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Raman P, Sagadevan Y, Dhanapalan S, Fernandez BJ, Tan SY, Appalasamy JR, Ramadas A. Lifestyle-Related Risk Factors and Primary Prevention Strategies for Cardiovascular Diseases in a Middle-Income Country: A Scoping Review and Implication for Future Research. JOURNAL OF PREVENTION (2022) 2024; 45:579-609. [PMID: 38839738 PMCID: PMC11271377 DOI: 10.1007/s10935-024-00782-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/04/2024] [Indexed: 06/07/2024]
Abstract
Cardiovascular diseases are the leading cause of death in middle-income countries such as Malaysia. There is a significant gap in knowledge between cardiovascular disease-related risk assessments and interventions in the Malaysian population. In this scoping review, we have determined the status of cardiovascular research in Malaysia by prioritising lifestyle-related risk assessments and interventions. We searched five electronic databases (Ovid MEDLINE, Cochrane Central Register of Controlled Trials, APA PsychINFO, Embase and Scopus) to identify relevant research articles that had been published. The Joanna Briggs Institute and the preferred reporting items for systematic reviews and meta-analyses extension for scoping reviews served as a guide for the scoping review. Study selection was made using the Covidence platform, screened, and extracted. Thirty-one studies were included in this review. Studies reviewed reported a significant positive association between physical inactivity, smoking, poor dietary patterns, working hours, clustering of lifestyle risk, and cardiovascular disease risk. Most interventions focused on physical activity and a multimodal lifestyle approach, significantly improving primary and secondary cardiovascular disease-related outcomes. The findings suggest improving lifestyle-related risk assessments and interventions to prevent cardiovascular diseases in this population. It is unclear if these outcomes can translate to higher effectiveness in preventing cardiovascular disease. Nevertheless, intervention using the multifaceted lifestyle approach can improve cardiovascular disease-related outcomes.
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Affiliation(s)
- Pragashini Raman
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Yoganishalini Sagadevan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Sornavalli Dhanapalan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Brandon J Fernandez
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Sheng Yew Tan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Jamuna Rani Appalasamy
- School of Pharmacy, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia
| | - Amutha Ramadas
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Sunway City, Malaysia.
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Abd Rahman IZ, Nor Hisam NS, Aminuddin A, Hamid AA, Kumar J, Ugusman A. Evaluating the Potential of Plukenetia volubilis Linneo (Sacha Inchi) in Alleviating Cardiovascular Disease Risk Factors: A Mini Review. Pharmaceuticals (Basel) 2023; 16:1588. [PMID: 38004453 PMCID: PMC10675584 DOI: 10.3390/ph16111588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
Plukenetia volubilis Linneo or Sacha Inchi (SI), a traditional natural remedy indigenous to Peru and Brazil, has garnered global attention due to its exceptional nutritional composition. Its protective effects against various non-communicable diseases, notably cardiovascular disease (CVD), have become a subject of interest in recent research. This comprehensive review summarizes the existing evidence from 15 relevant articles concerning the impact of SI on common CVD risk factors, including dyslipidemia, obesity, diabetes, and hypertension. The relevant articles were derived from comprehensive searches on PubMed, Scopus, Google Scholar, and Web of Science using predefined criteria and keywords related to the topic. Overall, SI demonstrated positive effects in attenuating dyslipidemia, obesity, diabetes, and hypertension. The multifaceted mechanisms responsible for the protective effects of SI against these CVD risk factors are primarily attributed to its antioxidative and anti-inflammatory properties. While preclinical studies dominate the current scientific literature on SI, there are limited clinical trials to corroborate these findings. Therefore, future well-designed, large-scale randomized clinical trials are highly recommended to establish the efficacy of SI and determine its optimal dosage, potential drug and food interactions, and practical integration into preventive strategies and dietary interventions for the high-risk populations.
