A comparison of the associations between risk factors and cardiovascular disease in Asia and Australasia

2005 ◽  
Vol 12 (5) ◽  
pp. 484-491 ◽  
Author(s):  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
New Zealand ◽  
Treatment Strategies ◽  
Haemorrhagic Stroke ◽  
Vascular Risk ◽  
Prevention And Treatment

Background Cardiovascular disease is already the leading cause of death in many Asian populations. Relationships between vascular risk factors and cardiovascular disease may differ in Asian and western populations. Previously, a lack of prospective data has prevented the reliable quantification of such differences, which, if they were shown to exist, would suggest that novel cardiovascular prevention and treatment strategies are required for Asia. Design An individual participant data meta-analysis of 32 studies from the Asia-Pacific region involving 331 100 subjects (75% from Asia; 25% from the predominantly Caucasian populations of Australia and New Zealand). Methods Outcomes were death from coronary heart disease, ischaemic and haemorrhagic stroke. Hazard ratios were estimated from Cox models for systolic blood pressure (SBP), total cholesterol, triglycerides, body mass index, diabetes and current cigarette smoking, stratified by study and sex and adjusted for age, the other risk factors and regression dilution. Results After an average period of follow-up of 4 years there were 2082 deaths from coronary heart disease, 600 from haemorrhagic stroke and 420 from ischaemic stroke. The direction and strength of the associations between risk factors and cardiovascular outcomes were similar in the two regions, although in two cases there were significant differences. Triglycerides were more strongly associated with coronary heart disease in Australia and New Zealand ( P = 0.03), whereas SBP showed a stronger relationship with haemorrhagic stroke in Asia ( P = 0.04). Conclusions Classical vascular risk factors act similarly in Asian and Caucasian populations; prevention and treatment strategies should thus be similar. Blood pressure reduction should be particularly effective in Asia.

scholarly journals What explains the effect of education on cardiovascular disease? Applying Mendelian randomization to identify the consequences of education inequality

2018 ◽  
Author(s):  
Alice R Carter ◽  
Dipender Gill ◽  
Neil M Davies ◽  
Amy E Taylor ◽  
Taavi Tillmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Body Mass Index ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Systolic Blood Pressure ◽  
Body Mass ◽  
Mendelian Randomization

Key PointsQuestionWhat is the role of body mass index, systolic blood pressure and smoking in mediating the effect of education on cardiovascular disease risk?FindingWe find consistent evidence that body mass index, systolic blood pressure and smoking mediate the effect of education, explaining up to 18%, 27% and 33% respectively. Including all three risk factors in a model together explains around 40% of the effect of education.MeaningIntervening on body mass index, systolic blood pressure and smoking would lead to reductions in cases of CVD attributable to lower levels of education. Over half of the effect of education on risk of cardiovascular disease is not mediated through these risk factors.ImportanceLower levels of education are causally related to higher cardiovascular risk, but the extent to which this is driven by modifiable risk factors also associated with education is unknown.ObjectiveTo investigate the role of body mass index, systolic blood pressure and smoking in explaining the effect of education on risk of cardiovascular disease outcomes.DesignMultivariable regression analysis of observational data and Mendelian randomization (MR) analysis of genetic data.SettingUK Biobank and international genome-wide association study consortia.ParticipantsPredominantly individuals of European ancestry.Main outcomes and measuresThe effects of education (per 1-standard deviation increase, equivalent to 3.6 years) on coronary heart disease, cardiovascular disease (all subtypes), myocardial infarction and stroke risk (all measured in odds ratio, OR), and the degree to which this is mediated through body mass index, systolic blood pressure and smoking.ResultsEach additional standard deviation of education associated with 13% lower risk of coronary heart disease (OR 0.87, 95% confidence interval [CI] 0.84 to 0.89) in observational analysis and 37% lower risk (OR 0.63, 95% CI 0.60 to 0.67) in Mendelian randomization analysis. As a proportion of the total risk reduction, body mass index mediated 15% (95% CI 13% to 17%) and 18% (95% CI 14% to 23%) in the observational and Mendelian randomization estimates, respectively. Corresponding estimates for systolic blood pressure were 11% (95% CI 9% to 13%) and 21% (95% CI 15% to 27%), and for smoking, 19% (15% to 22%) and 33% (95% CI 17% to 49%). All three risk factors combined mediated 42% (95% CI 36% to 48%) and 36% (95 % CI 16% to 63%) of the effect of education on coronary heart disease in observational and Mendelian randomization respectively. Similar results were obtained when investigating risk of stroke, myocardial infarction and all-cause cardiovascular disease.Conclusions and relevanceBMI, SBP and smoking mediate a substantial proportion of the protective effect of education on risk of cardiovascular outcomes and intervening on these would lead to reductions in cases of CVD attributable to lower levels of education. However, more than half of the protective effect of education remains unexplained and requires further investigation.

