1
|
Pereira WDS, Lelis DF, Cunha RS, Griep RH, Barreto SM, Molina MDCB, Schmidt MI, Duncan BB, Bensenor I, Lotufo PA, Mill JG, Baldo MP. Fasting Glucose, Glycated Hemoglobin, and 2h Post-load Blood Glucose Are Independently Associated With Arterial Stiffness in Diabetes: The ELSA-Brasil Study. Angiology 2024; 75:635-644. [PMID: 36951393 DOI: 10.1177/00033197231166180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/24/2023]
Abstract
The association of diabetes with increased large artery stiffness is not definitively established. We aimed to describe the carotid-femoral pulse wave velocity (cf-PWV) in participants with and without diabetes and whether the cf-PWV could vary among the different laboratory-based criteria used. A cross-sectional analysis using baseline data from 13,912 adults was used. cf-PWV as well as anthropometric, biochemical, and clinical data were measured. Diabetes was defined by previous medical diagnosis, medication use, fasting glucose, an oral glucose tolerance test (GTT), or glycated hemoglobin (HbA1c). The prevalence of diabetes was 18.7%, higher in men than in women. After adjustment, participants with diabetes showed higher cf-PWV (men: 9.7 ± 1.7 vs 9.4 ± 1.7 m/s, P < .05; women: 9.4 ± 1.6 vs 9.1 ± 1.7 m/s, P < .05). We observed a progressive increase in cf-PWV as >1 laboratory-based criterion for diabetes diagnosis was reached. Also, participants with diabetes with alterations in any laboratory-based criteria had higher cf-PWV than participants without diabetes, regardless of sex. In summary, diabetes is associated with higher cf-PWV as is each laboratory-based parameter used for its diagnosis. These results support the strong consequences of glucose dysregulation on the vascular system and provide evidence to screen all parameters involved in glycemic metabolism to improve vascular health.
Collapse
Affiliation(s)
- Wille D S Pereira
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| | - Deborah F Lelis
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| | - Roberto S Cunha
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Rosane H Griep
- Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Rio de Janeiro, Brazil
| | - Sandhi M Barreto
- School of Medicine and Clinical Hospital/EBSERH, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Maria Inês Schmidt
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Bruce B Duncan
- School of Medicine and Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Isabela Bensenor
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - Paulo A Lotufo
- Center for Clinical and Epidemiologic Research, University of São Paulo, São Paulo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espírito Santo, Vitória, Brazil
| | - Marcelo P Baldo
- Department of Pathophysiology, Montes Claros State University (UNIMONTES), Montes Claros, Brazil
| |
Collapse
|
2
|
Wang J, Ma X, Si X, Wu M, Han W. Mean platelet volume and the association with all-cause mortality and cardiovascular mortality among incident peritoneal dialysis patients. BMC Cardiovasc Disord 2023; 23:543. [PMID: 37940871 PMCID: PMC10634175 DOI: 10.1186/s12872-023-03551-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 10/09/2023] [Indexed: 11/10/2023] Open
Abstract
BACKGROUND While mean platelet volume (MPV) is linked to severity and all-cause mortality in patients with sepsis, its association with all-cause mortality and cardiovascular mortality in patients treated with peritoneal dialysis (PD) remains unknown. OBJECTIVES The purpose of this study was to estimate the relationship between MPV and all-cause mortality and cardiovascular mortality among patients treated with PD. METHOD We retrospectively collected 1322 patients treated with PD from November 1, 2005 to August 31, 2019. All-cause mortality and cardiovascular mortality was identified as the primary outcome. MPV was classified into three categories by means of X-tile software. The correlation between MPV and all-cause mortality was assessed by Cox model. Survival curves were performed by Kaplan-Meier method. RESULTS The median follow-up period was 50 months (30-80 months), and a total of 360 deaths were recorded. With respect to all-cause mortality, patients in MVP ≥ 10.2 fL had considerably higher risk of all-cause mortality among three models (HR 0.68, 95%CI 0.56-0.84; HR 0.70, 95%CI 0.56-0.87; HR 0.73, 95%CI 0.59-0.91; respectively). Moreover, patients treated with PD, whose MVP ≥ 10.2 fL, also suffered from significantly higher risk of cardiovascular mortality in model 1, 2, and 3 (HR 0.63, 95%CI 0.46-0.85; HR 0.66, 95%CI 0.48-0.91; HR 0.69, 95%CI 0.50-0.95; respectively). CONCLUSIONS This study indicates that MPV is independently correlated with both all-cause mortality and cardiovascular mortality in PD.
Collapse
Affiliation(s)
- Jianghai Wang
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China
| | - Xiaochen Ma
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China
| | - Xuepeng Si
- Obstetrics Department of Dongying People's Hospital, Dongying, 257091, China
| | - Mingyang Wu
- Department of Nephrology of Zhucheng People's Hospital, Weifang, China
| | - Wang Han
- Emergency Department of Dongying People's Hospital, Dongying, 257091, China.
