtained at baseline. We used Cox proportional hazards modeling to examine the association between depression and biological measures in relation to all-cause mortality and explore the mediating effects. RESULTS During follow-up, 418 participants died. Higher levels of depressive symptoms were associated with higher levels of CRP, IL-1Ra, and CT-proET. After adjustment for socioeconomic and life-style risk factors, depressive symptoms were significantly associated with all-cause mortality (hazard ratio = 1.10 per scale unit, 95% confidence interval = 1.04-1.16). This association was partly explained by CRP (7.3%) suggesting a minimal mediation effect. IL-1Ra, N-terminal pro-b-type natriuretic peptide, midregion pro-atrial natriuretic peptide, midregion pro-adrenomedullin, and CT-proET contributed marginally to the association between depression and subsequent mortality. CONCLUSIONS Inflammatory and cardiovascular risk markers are associated with depression and with increased mortality. However, depression and biological measures show additive effects rather than a pattern of meditation of biological factors in the association between depression and mortality.
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Cronin C, McCartan D, McMonagle M, Cross K, Dowdall J. Peripheral Artery Disease: A Marked Lack of Awareness in Ireland. Eur J Vasc Endovasc Surg 2015; 49:556-62. [DOI: 10.1016/j.ejvs.2014.12.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2014] [Accepted: 12/13/2014] [Indexed: 10/23/2022]
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Ahmadi A, Khaledifar A, Sajjadi H, Soori H. Relationship between risk factors and in-hospital mortality due to myocardial infarction by educational level: a national prospective study in Iran. Int J Equity Health 2014; 13:116. [PMID: 25428143 PMCID: PMC4251987 DOI: 10.1186/s12939-014-0116-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 11/12/2014] [Indexed: 01/28/2023] Open
Abstract
Introduction Since no hospital-based, nationwide study has been yet conducted on the association between risk factors and in-hospital mortality due to myocardial infarction (MI) by educational level in Iran, the present study was conducted to investigate relationship between risk factors and in-hospital mortality due to MI by educational level. Methods In this nationwide hospital-based, prospective analysis, follow-up duration was from definite diagnosis of MI to death. The cohort of the patients was defined in view of the date at diagnosis, hospitalization and the date at discharge (recovery or in-hospital death due to MI). 20750 patients hospitalized for newly diagnosed MI between April, 2012 and March, 2013 comprised sample size. Totally, 2511 deaths due to MI were obtained. The data on education level (four-level) were collected based on years of schooling. To determine in-hospital mortality rate and the associated factors with mortality, seven statistical models were developed using Cox proportional hazards models. Results Of the studied patients, 9611 (6.1%) had no education. in-hospital mortality rate was 8.36 (95% CI: 7.81-8.9) in women and 6.12 (95% CI: 5.83-6.43) in men per 100 person-years. This rate was 5.56 in under 65-year-old patients and 8.37 in over 65-year-old patients. This rate in the patients with no, primary, high school, and academic education was respectively 8.11, 6.11, 4.85 and 5.81 per 100 person-years. Being woman, chest pain prior to arriving in hospital, lack of thrombolytic therapy, right bundle branch block, ventricular tachycardia, smoking and ST-segment elevation myocardial infarction were significantly associated with increased hazard ratio (HR) of death. The adjusted HR of mortality was 1.27 (95% CI: 1.06-1.52), 0.93 (95% CI: 0.77-1.13), 0.72 (95% CI: 0.57-0.91) and 0.82 (95% CI: 0.66-1.01) in the patients with respectively illiterate, primary, secondary and high school education compared to academic education. Conclusion A disparity was noted in post-MI mortality incidence in different educational levels in Iran. HR of death was higher in illiterate patients than in the patients with academic education. Identifying disparities per educational level could contribute to detecting the individuals at high risk, health promotion and care improvement by relevant planning and interventions in clinics and communities.
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Affiliation(s)
- Ali Ahmadi
- Department of Epidemiology and Biostatistics, School of Public Health, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Arsalan Khaledifar
- Cardiology Department, School of Medicine, Hajar Hospital, Shahrekord University of Medical Sciences, Shahrekord, Iran.
| | - Homeira Sajjadi
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, IR, Iran.
| | - Hamid Soori
- Safety Promotion and Injury Prevention Research center, Department of Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, 7th Floor, 2nd SBMU Headquarters Building, Parvaneh St., Velenjak Area, Chamran High Way, Tehran, Iran.
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Meneton P, Kesse-Guyot E, Méjean C, Fezeu L, Galan P, Hercberg S, Ménard J. Unemployment is associated with high cardiovascular event rate and increased all-cause mortality in middle-aged socially privileged individuals. Int Arch Occup Environ Health 2014; 88:707-16. [PMID: 25385250 DOI: 10.1007/s00420-014-0997-7] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2014] [Accepted: 10/30/2014] [Indexed: 12/14/2022]
Abstract
PURPOSE To assess prospectively the association between employment status and cardiovascular health outcomes in socially privileged individuals. METHODS The incidence of fatal and non-fatal cardiovascular events and all-cause mortality rate were monitored during 12 years in a national sample of 5,852 French volunteers, aged 45-64 years, who were free of cardiovascular disease or other overt disease at baseline. The association between health outcomes and employment status was tested using Cox proportional modelling with adjustment for confounding factors. RESULTS Compared to randomly selected individuals, these volunteers were characterized by higher education level and socio-economic status and lower cardiovascular risk and mortality rate. A total of 242 cardiovascular events (3.5 events per 1,000 person-years) and 152 deaths from all causes (2.2 deaths per 1,000 person-years) occurred during follow-up. After adjustment for age and gender, both cardiovascular event risk [HR (95% CI) 1.84 (1.15-2.83), p = 0.01] and all-cause mortality [2.79 (1.66-4.47), p = 0.0002] were increased in unemployed individuals compared to workers. These poor health outcomes were observed to the same extent after further adjustment for clinical, behavioural and socio-demographic characteristics of individuals at baseline [HR (95% CI) 1.74 (1.07-2.72), p = 0.03 and 2.89 (1.70-4.69), p = 0.0002, respectively]. In contrast, neither cardiovascular event risk nor all-cause mortality was significantly increased in retired individuals compared to workers after adjustment for confounding factors. CONCLUSIONS These results support the existence of a link between unemployment and poor cardiovascular health and suggest that this link is not mediated by conventional risk factors in middle-aged socially privileged individuals.
