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Zeenny RM, Haddad C, Hajj A, Zeidan RK, Salameh P, Ferrières J. Adherence to the Mediterranean Diet and Cardiovascular Risk Factors among the Lebanese Population: A Nationwide Cross-Sectional Post Hoc Study. Nutrients 2024; 16:2426. [PMID: 39125308 PMCID: PMC11313688 DOI: 10.3390/nu16152426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2024] [Revised: 07/16/2024] [Accepted: 07/17/2024] [Indexed: 08/12/2024] Open
Abstract
OBJECTIVE This study aims to identify the association between adherence to healthy eating, using the Lebanese Mediterranean Diet Scale (LMDS), and cardiovascular risk factors in the Lebanese population. MATERIALS AND METHODS A cross-sectional study using a multistage cluster sample was conducted in Lebanon. Sociodemographic characteristics were collected through structured interviews and self-administered questionnaires. The LMDS assessed dietary habits. The associations between diabetes, dyslipidemia, and cardiovascular disease were investigated using stratification analysis. RESULTS The study included 2048 people (mean age: 41.54 ± 17.09 years). Higher adherence to the Mediterranean diet was associated with older age (Beta = 0.175, p < 0.001), being female (Beta = 0.085, p = 0.001), being married (Beta = 0.054, p = 0.047), participating in regular physical activity (Beta = 0.142, p < 0.001), and having cardiovascular disease (Beta = 0.115, p < 0.001) and diabetes (Beta = 0.055, p = 0.043). Adherence was, however, negatively associated with being a smoker (Beta = -0.083, p = 0.002), a previous smoker (Beta = -0.059, p = 0.026), and having higher distress levels (Beta = -0.079, p = 0.002). Stratification analysis by diabetes, dyslipidemia, and cardiovascular disease (CVD) consistently demonstrated these associations. CONCLUSIONS These findings suggest that demographic and health factors influence the Lebanese population's adherence to the Mediterranean diet. Older age, female gender, married status, physical activity, CVD, and diabetes were all found to be associated with adherence to the Mediterranean diet in the Lebanese population. In contrast, smoking and distress were inversely associated with it.
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Affiliation(s)
- Rony M. Zeenny
- Department of Mathématiques Informatique et Télécommunications, Université Toulouse III, Paul Sabatier, INSERM, UMR 1295, F-31000 Toulouse, France
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Department of Pharmacy, American University of Beirut Medical Center, Beirut 1107, Lebanon
| | - Chadia Haddad
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- School of Health Sciences, Modern University of Business and Science, Beirut 7501, Lebanon
- Research Department, Psychiatric Hospital of the Cross, Jal El Dib 1525, Lebanon
| | - Aline Hajj
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Faculté de Pharmacie, Université Laval, Québec, QC G1V 0A6, Canada
- Oncology Division, CHU de Québec-Université Laval Research Center, Québec, QC G1R 3S3, Canada
| | - Rouba K. Zeidan
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah 27272, United Arab Emirates
| | - Pascale Salameh
- INSPECT-LB (Institut National de Santé Publique, d’Épidémiologie Clinique et de Toxicologie-Liban), Beirut 1103, Lebanon; (C.H.); (A.H.); (R.K.Z.); (P.S.)
- Gilbert and Rose-Marie Chagoury School of Medicine, Lebanese American University, Byblos 4504, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadat 1103, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, 2417 Nicosia, Cyprus
| | - Jean Ferrières
- Department of Cardiology and INSERM UMR 1295, Rangueil University Hospital, F-31059 Toulouse, France;
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Ghaddar F, Zeidan RK, Salameh P, Maupas-Schwalm F. Physical activity and odds of coronary heart disease among Lebanese women. BMC Public Health 2024; 24:516. [PMID: 38373923 PMCID: PMC10875797 DOI: 10.1186/s12889-024-18042-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 02/07/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND It is known that physical activity (PA) is protective against cardiovascular morbidity and mortality. However, few studies have examined the association between PA, sedentary lifestyle and coronary heart disease (CHD) in women. This case-control study investigates the relationship between PA and sedentary behavior on CHD odds in Lebanese women over forty. METHODS One thousand five hundred selected Lebanese women (300 cases and 1200 controls) were included between 2018-2019. Cases were hospitalized women newly diagnosed with CHD, whereas the control groups were free of any heart diseases. Data on socio-demographic, lifestyle, cardiovascular factors, PA and sedentary lifestyle were collected. Multivariate logistic regressions, adjusted for covariates, were performed to investigate the association of PA domains and sedentary behavior with CHD. RESULTS A sedentary lifestyle combined with low activity levels increased the odds of CHD. Among cases, 46.7% participated in moderate or vigorous PA against almost 60.3% of controls. 36.3% of coronary patients had more than 10 h/day of sedentary time, with a positive correlation with CHD (adjusted OR: 1.533, 95%CI: 1.046-2.247). Conversely, moderate and high levels (respectively 600-3000 and ≥ 3000 metabolic equivalents [MET]-minutes/week) of domestic/garden PA revealed lower CHD odds (OR: 0.566, 95%CI: 0.396-0.808 and 0.193, 0.065-0.578 respectively). The detrimental influence of sedentary lifestyle appeared to be significantly reversed by weekly moderate PA, especially as weekly sedentary time was less (OR: 0.616, 95%CI: 0.427-0.888/ 6 to10h of sedentary time and OR: 0.537, 95% CI: 0.37-0.779/ ≤ 6 h), and except sedentary time exceeding 10 h daily. Two PA patterns revealed lower CHD odds: transport-related and domestic/garden PA, as early as low amount, even after adjustment for possible confounders. CONCLUSION The current study highlights the importance of combating sedentary behaviors and engaging in regular, easily accessible PA to reduce the odds of coronary disease among aging women. Therefore, better information regarding the benefits of physical activities such as transportation-related activities or gardening would be helpful in enhancing the prevention of CHD in aging women.
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Affiliation(s)
- Fatima Ghaddar
- Faculty of Public Health II, Lebanese University, Fanar, Lebanon.
| | - Rouba K Zeidan
- Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, UAE
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
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Elsheikh EA, Alqahtani OH, Aljedani HM, AlKulayb SM, Bamousa OM, Althobaiti RM, Alharbi LA, Alqahtani MM, Al-Amri OF, Alyami HS. Assessment of Knowledge and Awareness Regarding Coronary Artery Disease Risk Factors Among the Saudi Arabian Population: A Cross-Sectional Study. Cureus 2024; 16:e52299. [PMID: 38357057 PMCID: PMC10865921 DOI: 10.7759/cureus.52299] [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: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Background Coronary artery disease constitutes a critical public health issue due to its widespread prevalence, placing a significant burden on healthcare systems and posing considerable challenges to the well-being of the population. Limited recent data on coronary artery disease awareness in Saudi Arabia underscores the need for updated information to inform preventive programs. Methodology A cross-sectional questionnaire survey was conducted from August 2021 to October 2022, targeting individuals aged 18 and above in Saudi Arabia. The online survey collected demographic data and assessed knowledge and awareness of coronary artery disease risk factors. A scoring system categorized participants as possessing high, medium, or low levels of awareness and knowledge. Data analysis involved a multivariable regression approach to explore associations. Results The study included a total of 1,409 participants, representing a diverse demographic distribution. Knowledge scores revealed 70.3% high, 27.4% medium, and 2.3% low levels, while awareness scores showed 59.9% high, 32.9% medium, and 7.2% low levels. The study identified significant associations between knowledge scores and gender (p = 0.003) and age (p = 0.001). Similarly, awareness scores demonstrated associations with gender (p = 0.001), age (p = 0.001), marital status (p = 0.003), educational qualification (p = 0.036), and occupation (p = 0.001). These findings underscore the multifaceted nature of factors influencing awareness and knowledge levels. Conclusions The study highlights a strong foundation of knowledge and awareness among the Saudi population regarding coronary artery disease risk factors, indicating a positive starting point for preventive initiatives. However, targeted programs addressing regional variations and enhancing knowledge are recommended to improve early detection and treatment of coronary artery disease risk factors.
