scholarly journals Prevalence of American Heart Association defined ideal cardiovascular health metrics in Nepal: findings from a nationally representative cross-sectional study

2019 ◽  
Vol 12 (4) ◽  
pp. 325-331 ◽  
Author(s):  
Umesh Ghimire ◽  
Nipun Shrestha ◽  
Bishal Gyawali ◽  
Pranil Man Singh Pradhan ◽  
Shiva Raj Mishra

Abstract Background The ever-increasing burden of non-communicable diseases (NCDs) is posing a serious health challenge for Nepal. This study examines the status of ideal cardiovascular health (ICH) and its associated determinants in Nepal using the American Heart Association (AHA) definition of ICH metrics. Methods The AHA has defined ICH as having five to seven of the ideal health metrics. A representative sample from the NCD risk factors STEPS survey 2013 were drawn to analyse the prevalence and sociodemographic determinants of ideal, intermediate and poor cardiovascular health in Nepal. Multivariable logistic regression was used to measure the determinants of ICH. Results More than half of the participants had ICH metrics (51.6%), with the 45–69 y age group having the lowest prevalence of ICH (28%) and females having better cardiovascular health compared with their male counterparts (60.6% vs 41.7%). The prevalence of low intake of fruit and vegetables, tobacco smoking and elevated blood pressure were quite high (99%, 18.8% and 31.4%, respectively). The status of ICH declined with age: individuals 15–29 y of age had 6 times (95% confidence interval [CI] 4.80–8.60) higher odds of having ICH compared with those who were 45–69 y, and it was low among urban residents (referent: rural; adjusted odds ratio 0.77 [95% CI 0.58–1.01]). Conclusions Nearly half of the participants had ICH, which declined with ageing. Further, urban residents had poor cardiovascular health. This highlights the need for a comprehensive population-based intervention targeting elderly and urban residents to improve overall cardiovascular health.

Author(s):  
Grzegorz Nowicki ◽  
Barbara Ślusarska ◽  
Honorata Piasecka ◽  
Agnieszka Bartoszek ◽  
Katarzyna Kocka ◽  
...  

Ideal cardiovascular health (CVH) has been defined by the American Heart Association as the lack of cardiovascular disease and the presence of seven key factors and health behaviors. In this study, we aimed to estimate the prevalence of ideal and poor CVH among the Polish adult population based on the example of the inhabitants of Janów district in Lubelskie Voivodship, taking the chosen socio-demographic factors into consideration. This is a cross-sectional study conducted among 3901 adults without cardiovascular diseases, aged between 35 and 64 years. Participants completed a questionnaire, and they had anthropometric and physiological measurements taken. Blood samples were analyzed for fasting glucose and cholesterol levels. Ideal CVH was found in 5.4% of the participants, with the advantage of being toward city dwellers over those living in the rural areas (6.3% vs. 5.0%) p = 0.02. In the case of the residents of rural areas, their likelihood of having an ideal body mass index (BMI) was found to be 22% lower (odds ratio (OR) = 0.78; 95% CI: 0.66–0.92), their likelihood of having an ideal diet was found to be 27% lower (OR = 0.71; 95% CI: 0.54–0.94), their likelihood of having perfect blood pressure was found to be 29% lower (OR = 0.71; 95% CI: 0.56–0.89), and their likelihood of having the perfect glucose levels was found to be 28% lower (OR = 0.72; 95% CI: 0.63–0.84), than the residents of urban areas. The prevalence of ideal cardiovascular behaviors and factors is lower in the rural community compared with people living in the city. Results indicate that more effort should be dedicated toward the country’s health policy, specifically concerning primary prevention. Preventive actions in the field of cardiovascular disease should be addressed to the residents of rural areas to a larger extent.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Anshul Saxena ◽  
Muni Rubens ◽  
Sankalp Das ◽  
Tanuja Rajan ◽  
Gowtham Grandhi ◽  
...  