Mortality and associated risk factors in diabetics

1985 ◽  
Vol 110 (4_Suppl) ◽  
pp. S21-S26 ◽  
Author(s):  
R. J. Jarrett ◽  
M. J. Shipley
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Mortality Risk ◽  
Mortality Rates ◽  
Potential Risk Factors ◽  
Diabetic Population ◽  
Associated Risk Factors ◽  
The Relationship

Summary. In 168 male diabetics aged 40-64 years participating in the Whitehall Study, ten-year age adjusted mortality rates were significantly higher than in non-diabetics for all causes, coronary heart disease, all cardiovascular disease and, in addition, causes other than cardiovascular. Mortality rates were not significantly related to known duration of the diabetes. The predictive effects of several major mortality risk factors were similar in diabetics and non-diabetics. Excess mortality rates in the diabetics could not be attributed to differences in levels of blood pressure or any other of the major risk factors measured. Key words: diabetics; mortality rates; risk factors; coronary heart disease. There are many studies documenting higher mortality rates - particularly from cardiovascular disease -in diabetics compared with age and sex matched diabetics from the same population (see Jarrett et al. (1982) for review). However, there is sparse information relating potential risk factors to subsequent mortality within a diabetic population, information which might help to explain the increased mortality risk and also suggest preventive therapeutic approaches. In the Whitehall Study, a number of established diabetics participated in the screening programme and data on mortality rates up to ten years after screening are available. We present here a comparison of diabetics and non-diabetics in terms of relative mortality rates and the influence of conventional risk factors as well as an analysis of the relationship between duration of diabetes and mortality risk.

scholarly journals Sex Differences in the Age of Diagnosis for Cardiovascular Disease and Its Risk Factors Among US Adults: Trends From 2008 to 2017, the Medical Expenditure Panel Survey

2020 ◽  
Vol 9 (24) ◽  
Author(s):  
Victor Okunrintemi ◽  
Martin Tibuakuu ◽  
Salim S. Virani ◽  
Laurence S. Sperling ◽  
Annabelle Santos Volgman ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Medical Expenditure Panel Survey ◽  
Medical Expenditure ◽  
Age At Diagnosis ◽  
Panel Survey ◽  
Cvd Risk Factors ◽  
Cvd Risk

Background Sex differences in the trends for control of cardiovascular disease (CVD) risk factors have been described, but temporal trends in the age at which CVD and its risk factors are diagnosed and sex‐specific differences in these trends are unknown. Methods and Results We used the Medical Expenditure Panel Survey 2008 to 2017, a nationally representative sample of the US population. Individuals ≥18 years, with a diagnosis of hypercholesterolemia, hypertension, coronary heart disease, or stroke, and who reported the age when these conditions were diagnosed, were included. We included 100 709 participants (50.2% women), representing 91.9 million US adults with above conditions. For coronary heart disease and hypercholesterolemia, mean age at diagnosis was 1.06 and 0.92 years older for women, compared with men, respectively (both P <0.001). For stroke, mean age at diagnosis for women was 1.20 years younger than men ( P <0.001). The mean age at diagnosis of CVD risk factors became younger over time, with steeper declines among women (annual decrease, hypercholesterolemia [women, 0.31 years; men 0.24 years] and hypertension [women, 0.23 years; men, 0.20 years]; P <0.001). Coronary heart disease was not statistically significant. For stroke, while age at diagnosis decreased by 0.19 years annually for women ( P =0.03), it increased by 0.22 years for men ( P =0.02). Conclusions The trend in decreasing age at diagnosis for CVD and its risk factors in the United States appears to be more pronounced among women. While earlier identification of CVD risk factors may provide opportunity to initiate preventive treatment, younger age at diagnosis of CVD highlights the need for the prevention of CVD earlier in life, and sex‐specific interventions may be needed.