- Emergency Department of Dongying People's Hospital, Dongying, 257000, China.
| |
Collapse
|
3
|
Rauf A, Akram M, Anwar H, Daniyal M, Munir N, Bawazeer S, Bawazeer S, Rebezov M, Bouyahya A, Shariati MA, Thiruvengadam M, Sarsembenova O, Mabkhot YN, Islam MN, Emran TB, Hodak S, Zengin G, Khan H. Therapeutic potential of herbal medicine for the management of hyperlipidemia: latest updates. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:40281-40301. [PMID: 35320475 DOI: 10.1007/s11356-022-19733-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 03/10/2022] [Indexed: 06/14/2023]
Abstract
Hyperlipidemia, the most common form of dyslipidemia, is the main source of cardiovascular disorders, characterized by elevated level of total cholesterol (TC), triglycerides (TG) and low-density lipoprotein cholesterol (LDL-C) with high-density lipoprotein cholesterol (HDL-C) in peripheral blood. It is caused by a defect in lipid metabolism in the surface of Apoprotein C-II or a defect in lipoprotein lipase activity as well as reported in genetic, dietary and environmental factors. Several electronic databases were investigated as information sources, including Google Scholar, PubMed, Web of Science, Scopus, ScienceDirect, SpringerLink, Semantic Scholar, MEDLINE and CNKI Scholar. The current review focused on the risk factors of dyslipidemia, synthetic medication with their side effects and different types of medicinal plants having significant potential for the management of hyperlipidemia. The management of hyperlipidemia mostly involves a constant decrease in lipid level using different remedial drugs like statin, fibrate, bile acid sequestrates and niacin. However, this extensive review suggested that the consequences of these drugs are arguable, due to their numerous adverse effects. The selected parts of herb plants are used intact or their extracts containing active phytoconstituents to regulate the lipids in blood level. It was also noted that the Chinese herbal medicine and combination therapy is promising for the lowering of hyperlipidemia. This review intends to provide a scientific base for future endeavors, such as in-depth biological and chemical investigations into previously researched topics.
Collapse
Affiliation(s)
- Abdur Rauf
- Department of Chemistry, University of Swabi, Anbar, 23430, Khyber Pakhtunkhwa, Pakistan.
| | - Muhammad Akram
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Hina Anwar
- Department of Eastern Medicine, Government College University Faisalabad, Faisalabad, Pakistan
| | - Muhammad Daniyal
- TCM and Ethnomedicine Innovation and Development International Laboratory, School of Pharmacy, Hunan University of Chinese Medicine, Changsha, 410208, China
| | - Naveed Munir
- Department of Biochemistry, Government College University Faisalabad, Faisalabad, Pakistan
| | - Sami Bawazeer
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, P.O. Box 42, Makkah, Saudi Arabia
| | - Saud Bawazeer
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Umm Al-Qura University, P.O. Box 42, Makkah, Saudi Arabia
| | - Maksim Rebezov
- V. M. Gorbatov Federal Research Center for Food Systems of Russian Academy of Sciences, Moscow, Russian Federation
- Prokhorov General Physics Institute, Russian Academy of Sciences, Moscow, Russian Federation
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | - Abdelhakim Bouyahya
- Laboratory of Human Pathology Biology, Faculty of Sciences, and Genomic Center of Human Pathology, Mohammed V University, Rabat, Morocco
| | - Mohammad Ali Shariati
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | | | | | - Yahia N Mabkhot
- Department of Pharmaceutical Chemistry, College of Pharmacy, King Khalid University, Abha, 61421, Saudi Arabia
| | - Mohammad Nazmul Islam
- Department of Pharmacy, International Islamic University Chittagong, Chittagong, 4318, Bangladesh
| | - Talha Bin Emran
- Department of Pharmacy, BGC Trust University Bangladesh, Chittagong, 4381, Bangladesh
| | - Sergey Hodak
- K.G. Razumovsky Moscow State University of Technologies and Management (the First Cossack University), Moscow, Russian Federation
| | - Gokhan Zengin
- Department of Biology, Science Faculty, Selcuk University, Campus, Konya, Turkey.
| | - Haroon Khan
- Department of Pharmacy, Abdul Wali Khan University Mardan, Mardan, 23200, Pakistan
| |
Collapse
|
4
|
Liu Y, Li J, Dou Y, Ma H. Impacts of type 2 diabetes mellitus and hypertension on the incidence of cardiovascular diseases and stroke in China real-world setting: a retrospective cohort study. BMJ Open 2021; 11:e053698. [PMID: 34845072 PMCID: PMC8634005 DOI: 10.1136/bmjopen-2021-053698] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE The prevalence of type 2 diabetes mellitus (T2DM) and hypertension (HTN) has notably increased in recent years. However, there is little evidence from large-scale studies assessing the joint effect of T2DM and HTN on the risk of cardiovascular events in China. This study was performed to investigate the association of T2DM and HTN with the incidence of combined vascular events (VEs) and stroke in China. DESIGN A retrospective cohort study. SETTING Data were collected from the SuValue database which includes the electronic medical records of >90 million patients from 161 hospitals across 18 provinces in China. PARTICIPANTS Patients aged ≥18 with a diagnosis of T2DM and/or HTN were included. Non-T2DM and non-HTN patients were included in this study as controls. OUTCOMES Incidence of combined VEs and stroke during the study. RESULTS In the current study, 8012 patients with T2DM, 9653 patients with HTN, 3592 patients with both T2DM and HTN and 10 561 patients without T2DM or HTN were included. T2DM was significantly associated with combined VE and stroke risk (HR 1.332, 95% CI 1.134 to 1.565 and HR 1.584, 95% CI 1.246 to 2.014, respectively). HTN was significantly associated with combined VE and stroke risk (HR 3.244, 95% CI 2.946 to 3.572 and HR 4.543, 95% CI 3.918 to 5.268, respectively). T2DM combined with HTN was significantly associated with combined VE and stroke risk (HR 3.002, 95% CI 2.577 to 3.497 and HR 4.151, 95% CI 3.346 to 5.149, respectively). HTN was associated with a higher combined VE and stroke risk than T2DM (HR 2.435, 95% CI 2.113 to 2.805 and HR 2.868, 95% CI 2.341 to 3.513, respectively). CONCLUSION T2DM and HTN were strongly associated with combined VE and stroke risk; however, the HTN-only group had a higher combined VE and stroke risk than the T2DM-only group.
