Abstract P359: Cardiovascular Risk Factor and Diseases in the Italian Adult Population: The National Health Examination Surveys 2008-2012

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Luigi Palmieri ◽  
Cinzia Lo Noce ◽  
Francesco Dima ◽  
Amalia De Curtis ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Adult Population ◽  
Smoking Habit ◽  
Participation Rate ◽  
Health Examination ◽  
Biochemical Tests ◽  
Men And Women ◽  
Italian Regions

Background: From 2008 to 2012 an Health Examination Survey (HES)-Osservatorio Epidemiologico Cardiovascolare (OEC) has been implemented in Italy with the aim of assessing cardiovascular (CV) risk factors, prevalence of risk conditions and CV diseases for the Italian adult population. Methods: Random samples of general population stratified by age and sex were examined in all Italian regions (participation rate 56%). Risk factor were collected using standardized procedures and methods; biochemical tests were assayed in a central laboratory; a questionnaire investigates behaviours and CVD history; a ECG read in Minnesota code was used to define previous myocardial infarction. Comparisons between men and women were assessed using t-test for means and chi-squared test for prevalence. Results: Data of 4371 men and 4339 women ages 35-79 years were analysed. Majority of risk factors mean levels resulted higher in men than in women: systolic blood pressure (SBP) was 134 mmHg and 129 mmHg (p<0.0001), diastolic (DBP) was 84 mmHg and 79 mmHg (p<0.0001), fasting plasma glucose was 103 mg/dl and 95 mg/dl (p<0.0001), triglycerides was 135 mg/dl and 108 mg/dl (p<0.0001), respectively; as well as many CV risk conditions: smoking habit was 21% in men and 18% in women (p<0.0001), diabetes was 14% in men and 9% in women (p<0.0001) (28% of diabetic unaware both in men and women), 56% of men and 43% of women have SBP>=140 mmHg or DBP>=90 mmHg or in treatment (p<0.0001), 65% of men and 70% of women have total cholesterol (TC) >=200 mg/dl or in treatment for (p<0.0001), 48% of men and 33% of women are in overweight (BMI 25-29 kg/m 2 ) (p<0.0001). TC, LDL and HDL cholesterol resulted lower in men than in women: 209 mg/dl and 218 (44) (p<0.0001), 131 (38) mg/dl and 134 mg/dl (p<0.0001), 51 mg/dl and 62 mg/dl (p<0.0001), respectively. As well as prevalence of physical inactivity during leisure time: 31% in men and 43% in women (p<0.0001). Prevalence of obesity (BMI>=30 kg/m 2 ) resulted similar in men and women: 25% and 27% respectively (p=0.0818). Prevalence of myocardial infarction was 2.1% in men and 0.7% in women (p<0.0001), prevalence of by-pass or angioplasty surgery was 5.1% and 1.0% (p<0.0001), prevalence of angina pectoris was 3.2% and in 4.8% (p<0.0001), respectively. Conclusions: At present obesity and smoking are still a priority in public health. In combination with other information sources, the OEC can contribute greatly to plan community actions and health services at national and regional level.

Abstract P401: Time Trend of Cardiovascular Diseases Prevalence in The Italian Adult Population: The Italian Health Examination Survey

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Chiara Donfrancesco ◽  
Luigi Palmieri ◽  
Francesco Dima ◽  
Cinzia Lo Noce ◽  
Patrizia De Sanctis Caiola ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Diseases ◽  
Angina Pectoris ◽  
Adult Population ◽  
Geographical Area ◽  
Health Examination ◽  
Men And Women ◽  
Health Examination Survey ◽  
Cerebrovascular Events ◽  
Italian Regions

