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Cho SMJ, Lee H, Koyama S, Zou RS, Schuermans A, Ganesh S, Hornsby W, Honigberg MC, Natarajan P. Cumulative Diastolic Blood Pressure Burden in Normal Systolic Blood Pressure and Cardiovascular Disease. Hypertension 2024; 81:273-281. [PMID: 38084606 PMCID: PMC10841692 DOI: 10.1161/hypertensionaha.123.22160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/16/2023] [Indexed: 12/22/2023]
Abstract
BACKGROUND The clinical significance of isolated diastolic hypertension defined by the 2017 American College of Cardiology/American Heart Association blood pressure (BP) guidelines remains inconsistent. We examined whether long-term diastolic burden predicts the first major adverse cardiovascular event in participants with sustained and untreated normal systolic BP. METHODS The Mass General Brigham Biobank is a New England health care-based cohort recruited between 2010 and 2021. A total of 15 979 participants aged 18 to 64 years and without prior cardiovascular disease, antihypertensives, or high systolic BP were studied. The cumulative diastolic burden was determined as the area under the curve for diastolic BP (DBP) ≥80 mm Hg over 5 years before enrollment. Major adverse cardiovascular event was defined as a composite of first incident ischemic heart disease, stroke, heart failure, or all-cause death. RESULTS Of the 15 979 participants, mean (SD) age at enrollment was 47.6 (14.3) years, 11 950 (74.8%) were women, and the mean (SD) systolic BP and DBP were 118.0 (12.9) and 72.2 (9.3) mm Hg, respectively. Over a median (interquartile range) follow-up of 3.5 (1.8-5.4) years, 2467 (15.4%) major adverse cardiovascular events occurred. Using Cox proportional hazards regression, each SD increase in cumulative DBP was independently associated with a hazard ratio (95% CI) of 1.06 (1.02-1.10) without effect modification by sex (P=0.65), age (P=0.46), or race/ethnicity (P=0.24). In addition to traditional risk factors, cumulative DBP modestly improved the discrimination C index (95% CI) from 0.74 (0.72-0.75) to 0.75 (0.74-0.76; likelihood ratio test, P=0.037). CONCLUSIONS Among individuals with normal systolic BP, cumulative DBP may augment cardiovascular disease risk stratification beyond a single DBP measure and traditional risk factors.
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Affiliation(s)
- So Mi Jemma Cho
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Satoshi Koyama
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Roger S. Zou
- Department of Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Art Schuermans
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Cardiovascular Sciences, KU Leuven, Leuven, Flanders, Belgium
| | - Shriienidhie Ganesh
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Whitney Hornsby
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Michael C. Honigberg
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
| | - Pradeep Natarajan
- Program in Medical and Population Genetics and the Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Cardiovascular Research Center and Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Cardiology Division, Massachusetts General Hospital, Boston, MA, USA
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2
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Kuchi Bhotla H, Meyyazhagan A, Pushparaj K, Pappuswamy M, Chaudhary A, Arumugam VA, Balasubramanian B, Ragu Varman D, Orlacchio A, Rengasamy KRR. Prevalence of Cardiovascular Diseases in South Asians: Scrutinizing Traditional Risk Factors and Newly Recognized Risk Factors Sarcopenia and Osteopenia/Osteoporosis. Curr Probl Cardiol 2024; 49:102071. [PMID: 37690535 DOI: 10.1016/j.cpcardiol.2023.102071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 09/04/2023] [Indexed: 09/12/2023]
Abstract
One of the primary reasons for complications and death worldwide are cardiovascular diseases (CVDs), with a death toll of approximately 18 million per year. CVDs include cardiomyopathy, hypertension, ischemic heart disease, coronary heart disease, myocardial infarction, heart attack, hearth failure, etc. Over 80% of the CVD mortality is recorded from lower and middle-income countries. Records from the past decade have highlighted the increase of CVDs among the South Asian populations, and the prime purpose of the review is to jot down the reasons for the steep spike in CVDs. Studies analyzing the causative factors for the increase of CVDs in South Asians are still to be verified. Apart from known predisposing and lifestyle factors, other emerging risk factors associated with CVDs, namely the musculoskeletal diseases sarcopenia and osteopenia, should be tracked to tackle research gaps in upcoming analyses. This requires loads of scientific efforts. With proper monitoring, the raising alarm that the CVD burden generates can be reduced. This review discusses the already established signs and recognizes important clues to the emerging etiology of CVDs in the Asian population and prevention measures to keep it at bay.
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Affiliation(s)
- Haripriya Kuchi Bhotla
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Arun Meyyazhagan
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India; Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Karthika Pushparaj
- Department of Zoology, School of Biosciences, Avinashilingam Institute for Home Science and Higher Education for Women, Coimbatore, Tamil Nadu, India
| | - Manikantan Pappuswamy
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Aditi Chaudhary
- Department of Life Science, CHRIST (Deemed to be University), Bengaluru, Karnataka, India
| | - Vijaya Anand Arumugam
- Department of Human Genetics and Molecular Biology, Bharathiar University, Coimbatore, Tamil Nadu, India
| | | | - Durairaj Ragu Varman
- Department of Pharmacology and Toxicology, School of Medicine, Virginia Commonwealth University, Richmond, VA
| | - Antonio Orlacchio
- Laboratorio di Neurogenetica, Centro Europeo di Ricerca sul Cervello (CERC), Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Fondazione Santa Lucia, Rome, Italy; Dipartimento di Medicina e Chirurgia, Università di Perugia, Perugia, Italy
| | - Kannan R R Rengasamy
- Laboratory of Natural Products and Medicinal Chemistry (LNPMC), Center for Global Health Research, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences (SIMATS), Thandalam, Chennai, India.
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3
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Ciofani JL, Han D, Allahwala UK, Woolf B, Gill D, Bhindi R. Lipids, Blood Pressure, and Diabetes Mellitus on Risk of Cardiovascular Diseases in East Asians: A Mendelian Randomization Study. Am J Cardiol 2023; 205:329-337. [PMID: 37633070 PMCID: PMC7615095 DOI: 10.1016/j.amjcard.2023.08.007] [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: 06/20/2023] [Revised: 07/29/2023] [Accepted: 08/03/2023] [Indexed: 08/28/2023]
Abstract
Elevated blood pressure, dyslipidemia, and impaired glycemic control are well-established cardiovascular risk factors in Europeans, but there are comparatively few studies focused on East Asian populations. This study evaluated the potential causal relations between traditional cardiovascular risk factors and disease risk in East Asians through a 2-sample Mendelian randomization approach. We collected summary statistics for blood pressure parameters, lipid subsets, and type 2 diabetes mellitus liability from large genome-wide association study meta-analyses conducted in East Asians and Europeans. These were paired with summary statistics for ischemic heart disease (IHD), ischemic stroke (IS), peripheral vascular disease, heart failure (HF) and atrial fibrillation (AF). We performed univariable Mendelian randomization analyses for each exposure-outcome pair, followed by multivariable analyses for the available lipid subsets. The genetically predicted risk factors associated with IHD and AF were similar between East Asians and Europeans. However, in East Asians only genetically predicted elevated blood pressure was significantly associated with IS (odds ratio 1.05, 95% confidence interval 1.04 to 1.06, p <0.0001) and HF (odds ratio 1.05, 95% confidence interval 1.04 to 1.06, p <0.0001), whereas nearly all genetically predicted risk factors were significantly associated with IS and HF in Europeans. In conclusion, this study provides supportive evidence for similar causal relations between traditional cardiovascular risk factors and IHD and AF in both East Asian and European ancestry populations. However, the identified risk factors for IS and HF differed between East Asians and Europeans, potentially highlighting distinct disease etiologies between these populations.
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Affiliation(s)
- Jonathan L Ciofani
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia.
| | - Daniel Han
- Medical Research Council Laboratory of Molecular Biology, Cambridge, United Kingdom; Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, United Kingdom; School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Usaid K Allahwala
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Benjamin Woolf
- Medical Research Council Integrative Epidemiology Unit, University of Bristol, Bristol, United Kingdom; School of Psychological Science, University of Bristol, Bristol, United Kingdom; Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Dipender Gill
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, United Kingdom; Chief Scientific Advisor Office, Novo Nordisk, Copenhagen, Denmark
| | - Ravinay Bhindi
- Department of Cardiology, Royal North Shore Hospital, Sydney, New South Wales, Australia; Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Ma S, Wang H, Shen L, Dong Y, Zou Z. Higher vegetable consumption is related to a lower risk of cardiometabolic risk cluster among children and adolescents: A national cross-sectional study in China. Nutr Metab Cardiovasc Dis 2023; 33:1748-1759. [PMID: 37414666 DOI: 10.1016/j.numecd.2023.03.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 02/14/2023] [Accepted: 03/24/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND AND AIMS Evidence about the association between vegetable consumption and cardiometabolic risk factors (CMRFs) cluster among children and adolescents was inconsistent. We aimed to investigate the prevalence of CMRFs and CMRFs cluster, and to evaluate their associations with vegetable consumption. METHODS AND RESULTS A total of 14,061 participants aged 6-19 years were recruited from 7 provinces of China. A standard physical examination, including height, weight and blood pressure, was conducted. Information regarding CMRFs was obtained through anthropometric measurements and blood sample testing, while weekly frequency and daily servings of vegetable consumption data collected by questionnaires. Logistic regression models were used to analyze the odds ratios (OR) for associations between CMRFs, CMRFs cluster and vegetable consumption. The prevalence of no CMRFs cluster among children and adolescents was 26.4%. Participants whose daily vegetable consumption was 0.75-1.5 and ≥1.5 servings showed a lower risk of high blood pressure (HBP), high total cholesterol (TC), high triglyceride (TG), and high low-density lipoprotein cholesterol (LDL-C) compared to those with daily vegetable consumption of <0.75 servings. Besides, higher average daily vegetable consumption was strongly associated with lower risks of CMRFs cluster. Stratified analyses showed that the protective effects of more vegetable intake on CMRFs cluster were profounder in boys and young adolescents. CONCLUSION More vegetable intake was associated with lower risks of CMRFs cluster in Chinese children and adolescents aged 6-19 years, which further highlighted the significance of vegetable consumption to improve the cardiometabolic risk status.
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Affiliation(s)
- Sheng Ma
- Institute of Child and Adolescent Health, School of Public Health, Peking University National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Huan Wang
- Institute of Child and Adolescent Health, School of Public Health, Peking University National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Lijuan Shen
- Institute of Child and Adolescent Health, School of Public Health, Peking University National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China
| | - Yanhui Dong
- Institute of Child and Adolescent Health, School of Public Health, Peking University National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
| | - Zhiyong Zou
- Institute of Child and Adolescent Health, School of Public Health, Peking University National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
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Saki N, Babaahmadi-Rezaei H, Rahimi Z, Raeisizadeh M, Jorfi F, Seif F, Cheraghian B, Ghaderi-Zefrehi H, Rezaei M. Impact of modifiable risk factors on prediction of 10-year cardiovascular disease utilizing framingham risk score in Southwest Iran. BMC Cardiovasc Disord 2023; 23:358. [PMID: 37464305 DOI: 10.1186/s12872-023-03388-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 07/11/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND This cohort study was conducted to examine the association between modifiable risk factors, including hypertension, smoking, physical activity, diabetes, cholesterol, and high-density lipoprotein with Framingham risk score in the prediction of 10-year-risk of cardiovascular diseases (CVD) between men and women in an Arab community of Southwest Iran, Hoveyzeh. MATERIALS AND METHODS A total of 8,526 people aged 35-70 participated in this cohort study. Framingham was used to estimate the 10-year risk of CVD. Also, the linear regression models were used to assess the relationship between modifiable risk factors and the 10-year risk of CVD. Finally, the area under the receiver operating characteristic curve (AUC) was used to measure the ability of modifiable risk factors to predict the 10-year risk of CVD. RESULTS Our results of linear regression models showed that hypertension, smoking, PA, diabetes, cholesterol, and HDL were independently associated with the CVD risk in men and women. Also, AUC analysis showed that hypertension and diabetes have the largest AUC in men 0.841; 0.778 and in women 0.776; 0.715, respectively. However, physical activity had the highest AUC just in women 0.717. CONCLUSION Hypertension and diabetes in both gender and physical activity in women are the most important determinant for the prediction of CVD risk in Hoveyzeh. Our cohort study may be useful for adopting strategies to reduce CVD progression through lifestyle changes.