Collapse
Affiliation(s)
- Yan Liu
- Department of Endocrinology, The Third People's Hospital of Datong, Datong, China
| | - Jie Li
- Department of Endocrinology, The Third People's Hospital of Datong, Datong, China
| | - Ying Dou
- Department of Medicine, Ashermed Pharmaceutical Technology Co Ltd, Shanghai, China
| | - Hongshan Ma
- Department of Cardiology, The Third People's Hospital of Datong, Datong, China
| |
Collapse
|
5
|
Charoensri S, Kritmetapak K, Tangpattanasiri T, Pongchaiyakul C. The Impact of New-Onset Diabetes Mellitus and Hypertension on All-Cause Mortality in an Apparently Healthy Population: A Ten-Year Follow-Up Study. J Diabetes Res 2021; 2021:3964013. [PMID: 34778463 PMCID: PMC8589482 DOI: 10.1155/2021/3964013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 10/19/2021] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION The comparative effect of new-onset diabetes mellitus (DM) and hypertension (HT) on long-term mortality is a matter of debate. MATERIALS AND METHODS From 2007 to 2017, a 10-year longitudinal retrospective cohort study was conducted in Thailand's tertiary care setting. As baseline data, health check-up data from apparently healthy participants without underlying disease from 2007 were extracted. The vital status of all participants was determined in 2017, ten years after an initial examination. The impact of new-onset DM and HT at baseline on 10-year all-cause mortality was investigated using multivariable logistic regression analysis. RESULTS The prevalence of new-onset DM and HT was 6.4% and 28.8%, respectively, at baseline. Newly diagnosed diabetes increased the risk of all-cause mortality over 10 years (adjusted OR 4.77 and 95% CI 2.23-9.99). HT, on the other hand, did not increase the risk of death (adjusted OR 1.24 and 95% CI 0.65-2.35). Different HT and DM status combinations were compared to a nondiabetic, nonhypertensive reference. Individuals who were diabetic and hypertensive had a greater risk of death (adjusted OR 6.22 and 95% CI 2.22-17.00). Having DM without HT also increased the risk of death (adjusted OR 4.36 and 95% CI 1.35-12.87). However, having HT without DM did not result in a significant increase in 10-year mortality risk (adjusted OR 1.21 and 95% CI 0.57-2.56). CONCLUSION In an apparently healthy population, new-onset DM is more strongly associated with 10-year all-cause mortality than new-onset HT. Having both DM and HT was associated with a greater risk of death when compared to having DM or HT alone.
Collapse
Affiliation(s)
- Suranut Charoensri
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Kittrawee Kritmetapak
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | | | - Chatlert Pongchaiyakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| |
Collapse
|
6
|
Ferdinand AO, Akinlotan MA, Callaghan T, Towne SD, Bolin JN. Factors affecting the likelihood of a hospitalization following a diabetes-related emergency department visit: A regional and urban-rural analysis. J Diabetes 2020; 12:686-696. [PMID: 32436371 DOI: 10.1111/1753-0407.13066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/08/2020] [Accepted: 05/12/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The objective of this study is to examine place-based and individual-level predictors of diabetes-related hospitalizations that stem from emergency department (ED) visits. METHODS We conducted a pooled cross-sectional analysis of the National Inpatient Sample (NIS) for 2009 to 2014 to identify ED-initiated hospitalizations that were driven by the need for diabetes care. The odds of an ED-initiated diabetes-related hospitalization were assessed for the United States as a whole and separately for each census region. RESULTS Nationally, residents of noncore areas (odds ratio [OR] 1.10; CI 1.08, 1.12), the South (OR 8.03; CI 6.84, 9.42), Blacks (OR 2.49; CI 2.47, 2.52), Hispanics (OR 2.32; CI 2.29, 2.35), Asians or Pacific Islanders (OR 1.20; CI 1.16, 1.23), Native Americans (OR 2.18; CI 2.10, 2.27), and the uninsured (OR 2.14; CI 2.11, 2.27) were significantly more likely to experience an ED-initiated hospitalization for diabetes care. Census region-stratified models showed that noncore residents of the South (OR 1.17; CI 1.14, 1.20) and Midwest (OR 1.06; CI 1.02, 1.11) had higher odds of a diabetes-related ED-initiated hospitalization. CONCLUSIONS As continued efforts are made to reduce place-based disparities in diabetes care and management, targeted focus should be placed on residents of noncore areas in the South and Midwest, racial and ethnic minorities, as well as the uninsured population.
