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Al-Shudifat AE, Hammoudeh AJ, Al Saud W, Ibdah R, Araydah M, Zaqqa A, Fakhri ZR, Haikal LHF, Abuhalimeh LJ, Alghabban Z, Ja'arah D, Al-Mashayikh AN, Alhaddad I. Coexistence of Standard Modifiable, Other Classical, and Novel and Classical Atherosclerotic Cardiovascular Disease Risk Factors in Middle Eastern Young Women. Vasc Health Risk Manag 2024; 20:313-322. [PMID: 39005236 PMCID: PMC11244616 DOI: 10.2147/vhrm.s468209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 06/30/2024] [Indexed: 07/16/2024] Open
Abstract
Background The coexistence of multiple standard modifiable risk factors (SMuRFs),classical and novel risk factors (RFs) for atherosclerotic cardiovascular disease (ASCVD) is common in the Middle East (ME). There is a paucity of data on the coexistence of these RFs in ME young women. Aim Comparing the prevalence and the statistical patterns of the SMuRFs, classical and novel RFs in target population. Methods In this case-control (1:2) study, consecutive young women aged 18-50 years were enrolled in 12 centers (July 2021 to October 2023). Prevalence and coexistence of 19 RFs were compared between cases with ASCVD and their controls. The RFs included SMuRFs (hypertension, type 2 diabetes, dyslipidemia, and cigarette smoking), other classical RF (obesity, family history of premature ASCVD, and physical inactivity), novel RFs and social determinants of health (health insurance, place of residence, depression, and level of education). Results The study included 627 subjects; 209 had ASCVD (median age 46 years, IQR 49-42 years) and 418 controls (median age 45 years, IQR 48-41 years). The presence of 1-2 RFs; (ASCVD: 63.2%, Control: 54.1%, p=0.037) and 3-4 RFs; (ASCVD: 27.8%, Control: 3.3%, p < 0.001) SMuRFs was more prevalent in women with ASCVD. Similarly, the presence of 4-5 RFs; (ASCVD: 40.7%, Control: 14.6%, p<0.001), and 6-7 (ASCVD: 10.5%, Control: 1%, p < 0.001). The classical RF were also significantly common in these women. The distribution of multiple novel RF was not statistically significant across both groups. Finally, regarding the socioeconomic RFs in women with ASCVDs, the presence of 1-2 RFs (ASCVD: 59.8%, Control: 76.1%, p < 0.001) was significantly less common while the presence of 3-4 RFs (ASCVD: 39.2%, Control: 21.8%, p < 0.001) was vastly more common. Conclusion An elevated rate of coexistence of classical RF in the case group, mainly socioeconomic and SMuRFs. By managing them primary and secondary ASCVDs prevention attained.
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Affiliation(s)
- Abdel-Ellah Al-Shudifat
- Department of Internal and Family Medicine, Faculty of Medicine The Hashemite University, Zarqa, Jordan
| | | | - Wesam Al Saud
- Department of Clinical Pharmacy, Princess Salma Hospital, Ministry of Health, Amman, Jordan
| | - Rashid Ibdah
- Department of Internal Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Araydah
- Department of Internal Medicine, Istishari Hospital, Amman, Jordan
| | - Ayah Zaqqa
- Department of Clinical Research, Istishari Hospital, Amman, Jordan
| | - Zainab Raed Fakhri
- Medical Education department, King Abdullah University Hospital, Irbid, Jordan
| | | | | | - Zahraa Alghabban
- Medical Education department, Jordan University Hospital, Amman, Jordan
| | - Daria Ja'arah
- Medical education, Istishari Hospital, Amman, Jordan
| | | | - Imad Alhaddad
- Director of Cardiovascular Department, Jordan Hospital, Amman, Jordan
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Sarbast S, Mohamad JB. Study of Lipid-Modifying Therapy Use and Risk Factor Management in Patients With Dyslipidemia in Duhok City/Kurdistan Region, Iraq. Cureus 2024; 16:e53849. [PMID: 38465113 PMCID: PMC10924617 DOI: 10.7759/cureus.53849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Introduction Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of mortality globally, according to the World Health Organization. Research from the Middle East indicates that cardiovascular disease-related deaths in the region are among the highest worldwide. Multiple risk factors contribute to ASCVD. Elevated low-density lipoprotein cholesterol (LDL-C), often associated with hyperlipidemia, plays a pivotal role. The reduction of LDL cholesterol through statins has been extensively studied over the years and has demonstrated a significant decrease in rates of cardiovascular disease, particularly in high- and very high-risk groups. Study design This cross-sectional study enrolled 503 adult patients undergoing lipid-lowering therapy for primary and secondary prevention of ASCVD at the Azadi General & Teaching Hospital in Duhok City, Iraq. Data were collected from January 2, 2023, to October 31, 2023. The sample size was carefully determined to ensure a precise estimation of the primary outcome measure. Results Of the 503 patients aged 21-89 years, 315 (62.2%) were women. Among the 145 (28.8%) with ASCVD, 127 (87.5%) had coronary artery disease. Only 150 (29.8%) were on a high-intensity statin, compared to 293 (58.25%) on a moderate-intensity statin. In total, 155 (30.8%) attained LDL-C control (p<0.0001). Among the 207 with very high cardiovascular disease risk, only 10 (4.83%) achieved an LDL-C level below 55 mg/dl. Conclusion This study revealed inadequate management of LDL-C levels across various participant categories, particularly those classified as having high cardiovascular disease risk. Control of other risk factors (e.g., hypertension, diabetes, and metabolic syndrome) was overall very poor. Most participants were overweight or obese.
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Affiliation(s)
- Sipan Sarbast
- Medicine, College of Medicine, University of Duhok, Duhok, IRQ
| | - Jamal B Mohamad
- Medicine, College of Medicine, University of Duhok, Duhok, IRQ
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Kargar S, Ansari H. Prevalence of dyslipidemias in the Middle East region: A systematic review & meta-analysis study. Diabetes Metab Syndr 2023; 17:102870. [PMID: 37844434 DOI: 10.1016/j.dsx.2023.102870] [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: 06/28/2022] [Revised: 09/23/2023] [Accepted: 09/26/2023] [Indexed: 10/18/2023]
Abstract
BACKGROUND AND AIMS Dyslipidemia is a known main risk factor for cardiovascular diseases, and it can be controlled to reduce the incidence of cardiovascular diseases. This meta-analysis aimed to estimate the prevalence of dyslipidemias in the Middle East. METHODS The relevant published articles between 2000 and 2021 that investigated the prevalence of dyslipidaemias in the Middle East were found through international data sources such as Medline, PubMed, and Google Scholar. The random-effects model was used to estimate the pooled prevalence with 95% confidence intervals. RESULTS The pooled prevalence of dyslipidemias, hypertriglyceridemia, hypercholesterolemia, high levels of low-density lipoprotein cholesterol and low levels of high-density lipoprotein cholesterol in the Middle East were 54.08% (95% CI: 43.83-66.71), 32.51% (95% CI: 28.59-36.43), 29.44% (95% CI: 18.74-40.13), 32.09% (95% CI: 22.17-42.01), 44.71% (95% CI: 37.86-51.57), respectively. During the last two decades, an increasing trend in the prevalence of dyslipidemias was observed overall and in both sexes. Also, the age groups over 30 significantly had the highest prevalence of hypercholesterolemia, high levels of low-density lipoprotein cholesterol, and low levels of high-density lipoprotein cholesterol (p < 0.05). CONCLUSIONS The increasing trend in the prevalence of dyslipidemias during the last two decades is an alarming and significant concern in the Middle East. Therefore, special measures are needed to deal with dyslipidemias as a health priority in the Middle East.
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Affiliation(s)
- Shiva Kargar
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran.
| | - Hossein Ansari
- Department of Epidemiology and Biostatistics, Zahedan University of Medical Sciences, Zahedan, Iran.
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Ezzati F, Jafarzadeh M, Darabi F. Assessing and predicting the trend of cardiovascular risk factors in 40-80-year population based on the Ira-PEN program as an integrated service in primary health care. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:374. [PMID: 38144037 PMCID: PMC10743925 DOI: 10.4103/jehp.jehp_124_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 03/30/2023] [Indexed: 12/26/2023]
Abstract
BACKGROUND In Iran, half of all mortalities and 79% of those induced by noncommunicable diseases are attributed to cardiovascular diseases. In Iran, due to the high rate of noncommunicable diseases, a modified program (PEN) called Ira-PEN was integrated into the primary care program in health centers. The Ira-PEN program is adapted from the comprehensive WHO-PEN program to estimate the 10-year risk of cardiovascular diseases to control the main risk factors of noncommunicable diseases nationally. This study was conducted to investigate the process of service provision to determine the information needs and the necessary interventions in the comprehensive health service centers of Ardabil Province. MATERIALS AND METHODS The present descriptive and analytical study was conducted in the Ardabil University of Medical Sciences. It used the data available in the registration system of the Health Network. The research population consisted of all people aged between 40 and 80 who visited the comprehensive health service centers to perform risk assessment of cardiovascular strokes in the province from 2018 to the end of 2021. The collected data were added to Excel. FORCAST function was used to predict the future through a linear regression analysis. To compare the final results, which is actually a reduction in mortality due to cardiovascular diseases, the difference test of two mortality rates due to cardiovascular diseases was used in 2018 and 2021. Test of two death proportions was performed through z test and Minitab21 Software. RESULTS The prevalence of cardiovascular disease risk factors was as follows: history of heart attack (0.59%), history of stroke (0.51%), history of diabetes (7.9%), history of high blood pressure (15.7%), and history of prediabetics (12.8%). The probability of suffering from lipid disorder was 26.4% and BMI > 30 was 32.4%. The risk factors of hypertension, abdominal obesity, and smoking showed a decrease in the measurement of disease risk factors during 4 years. CONCLUSIONS Identification of the common risk factors in the region helps to focus interventions on effective prevention and treatment measures and adopt evidence-based policies in order to reduce these risk factors. Since the investigated risk factors are rooted in inappropriate behaviors and lifestyles, by modifying these behaviors and changing lifestyles, their prevalence can be reduced and reducing these risk factors will lead to a reduction in the prevalence of cardiovascular diseases.
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Affiliation(s)
- Farahnaz Ezzati
- Department of Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mohammad Jafarzadeh
- Department of Infectious Diseases School of Medicine, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Fatemeh Darabi
- Department of Public Health, Asadabad School of Medical Sciences, Asadabad, Iran
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Atrooz OM, Hiresh MN, Dlewan AR, Atrooz MO, Hiresh GN, Alasoufi AM, Atrooz IO. Prevalence of dyslipidemia and the association with levels of TSH and T4 hormones among patients in south region of Jordan. J Med Biochem 2023; 42:706-713. [PMID: 38084237 PMCID: PMC10710817 DOI: 10.5937/jomb0-40504] [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: 01/17/2023] [Accepted: 04/24/2023] [Indexed: 08/24/2024] Open
Abstract
BACKGROUND Glycolipid metabolism disorders (dysglycolipidemia) are characterized by elevated levels of glycolipid profile components and fasting blood glucose. Dysglycolipidemia are major threats to human health and life. Therefore, the aim of this cross-sectional study is to estimate the prevalence of dysglycolipidemia and the existence of association of TSH and T4 and glycolipid profiles. METHODS Cross-sectional data were obtained from the medical laboratory of Ma'an Governmental Hospital. A total of 141 patients' results were collected (18-60 years). Differences in the glycolipidemic profiles according to age and sex and TSH and T4 were compared. Different statistical analyses were used to analyze the prevalence of dysglycolipidemia and the correlation with the levels of TSH and T4. RESULTS The study involved results of 141 patients (54.7% males and 45.3% females) in Ma'an Province (Jordan), who visited the internal medicine clinic at Ma'an Governmental Hospital. Patients have overweight and BMI of more than 25 kg/m2. The overall results of the prevalence of dyslipidemia indicated that patients have 42.5% of hypercholesterolemia, 48.2% of high LDL-C, 34.1% of hypertriglyceridemia, and 41.8% of low HDL-C. The prevalence of isolated lipid profiles showed that 10 patients have mixed dyslipidemia. The association of dyslipidemia with age indicated a positive significance between triglyceride and older people (≥40 years), while HDL levels have a significance with gender (p=0.025). The overall ANOVA model yielded non-statistical significant results between levels of any components of lipid profile and levels of TSH and T4 hormones. Welch test (p=0.036) showed positive significance between levels of fasting blood glucose and triglyceride levels. CONCLUSIONS Our results showed and confirmed the presence of a high percentage of hyperlipidemia in Ma'an province and there was no relationship with levels of TSH and T4. A relationship exists between levels of triglycerides and blood glucose concentrations.
