scholarly journals Dyslipidemias and 10-Years Cardiovascular Risk Scores in Adults in Asmara, Eritrea: Findings From a Community-Based Cross-Sectional Study

Author(s):  
Oliver Okoth Achila ◽  
Nahom Fessahye ◽  
Samuel Tekle Mengstu ◽  
Naemi Tesfamariam Habtemikael ◽  
Wintana Yebio Werke ◽  
...  

Abstract Background: The objective of this study was to estimate the prevalence of dyslipidemias and associated factors in adults (≥35 to ≤ 85 years) living in Asmara, Eritrea. Methods: A total of 384 (144 (%) males and 242 (%) females, mean age ± SD, 68.06±6.16 years) respondents were randomly selected after stratified multistage sampling. The WHO NCD STEPS instrument version 3.1 questionnaire was used to collect data. Measurements/or analysis including anthropometric, lipid panel, fasting plasma glucose (FPG), and blood pressure (BP) were also undertaken. Results: The frequency of dyslipidemia in this population was disproportionately high (87.4%) with the worst affected subgroup in the 51-60 age band. The level of awareness was also low. In terms of individual lipid markers, the proportion were as follows: HDL-C (40 mg/dL men and 50 mg/dL females) (55.2%); TC ≥ 200 mg/d (49.7%); LDL≥130 mg/dL (44.8%); TG≥150 mg/dL (38.1%). The mean ± SD, for HDL-C, TC, LDL-C, non-HDL-C, and TG were 45.28±9.60; 205.24±45.77; 130.77±36.15; 160.22±42.09 and 144.5±61.26 mg/dl, respectively. Regarding NCEP ATP III risk criteria, 17.6%, 19.4%, 16.3%, 19.7%, and 54.7% were in high or very high-risk categories for TC, Non-HDL-C, TG, LDL-C, and HDL-C, respectively. Among all respondents, 59.6% had mixed dyslipidemias with TC+TG+LDL-C dominating. In addition, 27.3%, 28.04%, 23.0%, and 8.6% had abnormalities in 1, 2, 3 and 4 lipid abnormalities, respectively. In terms of Framingham CVD Risk scores, 12.7%, 2.8% were in the high risk and very high-risk strata. Further, the high burden of dyslipidemia coexisted with an equally high burden of abdominal obesity (71.8%), BMI≥25 kg/m2 (44.6%), dysglycemia (24.7%), hypertension (24.4%), and physical inactivity. Dyslipidemia was associated with employment status (ref: unemployed vs. employed, aOR 0.48, 95% CI 0.24–0.97, p=0.015) and self-employed (aOR 0.41, 95% CI 0.17–1.00, p=0.018); marital status (ref: not married vs married (aOR 2.35, 95% CI 1.19–4.66, p=0.009); increasing DBP (aOR 1.04 mmHg (1.00-1.09)=0.001) and increasing FPG (aOR 1.02 per 1 mg/dL, 95% CI 1.00–1.05, p=0.001). Conclusion: High frequency of poor lipid health may be a prominent contributor to the high burden of CVDs – related mortality and morbidity in Asmara, Eritrea. Consequently, efforts directed at early detection, and evidence-based interventions are warranted.

Author(s):  
Sienny Linawaty ◽  
JB. Suparyatmo ◽  
Tahono Tahono

Coronary Artery Disease has a high prevalence and is frequently occurred and associated with the high mortality and morbidity. Dyslipidemia is one of the risk factors of Coronary Heart Disease (CHD). ApoB contained in very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), LDL and small dense LDL (sd-LDL), with one molecule of apoB in each particle. Apo A-I is the major apolipoprotein in HDL particles. The ratio of apoB/apoA-I is a balance between apoB-containing particles and potentially atherogenic apoA-I that is antiaterogenik. This study is carried to know the determination whether there are differences between apoB/ apoA-I ratio in patients dyslipidemia with ACS and non ACS. The research used a cross-sectional study design with patients dyslipidemia subjects suffering Acute Coronary Syndrome (ACS) and non ACS who enter to the Laboratory of Pathology Clinic at Dr. Moewardi Hospital between July and November 2011. To determine the pattern of data distribution, the researchers used Kolmogorov Smirnov test. For the analysis of differences in mean apoB/apoA-I ratio in the two population groups is used the T test, using a computer program, with the significance level p<0.05, 95% confidence interval. From 74 samples examined the mean age is 56.42 year old. This patients consisted of 33 males (44.6%) and 41 women (55.4%). All subjects are grouped into two groups, dyslipidemia ACS and non dyslipidemia ACS. The results showed apoB/apoA-I ratio significantly different in patients with dyslipidemia with ACS and non ACS. The mean apoB/apoA-I ratio of women and men subjects in both groups, including groups at high risk of myocardial myokard and higher than the cut-off ratio of apoB/ apoA-I (men 0.9 and women 0.8). It can be concluded that the apoB/apoA-I ratio of women and men subjects in both groups, included the high risk category for infarct myokard although lipid abnormalities are still not demonstrated to the risk of infarct myokard.


