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Maldonado A, Laroche HH, Sewell DK, Afifi R, Hoffman RM, Baquero B, Gilbert PA. The Association Between State Characteristics and Latinx People's Treated Hypertension in Established and New Latinx Destination States: A Multilevel Analysis. FAMILY & COMMUNITY HEALTH 2024; 47:151-166. [PMID: 38372332 DOI: 10.1097/fch.0000000000000393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/20/2024]
Abstract
This study sought to quantify the contributions of state-level factors including income inequality, state's legislature political control, and Medicaid expansion in new and established Latinx destination states on Latinx individuals' treated hypertension. Mixed-effects logistic regression analyses were conducted to analyze 2017 Behavioral Risk Factor Surveillance System data from 7524 Latinx adults nested within 39 states. Overall, 70% reported being pharmacologically treated for hypertension, and 66% resided in established destination states. Compared with Latinx people in established destination states, Latinx people in new destinations had lower odds of having treated hypertension (odds ratio [OR] = 0.72, 95% CI = 0.54-0.95). Within established Latinx destinations, the odds of treated hypertension were lower in states where legislatures expanded Medicaid than in states that did not expand Medicaid (OR = 0.84, 95% CI = 0.79-0.89). However, after controlling for the effects of individual-level factors, this association was no longer statistically significant. In new Latinx destination states, Medicaid expansion, legislatures' political control, and income inequality were not associated with treated hypertension. The study results highlight the importance of considering both individual- and state-level factors, as the interplay of such factors could hinder the successful implementation of cardiovascular risk reduction interventions.
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Affiliation(s)
- Adriana Maldonado
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson (Dr Maldonado); Department of Pediatrics, Children's Mercy Kansas City and University of Missouri-Kansas City, Kansas City (Dr Laroche); Departments of Biostatistics (Dr Sewell) and Community and Behavioral Health (Drs Afifi and Gilbert), College of Public Health, University of Iowa, Iowa City; Department of Internal Medicine, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City (Dr Hoffman); and School of Public Health, Health Systems and Population Health, University of Washington, Seattle (Dr Baquero)
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Dehghani A. Development and Validation of the Companion's Satisfaction Questionnaire of Patient's Hospitalized in Intensive Care Units. INVESTIGACION Y EDUCACION EN ENFERMERIA 2024; 42:e09. [PMID: 39083821 PMCID: PMC11290899 DOI: 10.17533/udea.iee.v42n1e09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Accepted: 01/01/2024] [Indexed: 08/02/2024]
Abstract
Objective The current study aimed to develop and validate of companions' satisfaction questionnaire of patients hospitalized in ICUs. Methods This is a methodological study that was performed in three phases: In the first phase, the concept of companion's satisfaction of patients hospitalized in ICUs was defined through qualitative content analysis method. In the second phase, early items of questionnaire were generated based on findings of the first phase. In the third and final phase, validation of the questionnaire was evaluated using face, content and construct validity as well as reliability. Results In exploratory factor analysis, three subscales including: satisfaction with nursing staff communication (5 items), satisfaction with nursing care (12 items), and satisfaction with decision making (5 items) were extracted by Eigen value above one and factor load above 0.5. Internal consistency and stability of the developed questionnaire confirmed with 0.94 and 0.95 respectively that indicated acceptable reliability. Conclusion The 22-item developed questionnaire is valid and reliable for measurement of levels of companion's satisfaction of Iranian patients hospitalized in ICUs.
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Affiliation(s)
- Ali Dehghani
- Associate professor, Department of Community Health Nursing, School of Nursing, Jahrom University of Medical Sciences, Jahrom, Iran.
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Wakabayashi I. Alcohol Consumption and Cerebral Small- and Large-Vessel Diseases: A Mendelian Randomization Analysis. J Atheroscler Thromb 2024; 31:119-121. [PMID: 38008464 PMCID: PMC10857842 DOI: 10.5551/jat.ed249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 10/05/2023] [Indexed: 11/28/2023] Open
Affiliation(s)
- Ichiro Wakabayashi
- Department of Environmental and Preventive Medicine, School of Medicine, Hyogo Medical University, Hyogo, Japan
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Trius-Soler M, Martínez-Carrasco P, Tresserra-Rimbau A, Moreno JJ, Estruch R, Lamuela-Raventós RM. Effect of moderate beer consumption (with and without ethanol) on cardiovascular health in postmenopausal women. JOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE 2023; 103:7506-7516. [PMID: 37402233 DOI: 10.1002/jsfa.12826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 06/16/2023] [Accepted: 07/04/2023] [Indexed: 07/06/2023]
Abstract
BACKGROUND The main aim of this 2-year non-randomized parallel controlled clinical pilot trial was to evaluate the long-term effect of a moderate daily intake of beer (with and without alcohol) on cardiovascular health in postmenopausal women. A total of 34 participants were grouped into three study arms: 16 were administered alcoholic beer, 6 consumed non-alcoholic beer, and 12 were in the control group. Changes in glucose metabolism, lipid profile, liver enzymes, anthropometric measurements, body composition, and blood pressure variables were monitored. Data on medical history, diet, and exercise were collected, and gustatory capacities were determined. RESULTS Moderate consumption of beer, both alcoholic and non-alcoholic, seemed to have positive effects on biochemical indicators of cardiovascular health in postmenopausal women, with 660 mL day-1 of non-alcoholic beer reducing low-density lipoprotein cholesterol blood levels, and 330 mL day-1 of alcoholic beer increasing high-density lipoprotein cholesterol. The evolution of changes in android and gynoid fat percentage and their ratio differed significantly between study groups, which was attributable to either the interventions or the disparity between groups regarding the time elapsed since menopause onset. Iso-α-acids recognition threshold could be involved in intervention group election, whereas the sensory phenotypes studied were not associated with alcohol drinking frequency. CONCLUSIONS Moderate beer consumption was found to improve the lipid profile of postmenopausal women, although their effects in preventing cardiometabolic alterations deserve further research (trial registration number: ISRCTN13825020; https://doi.org/10.1186/ISRCTN13825020). © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.
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Affiliation(s)
- Marta Trius-Soler
- Department of Nutrition, Food Sciences and Gastronomy, XIA, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Santa Coloma de Gramanet, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Pamela Martínez-Carrasco
- Department of Nutrition, Food Sciences and Gastronomy, XIA, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
| | - Anna Tresserra-Rimbau
- Department of Nutrition, Food Sciences and Gastronomy, XIA, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Santa Coloma de Gramanet, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Juan J Moreno
- Department of Nutrition, Food Sciences and Gastronomy, XIA, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Santa Coloma de Gramanet, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
| | - Ramon Estruch
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
- Department of Internal Medicine, Hospital Clinic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Rosa M Lamuela-Raventós
- Department of Nutrition, Food Sciences and Gastronomy, XIA, School of Pharmacy and Food Sciences, University of Barcelona, Barcelona, Spain
- INSA-UB, Nutrition and Food Safety Research Institute, University of Barcelona, Santa Coloma de Gramanet, Spain
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain
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Park S, Shin J, Ihm SH, Kim KI, Kim HL, Kim HC, Lee EM, Lee JH, Ahn SY, Cho EJ, Kim JH, Kang HT, Lee HY, Lee S, Kim W, Park JM. Resistant hypertension: consensus document from the Korean society of hypertension. Clin Hypertens 2023; 29:30. [PMID: 37908019 PMCID: PMC10619268 DOI: 10.1186/s40885-023-00255-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/09/2023] [Indexed: 11/02/2023] Open
Abstract
Although reports vary, the prevalence of true resistant hypertension and apparent treatment-resistant hypertension (aTRH) has been reported to be 10.3% and 14.7%, respectively. As there is a rapid increase in the prevalence of obesity, chronic kidney disease, and diabetes mellitus, factors that are associated with resistant hypertension, the prevalence of resistant hypertension is expected to rise as well. Frequently, patients with aTRH have pseudoresistant hypertension [aTRH due to white-coat uncontrolled hypertension (WUCH), drug underdosing, poor adherence, and inaccurate office blood pressure (BP) measurements]. As the prevalence of WUCH is high among patients with aTRH, the use of out-of-office BP measurements, both ambulatory blood pressure monitoring (ABPM) and home blood pressure monitoring (HBPM), is essential to exclude WUCH. Non-adherence is especially problematic, and methods to assess adherence remain limited and often not clinically feasible. Therefore, the use of HBPM and higher utilization of single-pill fixed-dose combination treatments should be emphasized to improve drug adherence. In addition, primary aldosteronism and symptomatic obstructive sleep apnea are quite common in patients with hypertension and more so in patients with resistant hypertension. Screening for these diseases is essential, as the treatment of these secondary causes may help control BP in patients who are otherwise difficult to treat. Finally, a proper drug regimen combined with lifestyle modifications is essential to control BP in these patients.
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Affiliation(s)
- Sungha Park
- Division of Cardiology, Severance Cardiovascular Hospital, Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, South Korea
| | - Sang Hyun Ihm
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Republic of Korea.
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital327 Sosa-Ro, Wonmi-guGyunggi-do, Bucheon-si, 14647, Republic of Korea.
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Eun Mi Lee
- Division of Cardiology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University College of Medicine, Gunpo, Republic of Korea
| | - Jang Hoon Lee
- Department of Internal Medicine, Kyungpook National University Hospital, Daegu, South Korea
- School of Medicine, Kyungpook National University, Daegu, South Korea
| | - Shin Young Ahn
- Division of Nephrology, Department of Internal Medicine, Korea University Guro Hospital, Seoul, South Korea
| | - Eun Joo Cho
- Division of Cardiology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
| | - Ju Han Kim
- Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea
| | - Hee-Taik Kang
- Department of Family Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Sunki Lee
- Hallym University, Dongtan Hospital, Gyeonggi-do, Korea
| | - Woohyeun Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Seoul Hospital, Seoul, Korea
| | - Jong-Moo Park
- Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University, Uijeongbu, South Korea
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Martin FZ, Fraser A, Zuccolo L. Alcohol Intake and Hypertensive Disorders of Pregnancy: A Negative Control Analysis in the ALSPAC Cohort. J Am Heart Assoc 2022; 11:e025102. [PMID: 36172928 DOI: 10.1161/jaha.121.025102] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Alcohol intake increases blood pressure yet estimates of associations between maternal intake and hypertensive disorders of pregnancy (HDP) are sparse and range from null to a protective effect. Here we estimated the association of maternal drinking during pregnancy with preeclampsia and gestational hypertension (separately and jointly, as HDP). We used partner's alcohol intake as a negative control exposure, beverage type-specific models, and a range of sensitivity analyses to strengthen causal inference and reduce the influence of bias. Methods and Results We performed a longitudinal analysis of prospectively collected data on self-reported alcohol intake and presence of HDP from the UK ALSPAC (Avon Longitudinal Study of Parents and Children) cohort. Multivariable multinomial regression models were adjusted for confounders and mutually adjusted for partner's or maternal alcohol intake in the negative control analysis. We also performed a beverage type analysis of the effect of beer and wine separately on HDP risk, owing to different social patterning associated with different drinks. Sensitivity analyses assessed the robustness of results to assumptions of no recall bias, no residual confounding, and no selection bias. Of the 8999 women eligible for inclusion, 1490 fulfilled the criteria for HDP (17%). Both maternal and partner's drinking were associated with decreased HDP odds (mutually adjusted odds ratio [OR], 0.86; [95% CI, 0.77-0.96], P=0.008 and OR, 0.82; [95% CI, 0.70-0.97], P=0.018, respectively). We demonstrate the validity of the negative control analyses using the same approach for smoking as the exposure. This confirmed an inverse association for maternal but not partner's smoking, as expected. Estimates were more extreme for increasing levels of wine intake compared with increasing levels of beer. Multiple sensitivity analyses did not alter our conclusions. Conclusions We observed an inverse relationship between alcohol intake during pregnancy and risk of HDP for both maternal and, more surprisingly, partner's drinking. We speculate that this is more likely to be due to common environmental exposures shared between pregnant women and their partners rather than a true causal effect. This warrants further investigation using different study designs, including Mendelian randomization.