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Affiliation(s)
| | - Mazen Nayef Hiresh
- The Shrewsbury and Telford NHS Trust, Princess Royal Hospital, Emergency Department, Telford, United Kingdom
| | - Alghonmeen Reham Dlewan
- Resident in Jordanian Royal Medical Service, Anesthesia and Intensive Care Unit, Amman, Jordan
| | - Mohammad Omar Atrooz
- Resident in Jordanian Royal Medical Service, Anesthesia and Intensive Care Unit, Amman, Jordan
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Kalash A, Abdelrahman A, Al-Zakwani I, Al Suleimani Y. Potentially Harmful Drug-Drug Interactions and Their Associated Factors Among Hospitalized Cardiac Patients: A Cross-Sectional Study. Drugs Real World Outcomes 2023; 10:371-381. [PMID: 37178272 PMCID: PMC10491557 DOI: 10.1007/s40801-023-00373-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/26/2023] [Indexed: 05/15/2023] Open
Abstract
BACKGROUND Cardiovascular diseases are responsible for a significant proportion of mortalities worldwide. Elderly patients are the most affected by cardiovascular diseases, and because of factors such as polypharmacy, multimorbidity, and age-related changes in drug availability and metabolism, they are highly susceptible to the occurrence of drug-drug interactions. Drug-drug interactions are among the many drug-related problems leading to negative outcomes among inpatients and outpatients. Thus, it is important to investigate the prevalence, involved drugs, and factors related to potential drug-drug interactions (pDDIs) to properly optimize pharmacotherapy regimens for these patients. OBJECTIVE We aimed to determine the prevalence of pDDIs, drugs most frequently implicated, and significant predictors associated with these interactions among hospitalized patients in the Cardiology Unit at Sultan Qaboos University Hospital in Muscat, Oman. METHODS This retrospective cross-sectional study included 215 patients. Micromedex Drug-Reax® was used to identify pDDIs. Data extracted from patients' medical records were collected and analyzed. Univariable and multivariable linear regression was applied to determine the predictors associated with the observed pDDIs. RESULTS A total of 2057 pDDIs were identified, with a median of nine (5-12) pDDIs per patient. Patients with at least one pDDI accounted for 97.2% of all the included patients. The majority of pDDIs were of major severity (52.6%), fair level of documentation (45.5%), and pharmacodynamic basis (55.9%). Potential drug-drug interactions between atorvastatin and clopidogrel were the most frequently observed (9%). Of all the detected pDDIs, around 79.6% of them included at least one antiplatelet drug. Having diabetes mellitus as a comorbidity (B = 2.564, p < 0.001) and the number of drugs taken during the hospitalization period (B = 0.562, p < 0.001) were factors positively associated with the frequency of pDDIs. CONCLUSIONS Potential drug-drug interactions were highly prevalent among hospitalized cardiac patients at Sultan Qaboos University Hospital, Muscat, Oman. Patients having diabetes as a comorbidity and with a high number of administered drugs were at a higher risk of an increased number of pDDIs.
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Affiliation(s)
- Abdulrahman Kalash
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. BOX 35, PC 123 Al Khoudh, Muscat, Oman
| | - Aly Abdelrahman
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. BOX 35, PC 123 Al Khoudh, Muscat, Oman
| | - Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. BOX 35, PC 123 Al Khoudh, Muscat, Oman
| | - Yousuf Al Suleimani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. BOX 35, PC 123 Al Khoudh, Muscat, Oman.
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Al-Naggar R, Osman M. The Effects of Consuming Almonds and Almond Oil on Blood Lipids: A Systematic Review. ASIAN JOURNAL OF PHARMACEUTICAL RESEARCH AND HEALTH CARE 2023. [DOI: 10.4103/ajprhc.ajprhc_90_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Masrouri S, Moazzeni SS, Cheraghloo N, Azizi F, Hadaegh F. The clinical value of metabolic syndrome and its components with respect to sudden cardiac death using different definitions: Two decades of follow-up from the Tehran Lipid and Glucose Study. Cardiovasc Diabetol 2022; 21:269. [PMID: 36463175 PMCID: PMC9719125 DOI: 10.1186/s12933-022-01707-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 11/23/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND To evaluate the impact of different definitions of metabolic syndrome (MetS) and their components on the risk of sudden cardiac death (SCD) among the Iranian population according to the World Health Organization (WHO), International Diabetes Federation (IDF), Adult Treatment Panel III (ATP III), and Joint Interim Statement (JIS) criteria. METHODS The study population included a total of 5,079 participants (2,785 women) aged ≥ 40 years, free of cardiovascular disease (CVD) at baseline. Participants were followed for incident SCD annually up to 20 March 2018. Multivariable Cox proportional hazards regression models were applied to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MetS and its components for incident SCD. RESULTS The prevalence of MetS ranged from 27.16% to 50.81%, depending on the criteria used. Over a median of 17.9 years of follow-up, 182 SCD events occurred. The WHO, IDF, and JIS definitions were strong predictors of SCD with multivariable-adjusted HRs (95% CI) of 1.68 (1.20-2.35), 1.51 (1.12-2.03), and 1.47 (1.08-1.98), respectively; these associations significantly attenuated after further adjustment for MetS components. MetS by the ATP III definition was not associated with the risk of SCD after controlling for antihypertensive, glucose-lowering, and lipid-lowering medication use. Among the components of MetS, high blood pressure (WHO definition), high waist circumference (using the national cutoff of ≥ 95 cm), and high glucose component by the JIS/IDF definitions remained independent predictors of SCD with HRs of 1.79 (1.29-2.48), 1.46 (1.07-2.00), and 1.52 (1.12-2.05), respectively. CONCLUSIONS The constellation of MetS, except for when defined with ATP III definition, is a marker for identifying individuals at higher risk for SCD; however, not independent of its components. Among MetS components, abdominal obesity using the population-specific cutoff point, high glucose component (JIS/IDF definitions), and high blood pressure (WHO definition) were independent predictors of SCD.
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Affiliation(s)
- Soroush Masrouri
- grid.411600.2Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413 Iran
| | - Seyyed Saeed Moazzeni
- grid.411600.2Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413 Iran
| | - Neda Cheraghloo
- grid.411705.60000 0001 0166 0922Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Fereidoun Azizi
- grid.411600.2Endocrine Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farzad Hadaegh
- grid.411600.2Prevention of Metabolic Disorders Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, P.O. Box: 19395-4763, Tehran, 1985717413 Iran
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Djalalinia S, Azadnajafabad S, Ghasemi E, Yoosefi M, Rezaei N, Farzi Y, Kazemi A, Ahmadi N, Nasserinejad M, Fattahi N, Rezaei S, Abdolhamidi E, Foroutan Mehr E, Haghshenas R, Rezaei N, Abdi J, Moghisi A, Mahdavihezaveh A, Akbari Sari A, Raeisi A, Jamshidi H, Larijani B, Farzadfar F. Protocol Design for Surveillance of Risk Factors of Non-communicable Diseases During the COVID-19 Pandemic: An Experience from Iran STEPS Survey 2021. ARCHIVES OF IRANIAN MEDICINE 2022; 25:634-646. [PMID: 37543889 PMCID: PMC10685773 DOI: 10.34172/aim.2022.99] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/08/2022] [Indexed: 08/07/2023]
Abstract
BACKGROUND Regarding the growing burden of non-communicable diseases (NCDs) and exposure to their risk factors, and the continuous need for nationwide data, we aimed to develop the latest round of the STEPwise Approach to NCD Risk Factor Surveillance (STEPS) survey in 2021 in Iran, while the COVID-19 pandemic was still present. METHODS In addition to the three main steps of this survey, including questionnaires, physical measurements, and laboratory assessments, we adapted the survey with the situation caused by the COVID-19 pandemic, by adding to various aspects of study phases and changing some scientific and executive procedures in this round of STEPS survey in Iran. These changes were beyond the initial novelties embedded within the survey before the pandemic, by refining the study protocol benefiting from the previous experiences of the STEPS survey. RESULTS By amending the required changes, we could include a total of 27874 individuals in the first step of the survey. This number was 27745 and 18119 for the second and third steps. Comparing the preliminary results with the previous nationwide surveys, this study was highly representative on both national and provincial levels. Also, implementing the COVID-19 prevention and control strategies in all stages of survey led to the least infection transmission between the study investigators and participants. CONCLUSION The novel initiatives and developed strategies in this round of Iran STEPS survey provide a state-of-the-art protocol for national surveys in the presence of an overwhelming catastrophe like the COVID-19 pandemic and the triggered limitations and shortages of resources.
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Affiliation(s)
- Shirin Djalalinia
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Development of Research and Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Erfan Ghasemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Moein Yoosefi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Yosef Farzi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ameneh Kazemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Maryam Nasserinejad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, Faculty of Paramedical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Fattahi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahabeddin Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Ohio State University, Columbus, OH, USA
| | - Elham Abdolhamidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elmira Foroutan Mehr
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Rosa Haghshenas
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Nazila Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Jaleh Abdi
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Moghisi
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
| | | | - Ali Akbari Sari
- National Institute for Health Research, Tehran University of Medical Sciences, Tehran, Iran
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Raeisi
- Deputy of Health, Ministry of Health and Medical Education, Tehran, Iran
- School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamidreza Jamshidi
- Research Institute for Endocrine Sciences, School of Medicine, Department of Pharmacology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Yahya T, Acquah I, Taha MB, Valero-Elizondo J, Al-Mallah MH, Chamsi-Pasha MA, Zoghbi WA, Soliman A, Faza N, Cainzos-Achirica M, Nasir K. Cardiovascular risk profile of Middle Eastern immigrants living in the United States-the National Health Interview Survey. Am J Prev Cardiol 2022; 9:100312. [PMID: 35024678 PMCID: PMC8732795 DOI: 10.1016/j.ajpc.2021.100312] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Middle Eastern (ME) immigrants are one of the fastest-growing groups in the US. Although ME countries have a high burden of atherosclerotic cardiovascular disease (ASCVD), the cardiovascular health status among ME immigrants in the US has not been studied in detail. This study aims to characterize the cardiovascular health status (CVD risk factors and ASCVD burden) among ME immigrants in the US. METHODS We used 2012-2018 data from the National Health Interview Survey, a US nationally representative survey. ME origin, CVD risk factors, and ASCVD status were self-reported. We compared these to US-born non-Hispanic white (NHW) individuals in the US. RESULTS Among 139,778 adults included, 886 (representing 1.3 million individuals, mean age 46.8) were of ME origin, and 138,892 were US-born NHWs (representing 150 million US adults, mean age 49.3). ME participants were more likely to have higher education, lower income and be uninsured. The age-adjusted prevalence of hypertension (22.4% vs 27.4%) and obesity (21.4% vs 31.4%) were significantly lower in ME vs NHW participants, respectively. There were no significant differences between the groups in the age-adjusted prevalence of ASCVD, diabetes, hyperlipidemia, and smoking. Only insufficient physical activity was higher among ME individuals. ME immigrants living in the US for 10 years or more reported higher age-adjusted prevalence of hypertension, hyperlipidemia, and ASCVD. CONCLUSIONS ME immigrants in the US have lower odds of hypertension and obesity, and of having a suboptimal CRF profile compared to US-born NHWs. Further studies are needed to determine whether these findings are related to lower risk, selection of a healthier ME subgroup in NHIS, or possible under-detection of cardiovascular risk factors in ME immigrants living in the US.
