scholarly journals Pathways by Which Food Insecurity Is Associated With Atherosclerotic Cardiovascular Disease Risk

2021 ◽  
Author(s):  
Deepak Palakshappa ◽  
Edward H. Ip ◽  
Seth A. Berkowitz ◽  
Alain G. Bertoni ◽  
Kristie L. Foley ◽  
...  
Keyword(s):  
Mental Health ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Food Insecurity ◽  
Access To Care ◽  
Risk Score ◽  
Equation Modeling ◽  
Care Pathways ◽  
Atherosclerotic Cardiovascular Disease ◽  
Ascvd Risk

Background Food insecurity (FI) has been associated with an increased atherosclerotic cardiovascular disease (ASCVD) risk; however, the pathways by which FI leads to worse cardiovascular health are unknown. We tested the hypothesis that FI is associated with ASCVD risk through nutritional/anthropometric (eg, worse diet quality and increased weight), psychological/mental health (eg, increased depressive symptoms and risk of substance abuse), and access to care pathways. Methods and Results We conducted a cross‐sectional study of adults (aged 40–79 years) using the 2007 to 2016 National Health and Nutrition Examination Survey. Our primary exposure was household FI, and our outcome was 10‐year ASCVD risk categorized as low (<5%), borderline (≥5% –<7.5%), intermediate (≥7.5%–<20%), and high risk (≥20%). We used structural equation modeling to evaluate the pathways and multiple mediation analysis to determine direct and indirect effects. Of the 12 429 participants, 2231 (18.0%) reported living in a food‐insecure household; 5326 (42.9%) had a low ASCVD risk score, 1402 (11.3%) borderline, 3606 (29.0%) intermediate, and 2095 (16.9%) had a high‐risk score. In structural models, we found significant path coefficients between FI and the nutrition/anthropometric (β, 0.130; SE, 0.027; P <0.001), psychological/mental health (β, 0.612; SE, 0.043; P <0.001), and access to care (β, 0.110; SE, 0.036; P =0.002) pathways. We did not find a significant direct effect of FI on ASCVD risk, and the nutrition, psychological, and access to care pathways accounted for 31.6%, 43.9%, and 15.8% of the association, respectively. Conclusions We found that the association between FI and ASCVD risk category was mediated through the nutrition/anthropometric, psychological/mental health, and access to care pathways. Interventions that address all 3 pathways may be needed to mitigate the negative impact of FI on cardiovascular disease.

Arterial calcification in the prediction of atherosclerotic cardiovascular disease among women and men

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
J.E Van Der Toorn ◽  
D Bos ◽  
B Arshi ◽  
M.K Ikram ◽  
M.W Vernooij ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
The Netherlands ◽  
Arterial Calcification ◽  
Funding Source ◽  
Atherosclerotic Cardiovascular Disease ◽  
Intermediate Risk ◽  
C Statistic ◽  
Ascvd Risk ◽  
Risk Categories