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Affiliation(s)
- Florence Z Martin
- MRC Integrative Epidemiology Unit (IEU) University of Bristol United Kingdom
| | - Abigail Fraser
- MRC Integrative Epidemiology Unit (IEU) University of Bristol United Kingdom.,Department of Population Health Sciences, Bristol Medical School University of Bristol United Kingdom.,NIHR Biomedical Research Centre, Bristol Medical School University of Bristol United Kingdom
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit (IEU) University of Bristol United Kingdom.,Department of Population Health Sciences, Bristol Medical School University of Bristol United Kingdom
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Muhammad T, Paul R, Rashmi R, Srivastava S. Examining sex disparity in the association of waist circumference, waist-hip ratio and BMI with hypertension among older adults in India. Sci Rep 2022; 12:13117. [PMID: 35907951 PMCID: PMC9338983 DOI: 10.1038/s41598-022-17518-z] [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: 01/16/2022] [Accepted: 07/26/2022] [Indexed: 11/12/2022] Open
Abstract
Hypertension is a public health issue touted as a “silent killer” worldwide. The present study aimed to explore the sex differential in the association of anthropometric measures including body mass index, waist circumference, and waist-hip ratio with hypertension among older adults in India. The study used data from the Longitudinal Aging Study in India (LASI) conducted during 2017–18. The sample contains 15,098 males and 16,366 females aged 60 years and above. Descriptive statistics (percentages) along with bivariate analysis were presented. Multivariable binary logistic regression analyses were used to examine the associations between the outcome variable (hypertension) and putative risk or protective factors. About 33.9% of males and 38.2% of females aged 60 years and above suffered from hypertension. After adjusting for the socioeconomic, demographic and health-behavioral factors, the odds of hypertension were 1.37 times (CI: 1.27–1.47), significantly higher among older adults who were obese or overweight than those with no overweight/obese condition. Older adults with high-risk waist circumference and waist-hip ratio had 1.16 times (CI: 1.08–1.25) and 1.42 times (CI: 1.32–1.51) higher odds of suffering from hypertension, respectively compared to their counterparts with no high-risk waist circumference or waist-hip ratio. The interaction effects showed that older females with overweight/obesity [OR: 0.84; CI: 0.61–0.74], high-risk waist circumference [OR: 0.89; CI: 0.78–0.99], and high-risk waist-hip ratio [OR: 0.90; CI: 0.83–0.97] had a lower chance of suffering from hypertension than their male counterparts with the similar anthropometric status. The findings suggested a larger magnitude of the association between obesity, high-risk waist circumference, high-risk waist-hip ratio and prevalent hypertension among older males than females. The study also highlights the importance of measuring obesity and central adiposity in older individuals and using such measures as screening tools for timely identification of hypertension.
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Affiliation(s)
- T Muhammad
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Ronak Paul
- International Institute for Population Sciences, Mumbai, 400088, India
| | - Rashmi Rashmi
- International Institute for Population Sciences, Mumbai, 400088, India
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Cinelli C, LaPierre N, Hill BL, Sankararaman S, Eskin E. Robust Mendelian randomization in the presence of residual population stratification, batch effects and horizontal pleiotropy. Nat Commun 2022; 13:1093. [PMID: 35232963 DOI: 10.1101/2020.10.21.347773] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/14/2022] [Indexed: 05/25/2023] Open
Abstract
Mendelian Randomization (MR) studies are threatened by population stratification, batch effects, and horizontal pleiotropy. Although a variety of methods have been proposed to mitigate those problems, residual biases may still remain, leading to highly statistically significant false positives in large databases. Here we describe a suite of sensitivity analysis tools that enables investigators to quantify the robustness of their findings against such validity threats. Specifically, we propose the routine reporting of sensitivity statistics that reveal the minimal strength of violations necessary to explain away the MR results. We further provide intuitive displays of the robustness of the MR estimate to any degree of violation, and formal bounds on the worst-case bias caused by violations multiple times stronger than observed variables. We demonstrate how these tools can aid researchers in distinguishing robust from fragile findings by examining the effect of body mass index on diastolic blood pressure and Townsend deprivation index.
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Affiliation(s)
- Carlos Cinelli
- Department of Statistics, University of Washington, Seattle, WA, USA.
| | - Nathan LaPierre
- Department of Computer Science, University of California, Los Angeles, CA, USA
| | - Brian L Hill
- Department of Computer Science, University of California, Los Angeles, CA, USA
| | - Sriram Sankararaman
- Department of Computer Science, University of California, Los Angeles, CA, USA
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Department of Computational Medicine, University of California, Los Angeles, CA, USA
| | - Eleazar Eskin
- Department of Computer Science, University of California, Los Angeles, CA, USA
- Department of Human Genetics, University of California, Los Angeles, CA, USA
- Department of Computational Medicine, University of California, Los Angeles, CA, USA
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9
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Robust Mendelian randomization in the presence of residual population stratification, batch effects and horizontal pleiotropy. Nat Commun 2022; 13:1093. [PMID: 35232963 PMCID: PMC8888767 DOI: 10.1038/s41467-022-28553-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 01/14/2022] [Indexed: 01/07/2023] Open
Abstract
Mendelian Randomization (MR) studies are threatened by population stratification, batch effects, and horizontal pleiotropy. Although a variety of methods have been proposed to mitigate those problems, residual biases may still remain, leading to highly statistically significant false positives in large databases. Here we describe a suite of sensitivity analysis tools that enables investigators to quantify the robustness of their findings against such validity threats. Specifically, we propose the routine reporting of sensitivity statistics that reveal the minimal strength of violations necessary to explain away the MR results. We further provide intuitive displays of the robustness of the MR estimate to any degree of violation, and formal bounds on the worst-case bias caused by violations multiple times stronger than observed variables. We demonstrate how these tools can aid researchers in distinguishing robust from fragile findings by examining the effect of body mass index on diastolic blood pressure and Townsend deprivation index.
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10
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Munezero T, Tomita A. Hypertension and Its Associated Mental Health Challenges Among Female African Refugees in Durban, South Africa. J Nerv Ment Dis 2021; 209:802-808. [PMID: 34310523 DOI: 10.1097/nmd.0000000000001387] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT Hypertension is a serious medical condition that leads to various adverse health complications when left untreated. In addition to psychological challenge that female migrant refugees are exposed to premigration, they encounter barriers to care postmigration from xenophobia that affects their hypertension. We investigated the extent and mental health drivers of hypertension in refugees in Durban, South Africa. We interviewed 178 adult female African help-seeking refugees/migrants for hypertension (blood pressure ≥130/90 mm Hg) and mental health challenges (e.g., adverse childhood experience [ACE] and depression using the Center for Epidemiologic Studies-Depression scale). Eighty-six percent (n = 153) of participants were hypertensive, and based on the adjusted regression models, exposure to at least one ACE (adjusted odds ratio [aOR], 2.83; 95% confidence interval [CI], 1.11-7.26) and depression (aOR, 3.54; 95% CI, 1.10-11.37) were associated with hypertension, independent of smoking, alcohol, obesity, and physical exercise status. Hypertension and its associated mental health challenges are overlooked conditions in this population, with further efforts for screening being needed.
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Fairbairn CE, Bosch N. A new generation of transdermal alcohol biosensing technology: practical applications, machine -learning analytics and questions for future research. Addiction 2021; 116:2912-2920. [PMID: 33908674 PMCID: PMC8429066 DOI: 10.1111/add.15523] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/18/2021] [Accepted: 04/14/2021] [Indexed: 11/29/2022]
Abstract
The use of transdermal alcohol monitors has burgeoned in recent years, now encompassing hundreds of thousands of individuals globally. A new generation of sensors promises to expand the range of applications for transdermal technology exponentially, and advances in machine-learning modeling approaches offer new methods for translating the data produced by transdermal devices. This article provides (1) a review of transdermal sensor research conducted to date, including an analysis of methodological features of past studies potentially key in driving reported sensor performance; (2) updates on methodological developments likely to be transformative for the field of transdermal sensing, including the development of new-generation sensors featuring smartphone integration and rapid sampling capabilities as well as developments in machine-learning analytics suited to data produced by these novel sensors and; (3) an analysis of the expanded range of applications for this new generation of sensor, together with corresponding requirements for sensor accuracy and temporal specificity. We also note questions as yet unanswered and key directions for future research.
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Affiliation(s)
| | - Nigel Bosch
- School of Information Sciences and Department of Educational Psychology University of Illinois Urbana‐Champaign IL USA
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Abstract
Introduction: Despite the improved treatment protocol of hypertension, the magnitude of the disease and its related burden remains raised. Hypertension makes up the leading cause of stroke, kidney disease, arterial disease, eye disease, and cardiovascular disease (CVD) growth. Areas covered: This review provides the overview of the role of dietary salt and alcohol use reduction in the management of hypertension, a brief history of alcohol, the vascular endothelium functions, the effects of alcohol use on blood pressure (BP), the mechanisms of alcohol, brief history of salt, the effects of dietary salt intake on BP, and the mechanisms of salt. Expert opinion: Studies found that high dietary salt intake and heavy alcohol consumption have a major and huge impact on BP while both of them have been identified to increase BP. Also, they raise the risk of hypertension-related morbidity and mortality in advance. On the other way, the dietary salt and alcohol use reduction in the management of hypertension are significant in the control of BP and its related morbidity and mortality. Further, studies suggested that the dietary salt and alcohol use reductions are the cornerstone in the management of hypertension due to their significance as part of comprehensive lifestyle modifications.
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Affiliation(s)
- Addisu Dabi Wake
- Nursing Department, College of Health Sciences, Arsi University , Asella, Ethiopia
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Acin MT, Rueda JR, Saiz LC, Parent Mathias V, Alzueta N, Solà I, Garjón J, Erviti J. Alcohol intake reduction for controlling hypertension. Cochrane Database Syst Rev 2020; 9:CD010022. [PMID: 32960976 PMCID: PMC8094445 DOI: 10.1002/14651858.cd010022.pub2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND High blood pressure constitutes one of the leading causes of mortality and morbidity all over the world. At the same time, heavy drinking increases the risk for developing cardiovascular diseases, including cardiomyopathy, hypertension, atrial arrhythmias, or stroke. Several studies have already assessed specifically the relationship between alcohol intake and hypertension. However, the potential effect on blood pressure of alcohol intake reduction interventions is largely unknown. OBJECTIVES To assess the effect of any intervention to reduce alcohol intake in terms of blood pressure decrease in hypertensive people with alcohol consumption compared to a control intervention or no intervention at all. To determine additional effects related to mortality, major cardiovascular events, serious adverse events, or quality of life. SEARCH METHODS The Cochrane Hypertension Information Specialist searched the following databases for randomised controlled trials up to June 2020: the Cochrane Hypertension Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (Issue 5, 2020), MEDLINE Ovid (from 1946), MEDLINE Ovid Epub Ahead of Print, and MEDLINE Ovid In-Process, Embase Ovid (from 1974), ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform. Trial authors were contacted when needed and no language restrictions were applied. SELECTION CRITERIA We included randomised controlled trials with minimum 12 weeks duration and including 50 or more subjects per group with quantitative measurement of alcohol consumption and/or biological measurement of the outcomes of interest. Participants were adults (16 years of age or older) with systolic blood pressure (SBP) greater than 140 mmHg and diastolic blood pressure (DBP) greater than 90 mmHg, and SBP ≥ 130 or DBP ≥ 80 mmHg in participants with diabetes. We included any intervention implemented to reduce their alcohol intake. DATA COLLECTION AND ANALYSIS Two review authors independently assessed search results and extracted data using standard methodological procedures adopted by Cochrane. MAIN RESULTS A total of 1210 studies were screened. We included one randomised controlled trial involving a total of 269 participants with a two-year follow-up. Individual patient data for all participants were provided and used in this review. No differences were found between the cognitive-behavioural intervention group and the control group for overall mortality (RR 0.72, 95% CI 0.16 to 3.17; low-certainty evidence), cardiovascular mortality (not estimable) and cardiovascular events (RR 0.80, 95% CI 0.36 to 1.79; very low-certainty evidence). There was no statistical difference in systolic blood pressure (SBP) reduction (Mean Difference (MD) -0.92 mmHg, 95% confidence interval (CI) -5.66 to 3.82 mmHg; very low-certainty evidence) or diastolic blood pressure (DBP) decrease (MD 0.98 mmHg, 95% CI -1.69 to 3.65 mmHg; low-certainty evidence) between the cognitive-behavioural intervention group and the control group. We also did not find any differences in the proportion of subjects with SBP < 140 mmHg and DBP < 90 mmHg (Risk Ratio (RR) 1.21, 95% CI 0.88 to 1.65; very low-certainty evidence). Concerning secondary outcomes, the alcohol intake was significantly reduced in the cognitive-behavioural intervention compared with the control group (MD 191.33 g, 95% CI 85.36 to 297.30 g). We found no differences between the active and control intervention in the proportion of subjects with lower-risk alcohol intake versus higher-risk and extreme drinkers at the end of the study (RR 1.04, 95% CI 0.68 to 1.60). There were no estimable results for the quality of life outcome. AUTHORS' CONCLUSIONS An intervention for decreasing alcohol intake consumption did not result in differences in systolic and diastolic blood pressure when compared with a control intervention, although there was a reduction in alcohol intake favouring the active intervention. No differences were found either for overall mortality, cardiovascular mortality or cardiovascular events. No data on serious adverse events or quality of life were available to assess. Adequate randomised controlled trials are needed to provide additional evidence on this specific question.