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Affiliation(s)
- Tamer Yahya
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - Isaac Acquah
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
- Center for Outcomes Research, Houston Methodist, Houston TX, USA
| | - Mohamad B Taha
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | | | - Mouaz H. Al-Mallah
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - Mohammed A. Chamsi-Pasha
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - William A. Zoghbi
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - Ahmed Soliman
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - Nadeen Faza
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
| | - Miguel Cainzos-Achirica
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
- Center for Outcomes Research, Houston Methodist, Houston TX, USA
| | - Khurram Nasir
- Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, 6550 Fannin St Suite 1801, Houston TX 77030, USA
- Center for Outcomes Research, Houston Methodist, Houston TX, USA
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11
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Rimbert A, Daggag H, Lansberg P, Buckley A, Viel M, Kanninga R, Johansson L, Dullaart RPF, Sinke R, Al Tikriti A, Kuivenhoven JA, Barakat MT. Low Detection Rates of Genetic FH in Cohort of Patients With Severe Hypercholesterolemia in the United Arabic Emirates. Front Genet 2022; 12:809256. [PMID: 35047021 PMCID: PMC8762259 DOI: 10.3389/fgene.2021.809256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Programs to screen for Familial hypercholesterolemia (FH) are conducted worldwide. In Western societies, these programs have been shown to be cost-effective with hit/detection rates of 1 in 217-250. Thus far, there is no published data on genetic FH in the Gulf region. Using United Arab Emirates as a proxy for the Gulf region, we assessed the prevalence of genetically confirmed FH in the Emirati population sample. Materials and Methods: We recruited 229 patients with LDL-C >95th percentile and employed a customized next generation sequencing pipeline to screen canonical FH genes (LDLR, APOB, PCSK9, LDLRAP1). Results: Participants were characterized by mean total cholesterol and low-density lipoprotein cholesterol (LDL-c) of 6.3 ± 1.1 and 4.7 ± 1.1 mmol/L respectively. Ninety-six percent of the participants were using lipid-lowering medication with mean corrected LDL-c values of 10.0 ± 3.0 mmol/L 15 out of 229 participants were found to suffer from genetically confirmed FH. Carriers of causal genetic variants for FH had higher on-treatment LDL-c compared to those without causal variants (5.7 ± 1.5 vs 4.7 ± 1.0; p = 3.7E-04). The groups did not differ regarding high-density lipoprotein cholesterol, triglycerides, body mass index, blood pressure, glucose, and glycated haemoglobin. Conclusion: This study reveals a low 7% prevalence of genetic FH in Emiratis with marked hypercholesterolemia as determined by correcting LDL-c for the use of lipid-lowering treatment. The portfolio of mutations identified is, to a large extent, unique and includes gene duplications. Our findings warrant further studies into origins of hypercholesterolemia in these patients. This is further supported by the fact that these patients are also characterized by high prevalence of type 2 diabetes (42% in the current study cohort) which already puts them at an increased risk of atherosclerotic cardiovascular disease. These results may also be useful in public health initiatives for FH cascade screening programs in the UAE and maybe the Gulf region.
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Affiliation(s)
- Antoine Rimbert
- Department of Paediatrics, Section Molecular Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Hinda Daggag
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Peter Lansberg
- Department of Paediatrics, Section Molecular Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Adam Buckley
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Martijn Viel
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Roan Kanninga
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Lennart Johansson
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Robin P F Dullaart
- Department of Endocrinology, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Richard Sinke
- Department of Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
| | - Alia Al Tikriti
- Imperial College London Diabetes Centre, Abu Dhabi, United Arab Emirates
| | - Jan Albert Kuivenhoven
- Department of Paediatrics, Section Molecular Genetics, University Medical Centre Groningen, University of Groningen, Groningen, Netherlands
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12
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El Kenawy AM, Lopez-Moreno JI, McCabe MF, Domínguez-Castro F, Peña-Angulo D, Gaber IM, Alqasemi AS, Al Kindi KM, Al-Awadhi T, Hereher ME, Robaa SM, Al Nasiri N, Vicente-Serrano SM. The impact of COVID-19 lockdowns on surface urban heat island changes and air-quality improvements across 21 major cities in the Middle East. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 288:117802. [PMID: 34284210 PMCID: PMC9756818 DOI: 10.1016/j.envpol.2021.117802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Revised: 06/18/2021] [Accepted: 07/15/2021] [Indexed: 05/04/2023]
Abstract
This study investigates changes in air quality conditions during the restricted COVID-19 lockdown period in 2020 across 21 metropolitan areas in the Middle East and how these relate to surface urban heat island (SUHI) characteristics. Based on satellite observations of atmospheric gases from Sentinel-5, results indicate significant reductions in the levels of atmospheric pollutants, particularly nitrogen dioxide (NO2), sulfur dioxide (SO2), and carbon monoxide (CO). Air quality improved significantly during the middle phases of the lockdown (April and May), especially in small metropolitan cities like Amman, Beirut, and Jeddah, while it was less significant in "mega" cities like Cairo, Tehran, and Istanbul. For example, the concentrations of NO2 in Amman, Beirut, and Jeddah decreased by -56.6%, -43.4%, and -32.3%, respectively, during April 2020, compared to April 2019. Rather, there was a small decrease in NO2 levels in megacities like Tehran (-0.9%) and Cairo (-3.1%). Notably, during the lockdown period, there was a decrease in the mean intensity of nighttime SUHI, while the mean intensity of daytime SUHI experienced either an increase or a slight decrease across these locations. Together with the Gulf metropolitans (e.g. Kuwait, Dubai, and Muscat), the megacities (e.g. Tehran, Ankara, and Istanbul) exhibited anomalous increases in the intensity of daytime SUHI, which may exceed 2 °C. Statistical relationships were established to explore the association between changes in the mean intensity and the hotspot area in each metropolitan location during the lockdown. The findings indicate that the mean intensity of SUHI and the spatial extension of hotspot areas within each metropolitan had a statistically significant negative relationship, with Pearson's r values generally exceeding - 0.55, especially for daytime SUHI. This negative dependency was evident for both daytime and nighttime SUHI during all months of the lockdown. Our findings demonstrate that the decrease in primary pollutant levels during the lockdown contributed to the decrease in the intensity of nighttime SUHIs in the Middle East, especially in April and May. Changes in the characteristics of SUHIs during the lockdown period should be interpreted in the context of long-term climate change, rather than just the consequence of restrictive measures. This is simply because short-term air quality improvements were insufficient to generate meaningful changes in the region's urban climate.
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Affiliation(s)
- Ahmed M El Kenawy
- Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman; Department of Geography, Mansoura University, Mansoura, 35516, Egypt.
| | - Juan I Lopez-Moreno
- Instituto Pirenaico de Ecología, Campus de Aula Dei, Avda. Montañana, 50059, Zaragoza, Spain
| | - Matthew F McCabe
- Division of Biological and Environmental Sciences and Engineering, King Abdullah University of Science and Technology, Thuwal, Saudi Arabia
| | - Fernando Domínguez-Castro
- Aragonese Agency for Research and Development Researcher (ARAID), Department of Geography, University of Zaragoza, Zaragoza, Spain
| | - Dhais Peña-Angulo
- Instituto Pirenaico de Ecología, Campus de Aula Dei, Avda. Montañana, 50059, Zaragoza, Spain
| | - Islam M Gaber
- GIS specialist, Department of Geography, South Valley University, Qena branch, Qena, Egypt
| | - Abduldaem S Alqasemi
- Geography and Urban Sustainability, College of Humanities & Social Science, UAEU, Al-Ain, United Arab Emirates
| | - Khalifa M Al Kindi
- Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman
| | - Talal Al-Awadhi
- Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman
| | - Mohammed E Hereher
- Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman; Department of Environmental Sciences, Faculty of Science, Damietta University, New Damietta, Egypt
| | - Sayed M Robaa
- Department of Astronomy, Space Science and Meteorology, Faculty of Science, Cairo University, 12613, Egypt
| | - Noura Al Nasiri
- Department of Geography, Sultan Qaboos University, Al Khoud, Muscat, Oman
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13
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Malaeb D, Hallit S, Dia N, Cherri S, Maatouk I, Nawas G, Salameh P, Hosseini H. Effects of sociodemographic and socioeconomic factors on stroke development in Lebanese patients with atrial fibrillation: a cross-sectional study. F1000Res 2021; 10:793. [PMID: 34504688 DOI: 10.12688/f1000research.54236.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/27/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Non-communicable diseases, the major cause of death and disability, are susceptible to modifiable and non-modifiable risk factors. Atrial fibrillation (AF) increases the risk of stroke by 4-5 times and can lead to cardiovascular mortality. This study was conducted to assess the effects of different sociodemographic factors on stroke development in patients with AF. Methods: A cross-sectional study was conducted between January and June 2018 on patients recruited from Lebanese community pharmacies. The CHA 2DS 2-VASc scoring system is utilized as a stroke risk stratification tool in AF patients. Participants with a previous physician diagnosis of AF, documented on medical records, were included in this study. Results: A total of 524 patients were enrolled in the study with a mean age of 58.75 (± SD) ± 13.59 years with hypertension (78.38%) being the most predominant disease. The results showed that obesity (Beta=0.610, p-value =0.011), retirement and unemployment compared to employment (Beta=1.440 and 1.440, p-value=0.001 respectively), divorced/widow compared to married (Beta=1.380, p-value =0.001) were significantly associated with higher CHA 2DS 2-VASc scores whereas high versus low socio-economic status (Beta=-1.030, p=0.009) and high school education versus primary education level (Beta=-0.490, p-value=0.025) were significantly associated with lower CHA 2DS 2-VASc scores. Conclusions: The study highlights that the CHA 2DS 2-VASc score is affected by the presence of various sociodemographic and socioeconomic characteristics in patients with AF. Thus, screening for those factors may predict the progression of cardiovascular disease and may provide an optimal intervention.
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Affiliation(s)
- Diana Malaeb
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est University, Paris, France
| | - Souheil Hallit
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Jounieh, Lebanon.,Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Life Sciences and Health Department, Paris-Est Créteil University, Paris, France
| | - Nada Dia
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - Sarah Cherri
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - Imad Maatouk
- School of pharmacy, Lebanese International University, Beirut, Beirut, Lebanon
| | - George Nawas
- College of Pharmacy, Xavier University of Louisiana, Louisiana, USA
| | - Pascale Salameh
- Institut National de Santé Publique, Epidémiologie Clinique et Toxicologie - Liban (INSPECT-LB), Beirut, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadat, Lebanon.,University of Nicosia Medical School, Nicosia, Cyprus
| | - Hassan Hosseini
- Henri Mondor Hospital, Paris, France.,Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon
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14
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Comparing the measurement properties of the EQ-5D-5L and the EQ-5D-3L in hypertensive patients living in rural China. Qual Life Res 2021; 30:2045-2060. [PMID: 33821418 DOI: 10.1007/s11136-021-02786-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/29/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE The purpose of this study was to compare the measurement properties of two versions of EQ-5D (i.e.EQ-5D-3L and EQ-5D-5L) in hypertensive patients in rural China. METHODS A cross-sectional survey was carried out in hypertensive patients in rural China. We compared the ceiling effects, redistribution properties, informativity, known-groups validity, and relative efficiency of the 3L and 5L and examined their agreement. RESULTS A total of 11,412 patients were enrolled in our study. The mean EQ-5D index score was 0.84 (SD 0.21) according to the 5L and 0.86 (SD 0.17) according to the 3L. A good agreement was observed between the 3L and 5L. The overall ceiling effect decreased from 46.4% (3L) to 29.4% (5L). The Shannon index, H' improved in all dimensions when used 5L. When used 3L, the median responses of all groups were consistent with 5L across the three dimensions of 'mobility', 'self-care', 'usual activities', while the median responses were inconsistent for the 'pain/discomfort' and 'anxiety/depression' dimensions. The 3L performed better in eight comorbidities in terms of F-statistics and six comorbidities in terms of the area under the receiver operating characteristic curves (AUROCs). The 5L performed better both in terms of the F-statistics and AUROCs in age, education level, anti-hypertensive medication use. CONCLUSION Taking all comparisons into account, we recommend the EQ-5D-5L for use in patients with hypertension in rural China.
