scholarly journals Prevalence, determinants and association of unawareness of diabetes, hypertension and hypercholesterolemia with poor disease control in a multi-ethnic Asian population without cardiovascular disease

2019 ◽  
Vol 17 (1) ◽  
Author(s):  
Ryan E. K. Man ◽  
Alvin Hong Wei Gan ◽  
Eva K. Fenwick ◽  
Alfred Tau Liang Gan ◽  
Preeti Gupta ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Disease Control ◽  
Asian Population ◽  
Medical Practitioner ◽  
Public Health Education ◽  
Lipid Lowering ◽  
Cross Sectional ◽  
Current Smoking ◽  
Screening Programs

Abstract Background To explore the prevalence and determinants of unawareness of diabetes, hypertension and hypercholesterolemia and its association with poor disease control in a multi-ethnic Asian population without cardiovascular disease (CVD). Methods We included 6904 Chinese, Malay and Indian individuals (mean age [SD] 58.2 [10.2] years; 52.6% female) with diabetes, hypertension and/or hypercholesterolemia from the cross-sectional population-based Singapore Epidemiology of Eye Diseases study (2004–2011). Diabetes was defined as random blood glucose ≥ 11.1 mmol/L or HbA1c > 6.5% or self-reported use of diabetes medication; hypertension as systolic blood pressure ≥ 140 mmHg or diastolic blood pressure ≥ 90 mmHg or self-reported use of anti-hypertensive treatment; and hypercholesterolemia as total cholesterol ≥ 6.2 mmol/L or self-reported use of lipid-lowering medications. Unawareness was based on participants’ answers to the questions: “Did your medical practitioner ever tell you that you have diabetes/hypertension/high cholesterol?” The determinants of unawareness, and its association with poor disease control, were assessed using multivariable binary logistic regression models adjusted for known potential confounders. Results Of the 2380 (34.5%), 5386 (78.0%) and 3607 (52.2%) with diabetes, hypertension and hypercholesterolemia, respectively, unawareness rates were 30.7%, 43.1% and 40.9%, respectively. Having a higher BMI, particularly if obese, and Malay ethnicity were associated with greater unawareness of diabetes; Malay and Indian ethnicities and current smoking with greater unawareness of hypertension; and education ≤6 years, current smoking, and blue collar jobs or unemployment with greater unawareness of hypercholesterolemia (all P < 0.05). Lack of awareness of each condition was independently associated with poorer disease control in the case of hypertension and hypercholesterolemia, while the converse was true for diabetes (all P < 0.05). Conclusions Unawareness of diabetes, hypertension, or hypercholesterolemia is high in Singapore, with risk factors varying across all three diseases, although Malay ethnicity is a consistent one. Unawareness was also associated with poor management for hypertension and hypercholesterolemia. Public health education and screening programs should target at-risk individuals, especially Malays, to reduce the likelihood of incident CVD.

Associations of cardiovascular disease and blood pressure with cognition in hemodialysis patients: The Osaka Dialysis Complication Study

2021 ◽  
Author(s):  
Tetsuo Shoji ◽  
Hisako Fujii ◽  
Katsuhito Mori ◽  
Shinya Nakatani ◽  
Yuki Nagata ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Diastolic Pressure ◽  
Hemodialysis Patients ◽  
Maintenance Hemodialysis ◽  
Cross Sectional ◽  
Diabetic Kidney ◽  
Prior Stroke

Abstract Background Previous studies reported mixed results regarding the contributions of cardiovascular disease (CVD) and blood pressure to cognitive impairment in chronic kidney disease. Methods This was a cross-sectional study in 1213 patients on maintenance hemodialysis from 17 dialysis units in Japan. The main exposures were prior CVD and blood pressure components including systolic (SBP) and diastolic pressure (DBP). The outcome was low cognitive function evaluated with the Modified Mini-Mental State examination (3MS) with a cut-off level of 3MS &lt; 80. Results The median age was 67 years, median duration of dialysis was 71 months, 37% were women, 39% had diabetic kidney disease, and 36% had any pre-existing CVD. Median (interquartile range) of 3MS score was 91 (82 to 97), and 240 patients (20%) had 3MS &lt; 80. Logistic regression analysis showed that 3MS &lt; 80 was associated with the presence of any prior CVD, particularly prior stroke. 3MS &lt; 80 was associated with lower DBP but not with SBP. When patients were stratified by the presence of prior stroke, lower DBP, higher age, and lower education level were factors associated with 3MS &lt; 80 in both subgroups. In the subgroup of patients without prior stroke, diabetic kidney disease was an additional factor associated with 3MS &lt; 80. CVDs other than stroke were not associated with 3MS in either subgroup. Conclusions Prior stroke and lower DBP were associated with 3MS &lt; 80 in hemodialysis patients. These findings support the hypothesis that these vascular factors contribute to low cognitive performance in patients undergoing hemodialysis.