Abstract Background The Coronary Artery Calcium (CAC) Score has emerged as a valuable tool in atherosclerotic cardiovascular disease (ASCVD) risk stratification. However, data on the relevance of arterial calcification in different vascular territories for ASCVD risk prediction is lacking. Purpose First, to assess the sex-specific distribution of arterial calcification in different vessel beds across ASCVD risk categories. Second, to determine the added value of arterial calcification in different vascular territories for ASCVD risk prediction. Methods From a large population-based study, 2,139 participants (mean age 69 years, 55% women) underwent non-contrast computed tomography to quantify CAC, aortic arch calcification (AAC), extracranial- (ECAC) and intracranial carotid artery calcification (ICAC), and vertebrobasilar artery calcification (VBAC). The outcome measure, incident ASCVD, composed of fatal and nonfatal myocardial infarction (MI), other coronary heart disease (CHD) mortality, and stroke. We fitted sex-specific prediction models according to the Pooled Cohort Equations (PCE), and categorized participants into low- (&lt;5%), borderline- (5% to 7.5%), intermediate- (7.5% to 20%), and high ASCVD risk (≥20%), based on the American College of Cardiology (ACC) and American Heart Association (AHA) guideline. Subsequently, we determined the distribution of calcifications in different vascular territories across the risk categories. Next, we extended the PCE prediction model with calcification volumes and calculated the c-statistic and the net reclassification improvement for events (NRIe) and non-events (NRIne). Results The median follow-up for ASCVD was 9.3 years. Among women, 38% was classified as low-risk, 19% as borderline risk, 31% as intermediate risk, and 12% as high risk. Among men, 2% was classified as low-risk, 10% as borderline risk, 60% as intermediate risk, and 28% as high risk. With increasing risk of ASCVD, a larger burden of calcification was observed. In women, simultaneously adding calcification volumes in all vessel beds led to the largest increase in c statistic (from 0.71 to 0.75) for the prediction of ASCVD and the most beneficial reclassification (NRIe: 11%, NRIne: 2%). Among men, the addition of CAC alone most substantially improved the prediction of ASCVD (c statistic improved from 0.65 to 0.68, NRIe and NRIne were 4% and 14%, respectively). Conclusions Our findings suggest a potential role for comprehensive assessment of calcification in different vessel beds for ASCVD risk stratification in particular among women. Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): The Rotterdam Study is supported by Erasmus MC and Erasmus University Rotterdam; the Netherlands Organization for Scientific Research; the Netherlands Organization for Health Research and Development (ZonMw); the Research Institute for Diseases in the Elderly; the Netherlands Genomics Initiative; the Ministry of Education, Culture, and Science; the Ministry of Health, Welfare, and Sports; European Commission; and the Municipality of Rotterdam. Dr. Kavousi is supported by the VENI grant (91616079) from ZonMw. Dr. Bos was supported by a fellowship of the BrightFocus Foundation (A2017424F). Oscar L. Rueda-Ochoa receives a scholarship from COLCIENCIAS-Colombia and support from Universidad Industrial de Santander,UIS-Colombia. None of the funders had any role in study design; study conduct; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the article.

scholarly journals Baseline 10-Year Cardiovascular Risk Scores Predict Cognitive Function in Older Persons, and Particularly Women, Living With Human Immunodeficiency Virus Infection

2020 ◽  
Author(s):  
Felicia C Chow ◽  
Asya Lyass ◽  
Taylor F Mahoney ◽  
Joseph M Massaro ◽  
Virginia A Triant ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Human Immunodeficiency Virus ◽  
Cardiovascular Risk ◽  
Cognitive Function ◽  
Risk Score ◽  
Risk Scores ◽  
Atherosclerotic Cardiovascular Disease ◽  
Composite Effect ◽  
Immunodeficiency Virus ◽  
Ascvd Risk

Abstract Background Cardiovascular disease (CVD) and associated comorbidities increase the risk of cognitive impairment in persons living with human immunodeficiency virus (PLWH). Given the potential composite effect of multiple cardiovascular risk factors on cognition, we examined the ability of the Atherosclerotic Cardiovascular Disease (ASCVD) risk score and the Framingham Heart Study Global CVD risk score (FRS) to predict future cognitive function in older PLWH. Methods We constructed linear regression models evaluating the association between baseline 10-year cardiovascular risk scores and cognitive function (measured by a summary z-score, the NPZ-4) at a year 4 follow-up visit. Results Among 988 participants (mean age, 52 years; 20% women), mean 10-year ASCVD risk score at entry into the cohort was 6.8% (standard deviation [SD], 7.1%) and FRS was 13.1% (SD, 10.7%). In models adjusted only for cognitive function at entry, the ASCVD risk score significantly predicted year 4 NPZ-4 in the entire cohort and after stratification by sex (for every 1% higher ASCVD risk, year 4 NPZ-4 was lower by 0.84 [SD, 0.28] overall, P = .003; lower by 2.17 [SD, 0.67] in women, P = .001; lower by 0.78 [SD, 0.32] in men, P = .016). A similar relationship was observed between FRS and year 4 NPZ-4. In multivariable models, higher 10-year ASCVD risk and FRS predicted lower NPZ-4 in women. Conclusions Baseline 10-year ASCVD risk and FRS predicted future cognitive function in older PLWH with well-controlled infection. Cardiovascular risk scores may help to identify PLWH, especially women, who are at risk for worse cognition over time.