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15
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Xu Q, Wang Y, Xie Y, Zheng J, Guo R, Dai Y, Sun Z, Xing L, Zhang X, Ruan S, Zheng L, Sun Y. Blood Pressure Changes in a Chinese Population Have a Greater Impact on Short-Term Outcomes Rather Than Long-Term Outcomes of Major Adverse Cardiovascular Events. Asia Pac J Public Health 2020; 33:39-45. [PMID: 32930003 DOI: 10.1177/1010539520955088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The purpose of our study was to explore the association of blood pressure (BP) changes on short-and long-term outcomes of major adverse cardiovascular events (MACEs) in rural China. This study was designed to learn the effects of BP changes (2004-2008) on short-term (2008-2010, within 2 years of the initial examination) and long-term (2008-2017) outcomes of MACE, including 24 285 and 27 290 participants, respectively. In this study, 423 (short-term) and 1952 (long-term) MACEs were identified. For prehypertension to hypertension, the risk of long-term stroke was increased (hazard ratio [HR] = 1.18 [1.00-1.39]). For hypertension to prehypertension, the short-term MACE risk (0.65 [0.47-0.90]), short-term stroke risk (0.45 [0.26-0.76]), and long-term stroke risk (0.83 [0.70-0.99]) all decreased. Short-term outcomes conferred a stronger impact than long-term outcomes (Fisher Z test, measured as the difference of β coefficients, all P < .05).
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Affiliation(s)
- Qianyi Xu
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yali Wang
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yanxia Xie
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Jia Zheng
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Rongrong Guo
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yue Dai
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Zhaoqing Sun
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Liying Xing
- Liaoning Provincial Center for Disease Control and Prevention, Shenyang, People's Republic of China
| | - Xingang Zhang
- The First Affiliated Hospital of China Medical University, Shenyang, People's Republic of China
| | - Shikai Ruan
- University of Illinois at Urbana-Champaign, IL, USA
| | - Liqiang Zheng
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
| | - Yingxian Sun
- Shengjing Hospital of China Medical University, Shenyang, People's Republic of China
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16
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Nouri F, Feizi A, Taheri M, Mohammadifard N, Khodarahmi S, Sadeghi M, Sarrafzadegan N. Temporal Trends of the Incidence of Ischemic Heart Disease in Iran Over 15 Years: A Comprehensive Report from a Multi-Centric Hospital-Based Registry. Clin Epidemiol 2020; 12:847-856. [PMID: 32848474 PMCID: PMC7429231 DOI: 10.2147/clep.s259953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 07/19/2020] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND We sought to explore the temporal trend of ischemic heart disease (IHD) incidence rate (IR) in a large city of Iran. METHODS The study population comprised hospitalized patients who were living in Isfahan, Iran, with first or recurrent IHD during the period of 2001 to 2016. To identify patients, clinical diagnostic codes were applied according to the International Classification of Diseases 10 (ICD-10: I20.0, I21-I25) and the "World Health Organization Monitoring Trends and Determinants in Cardiovascular Disease" diagnostic categories (WHO-MONICA). Using a direct method, we calculated age-, sex-, and place-of-residence-adjusted incidence rates based on multiple reference populations. To examine the long-term trend for the IR, a bootstrap robust zero-truncated negative binomial regression model was used. RESULTS A total of 102,254 hospitalized patients, with a mean (SD) age of 61.85 (12.79), were registered between 2001 and 2016. After an initial reduction from 2006 to 2010, crude and adjusted IRs of IHD increased between 2010 and 2016. We further observed a significant increasing long-term temporal trend in the IR with an average annual change of 1.42% to 3.36% over the study period. CONCLUSION Our findings showed a decreasing trend in the IR of IHD between 2006 and 2010, possibly attributed to the comprehensive community-based interventions named "Isfahan Healthy Heart Program" performed from 2001 to 2007, followed by an increase in the adjusted IR of IHD between 2010 and 2016 in Isfahan; this indicates the importance of continuing the preventive measures to preclude the risk factors of cardiovascular diseases in our population.
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Affiliation(s)
- Fatemeh Nouri
- Pediatric Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Marzieh Taheri
- Interventional Cardiology Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Noushin Mohammadifard
- Hypertension Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Somayeh Khodarahmi
- Heart Failure Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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17
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Atallah B, Khaddage R, Sadik ZG, Mallah SI, Lee-St. John TJ, Alfardan S, Traina MI, Almahmeed W. Lipid Control Post Coronary Artery Bypass Graft: One Year Follow-Up of a Middle-Eastern Cohort. Glob Heart 2020; 15:12. [PMID: 32489785 PMCID: PMC7218787 DOI: 10.5334/gh.530] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 01/10/2020] [Indexed: 01/14/2023] Open
Abstract
Background Data on patient characteristics and provider practices in the management of lipids per the new guidelines in specific secondary prevention patients in the Middle East is limited. Objective To explore patient characteristics and lipid management practices according to the new cholesterol guidelines in secondary prevention patients, up to one year following discharge for coronary artery bypass graft surgery (CABG). Methods A retrospective chart review of patients discharged post CABG between February 2017 and February 2018 at a quaternary care centre in the Middle East. Patients were characterized by baseline demographics, comorbidities, and use of lipid lowering medications. Results 189 patients were included in the analysis. Most were diabetic (70.9%) and classified as very high risk per the ACC/AHA guidelines (84.1%) and as extremely high risk per the AACE guidelines (85.2%). Most patients (93.1%) were discharged on high intensity statin. About one third (28.6%) were never seen or only followed once within the first 2 weeks post discharge. Of those who continued to follow up beyond 3 months and within 1 year of discharge (44.4%), about half (51.2%) had follow-up lipid panels performed. Patients who followed up and were seen by a cardiologist were five times more likely to have lipid panels ordered than those seen solely by a CT surgeon. Of those with follow-up lipid panels beyond 3 months: 59.3% achieved LDL goal of <70 mg/dL and 29% achieved LDL <55 mg/dL based on their respective goals. Conclusions Most patients undergoing CABG in a quaternary care centre in the Middle East are high risk ASCVD. Nonetheless, lipid goals are not commonly achieved nor routinely monitored. Providers will need to transition from the previous risk stratification and statin-only focused approach to adopt the most recent guidelines.
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Affiliation(s)
- Bassam Atallah
- Cleveland Clinic Abu Dhabi, Department of Pharmacy Services, Al Maryah Island, Abu Dhabi, AE
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, US
| | - Ramzi Khaddage
- Cleveland Clinic Abu Dhabi, Department of Family Medicine, Al Maryah Island, Abu Dhabi, AE
| | - Ziad G. Sadik
- Cleveland Clinic Abu Dhabi, Department of Pharmacy Services, Al Maryah Island, Abu Dhabi, AE
| | - Saad I. Mallah
- Cleveland Clinic Abu Dhabi, Department of Research, Al Maryah Island, Abu Dhabi, AE
| | | | - Shamsah Alfardan
- Cleveland Clinic Abu Dhabi, Department of Research, Al Maryah Island, Abu Dhabi, AE
| | - Mahmoud I. Traina
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, Ohio, US
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Al Maryah Island, Abu Dhabi, AE
| | - Wael Almahmeed
- Cleveland Clinic Abu Dhabi, Heart and Vascular Institute, Al Maryah Island, Abu Dhabi, AE
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18
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Al-Duais MA, Al-Awthan YS. Prevalence of dyslipidemia among students of a Yemeni University. J Taibah Univ Med Sci 2019; 14:163-171. [PMID: 31435407 PMCID: PMC6694883 DOI: 10.1016/j.jtumed.2018.12.003] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/25/2018] [Accepted: 12/26/2018] [Indexed: 01/14/2023] Open
Abstract
Objectives To estimate the prevalence of dyslipidemia and patterns of lipid profile and associated factors among Yemeni university students. Methods This cross-sectional study included 240 Yemeni students (116 males and 124 females) at Ibb University. The students were randomly selected from various faculties of the university. Demographic and clinical data were obtained from all participants. Fasting blood specimens were collected from all students for measurement of serum levels of total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). The criteria of the National Cholesterol Education Program-Adult Treatment Panel III (NCEP-ATP III) were used. Results The mean age of the studied cohort was 19.8 ± 1.8 years; 48.3% were men and 51.7% were women. About 56.7% of the participants were from rural areas. Qat chewers and cigarette smokers comprised 63.3% and 6.7% of the cohort, respectively. No obese students were found in this study; however, 11.7% were overweight. The overall prevalence of dyslipidemia, hypercholesterolemia, hypertriglyceridemia, high LDL-C, and low HDL-C among the participating students were 86.7%, 21.7%, 23.8%, 31.7%, and 81.7%, respectively. Mixed hyperlipidemia was present in 8.8% of the students. The prevalence of isolated hypercholesterolemia, hypertriglyceridemia, and low HDL-C was 12.9%, 15%, and 70%, respectively. Dyslipidemia was significantly associated with male sex, increasing age, urban residence, and medical and natural science faculties. In contrast, smoking, qat chewing, physical activity, and the consumption of fast food, fruits and vegetables, and fish were not significantly associated with dyslipidemia. Conclusion To our knowledge, this is the first human study conducted at Ibb University during wartime in Yemen. Dyslipidemia was highly prevalent among healthy Yemeni university students in Ibb city. Low HDL-C was the most prevalent type of dyslipidemia, followed by increased levels of LDL-C. Gender, age, residence, and type of faculty were also closely related to dyslipidemia. These results indicate the need for specialized programs to determine blood lipid levels and initiate intervention programs to reduce the prevalence and prevent the complications of dyslipidemia among Yemeni university students.
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Affiliation(s)
- Mohammed A Al-Duais
- Department of Biochemistry, Faculty of Science, University of Tabuk, Tabuk, KSA
| | - Yahya S Al-Awthan
- Department of Biology, Faculty of Science, Ibb University, Ibb, Yemen
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Design, synthesis and biological evaluation of hypolipidemic compounds based on BRD4 inhibitor RVX-208. Bioorg Med Chem Lett 2019; 29:2168-2172. [PMID: 31257080 DOI: 10.1016/j.bmcl.2019.06.028] [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: 04/12/2019] [Revised: 06/10/2019] [Accepted: 06/19/2019] [Indexed: 11/21/2022]
Abstract
Bromodomain-containing protein 4 (BRD4) is a new therapeutic target for the treatment of diseases including cardiovascular diseases, cancer, inflammation and central nervous system (CNS) disorders. In this study, we introduced the pharmacophore of fibrates to a BRD4 inhibitor, RVX-208, to design dual-active hypolipidemic compounds, and found that some of new analogues showed favorable hypolipidemic activities. Synthetic accessibility towards this class of compounds optimized RVX-208 as well as would supply more thoughts on hypolipidemic drugs.