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Affiliation(s)
| | | | - Haneen M Aljedani
- General Practice, Ibn Sina National College for Medical Studies, Jeddah, SAU
| | | | - Omar M Bamousa
- General Practice, King Abdulaziz University, Jeddah, SAU
| | | | | | | | | | - Hadi S Alyami
- General Practice, King Faisal University, Hofuf, SAU
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El Zahran T, Ghandour L, Chami A, Saliba N, Hitti E. Comparing emergency department visits 10-year apart at a tertiary care center in Lebanon. Medicine (Baltimore) 2023; 102:e35194. [PMID: 37773845 PMCID: PMC10545388 DOI: 10.1097/md.0000000000035194] [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: 03/30/2023] [Accepted: 08/22/2023] [Indexed: 10/01/2023] Open
Abstract
Presentations to the emergency department (ED) are growing worldwide. With the increasing risk factors of non-communicable disease (NCD) and communicable diseases (CD) in low- and middle-income countries, it is crucial to understand how ED presentations are changing with time to meet patients' needs and allocate acute care resources. The aim of this study is to compare the changes in patient and diseases characteristics over 2 time periods 10 year apart at the largest tertiary care center in Lebanon. This was a retrospective descriptive study of patients presenting to the ED at a large tertiary care center in 2009/2010 and 2018/2019. The discharge diagnoses were coded into Clinical Classification Software codes. We used descriptive statistics, odds ratios (OR), and non-parametric test to compare the different diagnoses. The total number of ED visits increased by 33% from 2009/2010 to 2018/2019. The highest increase rate was among patients older than 65 years (2.6%), whereas the percentage of pediatric patients decreased from 30.8% to 25.3%. ED presentations shifted from NCD to CD. A shift in the discharge diagnoses was also noted within age groups, specifically a shift in cardiovascular diseases to a younger age. Our study suggests that the role of the ED is changing and moving towards treating the aging population and CD. There is a need to invest and mitigate CD, better allocate resources to accommodate the aging population, focus on awareness campaigns targeting early detection of cardiovascular diseases and modifying its risk factors.
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Affiliation(s)
- Tharwat El Zahran
- Department of Emergency Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Lara Ghandour
- Department of Emergency Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | | | - Najat Saliba
- Department of Chemistry, Faculty of Arts and Sciences, American University of Beirut, Beirut, Lebanon
| | - Eveline Hitti
- Department of Emergency Medicine, Faculty of Medicine, American University of Beirut Medical Center, Beirut, Lebanon
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Salari N, Morddarvanjoghi F, Abdolmaleki A, Rasoulpoor S, Khaleghi AA, Hezarkhani LA, Shohaimi S, Mohammadi M. The global prevalence of myocardial infarction: a systematic review and meta-analysis. BMC Cardiovasc Disord 2023; 23:206. [PMID: 37087452 PMCID: PMC10122825 DOI: 10.1186/s12872-023-03231-w] [Citation(s) in RCA: 61] [Impact Index Per Article: 61.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Accepted: 04/08/2023] [Indexed: 04/24/2023] Open
Abstract
BACKGROUND Myocardial infarction (MI) is one of the life-threatening coronary-associated pathologies characterized by sudden cardiac death. The provision of complete insight into MI complications along with designing a preventive program against MI seems necessary. METHODS Various databases (PubMed, Web of Science, ScienceDirect, Scopus, Embase, and Google scholar search engine) were hired for comprehensive searching. The keywords of "Prevalence", "Outbreak", "Burden", "Myocardial Infarction", "Myocardial Infarct", and "Heart Attack" were hired with no time/language restrictions. Collected data were imported into the information management software (EndNote v.8x). Also, citations of all relevant articles were screened manually. The search was updated on 2022.9.13 prior to the publication. RESULTS Twenty-two eligible studies with a sample size of 2,982,6717 individuals (< 60 years) were included for data analysis. The global prevalence of MI in individuals < 60 years was found 3.8%. Also, following the assessment of 20 eligible investigations with a sample size of 5,071,185 individuals (> 60 years), this value was detected at 9.5%. CONCLUSION Due to the accelerated rate of MI prevalence in older ages, precise attention by patients regarding the complications of MI seems critical. Thus, determination of preventive planning along with the application of safe treatment methods is critical.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
- Sleep Disorders Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Amir Abdolmaleki
- Department of Operating Room, Nahavand School of Allied Medical Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shabnam Rasoulpoor
- Department of Psychiatric Nursing, Miandoab School of Nursing, Urmia University of Medical Sciences, Urmia, Iran
| | - Ali Asghar Khaleghi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran
| | - Leila Afshar Hezarkhani
- Neuroscience Research Center, Health Technology Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor, Malaysia
| | - Masoud Mohammadi
- Cellular and Molecular Research Center, Gerash University of Medical Sciences, Gerash, Iran.
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Ul Sabah Z, Mohammed Alshorfi HA, Ali AlAsiri AA, Aziz S, Wani J, Khan H. Evaluation and Assessment of Community Awareness About Coronary Artery Disease in the Aseer Region. Cureus 2022; 14:e31667. [DOI: 10.7759/cureus.31667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/19/2022] [Indexed: 11/21/2022] Open
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Baeradeh N, Ghoddusi Johari M, Moftakhar L, Rezaeianzadeh R, Hosseini SV, Rezaianzadeh A. The prevalence and predictors of cardiovascular diseases in Kherameh cohort study: a population-based study on 10,663 people in southern Iran. BMC Cardiovasc Disord 2022; 22:244. [PMID: 35643460 PMCID: PMC9148515 DOI: 10.1186/s12872-022-02683-w] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND The prevalence of cardiovascular disease (CVD) is rapidly increasing in the world. The present study aimed to assess the prevalence and Predictors factors of CVD based on the data of Kherameh cohort study. METHODS The present cross-sectional, analytical study was done based on the data of Kherameh cohort study, as a branch of the Prospective Epidemiological Studies in Iran (PERSIAN). The participants consisted of 10,663 people aged 40-70 years. CVD was defined as suffering from ischemic heart diseases including heart failure, angina, and myocardial infarction. Logistic regression was used to model and predict the factors related to CVD. Additionally, the age-standardized prevalence rate (ASPR) of CVD was determined using the standard Asian population. RESULTS The ASPR of CVD was 10.39% in males (95% CI 10.2-10.6%) and 10.21% in females (95% CI 9.9-10.4%). The prevalence of CVD was higher among the individuals with high blood pressure (58.3%, p < 0.001) as well as among those who smoked (28.3%, p = 0.018), used opium (18.2%, p = 0.039), had high triglyceride levels (31.6%, p = 0.011), were overweight and obese (66.2%, p < 0.001), were unmarried (83.9%, p < 0.001), were illiterate (64.2%, p < 0.001), were unemployed (60.9%, p < 0.001), and suffered from diabetes mellitus (28.1%, p < 0.001). The results of multivariable logistic regression analysis showed that the odds of having CVD was 2.25 times higher among the individuals aged 50-60 years compared to those aged 40-50 years, 1.66 folds higher in opium users than in non-opium users, 1.37 times higher in smokers compared to non-smokers, 2.03 folds higher in regular users of sleeping pills than in non-consumers, and 4.02 times higher in hypertensive individuals than in normotensive ones. CONCLUSION The prevalence of CVD was found to be relatively higher in Kherameh (southern Iran) compared to other places. Moreover, old age, obesity, taking sleeping pills, hypertension, drug use, and chronic obstructive pulmonary disease had the highest odds ratios of CVD.