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Affiliation(s)
- Nader Saki
- Hearing Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossein Babaahmadi-Rezaei
- Department of Clinical Biochemistry, Faculty of Medicine, Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Zahra Rahimi
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maedeh Raeisizadeh
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fateme Jorfi
- Atherosclerosis Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Faeze Seif
- Department of Clinical Biochemistry, Faculty of Medicine, Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Hossien Ghaderi-Zefrehi
- Department of Clinical Biochemistry, Faculty of Medicine, Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Maryam Rezaei
- Department of Clinical Biochemistry, Faculty of Medicine, Hyperlipidemia Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zuber S, Bechtiger L, Bodelet JS, Golin M, Heumann J, Kim JH, Klee M, Mur J, Noll J, Voll S, O’Keefe P, Steinhoff A, Zölitz U, Muniz-Terrera G, Shanahan L, Shanahan MJ, Hofer SM. An integrative approach for the analysis of risk and health across the life course: challenges, innovations, and opportunities for life course research. DISCOVER SOCIAL SCIENCE AND HEALTH 2023; 3:14. [PMID: 37469576 PMCID: PMC10352429 DOI: 10.1007/s44155-023-00044-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 06/26/2023] [Indexed: 07/21/2023]
Abstract
Life course epidemiology seeks to understand the intricate relationships between risk factors and health outcomes across different stages of life to inform prevention and intervention strategies to optimize health throughout the lifespan. However, extant evidence has predominantly been based on separate analyses of data from individual birth cohorts or panel studies, which may not be sufficient to unravel the complex interplay of risk and health across different contexts. We highlight the importance of a multi-study perspective that enables researchers to: (a) Compare and contrast findings from different contexts and populations, which can help identify generalizable patterns and context-specific factors; (b) Examine the robustness of associations and the potential for effect modification by factors such as age, sex, and socioeconomic status; and (c) Improve statistical power and precision by pooling data from multiple studies, thereby allowing for the investigation of rare exposures and outcomes. This integrative framework combines the advantages of multi-study data with a life course perspective to guide research in understanding life course risk and resilience on adult health outcomes by: (a) Encouraging the use of harmonized measures across studies to facilitate comparisons and synthesis of findings; (b) Promoting the adoption of advanced analytical techniques that can accommodate the complexities of multi-study, longitudinal data; and (c) Fostering collaboration between researchers, data repositories, and funding agencies to support the integration of longitudinal data from diverse sources. An integrative approach can help inform the development of individualized risk scores and personalized interventions to promote health and well-being at various life stages.
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Affiliation(s)
- Sascha Zuber
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Geneva, Switzerland
| | - Laura Bechtiger
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | | | - Marta Golin
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | - Jens Heumann
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | - Jung Hyun Kim
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Matthias Klee
- University of Luxembourg, Esch-sur-Alzette, Luxembourg
| | - Jure Mur
- University of Edinburgh, Edinburgh, Scotland
| | - Jennie Noll
- Pennsylvania State University, State College, PA USA
| | - Stacey Voll
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
| | - Patrick O’Keefe
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
| | - Annekatrin Steinhoff
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Ulf Zölitz
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
| | | | - Lilly Shanahan
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- Department of Psychology, University of Zürich, Zürich, Switzerland
| | - Michael J. Shanahan
- Jacobs Center for Productive Youth Development, University of Zürich, Zürich, Switzerland
- Department of Sociology, University of Zürich, Zürich, Switzerland
| | - Scott M. Hofer
- Institute On Aging & Lifelong Health, University of Victoria, Victoria, BC Canada
- Department of Neurology, Oregon Health & Science University, Portland, OR USA
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Bafei SEC, Zhao X, Chen C, Sun J, Zhuang Q, Lu X, Chen Y, Gu X, Liu F, Mu J, Wei L, Wei P, Yin Y, Xie H, Yang S, Shen C. Interactive effect of increased high sensitive C-reactive protein and dyslipidemia on cardiovascular diseases: a 12-year prospective cohort study. Lipids Health Dis 2023; 22:95. [PMID: 37403063 PMCID: PMC10318784 DOI: 10.1186/s12944-023-01836-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 05/16/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND Dyslipidemia and inflammation are significant factors for the onset of cardiovascular diseases (CVD); however, studies regarding their interactions on the risk of CVD are scarce. This study aimed to assess the interaction of dyslipidemia and high-sensitivity C-reactive protein (hs-CRP) on CVD. METHODS This prospective cohort enrolled 4,128 adults at baseline in 2009 and followed them up until May 2022 for collecting CVD events. Cox-proportional hazard regression analysis estimated the hazard ratios (HRs) and 95% confidence intervals (CIs) of the associations of increased hs-CRP (≥ 1 mg/L) and dyslipidemia with CVD. The additive interactions were explored using the relative excess risk of interaction (RERI) and the multiplicative interactions were assessed with HRs (95% CI) while the multiplicative interactions were assessed by the HRs (95% CI) of interaction terms. RESULTS The HRs of the association between increased hs-CRP and CVD were 1.42 (95% CI: 1.14-1.79) and 1.17 (95% CI: 0.89-1.53) among subjects with normal lipid levels and subjects with dyslipidemia, respectively. Stratified analyses by hs-CRP levels showed that among participants with normal hs-CRP (< 1 mg/L), TC ≥ 240 mg/dL, LDL-C ≥ 160 mg/dL, non-HDL-C ≥ 190 mg/dL, ApoB < 0.7 g/L, and LDL/HDL-C ≥ 2.02 were associated with CVD [HRs (95%CIs): 1.75 (1.21-2.54), 2.16 (1.37-3.41), 1.95 (1.29-2.97), 1.37 (1.01-1.67), and 1.30 (1.00-1.69), all P < 0.05, respectively]. While in the population with increased hs-CRP, only ApoAI > 2.10 g/L had a significant association with CVD [HR (95% CI): 1.69 (1.14-2.51)]. Interaction analyses showed that increased hs-CRP had multiplicative and additive interactions with LDL-C ≥ 160 mg/dL and non-HDL-C ≥ 190 mg/dL on the risk of CVD [HRs (95%CIs): 0.309 (0.153-0.621), and 0.505 (0.295-0.866); RERIs (95%CIs): -1.704 (-3.430-0.021 and - 0.694 (-1.476-0.089), respectively, all P < 0.05]. CONCLUSION Overall our findings indicate negative interactions between abnormal blood lipid levels and hs-CRP on the risk of CVD. Further large-scale cohort studies with trajectories measurement of lipids and hs-CRP might verify our results as well explore the biological mechanism behind that interaction.
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Affiliation(s)
- Solim Essomandan Clémence Bafei
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Xianghai Zhao
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Changying Chen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Junxiang Sun
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Qian Zhuang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Xiangfeng Lu
- Department of Epidemiology, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Key Laboratory of Cardiovascular Epidemiology, Chinese Academy of Medical Sciences, Beijing, China
- Research Units of Cohort Study on Cardiovascular Diseases and Cancers, Chinese Academy of Medical Sciences, Beijing, China
| | - Yanchun Chen
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Xincheng Gu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Fangyuan Liu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Jialing Mu
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Lai Wei
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Pengfei Wei
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Yunjie Yin
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China
| | - Hankun Xie
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China
| | - Song Yang
- Department of Cardiology, Affiliated Yixing People's Hospital of Jiangsu University, People's Hospital of Yixing City, Yixing, 214200, China.
| | - Chong Shen
- Department of Epidemiology, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, 211166, China.
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8
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Feng X, Zhu J, Hua Z, Shi Q, Zhou J, Luo P. The prevalence and determinant of overweight and obesity among residents aged 40-69 years in high-risk regions for upper gastrointestinal cancer in southeast China. Sci Rep 2023; 13:8172. [PMID: 37210438 DOI: 10.1038/s41598-023-35477-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/18/2023] [Indexed: 05/22/2023] Open
Abstract
Being overweight or obese is one of the public health concerns worldwide, and its prevalence is gradually increasing. Obesity has been proven to be associated with some cancers, including upper gastrointestinal cancer (UGC). However, studies on the prevalence of obesity among residents of areas at high risk of UGC in China are minimal. The aim of this study is to assess the prevalence of obesity and its influencing factors among people aged 40-69 years (high-risk population) in high-risk areas for UGC in Jiangsu Province, southeast China. This cross-sectional study involved 45,036 subjects aged 40-69 years identified in the Rural Early Diagnosis and Treatment of UGC Project database in Jiangsu Province from 2017 to 2021. Differences in prevalence across gender and age were assessed using the Chi-square test. Using a multinomial logistic regression model, we examined independent risk factors for overweight/obesity and their gender and age differences. The prevalence of overweight, obesity, and overweight/obesity varied based on the standards used: Chinese standard (42.1%, 11.9%, and 54.0%) and WHO standard (34.7%, 4.7%, and 39.4%), respectively. Being overweight was more common in men than women, while obesity was more common in women than men. Age of 50-59 years, married, household size of 7-9, drinking, soy products, pickled food, and hot food intake were positively associated with overweight/obesity. Females, 60-69 years, higher education level, household size of 4-6, annual family income of more than 60,000 CNY, smoking, and fresh fruit intake were negatively associated with overweight/obesity. Stratified analysis showed that the effects of age, education and meat, egg and dairy products on overweight/obesity were different across gender. The impact of fresh fruit and vegetables on overweight/obesity was also heterogeneous between the younger (40-59 years) and older (60-69 years) groups. In conclusion, the prevalence of overweight and obesity is high among adults aged 40-69 years from high-risk areas for UGC of Jiangsu Province, southeast China. Independent influencing factors of being overweight/obese included gender, age, marital status, education, household size, annual family income, smoking, drinking, fresh fruit, soy products, pickled food and hot food intake, and may vary by gender and age. Screening-based interventions should be considered to control obesity levels among screened participants. Besides, heterogeneity of influencing factors across subgroups could be focused on to improve intervention effectiveness.
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Affiliation(s)
- Xiang Feng
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Jinhua Zhu
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China.
