Educational inequality in cardiovascular diseases: a sibling approach

2017 ◽  
Vol 46 (1) ◽  
pp. 83-91
Author(s):  
Grethe Søndergaard ◽  
Susanne Oksbjerg Dalton ◽  
Laust Hvas Mortensen ◽  
Merete Osler
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Educational Inequality ◽  
Circulatory System ◽  
Educational Status ◽  
Hazard Ratio ◽  
Cohort Analyses

Aims: Educational inequality in diseases in the circulatory system (here termed cardiovascular disease) is well documented but may be confounded by early life factors. The aim of this observational study was to examine whether the associations between education and all cardiovascular diseases, ischaemic heart disease and stroke, respectively, were explained by family factors shared by siblings. Methods: The study population included all individuals born in Denmark between 1950 and 1979 who had at least one full sibling born in the same period. Using Cox regression, data were analysed in conventional cohort and within-sibship analyses in which the association was examined within siblings discordant on education. Assuming that attenuation of associations in the within-sibship as compared with the cohort analyses would indicate confounding from factors shared within families. Results: A lower educational status was associated with a higher risk of cardiovascular disease, ischaemic heart disease and stroke. All associations attenuated in the within-sibship analyses, in particular in the analyses on ischaemic heart disease before age 45 years. For instance, in the cohort analyses, the hazard rate of ischaemic heart disease among women less than 45 years who had a primary school education was 94% (hazard ratio 1.94 (1.78–2.12) higher than among those with a vocational education, while it attenuated to 51% (hazard ratio 1.51 (1.34–1.71)) in the within-sibship analysis. Conclusions: Confounding from factors shared by siblings explained the associations between education and the cardiovascular disease outcomes but to varying degrees. This should be taken into account when planning interventions aimed at reducing educational inequalities in the development of cardiovascular disease, ischaemic heart disease and stroke.

Occupational groups and ischaemic heart disease in New Zealand – a longitudinal linkage study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
L.A Barnes ◽  
A Eng ◽  
M Corbin ◽  
H.J Denison ◽  
A t'Mannetje ◽  
...  
Keyword(s):  
Heart Disease ◽  
New Zealand ◽  
Ischaemic Heart Disease ◽  
Cox Regression ◽  
Health Data ◽  
Funding Source ◽  
Inverse Association ◽  
Occupational Groups ◽  
Routinely Collected Health Data ◽  
Machine Operators

Abstract Background/Introduction Occupation is a poorly characterised risk factor for cardiovascular disease (CVD), with females and minority populations particularly under-represented in research. There is also a lack of longitudinal studies using detailed health data that does not rely on self-reports. Purpose This study aimed to address these gaps by assessing the association between a range of occupational groups and ischaemic heart disease (IHD) in New Zealand (NZ), through linkage of population-based occupational surveys to routinely collected health data. Half of the study population were females and 40% were indigenous Māori (who comprise 15% of the total 4.8 million NZ population), which enabled sex and ethnicity-specific aspects of the relationship between occupation and IHD to be assessed. Methods Two probability-based sample surveys of the NZ adult population (New Zealand Workforce Survey (NZWS); 2004–2006; n=3003) and of the Māori population (NZWS Māori; 2009–2010; n=2107), for which detailed occupational histories and lifestyle factors were collected, were linked with routinely collected health data available through Statistics NZ. Cox regression was used to calculate hazard ratios (HR) for “ever-worked” in any one of nine major occupational groups, with “never worked” in that occupational group defined as the reference group. Analyses were controlled for age, deprivation and smoking, and stratified by sex and ethnicity. Results The strongest associations were found for “plant/machine operators and assemblers” and “elementary workers”, particularly among female Māori (HR 2.19, 95% CI 1.16–4.13 and HR 2.03, 1.07–3.82 respectively). In contrast, inverse associations with IHD across all groups were observed for “technicians and associate professionals”, which was significant for NZWS males (HR 0.52, 0.32–0.84). There were some sex and ethnic differences, particularly for “clerks”, where a positive association was found for NZWS males (HR 1.81, 1.19–2.74), whilst an inverse association was observed for Māori females (HR 0.42, 0.22–0.82). Duration analyses (≤2 years, 2–10 years and 10+ years) showed significant dose-response trends for “clerks” in NZWS males, and “plant/machine operators and assemblers” and “elementary workers” in Māori females. Further adjustments for other potential confounders such diabetes mellitus, hypertension and high cholesterol did not affect the results. Conclusion Associations between occupation and IHD differed significantly across occupational groups and between sexes and ethnicities, even within the same occupational groups. This suggests that results may not be generalised across these groups and occupational interventions to reduce IHD risk may therefore need different approaches depending on the population and specific groups of interest. Funding Acknowledgement Type of funding source: Other. Main funding source(s): Health Research Council (HRC) of New Zealand