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20
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Health-related quality of life among rural men and women with hypertension: assessment by the EQ-5D-5L in Jiangsu, China. Qual Life Res 2019; 28:2069-2080. [PMID: 30830645 DOI: 10.1007/s11136-019-02139-3] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE Hypertension is a major global public health problem, including rural China. However, studies examining health-related quality of life (HRQoL) for patients with hypertension have been mostly conducted in urban populations. This study aimed to use the EuroQol five-dimensional-five-level (EQ-5D-5L) and its recently developed Chinese value set to analyze HRQoL and its influencing factors among hypertensive population in rural China. METHODS This is a cross-sectional population-based survey. Standard interview of participants was conducted from July to September 2016 in Donghai County's 334 villages of Jiangsu Province, China. Data collection included the EQ-5D-5L, along with sociodemographic characteristics and disease-related factors such as duration of hypertension, antihypertensive treatment and comorbid conditions. The Tobit regression model was employed to analyze potential influencing factors on HRQoL. RESULTS A total of 16,596 adults (18 years and older) with hypertension participated in this study. 62.4% were women. The mean utility score was 0.85 (standard deviation [SD] = 0.23). The proportion of participants reporting pain/discomfort problems was highest, while least patients reported problems in self-care dimension. Females, elderly, illiterate patients, ex-smokers and patients with longer duration of hypertension or comorbidities scored lower on HRQoL than others. Stroke, heart failure and coronary heart disease were associated with a larger negative impact on HRQoL among all comorbidities. CONCLUSIONS The HRQoL was lower in this rural hypertensive population than previously reported urban counterparts. To improve the HRQoL of hypertensive patients in rural areas, it is important to control hypertension and prevent its associated co-morbidities. More attention needs to be directed to elderly female patients with less education who scored much lower HRQoL than their male counterparts.
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El Khoury P, Couvert P, Elbitar S, Ghaleb Y, Abou-Khalil Y, Azar Y, Ayoub C, Superville A, Guérin M, Rabès JP, Varret M, Boileau C, Jambart S, Giral P, Carrié A, Le Goff W, Abifadel M. Identification of the first Tangier disease patient in Lebanon carrying a new pathogenic variant in ABCA1. J Clin Lipidol 2018; 12:1374-1382. [DOI: 10.1016/j.jacl.2018.08.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 08/29/2018] [Accepted: 08/29/2018] [Indexed: 01/07/2023]
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Yeoh EK, Wong MCS, Wong ELY, Yam C, Poon CM, Chung RY, Chong M, Fang Y, Wang HHX, Liang M, Cheung WWL, Chan CH, Zee B, Coats AJS. Benefits and limitations of implementing Chronic Care Model (CCM) in primary care programs: A systematic review. Int J Cardiol 2018; 258:279-288. [PMID: 29544944 DOI: 10.1016/j.ijcard.2017.11.057] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Revised: 11/07/2017] [Accepted: 11/16/2017] [Indexed: 11/15/2022]
Abstract
BACKGROUND Chronic Care Model (CCM) has been developed to improve patients' health care by restructuring health systems in a multidimensional manner. This systematic review aims to summarize and analyse programs specifically designed and conducted for the fulfilment of multiple CCM components. We have focused on programs targeting diabetes mellitus, hypertension and cardiovascular disease. METHOD AND RESULTS This review was based on a comprehensive literature search of articles in the PubMed database that reported clinical outcomes. We included a total of 25 eligible articles. Evidence of improvement in medical outcomes and the compliance of patients with medical treatment were reported in 18 and 14 studies, respectively. Two studies demonstrated a reduction of the medical burden in terms of health service utilization, and another two studies reported the effectiveness of the programs in reducing the risk of heart failure and other cardiovascular diseases. However, CCMs were still restricted by limited academic robustness and social constraints when they were implemented in primary care. Higher professional recognition, tighter system collaborations and increased financial support may be necessary to overcome the limitations of, and barriers to CCM implementation. CONCLUSION This review has identified the benefits of implementing CCM, and recommended suggestions for the future development of CCM.
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Affiliation(s)
- E K Yeoh
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Martin C S Wong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Eliza L Y Wong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Carrie Yam
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - C M Poon
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Roger Y Chung
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Marc Chong
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Yuan Fang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Harry H X Wang
- School of Public Health, Sun Yat-Sen University, Guangzhou, PR China; General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Miaoyin Liang
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Wilson W L Cheung
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Chun Hei Chan
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
| | - Benny Zee
- School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong
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Gitt AK, Lautsch D, Ferrières J, De Ferrari GM, Vyas A, Baxter CA, Bash LD, Ashton V, Horack M, Almahmeed W, Chiang FT, Poh KK, Brudi P, Ambegaonkar B. Cholesterol target value attainment and lipid-lowering therapy in patients with stable or acute coronary heart disease: Results from the Dyslipidemia International Study II. Atherosclerosis 2017; 266:158-166. [DOI: 10.1016/j.atherosclerosis.2017.08.013] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/21/2017] [Accepted: 08/18/2017] [Indexed: 11/29/2022]
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Li Y, Zhao D, Li Y, Meng L, Enwer G. Serum C-peptide as a key contributor to lipid-related residual cardiovascular risk in the elderly. Arch Gerontol Geriatr 2017; 73:263-268. [PMID: 28869884 DOI: 10.1016/j.archger.2017.05.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 05/10/2017] [Accepted: 05/27/2017] [Indexed: 12/19/2022]
Abstract
OBJECTIVES The serum levels of C-peptide, an important risk factor for cardiovascular disease (CVD), increase with age. This study aimed to investigate the association between serum C-peptide and increased risk for CVD with altered lipid metabolism in the elderly. METHODS This was a population-based cross-sectional study that included 3091 elderly participants aged ≥65 years. Serum C-peptide and lipid levels were measured according to standard protocols. Sampling weights were used to estimate the characteristics of study participants. Stratified analysis of covariance was used to evaluate the changes in the serum lipid levels according to quartiles of serum C-peptide levels, and the linear trend was assessed using a linear model. The logistic regression model was carried out to determine the association between the serum C-peptide levels and serum lipid levels. RESULTS The results of the analysis of covariance stratified by sex and serum insulin level showed that the serum triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) levels were significantly associated with changes in the serum C-peptide levels, independent of the serum insulin level. The logistic regression analyses indicated that the serum C-peptide levels were positively associated with the serum TG levels, and negatively associated with the serum HDL-C levels. A significant dose-response association was obtained in both men and women. CONCLUSIONS Serum C-peptide levels were strongly associated with increased serum TG and reduced HDL-C levels in the elderly. Our results suggest that serum C-peptide increases the risk of CVD via a pathway that increases TG or decreases HDL-C levels.
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Affiliation(s)
- Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, China.
| | - DuoDuo Zhao
- School of Basic Medical Sciences, Zhejiang University, China
| | - Yue Li
- School of Basic Medical Sciences, Zhejiang University, China
| | - Lu Meng
- Department of Social Medicine, School of Public Health, Zhejiang University, China
| | - Gulmire Enwer
- Department of Social Medicine, School of Public Health, Zhejiang University, China
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Dementia prevalence, care arrangement, and access to care in Lebanon: A pilot study. Alzheimers Dement 2017; 13:1317-1326. [PMID: 28579315 DOI: 10.1016/j.jalz.2017.04.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 04/07/2017] [Accepted: 04/22/2017] [Indexed: 11/22/2022]
Abstract
INTRODUCTION In North Africa and the Middle East, studies about dementia prevalence are scarce. A pilot study was conducted in Lebanon to assess dementia prevalence, using the Arabic-validated 10/66 Dementia Research Group (DRG) diagnostic assessment for case ascertainment. The study also examined care arrangement and access to care. METHODS A random sample of 502 persons older than 65 years and their informant were recruited from Beirut and Mount Lebanon governorates through multistage cluster sampling. RESULTS The crude and age-standardized dementia prevalences were 7.4% and 9.0%, respectively. People with dementia were mainly cared for by relatives at home. Access to formal care was very limited. DISCUSSION Dementia prevalence in Lebanon ranks high within the global range of estimates. These first evidence-based data about disease burden and barriers to care serve to raise awareness and call for social and health care reform to tackle the dementia epidemic in Lebanon and in North Africa and the Middle East.
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Al Rasadi K, Almahmeed W, AlHabib KF, Abifadel M, Farhan HA, AlSifri S, Jambart S, Zubaid M, Awan Z, Al-Waili K, Barter P. Dyslipidaemia in the Middle East: Current status and a call for action. Atherosclerosis 2016; 252:182-187. [PMID: 27522462 DOI: 10.1016/j.atherosclerosis.2016.07.925] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 07/10/2016] [Accepted: 07/27/2016] [Indexed: 12/18/2022]
Abstract
The increase in the cardiovascular disease (CVD)-associated mortality rate in the Middle East (ME) is among the highest in the world. The aim of this article is to review the current prevalence of dyslipidaemia and known gaps in its management in the ME region, and to propose initiatives to address the burden of dyslipidaemia. Published literature on the epidemiology of dyslipidaemia in the ME region was presented and discussed at an expert meeting that provided the basis of this review article. The high prevalence of metabolic syndrome, diabetes, familial hypercholesterolaemia (FH) and consanguineous marriages, in the ME region, results in a pattern of dyslipidaemia (low high-density lipoprotein cholesterol and high triglycerides) that is different from many other regions of the world. Early prevention and control of dyslipidaemia is of paramount importance to reduce the risk of developing CVD. Education of the public and healthcare professionals and developing preventive programs, FH registries and regional guidelines on dyslipidaemia are the keys to dyslipidaemia management in the ME region.
