An energy dense, high saturated fat, low-fibre dietary pattern is longitudinally associated with CVD risk factors in a severely obese cohort

Introduction: The Healthy Eating Index (HEI)-2015 quantifies alignment with the 2015-2020 Dietary Guidelines for Americans by scoring and totaling 13 components. Higher scores have been associated with lower all-cause and cardiovascular disease (CVD) mortality. The contributions of individual components toward total diet quality and associations with health in American adults have not been determined. Hypothesis: It was hypothesized that the individual HEI-2015 components would differentially contribute to total diet quality and correlate with CVD risk factors in U.S. adults. Methods: Non-pregnant, non-lactating adult participants (age 19+ years) in the National Health and Nutrition Examination Survey (NHANES) 2001-2016 with at least one reliable 24-hour dietary recall were included in the analysis (n=39,799). Total and component HEI-2015 scores were calculated per person using a single recall. Linear regression models accounting for the complex sampling design were used to assess associations between total and component HEI-2015 scores and CVD risk factors after adjustment for potential confounders. Significance of beta coefficients was defined by p<0.01. Results: Total HEI-2015 score was positively associated with high-density lipoprotein cholesterol (HDL-C; ß±SE, 0.10±0.01 mg/dL) and inversely associated with BMI (-0.05±0 kg/m 2 ), waist circumference (WC; -0.13±0.01 cm), systolic blood pressure (SBP; -0.04±0.01 mmHg), low-density lipoprotein cholesterol (LDL-C; -0.09±0.03 mg/dL), triglycerides (-0.20±0.08 mg/dL), fasting glucose (-0.05±0.02 mg/dL), and insulin (-0.03±0.01 μU/mL). All component scores increased with total score. The Whole Grains and Fatty Acid Ratio components made the greatest contributions (both +0.12 points or 12%) to each one-unit increase in HEI-2015, followed by moderation components Refined Grains and Saturated Fat (both +0.11 or 11%). Increases in the Fatty Acid Ratio score were explained by decreasing saturated fat (-1.67 g/unit, 95% CI: -1.73 to -1.61) and increasing polyunsaturated fat (PUFA; 1.17 g/unit, 95% CI: 1.12, 1.22); increases in monounsaturated fats were relatively small (0.18 g/unit, 95% CI: 0.11 to 0.25). The predominant PUFA was linoleic acid, which increased 1.06 g/unit (95% CI: 1.02 to 1.11). Scores for grain-related components were favorably associated with BMI, WC, SBP and HDL-C; fat quality components were inversely associated with BMI, WC, HDL-C, LDL-C, and triglycerides. Conclusion: Diet quality is favorably associated with several CVD risk factors. Approximately 50% of each 1-point increase in HEI-2015 is related to the quality of grain-based products and fat sources. Choosing whole grains instead of refined grains, and PUFA in place of saturated fats, is associated with improvements in diet quality and cardiovascular health.

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Western dietary pattern increases risk of cardiovascular disease in Iranian adults: a prospective population-based study

Applied Physiology Nutrition and Metabolism ◽

10.1139/apnm-2016-0508 ◽

2017 ◽

Vol 42 (3) ◽

pp. 326-332 ◽

Cited By ~ 9

Author(s):

Parvin Mirmiran ◽

Zahra Bahadoran ◽

Azita Zadeh Vakili ◽

Fereidoun Azizi

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dietary Patterns ◽

Dietary Pattern ◽

Regression Models ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Western Dietary Pattern ◽