Abstract P253: Proton Pump Inhibitor Use is Positively Associated with Incidence of Cardiovascular Disease

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Elizabeth J Bell ◽  
Jennifer L St. Sauver ◽  
Veronique L Roger ◽  
Nicholas B Larson ◽  
Hongfang Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Language Processing ◽  
Proton Pump ◽  
Hazard Ratio ◽  
Time Varying ◽  
Increased Risk ◽  
The Impact

Introduction: Proton pump inhibitors (PPIs) are used by an estimated 29 million Americans. PPIs increase the levels of asymmetrical dimethylarginine, a known risk factor for cardiovascular disease (CVD). Data from a select population of patients with CVD suggest that PPI use is associated with an increased risk of stroke, heart failure, and coronary heart disease. The impact of PPI use on incident CVD is largely unknown in the general population. Hypothesis: We hypothesized that PPI users have a higher risk of incident total CVD, coronary heart disease, stroke, and heart failure compared to nonusers. To demonstrate specificity of association, we additionally hypothesized that there is not an association between use of H 2 -blockers - another commonly used class of medications with similar indications as PPIs - and CVD. Methods: We used the Rochester Epidemiology Project’s medical records-linkage system to identify all residents of Olmsted County, MN on our baseline date of January 1, 2004 (N=140217). We excluded persons who did not grant permission for their records to be used for research, were <18 years old, had a history of CVD, had missing data for any variable included in our model, or had evidence of PPI use within the previous year.We followed our final cohort (N=58175) for up to 12 years. The administrative censoring date for CVD was 1/20/2014, for coronary heart disease was 8/3/2016, for stroke was 9/9/2016, and for heart failure was 1/20/2014. Time-varying PPI ever-use was ascertained using 1) natural language processing to capture unstructured text from the electronic health record, and 2) outpatient prescriptions. An incident CVD event was defined as the first occurrence of 1) validated heart failure, 2) validated coronary heart disease, or 3) stroke, defined using diagnostic codes only. As a secondary analysis, we calculated the association between time-varying H 2 -blocker ever-use and CVD among persons not using H 2 -blockers at baseline. Results: After adjustment for age, sex, race, education, hypertension, hyperlipidemia, diabetes, and body-mass-index, PPI use was associated with an approximately 50% higher risk of CVD (hazard ratio [95% CI]: 1.51 [1.37-1.67]; 2187 CVD events), stroke (hazard ratio [95% CI]: 1.49 [1.35-1.65]; 1928 stroke events), and heart failure (hazard ratio [95% CI]: 1.56 [1.23-1.97]; 353 heart failure events) compared to nonusers. Users of PPIs had a 35% greater risk of coronary heart disease than nonusers (95% CI: 1.13-1.61; 626 coronary heart disease events). Use of H 2 -blockers was also associated with a higher risk of CVD (adjusted hazard ratio [95% CI]: 1.23 [1.08-1.41]; 2331 CVD events). Conclusions: PPI use is associated with a higher risk of CVD, coronary heart disease, stroke and heart failure. Use of a drug with no known cardiac toxicity - H 2 -blockers - was also associated with a greater risk of CVD, warranting further study.

scholarly journals Cardiovascular Disease Prediction using Data Mining Techniques

2017 ◽  
Vol 10 (2) ◽  
pp. 520-528 ◽  
Author(s):  
Mudasir Kirmani
Keyword(s):  
Data Mining ◽  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
High Risk ◽  
Learning Algorithm ◽  
Heart Diseases ◽  
Circulatory System ◽  
World Health ◽  
Support Vector ◽  
Predictive Tool