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Affiliation(s)
- Najibullah Baeradeh
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Leila Moftakhar
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ramin Rezaeianzadeh
- Experimental Medicine Program, Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | | | - Abbas Rezaianzadeh
- Non-Communicable Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Ghaddar F, Zeidan RK, Salameh P, Tatari S, Achkouty G, Maupas-Schwalm F. Risk Factors for Coronary Heart Disease Among Lebanese Women: A Case–Control Study. Vasc Health Risk Manag 2022; 18:297-311. [PMID: 35464735 PMCID: PMC9021001 DOI: 10.2147/vhrm.s350108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 03/30/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Women are increasingly concerned by coronary heart disease (CHD), with peculiarities of their own, particularly concerning risk factors. The aim of the study was to assess the risk factors for CHD in Lebanese women over forty. Patients and Methods A case–control study was carried out in 6 hospitals in Beirut and Mount-Lebanon, from December 2018 to December 2019 including 1500 patients (1200 controls and 300 cases). Women were stratified into pre- and post-menopausal groups. Personal and medical data were collected from hospital records and during an interview where validated questionnaires were used. Binary logistic regressions were performed to investigate potential predictors of CHD in the 2 groups. Results In post-menopausal women, dyslipidemia (adjusted odds ratio [aOR], 3.018; 95% confidence interval, 2.102–4.332), hypertension (aOR: 2.449, [1.386–4.327]), a family history of CHD (aOR: 2.724, [1.949–3.808]), cigarette smoking (aOR: 2.317, [1.574–3.410]) and common non-rheumatic joint pain (aOR: 1.457, [1.053–2.016]) were strongly associated with CHD. Conversely, living in Mount Lebanon seemed protective, compared to Beirut (aOR: 0.589, [0.406–0.854]), as well as having a moderate monthly income (aOR: 0.450, [0.220–0.923]), adhering to a Mediterranean diet (aOR: 0.965, [0.936–0.994]), and practicing physical activity [PA] (aOR: 0.396, [0.206–0.759] and 0.725, [0.529–0.992], respectively for high and moderate vs low PA). In pre-menopausal women, dyslipidemia (aOR: 6.938, [1.835–26.224]), hypertension (aOR: 6.195, [1.318–29.119]), family histories of dyslipidemia (aOR: 6.143, [1.560–24.191]) and CHD (aOR: 4.739, [1.336–16.805]) reached statistical significance. Conclusion The identification of factors associated with CHD in women, some of which are frequent and trivialized in post-menopause, underlines the need to put in place specific and dedicated CHD prevention strategies in women.
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Affiliation(s)
- Fatima Ghaddar
- Doctoral School of Biology Health and Biotechnologies, Toulouse University, Toulouse, France
- Correspondence: Fatima Ghaddar, Doctoral school of Biology Health and Biotechnologies, Toulouse University, Toulouse, France, Tel +32 470 53 71 52, Email
| | - Rouba K Zeidan
- Sharjah Institute of Medical Research, University of Sharjah, Sharjah, United Arab Emirates
- Faculty of Public Health II, Lebanese University, Mount-Lebanon, Lebanon
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- CERIPH, Center for Research in Public Health, Faculty of Public Health, Lebanese University, Mount-Lebanon, Lebanon
| | - Pascale Salameh
- INSPECT-LB, National Institute of Public Health, Clinical Epidemiology and Toxicology, Beirut, Lebanon
- Department of Research, Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- Department of Primary Care and Population Health, University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Lebanese American University, Byblos, Lebanon
| | - Souzan Tatari
- Cardiology department, Rafik Hariri University Hospital, Beirut, Lebanon
| | - Guy Achkouty
- Cardiology Department, Mount Lebanon University Hospital, Mount-Lebanon, Lebanon
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Merkeb Alamneh Y, Sume BW, Abebaw Shiferaw A. Musculoskeletal disorders among the population in Northwest Ethiopia. SAGE Open Med 2022; 10:20503121221085109. [PMID: 35321461 PMCID: PMC8935578 DOI: 10.1177/20503121221085109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/14/2022] [Indexed: 11/30/2022] Open
Abstract
Objective: This study aimed to assess the magnitude and patterns of chronic musculoskeletal disorders among the population in East Gojjam zone, Northwest Ethiopia. Methods: A community-based cross-sectional study with 846 recruited study participants was done using a multistage sampling technique in conjunction with a simple and systematic random sampling technique. Face-to-face interviews, physical examinations, a semi-structured questionnaire adapted from the Community Oriented Program for Control of Rheumatic Diseases, and other literature were used to collect data. EpiData 3.1 was used to enter the data, which were then exported to STATA 14.0 for analysis. Result: The study had a response rate of 98.8%, with about 836 people out of a total of 846 expected to take part. The magnitude of musculoskeletal disorders was found to be 40.1%. Back pain was the most common musculoskeletal condition (16%) of the population, followed by osteoarthritis (10%) and other forms of arthritis (rheumatoid arthritis (8%), gout arthritis (6%)). The most common comorbidity (multimorbidity) patterns were hypertension (9.8%), diabetes (5.6%), obesity (3.9%), and others (2.2%). Conclusion: Almost one in four participants have at least one musculoskeletal disorder in Northwest Ethiopia. Rheumatoid arthritis, osteoarthritis, low back pain, and gout arthritis were the most common musculoskeletal disorders. The most common comorbidity patterns were hypertension, diabetes, obesity, and others. An in-depth investigation of the musculoskeletal burden at the national level will be critical for implementing evidence-based strategies, as well as early detection and screening, linking to health institutions, and direct interventions.
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Affiliation(s)
- Yoseph Merkeb Alamneh
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Bickes Wube Sume
- Department of Biomedical Sciences, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Abtie Abebaw Shiferaw
- Department of Medical Laboratory, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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Labban M, Itani MM, Maaliki D, Nasreddine L, Itani HA. The Sweet and Salty Dietary Face of Hypertension and Cardiovascular Disease in Lebanon. Front Physiol 2022; 12:802132. [PMID: 35153813 PMCID: PMC8835350 DOI: 10.3389/fphys.2021.802132] [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: 10/26/2021] [Accepted: 12/20/2021] [Indexed: 12/11/2022] Open
Abstract
According to the World Health Organization (WHO), an estimated 1.28 billion adults aged 30–79 years worldwide have hypertension; and every year, hypertension takes 7.6 million lives. High intakes of salt and sugar (mainly fructose from added sugars) have been linked to the etiology of hypertension, and this may be particularly true for countries undergoing the nutrition transition, such as Lebanon. Salt-induced hypertension and fructose-induced hypertension are manifested in different mechanisms, including Inflammation, aldosterone-mineralocorticoid receptor pathway, aldosterone independent mineralocorticoid receptor pathway, renin-angiotensin system (RAS), sympathetic nervous system (SNS) activity, and genetic mechanisms. This review describes the evolution of hypertension and cardiovascular diseases (CVDs) in Lebanon and aims to elucidate potential mechanisms where salt and fructose work together to induce hypertension. These mechanisms increase salt absorption, decrease salt excretion, induce endogenous fructose production, activate fructose-insulin-salt interaction, and trigger oxidative stress, thus leading to hypertension. The review also provides an up-to-date appraisal of current intake levels of salt and fructose in Lebanon and their main food contributors. It identifies ongoing salt and sugar intake reduction strategies in Lebanon while acknowledging the country’s limited scope of regulation and legislation. Finally, the review concludes with proposed public health strategies and suggestions for future research, which can reduce the intake levels of salt and fructose levels and contribute to curbing the CVD epidemic in the country.
