scholarly journals 2212. Burden of Community-Acquired Pneumonia Attributable to Co-morbid Conditions in Adults

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S754-S754
Author(s):  
Melissa A Rolfes ◽  
Seema Jain ◽  
Anna Bramley ◽  
Wesley Self ◽  
Richard G Wunderink ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Adult Population ◽  
Age Groups ◽  
Population Attributable Fraction ◽  
Community Acquired Pneumonia ◽  
Behavioral Risk ◽  
Adjusted Relative Risk ◽  
Increased Risk ◽  
Co Morbidity ◽  
Combining Data

Abstract Background Few studies have quantified the risk of community-acquired pneumonia (CAP) among adults with co-morbidities. Combining data from the population-based, prospective Etiology of Pneumonia in the Community study (EPIC) and the nationwide health-related Behavioral Risk Factor Surveillance System (BRFSS) telephone-survey, we estimated the annual risk of hospitalization for CAP among adults with co-morbidities. Methods We identified adults hospitalized with radiographic and clinical CAP at hospitals in Chicago, IL and Nashville, TN from July 2010 to June 2012. Using 2011 BRFSS data, we estimated the prevalence of the population with selected co-morbidities (chronic lung disease [CLD], cardiovascular disease [CVD], chronic kidney disease [CKD], or diabetes) in the EPIC study catchment counties, as well as the population without co-morbidities. We estimated the incidence of hospitalized CAP, age-adjusted relative risk (RR) using Poisson regression, and population attributable fraction for each co-morbidity. Results Among 2,061 adult patients enrolled in EPIC, 1,428 (69%) had at least one selected co-morbidity, most commonly CLD (42%) and CVD (35%). Among the adult population in the EPIC catchment area, 17% had ≥1 selected co-morbidity. The overall incidence of hospitalized CAP was 24.8/10,000, 118.7/10,000 among adults with ≥1 co-morbidity, and 11.2/10,000 among adults without a co-morbidity. Compared with patients without co-morbidities, the incidence of hospitalization for CAP was higher among patients with CLD (aRR: 20.7 [95% confidence interval [CI]: 20.0–21.5]), CKD (aRR: 14.5 [CI: 13.8–15.1]), CVD (aRR: 14.0 [CI: 13.5–14.6]), and diabetes (aRR: 6.2 [CI: 5.9–6.4]). While CLD and CVD accounted for high proportions of the incidence of CAP hospitalizations in the study population, the contribution of the selected co-morbidities varied by age groups (figure). Conclusion There is an increased risk of hospitalization for CAP among adults with co-morbidities, particularly chronic lung and cardiovascular disease. As a large portion of CAP is attributable to these co-morbidities, targeted public health interventions, such as vaccination and risk communication, need to be reinforced among these high-risk groups. Disclosures All authors: No reported disclosures.

scholarly journals Use of seroprevalence to guide dengue vaccination plans for older adults in a dengue non-endemic country

2021 ◽  
Vol 15 (4) ◽  
pp. e0009312
Author(s):  
Yi-Hua Pan ◽  
Mei-Ying Liao ◽  
Yu-Wen Chien ◽  
Tzong-Shiann Ho ◽  
Hui-Ying Ko ◽  
...  
Keyword(s):  
Older Adults ◽  
Adult Population ◽  
Age Groups ◽  
The Elderly ◽  
Denv Infection ◽  
Serum Samples ◽  
Increased Risk ◽  
Southern Taiwan ◽  
Older Populations ◽  
Age Range

A shift in dengue cases toward the adult population, accompanied by an increased risk of severe cases of dengue in the elderly, has created an important emerging issue in the past decade. To understand the level of past DENV infection among older adults after a large dengue outbreak occurred in southern Taiwan in 2015, we screened 1498 and 2603 serum samples from healthy residents aged ≥ 40 years in Kaohsiung City and Tainan City, respectively, to assess the seroprevalence of anti-DENV IgG in 2016. Seropositive samples were verified to exclude cross-reaction from Japanese encephalitis virus (JEV), using DENV/JEV-NS1 indirect IgG ELISA. We further identified viral serotypes and secondary DENV infections among positive samples in the two cities. The overall age-standardized seroprevalence of DENV-IgG among participants was 25.77% in Kaohsiung and 11.40% in Tainan, and the seroprevalence was significantly higher in older age groups of both cities. Although the percentages of secondary DENV infection in Kaohsiung and Tainan were very similar (43.09% and 44.76%, respectively), DENV-1 and DENV-2 spanned a wider age range in Kaohsiung, whereas DENV-2 was dominant in Tainan. As very few studies have obtained the serostatus of DENV infection in older adults and the elderly, this study highlights the need for further investigation into antibody status, as well as the safety and efficacy of dengue vaccination in these older populations.

