Common risk factors for major noncommunicable disease, a systematic overview of reviews and commentary: the implied potential for targeted risk reduction

Noncommunicable disease now contributes to the World Health Organization top 10 causes of death in low-, middle- and high-income countries. Particular examples include stroke, coronary heart disease, dementia and certain cancers. Research linking clinical and lifestyle risk factors to increased risk of noncommunicable disease is now well established with examples of confirmed risk factors, including smoking, physical inactivity, obesity and hypertension. However, despite a need to target our resources to achieve risk reduction, relatively little work has examined the overlap between the risk factors for these main noncommunicable diseases. Our high-level review draws together the evidence in this area. Using a systematic overview of reviews, we demonstrate the likely commonality of established risk factors having an impact on multiple noncommunicable disease outcomes. For example, systematic reviews of the evidence on physical inactivity and poor diet found each to be associated with increased risk of cancers, coronary heart disease, stroke, diabetes mellitus and dementia. We highlight the potential for targeted risk reduction to simultaneously impact multiple noncommunicable disease areas. These relationships now need to be further quantified to allow the most effective development of public health interventions in this area.

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The Impact of Risk Factors for Coronary Heart Disease on Related Disability in Older Irish Adults

Journal of Aging and Health ◽

10.1177/0898264317726242 ◽

2017 ◽

Vol 31 (1) ◽

pp. 165-184 ◽

Cited By ~ 1

Author(s):

Sharon M. Cruise ◽

John Hughes ◽

Kathleen Bennett ◽

Anne Kouvonen ◽

Frank Kee

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Northern Ireland ◽

Physical Inactivity ◽

Relative Risks ◽

Chd Risk ◽

Health And Social Care ◽

Chd Risk Factors ◽

The Impact

Objective: The aim of this study is to examine the prevalence of coronary heart disease (CHD)–related disability (hereafter also “disability”) and the impact of CHD risk factors on disability in older adults in the Republic of Ireland (ROI) and Northern Ireland (NI). Method: Population attributable fractions were calculated using risk factor relative risks and disability prevalence derived from The Irish Longitudinal Study on Ageing and the Northern Ireland Health Survey. Results: Disability was significantly lower in ROI (4.1% vs. 8.8%). Smoking and diabetes prevalence rates, and the fraction of disability that could be attributed to smoking (ROI: 6.6%; NI: 6.1%), obesity (ROI: 13.8%; NI: 11.3%), and diabetes (ROI: 6.2%; NI: 7.2%), were comparable in both countries. Physical inactivity (31.3% vs. 54.8%) and depression (10.2% vs. 17.6%) were lower in ROI. Disability attributable to depression (ROI: 16.3%; NI: 25.2%) and physical inactivity (ROI: 27.5%; NI: 39.9%) was lower in ROI. Discussion: Country-specific similarities and differences in the prevalence of disability and associated risk factors will inform public health and social care policy in both countries.

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Hand osteoarthritis in relation to mortality and incidence of cardiovascular disease: data from the Framingham Heart Study

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2013-203789 ◽

2013 ◽

Vol 74 (1) ◽

pp. 74-81 ◽

Cited By ~ 57

Author(s):

Ida K Haugen ◽

Vasan S Ramachandran ◽

Devyani Misra ◽

Tuhina Neogi ◽

Jingbo Niu ◽

...

Keyword(s):