- Department of Gastroenterology, Zhongda Hospital, Southeast University, Nanjing, 210000, China.
| | - Zhaolai Hua
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Qiuping Shi
- Institute of Tumour Prevention and Control, Yangzhong People's Hospital, Yangzhong, 212200, China
| | - Jinyi Zhou
- Department of Non-communicable Disease Prevention and Control, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, 210009, China.
| | - Pengfei Luo
- Department of Non-communicable Disease Prevention and Control, Jiangsu Provincial Centre for Disease Control and Prevention, Nanjing, 210009, China
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9
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Castro O, Mair JL, Salamanca-Sanabria A, Alattas A, Keller R, Zheng S, Jabir A, Lin X, Frese BF, Lim CS, Santhanam P, van Dam RM, Car J, Lee J, Tai ES, Fleisch E, von Wangenheim F, Tudor Car L, Müller-Riemenschneider F, Kowatsch T. Development of "LvL UP 1.0": a smartphone-based, conversational agent-delivered holistic lifestyle intervention for the prevention of non-communicable diseases and common mental disorders. Front Digit Health 2023; 5:1039171. [PMID: 37234382 PMCID: PMC10207359 DOI: 10.3389/fdgth.2023.1039171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Accepted: 04/06/2023] [Indexed: 05/28/2023] Open
Abstract
Background Non-communicable diseases (NCDs) and common mental disorders (CMDs) are the leading causes of death and disability worldwide. Lifestyle interventions via mobile apps and conversational agents present themselves as low-cost, scalable solutions to prevent these conditions. This paper describes the rationale for, and development of, "LvL UP 1.0″, a smartphone-based lifestyle intervention aimed at preventing NCDs and CMDs. Materials and Methods A multidisciplinary team led the intervention design process of LvL UP 1.0, involving four phases: (i) preliminary research (stakeholder consultations, systematic market reviews), (ii) selecting intervention components and developing the conceptual model, (iii) whiteboarding and prototype design, and (iv) testing and refinement. The Multiphase Optimization Strategy and the UK Medical Research Council framework for developing and evaluating complex interventions were used to guide the intervention development. Results Preliminary research highlighted the importance of targeting holistic wellbeing (i.e., both physical and mental health). Accordingly, the first version of LvL UP features a scalable, smartphone-based, and conversational agent-delivered holistic lifestyle intervention built around three pillars: Move More (physical activity), Eat Well (nutrition and healthy eating), and Stress Less (emotional regulation and wellbeing). Intervention components include health literacy and psychoeducational coaching sessions, daily "Life Hacks" (healthy activity suggestions), breathing exercises, and journaling. In addition to the intervention components, formative research also stressed the need to introduce engagement-specific components to maximise uptake and long-term use. LvL UP includes a motivational interviewing and storytelling approach to deliver the coaching sessions, as well as progress feedback and gamification. Offline materials are also offered to allow users access to essential intervention content without needing a mobile device. Conclusions The development process of LvL UP 1.0 led to an evidence-based and user-informed smartphone-based intervention aimed at preventing NCDs and CMDs. LvL UP is designed to be a scalable, engaging, prevention-oriented, holistic intervention for adults at risk of NCDs and CMDs. A feasibility study, and subsequent optimisation and randomised-controlled trials are planned to further refine the intervention and establish effectiveness. The development process described here may prove helpful to other intervention developers.
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Affiliation(s)
- Oscar Castro
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Jacqueline Louise Mair
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Alicia Salamanca-Sanabria
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Aishah Alattas
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Roman Keller
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Shenglin Zheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Ahmad Jabir
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Xiaowen Lin
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
| | - Bea Franziska Frese
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Chang Siang Lim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
| | - Prabhakaran Santhanam
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Rob M. van Dam
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, George Washington University, Washington DC, DC, United States
| | - Josip Car
- Centre for Population Health Sciences, LKCMedicine, Nanyang Technological University, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Jimmy Lee
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Research Division, Institute of Mental Health, Singapore, Singapore
- North Region & Department of Psychosis, Institute of Mental Health, Singapore, Singapore
| | - E Shyong Tai
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Elgar Fleisch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions,Institute of Technology Management, University of St. Gallen, St. Gallen, Switzerland
| | - Florian von Wangenheim
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
| | - Lorainne Tudor Car
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, Singapore, Singapore
- Department of Primary Care and Public Health, School of Public Health, Imperial College London, London, United Kingdom
| | - Falk Müller-Riemenschneider
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
- Digital Health Center, Berlin Institute of Health, Charite University Medical Centre Berlin, Berlin, Germany
| | - Tobias Kowatsch
- Future Health Technologies, Singapore-ETH Centre, Campus for Research Excellence and Technological Enterprise (CREATE), Singapore, Singapore
- Centre for Digital Health Interventions, Department of Management, Technology, and Economics, ETH Zurich, Zurich, Switzerland
- Institute for Implementation Science in Health Care, University of Zurich, Zurich, Switzerland
- School of Medicine, University of St. Gallen, St. Gallen, Switzerland
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10
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Marzà-Florensa A, Gutierrez L, Gulayin P, Vaartjes I, Grobbee DE, Klipstein-Grobusch K, Irazola V. Risk factor clustering in men and women with CHD in the Southern Cone of Latin America. INTERNATIONAL JOURNAL OF CARDIOLOGY. CARDIOVASCULAR RISK AND PREVENTION 2023; 16:200172. [PMID: 36874043 PMCID: PMC9975232 DOI: 10.1016/j.ijcrp.2023.200172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/07/2023] [Accepted: 01/12/2023] [Indexed: 01/15/2023]
Abstract
Background Presence of multiple risk factors (RF) increases the risk for cardiovascular morbidity and mortality, and this is especially important in patients with coronary heart disease (CHD). The current study investigates sex differences in the presence of multiple cardiovascular RF in subjects with established CHD in the southern Cone of Latin America. Methods We analyzed cross-sectional data from the 634 participants aged 35-74 with CHD from the community-based CESCAS Study. We calculated the prevalence for counts of cardiometabolic (hypertension, dyslipidemia, obesity, diabetes) and lifestyle (current smoking, unhealthy diet, low physical activity, excessive alcohol consumption) RF. Differences in RF number between men and women were tested with age-adjusted Poisson regression. We identified the most common RF combinations among participants with ≥4 RF. We performed a subgroup analysis by educational level. Results The prevalence of cardiometabolic RF ranged from 76.3% (hypertension) to 26.8% (diabetes), and the prevalence of lifestyle RF from 81.9% (unhealthy diet) to 4.3% (excessive alcohol consumption). Obesity, central obesity, diabetes and low physical activity were more common in women, while excessive alcohol consumption and unhealthy diet were more common in men. Close to 85% of women and 81.5% of men presented with ≥4 RF. Women presented with a higher number of overall (relative risk (RR) 1.05, 95% CI 1.02-1.08) and cardiometabolic RF (1.17, 1.09-1.25). These sex differences were found in participants with primary education (RR women overall RF 1.08, 1.00-1.15, cardiometabolic RF 1.23, 1.09-1.39), but were diluted in those with higher educational attainment. The most common RF combination was hypertension/dyslipidemia/obesity/unhealthy diet. Conclusion Overall, women showed a higher burden of multiple cardiovascular RF. Sex differences persisted in participants with low educational attainment, and women with low educational level had the highest RF burden.
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Affiliation(s)
- Anna Marzà-Florensa
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Laura Gutierrez
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Pablo Gulayin
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
| | - Ilonca Vaartjes
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Diederick E Grobbee
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands
| | - Kerstin Klipstein-Grobusch
- Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.,Division of Epidemiology and Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Vilma Irazola
- Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina
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11
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Arshed M, Mahmud AB, Minhat HS, Ying LP, Umer MF. Effectiveness of mHealth Interventions in Medication Adherence among Patients with Cardiovascular Diseases: A Systematic Review. Diseases 2023; 11:diseases11010041. [PMID: 36975590 PMCID: PMC10047328 DOI: 10.3390/diseases11010041] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/30/2023] [Accepted: 02/21/2023] [Indexed: 03/06/2023] Open
Abstract
mHealth interventions have been reported to improve adherence to long-term therapies in chronic conditions. Therefore, this study aimed at determining the effectiveness of mHealth interventions in medication adherence among patients with cardiovascular diseases (CVDs), a leading cause of mortality globally. Relying on our inclusion criteria and the PRISMA recommendations, a literature search was carried out in the PubMed, Medline, and ProQuest databases for primary studies that investigated the impact of mHealth on medication adherence for cardiovascular disease (CVD) between 2000–2021. A total of 23 randomized controlled trials with 34,915 participants matched the selection criteria. The mHealth interventions used included text messages, mobile phone applications, and voice calls, which were used either as a single intervention or combined. Additionally, studies on enhancing drug adherence had contradictory findings: most of the studies elaborated positive results; however, six studies were unable to reveal any significant effect. Finally, a risk bias analysis revealed varying outcomes across all studies. This review, as a whole, supported the notion that mHealth interventions can be effective in improving adherence to CVD medication even though they could not improve adherence to all CVD medications when compared with controls. Further trials with more refined designs integrated with comprehensive interventions are needed to produce better health outcomes.
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Affiliation(s)
- Muhammad Arshed
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia
| | - Aidalina Binti Mahmud
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia
| | - Halimatus Sakdiah Minhat
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia
| | - Lim Poh Ying
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia (UPM), Serdang 43400, Selangor Darul Ehsan, Malaysia
| | - Muhammad Farooq Umer
- Department of Dental Public Health, College of Dentistry, King Faisal University, Hofuf 31982, Saudi Arabia
- Correspondence: ; Tel.: +966-590536962
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12
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Kim CY, Lee CM, Lee S, Yoo JE, Lee H, Park HE, Han K, Choi SY. The Association of Smoking Status and Clustering of Obesity and Depression on the Risk of Early-Onset Cardiovascular Disease in Young Adults: A Nationwide Cohort Study. Korean Circ J 2022; 53:17-30. [PMID: 36479644 PMCID: PMC9834560 DOI: 10.4070/kcj.2022.0179] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Revised: 08/22/2022] [Accepted: 09/27/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVES To evaluate the impact of smoking in young adults on the risk of cardiovascular disease (CVD) and the clustering effect of behavioral risk factors such as smoking, obesity, and depression. METHODS A Korean nationwide population-based cohort of a total of 3,280,826 participants aged 20-39 years old who underwent 2 consecutive health examinations were included. They were followed up until the date of CVD (myocardial infarction [MI] or stroke), or December 2018 (median, 6 years). RESULTS Current smoking, early age of smoking initiation, and smoking intensity were associated with an increased risk of CVD incidence. Even after quitting smoking, the risk of MI was still high in quitters compared with non-smokers. Cigarette smoking, obesity, and depression were independently associated with a 1.3-1.7 times increased risk of CVD, and clustering of 2 or more of these behavioral risk factors was associated with a 2-3 times increased risk of CVD in young adults. CONCLUSIONS In young adults, cigarette smoking was associated with the risk of CVD, and the clustering of 2 or more behavioral risk factors showed an additive risk of CVD.
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Affiliation(s)
- Choon-Young Kim
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Cheol Min Lee
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.,Department of Family Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Seungwoo Lee
- Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Heesun Lee
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Hyo Eun Park
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea
| | - Su-Yeon Choi
- Department of Internal Medicine, Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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13
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Niznik S, Rapoport MJ, Avnery O, Ellis MH, Hajyahia S, Agmon-Levin N. Ethnicity and Antiphospholipid Syndrome in Israel. Arthritis Care Res (Hoboken) 2022; 74:1917-1923. [PMID: 34057315 DOI: 10.1002/acr.24720] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/20/2021] [Accepted: 05/27/2022] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Antiphospholipid syndrome (APS) is an acquired coagulopathy associated with the presence of antiphospholipid antibodies. Whether ethnicity modulates APS clinical course is not known. The aim of our study was to assess the interplay of ethnicity and APS in Israel. METHODS We retrospectively evaluated the ethnic distribution of APS patients from 3 medical centers in Israel compared to the general population. Ethnic groups were defined according to the Israeli Bureau of Statistics as Ashkenazi (European), former Union of Soviet Socialist Republics (USSR), North African, Asian (West Asia, Greece, and Turkey), Israeli Arab individuals, and others. RESULTS Our cohort included 382 patients. The prevalence of Ashkenazi and Asian ethnicities was more pronounced (33% versus 12.8% and 15.4% versus 7.7%, respectively; P < 0.001), while Israeli Arabs were less represented (5.2% versus 31.1%; P < 0.001) relative to their part in the general population. Arab patients were younger at presentation (mean ± SD 28 ± 10 years versus 34 ± 13 years; P < 0.001) and were more likely to present with venous thrombosis (50% versus 35%; P = 0.037) and to suffer from venous thrombotic recurrence (45% versus 16%; P < 0.001) compared to other ethnicities. Mortality was higher among patients of Asian ethnic origin (8.8% versus 1.1%; P = 0.005); intriguingly, this group experienced cardiovascular risk factors more often (i.e., dyslipidemia and hypertension). CONCLUSION Ethnicity may affect the prevalence and/or natural course of APS, which is less prevalent and differs clinically in Israeli Arab patients, while mortality was linked with Asian ethnicity.
