Longitudinal association between adolescent negative emotions and adulthood cardiovascular disease risk: an opportunity for healthcare quality improvement

PurposeWhile cardiovascular disease (CVD) is the leading cause of death globally, over 80% of the cases could be prevented through early lifestyle changes. From the perspective of quality management in healthcare, this may offer an effective prevention window if modifiable CVD risk factors are identified and treated in adolescence. The purpose of this research is to examine the negative emotions in adolescents and determine if it independently increases CVD risk later in life.Design/methodology/approachLongitudinal data from 12,350 participants of the Add Health study, which conducted a multi-wave survey for 14 years from adolescence (Wave 1) through adulthood (Wave 4), were used to test the research hypothesis. Four items (perception of life, self-reported depression, perceived loneliness and fearfulness) reflective of adolescent negative emotion were identified from the Wave 1 questionnaire, and factor analysis was conducted to confirm the hypothesized structure. The outcome variable, 30-year adulthood CVD risk category (high or low risk), was estimated using biomarkers, biological data and other factors collected during the 14-year follow-up in Wave 4. A logistic regression analysis was employed to assess the impact of adolescent negative emotions on adulthood CVD risk after adjusting for common risk factors such as sociodemographic characteristics, socioeconomic status and medical conditions in adolescence.FindingsThe results indicated adolescent negative emotion to be significantly associated with CVD risk category (p-value < 0.0001), even after controlling for common risk factors. A unit increase in the level of adolescent negative emotion increased the chance of being in the high CVD risk group in adulthood by 8% (odds ratio = 1.08 ± 0.03).Practical implicationsHealthcare providers and organizations could capitalize on the research findings by screening for negative emotions early in life through individual and societal interventions. The findings also provide an opportunity for implementing quality improvement initiatives to deliver robust preventive care, which, in turn, could improve the overall population health, reduce healthcare costs and improve care quality.Originality/valueAlthough previous studies showed a strong link between adolescent physiological factors (e.g. obesity) and adulthood cardiovascular disease (CVD), the association between adolescent outlook/attitude (negative emotion) and CVD risk has not been examined.

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Don’t just screen intervene; a quality improvement initiative to improve physical health screening of young people experiencing severe mental illness

Mental Health Review Journal ◽

10.1108/mhrj-01-2015-0003 ◽

2016 ◽

Vol 21 (1) ◽

pp. 48-60 ◽

Cited By ~ 3

Author(s):

Paul Jon Greenwood ◽

David Edward Shiers

Keyword(s):

Risk Factors ◽

Quality Improvement ◽

Early Intervention ◽

Cardiometabolic Risk ◽

Cardiometabolic Health ◽

Cvd Risk ◽

Content Type ◽

North West ◽

Quality Improvement Programme ◽

Improvement Programme

Purpose – The purpose of this paper is to improve the quality of monitoring of risk factors that predict the likelihood of people with severe mental illness (SMI) developing cardiovascular disease (CVD), diabetes and obesity, major contributors to poor physical health and risk of premature mortality. Design/methodology/approach – The first phase of the AQuA “Don’t just screen-intervene” initiative supported five specialised community-based Early Intervention for Psychosis services in North West England to assess the effectiveness of monitoring of cardiometabolic risk in their patients using standards derived from the Lester Positive Cardiometabolic Health Resource, a nationally acknowledged framework for people with psychosis receiving antipsychotic medication. The initial findings formed the basis for a quality improvement programme which ran from November 2012 until May 2013. Findings – By the end of a six month quality improvement programme the likelihood of a patient receiving a comprehensive cardiometabolic risk screening (evidenced by recorded measurement of body mass index or waist circumference, blood pressure, blood glucose and lipid profile, assessment of smoking status and enquiry of relevant family history) had increased from 10 to between 63 and 80 per cent. Research limitations/implications – Cardiometabolic risk monitoring from the onset of psychosis and its treatment can be improved utilising quality improvement methodology in real-world specialist mental health services. Earlier identification and treatment of risk factors that predict higher rates of obesity, diabetes and SMI may help people with SMI avoid life-restricting and life-shortening physical disorders. Practical implications – Given the National Audit of Schizophrenia findings of inadequate screening in those with established SMI alongside evidence that CVD risk can emerge early in the course of psychosis, a group of early intervention in psychosis services in North West England decided to examine this aspect of their routine clinical practice. This service evaluation describes the effectiveness of a quality improvement programme based on the Lester Positive Cardiometabolic Health Resource (referred to as Lester resource henceforth) to improve the effectiveness of monitoring of risk factors that predict the likelihood of people experiencing psychosis and schizophrenia developing CVD diabetes and obesity. Social implications – A combination of social disadvantage and unhealthy lifestyles, adverse cardiometabolic impacts of antipsychotic medication and inequitable access to physical healthcare combine to put people with SMI at particular risk from CVD, the single biggest cause of premature death, and much more common than suicide (Brown et al., 2010). Despite higher rates of potentially modifiable CVD risk factors (De Hert et al., 2009) people with SMI appear to be missing out on opportunities to actively prevent conditions like CVD and diabetes compared to the general population. Originality/value – People with SMI such as schizophrenia die 15-20 years earlier on average than the general population. Around 20 per cent of premature deaths can be explained by suicide and injury, but the remainder arise from a variety of natural causes such as CVD, chronic obstructive pulmonary disorder and certain cancers and infections (Nordentoft et al., 2013). The authors worked with five mental health trusts in the North West of England covering a sample of over 500 cases within early intervention services.

