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Zhang Y, Xie W, Dai Y, Wu Z, Lin Y, Yang M, Hong H. Influencing and prognostic factors of end-stage hypertrophic cardiomyopathy. ESC Heart Fail 2024. [PMID: 39092527 DOI: 10.1002/ehf2.15010] [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: 02/25/2024] [Revised: 06/22/2024] [Accepted: 07/15/2024] [Indexed: 08/04/2024] Open
Abstract
AIMS End-stage hypertrophic cardiomyopathy (ES-HCM) is a disease with severe complications and a poor prognosis. This study aimed to explore the influencing and prognostic factors of ES-HCM. METHODS AND RESULTS A total of 1282 patients with HCM who were hospitalized for the first time at Fujian Medical University Union Hospital between 1 January 2013 and 30 September 2021 were recorded. The patients with HCM and left ventricular ejection fraction (LVEF) < 50% were defined as having ES-HCM, and a control group (LVEF ≥ 50%) was generated from the collected medical records of HCM. The patients were matched in a ratio of 4:1 based on age and sex. Logistic regression analysis was used to determine the influencing factors of ES-HCM. Kaplan-Meier survival analysis was performed to analyse the clinical outcomes of ES-HCM patients. A total of 250 inpatients with HCM were enrolled in the study; 50 patients had ES-HCM, and 200 had HCM with LVEF ≥ 50%. The mean age of the patients at enrolment was 62.5 ± 10.3 years, and 215 patients (215/250, 86.0%) were male. The median follow-up time of the patients was 2.8 (1.4-5.4) years. The incidence of all-cause death and cardiovascular death in patients with ES-HCM was higher than those in patients with HCM and LVEF ≥ 50% (22/50 [44.0%] vs. 13/200 [6.5%]; 12/50 [24.0%] vs. 4/200 [2.0%], all P < 0.001). Multivariate logistic regression analysis showed that the influencing factors associated with ES-HCM included age at first symptom onset (odds ratio [OR] = 0.95, 95% CI [0.90, 1.00], P = 0.042), New York Heart Association (NYHA) class (OR = 7.73, 95% CI [2.93, 20.41], P < 0.001), heart rate (OR = 1.07, 95% CI [1.02, 1.12], P = 0.003), QRS duration (OR = 1.03, 95% CI [1.00, 1.05], P = 0.020), left ventricular end-diastolic diameter (LVEDD) (OR = 1.15, 95% CI [1.04, 1.28], P = 0.006), left atrial anteroposterior diameter (LAD) (OR = 1.13, 95% CI [1.03, 1.24], P = 0.012), and maximum left ventricular wall thickness (MLVWT) (OR = 0.80, 95% CI [0.68, 0.93], P = 0.005). Among the 50 patients with ES-HCM, NYHA class (P < 0.001) and heart rate (P = 0.017) were each associated with a higher likelihood and earlier occurrence of heart transplantation or all-cause mortality in univariate analyses. CONCLUSIONS The influencing factors for ES-HCM included the age at first symptom onset, NYHA class, heart rate, QRS duration, LVEDD, LAD, and MLVWT. Both NYHA class and heart rate were related to the prognosis of ES-HCM.
