Abstract MP05: Impact of Gentrification on Cardiovascular Risk Factors and Outcomes in England: 2004-2018

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nrupen A Bhavsar ◽  
Danying Li ◽  
Miguel Ramos ◽  
Laura Richman
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
The United States ◽  
Living Environment ◽  
Length Of Residence ◽  
Lower Odds ◽  
Significant Difference ◽  
The Impact

Introduction: Dynamic changes to neighborhoods due to forces such as gentrification impact the health of residents. Much of this research has been conducted within the United States, where racial disparities and access to healthcare impact risk for health outcomes. Internationally, other factors may play a more prominent role in the association between gentrification and cardiovascular risk factors and outcomes. Hypothesis: Residents living in gentrified vs. non-gentrified neighborhoods will have lower odds of diabetes (DM), hypertension (HTN), depression and cardiovascular disease (CVD). Methods: We defined gentrification using changes in domains of the Index of Multiple Deprivation (IMD) at the level of the Lower Layer Super Output Areas (LSOA) in England from 2004-2010. We used all IMD domains (income, employment, education, crime, barriers to housing, and living environment), except the health domain, from 2004 and 2010 to define LSOA deprivation. The IMD for each LSOA was standardized to the mean IMD of England using z-scores. LSOAs were eligible to be gentrified if they had a positive z-score in 2004 and were considered to gentrify if they had a negative change in the transformed IMD from 2004 to 2010. We linked these data to individual participants in the Understanding Society Study (USS). The USS is a nationally representative cohort study of 60,000 United Kingdom residents started in 2009 with follow-up ongoing. We limited the analysis to residents in England who lived in top and bottom 25% deprived LSOAs (n=8782). We used multivariable logistic regression to calculate the odds ratio for self-reported DM, HTN, depression, and CVD in residents in neighborhoods that did and did not gentrify, adjusting for race, sex, length of residence (LOR), baseline IMD score, and baseline prevalence of health conditions. Results were stratified by age (<65 & >=65 years) and median LOR (<13 & >=13 years). Results: At baseline, 8782 participants had a median age of 43 years, 4% were black and 55% were female. There was no significant difference in the prevalence of DM, HTN, depression, or CVD at baseline. At follow-up, overall, there were no significant difference in the odds of DM, HTN, or CVD between residents living in gentrified vs. non-gentrified neighborhoods. Residents in neighborhoods that gentrified had a 39% lower odds of depression as compared to participants living in neighborhoods that did not gentrify (p=0.01). Results were not significantly modified by age or length of residence. Conclusions: Residents living in gentrified neighborhoods did not have differential risk for most CVD risk factors and outcomes as compared to residents living in neighborhoods that did not gentrify. However, the impact of gentrification on health is not uniform across all conditions. The positive health impact seen may suggest gentrification increases access to resources not present prior to gentrification.

HIV may indirectly accelerate coronary artery disease through enhancing the effects of conventional and non-conventional cardiovascular risk factors

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M Kolossvary ◽  
E.K Fishman ◽  
G Gerstenblith ◽  
D.A Bluemke ◽  
R.N Mandler ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Hiv Infection ◽  
Cardiovascular Risk Factors ◽  
Agatston Score ◽  
Funding Source ◽  
Significant Difference ◽  
Ascvd Risk ◽  
Artery Disease

Abstract Background/Introduction Cross-sectional studies are inconsistent on the potential independent adverse effects of human immunodeficiency virus (HIV)-infection on coronary artery disease (CAD). Furthermore, there is no information on the potential effects of HIV-infection on plaque volumes. Also, only the independent effects of HIV-infection on CAD have been investigated. Purpose In a prospective longitudinal observational cohort, we wished to assess whether HIV-infection accelerates CAD independently, or by acting in synergistic fashion with conventional and nonconventional cardiovascular risk factors to accelerate disease progression as assessed by clinical and volumetric parameters of CAD on coronary CT angiography (CCTA). Methods Overall, 300 asymptomatic individuals without cardiovascular symptoms but with CCTA-confirmed coronary plaques (210 males, age: 48.0±7.2 years) with or without HIV (226 HIV-infected) prospectively underwent CCTA at two time points (mean follow-up: 4.0±2.3 years). Agatston-score, number of coronary plaques, segment stenosis score were calculated, and we also segmented the coronary plaques to enumerate total, noncalcified (−100–350HU) and calcified (≥351HU) plaque volumes. Linear mixed models were used to assess the effects of HIV-infection, atherosclerotic cardiovascular disease (ASCVD) risk, years of cocaine use and high-sensitivity C-reactive protein on CCTA markers of CAD. Results In univariate analysis, there was no significant difference in CAD characteristics between HIV-infected and -uninfected, neither at baseline nor at follow-up (p&gt;0.05 for all). Furthermore, there was no significant difference in annual progression rates between the two groups (p&gt;0.05 for all). By multivariate analysis, HIV was not associated with any CAD parameter (p&gt;0.05 for all). However, among HIV-infected individuals, each year of cocaine use significantly increased all CAD parameters (p&lt;0.05 for all), while ASCVD risk score was significantly associated with CAD parameters except for Agatston-score (p&lt;0.05). These associations were only present among HIV-infected individuals. Conclusion(s) Instead of directly worsening CAD, HIV may promote CAD through increased susceptibility to conventional and nonconventional cardiovascular risk factors. Therefore, aggressive management of both conventional and nonconventional cardiovascular risk factors is needed to reduce cardiovascular burden of HIV-infection. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): National Institutes of Health, National Institute on Drug Abuse