scholarly journals Angiotensin II, Hypercholesterolemia, and Vascular Smooth Muscle Cells: A Perfect Trio for Vascular Pathology

2020 ◽  
Vol 21 (12) ◽  
pp. 4525
Author(s):  
Amanda St. Paul ◽  
Cali B. Corbett ◽  
Rachael Okune ◽  
Michael V. Autieri
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Smooth Muscle ◽  
Angiotensin Ii ◽  
Vascular Smooth Muscle ◽  
Vascular Diseases ◽  
Reduce Blood Pressure ◽  
Vascular Pathology ◽  
Lipid Lowering ◽  
Ang Ii

Cardiovascular disease is the leading cause of morbidity and mortality in the Western and developing world, and the incidence of cardiovascular disease is increasing with the longer lifespan afforded by our modern lifestyle. Vascular diseases including coronary heart disease, high blood pressure, and stroke comprise the majority of cardiovascular diseases, and therefore represent a significant medical and socioeconomic burden on our society. It may not be surprising that these conditions overlap and potentiate each other when we consider the many cellular and molecular similarities between them. These intersecting points are manifested in clinical studies in which lipid lowering therapies reduce blood pressure, and anti-hypertensive medications reduce atherosclerotic plaque. At the molecular level, the vascular smooth muscle cell (VSMC) is the target, integrator, and effector cell of both atherogenic and the major effector protein of the hypertensive signal Angiotensin II (Ang II). Together, these signals can potentiate each other and prime the artery and exacerbate hypertension and atherosclerosis. Therefore, VSMCs are the fulcrum in progression of these diseases and, therefore, understanding the effects of atherogenic stimuli and Ang II on the VSMC is key to understanding and treating atherosclerosis and hypertension. In this review, we will examine studies in which hypertension and atherosclerosis intersect on the VSMC, and illustrate common pathways between these two diseases and vascular aging.

Abstract 13272: High Density Lipoprotein Subclasses Predict Non-Cardiovascular Disease, Non-Cancer Chronic Inflammatory-Related Death and Hospitalization More Strongly than Cardiovascular Disease Events in the Multi-Ethnic Study of Atherosclerosis

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Daniel Duprez ◽  
James Otvos ◽  
Kenneth Feingold ◽  
Philip Greenland ◽  
Myron D Gross ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
High Density Lipoprotein ◽  
Inflammatory Markers ◽  
Density Lipoprotein ◽  
High Density ◽  
Lipid Lowering ◽  
Ethnic Study ◽  
Lipoprotein Particles ◽  
D Dimer

