scholarly journals Comparison of cardiovascular disease risk factors, assessment and management in men and women, including consideration of absolute risk: a nationally representative cross-sectional study

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e038761
Author(s):  
Emily Banks ◽  
Jennifer Welsh ◽  
Grace Joshy ◽  
Melonie Martin ◽  
Ellie Paige ◽  
...  

ObjectivesCardiovascular disease (CVD) is highly preventable and optimal treatments based on absolute risk can halve risk of future events. Compared with women, men have higher risks of developing CVD. However, women can experience suboptimal treatment. We aimed to quantify sex differences in CVD risk, assessment and treatment in Australian adults.Design, participants, settingCross-sectional analysis of nationally representative data from interview, physical measures, medication review and blood and urine samples, from 2011 to 2012 Australian Health Survey participants aged 45–74 (n=11 518).Outcome measuresCVD risk factors, absolute 5-year risk of a primary CVD event, blood pressure and cholesterol assessment in the previous 2 and 5 years and use of recommended CVD preventive medications were compared using Poisson regression to estimate age-adjusted male versus female prevalence ratios (PRs).ResultsWomen had a generally more favourable CVD risk factor profile than men, including lower: current smoking prevalence (women=14.5%; men=18.4%, PR=0.78, 95% CI=0.70 to 0.88); body mass index (women (mean)=28.3 kg/m2; men (mean)=28.8 kg/m2, p<0.01); systolic and diastolic blood pressure (systolic: women (mean)=127.1 mm Hg; men (mean)=130.5 mm Hg, p<0.001); blood glucose (women (mean)=5.2 mmol/L; men (mean)=5.5 mmol/L); diabetes prevalence (women=6.8%; men=12.5%, PR=0.55, 95% CI=0.44 to 0.67); prior CVD (women=7.9%; men=11.3%) and absolute primary CVD risk (absolute 5-year CVD risk >15%: women=6.6%, 95% CI=5.4 to 7.8; men=15.4%, 95% CI=13.9% to 16.9%). Compared with men, women had higher low-density lipoprotein, high-density lipoprotein and total cholesterol and sedentary behaviour and lower physical activity. Blood pressure and cholesterol assessment were common in both sexes. Among those at high absolute risk, age-adjusted proportions receiving recommended CVD medications were low, without sex differences (women=21.3%; men=23.8%, PR=0.93, 95% CI=0.49 to 1.78). Fewer women than men with prior atherosclerotic CVD were receiving recommended treatment (women=21.8%, men=41.4%, PR=0.55, 95% CI=0.31 to 0.96).ConclusionWomen have a more favourable CVD risk factor profile than men. Preventive treatment is uncommon and women with prior atherosclerotic CVD are around half as likely as men to be receiving recommended treatment.


2019 ◽  
Vol 11 (2) ◽  
pp. 138-146
Author(s):  
Leila Azadbakht ◽  
Fahime Akbari ◽  
Mostafa Qorbani ◽  
Mohammad Esmaeil Motlagh ◽  
Gelayol Ardalan ◽  
...  

Introduction: This cross-sectional study aimed to assess the association between cardiovascular disease (CVD) risk factors and dinner consumption in a nationally representative sample of Iranian adolescents. Methods: The present study was conducted on 5642 adolescents aged 10-18 years old in 27 provinces in Iran. The subjects were included applying by multistage random cluster sampling. Participants who ate ≥5 dinners during a week were considered as a dinner consumer. Results: Among 5642 subjects, 1412 (25%) did not consume dinner. Dinner consumers were less likely to be overweight or obese (P < 0.001) and abdominally obese (P < 0.001) as well as to have an abnormal level of HDL-C (P = 0.02). Dinner skipper youths had a higher risk for overweight or obesity (odds ratio [OR]: 1.62; 95% CI: 1.39-1.89) and abdominal obesity (OR: 1.59; 95% CI: 1.36-1.85) which remained significant after adjusting confounding factors (P <0001). No relationship was observed between dinner consumption and the rest of the CVD risk factors, neither in crude nor in adjusted models. A higher proportion of dinner-consumer adolescents had no CVD risk factors in comparison to dinner-skipper subjects (31.1% vs. 28%). Conclusion: Eating dinner might be inversely associated with some CVD risk factors among Iranian adolescents. Further prospective studies will need to prove this theory.