scholarly journals Optimisation of lipids for prevention of cardiovascular disease in a primary care

2018 ◽  
Vol 7 (3) ◽  
pp. e000071
Author(s):  
Smita Bakhai ◽  
Aishwarya Bhardwaj ◽  
Parteet Sandhu ◽  
Jessica L. Reynolds
Keyword(s):  
Cardiovascular Disease ◽  
Electronic Health Records ◽  
Lipid Profile ◽  
Statin Therapy ◽  
Risk Score ◽  
Completion Rate ◽  
Atherosclerotic Cardiovascular Disease ◽  
Health Records ◽  
Ascvd Risk ◽  
Electronic Health

The 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines focus on atherosclerotic cardiovascular disease (ASCVD) risk reduction, using a Pooled Cohort Equation to calculate a patient’s 10-year risk score, which is used to guide initiation of statin therapy. We identified a gap of evidence-based treatment for hyperlipidaemia in the Internal Medicine Clinic. Therefore, the aim of this study was to increase calculation of ASCVD risk scores in patients between the ages of 40 and 75 years from a baseline rate of less than 1% to 10%, within 12 months, for primary prevention of ASCVD. Root cause analysis was performed to identify materials/methods, provider and patient-related barriers. Plan-Do-Study-Act cycles included: (1) creation of customised workflow in electronic health records for documentation of calculated ASCVD risk score; (2) physician education regarding guidelines and electronic health record workflow; (3) refresher training for residents and a chart alert and (4) patient education and physician reminders. The outcome measures were ASCVD risk score completion rate and percentage of new prescriptions for statin therapy. Process measures included lipid profile order and completion rates. Increase in patient wait time, and blood test and medications costs were the balanced measures. We used weekly statistical process control charts for data analysis. The average ASCVD risk completion rate was 14.2%. The mean ASCVD risk completion rate was 4.0%. In eligible patients, the average lipid profile completion rate was 18%. ASCVD risk score completion rate was 33% 1-year postproject period. A team-based approach led to a sustainable increase in ASCVD risk score completion rate. Lack of automation in ASCVD risk score calculation and physician prompts in electronic health records were identified as major barriers. Furthermore, the team identified multiple barriers to lipid blood tests and treatment of increased ASCVD risk based on ACC/AHA guidelines.

scholarly journals Prediksi Tingkat Risiko Penyakit Kardiovaskuler Aterosklerotik pada Pasien yang Berobat di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado

e-CliniC ◽  
2017 ◽  
Vol 5 (2) ◽  
Author(s):  
Engelin E. Emor ◽  
Agnes L. Panda ◽  
Janry Pangemanan
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Risk Score ◽  
Framingham Risk Score ◽  
Low Risk ◽  
Risk Level ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cross Sectional ◽  
Framingham Risk