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Affiliation(s)
- Khalid Al Rasadi
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Wael Almahmeed
- Heart and Vascular Institute -Cleveland Clinic, Abu Dhabi, United Arab Emirates
| | - Khalid F AlHabib
- Department of Cardiac Sciences, King Fahad Cardiac Center, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Marianne Abifadel
- Laboratory of Biochemistry and Molecular Therapeutics, Faculty of Pharmacy, Saint-Joseph University of Beirut, Beirut, Lebanon
| | - Hasan Ali Farhan
- Baghdad Teaching Hospital, Medical City, Iraqi Board for Medical Specialization, Baghdad, Iraq
| | - Saud AlSifri
- Department of Internal Medicine, Alhada Armed Forces Hospital, Taif, Saudi Arabia
| | - Selim Jambart
- St Joseph University Faculty of Medicine and Hotel Dieu Hospital, Beirut, Lebanon
| | - Mohammad Zubaid
- Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait
| | - Zuhier Awan
- Department of Clinical Biochemistry, King Abdulaziz University, Abdullah Sulayman, Jeddah, Saudi Arabia
| | - Khalid Al-Waili
- Department of Clinical Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman
| | - Philip Barter
- School of Medical Sciences, University of New South Wales, Sydney, Australia
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Alfasfos N, Darawad MW, Nofal B, Samarkandi OA, Abdulqader B. Knowledge, Attitudes, Beliefs and Perceived Risk of Acute Coronary Syndrome among Jordanian Patients. Health (London) 2016. [DOI: 10.4236/health.2016.815175] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Shabbir M, Dilber A, Raza A, Suleria H, Saeed M, Sultan S. Influence of Thermal Processing on the Formation of Trans Fats in Various Edible Oils. J FOOD PROCESS PRES 2015. [DOI: 10.1111/jfpp.12367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M.A. Shabbir
- National Institute of Food Science and Technology; University of Agriculture, Faisalabad; Faisalabad Pakistan
| | - A. Dilber
- National Institute of Food Science and Technology; University of Agriculture, Faisalabad; Faisalabad Pakistan
| | - A. Raza
- National Institute of Food Science and Technology; University of Agriculture, Faisalabad; Faisalabad Pakistan
| | - H.A.R. Suleria
- School of Agriculture and Food Science; The University of Queensland; Hartley Teakle Building, Room C505 Brisbane Queensland 4072 Australia
| | - M. Saeed
- National Institute of Food Science and Technology; University of Agriculture, Faisalabad; Faisalabad Pakistan
| | - S. Sultan
- National Institute of Food Science and Technology; University of Agriculture, Faisalabad; Faisalabad Pakistan
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Al-Zakwani I, Al-Mahmeed W, Arafah M, Al-Hinai AT, Shehab A, Al-Tamimi O, Al-Awadhi M, Al-Herz S, Al-Anazi F, Al-Nemer K, Metwally O, Al-Khadra A, Fakhry M, Elghetany H, Medani AR, Yusufali AH, Al-Jassim O, Al-Hallaq O, Baslaib FOAS, Amin H, Santos RD, Al-Waili K, Al-Hashmi K, Al-Rasadi K. Control of Risk Factors for Cardiovascular Disease among Multinational Patient Population in the Arabian Gulf. Curr Vasc Pharmacol 2015; 14:374-81. [PMID: 26496982 PMCID: PMC4997936 DOI: 10.2174/1570161113666151026115921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Revised: 09/01/2015] [Accepted: 09/02/2015] [Indexed: 11/22/2022]
Abstract
We evaluated the control of cardiovascular disease (CVD) risk factors among patients with atherosclerotic cardiovascular disease (ASCVD) in the Centralized Pan-Middle East Survey on the undertreatment of hypercholesterolaemia (CEPHEUS) in the Arabian Gulf. Of the 4398 enrolled patients, overall mean age was 57 ± 11 years, 60% were males, 13% were smokers, 76% had diabetes, 71% had metabolic syndrome and 78% had very high ASCVD risk status. The proportion of subjects with body mass index <25 kg/m2, HbA1c <7% (in diabetics), low-density lipoprotein cholesterol (LDL-C) <2.6 mmol/L (100 mg/dL) and <1.8 mmol/L (70 mg/dL) for high and very high ASCVD risk cohorts, respectively and controlled blood pressure (<140/90 mmHg) was 14, 26, 31% and 60%, respectively. Only 1.4% of the participants had all of their CVD risk factors controlled with significant differences among the countries (P < .001). CVD risk goal attainment rates were significantly lower in those with very high ASCVD risk compared with those with high ASCVD risk status (P < .001). Females were also, generally, less likely to attain goals when compared with males (P < .001).
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Khalid Al-Rasadi
- Department of Biochemistry, Sultan Qaboos University Hospital, P.O. Box 38, Al-Khod, Muscat 123, Oman.
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Aslesh OP, Mayamol P, Suma RK, Usha K, Sheeba G, Jayasree AK. Level of Physical Activity in Population Aged 16 to 65 Years in Rural Kerala, India. Asia Pac J Public Health 2015; 28:53S-61S. [PMID: 26276364 DOI: 10.1177/1010539515598835] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Kerala is a state in India with a high prevalence of cardiovascular diseases and diabetes. In order to control these diseases, the prevalence of modifiable risk factors such as low physical activity need to be studied. For this a cross-sectional study was conducted to assess the level of physical activity among 240 residents aged between 15 and 65 years in Kulappuram, a village in north Kerala. Low level of physical activity was seen in 65.8% of the study participants. The average duration of moderate to vigorous intensity physical activity per day in different domains such as work, travel, and recreation were 40.5, 10.1, and 12.7 minutes, respectively. The average duration of sedentary activities was 284.3 minutes per day. The level of physical activity was more among those engaged in unskilled work (adjusted odds ratio = 4.32; confidence interval = 1.38-13.51) and unmarried persons (adjusted odds ratio = 3.65; confidence interval = 1.25-10.65). No statistically significant difference in physical activity level was seen in different age, education, religious, and economic categories. The study concludes that the physical activity level was low in the study population.
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Affiliation(s)
- O P Aslesh
- Academy of Medical Sciences, Kannur, Kerala, India
| | - P Mayamol
- Academy of Medical Sciences, Kannur, Kerala, India
| | - R K Suma
- Academy of Medical Sciences, Kannur, Kerala, India
| | - K Usha
- Academy of Medical Sciences, Kannur, Kerala, India
| | - G Sheeba
- College of Nursing, Pariyaram, Kannur, Kerala, India
| | - A K Jayasree
- Academy of Medical Sciences, Kannur, Kerala, India
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Mahmood D, Jahan K, Habibullah K. Primary prevention with statins in cardiovascular diseases: A Saudi Arabian perspective. J Saudi Heart Assoc 2015; 27:179-91. [PMID: 26136632 PMCID: PMC4481463 DOI: 10.1016/j.jsha.2014.09.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2014] [Revised: 09/15/2014] [Accepted: 09/22/2014] [Indexed: 02/08/2023] Open
Abstract
Cardiovascular disease (CVD) constitutes one of the major causes of deaths and disabilities, globally claiming 17.3 million lives a year. Incidence of CVD is expected to rise to 25 million by 2030, and Saudi Arabia, already witnessing a rapid rise in CVDs, is no exception. Statins are the drugs of choice in established CVDs. In the recent past, evidence was increasingly suggesting benefits in primary prevention. But over the last decade Saudi Arabia has a witnessed significant rise in CVD-related deaths. Smoking, high-fat, low-fiber dietary intake, lack of exercise, sedentary life, high blood cholesterol and glucose levels were reported as frequent CVD-risk factors among Saudis, who may therefore be considered for primary prevention with statin. The prevalence of dyslipidemia, in particular, indicates that treatment should be directed at reducing the disorder with lipid-modifying agents and therapeutic lifestyle changes. The recent American College of Cardiology (ACC)/American Heart Association (AHA) guidelines has reported lowering the low-density lipoprotein cholesterol (LDL-C) target levels, prescribed by the 2011 European Society of Cardiology (ESC)/the European Atherosclerosis Society (EAS). The new ACC/AHA guidelines have overemphasized the use of statin while ignoring lipid targets, and have recommended primary prevention with moderate-intensity statin to individuals with diabetes aged 40-75 years and with LDL-C 70-189 mg/dL. Treatment with statin was based on estimated 10-year atherosclerotic-CVD (ASCVD) risk in individuals aged 40-75 years with LDL-C 70 to 189 mg/dL and without clinical ASCVD or diabetes. Adoption of the recent ACC/AHA guidelines will lead to inclusion of a large population for primary prevention with statins, and would cause over treatment to some who actually would not need statin therapy but instead should have been recommended lifestyle modifications. Furthermore, adoption of this guideline may potentially increase the incidences of statin intolerance and side-effects. On the other hand, the most widely used lipid management guideline, the 2011 ESC/EAC guidelines, targets lipid levels at different stages of disease activity before recommending statins. Hence, the 2011 ESC/EAC still offers a holistic and pragmatic approach to treating lipid abnormalities in CVD. Therefore, it is the 2011 ESC/EAC guidelines, and not the recent ACC/AHA guidelines, that should be adopted to draw guidance on primary prevention of CVD in Saudi Arabia.
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Affiliation(s)
- D. Mahmood
- Unaizah College of Pharmacy, Qassim University, Saudi Arabia
| | - K. Jahan
- Department of Pharmacology, Faculty of Pharmacy, Hamdard University, Hamdard Nagar, New Delhi 110062, India
| | - K. Habibullah
- Unaizah College of Pharmacy, Qassim University, Saudi Arabia
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Bamimore MA, Zaid A, Banerjee Y, Al-Sarraf A, Abifadel M, Seidah NG, Al-Waili K, Al-Rasadi K, Awan Z. Familial hypercholesterolemia mutations in the Middle Eastern and North African region: A need for a national registry. J Clin Lipidol 2015; 9:187-94. [DOI: 10.1016/j.jacl.2014.11.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Revised: 11/15/2014] [Accepted: 11/23/2014] [Indexed: 01/01/2023]
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Li Y, Li Y, Meng L, Zheng L. Association between serum C-peptide as a risk factor for cardiovascular disease and high-density lipoprotein cholesterol levels in nondiabetic individuals. PLoS One 2015; 10:e112281. [PMID: 25559358 PMCID: PMC4283961 DOI: 10.1371/journal.pone.0112281] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 10/14/2014] [Indexed: 12/22/2022] Open
Abstract
Objective Objective: Although serum C-peptide has increasingly received attention as a new and important risk factor for cardiovascular disease (CVD), the potential mechanisms remain unclear. This study aimed to investigate the association between serum C-peptide as a risk factor for CVD and high-density lipoprotein cholesterol (HDL-C) levels. Methods The present study included 13,185 participants aged ≥20 years. Serum C-peptide and HDL-C levels were measured according to a standard protocol. Stratified analysis of covariance was used to compare serum HDL-C levels between different quartiles of serum C-peptide levels. Logistic regression analysis was used to determine the association between serum C-peptide and HDL-C levels. Cox proportional hazard regression analysis was conducted to determine the hazard ratio of serum HDL-C for CVD-related mortality. Results The results of the ANCOVA analysis showed a significant linear trend between the mean serum HDL-C level and the different quartiles of serum C-peptide. Compared to the first quartile (25th percentile), the second, third, and fourth quartiles had gradual reduction in serum HDL-C levels. Logistic regression analyses showed a strong negative association between serum C-peptide levels and HDL-C levels; the p value for the linear trend was <0.001. In men, compared with the lowest quartile of the serum C-peptide level, the relative risk was 1.75, 2.79, and 3.07 for the upper three quartiles of the serum C-peptide level. The relative risk was 1.60, 2.61, and 3.67 for women. The results of the survival analysis showed that serum HDL-C levels were negatively associated with CVD-related death in both men and women. Conclusion Serum C-peptide as a risk factor for CVD was significantly and negatively associated with serum HDL-C levels in individuals without diabetes. These findings suggest that serum C-peptide levels association with CVD death can be caused, at least in part, by the low serum HDL-C level.
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Affiliation(s)
- Ying Li
- Department of Social Medicine, School of Public Health, Zhejiang University, Zhejiang, China
- * E-mail: (YL); (LSZ)
| | - Yue Li
- School of Basic Medical Sciences, Zhejiang University, Zhejiang, China
| | - Lu Meng
- Department of Social Medicine, School of Public Health, Zhejiang University, Zhejiang, China
| | - LianShun Zheng
- School of Basic Medical Sciences, Zhejiang University, Zhejiang, China
- * E-mail: (YL); (LSZ)
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Shimony A, Grandi SM, Pilote L, Joseph L, O'Loughlin J, Paradis G, Rinfret S, Sarrafzadegan N, Adamjee N, Yadav R, Gamra H, Diodati JG, Eisenberg MJ. Utilization of evidence-based therapy for acute coronary syndrome in high-income and low/middle-income countries. Am J Cardiol 2014; 113:793-7. [PMID: 24440324 DOI: 10.1016/j.amjcard.2013.11.024] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 11/14/2013] [Accepted: 11/14/2013] [Indexed: 11/17/2022]
Abstract
Limited data exist regarding the management of patients with acute coronary syndrome (ACS) in high-income countries compared with low/middle-income countries. We aimed to compare in-hospital trends of revascularization and prescription of medications at discharge in patients with ACS from high-income (Canada and United States) and low/middle-income (India, Iran, Pakistan, and Tunisia) countries. Data from a double-blind, placebo-controlled, randomized trial investigating the effect of bupropion on smoking cessation in patients after an enzyme-positive ACS was used for our study. A total of 392 patients, 265 and 127 from high-income and from low/middle-income countries, respectively, were enrolled. Patients from high-income countries were older, and were more likely to have diagnosed hypertension and dyslipidemia. During the index hospitalization, patients from high-income countries were more likely to be treated by percutaneous coronary intervention (odds ratio [OR] 19.7, 95% confidence interval [CI] 10.5 to 37.0). Patients with ST elevation myocardial infarction from high-income countries were more often treated by primary percutaneous coronary intervention (OR 16.3, 95% CI 6.3 to 42.3) in contrast with thrombolytic therapy (OR 0.24, 95% CI 0.14 to 0.41). Patients from high-income countries were also more likely to receive evidence-based medications at discharge (OR 2.32, 95% CI 1.19 to 4.52, a composite of aspirin, clopidogrel, and statin). In conclusion, patients with ACS in low/middle-income countries were less likely to be revascularized and to receive evidence-based medications at discharge. Further studies are needed to understand the underutilization of procedures and evidence-based medications in low/middle-income countries.
