Abstract 16147: Sex, Gender Factors and Cardiovascular Health in Canadian and Austrian Populations

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Zahra Azizi ◽  
Teresa Gisinger ◽  
Uri Bender ◽  
Valeria Raparelli ◽  
Colleen M Norris ◽  
...  
Keyword(s):  
Heart Disease ◽  
Marital Status ◽  
Life Stress ◽  
Cardiovascular Health ◽  
Principal Component ◽  
Canadian Community Health Survey ◽  
Household Size ◽  
Biological Sex ◽  
Propensity Score Methods ◽  
Female Sex

Introduction: Little evidence exists differentiating the effect of biological sex from gender-related (i.e. psycho-socio-cultural) characteristics in cardiovascular outcomes. Hypothesis: Here, we explored the association between sex, gender, and cardiovascular health (CVH) among Canadians (CAN) and Austrians (AT). Methods: Data from the Canadian Community Health Survey (CCHS) (n=63,522, 55% Females) and Austrian Health Interview Survey (AT-HIS) (n=15,771, 56% Females), were analyzed. The CANHEART index, a measure of ideal CVH composed of 6 cardiometabolic risk factors ranging from 0 (worst) to 6 (ideal), was calculated in the CCHS as well as AT-HIS databases (ATHEART). A country-specific gender score was computed using principal component analysis-derived propensity score methods. The final gender scores (Range=0-1, higher score identifying characteristics traditionally ascribed to women) included: i) household size, perceived life stress, education, sense of belonging to community, marital status, and income (CAN); ii) household size, frequency of negative emotions, education, marital status and income (AT). Results: Median CANHEART and CAN gender scores were 4 [3-5] and 0.53 [0.49-0.60] while median ATHEART and AT gender scores were 4 [3-5] and 0.55 [0.46-0.64]. Although higher gender scores (CCHS: β=-1.33, 95%CI (-1.44,-1.22); AT-HIS: β=-1.11, 95%CI (-1.30,-0.91)) were associated with worse CVH, female sex (CCHS: β=0.35, 95% CI (0.33,0.37); AT-HIS: β=0.59, 95%CI (0.55,0.64)) was associated with better CVH in both populations. Additionally, higher gender scores were associated with a higher risk of heart disease, compared to female sex. The magnitude of this risk was higher in AT population (Table1). Conclusions: Individuals with characteristics typically ascribed to women reported poorer CVH and exhibited higher risk of heart disease independent of biological sex. Gender factors must be targeted for improving cardiovascular health.

Abstract P259: The Association Between Sex, Gender and Health Status of Stroke Survivors in the Canadian Population

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Zahra Azizi ◽  
Valeria Raparelli ◽  
Colleen M Norris ◽  
Khaled El Emam ◽  
Louise Pilote ◽  
...  
Keyword(s):  
Health Status ◽  
Life Stress ◽  
Health Utility Index ◽  
Stroke Survivors ◽  
Health State ◽  
Permanent Disability ◽  
Biological Sex ◽  
Female Sex ◽  
Canadian Population ◽  
And Gender

Background: Stroke is one of the most common cerebrovascular diseases causing permanent disability, and decreased quality of life (QoL). Both sex and gender have been reported to be associated with health outcomes. Gender, unlike biological sex, encompasses the psycho-socio-cultural roles, behaviors and identities of men, women, and gender-diverse people. Hypothesis: To examine the association between sociocultural gender, biological sex and health status among stroke survivors in the Canadian population. Methods: Data from cycles 2013-2014 and 2015-16 (n=237,121) of the Canadian Community Health Survey (CCHS) were analyzed. The primary endpoint of the study was Health Utility Index (HUI), a measure of health status and QoL. This index measures a range of health domains (i.e. vision, hearing, speech, ambulation, dexterity, emotion, cognition, and pain) and ranges between -0.36 (severe health state) to 1 (perfect health state). A gender score was computed based on the Genesis-Praxy method, using a principal component analysis-derived propensity score method. The final gender scores ranging from 0 to 1 (higher score identifying characteristics traditionally ascribed to women) included household size, perceived life stress, education, sense of belonging to community, marital status, and income. All statistical analyses were performed using R (V.4.0.2) with survey design. Results: Amongst 3,773 (1.1%) stroke survivors in two cycles, 47.8% were female and a majority were older than 50 years (85.3%). Overall, 76.4% of the stroke survivors had moderate to severe HUI (<=0.88), however, this rate was higher in females (82.5% vs 70.2%, P<0.001). Median gender score was 0.49 [0.46-0.55]. Higher gender scores (OR=12.5, 95%CI=1.4-116.2, P=0.02) and female sex (OR=1.8, 95%CI=1.2-2.8, P=0.002) were independently associated with moderately to severely diminished health status (HUI) in a model adjusted for age, and comorbidities (i.e. hypertension, diabetes, heart disease, and history of cancer). Conclusion: Characteristics traditionally ascribed to women’s gender and female sex were associated with poorer health status in stroke survivors. Gender-related factors must be targeted for improving the health status of patients suffering from stroke.