Increased Risk

Limited data are available regarding the association of major dietary patterns and risk of cardiovascular disease (CVD) in Middle Eastern countries. We aimed to evaluate the association of major dietary patterns, using factor analysis, with the risk of CVD. Participants without CVD (n = 2284) were recruited from the Tehran Lipid and Glucose Study and were followed for a mean of 4.7 years. Dietary intake of participants was assessed at baseline (2006–2008); biochemical variables were evaluated at baseline and follow-up examination. Multivariate Cox proportional hazard regression models, adjusted for potential confounders, were used to estimate risk of CVD across tertiles of dietary pattern scores. Linear regression models were used to indicate association of dietary pattern scores with changes of CVD risk factors over the study period. Two major dietary patterns, Western and traditional, were identified. During a mean 4.7 ± 1.4 years of follow-up, 57 participants experienced CVD-related events. In the fully adjusted model, we observed an increased risk of CVD-related events in the highest compared to the lowest tertile category of Western dietary pattern score (HR = 2.07, 95% CI = 1.03–4.18, P for trend = 0.01). Traditional dietary pattern was not associated with incidence of CVD or CVD risk factors. A significant association was observed between the Western dietary pattern and changes in serum insulin (β = 5.88, 95% CI = 0.34–11.4). Our findings confirm that the Western dietary pattern, characterized by higher loads of processed meats, salty snacks, sweets, and soft drinks, is a dietary risk factor for CVD in the Iranian population.

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Abstract P260: Low Physical Activity Level, Underweight and Abdominal Obesity among Nigerian Rural Adolescents; Implication for Cardiovascular Disease Prevention Program among Rural Adolescents in Nigeria

Circulation ◽

10.1161/circ.127.suppl_12.ap260 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Nse A Odunaiya ◽

Quinette A Louw ◽

Karen Grimmer-sommers

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Cardiovascular Disease ◽

Abdominal Obesity ◽

Physical Activity Level ◽

Dietary Pattern ◽

Activity Level ◽

Rural Adolescents ◽

Cvd Risk Factors ◽

Cvd Risk

Cardiovascular disease (CVD) is a global health problem. Studies have shown that the majority of people dying from CVD have one or more major risk factors that are influenced by lifestyle. Major predisposing risk factors include obesity, physical inactivity, abdominal obesity. These risk factors have been seen in adolescents in developed countries. Throughout the world the risks are starting to appear earlier. Adolescence is a critical temporal window for the development of obesity in adult age. Researchers have advocated that children and adolescent populations should be the target for cardiovascular risk factors prevention programs, however, there is paucity of information on these risk factors especially among rural adolescents. It is a general belief in Nigeria that rural dwellers are active, consume natural foods as such CVD and other chronic diseases may not be highly prevalent among rural people However, primordial prevention for cardiovascular is needed even in rural communities since prevention is better than cure. The study aimed to ascertain selected CVD risk factors such as physical activity level, BMI Waist Hip ratio and dietary pattern of adolescents in rural Nigeria The study was a cross sectional survey of 1079 adolescents aged 15-18 years, attending schools at Ibarapa central local government of South West Nigeria. Ethical approval was sought and obtained from Stellenbosch University ethics committee, approval from the local Education authority and principals of the selected schools. Informed consent was obtained from the principals of the schools who acted in place of the parents and guardians who were not in the community and also from parents within the community. Assent was obtained from adolescents either written or verbal. CVD risk factors were assessed using standard measures .Result shows 23% of adolescents are underweight, 75% normal weight and 1.4% overweight. Waist hip ratio of 84.6% of adolescents are normal, 15.4% abdominal obesity, for physical activity level; 27.9% had low physical activity level, 36.5% moderate physical activity level and 35.6% high physical activity level. More female had low activity level compared to male, 63.5% compared to 36.5% The adolescents generally have bad dietary pattern such as high fat consumption, low fruit and vegetable intake Underweight is still a major problem among rural adolescents. Many of the rural adolescents are not active enough to safeguard their future health. Sedentary living is more among female than male. Although these rural adolescents are not generally obese but there is a high prevalence of abdominal obesity, low fruit and vegetable consumption which is associated with cardiovascular disease Implication; there is need for CVD primordial and primary prevention program for Nigerian rural adolescents

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Abstract P196: Unhealthful Dietary Intake Pattern Identified by Reduced Rank Regression is Associated with Increased Arterial Stiffness among Youth with Type 1 Diabetes

Circulation ◽

10.1161/circ.129.suppl_1.p196 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Archana P Lamichhane ◽

Angela D Liese ◽

Elaine M Urbina ◽

Jamie L Crandell ◽

Lindsay M Jaacks ◽

...

