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Parker VL, La Manna A. From Early Trauma to Cardiovascular Risk Among a Nationally Representative Sample of Young Adults. CHILD MALTREATMENT 2024:10775595241277122. [PMID: 39180408 DOI: 10.1177/10775595241277122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/26/2024]
Abstract
This study aimed to investigate the connection between childhood abuse history and cardiovascular health indicators among a nationally representative sample of young adults aged 24-32. Using data from waves three and four of the National Longitudinal Study of Adolescent to Adult Health (n = 4, 164) multivariate logistic regression was employed to investigate childhood trauma (i.e., childhood physical abuse, sexual abuse, and neglect) as predictors for cardiovascular disease, hypertension, high cholesterol, diabetes, and obesity. Results showed that adults who reported history of sexual abuse were 4.3 times more likely to report diagnosis of cardiovascular disease and those who reported childhood physical abuse at wave three had 1.4 times the odds of reporting high cholesterol diagnosis. Although trauma history is often calculated as a composite, some forms of childhood abuse may have greater impacts on cardiovascular risk than others.
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Affiliation(s)
| | - Anna La Manna
- Center for Public Health Systems Science, George Warren Brown School of Social Work, Washington University- St Louis, St Louis, MO, USA
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Amaro-Gahete FJ, Vázquez-Lorente H, Jurado-Fasoli L, Dote-Montero M, Kohler I, Ruiz JR. Low vitamin D levels are linked with increased cardiovascular disease risk in young adults: a sub-study and secondary analyses from the ACTIBATE randomized controlled trial. J Endocrinol Invest 2024; 47:1645-1656. [PMID: 38172418 DOI: 10.1007/s40618-023-02272-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/02/2023] [Indexed: 01/05/2024]
Abstract
PURPOSE Vitamin D deficiency is related to metabolic disturbances. Indeed, a poor vitamin D status has been usually detected in patients with cardiovascular disease (CVD). However, the relationship between vitamin D and CVD risk factors in young adults remains controversial at present. This study aimed to examine the association between circulating 25-hydroxivitamin D (25(OH)D) and CVD risk factors in young adults. METHODS The present cross-sectional study included a cohort of 177 young adults aged 18-25 years old (65% women). 25(OH)D serum concentrations were assessed using a competitive chemiluminescence immunoassay. Fasting CVD risk factors (i.e., body composition, blood pressure, glucose metabolism, lipid profile, liver, and inflammatory markers) were determined by routine methods. A panel of 63 oxylipins and endocannabinoids (eCBs) was also analyzed by targeted metabolomics. RESULTS Circulating 25(OH)D concentrations were inversely associated with a wide range of CVD risk factors including anthropometrical (all P ≤ 0.005), body composition (all P ≤ 0.038), glucose metabolism (all P ≤ 0.029), lipid profile (all P < 0.035), liver (all P ≤ 0.011), and pro-inflammatory biomarkers (all P ≤ 0.030). No associations of serum 25(OH)D concentrations were found with pro-inflammatory markers (all P ≥ 0.104), omega-6 and omega-3 oxylipins, nor eCBs concentrations or their analogs (all P ≥ 0.05). CONCLUSION The present findings support the idea that 25(OH)D could be a useful predictor of CVD risk in young individuals.
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Affiliation(s)
- F J Amaro-Gahete
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain.
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain.
- Instituto de Investigación Biosanitaria, Ibs.Granada, Granada, Spain.
| | - H Vázquez-Lorente
- Department of Physiology, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Nutrition and Food Technology "José Mataix", University of Granada, Granada, Spain
| | - L Jurado-Fasoli
- Department of Physiology, Faculty of Medicine, University of Granada, Granada, Spain
| | - M Dote-Montero
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain
| | - I Kohler
- Division of BioAnalytical Chemistry, Amsterdam Institute of Molecular and Life Sciences (AIMMS), Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Center for Analytical Sciences Amsterdam, Amsterdam, The Netherlands
| | - J R Ruiz
- CIBER de Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, Granada, Spain.
- Instituto de Investigación Biosanitaria, Ibs.Granada, Granada, Spain.