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Affiliation(s)
- Izzat Zulhilmi Abd Rahman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
| | - Nur Syahidah Nor Hisam
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
- Programme of Biomedical Science, Centre for Toxicology & Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Amilia Aminuddin
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
| | - Adila A. Hamid
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
| | - Azizah Ugusman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia; (I.Z.A.R.); (N.S.N.H.); (A.A.H.); (J.K.)
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Ali MF, Ja'afar NIS, Krishnan TG, Zulkifle MAM, Khaidzir NK, Jamil TR, Man ZC, Aziz AFA. Dementia awareness among elderly at risk for developing mild cognitive impairment: a cross sectional study at a university-based primary care clinic. BMC Geriatr 2023; 23:496. [PMID: 37592221 PMCID: PMC10436505 DOI: 10.1186/s12877-023-04230-4] [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: 06/28/2022] [Accepted: 08/10/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The number of people living with dementia in Malaysia is expected to increase with the nation's growing elderly population and increased lifespan. The lack of public awareness of dementia is partly compounded by low personal health literacy, while scarce research on local patient awareness further impacts the execution of optimised healthcare services in Malaysia. Patients with chronic disease have an elevated risk of developing mild cognitive impairment (MCI). This study aimed to assess the level of awareness of basic knowledge on dementia among the elderly, especially those at risk of developing mild cognitive impairment and its associated factors. METHODS A total of 207 elderly patients aged 60 years and above with chronic diseases attending a university-based primary care clinic were recruited via a systematic randomised sampling method from the clinic patient attendance registry. Respondents were assessed using self-administered online questionnaires distributed via mobile devices. The questionnaire assessed awareness, i.e. ability to correctly answer a self-reported questionnaire on basic dementia knowledge; (adapted from Northern Ireland Life and Times Survey 2010), risk of MCI; (using Towards Useful Aging (TUA)-WELLNESS screening questionnaire) and help-seeking behaviour. Bivariate analysis was used to determine factors associated with dementia awareness. RESULTS The response rate was 77.1%, with the majority of participants were females, Chinese and had secondary school education. 39.1% of participants were categorised as high risk of developing MCI. The majority (92.8%) had low dementia awareness and had never shared their concerns regarding dementia (93.2%) nor had any discussion (87.0%) on cognitive impairment with their physicians. Three factors had an association with total dementia awareness score, i.e., younger age group, higher risk of MCI and presence of cardiovascular diseases have significantly lower awareness score (p < 0.05). CONCLUSION Awareness of dementia is low among elderly patients with potentially high risk of developing MCI. Efforts to improve awareness on dementia should focus on primary care doctors engaging with at-risk elderly patients to initiate discussion regarding dementia risk while managing modifiable risk factors i.e. hypertension control, diabetes, dyslipidaemia and obesity.
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Affiliation(s)
- Mohd Fairuz Ali
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia.