Abstract: Atherosclerotic cardiovascular disease is caused by the accumulation of plaque on the artery wall causing dysfunction of anatomical and hemodynamic system of the heart and blood flow. There are many risk factors that cause atherosclerotic cardiovascular disease which are divided into modifiable and unmodifiable risk factors. Prevention of this disease can be achieved with early detection, such as prediction the risk level of 10 years ahead of atherosclerotic cardiovascular disease by using the Framingham Risk Score (FRS). This study was aimed to obtain the risk level of atherosclerotic cardiovascular disease in patients at Internal Medicine Polyclinic of Prof. Dr. R. D. Kandou Hospital Manado by using their medical records from September to October 2017. This was a descriptive study with a cross sectional design. There were 100 samples obtained by using conclusive sampling technique. Of the 100 patients, 42 (42%) patients had low risk, 27 (27%) patients had moderate risk, and 31 (31%) patients had high risk of atherosclerotic cardiovascular disease in 10 years ahead. Conclusion: In this study, the highest percentage was in patients with low risk, followed by patients with high risk, and moderate risk.Keywords: ASCVD, Framingham Risk Score, Risk of atherosclerotic cardiovascular sisease. Abstrak: Penyakit kardiovaskuler aterosklerotik adalah penyakit yang disebabkan oleh adanya timbunan plak pada dinding arteri sehingga menyebabkan gangguan fungsional, anatomis serta sistem hemodinamis jantung dan pembuluh darah. Terdapat banyak faktor risiko yang menyebabkan terjadinya penyakit kardiovaskuler aterosklerotik yang dibagi menjadi faktor risiko yang dapat dimodifikasi dan yang tidak dapat dimodifikasi. Pencegahan penyakit ini dapat dilakukan dengan deteksi dini, salah satunya yaitu dengan memrediksi tingkat risiko 10 tahun kedepan terjadinya penyakit kardiovaskuler aterosklerotik dengan menggunakan Framingham Risk Score. Penelitian ini bertujuan untuk mengetahui tingkat risiko penyakit kardiovaskuler ateroskerotik pada pasien di Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ialah deskriptif dengan desain potong lintang menggunakan data rekam medik pasien Poliklinik Penyakit Dalam RSUP Prof. Dr. R. D. Kandou Manado periode September - Oktober 2017. Sampel penelitian berjumlah 100 orang dengan teknik pengambilan conclusive sampling. Terdapat 42 pasien (42%) dengan tingkat risiko rendah, 27 pasien (27%) dengan risiko sedang, dan 31 pasien (31%) dengan risiko tinggi terkena penyakit kardiovaskuler aterosklerotik 10 tahun kedepan. Simpulan: Pada studi ini, persentase tertinggi ialah pasien dengan tingkat risiko rendah terjadinya penyakit kardiovaskuler aterosklerotik, diikuti tingkat risiko tinggi dan risiko sedang.Kata kunci: ASCVD, Framingham Risk Score, tingkat risiko penyakit kardiovaskuler aterosklerotik

scholarly journals Cardiovascular Risk Awareness and Calculated 10-Year Risk Among Female Employees at Taibah University 2019

2021 ◽  
Vol 9 ◽  
Author(s):  
Amal M. Qasem Surrati ◽  
Walaa Mohammedsaeed ◽  
Ahlam B. El Shikieri
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
High Risk ◽  
Low Risk ◽  
Abdominal Circumference ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cvd Risk ◽  
Limited Knowledge ◽  
Ascvd Risk ◽  
Risk Estimator

Cardiovascular diseases (CVD) are the most common cause of death and disability worldwide. Saudi Arabia, one of the middle-income countries has a proportional CVD mortality rate of 37%. Knowledge about CVD and its modifiable risk factors is a vital pre-requisite to change the health attitudes, behaviors, and lifestyle practices of individuals. Therefore, we intended to assess the employee knowledge about risk of CVD, symptoms of heart attacks, and stroke, and to calculate their future 10-years CVD risk. An epidemiological, cross-sectional, community-facility based study was conducted. The women aged ≥40 years who are employees of Taibah University, Al-Madinah Al-Munawarah were recruited. A screening self-administrative questionnaire was distributed to the women to exclude those who are not eligible. In total, 222 women met the inclusion criteria and were invited for the next step for the determination of CVD risk factors by using WHO STEPS questionnaire: It is used for the surveillance of non-communicable disease risk factor, such as CVD. In addition, the anthropometric measurements and biochemical measurements were done. Based on the identified atherosclerotic cardiovascular disease (ASCVD) risk factors and laboratory testing results, risk calculated used the Framingham Study Cardiovascular Disease (10-year) Risk Assessment. Data were analyzed using GraphPad Prism 7 software (GraphPad Software, CA, USA). The result showed the mean age of study sample was 55.6 ± 9.0 years. There was elevated percentage of obesity and rise in abdominal circumference among the women. Hypertension (HTN) was a considerable chronic disease among the participants where more than half of the sample had it, i.e., 53%. According to the ASCVD risk estimator, the study participants were distributed into four groups: 63.1% at low risk, 20.2% at borderline risk, 13.5% at intermediate risk, and 3.2% at high risk. A comparison between these categories based on the CVD 10-year risk estimator indicated that there were significant variations between the low-risk group and the intermediate and high-risk groups (P = 0.02 and P = 0.001, respectively). The multivariate analysis detected factors related to CVD risk for women who have an intermediate or high risk of CVD, such as age, smoking, body mass index (BMI), unhealthy diet, blood pressure (BP) measurements, and family history of CVD (P &lt; 0.05). The present study reports limited knowledge and awareness of CVD was 8.6 that is considered as low knowledge. In conclusion, the present study among the university sample in Madinah reported limited knowledge and awareness of CVD risk. These findings support the need for an educational program to enhance the awareness of risk factors and prevention of CVD.

