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Hoang MT, Jung SJ, Lee H, Kim HC. Parent-Offspring Associations of Ideal Cardiovascular Health Metrics: Findings From the 2014 to 2021 Korea National Health and Nutrition Examination Survey. J Am Heart Assoc 2024; 13:e030995. [PMID: 38214252 PMCID: PMC10926814 DOI: 10.1161/jaha.123.030995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 12/14/2023] [Indexed: 01/13/2024]
Abstract
BACKGROUND Studies have reported the strength of cardiovascular health (CVH) metrics in parent-offspring relationships. This study aimed to describe the sex-specific associations between CVH in parents and adult offspring. METHODS AND RESULTS This study was conducted on the Korea National Health and Nutrition Examination Survey data set, which analyzed trios of mother-father-child, with the child's age from 20 to 39 years. To use the nature of sampling design, survey weighting was applied to all our analyses. Ideal CVH was defined as a cluster of at least 5 ideal individual CVH metrics. We examined the association between parents and their adult offspring regarding clustering CVH and individual CVH metrics through odds ratios and 95% CIs using multiple logistic regression with standard errors adjusted for within-family clustering. The study included 1267 married couples comprising 748 sons and 819 daughters. After adjusting for household income and offspring's sex, age, education, and alcohol consumption, an offspring with either parent attaining a nonideal CVH was 3.52 times more likely to have nonideal CVH. Fathers' nonideal CVH was significantly positively associated with the daughters' nonideal CVH. Maternal nonideal CVH was significantly positively associated with the son's nonideal CVH. When analyzing individual CVH metrics, ideal status in fathers or mothers reduced the likelihood of their offspring having a nonideal status. CONCLUSIONS This cross-sectional study showed positive and differential associations of CVH and its components between parents' and offsprings' nonideal status. Our hypothesis-generating results suggest the relevance of using CVH as a composite indicator in family-centered approaches and heart-health interventions.
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Affiliation(s)
- Manh Thang Hoang
- Department of Public HealthGraduate School, Yonsei UniversitySeoulKorea
- Department of Preventive MedicineHanyang University College of MedicineSeoulKorea
| | - Sun Jae Jung
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
| | - Hokyou Lee
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
| | - Hyeon Chang Kim
- Department of Preventive MedicineYonsei University College of MedicineSeoulKorea
- Institute for Innovation in Digital Healthcare, Yonsei UniversitySeoulKorea
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Shakya S, Shrestha V, Neupane D. Social determinants of health and cardiometabolic risk factors in Nepal: A scoping review. Nutr Metab Cardiovasc Dis 2023; 33:2308-2316. [PMID: 37798230 DOI: 10.1016/j.numecd.2023.08.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 05/23/2023] [Accepted: 08/02/2023] [Indexed: 10/07/2023]
Abstract
AIMS Cardiometabolic risk factors are modifiable contributors to cardiometabolic disease and adverse outcomes. Cardiometabolic risk factors are emerging health concerns among adults in low and middle-income countries. The role of social determinants of health on cardiometa gaps. DATA SYNTHESIS A comprehensive search was conducted in multiple databases: PubMed (MEDLINE), Web of Science (Clarivate), and CINAHL (EBSCO). Joanna Briggs Institute's (JBI) Scoping Review methodology and PRISMA extension for scoping reviews-SCRA guided this review. Forty-four cross-sectional studies published between 2010 and 2022 were eligible for this review. Men were more likely to have hypertension, while women were more likely to have obesity and abdominal obesity. Participants from marginalized caste/ethnicity, urban regions, and those with lower education, and greater wealth index had a greater likelihood of hypertension, dyslipidemia, and hyperglycemia; however, differences across these sociodemographic subgroups are narrowing. Smoking, harmful alcohol use, high salt intake, low fruit and vegetable intake, and sedentary lifestyles were associated with one or more cardiometabolic risk factors. Finally, one cardiometabolic risk factor increased the risk of others. CONCLUSIONS Findings reflect that Nepal is at the intersection of rapid urbanization, nutritional transition, and socioeconomic shift. Future studies should take a multilevel approach to investigate the role of social determinants in increasing the cardiometabolic risk burden in Nepal.
