Abstract 17284: Geographic Variation in Cardiovascular Health Among American Adults

Background: There are longstanding and pervasive geographic disparities in cardiovascular (CV) health in the US. We sought to evaluate the contemporary trends in CV risk factors by census regions from 2011-2017. The region-specific CV mortality for 2017 was evaluated to assess the geographic overlap between risk factors, CV mortality, and COVID-19 mortality. Methods: The age-adjusted prevalence (per 2010 US census proportions) of CV health index (CVHI) metrics (sum of ideal blood pressure, blood glucose, lipid levels, body mass index, smoking status, physical activity, and diet) (0-7 points), were estimated as both continuous and categorical (ideal, intermediate and poor CVHI) measures in the 2011-2017 BRFSS. Regional trends were evaluated with multivariable-adjusted logistic regression models. Age-adjusted CV mortality for 2017 was derived from the CDC WONDER database. COVID-19 crude mortality rates were ascertained from respective state public health departments. Results: Among 1,362,529 American adults, the CVHI score increased from 3.89±0.004 in 2011 to 3.96±0.01 in 2017 (P<0.001), modestly improvements in all regions (P<0.05 for all). Ideal CV health prevalence improved only in the northeastern (P=0.03) and southern regions (P=0.002). The CVHI score (3.81±0.01) and prevalence of ideal CV health [2017: 12.2% (95% CI: 11.7-12.7%)] was lowest in southern US. This corresponded with the distribution of CV mortality (per 100,000 persons), which was highest in southern region (233.0 [95% CI: 232.2-233.8]) and lowest in western region (197.5 [95% CI: 19.6-198.5]) ( Figure 1 ). State-level distribution of poor CV health did not track with COVID-19 mortality. Conclusion: Despite a modest improvement in CVHI, only one-in-six Americans have ideal CV health with significant regional and state-level differences that correlate with the geographical distribution of CV mortality but not COVID-19 mortality. These disparities may worsen after the COVID-19 pandemic.

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Abstract 17019: Obesity and Cardiovascular Health in Young American Adults

Circulation ◽

10.1161/circ.142.suppl_3.17019 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Sarabjeet S Suri ◽

Vibhu Parcha ◽

Rajat Kalra ◽

Garima Arora ◽

Pankaj Arora

Keyword(s):

Risk Factors ◽

Young Adults ◽

Cardiovascular Health ◽

Piecewise Linear ◽

The United States ◽

Obesity Prevalence ◽

Logistic Regression Models ◽

Prevalence Of Obesity ◽

Adjusted Logistic Regression ◽

The Impact

Background: The growing epidemic of obesity in the United States (US) is associated with cardiovascular (CV) morbidity and mortality. We evaluated the impact of the increasing obesity prevalence on the CV health of young American adults. Methods: The age-adjusted weighted prevalence of hypertension, diabetes, and hypercholesterolemia was estimated from the 2008-2018 National Health and Nutrition Examination Survey (NHANES) in American adults aged 18-44 years, stratified by the presence of obesity. The trends were evaluated using a piecewise linear regression approach. The odds for CV risk factors were estimated using multivariable-adjusted logistic regression models. Results: Among 14,919 young adults, the prevalence of obesity was 33.9% (95% CI: 32.6-35.3%). Obese young adults were more likely to be non-Hispanic Blacks and in lower socioeconomic and educational attainment strata (p<0.05 for all). Obese young adults had a greater risk of having hypertension (adjusted odds ratio [aOR]: 3.0 [95% CI: 2.7-3.4]), diabetes (aOR: 4.3 [95% CI: 3.3-5.6]), and hyperlipidemia (aOR: 1.47 [95% CI: 1.3-1.7]). Among obese, hypertension increased from 36.5% (33.9-39.1%) in 2007-2010 to 39.4% (35.6-43.1%) in 2015-2018 (p= 0.07) and diabetes increased from 4.7% (3.6-5.8%) in 2007-2010 to 7.1% (5.3-9.0%) in 2015-2018 (p=0.11). A modest increase in diabetes was seen in non-obese individuals ( Table ). Hypercholesterolemia prevalence remained unchanged from 12.6% (95% CI: 10.6-14.7%) 2007-2010 to 10.9% (95% CI: 9.0-12.8%) in 2015-2018 (p=0.27) among obese young adults. Non-obese young adults showed a decline in hypercholesterolemia from 9.5% (95% CI: 8.0-11.0%) in 2007- 2010 to 7.1% (95% CI: 5.8-8.4%) in 2015-2018 (p=0.002). Conclusions: Nearly one-in-every three young American adults have obesity, which is accompanied by a two-fold higher prevalence of CV risk factors. The CV morbidity in young adults is expected to increase with an increasing prevalence of obesity..