2019 ◽  
Vol 11 (1) ◽  
pp. 86-95
Author(s):  
Amna Umer ◽  
Candice Hamilton ◽  
Lesley Cottrell ◽  
Peter Giacobbi ◽  
Kim Innes ◽  
...  

AbstractThe reported associations between birth weight and childhood cardiovascular disease (CVD) risk factors have been inconsistent. In this study, we investigated the relationship between birth weight and CVD risk factors at 11 years of age. This study used longitudinally linked data from three cross-sectional datasets (N = 22,136) in West Virginia; analysis was restricted to children born full-term (N = 19,583). The outcome variables included resting blood pressure [systolic blood pressure (SBP), diastolic blood pressure (DBP)] and lipid profile [total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, non-HDL, and triglycerides (TG)]. Multiple regression analyses were performed, adjusting for child’s body mass index (BMI), sociodemographics, and lifestyle characteristics. Unadjusted analyses showed a statistically significant association between birth weight and SBP, DBP, HDL, and TG. When adjusted for the child’s BMI, the association between birth weight and HDL [b = 0.14 (95% CI: 0.11, 0.18) mg/dl per 1000 g increase] and between birth weight and TG [b = –0.007 (–0.008, –0.005) mg/dl per 1000 g increase] remained statistically significant. In the fully adjusted model, low birth weight was associated with higher LDL, non-HDL, and TGs, and lower HDL levels. The child’s current BMI at 11 years of age partially (for HDL, non-HDL, and TG) and fully mediated (for SBP and DBP) the relationship between birth weight and select CVD risk factors. While effects were modest, these risk factors may persist and amplify with age, leading to potentially unfavorable consequences in later adulthood.



Cholesterol ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Vincenzo Capuano ◽  
Norman Lamaida ◽  
Ernesto Capuano ◽  
Rocco Capuano ◽  
Eduardo Capuano ◽  
...  

The aim of this study was to determine the trends of cardiovascular risk factor prevalence between 1988/9 and 2008/9 in the 25–74-year-old population in an area of Southern Italy. We compared three cross-sectional studies conducted in random population samples, in 1988/9, 1998/9, and 2008/9 in Salerno, Italy. The methodology of data collection (lipid profile, systolic and diastolic blood pressure, glycaemia, and smoking) and conducting tests which the population underwent during the three phases was standardized and comparable. Prevalence of diabetes, hypertension, hypercholesterolemia, and smoking was calculated and standardized for age. A total of 3491 subjects were included. From 1988/9 to 2008/9, in males, the prevalence of all four risk factors was reduced. In women, there was a clear reduction of hypertension, a similar prevalence of hypercholesterolemia, and an increase of smoking and diabetes. In the area of Salerno, our data confirm that the global prevalence of the major risk factors is decreasing in men, but their absolute values are still far from optimization. In women, diabetes and smoking showed a negative trend, therefore requiring targeted interventions. These data are now used as a base for executive targeted programs to improve prevention of cardiovascular disease in our community.



2010 ◽  
Vol 109 (4) ◽  
pp. 1125-1132 ◽  
Author(s):  
Niels C. Møller ◽  
Anders Grøntved ◽  
Niels Wedderkopp ◽  
Mathias Ried-Larsen ◽  
Peter L. Kristensen ◽  
...  