- Department of Physical Education and Sports, Faculty of Sport Sciences, PROmoting FITness and Health through Physical Activity Research Group (PROFITH), Sport and Health University Research Institute (iMUDS), University of Granada, Granada, Spain.
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Wang Y, Zhang Y, Wang X, Chen S, Tian X, Xu Q, Xia X, Wu S, Liu F, Wang A. Cumulative remnant cholesterol burden increases the risk of cardiovascular disease among young adults. Ann Epidemiol 2024; 94:127-136. [PMID: 38735386 DOI: 10.1016/j.annepidem.2024.05.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/28/2024] [Accepted: 05/06/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Previous studies have shown that remnant cholesterol (RC) was associated with cardiovascular disease (CVD) among middle-aged or older adults. However, lack of evidence on long-term exposures to RC and their role in CVD risk among young adults. We thus aimed to explore the association between cumulative RC burden and CVD in young adults. METHODS We enrolled participants younger than 45 years free of CVD history in the Kailuan Study who completed the first three health examinations from 2006 to 2010. Cumulative RC burden included cumulative RC burden score, time-weighted cumulative RC, exposure duration of high RC, and time course of RC accumulation. The outcome was the incidence of CVD. Cox proportional hazard models were used to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) between cumulative RC burden and CVD risk. RESULTS A total of 15,219 participants were included (73.70% male, median age 39.13 years). During a median follow-up duration of 8.71 years (interquartile range: 8.4-9.15 years), 502 individuals developed CVD. After adjustment for traditional cardiovascular risk factors, highest risk of CVD was observed in participants with the highest cumulative RC burden score (HR, 1.66; 95% CI, 1.29-2.12), the highest quartile time-weighted cumulative RC (HR,1.50; 95% CI, 1.15-1.96), the longest exposure duration of high RC (HR, 1.71; 95% CI, 1.21-2.42), and those with cumulative RC burden and positive slope (HR, 1.79; 95% CI, 1.35-2.36). CONCLUSIONS Cumulative RC burden increased the risk of CVD among young adults, suggesting that maintaining low RC levels throughout young adulthood may minimize CVD risk. KEY LEARNING POINTS
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Affiliation(s)
- Yi Wang
- Majiagou Hospital of Kailuan, Tangshan, China
| | - Yijun Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xiaonan Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China
| | - Xue Tian
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Qin Xu
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Xue Xia
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China
| | - Shouling Wu
- Department of Cardiology, Kailuan Hospital, North China University of Science and Technology, Tangshan, China.
| | - Fen Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Anxin Wang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
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Yao L, Heizhati M, Lin M, Gan L, Yao X, Wang Y, Zhu Q, Wang L, Yuan Y, Li M, Yang W, Li N. Elevated body mass index increases the risk of cardiovascular events in hypertensive patients accompanied with obstructive sleep apnea: A cohort study. Obes Res Clin Pract 2022; 16:491-499. [PMID: 36437224 DOI: 10.1016/j.orcp.2022.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 10/11/2022] [Accepted: 10/19/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND Effects of body mass index (BMI) on cardiovascular events are inconsistent. We aimed to investigate the association of BMI with cardiovascular events in hypertensives with obstructive sleep apnea (OSA). METHODS Hypertensives with OSA diagnosed with polysomnography between 2011 and 2013 in UROSAH cohort were followed up till Jan 2021. Outcomes were non-fatal cardiovascular events and cardiac death. Cox regression was used to estimate the relationship of continuous and categorical BMI with total and specific outcomes. Sensitivity analyses were performed by excluding those on OSA treatment or underweight patients. Stratified analyses were conducted by parameters including sex and age. RESULTS 2239 hypertensives with OSA were included with 405 normal weight (BMI<25 kg/m2), 1164 overweight (25-29.9 kg/m2) and 670 obesity (≥30 kg/m2). 206 non-fatal cardiovascular events and 18 cardiac death were recorded during 6.6 years follow-up. Compared with normal weight group, overweight (HR=1.53, 95%CI: 1.01-2.32, P = 0.047) and obesity groups (1.85, 1.19-2.86, P = 0.006) showed increased risk for cardiovascular events, significant in obesity group and marginal in overweight group in fully-adjusted model. In specific events, obesity showed significantly elevated HR for non-fatal cardiovascular events (1.64, 1.04-2.60, P = 0.035). Continuous BMI showed significantly increased HR for total and specific events in all models. Sensitivity analysis yielded consistent results. In stratification analysis, stronger association between obesity and cardiovascular events was observed in the young (HR=5.97, P interaction=0.030). CONCLUSIONS BMI is in positive association with cardiovascular events in hypertensives with OSA, emphasizing importance of maintaining healthy BMI for prevention of adverse events in this population, on the basis of guideline-recommended treatment.