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Affiliation(s)
- Shamatree Shakya
- College of Nursing, University of Illinois at Chicago, United States.
| | | | - Dinesh Neupane
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Pengpid S, Peltzer K. Prevalence and Correlates of Cardiovascular Health Status among Adults in Afghanistan: Results of a National Survey in 2018. Int J Prev Med 2023; 14:29. [PMID: 37351042 PMCID: PMC10284193 DOI: 10.4103/ijpvm.ijpvm_252_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 05/31/2022] [Indexed: 06/24/2023] Open
Abstract
Background The aim of the study was to assess the prevalence and correlates of cardiovascular health (CVH) status among adults in Afghanistan. Methods In a national cross-sectional household survey 3,447 adults completed CVH measurements in Afghanistan. Criteria for ideal CVH (ICVH) were physical activity, healthy diet, non-smoking, fasting blood glucose (<100 mg/dL), body mass index (<25 kg/m2), total cholesterol (<200 mg/dL), and blood pressure (<120/<80 mmHg). Results More than one-third (34.3%) of participants had 5-7 ICVH, 45.7% 3-4 ICVH, and 20% had 0-2 ICVH. In adjusted logistic regression analysis, secondary or more education (AOR: 1.80, 95% CI: 1.22-2.66) was positively associated, and older age (45-69 years) (AOR: 0.33, 95% CI: 0.26-0.42), and urban residence (AOR: 0.67, 95% CI: 0.51-0.88) were inversely associated with 5-7 ICVH. Conclusions The prevalence of ICVH was low in Afghan adults. Population measures may be used to improve CVH targeting identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, Thailand
- Department of Public Health, Sefako Makgatho Health Sciences University, Pretoria, South Africa
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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Hoang MT, Lee H, Kim HC. Spousal concordance of ideal cardiovascular health metrics: findings from the 2014-2019 Korea National Health and Nutrition Examination Survey. Clin Hypertens 2022; 28:41. [PMID: 36517881 PMCID: PMC9753352 DOI: 10.1186/s40885-022-00224-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Accepted: 08/31/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUNDS We aimed to investigate whether a spouse's cardiovascular health (CVH) metrics status affects the other spouse's ideal CVH using a Korea nationwide representative survey. METHODS We used the health data of 6,030 married couples who participated in the Korea National Health and Nutrition Examination Survey from 2014 to 2019. The CVH was defined using seven metrics: smoking status, blood pressure, body mass index, total cholesterol, fasting blood glucose, physical activity, and diet, following the American Heart Association guidelines and modifications for body mass index cutoffs and diet quality. The CVH score was calculated on a scale ranging from 0 to 7, with the ideal CVH defined as attaining ideal scores in at least five CVH metrics. Multiple logistic regression analyses were used to assess whether husband's ideal CVH was associated with his wife's odds for having ideal CVH, and vice versa. RESULTS The mean CVH scores were 3.2 and 4.0 for husband and wife, respectively. After fully adjusting for age and education of both partners and household income, husbands had 1.49 times (95% confidence interval [CI], 1.27-1.69) higher odds of achieving ideal CVH if their wives had also achieved ideal CVH. Meanwhile, wives whose husbands achieved ideal CVH also had 1.46 times (95% CI, 1.27-1.69) higher odds of achieving ideal CVH. Nonsmoking (57.17%), ideal fasting blood glucose level (34.93%), and ideal diet intake (24.18%) were the most concordant CVH metrics among spouses. CONCLUSIONS Our study found a significant spousal concordance of ideal CVH in Korean married couples. This finding supports the use of a couple-based interventional strategy targeted to promote CVH.
