Abstract P059: Utilizing Electronic Health Records to Evaluate Racial Disparities in Metabolic Syndrome

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Denise Danos ◽  
Maura Kepper ◽  
Tekeda Ferguson ◽  
Claudia Leonardi ◽  
Richard Scribner
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Racial Disparities ◽  
White Women ◽  
Research Network ◽  
Common Data Model ◽  
Patient Centered ◽  
Phenotype Definition ◽  
Increased Risk ◽  
Metabolic Conditions

Purpose: Metabolic syndrome is defined as a clustering of clinical metabolic conditions (increased blood pressure, high blood sugar, increased body fat, abnormal cholesterol or triglycerides) and has been associated with an increased risk for several chronic diseases, such as cardiovascular disease. The aim of this project was to identify individuals presenting with metabolic syndrome using a computational patient phenotype definition derived from electronic medical records (EHR) clinical outcomes data. Secondly, this project evaluated racial disparities in metabolic syndrome across Southeast Louisiana. Methods: Data was obtained through Research Action for Health Network (REACHnet). Using the National Patient-Centered Clinical Research Network Common Data Model, REACHnet has standardized and made usable EHR data for patient-centered research across Louisiana and Texas. The computational patient phenotype definition for metabolic syndrome was developed based on the National Cholesterol Education Program Expert Panel in Adult Treatment Panel III (NCEP III) guidelines. The presence of metabolic conditions was established using ICD9 Diagnosis codes, patient vitals and lab results that are routinely available in EHR data. Logistic regression models to assess racial disparities were executed using SAS 9.4. Results: We analyzed 18,664 patient EHRs for individuals 18 years or older with complete clinical data spanning the years 2013 to 2014. The sample was 43.28% male (n=8,077) and 29.35% black (n=5,477). Based on the patient phenotype definition, the prevalence of metabolic syndrome in the sample was 39.09%. Controlling for age, the odds of metabolic syndrome were twice as high for black women than for white women (OR= 2 (1.83, 2.18)), while the odds were 15% greater for black men than for white men (OR: 1.15 (1.04, 1.28)). Conclusion: We observed significant disparities in the prevalence of clinically evident metabolic syndrome in southeast Louisiana. Racial disparities were greatest among women. It has been increasingly recognized that differential exposure to chronic social and nutritive stress from living in a disadvantaged neighborhood may be contributing to racial health disparities. Further research in this sample will link ancillary sources of neighborhood data to the successfully developed metabolic syndrome phenotype to explore potential mechanisms for racial disparities in cardiovascular disease among a clinically-rich, state-wide sample.

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

Abstract P189: Associations between Lactation and Maternal Measures of Total and Regional Adiposity 15 Years Postpartum: Results from the Study of Women’s Health Across the Nation

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Candace K McClure ◽  
Christina M Shay ◽  
Ping G Tepper ◽  
Molly B Conroy ◽  
Barbara Sternfeld ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Women’S Health ◽  
Women's Health ◽  
Menopausal Status ◽  
Lower Leg ◽  
Cross Sectional ◽  
The Metabolic Syndrome ◽  
Increased Risk ◽  
Regional Adiposity

Objective: It has been reported that mothers who do not breastfeed are at an increased risk of T2DM, metabolic syndrome, and CVD. We hypothesize that lactation may influence cardio-metabolic risk by altering maternal body composition. We examined the extent to which lactation was associated with regional and total adiposity in a sample of US women 15 years after their last birth. Study Design : Cross-sectional analysis of data provided by 1,268 women aged 45-58 who enrolled in the Study of Women’s Health Across the Nation (1996 -1997). Adiposity was assessed using dual-energy X-ray absorptiometry. History of lactation was self-reported and categorized into three groups: mothers who breastfed for ≥3 months after every birth, those who discontinued lactation within 3 months of some births, and those who never breastfed. Results: Compared with mothers who breastfed after every birth for at least 3 months, mothers who never breastfed had 0.87 kg greater trunk fat mass (FM), 1.3% greater % trunk FM, 1.3% lower % leg FM, and 0.075 greater trunk to leg FM ratio after adjustment for age, parity, height, years since last birth, race/ethnicity, socioeconomic, lifestyle, psychological, and family history variables, maximum gestational weight gain, and menopausal status. After additional adjustment for current BMI, women who never breastfed had 0.40 kg greater trunk FM and 0.053 greater trunk to leg FM ratio than mothers who breastfed every child for ≥3 months. Similarly, mothers who discontinued lactation within 3 months of some births had 0.28 kg greater trunk FM and 0.87% lower % leg FM than mothers who consistently breastfed. Conclusion : Women who did not breastfeed for at least 3 months after every birth exhibit less favorable body fat distributions 15 years postpartum. These results provide a potential physiologic basis for prior findings that women who do not breastfeed their children face increased risk of diabetes, the metabolic syndrome, and cardiovascular disease. Given existing disparities in rates of lactation, obesity and CVD, these findings have great clinical relevance and suggest the need for targeted lactation support for women at risk of cardiovascular disease.

scholarly journals Effects of Bilberry Supplementation on Metabolic and Cardiovascular Disease Risk