Essential Thrombocythemia: Analysis of Risk Factors for Thrombotic Events in a Series of 306 Patients.

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 4937-4937
Author(s):  
Franca Radaelli ◽  
Stefania Bramanti ◽  
Mariangela Colombi ◽  
Alessandra Iurlo ◽  
Alberto Zanella
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Essential Thrombocythemia ◽  
Thrombotic Event ◽  
Previous History ◽  
Significant Difference ◽  
Platelet Number ◽  
History Of

Abstract Essential thrombocythemia (ET) is a chronic myeloproliferative disorder characterized by peripheral thrombocytosis and abnormal proliferation of megakariocytes in the bone marrow. Even thought thrombosis is frequently associated to ET, the risk factors of this clinical complication are still controversial. The aim of this retrospective, single institution study was to investigate clinical and laboratory characteristics associated with the occurrence of thrombotic events, with the purpose of identifying subgroups of patients who could benefit from antiaggregant and/or cytostatic treatment. 306 consecutive ET patients (109 men and 197 females, median age 58 yr) diagnosed between January 1979 and December 2002 were included in the study. At the time of analysis, 196 patients were still alive with a median follow up of 96 months. The following variables were investigated for the association with thrombotic complications: age, platelet count, previous history of thrombotic events, time from diagnosis, treatment with antiaggregant/cytostatic drugs, and cardiovascular risk factors such as arterial hypertension, obesity, hypercolesterolemia, diabetes, cigarette smoking. At the time of last follow up, 46 patients (15%) experienced at least one thrombotic event. The occurrence of thrombotic events was observed in 26/64 (40.6%) patients with previous history of thrombosis and in 20/242 (8.3%) patients with no previous history of thrombosis (p&lt;0.0001 Fisher’s exact test, odd ratio 7.6). A significant difference between the two groups of patients was also confirmed when Kaplan Meier estimates of thrombosis-free survival were compared by log-rank test (p&lt;0.0001). By logistic regression, platelet number at diagnosis did not associate with occurrence of thrombosis in the whole patient population. When patients without previous history of thrombosis were stratified according to the number of cardiovascular risk factors (none vs one vs more than one), a significant correlation with occurrence of thrombotic events was observed (Mantel-Haenszel Chi-square 5.47, p&lt;0.05). This study confirms that history of thrombosis is strongly related with risk of further thrombotic events in patients with ET, whereas platelet number at diagnosis does not seem to represent a prognostic factor. In patients with no previous history of thrombosis, the presence of other cardiovascular risk factors has to be taken into account when establishing the therapeutic approach.

Has brief counselling an impact on the risk factors for cardiovascular disease in 40-year-old men. A three-year follow-up study

Open Medicine ◽  
2008 ◽  
Vol 3 (3) ◽  
pp. 300-307 ◽  
Author(s):  
Anita Näslindh-Ylispangar ◽  
Marja Sihvonen ◽  
Seppo Sarna ◽  
Hannu Vanhanen ◽  
Pertti Kekki
Keyword(s):  
Risk Factors ◽  
Health Care ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Repeated Measures ◽  
Follow Up Study ◽  
The Metabolic Syndrome ◽  
Old Men ◽  
The Impact

AbstractThe metabolic syndrome presents a serious challenge to health professionals. The aim of the present study is to analyze the impact of a brief counselling on cardiovascular risk factors among 40-year-old men. Forty-six males living in north-eastern Helsinki voluntarily completed the follow-up study between 2001 and 2004, and were assessed for clinical risk factors. The mean differences were determined by a paired t-test, and the interaction between groups and time by the F-test with repeated measures ANOVA. After baseline assessment and in 2002, males received a 45 minute nurse-delivered counselling session with self-administered protocol. Cardiovascular risk factors improved significantly (p<0.05) from baseline within months. However, the final measurements obtained after three years showed that almost all risk factors, except the low and high density lipoprotein, tended to revert back to baseline. The profiles were similar in all predictor groups. Brief counselling had an impact on risk factors measured in 2002, but only a partial effect on them in 2004. Conclusive results lead to the idea thatmore collaboration is needed between private health care agencies and official primary health care for ensuring the continuity of improved health habits among middle-aged males.

