Sex differences in prevalence, treatment and control of cardiovascular risk factors in England

ObjectiveTo investigate sex differences in prevalence, treatment and control of major cardiovascular risk factors in England.MethodsData from the Health Survey for England 2012–2017 on non-institutionalised English adults (aged ≥16 years) were used to investigate sex differences in prevalence, treatment and control of major cardiovascular risk factors: body mass index, smoking, systolic blood pressure and hypertension, diabetes, and cholesterol and dyslipidaemia. Physical activity and diet were not assessed in this study.ResultsOverall, 49 415 adults (51% women) were included. Sex differences persisted in prevalence of cardiovascular risk factors, with smoking, hypertension, overweight and dyslipidaemia remaining more common in men than in women in 2017. The proportion of individuals with neither hypertension, dyslipidaemia, diabetes nor smoking increased from 32% to 36% in women and from 28% to 29% in men between 2012 and 2017. Treatment and control of hypertension and diabetes improved over time and were comparable in both sexes in 2017 (66% and 51% for treatment and control of hypertension and 73% and 20% for treatment and control of diabetes). However, women were less likely than men to have treated and controlled dyslipidaemia (21% vs 28% for treatment and 15% vs 24% for control, for women versus men in 2017).ConclusionsImportant sex differences persist in cardiovascular risk factors in England, with an overall higher number of risk factors in men than in women. A combination of public health policy and individually tailored interventions is required to further reduce the burden of cardiovascular disease in England.

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Estimated effect of increased diagnosis, treatment, and control of diabetes and its associated cardiovascular risk factors among low-income and middle-income countries: a microsimulation model

The Lancet Global Health ◽

10.1016/s2214-109x(21)00340-5 ◽

2021 ◽

Author(s):

Sanjay Basu ◽

David Flood ◽

Pascal Geldsetzer ◽

Michaela Theilmann ◽

Maja E Marcus ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Low Income ◽

Microsimulation Model ◽

Middle Income ◽

Middle Income Countries ◽

Control Of Diabetes ◽

And Control

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Abstract P373: Trends in Cardiovascular Risk Factors by Clinical Definitions of Prediabetes

Circulation ◽

10.1161/circ.137.suppl_1.p373 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Caroline Liu ◽

Kathryn Foti ◽

Elizabeth Selvin

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Nutrition Examination Survey ◽

Risk Factor Management ◽

Health And Nutrition ◽

High Prevalence ◽

Definition Of ◽

And Control ◽

Over Time

Introduction: There are five different definitions of prediabetes currently used in clinical practice. How cardiovascular risk may differ by these different definitions of prediabetes and whether trends in cardiovascular risk in persons with prediabetes have changed over time is largely uncharacterized. Hypothesis: We expect the prevalence of cardiovascular risk factors will vary by prediabetes definition and will be highest among those who meet clinical definitions with higher cutoff values. We hypothesize awareness, treatment and control of hypertension and hypercholesterolemia have increased over time among those with prediabetes. Methods: We analyzed data for adults ages ≥ 20 years from the 1999-2014 National Health and Nutrition Examination Survey (NHANES). We used calibrated HbA1c and FPG values to estimate prediabetes prevalence. We examined the prevalence and trends of hypertension and hypercholesterolemia among those who met each clinical definition of prediabetes, as well as awareness, treatment, and control. Results: The prevalence of prediabetes by each definitions remained stable across survey years. The prevalence, awareness, treatment, and control of hypertension and hypercholesterolemia by clinical definition modestly increased over time. Conclusion: The prevalence of hypertension and hypercholesterolemia was higher among individuals who met HbA1c-based definitions of prediabetes than other measures and was highest when more restrictive criteria for prediabetes were used. Awareness, treatment, and control of cardiovascular risk factors increased over time by any definition, but the high prevalence of cardiovascular risk factors highlights the need for improvement in risk factor management in people with prediabetes.

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Sex Differences in the Prevalence of, and Trends in, Cardiovascular Risk Factors, Treatment, and Control in the United States, 2001 to 2016

Circulation ◽

10.1161/circulationaha.118.035550 ◽

2019 ◽

Vol 139 (8) ◽

pp. 1025-1035 ◽

Cited By ~ 46

Author(s):

Sanne A.E. Peters ◽

Paul Muntner ◽

Mark Woodward

Keyword(s):

United States ◽

Risk Factors ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

The United States ◽

And Control

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Sex differences in the association between major cardiovascular risk factors in midlife and dementia: a cohort study using data from the UK Biobank

BMC Medicine ◽

10.1186/s12916-021-01980-z ◽

2021 ◽

Vol 19 (1) ◽

Author(s):

Jessica Gong ◽

Katie Harris ◽

Sanne A. E. Peters ◽

Mark Woodward

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Sex Differences ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Sex Difference ◽