Collapse
Affiliation(s)
- Alva O Ferdinand
- Department of Health Policy & Management, Texas A&M University, School of Public Health, College Station, Texas, USA
- Southwest Rural Health Research Center, Texas A&M University, School of Public Health, College Station, Texas, USA
| | - Marvellous A Akinlotan
- Department of Health Policy & Management, Texas A&M University, School of Public Health, College Station, Texas, USA
- Southwest Rural Health Research Center, Texas A&M University, School of Public Health, College Station, Texas, USA
- College of Nursing, Texas A&M University, Bryan, Texas, USA
| | - Timothy Callaghan
- Department of Health Policy & Management, Texas A&M University, School of Public Health, College Station, Texas, USA
- Southwest Rural Health Research Center, Texas A&M University, School of Public Health, College Station, Texas, USA
| | - Samuel D Towne
- Southwest Rural Health Research Center, Texas A&M University, School of Public Health, College Station, Texas, USA
- Department of Health Management & Informatics, University of Central Florida, Orlando, Florida, USA
- Disability, Aging, & Technology Faculty Cluster Initiative, University of Central Florida, Orlando, Florida, USA
| | - Jane N Bolin
- Department of Health Policy & Management, Texas A&M University, School of Public Health, College Station, Texas, USA
- Southwest Rural Health Research Center, Texas A&M University, School of Public Health, College Station, Texas, USA
- College of Nursing, Texas A&M University, Bryan, Texas, USA
| |
Collapse
|
7
|
Deaths from total and premature cardiovascular disease associated with high normal blood pressure and hypertension in rural Chinese men and elderly people. J Hum Hypertens 2020; 35:741-750. [PMID: 32690863 DOI: 10.1038/s41371-020-0379-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 06/24/2020] [Accepted: 07/07/2020] [Indexed: 11/12/2022]
Abstract
To investigate the association of blood pressure (BP) categories with total and premature cardiovascular disease (CVD) mortality in rural Chinese. The study included 14,539 adults ≥18 years in rural China. Baseline study visits were conducted in 2007-2008, and follow-up visits in 2013-2014. Data were collected by face-to-face questionnaire interview, and anthropometric and laboratory measurements. A sub-distribution hazards model was used to calculate adjusted sub-distribution hazard ratios (aSHRs) and 95% confidence intervals (CIs). During the 6-year follow-up, 257 total and 209 premature CVD deaths occurred. As compared with normal BP (systolic BP/diastolic BP (SBP/DBP) < 120/80 mmHg), for men and people aged ≥60 years, hypertension (SBP/DBP ≥ 140/90 mmHg) associated with total CVD mortality (aSHR 3.57, 95% CI 2.06-6.17; aSHR 2.15, 1.29-3.56) and premature CVD mortality (aSHR 4.41, 2.37-8.21; aSHR 2.31, 1.27-4.19). Also, as compared with normal BP, for men and people aged ≥60 years with high normal BP (SBP/DBP 120-139/80-89 mmHg), risk of total CVD mortality increased (aSHR 1.85, 1.05-3.28; aSHR 1.78, 1.05-3.04), as was premature CVD mortality (aSHR 1.89, 0.99-3.64; aSHR 1.91, 1.03-3.54). Among men and people aged ≥60 years in rural China, risk of total and premature CVD mortality was increased for those with high normal BP and hypertension. Prevention and treatment strategies for additional CVD risk reduction targeting men and elderly people with hypertension or even high normal BP are needed to reduce CVD mortality risk.
Collapse
|
8
|
Ramezankhani A, Blaha MJ, Mirbolouk MH, Azizi F, Hadaegh F. Multi-state analysis of hypertension and mortality: application of semi-Markov model in a longitudinal cohort study. BMC Cardiovasc Disord 2020; 20:321. [PMID: 32631245 PMCID: PMC7336626 DOI: 10.1186/s12872-020-01599-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 06/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background Most previous research has studied the association of hypertension with cardiovascular disease (CVD) and all-cause mortality by focusing on the transition from the initial state to a single outcome. We investigated the impact of hypertension, defined according to the 2017 American College of Cardiology/American Heart Association (ACC/AHA) (new) and the Seventh Report of the Joint National Committee (JNC7) (old), on CVD death and all-cause mortality considering non-fatal CVD as an intermediate event between two CVD-free and mortality states. Methods A total of 3002 Iranian population (47.4% men), aged ≥50 years were followed from 1999 to 2014. Two multi-state semi-Markov models with three transitions were defined for CVD death and all-cause mortality as two outcomes. The multivariable Cox model was used to estimate the effect of hypertension on transition hazards. The mean of 15-year life expectancy of participants in each transition was estimated using the restricted mean survival time. Results The ACC/AHA guideline increased the prevalence of hypertension from 43.3 to 68.6%. Among CVD-free individuals, hypertension was significantly associated with increased risk of non-fatal CVD [Hazard Ratio, 1.52 (1.28–1.81) and 1.48 (1.21–1.80)], CVD death [2.96 (2.06–4.25) and 1.98 (1.30–3.04)] and all-cause mortality [1.64 (1.32–2.05) and 1.31 (1.01–1.69)] according the old and new guidelines, respectively. However, after incident non-fatal CVD, the association between hypertension and mortality events was not significant according to both definitions. Hypertensive participants experienced a first non-fatal CVD about 0.9 and 0.6 years earlier than normotensive population according to JNC7 and the 2017 ACC/AHA guidelines, respectively. Conclusion Hypertension, according to JNC7 and the ACC/AHA guidelines, significantly increased the risk of mortality events among CVD-free population although the risk was attenuated using ACC/AHA guideline. Hypertension also decreased the number of years lived without CVD and early onset of CVD, and consequently, an increase in the time spent with these diseases. After non-fatal CVD, hypertension had no significant impact on mortality risk according to both guidelines.
Collapse
Affiliation(s)
- Azra Ramezankhani
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Michael J Blaha
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Mohammad Hassan Mirbolouk
- Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, USA
| | - Fereidoun Azizi
- Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
9
|
Sun Y, Ni W, Yuan X, Chi H, Xu J. Prevalence, treatment, control of type 2 diabetes and the risk factors among elderly people in Shenzhen: results from the urban Chinese population. BMC Public Health 2020; 20:998. [PMID: 32586375 PMCID: PMC7318517 DOI: 10.1186/s12889-020-09045-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 06/03/2020] [Indexed: 11/10/2022] Open
Abstract
Background Type 2 diabetes is regarded as one of the major public health problems worldwide. We aim to investigate the prevalence, treatment, and control rate in the Chinese urban population aged 65 years or older and also identified associated risk factors. Methods One hundred twenty-four thousand seven participants aged 65 years old and older were recruited from January 2018 through December 2018 at local community health service centers in Shenzhen. Fasting plasma glucose, as well as other biochemical indicators, were measured by standard methods. The analysis of multivariate logistic regression was applied to assess associated risk factors of type 2 diabetes. Results Approximately 22.5% of elderly urban Chinese residents had diabetes. Among people with diabetes, 54.8% received medical treatment. Only 34.4% of those who were treated had their glycemic controlled. The prevalence of T2D increased with increasing age before 80 years old, male, inadequate active physical activity, drinking, previous history of CVD, higher BMI, central obesity, and hypertension. Conclusions Our findings suggested that attention should be paid to the prevention and control of T2D in Chinese urban elderly population. The health policy department should develop effective strategies aimed at improving health care management of T2D in elderly adults.