Background: Despite cardiovascular diseases (CVD) are the leading causes of death and hospitalization in nearly all countries in Europe, there are paucity, weak quality and comparability of data. The periodic Health Examination Survey (HES) represents in Italy the major source of information on CVD at national level thanks to the adoption of standardized methodologies throughout the country. The aim is to present differences in trends of CVD prevalence by gender in the Italian adult population from 1998 to 2008. Methods: Randomized population samples stratified by age and sex were examined. In 1998, 9,712 men and women aged 35–74 years were enrolled in all Italian regions; ongoing screening started in 2008 is enrolling 9,020 persons. A standardized questionnaire investigates cardiovascular disease and pharmacological treatments. The anamnesis is positive when clinical diagnosis has been made by a physician. Electrocardiograms read in Minnesota code are also performed and used to define previous myocardial infarction. Results: Data are from 12 regions in the North, Center, and South of Italy: 3,704 men and women in 1998 and 3,479 persons in 2008 are compared. In men, prevalence of cerebrovascular events decreases from 1.5% (95% confidence interval: 1.0-1.9%) in 1998 to 0.6 (0.3–0.9%) in 2008; in women, prevalence results stable: 0.9% in 1998 (0.5–1.3%) and 0.7% in 2008 (0.4–1.1%). Prevalence of myocardial infarction results stable both in men and women: in 1998, 1.9% in men (1.4–2.4%) and 0.6% in women (0.3–0.9%), and in 2008, 2.0% (1.4-2.7%) and 0.6% (0.3-0.9%) respectively; angina pectoris results stable as well: in 1998, 2.2% in men (1.7-2.8%) and 3.9% in women (3.1-4.6%), and in 2008, 3.2% (2.5-4.0%) and 4.5% (3.6-5.4%) respectively. Prevalence of by-pass or angioplasty surgery increases in men: 2.4% (1.8-3.0%) in 1998, and 4.5% (3.6-5.4%) in 2008; in women increasing is not significant: from 0.2% (0.0-0.4%) in 1998 to 0.7% (0.3-1.1%) in 2008. Stratifying data by geographical area (North, Center, South and Island) all comparisons become not significant; in men only, cerebrovascular decreasing and by-pass or angioplasty surgery increasing trends tend to be confirmed in all three areas. Conclusions: Trends between 1998 and 2008 decrease in cerebrovascular events and increase in prevalence of by-pass or angioplasty surgery, especially in men. Stable prevalence resulted for myocardial infarction and angina pectoris. Cerebrovascular decreasing trend is in line with smoking prevalence and mean of blood pressure decreasing in the country. Further analyses considering data from all Italian regions are needed to confirm results.

Abstract P306: Italian National Health Examination Surveys 2008-2012: Differences in Measured and Self-reported Anthropometric Data

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Luigi Palmieri ◽  
Chiara Donfrancesco ◽  
Cinzia Lo Noce ◽  
Francesco Dima ◽  
Lidia Gargiulo ◽  
...  
Keyword(s):  
Adult Population ◽  
Measured Data ◽  
Health Examination ◽  
Obesity Prevalence ◽  
Anthropometric Measures ◽  
Men And Women ◽  
Measured Weight ◽  
Italian Regions ◽  
Prevalence Of Obesity ◽  
Reported Data