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Affiliation(s)
- Pierre Meneton
- INSERM U1142 LIMICS, UMR_S 1142 Sorbonne Universités, UPMC Université Paris 06, Université Paris 13, Campus des Cordeliers, 15 rue de l'Ecole de Médecine, 75006, Paris, France,
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Igland J, Vollset SE, Nygård OK, Sulo G, Ebbing M, Tell GS. Educational inequalities in acute myocardial infarction incidence in Norway: a nationwide cohort study. PLoS One 2014; 9:e106898. [PMID: 25188248 PMCID: PMC4154768 DOI: 10.1371/journal.pone.0106898] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 07/28/2014] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Increasing differences in cardiovascular disease (CVD) mortality across levels of education have been reported in Norway. The aim of the study was to investigate educational inequalities in acute myocardial infarction (AMI) incidence and whether such inequalities have changed during the past decade using a nationwide longitudinal study design. METHODS Data on 141 332 incident (first) AMIs in Norway during 2001-2009 were obtained through the Cardiovascular Disease in Norway (CVDNOR) project. Educational inequalities in AMI incidence were assessed in terms of age-standardised incidence rates stratified on educational level, incidence rate ratios (IRR), relative index of inequality (RII) and slope index of inequality (SII). All calculations were conducted in four gender and age strata: Men and women aged 35-69 and 70-94 years. RESULTS AMI Incidence rates decreased during 2001-2009 for all educational levels except in women aged 35-69 among whom only those with basic education had a significant decrease. In all gender and age groups; those with the highest educational level had the lowest rates. The strongest relative difference was found among women aged 35-69, with IRR (95% CI) for basic versus tertiary education 3.04 (2.85-3.24)) and RII (95% CI) equal to 4.36 (4.03-4.71). The relative differences did not change during 2001-2009 in any of the four gender and age groups, but absolute inequalities measured as SII decreased among the oldest men and women. CONCLUSIONS There are substantial educational inequalities in AMI incidence in Norway, especially for women aged 35-69. Relative inequalities did not change from 2001 to 2009.
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Affiliation(s)
- Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- * E-mail:
| | - Stein Emil Vollset
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway
| | - Ottar K. Nygård
- Section for Cardiology, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Heart Disease, Haukeland University Hospital, Bergen, Norway
| | - Gerhard Sulo
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Marta Ebbing
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway
| | - Grethe S. Tell
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway
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Honjo K, Iso H, Inoue M, Sawada N, Tsugane S. Socioeconomic Status Inconsistency and Risk of Stroke Among Japanese Middle-Aged Women. Stroke 2014; 45:2592-8. [DOI: 10.1161/strokeaha.114.005238] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Kaori Honjo
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Graduate School of Medicine, University of Tokyo, Toyko, Japan (M.I.); and Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Hiroyasu Iso
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Graduate School of Medicine, University of Tokyo, Toyko, Japan (M.I.); and Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Manami Inoue
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Graduate School of Medicine, University of Tokyo, Toyko, Japan (M.I.); and Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Norie Sawada
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Graduate School of Medicine, University of Tokyo, Toyko, Japan (M.I.); and Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
| | - Shoichiro Tsugane
- From the Global Collaboration Center, Osaka University, Osaka, Japan (K.H.); Public Health, Department of Social and Environmental Health, Osaka University Graduate School of Medicine, Osaka, Japan (H.I.); Graduate School of Medicine, University of Tokyo, Toyko, Japan (M.I.); and Epidemiology and Prevention Division, Research Center for Cancer Prevention and Screening, National Cancer Center, Tokyo, Japan (M.I., N.S., S.T.)
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Prevalence of dyslipidemia and associated risk factors in Turkish adults. J Clin Lipidol 2014; 8:206-16. [PMID: 24636181 DOI: 10.1016/j.jacl.2013.12.011] [Citation(s) in RCA: 81] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2013] [Revised: 12/18/2013] [Accepted: 12/26/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND AND OBJECTIVES Dyslipidemia is a modifiable major risk factor for coronary heart disease. The objective of this study was to determine the prevalence of dyslipidemia among Turkish adults and its associations with other cardiovascular risk factors. METHODS This study included 4309 people ages 20 to 83 years old from 7 provinces of Turkey. People from the city centers, districts, and villages were selected by a stratified sampling method. Weight, height, and waist and hip circumferences were measured. Blood samples were obtained to determine glucose, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG); these parameters were measured with an autoanalyzer. Dyslipidemia was defined according to National Cholesterol Education Program Adult Treatment Panel III diagnostic criteria. RESULTS Of 4309 subjects, 43% had high TC, 41.5% had low HDL-C, 36.2% had high LDL-C, and 35.7% had high TG. Of these measures, at least 1 lipid abnormality was diagnosed in 78.7% of men and 80.4% of women. The prevalence of high TC, LDL-C, and TG increased with age, with the highest prevalence in the 46-to-65-year-old age group. The mean values (mg/dL) of TC, LDL-C, HDL-C, and TG were 194.2 ± 47.7, 117.7 ± 41.1, 50.3 ± 16.3, and 145.4 ± 96.3, respectively. Dyslipidemia was positively associated with age, body mass index, waist circumference, fasting blood glucose, and blood pressure, and negatively associated with altitude. CONCLUSIONS The high prevalence of dyslipidemia in Turkey is an important public health problem. Enhanced public health preventive measures should be implemented to better diagnose and comprehensively treat dyslipidemia in Turkey.
