scholarly journals Protocol for the WARM Hearts study: examining cardiovascular disease risk in middle-aged and older women - a prospective, observational cohort study

BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e044227
Author(s):  
Alexandra V Rose ◽  
Kevin F Boreskie ◽  
Jacqueline L Hay ◽  
Liam Thompson ◽  
Rakesh C Arora ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Cohort Study ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Observational Cohort Study ◽  
Moderate Intensity ◽  
Cvd Risk ◽  
Non Invasive ◽  
Observational Cohort

IntroductionCardiovascular disease (CVD) is a leading cause of death in women. Novel approaches to detect early signs of elevated CVD risk in women are needed. Enhancement of traditional CVD risk assessment approaches through the addition of procedures to assess physical function or frailty as well as novel biomarkers of cardiovascular, gut and muscle health could improve early identification. The Women’s Advanced Risk-assessment in Manitoba (WARM) Hearts study will examine the use of novel non-invasive assessments and biomarkers to identify women who are at elevated risk for adverse cardiovascular events.Methods and analysisOne thousand women 55 years of age or older will be recruited and screened by the WARM Hearts observational, cohort study. The two screening appointments will include assessments of medical history, gender variables, body composition, cognition, frailty status, functional fitness, physical activity levels, nutritional status, quality of life questionnaires, sleep behaviour, resting blood pressure (BP), BP response to moderate-intensity exercise, a non-invasive measure of arterial stiffness and heart rate variability. Blood sample analysis will be used to assess lipid and novel biomarker profiles and stool samples will support the characterisation of gut microbiota. The incidence of the adverse cardiovascular outcomes will be assessed 5 years after screening to compare WARM Hearts approaches to the Framingham Risk Score, the current clinical standard of assessing CVD risk in Canada.Ethics and disseminationThe University of Manitoba Health Research Ethics Board (7 October 2019) and the St Boniface Hospital Research Review Committee (7 October 2019) approved the trial (Ethics Number HS22576 (H2019:063)). Recruitment started 10 October 2020. Data gathered from the WARM Hearts study will be published in peer-reviewed journals and presented at national and international conferences. Knowledge translation strategies will be created to share our findings with stakeholders who are positioned to implement evidence-informed CVD risk assessment programming.Trial registration numberNCT03938155.

scholarly journals Cardiovascular risk assessment: Audit findings from a nurse clinic – a quality improvement initiative

2009 ◽  
Vol 1 (3) ◽  
pp. 226
Author(s):  
Sarah Waldron ◽  
Margaret Horsburgh
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Community Support ◽  
Lipid Lowering ◽  
Quality Improvement Initiative ◽  
Cvd Risk ◽  
Retrospective Audit ◽  
Prescribing Trends

BACKGROUND AND CONTEXT: Evidence has shown the effectiveness of risk factor management in reducing mortality and morbidity from cardiovascular disease (CVD). An audit of a nurse CVD risk assessment programme undertaken between November 2005 and December 2008 in a Northland general practice. METHOD : A retrospective audit of CVD risk assessment with data for the first entry of 621 patients collected exclusively from PREDICT-CVDTM, along with subsequent data collected from 320 of these patients who had a subsequent assessment recorded at an interval ranging from six months to three years (18 month average). RESULTS: Of the eligible population (71%) with an initial CVD risk assessment, 430 (69.2%) had a five year absolute risk less than 15%, with 84 (13.5%) having a risk greater than 15% and having not had a cardiovascular event. Of the patients with a follow-up CVD risk assessment, 34 showed improvement. Medication prescribing for patients with absolute CVD risk greater than 15% increased from 71% to 86% for anti-platelet medication and for lipid lowering medication from 65% to 72% in the audit period. STRATEGIES FOR IMPROVEMENT: The recently available ‘heart health’ trajectory tool will help patients become more aware of risks that are modifiable, together with community support to engage more patients in the nurse CVD prevention programme. Further medication audits to monitor prescribing trends. LESSONS: Patients who showed an improvement in CVD risk had an improvement in one or more modifiable risk factors and became actively involved in making changes to their health. KEYWORDS: Cardiovascular disease risk assessment; nurse clinics; audit

scholarly journals Cohort study on the effects of depression on atherosclerotic cardiovascular disease risk in Korea

BMJ Open ◽  
2019 ◽  
Vol 9 (6) ◽  
pp. e026913 ◽  
Author(s):  
Yon Ho Jee ◽  
Hyoungyoon Chang ◽  
Keum Ji Jung ◽  
Sun Ha Jee
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Population Based ◽  
Western World ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
National Health Insurance System ◽  
Increased Risk

