Cardiovascular Risk Factors and Evolution of Patients Attended with COVID-19 in a National Reference Hospital from Lima, Peru

Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Here, we evaluated those factors in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Design. A retrospective cohort observational study was done. For this study, information was obtained from clinical records of the hospital for the cases that were laboratory-diagnosed and related, during March 6th and April 30th, 2020. rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Calculation of the odds ratio (OR) with the respective 95% confidence interval (95% CI) was done, also logistic regression for adjusted OR (multivariate) was done. Values of p < 0.05 were considered significant for all analyses. Results. One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion. As observed in other regions of the world, cardiovascular risk factors represent a significant and independent threat to be considered in patients with COVID-19. Further studies and interventions in Peru and Latin America are expected.

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Factores de riesgo cardiovascular y evolución de pacientes con COVID-19 atendidos en un Hospital Nacional de Referencia de Lima, P

Revista Peruana de Investigación en Salud ◽

10.35839/repis.5.3.1071 ◽

2021 ◽

Vol 5 (3) ◽

pp. 195-200

Author(s):

Germán V. Valenzuela-Rodríguez ◽

Alfonso J. Rodriguez-Morales ◽

Roxana Mamani-Quiroz ◽

Ricardo Ayala-García ◽

Katherine Pérez ◽

...

Keyword(s):

Risk Factors ◽

Mechanical Ventilation ◽

Multivariate Analysis ◽

Cardiovascular Risk ◽

Arterial Hypertension ◽

Cardiovascular Risk Factors ◽

Associated Factors ◽

Myocardial Injury ◽

Bivariate Analysis ◽

Clinical Records

Introduction: Coronavirus disease 2019 (COVID-19) fatal outcomes have been associated with multiple cardiovascular risk factors. In new epidemic areas, such as Latin America, there is a lack of studies about this. Objectives: To evaluate demographic data, signs and symptoms during emergency arrival, prevalence of cardiovascular risk factors, laboratory and ECG findings and their influence in mortality, in a retrospective cohort of patients in a national reference hospital of Lima, Peru. Methods: Review the clinical records of the patients attended at Hospital Rebagliati Hospital during March 6th and April 30th, 2020, using rRT-PCR was used for the detection of the RNA of SARS-CoV-2 following the protocol Charité, Berlin, Germany, from nasopharyngeal swabs at the National Institute of Health. Bivariate analysis and multivariate analysis using logistic regression was done. Values of p < 0.05 were considered significant for all analyses. Results: One hundred six hospitalized patients were evaluated. The mean age of patients was 61.58 years (SD 16.81). Cardiovascular risk factors among them were hypertension (46.2%), diabetes (28.3%), and obesity (28.3%), among others. Fifty-six patients died (52.8%). Mortality associated factors at the multivariate analysis were arterial hypertension (OR=1.343, 95% 1.089-1.667), myocardial injury (OR=1.303, 95% 1.031-1.642), and mechanical ventilation (OR 1.262, 95% 1.034-1.665), as associated factors. Conclusion: Cardiovascular risk factors and cardiovascular signs or symptoms are common during emergency arrival in patients with COVID-19. Arterial hypertension, myocardial injury and mechanical ventilation were associated with mortality in multivariate analysis, as observed in other regions of the world.

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Major Cardiovascular Risk Factors in Latin America: A Comparison with the United States. The Latin American Consortium of Studies in Obesity (LASO)

PLoS ONE ◽

10.1371/journal.pone.0054056 ◽

2013 ◽

Vol 8 (1) ◽

pp. e54056 ◽

Cited By ~ 67

Author(s):

J. Jaime Miranda ◽

Victor M. Herrera ◽

Julio A. Chirinos ◽

Luis F. Gómez ◽

Pablo Perel ◽

...