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Affiliation(s)
- Ling Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Mulalibieke Heizhati
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Mengyue Lin
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Lin Gan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Xiaoguang Yao
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Yingchun Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Qing Zhu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Lin Wang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Yujuan Yuan
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Mei Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, China; Xinjiang Hypertension Institute, China; National Health Committee Key Laboratory of Hypertension Clinical Research Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", China; Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, China.
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Okoth K, Crowe F, Marshall T, Thomas GN, Nirantharakumar K, Adderley NJ. Sex-specific temporal trends in the incidence and prevalence of cardiovascular disease in young adults: a population-based study using UK primary care data. Eur J Prev Cardiol 2022; 29:1387-1395. [PMID: 35139185 DOI: 10.1093/eurjpc/zwac024] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 01/15/2022] [Accepted: 02/02/2022] [Indexed: 11/13/2022]
Abstract
AIMS There is concern that cardiovascular disease (CVD) in young adults is rising. However, current trends in the UK are unknown. We investigated sex-specific trends in the incidence and prevalence of CVD in young UK adults. METHODS AND RESULTS A series of annual (1998-2017) cohort and cross-sectional studies were conducted to estimate incidence rates and prevalence in men and women aged 16-50. Joinpoint regression models were fitted to evaluate changes in trends. From 1998 to 2017, incidence and prevalence had an overall downward trend for ischaemic heart disease (IHD) and angina, while coronary revascularization, stroke/transient ischaemic attack (TIA), and heart failure (HF) had an upward trend in both sexes. Myocardial infarction (MI) trends were stable in men and increased in women. For incidence, the average annual percentage change (AAPC) for men vs. women, respectively, was IHD -2.6% vs. -3.4%; angina -7.0% vs. -7.3%; MI 0.01% vs. 2.3%; revascularization 1.1% vs. 3.9%; stroke/TIA 1.9% vs. 0.6%; HF 5.6% vs. 5.0% (P for trend <0.05 for all except MI and revascularization in men and stroke/TIA in women). For prevalence, AAPCs for men vs. women, respectively, were IHD -2.8% vs. -4.9%; angina -7.2% vs. -7.8%; MI -0.2% vs. 2.0; revascularization 3.2% vs. 4.1%; stroke/TIA 3.1% vs. 3.6%; HF 5.0% vs. 3.0% (P for trend <0.05 for all except MI in men). In recent years, IHD and revascularization trends levelled off, while stroke/TIA and HF trends increased in both sexes. CONCLUSION Overall trends in incidence and prevalence of CVD are worsening in young adults. Factors behind unfavourable trends warrant investigation and public health intervention.