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Affiliation(s)
| | - José-Ramón Rueda
- Department of Preventive Medicine and Public Health, University of the Basque Country, Leioa, Spain
| | - Luis Carlos Saiz
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
| | | | - Natalia Alzueta
- Drug Prescribing Service, Navarre Health Service, Pamplona, Spain
| | - Ivan Solà
- Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Javier Garjón
- Medicines Advice and Information Service, Navarre Health Service, Pamplona, Spain
| | - Juan Erviti
- Unit of Innovation and Organization, Navarre Health Service, Pamplona, Spain
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Kim DH, Son BK, Min KW, Han SK, Na JU, Choi PC, Kim HL, Kwon MJ, Oh YH, Jung WY, Moon JY, Hong S, Oh KW, Kim YS. Chronic Gastritis Is Associated with a Decreased High-Density Lipid Level: Histological Features of Gastritis Based on the Updated Sydney System. J Clin Med 2020; 9:jcm9061856. [PMID: 32545889 PMCID: PMC7355915 DOI: 10.3390/jcm9061856] [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: 04/10/2020] [Revised: 05/20/2020] [Accepted: 06/07/2020] [Indexed: 12/14/2022] Open
Abstract
Chronic gastritis could activate a systemic inflammatory response that could result in adverse lipid profiles. To determine the severity of chronic gastritis, Helicobacter pylori (HP), mononuclear cell (lymphocytes and plasma cells), and neutrophil scores were assessed on the basis of the updated Sydney system (USS), which is widely used for histological grading. The aim of this study was to assess the relationships between gastric histological features and lipid profile levels. This study included 15,322 males and 5929 females who underwent a health checkup and gastric biopsy at the Kangbuk Samsung Medical Center (KBSMC). We analyzed whether the HP, mononuclear cell, and neutrophil grades according to the USS were related to serum leukocyte count, unhealthy behaviors, and lipid profile levels. Gastritis with HP, neutrophils, or moderate to severe mononuclear cells was associated with an elevated serum leukocyte count. A high leukocyte count was related to increased low-density lipoproteins (LDL) and triglycerides/very-low-density lipoprotein (VLDL) and decreased high-density lipoproteins (HDL). In multivariate analyses, chronic gastritis with HP or moderate to severe mononuclear cells was significantly associated with decreased HDL in males, while mononuclear cells were significantly related to decreased HDL in females. Chronic gastritis was associated with an increased systemic inflammatory response, which was associated with unfavorable lipid profiles, especially low HDL levels.
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Affiliation(s)
- Dong-Hoon Kim
- Departments of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea;
| | - Byoung Kwan Son
- Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul 01830, Korea;
| | - Kyueng-Whan Min
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Gyeonggi-do 11923, Korea; (Y.H.O.); (W.Y.J.)
- Correspondence: (K.-W.M.); (S.K.H.); Tel.: +82-31-560-2496 (K.-W.M); +82-02-2001-2591 (S.K.H.); Fax: +82-31-560-2339 (K.-W.M.); +82-02-2220-2891 (S.K.H.)
| | - Sang Kuk Han
- Departments of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (J.U.N.); (P.C.C.)
- Correspondence: (K.-W.M.); (S.K.H.); Tel.: +82-31-560-2496 (K.-W.M); +82-02-2001-2591 (S.K.H.); Fax: +82-31-560-2339 (K.-W.M.); +82-02-2220-2891 (S.K.H.)
| | - Ji Ung Na
- Departments of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (J.U.N.); (P.C.C.)
| | - Pil Cho Choi
- Departments of Emergency Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul 03181, Korea; (J.U.N.); (P.C.C.)
| | - Hack-Lyoung Kim
- Division of Cardiology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Boramae Medical Center, Seoul 07061, Korea;
| | - Mi Jung Kwon
- Department of Pathology, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang-si, Gyeonggi-do 14068, Korea;
| | - Young Ha Oh
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Gyeonggi-do 11923, Korea; (Y.H.O.); (W.Y.J.)
| | - Woon Yong Jung
- Department of Pathology, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Gyeonggi-do 11923, Korea; (Y.H.O.); (W.Y.J.)
| | - Ji-Yong Moon
- Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Gyeonggi-do 11923, Korea;
| | - Sangmo Hong
- Division of Endocrinology, Department of Internal Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri-si, Gyeonggi-do 11923, Korea;
| | - Ki-Wook Oh
- Department of Neurology, Hanyang University College of Medicine, Seoul 04763, Korea; (K.-W.O.); (Y.S.K.)
| | - Young Seo Kim
- Department of Neurology, Hanyang University College of Medicine, Seoul 04763, Korea; (K.-W.O.); (Y.S.K.)
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15
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Zhao F, Liu Q, Li Y, Feng X, Chang H, Lyu J. Association between alcohol consumption and hypertension in Chinese adults: Findings from the CHNS. Alcohol 2020; 83:83-88. [PMID: 31525410 DOI: 10.1016/j.alcohol.2019.09.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 09/06/2019] [Accepted: 09/09/2019] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To obtain information about alcohol consumption (henceforth "drinking") among Chinese adults from 1991 to 2011, and to explore the association between drinking behavior and hypertension. METHODS According to the longitudinal data obtained in the China Health and Nutrition Survey (1991-2011), 50,013 records of 12,577 adults were selected by applying eligibility criteria. The chi-test was employed to explore the association between drinking and hypertension, by considering the frequency of drinking, daily alcohol intake, alcohol type, and the prevalence of hypertension. A multilevel logistic regression model was used to analyze the longitudinal association between drinking frequency and the prevalence of hypertension. RESULTS The prevalence of hypertension was higher in participants with a high drinking frequency than in those with a low drinking frequency among both males and females (p < 0.001). A step increase in daily alcohol intake was not associated with any obvious changes in the prevalence of hypertension in males, but the prevalence in each drinking group was higher than that in the nondrinking group, the prevalence of hypertension in females was lowest among those with a daily alcohol intake below 15 g. The types of alcohol consumed differed significantly between males and females (p < 0.001). Longitudinal analysis results showed that compared with the nondrinking group, drinking frequency ≤2 times/week was positively correlated with hypertension in both males (OR = 1.51, 95% CI = 1.26-1.82, p < 0.001) and females (OR = 1.67, 95% CI = 1.08-2.58, p < 0.05) after adjusting for covariates, meanwhile, the same positive correlation also occurred in males with drinking frequency >2 times/week (OR = 2.13, 95% CI = 1.77-2.56, p < 0.05), the risk of hypertension increased with the increase in drinking frequency. CONCLUSIONS Drinking can increase the prevalence of hypertension in Chinese males and females. From the analysis results of longitudinal data, drinking alcohol is still an important risk factor for hypertension among Chinese subjects, especially those who drink with high frequency.
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Affiliation(s)
- Fanfan Zhao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Qingqing Liu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Yuanjie Li
- Department of Human Anatomy, Histology and Embryology, School of Basic Medical Sciences, Xi'an Jiaotong University Science Center, Xi'an, Shaanxi, China
| | - Xiaojie Feng
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Hong Chang
- Department of Teaching Office, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Jun Lyu
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.
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16
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Chevli PA, Aladin AI, Kanaya AM, Kandula NR, Malaver D, Herrington DM. Alcohol consumption and subclinical atherosclerosis among South Asians: Findings from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study. Nutr Metab Cardiovasc Dis 2020; 30:123-131. [PMID: 31753783 PMCID: PMC6934907 DOI: 10.1016/j.numecd.2019.07.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/05/2019] [Accepted: 07/23/2019] [Indexed: 11/18/2022]
Abstract
BACKGROUND South Asians are the second fastest growing ethnic group in the United States, and they have a high risk for cardiovascular disease (CVD). Moderate alcohol consumption has been associated with lower CVD risk in some race/ethnic groups, but the association of alcohol consumption and atherosclerosis in South Asians has not been investigated. METHODS AND RESULTS We used data from 906 South Asian participants who participated in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort (2010-2012). Alcohol consumption was ascertained via questionnaire, coronary artery calcium (CAC) was measured with computed tomography, and common carotid artery intima-media thickness (cIMT) was measured using B-mode ultrasonography. We used multivariable regression models to examine cross-sectional associations of alcohol consumption with the presence and amount of CAC and cIMT. Compared with never drinkers, participants consuming 4-7 drinks/week had a 63% decreased odds of any CAC after adjusting for potential confounders and mediators. Participants consuming 4-7 drinks/week had significantly lower odds of CAC score between 1 and 300 [OR (95% CI): 0.34 (0.16-0.72)]. A similar inverse association was seen for the odds of CAC>300 [OR (95% CI): 0.28 (0.07-0.97)]. Alcohol consumption of >7 drinks/week was associated with a 0.096 mm increase in common-cIMT. CONCLUSION There was an inverse association between the amount of alcohol intake and CAC among South Asians while a positive association was found between alcohol consumption and common-cIMT. Long-term follow-up of the MASALA cohort will examine prospective associations of alcohol intake with the progression of subclinical atherosclerosis, incident CVD events, and mortality.
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Affiliation(s)
- Parag A Chevli
- Department of Internal Medicine, Section on Hospital Medicine, Wake Forest School of Medicine, United States.
| | - Amer I Aladin
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, United States
| | - Alka M Kanaya
- Department of Medicine, University of California San Francisco, United States
| | - Namratha R Kandula
- Department of Medicine, Northwestern University Feinberg School of Medicine, United States
| | - Diego Malaver
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, United States
| | - David M Herrington
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, United States
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17
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Lee D, Lahiri SN, Sinha S. A test of homogeneity of distributions when observations are subject to measurement errors. Biometrics 2019; 76:821-833. [PMID: 31860740 DOI: 10.1111/biom.13207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 08/21/2019] [Accepted: 12/04/2019] [Indexed: 11/30/2022]
Abstract
When the observed data are contaminated with errors, the standard two-sample testing approaches that ignore measurement errors may produce misleading results, including a higher type-I error rate than the nominal level. To tackle this inconsistency, a nonparametric test is proposed for testing equality of two distributions when the observed contaminated data follow the classical additive measurement error model. The proposed test takes into account the presence of errors in the observed data, and the test statistic is defined in terms of the (deconvoluted) characteristic functions of the latent variables. Proposed method is applicable to a wide range of scenarios as no parametric restrictions are imposed either on the distribution of the underlying latent variables or on the distribution of the measurement errors. Asymptotic null distribution of the test statistic is derived, which is given by an integral of a squared Gaussian process with a complicated covariance structure. For data-based calibration of the test, a new nonparametric Bootstrap method is developed under the two-sample measurement error framework and its validity is established. Finite sample performance of the proposed test is investigated through simulation studies, and the results show superior performance of the proposed method than the standard tests that exhibit inconsistent behavior. Finally, the proposed method was applied to real data sets from the National Health and Nutrition Examination Survey. An R package MEtest is available through CRAN.