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Affiliation(s)
| | - Maha M Itani
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Dina Maaliki
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lara Nasreddine
- Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon.,Department of Nutrition and Food Sciences, Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon
| | - Hana A Itani
- Department of Pharmacology and Toxicology, Faculty of Medicine, American University of Beirut, Beirut, Lebanon.,Vascular Medicine Program, American University of Beirut Medical Center, Beirut, Lebanon.,Adjunct Clinical Pharmacology, Vanderbilt University Medical Center, Nashville, TN, United States
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Alruways AFH, Alotaibi NA, Rashikh MA, Alnufeie AA, Alshammari YJD, Alharthy MR, Alanazi FJM. Awareness and prevalence of coronary artery disease risk factors among Saudi adults in Dawadmi, Riyadh province: A cross-sectional study. J Family Med Prim Care 2021; 9:5629-5637. [PMID: 33532406 PMCID: PMC7842469 DOI: 10.4103/jfmpc.jfmpc_934_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 08/31/2020] [Accepted: 09/22/2020] [Indexed: 12/01/2022] Open
Abstract
Objective: Coronary artery disease (CAD) is one of the leading causes of death and disability worldwide. Amongst the Middle East countries, Saudi Arabia is facing rapid progressive urbanization by the adoption of a westernized lifestyle and food habits, which contribute to the rising burden of CAD. We aim to evaluate the awareness and prevalence of CAD risk factors among Saudi adults. Methods: This was a cross-sectional study conducted between January and March 2020. Data were collected through an online survey using a self-administered questionnaire. Data assessed on socio-demographic variables, family history of CAD, knowledge of risk factors, symptoms, and complications of CAD. Results data were entered and analyzed using IBM SPSS statistics, version 25. All comparisons were considered significant at P < 0.05. Results: A total of 311 subjects (48.6% men and 51.4% women) included, and most of the participants were between 18 and 25 years. A majority of the participants did not hear about CAD (82%) and unaware of any risk factors (26.4%), symptoms (25.1%), and complications (72.7%) of CAD. The prevalence of a family history of CAD (9.3%), overweight/obesity (58.6%), physical inactivity (79.1%), and smoking (24.1%) observed considerably high among the participants. Conclusion: The present study reveals that a significantly low level of awareness and a high prevalence of CAD risk factors found among Saudi adults. Therefore, the awareness program is needed at the public level to increase the knowledge of CAD risk factors so that persons with high risk for future CAD can be prevented.
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Abstract
The Middle East and North Africa regions, including Lebanon, have recently witnessed rapid urbanization and modernization over the last couple of decades that has led to a dramatic transformation affecting lifestyle and diet. The World Health Organization reports that the leading cause of death in Lebanon is due to cardiovascular disease (CVD) at 47% of all-cause mortality. Over the last 30 years, especially the last 10, the population of Lebanon has changed dramatically due to the effect of wars in the region and refugees seeking asylum. With a population of around 4.5 million and a relatively high rate of consanguinity in Lebanon, a variety of novel mutations have been discovered explaining several familial causes of hypercholesterolemia, diabetes mellitus, congenital heart disease, and cardiomyopathies. Due to the Syrian civil war, 1.5 million Syrian refugees now reside in Lebanon in either low-income housing or tented settlements. A National Institutes of Health study is examining diabetes and CVD in Syrian refugees in comparison to native Lebanese. We provide the first review of CVD in Lebanon in its metabolic component including coronary artery disease and its risk factors, mainly hyperlipidemia and diabetes mellitus, and its structural component, including congenital heart disease, valvular heart disease, cardiomyopathies, and heart failure. The knowledge in this review has been compiled to guide clinicians and assist researchers in efforts to recognize risk factors for disease, improve delivery of health care, and prevent and treat CVDs in Lebanon, both for the native Lebanese and Syrian refugees.
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Bifari AE, Sulaimani RK, Khojah YS, Almaghrabi OS, AlShaikh HA, Al-Ebrahim KE. Cardiovascular Risk Factors in Coronary Artery Bypass Graft Patients: Comparison Between Two Periods. Cureus 2020; 12:e10561. [PMID: 33101808 PMCID: PMC7577304 DOI: 10.7759/cureus.10561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background Information showing risk factor trends in patients undergoing coronary artery bypass graft in Saudi Arabia is scarce. Thus, we aimed to compare cardiovascular risk factors among coronary artery bypass graft patients between two periods: 2012 and 2018. Methods This was a cross-sectional study based on hospital records at a tertiary center in Saudi Arabia. The medical records of 72 patients in 2012 and 111 patients in 2018 were reviewed. The study included all patients who underwent coronary artery bypass grafting for the first time. The chi-square test and independent t-test were used for statistical analysis; P-values less than 0.05 were considered statistically significant. Results The mean (SD) of the patient age was 61.21 (9.74) years in the first period and 58.01 (11.14) years in the second period. The number of patients who smoked was significantly higher in the second period of the study (14.3% in the first period; 27.0% in the second period; P < 0.001). The study also showed an increase in hypertension and diabetes mellitus in the second period compared to the first (70% vs 71.2% and 68.6% vs 72.1%, respectively), and a reduction in the percentage of patients with hypercholesterolemia (18.3% vs 17.1%). However, these findings were non-significant. Conclusions The percentage of smokers was significantly higher in the second period of this research as a consequence of cultural variation and because of the popularity of water-pipe smoking in the society. We recommend the need for increased awareness regarding smoking and the implementation of smoking-cessation programs.
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Affiliation(s)
- Anas E Bifari
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Rakan K Sulaimani
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Yaser S Khojah
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
| | | | - Hesham A AlShaikh
- Medicine, College of Medicine, King Abdulaziz University, Jeddah, SAU
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Ziade N, El Khoury B, Zoghbi M, Merheb G, Abi Karam G, Mroue' K, Messaykeh J. Prevalence and pattern of comorbidities in chronic rheumatic and musculoskeletal diseases: the COMORD study. Sci Rep 2020; 10:7683. [PMID: 32376850 PMCID: PMC7203228 DOI: 10.1038/s41598-020-64732-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2019] [Accepted: 04/21/2020] [Indexed: 02/08/2023] Open
Abstract
Increased risk of comorbidities has been reported in Rheumatic and Musculoskeletal Diseases (RMD). We aimed to evaluate the prevalence and pattern of comorbidities in RMD patients nationwide, to identify multimorbidity clusters and to evaluate the gap between recommendations and real screening. Cross-sectional, multicentric nationwide study. Prevalence of comorbidities was calculated according to six EULAR axes. Latent Class Analysis identified multimorbidity clusters. Comorbidities' screening was compared to international and local recommendations. In 769 patients (307 RA, 213 OA, 63 SLE, 103 axSpA, and 83 pSA), the most frequent comorbidities were cardiovascular risk factors and diseases (CVRFD) (hypertension 36.5%, hypercholesterolemia 30.7%, obesity 22.7%, smoking 22.1%, diabetes 10.4%, myocardial infarction 6.6%), osteoporosis (20.7%) and depression (18.1%). Three clusters of multimorbidity were identified: OA, RA and axSpA. The most optimal screening was found for CVRF (> = 93%) and osteoporosis (53%). For malignancies, mammograms were the most optimally prescribed (56%) followed by pap smears (32%) and colonoscopy (21%). Optimal influenza and pneumococcus vaccination were found in 22% and 17%, respectively. Comorbidities were prevalent in RMD and followed specific multimorbidity patterns. Optimal screening was adequate for CVRFD but suboptimal for malignant neoplasms, osteoporosis, and vaccination. The current study identified health priorities, serving as a framework for the implementation of future comorbidity management standardized programs, led by the rheumatologist and coordinated by specialized health care professionals.