Objectives: Extensive data suggests that lesbian, gay and bisexual (LGB) adults are more likely to experience adverse cardiovascular outcomes relative to heterosexuals. However, evidence regarding cardiovascular health (CVH) disparities and sexual orientation is scarce. The aim of this study was to examine the distribution of CVH metrics in a US nationally representative population of heterosexual (HT), and LGB adults. Methods: This cross-sectional study analyzed 2445 participants (representing 115 million) adults aged 18 or over years in the 2011-2012 NHANES survey. The CVH factors of smoking, body mass index (BMI), physical activity (PA), diet, blood pressure (BP), total cholesterol (TC) and glucose (GLU) were measured. Each CVH factor was then classified as ideal; intermediate; or poor. Ideal CVH was defined as presence of >=5 ideal CVH metrics. Results: 95.1% of the weighted sample self-identified as HT (95% CI: 93.5%, 96.6%) compared to 4.9% (95%: 3.3%, 6.5%) LGB. The figure illustrates the distribution of each of the 7 CVH categories according to sexual orientation. In age, gender, and race adjusted analysis, LGB individuals were 36% (AOR: 0.64; 95%: 0.29, 1.4; p > 0.05) less likely to have ideal CVH compared to HT. These proportions go higher after adjusting for age. Conclusions: The results suggest that LGB individuals face a higher risk of being in the category for poor cardiovascular health compared to heterosexuals. Evidence suggests that there are sexual orientation disparities among adults. If confirmed in other studies, results point towards disproportionately higher risk for cardiovascular disease among sexual-minority populations. Figure


Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Adnan Younus ◽  
Ehimen Aneni ◽  
Oluseye Ogunmoroti ◽  
Omar Jamal ◽  
Shozab Ali ◽  
...  

Introduction: With the development of new health metrics to define ideal cardiovascular health (CVH), several studies have examined the distribution of the American Heart Association (AHA) 2020 ideal CVH metrics both within and outside the United States (US). In this meta-analysis of proportions, we synthesized available data on ideal CVH metrics distribution in US cohorts and compared them with non-US populations. Methods: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “ideal cardiovascular health” between January 2000 and October 2014. Studies were included in the meta-analysis if the proportions achieving ideal for 0, 1, 2, 3, 4, 5 or ≥6 ideal CVH metrics were known or could be estimated. A meta-analysis of proportions was conducted for US and non-US studies using a random effect model (REM). REM models were chosen because of the significant heterogeneity among studies. Results: Overall the pooled data consisted of 10 US cohorts with a total population of 94,761 participants and 6 non-US cohorts with a total of 130,242 participants. The table shows the pooled prevalence of ideal CVH factors in this population. Overall the pooled estimates of US cohorts showed 15% had 0-1 ideal CVH metrics (inter-study range: 7-22%), while 3% (inter-study range: 1-10%) had 6-7 ideal CVH metrics. This is comparable to 12% (inter-study range 1-17%) and 2% (inter-study range: 1-12%) for 0-1 and 6-7 ideal CVH metrics in the non-US studies. Conclusion: The proportion of persons achieving 6 or more ideal CVH metrics in both US and non-US cohorts is very low and the distribution of CVH metrics is similar in both US and non-US populations. Considering the strong association with worse outcomes, a coordinated global effort at improving CVH should be considered a priority.


Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Megan M Marron ◽  
Robert M Boudreau ◽  
Kaare Christensen ◽  
Stephanie Cosentino ◽  
Mary Feitosa ◽  
...  

