scholarly journals Are interventions to improve cardiovascular disease risk factors in premenopausal women effective? A systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e042103
Author(s):  
Lan Gao ◽  
Jan Faller ◽  
Ishani Majmudar ◽  
Phuong Nguyen ◽  
Marj Moodie
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Primary Prevention ◽  
Lifestyle Modification ◽  
Meta Analysis ◽  
Fasting Blood Glucose ◽  
Premenopausal Women ◽  
Prevention Interventions ◽  
Modification Intervention

ObjectivesNon-traditional risk factors place young women at increased risk of cardiovascular disease (CVD) over their lifetime. The current study undertakes a systematic review and meta-analysis of randomised controlled trials (RCTs) that examined the effectiveness of primary prevention interventions for CVD in premenopausal women.MethodsAn electronic literature search was performed in key databases in July 2018 and updated in May 2020. RCTs that recruited predominately female participants with a proportion aged under 55 years and that compared primary prevention interventions of CVD with usual practice were included. Two reviewers undertook the selection process for study inclusion. Meta-analysis was conducted for studies based on the same intervention in order to synthesise the results.Results14 RCTs with sample size ranging from 49 to 39 876 were included. Interventions included diet (2), vitamin E/antioxidants (3), lifestyle modification programme (7) and aspirin (2). The meta-analysis results indicated that diet nor vitamin E/antioxidant did not significantly lower the CVD risk profiles, while lifestyle modification programme involving components of lifestyle education, counselling and multiple follow-ups showed great potential to improve risk profiles. The lifestyle modification intervention improved blood pressure (−2.11 mm Hg, 95% CI −4.32 to 0.11, for systolic and −3.31 mm Hg (95% CI −4.72 to −1.91, for diastolic), physical activity (30.72 MET-min/week, 95% CI 23.57 to 37.87, for moderate physical activity 12.70 MET-min/week, 95% CI 8.27 to 17.14, for vigorous physical activity) and fasting blood glucose (−0.37 mmol/L, 95% CI −0.58 to −0.15). Subgroup meta-analysis in studies with a mean age under 51 years old suggested that lifestyle modification intervention remained to be effective in improving physical activity and fasting blood glucose.ConclusionThe effective interventions identified in this review although with a small sample size and short duration could potentially inform future design of primary prevention of CVD in premenopausal women.

The burden of cardiovascular disease risk factors in the Middle East: A systematic review and meta-analysis focusing on primary prevention

2020 ◽  
Vol 18 ◽  
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Abdullah Shehab ◽  
Anhar Ullah ◽  
Jamal Rahmani
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Family History ◽  
Primary Prevention ◽  
Middle East ◽  
Disease Risk ◽  
Meta Analysis ◽  
Middle Eastern ◽  
History Of

Background: The increasing incidence of cardiovascular disease (CVD) threatens the Middle Eastern population. Several epidemiological studies have assessed CVD and its risk factors in terms of the primary prevention of CVD in the Middle East. Therefore, summarizing the information from these studies is essential. Aim: We conducted a systematic review to assess the prevalence of CVD and its major risk factors among Middle Eastern adults based on the literature published between January 1, 2012 and December 31, 2018 and carried out a meta-analysis. Methods: We searched electronic databases such as PubMed/Medline, ScienceDirect, Embase and Google Scholar to identify literature published from January 1, 2012 to December 31, 2018. All the original articles that investigated the prevalence of CVD and reported at least one of the following factors were included: hypertension, diabetes, dyslipidaemia, smoking and family history of CVD. To summarize CVD prevalence, we performed a random-effects meta-analysis. Results: A total of 41 potentially relevant articles were included, and 32 were included in the meta-analysis (n=191,979). The overall prevalence of CVD was 10.1% (95% confidence interval (CI): 7.1-14.3%, p<0.001) in the Middle East. A high prevalence of CVD risk factors, such as dyslipidaemia (43.3%; 95% CI: 21.5-68%), hypertension (26.2%; 95% CI: 19.6-34%) and diabetes (16%; 95% CI: 9.9-24.8%), was observed. The prevalence rates of other risk factors, such as smoking (12.4%; 95% CI: 7.7-19.4%) and family history of CVD (18.7%; 95% CI: 15.4-22.5%), were also high. Conclusion: The prevalence of CVD is high (10.1%) in the Middle East. The burden of dyslipidaemia (43.3%) in this region is twice as high as that of hypertension (26.2%) and diabetes mellitus (16%). Multifaceted interventions are urgently needed for the primary prevention of CVD in this region.