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Kershaw KN, Droomers M, Robinson WR, Carnethon MR, Daviglus ML, Monique Verschuren WM. Quantifying the contributions of behavioral and biological risk factors to socioeconomic disparities in coronary heart disease incidence: the MORGEN study. Eur J Epidemiol 2013; 28:807-14. [PMID: 24037117 DOI: 10.1007/s10654-013-9847-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2012] [Accepted: 08/30/2013] [Indexed: 11/24/2022]
Abstract
Quantifying the impact of different modifiable behavioral and biological risk factors on socioeconomic disparities in coronary heart disease (CHD) may help inform targeted, population-specific strategies to reduce the unequal distribution of the disease. Previous studies have used analytic approaches that limit our ability to disentangle the relative contributions of these risk factors to CHD disparities. The goal of this study was to assess mediation of the effect of low education on incident CHD by multiple risk factors simultaneously. Analyses are based on 15,067 participants of the Dutch Monitoring Project on Risk Factors for Chronic Diseases aged 20-65 years examined 1994-1997 and followed for events until January 1, 2008. Path analysis was used to quantify and test mediation of the low education-CHD association by behavioral (current cigarette smoking, heavy alcohol use, poor diet, and physical inactivity) and biological (obesity, hypertension, diabetes, and hypercholesterolemia) risk factors. Behavioral and biological risk factors accounted for 56.6 % (95 % CI 42.6-70.8 %) of the low education-incident CHD association. Smoking was the strongest mediator, accounting for 27.3 % (95 % CI 17.7-37.4 %) of the association, followed by obesity (10.2 %; 95 % CI 4.5-16.1 %), physical inactivity (6.3 %; 95 % CI 2.7-10.0 %), and hypertension (5.3 %; 95 % CI: 2.8-8.0 %). In summary, in a Dutch cohort, the majority of the relationship between low education and incident CHD was mediated by traditional behavioral and biological risk factors. Addressing barriers to smoking cessation, blood pressure and weight management, and physical activity may be the most effective approaches to eliminating socioeconomic inequalities in CHD.
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Affiliation(s)
- Kiarri N Kershaw
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, 680 N. Lake Shore Drive, Suite 1400, Chicago, IL, 60611, USA,
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Méjean C, Droomers M, van der Schouw YT, Sluijs I, Czernichow S, Grobbee DE, Bueno-de-Mesquita HB, Beulens JWJ. The contribution of diet and lifestyle to socioeconomic inequalities in cardiovascular morbidity and mortality. Int J Cardiol 2013; 168:5190-5. [PMID: 23998549 DOI: 10.1016/j.ijcard.2013.07.188] [Citation(s) in RCA: 96] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Accepted: 07/20/2013] [Indexed: 12/22/2022]
Abstract
BACKGROUND The role of differences in diet on the relationship between socioeconomic factors and cardiovascular diseases remains unclear. We studied the contribution of diet and other lifestyle factors to the explanation of socioeconomic inequalities in cardiovascular diseases. METHODS We prospectively examined the incidence of coronary heart disease (CHD) and stroke events amongst 33,106 adults of the EPIC-NL cohort. Education and employment status indicated socioeconomic status. We used Cox proportional models to estimate hazard ratios ((HR (95% confidence intervals)) for the association of socioeconomic factors with CHD and stroke and the contribution of diet and lifestyle. RESULTS During 12 years of follow-up, 1617 cases of CHD and 531 cases of stroke occurred. The risks of CHD and stroke were higher in lowest (HR=1.98 (1.67;2.35); HR=1.55 (1.15;2.10)) and lower (HR=1.50 (1.29;1.75); HR=1.42 (1.08;1.86)) educated groups than in the highest. Unemployed and retired subjects more often suffered from CHD (HR=1.37 (1.19;1.58); HR=1.20 (1.05;1.37), respectively), but not from stroke, than the employed. Diet and lifestyle, mainly smoking and alcohol, explained more than 70% of the educational differences in CHD and stroke and 65% of employment status variation in CHD. Diet explained more than other lifestyle factors of educational and employment status differences in CHD and stroke (36% to 67% vs. 9% to 27%). CONCLUSION The socioeconomic distribution of diet, smoking and alcohol consumption largely explained the inequalities in CHD and stroke in the Netherlands. These findings need to be considered when developing policies to reduce socioeconomic inequalities in cardiovascular diseases.
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Affiliation(s)
- Caroline Méjean
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands; Université Paris 13, Sorbonne Paris Cité, UREN, Inserm (U557), Inra (U1125), Cnam, F-93017 Bobigny Cedex, France.
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Jiménez-Pavón D, Fernández-Vázquez A, Alexy U, Pedrero R, Cuenca-García M, Polito A, Vanhelst J, Manios Y, Kafatos A, Molnar D, Sjöström M, Moreno LA. Association of objectively measured physical activity with body components in European adolescents. BMC Public Health 2013; 13:667. [PMID: 23866681 PMCID: PMC3723445 DOI: 10.1186/1471-2458-13-667] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 06/25/2013] [Indexed: 12/03/2022] Open
Abstract
Background Physical activity (PA) is suggested to contribute to fat loss not only through increasing energy expenditure “per se” but also increasing muscle mass; therefore, it would be interesting to better understand the specific associations of PA with the different body’s components such as fat mass and muscle mass. The aim of the present study was to examine the association between objectively measured PA and indices of fat mass and muscle components independently of each other giving, at the same time, gender-specific information in a wide cohort of European adolescents. Methods A cross-sectional study in a school setting was conducted in 2200 (1016 males) adolescents (14.7 ±1.2 years). Weight, height, skinfold thickness, bioimpedance and PA (accelerometry) were measured. Indices of fat mass (body mass index, % fat mass, sum of skinfolds) and muscular component (assessed as fat-free mass) were calculated. Multiple regression analyses were performed adjusting for several confounders including fat-free mass and fat mass when possible. Results Vigorous PA was positively associated with height (p < 0.05) in males, whilst, vigorous PA, moderate-vigorous PA and average PA were negatively associated with all the indices of fat mass (all p < 0.01) in both genders, except for average PA in relation with body mass index in females. Regarding muscular components, vigorous PA showed positive associations with fat-free mass and muscle mass (all p < 0.05) in both genders. Average PA was positively associated with fat-free mass (both p < 0.05) in males and females. Conclusion The present study suggests that PA, especially vigorous PA, is negatively associated with indices of fat mass and positively associated with markers of muscle mass, after adjusting for several confounders (including indices of fat mass and muscle mass when possible). Future studies should focus not only on the classical relationship between PA and fat mass, but also on PA and muscular components, analyzing the independent role of both with the different PA intensities.