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Affiliation(s)
- Yisen Zhang
- Department of Cardiac Surgery, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Medical University Union Hospital, Fuzhou, China
| | - Wenhui Xie
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yaqing Dai
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
| | - Zefeng Wu
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
| | - Yuping Lin
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
| | - Ming Yang
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
| | - Huashan Hong
- Department of Geriatrics, Department of Cardiology, Fujian Key Laboratory of Vascular Aging (Fujian Medical University), Fujian Institute of Geriatrics, Fujian Heart Disease Center, Fujian Clinical Research Center for Senile Vascular Aging and Brain Aging, Fujian Medical University Union Hospital, Fuzhou, China
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Shen N, Liu J, Wang Y, Qiu Y, Li D, Wang Q, Chai L, Chen Y, Hu H, Li M. The global burden of ischemic heart disease attributed to high fasting plasma glucose: Data from 1990 to 2019. Heliyon 2024; 10:e27065. [PMID: 38495138 PMCID: PMC10943346 DOI: 10.1016/j.heliyon.2024.e27065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 02/16/2024] [Accepted: 02/23/2024] [Indexed: 03/19/2024] Open
Abstract
Background Ischemic heart disease (IHD) is the leading cause of death worldwide. High fasting plasma glucose (FPG) is an increasing risk factor for IHD. We aimed to explore the long-term trends of high FPG-attributed IHD mortality during 1990-2019. Methods Data were obtained from the Global Burden of Disease Study 2019 database. Deaths, disability-adjusted life-years (DALYs), the age-standardized mortality rate (ASMR) and age-standardized DALY rate (ASDR) of IHD attributable to high FPG were estimated by sex, socio-demographic index (SDI), regions and age. Estimated annual percentage changes (EAPCs) were calculated to assess the trends of ASMR and ASDR of IHD attributable to high FPG. Results IHD attributable to high FPG deaths increased from 1.04 million (0.62-1.63) in 1990 to 2.35 million (1.4-3.7) in 2019, and the corresponding DALYs rose from 19.82 million (12.68-29.4) to 43.3 million (27.8-64.2). In 2019, ASMR and ASDR of IHD burden attributable to high FPG were 30.45 (17.09-49.03) and 534.8 (340.7-792.2), respectively. The highest ASMR and ASDR of IHD attributable to high FPG occurred in low-middle SDI quintiles, with 39.28 (22.40-62.76) and 742.3 (461.5-1117.5), respectively, followed by low SDI quintiles and middle SDI quintiles. Males had higher ASMR and ASDR compared to females across the past 30 years. In addition, ASRs of DALYs and deaths were highest in those over 95 years old. Conclusion High FPG-attributed IHD mortality and DALYs have increased dramatically and globally, particularly in low, low-middle SDI quintiles and among the elderly. High FPG remains a great concern on the global burden of IHD and effective prevention and interventions are urgently needed to curb the ranking IHD burden, especially in lower SDI regions.
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Affiliation(s)
- Nirui Shen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Jin Liu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yan Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yuanjie Qiu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Danyang Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Qingting Wang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Limin Chai
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Yuqian Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Huizhong Hu
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
| | - Manxiang Li
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China
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Patriota P, Ko Maung K, Marques-Vidal P. Reported recommendations to address cardiovascular risk factors differ by socio-economic status in Brazil. Results from the Brazilian National Health Survey 2019. Prev Med Rep 2023; 36:102527. [PMID: 38116250 PMCID: PMC10728434 DOI: 10.1016/j.pmedr.2023.102527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 11/17/2023] [Accepted: 11/25/2023] [Indexed: 12/21/2023] Open
Abstract
Background Management of cardiovascular risk factors (high cholesterol, diabetes, and hypertension) should start by implementing a healthy lifestyle. Whereas lifestyle recommendations are provided irrespective of the patient's socio-economic status has not been recently assessed in the Brazilian population. Aims To assess the preventive measures against cardiovascular risk factors according to educational level and income in the Brazilian population. Methods Survey data of the 2019 Brazilian National Health Survey (PNS). The PNS is a nationwide household-based survey carried out by the Brazilian Ministry of Health. The PNS included face-to-face interviews and collected information on lifestyle management of high cholesterol, diabetes, and hypertension by a healthy diet, an adequate weight, exercise, and quitting smoking. The participant's educational level and income (in multiples of the basic salary per capita) was collected. Results Of the 88,052 participants included, 13,151 (14.9%), 6,986 (7.9%) and 22,516 (25.6%) reported being diagnosed with high cholesterol, diabetes, or hypertension, respectively. Dietary recommendations were the most frequently provided (94.5%, 94.6% and 88.1% for high cholesterol diabetes, and hypertension, respectively), while recommendations to quit smoking to current smokers were the least frequently provided (74.9%, 85.8% and 81.1% for high cholesterol, diabetes, and hypertension, respectively). After multivariable adjustment, participants with a higher educational level or a higher income had a higher likelihood of reporting receipt lifestyle recommendations for high cholesterol or hypertension, while no associations were found for most recommendations for diabetes. Conclusion Better-educated, wealthier Brazilians report receiving more lifestyle recommendations regarding high cholesterol and hypertension management more frequently than lower-educated or with low-income.