Cardiovascular disease represents various diseases associated with heart, lymphatic system and circulatory system of human body. World Health Organisation (WHO) has reported that cardiovascular diseases have high mortality rate and high risk to cause various disabilities. Most prevalent causes for cardiovascular diseases are behavioural and food habits like tobacco intake, unhealthy diet and obesity, physical inactivity, ageing and addiction to drugs and alcohol are to name few. Factors such as hypertension, diabetes, hyperlipidemia, Stress and other ailments are at high risk to cardiovascular diseases. There have been different techniques to predict the prevalence of cardiovascular diseases in general and heart disease in particular from time to time by implementing variety of algorithms. Detection and management of cardiovascular diseases can be achieved by using computer based predictive tool in data mining. By implementing data mining based techniques there is scope for better and reliable prediction and diagnosis of heart diseases. In this study we studied various available techniques like decision Tree and its variants, Naive Bayes, Neural Networks, Support Vector Machine, Fuzzy Rules, Genetic Algorithms, and Ant Colony Optimization to name few. The observations illustrated that it is difficult to name a single machine learning algorithm for the diagnosis and prognosis of CVD. The study further contemplates on the behaviour, selection and number of factors required for efficient prediction.

Features of the passage of rehabilitation routes by disabled people due to diseases of the circulatory system

2001 ◽  
Vol 82 (2) ◽  
pp. 145-148
Author(s):  
S. V. Chagarova
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Diseases ◽  
Circulatory System ◽  
Full Measure ◽  
Disabled People ◽  
Rehabilitation Programs ◽  
Rehabilitation Measures ◽  
The Individual

The conditions of passing rehabilitation routes by invalids with cardiovascular diseases are studied. The lowest inclusion of invalids by various rehabilitation measures is stated among invalids aged up to 29. They are rarely directed to rehabilitation by physicians of corresponding specialities and are often forced to pay for their treatment in full measure. The data obtained are used to develop the methodical recommendations directed to the optimization of the medicosocial examination and rehabilitation, to increase the efficary of the individual rehabilitation programs made for invalids with cardiovascular disease.

scholarly journals Cardiac rehabilitation

Curationis ◽  
1981 ◽  
Vol 4 (2) ◽  
Author(s):  
D Nieman
Keyword(s):  
South Africa ◽  
Heart Disease ◽  
Cardiac Rehabilitation ◽  
Ischaemic Heart Disease ◽  
Cause Of Death ◽  
Circulatory System ◽  
Age Group ◽  
The Republic

In the Republic of South Africa, ischaemic heart disease is the main cause of death amongst Whites in the age group 20 — 65 years. The percentage for ischaemic heart disease of all deaths from diseases of the circulatory system for Whites in the age group 25 — 34 is 63% for males and 21% for females. In the age group 35 — 44 the percentages are 77% for males and 34% for females (22, p.1025).

Cardiovascular disease

2014 ◽  
Author(s):  
Anthea Hatfield
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
Side Effects ◽  
Ischaemic Heart Disease ◽  
Myocardial Ischaemia ◽  
Cardiac Failure ◽  
Valvular Heart Disease ◽  
Recovery Room ◽  
Signs And Symptoms ◽  
Common Problems

Cardiovascular disease is common and patients coming to recovery room with any of these common problems will need special care. The essential signs and symptoms of hypertension, cardiac failure, ischaemic heart disease, and valvular heart disease are outlined. The actions and side-effects of the drugs that these patients take to control their symptoms are described. Recognizing and treating hypotension and myocardial ischaemia are very important and relevant, and they are fully discussed in this chapter.

scholarly journals Association between ambient fine particulate pollution and hospital admissions for cause specific cardiovascular disease: time series study in 184 major Chinese cities

BMJ ◽  
2019 ◽  
pp. l6572 ◽  
Author(s):  
Yaohua Tian ◽  
Hui Liu ◽  
Yiqun Wu ◽  
Yaqin Si ◽  
Jing Song ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiovascular Disease ◽  
Heart Disease ◽  
Ischaemic Stroke ◽  
Ischaemic Heart Disease ◽  
Hospital Admissions ◽  
Heart Rhythm ◽  
Haemorrhagic Stroke ◽  
Regulatory Limits ◽  
Short Term Exposure