Background: Health Interview Survey (HIS) collects only self-reported height and weight to estimate obesity prevalence. Because of self-reporting, estimated obesity prevalence could be too low. From 2008 to 2012 an Health Examination Survey/Osservatorio Epidemiologico Cardiovascolare (HES/OEC) has been implemented in Italy with the aim of assessing cardiovascular (CV) risk factors, prevalence of risk conditions and CV diseases for the Italian adult population. Differences in measured and self-reported main anthropometric measures are described. Methods: Random samples of general population stratified by age and sex were examined in all Italian regions (participation rate 56%). Self-reported height and weight were requested to participants just after the welcome at the screening center. Height and weight were then measured using standardized procedures and methods. BMI was categorized in 3 groups: normal (BMI<25 kg/m2), overweight (25<=BMI<30 kg/m2), obesity (BMI>=30 kg/m2). Comparisons between measured and reported height, weight, and calculated BMI in men and women were assessed using t-test for means and chi-squared test for prevalence for paired samples. Results: Data from 2,583 men and 2,575 women aged 35-79 years were analysed. In men, measured height was lower than self-reported (-2.1 cm.), measured weight resulted higher than self-reported (+0.3 kg.); as a consequence BMI calculated on measured data resulted higher than that based on self-reported data (+0.8 kg/m2). Prevalence of obesity was higher for measured data than for self-reported (+7.1%). In men, difference between measured and self-reported height resulted higher in obese category than in the overweight or normal groups (-2.6 cm.), as well as for weight (+1.6 kg.). Similar results were registered in women: measured height was lower than self-reported (-3.6 cm.), measured weight resulted higher than self-reported (+0.8 kg.); as a consequence BMI calculated on measured data resulted higher than that based on self-reported data (+1.6 kg/m2). Prevalence of obesity was higher for measured data than for self-reported (+9.2%). Difference between measured and self-reported height resulted higher in obese category than in the overweight or normal groups (-5.0 cm.), as well as for weight (1.8 kg.). Both in men and women differences increased by age-group. Conclusions: Our results confirm how important is to produce standardised measures, also to adjust and correct self-reported height and weight, in order to have a reliable picture of obesity in the population. At present obesity is still a priority in public health and is one of the main indicator to plan community actions for cardiovascular disease prevention in the population.

Prevalence and prognostic impact of left ventricular systolic dysfunction after acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T.J Jernberg ◽  
E.O Omerovic ◽  
E.H Hamilton ◽  
K.L Lindmark ◽  
L.D Desta ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Myocardial Infarction ◽  
Atrial Fibrillation ◽  
Risk Factor ◽  
Reperfusion Therapy ◽  
Left Ventricular ◽  
Funding Source ◽  
Additional Risk Factor ◽  
Additional Risk

Abstract Background Left ventricular dysfunction after an acute myocardial infarction (MI) is associated with poor outcome. The PARADISE-MI trial is examining whether an angiotensin receptor-neprilysin inhibitor reduces the risk of cardiovascular death or worsening heart failure (HF) in this population. The aim of this study was to examine the prevalence and prognosis of different subsets of post-MI patients in a real-world setting. Additionally, the prognostic importance of some common risk factors used as risk enrichment criteria in the PARADISE-MI trial were specifically examined. Methods In a nationwide myocardial infarction registry (SWEDEHEART), including 87 177 patients with type 1 MI between 2011–2018, 3 subsets of patients were identified in the overall MI cohort (where patients with previous HF were excluded); population 1 (n=27 568 (32%)) with signs of acute HF or an ejection fraction (EF) &lt;50%, population 2 (n=13 038 (15%)) with signs of acute HF or an EF &lt;40%, and population 3 (PARADISE-MI like) (n=11 175 (13%)) with signs of acute HF or an EF &lt;40% and at least one risk factor (Age ≥70, eGFR &lt;60, diabetes mellitus, prior MI, atrial fibrillation, EF &lt;30%, Killip III-IV and STEMI without reperfusion therapy). Results When all MIs, population 1 (HF or EF &lt;50%), 2 (HF or EF &lt;40%) and 3 (HF or EF &lt;40% + additional risk factor (PARADISE-MI like)) were compared, the median (IQR) age increased from 70 (61–79) to 77 (70–84). Also, the proportion of diabetes (22% to 33%), STEMI (38% to 50%), atrial fibrillation (10% to 24%) and Killip-class &gt;2 (1% to 7%) increased. After 3 years of follow-up, the cumulative probability of death or readmission because of heart failure in the overall MI population and in population 1 to 3 was 17.4%, 26.9%, 37.6% and 41.8%, respectively. In population 2, all risk factors were independently associated with death or readmission because of HF (Age ≥70 (HR (95% CI): 1.80 (1.66–1.95)), eGFR &lt;60 (1.62 (1.52–1.74)), diabetes mellitus (1.35 (1.26–1.44)), prior MI (1.16 (1.07–1.25)), atrial fibrillation (1.35 (1.26–1.45)), EF &lt;30% (1.69 (1.58–1.81)), Killip III-IV (1.34 (1.19–1.51)) and STEMI without reperfusion therapy (1.34 (1.21–1.48))) in a multivariable Cox regression analysis. The risk increased with increasing number of risk factors (Figure 1). Conclusion Depending on definition, post MI HF is present in 13–32% of all MI patients and is associated with a high risk of subsequent death or readmission because of HF. The risk increases significantly with every additional risk factor. There is a need to optimize management and improve outcomes for this high risk population. Figure 1 Funding Acknowledgement Type of funding source: Private company. Main funding source(s): Novartis