The epidemiology of DSM-IV specific phobia in the USA: results from the National Epidemiologic Survey on Alcohol and Related Conditions

2007 ◽  
Vol 37 (7) ◽  
pp. 1047-1059 ◽  
Author(s):  
FREDERICK S. STINSON ◽  
DEBORAH A. DAWSON ◽  
S. PATRICIA CHOU ◽  
SHARON SMITH ◽  
RISE B. GOLDSTEIN ◽  
...  
Keyword(s):  
Low Income ◽  
Adult Population ◽  
Age At Onset ◽  
Specific Phobia ◽  
Increased Risk ◽  
Co Morbidity ◽  
The Usa ◽  
Axis I ◽  
Dsm Iv ◽  
The Mean

Background. There is a lack of current detailed national data on the prevalence, correlates, disability and co-morbidity of DSM-IV specific phobia (SP), the prevalence of specific objects and situations feared, and associations between impairment, treatment and co-morbidity and the number of specific situations and objects feared, among adults in the USA.Method. The data were derived from a large (43093) representative sample of the adult population in the USA.Results. Prevalences of 12-month and lifetime DSM-IV SP were 7·1% and 9·4% respectively. Being female, young, and low income increased risk, while being Asian or Hispanic decreased risk (p<0·05). The mean age at onset of SP was 9·7 years, the mean duration of episode was 20·1 years and only 8·0% reported treatment specifically for SP. Most specific phobias involved multiple fears, and an increasing number of fears, regardless of content, was associated with greater disability and impairment, treatment seeking and co-morbidity with other Axis I and II disorders.Conclusions. SP is a highly prevalent, disabling and co-morbid disorder in the US adult population. The early onset of SP and the disorders most strongly associated with it highlights the need for longitudinal studies beginning in early childhood. Results suggest the existence of a generalized subtype of SP much like social phobia, which, once revealed, may lead to a classification of SP that is more etiologically and therapeutically meaningful.

scholarly journals Prevalence of and factors associated with self-reported high blood pressure in Brazilian adults

2017 ◽  
Vol 51 (suppl 1) ◽  
Author(s):  
Deborah Carvalho Malta ◽  
Regina Tomie Ivata Bernal ◽  
Silvânia Suely Caribé de Araújo Andrade ◽  
Marta Maria Alves da Silva ◽  
Gustavo Velasquez-Melendez
Keyword(s):  
Blood Pressure ◽  
High Blood Pressure ◽  
Skin Color ◽  
Adult Population ◽  
Age Groups ◽  
Federal District ◽  
Noncommunicable Diseases ◽  
Factors Associated ◽  
Brazilian State ◽  
Increased Risk

ABSTRACT OBJECTIVE To analyze factors associated with self-reported high blood pressure among adults in Brazilian state capitals. METHODS The study uses data from Sistema de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas por Inquérito Telefônico (Vigitel – Surveillance System of Risk and Protection Factors of Noncommunicable Diseases by Telephone Survey) collected in 2013. Prevalence rates and their respective 95% confidence intervals by gender were estimated according to sociodemographic variables, lifestyle, reported noncommunicable diseases and self-rated health status. Multivariate logistic regression modeling was used to identify variables associated with self-reported high blood pressure with α < 0.05. RESULTS Prevalence of self-reported high blood pressure among adults living in Brazilian state capitals and the Federal District was 24.1%. The following variables were associated with self-reported high blood pressure: age group, taking 18-24 as reference (all age groups presented increased risk – from 25-34 years [OR = 2.6; 95%CI 2.0–3.4] up to 65 years or more [OR = 28.1; 95%CI 21.7–36.4]); low education level (9 to 11 years of study [OR = 0.8; 95%CI 0.7–0.9] and 12 years or more [OR = 0.6; 95%CI 0.6–0.7]); Black race or skin color (OR = 1.3; 95%CI 1.1–1.5); being a former smoker (OR = 1.2; 95%CI 1.1–1.3); obesity (OR = 2.7; 95%CI 2.4–3.0); diabetes (OR = 2.9; 95%CI 2.5–3.5%), and high cholesterol (OR = 1.9; 95%CI 1.8–2.2). CONCLUSIONS Approximately one quarter of the adult population living in Brazilian state capitals reported having high blood pressure. Information from Vigitel is useful to monitor high blood pressure and identity its associated factors, supporting public policies for health promotion, surveillance and care.

