scholarly journals CVD risk factors and surrogate markers - Urban-rural differences

2019 ◽  
Vol 48 (7) ◽  
pp. 752-761
Author(s):  
Joel Nuotio ◽  
Lauri Vähämurto ◽  
Katja Pahkala ◽  
Costan G. Magnussen ◽  
Nina Hutri-Kähönen ◽  
...  

Aims: Disparity in cardiovascular disease (CVD) mortality and risk factor levels between urban and rural regions has been confirmed worldwide. The aim of this study was to examine how living in different community types (urban–rural) in childhood and adulthood are related to cardiovascular risk factors and surrogate markers of CVD such as carotid intima-media thickness (IMT) and left ventricular mass (LVM). Methods: The study population comprised 2903 participants (54.1% female, mean age 10.5 years in 1980) of the Cardiovascular Risk in Young Finns Study who had been clinically examined in 1980 (age 3–18 years) and had participated in at least one adult follow-up (2001–2011). Results: In adulthood, urban residents had lower systolic blood pressure (–1 mmHg), LDL-cholesterol (–0.05 mmol/l), lower body mass index (–1.0 kg/m2) and glycosylated haemoglobin levels (–0.05 mmol/mol), and lower prevalence of metabolic syndrome (19.9 v. 23.7%) than their rural counterparts. In addition, participants continuously living in urban areas had significantly lower IMT (–0.01 mm), LVM (1.59 g/m2.7) and pulse wave velocity (–0.22 m/s) and higher carotid artery compliance (0.07%/10 mmHg) compared to persistently rural residents. The differences in surrogate markers of CVD were only partially attenuated when adjusted for cardiovascular risk factors. Conclusions: Participants living in urban communities had a more favourable cardiovascular risk factor profile than rural residents. Furthermore, participants continuously living in urban areas had less subclinical markers related to CVD compared with participants living in rural areas. Urban–rural differences in cardiovascular health might provide important opportunities for optimizing prevention by targeting areas of highest need.

2020 ◽  
Author(s):  
Elena Flores-Guillen ◽  
Itandehui Castro-Quezada ◽  
Hector Ochoa ◽  
Rosario Garcia-Miranda ◽  
Miguel Cruz ◽  
...  

Objectives: The objective of this study was to determine the prevalence of cardiovascular risk factors among different sociodemographic and geographic areas of adolescents from indigenous areas of Chiapas, Mexico. Design: A cross-sectional study. Setting: Communities in the Totzil - Tseltal and Selva region of Chiapas, Mexico, were studied. Urban and rural areas of high marginalization according to the Human Development Index. Participants: 253 adolescents were studied, of which 48.2% were girls and 51.8% were boys. Primary and secondary outcome measures: a descriptive analysis of the quantitative variables was performed through central tendency and dispersion measures. Prevalence of cardiovascular risk factors and 95% confidence intervals (95% CI), stratified by sex, geographic area (rural/urban), schooling and ethnicity of mothers were estimated. Results: the predominant risk factor in the study population was low HDL-c (51%). Higher prevalences of abdominal obesity and high triglycerides in girls were found and abnormal diastolic blood pressure in boys was identified. In urban areas were found greater prevalences of overweight/obesity and of insulin resistance while abnormal blood pressure levels were more prevalent in rural areas. Differences were found in the educational levels and ethnicity of the adolescents' mothers. Prevalence of metabolic syndrome was 10% according to NCEP-ATPIII. Conclusions: In this study, sociodemographic and geographical disparities were found in cardiovascular risk factors. Prevalence of risk factors was high, affecting mostly girls and urban population. Thus, there is a great need to promote healthy lifestyles and health, social and economic interventions to prevent chronic diseases in adulthood.


2019 ◽  
Author(s):  
Mohsen Mirzaei ◽  
Masoud Mirzaei ◽  
Ali Reza Sarsangi ◽  
Nasser Bagheri

Abstract Background: Cardiovascular disease (CVD) is the leading cause of death in the world. With effective intervention and control of cardiovascular risk factors, mortality rates may be reduced. The aim of this study was to investigate the prevalence of modifiable cardiovascular risk factors across five municipalities in Yazd city. Methods: 10,000 residents of the Yazd greater area aged 20-69 years were selected using cluster random sampling method. Overall, 200 clusters were randomly selected based on the postcodes of residents who lived in the five municipalities of Yazd city. Those who lived in Yazd annexed cities and rural areas were excluded from the study. A valid questionnaire was completed and physical examination performed as done (94.9% response rate). Instances of self-reported diabetes mellitus, high blood cholesterol, tobacco smoking and unhealthy diet were recorded. Blood pressure, height and weight were measured and physical activity was classified by International Physical Activity Questionnaire (IPAQ). A chi-square test was used to analyze the differences in variables across municipalities. All statistical analyses were performed using SPSS V. 16. Results: We analyzed 8749 participants’ data from Yazd city. The prevalence of diabetes mellitus, hypercholesterolemia and hypertension in Yazd were 14.1, 16.7 and 18.6%, respectively. One in every four people consumed the recommended five servings of vegetables per day. Fish consumption was less than 5% at least once a week among participants. Unhealthy diet (85.7%); low physical activity (52.2%), hypertension (36.7) and obesity (26.3%) were the most common cardiovascular risk factors.. Only 2.1% of adults had no risk factors for CVD, and almost 75% of people had more than one risk factor. The prevalence of risk factors (excluding hypertension) - was significantly different across the municipalities. Residents of region 3 in the study area had the highest prevalence of all risk factors aside from low physical activity and unhealthy food patterns. Conclusion: Two-thirds of Yazd population had two or more cardiovascular risk factors and significant spatial variations observed across different urban areas in Yazd. This geographic health inequality requires more attention from policy makers to control risk actors and prevent non-communicable disease across different municipalities accordingly.