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Affiliation(s)
- Pollyanna Patriota
- Pôle Santé Vallée de Joux – Joux Valley Health Center, Le Sentier, Switzerland
| | - Ko Ko Maung
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
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Soto Á, Balboa-Castillo T, Andrade-Mayorga O, Marzuca-Nassr GN, Muñoz S, Morales G. Trends in mortality from cardiovascular diseases in Chile, 2000-2020. Rev Panam Salud Publica 2023; 47:e127. [PMID: 38024444 PMCID: PMC10666651 DOI: 10.26633/rpsp.2023.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 08/28/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To analyze trends in mortality caused by cardiovascular diseases (CVD) in Chile during the period 2000-2020. Methods Data on age-adjusted mortality rates (AAMR) from CVD per 100 000 population in Chile for 2000-2020 were extracted from the World Health Organization Mortality Database. Joinpoint regression was used to analyze the trends and compute the average annual percent change (AAPC) in Chile. In addition, analyses were conducted by sex and type of CVD. Results Between 2000 and 2020, the AAMR from CVD decreased in Chile from 159.5 to 94.6 per 100 000 population, with a statistically significant decrease in the AAPC of 2.6% (95% CI [-2.8, -2.4]). No joinpoints were identified. The AAMR from CVD decreased annually by 2.6% (95% CI [-2.8, -2.4]) and 2.8% (95% CI [-3.5, -2.6]) in men and women, respectively. The AAMR from ischemic heart disease reduced annually by 3.6% (95% CI [-4.6, -2.7]) with two joinpoints in 2011 and 2015. In the case of stroke, the mortality rate decreased annually by 3.7% (95% CI [-4.5, -3.0]), with two joinpoints in 2008 and 2011. Conclusions Cardiovascular disease mortality rates have decreased significantly in Chile, in both sexes, especially in women. This decrease could be explained mainly by a significant reduction in the case fatality in recent decades. These results could be a reference for developing primary prevention and acute management of CVD policies focused on populations with higher mortality.
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Affiliation(s)
- Álvaro Soto
- Universidad de La FronteraTemucoChileUniversidad de La Frontera, Temuco, Chile
| | | | | | | | - Sergio Muñoz
- Universidad de La FronteraTemucoChileUniversidad de La Frontera, Temuco, Chile
| | - Gladys Morales
- Universidad de La FronteraTemucoChileUniversidad de La Frontera, Temuco, Chile
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Silva FM, Giatti L, Fonseca MDJMD, Brant LCC, Diniz MDFHS, Molina MDCB, Matos SMAD, Vigo A, Barreto SM. Consumption of ultra-processed foods and eight-year risk of death from all causes and noncommunicable diseases in the ELSA-Brasil cohort. Int J Food Sci Nutr 2023:1-10. [PMID: 37821803 DOI: 10.1080/09637486.2023.2267797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/02/2023] [Indexed: 10/13/2023]
Abstract
Increased consumption of ultra-processed foods (UPF) is associated with higher incidences of many noncommunicable diseases (NCDs) and death from all causes. However, the association between UPF and cardiovascular disease (CVD) mortality remains controversial. Our study investigated whether UPF consumption is associated with a higher risk of death from all causes, NCDs, and CVD. This study includes 14,747 participants from the ELSA-Brasil cohort followed up over an eight-year period. The NOVA classification was used to estimate the proportion of UPF (grams/day) in one's diet. Cox regression was also applied. After adjustment for sociodemographic, health, and behavioural factors, a 10% increase in UPF in participants' diets raised the risk of death from all causes and NCDs by 10% (95%CI: 1.01-1.19) and 11% (95%CI:1.02-1.21), respectively. However, UPF consumption was not associated with CVD mortality. The findings support public policies aimed at reducing UPF consumption in an attempt to reduce the NCD burden.