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Affiliation(s)
- DongHyuk Lee
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - Soumendra N Lahiri
- Department of Statistics, North Carolina State University, Raleigh, North Carolina
| | - Samiran Sinha
- Department of Statistics, Texas A&M University, College Station, Texas
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18
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Pauli S, Bairros FSD, Nunes LN, Neutzling MB. Prevalência autorreferida de hipertensão e fatores associados em comunidades quilombolas do Rio Grande do Sul, Brasil. CIENCIA & SAUDE COLETIVA 2019; 24:3293-3303. [DOI: 10.1590/1413-81232018249.28002017] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 02/02/2018] [Indexed: 11/21/2022] Open
Abstract
Resumo Este estudo teve como objetivo identificar a prevalência e fatores associados à hipertensão arterial (HA) em adultos quilombolas do Rio Grande do Sul (RS). Trata-se de um estudo transversal de base populacional, realizado em 2011, com 589 adultos responsáveis por domicílios e amostragem proporcional ao tamanho. O desfecho foi obtido com a pergunta: “Algum médico já lhe disse que você tem hipertensão?”. Foi empregada regressão de Poisson, com variância robusta e entrada hierarquizada das variáveis. Por fim, foram calculadas as frações atribuíveis populacionais por componente (FAPC) para fatores modificáveis associados à HA. A prevalência autorreferida de HA foi de 38,3% (IC95% 31,4%-45,1%). A análise ajustada revelou associação do desfecho com faixa etária, escolaridade, consumo excessivo de álcool, circunferência da cintura acima do adequado e presença de diabetes. A análise dos FAPC revelou que, se os indivíduos tivessem maior escolaridade, a prevalência de HA seria reduzida. Diante da elevada prevalência de HA e da extrema vulnerabilidade social dessa população, políticas públicas que garantam seu acesso a direitos fundamentais (saúde, renda e escolaridade) poderiam ter impacto importante na diminuição desse desfecho.
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Affiliation(s)
- Sílvia Pauli
- Universidade Federal do Rio Grande do Sul, Brasil
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19
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Aung T, Hughes SM, Hone LSE, Puts DA. Operational Sex Ratio Predicts Binge Drinking Across U.S. Counties. EVOLUTIONARY PSYCHOLOGY 2019; 17:1474704919874680. [PMID: 31564134 PMCID: PMC8211380 DOI: 10.1177/1474704919874680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 07/31/2019] [Indexed: 12/25/2022] Open
Abstract
Previous research suggests that binge drinking among young men serves as a "costly signal" to potential mates, such that the binge drinker is capable of bearing the harmful consequences of alcohol consumption. Here, we propose that binge drinking among young adults is conditionally dependent upon the signaler's willingness to take risks, which is influenced by the local operational sex ratio (OSR). Using archived binge drinking estimates from 2009 to 2012 and Census Bureau records of OSRs, we tested the relationship between OSR and binge drinking rates at the county level across 3,143 U.S. counties against hypotheses drawn from evolutionary theory. Results from our mixed-effects models revealed that a higher overall OSR (i.e., more eligible men compared to women) was associated with higher male binge drinking rates but lower female binge drinking rates. A higher OSR particularly in the 20-29 and 50+ age groups predicted higher male binge drinking rates but lower female binge drinking rates. Our findings generally support predictions derived from evolutionary theory and suggest that binge drinking may function as a costly sexual signal, conditionally regulated by age and the local sex ratio.
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Affiliation(s)
- Toe Aung
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
| | - Susan M. Hughes
- Department of Psychology, Albright College, Reading, PA, USA
| | - Liana S. E. Hone
- Research Institute on Addictions, University at Buffalo, Buffalo, NY, USA
| | - David A. Puts
- Department of Anthropology, Pennsylvania State University, University Park, PA, USA
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20
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Sloof N, Hendershot E, Griffin M, Anderson L, Marjerrison S. The Impact of Physical Activity on the Health of Young Adult Survivors of Childhood Cancer: An Exploratory Analysis. J Adolesc Young Adult Oncol 2019; 8:602-609. [PMID: 31120346 DOI: 10.1089/jayao.2019.0001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Purpose: Physical activity (PA) habits of young adult survivors of childhood cancer (SCC) have not been well-characterized, and it is unclear whether PA has a relationship with the health status of young adult SCC. The objective of this study was to determine PA participation of young adult SCC and examine associations between PA participation and late adverse effects of treatment. Methods: A retrospective chart review, including SCC enrolled in the McMaster AfterCare program, was performed. Patient characteristics, health outcomes, and PA information were abstracted. Multivariable logistic regression models were used to examine associations in this exploratory analysis. Results: We identified 253 young adult SCC, 240 of whom had sufficient information on PA participation to determine a Leisure Score Index (LSI). Of these, 45% reported adequate PA (LSI ≥24) and 26% reported no PA (LSI = 0). Significant associations between PA and bone mineral density (p = 0.03), blood pressure (p = 0.04), triglycerides (p = 0.05), and high-density lipoprotein cholesterol (p < 0.01) were demonstrated. Conclusions: The majority of young adult SCC in this cohort reported inadequate PA, despite ongoing healthy active living counseling. We identified associations between PA and bone mineral density as well as lipid profile in this group, which suggest that PA may mitigate risk of sequelae of cancer treatment. Strategies to improve young adult SCC engagement in PA are required.
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Affiliation(s)
- Natalie Sloof
- Department of Kinesiology, McMaster University, Hamilton, ON, Canada.,Schulich School of Medicine & Dentistry, London, ON, Canada
| | - Eleanor Hendershot
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada.,Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Toronto, ON, Canada
| | - Meridith Griffin
- Department of Health, Aging, & Society, McMaster University, Hamilton, ON, Canada
| | - Loretta Anderson
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada
| | - Stacey Marjerrison
- Pediatric Hematology/Oncology, McMaster Children's Hospital, Hamilton, ON, Canada.,Division of Hematology/Oncology, Department of Pediatrics, McMaster University, Hamilton, ON, Canada
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21
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Kimani S, Mirie W, Chege M, Okube OT, Muniu S. Association of lifestyle modification and pharmacological adherence on blood pressure control among patients with hypertension at Kenyatta National Hospital, Kenya: a cross-sectional study. BMJ Open 2019; 9:e023995. [PMID: 30782721 PMCID: PMC6340423 DOI: 10.1136/bmjopen-2018-023995] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVE Association of lifestyle modification and pharmacological adherence among patients with hypertension attending a national referral hospital in Kenya. DESIGN Descriptive, cross-sectional. SETTING Medical wards and outpatient clinic of a national referral hospital. PARTICIPANTS Patients (n=229) diagnosed with primary hypertension for at least 6 months. PRIMARY OUTCOMES Clinical makers, cholesterol levels, anthropometrics, lifestyle/dietary habits adjusted for age, gender and education; antihypertensive adherence; views on prevention of hypertension and adequacy of hypertension information. RESULTS Ageing was associated with elevated diastolic blood pressure (BP) (p<0.05), heart rate (HR) and cholesterol. Females had higher body mass index (BMI). More males reported drinking alcohol and smoking (p<0.001), especially the highly educated. Higher BPs were observed in smokers and drinkers (p<0.05). Daily vegetables and fruits intake were linked to lower BP, HR and BMI (p<0.05). Intake of foods high in saturated fat and cholesterol were associated with raised HR (p<0.05). Respondents on antihypertensive medication, those engaged in healthy lifestyle and took their prescribed medications had lower mean BPs than those on medication only (138/85 vs 140/90). Few respondents (30.8%) considered hypertension as preventable, mainly the single and highly educated (p<0.05). Respondents (53.6%) believed they should stop taking their antihypertensive medication once hypertension is controlled. CONCLUSION Missed targets for BP control and hypertension-related risks are associated with ageing, female gender, fast food and animal fat intake. Alcohol and smoking is common in males associated with poor BP control. Daily vegetables and fruits intake are associated with better BP control and overall hypertension risk reduction. Observed suboptimal BP control despite pharmacological adherence suggests lifestyle modification is needed besides antihypertensive medication. Interventions should address modifiable risk factors aggravated by age and adverse lifestyles through adopting combined lifestyle modification, pharmacological adherence and tailored expert delivered hypertension-related information.
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Affiliation(s)
- Samuel Kimani
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Waithira Mirie
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
| | - Margaret Chege
- School of Nursing Sciences, University of Nairobi, Nairobi, Kenya
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22
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Lin WY, Huang CC, Liu YL, Tsai SJ, Kuo PH. Genome-Wide Gene-Environment Interaction Analysis Using Set-Based Association Tests. Front Genet 2019; 9:715. [PMID: 30693016 PMCID: PMC6339974 DOI: 10.3389/fgene.2018.00715] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 12/20/2018] [Indexed: 12/22/2022] Open
Abstract
The identification of gene-environment interactions (G × E) may eventually guide health-related choices and medical interventions for complex diseases. More powerful methods must be developed to identify G × E. The “adaptive combination of Bayes factors method” (ADABF) has been proposed as a powerful genome-wide polygenic approach to detect G × E. In this work, we evaluate its performance when serving as a gene-based G × E test. We compare ADABF with six tests including the “Set-Based gene-EnviRonment InterAction test” (SBERIA), “gene-environment set association test” (GESAT), etc. With extensive simulations, SBERIA and ADABF are found to be more powerful than other G × E tests. However, SBERIA suffers from a power loss when 50% SNP main effects are in the same direction with the SNP × E interaction effects while 50% are in the opposite direction. We further applied these seven G × E methods to the Taiwan Biobank data to explore gene× alcohol interactions on blood pressure levels. The ADAMTS7P1 gene at chromosome 15q25.2 was detected to interact with alcohol consumption on diastolic blood pressure (p = 9.5 × 10−7, according to the GESAT test). At this gene, the P-values provided by other six tests all reached the suggestive significance level (p < 5 × 10−5). Regarding the computation time required for a genome-wide G × E analysis, SBERIA is the fastest method, followed by ADABF. Considering the validity, power performance, robustness, and computation time, ADABF is recommended for genome-wide G × E analyses.
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Affiliation(s)
- Wan-Yu Lin
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ching-Chieh Huang
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Yu-Li Liu
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, National Yang-Ming University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.,Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
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Abstract
Background: There is a high propensity toward combined alcohol consumption and smoking. The aim of the study is to determine whether the association of alcohol consumption and the metabolic syndrome (MS) were different in among groups stratified by smoking exposure. Methods: Subjects consisted of 4,672 adult participants in the 2008 Korea National Health and Nutrition Examination Survey grouped into three categories of smoking using urinary cotinine concentration. Drinking categories were as follows: lifetime abstainers, ex-drinkers, responsible drinkers (<20 g alcohol/day for women; <40 g/day for men), and hazardous drinking (≥ 20 g/day for women; ≥ 40 g/day for men). Results: Compared with nonsmokers, heavy smokers had a higher risk of the MS (OR: 1.27, 95% CI: 1.00-1.62, p = .052). One standard deviation-higher urinary cotinine was also associated with higher risk of the MS (OR: 1.12, 95% CI: 1.03-1.23, p = .011). In nonsmokers and light/moderate smokers, alcohol had no effect on the MS. In heavy smokers, the risk of the MS was substantially higher in ex-drinkers (OR: 3.42; 95% CI: 0.99-11.82), responsible drinkers (OR: 2.80; 95% CI: 0.96-8.12), and hazardous drinkers (OR: 3.30; 95% CI: 1.21-9.03, p = .02) compared to lifetime abstainers. A profound effect modification of alcohol by smoking was found in current drinkers. Conclusions: Smoking is closely associated with the MS. Alcohol has detrimental effect on the risk of MS in heavy smokers and the effect of alcohol is enhanced by smoking.
