scholarly journals Factors associated with adherence to guideline-recommended cardiovascular disease prevention among HIV clinicians

2021 ◽  
Author(s):  
Karla I Galaviz ◽  
Jonathan A Colasanti ◽  
Ameeta S Kalokhe ◽  
Mohammed K Ali ◽  
Igho Ofotokun ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Glucose ◽  
Peer Pressure ◽  
Median Score ◽  
Factors Associated ◽  
Preventive Practices ◽  
Leadership Engagement ◽  
Clinician Beliefs ◽  
Inner Setting

Abstract Integrating cardiovascular disease (CVD) prevention in routine HIV care remains a challenge. This study aimed to identify factors associated with adherence to guideline-recommended CVD preventive practices among HIV clinicians. Clinicians from eight HIV clinics in Atlanta were invited to complete an online survey. The survey was informed by the Consolidated Framework for Implementation Research and assessed the following: clinician CVD risk screening and advice frequency (never to always), individual characteristics (clinician beliefs, self-efficacy, and motivation), inner setting factors (clinic culture, learning climate, leadership engagement, and resources available), and outer setting factors (peer pressure and patient needs). Bivariate correlations examined associations between these factors and guideline adherence. Thirty-eight clinicians completed the survey (82% women, mean age 42 years, 50% infectious disease physicians). For risk screening, clinicians always check patient blood pressure (median score 7.0/7), while they usually ask about smoking or check their blood glucose (median score 6.0/7). For advice provision, clinicians usually recommend quitting smoking, controlling cholesterol or controlling blood pressure (median score 6.0/7), while they often recommend controlling blood glucose, losing weight, or improving diet/physical activity (median score 5.5/7). Clinician beliefs, motivation and self-efficacy were positively correlated with screening and advice practices (r = .55−.84), while inner setting factors negatively correlated with lifestyle-related screening and advice practices (r = −.51 to −.76). Peer pressure was positively correlated with screening and advice practices (r = .57–.89). Clinician psychosocial characteristics and perceived peer pressure positively influence adherence to guideline-recommended CVD preventive practices. These correlates along with leadership engagement could be targeted with proven implementation strategies.

scholarly journals Association of normoalbuminuria and microalbuminuria with the components of metabolic syndrome in Bangladeshi adults

2020 ◽  
Vol 10 (3) ◽  
pp. 152-158
Author(s):  
Muntakim Mahmud Saadi ◽  
Farida Akhter Tania ◽  
Manindra Nath Roy ◽  
Rubena Haque ◽  
Farzana Akonjee Mishu ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Blood Glucose ◽  
Urinary Albumin Excretion ◽  
Fasting Blood Glucose ◽  
Urinary Albumin ◽  
Normal Range ◽  
Low Hdl

