scholarly journals O6C.1 Ischaemic heart disease and occupation: a linkage between two new zealand surveys and the integrated data infrastructure

2019 ◽  
Vol 76 (Suppl 1) ◽  
pp. A55.2-A55
Author(s):  
J Douwes ◽  
L Ellison-Loschmann ◽  
Marine Corbin ◽  
L Barnes ◽  
HJ Denison ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Occupational Exposures ◽  
Health Data ◽  
P Value ◽  
Odds Ratios ◽  
General Survey ◽  
Occupational Groups ◽  
Machine Operators

BackgroundAssociations between ischaemic heart disease (IHD) and occupation are poorly understood. We linked two previously conducted New Zealand workforce surveys with routinely collected health data to assess occupational risk factors of IHD in New Zealand.MethodsTwo probability-based sample surveys of the general New Zealand adult population (2004–2006; n=3003) and of the New Zealand indigenous peoples (M&_x0101;ori; 2009–2010; n=2107), for which occupational history was collected, were linked with health data up to the end of 2017 using Statistics New Zealand individual-level microdata. Incident IHD events were identified using hospitalisations, prescriptions and deaths. The odds ratios associated with ever being employed in occupational groups were estimated by logistic regression adjusting for age, smoking and socio-economic status separately for males and females in each cohort.ResultsA total of 282 IHD cases were identified in both surveys. Statistically significant elevated IHD risks were observed for male clerks in the general survey (OR=1.60, 95%CI=1.02–2.49) and agriculture and fishery male workers in the M&_x0101;ori survey (OR=1.70, 95%CI=1.02–2.82). Among females, the odds ratios for agriculture and fishery workers were 1.69 (95%CI=0.81–3.51) and 1.49 (95%CI=0.81–2.75) in the general survey and the M&_x0101;ori survey, respectively. A statistically significant increased risk was observed for female plant and machine operators and assemblers in the M&_x0101;ori survey (OR=1.87, 95%CI=1.05–3.31). In the general survey, male plant and machine operators and assemblers had an odds ratio of 1.26 (95%CI=0.81–1.95). We also identified borderline increased odds ratios for trades workers among males in the general survey (OR=1.39, 95%CI=0.92–2.12, p-value=0.12) and among females in the M&_x0101;ori survey (OR=2.26, 95%CI=0.98–5.21, p-value=0.06).ConclusionThis study identified associations between several occupational groups and IHD in the New Zealand population. Further analyses will be conducted to assess specific occupational exposures associated with IHD risk.

Occupational groups and ischaemic heart disease in New Zealand – a longitudinal linkage study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.A Barnes ◽  
A Eng ◽  
M Corbin ◽  
H.J Denison ◽  
A t'Mannetje ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Health Data ◽  
Funding Source ◽  
Inverse Association ◽  
Occupational Groups ◽  
Routinely Collected Health Data ◽  
Machine Operators

Abstract Background/Introduction Occupation is a poorly characterised risk factor for cardiovascular disease (CVD), with females and minority populations particularly under-represented in research. There is also a lack of longitudinal studies using detailed health data that does not rely on self-reports. Purpose This study aimed to address these gaps by assessing the association between a range of occupational groups and ischaemic heart disease (IHD) in New Zealand (NZ), through linkage of population-based occupational surveys to routinely collected health data. Half of the study population were females and 40% were indigenous Māori (who comprise 15% of the total 4.8 million NZ population), which enabled sex and ethnicity-specific aspects of the relationship between occupation and IHD to be assessed. Methods Two probability-based sample surveys of the NZ adult population (New Zealand Workforce Survey (NZWS); 2004–2006; n=3003) and of the Māori population (NZWS Māori; 2009–2010; n=2107), for which detailed occupational histories and lifestyle factors were collected, were linked with routinely collected health data available through Statistics NZ. Cox regression was used to calculate hazard ratios (HR) for “ever-worked” in any one of nine major occupational groups, with “never worked” in that occupational group defined as the reference group. Analyses were controlled for age, deprivation and smoking, and stratified by sex and ethnicity. Results The strongest associations were found for “plant/machine operators and assemblers” and “elementary workers”, particularly among female Māori (HR 2.19, 95% CI 1.16–4.13 and HR 2.03, 1.07–3.82 respectively). In contrast, inverse associations with IHD across all groups were observed for “technicians and associate professionals”, which was significant for NZWS males (HR 0.52, 0.32–0.84). There were some sex and ethnic differences, particularly for “clerks”, where a positive association was found for NZWS males (HR 1.81, 1.19–2.74), whilst an inverse association was observed for Māori females (HR 0.42, 0.22–0.82). Duration analyses (≤2 years, 2–10 years and 10+ years) showed significant dose-response trends for “clerks” in NZWS males, and “plant/machine operators and assemblers” and “elementary workers” in Māori females. Further adjustments for other potential confounders such diabetes mellitus, hypertension and high cholesterol did not affect the results. Conclusion Associations between occupation and IHD differed significantly across occupational groups and between sexes and ethnicities, even within the same occupational groups. This suggests that results may not be generalised across these groups and occupational interventions to reduce IHD risk may therefore need different approaches depending on the population and specific groups of interest. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Health Research Council (HRC) of New Zealand

scholarly journals Efficacy of a nurse-led lipid-lowering secondary prevention intervention in patients hospitalized for ischemic heart disease: A pilot randomized controlled trial