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Affiliation(s)
- Nelly Ziade
- Rheumatology department, Hotel-Dieu de France Hospital, Beirut, Lebanon.
- Rheumatology department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon.
| | - Bernard El Khoury
- Gastro-enterology department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Marouan Zoghbi
- Family Medicine department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
| | - Georges Merheb
- Notre-Dame des Secours University Hospital, Jbeil, Lebanon
- Holy Spirit University Kaslik, Jounieh, Lebanon
| | - Ghada Abi Karam
- Rheumatology department, Hotel-Dieu de France Hospital, Beirut, Lebanon
- Rheumatology department, Faculty of Medicine, Saint-Joseph University, Beirut, Lebanon
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Menopausal symptoms, physical activity level and quality of life of women living in the Mediterranean region. PLoS One 2020; 15:e0230515. [PMID: 32208445 PMCID: PMC7093012 DOI: 10.1371/journal.pone.0230515] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 03/02/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION The main purpose of this study is to investigate the relationship between menopause related discomforts and the quality of life of Lebanese women correlated with the physical activity level, anthropometric, medical, sociodemographic and lifestyle variables, during mid-life. MATERIALS AND METHODS This cross-sectional study was conducted among 1113 women, recruited from different Lebanese regions. The Menopause-Specific Quality of Life Questionnaire (MENQOL) was used to assess menopause related symptoms. Menopausal status was classified according to the World Health Organization's definition of menopause. The International Physical Activity Questionnaire was used to evaluate the physical activity level of participants. Anthropometric measurements were taken by the research team. RESULTS Participants were 49.53 ± 5.74 years old and had a mean body mass index of 26.69 ± 5.37 Kg/m2. The highest mean scores of MENQOL were found in the physical and psychosocial domains (p<0.001). Peri-menopausal women had the highest mean scores in the vasomotor, physical and psychosocial domains (p<0.001), while postmenopausal and menopausal women in the sexual domain (p<0.001). Almost half the participants (45.4%) had low physical activity level, which was significantly and inversely correlated with vasomotor, psychosocial, physical and sexual MENQOL subdomains (p<0.001). Menopausal status, educational level, crowding and body mass indexes, marital status, smoking and alcohol intake were among the factors that were significantly associated with the frequency and the severity of menopause related symptoms. CONCLUSION Physical activity may play a protective role in attenuating climacteric symptoms and hence improve the quality of life of women during mid-life.
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Amouzeshi Z, Safajou F, Kazemi T, Kianfar S. The relationship between cognitive perception of self-concept and coping styles in heart failure patients. Nurs Open 2020; 7:530-535. [PMID: 32089849 PMCID: PMC7024624 DOI: 10.1002/nop2.417] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2019] [Revised: 10/04/2019] [Accepted: 10/21/2019] [Indexed: 11/30/2022] Open
Abstract
Aim To determine the relationship between self-concept and coping styles in patients with heart failure in an Iranian population. Design This study had a correlational design. Methods In this study, 100 HF patients hospitalized in the CCU and cardiac ward of Vali-Asr Hospital of Birjand, Iran were selected by convenience sampling method. Two validated and reliable questionnaires including Cognitive Perception of Self-Concept and the Coping Styles questionnaires were completed by each patient. Results There were significant associations between emotion-oriented and threat to self-concept in total and physical sensation and self-consistency dimensions. Also, a significant association was observed between avoidance-oriented and threat to self-concept in total and body sensation dimension (p < .05). There was no significant association between the problem-oriented component and the threat to self-concept in total and none of its dimensions. The challenge to self-concept and its dimensions were not significantly related to any component of coping styles.
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Affiliation(s)
- Zahra Amouzeshi
- Faculty of Nursing and Midwifery, Atherosclerosis and Coronary Artery Research CenterBirjand University of Medical SciencesBirjandIran
- Department of Medical EducationMedical Education Development Research CenterIsfahan University of Medical SciencesIsfahanIran
| | - Farzaneh Safajou
- Student Research CommitteeSchool of Nursing & MidwiferyShahid Beheshti University of Medical SciencesTehranIran
- Ghaen Faculty of Nursing and MidwiferyBirjand University of Medical SciencesBirjandIran
| | - Tooba Kazemi
- Atherosclerosis and Coronary Artery Research CenterDepartment of CardiologyBirjand University of Medical SciencesBirjandIran
| | - Sedigheh Kianfar
- Department of MidwiferyBirjand University of Medical SciencesBirjandIran
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Albugami S, Al-Husayni F, Bakhsh L, Alhameed F, Alsulami A, Abumelha K, Balubaid M, Al-Harbi M, Mufti HN. The Perception of Coronary Artery Disease and Cardiac Catheterization in Saudi Arabia: "What the Public Know". Cureus 2020; 12:e6570. [PMID: 31956466 PMCID: PMC6944152 DOI: 10.7759/cureus.6570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2019] [Accepted: 01/05/2020] [Indexed: 11/10/2022] Open
Abstract
Objective Coronary artery disease (CAD) constitutes a significant health hazard in middle-aged individuals in Saudi Arabia. We sought to assess the level of knowledge of cardiovascular risk factors and describe the perception of coronary intervention among the general population in the city of Jeddah in the western part of Saudi Arabia. Methods A cross-sectional study was conducted in the city of Jeddah during the period from April 2019 to September 1, 2019, by using a structured online questionnaire to assess the participants' awareness of risk factors for CAD and coronary intervention. The survey included questions about socio-demographic data, risk factors of cardiovascular diseases, symptoms of heart attack, knowledge of coronary catheterizations, as well as resources of knowledge about coronary heart disease. Results The study included 984 participants. The majority of the participants had university diplomas (78.1%). Only 38.5 % were healthcare workers. Dyslipidemia and smoking were identified by 70.5% and 66.7%, respectively, as a recognized risk factor for CAD. Diabetes was mentioned by 32.1%. Participants without CAD risk factors had a significantly lower level of knowledge regarding the strong association between diabetes mellitus (DM) II and CAD (p-value=0.02). Healthcare professionals had a significantly lower level of knowledge regarding cardiac catheterization as compared to non-healthcare professionals. A higher percentage of healthcare professionals would agree to have cardiac catheterization if indicated (p-value=0.003). Awareness campaigns were the most common source of information for the public. Conclusion The current level of knowledge of CAD in the western part of Saudi Arabia is fair. National awareness campaigns are required to improve the level of healthcare education.