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Hemoglobin Decline and Health Outcomes in the Elderly: the Cardiovascular Health Study

Blood ◽

10.1182/blood.v112.11.3448.3448 ◽

2008 ◽

Vol 112 (11) ◽

pp. 3448-3448

Author(s):

Neil A Zakai ◽

Benjamin French ◽

Alice Arnold ◽

Anne Newman ◽

Linda F. Fried ◽

...

Keyword(s):

Risk Factors ◽

Kidney Disease ◽

Cardiovascular Health ◽

The Elderly ◽

Baseline Risk ◽

Health Study ◽

Cardiovascular Health Study ◽

Logistic Regression Models ◽

Concurrent Development ◽

Adjusted Logistic Regression

Abstract Introduction: Anemia is associated with increased morbidity and mortality in the elderly, though the risk factors for and the consequences of hemoglobin (HGB) decline are poorly characterized. Methods: We studied 5201 men and women ≥65 participating in the Cardiovascular Health Study. The cohort was followed biannually and had baseline and repeat hemograms 3 years later. HGB decline was defined as >1g/dL HGB drop, or incident anemia at 3 years by WHO criteria. Results: 4006 participants survived to 3 years and had two HGB measures. The median HGB change was −0.2g/dL (IQR-0.8, 0.1). 961 (24%) participants had a >1g/dL HGB drop and 335 (8%) developed incident anemia. The left side of the table presents adjusted logistic regression models of baseline risk factors for HGB decline. Those with baseline cardiovascular disease (CVD), diabetes and kidney disease were more likely to develop >1g/dL HGB drop while only baseline kidney disease was associated with incident anemia. The table also shows the adjusted risk of HGB decline with concurrent development of co-morbid conditions. A >1g/dL drop in HGB was more likely in those who concurrently developed incident CVD, hypertension or inflammation. Incident anemia was more likely in participants with concurrent development of kidney disease or inflammation. Both incident anemia and a HGB drop >1g/dL were associated with subsequent 9-year mortality adjusting for age, race, gender, year 3 HGB, hypertension, CVD, diabetes, and renal disease; HRs (95% CI) 1.4 (1.2, 1.6) and 1.2 (1.1, 1.4) respectively. Discussion: Among studied factors, baseline CVD, diabetes and kidney disease were risk factors for >1g/dL HGB drop while only baseline kidney disease was a risk factor for incident anemia. Incident CVD and hypertension were associated concurrently with >1g/dL HGB drop while kidney disease was associated with concurrent incident anemia. Inflammation development was the strongest risk factor accompanying HGB decline. HGB decline, especially a 1g/dL drop, was associated with subsequent mortality irrespective of HGB concentration. These data suggest that small HGB changes not captured by the WHO anemia criteria are associated with poor health outcomes and that inflammation is a major correlate of HGB decline in the elderly. Table: Risk Factors for HGB Decline in Age-, Race-, Gender, and Baseline HGB-Adjusted Logistic Regression Models Baseline Risk Factors for HGB Decline Risk of HGB Decline with Concurrent Conditions HGB Drop >1g/dL Incident Anemia HGB Drop >1g/dL Incident Anemia CVD 1.2 (1.1, 1.4) 1.0 (0.8, 1.3) 1.3 (1.1, 1.6) 1.0 (0.7, 1.3) Hypertension 1.1 (0.99, 1.3) 1.1 (0.8, 1.2) 1.4 (1.1, 1.7) 1.1 (0.8, 1.5) Diabetes 1.3 (1.1, 1.5) 1.1 (0.8, 1.4) 0.9 (0.6, 1.4) 0.8 (0.4, 1.7) Kidney Disease (GFR <60ml/min/1.73m2) 1.2 (1.0, 1.3) 1.3 (1.1, 1.7) 1.1 (0.8, 1.4) 1.5 (1.0, 2.1) Inflammation CRP ≥10mg/dL or WBC≥15×109/mm3 1.0 (0.8, 1.3) 1.3 (0.99 1.8) 2.3 (1.8, 2.8) 2.3 (1.8, 3.0)

