scholarly journals 4265 Effect of individual characteristics, healthcare access, and built environment on care coordination outcomes related to cardiovascular disease risk factors

2020 ◽  
Vol 4 (s1) ◽  
pp. 117-118
Author(s):  
Sonal J. Patil ◽  
Yan Wang ◽  
Angela Johnson ◽  
David Mehr ◽  
Randi Foraker ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Social Capital ◽  
Built Environment ◽  
Care Management ◽  
Individual Characteristics ◽  
Cvd Risk ◽  
Care Manager ◽  
Nurse Care ◽  
Comorbidity Index

OBJECTIVES/GOALS: We examined how individual characteristics and characteristics of the socioeconomic and built environment were associated with care coordination’s effect on cardiovascular disease (CVD) risks to identify geographic areas that may benefit from supplementary clinic-community linkages. METHODS/STUDY POPULATION: We analyzed data with geocoded residential addresses and data from electronic health records for 9946 adults from a Centers for Medicare & Medicaid Services funded innovation project from 7/1/2013 to 3/30/2015. Variables included patient-level demographics, Elixhauser comorbidity index, total time with a nurse care manager, and neighborhood factors such as poverty indicators, walkability, and social capital index. Outcomes were change in CVD risk factors, hemoglobin A1C, blood pressure (BP), and low-density lipoprotein (LDL). Generalized linear models were used to assess the effect of nurse care management program on outcomes after controlling for confounding factors. RESULTS/ANTICIPATED RESULTS: We report preliminary models that include patient demographics (age, sex, race), health care utilization, nurse care manager contact time, Elixhauser comorbidity index, neighborhood education status, percent of population below 200% federal poverty level, median home value, walkability score of the residential address, and social capital index. After adjusting for all mentioned variables, in adults with HbA1C more than 7.5% at baseline, females had worsening HbA1C by 0.53% over the study period. Additionally, LDL values in females worsened over the study period by 4.8 mg/dL after adjusting for all variables. No clinically significant changes were noted for BP. DISCUSSION/SIGNIFICANCE OF IMPACT: Women’s HbA1C and LDL worsened despite nurse care management and may benefit from additional community-based interventions or interventionists. In future analyses, we anticipate that CVD risk will worsen for patients with higher fast food proximity and with greater geographic distance from their PCP.

scholarly journals Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies

2021 ◽  
Vol 14 ◽  
pp. 117954412110287
Author(s):  
Mir Sohail Fazeli ◽  
Vadim Khaychuk ◽  
Keith Wittstock ◽  
Boris Breznen ◽  
Grace Crocket ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Literature Review ◽  
Rheumatoid Factor ◽  
Qualitative Evidence Synthesis ◽  
Cvd Risk ◽  
Rheumatoid Arthritis Risk ◽  
Published Evidence ◽  
Increased Risk

Objective: To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents. Methods: Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out. Results: A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients. Conclusion: Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.

scholarly journals Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2019 ◽  
Vol 10 (4) ◽  
pp. 634-646 ◽  
Author(s):  
Ehsan Ghaedi ◽  
Mohammad Mohammadi ◽  
Hamed Mohammadi ◽  
Nahid Ramezani-Jolfaie ◽  
Janmohamad Malekzadeh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Lipid Profile ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Cvd Risk Factors ◽  
Paleolithic Diet ◽  
Cvd Risk ◽  
Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

scholarly journals Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland

2021 ◽  
Vol 18 (3) ◽  
pp. 1044
Author(s):  
Magdalena Mijas ◽  
Karolina Koziara ◽  
Andrzej Galbarczyk ◽  
Grazyna Jasienska
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Gay Men ◽  
Disease Risk ◽  
Older Age ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Wide Range

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.

scholarly journals Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk

2021 ◽  
Vol 12 ◽  
pp. 215013272098095
Author(s):  
Marwa S. Said ◽  
Inas T. El Sayed ◽  
Eman E. Ibrahim ◽  
Ghada M. Khafagy
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Dietary Advice ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Post Intervention ◽  
Dash Diet ◽  
Significant Difference ◽  
Diet Versus

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.

scholarly journals Is night-time light intensity associated with cardiovascular disease risk factors among adults in early-stage urbanisation in South India? A cross-sectional study of the Andhra Pradesh Children and Parents Study

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e036213
Author(s):  
Tina Bonde Sorensen ◽  
Robin Wilson ◽  
John Gregson ◽  
Bhavani Shankar ◽  
Alan D Dangour ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Andhra Pradesh ◽  
South India ◽  
Early Stage ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Night Time ◽  
Cross Sectional ◽  
Children And Parents

ObjectivesTo explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.DesignCross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.Setting28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.ParticipantsData were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.ResultsIncreasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0 kg/m2 (95% CI 0.01 to 1.9) for BMI; 4.2 mm Hg (95% CI 1.0 to 7.4) for SBP; 0.3 mmol/L (95% CI −0.01 to 0.7) for LDL; and −0.01 mmol/L (95% CI −0.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.ConclusionThe association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.

scholarly journals Sleep Deficiency and Deprivation Leading to Cardiovascular Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Michelle Kohansieh ◽  
Amgad N. Makaryus
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Well Being ◽  
Underlying Mechanism ◽  
Vital Role ◽  
Quality Of Sleep ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Sleep Deficiency

Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.

scholarly journals Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African American ◽  
Depressive Symptoms ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Regression Analyses ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rachael R Baiduc ◽  
Brittany Bogle ◽  
Franklyn Gonzalez ◽  
Elizabeth Dinces ◽  
David J Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Hearing Loss ◽  
Total Cholesterol ◽  
Young Women ◽  
Young Men ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

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

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

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

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