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Affiliation(s)
| | - Micha J Rapoport
- Shamir Medical Center, Zerifin, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Orly Avnery
- Hematology Institute and Blood Bank, Meir Medical Center, Kfar Saba, Israel
| | - Martin H Ellis
- Hematology Institute and Blood Bank, Meir Medical Center, Kfar Saba, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Soad Hajyahia
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nancy Agmon-Levin
- The Zabludowicz Center for Autoimmune Diseases, Sheba Medical Center, Tel Hashomer, Tel Aviv, Israel, and Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
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14
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Xiao W, Wumaer A, Maimaitiwusiman Z, Liu J, Xuekelati S, Wang H. Heat maps of cardiovascular disease risk factor clustering among community-dwelling older people in Xinjiang: a cross-sectional study. BMJ Open 2022; 12:e058400. [PMID: 35981774 PMCID: PMC9394193 DOI: 10.1136/bmjopen-2021-058400] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/02/2022] Open
Abstract
OBJECTIVE The clustering of multiple cardiovascular disease (CVD) risk factors (CRFs) increases the risk of CVD prevalence and mortality. Little is known about CRF clustering among community-dwelling older people in Xinjiang. The objective of this study was to explore the prevalence of CRF clustering in this population. DESIGN Cross-sectional study. SETTING Xinjiang, China. PARTICIPANTS Multilevel random sampling was used to survey individuals aged ≥60 in six regions of Xinjiang. In total, 87 000 participants volunteered, with a response rate of 96.67%; 702 participants with incomplete data were excluded and data from 86 298 participants were analysed. OUTCOME MEASURES The prevalence of smoking, hypertension, diabetes, dyslipidaemia and overweight/obesity was 9.4%, 52.1%, 16.8%, 28.6% and 62.7%, respectively. The prevalence of CRF clusters among people of different ages, regions and ethnic groups differed significantly. The 85.7% of the participants presented at least one CRFs and 55.9% of the participants presented clustering of CRFs. The proportion of CRF clusters tended to be higher in men, 60-69-year-old group, northern Xinjiang and the Kazakh population. After adjusting for age and sex, logistic regression analysis revealed that men, 60-69-year-old group, northern Xinjiang and the Kazakh population were more likely to have clustering of CRFs, compared with their counterparts. CONCLUSIONS The prevalence of CRFs in the older Xinjiang population is high and their clustering differs by sex, age, region and ethnicity. CRF prevention and management should be active in this population, and strategies to reduce CVD risk based on sex, age, ethnic group and region are warranted.
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Affiliation(s)
- Wenwen Xiao
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Aishanjiang Wumaer
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Zhuoya Maimaitiwusiman
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Jinling Liu
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Saiyare Xuekelati
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
| | - Hongmei Wang
- Second Department of Cadre Health Care Center, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, China
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15
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Arsyad DS, Westerink J, Cramer MJ, Ansar J, Wahiduddin, Visseren FLJ, Doevendans PA, Ansariadi. Modifiable risk factors in adults with and without prior cardiovascular disease: findings from the Indonesian National Basic Health Research. BMC Public Health 2022; 22:660. [PMID: 35382783 PMCID: PMC8985337 DOI: 10.1186/s12889-022-13104-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/24/2022] [Indexed: 12/31/2022] Open
Abstract
Backgrounds The majority of risk factors for cardiovascular diseases (CVDs) are modifiable. Continuous monitoring and control of these factors could significantly reduce the risk of CVDs-related morbidity and mortality. This study estimated the prevalence of modifiable risk factors in Indonesia and its co-occurence of multiple risk factors stratified by prior CVDs diagnosis status and sex. Methods Adult participants (> 15 years, N = 36,329, 57% women) with median age of 40 years were selected from a nationwide Indonesian cross-sectional study called Basic Health Research or Riset Kesehatan Dasar (Riskesdas) conducted in 2018. Thirteen risk factors were identified from the study, including smoking, a high-risk diet, inadequate fruit and vegetable consumption, a low physical activity level, the presence of mental-emotional disorders, obesity, a high waist circumference (WC), a high waist-to-height ratio (WtHR), hypertension, diabetes, a high total cholesterol level, a high low-density lipoprotein (LDL) cholesterol level, and a low high-density lipoprotein (HDL) cholesterol level. Age-adjusted prevalence ratios stratified by CVDs status and sex were calculated using Poisson regression with the robust covariance estimator. Results CVDs were found in 3% of the study population. Risk factor prevalence in the overall population ranged from 5.7 to 96.5% for diabetes and inadequate fruit and vegetable consumption respectively. Smoking, a high-risk food diet, and a low HDL cholesterol level were more prevalent in men, whereas a low physical activity level, the presence of mental-emotional disorders, obesity, a high WC, a high WtHR, hypertension, diabetes, a high total cholesterol level, and a high LDL cholesterol level were more prevalent in women. Approximately 22% of men and 18% of women had at least 4 risk factors, and these proportions were higher in participants with prior CVDs diagnosis. Conclusions There is a high prevalence of modifiable risk factors in the Indonesian adult population. Sex, age, and the presence of CVD are major determinants of the variations in risk factors. The presence of multiple risk factors, which are often inter-related, requires a comprehensive approach through health promotion, lifestyle modification and patient education.
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Affiliation(s)
- Dian Sidik Arsyad
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands. .,Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia.
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten J Cramer
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands
| | - Jumriani Ansar
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Wahiduddin
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands.,Netherlands Heart Institute Utrecht, Utrecht, The Netherlands
| | - Ansariadi
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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16
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Risk Factor Clusters and Cardiovascular Disease in High-Risk Patients: The UCC-SMART Study. Glob Heart 2022; 16:85. [PMID: 35141126 PMCID: PMC8698229 DOI: 10.5334/gh.897] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Accepted: 11/11/2021] [Indexed: 02/02/2023] Open
Abstract
Background: Clustering of vascular risk factors, i.e., the co-existence of two or more risk factors, has been associated with a higher risk of cardiovascular disease (CVD) in the general population. This study aims to firstly, examine patterns of clustering of major cardiovascular risk factors in high-risk patients and their relation with the risk of recurrent cardiovascular disease and all-cause mortality. Secondly, to assess which combinations are associated with the highest risk of CVD and all-cause mortality and to study population attributable fractions. Methods: A total of 12,616 patients from the Utrecht Cardiovascular Cohort – Second Manifestations of ARTerial diseases (UCC-SMART) study consisting of patients with or a high risk to develop cardiovascular disease were studied. We constructed sixteen clusters based on four individual modifiable risk factors (hypertension, dyslipidemia, current smoking, overweight). Patients were followed from September 1997 to March 2017. Cox proportional hazard models were used to compute adjusted hazard ratios for CVD risk and all-cause mortality and 95% confidence intervals for clusters, with patients without any risk factor as reference group. The population attributable fractions (PAFs) were calculated. Subgroup analyses were conducted by age and sex. Results: During a mean follow-up period of 8.0 years, 1836 CVD events were registered. The prevalence of patients with zero, one, two, three, and four risk factors was 1.4, 11.4, 32.0, 44.8 and 10.4%. The corresponding hazard ratios (HR) for CVD risk and all-cause mortality were 1.65 (95% CI 0.77; 3.54) for one risk factor, 2.61 (1.24; 5.50) for two, 3.25 (1.55; 6.84) for three, and 3.74 (1.77; 7.93) for four risk factors, with patients without any risk factor as reference group. The PAFs were 6.9, 34.0, 50.1 and 22.2%, respectively. The smoking-hypertension-dyslipidemia combination was associated with the highest HR: 4.06 (1.91; 8.63) and the hypertension-dyslipidemia combination with the highest PAF: 37.1%. Conclusion: Clusters including smoking and hypertension contributed to the highest risk of CVD and all-cause mortality. This study confirms that risk factor clustering is common among patients at high-risk for CVD and is associated with an increased risk of CVD and all-cause mortality.
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Kizzee OP, Lo JC, Ramalingam ND, Rana JS, Gordon NP. Differential Cardiometabolic Risk Factor Clustering Across U.S. Asian Ethnic Groups. Am J Prev Med 2022; 62:e129-e131. [PMID: 34629200 DOI: 10.1016/j.amepre.2021.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 07/11/2021] [Accepted: 07/23/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Olivia P Kizzee
- Department of Medicine, Kaiser Permanente Oakland Medical Center, Oakland, California
| | - Joan C Lo
- Division of Research, Kaiser Permanente Northern California, Oakland, California; Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, California; The Permanente Medical Group, Oakland, California
| | - Nirmala D Ramalingam
- Graduate Medical Education, Kaiser Permanente Oakland Medical Center, Oakland, California
| | - Jamal S Rana
- Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Oakland, California; Department of Cardiology, Kaiser Permanente Oakland Medical Center, Oakland, California
| | - Nancy P Gordon
- Division of Research, Kaiser Permanente Northern California, Oakland, California; The Permanente Medical Group, Oakland, California.
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18
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Wells S, Choi Y, Jackson R, Parwaiz M, Mehta S, Selak V, Harwood M, Grey C, Kerse N, Poppe K. Cardiovascular disease preventive medication dispensing for almost every New Zealander 65 years and over: a preventive treatment paradox? Age Ageing 2022; 51:6514237. [PMID: 35077560 DOI: 10.1093/ageing/afab265] [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: 07/09/2021] [Revised: 09/15/2021] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To describe the dispensing of cardiovascular disease (CVD) preventive medications among older New Zealanders with and without prior CVD or diabetes. METHODS New Zealanders aged ≥65 years in 2013 were identified using anonymised linkage of national administrative health databases. Dispensing of blood pressure lowering (BPL), lipid lowering (LL) or antithrombotic (AT) medications, was documented, stratified by age and by history of CVD, diabetes, or neither. RESULTS Of the 593,549 people identified, 32% had prior CVD, 14% had diabetes (of whom half also had prior CVD) and 61% had neither diagnosis. For those with prior CVD, between 79-87% were dispensed BPL and 73-79% were dispensed AT medications, across all age groups. In contrast, LL dispensing was lower than either BPL or AT in every age group, falling from 75% at age 65-69 years to 43% at 85+ years. For people with diabetes, BPL and LL dispensing was similar to those with prior CVD, but AT dispensing was approximately 20% lower. Among people without prior CVD or diabetes, both BPL and AT dispensing increased with age (from 39% and 17% at age 65-69 years to 56% and 35% at 85+ years respectively), whereas LL dispensing was 26-31% across the 65-84 year age groups, falling to 17% at 85+ years. CONCLUSION The much higher dispensing of BPL and AT compared to LL medications with increasing age suggests a preventive treatment paradox for older people, with the medications most likely to cause adverse effects being dispensed most often.