Coronary Heart Disease ◽

Heart Disease ◽

Lower Limb ◽

Framingham Heart Study ◽

Cardiovascular Events ◽

Physical Inactivity ◽

Hand Osteoarthritis ◽

Coronary Insufficiency ◽

Heart Study ◽

Increased Risk

ObjectivesTo study whether hand osteoarthritis (OA) is associated with increased mortality and cardiovascular events in a large community based cohort (Framingham Heart Study) in which OA, mortality and cardiovascular events have been carefully assessed.MethodsWe examined whether symptomatic (≥1 joint(s) with radiographic OA and pain in the same joint) and radiographic hand OA (≥1 joint(s) with radiographic OA without pain) were associated with mortality and incident cardiovascular events (coronary heart disease, congestive heart failure and/or atherothrombotic brain infarction) using Cox proportional hazards models. In the adjusted models, we included possible confounding factors from baseline (eg, metabolic factors, medication use, smoking/alcohol). We also adjusted for the number of painful joints in the lower limb and physical inactivity.ResultsWe evaluated 1348 participants (53.8% women) with mean (SD) age of 62.2 (8.2) years, of whom 540 (40.1%) and 186 (13.8%) had radiographic and symptomatic hand OA, respectively. There was no association between hand OA and mortality. Although there was no significant relation to incident cardiovascular events overall or a relation of radiographic hand OA with events, we found a significant association between symptomatic hand OA and incident coronary heart disease (myocardial infarction/coronary insufficiency syndrome) (HR 2.26, 95% CI 1.22 to 4.18). The association remained after additional adjustment for pain in the lower limb or physical inactivity.ConclusionsSymptomatic hand OA, but not radiographic hand OA, was associated with an increased risk of coronary heart disease events. The results suggest an effect of pain, which may be a possible marker of inflammation.

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Risk factors of coronary heart disease: attitude and behaviour in family practice in Saudi Arabia

Eastern Mediterranean Health Journal ◽

10.26719/1999.5.1.35 ◽

1999 ◽

Vol 5 (1) ◽

pp. 35-45 ◽

Cited By ~ 2

Author(s):

M. S. Khattab ◽

M. A. Abolfotouh ◽

W. Alakija ◽

M. A. Al Humaidi ◽

S. Al Wahat

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Family Practice ◽

Physical Inactivity ◽

Fat Intake ◽

Significant Difference ◽

Lifestyle Questionnaire ◽

Males And Females ◽

The Mean

To study risk factors of attitudes and behaviour towards coronary heart disease [CHD], 280 Saudis > or = 20 years attending a family practice answered a structured health and lifestyle questionnaire and had their weight, height, blood pressure and random total cholesterol measured. Significant difference was found between males and females in the mean number of cardiovascular risk factors [t = -3.03, P < 0.01]. Few people with high dietary fat intake, obesity or physical inactivity perceived their behaviour as harmful. The number of people who perceived an associated risk to their health increased with incidence of smoking and obesity but not with high fat intake. Physically inactive people were least likely to perceive their behaviour as harmful

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Coronary Heart Disease: Diagnosis and Therapy

Solo Journal of Anesthesi, Pain and Critical Care (SOJA) ◽

10.20961/soja.v1i2.55191 ◽

2021 ◽

Vol 1 (2) ◽

pp. 74

Author(s):

Iin Novita Nurhudayati Mahmuda ◽

Nanda Nurkusumasari ◽

Fakhri Nofaldi ◽

Prihatin Puji Astuti ◽

Ferika Dian Syafitri ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Communicable Disease ◽

Developed Countries ◽

Disease Diagnosis ◽

Lifestyle Changes ◽

World Health ◽

Coronary Syndrome ◽

Health Organization

<p>Coronary heart disease (CHD), is one of the non-communicable diseases that has a tendency to increase every year and have an impact not only on developed countries, but also in developing countries. According to the World Health Organization (WHO), in 2012 there were 56 million deaths worldwide caused by non-communicable disease and heart disease contributed 46.2% or caused 17.5 million deaths. This review article to give brief explanation about CHD from risk factors, diagnosed criteria, management therapy and prognosis. Risk factors for CHD can be distinguished into major risk factors and minor risk factors. Symptoms of CHD are discomfort in the chest ranging from pain crushed during activity and improved with rest to continuous chest pain. The diagnosis of CHD is established based on anamnesis, physical examination, and laboratory examination. The CHD classification consists of Stable Angina Pectoris (APS) and Acute Coronary Syndrome (ACS). Lifestyle changes accompanied<em> </em>by right medication can reduce complications caused by CHD.</p>

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Association of Rosacea With Cardiovascular Disease: A Retrospective Cohort Study

Journal of the American Heart Association ◽

10.1161/jaha.120.020671 ◽

2021 ◽

Author(s):

Daein Choi ◽

Sungjun Choi ◽

Seulggie Choi ◽

Sang Min Park ◽

Hyun‐Sun Yoon

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Coronary Heart Disease ◽

Cohort Study ◽

Heart Disease ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Cox Regression ◽