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Affiliation(s)
- Manh Thang Hoang
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea
| | - Hokyou Lee
- grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hyeon Chang Kim
- grid.15444.300000 0004 0470 5454Department of Public Health, Graduate School, Yonsei University, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea ,grid.15444.300000 0004 0470 5454Institute of Health Services Research, Yonsei University College of Medicine, Seoul, Republic of Korea
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Qureshi F, Bousquet-Santos K, Okuzono SS, Tsao E, Delaney S, Guimond AJ, Boehm JK, Kubzansky LD. The social determinants of ideal cardiovascular health: A global systematic review. Ann Epidemiol 2022; 76:20-38. [PMID: 36191736 PMCID: PMC9930100 DOI: 10.1016/j.annepidem.2022.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 09/19/2022] [Accepted: 09/28/2022] [Indexed: 11/26/2022]
Abstract
This systematic review synthesizes research published from January 2010-July 2022 on the social determinants of ideal cardiovascular health (CVH) carried out around the world and compares trends in high-income countries (HICs) to those in low- and middle-income countries (LMICs). 41 studies met inclusion criteria (n = 28 HICs, n = 13 LMICs). Most were from the United States (n = 22) and cross-sectional (n = 33), and nearly all evaluated associations among adults. Among studies conducted in LMICs, nearly all were from middle-income countries and only one was carried out in low-income country. Education (n = 24) and income/wealth (n = 17) were the most frequently examined social determinants in both HICs and LMICs. Although most studies assessed ideal CVH using reliable and valid methods (n = 24), only 7 used criteria pre-defined by the American Heart Association to characterize ideal levels of each CVH metric. Despite heterogeneity in how outcome measures were derived and analyzed, consistent associations were evident between multiple markers of higher social status (i.e. greater education, income/wealth, socioeconomic status, racial/ethnic majority status) and greater levels of ideal CVH across both country contexts. Gaps in the literature include evidence from LMICs and HICs other than the United States, longitudinal research, and investigations of a wider array of social determinants beyond education and income/wealth.
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Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
| | - Kelb Bousquet-Santos
- Department of Biological and Health Sciences, University of Brasilia, Campus Universitario - Centro Metropolitano, Ceilandia Campus, Brasilia, FD, Brazil
| | - Sakurako S Okuzono
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Elaine Tsao
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Scott Delaney
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, CA
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA; Lee Kum Sheung Center for Health and Happiness, Harvard T. H. Chan School of Public Health, Boston, MA
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Gupta RD, Tamanna RJ, Hashan MR, Akonde M, Haider SS, Chakraborty PA, Hossain MB. Prevalence and Associated Factors with Ideal Cardiovascular Health Metrics in Bangladesh: Analysis of the Nationally Representative STEPS 2018 Survey. EPIDEMIOLOGIA 2022; 3:533-543. [PMID: 36547257 PMCID: PMC9778360 DOI: 10.3390/epidemiologia3040040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 11/25/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022] Open
Abstract
This study aims to find out the prevalence of the American Heart Association's (AHA)'s cardiovascular health metrics and associated socio-demographic factors. A secondary analysis of the World Health Organization (WHO) STEPwise approach to surveillance survey 2018 (STEPS 2018) data was conducted. Ideal Cardiovascular Health (ICH) was defined as the presence of 5-7 ideal metrics as defined by the AHA. Design-adjusted multivariable logistic regression was used to determine the associated factors of ICH. In total, 5930 respondents were included in our analysis, and 43.1% of the participants had ICH. The odds of ICH decreased with age [compared to 18-29 years old individuals, 30-49 years: AOR (Adjusted Odds Ratio): 0.4; 95% Confidence Interval (CI): 0.4-0.5; 50-69 years: AOR: 0.7; 95% CI: 0.6-0.8], and higher educational attainment (compared to those who received no formal education, being educated up to primary level: AOR:0.7; 95% CI: 0.6-0.8; being educated up to secondary level: AOR: 0.4; 95% CI: 0.4-0.5; being educated up to college and higher: AOR: 0.4; 95% CI: 0.3-0.5). Compared with female and urban residents, the odds were 30% and 40% less among male and rural residents, respectively. The public health promotion programs of Bangladesh should raise awareness among high-risk groups to prevent cardiovascular diseases.