ObjectivesDepression has been reported to be a risk factor of cardiovascular disease in the western world, but the association has not yet been studied among Asian populations. The aim of this study was to investigate whether depression increases the risk of developing atherosclerotic cardiovascular disease (ASCVD) in a large Korean cohort study.DesignPopulation based cohort study.SettingDatabase of National Health Insurance System, Republic of Korea.Participants481 355 Koreans (260 695 men and 220 660 women) aged 40–80 years who had a biennial health check-up between 2002 and 2005.Main outcome measureThe main outcome in this study was the first ASCVD event (hospital admission or death).ResultsDepression increased the risk of developing ASCVD by 41% for men and 48% for women. In men, 3–4 outpatient visits for depression increased the risk of angina pectoris by 2.12 times (95% CI 1.55 to 2.90) and acute myocardial infarction by 2.29 times (95% CI 1.33 to 3.95). Depression was also associated with stroke in men (HR 1.29, 95% CI 1.19 to 1.39) and in women (HR 1.37, 95% CI 1.29 to 1.46). However, no increased risk of ASCVD was found for men who received 10 or more depressive treatments, compared with those without any outpatient visit for depression.ConclusionsIn this cohort, depressed people were at increased risk of ASCVD incidence. Therefore, individuals with depression may need routine monitoring of heart health that may prevent their future CVD risk.

scholarly journals Cardiovascular disease risk assessment in diabetes and metabolic syndrome patients with and without non-alcoholic fatty liver disease

2015 ◽  
Vol 2 (4) ◽  
pp. 91 ◽  
Author(s):  
Mohammed Alim ◽  
Rakesh K. Sahay ◽  
Nuwairah Hafiz ◽  
B. Prabhakar ◽  
Mohammed Ibrahim
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Metabolic Syndrome ◽  
Fatty Liver ◽  
Risk Score ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Alcoholic Fatty Liver ◽  
Alcoholic Fatty Liver Disease

<p class="abstract"><strong><span lang="EN-US">Background:</span></strong><span lang="EN-US"> Recently non-alcoholic fatty liver disease (NAFLD) has been suggested as independent cardiovascular (CVD) risk factor and many studies have shown strong links between NAFLD and CVD but NAFLD has not been related to cardiovascular mortality independently on a long term follow up. Inflammation and oxidative stress is well recognized factors for NALFD which lead to many interrelated factors contributing to cardiovascular risk. Aim: To study the cardiovascular disease risk in diabetes and metabolic syndrome patients with and without NAFLD using different risk assessment calculators.</span></p><p class="abstract"><strong><span lang="EN-US">Methods: </span></strong>This was a single center, prospective cross sectional study. 62 patients with diabetes and metabolic syndrome attending the endocrinology &amp; gastroenterology clinics of Osmania General Hospital were enrolled in to the study with 31 patients in group A (NAFLD) and 31 patients in group B (Non-NAFLD). Patients were diagnosed with fatty liver by ultrasound examination.  </p><p class="abstract"><strong><span lang="EN-US">Results: </span></strong>The groups were individually evaluated for cardiovascular risk assessment by PROCAM risk score, atherosclerotic cardiovascular disease (ASCVD) score and atherosclerosis Index. The means ± standard(%) deviation of Procam risk score for NAFLD group was 6.00 ± 1.00 and for Non NAFLD group it was 10.00 ± 2.00 (p=0.039). ASCVD risk score shows 5.11 ± 1.12 for NAFLD and Non NAFLD group showed 8.25 ± 2.18 (p=0.235). The Atherosclerosis index for NAFLD group was 0.24 ± 0.03 and Non NAFLD 0.18 ± 0.04 (p=0.785). The QRsik2 score for NAFLD and Non-NAFLD patients was 13.16 ± 7.56 and 17.45 ± 10.36.</p><p class="abstract"><strong><span lang="EN-US">Conclusions: </span></strong>There was no difference in CVD risk assessment when assessed with different calculators in this population.</p>

scholarly journals Cross-sectional survey describing general practitioners’ absolute cardiovascular disease risk assessment practices and their relationship to knowledge, attitudes and beliefs about cardiovascular disease risk in Queensland, Australia

BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e033859
Author(s):  
Kim Greaves ◽  
Anita Smith ◽  
Jason Agostino ◽  
Kuhan Kunarajah ◽  
Tony Stanton ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Assessment ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Assessment Practices ◽  
Attitudes And Beliefs ◽  
Sufficient Time ◽  
Cross Sectional Survey ◽  
Cvd Risk ◽  
Cross Sectional