Keyword(s):

Risk Factors ◽

Dietary Pattern ◽

Risk Profile ◽

Cvd Risk Factors ◽

Reduced Rank Regression ◽

Cvd Risk ◽

Rank Regression ◽

Reduced Rank ◽

Diet Soda

Introduction: Youth with type 1 diabetes (T1DM) are at substantially increased risk for adverse vascular outcomes, but little is known about the influence of dietary behavior on cardiovascular disease (CVD) risk profile and outcomes. Objective: We applied reduced rank regression (RRR) to identify a specific dietary pattern that explained the maximum amount of variation in CVD risk factors, and was strongly associated with markers of arterial stiffness (AS) in a cohort of youth with T1DM. Methods: Baseline diet data from a food frequency questionnaire and CVD risk factors (triglycerides, LDL-cholesterol, systolic blood pressure, hemoglobin A1c, C-reactive protein and waist circumference) were available for 1,153 youth aged ≥10 years with T1DM from the SEARCH for Diabetes in Youth Study. Dietary intake patterns were identified using 33 food-groups as predictors and six CVD risk factors as responses in an RRR analysis. AS outcomes were measured on average 18.9±7.1 months after the baseline diet assessment and were available only in a subset of participants from the SEARCH CVD pilot study. Associations between the RRR-derived dietary pattern explaining the maximum variation in CVD risk factors and AS measures [augmentation index(AIx75),n=229; pulse wave velocity(PWV),n=237; and brachial distensibility(BrachD),n=228] were then assessed using linear regression. Results: The RRR-derived pattern of interest was characterized by high intakes of sugar-sweetened beverages (SSB) and diet soda, eggs, potatoes and high-fat meats, and low intakes of sweets/desserts and low-fat dairy; major contributors were SSB and diet soda. This pattern captured the largest variability in the adverse CVD risk profile and was subsequently positively associated with AIx75 in the final model (β=0.47; p<0.01). The mean difference in AIx75 concentration between the highest and the lowest dietary pattern quartiles was 4.3% in fully adjusted model. Associations of the dietary pattern with the other measures of AS, PWV and BrachD, were attenuated and became non-significant after adjustment for potential confounders. Conclusions: Intervention strategies to reduce consumption of unhealthful foods and beverages among youth with T1DM may significantly improve CVD risk profile and ultimately reduce the risk for AS. Future studies with larger samples are needed to explore the associations between the derived dietary pattern and other measures of AS (PWV and BrachD), which can provide further insights into possible pathways linking diet to AS in this high risk population.

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Association of eggs with dietary nutrient adequacy and cardiovascular risk factors in US adults

Public Health Nutrition ◽

10.1017/s1368980019000211 ◽

2019 ◽

Vol 22 (11) ◽

pp. 2033-2042 ◽

Cited By ~ 3

Author(s):

Melissa M Melough ◽

Sang-Jin Chung ◽

Maria Luz Fernandez ◽

Ock K Chun

Keyword(s):

Risk Factors ◽

Dietary Cholesterol ◽

Saturated Fat ◽

Sociodemographic Factors ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional ◽