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Affiliation(s)
- David Jiménez-Pavón
- GENUD (Growth, Exercise, Nutrition and Development), Department of Physiotherapy and Nursing, Research Group, Faculty of Health Sciences, University of Zaragoza, Avd, Domingo Miral s/n, CP: 50009, Zaragoza, Spain.
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Pisa PT, Behanan R, Vorster HH, Kruger A. Social drift of cardiovascular disease risk factors in Africans from the North West Province of South Africa: the PURE study. Cardiovasc J Afr 2013; 23:371-8, e379-88. [PMID: 22914994 PMCID: PMC3721859 DOI: 10.5830/cvja-2012-018] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 03/05/2012] [Indexed: 12/02/2022] Open
Abstract
Objective This study examined whether the association between socio-economic status (SES) and cardiovascular disease (CVD) risk factors in black South Africans from the North West Province had shifted from the more affluent groups with higher SES to the less affluent, lower SES groups over a period of nine years. Method Cross-sectional baseline data of 2 010 urban and rural subjects (35 years and older) participating in the Prospective Urban and Rural (PURE) study and collected in 2005 were analysed to examine the relationship of level of education, employment and urban or rural residence with dietary intakes and other CVD risk factors. These relationships were compared to those found nine years earlier in the Transition and Health during the Urbanisation of South Africans (THUSA) study conducted in the same area. Results The results showed that urban women had higher body mass index (BMI), serum triglyceride and fasting glucose levels compared to rural women and that both urban men and women had higher blood pressures and followed a more Westernised diet. However, rural men and women had higher plasma fibrinogen levels. The more highly educated subjects (which included both urban and rural subjects) were younger than those with no or only primary school education. Few of the risk factors differed significantly between education groups, except that more highly educated men and women had lower BMIs, and women had lower blood pressure and triglyceride levels. These women also followed a more prudent diet than those with only primary school education. Employed men and women had higher BMIs, higher energy intakes but lower plasma fibrinogen levels, and employed women had lower triglyceride levels. No significant differences in total serum cholesterol values were observed. Conclusion These results suggest a drift of CVD risk factors from groups with higher SES to groups with a lower SES from 1996 to 2005, indicating that interventions to prevent CVD should also be targeted at Africans living in rural areas, those with low educational levels, and the unemployed.
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Affiliation(s)
- P T Pisa
- Centre of Excellence for Nutrition (CEN), North-West University, Potchefstroom, South Africa.
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Friedrich N, Schneider HJ, John U, Dörr M, Baumeister SE, Homuth G, Völker U, Wallaschofski H. Correlates of adverse outcomes in abdominally obese individuals: findings from the five-year followup of the population-based study of health in Pomerania. J Obes 2013; 2013:762012. [PMID: 24191195 PMCID: PMC3804035 DOI: 10.1155/2013/762012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Accepted: 08/26/2013] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Abdominal obesity is a major risk factor of cardiovascular disease (CVD), type 2 diabetes (T2DM), and premature death. However, it has not been resolved which factors predispose for the development of these adverse obesity-related outcomes in otherwise healthy individuals with abdominal obesity. METHODS We studied 1,506 abdominal obese individuals (waist-to-height ratio (WHtR) ≥ 0.5) free of CVD or T2DM from the population-based Study of Health in Pomerania and assessed the incidence of CVD or T2DM after a five-year followup. Logistic regression models were adjusted for major cardiovascular risk factors and liver, kidney diseases, and sociodemographic status. RESULTS During follow-up time, we observed 114 and 136 new T2DM and CVD cases, respectively. Regression models identified age, waist circumference, serum glucose, and liver disease as predictors of T2DM. Regarding CVD, only age, unemployment, and a divorced or widowed marital status were significantly associated with incident CVD. In this subgroup of obese individuals blood pressure, serum glucose, or lipids did not influence incidence of T2DM or CVD. CONCLUSION We identified various factors associated with an increased risk of incident T2DM and CVD among abdominally obese individuals. These findings may improve the detection of high-risk individuals and help to advance prevention strategies in abdominal obesity.
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Affiliation(s)
- Nele Friedrich
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, 17475 Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- *Nele Friedrich:
| | - Harald J. Schneider
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- Medizinische Klinik—Innenstadt, Ludwig-Maximilians University, Ziemssenstraße 1, 80336 Munich, Germany
| | - Ulrich John
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- Institute of Epidemiology and Social Medicine, University Medicine Greifswald, Walther-Rathenau-Straße 48, 17475 Greifswald, Germany
| | - Marcus Dörr
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- Department of Cardiology, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, 17475 Greifswald, Germany
| | - Sebastian E. Baumeister
- Institute for Community Medicine, University Medicine Greifswald, Walther-Rathenau-Strße 48, 17475 Greifswald, Germany
| | - Georg Homuth
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475 Greifswald, Germany
| | - Uwe Völker
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Friedrich-Ludwig-Jahn-Straße 15a, 17475 Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Ferdinand-Sauerbruch-Straße NK, 17475 Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK), Partner Site Greifswald, 13347 Berlin, Germany
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Fukuda Y, Hiyoshi A. Associations of household expenditure and marital status with cardiovascular risk factors in Japanese adults: analysis of nationally representative surveys. J Epidemiol 2012. [PMID: 23208515 PMCID: PMC3700239 DOI: 10.2188/jea.je20120021] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background Socioeconomic inequalities in health and social determinants of health are important issues in public health and health policy. We investigated associations of cardiovascular risk factors with household expenditure (as an indicator of socioeconomic status) and marital status in Japan. Methods We combined data from 2 nationally representative surveys—the Comprehensive Survey of Living Conditions and the National Health and Nutrition Survey, 2003–2007—and analyzed sex-specific associations of household expenditure quartiles and marital status with cardiovascular risk factors, including obesity, hypertension, dyslipidemia, and diabetes, among 6326 Japanese adults (2664 men and 3662 women) aged 40 to 64 years. Results For men, there was no statistically significant association between household expenditure and cardiovascular risk factors. For women, lower household expenditure was significantly associated with obesity, hypertension, diabetes, and the presence of multiple risk factors: the ORs for the lowest versus the highest quartile ranged from 1.39 to 1.71. In a comparison of married and unmarried participants, the prevalence of cardiovascular risk factors was higher among married women and lower among married men. Conclusions Lower socioeconomic status, as indicated by household expenditure, was associated with cardiovascular risk factors in Japanese women. Socioeconomic factors should be considered in health promotion and prevention of cardiovascular disease.