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Risk Factors for Olfactory and Gustatory Dysfunctions in Patients with SARS-CoV-2 Infection

Neuroepidemiology ◽

10.1159/000514888 ◽

2021 ◽

pp. 1-8

Author(s):

Francesca Galluzzi ◽

Veronica Rossi ◽

Cristina Bosetti ◽

Werner Garavello

Keyword(s):

Risk Factors ◽

Smoking Status ◽

Inverse Association ◽

Current Smoking ◽

Logistic Regression Models ◽

Respiratory Allergies ◽

History Of ◽

Never Smokers ◽

Smell Loss ◽

Relevant Covariates

Introduction: Smell and taste loss are characteristic symptoms of SARS-CoV-2 infection. The aim of this study is to investigate the prevalence and risk factors associated with olfactory and gustatory dysfunctions in coronavirus disease (COVID-19) patients. Methods: We conducted an observational, retrospective study on 376 patients with documented SARS-CoV-2 infection admitted to the San Gerardo Hospital in Monza, Italy, from March to July 2020. All patients answered a phone questionnaire providing information on age, sex, smoking status, and clinical characteristics. Adjusted odds ratios (ORs) and corresponding 95% confidence intervals (CIs) were estimated through logistic regression models including relevant covariates. Results: The prevalence of olfactory and gustatory dysfunctions in COVID-19 patients was 33.5 and 35.6%, respectively. Olfactory dysfunctions were significantly directly associated with current smoking and history of allergy, the multivariable ORs being 6.53 (95% CI 1.16–36.86) for current smokers versus never smokers, and 1.89 (95% CI 1.05–3.39) for those with an allergy compared to those without any allergy. Respiratory allergy in particular was significantly associated with olfactory dysfunctions (multivariable OR 2.30, 95% CI 1.02–5.17). Significant inverse associations were observed for patients aged 60 years or more (multivariable OR 0.33, 95% CI 0.19–0.57) and hospitalization (multivariable OR 0.22, 95% CI 0.06–0.89). Considering gustatory dysfunctions, after allowance of other variables a significant direct association was found for respiratory allergies (OR 2.24, 95% CI 1.03–4.86), and an inverse association was found only for hospitalization (OR 0.21, 95% CI 0.06–0.76). Conclusion: Our study indicates that current smoking and history of allergy (particularly respiratory) significantly increase the risk for smell loss in COVID-19 patients; the latter is also significantly associated to taste loss. Hospitalization has an inverse association with the risk of olfactory and gustatory dysfunctions, suggesting that these may be symptoms characteristics of less severe SARS-CoV-2 infection.