scholarly journals The Population-Attributable Fraction for Premature Mortality Due to Cardiovascular Disease Associated With Stage 1 and 2 Hypertension Among Japanese

2020 ◽  
Author(s):  
Yu Hatano ◽  
Yuichiro Yano ◽  
Shouichi Fujimoto ◽  
Yuji Sato ◽  
Kunitoshi Iseki ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Population Attributable Fraction ◽  
Heart Association ◽  
Premature Mortality ◽  
Attributable Fraction ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Stage 1 ◽  
Cvd Mortality

Abstract BACKGROUND Our aim was to assess how the population-attributable fraction (PAF) for premature mortality due to cardiovascular disease (CVD) associated with hypertension changes if blood pressure (BP) thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 mm Hg to ≥130/80 mm Hg, as defined using the 2017 American College of Cardiology/American Heart Association blood pressure guideline. METHODS Analyses were conducted using a database of participants who underwent a national health checkup examination started in 2008 in Japan (n = 510,238; mean age, 59.6 ± 8.1 years; 42% men). Each participant was categorized as having normal or elevated BP, or stage 1 or 2 hypertension according to the guideline. Data on premature mortality due to CVD occurring before age 70 years were available through March 2015. RESULTS Over a median follow-up of 3.4 years, 739 deaths from CVD occurred. After multivariable adjustment, hazard ratios for premature CVD mortality for elevated BP, stage 1 hypertension, and stage 2 hypertension vs. normal BP were 1.02 (95% confidence interval, 0.72, 1.44), 1.33 (1.02, 1.75), and 2.41 (1.90, 3.05), respectively. The PAF associated with stage 1 and 2 hypertension was 4.4% and 39.4%, respectively. CONCLUSIONS In the current nationwide study of Japanese adults, stage 1 and 2 hypertension were associated with an increased risk for premature CVD mortality. The PAF for premature CVD mortality associated with hypertension increased by 4.4% if BP thresholds for hypertension were lowered from systolic/diastolic BP ≥140/90 to ≥130/80 mm Hg.

Abstract P447: Cellular Adhesion Molecules: Early Indicators of Subsequent Clinical Cardiovascular Disease Events in a Young Adult Population. The CARDIA Study.

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Myron D Gross ◽  
Andrew O Odegaard ◽  
Suzette J Bielinski ◽  
Jose R Suarez-Lopez ◽  
J. Jeffrey Carr ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Young Adults ◽  
Coronary Artery ◽  
Adhesion Molecules ◽  
Cox Regression ◽  
Early Stage ◽  
Adult Population ◽  
Cellular Adhesion ◽  
Cellular Adhesion Molecules ◽  
Increased Risk

Background: Cellular adhesion molecules (CAM) have a central role in the accumulation of circulating leukocytes at sites of vascular injury, infection and/ inflammation, and have been associated with the development of atherosclerotic plaque and coronary artery disease in mature adults. Objective: To test the hypothesis that higher overall circulating CAM levels in young adults predict cardiovascular disease (CVD) events over the next 18 years. Method: We measured several circulating CAM molecules (ICAM-1, P-selectin, E-selectin and VCAM) in the Coronary Artery Risk Development in Young Adults (CARDIA) study at exam year 7 (1992-93, black and white men and women, CVD-free, mean age 32, range 25-37 years, n=2428) and monitored incident CVD events (n=70, including coronary heart disease, stroke, and heart failure, adjudicated based on medical records) through exam year 25, mean age of 50 years. We ranked each CAM in quintiles (coded 0-4) and summed the ranks across CAMs into an index to examine the association with incident CVD with Cox regression models. Results: Unadjusted cumulative CVD event rates were 1.6% (sum of CAM quartile ranks 0-8: 22 events in 1353 participants), 2.3% (sum of ranks 9-12: 29/813), and 7.3% (sum of ranks 13-16: 19/262). In proportional hazards regression analysis adjusted for year 7 age, sex, race, clinic, education, smoking, diet, physical activity, body mass index, blood pressure, blood lipids, and blood glucose, sum of ranks 13-16 were associated with a higher risk of CVD compared to the referent (rank sum 0-8) (See Table). Conclusion: High levels of circulating CAMs at an early stage of adulthood (mean age 32, range 25-37 years) were associated with an increased risk of incident CVD events. CAMs may be an early biomarker for development of subclinical CVD, even in CVD-free young adults with low atherosclerosis burden and decades prior to the development of clinical CVD.