Collapse
Affiliation(s)
- Yuanying Sun
- Department of Health Management, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Rd, Shenzhen, Guangdong, 518020, PR China
| | - Wenqing Ni
- Department of Health Management, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Rd, Shenzhen, Guangdong, 518020, PR China
| | - Xueli Yuan
- Department of Health Management, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Rd, Shenzhen, Guangdong, 518020, PR China
| | - Hongshan Chi
- Department of Health Management, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Rd, Shenzhen, Guangdong, 518020, PR China
| | - Jian Xu
- Department of Health Management, Shenzhen Center for Chronic Disease Control, No.2021, Buxin Rd, Shenzhen, Guangdong, 518020, PR China.
| |
Collapse
|
10
|
Qiu S, Du Z, Li W, Chen J, Wu H, Liu J, Cai M, Wang B, Guo H, Sun Z. Exploration and Validation of the Performance of Hemoglobin A1c in Detecting Diabetes in Community-Dwellers With Hypertension. Ann Lab Med 2020; 40:457-465. [PMID: 32539301 PMCID: PMC7295957 DOI: 10.3343/alm.2020.40.6.457] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Revised: 02/27/2020] [Accepted: 05/27/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Diabetes can complicate hypertension management by increasing the risk of cardiovascular disease (CVD) and all-cause mortality. Studies targeting diabetes detection in hypertensive individuals demonstrating an increased risk of diabetes are lacking. We aimed to assess the performance of hemoglobin A1c (HbA1c) and its cut-off point in detecting diabetes in the abovementioned population. METHODS Data from 4,096 community-dwellers with hypertension but without known diabetes were obtained from the Study on Evaluation of iNnovated Screening tools and determInation of optimal diagnostic cut-off points for type 2 diaBetes in Chinese muLti-Ethnic (SENSIBLE) study; these data were randomly split into exploration (70% of the sample) and internal validation (the remaining 30%) datasets. The optimal HbA1c cut-off point was derived from the exploration dataset and externally validated using another dataset from 2,431 hypertensive individuals. The oral glucose tolerance test was considered the gold-standard for confirming diabetes. RESULTS The areas under the ROC curves for HbA1c to detect diabetes were 0.842, 0.832, and 0.829 for the exploration, internal validation, and external validation datasets, respectively. An optimal HbA1c cut-off point of 5.8% (40 mmol/mol) yielded a sensitivity of 76.2% and a specificity of 74.5%. Individuals who were not diagnosed as having diabetes by HbA1c at 5.8% (40 mmol/mol) had a lower 10-year CVD risk score than those diagnosed as having diabetes (P=0.01). HbA1c≤5.1% (32 mmol/mol) and ≥6.4% (46 mmol/mol) could indicate the absence and presence of diabetes, respectively. CONCLUSIONS HbA1c could detect diabetes effectively in community-dwellers with hypertension.
Collapse
Affiliation(s)
- Shanhu Qiu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Ziwei Du
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Wei Li
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Juan Chen
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Hang Wu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Jingbao Liu
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Min Cai
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| | - Bei Wang
- School of Public Health, Southeast University, Nanjing, China
| | - Haijian Guo
- Department of Integrated Services, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
| | - Zilin Sun
- Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, China
| |
Collapse
|
11
|
Gray CA, Sims OT, Oh H. Prevalence and Predictors of Co-occurring Hypertension and Depression Among Community-Dwelling Older Adults. J Racial Ethn Health Disparities 2020; 7:365-373. [DOI: 10.1007/s40615-019-00665-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 10/21/2019] [Accepted: 10/28/2019] [Indexed: 11/25/2022]
|
12
|
Paranjpe R, Johnson ML, Essien EJ, Barner JC, Serna O, Gallardo E, Majd Z, Fleming ML, Ordonez N, Holstad MM, Abughosh SM. Group-Based Trajectory Modeling to Identify Patterns of Adherence and Its Predictors Among Older Adults on Angiotensin-Converting Enzyme Inhibitors (ACEIs)/Angiotensin Receptor Blockers (ARBs). Patient Prefer Adherence 2020; 14:1935-1947. [PMID: 33116437 PMCID: PMC7568634 DOI: 10.2147/ppa.s270809] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 09/11/2020] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Commonly prescribed medications among patients with comorbid diabetes mellitus and hypertension include ARBs and ACEIs. However, these medications are associated with suboptimal adherence leading to inadequately controlled blood pressure. Unlike traditional single estimates of proportion of days covered (PDC), group-based trajectory modeling (GBTM) can graphically display the dynamic nature of adherence. The objective of this study was to evaluate adherence using GBTMs among patients prescribed ACEI/ARBs and identify predictors associated with each adherence trajectory. PATIENTS AND METHODS Patients with an ACEI/ARBs prescription were identified between July 2017 and December 2017 using a Medicare Advantage dataset. PDC was used to measure monthly patient adherence during the one-year follow-up period. The monthly PDC was added to a logistic group-based trajectory model to provide distinct patterns of adherence. Further, a multinomial logistic regression was conducted to determine predictors of each identified adherence trajectory. Predictors included various socio-demographic and clinical patient characteristics. RESULTS A total of 22,774 patients were included in the analysis and categorized into 4 distinct adherence trajectories: rapid decline (12.6%); adherent (58.5%); gaps in adherence (12.2%), and gradual decline (16.6%). Significant predictors associated with all lower adherence trajectories included 90 days refill, >2 number of other medications, ≥1 hospitalizations, and prevalent users. Significant predictors associated with the rapid decline trajectory included male sex, comorbidities, and increased CMS risk score. Further, significant predictors associated with the gaps in adherence trajectory included increasing age, and comorbidities. Lastly, significant predictors associated with the gradual decline trajectory included increasing age, no health plan subsidy, comorbidities, and increasing CMS risk score. CONCLUSION Identifying various patient characteristics associated with non-adherent trajectories can guide the development of tailored interventions to enhance adherence to ACEI/ARBs.