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Affiliation(s)
- Avi Shimony
- Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada
| | - Sonia M Grandi
- Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Louise Pilote
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada; Division of General Internal Medicine, McGill University Health Centre, Montreal, Quebec, Canada
| | - Lawrence Joseph
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada; Division of Clinical Epidemiology, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jennifer O'Loughlin
- Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec, Canada
| | - Gilles Paradis
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Stéphane Rinfret
- Multidisciplinary Cardiology Department, Quebec Heart-Lung Institute, Quebec City, Quebec, Canada
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nasreen Adamjee
- Interactive Research and Development Center, Karachi, Pakistan
| | - Rakesh Yadav
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - Habib Gamra
- Cardiac Thrombosis Research Unit, Department of Cardiology A, Fattouma Bourguiba University Hospital, Monastir, Tunisia
| | - Jean G Diodati
- Division of Cardiology, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | - Mark J Eisenberg
- Divisions of Cardiology and Clinical Epidemiology, Jewish General Hospital, Lady Davis Institute for Medical Research, McGill University, Montreal, Quebec, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada.
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Al Sifri SN, Almahmeed W, Azar S, Okkeh O, Bramlage P, Jünger C, Halawa I, Ambegaonkar B, Wajih S, Brudi P. Results of the Dyslipidemia International Study (DYSIS)-Middle East: clinical perspective on the prevalence and characteristics of lipid abnormalities in the setting of chronic statin treatment. PLoS One 2014; 9:e84350. [PMID: 24400085 PMCID: PMC3882235 DOI: 10.1371/journal.pone.0084350] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2013] [Accepted: 11/14/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Therapeutic intervention with low-density lipoprotein cholesterol-lowering agents known as statins has been demonstrated to reduce cardiovascular risk. However, many patients on statin treatment have persistent dyslipidemia and remain at a high risk of cardiovascular disease. Therefore, the objective of this study was to assess the frequency of lipid abnormalities in patients receiving chronic statin treatment. METHODS As part of an international, cross-sectional, observational study, DYSIS-Middle East enrolled 2,182 patients in the United Arab Emirates (UAE), Saudi Arabia, Lebanon and Jordan. All patients were over 45 years of age and had been on statin treatment for at least three months. Data on demographics, lipid parameters and cardiovascular risk profile were recorded. Cardiovascular risk was defined according the guidelines of the European Society of Cardiology. RESULTS The majority of patients (82.6%) were classified as being at very high risk of cardiovascular events, and 61.8% of all patients did not attain LDL-C target levels. Low high-density lipoprotein cholesterol levels and elevated triglyceride levels were noted in 55.5% and 48.5% of patients, respectively. Multivariate logistical regression modeling indicated that factors independently associated with LDL-C levels not being at goal were lifestyle choices, diabetes mellitus, ischemic heart disease, and blood pressure ≥ 140/90 mmHg. CONCLUSIONS Almost two-thirds of statin-treated patients in the United Arab Emirates, Saudi Arabia, Lebanon and Jordan had inadequately controlled lipid levels. More comprehensive surveillance, awareness and treatment regimens, as well as modification of lifestyle choices, is necessary to halt the rise in cardiovascular disease-related mortality.
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Affiliation(s)
- Saud N. Al Sifri
- Endocrinology Department, Al Hada Military Hospitals, Taif, Saudi Arabia
| | - Wael Almahmeed
- Institute of Cardiac Sciences, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
| | - Sami Azar
- American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Peter Bramlage
- Institut für Pharmakologie und präventive Medizin, Mahlow, Germany
| | - Claus Jünger
- Institut für Herzinfarktforschung, Ludwigshafen, Germany
- University Medical Center, Johannes Gutenberg University, Mainz, Germany
| | - Islam Halawa
- Medical Department, MSD Saudi Arabia, Riyadh, Saudi Arabia
| | | | - Sameh Wajih
- Medical Department, MSD United Arab Emirates, Abu Dhabi, United Arab Emirates
| | - Philippe Brudi
- Merck & Co., Inc., Whitehouse Station, New Jersey, United States of America
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Lee JE, McLerran DF, Rolland B, Chen Y, Grant EJ, Vedanthan R, Inoue M, Tsugane S, Gao YT, Tsuji I, Kakizaki M, Ahsan H, Ahn YO, Pan WH, Ozasa K, Yoo KY, Sasazuki S, Yang G, Watanabe T, Sugawara Y, Parvez F, Kim DH, Chuang SY, Ohishi W, Park SK, Feng Z, Thornquist M, Boffetta P, Zheng W, Kang D, Potter J, Sinha R. Meat intake and cause-specific mortality: a pooled analysis of Asian prospective cohort studies. Am J Clin Nutr 2013; 98:1032-41. [PMID: 23902788 PMCID: PMC3778858 DOI: 10.3945/ajcn.113.062638] [Citation(s) in RCA: 103] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Total or red meat intake has been shown to be associated with a higher risk of mortality in Western populations, but little is known of the risks in Asian populations. OBJECTIVE We examined temporal trends in meat consumption and associations between meat intake and all-cause and cause-specific mortality in Asia. DESIGN We used ecological data from the United Nations to compare country-specific meat consumption. Separately, 8 Asian prospective cohort studies in Bangladesh, China, Japan, Korea, and Taiwan consisting of 112,310 men and 184,411 women were followed for 6.6 to 15.6 y with 24,283 all-cause, 9558 cancer, and 6373 cardiovascular disease (CVD) deaths. We estimated the study-specific HRs and 95% CIs by using a Cox regression model and pooled them by using a random-effects model. RESULTS Red meat consumption was substantially lower in the Asian countries than in the United States. Fish and seafood consumption was higher in Japan and Korea than in the United States. Our pooled analysis found no association between intake of total meat (red meat, poultry, and fish/seafood) and risks of all-cause, CVD, or cancer mortality among men and women; HRs (95% CIs) for all-cause mortality from a comparison of the highest with the lowest quartile were 1.02 (0.91, 1.15) in men and 0.93 (0.86, 1.01) in women. CONCLUSIONS Ecological data indicate an increase in meat intake in Asian countries; however, our pooled analysis did not provide evidence of a higher risk of mortality for total meat intake and provided evidence of an inverse association with red meat, poultry, and fish/seafood. Red meat intake was inversely associated with CVD mortality in men and with cancer mortality in women in Asian countries.
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Affiliation(s)
- Jung Eun Lee
- Department of Food and Nutrition, Sookmyung Women's University, Seoul, South Korea
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Tennakoon SUB, Kumar BN, Meyer HE. Differences in Selected Lifestyle Risk Factors for Cardiovascular Disease Between Sri Lankans in Oslo, Norway, and in Kandy, Sri Lanka. Asia Pac J Public Health 2013; 27:NP616-25. [DOI: 10.1177/1010539513485973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sri Lankans in Oslo have previously been shown to have lower risk of cardiovascular disease compared with those in Kandy, Sri Lanka. Here we present lifestyle risk factors for cardiovascular diseases: frequency and type of fat consumed, frequency of fruit and vegetable intake, alcohol consumption, and leisure time physical activity between 1145 Sri Lankans living in Oslo and 678 Tamils and Sinhalese Sri Lankans living in Kandy as possible explanatory factors for the differences observed. Those in Oslo were consuming healthier fats and reported higher levels of physical activity but frequency of vegetable and fruit consumption was lower. Alcohol consumption among women was negligible. Type of fats consumed might be protective for Oslo group compared with predominantly saturated fat diet in Kandy. Higher leisure time physical activity may also be protective for the Oslo group. Higher frequency of consumption of vegetables and fruits may be beneficial in Kandy.
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Affiliation(s)
| | | | - Haakon E. Meyer
- University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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Al-Zakwani I, Ali A, Zubaid M, Panduranga P, Sulaiman K, Abusham A, Almahmeed W, Al-Motarreb A, Al Suwaidi J, Amin H. Impact of type of thrombolytic agent on in-hospital outcomes in ST-segment elevation myocardial infarction patients in the Middle East. J Thromb Thrombolysis 2012; 33:280-6. [PMID: 22359050 DOI: 10.1007/s11239-012-0698-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Little is known about the impact of thrombolytic agents on in-hospital outcomes in the Middle East. The objective of this study was to evaluate the impact of thrombolytic agents on in-hospital outcomes in ST-segment elevation myocardial infarction (STEMI) patients in six Middle Eastern countries. Gulf Registry of Acute Coronary Events was a prospective, multinational, multicentre, observational survey of consecutive acute coronary syndrome patients admitted to 65 hospitals in 2006 and 2007. Out of 1,765 STEMI patients admitted to hospitals within 12 h of symptoms onset, 25, 43, and 30% were treated with streptokinase, reteplase, and tenecteplase, respectively. Median age of the study cohort was 50 (45-59) years and majority were males (89%). The overall median symptom onset-to-presentation and median door-to-needle times were 130 min (65-240) and 45 min (30-75), respectively. Streptokinase patients had worse GRACE risk scores compared to patients who received fibrin specific thrombolytics. Academic hospitals and cardiologists as admitting physicians were associated with the use of fibrin specific thrombolytics. After significant covariate adjustment, both reteplase [odds ratio (OR), 0.38; 95% CI: 0.18-0.79; P = 0.009] and tenecteplase (OR, 0.30; 95% CI: 0.12-0.77; P = 0.012) were associated with lower all-cause in-hospital mortality compared with streptokinase. No significant differences in other in-hospital outcomes were noted between the thrombolytic agents. In conclusion, in light of the study's limitations, fibrin specific agents, reteplase and tenecteplase, were associated with lower all-cause in-hospital mortality compared to the non-specific fibrin agent, streptokinase. However, the type of thrombolytic agent used did not influence other in-hospital outcomes.
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Affiliation(s)
- Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 38, Al-Khodh, Muscat 123, Sultanate of Oman.