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Affiliation(s)
- Kelvin Okoth
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Francesca Crowe
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Tom Marshall
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
| | - Krishnarajah Nirantharakumar
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.,Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Institute of Metabolism and Systems Research, Edgbaston, Birmingham B15 2TT, UK
| | - Nicola J Adderley
- Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK
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Park J, Kim Y. Factors Associated with Chronic Disease and Health Care Utilization Among Young Adults in South Korea. Popul Health Manag 2021; 25:407-412. [PMID: 34870474 DOI: 10.1089/pop.2021.0196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Hypertension, diabetes, and hyperlipidemia have become prevalent in young adults. Health care utilization is a key factor in managing early onset chronic diseases. This study aimed to examine the factors affecting health care utilization among young South Korean adults with a single chronic disease. From the Korea Health Panel Survey data collected between 2014 and 2017, young adults who were 30-49 years old and diagnosed with a single chronic condition (hypertension, diabetes, or hyperlipidemia) were included in this study (n = 993). The factors affecting health care utilization were analyzed through multiple logistic regression. The health care utilization rate of the 40-49 and 30-39-year age groups was 84.2% and 71.1%, respectively, and it was significantly higher in the healthy behavior group, who had no smoking and drinking habits and joined in physical activities. Among the chronic diseases, hyperlipidemia obtained the lowest health care utilization rate (62.8%). From the multiple logistic regression analysis, medication intake was likely to increase in the older, unemployed, and healthy behavior groups. Patients with hypertension and diabetes were more likely to use health care services than those with hyperlipidemia. Given the rising prevalence of chronic diseases among young adults, these findings may be helpful in implementing new public health approaches for this type of population by encouraging proper health care utilization.
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Affiliation(s)
- Jongho Park
- Division of Health Administration, Gwangju University, Gwangju, South Korea
| | - Yeaeun Kim
- Department of Health Care Management, Catholic University of Pusan, Busan, South Korea
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Mohan ARM, Thomson P, Haw S, Leslie SJ, McKay J. Knowledge and cardiovascular disease risk perception from the perspectives of prisoners and staff in a Scottish prison: a qualitative study. Int J Prison Health 2021; 18:335-349. [PMID: 34664807 DOI: 10.1108/ijph-05-2021-0037] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Prisoners have an increased risk of cardiovascular disease (CVD) compared to the general population. Knowledge and risk perception of CVD can influence engagement in preventative behaviours that lower an individual's CVD risk. This paper aims to explore prisoners' knowledge of CVD, and prisoners and staff's perceptions of prisoners' CVD risk. DESIGN/METHODOLOGY/APPROACH This was a qualitative study in which semi-structured interviews were conducted with 16 prisoners and 11 prison and National Health Services staff in a Scottish prison. Data were analysed thematically using the framework method. FINDINGS Most prisoners had limited knowledge of CVD as they could not describe it or could only identify one or two risk factors or cardiovascular events. Both prisoners and staff viewed prisoners' CVD risk as either pertaining to one individual, or pertaining to the general prisoner population. Unhealthy behaviours that were believed to increase CVD risk were linked to three perceived consequences of imprisonment: mental health problems, boredom and powerlessness. ORIGINALITY/VALUE To the best of the authors' knowledge, this is the first study to explore the CVD knowledge of prisoners, and perceptions of CVD risk from the perspectives of prisoners and prison staff. Findings from this study indicate that CVD education needs to be a priority for prisoners, addressing knowledge of CVD, its risk and risk perceptions. Additionally, the findings indicate that individual and socio-environmental factors linked to prisoners' CVD risk need to be targeted to reduce this risk. Future research should focus on socio-environmental interventions that can lead to reducing the CVD risk of prisoners.