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Affiliation(s)
- Yoshiharu Fukuda
- Department of Community Health and Medicine, Yamaguchi University School of Medicine, Ube, Yamaguchi, Japan.
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Rastrelli G, Corona G, Fisher AD, Silverii A, Mannucci E, Maggi M. Two Unconventional Risk Factors for Major Adverse Cardiovascular Events in Subjects with Sexual Dysfunction: Low Education and Reported Partner's Hypoactive Sexual Desire in Comparison with Conventional Risk Factors. J Sex Med 2012; 9:3227-38. [DOI: 10.1111/j.1743-6109.2012.02947.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Associations of parental education and parental physical activity (PA) with children's PA: the ENERGY cross-sectional study. Prev Med 2012; 55:310-314. [PMID: 22846500 DOI: 10.1016/j.ypmed.2012.07.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 07/14/2012] [Accepted: 07/18/2012] [Indexed: 11/21/2022]
Abstract
OBJECTIVE The present study sought to examine the independent associations of parental education and physical activity (PA) with children's PA across Europe. METHODS A total of 7214 children (10-12 years) were recruited from a school-based cross-sectional survey during 2010 in seven European countries. Weight and height were measured. Parental educational level (PEL) and parents' and children's PA were collected using self-reported questionnaires. Multiple linear regression models were used, comparing children's PA with PEL and PA levels. RESULTS PEL was directly associated with children's PA in Greek and Spanish girls (all P<0.01) and boys' PA in Norway (all P<0.05). Paternal education was directly associated with PA in Hungarian boys (P<0.05). In overall, parental PA was directly associated with children's PA in more than half of the countries involved (all P<0.05). CONCLUSIONS Our observations suggest that PEL and parental modeling of PA are two independent factors from the home environment influencing the children's PA, but the relationships were gender- and country-specific. Further studies should be focused on intervention strategies for increasing children's PA but considering the important role of these two aspects and especially on the modification of parental modeling of PA.
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Environmental determinants of obesity‐associated morbidity risks for truckers. INTERNATIONAL JOURNAL OF WORKPLACE HEALTH MANAGEMENT 2012. [DOI: 10.1108/17538351211239162] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Gallo LC, Fortmann AL, de Los Monteros KE, Mills PJ, Barrett-Connor E, Roesch SC, Matthews KA. Individual and neighborhood socioeconomic status and inflammation in Mexican American women: what is the role of obesity? Psychosom Med 2012; 74:535-42. [PMID: 22582313 PMCID: PMC3372661 DOI: 10.1097/psy.0b013e31824f5f6d] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Inflammation may represent a biological mechanism underlying associations of socioeconomic status (SES) with cardiovascular disease. We examined relationships of individual and neighborhood SES with inflammatory markers in Mexican American women and evaluated contributions of obesity and related heath behaviors to these associations. METHODS Two hundred eighty-four Mexican American women (mean age = 49.74 years) were recruited from socioeconomically diverse South San Diego communities. Women completed measures of sociodemographic characteristics and health behaviors, and underwent a physical examination with fasting blood draw for assay of plasma C-reactive protein (CRP), interleukin 6 (IL-6), and soluble intercellular adhesion molecule 1 (sICAM-1). Neighborhood SES was extracted from the US Census Bureau 2000 database. RESULTS In multilevel models, a 1-standard deviation higher individual or neighborhood SES related to a 27.35% and 23.56% lower CRP level (p values < .01), a 7.04% and 5.32% lower sICAM-1 level (p values < .05), and a 10.46% (p < .05) and 2.40% lower IL-6 level (not significant), respectively. Controlling for individual SES, a 1-standard deviation higher neighborhood SES related to a 18.05% lower CRP level (p = .07). Differences in body mass index, waist circumference, and dietary fat consumption contributed significantly to SES-inflammation associations. CONCLUSIONS The findings support a link between SES and inflammatory markers in Mexican American women and implicate obesity and dietary fat in these associations. Additional effects of neighborhood SES were not statistically significant; however, these findings should be viewed tentatively due to the small sample size to evaluate contextual effects. Trial Registration ClinicalTrials.gov identifier: NCT00387166.
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Affiliation(s)
- Linda C Gallo
- Department of Psychology, San Diego StateUniversity, San Diego, CA, USA.
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Woodside JV, Yarnell JWG, Patterson CC, Arveiler D, Amouyel P, Ferrières J, Kee F, Evans A, Bingham A, Ducimetière P. Do lifestyle behaviours explain socioeconomic differences in all-cause mortality, and fatal and non-fatal cardiovascular events? Evidence from middle aged men in France and Northern Ireland in the PRIME Study. Prev Med 2012; 54:247-53. [PMID: 22306980 DOI: 10.1016/j.ypmed.2012.01.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 01/19/2012] [Accepted: 01/19/2012] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To examine the contribution of lifestyle behaviours to the socioeconomic gradient in all-cause mortality, and fatal and non-fatal cardiovascular events. METHOD 10,600 men aged 50-59 years examined in 1991-1994 in Northern Ireland (NI) and France and followed annually for deaths and cardiovascular events for 10 years. Baseline smoking habit, physical activity, and fruit, vegetable, and alcohol consumption were assessed. RESULTS All lifestyle behaviours showed marked socioeconomic gradients for most indicators in NI and France, with the exception of percentage of alcohol consumers in NI and frequency of alcohol consumption in NI and France. At 10 years, there were 544 deaths from any cause and 440 fatal and non-fatal cardiovascular events. After adjustment for country and age, socioeconomic gradients were further adjusted for lifestyle behaviours. For total mortality, the median residual contribution of lifestyle behaviours was 28% and for cardiovascular incidence, 41%. When cardiovascular risk factors were considered in conjunction with lifestyle behaviours these percentages increased to 38% and 67% respectively. CONCLUSION Lifestyle behaviours contribute to the gradient in mortality and cardiovascular incidence between socioeconomic groups, particularly for cardiovascular incidence, but a substantial proportion of these differentials was not explained by lifestyle behaviours and cardiovascular risk factors.