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Affiliation(s)
- Rajat Das Gupta
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Rownak Jahan Tamanna
- Institute of Statistical Research and Training (ISRT), University of Dhaka, Dhaka 1000, Bangladesh
| | - Mohammad Rashidul Hashan
- Bangladesh Civil Service, Ministry of Health and Family Welfare, Government of Bangladesh, Dhaka 1000, Bangladesh
- School of Health, Medical and Applied Sciences, Central Queensland University, Rockhampton North, Queensland 4701, Australia
| | - Maxwell Akonde
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA
| | - Shams Shabab Haider
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
| | - Promit Ananyo Chakraborty
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
| | - Md. Belal Hossain
- School of Population and Public Health, University of British Columbia, Vancouver, BC V6T 1Z8, Canada
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Adhikari C, Dhakal R, Adhikari LM, Parajuli B, Subedi KR, Aryal Y, Thapa AK, Shah K. Need for HTA supported risk factor screening for hypertension and diabetes in Nepal: A systematic scoping review. Front Cardiovasc Med 2022; 9:898225. [PMID: 35979024 PMCID: PMC9376353 DOI: 10.3389/fcvm.2022.898225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/12/2022] [Indexed: 11/13/2022] Open
Abstract
Objective Health Technology Assessment (HTA) is a comprehensive and important tool for assessment and decision-making in public health and healthcare practice. It is recommended by the WHO and has been applied in practice in many countries, mostly the developed ones. HTA might be an important tool to achieve universal health coverage (UHC), especially beneficial to low-and-middle-income countries (LMIC). Even though the Package for Essential Non-communicable Diseases (PEN) has already been initiated, there is a clear policy gap in the HTA of any health device, service, or procedure, including the assessment of cardiovascular risk factors (CVRFs) in Nepal. Hence, we carried out the review to document the HTA supported evidence of hypertension and diabetes screening, as CVRFs in Nepal. Materials and methods We searched in PubMed, Cochrane, and Google Scholar, along with some gray literature published in the last 6 years (2016–2021) in a systematic way with a controlled vocabulary using a well-designed and pilot tested search strategy, screened them, and a total of 53 articles and reports that matched the screening criteria were included for the review. We then, extracted the data in a pre-designed MS-Excel format, first in one, and then, from it, in two, with more specific data. Results Of 53 included studies, we reported the prevalence and/or proportion of hypertension and diabetes with various denominators. Furthermore, HTA-related findings such as cost, validity, alternative tool or technology, awareness, and intervention effectiveness have been documented and discussed further, however, not summarized due to their sparingness. Conclusion Overall, the prevalence of DM (4.4–18.8%) and HTN (17.2–70.0%) was reported in most studies, with a few, covering other aspects of HTA of DM/HTN. A national policy for establishing an HTA agency and some immediately implementable actions are highly recommended.