scholarly journals Women’s Cardiac Health in 2020: A Systematic Review

2020 ◽  
Vol 4 (02) ◽  
pp. 104-110
Author(s):  
Fabiola B. Sozzi ◽  
Marta Belmonte ◽  
Marco Schiavone ◽  
Ciro Canetta ◽  
Rakesh Gupta ◽  
...  
Keyword(s):  
Risk Factors ◽  
Heart Disease ◽  
Cardiovascular Health ◽  
The Novel ◽  
Cvd Risk ◽  
Disease Manifestation ◽  
Substantial Progress ◽  
Diagnostic Approaches ◽  
Traditional Risk Factors ◽  
Gender Specific

AbstractAlthough substantial progress has been made toward improving gender- and sex-specific cardiovascular disease (CVD) management and outcomes, contemporary reports indicate a persistent knowledge gap with regard to optimal risk-stratification and management in female cardiac heart disease (CHD) patients. Prominent patient and system delays in diagnosing CHD are, in part, due to the limited awareness for the latent CVD risk in women, a lack of sex-specific thresholds within clinical guidelines, and subsequent limited performance of contemporary diagnostic approaches in women. Several traditional risk factors for CHD affect both women and men. But other factors can play a bigger role in the development of heart disease in women. In addition, little is known about the influence of socioenvironmental and contextual factors on gender-specific disease manifestation and outcomes. It is imperative that we understand the mechanisms that contribute to worsening risk factors profiles in young women to reduce future atherosclerotic CVD morbidity and mortality. This comprehensive review focuses on the novel aspects of cardiovascular health in women and sex differences as they relate to clinical practice and prevention, diagnosis, and treatment of CVD. Increased recognition of the prevalence of traditional cardiovascular risk factors and their differential impact in women, as well as emerging nontraditional risk factors unique to or more common in women, contribute to new understanding mechanisms, leading to worsening outcome for women.

scholarly journals Biological age in UK Biobank: biomarker composition and prediction of mortality, coronary heart disease and hospital admissions

2019 ◽  
Author(s):  
Mei Sum Chan ◽  
Matthew Arnold ◽  
Alison Offer ◽  
Imen Hammami ◽  
Marion Mafham ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Principal Components ◽  
Hospital Admissions ◽  
Principal Component ◽  
Age Effects ◽  
Biological Age ◽  
Chronological Age ◽  
Uk Biobank