Collapse
Affiliation(s)
- Rutugandha Paranjpe
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Michael L Johnson
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Ekere J Essien
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Jamie C Barner
- Health Outcomes Division, The University of Texas at Austin, Austin, TX, USA
| | | | | | - Zahra Majd
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Marc L Fleming
- Department of Pharmacotherapy, University of North Texas Health Science Center, Fort Worth, TX, USA
| | - Nancy Ordonez
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
| | - Marcia M Holstad
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
| | - Susan M Abughosh
- Pharmaceutical Health Outcomes and Policy, University of Houston, Houston, TX, USA
- Correspondence: Susan M Abughosh Department of Pharmaceutical Health Outcomes and Policy, University of Houston, College of Pharmacy, 4849 Calhoun Road, Houston, TX77204-5047, USATel +1 832-842-8395Fax +1 832-842-8383 Email
| |
Collapse
|
13
|
Blood pressure level associated with lowest cardiovascular event in hypertensive diabetic patients. J Hypertens 2019; 36:2434-2443. [PMID: 30015754 DOI: 10.1097/hjh.0000000000001842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND The ACCORD BP trial failed to show the benefit of strict blood pressure (BP) control on cardiovascular events in diabetics with high cardiovascular risk. However, this result cannot be generalized to all diabetics. We investigated whether lower mean BP in diabetic people with hypertension is associated with better prognosis. METHODS Participants from the Korea National Health Insurance Service Health Examinee Cohort who were diagnosed with diabetes and hypertension between 2003 and 2006 were included in the analysis (N = 7926). Mortality and cardiovascular events were compared among three groups according to mean SBP (<130, 130-<140, ≥140 mmHg) and mean DBP (<80, 80-<90, ≥ 90 mmHg) recorded during follow-up health examinations for up to 11 years. RESULTS Significant reductions in the risk of all-cause death, nonfatal myocardial infarction (MI), nonfatal stroke, and end-stage renal disease were observed in patients with a mean SBP of 130 mmHg to less than 140 mmHg, as compared with patients with a mean SBP of at least 140 mmHg. The additional clinical benefit of a mean SBP of less than 130 mmHg was unclear. Lower risk of all-cause death, cardiovascular mortality, and nonfatal strokes was observed in patients with a mean DBP of 80 mmHg to less than 90 mmHg. A mean DBP of less than 80 mmHg was associated with further reduction in all-cause mortality, cardiovascular mortality, ischaemic stroke, and total stroke. CONCLUSION A mean BP of less than 140/80 mmHg was associated with further reduction in the risk of all-cause mortality, cardiovascular mortality, and nonfatal cardiovascular events in diabetic hypertensive patients.
Collapse
|
14
|
Zeng X, Jia N, Liu D, Wang L, Xu Z, Zhang Y, Wang H, Zhang R, Zhou J, Pan C, Gan Y, Qiao W. A cross-sectional study of the ambulatory central artery stiffness index in patients with hypertension. Medicine (Baltimore) 2019; 98:e16053. [PMID: 31261512 PMCID: PMC6616313 DOI: 10.1097/md.0000000000016053] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The present study aimed to investigate the characteristics of the ambulatory central artery stiffness index (AcASI) and its related factors. The association between AcASI and the left ventricular mass index (LVMI), and other factors related to atherosclerosis were explored.Patients with primary hypertension were enrolled into this study. Ambulatory central artery blood pressure (CABP) and ambulatory brachial artery blood pressure (BABP) were assessed using a Mobil-O-Graph NG hemomanometer, whereas AcASI and the ambulatory arterial stiffness index (AASI) were determined. LVMI was assessed by echocardiography.A total of 136 patients with primary hypertension were enrolled from May 2011 to January 2013 in Beijing Hospital. AcASI was significantly associated with AASI (r = 0.879, P < .001). AcASI was significantly lower than AASI (0.422 ± 0.302 vs 0.482 ± 0.270; P < .001). AcASI increased with age, ambulatory brachial mean blood pressure (MBP), and fasting glucose. AcASI was significantly associated with office pulse pressure (PP), ambulatory brachial PP, ambulatory central PP, and pulse wave velocity (PWV). AcASI, but not AASI, was significantly associated with LVMI. Receiver operator characteristic analysis indicated that AcASI and AASI could may be a predictor of left ventricular hypertrophy (LVH). Multiple regression analysis indicated that AcASI, chronic kidney disease, and hypertension course were associated with LVMI, but AASI was not.AcASI, which is obtained from ambulatory CABP monitoring, could be a new marker for the evaluation of atherosclerosis. AcASI may be stronger associated with LVH than AASI.