2019 ◽  
Vol 18 (5) ◽  
pp. 366-374
Author(s):  
Sonia Ruiz-Bustillo ◽  
Consol Ivern ◽  
Neus Badosa ◽  
Nuria Farre ◽  
Esther Marco ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Ldl Cholesterol ◽  
Controlled Trial ◽  
Lipid Level ◽  
Standard Of Care ◽  
Lipid Lowering ◽  
P Value ◽  
Cholesterol Levels

Background and aims: Lack of achievement of secondary prevention objectives in patients with ischaemic heart disease remains an unmet need in this patient population. We aimed at evaluating the six-month efficacy of an intensive lipid-lowering intervention, coordinated by nurses and implemented after hospital discharge, in patients hospitalized for an ischaemic heart disease event. Methods: Randomized controlled trial, in which a nurse-led intervention including periodic follow-up, serial lipid level controls, and subsequent optimization of lipid-lowering therapy, if appropriate, was compared with standard of care alone in terms of serum lipid-level control at six months after discharge. Results: The nurse-led intervention was associated with an improved management of low-density lipoprotein (LDL) cholesterol levels compared with standard of care alone: LDL cholesterol levels ⩽100 mg/dL were achieved in 97% participants in the intervention arm as compared with 67% in the usual care arm ( p value <0.001), the LDL cholesterol ⩽70 mg/dL target recommended by the 2016 European Society of Cardiology guidelines was achieved in 62% vs. 37% participants ( p value 0.047) and the LDL cholesterol reduction of ⩾50% recommended by the American College of Cardiology/American Heart Association in 2013 was achieved in 25.6% of participants in the intervention arm as compared with 2.6% in the usual care arm ( p value 0.007). The intervention was also associated with improved blood pressure control among individuals with hypertension. Conclusions: Our findings highlight the opportunity that nurse-led, intensive, post-discharge follow-up plans may represent for achieving LDL cholesterol guideline-recommended management objectives in patients with ischaemic heart disease. These findings should be replicated in larger cohorts.

Ethnic differences in case fatality following an acute ischaemic heart disease event in New Zealand: ANZACS-QI 13

2016 ◽  
Vol 23 (17) ◽  
pp. 1823-1830 ◽  
Author(s):  
Corina Grey ◽  
Rod Jackson ◽  
Susan Wells ◽  
Roger Marshall ◽  
Suneela Mehta ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Ethnic Differences ◽  
Case Fatality

scholarly journals Occupational Exposures and Ischaemic Heart Disease: Results from The Entire New Zealand Population

2020 ◽  
Vol 5 (5) ◽  
Author(s):  
Amanda Eng ◽  
Marine Corbin ◽  
Hayley Denison ◽  
Lucy Barnes ◽  
Andrea 't Mannetje ◽  
...  
Keyword(s):  
Socioeconomic Status ◽  
Heart Disease ◽  
New Zealand ◽  
Noise Exposure ◽  
Cox Regression ◽  
Statistical Significance ◽  
Working Hours ◽  
Occupational Exposures ◽  
Loud Noise ◽  
Long Working Hours

IntroductionIschaemic Heart Disease (IHD) is a leading cause of death in Western countries. Common occupational exposures such as loud noise, long working hours, and sedentary work have been associated with increased IHD risks, but inconsistently. Objectives and ApproachThis study examines associations between incident IHD and exposure to long working hours, sedentary work, and loud noise. Individual-level microdata from Statistics New Zealand Integrated Data Infrastructure (IDI) were extracted for adults (age 20-64 years) with occupation recorded on the 2013 Census. The number of working hours was extracted from the Census, and exposure to sedentary work and loud noise was assessed through job exposure matrices (JEMs). IHD events (from 2013 to end of 2018) were identified using hospitalisations, prescriptions and deaths. Hazard ratios (HRs) were calculated using cox regression adjusted for age, socioeconomic status, and smoking. Results were stratified by sex and ethnicity. ResultsA total of 20,610 IHD cases were identified from 1,594,680 individuals employed at time of Census. Both short (<35) and long (55+) working hours were associated with an increased IHD risk in crude analyses, but effects disappeared after adjustment for age and socioeconomic status. For females, sedentary work (>90% of the time compared to <50%) was associated with a reduced risk (HR(Non-Māori)=0.86, 95%CI=0.75-0.99; HR(Māori)=0.71, 95%CI=0.44-1.14). For males, exposure to the highest noise category (>90dBA) compared to no exposure (<80dBA) was associated with elevated HRs without reaching statistical significance (HR(Non-Māori)=1.12, 95%CI=0.96-1.29; HR(Māori)=1.25, 95%CI=0.89-1.75). For females exposure to the 80-85dBA category compared to no exposure also showed elevated HRs (HR(Non-Māori)=1.14; 95%CI=1.04-1.26; HR(Māori)=1.16; 95%CI=0.93-1.46), but too few females were employed in jobs with the highest noise exposure. ConclusionThese preliminary analyses do not support sedentary work or long working hours as IHD risk factors, but do suggest a modest increase in IHD risk associated with occupational exposure to noise.