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Abstract 17220: Risk Factors for Recurrent Peripartum Cardiomyopathy in 783 Women in California

Circulation ◽

10.1161/circ.138.suppl_1.17220 ◽

2018 ◽

Vol 138 (Suppl_1) ◽

Author(s):

Punag Divanji ◽

Gregory Nah ◽

Ian Harris ◽

Anu Agarwal ◽

Nisha I Parikh

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Logistic Regression ◽

Regression Models ◽

Subsequent Pregnancy ◽

Peripartum Cardiomyopathy ◽

Lv Function ◽

Logistic Regression Models ◽

Grand Multiparity ◽

Adjusted Logistic Regression

Introduction: Characterized by significant left ventricular (LV) dysfunction and clinical heart failure (HF), peripartum cardiomyopathy (PPCM) has an incidence of approximately 1/2200 live births (0.04%). Prior studies estimate that approximately 25% of those with recovered LV function will have recurrent clinical PPCM during subsequent pregnancies, compared to 50% of those without recovered LV function. Specific predictors of recurrent PPCM have not been studied in cohorts with large numbers. Methods: From 2005-2011, we identified 1,872,227 pregnancies by International Classification of Diseases, 9th Revision (ICD-9) codes in the California Healthcare Cost and Utilization Project (HCUP) database, which captures over 95% of the California hospitalized population. Excluding 15,765 women with prior cardiovascular disease (myocardial infarction, coronary artery disease, stroke, HF, valve disease, or congenital heart disease), yielded n=1,856,462 women. Among women without prior cardiovascular disease, we identified index and subsequent pregnancies with PPCM to determine episodes of recurrent PPCM. We considered the following potential predictors of PPCM recurrence in both univariate and age-adjusted logistic regression models: age, race, hypertension, diabetes, smoking, obesity, chronic kidney disease, family history, pre-eclampsia, ectopic pregnancy, income, and insurance status. Results: In HCUP, n=783 women had pregnancies complicated by PPCM (mean age=30.8 years). Among these women, n=133 had a subsequent pregnancy (17%; mean age=28.1 years), with a mean follow-up of 4.34 years (±1.71 years). In this group of 133 subsequent pregnancies, n=14 (10.5%) were complicated by recurrent PPCM, with a mean time-to-event of 2.2 years (±1.89 years). Among the risk factors studied, the only univariate predictor of recurrent PPCM was grand multiparity, defined as ≥ 5 previous deliveries (odds ratio: 22; 95% confidence interval 4.43-118.22). The other predictors we studied were not significantly associated with recurrent PPCM in either univariate or multivariable models. Conclusion: In a large population database in California with 783 cases of PPCM over a 6-year period, 17% of women had a subsequent pregnancy, of which 10.5% had recurrent PPCM. In age-adjusted logistic regression models, grand multiparity was the only statistically significant predictor of recurrent PPCM.

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Consumption of Foods Derived from Subsidized Crops Remains Associated with Cardiometabolic Risk: An Update on the Evidence Using the National Health and Nutrition Examination Survey 2009–2014

Nutrients ◽

10.3390/nu12113244 ◽

2020 ◽

Vol 12 (11) ◽

pp. 3244

Author(s):

Whitney L. Do ◽

Kai M. Bullard ◽

Aryeh D. Stein ◽

Mohammed K. Ali ◽

K. M. Venkat Narayan ◽

...

Keyword(s):

Risk Factors ◽

Cardiometabolic Risk ◽

Smoking Status ◽

Cardiometabolic Risk Factors ◽

Calorie Intake ◽

Abdominal Adiposity ◽

Daily Consumption ◽

Farm Bill ◽

Logistic Regression Models ◽

Food Commodities

In this study, we examined the associations between the consumption of foods derived from crops subsidized under the 2008 United States (US) Farm Bill and cardiometabolic risk factors and whether the magnitude of these associations has changed since the 2002 US Farm Bill. Four federal databases were used to estimate daily consumption of the top seven subsidized commodities (corn, soybeans, wheat, rice, sorghum, dairy, and livestock) and to calculate a subsidy score (0–1 scale) for Americans’ daily dietary intake during 2009–2014, with a higher score indicative of a higher proportion of the diet derived from subsidized commodities. The cardiometabolic risk factors included obesity, abdominal adiposity, hypertension, dyslipidemia, and dysglycemia. Linear and logistic regression models were adjusted for age, sex, race/ethnicity, the poverty–income ratio, the smoking status, educational attainment, physical activity, and daily calorie intake. During 2009–2014, adults with the highest subsidy score had higher probabilities of obesity, abdominal adiposity, and dysglycemia compared to the lowest subsidy score. After the 2002 Farm Bill (measured using data from 2001–2006), the subsidy score decreased from 56% to 50% and associations between consuming a highly-subsidized diet and dysglycemia did not change (p = 0.54), whereas associations with obesity (p = 0.004) and abdominal adiposity (p = 0.002) significantly attenuated by more than half. The proportion of calories derived from subsidized food commodities continues to be associated with adverse cardiometabolic risk factors, though the relationship with obesity and abdominal adiposity has weakened in recent years.