Collapse
Affiliation(s)
| | | | | | | | | | - Yan Zhang
- Special Care Ward, Beijing Hospital, National Center of Gerontology, Beijing, China
| | | | | | | | | | | | | |
Collapse
|
15
|
Bazargan M, Smith JL, King EO. Potentially inappropriate medication use among hypertensive older African-American adults. BMC Geriatr 2018; 18:238. [PMID: 30290768 PMCID: PMC6173851 DOI: 10.1186/s12877-018-0926-9] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 09/23/2018] [Indexed: 12/30/2022] Open
Abstract
Background Inappropriate use of medications, particularly among minority older adults with co-morbidity, remains a major public health concern. The American Geriatrics Society (AGS) reports that Potentially Inappropriate Medication (PIM) continues to be prescribed for older adults, despite evidence of poor outcomes. The main objective of this study was to examine the prevalence of PIM use among underserved non-institutionalized hypertensive older African-American adults. Furthermore, this study examines potential correlations between PIM use and the number and type of chronic conditions. Methods This cross-sectional study is comprised of a convenience sample of 193 hypertensive non-institutionalized African-American adults, aged 65 years and older recruited from several senior housing units located in underserved areas of South Los Angeles. The updated 2015 AGS Beers Criteria was used to identify participants using PIMs. Results Almost one out of two participants had inappropriate medication use. While the average number of PIMs taken was 0.87 drugs, the range was from one to seven medications. Almost 23% of PIMs were due to drugs with potential drug-drug interactions. The most common PIM was the use of proton pump inhibitors (PPI) and Central Nervous System (CNS) active agents. Nearly 56% of PIMs potentially increased the risk of falls and fall-associated bone fractures. The use of PIMs was significantly higher among participants who reported a higher number of chronic conditions. Nearly 70% of participants with PIM use reported suffering from chronic pain. Conclusions The major reason for high levels of polypharmacy, PIMs, and drug interactions is that patients suffer from multiple chronic conditions. But it may not be possible or necessary to treat all chronic conditions. Therefore, the goals of care should be explicitly reviewed with the patient in order to determine which of the many chronic conditions has the greatest impact on the life goals and/or functional priorities of the patient. Those drugs that have a limited impact on the patient’s functional priorities and that may cause harmful drug-drug interactions can be reduced or eliminated, while the remaining medications can focus on the most important functional priorities of the patient.
Collapse
Affiliation(s)
- Mohsen Bazargan
- Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA. .,University of California, Los Angeles, USA.
| | - James L Smith
- Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA
| | - Ebony O King
- Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA.,University of California, Los Angeles, USA
| |
Collapse
|
16
|
Bujang MA, Tiong XT, Saperi FE, Ismail M, Mustafa FI, Abd Hamid AM. The all-cause mortality and risk factors for mortality within five years among prevalent Type 1 Diabetes Mellitus Patients. Int J Diabetes Dev Ctries 2018. [DOI: 10.1007/s13410-018-0686-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
|
17
|
Sims OT, Oh H, Noh H, Melton PA, Sheffield S, Ingram K, Sawyer P. Prevalence and predictors of co-occurring diabetes and hypertension in community-dwelling older adults. Geriatr Gerontol Int 2018; 18:1356-1360. [PMID: 30094913 DOI: 10.1111/ggi.13489] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 05/09/2018] [Accepted: 06/15/2018] [Indexed: 01/02/2023]
Abstract
AIM The objectives of the present study were to estimate the prevalence of co-occurring diabetes and hypertension among older adults, examine predictors of co-occurring diabetes and hypertension, and ascertain whether predictors varied by race. METHODS A retrospective analysis was carried out using a statewide survey of Alabama community-dwelling older adults (n = 1204). Measures of central tendency and frequency distributions were used for univariate analysis. Logistic regression was used to predict co-occurring diabetes and hypertension. RESULTS The prevalence of co-occurring diabetes and hypertension among older adults was 17%. African American race (OR 2.28, 95% CI 1.596-3.255), body mass index ≥30 (OR 2.45, 95% CI 1.732-3.463), heart disease (OR 1.93, 95% CI 1.355-2.756) and eye disease (OR 1.44, 95% CI 1.018-2.024) were associated positively with co-occurring diabetes and hypertension. CONCLUSIONS The prevalence of co-occurring diabetes and hypertension among older adults was alarmingly high. The notable difference in the likelihood of co-occurring diabetes and hypertension is representative of a racial health disparity that largely disfavors African American older adults. Findings from the present study highlight a need for identification of older adults who have and who are at risk of co-occurring diabetes and hypertension in the general population and in clinical settings, and the development and implementation of suitable interventions, particularly targeting older African American adults. Geriatr Gerontol Int 2018; 18: 1356-1360.
Collapse
Affiliation(s)
- Omar T Sims
- Department of Social Work, College of Arts and Sciences, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Comprehensive Center for Healthy Aging, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.,Center for AIDS Research, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Hyejung Oh
- Department of Social Work, School of Social Sciences & Education, California State University Bakersfield, Bakersfield, California, USA
| | - Hyunjin Noh
- School of Social Work, University of Alabama, Tuscaloosa, Alabama, USA
| | - Pamela A Melton
- Department of Social Work, Psychology and Counseling, College of Education, Humanities, and Behavioral Sciences, Alabama A&M University, Normal, Alabama, USA
| | - Samantha Sheffield
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Kacey Ingram
- Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Patricia Sawyer
- Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA
| |
Collapse
|
18
|
Lee SE, Han K, Kang YM, Kim SO, Cho YK, Ko KS, Park JY, Lee KU, Koh EH. Trends in the prevalence of metabolic syndrome and its components in South Korea: Findings from the Korean National Health Insurance Service Database (2009-2013). PLoS One 2018; 13:e0194490. [PMID: 29566051 PMCID: PMC5864027 DOI: 10.1371/journal.pone.0194490] [Citation(s) in RCA: 74] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 03/05/2018] [Indexed: 12/15/2022] Open
Abstract
Background The prevalence of metabolic syndrome has markedly increased worldwide. However, studies in the United States show that it has remained stable or slightly declined in recent years. Whether this applies to other countries is presently unclear. Objectives We examined the trends in the prevalence of metabolic syndrome and its components in Korea. Methods The prevalence of metabolic syndrome and its components was estimated in adults aged >30 years from the Korean National Health Insurance Service data from 2009 to 2013. The revised National Cholesterol Education Program criteria were used to define metabolic syndrome. Results Approximately 10 million individuals were analyzed annually. The age-adjusted prevalence of metabolic syndrome increased from 28.84% to 30.52%, and the increasing trend was more prominent in men. Prevalence of hypertriglyceridemia, low HDL-cholesterol, and impaired fasting plasma glucose significantly increased. However, the prevalence of hypertension decreased in both genders. The prevalence of abdominal obesity decreased in women over 50 years-of-age but significantly increased in young women and men (<50 years). Conclusions The prevalence of metabolic syndrome is still increasing in Korea. Trends in each component of metabolic syndrome are disparate according to the gender, or age groups. Notably, abdominal obesity among young adults increased significantly; thus, interventional strategies should be implemented particularly for this age group.
