Cardiovascular Risk, Risk Knowledge, and Related Factors in Patients With Type 2 Diabetes

Cardiovascular health worsening in patients with autoimmune rheumatological diseases during the COVID-19 pandemic

Rheumatic autoimmune diseases are associated with a myriad of comorbidities. Of particular importance due to their morbimortality are cardiovascular diseases. COVID-19 greatly impacted the world population in many different areas. Patients with rheumatic diseases had to face changes in their healthcare, in addition to unemployment, a decrease in physical activity, social isolation, and lack of access to certain medications. This review summarizes the impact of COVID-19 pandemic on cardiovascular risk factors, comorbidities, and unhealthy behaviors in patients with rheumatic inflammatory autoimmune diseases, particularly focused on rheumatoid arthritis and systemic lupus erythematosus. Searches were carried out in MEDLINE/PubMed and Scopus from August to December 2022. Four reviewers screened the title and abstract of retrieved records. Potentially eligible reports were then reviewed in full text. Differences were reconciled by either consensus or discussion with an external reviewer. During the COVID-19 pandemic, patients with rheumatic diseases showed an increase in the prevalence of mental health disorders (43.2-57.7%), reduced physical activity (56.8%), and a worsening in eating behaviors. Alcohol intake increased (18.2%), especially in early phases of the pandemic. Smoking prevalence decreased (28.2%). Dyslipidemia and hypertension showed no changes. The pandemic and lockdown affected rheumatic patients not only in disease-related characteristics but in the prevalence of their cardiovascular comorbidities and risk factors. Lifestyle changes, such as healthy eating, physical activity, and optimal management of their rheumatic diseases and comorbidities, are essential to manage the long-lasting consequences of the COVID-19 outbreak. Key Points • During the COVID-19 pandemic, anxiety, depression, sedentarism, obesity, and a worsening in eating behaviors increased. •Patients with rheumatic diseases and comorbidities have worse clinical outcomes and a higher cardiovascular disease burden than those without them. •Comparative studies are necessary to precisely elucidate the pandemic's impact on the prevalence of cardiovascular disease, risk factors, and comorbidities in patients with rheumatoid arthritis and systemic lupus erythematosus.

Knowledge about the Risk of Cardiovascular Disease among Adults with Type 2 Diabetes Visiting the Outpatient Clinics at Tertiary Hospital in Riyadh, Saudi Arabia: A Cross-Sectional Study

Background: One of the primary goals of diabetes management is to prevent cardiovascular events. The rate of cardiovascular diseases (CVDs) is significantly high in the diabetic population. Inadequate knowledge of CVDs risk in diabetes may result in the failure of its early prevention, causing increased morbidity and mortality. The objectives of this study were to assess the CVD risk knowledge and determine the predictors of the knowledge among adults with type 2 diabetes. Methods: A cross-sectional study was conducted to examine the study objectives. Convenience sampling was used to recruit adults with type 2 diabetes mellitus (DM) who visited the King Saud University Medical City (KSUMC) outpatient clinics. Data were collected using the Heart Disease Fact Questionnaire. SPSS software (version 24.0) was used for data analysis. Results: A total of 383 patients were recruited. The level of CVD risk knowledge was high among all participants (19.04 ± 3.47). There were significant differences in knowledge scores between different groups, including age (p = 0.01), marital status (p = 0.01), and type of residence (p = 0.04). Participants who were older than 40 years, married, and lived in traditional houses had higher knowledge scores. Conclusion: The study findings indicated a high level of CVD risk knowledge in our study population. The presence of multidisciplinary intensive education programmes targeting type 2 DM patients, such as that conducted at KSUMC, might be responsible for the higher levels of knowledge among our study population. Thus, increasing the efforts towards the education of patients will improve the level of knowledge, including CVD risk knowledge.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

Knowledge and Perceptions Towards Cardiovascular Disease Prevention Among Patients with Type 2 Diabetes Mellitus: A Review of Current Assessments and Recommendations

INTRODUCTION

Patients with type 2 diabetes mellitus (T2DM) are at significantly higher risk of developing cardiovascular diseases (CVD). There is a scarcity of literature reviews that describe and summarize T2DM patients' knowledge and perception about CVD prevention.

OBJECTIVES

To describe and summarize the assessment of knowledge and perceptions about CVD risk and preventive approaches among patients with T2DM.

METHODS

A scoping review methodology was adopted, and three scientific databases, Google Scholar, Science Direct, and PubMed were searched using predefined search terms. A multistage screening process that considered relevancy, publication year (2009-2019), English language, and article type (original research) was followed. We formulated research questions focused on the assessment of levels of knowledge and perceptions of the illness relevant to CVD prevention and the identification of associated patients' characteristics.

RESULTS

A total of 16 studies were included. Patients were not confident to identify CVD risk and other clinical consequences that may occur in the prognostic pathway of T2DM. Furthermore, patients were less likely to identify all CV risk factors indicating a lack of understanding of the multi-- factorial contribution of CVD risk. Patients' beliefs about medications were correlated with their level of adherence to medications for CVD prevention. Many knowledge gaps were identified, including the basic disease expectations at the time of diagnosis, identification of individuals' CVD risk factors, and management aspects. Knowledge and perceptions were affected by patients' demographic characteristics, e.g., educational level, race, age, and area of residence.

CONCLUSION

There are knowledge gaps concerning the understanding of CVD risk among patients with T2DM. The findings necessitate educational initiatives to boost CVD prevention among patients with T2DM. Furthermore, these should be individualized based on patients' characteristics, knowledge gaps, disease duration, and estimated CVD risk.

BMI differences among in-hospital management and outcomes in patients with atrial fibrillation: findings from the Care for Cardiovascular Disease project in China

BACKGROUND

Underweight or obese status influences the prognosis of atrial fibrillation (AF). However, the association between stratification of body mass index (BMI) and in-hospital outcomes in patients with AF, remains lacking in China.

METHODS

Using data from the Improving Care for Cardiovascular Disease in China-AF project, which was launched in February 2015 and recruited 150 hospitals in China, we compared characteristics, in-hospital treatments and clinical outcomes among the stratifications of BMI for Asians.

RESULTS

A total of 15,867 AF patients with AF were enrolled, including 830 (5.23%) underweight, 4965 (31.29%) with normal weight, 3716 (23.42%) overweight, 5263 (33.17%) obese class I and 1093 (6.89%) obese class II participants. Compared with normal weight patients, underweight, overweight, and obese patients showed increased percentages of CHADS₂ scores (3-6) and CHA₂DS₂-VASc scores (5-9). During hospitalization, overweight or obese patients showed greater use of rhythm control medications, anticoagulant drugs, and intervention therapies than underweight-normal weight patients. In adjusted logistic models, BMI was a strong predictor of in-hospital mortality. Especially, underweight BMI was associated with higher incidence of in-hospital mortality, with an adjusted odds ratio of 2.08 (95% confidence interval, 1.56-4.46; p = 0.04) than overweight and obese BMI.

CONCLUSIONS

Asian patients with AF and high BMI received more medical treatments and presented less adverse in-hospital outcomes compared with those with underweight-normal weight. Although low BMI may be associated with other comorbidities and advanced age, underweight BMI retained a negative correlation with all-cause mortality in the patients with AF during hospitalization.