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Affiliation(s)
- Chiranjivi Adhikari
- Department of Public Health, SHAS, Pokhara University, Pokhara, Nepal
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
- *Correspondence: Chiranjivi Adhikari
| | - Rojana Dhakal
- Department of Nursing, School of Health and Allied Sciences, Pokhara University, Pokhara, Nepal
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
| | - Lal Mani Adhikari
- Health Research and Social Development Forum International, Kathmandu, Nepal
| | - Bijaya Parajuli
- Ministry of Health and Population, Gandaki Province, Myagdi Health Office, Myagdi, Nepal
| | - Khem Raj Subedi
- Department of Economics, Far Western University, Tikapur Multiple Campus, Kailali, Nepal
| | | | - Arjun Kumar Thapa
- Department of Economics, School of Humanities and Social Sciences, Pokhara University, Pokhara, Nepal
| | - Komal Shah
- Indian Institute of Public Health Gandhinagar, Gandhinagar, India
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Ghimire U, Yasmin S, Chand S, Timalsena BK, Bhat T, Thapa S, Ranabhat K, Paudel K, Shah S. Cardiovascular disease risk factors distribution and clustering across different geographic levels in Nepal. Am J Hum Biol 2022; 34:e23787. [PMID: 35899931 DOI: 10.1002/ajhb.23787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 07/14/2022] [Accepted: 07/15/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND In an effort to reduce the burgeoning problem of cardiovascular diseases (CVD), it is imperative to understand the variation of risk factors across different geographic regions. This study aims to shed light on examining the leading risk factors of CVD and it's clustering across Nepal. METHODS Data from a nationally representative survey were analyzed to estimate the distribution of four major risk factors (high blood pressure, overweight, obesity, and smoking) of cardiovascular diseases. Similarly, this study also assessed the intra-cluster correlation coefficients (ICCs) of CVD risk factors at the household, community (urban/rural), district, and province level. RESULTS This study included 14 418 adult population with age of 15 years and above of which 41.7% were male and 58.3% were female. Higher prevalence of all four CVD risk factors was found in the richest quintile, people living in hilly region, most noticeably among residents of metropolitan city and in Gandaki, Bagmati, and Province 1. The ICC decreased as the socio-geographic clustering units decreased in size from province, district, and household level clustering. The ICC was highest at province level for "province 1" for raised blood pressure than other provinces. CONCLUSIONS Risk factors of CVD in Nepal are concentrated prominent in highly urbanized areas and ICC is low as the level of geography decreased from province, district, and household. The findings can be applied in directing prevention activities at different levels to mitigate the higher burden of risk factors of CVD in Nepal.
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Affiliation(s)
- Umesh Ghimire
- Department of Public health, University of Minnesota, School of Public Health, Minneapolis, Minnesota, USA
| | - Sabina Yasmin
- Department of Research, Krea University, Sri City, India
| | - Swati Chand
- Department of Cardiology, Rochester General Hospital, Rochester, New York, USA
| | | | - Tikendra Bhat
- Department of Public health, National Open College, Sanepa, Lalitpur, Nepal
| | - Sangharsha Thapa
- Department of Neurology, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Kamal Ranabhat
- Department of Internal Medicine, Tribhuvan University, Institute of Medicine, Maharajgunj, Nepal.,Department of Public health, Ministry of Health and Population, Kathmandu, Nepal
| | - Kiran Paudel
- Department of Public health, Nepal Health Frontiers, Kathmandu, Nepal
| | - Sangam Shah
- Department of Internal Medicine, Tribhuvan University, Institute of Medicine, Maharajgunj, Nepal
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Pengpid S, Peltzer K. National Cross-Sectional Data on Ideal Cardiovascular Health Among Adults in Mongolia in 2019. Glob Heart 2022; 17:34. [PMID: 35837357 PMCID: PMC9165669 DOI: 10.5334/gh.1122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Accepted: 05/09/2022] [Indexed: 11/20/2022] Open
Abstract
Background The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20-69 years) in Mongolia. Method Cross-sectional data were analyzed from 4,516 individuals (20-69 years, mean age = 42.3 years) who participated in the Mongolia STEPS survey in 2019, who had complete measurement of CVH metrics and no history of cardiovascular disease. Ideal CVH measures included non-smoking, healthy diet, physical activity, fasting blood glucose <100 mg/dL, body mass index (<23 kg/m2), total cholesterol <200 mg/dL, and blood pressure <120/<80 mmHg). Results The prevalence of five to seven ideal CVH metrics was 27.7% in 2019. Most Mongolians had ideal total cholesterol (77.4%), ideal smoking (67.8%), ideal fasting glucose (73.8%) and ideal physical activity (66.0%), while a lower prevalence was found for ideal blood pressure (42.4%), ideal body mass index (31.4%), and ideal healthy diet (1.8%). The prevalence of poor smoking, poor fruit/vegetable intake, poor fasting glucose, poor blood pressure, and poor total cholesterol was higher in men than in women, while poor physical activity was higher in women than in men, and poor BMI did not differ by sex. In the adjusted logistic regression analysis, older age, male sex, and belonging to the Khalkh ethnic group were negatively associated, and a higher number of adult household members was positively associated with meeting the ideal 5-7 CVH metrics. Conclusions The proportion of meeting 5-7 ideal CVH metrics was moderate among adults in Mongolia. Primary and secondary prevention programmes should be strengthened to improve CVH in Mongolia, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public Health, Mahidol University, Bangkok, TH