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Zhang Y, Miao H, Chia YC, Buranakitjaroen P, Siddique S, Shin J, Turana Y, Park S, Tsoi K, Chen CH, Cheng HM, Li Y, Minh HV, Nagai M, Nailes J, Sison J, Soenarta AA, Sogunuru GP, Sukonthasarn A, Tay JC, Teo BW, Verma N, Wang TD, Hoshide S, Kario K, Wang J. Cardiovascular risk assessment tools in Asia. J Clin Hypertens (Greenwich) 2022; 24:369-377. [PMID: 34981620 PMCID: PMC8989745 DOI: 10.1111/jch.14336] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/29/2022]
Abstract
Cardiovascular disease (CVD) is becoming the most important burden to health care systems in most part of the world, especially in Asia. Aiming at identifying high risk individuals and tailoring preventive treatment, many cardiovascular risk assessment tools have been established and most of them were developed in Western countries. However, these cardiovascular risk assessment tools cannot be used interchangeably without recalibration because of the different risk factor profiles (ie, greater absolute burden of hypertension and lower level of total‐cholesterol in Asians and higher prevalence of metabolic disorders in South Asians) and different CVD profiles (higher ratio of stroke/coronary heart disease in Asians) between Western and Asian populations. Original risk models such as Prediction for ASCVD Risk in China (China‐PAR) and Japan Arteriosclerosis Longitudinal Study (JALS) score have been developed and well validated for specific countries, while most of countries/regions in Asia are using established models. Due to higher incidence of stroke in Asians, risk factors like hypertension should weigh more in cardiovascular risk assessment comparing with Western populations, but their actual proportions should be based on CVD profiles in specific countries/regions. The authors encourage the development of new cardiovascular risk assessment tools for Asians, if possible. Still, modifying established models with native epidemiological data of risk factor as well as CVD is acceptable in regions where health care resources are insufficient.
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Affiliation(s)
- Yuqing Zhang
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Huanhuan Miao
- Department of Cardiology, Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yook-Chin Chia
- Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Bandar Sunway, Selangor Darul Ehsan, Malaysia.,Department of Primary Care Medicine, Faculty of Medicine, University of Malaya Kuala, Lumpur, Malaysia
| | - Peera Buranakitjaroen
- Department of Medicine, Division of Hypertension, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | | | - Jinho Shin
- Faculty of Cardiology Service, Hanyang University Medical Center, Seoul, Korea
| | - Yuda Turana
- School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Sungha Park
- Division of Cardiology, Cardiovascular Hospital, Yonsei Health System, Seoul, Korea
| | - Kelvin Tsoi
- JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chen-Huan Chen
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan
| | - Hao-Min Cheng
- Institute of Public Health and Community Medicine Research Center, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medicine, Division of Cardiology, Taipei Veterans General Hospital, Taipei, Taiwan.,Faculty of Medicine, National Yang-Ming University School of Medicine, Taipei, Taiwan.,Department of Medical Education, Center for Evidence-based Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yan Li
- Centre for Epidemiological Studies and Clinical Trials and Center for Vascular Evaluations, Shanghai Key Lab of Hypertension, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Huynh Van Minh
- Department of Internal Medicine, University of Medicine and Pharmacy, Hue University, Hue City, Vietnam
| | - Michiaki Nagai
- Department of Internal Medicine, General Medicine and Cardiology, Hiroshima City Asa Hospital, Hiroshima, Japan
| | - Jennifer Nailes
- Department of Preventive and Community Medicine and Research Institute for Health Sciences, University of the East Ramon Magsaysay Memorial Medical Center Inc., Quezon City, Philippines
| | - Jorge Sison
- Department of Medicine, Section of Cardiology, Medical Center Manila, Manila, Philippines
| | - Arieska Ann Soenarta
- Department of Cardiology and Vascular Medicine, Faculty of Medicine, University of Indonesia-National Cardiovascular Center, Harapan Kita, Jakarta, Indonesia
| | - Guru Prasad Sogunuru
- MIOT International Hospital, Chennai, Tamil Nadu, India.,College of Medical Sciences, Kathmandu University, Bharatpur, Nepal
| | - Apichard Sukonthasarn
- Department of Internal Medicine, Cardiology Division, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Jam Chin Tay
- Department of General Medicine, Tan Tock Seng Hospital, Singapore, Singapore
| | - Boon Wee Teo
- Department of Medicine, Division of Nephrology, Yong Loo Lin School of Medicine, Singapore, Singapore
| | - Narsingh Verma
- Department of Physiology, King George's Medical University, Lucknow, India
| | - Tzung-Dau Wang
- Department of Internal Medicine, Cardiovascular Center and Division of Cardiology, National Taiwan University Hospital, Taipei City, Taiwan.,Department of Internal Medicine, Division of Hospital Medicine, National Taiwan University Hospital, Taipei City, Taiwan
| | - Satoshi Hoshide
- Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Kazuomi Kario
- Department of Medicine, Division of Cardiovascular Medicine, Jichi Medical University School of Medicine, Tochigi, Japan
| | - Jiguang Wang
- Department of Hypertension, Centre for Epidemiological Studies and Clinical Trials, the Shanghai Institute of Hypertension, Shanghai Key Laboratory of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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20
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Association between Lifetime Tobacco Use and Alcohol Consumption Trajectories and Cardiovascular and Chronic Respiratory Diseases among Older People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111275. [PMID: 34769792 PMCID: PMC8582987 DOI: 10.3390/ijerph182111275] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 10/21/2021] [Accepted: 10/24/2021] [Indexed: 11/16/2022]
Abstract
Background: We identify representative types of simultaneous tobacco use and alcohol consumption trajectories across the life course and estimate their association with cardiovascular and chronic respiratory diseases (CVDs and CRDs) among older people in Chile. Methods: We used data from a population-representative, face-to-face and longitudinal-retrospective survey focused on people aged 65–75 (N = 802). To reconstruct trajectory types, we employed weighted multichannel sequence analysis. Then, we estimated their associations with CVDs and CRDs through weighted logistic regression models. Results: Long-term exposure to tobacco use and alcohol consumption across life are associated with the highest CVD and CRD risks. Long-term nonsmokers and nondrinkers do not necessarily show the lowest CVDs and CRDs risks if these patterns are accompanied by health risk factors such as obesity or social disadvantages such as lower educational levels. Additionally, trajectories showing regular consumption in one domain but only in specific periods of life, whether early or late, while maintaining little or no consumption across life in the other domain, lead to lower CVDs or CRDs risks than trajectories indicating permanent consumption in both domains. Conclusions: A policy approach that considers CVDs and CRDs as conditions that strongly depend on previous individual experiences in diverse life domains can contribute to the improved design and evaluation of preventive strategies of tobacco use and alcohol consumption across the life course.
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21
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Chan YY, Sahril N, Rezali MS, Kuang Kuay L, Baharudin A, Abd Razak MA, Azlan Kassim MS, Mohd Yusoff MF, Omar MA, Ahmad NA. Self-Reported Modifiable Risk Factors of Cardiovascular Disease among Older Adults in Malaysia: A Cross-Sectional Study of Prevalence and Clustering. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18157941. [PMID: 34360235 PMCID: PMC8345577 DOI: 10.3390/ijerph18157941] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 12/23/2022]
Abstract
The co-occurrence of multiple modifiable risk factors increases the risk of cardiovascular disease (CVD) morbidity or mortality. This study examines the prevalence and clustering of self-reported modifiable CVD risk factors among older adults in Malaysia. A total of 7117 adults aged ≥50 years participated in the National Health and Morbidity Survey (NHMS) 2018: Elderly Health, a community-based cross-sectional survey. Data were collected using a standardized structured questionnaire. Multivariable logistic regression was used to determine the factors associated with the clustering of self-reported modifiable CVD risk factors. The prevalence of self-reported diabetes, hypertension, hypercholesterolemia, overweight/obesity, and current smoking was 23.3%, 42.2%, 35.6%, 58.4%, and 17.5%, respectively. Overall, the prevalence of clustering of ≥1, ≥2, and ≥3 modifiable CVD risk factors was 83.3%, 75.4%, and 62.6%, respectively. Multivariable logistic regression analysis showed that men, 60–69 age group, urban dwellers, having no formal education, unemployed/retirees/homemakers, and being physically inactive were independently associated with self-reported modifiable CVD risk factors clustering. There are also ethnic differences in self-reported modifiable CVD risk factors clustering. Our findings underscore the necessity of targeted interventions and integrated strategies for early detection and treatment of modifiable CVD risk factors among older adults, considering age, sex, ethnicity, and socioeconomic status.
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Affiliation(s)
- Ying Ying Chan
- Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia; (N.S.); (M.S.R.); (M.A.A.R.); (M.S.A.K.)
- Correspondence:
| | - Norhafizah Sahril
- Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia; (N.S.); (M.S.R.); (M.A.A.R.); (M.S.A.K.)
| | - Muhammad Solihin Rezali
- Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia; (N.S.); (M.S.R.); (M.A.A.R.); (M.S.A.K.)
| | - Lim Kuang Kuay
- Centre for Occupational Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia;
| | - Azli Baharudin
- Centre for Nutrition Epidemiology Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia;
| | - Mohamad Aznuddin Abd Razak
- Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia; (N.S.); (M.S.R.); (M.A.A.R.); (M.S.A.K.)
| | - Mohd Shaiful Azlan Kassim
- Centre for Family Health Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia; (N.S.); (M.S.R.); (M.A.A.R.); (M.S.A.K.)
| | - Muhammad Fadhli Mohd Yusoff
- Centre for Non-Communicable Diseases Research, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia;
| | - Mohd Azahadi Omar
- Sector for Biostatistics & Data Repository, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia;
| | - Noor Ani Ahmad
- Director Office, Institute for Public Health, National Institutes of Health, Ministry of Health Malaysia, Setia Alam, Shah Alam 40170, Malaysia;
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22
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Kim HC. Epidemiology of cardiovascular disease and its risk factors in Korea. Glob Health Med 2021; 3:134-141. [PMID: 34250288 DOI: 10.35772/ghm.2021.01008] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/27/2021] [Accepted: 04/02/2021] [Indexed: 01/04/2023]
Abstract
Cardiovascular disease (CVD) is the leading cause of death and a major contributor to disability worldwide. Currently, Korea is among countries with the lowest CVD mortality rates, and the age-adjusted CVD mortality rate is still decreasing. However, depending on the CVD type, the mortality and incidence trends vary. Without age-standardization, cerebrovascular disease mortality peaked in 1994 (82.1 per 100K) and continued to decline until 2018 (44.7 per 100K), while heart disease mortality recorded the lowest level in 2001 (44.9 per 100K) then increased again until 2018 (74.5 per 100K). Age-standardized mortality rates showed different trends: both cerebrovascular disease and heart disease mortality rates have declined over the past few decades, although the rate of decline varies. Based on the National Health Insurance claim database, the numbers of hospitalization for cerebrovascular disease and ischemic heart disease are increasing, but the age-standardized hospitalization rates are decreasing. Unlike other types of CVDs, heart failure is rapidly increasing in both mortality and hospitalization rates regardless of age-standardization. Seventy percent of Korean adults have at least one risk factor, 41% have ≥ 2 risk factors, and 19% have ≥ 3 risk factors including hypertension, diabetes, hypercholesterolemia, obesity, and smoking. Exposure to multiple risk factors increases with age, with 65% of senior citizens over 70 having ≥ 2 risk factors and 34% having ≥ 3 risk factors. As the elderly population, especially those with multiple risk factors and chronic disorders, is increasing, the management of this high-risk group will be an important challenge to prevent CVD in Korea.
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Affiliation(s)
- Hyeon Chang Kim
- Department of Preventive Medicine, Integrative Research Center for Cerebrovascular and Cardiovascular Diseases, Yonsei University College of Medicine, Seoul, Korea
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23
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Alkhalidy H, Orabi A, Alzboun T, Alnaser K, Al-Shami I, Al-Bayyari N. Health-Risk Behaviors and Dietary Patterns Among Jordanian College Students: A Pilot Study. Front Nutr 2021; 8:632035. [PMID: 34055850 PMCID: PMC8160432 DOI: 10.3389/fnut.2021.632035] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2020] [Accepted: 04/19/2021] [Indexed: 12/31/2022] Open
Abstract
Background/Aims: Health promotion and the incorporation of health-protective behaviors in people's lifestyles have a great role in enhancing individuals' overall health and well-being. College students are at increased risk of developing unhealthy dietary and lifestyle behaviors. A cross-sectional pilot study was conducted to assess the health-risk behaviors among undergraduate college students at Jordan University of Science and Technology. Methods: The final sample included 136 students, with a mean age of 21.1 ± 2.37 years, mostly females (69%). A self-reported questionnaire was used for data collection about dietary and lifestyle behaviors among college students. The questionnaire consisted of four parts: sociodemographic characteristics, body weight classifications, lifestyle behaviors, and dietary patterns and intake, and eating behaviors. Results: Most of the students did not meet the daily recommendations for fruit (76%) and vegetable (82%) intake. Males were significantly consuming fast food more frequently (p = 0.019), and smoked cigarettes (p < 0.001) or hookah (p = 0.015) more frequently than did females. Further, the majority met the recommendations for physical activity (81%), but exceeded recommendations for sedentary behavior. Females were more likely to have normal weight or be underweight (OR = 4.865), to have a fear of weight gain (OR = 3.387), and to have the recommended sleeping hours (OR = 7.685) than were males. Conclusion: The results indicate the health-risk behaviors and the gender-related differences among college students.