| | - Nur Iman Suraiya Ja'afar
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
- Class of 2021/2022, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Thayaletchumy Gophala Krishnan
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
- Class of 2021/2022, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Mohamad Azizi Mohamad Zulkifle
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
- Class of 2021/2022, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Nur Khairunnisa Khaidzir
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
- Class of 2021/2022, Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Teh Rohila Jamil
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Zuraidah Che Man
- Quality Service Unit, Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
| | - Aznida Firzah Abdul Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, 56000, Malaysia
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Le C, Liu L, Li GH, Zhao Y, Wu X, Rabkin Golden A. Trends in prevalence and clustering of modifiable cardiovascular disease risk factors across socioeconomic spectra in rural southwest China: a cross-sectional study. BMJ Open 2023; 13:e071152. [PMID: 37105696 PMCID: PMC10151950 DOI: 10.1136/bmjopen-2022-071152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/29/2023] Open
Abstract
OBJECTIVES This study aimed to determine the changing prevalence of clustering of cardiovascular disease (CVD) risk factors across socioeconomic spectra in rural southwest China. DESIGN Data were collected from two waves of cross-sectional health interviews and examinations among individuals aged ≥35 years in rural China. Anthropometric measurements, blood pressure and fasting blood sugar levels were recorded for each participant. SETTING This study was conducted in rural Yunnan Province of China. PARTICIPANTS 8187 individuals in 2011 and 7572 in 2021 consented to participate in this study. RESULTS From 2011 to 2021, prevalence increased of hypertension (26.1% vs 41.6%), diabetes mellitus (5.9% vs 9.8%), obesity (5.9% vs 12.0%) and central obesity (50.0% vs 58.3%) (p<0.01), while prevalence decreased of current smoking (35.2% vs 29.6%), secondhand smoke exposure (42.6% vs 27.4%) and current drinking (26.6% vs 29.6%) (p<0.01). This decade also saw an increase in the prevalence of participants with clustering of ≥2 (61.8% vs 63.0%) and ≥3 CVD risk factors (28.4% vs 32.2%) (p<0.05). These increasing rates were also observed among subgroups categorised by sex, ethnicity, education level, income level and those ≥45 years of age (p<0.05). In both 2011 and 2021, male participants and participants with a lower education level had higher prevalence of clustering of ≥2 and ≥3 CVD risk factors than their counterparts (p<0.01). Ethnic minority participants and participants with higher annual income had higher prevalence of clustering of CVD risk factors in 2011 but presented opposite associations in 2021 (p<0.01). CONCLUSION The prevalence of clustering of CVD risk factors increased substantially across all socioeconomic spectra in rural southwest China from 2011 to 2021. Future efforts to implement comprehensive lifestyle interventions to promote the prevention and control of CVD should in particular focus on men, those of Han ethnicity and those with low socioeconomic status.
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Affiliation(s)
- Cai Le
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Lan Liu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Guo-Hui Li
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yi Zhao
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Xia Wu
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
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Firus Khan AY, Ramli AS, Abdul Razak S, Mohd Kasim NA, Chua YA, Ul-Saufie AZ, Jalaludin MA, Nawawi H. The Mala ysian HEalth and Well Being Assessmen T (MyHEBAT) Study Protocol: An Initiation of a National Registry for Extended Cardiovascular Risk Evaluation in the Community. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph191811789. [PMID: 36142062 PMCID: PMC9517557 DOI: 10.3390/ijerph191811789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 06/01/2023]
Abstract
Cardiovascular disease (CVD) has been a burden to many developing countries for decades, including Malaysia. Although various steps have been taken to prevent and manage CVD, it remains the leading cause of morbidity and mortality. The rising prevalence of CVD risk factors such as hypertension, hypercholesterolaemia, diabetes, overweight and obesity is the main driving force behind the CVD epidemic. Therefore, a nationwide health study coined as the Malaysian Health and Wellbeing Assessment (MyHEBAT) was designed. It aimed to investigate the prevalence of CVD and the associated risk factors in the community across Malaysia. The MyHEBAT study recruited participants (18-75 years old) through community health screening programmes from 11 states in Malaysia. The MyHEBAT study was further divided into two sub-studies, namely, the Cardiovascular Risk Epidemiological Study (MyHEBAT-CRES) and the MyHEBAT Familial Hypercholesterolaemia Study (MyHEBAT-FH). These studies assessed the prevalence of CVD risk factors and the prevalence of FH in the community, respectively. The data garnered from the MyHEBAT study will provide information for healthcare providers to devise better prevention and clinical practice guidelines for managing CVD in Malaysia.