- Department of Research Administration and Development, University of Limpopo, Polokwane, ZA
| | - Karl Peltzer
- Department of Psychology, University of the Free State, Bloemfontein, South Africa
- Department of Psychology, College of Medical and Health Sciences, Asia University, Taichung, TW
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Pengpid S, Peltzer K. Prevalence and associated factors of ideal cardiovascular health: A cross-sectional national population-based study of adults in the Marshall Islands. POPULATION MEDICINE 2022. [DOI: 10.18332/popmed/148425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Pengpid S, Peltzer K. National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019. Sci Rep 2022; 12:5660. [PMID: 35383251 PMCID: PMC8983656 DOI: 10.1038/s41598-022-09688-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 03/21/2022] [Indexed: 11/29/2022] Open
Abstract
The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) across three cross-sectional surveys in 2007, 2014 and 2019 in Bhutan. Cross-sectional data were analysed from 9712 individuals (20–69 years, mean age = 37.6 years) who participated in the 2007, 2014 or 2019 Bhutan STEPS surveys, had complete measurement of CVH metrics, and had no history of a cardiovascular disease in 2014 and 2019. Ideal CVH measures included non-smoking, healthy diet, physical activity, body mass index (< 23 kg/m2), blood pressure < 120/ < 80 mmHg, total cholesterol < 200 mg/dL, and fasting blood glucose < 100 mg/dL). The prevalence of five to seven ideal CVH metrics increased from 11.6% in 2007 to 37.9% in 2019. Trend analyses showed that ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal fasting glucose increased from 2007 to 2019, while ideal fruit and vegetable intake, ideal smoking, and ideal body mass index decreased from 2007 to 2019. Five to seven ideal CVH metrics, 0–7 ideal CVH metrics, and 0–14 poor, intermediate, and ideal CVH metrics increased from 2007 to 2019. In the adjusted logistic regression analysis, older age decreased the odds of having 5–7 ideal CVH metrics in all three study years. Male sex increased the odds, and employment decreased the odds of 5–7 ideal CVH metrics in 2007, and urban residence increased the odds of 5–7 ideal CVH metrics in 2014 and decreased the odds in 2019. The proportion of meeting 5–7 ideal CVH metrics increased in Bhutan. Primary and secondary prevention programmes must be strengthened to improve CVH in Bhutan, considering identified associated factors.
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Affiliation(s)
- Supa Pengpid
- Department of Health Education and Behavioral Sciences, Faculty of Public, Health Mahidol University, Bangkok, Thailand.,Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa
| | - Karl Peltzer
- Department of Research Administration and Development, University of Limpopo, Polokwane, South Africa. .,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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Janković J, Mandić-Rajčević S, Davidović M, Janković S. Demographic and socioeconomic inequalities in ideal cardiovascular health: A systematic review and meta-analysis. PLoS One 2021; 16:e0255959. [PMID: 34379696 PMCID: PMC8357101 DOI: 10.1371/journal.pone.0255959] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Accepted: 07/28/2021] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND In 2010, the American Heart Association introduced a new concept of ideal cardiovascular health (CVH) defined as the simultaneous presence of 7 favorable CVH metrics (smoking, diet, physical activity, body mass index, blood pressure, total cholesterol, and fasting blood glucose). The objective of this study was to conduct a systematic literature review and meta-analysis of studies examining the prevalence of ideal CVH, and each of the ideal CVH metrics as well as the relationship between socio-demographic determinants and ideal CVH. METHODS A comprehensive literature search was conducted in Medline and Scopus databases for studies published between 1 January 2010 and 30 June 2020. A total of 50 studies including 2,148,470 participants were analyzed. Associations were estimated using DerSimonian-Laird random-effect models. Heterogeneity was investigated through subgroup analyses, Q-test, and I2 statistics. RESULTS This study showed a low prevalence of ideal CVH defining as 6 and 7 ideal metrics (3.3%). Among seven ideal CVH metrics, smoking was the best metric (71%), while the poorest CVH metric was a healthy diet (5.8%). Gender was a statistically significant moderator of ideal smoking (81% in females and 60% in males) and ideal blood pressure (42% in females and 30% in males). Females and young adults had better CVH status compared to males and older adults. Also, more educated and better-off individuals had a greater number of ideal CVH metrics. CONCLUSIONS To the best of our knowledge, this is the first systematic review on the relationship between participants' socioeconomic status and ideal CVH. The results suggest that the prevalence of ideal CVH and most metrics was unsatisfactory. In order to achieve the improvement of the CVH metrics and the overall ideal CVH, nationwide prevention efforts at the population and individual levels are urgently needed.