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Al-Zakwani I, Zubaid M, Al-Riyami A, Alanbaei M, Sulaiman K, Almahmeed W, Al-Motarreb A, Al Suwaidi J. Primary coronary intervention versus thrombolytic therapy in myocardial infarction patients in the Middle East. Int J Clin Pharm 2012; 34:445-51. [PMID: 22477207 DOI: 10.1007/s11096-012-9627-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2011] [Accepted: 03/16/2012] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little is known about predictors and outcome differences of primary percutaneous coronary intervention (PPCI) and thrombolytic therapy (TT) in ST-segment elevation myocardial infarction (STEMI) patients in the Middle East. OBJECTIVE To compare predictors as well as in-hospital outcomes of PPCI and TT in STEMI patients in six Middle Eastern countries. SETTING Sixty-five hospitals (covering at least 85 % of the population) in Oman, United Arab Emirates, Qatar, Bahrain, Kuwait and Yemen. METHODS This was a prospective, multinational, multicentre, observational survey of consecutive acute coronary syndrome patients who were admitted to 65 hospitals during May 8, 2006 to June 6, 2006 and from January 29, 2007 to June 29, 2007, as part of Gulf RACE (Registry of Acute Coronary Events). Analyses were performed using univariate and multivariate statistical techniques. MAIN OUTCOME MEASURES Predictors as well as in-hospital outcomes of PPCI and TT in STEMI patients. RESULTS Out of 2,155 STEMI patients admitted to hospitals within 12 h of symptoms onset, 92 % received reperfusion (8 % PPCI and 84 % TT). TT use included reteplase (43 %), tenecteplase (30 %), streptokinase (25 %), and alteplase (2 %). Median age of the study cohort was 50 (44-58) years with majority being males (90 %). There were no significant differences in median onset time to presentation between the TT and PPCI groups (130 vs. 120 min; P = 0.422). Median door-to-needle time and door-to-balloon time were 45 min (29-75) and 75 min (58-120), respectively. Predictors of PPCI included prior PCI, hospitals with catheterization laboratory facilities as well as those involved with academia. Multivariate logistic regression model demonstrated that patients that had PPCI were less likely to have recurrent ischemic attacks than those that had TT (odds ratio, 0.18; 95 % CI, 0.06-0.56; P = 0.003). CONCLUSIONS The main reperfusion strategy for STEMI patients in the Arab Middle East region is thrombolytic therapy. Predictors of primary percutaneous coronary intervention included prior percutaneous coronary intervention, hospitals with catheterization laboratory facilities as well as those involved with academia. Primary percutaneous coronary intervention resulted in significant reductions in recurrent ischemic events when compared to thrombolytic therapy.
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Affiliation(s)
- Ibrahim Al-Zakwani
- Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, P.O. Box 38, Al-Khodh, Muscat, 123, Sultanate of Oman.
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Boutayeb A, E. N. Lamlili M, Boutayeb W, Maamri A, Ziyyat A, Ramdani N. The rise of diabetes prevalence in the Arab region. ACTA ACUST UNITED AC 2012. [DOI: 10.4236/ojepi.2012.22009] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Lee MH, So ES. Impact of Hypertension-Related Comorbidity on Health-Related Quality of Life. Asia Pac J Public Health 2011; 24:753-63. [DOI: 10.1177/1010539511431822] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The aim of this study was to examine the impact of the most prevalent comorbid chronic diseases in hypertensives on health-related quality of life (HRQOL) in the general representative Korean population using the EuroQOL-5D (EQ-5D) and to assess this impact by sex and after controlling for sociodemographic factors. The effects of hypertension and comorbidity on HRQOL were examined using multiple linear regression models with Fourth Korean National Health and Nutrition Examination Survey data. In a total of 5736 adults, the prevalence of hypertension alone was 20.8%, and the prevalence rates of hypertension comorbid with diabetes mellitus (DM), cardiovascular disease (CVD), and musculoskeletal (MS) disease were 9.5%, 3.8%, and 33.5%, respectively. Females with hypertension and other comorbidity showed worse HRQOL scores, with the exception of hypertension and CVD, where males scored worse for HRQOL. After adjustment, subjects with comorbid DM, CVD, or MS experienced EQ-5D scores decreasing by 0.01, 0.09, and 0.05, respectively. Since comorbidity impairs HRQOL in hypertensives, health providers should consider comorbid diseases in hypertensives when developing methods of intervention to effectively manage hypertension.
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Affiliation(s)
| | - Eun Sun So
- Seoul National University, Seoul, South Korea
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Li Y, Sato Y, Yamaguchi N. Lifestyle Factors as Predictors of General Cardiovascular Disease. Asia Pac J Public Health 2011; 26:414-24. [DOI: 10.1177/1010539511423067] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
This study aims to examine the effectiveness of lifestyle factors in predicting general cardiovascular events and to investigate the feasibility of using the lifestyle model as a self-screening tool. The authors conducted a longitudinal study over a 10-year follow-up in Japan. Logistic regression analysis was used to create prediction models for general cardiovascular disease (CVD) death. The authors estimated the predictive power of the models by calculating the area under the receiver operating characteristic (AUROC) curve. The total of 6 traditional and 5 lifestyle risk factors were significantly associated with the incidence of CVD events. Hazard ratios (HRs) were 0.26 (95% confidence interval [CI] = 0.17, 0.41) for regular physical activity, 0.57 (95% CI = 0.50, 0.67) for moderate- or high-intensity work, and 1.72 (95% CI = 1.31-2.26) for short sleep duration; the HRs for traditional and Western dietary patterns were 1.53 (95% CI = 1.12, 2.09) and 2.62 (95% CI = 1.46, 4.68), respectively. The AUROC curve was significantly different between the classic and lifestyle prediction models. These results suggest that lifestyle factors are significant predictors of CVD events.
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Affiliation(s)
- Ying Li
- Zhejiang University, Zhejiang, China
| | - Yasuto Sato
- Tokyo Women’s Medical University, Tokyo, Japan
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Fields J, Trivedi NJ, Horton E, Mechanick JI. Vitamin D in the Persian Gulf: integrative physiology and socioeconomic factors. Curr Osteoporos Rep 2011; 9:243-50. [PMID: 21901427 DOI: 10.1007/s11914-011-0071-2] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Countries of the Persian Gulf region--Bahrain, Iran, Iraq, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates--have become increasingly modernized, resulting in a transformation of lifestyle based on technology, sedentary activity, lack of sunlight, and unhealthy dietary patterns. These factors have led to a higher prevalence not only of vitamin D undernutrition, but also chronic obesity, insulin resistance, prediabetes, and type 2 diabetes. This review explores the integrative physiologic effects of vitamin D with socioeconomic factors and propose a hypothesis-driven model for their contributions to obesity and diabetes in the Persian Gulf. Further research into these interactions may ultimately lead to novel preventive strategies and therapies for metabolic disorders in this geographic region.
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Affiliation(s)
- Jessica Fields
- Division of Endocrinology, Diabetes, and Bone Disease, Mount Sinai School of Medicine, New York, NY 10128, USA
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Mujtaba SH, Ashraf T, Anjum Q. Improving General Practitioners’ Knowledge Regarding Blood Pressure Measurement in Selected Cities of Pakistan Through Workshop. Asia Pac J Public Health 2011; 25:84-91. [DOI: 10.1177/1010539511415662] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The objective of this study was to evaluate enhancement in the knowledge of general practitioners (GPs), from the urban cities in the province of Sindh, Pakistan, regarding blood pressure measurement through workshop. This was a quasi-experimental study that involved GPs from 5 cities of Sindh province, Pakistan. The GPs were required to complete a pretested self-administered questionnaire before and after the workshop session. The questionnaire included few demographic variables and 17 questions based on the American Heart Association recommendations. The mean pretest and posttest scores were compared using Student’s t test. A total of 350 GPs returned completed questionnaires, with a preponderance of males (n = 264, 75.4%) than females (n = 86, 24.6%). The mean correct responses increased significantly after the workshop session from 8 ± 2.1 to 14 ± 2.5 ( P = .01). The knowledge of GPs was almost doubled after the workshop and was significantly different for variables such as qualification, affiliation with teaching hospital, and number of years of practice ( P = .001). This survey, a representation of GPs from the Sindh province, indicated a significant doubling in knowledge after the workshop, proving that continuing medical education sessions play an important role in increasing awareness and staying updated.
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Affiliation(s)
| | - Tariq Ashraf
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - Qudsia Anjum
- International Medical Center, Rabigh, Saudi Arabia
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Abstract
Mortality and morbidity are still high in cardiovascular disease (CVD). Myocardial ischemia reperfusion injury leading to myocardial infarction is one of the most frequent causes of the death in humans. Atherosclerosis and generation of reactive oxygen species through oxidative stress is the major risk factor for CVD. From the literature collection, it has been identified that moderate consumption of red wine helps in preventing CVD through several mechanisms, including increasing the high-density lipoprotein cholesterol plasma levels, decreasing platelet aggregation, by antioxidant effects, and by restoration of endothelial function. The aim of this review is to discuss the accumulating evidence that suggests that red wine possesses a diverse range of biological actions and may be beneficial in the prevention of CVD.
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Affiliation(s)
- T S Mohamed Saleem
- Department of Pharmacology, Annamacharya College of Pharmacy, New Boyanapalli, Rajampet - 516 126, Andhra Pradesh, India
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Toghianifar N, Najafian J, Pooya A, Rabiei K, Eshrati B, Anaraki J, Sarrafzadegan N. Association of Smoking Status With Quality of Life in a Cross-sectional Population-Based Sample of Iranian Adults. Asia Pac J Public Health 2011; 24:786-94. [PMID: 21490110 DOI: 10.1177/1010539511403800] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aimed to examine the association between smoking status and quality of life (QOL) in a population-based sample of Iranian adults. The study used data from the Isfahan Healthy Heart Program (IHHP). A total of 5830 participants were included. They were categorized as current, former, or never smokers. QOL was evaluated using the World Health Organization Quality of Life Questionnaire (WHOQOL-BREF), Persian version. Data entry was performed using SPSS (SPSS Inc, Chicago, IL) software version 13.0. QOL was associated with marital status ( P = .014), education ( P = .001), occupation ( P = .007), and income ( P < .000) among current smokers. After adjusting for sociodemographic characteristics, smoking decreased QOL among current (odds ratio [OR] = 0.98; 95% confidence interval [CI] = 0.97-0.99) and past (OR = 0.97; 95%CI = 0.95-0.98) smokers relative to never smokers. QOL is lower among Iranian current and past smokers, and the relation is independent of underlying sociodemographic factors.
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Affiliation(s)
- Nafiseh Toghianifar
- Isfahan Institute for Cardiovascular Research, Isfahan University of Medical Sciences
| | - Jamshid Najafian
- Isfahan Institute for Cardiovascular Research, Isfahan University of Medical Sciences
| | - Arash Pooya
- Isfahan Institute for Cardiovascular Research, Isfahan University of Medical Sciences
| | - Katayoun Rabiei
- Isfahan Institute for Cardiovascular Research, Isfahan University of Medical Sciences
| | - Babak Eshrati
- Isfahan Provincial Health Center, Isfahan University of Medical Sciences
| | - Jafar Anaraki
- Deputy of Health, Arak Provincial Health Center, Arak University of Medical Sciences
| | - Nizal Sarrafzadegan
- Isfahan Institute for Cardiovascular Research, Isfahan University of Medical Sciences
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Al-Zakwani I, Zubaid M, Panduranga P, Rashed W, Sulaiman K, Almahmeed W, Al-Motarreb A, Al Suwaidi J, Amin H. Medication use pattern and predictors of optimal therapy at discharge in 8176 patients with acute coronary syndrome from 6 Middle Eastern countries: data from the gulf registry of acute coronary events. Angiology 2011; 62:447-54. [PMID: 21421625 DOI: 10.1177/0003319710394163] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
We evaluated the use of quadruple evidence-based medication (EBM) combination consisting of antiplatelet therapy, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker, β-blocker, and lipid-lowering agent concurrently at discharge among patients (n = 8154) with acute coronary syndrome (ACS) in 6 Middle Eastern countries. In all, 49% of the patients received the quadruple EBM combination concurrently at discharge. An adjusted model demonstrated that old age, diabetes mellitus, hyperlipidemia, hypertension, ST-segment elevation myocardial infarction, cardiac catheterization, as well as cardiologists as care providers and hospitals with cardiac catheterization facilities were all positively correlated with the use of the quadruple EBM combination. However, patients with cardiogenic shock, renal impairment, higher risk score, congestive heart failure, recurrent ischemia, and those admitted to academic hospitals were negatively correlated with the use of the quadruple EBM combination. Guideline adherence to the concurrent use of quadruple EBM combination in patients with ACS at discharge was suboptimal with wide disparity among the 6 countries.
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Affiliation(s)
- Ibrahim Al-Zakwani
- Department of Pharmacology & Clinical Pharmacy, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman, Gulf Health Research, Muscat, Oman.
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