scholarly journals Prevalence of cardiovascular disease risk factors and long-term outcomes in the Saudi population: Results from the Prospective Urban Rural Epidemiology study (PURE-Saudi)

2020 ◽  
Author(s):  
Khalid Alhabib ◽  
Mohammed A Batais ◽  
Turky H Almigbal ◽  
Mostafa Q Alshamiri ◽  
Hani Altaradi ◽  
...  

Abstract Objective We report the prevalence of unhealthy lifestyle behaviors, cardiovascular disease (CVD) risk factors, and long-term outcomes within the Saudi population, stratified by age, sex, and place of residence. Methods The Prospective Urban Rural Epidemiology (PURE) study is a global cohort study including adults of 35–70 years old in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Clinical follow-up of major CVD events and mortality is ongoing. Results The PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural ). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, 25.1% diabetes, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had history of stress (several periods), 6.8% had permanent stress, 0.98% had history of stroke, 0.64% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers (21% vs. 0.45%, p<0.001), have diabetes (28.2% vs. 21.3%, p<0.001), and have history of CHD (3.2% vs. 1.6%, p=0.02); while women were more likely to be obese (58.6% vs. 42.8%, p<0.001), have central obesity (70.7% vs. 32.7%, p<0.001), self-report sadness (22.7%, vs. 9.9% p<0.001), experience stress (several periods), feel permanent stress (9.9% vs. 4.5%, p<0.001), and have low education (46.6% vs. 20.2%, p<0.001). Compared to participants in urban areas, those in rural areas had higher rates of diabetes (31.1% vs. 23.3%, p<0.001), obesity (56.6% vs. 47.3%, p<0.001), and hypertension (35.5% vs. 28.6%, p=0.004); and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle- and old-age individuals, younger participants more commonly reported unhealthy diet, permanent stress, and self-reporting of being sad. Conclusion PURE-Saudi, the first population cohort study in Saudi Arabia, revealed a high prevalence of CVD risk factors in the adult Saudi population, with higher rates in rural than urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the burden of CVD risk and mortality.

2020 ◽  
Author(s):  
Khalid Alhabib ◽  
Mohammed A Batais ◽  
Turky H Almigbal ◽  
Mostafa Q Alshamiri ◽  
Hani Altaradi ◽  
...  

Abstract ObjectiveWe report the prevalence of unhealthy lifestyle behaviors, cardiovascular disease (CVD) risk factors, and long-term outcomes within the Saudi population, stratified by age, sex, and place of residence.MethodsThe Prospective Urban Rural Epidemiology (PURE) study is a global cohort study including adults of 35–70 years old in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Clinical follow-up of major CVD events and mortality is ongoing.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, 25.1% diabetes, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had history of stress (several periods), 6.8% had permanent stress, 0.98% had history of stroke, 0.64% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers (21% vs. 0.45%, p<0.001), have diabetes (28.2% vs. 21.3%, p<0.001), and have history of CHD (3.2% vs. 1.6%, p=0.02); while women were more likely to be obese (58.6% vs. 42.8%, p<0.001), have central obesity (70.7% vs. 32.7%, p<0.001), self-report sadness (22.7%, vs. 9.9% p<0.001), experience stress (several periods), feel permanent stress (9.9% vs. 4.5%, p<0.001), and have low education (46.6% vs. 20.2%, p<0.001). Compared to participants in urban areas, those in rural areas had higher rates of diabetes (31.1% vs. 23.3%, p<0.001), obesity (56.6% vs. 47.3%, p<0.001), and hypertension (35.5% vs. 28.6%, p=0.004); and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle- and old-age individuals, younger participants more commonly reported unhealthy diet, permanent stress, and self-reporting of being sad. ConclusionPURE-Saudi, the first population cohort study in Saudi Arabia, revealed a high prevalence of CVD risk factors in the adult Saudi population, with higher rates in rural than urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.


2020 ◽  
Author(s):  
Khalid Alhabib ◽  
Mohammed A Batais ◽  
Turky H Almigbal ◽  
Mostafa Q Alshamiri ◽  
Hani Altaradi ◽  
...  