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Affiliation(s)
- Fernanda Marcelina Silva
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luana Giatti
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- School of Medicine and Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Maria de Jesus Mendes da Fonseca
- Department of Epidemiology and Quantitative Methods in Health, National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Luisa Campos Caldeira Brant
- School of Medicine and Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | | | - Maria Del Carmen Bisi Molina
- Department of Collective Health and Nutrition and Health, Universidade Federal do Espírito Santo, Vitória, Brazil
| | | | - Alvaro Vigo
- Postgraduate Program in Epidemiology, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sandhi Maria Barreto
- Postgraduate Program in Public Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- Department of Preventive Medicine, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
- School of Medicine and Clinical Hospital/EBSERH, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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Wu J, Jiao B, Zhao J. Gender Disparities in Blood Pressure and the Role of Body Mass Index: A Birth Cohort Analysis in China. J Epidemiol Glob Health 2023; 13:485-494. [PMID: 37302107 PMCID: PMC10468457 DOI: 10.1007/s44197-023-00127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/26/2023] [Indexed: 06/13/2023] Open
Abstract
BACKGROUND The slow decline in cardiovascular disease (CVD) mortality and the stagnant or increasing hypertension prevalence in low- and middle-income countries necessitate investigation. Evolving gender disparities suggested that male cardiovascular health disadvantage may be preventable, offering potential for enhancing population cardiovascular health. Despite global body mass index (BMI) increases, its role in shaping the gender disparities remains underexplored. OBJECTIVE This study investigated the birth cohort dynamics of gender disparities in systolic/diastolic blood pressure (SBP/DBP) in China, one of the world's largest low- and middle-income countries, and explored the potential role of BMI in explaining the changing gender disparities. METHODS Data from the China Health and Nutrition Survey (1991-2015) were analyzed using multilevel growth-curve models to estimate gender- and cohort-specific SBP/DBP trajectories among individuals born between 1950 and 1975. RESULTS Men had higher SBP and DBP than women at the sample's mean age of 41.7 years. The gender disparities in SBP and DBP increased with each successive one-year cohort from 1950 to 1975 by 0.14 mm Hg and 0.09 mm Hg, respectively. Adjusting for BMI reduced the increasing gender disparities in SBP and DBP by 31.9% and 34.4%, respectively. CONCLUSION Chinese men experienced a greater increase in SBP/DBP across successive cohorts compared to women. The increasing gender disparities in SBP/DBP were partially attributable to a greater BMI increase across cohorts among men. Given these findings, prioritizing interventions that aim to reduce BMI, particularly among men, could potentially alleviate the burden of CVD in China through lowering SBP/DBP.
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Affiliation(s)
- Jinjing Wu
- Asian Demographic Research Institute, Shanghai University, Shanghai, 200444, China
| | - Boshen Jiao
- Harvard T.H. Chan School of Public Health, Harvard University, Boston, 02115, USA
| | - Jiaying Zhao
- RSSS Building, 146 Ellery Crescent, School of Demography, ANU College of Arts and Social Sciences, The Australian National University, Acton ACT, Canberra, 2601, Australia.
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Diego LADS. Anesthesia and women's peculiarities. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:e2023S103. [PMID: 37556622 PMCID: PMC10411693 DOI: 10.1590/1806-9282.2023s103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 08/11/2023]
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The Interplay of Sirtuin-1, LDL-Cholesterol, and HDL Function: A Randomized Controlled Trial Comparing the Effects of Energy Restriction and Atorvastatin on Women with Premature Coronary Artery Disease. Antioxidants (Basel) 2022; 11:antiox11122363. [PMID: 36552571 PMCID: PMC9774144 DOI: 10.3390/antiox11122363] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 11/16/2022] [Accepted: 11/24/2022] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION HDL function has gained prominence in the literature as there is a greater predictive capacity for risk in early coronary artery disease when compared to the traditional parameters. However, it is unclear how dietary energy restriction and atorvastatin influence HDL function. METHODS A randomized controlled trial with 39 women with early CAD divided into three groups (n = 13): energy restriction (30% of VET), atorvastatin (80 mg), and control. Analyses of traditional biochemical markers (lipid and glucose profile), circulating Sirt-1, and HDL function (lipid composition, lipid transfer, and antioxidant capacity). RESULTS Participants' mean age was 50.5 ± 3.8 years. Energy restriction increased Sirt-1 by 63.6 pg/mL (95%CI: 1.5-125.7; p = 0.045) and reduced BMI by 0.8 kg/m2 (95%CI: -1.349--0.273; p = 0.004) in a manner independent of other cardiometabolic factors. Atorvastatin reduced LDL-c by 40.0 mg/dL (95%CI: -69.910--10.1; p = 0.010). Increased Sirt-1 and reduced BMI were independently associated with reduced phospholipid composition of HDL (respectively, β = -0.071; CI95%:-0.136--0.006; p = 0.033; β = 7.486; CI95%:0.350-14.622; p = 0.040). Reduction in BMI was associated with lower HDL-free cholesterol (β = 0.818; CI95%:0.044-1.593; p = 0.039). LDL-c reduction by statins was associated with reduced maximal lipid peroxide production rate of HDL (β = 0.002; CI95%:0.000-0.003; p = 0.022) and total conjugated diene generation (β = 0.001; CI95%:0.000-0.001; p = 0.029). CONCLUSION This study showed that energy restriction and atorvastatin administration were associated with changes in lipid profile, serum Sirt-1 concentrations, and HDL function.
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