Keyword(s):

United States ◽

Risk Factors ◽

Latin America ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Latin American ◽

The United States

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Multiple cardiovascular risk factors in adolescents from a middle-income country: Prevalence and associated factors

PLoS ONE ◽

10.1371/journal.pone.0200075 ◽

2018 ◽

Vol 13 (7) ◽

pp. e0200075

Author(s):

Thiago Veiga Jardim ◽

Thomas A. Gaziano ◽

Flávia Miquetichuc Nascente ◽

Carolina de Souza Carneiro ◽

Polyana Morais ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Associated Factors ◽

Middle Income Country ◽

Income Country ◽

Middle Income

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The significant gap between international standards and stroke management practices at Queen Elizabeth Central Hospital (Malawi): An audit report

Malawi Medical Journal ◽

10.4314/mmj.v31i4.6 ◽

2019 ◽

Vol 31 (4) ◽

pp. 249-255 ◽

Cited By ~ 1

Author(s):

Yohane Gadama

Keyword(s):

Risk Factors ◽

Cardiovascular Risk ◽

Acute Stroke ◽

Cardiovascular Risk Factors ◽

Management Practices ◽

Vital Signs ◽

Central Hospital ◽

Stroke Management ◽

The Mean ◽

Queen Elizabeth Central Hospital

BackgroundThe Queen Elizabeth Central Hospital (QECH) is preparing to set up the first stroke unit in Blantyre, Malawi. We conducted this audit to assess current stroke management practices and outcomes at QECH and identify priority areas for intervention.MethodsFrom April to June 2018, we prospectively enrolled patients with acute stroke and collected data on clinical presentation, cardiovascular risk factors, investigations and interventions, in-hospital outcomes, and follow-up plans after discharge. The American Heart Association/American Stroke Association (AHA/ASA) guidelines were used as the standard of care for comparison.ResultsFifty patients with acute stroke were enrolled (46% women, 54% men). The mean age was 63.1 years (95% CI: 59.7–66.6). The diagnosis of stroke was based on the World Health Organization criteria. The diagnosis was made within 24 hours of admission in 19 patients (38%). Acute revascularisation therapy was not available. Forty-eight patients (96%) had their vital signs checked at baseline and <10% had their vital signs checked more than three times within the first 24 hours. Essential blood tests including random blood sugar (RBS), full blood count (FBC), urea/creatinine, and lipid profiles were performed in 72%, 68%, 48%, and 4%, respectively. An electrocardiogram was performed on 34 patients (68%). Blood pressure on admission was >140/90 mmHg in 34 patients (68%), including 4 with values >220/120 mmHg. Nine patients had an RBS >10 mmol/L and four received insulin. Prophylaxis for deep venous thrombosis was offered to 12 patients (24%). Aspiration pneumonia was reported in 16 patients (32%) and was the most common hospital complication. The mean duration of hospitalisation was 10.4 days (95% CI: 5.6–15.2), and case fatality was 18%. The modified Rankin scale at discharge was ≤2 in 32% of patients. Only four patients (8%) were transferred to a rehabilitation centre. At the time of discharge, only 32% of patients received education on stroke.ConclusionAcute stroke care is less than optimal in this setting. Simple interventions such as reducing the delay in making a stroke diagnosis, early swallow assessments, and closer monitoring of vital signs could make a significant difference in stroke outcome. Furthermore, treating cardiovascular risk factors and setting up health education programmes to improve secondary prevention represent key priorities.

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High prevalence of obesity in rheumatoid arthritis patients: association with disease activity, hypertension, dyslipidemia and diabetes, a multi-center study

Advances in Rheumatology ◽

10.1186/s42358-019-0089-1 ◽

2019 ◽

Vol 59 (1) ◽

Cited By ~ 4

Author(s):

Maria Fernanda Brandão de Resende Guimarães ◽

Carlos Ewerton Maia Rodrigues ◽

Kirla Wagner Poti Gomes ◽

Carla Jorge Machado ◽

Claiton Viegas Brenol ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Cardiovascular Disease ◽