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Affiliation(s)
- Hana Alkhalidy
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Aliaa Orabi
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Tamara Alzboun
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Khadeejah Alnaser
- Department of Nutrition and Food Technology, Faculty of Agriculture, Jordan University of Science and Technology, Irbid, Jordan
| | - Islam Al-Shami
- Department of Clinical Nutrition and Dietetics, Faculty of Allied Health Science, The Hashemite University, Zarqa, Jordan
| | - Nahla Al-Bayyari
- Department of Nutrition and Food Technology, Faculty of Al-Huson University College, Al-Balqa Applied University, Al-Salt, Jordan
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24
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Lee ZV, Llanes EJ, Sukmawan R, Thongtang N, Ho HQT, Barter P. Prevalence of plasma lipid disorders with an emphasis on LDL cholesterol in selected countries in the Asia-Pacific region. Lipids Health Dis 2021; 20:33. [PMID: 33858442 PMCID: PMC8051043 DOI: 10.1186/s12944-021-01450-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 03/02/2021] [Indexed: 12/20/2022] Open
Abstract
Cardiovascular disease (CVD) is a major cause of mortality and morbidity within the Asia-Pacific region, with the prevalence of CVD risk factors such as plasma lipid disorders increasing in many Asian countries. As members of the Cardiovascular RISk Prevention (CRISP) in Asia network, the authors have focused on plasma lipid disorders in the six countries within which they have clinical experience: Indonesia, Malaysia, Philippines, Thailand, Vietnam, and Australia. Based on country-specific national surveys, the prevalence of abnormal levels of total cholesterol, low- and high-density lipoprotein cholesterol (LDL-C and HDL-C, respectively), and triglycerides (TG) are reported. An important caveat is that countries have used different thresholds to define plasma lipid disorders, making direct comparisons difficult. The prevalence of abnormal lipid levels was as follows: high total cholesterol (30.2-47.7%, thresholds: 190-213 mg/dL); high LDL-C (33.2-47.5%; thresholds: 130-135 mg/dL); low/abnormal HDL-C (22.9-72.0%; thresholds: 39-50 mg/dL); and high/abnormal TG (13.9-38.7%; thresholds: 150-177 mg/dL). Similarities and differences between country-specific guidelines for the management of plasma lipid disorders are highlighted. Based on the authors' clinical experience, some of the possible reasons for suboptimal management of plasma lipid disorders in each country are described. Issues common to several countries include physician reluctance to prescribe high-dose and/or high-intensity statins and poor understanding of disease, treatments, and side effects among patients. Treatment costs and geographical constraints have also hampered disease management in Indonesia and the Philippines. Understanding the factors governing the prevalence of plasma lipid disorders helps enhance strategies to reduce the burden of CVD in the Asia-Pacific region.
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Affiliation(s)
- Zhen-Vin Lee
- University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Elmer Jasper Llanes
- Division of Cardiovascular Medicine, University of the Philippines, Manila, Philippines
| | - Renan Sukmawan
- Department of Cardiology & Vascular Medicine, Universitas Indonesia, National Cardiovascular Center Harapan Kita, Jakarta, Indonesia
| | - Nuntakorn Thongtang
- Division of Endocrinology and Metabolism, Faculty of Medicine, Siriraj Hospital Mahidol University, Bangkok, Thailand
| | | | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.
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25
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Kwan SC, Ismail R, Ismail NH, Mohamed N. An ecological study of the relationship between urban built environment and cardiovascular hospital admissions (2004-2016) in an Asian developing country. Soc Sci Med 2021; 276:113868. [PMID: 33799201 DOI: 10.1016/j.socscimed.2021.113868] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/08/2021] [Accepted: 03/16/2021] [Indexed: 11/26/2022]
Abstract
This study aims to evaluate the relationship between urban built environment and hospital admissions from cardiovascular diseases in Kuala Lumpur, Malaysia. Hospital admission data from 2004 to 2016 for cardiovascular diseases were used with patient residential postcodes as the unit of analysis. Data was split into 2004-2009 (12,551 cases) and 2010-2016 (17,154 cases) periods corresponding to land use data. We used generalized linear mixed model to analyse population density, property value, entropy index, and the kernel density (800 m) of specific land use, bus and rail stations, and road junctions, with time period and postcodes as the random effects to generate incidence rate ratios (IRRs). Results indicated that entropy index and recreational area density were associated with fewer hypertensive disease and ischemic heart disease hospital admissions (IRR range: 0.49-0.68, 95%CI: 0.27, 0.97). Population density and property value were associated with fewer cerebrovascular disease hospital admissions (IRR range: 0.29-0.34, 95%CI: 0.11, 0.75). Contrarily, density of road junctions was associated with 2.5-6.3 times more hospital admissions for cardiovascular disease hospital admissions (IRR range: 2.53-6.34, 95%CI: 1.07,17.91). There were no significant association between hospital admission and density of residential area, undeveloped land, rail and bus stations. The shapes of relationships for all attributes were non-linear, and changed markedly at the third quartile except for recreational area density. The findings suggest that land use attributes have some protective effects on the cardiovascular disease admission cases as compared to the transport attributes. These findings have important merits for integrating health into urban planning.
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Affiliation(s)
- Soo Chen Kwan
- Center for Southeast Asian Studies (CSEAS), Kyoto University, Kyoto, Japan; Center for Toxicology and Health Risk Studies (CORE), Faculty of Health Sciences, National University of Malaysia, Malaysia.
| | - Rohaida Ismail
- Environmental Health Research Centre, Institute for Medical Research, Ministry of Health Malaysia, Malaysia
| | | | - Norlen Mohamed
- Disease Control Division, Ministry of Health Malaysia, Malaysia
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26
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Yeom HE, Lee J. Sex Differences in the Influence of Sleep on Body Mass Index and Risk of Metabolic Syndrome in Middle-Aged Adults. Healthcare (Basel) 2020; 8:healthcare8040561. [PMID: 33327607 PMCID: PMC7765030 DOI: 10.3390/healthcare8040561] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/10/2020] [Accepted: 12/11/2020] [Indexed: 12/15/2022] Open
Abstract
Poor sleep and obesity are intimately related to cardiovascular diseases. We aimed to examine whether the influence of sleep and body mass index (BMI) on the risk of metabolic syndrome (MetS) differed by sex in middle-aged people. It is a cross-sectional study of 458 Korean participants who completed self-administered surveys; the data were analyzed using the PROCESS macro for SPSS. We found that both sleep and BMI were significant predictors of MetS risk in women, particularly by the role of BMI connecting the impact of sleep to MetS risk. However, the association was not found in men, showing that BMI, but not sleep, was a significant predictor of MetS. This sex-related difference was due to different relationships between sleep and BMI, indicating that BMI was more dependent on sleep quality for women than for men. Therefore, a sex-specific approach to decrease the risk of MetS is warranted.
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Affiliation(s)
- Hyun-E Yeom
- College of Nursing, Chungnam National University, Munhwaro 266, Junggu, Daejeon 35015, Korea;
| | - Jungmin Lee
- Youth Independence & Competencies Research Office, National Youth Policy Institute, Social Policy BLDG, Sejong National Research Complex, 370, Sicheong-daero, Sejong-si 30147, Korea
- Correspondence: ; Tel.: +82-42-580-8327
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Li JJ, Yeo KK, Tan K, Ako J, Krittayaphong R, Tan RS, Aylward PE, Lam C, Baek SH, Dalal J, Fong A, Li YH, O’Brien RC, Koh SYN, Scherer DJ, Tada H, Kang V, Butters J, Nicholls SJ. Tackling cardiometabolic risk in the Asia Pacific region. Am J Prev Cardiol 2020; 4:100096. [PMID: 34327472 PMCID: PMC8315619 DOI: 10.1016/j.ajpc.2020.100096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 09/28/2020] [Accepted: 10/10/2020] [Indexed: 12/17/2022] Open
Abstract
With the global spread of abdominal obesity, cardiovascular disease continues to spread to all countries of the world. Given the large population, the challenges presented by cardiometabolic risk in the Asia Pacific region are considerable. In addition to the clinical consequences of cardiovascular disease, in terms of its morbidity and mortality, the diversity of the Asia Pacific region brings heterogeneity in approaches to prevention, diagnosis and treatment of cardiometabolic risk. In this manuscript, we will review the current state of knowledge of cardiometabolic risk in Asia Pacific and highlight the needs moving forward to tackle this public health challenge.
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Affiliation(s)
- Jian-Jun Li
- State Key Laboratory of Cardiovascular Disease, FuWai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences, Peking Union Medical College, BeiLiShi Road 167, Beijing 100037, China
| | - Khung Keong Yeo
- National Heart Centre Singapore and Duke-NUS Medical School, Singapore
| | - Kathyrn Tan
- Department of Medicine, University of Hong Kong; Kitasato University, Sagamihara, Japan
| | - Junya Ako
- Kitasato University, Sagamihara, Japan
| | - Rungroj Krittayaphong
- Division of Cardiology, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Ru San Tan
- National Heart Centre Singapore and Duke-NUS Medical School, Singapore
| | - Philip E. Aylward
- South Australian Health and Medical Research Institute and Flinders University, Adelaide, Australia
| | - CarolynS.P. Lam
- National Heart Centre Singapore and Duke-NUS Medical School, Singapore
| | - Sang Hong Baek
- Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea
| | | | - Alan Fong
- Department of Cardiology, Sarawak Heart Centre; and Clinical Research Centre, Sarawak General Hospital, Kuching, Malaysia
| | - Yi-Heng Li
- National Cheng Kung University Hospital, Tainan, Taiwan
| | | | - Si Ya Natalie Koh
- National Heart Centre Singapore and Duke-NUS Medical School, Singapore
| | | | - Hayato Tada
- Kanazawa University Graduate School of Medicine, Kanazawa, Japan
| | | | - Julie Butters
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Australia
| | - Stephen J. Nicholls
- Monash Cardiovascular Research Centre, Victorian Heart Institute, Monash University, Melbourne, Australia
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Farag HAM, Baqi HR, Qadir SA, El Bilbeisi AH, Hamafarj KK, Taleb M, El Afifi A. Effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients in the Kurdistan region of Iraq. SAGE Open Med 2020; 8:2050312120965780. [PMID: 33294186 PMCID: PMC7705764 DOI: 10.1177/2050312120965780] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Accepted: 09/22/2020] [Indexed: 12/17/2022] Open
Abstract
Objective This study was employed to assess the effects of Ramadan fasting on anthropometric measures, blood pressure, and lipid profile among hypertensive patients. Method This cross-sectional study was conducted among a representative sample, which was selected using a census survey of hypertensive patients (both gender, aged 25-50 years, on regular antihypertensive drugs (atenolol: 50 mg orally once a day)), during Ramadan month that was falling in April to May 2020. The patients were receiving care at Halabja hospital in the Kurdistan region of Iraq. All patients were assessed in two phase's baseline (a week before Ramadan) and end stage (a week after Ramadan), using anthropometric indices, physical examination, biochemical tests, and a structured questionnaire. Statistical analysis was performed using SPSS version 21. Results A total of 120 hypertensive patients were included in the study (50% females and 50% males), with a mean age of 37.5 ± 6.6 years. The major finding of our study was the significant decrease in blood pressure (P < 0.001). Furthermore, the body weight, body mass index, and waist circumference of the participants decreased after Ramadan fasting in a significant approach (P < 0.001 for all). However, for the lipid profile components, the total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol change persisted not statistically significant (P > 0.05), while only triglyceride decreased drastically after Ramadan fasting (P < 0.001). Conclusion Ramadan fasting could contribute in the improvement of blood pressure and lowers triglyceride levels, body weight, body mass index, and waist circumference of adult hypertensive patients.