scholarly journals Incidence and risk factors of delirium after percutaneous coronary intervention in individuals hospitalised for acute myocardial infarction: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e044564
Author(s):  
Kaizhuang Huang ◽  
Jiaying Lu ◽  
Yaoli Zhu ◽  
Tao Cheng ◽  
Dahao Du ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Systematic Review ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Risk Factor ◽  
Meta Analysis ◽  
Coronary Intervention ◽  
Cochrane Library ◽  
Percutaneous Coronary

IntroductionDelirium in the postoperative period is a wide-reaching problem that affects important clinical outcomes. The incidence and risk factors of delirium in individuals with acute myocardial infarction (AMI) after primary percutaneous coronary intervention (PCI) has not been completely determined and no relevant systematic review and meta-analysis of incidence or risk factors exists. Hence, we aim to conduct a systematic review and meta-analysis to ascertain the incidence and risk factors of delirium among AMI patients undergoing PCI.Methods and analysesWe will undertake a comprehensive literature search among PubMed, EMBASE, Cochrane Library, PsycINFO, CINAHL and Google Scholar from their inception to the search date. Prospective cohort and cross-sectional studies that described the incidence or at least one risk factor of delirium will be eligible for inclusion. The primary outcome will be the incidence of postoperative delirium. The quality of included studies will be assessed using a risk of bias tool for prevalence studies and the Cochrane guidelines. Heterogeneity of the estimates across studies will be assessed. Incidence and risk factors associated with delirium will be extracted. Incidence data will be pooled. Each risk factor reported in the included studies will be recorded together with its statistical significance; narrative and meta-analytical approaches will be employed. The systematic review and meta-analysis will be presented according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.Ethics and disseminationThis proposed systematic review and meta-analysis is based on published data, and thus there is no requirement for ethics approval. The study will provide an up to date and accurate incidence and risk factors of delirium after PCI among patients with AMI, which is necessary for future research in this area. The findings of this study will be disseminated through publication in a peer-reviewed journal.PROSPERO registration numberCRD42020184388.

Long-term effects of an intensive prevention program (IPP) after acute myocardial infarction – the IPP Follow-up and Prevention Boost Trial

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
H Wienbergen ◽  
A Fach ◽  
S Meyer ◽  
J Schmucker ◽  
R Osteresch ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Prevention Program ◽  
Study Endpoint ◽  
Funding Source ◽  
Risk Factor Control ◽  
One Year