Nutrient Adequacy ◽

Egg Consumption ◽

Whole Egg

AbstractObjectiveWhole eggs are rich sources of several micronutrients. However, it is not well known how egg consumption contributes to overall nutrient adequacy and how it may relate to CVD risk factors. Therefore, the present study aimed to determine how whole egg consumption contributes to nutrient intakes and to assess its association with CVD risk factors in US adults.DesignCross-sectional study.SettingThe study was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2003–2012, a nationally representative survey of the US civilian population.ParticipantsAdults who completed two dietary recalls and provided information on relevant sociodemographic factors were included in the study (n21 845).ResultsApproximately 73 % of adults were classified as whole egg consumers. Egg consumption was associated with greater intakes of protein, saturated fat, mono- and polyunsaturated fats, Fe, Zn, Ca, Se, choline, and several other vitamins and minerals. Egg consumption was associated with a higher likelihood of meeting or exceeding recommendations for several micronutrients. Egg intake was positively associated with dietary cholesterol consumption, but not with serum total cholesterol (TC) when adjusted for multiple potential confounders. In multiple linear regression analyses, TAG, TAG:HDL-cholesterol and TC:HDL-cholesterol were significantly lower with greater egg consumption. Egg consumption had no significant relationship with LDL-cholesterol or C-reactive protein, but was associated with higher BMI and waist circumference.ConclusionsWhole eggs are important dietary contributors of many nutrients and had either beneficial or non-significant associations with most CVD risk biomarkers examined.

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Abstract P173: Dietary Patterns And Their Association With Cardiovascular Disease Risk Factors In Mexican Origin Adults Living In The U.s. Mexico Border

Circulation ◽

10.1161/circ.129.suppl_1.p173 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Ximena Burgos ◽

Joe Tomaka ◽

Hector G Balcazar ◽

Maria Duarte-Gardea

Keyword(s):

Risk Factors ◽

Dietary Patterns ◽

Dietary Pattern ◽

Risk Index ◽

Baseline Data ◽

Mexican Origin ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Mexico Border ◽

The U.S

Background: Cardiovascular diseases (CVD) are the leading cause of death for Hispanics in the U.S. Hispanics are disproportionally affected by CVD and experience risk factors at higher rates than non-Hispanic whites. Moreover, the prevalence of obesity has increased for Hispanics in the last decades. Although CVD are among the most expensive and widespread health problems, they are among the most preventable. Evidence shows that diet plays an important role in the development of CVD; population-wide dietary changes are partially responsible for the increasing epidemic of chronic diseases and the consumption of a healthier dietary pattern can help prevent and control CVD morbidity and mortality. The H.E.A.R.T. (Health Education Awareness Research Team) study was an 8-year NIH funded project that implemented risk-reduction strategies to improve heart health in Hispanics living in the U.S.-Mexico border. Baseline data from the H.E.A.R.T. study was used to evaluate dietary patterns among participants in the intervention and learn how to best utilize these patterns as potential risk or preventive factors in addressing CVD among Hispanics. Objective: The primary aim of this study was to characterize the dietary patterns of Hispanics, of Mexican origin, and assess their associations with CVD risk factors. We hypothesized that the consumption of an unhealthier dietary pattern would be associated with higher prevalence of risk factors when compared to a healthier pattern. Results: Baseline data included 605 Hispanics living in the U.S. -Mexico border. The average age was 44 ± 12.9 years. The majority of the sample was female (84.5%), almost two-thirds were born in Mexico and more than 50% were obese. Factor analysis identified five dietary patterns; two major patterns were labeled Western and Prudent; three minor patterns were labeled Mexican, Juice, and Sweets. The Western pattern was predominantly consumed by younger adults, males, and adults born in the U. S. The Prudent pattern was predominantly consumed by older adults, females, and adults born in Mexico. The Western pattern was positively and significantly associated with waist circumference (WC) only, but not BMI, blood pressure, or CVD risk index. The Prudent pattern was negatively and significantly associated with reduced CVD risk Index, as measured by an 11 item questionnaire. Conclusions: This study identified different dietary patterns among Hispanics. Two patterns were similar to those found previously in different populations. In addition, we identified that a healthy pattern, with high intake of fruit, vegetables, fish and poultry is associated with lower CVD risk index in a high risk population. Although the Western pattern was only associated with WC but not other CVD risk factor, overweight and obesity was present in 85% of participants indicating a strong need for strategies to reduce obesity and CVD risk factors in this population.