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Affiliation(s)
- Seung Ha Park
- Department of Internal Medicine, Inje University Haeundae Paik-Hospital, Inje University College of Medicine, Busan, Korea
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24
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French and Mediterranean-style diets: Contradictions, misconceptions and scientific facts-A review. Food Res Int 2018; 116:840-858. [PMID: 30717015 DOI: 10.1016/j.foodres.2018.09.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Revised: 08/29/2018] [Accepted: 09/08/2018] [Indexed: 12/15/2022]
Abstract
The determination of appropriate dietary strategies for the prevention of chronic degenerative diseases, cancer, diabetes, and cardiovascular diseases remains a challenging and highly relevant issue worldwide. Epidemiological dietary interventions have been studied for decades with contrasting impacts on human health. Moreover, research scientists and physicians have long debated diets encouraging alcohol intake, such as the Mediterranean and French-style diets, with regard to their impact on human health. Understanding the effects of these diets may help to improve in the treatment and prevention of diseases. However, further studies are warranted to determine which individual food components, or combinations thereof, have a beneficial impact on different diseases, since a large number of different compounds may occur in a single food, and their fate in vivo is difficult to measure. Most explanations for the positive effects of Mediterranean-style diet, and of the French paradox, have focused largely on the beneficial properties of antioxidants, among other compounds/metabolites, in foods and red wine. Wine is a traditional alcoholic beverage that has been associated with both healthy and harmful effects. Not withstanding some doubts, there is reasonable unanimity among researchers as to the beneficial effects of moderate wine consumption on cardiovascular disease, diabetes, osteoporosis, and longevity, which have been ascribed to polyphenolic compounds present in wine. Despite this, conflicting findings regarding the impact of alcohol consumption on human health, and contradictory findings concerning the effects of non-alcoholic wine components such as resveratrol, have led to confusion among consumers. In addition to these contradictions and misconceptions, there is a paucity of human research studies confirming known positive effects of polyphenols in vivo. Furthermore, studies balancing both known and unknown prognostic factors have mostly been conducted in vitro or using animal models. Moreover, current studies have shifted focus from red wine to dairy products, such as cheese, to explain the French paradox. The aim of this review is to highlight the contradictions, misconceptions, and scientific facts about wines and diets, giving special focus to the Mediterranean and French diets in disease prevention and human health improvement. To answer the multiplicity of questions regarding the effects of diet and specific diet components on health, and to relieve consumer uncertainty and promote health, comprehensive cross-demographic studies using the latest technologies, which include foodomics and integrated omics approaches, are warranted.
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Malik K, Ahmad M, Bussmann RW, Tariq A, Ullah R, Alqahtani AS, Shahat AA, Rashid N, Zafar M, Sultana S, Shah SN. Ethnobotany of Anti-hypertensive Plants Used in Northern Pakistan. Front Pharmacol 2018; 9:789. [PMID: 30087613 PMCID: PMC6066661 DOI: 10.3389/fphar.2018.00789] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 06/28/2018] [Indexed: 12/12/2022] Open
Abstract
Hypertension is one of the most important factors responsible for cardiovascular ailments worldwide. It has been observed that herbal products and alternative herbal therapies played a significant role in decreasing hypertension. The aim of the current study is to provide significant ethnopharmacological information, both qualitative and quantitative on medicinal plants related to hypertension from Northern Pakistan. The documented data were quantitatively analyzed for the first time in this area. A total of 250 participants were interviewed through semi-structured discussions and questionnaires. Quantitative indices including FC (Frequency citation), FIV (Family importance value), RFC (Relative frequency of citation) and DCI (Disease Consensus index) were calculated. A total of 192 plant species, belonging to 77 families were reported to be used in treatment of hypertension in Northern Pakistan. The most dominant life form reported was herbs (54%), with decoction (72 reports) and leaves (55.1%) were commonly utilized plant part. Highest FIV was recorded in Lamiaceae (327 FIV). RFC ranged from 0.08 to 1.08% while DCI varied from 0.233 to 0.000. In this study original data was compared with thirty one previous national and international published papers from neighboring region to compare the medicinal uses and obtain some novel plant species. About 42% of the medicinal plant species were reported for the first time in treatment of hypertension in comparison to these 31 published papers. Different phytochemical activities of antihypertensive plants were also reported from literature. This research work documents the traditional knowledge of medicinal plants usage and provides baseline in designing clinical trials and pharmacological analysis for treatment of hypertension.
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Affiliation(s)
- Khafsa Malik
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Mushtaq Ahmad
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
- Center for Natural Products Lab, Chengdu Institute of Biology, Sichuan, China
| | - Rainer W. Bussmann
- Department of Ethnobotany, Institute of Botany, Ilia State University, Tbilisi, Georgia
| | - Akash Tariq
- Key Laboratory of Mountain Ecological Restoration, Bioresource Utilization and Ecological Restoration Biodiversity Conservation Key Laboratory of Sichuan Province, Chengdu Institute of Biology, Chinese Academy of Sciences, Chengdu, China
- University of Chinese Academy of Sciences, Beijing, China
| | - Riaz Ullah
- Medicinal Aromatic and Poisonous Plants Research Center, College of Pharmacy King Saud University, Riyadh, Saudi Arabia
| | - Ali S. Alqahtani
- Medicinal Aromatic and Poisonous Plants Research Center, College of Pharmacy King Saud University, Riyadh, Saudi Arabia
| | - Abdelaaty A. Shahat
- Medicinal Aromatic and Poisonous Plants Research Center, College of Pharmacy King Saud University, Riyadh, Saudi Arabia
- Phytochemistry Department, National Research Centre, Giza, Egypt
| | - Neelam Rashid
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Muhammad Zafar
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Shazia Sultana
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
- Center for Natural Products Lab, Chengdu Institute of Biology, Sichuan, China
| | - Syed N. Shah
- Department of Plant Sciences, Quaid-i-Azam University, Islamabad, Pakistan
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Alcohol and CV Health: Jekyll and Hyde J-Curves. Prog Cardiovasc Dis 2018; 61:68-75. [DOI: 10.1016/j.pcad.2018.02.001] [Citation(s) in RCA: 82] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 02/11/2018] [Indexed: 12/16/2022]
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Barclay GA, Barbour J, Stewart S, Day CP, Gilvarry E. Adverse physical effects of alcohol misuse. ACTA ACUST UNITED AC 2018. [DOI: 10.1192/apt.bp.105.001263] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This article outlines the majority of the adverse physical effects that have been described secondary to the consumption of alcohol at levels above recommended sensible limits. These conditions are cited according to the organ system they belong to. Only brief descriptions are provided because of the vastness of this topic. The underlying pathophysiology of tolerance and withdrawal is touched upon as this is of relevance to the psychiatrist. Definitions of the terms used describing alcohol misuse, and sensible upper limits of alcohol consumption are also mentioned.
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29
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Fiala J, Sochor O, Klimusová H, Homolka M. Alcohol Consumption in Population Aged 25-65 Years Living in the Metropolis of South Moravia, Czech Republic. Cent Eur J Public Health 2017; 25:191-199. [PMID: 29022677 DOI: 10.21101/cejph.a4481] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 12/02/2016] [Indexed: 11/15/2022]
Abstract
OBJECTIVE The aim of the study was to evaluate alcohol consumption in a representative sample of the population of the city of Brno, as part of research on cardiovascular risk factors. METHODS Cross-sectional survey on a sample of 2,160 randomly selected residents 35-65 years old was carried out. For the invited volunteers who became a part of the investigation, alcohol consumption was determined in a controlled, face to face interview structured in accordance with a special questionnaire form. The frequency of alcohol consumption during the previous year was determined, in more detail during the last month (including quantification using "units of alcohol", their normal and maximum level of drinking, and any association between alcohol consumption and meals), and during the last week in the form of a complete, beverage specified and quantified 7-day recall period. Typical patterns of alcohol consumption were explored by the means of cluster analysis. RESULTS During the past 12 months, 90.0% of the men and 79.0% of the women had consumed alcohol, the rest can be considered abstinent. The most commonly reported frequency was 2-4 times per week (35.6% of the men), or 1-3 times per month (22.8% of the women). Daily or almost daily consumption was reported by 24.8% of the men and 12.8% of the women. The number of units of alcohol consumed usually on one occasion amounts to an average of 3.88±4.80 for the men and 2.25±1.39 for the women, but the amount most often cited by both sexes was 2 drinks (36.4% of the men and 40.4% of the women). The largest amount consumed on any occasion during the last 30 days was 5 or more units in 69.3% of the men, and in 33.9% of the women it was 4 or more units (this amount of alcohol leads to a blood alcohol concentration (BAC) of 0.08, the border of drunkenness). In 19.9% of the men and 7.5% of the women, this border was exceeded more than 5 times in the past month. Only 14.7% of the men and 10.3% of the women reported that the majority of their alcohol consumption occurs with food; on the contrary, 64.3% of the men and 77.6% of the women drinkers drink it either always without food or only rarely with it. During the past week, 81.6% of the men and 63.4% of the women drank alcohol (p<0.001, chi-square). The average value of consumption for one man was 11.57±11.91 doses, and for one woman 4.68±6.38 doses per week (p<0.001, t-test). A total of 17.8% of the men exceeded the limit of 21 doses per week, and 7.4% of the women exceeded 14 doses/week. After converting the weekly consumption into the number of units of alcohol per week expressed in litres per year, the total average consumption was 5.01±6.36 litres; for the men 7.26±7.62 litres and for the women 3.02±4.08 litres of pure alcohol per person annually. Consumption during the week was not uniform (p<0.001, ANOVA), with the highest occurring on Saturday, followed by Friday. The men mostly drank beer (62.9% of the total volume of alcohol), the women wine (68.6%). The cluster analysis identified 5 clusters of respondents, based on a set of alcohol consumption variables, as follows: very heavy drinking (1.6% of the respondents who drink alcohol); heavy drinking (8.8%); binge drinking (6.3%); moderate drinking (31.1%); and occasional drinking (52.3%). CONCLUSIONS The results show a relatively high consumption of alcohol in the examined group. The recommended weekly limits were exceeded by only a small portion, but that consumption had a binge character. Conversion into a form allowing comparison with conventional national statistics shows a significantly lower consumption than these reported statements. Overall, men consume significantly more alcohol than women.