scholarly journals Effects on exercise and fitness outcomes of workplace physical activity interventions targeting older employees: A systematic review and meta-analysis

2019 ◽  
Author(s):  
Dafna Merom ◽  
Fiona Stanaway ◽  
Joanna J Sweeting ◽  
Anne Tiedemann ◽  
Shirin J Mumu ◽  
...  
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Injury Risk ◽  
Disease Risk ◽  
Meta Analysis ◽  
Cardiovascular Disease Risk ◽  
Active Ageing ◽  
Intervention Component ◽  
Older Employees

Abstract Background: “Active Ageing” policy to delay retirement mean that maintaining the health and fitness of older employees has become increasingly important. This systematic review summarises the characteristics and effect on exercise and fitness outcomes of workplace physical activity (PA) interventions targeting older employees. Methods: Five online databases were searched from inception to December 2018. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes. Results: Titles and abstracts of 7470 records were screened and 16 unique interventions were included (3,215 participants). Eleven studies were RCTs. Six interventions targeted multiple risk factors (n=1,586) involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1,127), and six intervention (n=195) focused only on PA. Seven interventions were short –term (<15 weeks), six interventions lasted 6-9 months and three interventions were long-term (10-12 months). Interventions overwhelmingly targeted aerobic PA compared to strength, balance and flexibility. No studies involved screening for falls/injury risk. Computation of effect sizes (ES) was only possible in a maximum of three RCTs per outcome. ESs were statistically non-significant for all outcomes. ESs were medium for PA behaviour (ES=0.25 95% CI: -0.07 to 0.56), muscle strength (ES=0.27, 95%CI: -0.26- 0.80), cardiorespiratory fitness (ES=0.28, 95%CI: -22 to 0.78) and flexibility (ES=0.50, 95% CI: -0.04- 1.05) and large for balance (ES=1.29, 95% CI: -0.56- 3.15). GRADE criteria-rated quality of evidence were ‘low’ due to high risk of bias, imprecision and inconsistency. Conclusions: The effect of workplace interventions for improving fitness outcomes of older employees is uncertain. There is a need for high-quality PA interventions that takes into account the broader PA recommendations for older adults. Such interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.

Cycling is associated with a lower incidence of cardiovascular diseases and death: Part 1 – systematic review of cohort studies with meta-analysis

2019 ◽  
Vol 53 (14) ◽  
pp. 870-878 ◽  
Author(s):  
Solveig Nordengen ◽  
Lars Bo Andersen ◽  
Ane K Solbraa ◽  
Amund Riiser
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Dose Response ◽  
Meta Analysis ◽  
Effect Estimate ◽  
Cvd Risk ◽  
Eligibility Criteria ◽  
Relative Risks ◽  
Quantitative Studies

ObjectivesPhysical inactivity is a risk factor for cardiovascular disease (CVD). Cycling as a physical activity holds great potential to prevent CVD. We aimed to determine whether cycling reduces the risk of CVD and CVD risk factors and to investigate potential dose-response relationships.DesignSystematic review and meta-analysis of quantitative studies.Eligibility criteria for selecting studiesWe searched four databases (Web of Science, MEDLINE, SPORTDiscus and Scopus). All quantitative studies, published until August 2017, were included when a general population was investigated, cycling was assessed either in total or as a transportation mode, and CVD incidence, mortality or risk factors were reported. Studies were excluded when they reported continuous outcomes or when cycling and walking were combined in them. We pooled adjusted relative risks (RR) and OR. Heterogeneity was investigated using I.ResultsThe search yielded 5174 studies; 21 studies which included 1,069,034 individuals. We found a significantly lower association in combined CVD incidence, mortality and physiological risk factors with total effect estimate 0.78 (95% CI (CI): 0.74–0.82; P<0.001; I2=58%). Separate analyses for CVD incidence, mortality and risk factors showed estimates of RR 0.84 (CI, 0.80 to 0.88; P<0.001; I2=29%), RR 0.83 (CI, 0.76 to 0.90; P<0.001; I2=0%), and OR 0.75 (CI, 0.69 to 0.82; P<0.001; I2=66%), respectively. We found no dose-response relationship or sex-specific difference.ConclusionsAny form of cycling seems to be associated with lower CVD risk, and thus, we recommend cycling as a health-enhancing physical activity.Systematic review registrationProspero CRD42016052421.