Elevated Tissue Factor and Tissue Factor Pathway Inhibitor Circulating Levels in Ischaemic Heart Disease Patients

1998 ◽  
Vol 79 (03) ◽  
pp. 495-499 ◽  
Author(s):  
Anna Maria Gori ◽  
Sandra Fedi ◽  
Ludia Chiarugi ◽  
Ignazio Simonetti ◽  
Roberto Piero Dabizzi ◽  
...  
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Tissue Factor ◽  
Plasma Levels ◽  
Tissue Factor Pathway Inhibitor ◽  
Common Source ◽  
Previous Myocardial Infarction ◽  
Control Subjects ◽  
Tissue Factor Pathway ◽  
Circulating Levels

SummarySeveral studies have shown that thrombosis and inflammation play an important role in the pathogenesis of Ischaemic Heart Disease (IHD). In particular, Tissue Factor (TF) is responsible for the thrombogenicity of the atherosclerotic plaque and plays a key role in triggering thrombin generation. The aim of this study was to evaluate the TF/Tissue Factor Pathway Inhibitor (TFPI) system in patients with IHD.We have studied 55 patients with IHD and not on heparin [18 with unstable angina (UA), 24 with effort angina (EA) and 13 with previous myocardial infarction (MI)] and 48 sex- and age-matched healthy volunteers, by measuring plasma levels of TF, TFPI, Prothrombin Fragment 1-2 (F1+2), and Thrombin Antithrombin Complexes (TAT).TF plasma levels in IHD patients (median 215.4 pg/ml; range 72.6 to 834.3 pg/ml) were significantly (p<0.001) higher than those found in control subjects (median 142.5 pg/ml; range 28.0-255.3 pg/ml).Similarly, TFPI plasma levels in IHD patients were significantly higher (median 129.0 ng/ml; range 30.3-316.8 ng/ml; p <0.001) than those found in control subjects (median 60.4 ng/ml; range 20.8-151.3 ng/ml). UA patients showed higher amounts of TF and TFPI plasma levels (TF median 255.6 pg/ml; range 148.8-834.3 pg/ml; TFPI median 137.7 ng/ml; range 38.3-316.8 ng/ml) than patients with EA (TF median 182.0 pg/ml; range 72.6-380.0 pg/ml; TFPI median 115.2 ng/ml; range 47.0-196.8 ng/ml) and MI (TF median 213.9 pg/ml; range 125.0 to 341.9 pg/ml; TFPI median 130.5 ng/ml; range 94.0-207.8 ng/ml). Similar levels of TF and TFPI were found in patients with mono- or bivasal coronary lesions. A positive correlation was observed between TF and TFPI plasma levels (r = 0.57, p <0.001). Excess thrombin formation in patients with IHD was documented by TAT (median 5.2 μg/l; range 1.7-21.0 μg/l) and F1+2 levels (median 1.4 nmol/l; range 0.6 to 6.2 nmol/l) both significantly higher (p <0.001) than those found in control subjects (TAT median 2.3 μg/l; range 1.4-4.2 μg/l; F1+2 median 0.7 nmol/l; range 0.3-1.3 nmol/l).As in other conditions associated with cell-mediated clotting activation (cancer and DIC), also in IHD high levels of circulating TF are present. Endothelial cells and monocytes are the possible common source of TF and TFPI. The blood clotting activation observed in these patients may be related to elevated TF circulating levels not sufficiently inhibited by the elevated TFPI plasma levels present.

Plasma Fibrinolytic Activity Following Oral Anabolic Steroid Therapy

1975 ◽  
Vol 34 (01) ◽  
pp. 236-245 ◽  
Author(s):  
I. D Walker ◽  
J. F Davidson ◽  
P Young ◽  
J. A Conkie
Keyword(s):  
Heart Disease ◽  
Ischaemic Heart Disease ◽  
Anabolic Steroid ◽  
Fibrinolytic Activity ◽  
Anabolic Steroids ◽  
Long Term Effects ◽  
Lysis Time ◽  
Detailed Evaluation ◽  
Euglobulin Lysis Time

SummarySix anabolic steroids were assessed for their ability to enhance plasma fibrinolytic activity in males with ischaemic heart disease. Five 17α-alkylated steroids (Ethyloestrenol, Norethandrolone, Methandienone, Methylandrostenediol and Oxymetholone) were examined and all produced a significant increase in plasma plasminogen activator as measured by the euglobulin lysis time. The only non-17α-alkylated steroid studied (Methenolone acetate) failed to enhance fibrinolysis. The 17α-alkylated steroids studied all deserve more detailed evaluation of their long term effects on plasma fibrinolytic activity.

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