Hazard Ratios ◽

Increased Risk

Background There is emerging evidence that rosacea, a chronic cutaneous inflammatory disease, is associated with various systemic diseases. However, its association with cardiovascular disease (CVD) remains controversial. We aimed to investigate whether patients with rosacea are at increased risk of developing CVD. Methods and Results This retrospective cohort study from the Korean National Health Insurance Service‐Health Screening Cohort included patients with newly diagnosed rosacea (n=2681) and age‐, sex‐, and index year–matched reference populations without rosacea (n=26 810) between 2003 and 2014. The primary outcome was subsequent CVD including coronary heart disease and stroke. Multivariable Cox regression analyses were used to evaluate adjusted hazard ratios for subsequent CVD adjusted for major risk factors of CVD. Compared with the reference population (13 410 women; mean [SD] age, 57.7 [9.2] years), patients with rosacea (1341 women; mean [SD] age, 57.7 [9.2] years) displayed an increased risk for CVD (adjusted hazard ratios, 1.20; 95% CI, 1.03–1.40) and coronary heart disease (adjusted hazard ratios, 1.29; 95% CI, 1.05–1.60). The risk for stroke was not significantly elevated (adjusted hazard ratios, 1.12; 95% CI, 0.91–1.37). Conclusions This study suggests that patients with rosacea are more likely to develop subsequent CVD. Proper education for patients with rosacea to manage other modifiable risk factors of CVD along with rosacea is needed.

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Faktor Dominan Risiko Terjadinya Penyakit Jantung Koroner (PJK)

(JKG) JURNAL KEPERAWATAN GLOBAL ◽

10.37341/jkg.v1i1.12 ◽

2016 ◽

Vol 1 (1) ◽

Author(s):

Ros Endah Happy Patriyani ◽

David Ferry Purwanto

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Blood Vessels ◽

Physical Inactivity ◽

Serum Lipids ◽

Dominant Effect ◽

Cross Sectional ◽

Cross Sectional Design ◽

And Gender

Abstract: Risk Factors, CHD. Coronary Heart Disease (CHD) is the coronary atherosclerotic disease that causes narrowing of blood vessels. Constriction of blood vessels occurs because of atherosclerosis or spasm or a combination of both. the risk factors of CHD were divided into two, namely the factors that can not be changed and the factors can be changed. Factors that can not be changed include age, family history and gender. While the factors that can be changed include an increase in serum lipids (hyperlipidemia), personality type, smoking, impaired glucose tolerance (diabetes mellitus), lifestyle is less activity (physical inactivity), psychological stress, and hypertension. The purpose of this study to determine the risk factors that lead to increased incidence of coronary heart disease. The study is an observational analytic epidemiologic approach with cross sectional design with a sample of 40 respondents. The data analysis using logistic regression. The results showed the significant influence of CHD events by a factor of age> 40 years (p = 0.7370, hyperlipidemia (p = 0162), hypertension (p = 0365), smoking (p = 0153), as well as physical inactivity (p = 0535 ). Smoking is a risk factor most dominant effect on the incidence of CHD with OR = 4,500. the case studies are necessary to further research with a number of larger samples and develop variable-varabel to be studied is associated with other behaviors and lifestyles that affect developing CHD.

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Thrombin Generation Markers and Coronary Heart Disease Risk Factors in a Polish Population Sample

Thrombosis and Haemostasis ◽

10.1055/s-0038-1656036 ◽

1997 ◽

Vol 77 (04) ◽

pp. 697-700 ◽

Cited By ~ 6

Author(s):

Jacek Musiał ◽

Andrzej Pająk ◽

Anetta undas ◽

Ewa Kawalec ◽

Roman Topór-Mądry ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Thrombin Generation ◽