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Affiliation(s)
| | - Patricia Thomson
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | - Sally Haw
- Faculty of Health Sciences and Sport, University of Stirling, Stirling, UK
| | | | - Janet McKay
- Cardiac Rehabilitation, Lister Centre, University Hospital Crosshouse, NHS Ayrshire and Arran, Ayr, UK
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Halcomb E, Ashley C, Middleton R, Lucas E, Robinson K, Harvey S, Charlton K, McInnes S. Understanding perceptions of health, lifestyle risks and chronic disease in middle age. J Clin Nurs 2021; 30:2279-2286. [PMID: 33594746 DOI: 10.1111/jocn.15711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 02/02/2021] [Accepted: 02/05/2021] [Indexed: 11/28/2022]
Abstract
AIM The aim of this paper is to explore the perceptions, attitudes and beliefs of middle-aged Australians around their health, lifestyle risks and chronic disease. BACKGROUND Health promotion and risk reduction are important to stem the rising prevalence of chronic disease. While there has been much emphasis on supporting these strategies in older Australians, there has been less attention on those in middle age. However, as this group age, their health will inevitably be impacted by lifestyle risk. DESIGN A qualitative descriptive study using semi-structured interviews. Reporting was guided by the COREQ checklist. METHODS Thirty-four participants aged 40-65 years were recruited across South Eastern New South Wales, Australia, using convenience sampling. Semi-structured interviews were conducted by four registered nurses with qualitative research experience. Verbatim transcripts were analysed using thematic analysis. RESULTS Sixteen women and 18 men participated in the interviews. Four themes emerged, namely: adopting healthy lifestyles; denial; an impetus for change; and sustaining change. Perceptions about what constituted good health varied, with male participants being more ambivalent about their health. Impetus for change was mostly influenced by family history, awareness of health risks and identification of risks by health professionals. Participants found sustaining change challenging, particularly with regard to smoking cessation and dietary modifications. CONCLUSIONS Understanding the perceptions of health of middle-aged people is important and enables health professionals to engage in early behavioural change conversations that consider perceived barriers to lifestyle modification. Findings from this study emphasise the importance of discussions about lifestyle risk to reduce the future burden of chronic disease. RELEVANCE TO CLINICAL PRACTICE These findings illustrate the importance of understanding perceptions of health to guide primary health care nurses to develop person-centred health promotion and chronic disease prevention strategies in this age group.
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Affiliation(s)
- Elizabeth Halcomb
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | - Christine Ashley
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Rebekkah Middleton
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.,Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia
| | | | | | - Sue Harvey
- Grand Pacific Health, Nowra, NSW, Australia
| | - Karen Charlton
- Illawarra Health and Medical Research Institute, Wollongong, NSW, Australia.,School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
| | - Susan McInnes
- School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia
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Fernström M, Fernberg U, Hurtig-Wennlöf A. The importance of cardiorespiratory fitness and sleep duration in early CVD prevention: BMI, resting heart rate and questions about sleep patterns are suggested in risk assessment of young adults, 18-25 years : The cross-sectional lifestyle, biomarkers and atherosclerosis (LBA) study. BMC Public Health 2020; 20:1715. [PMID: 33198684 PMCID: PMC7667815 DOI: 10.1186/s12889-020-09801-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/30/2020] [Indexed: 12/04/2022] Open
Abstract
Background Cardiorespiratory fitness (CRF) and sleep habits are lifestyle factors with potential to prevent cardiovascular disease (CVD). CVD is the leading cause of death worldwide. It is therefore important to establish a healthy lifestyle at a young age. In the Lifestyle, Biomarkers and Atherosclerosis (LBA) study we have examined 834 healthy non-smoking adults, aged 18–25 years. The general purpose of the LBA study was to study the effect of lifestyle on traditional biomarkers known to influence CVD risk. The aims of the present study were to evaluate sleep habits of young adult women and men participating in the LBA study, and to compare the importance of sleep and other lifestyle habits on clinically relevant biomarkers for CVD. An additional aim was to find easy and reliable non-invasive biomarkers to detect young adults with increased risk of developing CVD later in life. Methods The participants had previously been examined for lifestyle factors, biomarkers and CVD risk score. They filled in a validated computerized questionnaire about their general physical and mental health. The questionnaire included questions on sleep duration and experienced quality of sleep. Results In total 27% of the young adult participants reported difficulties falling asleep or experienced troubled sleep with frequent awakenings per night. The experienced troubled sleep was not related to a higher CVD risk score, but sleep quality and duration were correlated. Shorter sleep duration was significantly associated to higher body mass index (BMI), body fat (%), homeostasis model assessment of insulin resistance (HOMA-IR) and CVD risk. The modifiable lifestyle factor with the highest odds ratio (OR) for CVD risk was CRF. Sleep duration was the second most influential lifestyle factor, more important than moderate- and vigorous physical activity (MVPA) and food habits. Correlations between CRF and heart rate (HR), (P < 0.01) and HOMA-IR and BMI (P < 0.01) were observed, indicating that BMI and resting HR in combination with questions about sleep patterns are easy and reliable non-invasive biomarkers to detect young adults who need counselling on a healthy lifestyle. Conclusion Decreased sleep duration in combination with decreased CRF, in young adults, is a serious health issue.