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NDSP-12: Atherogenic index of plasma as a useful marker of cardiovascular disease risk among Pakistani individuals; a study from the second National Diabetes Survey of Pakistan (NDSP) 2016-2017

10.22541/au.163254263.33378771/v1 ◽

2021 ◽

Author(s):

Asher Fawwad ◽

Yasir Mahmood ◽

Saima Askari ◽

Anum Butt ◽

Abdul Basit ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Disease Risk ◽

Atherogenic Index ◽

Risk Category ◽

Oral Glucose ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Atherogenic Index Of Plasma ◽

Diabetes Survey

Aim To assess the correlation between atherogenic index of plasma (AIP) and cardiovascular disease (CVD) risk factors. Methodology This is a sub study of the second National Diabetes Survey of Pakistan (NDSP) 2016–2017, an epidemiological survey including people of > 20 years of age and both genders in all four provinces of Pakistan. Out of 213 clusters, twenty-seven clusters were selected from all over the Pakistan. Households were identified and selected members of every 10th household were counseled to come to the campsite after observing an overnight fast. Standardized techniques were used for measuring height, weight, BMI, waist circumference, and blood pressure. Standard methods were used for analyzing biochemical parameters including oral glucose tolerance test, lipid profile and various lipid derived parameter/ratios were calculated. The AIP was calculated by using formula log10 (TG/HDL) for all survey participants. Statistical analyses were conducted by using statistical package for social sciences, version 20. Results A total of 7351 people (2877 males and 4201females) were selected for this sub-analysis after fulfilling the inclusion criteria. Overall AIP score was calculated as 0.74±0.31 and according to the AIP risk categorization, the majority 6996 (95.2%) fell in the high-risk category of developing CVD, whereas 258(3.5%) were in moderate and only 97(1.3%) people were found in low-risk category. Multiple logistic regression analyses showed male gender and diabetes as risk factor for developing CVD based on AIP score. Furthermore, various lipid derived parameters LDL-C and HDL-C, TG and HDL-C, lipoprotein combined index (LCI) were shown strong correlation with AIP. Conclusion The significant association between AIP and CVD risk factors exists and high levels of AIP in Pakistani population may be an alarming sign in developing cardiovascular disease.