Risk Factors of Coronary Heart Disease among Civil Employees of a Tertiary Level Hospital

2020 ◽  
Vol 11 (1) ◽  
pp. 22-28
Author(s):  
Md Saydur Rahman ◽  
Nurun Nahar
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Heart Diseases ◽  
Positive Family History ◽  
Risk Behaviour ◽  
Educational Status ◽  
Normal Weight ◽  
Cross Sectional

Background: Cardiovascular risk factors are the most inimical and deleterious elements to develop coronary heart disease (CHD). To identify the factors contributing to develop CHD is therefore of paramount importance. It needs endless attention to address the riddle. This effort is to candle the light on sociodemographic & other factors of CHD. Methods & Materials: This cross-sectional study was conducted in CMH Dhaka from September to December 2011 on 287 respondents. Data were collected by interview using semi-structured questionnaire. Data were checked, edited, coded, categorized, cleaned and analyzed using (SPSS version 20). Results: The study disclosed that respondent's mean age was 39.40+9.42 years, 67.2% were male and 32.8% were female. It was founded that 34.14% were smoker. The prevalence rate of HTN and DM were 14.3% and 4.5% respectably. The mean BMI was 24.55 with 58.5% had normal weight and 41.5% were overweight, 18.8% had positive family history of suffering from CHD. among the respondents 88.5% has got at least one risk factor, 60% has got 5-10 risk factors, 13.6% got 6-10 risk factors, 14.3% got>10 risk factors. Age was significantly associated with smoking (p<.049), educational status (p<.001) and blood pressure (p<.001). Physical exercise was associated with BMI (p<.001) and blood pressure (p<.001). Risk factors had highly significant association with age (p<.001). Conclusion: All these findings suggest that a substantial evidence of risk factors of coronary heart diseases were prevailing among the study population. Proper care through positive motivation, avoidance of risk behaviour, intervention of clinical conditions can resist risk factors of coronary heart disease thus coronary heart disease can be prevented. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 22-28

Relationship of Fitness, Fatness, and Coronary-Heart-Disease Risk Factors in 12- to 13-Year-Olds

2007 ◽  
Vol 19 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Non-Eleri Thomas ◽  
Stephen-Mark Cooper ◽  
Simon P. Williams ◽  
Julien S. Baker ◽  
Bruce Davies
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Disease Risk ◽  
Reactive Protein ◽  
Chd Risk ◽  
Heart Disease Risk Factors ◽  
Chd Risk Factors ◽  
Lipids And Lipoproteins

The purpose of this study was to examine relationships between aerobic fitness (AF), fatness, and coronary-heart-disease (CHD) risk factors in 12- to 13-year-olds. The data were obtained from 208 schoolchildren (100 boys; 108 girls) ages 12.9 ± 0.3 years. Measurements included AF, indices of obesity, blood pressure, blood lipids and lipoproteins, fibrinogen, homocysteine, and C-reactive protein. An inverse relationship was found between AF and fatness (p < .05). Fatness was related to a greater number of CHD risk factors than fitness was (p < .05). Further analysis revealed fatness to be an independent predictor of triglyceride and blood-pressure levels (p < .05). Our findings indicate that, for young people, fatness rather than fitness is independently related to CHD risk factors.

scholarly journals Prevention and treatment of diabetic microangiopathy: A lecture