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Affiliation(s)
- Maria Fernström
- Åstrand Laboratory of Work Physiology, The Swedish school of sport and health science, GIHLidingövägen 1, Box 5626, 114 86, Stockholm, Sweden.
| | - Ulrika Fernberg
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
| | - Anita Hurtig-Wennlöf
- School of Health Sciences, Faculty of Medicine and Health, Örebro University, 701 82, Örebro, Sweden
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10
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Gooding HC, Brown CA, Revette AC, Vaccarino V, Liu J, Patterson S, Stamoulis C, de Ferranti SD. Young Women's Perceptions of Heart Disease Risk. J Adolesc Health 2020; 67:708-713. [PMID: 32622924 PMCID: PMC7606261 DOI: 10.1016/j.jadohealth.2020.05.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/02/2020] [Indexed: 11/18/2022]
Abstract
PURPOSE Heart disease is the number one cause of death in women. Little is known about how adolescent and young adult women perceive their risk of heart disease. METHODS We conducted eight online, semistructured focus groups with 35 young women aged 15-24 years recruited from two primary care practices in Boston, MA. Focus group discussion topics built upon data from a larger sample of women who completed the American Heart Association Women's Health Study survey. Topics included health concerns salient to young women, perceived susceptibility to heart disease, and barriers to heart-healthy behaviors. We used qualitative coding and thematic analyses to synthesize data. RESULTS Participants were surprised to learn that heart disease is the leading cause of death in women. Young women discussed age ("I feel like those are things I associate with older people like 40"), gender ("I usually hear more about men suffering from heart problems than women"), and social norms ("we're so pressured just to grow up and [be] more focused on pregnancies or depression or our weight") as reasons for their low perceived risk for heart disease. Participants noted several barriers to adopting heart-healthy behaviors including stress, lack of time, and low perceived risk. "We just don't have time to worry about hearts. Especially if our hearts aren't bothering us to begin with and we can't see it." CONCLUSIONS Perceptions of age, gender, and social norms contribute to low heart disease awareness among young women, which in turn may limit heart-healthy behaviors.
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Affiliation(s)
- Holly C Gooding
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia.
| | - Courtney A Brown
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts
| | - Anna C Revette
- Division of Population Sciences, Survey and Data Management Core, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Viola Vaccarino
- Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia
| | - Jingyi Liu
- Department of Medicine, Stanford Healthcare, Stanford, California
| | - Sierra Patterson
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Catherine Stamoulis
- Division of Adolescent and Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Sarah D de Ferranti
- Department of Cardiology, Boston Children's Hospital, Boston, Massachusetts; Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
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Parcha V, Patel N, Kalra R, Arora G, Arora P. Prevalence, Awareness, Treatment, and Poor Control of Hypertension Among Young American Adults: Race-Stratified Analysis of the National Health and Nutrition Examination Survey. Mayo Clin Proc 2020; 95:1390-1403. [PMID: 32622447 DOI: 10.1016/j.mayocp.2020.01.041] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Revised: 01/25/2020] [Accepted: 01/31/2020] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To evaluate the race-stratified trends for prevalence, awareness, treatment, and control of hypertension in young American adults aged 18 to 44 years. PATIENTS AND METHODS The National Health and Nutrition Examination Survey data from 2005-2016 for adults aged 18 to 44 years was used to calculate age-adjusted (using 2005, 2010, and 2015 US Census population proportions) weighted trends in prevalence, awareness, treatment, and control of hypertension among non-Hispanic white, non-Hispanic black, and Mexican-American participants as per the 2017 American College of Cardiology/American Heart Association guidelines. Trends were estimated by logistic regression models including demographic, socioeconomic, health care access, and Bonferroni correction for multiple comparisons as covariates. RESULTS Among 15,171 young American adults, stable trends for the prevalence, awareness, treatment, and control of hypertension was seen in all racial groups (Plinear trend>.05 for all). The prevalence from 2013 to 2016 was highest in non-Hispanic blacks (30.7%; 95% CI, 27.3 to 34.0%), followed by non-Hispanic whites (21.9%; 95% CI, 19.6 to 24.1%), and Mexican Americans (21.9%; 95% CI, 18.6 to 25.1%). The awareness was stable at ∼43.2% in non-Hispanic blacks, ∼34.8% in non-Hispanic whites, and ∼28.4% in Mexican Americans from 2005 to 2008 through 2013 to 2016. The stable treatment rates at nearly 34.4%, 23.7%, and 20.6%, were seen in non-Hispanic black, non-Hispanic white, and Mexican-Americans, respectively. The optimal control of hypertension was seen in 14.5% (95% CI, 12.1 to 17.0%) non-Hispanic blacks, 12.2% (95% CI, 10.3 to 14.0%) non-Hispanic whites, and 10.3% (95% CI, 7.1 to 13.5%) Mexican Americans from 2013 to 2016. CONCLUSION Nearly one in every three non-Hispanic young black and one in every five young Mexican American and non-Hispanic white adults have hypertension. Our race-stratified analyses highlight the categorical need to improve the abysmal control of hypertension which is approximately 1 in 10 young adults.