Abstract Background The effects of an intensive prevention program (IPP) for 12 months following 3-week rehabilitation after myocardial infarction (MI) have been proven by the randomized IPP trial. The present study investigates if the effects of IPP persist one year after termination of the program and if a reintervention after &gt;24 months (“prevention boost”) is effective. Methods In the IPP trial patients were recruited during hospitalization for acute MI and randomly assigned to IPP versus usual care (UC) one month after discharge (after 3-week rehabilitation). IPP was coordinated by non-physician prevention assistants and included intensive group education sessions, telephone calls, telemetric and clinical control of risk factors. Primary study endpoint was the IPP Prevention Score, a sum score evaluating six major risk factors. The score ranges from 0 to 15 points, with a score of 15 points indicating best risk factor control. In the present study the effects of IPP were investigated after 24 months – one year after termination of the program. Thereafter, patients of the IPP study arm with at least one insufficiently controlled risk factor were randomly assigned to a 2-months reintervention (“prevention boost”) vs. no reintervention. Results At long-term follow-up after 24 months, 129 patients of the IPP study arm were compared to 136 patients of the UC study arm. IPP was associated with a significantly better risk factor control compared to UC at 24 months (IPP Prevention Score 10.9±2.3 points in the IPP group vs. 9.4±2.3 points in the UC group, p&lt;0.01). However, in the IPP group a decrease of risk factor control was observed at the 24-months visit compared to the 12-months visit at the end of the prevention program (IPP Prevention Score 10.9±2.3 points at 24 months vs. 11.6±2.2 points at 12 months, p&lt;0.05, Figure 1). A 2-months reintervention (“prevention boost”) was effective to improve risk factor control during long-term course: IPP Prevention Score increased from 10.5±2.1 points to 10.7±1.9 points in the reintervention group, while it decreased from 10.5±2.1 points to 9.7±2.1 points in the group without reintervention (p&lt;0.05 between the groups, Figure 1). Conclusions IPP was associated with a better risk factor control compared to UC during 24 months; however, a deterioration of risk factors after termination of IPP suggests that even a 12-months prevention program is not long enough. The effects of a short reintervention after &gt;24 months (“prevention boost”) indicate the need for prevention concepts that are based on repetitive personal contacts during long-term course after coronary events. Figure 1 Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Stiftung Bremer Herzen (Bremen Heart Foundation)

scholarly journals Risk factor Analysis and Angiographic Profiles in First 228 Cases Undergone Coronary Angiography in Cardiac Cath Lab of Dhaka Medical College Hospital

1970 ◽  
Vol 3 (2) ◽  
pp. 122-125 ◽  
Author(s):  
AEMM Islam ◽  
M Faruque ◽  
AW Chowdhury ◽  
HIR Khan ◽  
MS Haque ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Risk Factor ◽  
Coronary Angiography ◽  
Medical Therapy ◽  
Stable Angina ◽  
College Hospital ◽  
Mortality And Morbidity ◽  
Medical College ◽  
Single Vessel

Background: Coronary artery diseases are one of the major challenges faced by cardiologists. Control of certain risk factors for CAD is associated with decrease in mortality and morbidity from myocardial infarction and unstable angina. So, identification and taking appropriate measures for primary and secondary prevention of such risk factors is, therefore, of great importance. This retrospective study was carried at the newly set up cath lab in Dhaka Medical college. Materials and Methods: Total 228 consecutive case undergone diagnostic coronary angiogram from 10th January 2007 to31st January 2009 out of which 194(80%) were male and 34 (20%) were female. In both sexes most of the patients were between 41 to 60 years of age. Risk factors of the patients were evaluated. Results: In females commonest risk factor was Diabetes (58.8%) followed by dyslipidaemia (35.3%). In males commonest risk factor was hypertension (30.9%) followed by smoking (29.9%) and diabetes (28.3%). In males 44.3% patients presented with acute myocardial infarction followed by stable angina (43.3%); but in females stable angina was the commonest presentation (50.0%) followed by myocardial infarction (38.2%).CAG findings revealed that in males 33.5% had double vessel disease 26.8% followed by single vessel 26.8% and multivessel disease 25.3%. In females normal CAG was found in 35.5% followed by double vessel 23.5%, multivessel 20.6% and single vessel 20.6%. On the basis of CAG findings; in males 41.8% patients were recommended for CABG, followed by PTCA & stenting 26.3% and medical therapy 30.0%; where as in females 55.9% were recommended for medical therapy , followed by CABG 32.4% and PTCA & stenting11.8%. Conclusion: The commonest presentation of CAD was 4th and 5th decades in both sexes. Diabetes and dyslipidaemia were more common in females whereas hypertension and smoking were more common in males. Myocardial infarction and stable angina were most common presentation in both sexes though in males myocardial infarction was more common. In males the angiographic severity of CAD was more and they were more subjected for CABG in comparison to females. Key words: Risk factors; Coronary angiography. DOI: http://dx.doi.org/10.3329/cardio.v3i2.9179 Cardiovasc. J. 2011; 3(2): 122-125