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Affiliation(s)
- Jindřich Fiala
- Department of Public Health, Faculty of Medicine, Masaryk University, Brno, Czech Republic.,International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Ondřej Sochor
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
| | - Helena Klimusová
- Institute of Psychology, Faculty of Arts, Masaryk University, Brno, Czech Republic
| | - Martin Homolka
- International Clinical Research Centre, St. Anne's University Hospital Brno, Brno, Czech Republic
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30
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The relationship between obesity and hypertension: an updated comprehensive overview on vicious twins. Hypertens Res 2017; 40:947-963. [DOI: 10.1038/hr.2017.75] [Citation(s) in RCA: 101] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2017] [Revised: 04/07/2017] [Accepted: 04/14/2017] [Indexed: 02/07/2023]
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Rehm J, Anderson P, Prieto JAA, Armstrong I, Aubin HJ, Bachmann M, Bastus NB, Brotons C, Burton R, Cardoso M, Colom J, Duprez D, Gmel G, Gual A, Kraus L, Kreutz R, Liira H, Manthey J, Møller L, Okruhlica Ľ, Roerecke M, Scafato E, Schulte B, Segura-Garcia L, Shield KD, Sierra C, Vyshinskiy K, Wojnar M, Zarco J. Towards new recommendations to reduce the burden of alcohol-induced hypertension in the European Union. BMC Med 2017; 15:173. [PMID: 28954635 PMCID: PMC5618725 DOI: 10.1186/s12916-017-0934-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 08/22/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Hazardous and harmful alcohol use and high blood pressure are central risk factors related to premature non-communicable disease (NCD) mortality worldwide. A reduction in the prevalence of both risk factors has been suggested as a route to reach the global NCD targets. This study aims to highlight that screening and interventions for hypertension and hazardous and harmful alcohol use in primary healthcare can contribute substantially to achieving the NCD targets. METHODS A consensus conference based on systematic reviews, meta-analyses, clinical guidelines, experimental studies, and statistical modelling which had been presented and discussed in five preparatory meetings, was undertaken. Specifically, we modelled changes in blood pressure distributions and potential lives saved for the five largest European countries if screening and appropriate intervention rates in primary healthcare settings were increased. Recommendations to handle alcohol-induced hypertension in primary healthcare settings were derived at the conference, and their degree of evidence was graded. RESULTS Screening and appropriate interventions for hazardous alcohol use and use disorders could lower blood pressure levels, but there is a lack in implementing these measures in European primary healthcare. Recommendations included (1) an increase in screening for hypertension (evidence grade: high), (2) an increase in screening and brief advice on hazardous and harmful drinking for people with newly detected hypertension by physicians, nurses, and other healthcare professionals (evidence grade: high), (3) the conduct of clinical management of less severe alcohol use disorders for incident people with hypertension in primary healthcare (evidence grade: moderate), and (4) screening for alcohol use in hypertension that is not well controlled (evidence grade: moderate). The first three measures were estimated to result in a decreased hypertension prevalence and hundreds of saved lives annually in the examined countries. CONCLUSIONS The implementation of the outlined recommendations could contribute to reducing the burden associated with hypertension and hazardous and harmful alcohol use and thus to achievement of the NCD targets. Implementation should be conducted in controlled settings with evaluation, including, but not limited to, economic evaluation.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
- Institute of Medical Science, University of Toronto, Faculty of Medicine, Medical Sciences Building, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Peter Anderson
- Substance Use, Policy and Practice, Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
- Alcohol and Health, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, Netherlands
| | | | - Iain Armstrong
- Health and Wellbeing Directorate, Public Health England, London, UK
| | - Henri-Jean Aubin
- CESP, University Paris-Sud, UVSQ, INSERM, Université Paris-Saclay, APHP, Hôpitaux Universitaires Paris-Sud, Villejuif, France
| | | | | | - Carlos Brotons
- Sardenya Primary Health Care Center, Biomedical Research Institute Sant Pau, Barcelona, Spain
| | - Robyn Burton
- Health and Wellbeing Directorate, Public Health England, London, UK
| | - Manuel Cardoso
- General Directorate for Intervention on Addictive Behaviours and Dependencies (SICAD), Lisbon, Portugal
| | - Joan Colom
- Program on Substance Abuse, Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Barcelona, Spain
| | - Daniel Duprez
- Cardiovascular Division, School of Medicine, University of Minnesota, Minneapolis, USA
| | - Gerrit Gmel
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Implant Systems Group, National ICT Australia, Eveleigh, Australia
- Faculty of Engineering, University of New South Wales, Sydney, Australia
| | - Antoni Gual
- Addictions Unit, Psychiatry Department, Neurosciences Institute, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Ludwig Kraus
- IFT Institut für Therapieforschung, Munich, Germany
- Centre for Social Research on Alcohol and Drugs (SoRAD), Stockholm University, Stockholm, Sweden
| | - Reinhold Kreutz
- Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Helena Liira
- General Practice, School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, Australia
- University of Helsinki, Department of General Practice, and Helsinki University Central Hospital, Unit of Primary Health Care, Helsinki, Finland
| | - Jakob Manthey
- Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Lars Møller
- Division of Noncommunicable Diseases through the Life Course, WHO Regional Office for Europe, Copenhagen, Denmark
| | | | - Michael Roerecke
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Canada
- Addiction Policy, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Emanuele Scafato
- National Observatory on Alcohol, National Centre on Addiction and Doping, Istituto Superiore di Sanità, Rome, Italy
- Società Italiana di Alcologia (SIA), Italian Society of Alcohology, Bologna, Italy
| | - Bernd Schulte
- Centre for Interdisciplinary Addiction Research, Hamburg University, Universitätsklinik Hamburg-Eppendorf, Hamburg, Germany
| | - Lidia Segura-Garcia
- Program on Substance Abuse, Public Health Agency of Catalonia, Department of Health, Government of Catalonia, Barcelona, Spain
| | - Kevin David Shield
- Institute for Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto, Canada
| | - Cristina Sierra
- Hypertension and Vascular Risk Unit, Internal Medicine Department, Hospital Clinic of Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Konstantin Vyshinskiy
- Research Institute on Addictions, Federal Medical Research Centre for Psychiatry and Narcology n.a. V. Serbsky, Moscow, Russia
| | - Marcin Wojnar
- Department of Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - José Zarco
- Drugs Intervention Group, semFYC, Ibiza Primary Health Care Center, Madrid, Spain
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Gaynor E, Brewer L, Mellon L, Hall P, Horgan F, Shelley E, Dolan E, Hickey A, Bennett K, Williams DJ. Interarm blood pressure difference in a post-stroke population. ACTA ACUST UNITED AC 2017; 11:565-572.e5. [DOI: 10.1016/j.jash.2017.06.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 06/02/2017] [Accepted: 06/20/2017] [Indexed: 02/01/2023]
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Physiological health parameters among college students to promote chronic disease prevention and health promotion. Prev Med Rep 2017; 7:64-73. [PMID: 28593125 PMCID: PMC5458063 DOI: 10.1016/j.pmedr.2017.05.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2017] [Accepted: 05/15/2017] [Indexed: 01/26/2023] Open
Abstract
This study aimed to provide physiologic health risk parameters by gender and age among college students enrolled in a U.S. Midwestern University to promote chronic disease prevention and ameliorate health. A total of 2615 college students between 18 and 25 years old were recruited annually using a series of cross-sectional designs during the spring semester over an 8-year period. Physiologic parameters measured included body mass index (BMI), percentage body fat (%BF), blood serum cholesterol (BSC), and systolic (SBP) and diastolic (DBP) blood pressure. These measures were compared to data from NHANES to identify differences in physiologic parameters among 18–25 year olds in the general versus college-enrolled population. A quantitative instrument assessed health behaviors related to physical activity, diet, and licit drug use. Results suggest that average physiologic parameters from 18 to 25 year olds enrolled in college were significantly different from parameters of 18–25 year olds in the general population. Generally, men reported higher percentiles for BMI, SBP, and DBP than women, but lower %BF and BSC percentiles than women at each age. SBP and DBP significantly increased with age and alcohol use. Students in the lowest (5th) and highest percentiles (95th and 75th), for most age groups, demonstrated DBP, BMI, and %BF levels potentially problematic for health and future development of chronic disease based on percentiles generated for their peer group. Newly identified physiologic parameters may be useful to practitioners serving college students 18–25 years old from similar institutions in determining whether behavior change or treatment interventions are appropriate.
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Rehm J, Gmel GE, Gmel G, Hasan OSM, Imtiaz S, Popova S, Probst C, Roerecke M, Room R, Samokhvalov AV, Shield KD, Shuper PA. The relationship between different dimensions of alcohol use and the burden of disease-an update. Addiction 2017; 112:968-1001. [PMID: 28220587 PMCID: PMC5434904 DOI: 10.1111/add.13757] [Citation(s) in RCA: 663] [Impact Index Per Article: 94.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 12/19/2016] [Accepted: 01/09/2017] [Indexed: 02/06/2023]
Abstract
BACKGROUND AND AIMS Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). METHODS Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. RESULTS In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. CONCLUSIONS Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Campbell Family Mental Health Research Institute, CAMHTorontoOntarioCanada
- Institute of Medical Science (IMS)University of TorontoTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Institute for Clinical Psychology and Psychotherapy, TU DresdenDresdenGermany
| | - Gerhard E. Gmel
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Alcohol Treatment CenterLausanne University HospitalLausanneSwitzerland
- Addiction SwitzerlandLausanneSwitzerland
- University of the West of EnglandBristolUK
| | - Gerrit Gmel
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
| | - Omer S. M. Hasan
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Institute of Medical Science (IMS)University of TorontoTorontoOntarioCanada
| | - Svetlana Popova
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Institute of Medical Science (IMS)University of TorontoTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
- Factor‐Inwentash Faculty of Social WorkUniversity of TorontoOntarioCanada
| | - Charlotte Probst
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Institute for Clinical Psychology and Psychotherapy, TU DresdenDresdenGermany
| | - Michael Roerecke
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
| | - Robin Room
- Centre for Alcohol Policy ResearchLa Trobe UniversityMelbourneVictoriaAustralia
- Centre for Social Research on Alcohol and DrugsStockholm UniversityStockholmSweden
| | - Andriy V. Samokhvalov
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Institute of Medical Science (IMS)University of TorontoTorontoOntarioCanada
- Department of PsychiatryUniversity of TorontoTorontoOntarioCanada
| | - Kevin D. Shield
- Section of Cancer SurveillanceInternational Agency for Research on CancerLyonFrance
| | - Paul A. Shuper
- Institute for Mental Health Policy Research, CAMHTorontoOntarioCanada
- Dalla Lana School of Public HealthUniversity of TorontoTorontoOntarioCanada
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Bolbrinker J, Zaidi Touis L, Gohlke H, Weisser B, Kreutz R. European guidelines on lifestyle changes for management of hypertension : Awareness and implementation of recommendations among German and European physicians. Herz 2017; 43:352-358. [PMID: 28534177 DOI: 10.1007/s00059-017-4575-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2017] [Accepted: 04/26/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND In the 2013 European Society of Hypertension (ESH) and European Society of Cardiology (ESC) guidelines for the management of arterial hypertension, six lifestyle changes for treatment are recommended for the first time with class I, level of evidence A. We initiated a survey among physicians to explore their awareness and consideration of lifestyle changes in hypertension management. METHODS The survey included questions regarding demographics as well as awareness and implementation of the recommended lifestyle changes. It was conducted at two German and two European scientific meetings in 2015. RESULTS In all, 1064 (37.4% female) physicians participated (806 at the European and 258 at the German meetings). Of the six recommended lifestyle changes, self-reported awareness was highest for regular exercise (85.8%) followed by reduction of weight (66.2%). The least frequently self-reported lifestyle changes were the advice to quit smoking (47.3%) and moderation of alcohol consumption (36.3%). Similar frequencies were observed for the lifestyle changes implemented by physicians in their care of patients. CONCLUSION A close correlation between awareness of guideline recommendations and their implementation into clinical management was observed. European physicians place a stronger emphasis on regular exercise and weight reduction than on the other recommended lifestyle changes. Moderation of alcohol consumption is the least emphasized lifestyle change.