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Affiliation(s)
- Saad Albugami
- Cardiac Sciences / Interventional Cardiology, King Faisal Cardiac Center, King Saud Bin Abdulaziz University for Health Sciences / King Abdullah International Research Center, Jeddah, SAU
| | | | - Lama Bakhsh
- Internal Medicine, National Guard Hospital, Jeddah, SAU
| | - Faisal Alhameed
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Ahmad Alsulami
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Khalid Abumelha
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | - Marwan Balubaid
- Internal Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, SAU
| | | | - Hani N Mufti
- Cardiac Sciences / Cardiac Surgery, King Faisal Cardiac Center, King Saud Bin Abdulaziz University for Health Sciences / King Abdullah International Research Center, Jeddah, SAU
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18
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Haidar SA, de Vries NK, Karavetian M, Laviano A, Rached M. Association between β-amino-isobutyric acid (BAIBA) and cardiometabolic risk factors. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-190294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Suzan A. Haidar
- Lebanese International University, Beirut, Lebanon
- Maastricht University, Maastricht, The Netherlands
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Taee N, Faraji Goodarzi M, Safdari M, Bajelan A. A 10-year prevalence of congenital hypothyroidism in Khorramabad (Urban Western Iran). Mol Genet Genomic Med 2019; 7:e817. [PMID: 31215165 PMCID: PMC6687863 DOI: 10.1002/mgg3.817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Revised: 03/28/2019] [Accepted: 05/29/2019] [Indexed: 11/18/2022] Open
Abstract
Background Congenital hypothyroidism in infants is the cause of mental retardation in children, it can be detected in patient and treated at a relatively cheap rate, preventing patient retard. This study aimed to determine the prevalence of congenital hypothyroidism among Khorramabad children. Methods In the present study, we identified all patients who had received levothyroxine prescriptions during the study period (2007–2017). Using this as a congenital hypothyroidism surrogate marker, we considered the congenital hypothyroidism prevalence in children above 3 years. Results Of 574 patients who had received levothyroxine during the neonatal period up to 3 years, the results of one‐variable logistic regression analysis showed that the chance of temporary disease in children with small thyroid ultrasonography was 62% less, than for those without problems, and this difference was significant. The chance of temporary disease in children who had other cases was 87% less than those without problems, and this difference was statistically significant. Conclusion The overall prevalence of congenital hypothyroidism in young patients up to 3 years is 0.143%, these values are at least twice those of previous estimates. This proposes an elevation in autoimmune thyroid disease, which is similitude to the rising prevalence of diabetes type 1, which possibly indicates a rising incidence of autoimmunity in youth.
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Affiliation(s)
- Nadereh Taee
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mojgan Faraji Goodarzi
- Department of Pediatrics, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Mohammad Safdari
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
| | - Amir Bajelan
- Student Research Committee, Lorestan University of Medical Sciences, Khorramabad, Iran
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Haidar SA, Karavetian M, Radwan H, de Vries NK. University Lebanese students are not immune to the metabolic syndrome. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2019. [DOI: 10.3233/mnm-180237] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Suzan A. Haidar
- Maastricht University/Lebanese International University, Beirut, Lebanon
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Jamee Shahwan A, Abed Y, Desormais I, Magne J, Preux PM, Aboyans V, Lacroix P. Epidemiology of coronary artery disease and stroke and associated risk factors in Gaza community -Palestine. PLoS One 2019; 14:e0211131. [PMID: 30682090 PMCID: PMC6347168 DOI: 10.1371/journal.pone.0211131] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Accepted: 01/08/2019] [Indexed: 11/19/2022] Open
Abstract
AIM OF STUDY To determine the prevalence of cardiovascular disease and associated risk factors in the population of Gaza strip in Palestine. METHODS A cross-sectional stratified cluster sample design was applied in this study. A sample of 2240 participant (1121 males and 1119 females) aged ≥25 years participated in the study. For each individual, trained staff administered a questionnaire, where all variables of interest followed WHO's STEP wise approach to surveillance chronic disease risk factors (STEPS) (WHO, 2001). Sociodemographic data, anthropometric measure (body mass index, blood pressure), and biochemical test (blood sugar and lipids profiles) were measured. Short International Physical Activity (IPAQ) questionnaire form was used. Bivariate analysis and logistic regression were used with SPSS (version 22.0) to analyze the data. RESULTS The most common condition was coronary artery disease (8.3%), followed by stroke events (3%). The associated risk factors were obesity (47.8%), hypertension (28.4%), current smoking account for (23.2%), diabetes mellitus (19.1%), high cholesterol level (8.8%), and high triglycerides level (40.2%). Additionally, the proportion of being physical active was found to be low (48.3%); particularly with increasing age. More than 30% of the population has less than 4 days of consumption of fruit and vegetables per week and 65.9% has less than 2 servings per day. CONCLUSION The burden of CVDs and their associated risk factors is considerable in Gaza and represents a major public health concern. Effective strategies in management, education and healthcare centers are required for an accurate management and implementation of preventive measure in this area.
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Affiliation(s)
- Amal Jamee Shahwan
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Cardiology department, Ministry of health, Gaza-Palestine
| | | | - Ileana Desormais
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Department of Thoracic and Vascular Surgery–Vascular Medicine, Dupuytren University Hospital, Limoges, France
| | - Julien Magne
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Pierre Marie Preux
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
| | - Victor Aboyans
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Department of Cardiology, Dupuytren University Hospital, Limoges, France
| | - Philippe Lacroix
- INSERM UMR 1094, Tropical Neuroepidemiology, Limoges, France
- University of Limoges, School of Medicine, Institute of Neuroepidemiology and Tropical Neurology, CNRS FR 3503 GEIST, Limoges, France
- Department of Thoracic and Vascular Surgery–Vascular Medicine, Dupuytren University Hospital, Limoges, France
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Almalki MA, AlJishi MN, Khayat MA, Bokhari HF, Subki AH, Alzahrani AM, Alhejily WA. Population awareness of coronary artery disease risk factors in Jeddah, Saudi Arabia: a cross-sectional study. Int J Gen Med 2019; 12:63-70. [PMID: 30666149 PMCID: PMC6333320 DOI: 10.2147/ijgm.s184732] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Coronary artery disease (CAD) is a serious cardiovascular disorder affecting middle-aged individuals. It is a major cause of death among adults over the age of 35 years. In Saudi Arabia, CAD is associated with higher mortality rate, and Saudi patients are reported to have significantly higher prevalence of risk factors for CAD than the Western population. Furthermore, as, to date, there is no definite cure for CAD, prevention of the disease and tight control of the known risk factors are the cornerstones for reducing CAD-associated mortality. Thus, the present work aimed to assess the population awareness of CAD risk factors in Saudi Arabia. METHODS A cross-sectional study was conducted in Jeddah during the period January 2017 to December 2017 by using an online survey questionnaire to assess participants' awareness of 14 risk factors for CAD, namely: smoking, lack of physical activity, fast food and soft drink intake, television and computer use; history of diabetes mellitus, myocardial infarction and stroke; as well as a family history of diabetes mellitus, diabetes, hypertension, hyperlipidemia, CAD and myocardial infarction. RESULTS Of 468 respondents, 41% were males. The mean age was 31.9±12.4. Approximately 86% were Saudi, and ~60% had a university education. The mean overall awareness score was 4.31±1.36 (1.00-8.00). Fast food, soft drinks, and family history of diabetes were the most commonly identified risk factors, reported by 74.8%, 64.3%, and 47.2% of participants, respectively. There was a strong correlation between overall awareness score and awareness of each risk factor individually (P<0.003). CONCLUSION There is an evident limited knowledge among the population in Jeddah, Saudi Arabia regarding the risk factors for CAD, and it is recommended that the healthcare sector in the country focus on public health education programs about the disease.