scholarly journals A Comprehensive Systematic Review and Meta-analysis on the Risk Factors of Stroke in Iranian Population

2021 ◽  
Vol 24 (1) ◽  
pp. 64-77
Author(s):  
Reza Tabrizi ◽  
Kamran B Lankarani ◽  
Bahareh Kardeh ◽  
Hamed Akbari ◽  
Mahmoud Reza Azarpazhooh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Meta Analysis ◽  
Scientific Information ◽  
Fasting Blood Glucose ◽  
Random Effect ◽  
Density Lipoprotein ◽  
Iranian Population ◽  
Lipoprotein Cholesterol ◽  
Increased Risk

Background: There are limited data on vascular risk factors (VRFs) in low- and middle-income countries (LMICs). This meta-analysis was completed to summarize the existing evidence on stroke risk factors (SRFs) in the Iranian population. Methods: An electronic literature search of the databases including PubMed, Embase, Web of Science, Scopus, Scientific Information Database (SID), Magiran, and IranMedex was performed to identify the related articles published up to March 2018. For categorical or continuous variables, the data were also pooled using the fixed- or the random-effect models, respectively, expressed as odds ratio (OR) or weighted mean difference (WMD). Results: A total of 15 articles were recruited. The risk of stroke was associated with mean age, but not gender. Among traditional VRFs, hypertension (HTN), systolic and diastolic blood pressure (DBP), diabetes mellitus (DM), and fasting blood glucose (FBG) were associated with increased risk of stroke. Apart from the high circulating levels of triglycerides (TG), low-density lipoprotein-cholesterol (LDL-C), total cholesterol (TC), and low high-density lipoprotein-cholesterol (HDL-C), other potential risk factors namely cigarette smoking (CS), opioid addiction (OD), and waist circumference (WC) were identified to be independent stroke determinants. Conclusion: The present systematic review and meta-analysis provided a summary of the most important SRFs, which are potentially modifiable and preventable. Overall, Iran, similar to many other LMICs, is experiencing an ever-increasing rate of stroke-prone elderly people. The LMICs are thus suggested to develop national approaches to recognize and address VRFs, to monitor and control CS and OD rates, and to encourage a healthy lifestyle.

Effect of mediterranean diets on cardiovascular risk factors and diseases in the primary prevention setting: a systematic review and meta-analysis of randomized controlled trials

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A.V Hernandez ◽  
A Piscoya ◽  
K.M Marti ◽  
K.E Marti ◽  
V Pasupuleti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Primary Prevention ◽  
Randomized Controlled Trials ◽  
Clinical Outcomes ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Obese Patients ◽  
Randomized Controlled ◽  
Subgroup Analyses