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Cardiovascular Disease in Rheumatoid Arthritis: Risk Factors, Autoantibodies, and the Effect of Antirheumatic Therapies

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.1177/11795441211028751 ◽

2021 ◽

Vol 14 ◽

pp. 117954412110287

Author(s):

Mir Sohail Fazeli ◽

Vadim Khaychuk ◽

Keith Wittstock ◽

Boris Breznen ◽

Grace Crocket ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Disease ◽

Literature Review ◽

Rheumatoid Factor ◽

Qualitative Evidence Synthesis ◽

Cvd Risk ◽

Rheumatoid Arthritis Risk ◽

Published Evidence ◽

Increased Risk

Objective: To scope the current published evidence on cardiovascular risk factors in rheumatoid arthritis (RA) focusing on the role of autoantibodies and the effect of antirheumatic agents. Methods: Two reviews were conducted in parallel: A targeted literature review (TLR) describing the risk factors associated with cardiovascular disease (CVD) in RA patients; and a systematic literature review (SLR) identifying and characterizing the association between autoantibody status and CVD risk in RA. A narrative synthesis of the evidence was carried out. Results: A total of 69 publications (49 in the TLR and 20 in the SLR) were included in the qualitative evidence synthesis. The most prevalent topic related to CVD risks in RA was inflammation as a shared mechanism behind both RA morbidity and atherosclerotic processes. Published evidence indicated that most of RA patients already had significant CV pathologies at the time of diagnosis, suggesting subclinical CVD may be developing before patients become symptomatic. Four types of autoantibodies (rheumatoid factor, anti-citrullinated peptide antibodies, anti-phospholipid autoantibodies, anti-lipoprotein autoantibodies) showed increased risk of specific cardiovascular events, such as higher risk of cardiovascular death in rheumatoid factor positive patients and higher risk of thrombosis in anti-phospholipid autoantibody positive patients. Conclusion: Autoantibodies appear to increase CVD risk; however, the magnitude of the increase and the types of CVD outcomes affected are still unclear. Prospective studies with larger populations are required to further understand and quantify the association, including the causal pathway, between specific risk factors and CVD outcomes in RA patients.

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Effects of a Paleolithic Diet on Cardiovascular Disease Risk Factors: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Advances in Nutrition ◽

10.1093/advances/nmz007 ◽

2019 ◽

Vol 10 (4) ◽

pp. 634-646 ◽

Cited By ~ 12

Author(s):

Ehsan Ghaedi ◽

Mohammad Mohammadi ◽

Hamed Mohammadi ◽

Nahid Ramezani-Jolfaie ◽

Janmohamad Malekzadeh ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Disease ◽

Lipid Profile ◽

Meta Analysis ◽

Controlled Trials ◽

Cvd Risk Factors ◽

Paleolithic Diet ◽

Cvd Risk ◽

Randomized Controlled

ABSTRACTThere is some evidence supporting the beneficial effects of a Paleolithic diet (PD) on cardiovascular disease (CVD) risk factors. This diet advises consuming lean meat, fish, vegetables, fruits, and nuts and avoiding intake of grains, dairy products, processed foods, and added sugar and salt. This study was performed to assess the effects of a PD on CVD risk factors including anthropometric indexes, lipid profile, blood pressure, and inflammatory markers using data from randomized controlled trials. A comprehensive search was performed in the PubMed, Scopus, ISI Web of Science, and Google Scholar databases up to August 2018. A meta-analysis was performed using a random-effects model to estimate the pooled effect size. Meta-analysis of 8 eligible studies revealed that a PD significantly reduced body weight [weighted mean difference (WMD) = −1.68 kg; 95% CI: −2.86, −0.49 kg], waist circumference (WMD = −2.72 cm; 95% CI: −4.04, −1.40 cm), BMI (in kg/m2) (WMD = −1.54; 95% CI: −2.22, −0.87), body fat percentage (WMD = −1.31%; 95% CI: −2.06%, −0.57%), systolic (WMD = −4.75 mm Hg; 95% CI: −7.54, −1.96 mm Hg) and diastolic (WMD = −3.23 mm Hg; 95% CI: −4.77, −1.69 mm Hg) blood pressure, and circulating concentrations of total cholesterol (WMD = −0.23 mmol/L; 95% CI: −0.42, −0.04 mmol/L), triglycerides (WMD = −0.30 mmol/L; 95% CI: −0.55, −0.06 mmol/L), LDL cholesterol (WMD = −0.13 mmol/L; 95% CI: −0.26, −0.01 mmol/L), and C-reactive protein (CRP) (WMD = −0.48 mg/L; 95% CI: −0.79, −0.16 mg/L) and also significantly increased HDL cholesterol (WMD = 0.06 mmol/L; 95% CI: 0.01, 0.11 mmol/L). However, sensitivity analysis revealed that the overall effects of a PD on lipid profile, systolic blood pressure, and circulating CRP concentrations were sensitive to removing some studies and to the correlation coefficients, hence the results must be interpreted with caution. Although the present meta-analysis revealed that a PD has favorable effects on CVD risk factors, the evidence is not conclusive and more well-designed trials are still needed.