Abstract P347: The Impact of the Length of the Follow-up on the the Strengths of the Associations Between Cardiovascular Risk Factors and Future Myocardial Infarction, Stroke and Heart Failure

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Lars Lind ◽  
Erik Ingelsson ◽  
Johan Sundström ◽  
Johan ärnlöv
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Heart Failure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cardiovascular Outcomes ◽  
Rapid Decline ◽  
The Impact ◽  
Over Time

Objective: The aim of this study was to investigate how the length of the follow-up period influences the strength of the associations between major cardiovascular risk factors and different cardiovascular outcomes (myocardial infarction [MI], stroke and heart failure). Methods: We examined 1826 men aged 50 regarding cardiovascular risk factors in 1970-74. The follow-up time was 33 years. The hazard ratio (HR) was calculated yearly for each risk factor and outcome. During follow-up, 571 cases of MI, 381 cases of stroke and 384 cases of heart failure occurred. Results: Two major patterns were found regarding influence of the follow-up time on the associations between risk factors and the different cardiovascular outcomes. First, a gradual decline in the HR over time was seen for blood pressure in relation to all three outcomes, with the most rapid decline for heart failure and stroke. This pattern was also seen for BMI in relation to MI and heart failure, and for smoking regarding MI and stroke. Second, we observed a gradual increase in HRs to a maximum at 20-25 years, and thereafter a slight decline. This pattern was seen for the apoB/A1 ratio, HDL, and triglycerides, mainly in relation to MI and heart failure. Conclusion: The length of follow-up influenced the associations between traditional risk factors and cardiovascular outcomes in different ways. The collective influence of the risk factors did however show a substantial decline in discrimination over time for the outcomes stroke and heart failure, but not regarding myocardial infarction.

scholarly journals Major dietary patterns and cardiovascular risk factors from childhood to adulthood. The Cardiovascular Risk in Young Finns Study

2007 ◽  
Vol 98 (1) ◽  
pp. 218-225 ◽  
Author(s):  
Vera Mikkilä ◽  
Leena Räsänen ◽  
Olli T. Raitakari ◽  
Jukka Marniemi ◽  
Pirjo Pietinen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Dietary Patterns ◽  
Dietary Pattern ◽  
Alcoholic Beverages ◽  
High Consumption ◽  
The Impact ◽  
Young Finns Study

Studies on the impact of single nutrients on the risk of CVD have often given inconclusive results. Recent research on dietary patterns has offered promising information on the effects of diet as a whole on the risk of CVD. The Cardiovascular Risk in Young Finns Study is an ongoing, prospective cohort study with a 21-year follow-up to date. The subjects were children and adolescents at baseline (3–18 years,n1768) and adults at the latest follow-up study (24–39 years,n1037). We investigated the associations between two major dietary patterns and several risk factors for CVD. In longitudinal analyses with repeated measurements, using multivariate mixed linear regression models, the traditional dietary pattern (characterised by high consumption of rye, potatoes, butter, sausages, milk and coffee) was independently associated with total and LDL cholesterol concentrations, apolipoprotein B and C-reactive protein concentrations among both genders, and also with systolic blood pressure and insulin levels among women and concentrations of homocysteine among men (P < 0·05 for all). A dietary pattern reflecting more health-conscious food choices (such as high consumption of vegetables, legumes and nuts, tea, rye, cheese and other dairy products, and alcoholic beverages) was inversely, but less strongly associated with cardiovascular risk factors. Our results support earlier findings that dietary patterns have a role in the development of CVD.

scholarly journals Cardiovascular risk factors in Saudi Arabian and non-Saudi Arabian diabetic patients in Saudi Arabia

2003 ◽  
Vol 9 (5-6) ◽  
pp. 884-892
Author(s):  
D. H. Akbar
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Blood Glucose Control ◽  
Saudi Arabian ◽  
University Hospital ◽  
Diabetic Patients ◽  
Significant Difference ◽  
King Abdulaziz University

To determine frequency of cardiovascular risk factors in Saudi and non-Saudi diabetics, we studied patients attending King Abdulaziz University Hospital for follow-up in the period January 1997 to December 2001. Cardiovascular risk factors, including hypertension, hyperlipidaemia, obesity and smoking, were studied as well as degree of blood glucose control. Of 1122 patients in the study, 48% were Saudis and 52% non-Saudis. No statistically significant difference was found for prevalence of cardiovascular risk factors between the two groups. Correlation of each of the risk factors to patient’s age showed significant correlation to hypertension and smoking

scholarly journals A Cross Sectional Analysis of the Prevalence of Co-Morbidities in Older Transgender Individuals Receiving Hormone Affirming Therapy in Comparison With the General Population