In vitro studies have demonstrated that high density lipoprotein particles (HDL-P) antagonize inflammatory processes. We studied the predictive value of HDL-P and inflammatory markers for incident cardiovascular disease (CVD) and non-CVD, non-cancer, chronic inflammatory-related events. Methods: In the Multi-Ethnic Study of Atherosclerosis, we studied 6475 men and women free of overt CVD, baseline age 45-84 years, who had fasting venous samples for lipid profile, lipoprotein particles, and inflammatory markers Interleukin-6 (IL-6), hs-CRP and D-dimer at baseline. Median follow-up was 10.1 years. Poisson regression models predicted non-CVD, non-cancer, chronic inflammatory-related events (death and hospitalization), based on diagnostic codes, n=1054) and CVD events due to coronary heart disease, myocardial infarction, coronary artery disease requiring revascularization, stroke, peripheral arterial disease, congestive heart failure and CVD or unwitnessed death (adjudicated, n=756). Adjustment was for age, race, gender, clinic, heart rate, smoking, body mass index, blood pressure, blood pressure and lipid lowering medication, diabetes mellitus, plus all lipid, lipoprotein particle and inflammatory variables. Results: Non-CVD, non-cancer, chronic inflammatory-related events were inversely associated with the sum of small+medium HDL-P independent of covariates (relative risk (RR) per standard deviation (95% confidence limits), RR: 0.85 (0.79-0.91, P < 0.0001). Non-CVD, non-cancer, chronic inflammatory-related events were positively associated with IL-6, RR:1.19 (1.11-1.27, P < 0.0001) and D-dimer, RR: 1.10 (1.05-1.16, P < 0.0001). CVD was associated with small+medium HDL-P, RR: 0.90 (0.82-0.99, P < 0.03) and IL-6, RR:1.15 (1.06-1.25 P < 0.0001). hsCRP was unrelated to either outcome after adjustment for other inflammatory markers. Conclusion: The long-term inverse association of small+medium HDL-P with non-CVD, non-cancer, chronic inflammatory-related death and hospitalization was stronger than with fatal and non-fatal CVD in subjects initially free of overt CVD. These findings provide clinical evidence that small+medium HDL-P have anti-inflammatory properties and may rethink the importance of HDL-P beyond CVD.

Disparities in Secondary Prevention between Stroke and Coronary Heart Disease in China: Cross-Sectional Community-Based Study, 2014–2016

2021 ◽  
pp. 1-10
Author(s):  
Shijun Xia ◽  
Chi Wang ◽  
Xin Du ◽  
Lizhu Guo ◽  
Jing Du ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Health Care ◽  
Coronary Heart Disease ◽  
Heart Disease ◽  
Secondary Prevention ◽  
Lipid Lowering ◽  
Community Based ◽  
Cross Sectional ◽  
History Of ◽  
Cvd Prevention

<b><i>Background:</i></b> Health care quality and insurance coverage have improved with economic development in China, but the burden of cardiovascular diseases (CVDs) continues to increase with ongoing gaps in prevention. We aimed to compare the uptake of secondary CVD prevention between stroke and coronary heart disease (CHD) patients in China. <b><i>Methods:</i></b> In a cross-sectional community-based survey of 47,841 adults (age ≥45 years) in 7 regions of China between 2014 and 2016, we identified those with a history of stroke or CHD to quantify disparities in conventional secondary CVD prevention strategies in multivariable logistic regression models. <b><i>Results:</i></b> There were 4,105 and 1,022 participants with a history of stroke and CHD, respectively. Compared to participants with CHD, those with a history of stroke were significantly less likely to be taking blood-pressure-lowering (39.7% vs. 53%), lipid-lowering (13.7% vs. 36.8%), and antiplatelet (20.8% vs. 50.6%) agents, at least one (48.9% vs. 70.8%) or all 3 recommended medicines (6.1% vs. 24.0%), and were less likely to achieve a lipid-cholesterol target (30.3% vs. 44.0%). Participants with a history of stroke achieved less optimal secondary prevention goals for medication use, either from any (adjusted odds ratio [aOR] 0.54, 95% confidence interval [CI] 0.44–0.66) or all 3 medications (aOR 0.27, 95% CI 0.20–0.36), as well as better blood pressure (aOR 0.81, 95% CI 0.66–0.98) and low-density lipoprotein cholesterol (aOR 0.34, 95% CI 0.27–0.43) levels of control. There were no significant differences in weight, smoking, or physical activity between the groups. <b><i>Conclusion:</i></b> Stroke patients had lower use of secondary CVD-preventive medication and achieved lower levels of risk factor control than those of CHD patients in China. Nationwide disease-specific strategies, and better education of participants and health care providers, may narrow these gaps.

scholarly journals Absolute risk of cardiovascular disease events, and blood pressure‐ and lipid‐lowering therapy in Australia