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Affiliation(s)
- J V Woodside
- Queen's University Belfast, Belfast, United Kingdom.
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Population compliance with national dietary recommendations and its determinants: findings from the ORISCAV-LUX study. Br J Nutr 2012; 108:2083-92. [PMID: 22313864 DOI: 10.1017/s0007114512000232] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The objective of the present study was to determine the proportion of adults meeting national recommendations for food and nutrient intake and to identify the demographic, socio-economic and behavioural factors that may contribute to weaken dietary compliance. ORISCAV-LUX is a cross-sectional study that took place in Luxembourg (2007-8). A representative stratified random sample of 1352 adults aged 18-69 years participated in the nationwide cardiovascular health survey. A FFQ was used to estimate food intake. Radar charts were built to compare graphically the compliance of the participants with different key dietary guidelines on the same set of axes. The thirteen food- and nutrient-based recommendations were scored and summed to create a recommendation compliance index (range -0·5 to 14). Ordinal logistic regression analyses were performed to determine the factors contributing to poor dietary compliance. Several food- and nutrient-based guidelines were insufficiently respected compared with others. The greatest gaps occurred in the adherence to grain and dairy product consumption guidelines, as well as to total fat and notably to SFA recommendations. Age, country of birth, economic status, smoking status and subject's awareness of the importance of balanced meals emerged as independently associated with weak dietary compliance. Obese subjects conformed more to dietary recommendations compared with normal-weight subjects. The findings underscore the need for specific nutrition education messages along with targeted interventions. Efforts should be continued to increase population awareness of the importance of a healthy lifestyle and a balanced diet.
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F. Al-Kaabba A, A. Al-Hamdan N, El Tahir A, M. Abdalla A, A. Saeed A, A. Hamza M. Prevalence and Correlates of Dyslipidemia among Adults in Saudi Arabia: Results from a National Survey. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojemd.2012.24014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Wee LE, Koh GCH. The effect of neighborhood, socioeconomic status and a community-based program on multi-disease health screening in an Asian population: a controlled intervention study. Prev Med 2011; 53:64-9. [PMID: 21624394 DOI: 10.1016/j.ypmed.2011.05.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2010] [Revised: 05/11/2011] [Accepted: 05/16/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVES We studied whether individual socioeconomic and neighborhood factors such as living in a poor community independently affected health screening participation. METHODS We studied 3 blocks of public-rental flats (the poorer neighborhood) adjacent to 3 blocks of owner-occupied public housing (the better-off neighborhood) in a precinct in Taman Jurong, Singapore. Demographic details and reasons for not having regular hypertension, diabetes mellitus, hyperlipidemia and colorectal cancer screening were collected from 2009 to 2010. An access-enhancing intervention was implemented in both neighborhoods to raise health screening rates. RESULTS Participation rates for rental flats and owner-occupied flats were 89.0% (356/400) and 70.2% (351/500) respectively. Living in a better-off neighborhood was independently associated with diabetes mellitus (66% vs. 35%, adjusted odds ratio (AOR)=2.12, p<0.01), hyperlipidemia (53% vs. 26%, AOR=4.34, p<0.01) and colorectal cancer screening (17% vs. 6%, AOR=15.43, p<0.01), as were individual socioeconomic factors such as employment, need for financial aid and household income. Uptake of all screening modalities significantly increased in the poorer neighborhood post-intervention (all p<0.05). Cost was cited more commonly as a barrier to health screening in the poorer neighborhood. CONCLUSION Differing neighborhoods within one geographical location, as well as individual socioeconomic factors, were independently associated with differences in health screening.
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Affiliation(s)
- Liang En Wee
- Department of Epidemiology and Public Health, Yong Loo Lin School of Medicine, National University Health System, National University of Singapore,16 Medical Drive, Singapore.
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Schumann B, Kluttig A, Tiller D, Werdan K, Haerting J, Greiser KH. Association of childhood and adult socioeconomic indicators with cardiovascular risk factors and its modification by age: the CARLA Study 2002-2006. BMC Public Health 2011; 11:289. [PMID: 21569269 PMCID: PMC3098172 DOI: 10.1186/1471-2458-11-289] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2010] [Accepted: 05/10/2011] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The influence of socioeconomic status (SES) on cardiovascular diseases and risk factors is widely known, although the role of different SES indicators is not fully understood. The aim of this study was to investigate the role of different SES indicators for cardiovascular disease risk factors in a middle and old aged East German population. METHODS Cross-sectional data of an East German population-based cohort study (1779 men and women aged 45 to 83) were used to assess the association of childhood and adulthood SES indicators (childhood SES, education, occupational position, income) with cardiovascular risk factors. Adjusted means and odds ratios of risk factors by SES indicators with 95% confidence intervals (CI) were calculated by linear and logistic regression models, stratified by sex. The interaction effect of education and age on cardiovascular risk factors was tested by including an interaction term. RESULTS In age-adjusted models, education, occupational position, and income were statistically significantly associated with abdominal obesity in men, and with smoking in both sexes. Men with low education had a more than threefold risk of being a smoker (OR 3.44, CI 1.58-7.51). Low childhood SES was associated with higher systolic blood pressure and abdominal obesity in women (OR 2.27, CI 1.18-4.38 for obesity); a non-significant but (in terms of effect size) relevant association of childhood SES with smoking was observed in men. In women, age was an effect modifier for education in the risk of obesity and smoking. CONCLUSIONS We found considerable differences in cardiovascular risk factors by education, occupational position, income, and partly by childhood social status, differing by sex. Some social inequalities levelled off in higher age. Longitudinal studies are needed to differentiate between age and birth cohort effects.