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A786-A787
Author(s):  
Ido Breda ◽  
Iris Yaish ◽  
Yael Sofer ◽  
Karen Michele Tordjman ◽  
Yona Greenman
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
General Population ◽  
Cardiovascular Risk Factors ◽  
Transgender Women ◽  
Cardiovascular Morbidity ◽  
Men And Women ◽  
The Impact ◽  
Transgender Men

Abstract Background: Transgender individuals feel an incongruity between the assigned gender at birth and their gender identity. Because the prevalence of cardiovascular risk factors and morbidity associated with cross-sex hormonal therapy is not well established, particularly in the older transgender population, we set out to compare it to that of the general population. Methods: Data were collected from medical records of transgender patients treated in the Endocrine Institute at the Tel Aviv-Sourasky Medical Center until October 2018. Data from the Israel National Health Survey INHIS-3 2013-2015 were used as reference. Results: 104 (75 transgender women and 29 transgender men) patients over 35 y were identified. The median follow up time was 3 y (1-6.1). Transgender women had a high standardized prevalence rate (SPR) of overweight, smoking and engaging in physical exercise, but not of dyslipidemia compared with cisgender men and women. The SPR for overweight was high in transgender males compared with cisgender men and women. The SPR for smoking and dyslipidemia was high in transgender men compared with cisgender women but not men. Depression and anxiety were markedly increased in transgender women compared with cisgender men [SPR 5.5 (95% CI 3.3-8.5), p&lt;0.001] and women [SPR 2.8 (95% CI 1.7-4.3), p&lt;0.001] in the control population. The SPR of hypertension, diabetes and cerebrovascular disease was not elevated among transgender patients. Conclusions: The prevalence of cardiovascular risk factors but not cardiovascular morbidity was higher in the transgender patients compared with the general population. Further studies including a larger population and a longer follow up time are needed to better assess the impact of a high prevalence of risk factors on cardiovascular morbidity on the long run.

The interaction between dietary approaches to stop hypertension and MC4R gene variant in predicting cardiovascular risk factors

2020 ◽  
pp. 1-9
Author(s):  
Habib Yarizadeh ◽  
Alireza Bahiraee ◽  
Sara Asadi ◽  
Niloofar Sadat Maddahi ◽  
Leila Setayesh ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Model Assessment ◽  
Iranian Women ◽  
Cvd Risk ◽  
Dash Diet ◽  
Melanocortin 4 Receptor Gene ◽  
Significant Difference ◽  
High Adherence

Abstract. Objective: The genetic variants near the melanocortin-4 receptor gene (MC4R), a key protein regulating energy balance and adiposity, have been related to obesity and cardiovascular risk factors. However, qualitative and quantitative aspects of diet may modulate the association of this polymorphism with obesity and cardiovascular diseases (CVDs). The aim of this study was to evaluate interactions among MC4R rs17782313, the Dietary Approaches to Stop Hypertension (DASH) diet and risk factors for CVDs. Method: This cross-sectional study was conducted on 266 Iranian women categorized by body mass index (BMI) range of 25–40 kg/m2 as overweight or obese. CVD risk factors included waist circumference (WC), lipid profile, blood pressure, insulin circulation and fasting blood sugar (FBS). Insulin and FBS were used to calculate homeostatic model assessment insulin resistance (HOMA-IR) Body composition was assessed by a multi-frequency bioelectrical impedance analyzer, InBody 770 scanner. Results: The findings of this study show that high adherence to the DASH diet in the CC groups were associated with decreased SBP and DBP compared to the TT group. In addition, a significant difference between women with high adherence to the DASH diet compared to low adherence was observed for body weight (p < 0.001), fat free mass (FFM) (p = 0.01) and BMI (p = 0.02). Women with the CC genotype had higher insulin (mg/dl) (mean and SD, for TT: 14.6 ± 4.6, TC: 17.3 ± 9.2, CC: 15.3 ± 4.8, p = 0.04) and HOMA-IR (mean for and SD, TT: 3.1 ± 1.07, TC: 3.9 ± 2.4, CC: 3.2 ± 1.1, p = 0.01) than TT group. Inclusion of potential confounding variables (age, physical activity, BMI and daily caloric intake) did not attenuate the difference. Conclusion: Among overweight/obese Iranian women with the CC genotype, incorporating the DASH diet may serve as a dietary prescription to decrease CVD risk. A dietary intervention trial is warranted.

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