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Affiliation(s)
- Mohammed Ali Almalki
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Maram Nader AlJishi
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Maie Abdulrhman Khayat
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Hotoun Fayez Bokhari
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | - Ahmed Hussein Subki
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
| | | | - Wesam Awad Alhejily
- Department of Internal Medicine, College of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia,
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Ziade N, Khoury B, Zoghbi M, Merheb G, Abi Karam G, Mroue’ K, Messayke J. Prevalence and pattern of COMOrbidities in chronic Rheumatic and musculoskeletal Diseases: results of the COMORD study. BMC Rheumatol 2018. [DOI: 10.1186/s41927-018-0025-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Isma'eel HA, Almedawar MM, Breidy J, Nasrallah M, Nakhoul N, Mouneimne Y, Nasreddine L, Khoueiry-Zgheib N, Abiad M, Tamim H. Worsening of the Cardiovascular Profile in a Developing Country. Glob Heart 2018; 13:275-283. [DOI: 10.1016/j.gheart.2018.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Revised: 01/17/2018] [Accepted: 03/08/2018] [Indexed: 01/27/2023] Open
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Cardiovascular Diseases and Long-term Self-reported Exposure to Pollution: RESULTS OF A NATIONAL EPIDEMIOLOGICAL STUDY IN LEBANON. J Cardiopulm Rehabil Prev 2018; 39:43-49. [PMID: 30418257 DOI: 10.1097/hcr.0000000000000378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Cardiovascular diseases (CVDs) are linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution to CVD, but results are inconsistent. Our objective was to assess this association in Lebanon, a Middle Eastern country. METHODS A national cross-sectional study was conducted across Lebanon. CVD prevalence, which included prevalent ischemic heart and cerebrovascular diseases, was assessed. Moreover, in addition to self-reported items of pollution exposure, we assessed potential predictors of CVD, including sociodemographic characteristics, self-reported health information, and biological measurements. RESULTS We assessed the dose-effect relationship of pollution items in relation with CVD. Self-reported indoor and outdoor pollution exposures were associated with CVD, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (44% increase in risk of CVD for every additional pollution exposure item), after adjustment for sociodemographic and biological characteristics. CONCLUSION Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of pollution on chronic diseases and the work of reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.
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Salameh P, Chahine M, Hallit S, Farah R, Zeidan RK, Asmar R, Hosseiny H. Hypertension prevalence and living conditions related to air pollution: results of a national epidemiological study in Lebanon. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:11716-11728. [PMID: 29442307 DOI: 10.1007/s11356-018-1411-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 01/29/2018] [Indexed: 06/08/2023]
Abstract
Hypertension is a risk factor of several diseases, linked to high mortality and morbidity, particularly in developing countries. Some studies have linked indoor and outdoor pollution exposure items to hypertension, but results were inconsistent. Our objective was to assess the association of living conditions related to air pollution to hypertension in Lebanon, a Middle Eastern country. A national cross-sectional study was conducted all over Lebanon. Blood pressure and its related medications were assessed to be able to classify participants as hypertensive or not. Moreover, in addition to living conditions related to air pollution exposure, we assessed potential predictors of hypertension, including sociodemographic characteristics, self-reported health information and biological measurements. Furthermore, we assessed dose-effect relationship of air pollution items in relation with hypertension. Living conditions related to indoor and outdoor air pollution exposures were associated with hypertension, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease (15% increase in risk of disease for every additional pollution exposure item), after adjustment for sociodemographics and biological characteristics (Ora = 1.15 [1.03-1.28]). Although additional studies would be necessary to confirm these findings, interventions should start to sensitize the population about the effect of air pollution on chronic diseases. The work on reducing pollution and improving air quality should be implemented to decrease the disease burden on the population and health system.
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Affiliation(s)
- Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
| | - Mirna Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes, F-MRI, Beirut, Lebanon
| | - Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.
- Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, Bordeaux, France.
- Faculty of Pharmacy, Saint Joseph University, Beirut, Lebanon.
| | - Rita Farah
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Faculty of Public Health 2, Lebanese University, Fanar, Lebanon
| | - Rouba Karen Zeidan
- Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon
- Faculty of Public Health 2, Lebanese University, Fanar, Lebanon
| | - Roland Asmar
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes, F-MRI, Beirut, Lebanon
| | - Hassan Hosseiny
- Department of Neurology, Henri Mondor Hospital AP-HP, Creteil, France
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Cherfan M, Blacher J, Asmar R, Chahine MN, Zeidan RK, Farah R, Salameh P. Prevalence and risk factors of hypertension: A nationwide cross-sectional study in Lebanon. J Clin Hypertens (Greenwich) 2018; 20:867-879. [PMID: 29604167 DOI: 10.1111/jch.13268] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 02/21/2018] [Accepted: 02/28/2018] [Indexed: 11/26/2022]
Abstract
There is limited epidemiologic data on hypertension (HTN) in Lebanon. This study aimed to determine the prevalence and associated risk factors of HTN in the adult Lebanese population and evaluate the association between dietary and psychological factors on systolic blood pressure (SBP). Cross-sectional analyses were conducted using a multistage cluster sample across Lebanon. A total of 2014 participants were included. The prevalence and control rates of HTN were 31.2% and 28.7%, respectively. In women, educational level and physical activity were negatively associated with HTN (P < .05 for both) and adherence to the Lebanese Mediterranean diet was associated with a lower SBP. Other factors were associated with HTN in men. There was no relationship with SBP and psychological distress. Of the modifiable risk factors, body mass index persisted as the only contributory factor in both sexes (P < .01). Accordingly, prevention of HTN at the population level should focus mainly on overweight prevention.
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Affiliation(s)
- Michelle Cherfan
- Nutritional Epidemiology Research Unit (EREN), Galilee Doctoral School of Sciences, Technology and Health, Centre of Research in Epidemiology and Biostatistics (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University Sorbonne Paris Cite, Bobibny, France.,Faculty of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Jacques Blacher
- Nutritional Epidemiology Research Unit (EREN), Galilee Doctoral School of Sciences, Technology and Health, Centre of Research in Epidemiology and Biostatistics (CRESS), Inserm U1153, Inra U1125, Cnam, Paris 13 University Sorbonne Paris Cite, Bobibny, France.,Faculty of Medicine, Diagnosis and Therapeutic Center, Hôtel-Dieu Hospital, Paris-Descartes University, AP-HP, Paris, France
| | - Roland Asmar
- Foundation-Medical Research Institutes, F-MRI®, Geneva, Switzerland
| | - Mirna N Chahine
- Foundation-Medical Research Institutes, F-MRI®, Beirut, Lebanon.,Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
| | - Rouba K Zeidan
- Faculty of Public Health, Lebanese University, Fanar, Lebanon
| | - Rita Farah
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
| | - Pascale Salameh
- Faculty of Public Health, Lebanese University, Fanar, Lebanon.,Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
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Efficacy of Suxiao Jiuxin Pill on Coronary Heart Disease: A Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 2018:9745804. [PMID: 29770157 PMCID: PMC5892298 DOI: 10.1155/2018/9745804] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Accepted: 01/29/2018] [Indexed: 12/16/2022]
Abstract
Suxiao jiuxin pill is considered an effective ancillary drug in patients with coronary heart disease. Although numerous small, single-center clinical trials have been conducted, the benefits and harms of suxiao jiuxin pill remain controversial. We performed a meta-analysis to clarify the efficacy of suxiao jiuxin pill on patients with coronary heart disease. Randomized controlled trials were identified by using the Cochrane Library, PubMed, Web of Science, Embase, Wanfang, Weipu, and China Knowledge Resource Integrated databases (until June 2016). Pooled relative risks (RR), weighted mean differences (WMD), and 95% confidence intervals (95% CIs) were estimated using random-effects models. Forty-one trials involving 6276 patients were included in our analysis. Administration of suxiao jiuxin pill significantly improved electrocardiogram (ECG) results when compared with other therapies (RR 1.32, 95% CI 1.26 to 1.38, and P < 0.001). Subgroup analyses revealed that suxiao jiuxin pills improve ECG results more than salvia tablets (RR 1.54, 95% CI 1.41 to 1.67, and P < 0.001), isosorbide dinitrate (RR 1.14, 95% CI 1.21 to 1.44, and P = 0.001), nitroglycerin (RR 1.35, 95% CI 1.16 to 1.56, and P < 0.001), and other drugs (RR 1.32, 95% CI 1.21 to 1.44, and P < 0.001). Available evidence additionally suggests that suxiao jiuxin pills could significantly reduce total cholesterol (WMD −0.62 mmol/L, 95% CI −1.06 to –0.18 mmol/L, and P = 0.005) and low-density lipoprotein (LDL) levels (WMD −1.12 mmol/L, 95% CI −1.42 to −0.82 mmol/L, and P < 0.001) and increase high-density lipoprotein (HDL) levels (WMD 0.32 mmol/L, 95% CI 0.07 to 0.58 mmol/L, and P = 0.014). However, no significant differences were observed in total triglyceride levels, plasma viscosity, hematocrit, and fibrinogen. No incidences of adverse reactions were observed after administration of suxiao jiuxin pill. Improvements in ECG results and lipid profiles were also observed after suxiao jiuxin administration compared to other therapies. It also decreased low-cut and high-cut whole blood viscosity without significant adverse reactions.