514 FRAILTY IN OSTEOARTHRITIS AND THE INFLUENCE OF CO-MORBIDITY

2021 ◽  
Vol 50 (Supplement_2) ◽  
pp. ii5-ii7
Author(s):  
M J Cook ◽  
S M M Verstappen ◽  
M Lunt ◽  
T W O’Neill
Keyword(s):  
Physical Activity ◽  
Grip Strength ◽  
Negative Binomial ◽  
Adjusted Relative Risk ◽  
Additive Interaction ◽  
Frailty Phenotype ◽  
Attributable Proportion ◽  
Physical Measurements ◽  
Increased Risk ◽  
Co Morbidity

Abstract Introduction Risk factors for frailty, including low physical activity and chronic pain, are common among people with osteoarthritis. The aim of this analysis was to determine the association between osteoarthritis and frailty and to determine whether comorbidities interact additively with OA to increase the likelihood of frailty. Methods Men and women aged 40-69 years who contributed to the UK Biobank were analysed. Data about self-reported physician-diagnosed diseases was collected, as well physical measurements, including hand-grip strength. Frailty (robust, pre-frail, frail) was assessed using a modified frailty phenotype, comprising five components: low grip strength, slow walking speed, weight loss, low physical activity, and exhaustion. The association between osteoarthritis and the frailty phenotype was determined using negative binomial regression, adjusting for age, sex, body mass index, smoking status, and Townsend deprivation score. We calculated the attributable proportion of risk of frailty due to additive interaction between osteoarthritis and common co-morbidities (cardiovascular disease, diabetes, COPD, and depression). Results 457,561 people were included, 35,884 (7.8%) had osteoarthritis. The adjusted relative risk ratio (95% CI) for pre-frailty and frailty (versus robust), respectively was higher among people with (versus without) osteoarthritis: 1.58 (1.54, 1.62) and 3.41 (3.26, 3.56). There was significant additive interaction between the presence of osteoarthritis and each of the co-morbidities considered in increasing risk of frailty, particularly diabetes (attributable proportion of risk due to additive interaction with osteoarthritis (95% CI)), 0.49 (0.42, 0.55), coronary heart disease 0.48 (0.41, 0.55), and depression 0.47 (0.41, 0.53). Conclusions Our results suggest that people with OA are at increased risk of pre-frailty and frailty. The mechanisms are not fully understood, though co-morbidity appears to contribute to the risk of frailty beyond the expected additivity of risk due to OA and co-morbidity. Early diagnosis and optimal management of co-morbidities in people with OA may be beneficial.

Differences in Multimorbidity among Cisgender Sexual Minority and Heterosexual Adults: Investigating Differences across Age-Groups

2020 ◽  
pp. 089826432098366
Author(s):  
Billy A. Caceres ◽  
Jasmine Travers ◽  
Yashika Sharma
Keyword(s):  
Sexual Minority ◽  
Multinomial Logistic Regression ◽  
Age Groups ◽  
Behavioral Risk ◽  
Lesbian Women ◽  
Same Sex ◽  
Adverse Health Outcomes ◽  
Behavioral Risk Factor Surveillance ◽  
Increased Risk ◽  
And Bisexual

Objectives: Despite increased risk for chronic disease, there is limited research that has examined disparities in multimorbidity among sexual minority adults and whether these disparities differ by age. Methods: Data were from the 2014–2018 Behavioral Risk Factor Surveillance System. We used sex-stratified multinomial logistic regression to examine differences in multimorbidity between sexual minority and heterosexual cisgender adults and whether hypothesized differences varied across age-groups. Results: The sample included 687,151 adults. Gay, lesbian, and bisexual adults had higher odds of meeting criteria for multimorbidity than same-sex heterosexual adults. These disparities were greater among sexual minority adults under the age of 50 years. Only other non-heterosexual men over the age of 50 years and lesbian women over the age of 80 years were less likely to have multimorbidity than their same-sex heterosexual counterparts. Discussion: Health promotion interventions to reduce adverse health outcomes among sexual minorities across the life span are needed.

scholarly journals Psychosocial distress and cardiovascular disease

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
Y Natt och Dag ◽  
K Mehlig ◽  
A Rosengren ◽  
L Lissner ◽  
M Rosvall
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Psychological Distress ◽  
Psychological Health ◽  
Age Groups ◽  
Psychosocial Distress ◽  
Study Cohort ◽  
Increased Risk ◽  
Wide Range ◽  
The Impact