Cardiovascular Risk ◽

Disease Activity ◽

Cardiovascular Risk Factors ◽

Laboratory Data ◽

Premature Cardiovascular Disease ◽

Prevalence Of Obesity ◽

The Mean

Abstract Introduction Rheumatoid arthritis (RA) is a well-documented independent risk factor for cardiovascular disease. Obesity may provide an additional link between inflammation and accelerated atherosclerosis in RA. Objective To evaluate the association between obesity and disease parameters and cardiovascular risk factors in RA patients. Method Cross-sectional study of a cohort of RA patients from three Brazilian teaching hospitals. Information on demographics, clinical parameters and the presence of cardiovascular risk factors was collected. Blood pressure, weight, height and waist circumference (WC) were measured during the first consultation. Laboratory data were retrieved from medical records. Obesity was defined according to the NCEP/ATPIII and IDF guidelines. The prevalence of obesity was determined cross-sectionally. Disease activity was evaluated using the DAS28 system (remission < 2.6; low 2.6–3.1; moderate 3.2–5.0; high > 5.1). Results The sample consisted of 791 RA patients aged 54.7 ± 12.0 years, of whom 86.9% were women and 59.9% were Caucasian. The mean disease duration was 12.8 ± 8.9 years. Three quarters were rheumatoid factor-positive, the mean body mass index (BMI) was 27.1 ± 4.9, and the mean WC was 93.5 ± 12.5 cm. The observed risk factors included dyslipidemia (34.3%), type-2 diabetes (15%), hypertension (49.2%) and family history of premature cardiovascular disease (16.5%). BMI-defined obesity was highly prevalent (26.9%) and associated with age, hypertension and dyslipidemia. Increased WC was associated with diabetes, hypertension, dyslipidemia and disease activity. Conclusion: Obesity was highly prevalent in RA patients and associated with disease activity.

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Role of nurse practitioners in reducing cardiovascular risk factors: a retrospective cohort study

Journal of Clinical Nursing ◽

10.1111/jocn.12889 ◽

2015 ◽

Vol 24 (21-22) ◽

pp. 3077-3083 ◽

Cited By ~ 6

Author(s):

Zalika Klemenc-Ketis ◽

Alenka Terbovc ◽

Bostjan Gomiscek ◽

Janko Kersnik

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Nurse Practitioners ◽

Retrospective Cohort Study ◽

Retrospective Cohort

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Feasibility of Aerobic Interval Training in Nonambulant Persons after Stroke

Journal of Clinical Exercise Physiology ◽

10.31189/2165-6193-8.3.97 ◽

2019 ◽

Vol 8 (3) ◽

pp. 97-101

Author(s):

Sarah R. Valkenborghs ◽

Kirk I. Erickson ◽

Michael Nilsson ◽

Paulette van Vliet ◽

Robin Callister

Keyword(s):

Risk Factors ◽

Heart Rate ◽

Cardiovascular Risk ◽

Aerobic Exercise ◽

Cardiovascular Risk Factors ◽

Interval Training ◽

Cycle Ergometer ◽

Recovery Interval ◽

Aerobic Interval Training ◽

The Mean

ABSTRACT Background: Modifiable cardiovascular risk factors are prevalent and poorly managed in people after stroke. Aerobic exercise is effective in reducing many modifiable cardiovascular risk factors after stroke but is challenging and under-researched in nonambulant persons. This pilot study aimed to investigate the feasibility of aerobic interval training in nonambulant persons after stroke. Methods: Aerobic exercise was performed on an upright or semi-recumbent cycle ergometer. Participants were prescribed 4 × 4-min intervals of exercise at 85% maximum age-predicted heart rate (APHRmax) with a 3-min active recovery at 70%APHRmax per 30-min session, 3 times per week for 10 weeks. Heart rate, rating of perceived exertion, workload, cadence, and duration of exercise achieved were recorded for each interval. Results: Nine participants (mean ± SD; age 62 ± 12 y; 5 males) unable to walk without assistance after stroke (2.9 ± 3.9 y) were recruited. There were no adverse events reported, but there was one dropout (due to bronchitis). Attendance for the remaining participants was 93 ± 6%. The mean training %APHRmax was 72 ± 14% for the higher intensity interval and 57 ± 21% for the recovery interval. The mean increase in training workload between weeks 1 and 10 was 11.2 ± 11.6 W (27 ± 28%) for the higher intensity interval and 4.0 ± 7.7W (17 ± 33%) for the recovery interval. The mean increase in VO2peak was 2.3 ± 2.9 mL·kg−1·min−1 (18 ± 22%) over the 10-week intervention. Conclusion: Aerobic interval training at a moderate-vigorous intensity on an upright or recumbent cycle ergometer is feasible for nonambulant persons after stroke. Aerobic interval training should be further investigated to determine its potential to improve cardiorespiratory fitness after stroke and risk factors for recurrent stroke.