AbstractBackgroundAge is the strongest risk factor for most chronic diseases, and yet individuals may age at different rates biologically. A biological age formed from biomarkers may be a stronger risk factor than chronological age and understanding what factors contribute to it could provide insight into new opportunities for disease prevention.Methods and findingsAmong 480,019 UK Biobank participants aged 40-70 recruited in 2006-2010 and followed up for 6-12 years via linked death registry and secondary care records, a subpopulation of 141,254 (29.4%) non-smoking adults in good health and with no medication use or disease history at baseline were identified. Independent components of 72 biomarkers measured at baseline were characterised by principal component analysis. The Klemera Doubal method (KDM), which derived a weighted sum of biomarker principal components based on the strengths of their linear associations with chronological age, was used to derive sex-specific biological ages in this healthy subpopulation. The proportions of the overall biological and chronological age effects on mortality, coronary heart disease and age-related non-fatal hospital admissions (based on a hospital frailty index) that were explained by biological age were assessed using log-likelihoods of proportional hazards models.Reduced lung function, reduced kidney function, slower reaction time, lower insulin-like-growth factor 1, lower hand grip strength and higher blood pressure were key contributors to biological age (explaining the highest percentages of its variance) in both men and women, while lower albumin, higher sex hormone-binding globulin and lower muscle mass in men, and higher liver enzymes, blood lipids and HbA1c in women were also important. Across both sexes, a 51-principal component biological age explained 66%, 80% and 63% of the age effects on mortality, coronary heart disease and hospital admissions, respectively. Restricting the biological age to the 12-13 key biomarkers corresponding to the 10 most importantly contributing principal components resulted in little change in these proportions for women, but a reduction to 53%, 63% and 50%, respectively, for men.ConclusionsThis study identified that markers of impaired function in a range of organs account for a substantial proportion of the apparent effect of age on disease and hospital admissions. It supports a broader, multi-system approach to research and prevention of diseases of ageing.

2008 Stroke Council Award and Lecture—Brain and Heart: The Good, the Bad, and the Different

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Vladimir Hachinski
Keyword(s):  
Quality Of Life ◽  
Heart Disease ◽  
Cardiovascular Health ◽  
Stroke Recovery ◽  
Heart Attacks ◽  
Electrical Systems ◽  
Ischemic Attack ◽  
Mental Exercise ◽  
The Brain

The brain and the heart are unique and essential organs, with autoregulated blood supplies and sophisticated electrical systems, functioning with harmonious complementarity in health; however, disease of one organ can threaten the other. Cardiac valvular disease, atrial fibrillation, and acute myocardial infarction carry a risk of stroke, and both ischemic and hemorrhagic strokes can lead to cardiac abnormalities and sudden death. Heart disease and stroke share most of the same risk factors, but not to the same degree, nor necessarily with the same consequences. For example, hypertension represents the single most powerful risk factor for stroke and can result in a major intracerebral hemorrhage, a condition without equivalent in any other organ. Despite the superficial resemblance between angina and transient ischemic attack, the mechanisms differ. Angina can be brought on by exercise, but no amount of mental exercise will lead to “brain angina.” Most cardiac patients can maintain a reasonable quality of life on half of their cardiac output. No meaningful quality of life is likely with half of brain output. Stroke recovery is complex. The brain is the only organ with which one can communicate directly and whose feelings have to be considered in recovery. Although stroke and heart disease prevention have much in common, puzzling differences remain. In primary prevention, aspirin prevents heart attacks in men but not in women, and strokes in women but not in men. Given the great commonalities and interrelationships between vascular brain and heart disease, it has been sensible and successful to have one organization encompassing cerebrovascular and cardiovascular health and diseases. To continue to progress at an accelerated pace, we need to become more familiar with the mutual relationship between cerebrovascular and cardiovascular disease, work together where we can, and separately where we must, but with the common aim of vanquishing both.

Abstract P397: Social Determinants of Hypertension and Diabetes Among African Immigrants: The African Immigrant Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Oluwabunmi Ogungbe ◽  
Ruth-alma N Turkson-ocran ◽  
Diana Baptiste ◽  
Binu Koirala ◽  
Cheryl R Dennison Himmelfarb ◽  
...  
Keyword(s):  
Health Insurance ◽  
Marital Status ◽  
Social Determinants ◽  
Immigrant Health ◽  
Cardiovascular Health ◽  
African Immigrants ◽  
Health Study ◽  
Cross Sectional ◽  
African Immigrant ◽  
African Immigrant Health