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Affiliation(s)
- J Bolbrinker
- Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany.
| | - L Zaidi Touis
- Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
| | - H Gohlke
- , Neue Kirchstr. 22, 79282, Ballrechten-Dottingen, Germany
| | - B Weisser
- Institut für Sportwissenschaft, Arbeitsbereich Sportmedizin, Christian-Albrechts-Universität zu Kiel, Olshausenstraße 74, 24098, Kiel, Germany
| | - R Kreutz
- Institut für Klinische Pharmakologie und Toxikologie, Charité - Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany
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Rehm J, Gmel GE, Gmel G, Hasan OSM, Imtiaz S, Popova S, Probst C, Roerecke M, Room R, Samokhvalov AV, Shield KD, Shuper PA. The relationship between different dimensions of alcohol use and the burden of disease-an update. ADDICTION (ABINGDON, ENGLAND) 2017. [PMID: 28220587 DOI: 10.1111/add.13757.] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND AIMS Alcohol use is a major contributor to injuries, mortality and the burden of disease. This review updates knowledge on risk relations between dimensions of alcohol use and health outcomes to be used in global and national Comparative Risk Assessments (CRAs). METHODS Systematic review of reviews and meta-analyses on alcohol consumption and health outcomes attributable to alcohol use. For dimensions of exposure: volume of alcohol use, blood alcohol concentration and patterns of drinking, in particular heavy drinking occasions were studied. For liver cirrhosis, quality of alcohol was additionally considered. For all outcomes (mortality and/or morbidity): cause of death and disease/injury categories based on International Classification of Diseases (ICD) codes used in global CRAs; harm to others. RESULTS In total, 255 reviews and meta-analyses were identified. Alcohol use was found to be linked causally to many disease and injury categories, with more than 40 ICD-10 three-digit categories being fully attributable to alcohol. Most partially attributable disease categories showed monotonic relationships with volume of alcohol use: the more alcohol consumed, the higher the risk of disease or death. Exceptions were ischaemic diseases and diabetes, with curvilinear relationships, and with beneficial effects of light to moderate drinking in people without heavy irregular drinking occasions. Biological pathways suggest an impact of heavy drinking occasions on additional diseases; however, the lack of medical epidemiological studies measuring this dimension of alcohol use precluded an in-depth analysis. For injuries, except suicide, blood alcohol concentration was the most important dimension of alcohol use. Alcohol use caused marked harm to others, which has not yet been researched sufficiently. CONCLUSIONS Research since 2010 confirms the importance of alcohol use as a risk factor for disease and injuries; for some health outcomes, more than one dimension of use needs to be considered. Epidemiological studies should include measurement of heavy drinking occasions in line with biological knowledge.
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Affiliation(s)
- Jürgen Rehm
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Campbell Family Mental Health Research Institute, CAMH, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
| | - Gerhard E Gmel
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Alcohol Treatment Center, Lausanne University Hospital, Lausanne, Switzerland.,Addiction Switzerland, Lausanne, Switzerland.,University of the West of England, Bristol, UK
| | - Gerrit Gmel
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada
| | - Omer S M Hasan
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada
| | - Sameer Imtiaz
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada
| | - Svetlana Popova
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.,Factor-Inwentash Faculty of Social Work, University of Toronto, Ontario, Canada
| | - Charlotte Probst
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Institute for Clinical Psychology and Psychotherapy, TU Dresden, Dresden, Germany
| | - Michael Roerecke
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, Melbourne, Victoria, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, Sweden
| | - Andriy V Samokhvalov
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Institute of Medical Science (IMS), University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Kevin D Shield
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Paul A Shuper
- Institute for Mental Health Policy Research, CAMH, Toronto, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
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Watkins KE, Ober AJ, Lamp K, Lind M, Diamant A, Osilla KC, Heinzerling K, Hunter SB, Pincus HA. Implementing the Chronic Care Model for Opioid and Alcohol Use Disorders in Primary Care. Prog Community Health Partnersh 2017; 11:397-407. [PMID: 29332853 PMCID: PMC6124482 DOI: 10.1353/cpr.2017.0047] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND Effective treatments for opioid and alcohol use disorders (OAUD) are available, yet only a small percentage of those needing treatment receive it. OBJECTIVES This paper describes a collaborative planning and development process used by researchers and community providers to apply the chronic care model to the delivery of treatment for OAUD in primary care. The goal was to develop and implement an intervention that would support the delivery of brief psychotherapy and medication-assisted treatment (MAT). METHODS We used focus groups and interviews to identify barriers and facilitators, and organized the results using the chronic care model. We then identified implementation strategies, the intended organizational changes, and the materials necessary to carry out each strategy, and pilot-tested the process. RESULTS AND CONCLUSIONS We describe the methods and outcomes of the collaborative planning and development process, and discuss implications of the work for the integration of substance use treatment with primary care.
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A Community-Based Assessment of Hypertension and Some Other Cardiovascular Disease Risk Factors in Ngaoundéré, Cameroon. Int J Hypertens 2016; 2016:4754636. [PMID: 28097019 PMCID: PMC5206854 DOI: 10.1155/2016/4754636] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2016] [Accepted: 11/15/2016] [Indexed: 02/02/2023] Open
Abstract
Background and Objective. Cardiovascular diseases are primary causes of death worldwide with well documented risk factors whose varying impacts added to the complexity in CVD management dictate the need for region-specific studies. We aimed at investigating the interactions between CVD risk factors and hypertension in Ngaoundéré. Methods. A cross-sectional survey was carried out from March to August 2014. Sociodemographic, fasting blood glucose, blood pressure, and anthropometric data were recorded. Statistical analyses were carried out using SAS software version 9.1. Results. 700 adults resident in Ngaoundéré for at least two years consented and were included in the survey. Abdominal obesity, physical inactivity, and hypertension were the dominant risk factors recording 51.1%, 35.4%, and 20.4%, respectively. The prevalence of hyperglycaemia, tobacco consumption, obesity, and alcohol consumption was 5.6%, 8.3%, 9.6%, and 18.1%, respectively. Advanced age, hyperglycaemia, a divorced marital status, and alcohol consumption were independent determinants of high blood pressure. Conclusion. Physical inactivity, abdominal obesity, and hypertension were the most prevalent CVD risk factors, and the role of advanced age and hyperglycaemia in the occurrence of high blood pressure was reiterated. Health programs need to focus on effective screening, prevention, and control of CVDs in the Adamawa Region and Cameroon at large.
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Garbett TM, Garbett DL, Wendorf A. Vegetarian Diet: A Prescription for High Blood Pressure? A Systematic Review of the Literature. J Nurse Pract 2016. [DOI: 10.1016/j.nurpra.2016.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Wellman RJ, Vaughn JA, Sylvestre MP, O'Loughlin EK, Dugas EN, O'Loughlin JL. Relationships Between Current and Past Binge Drinking and Systolic Blood Pressure in Young Adults. J Adolesc Health 2016; 58:352-7. [PMID: 26903432 DOI: 10.1016/j.jadohealth.2015.10.251] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 10/28/2015] [Accepted: 10/28/2015] [Indexed: 12/28/2022]
Abstract
PURPOSE Heavy episodic (i.e., "binge") drinking (i.e., ≥five drinks/occasion) is highly prevalent among young adults; those who binge do so four times per month on average, consuming nine drinks on average on each occasion. Although it is well established that chronic heavy drinking (≥two alcoholic beverages per day) increases the risk of hypertension, the relationship between binge drinking and blood pressure is not well described. Our aim was to describe the relationship between frequency of binge drinking, both current (at age 24 years) and past (at age 20 years), and systolic blood pressure (SBP) at age 24 years. METHODS Participants (n = 756) from the longitudinal Nicotine Dependence in Teens study reported alcohol consumption at ages 20 and 24 years and had SBP measured at age 24 years. We examined the association between binge drinking and SBP using multiple linear regression, controlling for sex, race/ethnicity, education, monthly drinking in high school, cigarette smoking, and body mass index. RESULTS Compared to nonbinge drinkers, SBP at age 24 years was 2.61 [.41, 4.82] mm Hg higher among current monthly bingers and 4.03 [1.35, 6.70] mm Hg higher among current weekly bingers. SBP at age 24 years was 2.90 [.54, 5.25] mm Hg higher among monthly bingers at age 20 years and 3.64 [.93, 6.35] mm Hg higher among weekly bingers at age 20 years, compared to nonbinge drinkers. CONCLUSIONS Frequent binge drinking at ages 20 and 24 years is associated with higher SBP at age 24 years and may be implicated in the development of hypertension.
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Affiliation(s)
- Robert J Wellman
- Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, Massachusetts
| | - John A Vaughn
- Student Health Service and Department of Community and Family Medicine, Duke University, Durham, North Carolina
| | - Marie-Pierre Sylvestre
- Department of Social and Preventive Medicine, University of Montréal, Montreal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Erin K O'Loughlin
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada; INDI Department, Concordia University, Montreal, Québec, Canada
| | - Erika N Dugas
- Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada
| | - Jennifer L O'Loughlin
- Department of Social and Preventive Medicine, University of Montréal, Montreal, Québec, Canada; Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal, Québec, Canada.
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Jiang H, Delgado S, Tan J, Liu C, Rammohan KW, DeBuc DC, Lam BL, Feuer WJ, Wang J. Impaired retinal microcirculation in multiple sclerosis. Mult Scler 2016; 22:1812-1820. [PMID: 26903007 DOI: 10.1177/1352458516631035] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2015] [Revised: 12/02/2015] [Accepted: 01/14/2016] [Indexed: 01/01/2023]
Abstract
BACKGROUND The transparent ocular structure enables quantitative analysis of microvasculature of retina, a neuronal tissue affected by multiple sclerosis (MS). OBJECTIVE The aim of this study was to determine whether the retinal blood flow velocity and flow volume at the macula are impaired in patients with relapsing remitting multiple sclerosis (RRMS). METHODS A total of 17 RRMS patients and 17 age- and gender-matched healthy subjects were assessed. A retinal function imager was used to measure the blood flow velocity of retinal arterioles and venules and to calculate the total perifoveal blood flow volume. RESULTS The blood flow velocities of the retinal arterioles (3.34 ± 0.89 mm/s) and venules (2.61 ± 0.6 mm/s) were significantly lower in MS patients than normal subjects (arteriole: 4.10 ± 0.87 mm/s; venule: 3.22 ± 0.65 mm/s, both p = 0.01). In addition, the total perifoveal blood flow volume in arterioles (3.74 ± 1.64 nL/s) and venules (3.81 ± 1.60 nL/s) were significantly lower in MS patients than in normal subjects (arteriole: 4.87 ± 1.41 nL/s, p = 0.02; venule: 4.71 ± 1.64 nL/s, p = 0.04). CONCLUSION The impaired retinal microcirculation in RRMS patients indicates microvascular dysfunction in MS.
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Affiliation(s)
- Hong Jiang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA/Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Silvia Delgado
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jia Tan
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA/Department of Ophthalmology, The Second Xiangya Hospital, Central-South University, Changsha, China
| | - Che Liu
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Kottil W Rammohan
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Delia Cabrera DeBuc
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Byron L Lam
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - William J Feuer
- Statistic Division, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Jianhua Wang
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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Wakabayashi M, McKetin R, Banwell C, Yiengprugsawan V, Kelly M, Seubsman SA, Iso H, Sleigh A. Alcohol consumption patterns in Thailand and their relationship with non-communicable disease. BMC Public Health 2015; 15:1297. [PMID: 26704520 PMCID: PMC4690366 DOI: 10.1186/s12889-015-2662-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 12/21/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Heavy alcohol consumption is an established risk factor for non-communicable diseases (NCDs) but few studies have investigated drinking and disease risk in middle income, non-western countries. We report on the relationship between alcohol consumption and NCDs in Thailand. METHODS A nationwide cross sectional survey was conducted of 87,151 Thai adult open university students aged 15 to 87 years (mean age 30.5 years) who were recruited into the Thai Cohort Study. Participants were categorized as never having drunk alcohol (n = 22,527), as being occasional drinkers who drank infrequently but heavily (4+ glasses/occasion - occasional heavy drinkers, n = 24,152) or drank infrequently and less heavily (<4 glasses/occasion - occasional light drinkers, n = 26,861). Current regular drinkers were subdivided into those who either drank heavily (4 + glasses per occasion - regular heavy drinkers, n = 3,675) or those who drank less (<4 glasses/occasion -regular light drinkers, n = 490). There were 7,548 ex-drinkers in the study. Outcomes were lifetime diagnoses of self-reported NCDs and obesity (body mass index ≥ 25). RESULTS Most women were never drinkers (40 % among females) or occasional light drinkers (39 %), in contrast to men (11 % and 22 %, respectively). Alcohol consumption was associated with urban in-migration and other recognized risks for NCDs (sedentary lifestyle and poor diet). After adjustment for these factors the odds ratios (ORs) for several NCDs outcomes - high cholesterol, hypertension, and liver disease - were significantly elevated among both occasional heavy drinkers (1.2 to 1.5) and regular heavy drinkers (1.5 to 2.0) relative to never drinkers. CONCLUSIONS Heavy alcohol consumption of 4 or more glasses per occasion, even if the occasions were infrequent, was associated with elevated risk of NCDs in Thailand. These results highlight the need for strategies in Thailand to reduce the quantity of alcohol consumed to prevent alcohol-related disease. Thailand is fortunate that most of the female population is culturally protected from drinking and this national public good should be endorsed and supported.