Introduction: We assessed the hypothesis that a novel healthy blood pressure phenotype is familial and sought to identify factors associated with this phenotype in the Long Life Family Study (LLFS). Methods: The LLFS is a unique multi-center, international study that recruited families demonstrating clustering for longevity. Families were recruited from four centers; three in the U.S.: Boston, New York, and Pittsburgh and one in Denmark. The pedigrees included two generations: 1) probands and their siblings and 2) offspring of participants in the proband generation. Offspring (n=2211, ages 32-88, mean age=60.5; 43% male) were classified as having healthy blood pressure if their age- and sex-adjusted systolic blood pressure z-score was between -1.5 and -0.5 (i.e., a systolic blood pressure lower than expected for their age and sex, but not “too low”). Offspring on anti-hypertensive medications were classified as not having healthy blood pressure. Families (n=419) were defined as having healthy blood pressure if ≥2 and ≥50% of their offspring met the healthy blood pressure phenotype. Results: There were 476 (22%) offspring who met the healthy blood pressure phenotype. These offspring tended to have a better health profile than remaining offspring. When examining families, only 44 (11%) families met the criteria for healthy blood pressure. Both offspring and probands from families with healthy blood pressure performed better on neuropsychological tests that place demands on complex attention and executive function than offspring and probands from remaining families. Among families with healthy blood pressure, a higher proportion of offspring met the American Heart Association ideal cardiovascular health definition compared to remaining families (11% versus 4%, respectively, p<0.0001; not including the diet component). There was also a larger proportion of probands (n=1164, ages 71-110, mean age=90.5; 45% male) who met the American Heart Association ideal cardiovascular health definition when compared to the U.S. prevalence for ≥6 components among those ages ≥60 (1% versus 0.1%, respectively). Conclusion: In this cohort of familial longevity, few families had a novel healthy blood pressure phenotype in multiple members. Families and individuals with healthy blood pressure performed better on neuropsychological tests that represent aspects of executive function and had a higher proportion with ideal cardiovascular health than the U.S. population. In summary, a novel healthy blood pressure phenotype was rarely familial in this cohort; however, when it was, it was associated with cognitive and cardiovascular health benefits. Blood pressure may be a key pathway for family longevity.


2019 ◽  
Vol 35 (1) ◽  
pp. 232-239 ◽  
Author(s):  
Markus Juonala ◽  
Sharon Lewis ◽  
Robert McLachlan ◽  
Karin Hammarberg ◽  
Joanne Kennedy ◽  
...  

Abstract STUDY QUESTION Is ART related with the association of American Heart Association (AHA) ideal cardiovascular health score and markers of subclinical atherosclerosis? SUMMARY ANSWER The associations between AHA score and markers of subclinical atherosclerosis in ART and non-ART groups were similar in magnitude. WHAT IS KNOWN ALREADY Long-term consequences of ART on cardiovascular health are unknown. STUDY DESIGN, SIZE, DURATION The study cohort for the cross-sectional analyses consisted of 172 ART-conceived and 78 non-ART conceived individuals of same age (range 22–35 years). PARTICIPANTS/MATERIALS, SETTING, METHODS Cardiovascular risk factor status was evaluated with American Heart Association (AHA) ideal cardiovascular health score consisting of seven factors (body mass index, blood pressure, total cholesterol, glucose, diet and physical activity, non-smoking). Carotid artery intima-media thickness (cIMT), arterial pulse-wave velocity (PWV) and retinal microvascular parameters were evaluated as markers of early atherosclerosis. Group comparisons in continuous variables were performed with t-tests. For categorical variables, comparisons were performed with chi-square tests. The relationships between AHA score and the markers of atherosclerosis were examined with linear regression analyses adjusted for age and sex. MAIN RESULTS AND THE ROLE OF CHANCE There was no difference in AHA ideal health score between the ART and non-ART groups; mean (SD) scores were 4.1(1.4) versus 4.0(1.5), respectively, P = 0.65. No differences were observed between groups for any individual ideal health metric (P always &gt;0.2). AHA score was not associated with cIMT or retinal measures in either group (P always &gt;0.05). An inverse association was observed between AHA score and PWV in the ART group (beta (95% CI) −0.18(−0.26 to −0.10)). A numerically similar relationship was observed in the smaller non-ART group (−0.19(−0.39 to 0.01)). LIMITATIONS, REASONS FOR CAUTION Even though this cohort is among the largest ART studies with extensive cardiovascular data, the sample is still relatively small and the statistical power is limited. As the study population was still in early adulthood, we were not able to evaluate the associations with clinical cardiovascular events, but utilized non-invasive methods to assess early markers of subclinical atherosclerosis. WIDER IMPLICATIONS OF THE FINDINGS These findings suggest that ART-conceived individuals do not have increased vulnerability for cardiovascular risk factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by a National Health & Medical Research Council Project Grant (APP1099641), The Royal Children’s Hospital Research Foundation, Monash IVF Research and Education Foundation, and Reproductive Biology Unit Sperm Fund, Melbourne IVF. The authors have no conflicts of interest relevant to this article to disclose.