scholarly journals Optimal waist:height ratio cut-off point for cardiometabolic risk factors in Turkish adults

2009 ◽  
Vol 13 (4) ◽  
pp. 488-495 ◽  
Author(s):  
Ahmet Selçuk Can ◽  
Emine Akal Yıldız ◽  
Gülhan Samur ◽  
Neslişah Rakıcıoğlu ◽  
Gülden Pekcan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Cardiometabolic Risk ◽  
Roc Curves ◽  
Cross Sectional Study ◽  
Cardiometabolic Risk Factors ◽  
Youden Index ◽  
Cross Sectional ◽  
Men And Women

AbstractObjectiveTo identify the optimal waist:height ratio (WHtR) cut-off point that discriminates cardiometabolic risk factors in Turkish adults.DesignCross-sectional study. Hypertension, dyslipidaemia, diabetes, metabolic syndrome score ≥2 (presence of two or more metabolic syndrome components except for waist circumference) and at least one risk factor (diabetes, hypertension or dyslipidaemia) were categorical outcome variables. Receiver-operating characteristic (ROC) curves were prepared by plotting 1 − specificity on the x-axis and sensitivity on the y-axis. The WHtR value that had the highest Youden index was selected as the optimal cut-off point for each cardiometabolic risk factor (Youden index = sensitivity + specificity − 1).SettingTurkey, 2003.SubjectsAdults (1121 women and 571 men) aged 18 years and over were examined.ResultsAnalysis of ROC coordinate tables showed that the optimal cut-off value ranged between 0·55 and 0·60 and was almost equal between men and women. The sensitivities of the identified cut-offs were between 0·63 and 0·81, the specificities were between 0·42 and 0·71 and the accuracies were between 0·65 and 0·73, for men and women. The cut-off point of 0·59 was the most frequently identified value for discrimination of the studied cardiometabolic risk factors. Subjects classified as having WHtR ≥ 0·59 had significantly higher age and sociodemographic multivariable-adjusted odds ratios for cardiometabolic risk factors than subjects with WHtR < 0·59, except for diabetes in men.ConclusionsWe show that the optimal WHtR cut-off point to discriminate cardiometabolic risk factors is 0·59 in Turkish adults.

Arterial disease in the young

ESC CardioMed ◽  
2018 ◽  
pp. 775-778
Author(s):  
Marietta Charakida ◽  
John Deanfield
Keyword(s):  
Risk Factors ◽  
Congenital Heart Disease ◽  
Risk Factor ◽  
Congenital Heart ◽  
Cardiovascular Health ◽  
Adult Population ◽  
Arterial Disease ◽  
Ideal Cardiovascular Health ◽  
Reduce Risk ◽  
Reduce Risk Factor

The growing adult population with congenital heart disease (CHD) are getting older and their clinical presentation and outcomes are likely to be determined not only by their underlying CHD, but also by the development of acquired cardiovascular diseases such as atherosclerosis. This begins in childhood. The adult CHD population have multiple cardiovascular risk factors, as found in the general population, including obesity, smoking, and sedentary behaviour. Adults with complex congenital heart circulation are likely to be particularly vulnerable to the development of acquired arterial disease. Maintenance of ‘ideal cardiovascular health’ from childhood, is a key target, as leveraged gains can be achieved by early intervention to reduce risk factor exposure.

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