1995 ◽  
Vol 41 (6) ◽  
pp. 29-34
Author(s):  
A. K. Dreval
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Blood Pressure ◽  
Coronary Heart Disease ◽  
Diabetic Microangiopathy ◽  
Diabetic Patients ◽  
Atherosclerotic Vascular Disease ◽  
Diabetic Macroangiopathy ◽  
Prevention And Treatment ◽  
Patients With Diabetes

One of the main complications leading to high disability and mortality in patients with diabetes mellitus is atherosclerotic vascular disease (diabetic macroangiopathy). At the same time, the frequency of atherosclerosis among patients with diabetes mellitus is significantly affected by the so-called risk factors for atherosclerosis. In particular, the incidence of atherosclerosis among the general population and among diabetics increases with increased levels of cholesterol (cholesterol) in the blood, blood pressure, smoking and obesity. However, in patients with diabetes mellitus, mortality, for example, from coronary heart disease increases by 3 times against any of the known risk factors. But even without risk factors, the frequency of atherosclerotic vascular damage in patients with diabetes is much higher than in non-diabetic patients, i.e. diabetes in itself is a risk factor for atherosclerosis.

scholarly journals The role of noninvasive cardiovascular testing, applied clinical nutrition and nutritional supplements in the prevention and treatment of coronary heart disease

2018 ◽  
Vol 12 (3) ◽  
pp. 85-108 ◽  
Author(s):  
Mark Houston
Keyword(s):  
Risk Factors ◽  
Coronary Heart Disease ◽  
Body Composition ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Structural Damage ◽  
Visceral Obesity ◽  
Prevention And Treatment ◽  
Cardiovascular Testing ◽  
Chd Risk Factors

Numerous clinical trials suggest that we have reached a limit in our ability to decrease the incidence of coronary heart disease (CHD) and cardiovascular disease (CVD) utilizing the traditional diagnostic evaluation, prevention and treatment strategies for the top five cardiovascular risk factors of hypertension, diabetes mellitus, dyslipidemia, obesity and smoking. About 80% of heart disease (heart attacks, angina, coronary heart disease and congestive heart failure) can be prevented by optimal nutrition, optimal exercise, optimal weight and body composition, mild alcohol intake and avoiding smoking. Statistics show that approximately 50% of patients continue to have CHD or myocardial infarction (MI) despite presently defined ‘normal’ levels of the five risk factors listed above. This is often referred to as the ‘CHD gap’. Novel and more accurate definitions and evaluations of these top five risk factors are required, such as 24 h ambulatory blood pressure (ABM) results, advanced lipid profiles, redefined fasting and 2 h dysglycemia parameters, a focus on visceral obesity and body composition and the effects of adipokines on cardiovascular risk. There are numerous traumatic insults from the environment that damage the cardiovascular system but there are only three finite vascular endothelial responses, which are inflammation, oxidative stress and immune vascular dysfunction. In addition, the concept of translational cardiovascular medicine is mandatory in order to correlate the myriad of CHD risk factors to the presence or absence of functional or structural damage to the vascular system, preclinical and clinical CHD. This can be accomplished by utilizing advanced and updated CV risk scoring systems, new and redefined CV risk factors and biomarkers, micronutrient testing, cardiovascular genetics, nutrigenomics, metabolomics, genetic expression testing and noninvasive cardiovascular testing.

scholarly journals Mathematical Modelling of Acute Rheumatic Fever

2021 ◽  
Author(s):  
◽  
Melissa Welsh
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
New Zealand ◽  
Mathematical Modelling ◽  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Treatment Strategies ◽  
Developed Countries ◽  
Deterministic Methods ◽  
The World

<p>Acute rheumatic fever is a major cause of heart disease in many parts of the world. Though it is generally considered rare in developed countries, is remains a large issue in New Zealand. Of particular concern is the prevalence of acute rheumatic fever among Maori and Paci c Island peoples. In this thesis we develop a model to simulate acute rheumatic fever in a population. We discuss the use of both deterministic methods and stochastic processes. Demographics and statistics speci c to New Zealand are then used to develop the model in a way that ts speci cally to the situation in New Zealand. We also consider the introduction of treatment strategies for acute rheumatic fever and discuss how risk factors can be used to focus such strategies.</p>

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