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Joint associations of dietary pattern and television viewing with CVD risk factors among urban men and women in China: a cross-sectional study

British Journal Of Nutrition ◽

10.1017/s0007114517003075 ◽

2017 ◽

Vol 119 (1) ◽

pp. 74-82 ◽

Cited By ~ 2

Author(s):

Qing Ye ◽

Xin Hong ◽

Zhiyong Wang ◽

Zhenzhen Qin ◽

Chao Li ◽

...

Keyword(s):

Risk Factors ◽

Dietary Patterns ◽

Dietary Pattern ◽

Television Viewing ◽

Cross Sectional Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Cross Sectional ◽

Television Time ◽

Joint Associations

AbstractThe purpose of this study was to investigate the joint associations of dietary pattern and television viewing with risk factors of CVD among urban adults in China. A community-based cross-sectional study was conducted among urban adults in Nanjing, China. Five dietary patterns were identified based on a FFQ. Television time was obtained from a standard questionnaire and further classified into two categories (≤7, >7 h/week). Multiple logistic regression was used to calculate the OR and 95 % CI for the separate and joint associations of dietary patterns and television viewing with CVD risk factors. Compared with other dietary patterns, participants who followed the healthy traditional pattern had a lower likelihood of abdominal obesity (AO) (OR 0·52; 95 % CI 0·41, 0·67). Participants watching television no more than 7 h/week presented a 19 and 21 % lower likelihood for hypertension (HT) and elevated total cholesterol (ETC) than those with television time >7 h/week. Individuals who had less television time and a healthy dietary pattern had a lower OR for the presence of AO (OR 0·48; 95 % CI 0·36, 0·65), HT (OR 0·71; 95 % CI 0·66, 0·77), ETC (OR 0·72; 95 % CI 0·57, 0·91) and elevated TAG (OR 0·76; 95 % CI 0·61, 0·95), compared with those who followed other dietary patterns and television time >7 h/week. In conclusion, both healthy traditional pattern and less television time are jointly associated with reduced levels of CVD risk factors. It has important public health implications regarding the precision prevention of CVD at population level.

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CVD Risk Factors Greater in Girls With Type 1 Diabetes

Pediatric News ◽

10.1016/s0031-398x(11)70187-4 ◽

2011 ◽

Vol 45 (8) ◽

pp. 6

Author(s):

DOUG BRUNK

Keyword(s):

Risk Factors ◽

Type 1 Diabetes ◽

Cvd Risk Factors ◽

Cvd Risk

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Geographical profiles of cardiovascular risk and the risk factors in China: data from a nationwide population-based screening project

European Heart Journal ◽

10.1093/ehjci/ehaa946.2826 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

C.Q Wu ◽

X Li ◽

J.P Lu ◽

B.W Chen ◽

Y.C Li ◽

...

Keyword(s):

