The Impact of Obesity on Risk Factors and Prevalence and Prognosis of Coronary Heart Disease—The Obesity Paradox

2014 ◽  
Vol 56 (4) ◽  
pp. 401-408 ◽  
Author(s):  
Alban De Schutter ◽  
Carl J. Lavie ◽  
Richard V. Milani
2017 ◽  
Vol 31 (1) ◽  
pp. 165-184 ◽  
Author(s):  
Sharon M. Cruise ◽  
John Hughes ◽  
Kathleen Bennett ◽  
Anne Kouvonen ◽  
Frank Kee

Objective: The aim of this study is to examine the prevalence of coronary heart disease (CHD)–related disability (hereafter also “disability”) and the impact of CHD risk factors on disability in older adults in the Republic of Ireland (ROI) and Northern Ireland (NI). Method: Population attributable fractions were calculated using risk factor relative risks and disability prevalence derived from The Irish Longitudinal Study on Ageing and the Northern Ireland Health Survey. Results: Disability was significantly lower in ROI (4.1% vs. 8.8%). Smoking and diabetes prevalence rates, and the fraction of disability that could be attributed to smoking (ROI: 6.6%; NI: 6.1%), obesity (ROI: 13.8%; NI: 11.3%), and diabetes (ROI: 6.2%; NI: 7.2%), were comparable in both countries. Physical inactivity (31.3% vs. 54.8%) and depression (10.2% vs. 17.6%) were lower in ROI. Disability attributable to depression (ROI: 16.3%; NI: 25.2%) and physical inactivity (ROI: 27.5%; NI: 39.9%) was lower in ROI. Discussion: Country-specific similarities and differences in the prevalence of disability and associated risk factors will inform public health and social care policy in both countries.


PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0242930
Author(s):  
Carmen Arroyo-Quiroz ◽  
Martin O’Flaherty ◽  
Maria Guzman-Castillo ◽  
Simon Capewell ◽  
Eduardo Chuquiure-Valenzuela ◽  
...  

Background Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. Methods We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. Results From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. Conclusions CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Serrao ◽  
M Temtem ◽  
A Pereira ◽  
J Monteiro ◽  
M Santos ◽  
...  

Abstract Background Despite being a controversial subject, multiple guidelines mention the use of Coronary Artery Calcification (CAC) scoring in the cardiovascular risk prediction, in asymptomatic population. The inclusion of CAC scoring in traditional risk models may help in decision-make providing better cardiovascular risk stratification. Purpose The aim of our study is to estimate the impact of CAC scoring in cardiovascular events risk prediction in a model based on traditional risk factors (TRFs). Methods and results The study consisted of 1052 asymptomatic individuals free of known coronary heart disease, enrolled from GENEMACOR study and referred for computed tomography for the CAC scoring assessment. A cohort of 952 was followed for a mean of 5.2±3.2 years for the primary endpoint of all-cause of cardiovascular events. The following traditional risk factors were considered: (1) current cigarette smoking, (2) dyslipidemia, (3) diabetes mellitus, (4) hypertension and (5) family history of coronary heart disease. Among this population, the extent of CAC differs significantly between men and women in the same age group. Therefore, the distribution of CAC score by age and gender was done by using the Hoff's nomogram (a). According to this nomogram, 3 categories were created: low CAC (0≤CAC<100 and P<50); moderate CAC (100≤CAC<400 or P50–75) and high CAC (CAC≥400 or P>75). Two Cox regression models were created, the first only with TRFs and the second adding the CAC severity categories. When including CAC categories to the TRFs, the higher severity level presented a significant risk of MACE occurrence with an HR of 4.39 (95% CI 1.83–10.52; p=0.001). Conclusion Our results point to the importance of the inclusion of CAC in both primary and secondary prevention to an improved risk stratification. Larger prospective multicentre cohorts with longer follow-up should reproduce and validate these findings. Funding Acknowledgement Type of funding source: None


2016 ◽  
Vol 40 (11) ◽  
pp. 1730-1735 ◽  
Author(s):  
A De Schutter ◽  
S Kachur ◽  
C J Lavie ◽  
R S Boddepalli ◽  
D A Patel ◽  
...  