Background: Metabolic syndrome (MetS) is clustering of metabolic abnormalities characterized by obesity, hypertension, dyslipidemia and glucose intolerance that collectively increases the risk of diabetes mellitus, cardiovascular disease, stroke and overall mortality. Microalbuminuria is associated with diabetes mellitus, hypertention, obesity all are components of metabolic syndrome. Microalbuminuria and MetS have both been linked to chronic kidney disease and cardiovascular disease. Before development of microalbuminuria there is a wide normal range for urinary albumin excretion. By comparing the strength of the association between MetS and its components with normoalbuminuria and microalbuminuria, we can assess the risk of cardiovascular and renal diseases. This study aimed to evaluate the association of normoalbuminuria and microalbuminuria with the components of MetS in Bangladeshi adult subjects. Methods: It was a cross-sectional analytical study, carried out in the Department of Biochemistry of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh during the period of March 2017 to January 2018. Total 175 patients with MetS attending the outpatient department of Medicine and Endocrinology of Mitford Hospital were included. Collected data was checked, edited and analyzed with the help of software SPSS (Statistical Package for Social Sciences) version 22. Results: This study showed, among the total 175 study subjects, 125 subjects were with normoalbuminuria (71.43%) and 50 subjects had microalbuminuria (28.57%). With an average age 42.4 years, female were 52% in this study. There was also female predominance among microalbuminuric subjects (13.71% vs 14.75%). Participants with microalbuminuria were more likely to have higher systolic blood pressure (SBP), diastolic blood pressure (DBP) and fasting blood glucose (FBG) than those with normoalbuminuria. The albumin creatinine ratio (ACR) of study subjects ranged from 3.00 to 270.39 mg/g and mean ACR was 27.14 mg/g. The mean ACR for participants with three (n=34), four (n=72) and five (n=69) components of MetS were 14.73, 19.94 and 40.77 mg/g respectively and corresponding prevalence of microalbuminuria was 10%, 32% and 58% respectively. Normal range of urinary albumin excretion rate (normoalbuminuria) were classified into four quartiles according to their ACR values and ranges for Q1, Q2, Q3 & Q4 were respectively Q1 = 3.00 to 5.1, Q2 = 5.1 to 8.2, Q3 = 8.2 to 13.89, Q4 = 13.89 to 28.1mg/g. The means of elevated DBP, SBP, FBG and tri-acyl glycerol (TAG) among the components of MetS showed increasing trend from lower to upper quartiles within normal range. Q1 was considered as base line in comparison to other quartiles. Odds of elevated WC, FBG, TAG, BP and low HDL-C were high across increasing quartiles of ACR (1.00 vs 1.33 vs 2.24 vs 1.79 respectively for central obesity; 1.00 vs 1.07 vs 1.97 vs 2.07 respectively for elevated fasting blood glucose; 1.00 vs 1.51 vs 1.69 vs 1.69 respectively for elevated TAG; 1.00 vs 6.86 vs 3.87 vs 2.88 respectively for elevated BP and 1.00 vs 1.35 vs 2.79 vs 2.79 respectively for low HDL-C; p-values <0.05 for all). Among the components of MetS, most significant relationship was observed between elevated BP and increasing ACR quartile within normal range. Conclusions: In conclusion, we demonstrated that microalbuminuria was strongly associated with MetS and its components. Microalbuminuria should be reconsidered as a component of MetS as it shows incremental effect with severity of MetS. Even upper normal range of albuminuria (higher normoalbuminuria) is strongly associated with elevated BP, FBG and TAG among the components of MetS. So, normal range of albuminuria should be rearranged after performing large scale population study in this regard. Birdem Med J 2020; 10(3): 152-158

scholarly journals Korelasi Lingkar Pinggang dengan Kadar Gula Darah Puasa, Kadar Trigliserida, dan Tekanan Darah pada Mahasiswa Fakultas Kedokteran Universitas HKBP Nommensen

2021 ◽  
Vol 3 (2) ◽  
pp. 08-13
Author(s):  
Ervina Julien Sitanggang
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Young Adults ◽  
Blood Glucose ◽  
Waist Circumference ◽  
Blood Sugar ◽  
Fasting Blood Glucose ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Sugar Levels

Introduction: Cardiovascular disease is the number one cause of death globally with an incidence of adolescents and young adults in Indonesia as many as 153.705 cases. Central obesity is associated with the risk of cardiovascular disease due to increase in fasting blood glucose levels, cholesterol and triglyceride levels, and blood pressure. Aims: to determine the correlation between waist circumference and fasting blood glucose levels, triglyceride levels, and blood pressure in young adults. Method: This analytic study with a cross-sectional approach involved 53 young adult subjects (18-25 years old). Waist circumference is measured using a tape measure. Blood sugar and triglyceride levels were measured using Cobas® 6000 analyzer machine from blood samples of subjects after fasting for 8-12 hours. Blood pressure data are obtained by measurement using aneroid sphygmomanometer. Results: In this study, the mean waist circumference of the research subjects was 77,4 cm. No correlation was found between waist circumference and fasting blood sugar levels (p = 0,159). However, a positive correlation was found between waist circumference and triglyceride levels (p = 0,008; r = 0,332), between waist circumference and systolic blood pressure (p = 0,049; r = 0,230), and between waist circumference and diastolic blood pressure (p = 0,017; r = 0,293). Conclusion: waist circumference is positively correlated with triglyceride levels and blood pressure, but does not correlate with fasting blood sugar levels.