Physical Activity ◽

Risk Factors ◽

Blood Pressure ◽

Population Based ◽

Staple Food ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Food Factor ◽

Rural And Urban ◽

Activity Factor

Abstract Background In China, an abundance of cardiovascular risk factors has contributed to the increasing prevalence of cardiovascular diseases (CVD), which caused almost 4 million deaths per year. However, comprehensive evidence on the geographical profiles of cardiovascular disease risk in China is lacking, as findings in prior studies have been limited to relatively small sample sizes, had incomplete regional coverage, or focused on a narrow risk factor spectrum. Purpose To compare the population CVD risk among different regions across China, and to describe the geographical distributions of CVD risk factors and their clusters throughout the nation. Methods In a nationwide population-based screening project covering 252 counties of China, standardized measurements were conducted to collect information on 12 major CVD risk factors. Individuals of high CVD risk were identified as those with previous CVD, or with a predicted 10-year risk of CVD greater than 10% according to the WHO risk prediction charts. We applied factor analysis to generate “clusters” that characterized the clustering of these risk factors, then explored their relationship with the local ambient temperature and per capital GDP. Results Among 983476 participants included, 9.2% were of high CVD risk, with a range of 1.6% to 23.6% across counties. Among the seven regions in China, the rate was relatively high in the Northeast (11.8%) and North China (10.4%), while low in the South China (7.2%) and Northwest (7.8%). We identified 6 clusters underlying CVD risk factors, including Obesity factor, Blood pressure factor, Staple food factor, Non-staple food factor, Smoking and alcohol factor, and Metabolic and physical activity factor (Figure). We found high risk regions were facing different leading challenges, like obesity and blood pressure for the North China, while unhealthy non-staple food for the Northeast. The South China, as the region with the lowest CVD risk, still had the highest prevalence of unhealthy staple food. Lower annual average ambient temperature was associated with higher risk in Blood pressure factor, Obesity factor and Non-staple food factor, but lower risk in Staple food factor and Metabolic and physical activity factor (p<0.001 for all), consistently between rural and urban. Higher per capital GDP was associated with lower risk in Non-staple food factor in urban and higher risk in Metabolic and physical activity factor in rural (p<0.05 for both). The correlation between per capital GDP and Smoking and alcohol factor differed significantly between in rural and urban regions (p=0.042). Conclusions The geographical profile of CVD risk in China is complex - population risk levels varied substantially across regions, which were contributed by different risk factors. China needs geographically targeted intervention strategies considering environmental and socio-economic factors to control CVD risk and reduce the burden related to CVD. Geographical disparity of risk clusters Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): The National Key Research and Development Program from the Ministry of Science and Technology of China; the CAMS Innovation Fund for Medical Science

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FRI0420 ASSOCIATION BETWEEN RED BLOOD CELLS DISTRIBUTION WIDTH AND CARDIOVASCULAR RISK IN OSTEOARTHRITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.2647 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 808.2-808

Author(s):

N. Hammam ◽

G. Salem ◽

D. Fouad ◽

S. Rashad

Keyword(s):

Risk Factors ◽

Body Mass Index ◽

Functional Limitations ◽

Functional Limitation ◽

C Reactive Protein ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Distribution Width ◽

Reactive Protein ◽

Lipid Panel

Background:Osteoarthritis (OA) is the most common joint disease that results in patient’s morbidity and disabilities. There is strong evidence that OA is a significant risk factor for cardiovascular disease (CVD). Red cell distribution width (RDW) blood test is a measure of the variation in red blood cell volume and size. Elevated RDW has recently been found to correlate with CVD risk in patients with and without heart disease and autoimmune diseases. RDW may be a marker for factors driving CVS risk.Objectives:: To investigate whether RDW can serve as a potential parameter for indicating cardiovascular risk in OA patients.Methods:A subsample of 819 OA patients was extracted from 2003-2006 National Health & Nutrition Examination Survey in a cross-sectional study. 63.7% of them were females. Their mean age was 66.4 ± 14.1 yrs. Demographic, medical data, inflammatory markers & lipid panel were obtained. Only patients with Haemoglobin>12 mg/dl were included. Functional limitations were assessed using a physical function questionnaire.Results:Elevated levels of RDW were associated with CVD risk factors in OA patients. 532 (65.8%) OA patients had functional limitations, while 78 (9.5%) and 63 (7.6%) known to have heart attacks or stroke ever. Mean RDW was 12.9±1.1fL. There was a positive significant correlation between RDW & CVD risk factors including body mass index (r=0.17, p<0.001), C-reactive protein (r=0.29, p<0.001), serum uric acid (r=0.12, p<0.001), and functional limitation (0.16, p<0.001). No significant association between RDW & lipid panel was found. In multiple regression analysis controlling for age, sex as covariates, body mass index (β =0.02, 95%CI: 0.01, 0.03, p=0.002), C-reactive protein (β =0.35, 95%CI: 0.26, 0.45, p<0.001), and functional limitation (β =0.18, 95%CI: 0.13, 0.35, p=0.03).Conclusion:In addition to known CVD risk in OA patients, elevated RDW levels should prompt physicians to aggressively screen and treat their patients for modifiable CVS risk factors, in addition to OA.Disclosure of Interests:None declared

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