Raised blood pressure (BP) response during exercise independently predicts future hypertension. Subjects with higher BP in childhood also have elevated BP later in life. Therefore, the factors related to the regulation of exercise BP in children needs to be well understood. We hypothesized that physiological cardiovascular disease (CVD) risk factors would influence BP response during exercise in children and adolescents. This is a cross-sectional study of 439 Danish third-grade children and 364 ninth-grade adolescents. Systolic blood pressure (SBP) was measured with sphygmomanometer during a maximal aerobic fitness test. Examined CVD risk factors were high-density lipoprotein (HDL)- and low-density lipoprotein (LDL)-cholesterol, triglyceride, homeostasis model of assessment of insulin resistance (HOMA-IR) score, body mass index (BMI), waist circumference, and aerobic fitness. A random effect model was used to test the hypotheses. In boys, HOMA-IR score and BMI were positively related to SBP response during exercise (β = 1.03, P = 0.001, and β = 0.58, P = 0.017, respectively). The effects sizes of HOMA-IR score and BMI and the significance levels only changed slightly (β = 0.91, P = 0.004, and β = 0.43, P = 0.08, respectively) when the two variables were added in the same model. A significant positive association was observed between aerobic fitness and SBP response in girls (β = 3.13 and P = 0.002). HOMA-IR score and BMI were found to be positively related to the SBP response in male children and youth. At least partly, adiposity and insulin sensitivity seem to influence exercise SBP through different mechanisms. The positive relationship observed between aerobic fitness and SBP response in girls remains unexplainable for us, although post hoc analyses revealed that it was the case in the ninth graders only.



2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Brandon Stuwart Shaw ◽  
Stacey Turner ◽  
Ina Shaw

Background: Cardiovascular disease (CVD) exemplifies a major medical problem as it is the most considerable cause of morbidity and mortality. While sport conditioning specialists understand and differentiate the different benefits of resistance training (RT) subtypes on athletic performance, this distinction is less clear for health professionals when designing CVD risk reduction programs. Objectives: This study attempted to investigate and compare the effects of hypertrophy and muscular endurance RT on CVD risk in sedentary males. Methods: Sedentary male smokers were randomly assigned to either an eight-week hypertrophy RT group (HTG) (n = 15), muscular endurance RT groups (METG) (n = 15), or a non-exercising control group (CON) (n = 15) to assess their impact on smoking, blood pressure, cholesterol, and cardiorespiratory fitness (VO2max) variables associated with the four most prominent CVD risk factors. Data were analyzed using SPSS-25 software using a paired sample t-test and ANOVA. Results: Significant (P ≤ 0.05) improvements were found in three of the 15 measured variables in the HTG (resting mean arterial pressure (RMAP) (P = 0.024); total cholesterol (TC): HDL-C ratio (P = 0.009), and HDL-C: low-density lipoprotein cholesterol (LDL-C) ratio (P = 0.038), with a deleterious decrease in high-density lipoprotein cholesterol (HDL-C) (P = 0.027). In turn, significant improvements were found in the METG in 10 of the 15 measured variables, namely; cigarettes smoked per day (P = 0.037), resting systolic blood pressure (RSBP) (P = 0.002), resting diastolic blood pressure (RDBP) (P = 0.006), RMAP (P = 0.000), TC (P = 0.010), triglycerides (TG) (P = 0.010), LDL-C (P = 0.007), HDL-C: LDL-C (P = 0.018), non-HDL-C (n-HDL-C) (P = 0.010), and VO2max (P = 0.001), and a deleterious decrease in HDL-C (P = 0.026). Conclusions: While the oversimplification of RT design for CVD reduction has resulted in cardio-centric CVD training programs, this study demonstrates that some subtypes of RT (i.e. muscular endurance training) may prove more useful than others in reducing multiple CVD risk factors simultaneously.



Author(s):  
Danladi I. Musa ◽  
Abel L. Toriola ◽  
Daniel T. Goon ◽  
Sunday U. Jonathan

Purpose: This study examinedthe independent and joint association of fitness and fatness with clustered cardiovascular disease risk (CVDrs) in 11–18 year-old Nigerian adolescents. Methods: A hundred and ninety seven adolescents (100 girls and 97 boys) were evaluated forfitness, fatness and CVDrs. Fitness was evaluated with the progressive aerobic cardiovascular endurance run test while fatness was assessed using body mass index. A clustered CVDrs was computed from the standardized residuals of total cholesterol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol, triglycerides, plasma glucose, systolic blood pressure, and diastolic blood pressure. Regression models controlling for waist circumference assessed the association of fitness and fatness with CVDrs. Results: Prevalence of clustered CVD risk was 7.1% (girls = 3.0%; boys = 4.1%). Based on risk factor abnormalities, 52.8% of participants had one or more CVD risk factor abnormalities with more boys (27.4%) affected. Low fitness was associated with clustered CVDrs in both girls (R2 = 9.8%, β = −0.287, p = 0.05) and boys (R2 = 17%, β = −0.406, p < 0.0005). Fatness was not associated with the CVDrs in both sexes. After controlling for all the variables in the model, only fitness (R2 = 10.4%) and abdominal fat (R2 = 19.5%) were associated with CVDrs respectively. Unfit girls were 3.2 (95% CI = 1.31–7.91, p = 0.011) times likely to develop CVD risk abnormality compared to their fit counterparts. The likelihood of unfit boys developing CVD risk abnormality was 3.9 (95% CI = 1.15–10.08, p = 0.005) times compared to their fit peers. Conclusions: Fitness but not fatness was a better predictor of CVDrs in Nigerian boys and girls. The result of this study suggests that any public health strategies aimed at preventing or reversing the increasing trends of CVD risk in adolescents should emphasize promotion of aerobic fitness.



Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Amna Umer ◽  
Candice Hamilton ◽  
Cris Britton ◽  
Lesley Cottrell ◽  
Peter Giacobbi ◽  
...  

Introduction: Reported associations between birth weight (BTW) and childhood cardiovascular disease (CVD) risk factors have been inconsistent. The relationship between infants’ BTW and later maternal CVD is also a more recent and active area of research. We aimed to examine the association between BTW and subsequent childhood and maternal CVD risk factors 11 years post-partum. Methods: The study used longitudinally linked data from three cross-sectional datasets in West Virginia (N=19,583). The outcome variables included blood pressure for children and lipid levels for both mothers and children. The exposure was BTW of the infants born full-term. The role of the child’s current body mass index (BMI) was assessed as a potential mediator. Results: Unadjusted analyses showed a positive association between BTW and the child’s systolic blood pressure (SBP), diastolic blood pressure (DBP), high-density lipoprotein cholesterol (HDL), and a negative association with triglycerides (TGs). When adjusted for the child’s BMI, the association became non-significant for SBP and DBP but remained significant for HDL [β= 0.14 mg/dL (95% CI: 0.11, 0.18) per1000g increase in BTW] and TGs [β= -0.007 mg/dL (-0.008, -0.005) per 1000g increase in BTW]. Low-density lipoprotein cholesterol (LDL) and non-HDL became significant and negatively associated with BTW in the adjusted analysis [LDL (β = -0.1 mg/dL (-0.19, - 0.16) per 1000 g increase in BTW; non-HDL (b = - 0.18 mg/dL (-0.28, -0.09) per 1000 g increase in BTW]. There was a positive association between infant’s birth weight and maternal total cholesterol (TC) levels, which became non-significant in the adjusted analysis [β = 0.4 (95% CI: -0.01, 0.90) mg/dL per1000g increase in birth weight]. None of the other maternal lipids levels (LDL, HDL, and TG) were significant in the unadjusted or the adjusted analysis. Conclusion: Low BTW was associated with higher LDL, non-HDL, and TGs, and lower HDL levels in fifth grade children independent of the current weight status. As childhood CVD risk factors persist and are often amplified over time, these small effect sizes can have potential unfavorable consequences on lipid levels in later adulthood.



BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e019664 ◽  
Author(s):  
Udeme E Ekrikpo ◽  
Effiong E Akpan ◽  
John U Ekott ◽  
Aminu K Bello ◽  
Ikechi G Okpechi ◽  
...  