Abstract BackgroundCardiovascular disease (CVD) is the major cause of death in Saudi Arabia. We aimed to assess associated demographic, behavioral, and CVD risk factors as part of the Prospective Urban Rural Epidemiology (PURE) study.MethodsPURE is a global cohort study of adults ages 35–70 years in 20 countries. PURE-Saudi study participants were recruited from 19 urban and 6 rural communities randomly selected from the Central province (Riyadh and Alkharj) between February 2012 and January 2015. Data were stratified by age, sex, and urban vs rural and summarized as means and standard deviations for continuous variables and as numbers and percentages for categorical variables. Proportions and means were compared between men and women, among age groups, and between urban and rural areas, using Chi-square test and t-tests, respectively.ResultsThe PURE-Saudi study enrolled 2047 participants (mean age, 46.5 ± 9.12 years; 43.1% women; 24.5% rural). Overall, 69.4% had low physical activity, 49.6% obesity, 34.4% unhealthy diet, 32.1% dyslipidemia, 30.3% hypertension, and 25.1% diabetes. In addition, 12.2% were current smokers, 15.4% self-reported feeling sad, 16.9% had a history of periods of stress, 6.8% had permanent stress, 1% had a history of stroke, 0.6% had heart failure, and 2.5% had coronary heart disease (CHD). Compared to women, men were more likely to be current smokers and have diabetes and a history of CHD. Women were more likely to be obese, have central obesity, self-report sadness, experience stress, feel permanent stress, and have low education. Compared to participants in urban areas, those in rural areas had higher rates of diabetes, obesity, and hypertension, and lower rates of unhealthy diet, self-reported sadness, stress (several periods), and permanent stress. Compared to middle-aged and older individuals, younger participants more commonly reported an unhealthy diet, permanent stress, and feeling sad.ConclusionThese results of the PURE-Saudi study revealed a high prevalence of unhealthy lifestyle and CVD risk factors in the adult Saudi population, with higher rates in rural vs urban areas. National public awareness programs and multi-faceted healthcare policy changes are urgently needed to reduce the future burden of CVD risk and mortality.


Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Ahmed A Hassoon ◽  
Lawrence Appel ◽  
Hsin-Chieh Yeh

In 2017 161,000 new cases of prostate cancer diagnosed in the U.S. With improved survival from prostate cancer, cardiovascular disease has emerged as competing cause of morbidity and mortality. However, few studies have assessed CVD risk factors among prostate cancer survivors. We analyzed National Health and Nutrition Examination Survey (NHANES) from 1999-2014 to assess CVD risk factors, as defined by AHA/ACC, in adult men with and without a history of prostate cancer. A total of 602 men, age 50 years and older, with prostate cancer history and 8,226 men without cancer history were included in the analysis. Among men with prostate cancer history, the mean (SE) age at survey was 72.3(0.4); 41% of the survivors had their diagnoses less than 5 years ago, while 31% survived more than 10 years after diagnosis. Compared to men without cancer, prostate cancer survivors were older (mean age 72 (0.4) vs 62y (0.1)), but with similar education level ( p =0.41). For CVD risk factors, prostate cancer survivors were less likely to be current smokers (6.5% vs 20.3%), but more likely to have hypertension and on anti-hypertensive medication (95.6% vs 88.9%) with age-adjusted prevalence odds ratio of 1.53 ([95% CI, 1.2 - 1.9]; p =0.001) and 1.78 ([95% CI, 1.1 - 2.9]; p =0.024), respectively. There were no differences in lipids profiles between men with and without prostate cancer. In stratified analysis, non-Hispanic blacks’ survivors have almost two times the prevalence of hypertension compared to non-Hispanic blacks free of cancer, with age-adjusted prevalence odds ratio of 1.9 ([95% CI, 1.2 - 2.96]; p=0.005). In conclusion, CVD risk factors were prevalent in prostate cancer survivors. Improving cardiovascular health through lifestyle change and preventive strategies is a public health priority, particularly among non-Hispanic Blacks.


BMJ Open ◽  
2019 ◽  
Vol 9 (10) ◽  
pp. e029858 ◽  
Author(s):  
Jobert Richie Nansseu ◽  
Bibiane Siaheu Kameni ◽  
Felix Kembe Assah ◽  
Jean Joel Bigna ◽  
Saint-Just Petnga ◽  
...  

ObjectiveTo determine the prevalence estimates of some major risk factors for cardiovascular disease (CVD) in a young adult-aged population living in Yaoundé, Cameroon.DesignA cross-sectional study held from May to July 2017.SettingParticipantsStudents aged 18–35 years, with no known history of CVD, found at the campus during recruitment and who voluntarily agreed to be included in the study.Primary and secondary outcome measuresData were collected on personal and family history as well as lifestyle and nutritional habits; anthropometric parameters and blood pressure were also measured. Prevalence rates were calculated with their respective 95% CI.ResultsOverall, 931 participants (53.8% males) were included, with a median age of 23 years (IQR 21–25). The prevalence estimates for some major CVD risk factors were: 3.1% (95% CI 2.0 to 4.2) for family history of heart attack, 6.3% (95% CI 4.7 to 7.9) for family history of stroke, 26.7% (95% CI 23.9 to 29.5) for hazardous alcohol consumption, 0.9% (95% 0.3 to 1.5) for current tobacco smoking, 27.6% (95% CI 24.7 to 30.5) for secondhand smoking, 88.9% (95% CI 86.9 to 90.9) for physical inactivity, 99.0% (95% CI 98.4 to 99.6) for inadequate fruits and/or vegetables consumption, 39.8% (95% CI 36.7 to 42.9) for self-reported anxiety, 49.2% (95% CI 46.0 to 52.4) for self-reported depression, 22.1% (95% CI 19.4 to 24.8) for overweight, 3.9% (95% CI 2.7 to 5.1) for obesity, 14.4% (95% CI 12.1 to 16.7) for abdominal obesity, 14.5% (95% CI 12.2 to 16.8) for excess body fat mass, 30.0% (95% CI 27.1 to 32.9) for suspected prehypertension and 2.8% (95% CI 1.7 to 3.9) for suspected hypertension.ConclusionThe prevalence of some major CVD risk factors is high among young adults living in Yaoundé, Cameroon. Therefore, specific actions should be undertaken in this population to mitigate the upcoming burden of CVD. Accordingly, younger-aged adult populations should be encouraged and accompanied to practice physical activity, eat healthily, and stop or avoid smoking and/or hazardous alcohol consumption.