Introduction: The differences in the risk of cardiovascular disease (CVD) among Black ethnic groups in the U.S. remain largely unexplained. African immigrants are particularly likely to have high rates of hypertension and diabetes, and less likely to be screened, diagnosed or receive treatment. Objective: To examine the association between social determinants of health (SDoH) and hypertension and diabetes among African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of 465 African immigrants living in the Baltimore-Washington metropolitan area. Data collection was performed through a combination of physical examinations and questionnaires. The outcomes were self-reported hypertension and diabetes. Elements of SDoH collected were education, income, health insurance, employment and marital status. Logistic regression analyses were used to assess the association between SDoH and hypertension/diabetes. Results: The mean age of participants was 46.8(±11.5) years and 60% were women; 64% had ≥ college degree, 83% were employed, 67% had health insurance, and 70% were married/co-habiting. Mean body mass index was 30.7 (±18.3) kg/m 2 . The prevalence of hypertension and diabetes was 32%, and 13% respectively. The odds of diabetes were higher amongst those who were unemployed [aOR: 2.86 (1.39-5.56)] ( Table ). Education, health insurance, income and marital status were not associated with hypertension or diabetes after accounting for age and sex. Conclusion: Among African immigrants, we observed that those who were unemployed had a higher likelihood of self-reported diabetes than those who were employed. Additional studies are needed to further study the contributions of social determinants of hypertension and diabetes as well as and developing health policy and interventions to improve cardiovascular health.

Abstract 07: Association of Social Network Characteristics With Cardiovascular Health and Coronary Artery Calcium in South Asians: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Nilay S Shah ◽  
Mark D Huffman ◽  
Sadiya S Khan ◽  
John A Schneider ◽  
Juned Siddique ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Heart Disease ◽  
Social Network ◽  
Coronary Artery ◽  
High Risk ◽  
Coronary Artery Calcium ◽  
Cardiovascular Health ◽  
South Asians ◽  
High Risk Population ◽  
Lower Odds

Introduction: South Asian Americans (SAs) have disproportionately high burden of poor cardiovascular health (CVH) and CVD, which may be influenced by people within their social network (SN). We examined the association of SN characteristics and SN member (“alter”) health with CVH and coronary artery calcium (CAC) in SAs to identify targets for CVD prevention in this high-risk community. Hypothesis: Smaller SN size and worse alter health is associated with poor CVH and CAC in SAs. Methods: In 699 SAs in the MASALA Study, SN characteristics (size, density, proportion of kin or SA ethnicity), alter health status (self-report of an alter with high blood pressure [HTN], hyperlipidemia [HL], heart disease, diabetes, or stroke), CVH score (0-14, based on poor, intermediate, or ideal blood pressure, cholesterol, glucose, physical activity, diet, weight, and smoking), and CAC data were collected between 2016-2018. Multiple logistic regression evaluated the association of SN characteristics or alter health with prevalent CVH and CAC. Results: Participants were mean age 59±9 years and 43% women. Mean CVH score was 8.9±1.9, median CAC score 8 (range 0 - 4217). SNs were mean 6±3 people, density 79±26%, 72±28% kin, 88±23% SA ethnicity; 48% had an alter with HTN, 42% with HL, 18% with heart disease, 40% with diabetes, and 2% with stroke. A 1-person larger SN size was associated with a 19% higher odds of ideal vs. poor CVH in men (p=0.02), and an 11% lower odds of CAC in women (p=0.05, Table). In men, having at least 1 alter with HTN or HL was associated with a 58% or 54% lower odds of ideal vs. poor CVH (p=0.03, p=0.04), and having at least 1 alter with HL was associated with a 78% higher odds of CAC (p=0.05). No associations were seen between other SN characteristics, nor alters with other CVD risk factors, and CVH or CAC. Conclusions: In SAs, larger SN size was associated with better CVH. Having a SN member with HTN or HL may be associated with poorer CVH and CAC. Interventions to increase SN size or target SN member CVH may promote CVH in this high-risk population.

The abnormal ECG without apparent heart disease and the normal ECG in serious heart diseases: two extremes

ESC CardioMed ◽  
2018 ◽  
pp. 391-393
Author(s):  
Antonio Bayés de Luna ◽  
Günter Breithardt
Keyword(s):  
Heart Disease ◽  
Cardiovascular Health ◽  
Heart Diseases ◽  
Clinical Context ◽  
Electrocardiogram Ecg

It is clear that the electrocardiogram (ECG) must be evaluated within the clinical context. Therefore, this chapter can be summarized with the following sentence: a normal ECG is not a guarantee of cardiovascular health, nor is a pathological ECG an unequivocal sign of heart disease. This must always be remembered when interpreting an ECG.

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