Incidence Rates ◽

Cox Proportional Hazards ◽

Uk Biobank ◽

The Uk

Abstract Background Sex differences in major cardiovascular risk factors for incident (fatal or non-fatal) all-cause dementia were assessed in the UK Biobank. The effects of these risk factors on all-cause dementia were explored by age and socioeconomic status (SES). Methods Cox proportional hazards models were used to estimate hazard ratios (HRs) and women-to-men ratio of HRs (RHR) with 95% confidence intervals (CIs) for systolic blood pressure (SBP) and diastolic blood pressure (DBP), smoking, diabetes, adiposity, stroke, SES and lipids with dementia. Poisson regression was used to estimate the sex-specific incidence rate of dementia for these risk factors. Results 502,226 individuals in midlife (54.4% women, mean age 56.5 years) with no prevalent dementia were included in the analyses. Over 11.8 years (median), 4068 participants (45.9% women) developed dementia. The crude incidence rates were 5.88 [95% CI 5.62–6.16] for women and 8.42 [8.07–8.78] for men, per 10,000 person-years. Sex was associated with the risk of dementia, where the risk was lower in women than men (HR = 0.83 [0.77–0.89]). Current smoking, diabetes, high adiposity, prior stroke and low SES were associated with a greater risk of dementia, similarly in women and men. The relationship between blood pressure (BP) and dementia was U-shaped in men but had a dose-response relationship in women: the HR for SBP per 20 mmHg was 1.08 [1.02–1.13] in women and 0.98 [0.93–1.03] in men. This sex difference was not affected by the use of antihypertensive medication at baseline. The sex difference in the effect of raised BP was consistent for dementia subtypes (vascular dementia and Alzheimer’s disease). Conclusions Several mid-life cardiovascular risk factors were associated with dementia similarly in women and men, but not raised BP. Future bespoke BP-lowering trials are necessary to understand its role in restricting cognitive decline and to clarify any sex difference.

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Do Cardiovascular Risk Factors and Cardiovascular Disease Explain Sex Differences in Cognitive Functioning in Old Age?

Journal of Alzheimer s Disease ◽

10.3233/jad-201173 ◽

2021 ◽

pp. 1-13

Author(s):

Elisabeth Maria van Zutphen ◽

Judith Johanna Maria Rijnhart ◽

Didericke Rhebergen ◽

Majon Muller ◽

Martijn Huisman ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Sex Differences ◽

Information Processing ◽

Cardiovascular Risk ◽

Episodic Memory ◽

Cognitive Functioning ◽

Cardiovascular Risk Factors ◽

Processing Speed ◽

Information Processing Speed

Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.

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The effect of surgery on fat mass, lipid and glucose metabolism in mild primary hyperparathyroidism

Endocrine Connections ◽

10.1530/ec-18-0259 ◽

2018 ◽

Vol 7 (8) ◽

pp. 941-948 ◽

Cited By ~ 3

Author(s):

Kristin Godang ◽

Karolina Lundstam ◽

Charlotte Mollerup ◽

Stine Lyngvi Fougner ◽

Ylva Pernow ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Glucose Metabolism ◽

Primary Hyperparathyroidism ◽

Cardiovascular Risk Factors ◽

Outcome Measures ◽

Fat Mass ◽

Lipid Lowering ◽

Mild Primary Hyperparathyroidism ◽

Over Time

Context Mild primary hyperparathyroidism has been associated with increased body fat mass and unfavorable cardiovascular risk factors. Objective To assess the effect of parathyroidectomy on fat mass, glucose and lipid metabolism. Design, patients, interventions, main outcome measures 119 patients previously randomized to observation (OBS; n = 58) or parathyroidectomy (PTX; n = 61) within the Scandinavian Investigation of Primary Hyperparathyroidism (SIPH) trial, an open randomized multicenter study, were included. Main outcome measures for this study were the differences in fat mass, markers for lipid and glucose metabolism between OBS and PTX 5 years after randomization. Results In the OBS group, total cholesterol (Total-C) decreased from mean 5.9 (±1.1) to 5.6 (±1.0) mmol/L (P = 0.037) and LDL cholesterol (LDL-C) decreased from 3.7 (±1.0) to 3.3 (±0.9) mmol/L (P = 0.010). In the PTX group, the Total-C and LDL-C remained unchanged resulting in a significant between-group difference over time (P = 0.013 and P = 0.026, respectively). This difference was driven by patients who started with lipid-lowering medication during the study period (OBS: 5; PTX: 1). There was an increase in trunk fat mass in the OBS group, but no between-group differences over time. Mean 25(OH) vitamin D increased in the PTX group (P < 0.001), but did not change in the OBS group. No difference in parameters of glucose metabolism was detected. Conclusion In mild PHPT, the measured metabolic and cardiovascular risk factors were not modified by PTX. Observation seems safe and cardiovascular risk reduction should not be regarded as a separate indication for parathyroidectomy based on the results from this study.

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