2019 ◽  
Vol 26 (3-4) ◽  
pp. 50-54
Author(s):  
Uma A. Bhosale ◽  
Radha Yegnanarayan ◽  
Akhil Agrawal ◽  
Ashwini Patil

Background: Epilepsy is a chronic medical condition that requires long-term therapy with antiepileptic drugs (AEDs). However, long-term employment of AEDs may lead to the onset of hyperhomocysteinemia, which has been found to modulate imperative metabolic mechanisms and induce cardiovascular disorders (CVDs). Therefore, adolescent population that have been diagnosed with epilepsy and utilize AEDs are among the most vulnerable, exhibiting higher risks of developing CVDs. Purpose: The present study was designed to explore the effects of folic acid (FA) supplementation on AED-induced hyperhomocysteinemia and CVD risk factors in adolescent epileptics. Methods: The randomized clinical trial included adolescent epileptics (i.e., 10–19 years of age) of either sex, on antiepileptic therapy for > 6 months with high homocysteine levels (i.e., >10.9 µmol/L). At the time of enrolment, their baseline BP, lipid and homocysteine levels were recorded. Participants were randomly assigned to either treatment or placebo groups and received the respective treatments. At the end of the first month, BP, lipid and homocysteine levels were recorded and compared to determine the effect of FA on these parameters. Results and conclusion: A significant fall in homocysteine levels was observed with FA supplementation ( P < 0.05). However, this fall was significantly high in valproic acid treated epileptic patients. In addition, we observed an improvement in high-density lipoprotein levels, a risk factor for CVDs, but the change was statistically insignificant ( P > 0.05). The study results suggest that FA supplementation in epileptic patients receiving AED therapy may minimize AED-induced hyperhomocysteinemia and other CVD risk factors.


2020 ◽  
Vol 28 (1) ◽  
pp. 75-79
Author(s):  
Mark Savage ◽  
Ross Kung ◽  
Cameron Green ◽  
Brandon Thia ◽  
Dinushka Perera ◽  
...  

Objective: To describe the characteristics of patients presenting to an Emergency Department (ED) following overdoses; to identify risk factors for intensive care unit (ICU) admission among these patients; and to identify the rate of mortality and repeat overdose presentations over four years. Methods: Adult patients presenting to ED following drug overdose during 2014 were included. Data were collected from medical notes and hospital databases. Results: During the study period, 654 patients presented to ED 800 times following overdose. Seventy-eight (9.8%) resulted in ICU admission, and 59 (7.4%) required intubation; 57.2% had no history of overdose presentations, and 72.9% involved patients with known psychiatric illness. Overdose of atypical antipsychotics (AAP), age and history of prior overdose independently predicted ICU admission. A third of patients ( n = 196, 30%) had subsequent presentations to ED following overdose, in the four years from their index presentation, with an all-cause four-year mortality of 3.4% ( n = 22). Conclusion: A history of overdose, use of AAP and older age were risk factors for ICU admission following ED presentations. Over a third of patients had repeat overdose presentation in the four-year follow-up with a mortality of 3.4%.


2020 ◽  
Author(s):  
Alessandro Giollo ◽  
Giovanni Cioffi ◽  
Federica Ognibeni ◽  
Giovanni Orsolini ◽  
Andrea Dalbeni ◽  
...  