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Affiliation(s)
- Halgord Ali M Farag
- Nursing Department, Technical College of Health, Research Center, Sulaimani Polytechnic University, Sulaimani, Iraq
| | - Hardi Rafat Baqi
- Medical Laboratory Science, Technical College of Applied Sciences, Research Center, Sulaimani Polytechnic University, Sulaimani, Kurdistan, Iraq
| | - Syamand Ahmed Qadir
- Medical Laboratory Science, Technical College of Applied Sciences, Research Center, Sulaimani Polytechnic University, Sulaimani, Kurdistan, Iraq
| | - Abdel Hamid El Bilbeisi
- Department of Clinical Nutrition, Faculty of Pharmacy, Al Azhar University of Gaza, Gaza Strip, Palestine
| | - Kawa Khwarahm Hamafarj
- Nursing Department, Technical College of Health, Research Center, Sulaimani Polytechnic University, Sulaimani, Iraq
| | - Mahmoud Taleb
- Faculty of Pharmacy, Al Azhar University of Gaza, Gaza Strip, Palestine
| | - Amany El Afifi
- Faculty of Pharmacy, Al Azhar University of Gaza, Gaza Strip, Palestine
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Fung AWT. Effect of physical exercise and medication on enhancing cognitive function in older adults with vascular risk. Geriatr Gerontol Int 2020; 20:1067-1071. [PMID: 32989840 DOI: 10.1111/ggi.14048] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 08/21/2020] [Accepted: 09/11/2020] [Indexed: 01/14/2023]
Abstract
AIM To examine the association of physical exercise (PE) and medication on cognitive function in older adults with vascular risk. METHODS This was a cross-sectional study of 478 non-demented participants aged ≥60 years with vascular risk. Management strategy included PE (mind-body exercise and/or strenuous exercise), medication, PE combined with medication and no management at all. Participation of PE was determined by self-reporting exercise engagement in the past year. Cognitive preservation was defined as a global composite z-score that was equal to or above the age and educational adjusted mean of cognitively normal older adults. Binary logistic regression was carried out to examine the association between management strategy and cognitive preservation in each exercise modality adjusted by sociodemographic, physical, mental and genetic factors. RESULTS An association was found in preserved cognitive function for those who managed their vascular risk through PE (OR 2.5, 95% CI 1.2-5.3, P = 0.015) and in combination with medication (OR 2.1, 95% CI 1.0-4.6, P = 0.05). A similar pattern was also found in each exercise subtype. A significant short-term (OR 3.6, 95% CI 1.0-12.4, P = 0.042) to lifelong (OR 3.5, 95% CI 1.4-8.5, P = 0.006) cognitive benefit was found in MB exercise. CONCLUSION Medication alone may be insufficient to preserve cognitive function in older adults with vascular risk. In our sample, medication in combined with PE is found to have significant impact on cognitive improvement. Mind-body exercise might be better than strenuous exercise, as a more sustainable cognitive effect is observed. Geriatr Gerontol Int 2020; 20: 1067-1071..
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Affiliation(s)
- Ada Wai-Tung Fung
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Ko T, Yang CH, Mao CT, Kuo LT, Hsieh MJ, Chen DY, Wang CY, Lin YS, Hsieh IC, Chen SW, Hung MJ, Cherng WJ, Chen TH. Effects of National Hospital Accreditation in Acute Coronary Syndrome on In-Hospital Mortality and Clinical Outcomes. ACTA CARDIOLOGICA SINICA 2020; 36:416-427. [PMID: 32952351 DOI: 10.6515/acs.202009_36(5).20200421a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Acute coronary syndrome (ACS) is a life-threatening medical condition that accounts for an annual expenditure of more than $300 billion in the United States. Hospital accreditation has been shown to improve patient and hospital outcomes for various conditions. Objectives This study aimed to determine the benefits of hospital accreditation in patients with ACS. Methods This nationwide population-based cohort study used Taiwan's National Health Insurance Research Database from 1997 to 2011 (n = 249,354). Multivariable logistic regression was used to analyze the risk of in-hospital events among those treated in accredited and non-accredited hospitals, and to compare outcomes in hospitals before and after accreditation. The effect of accreditation on these events was also stratified by accreditation grade. Results A total of 823 hospitals were included, of which 2.4% were medical centers, 13.7% were regional hospitals, and 83.8% were district hospitals. The in-hospital mortality [odds ratio (OR), 0.82; 95% confidence interval (CI), 0.79-0.85; p < 0.001] and recurrent acute myocardial infarction (AMI) admission (OR, 0.81; 95% CI, 0.71-0.93; p = 0.003) rates were significantly lower in the after-accreditation group than in the before-accreditation group. There was a substantial and marked decrease in the in-hospital mortality rate after accreditation in 2008. Conclusions This cohort study demonstrated that ACS accreditation was associated with better in-hospital mortality and recurrent AMI admission rates in ACS patients.
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Affiliation(s)
- Ta Ko
- Division of Cardiology, Department of Internal Medicine, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung; Chang Gung University College of Medicine, Taoyuan
| | - Chia-Hung Yang
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Chun-Tai Mao
- Division of Cardiology, Department of Internal Medicine, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung; Chang Gung University College of Medicine, Taoyuan
| | - Li-Tang Kuo
- Division of Cardiology, Department of Internal Medicine, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung; Chang Gung University College of Medicine, Taoyuan
| | - Ming-Jer Hsieh
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Dong-Yi Chen
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Chao-Yung Wang
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Yu-Sheng Lin
- Division of Cardiology, Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi; Chang Gung University College of Medicine, Taoyuan
| | - I-Chang Hsieh
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Shao-Wei Chen
- Department of Cardiac Surgery, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ming-Jui Hung
- Division of Cardiology, Department of Internal Medicine, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung; Chang Gung University College of Medicine, Taoyuan
| | - Wen-Jin Cherng
- Division of Cardiology, Department of Internal Medicine, Percutaneous Coronary Intervention Center, Chang Gung Memorial Hospital, Linkou; Chang Gung University College of Medicine, Taoyuan
| | - Tien-Hsing Chen
- Division of Cardiology, Department of Internal Medicine, Community Medicine Research Center, Chang Gung Memorial Hospital, Keelung; Chang Gung University College of Medicine, Taoyuan
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Costa J, Alarcão J, Araujo F, Ascenção R, Caldeira D, Fiorentino F, Gil V, Gouveia M, Lourenço F, Mello E Silva A, Sampaio F, Vaz Carneiro A, Borges M. The burden of atherosclerosis in Portugal. EUROPEAN HEART JOURNAL. QUALITY OF CARE & CLINICAL OUTCOMES 2020; 7:154-162. [PMID: 32946553 PMCID: PMC7962771 DOI: 10.1093/ehjqcco/qcaa060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 07/17/2020] [Accepted: 08/04/2020] [Indexed: 12/30/2022]
Abstract
Aims This article sought to estimate the burden of disease attributable to atherosclerosis in mainland Portugal in 2016. Methods and results The burden of atherosclerosis was measured in disability-adjusted life years following the latest 2010 Global Burden of Disease (GBD) methodology. Disability-adjusted life years were estimated as the sum of years of life lost (YLL) with years lived with disability (YLD). The following clinical manifestations of atherosclerosis were included: ischaemic heart disease (IHD) (including acute myocardial infarction, stable angina, and ischaemic heart failure), ischaemic cerebrovascular disease (ICVD), and peripheral arterial disease (PAD). Years of life lost were estimated based on all-cause mortality data for the Portuguese population and mortality due to IHD, ICVD, and PAD for the year 2016 sourced from national statistics. Standard life expectancy was sourced from the GBD study. Years lived with disability corresponded to the product of the number of prevalent cases by an average disability weight for all possible combinations of disease. Prevalence data for the different clinical manifestations of atherosclerosis were sourced from epidemiological studies. Disability weights were sourced from the published literature. In 2016, 15 123 deaths were attributable to atherosclerosis, which corresponded to 14.3% of overall mortality in mainland Portugal. Disability-adjusted life years totalled 260 943, 75% due to premature death (196 438 YLL) and 25% due to disability (64 505 YLD). Conclusion Atherosclerosis entails a high disease burden to society. A large part of this burden would be avoidable if evidence-based effective and cost-effective interventions targeting known risk factors, from prevention to treatment, were implemented.
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Affiliation(s)
- João Costa
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Joana Alarcão
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Francisco Araujo
- Serviço de Medicina, Hospital Beatriz Ângelo, Av. Carlos Teixeira 3, 2674-514 Loures, Portugal
| | - Raquel Ascenção
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Instituto de Medicina Preventiva, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Centro Cardiovascular da Universidade de Lisboa e Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Daniel Caldeira
- Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Centro Cardiovascular da Universidade de Lisboa e Centro Académico de Medicina de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Francesca Fiorentino
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Victor Gil
- Unidade Cardiovascular, Hospital dos Lusíadas, R. Abílio Mendes 12, 1500-458 Lisboa, Portugal.,Departamento de Medicina, Centro Cardiovascular da Universidade de Lisboa, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Departamento de Medicina, Faculdade de Medicina, Universidade do Porto, Alameda Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
| | - Miguel Gouveia
- Centro de Estudos Aplicados, Católica Lisbon School of Business and Economics, Universidade Católica Portuguesa, Palma de Cima, 1649-023 Lisboa, Portugal
| | - Francisco Lourenço
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Alberto Mello E Silva
- Sociedade Portuguesa de Aterosclerose, Av. José Malhoa, n.º 2, 1070-158 Lisboa, Portugal
| | - Filipa Sampaio
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Department of Public Health and Caring Sciences, Uppsala Biomedical Centre, Uppsala University, Husargatan 3, 751 22 Uppsala, Sweden
| | - António Vaz Carneiro
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Instituto de Saúde Baseada na Evidência, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - Margarida Borges
- Centro de Estudos de Medicina Baseada na Evidência (CEMBE), Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Laboratório de Farmacologia Clínica e Terapêutica, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.,Unidade de Farmacologia Clínica, Centro Hospitalar Lisboa Central EPE, Alameda Santo António dos Capuchos, 1169-050 Lisboa, Portugal
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Dong S, Fang J, Li Y, Ma M, Hong Y, He L. The population attributable risk and clustering of stroke risk factors in different economical regions of China. Medicine (Baltimore) 2020; 99:e19689. [PMID: 32311944 PMCID: PMC7220510 DOI: 10.1097/md.0000000000019689] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The greatest regional variation in stroke prevalence exists in China. However, whether there are differences in population attributable risk (PAR) and clustering of stroke risk factors among regions resulting in stroke geographic variation is unclear.We conducted face-to-face surveys of residents of 14 provinces from September 2016 to May 2017 who participated in the Chinese Stroke Screening and Prevention Project. We compared the specific PAR values of eight risk factors and the different cluster rates and patterns in China.A total of 84,751partipants were included. Eight factors accounted for 70% to 80% of the PAR of overall stroke in China. Not only did the PAR of the total risk factors differ among the 3 regions, but the PAR of the same risk factor also varied among different regions. The top 3 factors with the greatest PAR variations among the 3 regions were dyslipidemia, physical inactivity and family history of stroke. The clustering rates and patterns varied by regions. The overall proportion of participants with 0, 1, 2, 3, and ≥4 risk factors were 34.4%, 28.0%, 17.4%, 9.2%, and 10.3% in eastern China; 31.0%, 27.9%, 19.8%, 10.8%, and 9.9% in Central China and 28.2%, 29.5%, 19.9%, 10.8%, and 11.0% in western China, respectively. On basis of hypertension, the most common risk cluster patterns were overweight or smoking, dyslipidemia and physical inactivity, with other risk factors in the eastern, central and western regions, respectively.The rates and patterns of clustering and the potential importance of stroke risk factors in different regions may together contribute to the geographical variation in stroke prevalence in China.