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Affiliation(s)
- Vibhu Parcha
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL. https://twitter.com/vibhuparcha
| | - Nirav Patel
- Department of Medicine, University of Alabama at Birmingham, Birmingham, AL
| | - Rajat Kalra
- Cardiovascular Division, University of Minnesota, Minneapolis, MN
| | - Garima Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL
| | - Pankaj Arora
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL; Section of Cardiology, Birmingham Veterans Affairs Medical Center, Birmingham, AL.
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Aycock DM, Clark PC, Anderson AM, Sharma D. Health Perceptions, Stroke Risk, and Readiness for Behavior Change: Gender Differences in Young Adult African Americans. J Racial Ethn Health Disparities 2019; 6:821-829. [PMID: 30895478 PMCID: PMC6669899 DOI: 10.1007/s40615-019-00581-0] [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: 10/22/2018] [Revised: 02/03/2019] [Accepted: 02/04/2019] [Indexed: 01/14/2023]
Abstract
The presence of traditional cardiovascular risk factors has increased among young African American (AA) adults, making them more susceptible to stroke. We examined baseline data from the Stroke COunseling for Risk REduction (SCORRE) study to describe health perceptions, stroke risk, and readiness for behavior change along with gender differences in a cohort of young AA. Self-administered questionnaires were used to assess perceptions of general health, stroke risk, competence to live a healthy lifestyle, and readiness for behavior change. Actual stroke risk was measured using the American Heart Association (AHA) Life's Simple 7® (LS7) program. Data were collected from 116 participants (86 women, 30 men) who had a mean age of 24.6 (SD = 4.5). On average, participants had 2.6 (SD = 1.1) out of 7 risk factors for stroke, rated their overall health at the midpoint of the scale ("good"), perceived a low risk of future stroke, felt competent they could live a healthy lifestyle, but were not at a stage of readiness for behavior change. A significantly higher proportion of men than women met AHA recommendations for physical activity (77% vs. 49%; p < 0.01), but had blood pressure readings > 120/80 (70% vs. 34%; p < 0.01), and smoked cigarettes/cigars (20% vs. 2%; p < 0.01). Fewer men than women were at a stage of readiness for behavior change to reduce stroke risk (13% vs. 40%; p < 0.01). Stroke risk needs to be assessed early in AA and the LS7 can be used to assess and communicate risk. Understanding gender differences may help with tailoring stroke prevention education and treatment programs.
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Affiliation(s)
- Dawn M Aycock
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 4019, Atlanta, GA, 30302, USA.
| | - Patricia C Clark
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 4019, Atlanta, GA, 30302, USA
| | - Aaron M Anderson
- Department of Neurology 201 Dowman Drive, Emory University School of Medicine, Atlanta, GA, 30322, USA
| | - Dhruvangi Sharma
- Byrdine F. Lewis College of Nursing and Health Professions, Georgia State University, P.O. Box 4019, Atlanta, GA, 30302, USA
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