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Determinants, circumstances and consequences of injurious falls among older women living in the community

Injury Prevention ◽

10.1136/injuryprev-2019-043499 ◽

2020 ◽

pp. injuryprev-2019-043499

Author(s):

Elizabeth A Phelan ◽

Eileen Rillamas-Sun ◽

Lisa Johnson ◽

Michael J LaMonte ◽

David M Buchner ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Older Women ◽

Cardiovascular Health ◽

Health Study ◽

Cardiovascular Health Study ◽

Logistic Regression Models ◽

The Past ◽

Injurious Falls ◽

Injurious Fall

ObjectiveTo identify the risk factors of women who fell with injury relative to women who did not fall or fell without injury and to describe the circumstances and consequences of injurious and non-injurious falls.MethodsWe analysed 5074 older women from the Objective Physical Activity and Cardiovascular Health Study who prospectively tracked their falls using a 13-month calendar. Women with a reported fall were phone interviewed about fall-related details, including injuries. Risk factors were identified from surveys and clinical home visits. Logistic regression models were used to calculate adjusted ORs and 95% CIs for injurious falls relative to not falling or falling without injury. Circumstances of injurious and non-injurious falls were compared.ResultsAt least one fall was experienced by 1481 (29%) participants. Of these, 1043 were phone interviewed, of whom 430 (41%) reported at least one injurious fall. Relative to not falling, the risk factor most strongly associated with experiencing an injurious fall was having fallen ≥2 times (OR 4.0, CI 2.7 to 5.8) in the past year. Being black was protective for fall-related injury (OR 0.6, CI 0.4 to 0.9). No strong associations in risk factors were observed for injurious relative to non-injurious falls. Injurious falls were more likely to occur away from and outside of the home (p<0.05). Over half of those who injured self-managed their injury.ConclusionFalling repeatedly is a powerful risk factor for injurious falls. Those who have fallen more than once should be prioritised for interventions to mitigate the risk of an injurious fall.

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Abstract 37: The Association of Cardiorespiratory Fitness and Ideal Cardiovascular Health in the Aerobics Center Longitudinal Study

Circulation ◽

10.1161/circ.135.suppl_1.37 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Leanna M Ross ◽

Jacob L Barber ◽

Xuemei Sui ◽

Steven N Blair ◽

Mark A Sarzynski

Keyword(s):