Abstract Background. Major cardiovascular disease (CVD) benefits of disease-modifying anti-rheumatic drugs (DMARDs) therapy occur in early RA patients with treat-to-target strategy. However, it is unknown whether long-term DMARDs treatment in established RA could be useful to improve CVD risk profile.Methods. Ultrasound aortic stiffness index (AoSI) has to be considered a proxy outcome measure in established RA patients. We measured AoSI in a group of RA patients on long-term treatment with tumour necrosis factor inhibitors (TNFi) or conventional synthetic DMARDs (csDMARDs). Eligible participants were assessed at baseline and after 12 months; changes in serum lipids, glucose and arterial blood pressure were assessed. All patients were on stable medications during the entire follow-up. Results. We included 107 (64 TNFi and 43 csDMARDs) RA patients. Most patients (74%) were in remission or low disease activity and had some CVD risk factors (45.8% hypertension, 59.8% dyslipidemia, 45.3% smoking). The two groups did not differ significantly for baseline AoSI (5.95±3.73% vs 6.08±4.20%, p=0.867). Follow-up AoSI was significantly increased from baseline in the csDMARDs group (+1.00%; p<0.0001) but not in the TNFi group (+0.15%, p=0.477). Patients on TNFi had significantly lower follow-up AoSI from baseline than the csDMARD group (-1.02%, p<0.001; ANCOVA corrected for baseline AoSI, age and systolic blood pressure). Furthermore, follow-up AoSI was significantly lower in TNFi users with 1-2 or >2 CVD risk factors than in those without. Conclusion. Long-term treatment with TNFi was associated with reduced aortic stiffness in patients with established RA and several CVD risk factors.


2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and risk factors of ECG abnormalities in the general population of Chinese adults.Methods: ECG data were obtained from 34965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test.Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, the older age significantly increased the risk of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds ratios of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left.Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases had important impact on ECG abnormalities.# Liping Yu and Xiaojun Ye contributed equally to this work.


2020 ◽  
Author(s):  
Liping Yu ◽  
Xiaojun Ye ◽  
Zhaojun Yang ◽  
Wenying Yang ◽  
Bo Zhang

Abstract Background: Electrocardiogram (ECG) is widely used to screen cardiac diseases. To date, no large population study has provided estimates of the prevalences of ECG findings in China. We aim to investigate the prevalences and associated factors of ECG abnormalities in a general population of Chinese adults. Methods: ECG data were obtained from 34,965 participants in the 2007-2008 China National Diabetes and Metabolic Disorders Study. ECG abnormalities were classified according to the Minnesota coding (MC) criteria. Prevalences of variant ECG abnormalities were calculated. The associations between ECG abnormalities and gender, age and other risk factors for cardiovascular diseases (CVD) were analyzed by multivariate logistic regression test. Results: The prevalences of major arrhythmias were 1.70%, 2.37% and 1.04% in the whole population, men and women, respectively. Atrial fibrillation/flutter was found in 0.35% of men and 0.20% of women. ST depression and T abnormalities accounted for 10.96%, 7.54% and 14.32% in the whole population, men and women, respectively. Independent of gender and other CVD risk factors, older age significantly increased the odds of having atrial fibrillation/flutter, complete left bundle branch block, complete right bundle branch block, sinus tachycardia, atrial/junctional/ventricular premature beats, ST depression and T abnormalities, tall R wave left, left/right atrial hypertrophy, left axis deviation and low voltage. Hypertension, overweight, obesity and hypercholesterolemia all independently increased the odds of having ST depression and T abnormalities. History of cardiovascular/cerebrovascular diseases was positively associated with major arrhythmias, ST depression and T abnormalities and tall R wave left. Conclusions: This study provides estimates of the prevalences of ECG findings in a large population of Chinese adults. Gender, age, CVD risk factors and history of cardiovascular/cerebrovascular diseases were significantly associated with ECG abnormalities.


2020 ◽  
Vol 12 (23) ◽  
pp. 10038
Author(s):  
Won Ju Hwang ◽  
Jin Ah Kim ◽  
Ji Sun Ha

The purpose of this study was to evaluate the effects of a yoga program provided to workers in small businesses to reduce cardiovascular disease (CVD) risk factors. A nonequivalent control group pre/post-test design was used. The experimental group (n = 31) was assigned a yoga program consisting of yoga postures designed for meditation, strengthening, stretching, and balancing, given twice weekly for 12 weeks. The control group (n = 38) was given no other intervention. The mean age was 48.1 years old in the experimental group and 47.7 years old in the control group. Three trained investigators collected the questionnaires and one month after completing the 12-week yoga program, the same questionnaires that were administered at baseline were again administered. Psychosocial variables (depressive symptoms and job stress), health promotion behaviors, and body measurements (weight and waist circumference) were measured for the program evaluation. The yoga program was effective in improving waist circumference (from 81.8 to 79.2, p < 0.001) and diastolic blood pressure (from 81.0 to 79.1, p = 0.004) as compared to the control group. Furthermore, the experimental group’s job stress score decreased from 1.38 to 1.02, but it was not statistically significant (p = 0.240). A yoga program could be a useful intervention for workers with CVD risk factors, but it was not effective in psychological factors such as job stress and depression. A long-term intervention approach is important to confirm the psychosocial effect. Therefore, future research is needed to investigate the long-term outcomes of such interventions.


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