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Affiliation(s)
- Barbara Schumann
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, 06097 Halle (Saale), Germany.
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Falkstedt D, Hemmingsson T. Educational Level and Coronary Heart Disease: A Study of Potential Confounding from Factors in Childhood and Adolescence Based on the Swedish 1969 Conscription Cohort. Ann Epidemiol 2011; 21:336-42. [DOI: 10.1016/j.annepidem.2010.12.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2010] [Revised: 12/16/2010] [Accepted: 12/30/2010] [Indexed: 12/19/2022]
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Egger G, Dixon J. Non-nutrient causes of low-grade, systemic inflammation: support for a 'canary in the mineshaft' view of obesity in chronic disease. Obes Rev 2011; 12:339-45. [PMID: 20701689 DOI: 10.1111/j.1467-789x.2010.00795.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
A form of low-grade, systemic inflammation ('metaflammation') is linked to many types of chronic disease. Initially, this was thought to be causally related to weight gain and obesity and a possible explanation of the link between obesity and disease. However, several lifestyle-related inducers of such inflammation, some of which are associated with obesity, but some of which are not, have now been identified. The most common of these have been nutritive related, suggesting that there could still be a relationship, either directly or indirectly, with obesity. Here we provide evidence for non-nutritive inflammatory inducers, providing further support for an earlier suggestion that while obesity, beyond a point, may have a direct link with disease, this may be neither necessary nor sufficient to explain the current epidemic of chronic disease. A more ubiquitous cause encompassing all inflammatory inducers is the modern, post-industrial environment and lifestyles emanating from this. Obesity may thus be more of 'a canary in the mineshaft', warning of bigger global problems, than just a single pathway to modern environmentally driven disease.
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Affiliation(s)
- G Egger
- Health & Human Sciences, Southern Cross University, Lismore, Australia, and Centre for Health Promotion and Research, Sydney, NSW, Australia.
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Dyslipidemia in northeastern China. Open Med (Wars) 2011. [DOI: 10.2478/s11536-010-0075-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AbstractDyslipidemia, is a major risk factor for premature coronary artery disease. Our aim was to estimate the prevalence of dyslipidemia (blood lipid abnormalities) and other risk factors associated with coronary artery diseases among an adult population in northeastern China. Throughout the months of September and October of 2007,a population-based cross-sectional study was conducted and a total of 3,815 individuals were included. Total cholesterol (TC), high-density cholesterol (HDL-C), low-density cholesterol (LDL-C), and triglycerides (TG) were measured. A binary logistic regression analysis was conducted to determine risk factors associated with dyslipidemia. The prevalence of hypercholesterolemia, high LDL-C, low HDL-C, and hypertriglyceridemia were 17.3%, 27.8%, 11.66% and 29.85%, respectively. The prevalence of hypertension, central obesity, alcoholic liver disease (ALD), non-ALD, diabetes and metabolic syndrome was higher in serum lipid abnormality groups than in the non-dyslipidemia group (p < 0.001). In a binary logistic regression, hyperlipidemia was positively correlated with age, male, hypertension, high body mass index, etc. There were negative correlations with being female and the level of education a subject had attained. Dyslipidemia is a major risk factor for premature coronary artery diseases and an important public health issue in the northeastern part of China. Dyslipidemia is more frequent than expected based on previous studies. To control dyslipidemia, routine evaluations in clinics and community centers are needed, as well as effective public health education.
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Giskes K, Turrell G, Bentley R, Kavanagh A. Individual and household-level socioeconomic position is associated with harmful alcohol consumption behaviours among adults. Aust N Z J Public Health 2011; 35:270-7. [DOI: 10.1111/j.1753-6405.2011.00683.x] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Donyavi T, Naieni KH, Nedjat S, Vahdaninia M, Najafi M, Montazeri A. Socioeconomic status and mortality after acute myocardial infarction: a study from Iran. Int J Equity Health 2011; 10:9. [PMID: 21299888 PMCID: PMC3042926 DOI: 10.1186/1475-9276-10-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2010] [Accepted: 02/07/2011] [Indexed: 11/28/2022] Open
Abstract
Background Studies have shown an inverse relationship between socioeconomic status (SES) and mortality due to coronary heart disease (CHD). Little is known about this association in Iran. This study aimed to investigate whether mortality after myocardial infarction (MI) varies by SES. Methods In a retrospective study, 1283 MI patients who hospitalized in Tehran Heart Center from March 2005 to March 2006 were followed up in March 2008. Demographic, clinical and SES data were collected from case records and by telephone interviews. Multiple logistic regression analysis was performed to estimate the predictive effect of socioeconomic factors on outcome. Results In all 664 patients were studied. Of these, 500 patients were alive and 164 were dead due to MI (64 died at hospital and 100 died at home). The results of regression analysis showed that in addition to treatment (OR = 9.52, 95%CI 4.84-18.7), having diabetes (OR = 1.78, 95% CI 1.12-2.81) or hyperlipidemia (OR = 1.82, 95% CI 1.14-2.90), socioeconomic variables including living area in square per person (lowest level vs. upper level OR = 4.92, 95% CI 2.11-11.4), unemployment (OR = 3.50, 95% CI 1.50-8.13) and education (OR for illiterate patients = 2.51, 95% CI 1.00-6.31) were the most significant contributing factors to increased mortality after MI. Conclusion Although the findings should be interpreted with caution, the study results indicated that socioeconomic variables were significant contributing factors to increased mortality after myocardial infarction. The underlying role of socioeconomic status on increased mortality after MI deserves further investigation.
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Affiliation(s)
- Tahereh Donyavi
- Department of Mental Health, Iranian Institute for Health Sciences Research, ACECR, Tehran, Iran.