2014 ◽  
pp. 26-30
Author(s):  
Huu Thinh Nguyen ◽  
Thi Thuy Hang Nguyen ◽  
Bui Bao Hoang

Background: Cardiovascular disease is the major cause of death in dialysis patients, as well as in kidney transplant patients. Assessment of cardiovascular risks of renal transplant candidates to prevent or slow the progression of cardiovascular abệnh nhânormalities. Aim: 1) Evaluating cardiovascular risk factors, electrocardiographic and echocardiographic abnormalities in renal transplant candidates. 2) Identifying the correlation between cardiac morphological parameters with a number of factors involved. Subjects and Methods: We assessed 57 patients (73.7% male, mean age 32.4±8.8) with end-stage renal disease waiting for renal transplantation at Cho Ray Hospital between Jan 2012 and Jan 2013. All patients received a physical examination, blood pressure measurement, Hb, blood glucose test, lipid profile, ECG, echocardiography. Results: The percentage of hypertension was 98.2%, smoking (69.2%), dyslipidemia 40.4% and diabetes 12.3%. All patients had sinus rhythm, left ventricular hypertrophy 61.4% in ECG. Pericardial effusion 5.3%, mitral valve insufficiency 56.1%, aortic valve insufficiency 12.3%, left ventricular hypertrophy 94.7% in echocardiography. IVSd, LVPWd, LVMI positively correlated with kidney failure time (p <0.01, p<0.001), with DBP and SBP (p <0.05) and the degree of anemia (p <0.05). Percentage the degree of hypertension associated with proportion of left ventricular hypertrophy (p <0.05). Conclusions: Identification of cardiovascular risk factors for the prevention or intervention to reduce mortality in renal transplantation. Keywords: Cardiovascular risk factors, end-stage chronic renal failure, renal transplantation.


Author(s):  
Güzin Özden ◽  
Ayşe Esin Kibar Gül ◽  
Eda Mengen ◽  
Ahmet Ucaktürk ◽  
Hazım Alper Gürsu ◽  
...  

Abstract Objectives The objective of this study is to investigate the cardiovascular risk factors associated with metabolic syndrome (MetS), which is increasingly becoming prevalent in childhood obesity. Methods A total of 113 patients, 76 of whom were between the ages of 10 and 17 (mean age: 14.5 ± 1.8 years) and diagnosed with obesity (30 non-MetS and 46 MetS using IDF) and 37 of whom constituted the control group, participated in the study. Echocardiographic examination and atherogenicity parameters (Atherogenic index of plasma [AIP: logTG/HDL], total cholesterol/HDL, and TG/HDL ratio and non-HDL) were evaluated. Results The most common component accompanying obese MetS was found to be hypertension and low HDL. While obesity duration, body mass index (BMI), blood pressure, fasting insulin, insulin resistance, atherogenicity parameters were determined to be significantly higher in the obese-MetS group. Echocardiography showed that while the thickness, volume, and diameter of LV end-diastolic wall, left ventricular mass (LVM), LVM index (LVMI g/m2) and relative wall thickness (RWT) were significantly high in the MetS group, however, mitral E/A ratio was significantly lower (p<0.05). Change in LV geometry consistent with concentric remodeling (increased RWT, normal LVMI) was visible in obese groups. LVM were positively significantly related to BMI, waist circumference, insulin resistance, blood pressure, LDL level, and negative to mitral E/A ratio. In the obese-MetS group, LVMI was positively correlated to office systolic BP, left atrium end-diastolic volume/index. Conclusions LVMI and atherogenicity parameters that were found to be significantly higher in obese MetS exhibit increased cardiovascular risk in childhood.


Author(s):  
Jan-Per Wenzel ◽  
Ramona Bei der Kellen ◽  
Christina Magnussen ◽  
Stefan Blankenberg ◽  
Benedikt Schrage ◽  
...  

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.


Author(s):  
В.В. Шерстнёв ◽  
М.А. Грудень ◽  
О.В. Сенько ◽  
В.П. Карлина ◽  
А.В. Кузнецова ◽  
...  