2019 ◽  
Vol 26 (15) ◽  
pp. 1605-1612 ◽  
Author(s):  
Kaisla Komulainen ◽  
Murray A Mittleman ◽  
Markus Jokela ◽  
Tomi T Laitinen ◽  
Katja Pahkala ◽  
...  

Background Promoting ideal cardiovascular health behaviors is an objective of the American Heart Association 2020 goals. We hypothesized that ideal health behaviors of parents are associated with health behaviors of their adult offspring, and that higher socioeconomic position in either generation enhances intergenerational associations of ideal health behaviors. Design Prospective cohort study. Methods We included 1856 Young Finns Study participants who had repeated measurements of socioeconomic position (education, income, occupation), smoking status, body mass index, physical activity and diet from 2001, 2007 and 2011, and data on parental socioeconomic position and health behaviors from 1980. We calculated the total number of ideal behaviors in both generations using American Heart Association definitions. Intergenerational associations were examined using ordinal and linear multilevel regression with random intercepts, in which each participant contributed one, two or three measurements of adult health behaviors (2001, 2007, 2011). All analyses were adjusted for offspring sex, birth year, age, parental education and single parenthood. Results Overall, parental ideal health behaviors were associated with ideal behaviors among offspring (odds ratio (OR) 1.28, 95% confidence interval 1.17, 1.39). Furthermore, ORs for these intergenerational associations were greater among offspring whose parents or who themselves had higher educational attainment (OR 1.56 for high vs. OR 1.19 for low parental education; P = 0.01 for interaction, OR 1.32 for high vs. OR 1.04 for low offspring education; P = 0.02 for interaction). Similar trends were seen with parental income and offspring occupation. Results from linear regression analyses were similar. Conclusions These prospective data suggest higher socioeconomic position in parents or in their adult offspring strengthens the intergenerational continuum of ideal cardiovascular health behaviors.


Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
Adnan Younus ◽  
Rehan Malik ◽  
Rameez Ahmad ◽  
Shozab Ali ◽  
Muhammad Aziz ◽  
...  

Introduction: In 2010, the American Heart Association set 2020 national goals for promoting cardiovascular health (CVH), emphasizing measurement of reproducible health behaviors and health factors and attaining ideal CVH status. In recent years, significant emphasis has been placed on adopting these metrics globally to monitor strategies to improve CVH. In this study, we synthesize available data to compare distribution of CVH metric metrics detailed in national representative cohorts a focus on presence of ideal CVH (ICVH). Method: A MEDLINE database search was conducted using relevant free text terms such as “life’s simple 7”, “AHA 2020”, “American Heart Association 2020” and “Ideal cardiovascular health”. Ideal CVH was defined as 6-7 ideal factors; conversely poor ICVH was considered as 0-1 ideal factors. Results: The pooled data comprised of 7 cross-national cohorts with a total of 152289 participants from India, United States, China, Spain, Korea, Luxembourg and Republic of Srpska. Significant variations in individual ideal CVH metrics were noted. Across population cohorts, diet metric consistently appeared suboptimal apart from Korea in which 55% participants reported ideal diet status. Overall majority population in each of the 7 cross-national cohorts lied in the range having 2-5 ideal CV health metrics (79-88%). A very small percentage of each population had 0-1 METRICS, with Spain, USA and Republic of Srpska having the highest percentage (18%) of reported poor ICVH. On the other hand, only representative cohorts from China and Korea reported ideal CVH status in more than 10% population. Conclusion: Overall suboptimal proportion of national representative cohorts have reported ideal CVH status. Significant efforts are needed to streamline current policies for enhancing CVH and sharpening focus interventions that will yield the greatest sustainable improvement in population CVH status.