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Affiliation(s)
- Janko Janković
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Stefan Mandić-Rajčević
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Maša Davidović
- Institute of Social Medicine, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Slavenka Janković
- Institute of Epidemiology, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
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Ghimire U, Vatsa R. Spatial distribution of various forms of malnutrition among reproductive age women in Nepal: A Bayesian geoadditive quantile regression approach. SSM Popul Health 2021; 14:100781. [PMID: 33997241 PMCID: PMC8099780 DOI: 10.1016/j.ssmph.2021.100781] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 02/21/2021] [Accepted: 03/23/2021] [Indexed: 01/21/2023] Open
Abstract
Addressing both the under-and over-nutritional status of women is an eminent challenge for developing countries like Nepal. This paper examined a critical analysis of factors associated with various forms of malnutrition using Bayesian geoadditive quantile regression approach and assessed spatial variations of malnutrition among Nepalese women using Asian cut-off values. Data drawn from the 2016 Nepal Demographic and Health Survey was utilized to assess the spatial distributions of underweight, overweight and obesity at the provincial level. Spatial and nonlinear components were estimated using Markov random fields and Bayesian P-splines, respectively. The analysis of 4,338 women confirmed that women living in extremely urbanized areas and in Province 1, Province 3, and Province 4 were more likely to be overweight/obese. Similarly, the likelihood of being underweight was prominently high among women residing in rural municipality and women residing in Province 2 and Province 7. Women from the richest and richer quintiles, and with primary education were more likely to be obese. Furthermore, currently-working women and women having access to protected water source were less likely to be obese while improved toilet and access to electricity facility were associated with obesity. Women with access to newspaper and radio were less prone to obesity. Inconsistent distribution of under- and over-nutrition existed in Nepal, given that the high prevalence of overweight/obesity among women living in metropolitan and undernutrition among rural women. Specific intervention measures, addressing location-specific nutrition issues are urgent. Rigorous implementation of strategies incorporated in the national nutrition plan is called for to curb the burden of overweight/obesity. Involving mass media to promote healthier lifestyle and nutritious food could be advantageous at the population level, especially in rural municipalities.