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Meta-regression analysis of the effect of lifestyle interventions on mediators of inflammation in postmenopausal breast cancer women with cardiovascular risk factors

10.21203/rs.2.18867/v1 ◽

2019 ◽

Author(s):

Jean Paul Muambngu Milambo ◽

Maritha Kotze ◽

Erasmus Rajiv ◽

John Akudugu ◽

Tamuzi Lukenze Jacques

Keyword(s):

Breast Cancer ◽

Risk Factors ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

Cochrane Library ◽

Lifestyle Interventions ◽

Mediators Of Inflammation ◽

The Mean ◽

Meta Regression ◽

Shared Risk

Abstract Background: Chronic inflammation is associated with obesity, dyslipidemia, and different types of malignancies that may play a complex role in the risk of breast cancer (BC) recurrence and therapy related side effects. The purpose of this review was to determine the effects of lifestyle interventions on mediators of inflammation (C-reactive protein (CRP), interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α)) and other therapy related adverse events in postmenopausal BCS with cardiovascular related risk factors. Methods: A systematic search for relevant articles was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis criteria using available databases (PubMed, Scopus, The Cochrane Library, OpenGrey, Google Scholar and CENTRAL). Results: Twelve eligible randomized controlled trials (RCT) met the inclusion criteria. The mean ages of postmenopausal BC women ranged from 49 to 56 years. The meta-regression revealed that there was moderate evidence that MSE decreased the mean difference (MD) of inflammatory markers in BCS, with CVD risk factors (MD: 0.31; 95% CI: 0.05 to 0.57, P=0.02; heterogeneity: Tau² = 0. 12; Chi² = 106.30, df = 19, I² = 0. 50.4%). Conclusion: There is a moderate level of evidence on the effects of MSE on mediators of inflammation in postmenopausal BCS with cardiovascular risk factors. A number of shared risk factors between postmenopausal status and CVD should be considered, while treating postmenopausal BCS.

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Abstract WP241: Prevalence of Subclinical Extracranial Carotid Atherosclerosis Detected by Ultrasound Among Amerindians: A Population Study in Rural Ecuador

Stroke ◽

10.1161/str.51.suppl_1.wp241 ◽

2020 ◽

Vol 51 (Suppl_1) ◽

Author(s):

Victor J Del Brutto ◽

Jose G Romano ◽

Robertino M Mera ◽

Jonathan P Amodio ◽

Tatjana Rundek ◽

...

Keyword(s):

Risk Factors ◽

Blood Pressure ◽

Cardiovascular Risk ◽

Cardiovascular Risk Factors ◽

High Blood Pressure ◽

Carotid Atherosclerosis ◽

Male Gender ◽

Rural Setting ◽

Carotid Plaques ◽

The Mean

Background: Epidemiological information on extracranial carotid atherosclerosis (ECA) among Amerindians is limited. We aim to determine the prevalence of subclinical ECA and its correlation with cardiovascular risk factors in community-dwelling adults of Amerindian ancestry living in a rural Ecuadorian village. Methods: Utilizing a population-based design, stroke-free individuals aged ≥40 years were invited to undergo carotid ultrasound. Subclinical ECA was defined as an intima-media thickness (cIMT) >1mm and/or the presence of carotid plaques (focal intima thickening >1.5mm that protrudes into the lumen). Degree of luminal stenosis was calculated and considered significant if >50%. We investigated the association between these biomarkers and cardiovascular risk factors. Results: Of 728 candidates, 559 (77%) stroke-free individuals underwent carotid sonographic evaluation and were included. The mean age was 62.3 ±12.5 and 238 (43%) were men. The mean value of the cIMT was 0.85 ± 0.17mm (median cIMT: 0.83mm; IQ range: 0.74-0.92 mm). The prevalence of increased cIMT, carotid plaques, and increased cIMT and/or carotid plaques were 14%, 23.8%, and 26.1%, respectively. Table depicts the association of these biomarkers with cardiovascular risk factors. A multinomial logistic regression model, using individuals with normal carotids as the referent category, showed significant associations of ECA with increasing age, male gender, smoking and high blood pressure. Significant carotid stenosis was found in 19 subjects (3.4%). Conclusions: About one-fourth of Amerindians living in a rural setting have subclinical ECA. Increasing age, male gender, smoking and high blood pressure were independent determinants of the burden of ECA, while elevated glucose and total cholesterol showed no significant association. Obesity was inversely associated with ECA in univariate analysis, but such association disappeared in the multivariate model.

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