Monitoring cardiovascular disease risk in individuals with severe mental illness in an inpatient mental health setting: a secondary data analysis

2020 ◽  
Vol 15 (11) ◽  
pp. 1-15
Author(s):  
Herbert P Mwebe ◽  
Margaret Volante ◽  
Tim Weaver
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Mental Illness ◽  
Blood Glucose ◽  
Severe Mental Illness ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Electronic Records

Background/Aims Life expectancy in people with lived experience of mental health conditions is reduced by up to 25 years; this is from preventable physical medical comorbidities and multi-morbidities such as cardiovascular disease, diabetes, cancers and smoking-related lung disease. Two-thirds of these deaths are avoidable if people with severe mental illness are offered prompt physical screening checks and monitoring. The aim of this article was to explore barriers to the management of cardiovascular disease risk on inpatient wards and make recommendations in relation to cardiovascular disease risk management in people with severe mental illness. Methods A structured MS Excel extraction data tool informed by best practice guidance was developed and used to extract electronic patient data on screening and monitoring of cardiovascular disease risk factors (blood pressure, smoking, alcohol, lipids, body mass index/weight, blood glucose level) across 10 inpatient psychiatric wards within one London mental health trust. A target sample of 245 electronic records of patients with severe mental illness discharged between 25 August 2018 and 13 February 2019 with length of inpatient stay >40 days was examined. Simple random sampling (MS Excel random number generator) was used to select a final sample of 120 electronic records. All the included samples had been prescribed psychotropic medication. Results Regarding patient demographics, there was an inverse correlation with age, with a greater proportion of inpatients being of a younger age: 51% aged 18–39 years compared with 14% aged 60–79 years. The study found an average of 71% compliance of the documentation of data on all individual parameters (smoking, alcohol, body mass index, blood pressure, serum glucose, serum lipids, electrocardiogram) at baseline. Results showed an average of 79% compliance for monitoring review at least once across the parameters within 3 months of admission. Conclusions It is recommended as a minimum for individuals with severe mental illness under the care of mental health services and/or taking psychotropic medication to have regular cardiometabolic risk assessment and management of risk at the point of entry into services and a review for weight, waist circumference, blood glucose checks, lipid profile, blood pressure, lifestyle choice behaviours and personal assessment of cardiovascular disease. Although progress is being made across provider services to implement the above, gaps in practice are still evident, as demonstrated in these findings.

scholarly journals Direct and indirect effects of central and general adiposity on cardiovascular diseases: The Tehran Lipid and Glucose Study

2018 ◽  
Vol 25 (11) ◽  
pp. 1170-1181 ◽  
Author(s):  
Mahmood Bakhtiyari ◽  
Nicole Schmidt ◽  
Farzad Hadaegh ◽  
Davood Khalili ◽  
Nasrin Mansournia ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Glucose ◽  
Cardiovascular Diseases ◽  
Confidence Interval ◽  
Indirect Effects ◽  
Total Serum ◽  
Total Serum Cholesterol ◽  
Direct And Indirect Effects ◽  
General Adiposity

Aim The mechanisms linking body mass index to cardiovascular disease are still not clearly defined. The purpose of this study was to find out how much of the effect of central and general adiposity on cardiovascular disease is mediated through blood pressure, cholesterol, and glucose, and how much is independent of these factors. Methods and results The study population included participants, aged ≥30 years, free of cardiovascular disease at baseline with median follow-up of 13.9 years. The total effects were broken down into natural direct and indirect effects using the inverse odds weighting method in the context of survival models. Systolic blood pressure, total serum cholesterol, and fasting plasma glucose as the primary measure of blood glucose were used as mediators. Blood pressure and cholesterol with indirect hazard ratios of 1.09 (95% confidence interval: 1.006–1.18) and 1.35 (95% confidence interval: 1.12–1.62) were the most important mediators for overweight-cardiovascular disease and obesity-cardiovascular disease relationships, respectively. The proportion mediated of overweight was 22% (6–47%) for blood pressure, 18% (5–37%) for blood glucose, and 20% (7–43%) for cholesterol. The same measure for obesity was 65% (35–91%) for cholesterol. For central adiposity, blood pressure, glucose, and cholesterol were the most important mediators with proportion mediated of 36% (17–72%), 23% (9–48%), and 21% (8–45%), respectively. Conclusions The findings of this study show that proper control of cardiometabolic risk factors of blood pressure, blood glucose, and dyslipidemia in an adult population can be effective to significantly reduce the effects of general and abdominal adiposity on cardiovascular diseases.

scholarly journals Biomedical factors associated with hospitalization of older adults: The Bambuí Health and Aging Study (BHAS)