Disease Risk ◽

Population Sample ◽

Plasma Fibrinogen ◽

Factor Vii ◽

Increased Risk ◽

Chd Risk Factors

SummaryThrombosis plays a major role in the development of atherosclerosis and its acute vascular complications. Epidemiological studies have shown that elevated levels of plasma fibrinogen are associated with an increased risk of coronary heart disease (CHD). It is not clear whether this association is linked to hemostatic functions of fibrinogen which serves as a substrate for thrombin. Generation of thrombin in vivo can be evaluated by measurement of its specific markers in plasma, i.e. thrombin-antithrombin III complex (TAT) and prothrombin fragment 1+2 (F1+2). We determined plasma levels of TAT and F1+2 in a population sample of southeastern Poland and evaluated relations of these markers with plasma fibrinogen, factor VII coagulant activity (FVIIc), and other known CHD risk factors. The population studied consisted of 215 men and 251 women, aged 43-75 years. Final analysis was performed on 195 men and 222 women.The distribution of plasma TAT and F1+2 concentrations were highly skewed with the higher median values for women than for men. Log values of TAT correlated with log values of F1+2 in men (r = 0.27, p <0.01) and in women (r = 0.15, p <0.05). In the regression analysis both markers were positively related to age in women but not in men. After adjustment to age there was a positive relation between TAT and fibrinogen in both sexes. In women, but not in men, F1+2 showed a positive association with FVIIc. Total plasma cholesterol was negatively related to TAT in women only. There was no association between thrombin generation markers and plasma triglycerides, HDL-choles- terol, LDL-cholesterol, blood pressure, cigarette smoking and body mass index (BMI).The association of plasma fibrinogen and FVIIc with thrombin generation markers points to an important role of the hemostatic system in the pathogenesis of atherosclerosis and coronary heart disease in humans.

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Abstract 205: Potential Cardiovascular Risk Reduction in High-Risk Uninsured Patients: An Analysis of the Heart Improvement Project

Hypertension ◽

10.1161/hyp.64.suppl_1.205 ◽

2014 ◽

Vol 64 (suppl_1) ◽

Author(s):

Joshua R Thomas ◽

Gopal Chandrasekharan ◽

Daniel Zhao ◽

Mark D Fox

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

High Risk ◽

Risk Reduction ◽

Prediction Models ◽

Disease Risk ◽

First Line ◽

Uninsured Patients ◽

Improvement Project

Background: The Heart Improvement Project (HIP) is a cardiovascular (CV) risk reduction clinic targeting high-risk, uninsured patients. Using coronary heart disease prediction models from the Framingham Heart Study, it is possible to project an individual’s 10-year CV disease risk based on status of the following risk factors: sex, age, LDL-Cholesterol (LDL-C), HDL-Cholesterol (HDL-C), blood pressure (BP), diabetes, and smoking status. Objective: To project the reduction in CV risk associated with two levels of intervention: first-line therapy (designed to decrease the systolic BP by 15 mm Hg and LDL-C by 30%) and maximal therapy to optimally control all modifiable risk factors. Methods: Data on 251 patients (52% male, mean age 51 yrs; 48% with Diabetes, 45% smokers) from HIP were analyzed. For each patient, their Framingham Risk Scores (FRS) and 10-year Coronary Heart Disease Risk (CHDR) were calculated in three different conditions: their actual risk assessment, and that projected under first-line, and maximal therapy. The three sets of FRS and CHDR were summarized using descriptive statistics. Pairwise differences between the three sets of FRS and CHDR were tested using two-sample t-test and 95% confidence intervals for the differences were computed. Results: Table 1 shows that the mean FRSs were 7.33, 4.90, and 3.51 (under initial, first-line, and maximal conditions, respectively). The corresponding CHDRs were 13%, 8%, and 6% respectively. All comparisons were statistically significant at the p<0.001 level. Conclusions: First-line interventions for BP and lipid management can yield significant improvement in CHD risk in a population of high-risk uninsured patients.

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Abstract 19: Dietary Lipophilic Load and Dietary Lipophilic Index with Risk of Coronary Heart Disease in Middle-Aged Women: Beyond Conventional Fat Classifications

Circulation ◽

10.1161/circ.131.suppl_1.19 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Eric L Ding ◽

Katerina M De Vito ◽

Hongyu Wu ◽

Qi Sun ◽

An Pan ◽

...