2020 ◽  
Vol 14 ◽  
Author(s):  
Christina Silva da Costa Klippe ◽  
Evellin Camargo Bastos Nieto ◽  
Heloisa Andreia Silva Dos Santos ◽  
Liszety Guimarães Emmerick ◽  
Luiza Cerqueira Reis Da Costa ◽  
...  

Objetivo: analisar a percepção de residentes de enfermagem quanto à contribuição do debriefing para a sua aprendizagem a partir de uma experiência de Simulação de Alta Fidelidade. Método: trata-se de um estudo quantitativo, descritivo, transversal, com 103 enfermeiros do 1o ano do Programa de Residência de Enfermagem de uma universidade federal brasileira. Criou-se o workshop “Simulação na assistência de enfermagem ao paciente em alta complexidade” em cinco etapas: aula expositiva sobre o Protocolo ACLS 2015 da American Heart Association; oficina de habilidades práticas; instrução sobre o ambiente de simulação e as funções dos membros da equipe para a atuação nos cenários; debriefing e preenchimento do instrumento “Escala de Experiência com o debriefing” (EED). Considerou-se, para a análise e classificação dos dados, o ponto de corte de 70% de concordância entre os itens avaliados pela EED. Resultados: indicou-se, por 75% dos respondentes, o índice Likert “concordo totalmente” e 25%, o índice “concordo parcialmente”. Conclusão: demonstra-se, no estudo, que residentes de Enfermagem consideraram o processo de debriefing como fator de grande contribuição para sua aprendizagem e formação profissional. Descritores: Simulação; Enfermagem; Educação em Enfermagem; Aprendizagem Metodologia; Aprendizagem; Reeducação Profissional.AbstractObjective: to analyze the perception of nursing residents regarding the contribution of debriefing to their learning from a High Fidelity Simulation experience. Method: this is a quantitative, descriptive, cross-sectional study with 103 nurses from the 1st year of the Nursing Residency Program of a Brazilian federal university. The workshop “Simulation in nursing care for highly complex patients” was created in five stages: lecture on the ACLS Protocol 2015 of the American Heart Association; practical skills workshop; instruction on the simulation environment and the functions of the team members to act in the scenarios; debriefing and filling in the instrument "Debriefing Experience Scale" (DES). For the analysis and classification of the data, the cut-off point of 70% of agreement between the items evaluated by the DES was considered. Results: the Likert index “totally agree” and 25% the “partially agree” index was indicated by 75% of respondents. Conclusion: in the study, it is shown that nursing residents considered the debriefing process as a factor of great contribution to their learning and professional training. Descriptors: Simulation; Nursing; Education, Nursing; Learning Methodology; Learning; Education, Professional.ResumenObjetivo: analizar la percepción de los residentes de enfermería con respecto a la contribución del debriefing  para su aprendizaje a partir de una experiencia de Simulación de Alta Fidelidad. Método: este es un estudio cuantitativo, descriptivo, transversal con 103 enfermeros del primer año del Programa de Residencia de Enfermería de una universidad federal brasileña. El taller "Simulación de la atención de pacientes de enfermería altamente compleja" se creó en cinco pasos: conferencia sobre el Protocolo ACLS 2015 de la American Heart Association; taller de habilidades prácticas; instrucción sobre el entorno de simulación y los roles de los miembros del equipo para desempeñarse en los escenarios; debriefing y completar el instrumento "Debriefing Experience Scale" (DES). Para el análisis y la clasificación de los datos, se consideró el punto de corte del 70% de acuerdo entre los elementos evaluados por el DSE. Resultados: el 75% de los encuestados indicó el índice Likert "totalmente de acuerdo" y el 25% índice "parcialmente de acuerdo". Conclusión: el estudio muestra que los residentes de Enfermería consideraron el proceso de debriefing como un factor de gran contribución a su aprendizaje y formación profesional. Descriptores: Simulación; Enfermería; Educación en Enfermería; Aprenizage Metodología; Aprendizage; Reentrenamiento en Educación Profesional.


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