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Affiliation(s)
- Umesh Ghimire
- New ERA, Rudramati Marga, Kalopul, Kathmandu, 44600, Nepal
| | - Richa Vatsa
- Central University of South Bihar, SH-7, Gaya Panchanpur Road, Village – Karhara, Post. Fatehpur, Gaya, 824236, Bihar, India
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Ideal Cardiovascular Health in a Nationally Representative Population-Based Sample of Adults in Malawi. Glob Heart 2021; 16:24. [PMID: 34040937 PMCID: PMC8064282 DOI: 10.5334/gh.986] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Background: Ideal cardiovascular health (ICH) measures four ideal health behaviours (non-smoking, body mass index <25 kg/m2, healthy diet, and physical activity) and three health factors (total cholesterol <200 mg/dL, blood pressure <120/<80 mmHg, and fasting blood glucose <100 mg/dL). Objective: This study aimed to determine the prevalence, distribution, and correlates of ICH among adults in Malawi. Methods: National cross-sectional survey data of 3,441 persons aged 18–69 years with complete ICH measurements in Malawi in 2017 were analysed. Results: Almost one in ten (7.4%) of respondents had 0–2 ICH metric), 21.2% 3–4 ICH metrics, and 71.5% 5–7 ICH metrics). Only 3.3% had all seven ICH metrics, 15.3% had intermediate ICH (≥1 metric in the intermediate category and none in the poor category), and 81.5% poor ICH (≥1 metric in poor category). In adjusted logistic regression analysis, older age (50–69 years) (Adjusted Odds Ratio-AOR: 0.25, 95% Confidence Interval-CI: 0.17–0.36) and urban residence (AOR: 0.56, 95% CI: 0.40–0.78) were negatively associated with meeting 5–7 ICH metrics. In addition, in unadjusted analysis, higher education was positively associated with meeting 5–7 ICH metrics. Conclusion: The proportion of meeting 5–7 ICH metrics was high in Malawian adults. Both high-risk and population-wide intervention programmes targeting older adults and urban residents should be implemented in aiding to improve cardiovascular health in Malawi. Highlights
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Guo A, Zhang KW, Reynolds K, Foraker RE. Coronary heart disease and mortality following a breast cancer diagnosis. BMC Med Inform Decis Mak 2020; 20:88. [PMID: 32404163 PMCID: PMC7218836 DOI: 10.1186/s12911-020-1127-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/05/2020] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Coronary heart disease (CHD) is a leading cause of morbidity and mortality for breast cancer survivors, yet the joint effect of adverse cardiovascular health (CVH) and cardiotoxic cancer treatments on post-treatment CHD and death has not been quantified. METHODS We conducted statistical and machine learning approaches to evaluate 10-year risk of these outcomes among 1934 women diagnosed with breast cancer during 2006 and 2007. Overall CVH scores were classified as poor, intermediate, or ideal for 5 factors, smoking, body mass index, blood pressure, glucose/hemoglobin A1c, and cholesterol from clinical data within 5 years prior to the breast cancer diagnosis. The receipt of potentially cardiotoxic breast cancer treatments was indicated if the patient received anthracyclines or hormone therapies. We modeled the outcomes of post-cancer diagnosis CHD and death, respectively. RESULTS Results of these approaches indicated that the joint effect of poor CVH and receipt of cardiotoxic treatments on CHD (75.9%) and death (39.5%) was significantly higher than their independent effects [poor CVH (55.9%) and cardiotoxic treatments (43.6%) for CHD, and poor CVH (29.4%) and cardiotoxic treatments (35.8%) for death]. CONCLUSIONS Better CVH appears to be protective against the development of CHD even among women who had received potentially cardiotoxic treatments. This study determined the extent to which attainment of ideal CVH is important not only for CHD and mortality outcomes among women diagnosed with breast cancer.
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Affiliation(s)
- Aixia Guo
- Institute for Informatics (I2), Washington University School of Medicine, 600 S. Taylor Avenue, Suite 102, Campus Box 8102, St. Louis, MO, 63110, USA
| | - Kathleen W Zhang
- Cardiovascular Division, Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO, USA
| | - Kristi Reynolds
- Department of Research and Evaluation Southern California Permanente Medical Group, Pasadena, California, USA
- Department of Health Systems Science, Kaiser Permanente School of Medicine, Pasadena, California, USA
| | - Randi E Foraker
- Institute for Informatics (I2), Washington University School of Medicine, 600 S. Taylor Avenue, Suite 102, Campus Box 8102, St. Louis, MO, 63110, USA.
- Division of General Medical Sciences, Department of Internal Medicine, Washington University School of Medicine, 600 S. Taylor Avenue, Suite 102, Campus Box 8102, St. Louis, MO, 63110, USA.
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