Molecules ◽  
2020 ◽  
Vol 25 (7) ◽  
pp. 1653
Author(s):  
Sze Wa Chan ◽  
Brian Tomlinson
Keyword(s):  
Oxidative Stress ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Vision Loss ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cardiovascular Complications ◽  
Increased Risk ◽  
Potential Benefits

Metabolic syndrome is a cluster of interrelated conditions that is associated with an increased risk of cardiovascular disease (CVD) and type 2 diabetes mellitus (T2DM). Oxidative stress may impair normal physiological functions, leading to various illnesses. T2DM is considered to be associated with increased oxidative stress, inflammation, and dyslipidemia, which may play a significant role in the development of cardiovascular complications, cancer and vision loss through cataracts and retinopathy. While conventional therapies are a cornerstone for the management of the major risk factors of metabolic syndrome, increasing antioxidant defense by increasing intake of antioxidant-rich foods may improve long term prospects in CVD, obesity and T2DM. Bilberry (Vaccinium myrtillus L.) is one of the richest natural sources of anthocyanins which give berries their red/purple/blue coloration. Anthocyanins are powerful antioxidants and are reported to play an important role in the prevention of metabolic disease and CVD as well as cancer and other conditions. This review focuses on the potential effects of bilberry supplementation on metabolic and cardiovascular risk factors. Although there is evidence to support the use of bilberry supplementation as part of a healthy diet, the potential benefits from the use of bilberry supplementation in patients with T2DM or CVD needs to be clarified in large clinical trials.

scholarly journals Posttransplant Metabolic Syndrome

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
M. Shadab Siddiqui ◽  
Richard K. Sterling
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Liver Disease ◽  
Liver Transplant ◽  
Cardiovascular Mortality ◽  
Early Recognition ◽  
Health Concern ◽  
Rapid Progression ◽  
Factors Associated ◽  
Increased Risk

Metabolic syndrome (MS) is a cluster of metabolic derangements associated with insulin resistance and an increased risk of cardiovascular mortality. MS has become a major health concern worldwide and is considered to be the etiology of the current epidemic of diabetes and cardiovascular disease. In addition to cardiovascular disease, the presence of MS is also closely associated with other comorbidities including nonalcoholic fatty liver disease (NAFLD). The prevalence of MS in patients with cirrhosis and end-stage liver disease is not well established and difficult to ascertain. Following liver transplant, the prevalence of MS is estimated to be 44–58%. The main factors associated with posttransplant MS are posttransplant diabetes, obesity, dyslipidemia, and hypertension. In addition to developing NAFLD, posttransplant MS is associated with increased cardiovascular mortality that is 2.5 times that of the age- and sex-matched individuals. Additionally, the presence of posttransplant MS has been associated with rapid progression to fibrosis in individuals transplanted for HCV cirrhosis. There is an urgent need for well-designed prospective studies to fully delineate the natural history and risk factors associated with posttransplant MS. Until then, early recognition, prevention, and treatment of its components are vital in improving outcomes in liver transplant recipients.

scholarly journals MANAGEMENT OF ENDOCRINE DISEASE: Metabolic effects of bariatric surgery

2016 ◽  
Vol 174 (1) ◽  
pp. R19-R28 ◽  
Author(s):  
Ricard Corcelles ◽  
Christopher R Daigle ◽  
Philip R Schauer
Keyword(s):  
Cardiovascular Disease ◽  
Bariatric Surgery ◽  
Metabolic Syndrome ◽  
Weight Loss ◽  
Metabolic Effects ◽  
Perioperative Morbidity ◽  
Increased Risk ◽  
Long Term Impact

Obesity is associated with an increased risk of type 2 diabetes, hypertension, dyslipidemia, cardiovascular disease, osteoarthritis, numerous cancers and increased mortality. It is estimated that at least 2.8 million adults die each year due to obesity-related cardiovascular disease. Increasing in parallel with the global obesity problem is metabolic syndrome, which has also reached epidemic levels. Numerous studies have demonstrated that bariatric surgery is associated with significant and durable weight loss with associated improvement of obesity-related comorbidities. This review aims to summarize the effects of bariatric surgery on the components of metabolic syndrome (hyperglycemia, hyperlipidemia and hypertension), weight loss, perioperative morbidity and mortality, and the long-term impact on cardiovascular risk and mortality.

scholarly journals Psoríase e Doença Cardiovascular

2013 ◽  
Vol 26 (5) ◽  
pp. 601
Author(s):  
Tiago Torres ◽  
Rita Sales ◽  
Carlos Vasconcelos ◽  
Manuela Selores
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Risk Factor ◽  
Independent Risk Factor ◽  
Cardiovascular Comorbidities ◽  
Increased Risk ◽  
Systemic Inflammatory Disease ◽  
Obesity Hypertension