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Cho SMJ, Lee H, Kim HC. Comparison and Implication of the Contemporary Blood Pressure Guidelines on Korean Population. Korean Circ J 2020; 50:485-498. [PMID: 32212423 PMCID: PMC7234852 DOI: 10.4070/kcj.2019.0347] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/21/2019] [Accepted: 02/06/2020] [Indexed: 12/30/2022] Open
Abstract
Background and Objectives This study compared the potential impacts of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target blood pressure (BP) in Korean population. Methods We analyzed the 2007–2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on 59,767 adults aged 20 years or older by sex and age. Results The prevalence of hypertension was markedly higher 46.3% by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% by the KSH guideline; the increase was most pronounced in young adults. Yet, there was only a marginal 1.6% increase in the percentage of adults suggested pharmacological approach by the ACC/AHA guideline, but selectively in the older subgroups. Overall, 45.6% of Korean adults treated for hypertension failed to meet BP goal according to the KSH guideline; the underachievement extended to 61.7% of participants according to the ACC/AHA guideline. Conclusions The lowered BP threshold, 130/80 mmHg, by the 2017 ACC/AHA guideline, in conjuncture with 10-year risk calculation largely driven by age, would increase pharmacological treatment preferentially in very old individuals, while increasing prevalence and uncontrolled rate mostly in younger subgroups. Adoption of lower BP cutoff to the KSH guideline would require validated cardiovascular disease risk assessment tools accounting for risk distributions specific to Korean population.
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Affiliation(s)
- So Mi Jemma Cho
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hokyou Lee
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.,Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea.
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Clusters of Cardiovascular Risk Factors and Their Impact on the 20-Year Cardiovascular Risk in a General Population. J Cardiovasc Nurs 2020; 35:210-216. [DOI: 10.1097/jcn.0000000000000637] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kim J, Hoang T, Bu SY, Kim JM, Choi JH, Park E, Lee SM, Park E, Min JY, Lee IS, Youn SY. Associations of Dietary Intake with Cardiovascular Disease, Blood Pressure, and Lipid Profile in the Korean Population: a Systematic Review and Meta-Analysis. J Lipid Atheroscler 2020; 9:205-229. [PMID: 32821732 PMCID: PMC7379076 DOI: 10.12997/jla.2020.9.1.205] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Previous studies have separately reported the contributions of dietary factors to the risk of cardiovascular disease (CVD) and its markers, including blood pressure (BP) and lipid profile. This study systematically reviewed the current evidence on this issue in the Korean population. METHODS Sixty-two studies from PubMed and Embase were included in this meta-analysis. We performed a random-effects model to analyze pooled odds ratios (ORs) and hazard ratios (HRs) and their 95% confidence intervals (CIs) for the consumption of 14 food items, three macro- and eight micro-nutrients, two dietary patterns, and three dietary indices. RESULTS An analysis of pooled effect sizes from at least four individual study populations showed significant associations between coffee consumption and CVD (OR/HR, 0.71; 95% CI, 0.52-0.97) and elevated/high triglycerides (TG) (OR, 0.84; 95% CI, 0.78-0.90), sugar-sweetened beverage intake and elevated BP (OR/HR, 1.20; 95% CI, 1.09-1.33), and milk and dairy intake and elevated/high TG and low high-density lipoprotein cholesterol (HDL-C) (OR/HR, 0.82; 95% CI, 0.76-0.89 for both). Carbohydrate consumption and the low-carbohydrate-diet score were consistently related to an approximately 25% risk reduction for elevated TG and low HDL-C. A lower risk of elevated total cholesterol, but not low-density lipoprotein, was additionally observed for those with a higher low-carbohydrate-diet score. A healthy dietary pattern was only associated with a reduced risk of elevated TG in the Korea National Cancer Screenee Cohort (OR, 0.81; 95% CI, 0.67-0.98). CONCLUSION This study showed that milk and dairy and coffee had protective effects for CVD and its risk factors, such as BP and lipid profile, while sugar-sweetened beverages exerted harmful effects.
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Affiliation(s)
- Jeongseon Kim
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - Tung Hoang
- Department of Cancer Biomedical Science, National Cancer Center Graduate School of Cancer Science and Policy, Goyang, Korea
| | - So Young Bu
- Department of Food and Nutrition, Daegu University, Gyeongsan, Korea
| | - Ji-Myung Kim
- Food and Nutrition Major, Division of Food Science and Culinary Arts, Shinhan University, Uijeongbu, Korea
| | - Jeong-Hwa Choi
- Department of Food and Nutrition, Keimyung University, Daegu, Korea
| | - Eunju Park
- Department of Food and Nutrition, Kyungnam University, Changwon, Korea
| | - Seung-Min Lee
- Department of Food and Nutrition, Yonsei University, Seoul, Korea
| | - Eunmi Park
- Department of Food and Nutrition, Hannam University, Daejeon, Korea
| | - Ji Yeon Min
- Dietetics and Nutrition Services Team, Asan Medical Center, Seoul, Korea
| | - In Seok Lee
- Nutrition Support Team, Kyung Hee University Medical Center, Seoul, Korea
| | - So Young Youn
- Clinical Nutrition Part, Samsung Medical Center, Seoul, Korea
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Sun HX, Ji HH, Chen XL, Wang L, Wang Y, Shen XY, Lu X, Gao W, Wang LS. Serum retinol-binding protein 4 is associated with the presence and severity of coronary artery disease in patients with subclinical hypothyroidism. Aging (Albany NY) 2019; 11:4510-4520. [PMID: 31278889 PMCID: PMC6660052 DOI: 10.18632/aging.102065] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 06/25/2019] [Indexed: 04/12/2023]
Abstract
Subclinical hypothyroidism (SCH) plays a crucial role in the development and progression of coronary heart disease (CAD). Retinol-binding protein 4 (RBP4) is an adipokine correlated with cardiovascular diseases. Recent studies found that RBP4 levels are increased in patients with SCH. However, the relationship of RBP4 with CAD in SCH patients remains unclear. A total of 199 SCH patients (148 with CAD and 51 without CAD) and 102 healthy controls were enrolled in this study. Serum RBP4 was increased in SCH patients than controls. Moreover, serum RBP4 was higher in SCH patients with CAD. Although there was no significant difference of metabolic parameters between SCH patients with and without CAD, serum RBP4 was positively correlated with body mass index, total cholesterol, and low-density lipoprotein cholesterol, as well as thyroid stimulating hormone. Multivariable logistic regression analyses revealed elevated RBP4 was correlated with increased risk for CAD in SCH patients. Serum RBP4 levels were also increased as the number of stenosed vessels increased. Furthermore, increased RBP4 was positively correlated with the severity of CAD quantified by the Gensini score. Our findings demonstrate that serum RBP4 is associated with the presence and severity of CAD in patients with SCH.
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Affiliation(s)
- Hui-Xian Sun
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
- Department of Respiratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Hui-Hong Ji
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Internal Medicine, The Hospital of HoHai University, Nanjing, China
| | - Xiao-Lin Chen
- Department of Respiratory, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
| | - Li Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
| | - Yue Wang
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
| | - Xi-Yu Shen
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
| | - Xiang Lu
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
| | - Wei Gao
- Department of Geriatrics, Sir Run Run Hospital, Nanjing Medical University, Nanjing, China
- Key Laboratory for Aging and Disease, Nanjing Medical University, Nanjing, China
| | - Lian-Sheng Wang
- Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China
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High-sensitivity troponin I for cardiovascular risk stratification in the general asymptomatic population: Perspectives from Asia-Pacific. Int J Cardiol 2019; 282:93-98. [DOI: 10.1016/j.ijcard.2019.01.107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Revised: 12/22/2018] [Accepted: 01/14/2019] [Indexed: 11/15/2022]
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Gonzalez-Navarro B, Pintó-Sala X, Corbella E, Jané-Salas E, Miedema MD, Yeboah J, Shea S, Nasir K, Comin-Colet J, Corbella X, Lopez-López J, Blumenthal RS, Blaha MJ, Cainzos-Achirica M. Associations between self-reported periodontal disease, assessed using a very short questionnaire, cardiovascular disease events and all-cause mortality in a contemporary multi-ethnic population: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2018; 278:110-116. [PMID: 30265891 DOI: 10.1016/j.atherosclerosis.2018.09.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/18/2018] [Accepted: 09/19/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND AND AIMS Periodontal disease (PD) is believed to be associated with cardiovascular disease (CVD) events. Nevertheless, the additive prognostic value of PD for the prediction of CVD events beyond traditional risk factors is unclear, particularly when self-reported using a short questionnaire. METHODS In the community-based, multicenter, prospective, Multi-Ethnic Study of Atherosclerosis (MESA), PD was assessed at baseline using a two-item questionnaire. We used Cox proportional hazards regression models to evaluate the independent associations between self-reported PD and coronary heart disease (CHD), CVD events, and all-cause death. In addition, the area under the receiver-operator characteristic curve (AUC) was calculated for each of the study endpoints, for models including traditional CVD risk factors alone and models including traditional CVD risk factors plus information on PD. Subgroup analyses were performed stratifying by age and tobacco use. RESULTS Among the 6640 MESA participants, high education level, high income, and access to healthcare were more frequent among individuals who self-reported PD. In multivariable analyses, null associations were observed between self-reported PD and incident CVD events, CHD events, and all-cause mortality; and self-reported PD did not improve risk prediction beyond traditional CVD risk factors in terms of AUC, for any of the three study endpoints. Subgroup analyses were consistent with the overall results. CONCLUSIONS Our findings suggest that the prevalence of self-reported PD may be strongly influenced by educational status and other socioeconomic features. In this context, self-reported PD does not improve CVD risk assessment when evaluated using a brief questionnaire. Future studies should prioritize objective, dental health-expert assessments of PD.
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Affiliation(s)
- Beatriz Gonzalez-Navarro
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | - Xavier Pintó-Sala
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Emili Corbella
- Cardiovascular Risk Unit, Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Ciber Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), Madrid, Spain
| | - Enric Jané-Salas
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain
| | | | | | - Steve Shea
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | | | - Josep Comin-Colet
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Department of Clinical Sciences, University of Barcelona, Barcelona, Spain
| | - Xavier Corbella
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Internal Medicine, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Hestia Chair in Integrated Health and Social Care, Faculty of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain
| | - Jose Lopez-López
- Oral Health and Masticatory System Research Group, Institut d'Investigació Biomèdica de Bellvitge (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Odonto-Stomatology, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain; Dental Hospital Barcelona University (HOUB), University of Barcelona, Barcelona, Spain
| | - Roger S Blumenthal
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Miguel Cainzos-Achirica
- Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain; Department of Cardiology, Bellvitge University Hospital, L'Hospitalet de Llobregat, Barcelona, Spain; Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins Medical Institutions, Baltimore, MD, USA; School of Medicine and Health Sciences, Universitat Internacional de Catalunya, Barcelona, Spain; RTI Health Solutions, Pharmacoepidemiology and Risk Management, Barcelona, Spain.
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