ObjectivesTo describe general practitioners’ (GPs’) absolute cardiovascular disease risk (ACVDR) self-reported assessment practices and their relationship to knowledge, attitudes and beliefs about ACVDR.DesignCross-sectional survey with opportunistic sampling (October–December 2017).SettingSunshine Coast region, Queensland, Australia.Participants111 GPs responded to the survey.Primary and secondary outcome measuresProportion of GPs reporting a high (≥80%) versus moderate (60%–79%)/low (<60%) percentage of eligible patients receiving ACVDR assessment; proportion agreeing with statements pertaining to knowledge, attitudes and beliefs about ACVDR and associations between these factors.ResultsOf the 111 respondents, 78% reported using the Australian ACVDR calculator; 45% reported high, 25% moderate and 30% low ACVDR assessment rates; >85% reported knowing how to use ACVDR assessment tools, believed assessment valuable and were comfortable with providing guideline-recommended treatment. Around half believed patients understood the concept of high risk and were willing to adopt recommendations. High assessment rates (vs moderate/low) were less likely among older GPs (≥45 vs ≤34 years, age-adjusted and sex-adjusted OR (aOR) 0.36, 95% CI 0.12 to 0.97). Those who answered knowledge-based questions about the guidelines incorrectly had lower assessment rates, including those who answered questions on patient eligibility (aOR 0.13, 95% CI 0.02 to 1.11). A high assessment rate was more likely among GPs who believed there was sufficient time to do the assessment (aOR 3.79, 95% CI 1.23 to 11.61) and that their patients were willing to undertake lifestyle modification (aOR 2.29, 95% CI 1.02 to 5.15). Over 75% of GPs agreed better patient education, nurse-led assessment and computer-reminder prompts would enable higher assessment rates.ConclusionsAlthough the majority of GPs report using the ACVDR calculator when undertaking a CVD risk assessment, there is a need to increase the actual proportion of eligible patients undergoing ACVDR assessment. This may be achieved by improving GP assessment practices such as GP and patient knowledge of CVD risk, providing sufficient time and nurse-led assessment.

Abstract 17098: Evaluation of a Non-laboratory-based Cardiovascular Disease Risk Score in Predicting Cardiovascular Mortality in the Southern Community Cohort Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Jai Singh ◽  
Edmond K Kabagambe ◽  
Meng Xu ◽  
Thomas A Gaziano ◽  
Thomas J Wang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Cohort Study ◽  
Risk Score ◽  
Low Socioeconomic Status ◽  
Low Income ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk ◽  
Southeastern Us ◽  
Blacks And Whites

Introduction: Cardiovascular disease (CVD) risk prediction guides clinical recommendations regarding primary prevention strategies. Recently, a non-laboratory-based CVD risk score was derived and validated in several populations. We evaluated the performance of the non-laboratory CVD risk score among individuals of low socioeconomic status in the southeastern US, with high CVD incidence rates. Methods: The Southern Community Cohort Study (SCCS) is a prospective cohort study of black and white adults enrolled primarily from community health centers in the southeastern US between 2002-2009. We calculated c-statistics and 95% confidence intervals (CI) to assess the performance of the non-laboratory risk score in discriminating 5- year risk of CVD death (ICD-10 I00-I99) in 14,243 participants (median enrollment age 51 yrs; 74% black, 71% female, 61% income < $15,000 yr) with no history of MI/CABG or stroke at baseline and with complete data on all input variables (age, sex, smoking, diabetes mellitus, reported hypertension (HTN), measured SBP, and BMI). Reported HTN was substituted for anti-HTN therapy, used in the original risk score, because the latter was available only for a subset of the SCCS population. However, among this subset, 82% of individuals who reported HTN also reported use of anti-HTN drugs. Results: CVD risk factors were common: HTN (66%), smoking (59%), diabetes (29%), median SBP 130 mmHg, and median BMI 31 kg/m2. CVD death occurred in 263 participants (1.8%). The non-laboratory CVD risk score demonstrated poor discrimination for CVD mortality, with c-statistics of 0.65 (95% CI: 0.61-0.68) overall and 0.64 (0.59-0.69), 0.65 (0.6-0.7), 0.67 (0.63-0.71) and 0.58 (0.51-0.65) for males, females, blacks and whites, respectively. In an additional logistic regression model fit to the SCCS data, the inclusion of education and income did not substantially improve model performance; overall c-statistic 0.70 (0.67-0.73). Conclusion: In this population of predominantly low-income blacks and whites, a non-laboratory CVD risk score did not perform well in predicting CVD death in any of the race and gender groups. Future studies are warranted to develop algorithms for identifying individuals at increased CVD risk in low resource populations.

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