Abstract Background The effects of Mediterranean diets (MED) on various health parameters suggest potential cardiovascular (CV) health benefits. Purpose We evaluated the effects of MED for primary prevention of CV risk factors and disease in overweight or obese adults. Methods A systematic review and meta-analysis of randomized controlled trials (RCTs) was performed using PRISMA guidelines. PubMed, EMBASE, Web of Science, Scopus, Cochrane Library, clinicaltrials.gov, and clinicaltrialsregister.eu were searched until January 2020. RCTs evaluating any type of MED compared to other diets or advice in adults were included. Predefined CV risk factors were lipid, liver, glucose, anthropometric, and blood pressure outcomes. Clinical outcomes were all cause mortality, CV mortality, myocardial infarction (MI), coronary artery disease, stroke, cerebrovascular disease, and diabetes. Meta-analyses of random effects models were performed and effects were described as mean difference (MD) and their 95% confidence intervals (CI). Subgroup analyses by weight, type of MED, type of control, and trial duration were performed when heterogeneity was high (I2&gt;60%). Results Eighteen RCTs (n=915) were included. Two RCTs evaluated only obese patients, 13 evaluated overweight and obese patients, and three did not specify. Fifteen RCTs evaluated MED alone while three evaluated MED combined with another diet. Thirteen RCTs evaluated effects of another diet while five evaluated diet advice or no treatment as controls. The median time to follow up was 6 months (range 6 weeks to 24 months). Clinical outcomes were only described in the revised 2018 PREDIMED trial where MED were associated with 35% lower risk of MI, stroke, and CV death vs advice (HR 0.65, 95% CI 0.50 to 0.85). MED were significantly associated with lower levels of triglycerides (TG) (MD −12.70 mg/dL, 95% CI −18.58 to −6.82), waist circumference (WC) (MD −1.92 cm, 95% CI −3.59 to −0.24), weight (MD −1.75 kg, 95% CI −2.82 to −0.69), and body mass index (BMI) (MD −0.69 kg/m2, 95% CI −1.11 to −0.27), and higher levels of HDL (MD 2.03 mg/dL, 95% CI 1.13 to 2.92) compared to other diets or advice. MED did not significantly change any other CV risk factors. Subgroup analyses showed some differences vs main analyses, but were based on a small set of RCTs in most of cases. Excluding five high risk of bias RCTs showed significant reductions in total cholesterol (MD −6.57 mg/dL, 95% CI −12.22 to −0.93), Fatty Liver Index (MD −23.30, 95% CI −30.20 to −16.40), HOMA-IR (MD −0.53, 95% CI −1.02 to −0.05), and SBP (MD −2.35 mmHg, 95% CI −4.02 to −0.68). Conclusion MED significantly decreased TG and anthropometric outcomes, and increased HDL when compared to other diets or advice. There was no significant association between MED and the other predefined CV risk factors. Newer RCTs without the flaws of PREDIMED are needed to further evaluate clinical outcomes. Funding Acknowledgement Type of funding source: None

scholarly journals Cardiovascular Health of Retired Field-Based Athletes: A Systematic Review and Meta-analysis

2019 ◽  
Vol 7 (8) ◽  
pp. 232596711986275 ◽  
Author(s):  
Cliodhna McHugh ◽  
Karen Hind ◽  
Daniel Davey ◽  
Fiona Wilson
Keyword(s):  
Physical Activity ◽  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Health ◽  
Meta Analysis ◽  
Density Lipoprotein ◽  
American Football ◽  
Control Groups ◽  
Cvd Risk ◽  
Carotid Artery Plaque

Background: Retirement from elite sport participation is associated with decreased physical activity, depression, obesity, and ischemic heart disease. Although engagement in physical activity through sport is recognized as cardioprotective, an estimated one-quarter of deaths in American football players are associated with cardiovascular disease (CVD), predominately in players classified as obese. Purpose: To systematically investigate the cardiovascular health profile of retired field-based athletes. Study Design: Systematic review; Level of evidence, 4. Methods: This review was conducted and reported in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and preregistered with PROSPERO. Four databases (PubMed, CINAHL, Embase, and Web of Science) were systematically searched from inception to October 2018 using MeSH terms and keywords. Inclusion criteria were retired field-based athletes, age >18 years, and at least 1 CVD risk factor according to the European Society of Cardiology and the American Heart Association. Review articles were not included. Control groups were not required for inclusion, but when available, an analysis was included. Eligible articles were extracted using Covidence. Methodological quality was assessed independently by 2 reviewers using the AXIS tool. The accuracy of individual study estimates was analyzed using a random-effects meta-analysis. Results: This review yielded 13 studies. A total of 4350 male retired field-based athletes from 2 sports (football and soccer; age range, 42.2-66 years) were included. Eight studies compared retired athletes with control groups. Retired athletes had elevated systolic blood pressure in 4 of 6 studies; approximately 50% of studies found greater high-density lipoprotein, approximately 80% found lower triglyceride levels, and all studies found greater low-density lipoprotein for retired athletes compared with controls. The prevalence and severity of coronary artery calcium and carotid artery plaque were similar to controls. Retired linemen had double the prevalence of cardiometabolic syndrome compared with nonlinemen. Conclusion: The overall findings were mixed. Inconsistencies in the reporting of CVD risk factors and methodological biases reduced the study quality. Retired athletes had a comparable CVD risk profile with the general population. Retired athletes with an elevated body mass index had an increased prevalence and severity of risk factors. Significant gaps remain in understanding the long-term cardiovascular effects of elite athleticism.

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