Collapse
Affiliation(s)
- Seung Eun Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, The Catholic University of Korea, Seoul, Korea
| | - Yu Mi Kang
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seon-Ok Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yun Kyung Cho
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Kyung Soo Ko
- Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Joong-Yeol Park
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Ki-Up Lee
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Eun Hee Koh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- * E-mail:
| | | |
Collapse
|
19
|
Impact Of Hypertension versus Diabetes on Cardiovascular and All-cause Mortality in Iranian Older Adults: Results of 14 Years of Follow-up. Sci Rep 2017; 7:14220. [PMID: 29079827 PMCID: PMC5660198 DOI: 10.1038/s41598-017-14631-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Accepted: 10/12/2017] [Indexed: 12/25/2022] Open
Abstract
To evaluate the joint effect of hypertension (HTN) and diabetes (DM) on coronary heart disease (CHD), and stroke event, all-cause, and cardiovascular disease (CVD) mortality in Middle Eastern older adults, 2747 people (1436 women) aged ≥ 50 years, free of CVD at baseline, were categorized into four groups (HTN−/DM−, HTN+/DM−, HTN−/DM+, HTN+/DM+). Multivariate Cox proportional hazard models were run for different outcomes. To compare the impact of HTN versus DM, HTN+/DM− was considered as reference. In a median of 13.9 years, incidence rate of CHD, and stroke event, all-cause and CVD mortality in total population were 19.0, 4.7, 13.5, and 6.4 per 1000 person-years, respectively. The multivariate sex-adjusted hazard ratios (HRs) of HTN−/DM+ for CHD, stroke, all-cause mortality and CVD mortality were 1.19 (confidence interval (CI): 0.9–1.57), 1.07 (CI: 0.63–1.82), 1.62 (CI: 1.2–2.18), and 1.28 (CI: 0.83–1.97); the corresponding HRs for HTN+/DM+ were 1.96 (CI: 1.57–2.46), 1.66 (CI: 1.1–2.52), 2.32 (CI: 1.8–2.98), and 2.6 (CI: 1.85–3.65) respectively. The associations between HTN/DM status with stroke incidence and all-cause mortality were stronger among men than in women (P for interaction <0.05). Compared to HTN+/DM−, HTN−/DM+ increases all-cause mortality by 62%, however, they are not considerably different regarding CHD, stroke incidence and CVD mortality.
Collapse
|
20
|
Different combinations of glucose tolerance and blood pressure status and incident cardiovascular disease and all-cause mortality events. J Hum Hypertens 2017; 31:744-749. [PMID: 28748918 DOI: 10.1038/jhh.2017.49] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2017] [Revised: 05/07/2017] [Accepted: 06/02/2017] [Indexed: 12/29/2022]
Abstract
The purpose of this study was to evaluate the effect of combinations of blood pressure and glucose tolerance status on cardiovascular and all-cause mortality. A total of 7619 participants aged ⩾30 years old were stratified to nine categories as follows: (1) normotension (NTN) and normal glucose tolerance (NGT) (reference group), (2) NTN and pre-diabetes mellitus (pre-DM), (3) NTN and DM, (4) pre-hypertension (pre-HTN) and NGT, (5) pre-HTN and pre-DM, (6) pre-HTN and DM, (7) HTN and NGT, (8) HTN and pre-DM and (9) HTN and DM. Cox proportional hazards were applied to calculate the multivariate hazard ratios (HRs) of different groups for outcomes. For all-cause mortality outcomes, prevalent cardiovascular disease (CVD) was also adjusted. In a median follow-up of 11.3 years, 696 CVD and 412 all-cause mortality events occurred. Among the population free from CVD at baseline (n=7249), presence of HTN was associated with increased risk of CVD, regardless of glucose tolerance status with HRs of 1.97 (95% confidence interval (CI), 1.49-2.61), 2.25 (1.68-3.02) and 3.16 (2.28-4.37) for phenotypes of HTN and NGT, HTN and pre-DM and HTN and DM for CVD, respectively; corresponding HRs for all-cause mortality were 1.65 (95% CI, 1.15-2.37), 1.69 (1.15-2.49) and 2.73 (1.80-4.14), respectively. Phenotypes of NTN and pre-DM (1.48; 1.03-2.14) and NTN and DM (2.04; 1.06-3.92) were also associated with CVD and all-cause mortality, respectively. HTN was significantly associated with CVD/mortality events, regardless of glucose tolerance status. Blood pressure <120/80 mm Hg among pre-diabetic/diabetic population, not on antihypertensive medications, was generally associated with worse outcomes.
Collapse
|