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Cardiovascular Disease Risk in Bears and Other Gay Men: A Descriptive Study from Poland

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18031044 ◽

2021 ◽

Vol 18 (3) ◽

pp. 1044

Author(s):

Magdalena Mijas ◽

Karolina Koziara ◽

Andrzej Galbarczyk ◽

Grazyna Jasienska

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Gay Men ◽

Disease Risk ◽

Older Age ◽

Analysis Of Covariance ◽

Control Group ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Wide Range

A risk of cardiovascular disease (CVD) is increased by multiple factors including psychosocial stress and health behaviors. Sexual minority men who identify as Bears form a subculture distinguished by characteristics associated with increased CVD risk such as elevated stress and high body weight. However, none of the previous studies comprehensively investigated CVD risk in this population. Our study compared Bears (N = 31) with other gay men (N = 105) across a wide range of CVD risk factors. Logistic regression and analysis of covariance (ANCOVA) models were performed to compare both groups concerning behavioral (e.g., physical activity), medical (e.g., self-reported hypertension), and psychosocial (e.g., depressiveness) CVD risk factors. Bears were characterized by older age and higher body mass index (BMI) than the control group. We also observed higher resilience, self-esteem, as well as greater prevalence of self-reported hypertension, diabetes, and hypercholesterolemia in Bears. None of these differences remained statistically significant after adjusting for age and, in the case of self-reported diagnosis of diabetes, both age and BMI. Our study demonstrates that Bears are characterized by increased CVD risk associated predominantly with older age and higher BMI. Health promotion interventions addressed to this community should be tailored to Bears’ subcultural norms and should encourage a healthier lifestyle instead of weight loss.

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Effect of DASH Diet Versus Healthy Dietary Advice on the Estimated Atherosclerotic Cardiovascular Disease Risk

Journal of Primary Care & Community Health ◽

10.1177/2150132720980952 ◽

2021 ◽

Vol 12 ◽

pp. 215013272098095

Author(s):

Marwa S. Said ◽

Inas T. El Sayed ◽

Eman E. Ibrahim ◽

Ghada M. Khafagy

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Dietary Advice ◽

Atherosclerotic Cardiovascular Disease ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Post Intervention ◽

Dash Diet ◽

Significant Difference ◽

Diet Versus

Introduction: Cardiovascular disease (CVD) is the most leading cause of mortality worldwide. Changes in diet can reduce subclinical cardiac injury and inflammation in parallel with reductions of other CVD risk factors. Aim: The study aimed to evaluate the beneficial effect of the DASH diet versus usual healthy dietary advice (HDA) on the estimated risk of atherosclerotic cardiovascular disease (ASCVD). Methods: It was a prospective interventional nonrandomized controlled study, conducted on 92 participants attending Family Medicine Outpatient Clinics, Cairo University. The participants were assigned to 2 dietary groups, the DASH and HDA groups, for 12 weeks. All subjects were subjected to anthropometric measurement, assessment of lipid profile, and the estimated cardiovascular risk pre-and post-intervention. Results: The estimated cardiovascular risk was reduced significantly in both the DASH and HDA groups, with no statistically significant difference between the 2 groups regarding the risk reduction. By comparing the percent change between pre and post-intervention in both DASH and HDA groups, the following are the results: BMI dropped by 6.5% versus 2.5%, systolic blood pressure decreased by 6.9% and 4.1%, fasting blood sugar dropped by 5.5% and 3.1%, total cholesterol dropped by 5.2% and 3.1%, LDL dropped by 8.2%, and 3.1%, and HDL increased by 8.2% and 2.4%, in DASH and HDA groups, respectively. Conclusion: Both the DASH diet and HDA are associated with improvement in CVD risk factors. Although better risk factors decline with the DASH diet, there was no statistically significant difference between the 2 groups.