Longitudinal Study ◽

Cardiorespiratory Fitness ◽

Cardiovascular Health ◽

Smoking Status ◽

Cross Sectional ◽

Ideal Cardiovascular Health ◽

Logistic Regression Models ◽

Using Data ◽

Middle Aged Adults ◽

Aerobics Center Longitudinal Study

Purpose: To examine the cross-sectional association between cardiorespiratory fitness (CRF) and ideal cardiovascular health (CVH) in middle-aged adults. Methods: The association between CRF and ideal CVH score was examined in 11,590 adults (8,865 men, 2,725 women) from the Aerobics Center Longitudinal Study. CRF was measured as duration in minutes from a maximal treadmill test. The AHA’s ideal CVH score was calculated on a 14 point scale using data on smoking status, BMI, physical activity (MET-min/wk), healthy diet, total cholesterol, blood pressure, and fasting plasma glucose recorded between 1987 and 1999. Participants were grouped into categories of inadequate (0-4), average (5-9), and optimum (10-14) based on their CVH score. Three CRF groups were created from age- and sex-specific quintiles based on the previously established cutpoints of treadmill time: low, moderate, and high CRF. We used general linear and logistic regression models adjusted for age, sex, and year of examination to evaluate the association of CRF with ideal CVH score. Results: The mean CVH score for men was 8.4 ± 2.2 and 9.7 ± 2.0 for women. Approximately 33% of men and 57% of women had optimum CVH, while only a small proportion of participants had inadequate CVH (5.1% M, 1.4% F). Treadmill time was moderately correlated (p<0.0001) with CVH score in both men (r=0.56) and women (r=0.50). CRF explained 16% and sex 18% of the variance in CVH score (both p<0.0001). Our adjusted model found that participants in the optimum CVH category had 20% and 43% higher CRF levels than those in the average and inadequate CVH groups (p<0.0001), respectively ( Figure 1 ). The adjusted odds (95% CI) of having optimum CVH were 14.0 (11.0-17.8) and 3.1 (2.4-4.0) times greater for high CRF and moderate CRF, respectively, compared to low CRF (p<0.0001). Discussion: Higher levels of cardiorespiratory fitness are associated with better cardiovascular health profiles in both men and women. Thus, improving fitness represents a strategy to improve cardiovascular and public health.

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Abstract 14193: Depression Worsens Cardiovascular Health: A Population-based Cohort Study (NHANES, 2015-16)

Circulation ◽

10.1161/circ.142.suppl_3.14193 ◽

2020 ◽

Vol 142 (Suppl_3) ◽

Author(s):

Brent Medoff ◽

Andrew Baird ◽

Brandon Herbert ◽

Jared W Magnani

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Health ◽

Smoking Status ◽

Population Based ◽

Mild Depression ◽

Health And Nutrition ◽

Patient Health ◽

Cardiovascular Health Promotion

Introduction: Depression increases cardiovascular risk, but associations between depression and cardiovascular risk profiles have had limited investigation. We hypothesized that depression is associated with cardiovascular risk factors in a population-based cohort. Methods: We selected participants from the 2015-16 National Health and Nutrition Examination Survey (NHANES) and age ≥25 years. Participants completed the Patient Health Questionnaire (PHQ), a 9-item, validated instrument categorizing minimal (0-4), mild (5-9) or moderate-to-severe (≥10) depression. We employed the American Heart Association’s assessment of cardiovascular health, Life’s Simple 7 (LS7) which uses risk factors (smoking status, BMI, physical activity, diet, cholesterol, blood pressure, and glycohemoglobin) to categorize cardiovascular health as poor (0-1), intermediate (5-9) or ideal (10-14). We related PHQ scores to cardiovascular health as measured by LS7 in regression analyses adjusted for relevant covariates (age, sex, race, education, health insurance and poverty-income level). Results: Among 5053 NHANES participants, 4003 (79%) had data for the PHQ and determination of LS7 scores (age 51±16; 52% female; 67% white race). Individuals with mild depression (PHQ 5-9) had 1.4-times greater likelihood (95% CI, 1.07-1.92) of lower cardiovascular health compared to those without depression in multivariable-adjusted models. Likewise, individuals with moderate depression (PHQ≥10) had 3-times greater likelihood (95% CI, 1.90-4.97) of lower cardiovascular health compared to those without depression. Conclusions: In a socially diverse cohort, individuals with depression were more likely to have significantly lower cardiovascular health compared to those without depression. Our findings show that depression may be a barrier to cardiovascular health promotion. Addressing depression appears essential to improve cardiovascular health.