В настоящее время доказано, что предгипертензия, характеризующая состояние лиц с артериальным давлением (АД) от 120/80 мм рт.ст. до 139/89 мм рт.ст., имеет высокую и постоянно возрастающую распространенность среди населения во всем мире и является независимым фактором риска формирования артериальной гипертонии, развития сердечно-сосудистой заболеваемости и смертности. Это делает актуальным изучение взаимосвязи развития предгипертензии с наличием других факторов риска сердечно-сосудистых заболеваний. Целью данного исследования явилось изучение гендерных особенностей взаимосвязи факторов риска сердечно-сосудистых заболеваний и развития предгипертензии. Методы исследования. Проведен сравнительный и корреляционный анализ показателей модифицируемых и немодифицируемых факторов риска сердечно-сосудистых заболеваний у 115 обследованных лиц мужского (n = 49) и женского пола (n = 66), средний возраст которых составил 47,6 ± 0,7 года с оптимальным АД (n = 63, АД < 120/80 мм рт.ст.) и предгипертензией (n = 52, АД 120-139/80-89 мм рт.ст.). Результаты исследования. Обнаружено, что мужчины и женщины с оптимальным АД и с предгипертензией различаются спектром факторов риска и структурой взаимосвязи исследованных показателей. У мужчин предгипертензия ассоциирована с повышенным содержанием креатинина в крови и табакокурением, тогда как у женщин - с гипертрофией левого желудочка сердца, стрессом и наследственной отягощенностью по гипертонической болезни. Развитие предгипертензии у женщин по сравнению с мужчинами характеризуется более выраженными количественными и качественными изменениями структуры взаимосвязей показателей исследованных факторов риска сердечно-сосудистых заболеваний. Заключение. Полученные результаты представляют интерес для понимания механизмов патогенеза предгипертензии и разработки стратегии её персонифицированной немедикаментозной и медикаментозной профилактики, основанной на устранении или ослаблении определенных факторов риска сердечно-сосудистых заболеваний. Currently it is proved that prehypertension characterizing the condition of individuals with blood pressure (BP) from 120/80 mm Hg to 139/89 mm Hg has a high, continuously increasing prevalence worldwide and is an independent risk factor for development of arterial hypertension and cardiovascular morbidity and mortality, which justifies studying the relationship between prehypertension and the presence of other risk factors for cardiovascular diseases. The aim of this study was to investigate gender features of the relationship between risk factors for cardiovascular disease and development of prehypertension. Methods. Comparative and correlation analyses of modifiable and non-modifiable cardiovascular risk factors were performed for 115 males (n = 49) and females (n = 66) aged 47.6 ± 0.7 with optimal BP (n = 63, BP < 120/80 mm Hg) or prehypertension (n = 52, AD = 120-139/80-89 mm Hg). Results. Men and women with optimal BP and prehypertension differed in the array of risk factors and the structure of relationship between the studied indices. In men, prehypertension was associated with an elevated blood creatinine and tobacco smoking whereas in women - with left ventricular hypertrophy, stress, and hereditary burden of hypertension. The development of prehypertension in women compared to men was characterized by more pronounced quantitative and qualitative changes in the structure of interrelationships between indices of the studied cardiovascular risk factors. Conclusion. The obtained results provide insight into pathogenetic mechanisms of prehypertension. They can be used for developing a strategy for individualized non-drug and drug prevention of hypertension based on elimination or reduction of certain cardiovascular risk factors.


Author(s):  
Andrew H. Tran ◽  
Thomas R. Kimball ◽  
Philip R. Khoury ◽  
Lawrence M. Dolan ◽  
Elaine M. Urbina

Objective: Pulse wave analysis estimates arterial wave reflections relating to left ventricular dysfunction and cardiovascular event risk in adults. Forward and backward waves (Pf and Pb) may improve risk stratification for cardiovascular events. Data in youth are lacking. We hypothesized that a significant difference in wave reflections would be identified in young subjects with adverse cardiovascular risk factors. Approach and Results: Vital signs and labs were obtained in 551 patients aged 10 to 24 years who were lean (L=199), obese (O=173), or had type 2 diabetes (T=179). Wave separation was performed. Differences in cardiovascular risk factors and wave reflections were assessed using ANOVA. General linear models were constructed to elucidate independent predictors of wave reflections. O and T subjects had an adverse cardiovascular risk profile versus L. O and T subjects had higher Pf and Pb versus L ( P ≤0.05). When adjusted for adiposity and other cardiovascular risk factors, reflection magnitude increased from L to O to T with higher T versus L values ( P ≤0.05) and near-significant O versus L values ( P =0.06). Adiposity and blood pressure were major determinants of wave reflections. Pb influenced log left ventricular mass index, log E/e′, and log composite carotid intima-media thickness. Conclusions: Adolescents and young adults with obesity and type 2 diabetes have altered forward and backward wave reflections versus lean controls related to adiposity, BP, and insulin levels. These parameters may help risk stratify patients with adverse cardiovascular risk factors.


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