scholarly journals Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States

2021 ◽  
Author(s):  
Shiwani Mahajan ◽  
Gowtham R. Grandhi ◽  
Javier Valero‐Elizondo ◽  
Reed Mszar ◽  
Rohan Khera ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Food Security ◽  
High Risk ◽  
Food Insecurity ◽  
Family Income ◽  
The United States ◽  
Atherosclerotic Cardiovascular Disease ◽  
Risk Characteristics ◽  
Sociodemographic Determinants

Background Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown. Methods and Results Using 2013 to 2018 National Health Interview Survey data, we evaluated the prevalence and sociodemographic determinants of food insecurity among adults with ASCVD in the United States. ASCVD was defined as self‐reported diagnosis of coronary heart disease or stroke. Food security was measured using the 10‐item US Adult Food Security Survey Module. Of the 190 113 study participants aged 18 years or older, 18 442 (adjusted prevalence 8.2%) had ASCVD, representing ≈20 million US adults annually. Among adults with ASCVD, 2968 or 14.6% (weighted ≈2.9 million US adults annually) reported food insecurity compared with 9.1% among those without ASCVD ( P <0.001). Individuals with ASCVD who were younger (odds ratio [OR], 4.0 [95% CI, 2.8–5.8]), women (OR, 1.2 [1.0–1.3]), non‐Hispanic Black (OR, 2.3 [1.9–2.8]), or Hispanic (OR, 1.6 [1.2–2.0]), had private (OR, 1.8 [1.4–2.3]) or no insurance (OR, 2.3 [1.7–3.1]), were divorced/widowed/separated (OR, 1.2 [1.0–1.4]), and had low family income (OR, 4.7 [4.0–5.6]) were more likely to be food insecure. Among those with ASCVD and 6 of these high‐risk characteristics, 53.7% reported food insecurity and they had 36‐times (OR, 36.2 [22.6–57.9]) higher odds of being food insecure compared with those with ≤1 high‐risk characteristic. Conclusion About 1 in 7 US adults with ASCVD experience food insecurity, with more than 1 in 2 adults reporting food insecurity among the most vulnerable sociodemographic subgroups. There is an urgent need to address the barriers related to food security in this population.

scholarly journals Estimation of the 10-Year Atherosclerotic Cardiovascular Disease and The Framingham Risk Score Among Adults Living with HIV/AIDS in Addis Ababa, Ethiopia: A Hospital-Based, Observational Study.

2021 ◽  
Author(s):  
Minyahil Woldu ◽  
Omary Minzi ◽  
Workineh Shibeshi ◽  
Aster Shewaamare ◽  
Ephrem Engidawork
Keyword(s):  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
High Risk ◽  
Risk Score ◽  
Significant Contribution ◽  
Framingham Risk Score ◽  
Atherosclerotic Cardiovascular Disease ◽  
Framingham Risk ◽  
Living With Hiv