2016 ◽  
Vol 204 (8) ◽  
pp. 320-320 ◽  
Author(s):  
Emily Banks ◽  
Simon R Crouch ◽  
Rosemary J Korda ◽  
Bill Stavreski ◽  
Karen Page ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Absolute Risk ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Lowering Therapy

scholarly journals The Otsego-Schoharie healthy heart program: prevention of cardiovascular disease in the rural US

2001 ◽  
Vol 29 (56_suppl) ◽  
pp. 21-32 ◽  
Author(s):  
A.N. Nafziger ◽  
T.A. Erb ◽  
P.L. Jenkins ◽  
C. Lewis ◽  
T.A. Pearson
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Reduction ◽  
Rural Population ◽  
Intervention Program ◽  
Community Intervention ◽  
Panel Study ◽  
New York State ◽  
Cross Sectional ◽  
Cross Sectional Studies

Objectives: To describe a rural, hospital-based public health intervention program and to evaluate its effectiveness in cardiovascular disease (CVD) risk reduction using cross-sectional studies and a panel study. Methods: A rural population of 158,000 located in New York state comprised the intervention population. A similar but separate population was used for reference. A multifaceted, multimedia 5-year program provided health promotion and education initiatives to increase physical activity, decrease smoking, improve nutrition, and identify hypercholesterolemia and hypertension. To evaluate the effectiveness of the intervention, surveys were conducted at baseline in 1989 (cross-sectional) and at follow-up in 1994- 95 (cross-sectional and panel). For cross-sectional studies, a random sample of adults was obtained using a three-stage cluster design. Self-reported and objective risk factor measurements were obtained. Comparison of pre- to post- changes in intervention versus reference populations was done using 2× 2randomized block ANOVA, 2 × 2 mixed ANOVA, and extension of the McNemar test. Results: Smoking prevalence declined (from 27.9% to 17.6%) in the intervention population. Significant adverse trends were observed for high-density lipoprotein cholesterol and triglycerides. Systolic blood pressure was reduced while diastolic blood pressure remained stable. Body mass index increased significantly in both populations. Conclusions: This rural, 5-year CVD community intervention program decreased smoking. The risk reduction may be attributable to tailoring of a multifaceted approach (multiple risk factors, multiple messages, and multiple population subgroups) to a target rural population. The study period was too short to identify changes in CVD morbidity and mortality.

scholarly journals Depression in type 1 diabetes was associated with high levels of circulating galectin-3

2018 ◽  
Vol 7 (6) ◽  
pp. 819-828 ◽  
Author(s):  
Eva Olga Melin ◽  
Jonatan Dereke ◽  
Maria Thunander ◽  
Magnus Hillman
Keyword(s):  
Blood Pressure ◽  
Type 1 Diabetes ◽  
Depression Scale ◽  
Cardiovascular Complications ◽  
Lipid Lowering ◽  
Cross Sectional ◽  
Diabetes Registry ◽  
Increased Risk ◽  
Galectin 3

Objective Neuroinflammatory responses are implicated in depression. The aim was to explore whether depression in patients with type 1 diabetes (T1D) was associated with high circulating galectin-3, controlling for metabolic variables, s-creatinine, life style factors, medication and cardiovascular complications. Design Cross-sectional. Methods Participants were T1D patients (n = 283, 56% men, age 18–59 years, diabetes duration ≥1 year). Depression was assessed by Hospital Anxiety and Depression Scale-depression subscale. Blood samples, anthropometrics and blood pressure were collected, and supplemented with data from medical records and the Swedish National Diabetes Registry. Galectin-3 ≥2.562 µg/l, corresponding to the 85th percentile, was defined as high galectin-3. Results Median (quartile1, quartile3) galectin-3 (µg/l) was 1.3 (0.8, 2.9) for the 30 depressed patients, and 0.9 (0.5, 1.6) for the 253 non-depressed, P = 0.009. Depression was associated with high galectin-3 in all the 283 patients (adjusted odds ratio (AOR) 3.5), in the 161 men (AOR 3.4), and in the 122 women (AOR 3.9). HbA1c, s-lipids, s-creatinine, blood pressure, obesity, smoking, physical inactivity, cardiovascular complications and drugs (antihypertensive, lipid lowering, oral antidiabetic drugs and antidepressants) were not associated with high galectin-3. Conclusions This is the first study to show an association between depression and galectin-3. Depression was the only explored parameter associated with high circulating galectin-3 levels in 283 T1D patients. High galectin-3 levels might contribute to the increased risk for Alzheimer’s disease, cardiovascular and all-cause mortality observed in persons with depression. Potentially, in the future, treatment targeting galactin-3 might improve the prognosis for patients with high galectin-3 levels.