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Affiliation(s)
- Al’aina Yuhainis Firus Khan
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Anis Safura Ramli
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- Departments of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Suraya Abdul Razak
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- Departments of Primary Care Medicine, Faculty of Medicine, Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- Cardio Vascular and Lungs Research Institute (CaVaLRI), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Noor Alicezah Mohd Kasim
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- UiTM Al-Sultan Abdullah Hospital, Puncak Alam 42300, Selangor, Malaysia
- Department of Pathology, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia
| | - Yung-An Chua
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
| | - Ahmad Zia Ul-Saufie
- Faculty of Computer and Mathematical Sciences, Universiti Teknologi MARA, Shah Alam 40450, Selangor, Malaysia
| | - Mohd Amin Jalaludin
- Department of Otorhinolaringology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Hapizah Nawawi
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA, Sungai Buloh 47000, Selangor, Malaysia
- UiTM Al-Sultan Abdullah Hospital, Puncak Alam 42300, Selangor, Malaysia
- Department of Pathology, Faculty of Medicine, Sungai Buloh Campus, Universiti Teknologi MARA, Jalan Hospital, Sungai Buloh 47000, Selangor, Malaysia
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Arsyad DS, Westerink J, Cramer MJ, Ansar J, Wahiduddin, Visseren FLJ, Doevendans PA, Ansariadi. Modifiable risk factors in adults with and without prior cardiovascular disease: findings from the Indonesian National Basic Health Research. BMC Public Health 2022; 22:660. [PMID: 35382783 PMCID: PMC8985337 DOI: 10.1186/s12889-022-13104-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 03/24/2022] [Indexed: 12/31/2022] Open
Abstract
Backgrounds The majority of risk factors for cardiovascular diseases (CVDs) are modifiable. Continuous monitoring and control of these factors could significantly reduce the risk of CVDs-related morbidity and mortality. This study estimated the prevalence of modifiable risk factors in Indonesia and its co-occurence of multiple risk factors stratified by prior CVDs diagnosis status and sex. Methods Adult participants (> 15 years, N = 36,329, 57% women) with median age of 40 years were selected from a nationwide Indonesian cross-sectional study called Basic Health Research or Riset Kesehatan Dasar (Riskesdas) conducted in 2018. Thirteen risk factors were identified from the study, including smoking, a high-risk diet, inadequate fruit and vegetable consumption, a low physical activity level, the presence of mental-emotional disorders, obesity, a high waist circumference (WC), a high waist-to-height ratio (WtHR), hypertension, diabetes, a high total cholesterol level, a high low-density lipoprotein (LDL) cholesterol level, and a low high-density lipoprotein (HDL) cholesterol level. Age-adjusted prevalence ratios stratified by CVDs status and sex were calculated using Poisson regression with the robust covariance estimator. Results CVDs were found in 3% of the study population. Risk factor prevalence in the overall population ranged from 5.7 to 96.5% for diabetes and inadequate fruit and vegetable consumption respectively. Smoking, a high-risk food diet, and a low HDL cholesterol level were more prevalent in men, whereas a low physical activity level, the presence of mental-emotional disorders, obesity, a high WC, a high WtHR, hypertension, diabetes, a high total cholesterol level, and a high LDL cholesterol level were more prevalent in women. Approximately 22% of men and 18% of women had at least 4 risk factors, and these proportions were higher in participants with prior CVDs diagnosis. Conclusions There is a high prevalence of modifiable risk factors in the Indonesian adult population. Sex, age, and the presence of CVD are major determinants of the variations in risk factors. The presence of multiple risk factors, which are often inter-related, requires a comprehensive approach through health promotion, lifestyle modification and patient education.
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Affiliation(s)
- Dian Sidik Arsyad
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands. .,Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia.
| | - Jan Westerink
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maarten J Cramer
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands
| | - Jumriani Ansar
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Wahiduddin
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
| | - Frank L J Visseren
- Department of Vascular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Pieter A Doevendans
- Department of Cardiology, Division of Heart and Lungs, University Medical Centre Utrecht, University of Utrecht, 3584 CT, Utrecht, The Netherlands.,Netherlands Heart Institute Utrecht, Utrecht, The Netherlands
| | - Ansariadi
- Department of Epidemiology, Faculty of Public Health, Hasanuddin University, Makassar, Indonesia
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