Abstract Background With a much improved ART of the present day, most morbidities and mortalities in people living with HIV/AIDS (PLWHA) are associated with factors such as non-infectious diseases (NIDs) in the form of coronary heart disease (CHD). This study aimed at determining the prevalence and predictors of coronary heart disease (CHD) using the 10-year atherosclerotic cardiovascular disease (ASCVD) and Framingham risk score (FRS) tools among PLWHA. Methods A hospital-based, observational study was carried out from January 2019 to February 2020 in HIV infected adults. Prevalence of FRS (age 20 to 79) was determined using the National, Heart, Lung and Blood Institute (NHLBI) and prevalence of ASCVD (age 40 to 79) was determined using the peer-reviewed online (ClinCalc.com) tool. Results Using the 10-years ASCVD risk estimation 27.3% of the study participants had an elevated risk > 7.5 % CHD. Similarly using the 10-year FRS, 1.4 % had high-risk score of developing CHD. Using multiple linear regression analysis age (β = .061, p < .001), gender (β = .816, p < .001), systolic blood pressure (β = .21, p < .001), total cholestrol (β = .002, p = .001), high density lipoprotein (β = − .02, p < .001), and Tobacco use (β = .559, p < .001) had significant contribution to the risk of CHD using the ASCVD tool, while using binary logistic regression for the FRS tool, gender (OR = 26.105, 95% C.I. [6.110, 111,543], p < 0.001), age (OR = 1.293, 95% C.I. [1.181, 1.415], P < 0.001), and low HDL-C (OR = 0.887, 95% C.I. [.786, .979], P = 0.19) had significant contribution. Conclusions The prevalence of high-risk CHD among PLWHA using the FRS and ASCVD tools were 1.4 & 27.3 percent respectively. In both the tools advanced age, male gender, and low level HDL were significant contributor for the risk of CHD in PLWHA.

Osteocalcin value to identify subclinical atherosclerosis over atherosclerotic cardiovascular disease (ASCVD) risk score in middle-aged and elderly Chinese asymptomatic men

2018 ◽  
Vol 56 (11) ◽  
pp. 1962-1969 ◽  
Author(s):  
Yiting Xu ◽  
Xiaojing Ma ◽  
Qin Xiong ◽  
Xueli Zhang ◽  
Yun Shen ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Risk Score ◽  
Subclinical Atherosclerosis ◽  
Recognition Rate ◽  
Negative Relationship ◽  
Atherosclerotic Cardiovascular Disease ◽  
Serum Osteocalcin ◽  
Middle Aged ◽  
Elderly Men ◽  
Ascvd Risk

Abstract Background: Our study examined whether osteocalcin contributed to identifying carotid intima-media thickness (C-IMT) over the atherosclerotic cardiovascular disease (ASCVD) risk score. Methods: We recruited 618 middle-aged and elderly men from communities in Shanghai. Serum osteocalcin levels were determined using an electrochemiluminescence immunoassay. C-IMT was measured by ultrasonography. Results: The study included 245 men with low ASCVD risk and 373 men with moderate-to-high ASCVD risk. Serum osteocalcin levels were lower in the moderate-to-high risk vs. low risk men (p=0.042). Multivariate stepwise regression analysis showed that body mass index (BMI) and glycated hemoglobin were predictors for reduced osteocalcin levels (both p<0.001). Among all subjects, the proportion with an elevated C-IMT was higher in the low-osteocalcin group than in the high-osteocalcin group (p=0.042), and the significance of this result was greater when considering only subjects with a moderate-to-high ASCVD risk (p=0.011). The recognition rate of elevated C-IMT was superior with both low osteocalcin and moderate-to-high ASCVD risk vs. either parameter alone (p<0.001 and p=0.015, respectively). Osteocalcin was independently and inversely associated with elevated C-IMT after adjusting for the 10-year ASCVD risk score (p=0.004). The negative relationship remained statistically significant in subjects with a moderate-to-high ASCVD risk in particular (standardized β=−0.104, p=0.044). Conclusions: In middle-aged and elderly men, serum osteocalcin levels strengthen identifying subclinical atherosclerosis over ASCVD risk score, especially among subjects with a moderate-to-high ASCVD risk.