Public Health ◽  
1997 ◽  
Vol 111 (4) ◽  
pp. 231-237
Author(s):  
AP Baxter ◽  
PC Milner ◽  
S Hawkins ◽  
M Leaf ◽  
C Simpson ◽  
...  

Medicina ◽  
2012 ◽  
Vol 48 (3) ◽  
pp. 24 ◽  
Author(s):  
Raimondas Kubilius ◽  
Lina Jasiukevičienė ◽  
Vytautas Grižas ◽  
Loreta Kubilienė ◽  
Edita Jakubsevičienė ◽  
...  

Background. Each year more than 4.3 million people in Europe will die of cardiovascular disease. Therefore, the implementation of simple interventions such as smoking cessation, weight loss, improved diets, and increased exercise is the top priority in prevention and rehabilitation programs. The aim of this study was to evaluate the impact of complex rehabilitation on the manifestation of risk factors and cardiac events in patients with coronary heart disease. Material and Methods. A total of 140 patients with coronary heart disease and NYHA functional class II–IV ischemic heart failure were recruited to the study. The patients were divided into 2 groups: 70 patients who underwent a 6-month complex rehabilitation course (rehabilitation group) and 70 patients who received drug treatment only (control group). Smoking, dietary, and physical activity habits were documented using the questionnaires. Blood pressure (BP), body weight and height, and total serum cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride (Tg), and blood glucose levels were measured. Measurements were repeated after 3 and 6 months. Results. After 6 months, significantly reduced systolic BP was observed in both the groups as compared with the baseline values (P<0.05). A significant decrease in the diastolic BP; total cholesterol, LDL-cholesterol, triglyceride and blood glucose levels; body mass index, and percentage of patients with the metabolic syndrome as compared with the baseline data was documented only in the rehabilitation group (P<0.05). All the patients quitted smoking as well as all the patients in the rehabilitation group changed their dietary habits (P<0.05). Fewer patients were excluded from the rehabilitation group because of cardiac events as compared with the control group (7.1% vs. 11.4%, P<0.05). Conclusions. Complex long-term rehabilitation of cardiovascular patients significantly reduced the manifestation of major cardiovascular risk factors and the rate of cardiac events. Aerobic exercise must be the most important part of training but well-done resistance training must also be encouraged.


Author(s):  
Nikolay I. Panev ◽  
Natalya A. Evseeva ◽  
Sergey N. Filimonov ◽  
Olga Yu. Korotenko ◽  
Igor P. Danilov

Introduction. Among underground miners, the pathology of the cardiovascular system is much more common than among workers on the surface, which indicates the negative role of the impact of harmful production factors. There is evidence of a high prevalence of traditional risk factors for the development of coronary heart disease among miners with dust pathology of the lungs. Preventive measures for coronary heart disease exist for the timely detection and elimination of risk factors. In this regard, it is relevant to optimize methods for predicting the risk of developing coronary heart disease in coal mine workers. The study aims to develop a system for predicting the probability of developing coronary heart disease in miners with anthracosilicosis based on determining the most significant risk factors. Materials and methods. The experts studied the frequency of coronary heart disease and its risk factors in 139 employees of the primary professions of coal mines. The scientists performed daily ECG monitoring, bicycle ergometry according to the Rose questionnaire. They also studied the indicators of lipid metabolism, hemostasis, the level of homocysteine, C-reactive protein, glycemia, the presence of excess body weight, constitutional and morphological types according to Rice-Eysenck and Tanner. The experts developed a predictive system using the Bayes method. We calculated a predictive coefficient for each factor. Scientists determined the probability of coronary heart disease by the value of the sum of prognostic coefficients. Results. Workers aged 45 years and older have the highest risk of developing coronary heart disease. The experience of working in harmful working conditions for 20 years or more, the presence of arterial hypertension, metabolic syndrome, respiratory failure, andromorphic constitutional-morphological type according to the Tanner index, as well as the presence of hyperhomocysteinemia, hyperfibrinogenemia, increased levels of soluble fibrin-monomer complexes and C-reactive protein - all these are the risks of developing coronary heart disease in miners with anthracosilicosis. Conclusions. The developed system of personalized prediction of the probability of developing coronary heart disease in miners with anthracosilicosis allows us to identify a group of high-risk workers for timely treatment and preventive measures for them.


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