ObjectivesHIV infection environment presents a classic example of the interplay between infectious diseases and non-communicable diseases (NCDs). Traditional cardiovascular disease (CVD) risk factors abound in the HIV population even before initiation of antiretrovirals (ARVs) and predispose them to the development of stroke and myocardial infarction. This work focuses on determining the prevalence of traditional CVD risk factors among ARV-naive HIV individuals in southern Nigeria.MethodsThis was a cross-sectional study of ARV-naive patients initiating care at the University of Uyo Teaching Hospital HIV clinic cohort to determine the prevalence and correlates of hypertension, diabetes mellitus (DM), obesity and dyslipidaemia.ResultsThe sample consisted of 4925 assessed for hypertension, 5223 for obesity, 1818 for DM and 926 for dyslipidaemia. Hypertension prevalence was 26.7% (95% CI 25.5% to 28.0%) with a male preponderance (p=0.02). DM was found in 5.6% (95% CI 4.5% to 6.7%), obesity in 8.3% (95% CI 7.6% to 9.1%) and dyslipidaemia in 29.1% (95% CI 26.1% to 32.1%) with a high prevalence of low high-density lipoprotein-c (42.6%). Hypertension was independently associated with age (OR 1.04 (95% CI 1.03 to 1.05), p<0.001) and body mass index (BMI) (OR 1.06 (95% CI 1.03 to 1.08), p<0.001), obesity with age (OR 1.02 (95% CI 1.01 to 1.03), p<0.001), male gender (OR 0.38 (95% CI 0.29 to 0.49), p<0.001) and CD4 count (OR 2.63 (95% CI 1.96 to 3.53), p<0.001) while dyslipidaemia was associated with BMI (OR 1.05 (95% CI 1.01 to 1.10), p=0.03).ConclusionThe prevalence of traditional CVD risk factors is high in this ART-naive HIV population. An integrated approach of HIV and NCD screening/treatment may be relevant for centres in sub-Saharan Africa.



2015 ◽  
Vol 18 (2) ◽  
pp. 151-157 ◽  
Author(s):  
Yun-Mi Song ◽  
Kayoung Lee ◽  
Joohon Sung

We aimed to assess the non-genetic contribution to the associations between the change in weight and changes in cardiovascular disease (CVD) risk factors. This analysis included 194 Korean monozygotic (MZ) twin pairs (116 men, 272 women; mean age, 38.5 ± 6.8 years) who were first examined for weight and CVD risk factors (blood pressure (BP), glucose, total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL), and low-density lipoprotein cholesterol (LDL)) between December 2005 and December 2008, and returned for a repeat examination after 2.7 ± 0.9 years. The within-pair correlations were 0.21 for the change in weight and 0.05-0.42 for the changes in CVD risk factors. Bivariate analyses showed significant environmental correlations shared between the change in weight and the changes in CVD risk factors (p < .05), except for glucose, while there were no significant genetic effects shared between the phenotypes. After adjusting for baseline values of weight, smoking, and alcohol consumption, diastolic blood pressure (DBP), TG, TC, and LDL significantly increased by 1.6 mmHg, 0.09 mmol/L, 0.10 mmol/L, and 0.09 mmol/L, respectively, per 1 kg increase in within-pair differences in weight change. In Korean MZ twins, similarity between twins for changes in weight and CVD risk factors were small to moderate, and non-genetic factors were responsible for the associations between the change in weight and changes in DBP, TG, TC, and LDL.



PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0247105
Author(s):  
Dieu-My T. Tran ◽  
Nirmala Lekhak ◽  
Karen Gutierrez ◽  
Sheniz Moonie

ObjectiveCardiovascular disease (CVD) remains the number one cause of death in the US and Nevada is ranked 11th highest for CVD mortality. The study sought to examine the association between self-reported risk factors and CVD presence among adult Nevadans, between years 2011 and 2017.MethodsThis is a cross-sectional, population-based study that utilized the 2011 and 2017 Nevada Behavioral Risk Factor Surveillance System data. Data were analyzed between 2019 and 2020.ResultsA total of 5,493 and 3,764 subjects in 2011 and 2017, respectively were included. BMI (overweight/obesity) remained the most prevalent CVD risk factor. The second most common CVD risk factor was high cholesterol, followed by hypertension. Compared to females, males were 1.64 times more likely to have reported CVD in 2011, which increased to 1.92 in 2017. Compared to non-smokers, everyday smokers were 1.96 times more likely in 2011 and 3.62 times more likely in 2017. Individuals with high cholesterol status were 2.67 times more likely to have reported CVD compared to those with normal levels in 2011. In 2011, individuals with hypertension were 3.74 times more likely to have reported CVD compared to those who did not have hypertension. This relationship increased its magnitude of risk to 6.18 times more likely in 2017. In 2011, individuals with diabetes were 2.90 times more likely to have reported CVD compared to those without the condition.ConclusionsPublic health and healthcare providers need to target preventable cardiovascular risk factors and develop recommendations and strategies locally, nationally, and globally.



Sign in / Sign up

Export Citation Format

Share Document