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Dietary Fat ◽

Hdl Cholesterol ◽

Health Study ◽

Chd Risk ◽

Increased Risk ◽

Total Fat ◽

Traditional Risk Factors

Introduction: Studies indicate dietary types of fats are associated with risk of coronary heart disease (CHD). Traditional broad classifications may incompletely capture the diversity of fatty acids on CHD. The novel lipid index Dietary Lipophilic Load (DLL) reflects a unique combination of fatty acid fluidity, intermolecular attraction, plus relative fat quantity, while Dietary Lipophilic Index (DLI) is a measure of average fat fluidity, regardless of fat quantity. Thus, we evaluated the association, DLL and DLI, with risk of incident CHD. METHODS: Participants included 30,932 women in the Women’s Health Study (WHS), who were free of major chronic diseases at baseline. DLL was calculated by weighted summation of the multiplicative product of each fatty acid’s intakes (g/day) and its melting points (Celcius); DLI was calculated by dividing DLL by total fat intake (g/day). Hazard ratios (HRs) were adjusted for established risk factors, with updated dietary data, and potential mediators. We also investigated hypothesized interactions with C-Reactive Protein (CRP). RESULTS: There were 1137 cases of incident CHD in 525,828 person-years over 19 years follow-up. At baseline in over 27,000 women with blood samples, DLL and DLI were not correlated with serum cholesterol, triglyceride, HbA1c, ICAM-1, or CRP biomarkers (r<0.02 for all). In overall multivariate analysis, DLL was associated with higher risk of CHD (extreme quintile HR=1.40, 95%CI: 1.11-1.76, P trend=0.0002), while DLI was not (HR=0.83, 95%CI: 0.67-1.03, P trend=0.75). DLL results were independent beyond adjustment for dietary trans, saturated, monounsaturated, and polyunsaturated fats, nor their aggregate adjustment or the P:S ratio. DLL effects persisted even adjusting for CRP (HR=1.29, P-trend=1 mg/dL for DLL (extreme quintile HR=1.38, 1.02-1.88), than among individuals with low CRP <1 mg/dl for DLL (HR=1.08, 0.68-1.72), with P-interaction<0.0001. Furthermore, CRP also modified DLI, where effects again diverged among higher CRP (HR=0.98, 0.73-1.31) versus low CRP (HR=0.45, 0.27-0.74), with P-interaction<0.0001. Moreover, adjustment of triglycerides, HbA1c, ICAM-1, LDL or HDL cholesterol also did not materially affect overall results. CONCLUSION: Results indicate that DLL is associated with increased risk of incident CHD, independent of traditional risk factors, conventional dietary fat classifications, and major CHD biomarkers. Effects of DLL and DLI appear to be modified by levels of CRP. DLL appears to be an important novel dietary fat index that captures additional CHD risk information beyond biomarkers and traditional dietary fat categories. Further studies are warranted.

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Fifteen-year risk of major coronary events predicted by Holter ST-monitoring in asymptomatic middle-aged men

European Journal of Cardiovascular Prevention & Rehabilitation ◽

10.1097/01.hjr.0000176511.22284.c1 ◽

2005 ◽

Vol 12 (5) ◽

pp. 478-483 ◽

Cited By ~ 6

Author(s):

Martin Stagmo ◽

Steen Juul-Möller ◽

Bo Israelsson

Keyword(s):

Risk Factors ◽

Coronary Heart Disease ◽

Heart Disease ◽

Coronary Revascularization ◽

Holter Monitoring ◽

Middle Aged ◽

Major Coronary Event ◽

St Segment ◽

Increased Risk ◽

Coronary Events

Background Ambulatory electrocardiogram monitoring (Holter) with ST-analysis as a measure of myocardial ichemia has in populations with coronary heart disease been shown to predict major coronary events: death, myocardial infarction or coronary revascularization. There has, however, been conflicting evidence regarding the usefulness of this technique in identification of healthy subjects with increased risk for coronary heart disease. The aim of this study was to assess if Holter monitoring with ST-analysis could be used to predict future major coronary events in asymptomatic middle-aged men with a defined aggregation of traditional risk factors for coronary heart disease. Methods One hundred and fifty-five asymptomatic participants from the city of Malmö, Sweden, with known levels of conventional cardiovascular risk factors underwent Holter monitoring for analysis of transient ST-segment depression at the age of 55 years. Fifteen years after the Holter monitoring, hospital records, diagnosis and death registries were revisited for major coronary events. Results An ST-segment depression of 1 mm or greater (0.1 mV) was considered significant for myocardial ischemia and was found in 54 of the 155 men. There were no significant differences in risk factors in the two groups at baseline. The 15-year incidence of a first major coronary event was significantly higher in men with ST-segment depression (39%) than in men without ST-segment depression (20%) ( P < 0.015). A Holter electrocardiogram could predict future major coronary events with a positive and negative predictive value of 35 and 80%, respectively. Conclusions Holter monitoring can be used as a complement to conventional risk factor evaluation in deciding whether or not to treat risk factors for CHD in asymptomatic subjects.

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