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Chen H, Zheng P, Zhu H, Zhu J, Zhao L, El Mokhtari NE, Eberhard J, Lins M, Jepsen S. Platelet-activating factor levels of serum and gingival crevicular fluid in nonsmoking patients with periodontitis and/or coronary heart disease. Clin Oral Investig 2010; 14:629-36. [PMID: 19826843 PMCID: PMC3128738 DOI: 10.1007/s00784-009-0346-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2009] [Accepted: 09/22/2009] [Indexed: 11/17/2022]
Abstract
The purpose of the present study was to investigate systemic and local levels of platelet-activating factor (PAF), a potent proinflammatory mediator implicated in cardiovascular pathophysiology in adult nonsmoking patients with periodontitis with or without coronary heart disease (CHD). Eighty-seven volunteers, 25 periodontitis patients, 19 periodontitis with CHD patients, 19 CHD patients, and 24 healthy controls were included, and periodontal conditions were assessed. Gingival crevicular fluid (GCF) and venous blood were collected, and PAF levels were measured by enzyme-linked immunosorbent assay. PAF levels in serum (303.3 ± 204 pg/ml) and in GCF (26.3 ± 6 pg/μl) of the periodontitis group with CHD, the periodontitis group (serum, 302.4 ± 241 pg/ml and GCF, 26.3 ± 8 pg/μl) and the CHD group (serum, 284.7 ± 192 pg/ml and GCF, 20.8 ± 6 pg/μl) were significantly higher than the healthy control group (serum, 65.4 ± 35 pg/ml and GCF, 7.7 ± 3 pg/μl; p < 0.05). In summary, the present study could demonstrate that in patients with periodontitis, the inflammatory mediator PAF is released into serum at least in the same range as for patients with coronary heart disease. However, no additive effects were seen when both conditions were present.
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Affiliation(s)
- Hui Chen
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Pei Zheng
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Haihua Zhu
- Department of Conservative Dentistry and Periodontics, Affiliated Hospital of Stomatology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Jianhua Zhu
- Department of Cardiology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Lili Zhao
- Department of Cardiology, Medical College, Zhejiang University, Hangzhou, People’s Republic of China
| | - Nour Eddine El Mokhtari
- Department of Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Jörg Eberhard
- Department of Preventive Dentistry, Periodontology and Cariology, University of Göttingen, Göttingen, Germany
| | - Markus Lins
- Department of Cardiology, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Søren Jepsen
- Department of Periodontology, Operative and Preventive Dentistry, University of Bonn, Welschnonnenstr, 17, 53111 Bonn, Germany
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Veronesi G, Ferrario MM, Chambless LE, Sega R, Mancia G, Corrao G, Fornari C, Cesana G. Gender differences in the association between education and the incidence of cardiovascular events in Northern Italy. Eur J Public Health 2010; 21:762-7. [PMID: 21071391 DOI: 10.1093/eurpub/ckq155] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The educational differences in the incidence of major cardiovascular events are under-studied in Southern Europe and among women. METHODS The study sample includes n = 5084 participants to 4 population-based Northern Italian cohorts, aged 35-74 at baseline and with no previous cardiovascular events. The follow-up to ascertain the first onset of coronary heart disease (CHD) or ischaemic stroke ended in 2002. At baseline, major cardiovascular risk factors were investigated adopting the standardized MONICA procedures. Two educational classes were obtained from years of schooling. Age- and risk factors-adjusted hazard ratios of first CHD or ischaemic stroke were estimated through sex-specific separate Cox models (high education as reference). RESULTS Median follow-up time was 12 years. Event rates were 6.38 (CHD) and 2.12 (ischaemic stroke) per 1000 person-years in men; and 1.59 and 0.94 in women. In men, low education was associated with higher mean Body Mass Index and prevalence of diabetes and cigarette smokers; but also with higher HDL cholesterol and a more favourable alcohol intake pattern. Less-educated women had higher mean systolic blood pressure, Body Mass Index and HDL cholesterol and were more likely to have diabetes. Men and women in the low educational class had a 2-fold increase in ischaemic stroke and CHD incidence, respectively, after controlling for major risk factors. Education was not associated with CHD incidence in men. Higher ischaemic stroke rates were observed among more educated women. CONCLUSION In this northern Italian population, the association between education and cardiovascular risk seems to vary by gender.
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Affiliation(s)
- Giovanni Veronesi
- Dipartimento di Medicina Sperimentale, Università degli Studi dell'Insubria, Varese, Italy
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Wee LE, Koh GCH, Toh ZJ. Multi-disease Health Screening in an Urban Low-income Setting: A Community-based Study. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2010. [DOI: 10.47102/annals-acadmedsg.v39n10p750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Introduction: We were interested to determine the participation rates for health screening in a multi-ethnic urban low-income community. We assessed the health screening rates at baseline, collected data on reasons for non-participation and assessed the impact that a 5-month intervention had on health screening in this community. Materials and Methods: The study population involved all residents aged ≥40 years, living in heavily subsidised public rental flats in Taman Jurong Constituency, Singapore. From January 2009 to May 2009, we collected baseline information and offered eligible residents free blood pressure, fasting blood glucose and lipid measurements, fecal occult blood testing and Pap smears. Screenings were conducted either at or near the residents’ homes. Results: The participation rate was 60.9% (213/350). At baseline, 18.9% (24/127), 26.4% (42/159) and 18.7% (31/166) had gone for regular hypertension, diabetes and hyperlipidaemia screening, respectively; 3.8% (6/157) and 2.9% (2/70) had had regular colorectal and cervical cancer screening, respectively. Post-intervention, rates for hypertension screening increased to 97.6% but increases for other modalities were marginal. High cost, lack of time, not at risk, too old, or unnecessary for healthy people were commonly cited reasons for skipping regular health screening. Being unemployed was associated with missing regular hypertension screening (adjusted OR = 2.48, CI = 1.12-5.53, P = 0.026); those who did not need financial aid were less likely to miss regular hyperlipidaemia screening (adjusted OR = 0.27, CI = 0.10-0.72, P = 0.008). Conclusion: The participation rates for health screening were poor in this low-income community. More can be done to encourage regular health screening participation amongst this segment of the populace, both by reducing costs as well as addressing misperceptions.
Key words: Cervical cancer, Colorectal cancer, Diabetes, Hyperlipidaemia, Hypertension
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Affiliation(s)
- Liang En Wee
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Gerald CH Koh
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
| | - Zheng Jie Toh
- Yong Loo Lin School of Medicine, National University of Singapore, National University Health System, Singapore
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