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Is night-time light intensity associated with cardiovascular disease risk factors among adults in early-stage urbanisation in South India? A cross-sectional study of the Andhra Pradesh Children and Parents Study

BMJ Open ◽

10.1136/bmjopen-2019-036213 ◽

2020 ◽

Vol 10 (11) ◽

pp. e036213

Author(s):

Tina Bonde Sorensen ◽

Robin Wilson ◽

John Gregson ◽

Bhavani Shankar ◽

Alan D Dangour ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Andhra Pradesh ◽

South India ◽

Early Stage ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Night Time ◽

Cross Sectional ◽

Children And Parents

ObjectivesTo explore associations of night-time light intensity (NTLI), a novel proxy for continuous urbanisation levels, with mean systolic blood pressure (SBP), body mass index (BMI), fasting serum low-density lipoprotein (LDL) and fasting plasma glucose (FPG), among adults in early-stage urbanisation in Telangana, South India.DesignCross-sectional analysis of the third wave of the Andhra Pradesh Children and Parents Study cohort.Setting28 villages representing a continuum of urbanisation levels, ranging from rural settlement to medium-sized town in Telangana, South India.ParticipantsData were available from 6944 participants, 6236 of whom were eligible after excluding pregnant women, participants younger than 18 years of age and participants missing data for age. Participants were excluded if they did not provide fasting blood samples, had implausible or missing outcome values, were medicated for hypertension or diabetes or had triglyceride levels invalidating derived LDL. The analysis included 5924 participants for BMI, 5752 participants for SBP, 5287 participants for LDL and 5328 participants for FPG.ResultsIncreasing NTLI was positively associated with mean BMI, SBP and LDL but not FPG. Adjusted mean differences across the range of village-level NTLI were 1.0 kg/m2 (95% CI 0.01 to 1.9) for BMI; 4.2 mm Hg (95% CI 1.0 to 7.4) for SBP; 0.3 mmol/L (95% CI −0.01 to 0.7) for LDL; and −0.01 mmol/L (95% CI −0.4 to 0.4) for FPG. Associations of NTLI with BMI and SBP were stronger in older age groups.ConclusionThe association of NTLI with cardiovascular disease (CVD) risk factors identify NTLI as a potentially important tool for exploring urbanisation-related health. Consistent associations of moderate increases in urbanisation levels with important CVD risk factors warrant prevention strategies to curb expected large public health impacts from continued and rapid urbanisation in India.

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Sleep Deficiency and Deprivation Leading to Cardiovascular Disease

International Journal of Hypertension ◽

10.1155/2015/615681 ◽

2015 ◽

Vol 2015 ◽

pp. 1-5 ◽

Cited By ~ 22

Author(s):

Michelle Kohansieh ◽

Amgad N. Makaryus

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Well Being ◽

Underlying Mechanism ◽

Vital Role ◽

Quality Of Sleep ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Sleep Deficiency

Sleep plays a vital role in an individual’s mental, emotional, and physiological well-being. Not only does sleep deficiency lead to neurological and psychological disorders, but also the literature has explored the adverse effects of sleep deficiency on the cardiovascular system. Decreased quantity and quality of sleep have been linked to cardiovascular disease (CVD) risk factors, such as hypertension, obesity, diabetes, and dyslipidemia. We explore the literature correlating primary sleep deficiency and deprivation as a cause for cardiovascular disease and cite endothelial dysfunction as a common underlying mechanism.

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Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

Depression Research and Treatment ◽

10.1155/2011/836542 ◽

2011 ◽

Vol 2011 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Ali A. Weinstein ◽

Preetha Abraham ◽

Guoqing Diao ◽

Stacey A. Zeno ◽

Patricia A. Deuster

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

African American ◽

Depressive Symptoms ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Regression Analyses ◽

Cvd Risk Factors ◽

Cvd Risk ◽

The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

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Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.137.suppl_1.p006 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Rachael R Baiduc ◽

Brittany Bogle ◽

Franklyn Gonzalez ◽

Elizabeth Dinces ◽

David J Lee ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Hearing Loss ◽

Total Cholesterol ◽

Young Women ◽

Young Men ◽

Health Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

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