Abstract Background The contemporary increase in psychological distress observed in many countries is, by itself, a public health issue of great concern. Methods This prospective study aims to investigate the impact of psychological distress on incident cardiovascular disease, in different age groups and also with respect to sex, among participants in the Gothenburg-based InterGene Study cohort. This cohort comprises a total of 3614 men and women, aged 25-75 years. Included in the present study were individuals who were free of previous CVD diagnoses and who fully completed all baseline examinations. Inclusions took place during 2001-2004. Psychological distress at baseline was assessed by self-rating depression and anxiety scales. A wide range of physiological and behavioral parameters were also assessed, which allowed for relevant adjustments. The outcome was incident CVD, and with a 12 year follow-up. Cox-regression analyses were performed. Results The results showed an increased risk of incident CVD with higher scores on each of the scales. The majority of the findings persisted after adjustments for relevant confounders. It was most common for young women to score high on the anxiety and depression scales. Conclusions The associations between psychological distress and later life cardiovascular disease calls for enhanced public health measures aiming at ameliorating psychological health, not least in younger age groups. Key messages There was an increased risk of incident CVD with higher scores on psychosocial distress scales. The majority of the findings persisted after adjustments for relevant confounders.

scholarly journals The problem of accelerated atherosclerosis in systemic lupus erythematosus: Insights into a complex co-morbidity

2011 ◽  
Vol 106 (11) ◽  
pp. 849-857 ◽  
Author(s):  
Nekeithia Wade ◽  
Amy Major
Keyword(s):  
Rheumatoid Arthritis ◽  
Systemic Lupus Erythematosus ◽  
Cardiovascular Disease ◽  
Autoimmune Diseases ◽  
Lupus Erythematosus ◽  
Inflammatory Responses ◽  
Systemic Lupus ◽  
Accelerated Atherosclerosis ◽  
Increased Risk ◽  
Co Morbidity

SummaryRheumatic autoimmune diseases, such as rheumatoid arthritis and systemic lupus erythematosus (SLE), are associated with antibodies to “self” antigens. Persons with autoimmune diseases, most notably SLE, are at increased risk for developing accelerated cardiovascular disease. The link between immune and inflammatory responses in the pathogenesis of cardiovascular disease has been firmly established; yet, despite our increasing knowledge, accelerated atherosclerosis continues to be a significant co-morbidity and cause of mortality in SLE. Recent animal models have been generated in order to identify mechanism(s) behind SLE-accelerated atherosclerosis. In addition, clinical studies have been designed to examine potential treatments options. This review will highlight data from recent studies of immunity in SLE and atherosclerosis and discuss the potential implications of these investigations.

scholarly journals Assessment of Predictors of Hyperkalemia in Cardiovascular Diseased Patients

2021 ◽  
Vol 11 (2) ◽  
pp. 51-54
Author(s):  
Manasa R ◽  
Aksa Johnson ◽  
Presly Thomas Augustine ◽  
Anjana Tom
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Observational Study ◽  
Tertiary Care ◽  
Age Groups ◽  
Common Type ◽  
Age Group ◽  
Aged Patients ◽  
Cross Sectional ◽  
Increased Risk

Purpose: The objective is to determine the predictors of hyperkalaemia, severity of hyperkalaemia and to access the prevalence of cardiovascular diseases Methodology: A cross sectional observational study was conducted on the predictors of hyperkalaemia in CVD patients, in a tertiary care teaching hospital for a period of 6 months. Results: Among 105 patients, there were 83 males and 22 females, the age group from 41-60 year shows more CVDs and 61-80 years aged patients are more prone to hyperkalaemia and shows more prevalent when compared to other age groups. The major risk factors of hyperkalaemia were Drugs (30.23%), Disease (58.13%), and Drug interactions (11.62%).Among the cardiovascular diseases, Myocardial Infarction (38%) were the most common type of CVD, while in hyperkalaemia Ischemic Heart Disease (48.83%) were more prevalent. The severity of hyperkalaemia is measured as Mild (60.46%), Moderate (37.20%), and Severe (2.32%). Conclusion: The present study was carried out in order to assess the predictors, prevalence and severity of hyperkalaemia in cardiovascular disease patients. Our study concluded that patients with cardiovascular disease can have an increased risk of hyperkalaemia. Keywords:  CVD, Hyperkalaemia, Cross sectional observational study, Predictors, Prevalence, Severity.

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