scholarly journals Trends of Prevalence of Uncontrolled Risk Factors for Cerebrocardiovascular Disease: Southern Italy from 1988/9 to 2008/9

Cholesterol ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-7
Author(s):  
Vincenzo Capuano ◽  
Norman Lamaida ◽  
Ernesto Capuano ◽  
Rocco Capuano ◽  
Eduardo Capuano ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Risk Factor ◽  
Southern Italy ◽  
Cross Sectional ◽  
Targeted Interventions ◽  
Risk Factor Prevalence ◽  
Cross Sectional Studies ◽  
Prevention Of Cardiovascular Disease

The aim of this study was to determine the trends of cardiovascular risk factor prevalence between 1988/9 and 2008/9 in the 25–74-year-old population in an area of Southern Italy. We compared three cross-sectional studies conducted in random population samples, in 1988/9, 1998/9, and 2008/9 in Salerno, Italy. The methodology of data collection (lipid profile, systolic and diastolic blood pressure, glycaemia, and smoking) and conducting tests which the population underwent during the three phases was standardized and comparable. Prevalence of diabetes, hypertension, hypercholesterolemia, and smoking was calculated and standardized for age. A total of 3491 subjects were included. From 1988/9 to 2008/9, in males, the prevalence of all four risk factors was reduced. In women, there was a clear reduction of hypertension, a similar prevalence of hypercholesterolemia, and an increase of smoking and diabetes. In the area of Salerno, our data confirm that the global prevalence of the major risk factors is decreasing in men, but their absolute values are still far from optimization. In women, diabetes and smoking showed a negative trend, therefore requiring targeted interventions. These data are now used as a base for executive targeted programs to improve prevention of cardiovascular disease in our community.

scholarly journals A Study to Assess the Prevalence of Depression in Cardiovascular Disease Patient in The Nilgiris Population: Association with Blood Pressure

2020 ◽  
Vol 11 (1) ◽  
pp. 1214-1219
Author(s):  
Asish Kumar Saha ◽  
Asem Veeves Singh ◽  
Kavuri Srikar ◽  
Anand Vijayakumar P R
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Hpa Axis ◽  
Disease Patient ◽  
Blood Pressure Level ◽  
Pathophysiological Mechanism ◽  
Cross Sectional ◽  
Cardiac Morbidity ◽  
The Nilgiris ◽  
The Impact

Depression is a common disorder in Cardio-vascular patients with a prevalence of twenty percent (20%) to forty five percent (45%), which is much more frequent than in the general population. Depressive symptoms are often overlooked in cardiac patients and their manifestation, especially after MI, is considered normal. Almost every life-threatening condition, including MI, stimulates the hypothalamus to secrete the corticotropic-releasing hormone, which stimulates the HPA axis. The two-way connection between depression and heart disease, which share the pathophysiological mechanism of origin, affects the prognosis of post-infarction recovery of depressed patients due to the impact of depression on the HPA axis activation, endothelial dysfunction, platelet reactivation and enhanced inflammatory response. An observational, cross-sectional study was conducted at secondary care government hospitals located at the Nilgiris district on different cardiovascular disease patients using HAM-D questionnaires for the assessment of depression. In this study, the level of depression in cardiovascular disease patients were assessed associating with patient variability in relation to age, gender, education, food habits, social habits, duration of disease and blood pressure values. There was a significant increase in depression score with the increase in blood pressure level. The patients were found to be having depression even though they were on cardiovascular treatment after they were being diagnosed with cardiovascular disease. With the treatment of cardiovascular disease conditions, the assessment for depression should be done and if required, depending on the level of depression, counselling and/with psychotherapy (eg. Cognitive behavioural therapy) may be recommended to avoid cardiac morbidity and mortality.  

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