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PREVALENCE OF AND RISK FACTORS ASSOCIATED WITH ALCOHOL ABUSE IN MOSHI, NORTHERN TANZANIA

Journal of Biosocial Science ◽

10.1017/s0021932007002441 ◽

2008 ◽

Vol 40 (3) ◽

pp. 379-399 ◽

Cited By ~ 15

Author(s):

TISHA MITSUNAGA ◽

ULLA LARSEN

Keyword(s):

Risk Factors ◽

Alcohol Use ◽

Alcohol Abuse ◽

Higher Alcohol ◽

Logistic Regression Models ◽

Factors Associated ◽

Raising Awareness ◽

Northern Tanzania ◽

Adjusted Logistic Regression ◽

Harmful Effects

SummaryThis study aimed to assess the prevalence of and risk factors associated with alcohol abuse among women and men in Moshi in northern Tanzania. Alcohol abuse was measured by a CAGE score of 2–4, versus 0–1 for no alcohol abuse (Ewing, 1984). Crude and adjusted logistic regression models determined odds ratios (OR) and 95% confidence intervals (95% CI) of alcohol abuse by characteristics of, respectively, women with partners (n=1200), women without partners (n=614) and men (n=788) (women’s partners). Prevalence of alcohol abuse was 7·0% (95% CI: 5·6–8·4) among women with partners, 9·3% (95% CI: 7·0–11·6) among women without partners, and more than double among men at 22·8% (95% CI: 19·9–25·8). In general, Christians had higher alcohol abuse than Muslims or other religions, as did Chagga men compared with men of other ethnic groups. Other socio-demographic characteristics, such as education or income, were not significant. Sexual behaviours were significant predictors of alcohol abuse. For example, women without partners who reported more than two partners in the last year had higher alcohol abuse compared with women reporting no partners (OR=8·75; 95% CI: 2·37–32·31), as did men reporting it is ‘OK to hit a partner’ for any reason (OR=1·79; 95% CI: 1·16–2·77) compared with men who did not. HIV-1 infection was not significantly associated with alcohol abuse by women or men. The Christian Church in Moshi should consider raising awareness about the harmful effects of high alcohol use among its adherents. Comprehensive programmes focusing on reducing number of partners and alcohol use, particularly by men, are needed in this community.

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Determinants of coronary artery disease risk factor management across three world regions

Heart Asia ◽

10.1136/heartasia-2018-011112 ◽

2019 ◽

Vol 11 (1) ◽

pp. e011112

Author(s):

Min Zhao ◽

Ian Graham ◽

Marie Therese Cooney ◽

Diederick E Grobbee ◽

Ilonca Vaartjes ◽

...

Keyword(s):

Risk Factors ◽

Risk Factor ◽

Middle East ◽

Cardiac Rehabilitation ◽

Cardiovascular Health ◽

Disease Risk ◽

Low Density Lipoprotein ◽

Density Lipoprotein ◽

Risk Factor Management ◽

Logistic Regression Models

BackgroundThe SUrvey of Risk Factors (SURF) indicated poor control of risk factors in subjects with established coronary heart disease (CHD). The present study aimed to investigate determinants of risk factor management in patients with CHD.Methods and resultsSURF recruited 9987 consecutive patients with CHD from Europe, Asia and the Middle East between 2012 and 2013. Risk factor management was summarised as a Cardiovascular Health Index Score (CHIS) based on six risk factor targets (non-smoker/ex-smoker, body mass index <30, adequate exercise, controlled blood pressure, controlled low-density lipoprotein and controlled glucose). Logistic regression models assessed the associations between determinants (age, sex, family history, cardiac rehabilitation, previous hospital admission and diabetes) and achievement of moderate CHIS (≥3 risk factors controlled). The results are presented as OR with corresponding 95% CI. A moderate CHIS was less likely to be reached by women (OR 0.90, 95% CI 0.69 to 1.00), those aged <55 years old (OR 0.62, 95% CI 0.53 to 0.76) and those with diabetes (OR 0.41, 95% CI 0.37 to 0.46). Attendance in cardiac rehabilitation was associated with better CHIS achievements (OR 1.62, 95% CI 1.42 to 1.87). Younger Asian and European patients had poorer risk factor management, whereas for patients from the Middle East age was not significantly associated with risk factor management. The availability and applicability of cardiac rehabilitation varied by region.ConclusionsOverall, risk factor management was poorer in women, those younger than 55 years old, those with diabetes and those who did not participate in a cardiac rehabilitation. Determinants of cardiovascular risk factor management differed by region.

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