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Salameh P, Farah R, Hallit S, Zeidan RK, Chahine MN, Asmar R, Hosseini H. Self-reported history of stroke and long-term living conditions near air pollution sources: results of a national epidemiological study in Lebanon. ENVIRONMENTAL MONITORING AND ASSESSMENT 2018; 190:153. [PMID: 29460147 DOI: 10.1007/s10661-018-6545-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2017] [Accepted: 02/12/2018] [Indexed: 06/08/2023]
Abstract
Stroke is a disease related to high mortality and morbidity, particularly in developing countries. Some studies have linked self-reported indoor and outdoor pollution to stroke and mini-stroke, while some others showed no association. Our objective was to assess this association in Lebanon, a Middle Eastern developing country. A national cross-sectional study was conducted all over Lebanon. In addition to self-reported items of pollution exposure, we assessed potential predictors of stroke and mini-stroke, including sociodemographic characteristics, self-reported health information, and biological measurements. Moreover, we assessed dose-effect relationship of pollution items in relation with stroke. Self-reported indoor pollution exposure was associated with stroke and mini-stroke, with or without taking biological values into account. Moreover, we found a dose-effect relationship of exposure with risk of disease, but this effect did not reach statistical significance after adjustment for sociodemographics and biological characteristics. No association was found for any outdoor pollution item. Although additional studies would be necessary to confirm these findings, sensitizing the population about the effect of pollution on chronic diseases, working on reducing pollution, and improving air quality should be implemented to decrease the burden of the disease on the population and health system.
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Affiliation(s)
- Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Faculty of Public Health, INSPECT-LB (Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxocologie - Liban), Fanar, Lebanon
| | - Rita Farah
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon
- Faculty of Public Health, INSPECT-LB (Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxocologie - Liban), Fanar, Lebanon
| | - Souheil Hallit
- Faculty of Pharmacy, Lebanese University, Hadath, Lebanon.
- Faculty of Public Health, INSPECT-LB (Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxocologie - Liban), Fanar, Lebanon.
- Faculty of Pharmacy, Saint-Joseph University, Beirut, Lebanon.
- Faculty of Medicine and Medical Sciences, Holy Spirit University of Kaslik, Kaslik, Lebanon.
- Research Department, Psychiatric Hospital of the Cross, P.O Box 60096, Jal Eddib, Lebanon.
- Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center Inserm - Université de Bordeaux, Bordeaux, France.
| | - Rouba Karen Zeidan
- Faculty of Public Health, INSPECT-LB (Institut National de Santé Publique, d'Epidémiologie Clinique et de Toxocologie - Liban), Fanar, Lebanon
- Faculty of Public Health 2, Lebanese University, Fanar, Lebanon
| | - Mirna N Chahine
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes, F-MRI, Beirut, Lebanon
| | - Roland Asmar
- Faculty of Medical Sciences, Lebanese University, Hadath, Lebanon
- Foundation-Medical Research Institutes, F-MRI, Beirut, Lebanon
| | - Hassan Hosseini
- Department of Neurology, Henri Mondor Hospital AP-HP, Creteil, France
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Turk-Adawi K, Sarrafzadegan N, Fadhil I, Taubert K, Sadeghi M, Wenger NK, Tan NS, Grace SL. Cardiovascular disease in the Eastern Mediterranean region: epidemiology and risk factor burden. Nat Rev Cardiol 2017; 15:106-119. [PMID: 28933782 DOI: 10.1038/nrcardio.2017.138] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The Eastern Mediterranean region (EMR) comprises 22 countries or territories spanning from Morocco in the west to Pakistan in the east, and contains a population of almost 600 million people. Like many other developing regions, the burden of disease in the EMR has shifted in the past 30 years from primarily communicable diseases to noncommunicable diseases such as cardiovascular disease (CVD). Cardiovascular mortality in the EMR, mostly attributable to ischaemic heart disease, is expected to increase more dramatically in the next decade than in any other region except Africa. The most prominent CVD risk factors in this region include tobacco consumption, physical inactivity, depression, obesity, hypertension, and diabetes mellitus. Many individuals living in the EMR are unaware of their risk factor status, and even if treated, these risk factors are often poorly controlled. Furthermore, infrequent use of emergency medical services, delays in access to care, and lack of access to cardiac catheterization affects the timely diagnosis of CVD. Treatment of CVD is also suboptimal in this region, consisting primarily of thrombolysis, with insufficient provision of timely revascularization. In this Review, we summarize what is known about CVD burden, risk factors, and treatment strategies for individuals living in the EMR. This information will hopefully aid decision-makers when devising strategies on how to improve CVD prevention and management in this region.
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Affiliation(s)
- Karam Turk-Adawi
- Public Health Department, College of Health Sciences, Qatar University, Al Jamea Street, Doha, Qatar
| | - Nizal Sarrafzadegan
- Isfahan Cardiovascular Research Center, Cardiovascular Research Institute, Isfahan University of Medical Sciences, Khorram Ave, Isfahan, Iran.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, 2206 East Mall, Vancouver, British Columbia V6T 1Z3, Canada
| | - Ibtihal Fadhil
- Noncommunicable Diseases, World Health Organization, East Mediterranean Regional Office, Monazamet El Seha El Alamia Street, extension of Abdel Razak El Sanhouri Street, Nasr City, Cairo, Egypt
| | - Kathryn Taubert
- International Science and Health Strategies, American Heart Association, Aeschengraben 14, Basel 4051, Switzerland
| | - Masoumeh Sadeghi
- Cardiac Rehabilitation Research Center. Cardiovascular Research Institute. Isfahan University of Medical Sciences, Khorram Ave, Isfahan, Iran
| | - Nanette K Wenger
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, 49 Jesse Hill Jr. Drive SE, Atlanta, Georgia 30303, USA
| | - Nigel S Tan
- University Health Network, 585 University Ave, Toronto, Ontario M5G 2N2, Canada
| | - Sherry L Grace
- University Health Network, 585 University Ave, Toronto, Ontario M5G 2N2, Canada.,School of Kinesiology and Health Science, York University, Bethune 368, 4700 Keele Street, Toronto, Ontario, M3J 1P3, Canada
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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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