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Affiliation(s)
- Mami Wakabayashi
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan.
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia.
| | - Rebecca McKetin
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, Australian National University, Canberra, Australia
| | - Cathy Banwell
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Vasoontara Yiengprugsawan
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
| | - Sam-ang Seubsman
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
- School of Human Ecology, The Sukhothai Thammathirat Open University, Bankgok, Nonthaburi, Thailand
| | - Hiroyasu Iso
- Public Health, Department of Social and Environmental Medicine, Graduate School of Medicine, Osaka University, 2-2 Yamadaoka, Suita-shi, Osaka, 565-0871, Japan
| | - Adrian Sleigh
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australia
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Buckman JF, Eddie D, Vaschillo EG, Vaschillo B, Garcia A, Bates ME. Immediate and Complex Cardiovascular Adaptation to an Acute Alcohol Dose. Alcohol Clin Exp Res 2015; 39:2334-44. [PMID: 26614647 PMCID: PMC4971776 DOI: 10.1111/acer.12912] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 09/15/2015] [Indexed: 01/30/2023]
Abstract
BACKGROUND The detrimental effects of chronic heavy alcohol use on the cardiovascular system are well established and broadly appreciated. Integrated cardiovascular response to an acute dose of alcohol has been less studied. This study examined the early effects of an acute dose of alcohol on the cardiovascular system, with particular emphasis on system variability and sensitivity. The goal was to begin to understand how acute alcohol disrupts dynamic cardiovascular regulatory processes prior to the development of cardiovascular disease. METHODS Healthy participants (N = 72, age 21 to 29) were randomly assigned to an alcohol, placebo, or no-alcohol control beverage condition. Beat-to-beat heart rate (HR) and blood pressure (BP) were assessed during a low-demand cognitive task prior to and following beverage consumption. Between-group differences in neurocardiac response to an alcohol challenge (blood alcohol concentration ~ 0.06 mg/dl) were tested. RESULTS The alcohol beverage group showed higher average HR, lower average stroke volume, lower HR variability and BP variability, and increased vascular tone baroreflex sensitivity after alcohol consumption. No changes were observed in the placebo group, but the control group showed slightly elevated average HR and BP after beverage consumption, possibly due to juice content. At the level of the individual, an active alcohol dose appeared to disrupt the typically tight coupling between cardiovascular processes. CONCLUSIONS A dose of alcohol quickly invoked multiple cardiovascular responses, possibly as an adaptive reaction to the acute pharmacological challenge. Future studies should assess how exposure to alcohol acutely disrupts or dissociates typically integrated neurocardiac functions.
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Affiliation(s)
- Jennifer F Buckman
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - David Eddie
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Evgeny G Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Bronya Vaschillo
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Aaron Garcia
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
| | - Marsha E Bates
- Center of Alcohol Studies, Rutgers, The State University of New Jersey, Piscataway, New Jersey
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Marczinski CA, Fillmore MT. Energy drinks mixed with alcohol: what are the risks? Nutr Rev 2015; 72 Suppl 1:98-107. [PMID: 25293549 DOI: 10.1111/nure.12127] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Energy drinks are popular beverages that typically include high levels of caffeine and other ingredients such as taurine, or caffeine-containing herbs, such as guarana. While energy drinks are often consumed alone, they are also frequently used as mixers for alcoholic beverages. This review summarizes what is known about the scope of use of alcohol mixed with energy drinks, the risks associated with such mixtures, and the objective laboratory data examining how the effects of their consumption differ from consuming alcohol alone. The weight of the evidence reveals that consuming alcohol mixed with energy drinks is riskier than consuming alcohol alone and constitutes a public health concern. Consumption of these mixed beverages is frequent, especially in young and underage drinkers, and compared with alcohol alone, their use is associated with elevated rates of binge drinking, impaired driving, risky sexual behavior, and risk of alcohol dependence. Laboratory research (human and animal) has demonstrated that consuming alcohol mixed with energy drinks leads to altered subjective states including decreased perceived intoxication, enhanced stimulation, and increased desire to drink/increased drinking compared to consuming alcohol alone. Possible underlying mechanisms explaining these observations are highlighted in this review.
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Affiliation(s)
- Cecile A Marczinski
- Department of Psychological Science, Northern Kentucky University, Highland Heights, Kentucky, USA
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Antihypertensive effect of radix paeoniae alba in spontaneously hypertensive rats and excessive alcohol intake and high fat diet induced hypertensive rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:731237. [PMID: 25784949 PMCID: PMC4345252 DOI: 10.1155/2015/731237] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 01/21/2015] [Accepted: 01/22/2015] [Indexed: 02/07/2023]
Abstract
Radix Paeoniae Alba (Baishao, RPA) has long been used in traditional Chinese medicine formulation to treat hypertension by repression the hyperfunction of liver. However, whether the RPA itself has the antihypertensive effect or not is seldom studied. This study was to evaluate the protective effect of RPA on hypertensive rats. Alcohol in conjunction with a high fat diet- (ACHFD-) induced hypertensive rats and spontaneously hypertensive rats (SHR) was constantly received either RPA extract (25 or 75 mg/kg) or captopril (15 mg/kg) all along the experiments. As a result, RPA extract (75 mg/kg) could significantly reduce systolic blood pressure of both ACHFD-induced hypertensive rats and SHR after 9-week or 4-week treatment. In ACHFD-induced hypertensive rats, the blood pressure was significantly increased and the lipid profiles in serum including triglyceride, total cholesterol, LDL-cholesterol, and HDL-cholesterol were significantly deteriorated. Also, hepatic damage was manifested by a significant increase in alanine transaminase (ALT) and aspartate transaminase (AST) in serum. The RPA extract significantly reversed these parameters, which revealed that it could alleviate the liver damage of rats. In SHR, our result suggested that the antihypertensive active of RPA extract may be related to its effect on regulating serum nitric oxide (NO) and endothelin (ET) levels.
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Fagernaes CF, Heuch I, Zwart JA, Winsvold BS, Linde M, Hagen K. Blood pressure as a risk factor for headache and migraine: a prospective population-based study. Eur J Neurol 2014; 22:156-62, e10-1. [DOI: 10.1111/ene.12547] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Accepted: 07/02/2014] [Indexed: 01/15/2023]
Affiliation(s)
- C. F. Fagernaes
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
| | - I. Heuch
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
| | - J.-A. Zwart
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - B. S. Winsvold
- Department of Neurology and FORMI; Oslo University Hospital; Oslo Norway
- Institute of Clinical Medicine; University of Oslo; Oslo Norway
| | - M. Linde
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
| | - K. Hagen
- Department of Neuroscience; Norwegian University of Science and Technology; Trondheim Norway
- Norwegian National Headache Centre; St Olavs University Hospital; Trondheim Norway
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McCartney DMA, Byrne DG, Turner MJ. Dietary contributors to hypertension in adults reviewed. Ir J Med Sci 2014; 184:81-90. [PMID: 25150713 DOI: 10.1007/s11845-014-1181-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/09/2014] [Indexed: 02/07/2023]
Abstract
Recent national surveys which measured respondents' blood pressure (BP) levels have shown a high prevalence of hypertension amongst the Irish population, with approximately two-thirds of men and over half of women aged 45 years and over affected. Higher prevalence rates are observed with advancing age. Established diet- and lifestyle-related risk factors for hypertension such as high salt intake, high alcohol consumption and physical inactivity are pervasive in Ireland and are believed to contribute significantly to the high national prevalence of this condition. Additional dietary deficits have been implicated in the development of hypertension, however, including low fruit and vegetable intake, low dairy food consumption and low intake of oily fish. Deficiencies of single micro-nutrients such as folate, riboflavin, vitamin C and vitamin D have also been recently recognised as risk factors for hypertension. For each of these factors, there is evidence that the food and nutrient intakes of many Irish adults fall short of the ideal. These dietary and nutritional deficits, when superimposed on Ireland's existing health-subversive behaviours and escalating rates of obesity, constitute a potent constellation of risk factors for hypertension. However, they also represent viable and potentially effective targets for health promotion initiatives. This review aims to describe the main nutritional, dietary and lifestyle contributors to hypertension in Ireland with a view to informing future interventions aimed at alleviating Ireland's burden of hypertensive disease.
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Affiliation(s)
- D M A McCartney
- School of Biological Sciences, Dublin Institute of Technology, Kevin Street, Dublin 8, Ireland,
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Padrão P, Severo M, Damasceno A, Silva-Matos C, Prista A, Azevedo A, Lunet N. Model-based patterns of cardiovascular risk factors in Mozambique. Ann Hum Biol 2014; 42:159-66. [PMID: 25010409 DOI: 10.3109/03014460.2014.932010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND Risk factors for cardiovascular diseases tend to cluster, although evidence from settings under epidemiological transition is scarce. AIM To identify patterns of clustering of cardiovascular risk factors and to quantify their association with sociodemographic characteristics, in Mozambique. SUBJECTS AND METHODS A national representative sample (n = 3323) of subjects aged 25-64 years was evaluated in 2005, using the World Health Organization Stepwise Approach to Chronic Disease Risk Factor Surveillance (STEPS). Patterns of joint exposure to high blood pressure, high fasting blood glucose, high body mass index, smoking, excessive alcohol consumption, low fruit/vegetables intake and insufficient physical activity were identified through latent class analysis. RESULTS Three patterns were identified among women: (1) "healthier", lower frequency of most risk factors (53.0%); (2) "hypertension-overweight" (21.1%), more frequent among older and urban subjects; and (3) "hypertension-smoking-alcohol" (25.9%), whose frequency increased with age and decreased with education. In men, two clusters were identified: (1) "hypertension-overweight" (30.1%); and (2) "smoking" (69.9%). The frequency of the latter pattern was higher in urban areas and increased with age and education. CONCLUSION Hypertension, overweight/obesity, smoking and excessive alcohol intake defined the main clusters of cardiovascular risk factors. This should be considered when planning prevention and control strategies for cardiovascular diseases in Mozambique.
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Abstract
Acute alcohol (ethanol) toxicity is a definition that encompasses both the metabolic toxicity of alcohol and the association of alcohol with traumatic deaths, suicide, and criminal activities. As with any postmortem measurement, there must be control of postmortem sampling, storage of specimens, and appropriate analysis to ensure that there is not artifactual alcohol production or incorrect measurement of other postmortem alcohols. It is almost unheard of for acute alcohol toxicity to cause death secondary to metabolic effects in a naïve individual, although there has been a recent trend in social media dares that have led to deaths due to isolated episodes of extreme alcohol consumption. However, in most cases, there will be evidence for chronic alcohol misuse at the postmortem examination.
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Affiliation(s)
- Stephen R. Morley
- Leicster Royal Infirmary, UK and Kings college London, UK, and the University of the West Indies
| | - Paul Smith
- Leicster Royal Infirmary - Toxicology Section, Leicster, UK
| | - Christopher Johnson
- University of Leicester - East Midlands Forensic Pathology Unit, Leicester, UK
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