Psoriasis is a common, chronic and systemic inflammatory disease associated with several comorbidities, such as obesity, hypertension, diabetes, dyslipidaemia and metabolic syndrome, but also with an increased risk of cardiovascular disease, like myocardial infarction or stroke. The chronic inflammatory nature of psoriasis has been suggested to be a contributing and potentially independent risk factor for the development of cardiovascular comorbidities and precocious atherosclerosis. Aiming at alerting clinicians to the need of screening and monitoring cardiovascular diseases and its risk factors in psoriatic patients, this review will focus on the range of cardiometabolic comorbidities and increased risk of cardiovascular disease associated with psoriasis.

scholarly journals Association of Metabolic Factors with Essential Hypertension

2011 ◽  
Vol 24 (1) ◽  
pp. 21-25
Author(s):  
N Rahman Khandaker ◽  
Akhtaruzzaman ◽  
K Rahat Mahfuz ◽  
AR Khandakar ◽  
MMR Khan ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Metabolic Syndrome ◽  
Waist Circumference ◽  
Density Lipoprotein ◽  
Hdl Cholesterol ◽  
Metabolic Factors ◽  
College Hospital ◽  
High Waist Circumference ◽  
Increased Risk ◽  
Low Hdl

Background-Metabolic syndrome is a risk factor for cardiovascular disease, so it should call attention. South Asian person has preponderance to it. Objectives-The proper findings of metabolic syndrome are a key to prevent cardiovascular disease. Hypertension is a component of metabolic syndrome with which patients are at increased risk for cardiovascular disease. Methods-This study was carried out in cardiology outdoor of Shaheed Suhrawardy medical college hospital, Dhaka. A total of 322 patients were enrolled from January 2008 to December 2010. Metabolic syndrome was defined as three of the followings: (a) Abnormal fasting serum level of glucose (≥110 mg/dl or 6.1 mmol/L), ( b) abdominal obesity (waist circumference >102 cm in men and >88 cm in women), (c) Triglycerides (≥150 mg/dl), (d) High density lipoprotein cholesterol (<40 mg/dl in men and <50 mg/dl in woman), (e) Hypertension, which was common in all patients. Results- Among hypertensive’s patients 31.8% had hyperglycemia, 37.9% had high waist circumference, 69.8% had low HDL cholesterol and 54.3% high triglycerides. As per definition of NCEP-ATP-III, metabolic syndrome had been detected in 17% of male, 37% of female and 27% of the total population. Conclusion- Metabolic factors are a common association in hypertensive cases. These patients are at increased risk of coronary and cerebro-vascular disease and require more vigorous prevention. Furthermore in all hypertensive patients metabolic screening is recommended. TAJ 2011; 24(1): 21-25

Validation of Cardiovascular End Points Ascertainment Leveraging Multisource Electronic Health Records Harmonized Into a Common Data Model in the ADAPTABLE Randomized Clinical Trial

2021 ◽  
Author(s):  
Guillaume Marquis-Gravel ◽  
Bradley G. Hammill ◽  
Hillary Mulder ◽  
Matthew T. Roe ◽  
Holly R. Robertson ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Positive Predictive Value ◽  
Clinical Research ◽  
Predictive Value ◽  
Research Network ◽  
Common Data Model ◽  
Patient Centered ◽  
End Points ◽  
Clinical Research Network ◽  
National Patient

Background: The ADAPTABLE trial (Aspirin Dosing: A Patient-Centric Trial Assessing Benefits and Long-Term Effectiveness) is the first randomized trial conducted within the National Patient-Centered Clinical Research Network to use the electronic health record data formatted into a common data model as the primary source of end point ascertainment, without confirmation by standard adjudication. The objective of this prespecified study is to assess the validity of nonfatal end points captured from the National Patient-Centered Clinical Research Network, using traditional blinded adjudication as the gold standard. Methods: A total of 15 076 participants with established atherosclerotic cardiovascular disease were randomized to two doses of aspirin (81 mg and 325 mg once daily). Nonfatal end points (hospitalization for nonfatal myocardial infarction, nonfatal stroke, and major bleeding requiring transfusion of blood products) were captured with the use of programming algorithms applied to National Patient-Centered Clinical Research Network data. A random subset of end points was independently reviewed by a disease-specific expert adjudicator. The positive predictive value of the programming algorithms were calculated separately for end points listed as primary and as nonprimary diagnoses. Results: A total of 225 end points were identified (91 myocardial infarction events, 89 stroke events, and 45 bleeding events), including 142 (63%) that were listed as primary diagnoses. Complete source documents were missing for 14% of events. The positive predictive value were 90%, 72%, and 93% for hospitalizations for myocardial infarction, stroke, and major bleeding, respectively, as compared to adjudication. When only primary diagnoses were considered, positive predictive value were 93%, 91%, and 97%, respectively. When only nonprimary diagnoses were considered, positive predictive value were 82%, 36%, and 71%. Conclusions: As compared with blinded adjudication, clinical end point ascertainment from queries of the National Patient-Centered Clinical Research Network distributed harmonized data was valid to identify hospitalizations for myocardial infarction in ADAPTABLE. The proportion of contradicted events was high for hospitalizations for bleeding and strokes when nonprimary diagnoses were analyzed, but not when only primary diagnoses were considered.

Sign in / Sign up

Export Citation Format

Share Document