Abstract 15540: Prevalence and Sociodemographic Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Shiwani Mahajan ◽  
Gowtham R Grandhi ◽  
Javier Valero Elizondo ◽  
Isaac Acquah ◽  
Tamer Yahya ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Food Insecurity ◽  
Low Income ◽  
Cumulative Effect ◽  
The United States ◽  
Atherosclerotic Cardiovascular Disease ◽  
Risk Characteristics ◽  
The Us ◽  
Sociodemographic Determinants

Background: High out-of-pocket healthcare expenditures among US adults with atherosclerotic cardiovascular disease (ASCVD) may expose them to food insecurity, which can lead to worse health outcomes. However, few studies have examined the prevalence and determinants of food insecurity in this population. Methods: Using data from the 2013-18 National Health Interview Survey, a nationally representative annual survey of the US, we assessed prevalence and sociodemographic determinants of food insecurity among adults (≥18 years) with ASCVD. Food insecurity was defined as 3+ affirmative responses on a validated 10-item questionnaire with a 30-day look-back period. Results: Among 190,113 adults included, 18,442 (8.2%; ~19.9 million US adults annually) had ASCVD (38.3% <65 years; 47.6% women). Overall, 14.6% adults with ASCVD (~2.9 million US adults annually) reported being food insecure compared with 9.1% among those without ASCVD. Among adults with ASCVD, those who were <65 years, women, Black or Hispanic, uninsured, and had low income had significantly higher odds of reporting food insecurity (Table). On assessment of the cumulative effect of these high-risk characteristics, 4.2% individuals were food insecure among those with ≤1 of these characteristics compared with 18.1%, 36.0%, and 43.7% among those with 2, 3, and ≥4 high-risk characteristics, respectively. Using multivariable analyses, individuals with 2, 3, and ≥4 high-risk characteristics had nearly 4-fold (OR 4.26, 95% CI 3.59-5.07), 10-fold (OR 9.73, 95% CI 8.15-11.62), and 15-fold (OR 15.34, 95% CI 12.07-19.49) higher odds of being food insecure compared with those with ≤1. Conclusion: Nearly 1 in 7 adults with ASCVD in the US reported food insecurity, with prevalence being as high as 50% among the most vulnerable sociodemographic subgroups. There is a critical need to address the hindrances relating to social determinants of health, including food insecurity, among adults with ASCVD in the US.

scholarly journals Association between Breakfast Frequency and Atherosclerotic Cardiovascular Disease Risk: A Cross-Sectional Study of KNHANES Data, 2014–2016

2019 ◽  
Vol 16 (10) ◽  
pp. 1853 ◽  
Author(s):  
Hyeon Ji Lee ◽  
Jieun Jang ◽  
Sang Ah Lee ◽  
Dong-Woo Choi ◽  
Eun-Cheol Park
Keyword(s):  
Cardiovascular Disease ◽  
High Risk ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
High Risk Group ◽  
Atherosclerotic Cardiovascular Disease ◽  
Cross Sectional ◽  
Breakfast Consumption ◽  
History Of ◽  
Ascvd Risk

The burden of cardiovascular disease (CVD) is increasing worldwide and one related lifestyle choice is breakfast consumption. This study examined the association between breakfast frequency and the 10-year risk of atherosclerotic CVD (ASCVD). The 10-year risk of ASCVD was defined as the risk of the first event of nonfatal myocardial infarction, coronary heart disease death, and nonfatal or fatal stroke within 10 years. Data from the Korean National Health and Nutrition Examination Survey, 2014–2016 were analyzed, and 7212 participants aged 40–79 years with no history of CVD were included. ASCVD risk was calculated according to the pooled cohort ASCVD equation, and participants with a score >7.5% were considered at high risk of ASCVD. The association between breakfast frequency and high ASCVD risk was confirmed by logistic regression analysis. Participants who never ate breakfast were more likely to be in the high-risk group compared to participants who ate breakfast >5 times per week (OR (adjusted odds ratio) = 1.46; 95% CI (confidence interval) = 1.12–1.89), and the risk was especially higher in female participants and those with a family history of CVD. Our study confirms that breakfast consumption even once per week may prevent CVD.

Sign in / Sign up

Export Citation Format

Share Document