AbstractObjectiveTo estimate the risks of daily hospital admissions for cause specific major cardiovascular diseases associated with short term exposure to ambient fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) pollution in China.DesignNational time series study.Setting184 major cities in China.Population8 834 533 hospital admissions for cardiovascular causes in 184 Chinese cities recorded by the national database of Urban Employee Basic Medical Insurance from 1 January 2014 to 31 December 2017.Main outcome measuresDaily counts of city specific hospital admissions for primary diagnoses of ischaemic heart disease, heart failure, heart rhythm disturbances, ischaemic stroke, and haemorrhagic stroke among different demographic groups were used to estimate the associations between PM2.5 and morbidity. An overdispersed generalised additive model was used to estimate city specific associations between PM2.5 and cardiovascular admissions, and random effects meta-analysis used to combine the city specific estimates.ResultsOver the study period, a mean of 47 hospital admissions per day (standard deviation 74) occurred for cardiovascular disease, 26 (53) for ischaemic heart disease, one (five) for heart failure, two (four) for heart rhythm disturbances, 14 (28) for ischaemic stroke, and two (four) for haemorrhagic stroke. At the national average level, an increase of 10 μg/m3 in PM2.5 was associated with a 0.26% (95% confidence interval 0.17% to 0.35%) increase in hospital admissions on the same day for cardiovascular disease, 0.31% (0.22% to 0.40%) for ischaemic heart disease, 0.27% (0.04% to 0.51%) for heart failure, 0.29% (0.12% to 0.46%) for heart rhythm disturbances, and 0.29% (0.18% to 0.40%) for ischaemic stroke, but not with haemorrhagic stroke (−0.02% (−0.23% to 0.19%)). The national average association of PM2.5 with cardiovascular disease was slightly non-linear, with a sharp slope at PM2.5 levels below 50 μg/m3, a moderate slope at 50-250 μg/m3, and a plateau at concentrations higher than 250 μg/m3. Compared with days with PM2.5 up to 15 μg/m3, days with PM2.5 of 15-25, 25-35, 35-75, and 75 μg/m3 or more were significantly associated with increases in cardiovascular admissions of 1.1% (0 to 2.2%), 1.9% (0.6% to 3.2%), 2.6% (1.3% to 3.9%), and 3.8% (2.1% to 5.5%), respectively.According to projections, achieving the Chinese grade 2 (35 μg/m3), Chinese grade 1 (15 μg/m3), and World Health Organization (10 μg/m3) regulatory limits for annual mean PM2.5 concentrations would reduce the annual number of admissions for cardiovascular disease in China. Assuming causality, which should be done with caution, this reduction would translate into an estimated 36 448 (95% confidence interval 24 441 to 48 471), 85 270 (57 129 to 113 494), and 97 516 (65 320 to 129 820), respectively.ConclusionsThese data suggest that in China, short term exposure to PM2.5 is associated with increased hospital admissions for all major cardiovascular diseases except for haemorrhagic stroke, even for exposure levels not exceeding the current regulatory limits.

scholarly journals Mortality from cancer and cardiovascular diseases in the county boroughs of England and Wales classified according to the sources and hardness of their water supplies, 1958–1967

1973 ◽  
Vol 71 (2) ◽  
pp. 237-252 ◽  
Author(s):  
Percy Stocks
Keyword(s):  
Cardiovascular Disease ◽  
Nervous System ◽  
Heart Disease ◽  
Cardiovascular Diseases ◽  
England And Wales ◽  
Average Hardness ◽  
Female Breast ◽  
Total Cancer ◽  
Artesian Wells ◽  
Rheumatic Heart

SUMMARYRelative rates of proportionate mortality from cancer of six sites based on total cancer deaths and the proportions expected in all towns, and from four types of cardiovascular disease based on total deaths from all causes, have been related in the 80 county boroughs of England and Wales to the sources of water supply and to the average hardness of water in. the towns. The sources of water, from upland surfaces, artesian wells and rivers, were classified in eight groups, and significant associations were found for cancers of the stomach, oesophagus, prostate, male bladder and female breast, and for hypertensive and chronic rheumatic heart disease. No associations were apparent with intestinal cancer, vascular disease of the nervous system or arteriosclerotic heart disease. Hardness or softness of the water was classified in seven groups and significant associations were found for the same diseases as for source of water, none being evident for coronary disease.

Psychosocial Stress and Ischaemic Heart Disease: A Response to Tennant

1982 ◽  
Vol 16 (4) ◽  
pp. 265-278
Author(s):  
Bruce Boman
Keyword(s):  
Cardiovascular Disease ◽  
Heart Disease ◽  
World War Ii ◽  
Ischaemic Heart Disease ◽  
Psychosocial Stress ◽  
Military Service ◽  
Recent Article ◽  
The Other ◽  
World War ◽  
The One

In a recent article appearing in this journal, a decision of the Administrative Appeals Tribunal granting a war pension for ischaemic heart disease arising out of the stresses of military service in World War II was severely criticised. The following is a literature review supporting the Tribunal's judgement by providing evidence for an association between both neurotic illness and stresses of varying severity on the one hand and cardiovascular disease on the other.

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