2003 ◽  
Vol 19 (3) ◽  
pp. 829-838 ◽  
Author(s):  
Henrique L. Guerra ◽  
Pedro G. Vidigall ◽  
Maria Fernanda Lima-Costa
Keyword(s):  
Blood Pressure ◽  
Older Adults ◽  
Body Mass Index ◽  
Blood Glucose ◽  
Total Cholesterol ◽  
Body Mass ◽  
Factors Associated ◽  
Minas Gerais State ◽  
Aging Study ◽  
The Town

The objective of this study was to identify biomedical factors (body mass index, blood pressure, blood glucose, total cholesterol and fractions, triglycerides, and albumin) associated with hospitalization of older adults. All residents of the town of Bambuí, Minas Gerais State, ages <FONT FACE=Symbol>³</FONT> 60 years (n = 1,742) were selected for the study, of whom 1,494 (85.2%) participated. None of the biomedical factors studied was independently associated with occurrence of 1 hospitalization during the previous 12 months. Body mass index < 20Kg/m² and total cholesterol = 200-263mg/dl and <FONT FACE=Symbol>³</FONT> 264mg/dl were independently associated with <FONT FACE=Symbol>³</FONT> 2 hospitalizations. The introduction of biomedical factors did not modify the previously identified associations between hospitalization and indicators constructed from information obtained in a questionnaire survey. The results show that data easily obtained through interviews can be useful both for identifying older adults at risk of hospitalization and thus for assisting in prevention.

Monitoring cardiovascular disease risk in individuals with severe mental illness in an inpatient mental health setting: a secondary data analysis

2020 ◽  
Vol 9 (3) ◽  
pp. 1-14
Author(s):  
Herbert P Mwebe ◽  
Margaret Volante ◽  
Tim Weaver
Keyword(s):  
Mental Health ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Mental Illness ◽  
Blood Glucose ◽  
Severe Mental Illness ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Electronic Records

Background/Aims Life expectancy in people with lived experience of mental health conditions is reduced by up to 25 years; this is from preventable physical medical comorbidities and multi-morbidities such as cardiovascular disease, diabetes, cancers and smoking-related lung disease. Two-thirds of these deaths are avoidable if people with severe mental illness are offered prompt physical screening checks and monitoring. The aim of this article was to explore barriers to the management of cardiovascular disease risk on inpatient wards and make recommendations in relation to cardiovascular disease risk management in people with severe mental illness. Methods A structured MS Excel extraction data tool informed by best practice guidance was developed and used to extract electronic patient data on screening and monitoring of cardiovascular disease risk factors (blood pressure, smoking, alcohol, lipids, body mass index/weight, blood glucose level) across 10 inpatient psychiatric wards within one London mental health trust. A target sample of 245 electronic records of patients with severe mental illness discharged between 25 August 2018 and 13 February 2019 with length of inpatient stay >40 days was examined. Simple random sampling (MS Excel random number generator) was used to select a final sample of 120 electronic records. All the included samples had been prescribed psychotropic medication. Results Regarding patient demographics, there was an inverse correlation with age, with a greater proportion of inpatients being of a younger age: 51% aged 18–39 years compared with 14% aged 60–79 years. The study found an average of 71% compliance of the documentation of data on all individual parameters (smoking, alcohol, body mass index, blood pressure, serum glucose, serum lipids, electrocardiogram) at baseline. Results showed an average of 79% compliance for monitoring review at least once across the parameters within 3 months of admission. Conclusions It is recommended as a minimum for individuals with severe mental illness under the care of mental health services and/or taking psychotropic medication to have regular cardiometabolic risk assessment and management of risk at the point of entry into services and a review for weight, waist circumference, blood glucose checks, lipid profile, blood pressure, lifestyle choice behaviours and personal assessment of cardiovascular disease. Although progress is being made across provider services to implement the above, gaps in practice are still evident, as demonstrated in these findings.

scholarly journals Prevalence of metabolic syndrome and associated factors among human immunodeficiency virus patients on highly active antiretroviral therapy in North central Nigeria

2021 ◽  
Vol 9 (10) ◽  
pp. 2892
Author(s):  
Rifkatu S. Reng ◽  
Gerald A. Onwuegbuzie ◽  
Muaz Salisu ◽  
Felicia Anumah
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Blood Glucose ◽  
Antiretroviral Therapy ◽  
Waist Circumference ◽  
Highly Active Antiretroviral Therapy ◽  
Fasting Blood Glucose ◽  
Highly Active

Background: Metabolic syndrome (MS) is a complex disorder defined by cluster of risk factors for cardiovascular disease and type 2 diabetes mellitus. The Use of Highly active antiretroviral therapy in HIV patients is associated with metabolic syndrome which increases the risk of cardiovascular disease (CVD). The aim of the study was to determine the prevalence of MS among HAART treated HIV patients and HAART naïve patients.Methods: This was a cross-sectional study that evaluated 581 (396 females, 184 males) consenting HIV patents in the hospital. Clinical characteristics, anthropometry, blood pressure, lipid profile, fasting blood glucose, fasting plasma insulin, CD4 cell counts and viral load were determined using appropriate standard techniques. MS was defined using International Diabetes Federation (IDF) cut-off values.Results: The overall prevalence of MS was 10.7%, with more females 52 (13.1%) than males 10 (5.4%), p=0.005. MS in patients on HAART was 58 (15.1%) and HAART naive 4 (2.0%). Overall, waist circumference, BMI, systolic blood pressure (BP), diastolic blood pressure (BP), triglycerides and fasting blood glucose were 82.7±11.5, 22.7±, 120.6±17.6, 77.5±10.6, 1.1±0.7 and 5.1±1.9 respectively. Patients with MS had significantly higher (p<0.05) waist circumference (94.1 vs 81.3 cm), BMI (24.8 vs 22.5 kg/m2), systolic BP (135.4 vs 118.8 mmHg), diastolic BP (86.2 vs 76.5 mmHg), triglycerides (1.3 vs 1.0 mmol/l) and fasting blood glucose (6.3 vs 4.9 mmol/l).  Insulin resistance (IR) was higher in patients with MS 11.8(7.9) compared with patients without MS 5.5 (6.8) p=0.02.Conclusions: Prevalence of metabolic syndrome in this study was lower than that reported in previous works, the prevalence is much higher in the HAART treated patients. The risk of MS were high triglycerides, hypertension and abnormal fasting blood glucose. There was significant association with the traditional risk factors, age, female gender and HIV duration. 

scholarly journals Consumption of cashew nuts does not influence blood lipids or other markers of cardiovascular disease in humans: a randomized controlled trial

2019 ◽  
Vol 109 (2) ◽  
pp. 269-275 ◽  
Author(s):  
David J Baer ◽  
Janet A Novotny
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Blood Glucose ◽  
Stearic Acid ◽  
Blood Lipids ◽  
Augmentation Index ◽  
Health Claim ◽  
Tree Nuts ◽  
Cashew Nut

ABSTRACT Background The US Food and Drug Administration (FDA) approved a qualified health claim for tree nuts and reduction of cardiovascular disease. However, cashews are excluded from that claim due to their content of saturated fats, which is predominantly stearic acid. Because stearic acid is neutral with respect to blood lipids, several studies have been conducted to test the effect of cashew nuts on blood lipids, and these studies have produced conflicting results. Objectives The aim of this study was to conduct a highly controlled intervention to determine the effect of cashews fed at the amount specified in the health claim on risk factors for cardiovascular disease. Methods A total of 42 adults participated in a controlled-feeding study conducted as a randomized crossover trial with 2 treatment phases. The volunteers were provided the same base diet in both treatment phases, with no additions during the control phase and with the addition of 1.5 servings (42 g) of cashews/d for the cashew nut phase. During the cashew nut phase, the amount of all foods was decreased proportionally to achieve isocaloric overall diets in the 2 phases. After 4 wk of intervention, assessments included blood lipids, blood pressure, central (aortic) pressure, augmentation index, blood glucose, endothelin, proprotein convertase subtilisin/kexin type 9 (PCSK9), adhesion molecules, and clotting and inflammatory factors. Results There were no significant differences in blood lipids, blood pressure, augmentation index, blood glucose, endothelin, adhesion molecules, or clotting factors in this weight-stable cohort. PCSK9 was significantly decreased after cashew consumption, although there was no change in LDL cholesterol. Conclusions Consumption of 1.5 servings of cashew nuts/d, the amount associated with the FDA qualified health claim for tree nuts and cardiovascular disease, did not positively or adversely affect any of the primary risk factors for cardiovascular disease. This trial was registered at clinicaltrials.gov as NCT02628171.

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