Author(s):  
Bibhava Vikramaditya ◽  
Mahesh Satija ◽  
Anurag Chaudhary ◽  
Sarit Sharma ◽  
Sangeeta Girdhar ◽  
...  

Background: Cardiovascular diseases (CVD) are leading cause of non communicable deaths in India. CVD risk prediction charts by World Health Organization/International Society of Hypertension (WHO/ISH) are designed for implementing timely preventive measures. The objective of the study was to assess the prevalence of CVD risk parameters and to estimate total CVD risk among adults aged ≥40 years, using the WHO/ISH risk charts alone and also to assess the effect of the inclusion of additional criteria on CVD risk.Methods: A community based cross sectional study was conducted in fifteen villages of Ludhiana district under rural health training centre of Department of Community Medicine, Dayanand Medical College & Hospital, Ludhiana, Punjab. Desired information was obtained using WHO STEPS survey (STEP wise approach to surveillance) from 324 adults aged ≥40 years. Anthropometric, clinical and laboratory measurements were also performed. WHO/ISH risk prediction chart for South East Asian region (SEAR-D) was used to assess the cardiovascular risk among the subjects.Results: WHO/ISH risk prediction charts identified 16.0% of the subjects with high risk (≥20%) of developing a cardiovascular event. The study population showed higher prevalence of physical inactivity, obesity, abdominal obesity, hypertension and diabetes. Amongst high risk CVD group, maximum prevalence was of hypertension and high perceived stress level. However, the proportion of high CVD risk (≥20%) increased to 33.6% when subjects with blood pressure ≥160/100 mmHg and /or on hypertension medication were added as high risk.Conclusions: A substantial proportion of this community is at high risk of developing cardiovascular diseases.


Medicina ◽  
2020 ◽  
Vol 56 (3) ◽  
pp. 134
Author(s):  
Gediminas Urbonas ◽  
Lina Vencevičienė ◽  
Leonas Valius ◽  
Ieva Krivickienė ◽  
Linas Petrauskas ◽  
...  

Background and Objectives: Cardiovascular disease (CVD) prevention guidelines define targets for lifestyle and risk factors for patients at high risk of developing CVD. We assessed the control of these factors, as well as CVD risk perception in patients enrolled into the primary care arm of the European Action on Secondary and Primary Prevention by Intervention to Reduce Events (EUROASPIRE V) survey in Lithuania. Materials and Methods: Data were collected as the part of the EUROASPIRE V survey, a multicenter, prospective, cross-sectional observational study. Adults without a documented CVD who had been prescribed antihypertensive medicines and/or lipid-lowering medicines and/or treatment for diabetes (diet and/oral antidiabetic medicines and/or insulin) were eligible for the survey. Data were collected through the review of medical records, patients’ interview, physical examination and laboratory tests. Results: A total of 201 patients were enrolled. Very few patients reached targets for low-density lipoprotein cholesterol (LDL-C) (4.5%), waist circumference (17.4%) and body mass index (15.4%). Only 31% of very high CVD risk patients and 52% of high-risk patients used statins. Blood pressure target was achieved by 115 (57.2%) patients. Only 21.7% of patients at very high actual CVD risk and 27% patients at high risk correctly estimated their risk. Of patients at moderate actual CVD risk, 37.5% patients accurately self-assessed the risk. About 60%–80% of patients reported efforts to reduce the intake of sugar, salt or alcohol; more than 70% of patients were current nonsmokers. Only a third of patients reported weight reduction efforts (33.3%) or regular physical activity (27.4%). Conclusions: The control of cardiovascular risk factors in a selected group of primary prevention patients was unsatisfactory, especially in terms of LDL-C level and body weight parameters. Many patients did not accurately perceive their own risk of developing CVD.


2013 ◽  
Vol 2013 ◽  
pp. 1-9 ◽  
Author(s):  
Max Weyler Nery ◽  
Celina Maria Turchi Martelli ◽  
Erika Aparecida Silveira ◽  
Clarissa Alencar de Sousa ◽  
Marianne de Oliveira Falco ◽  
...  

This study aims to estimate the risk of cardiovascular disease (CVD) and to assess the agreement between the Framingham, Framingham with aggravating factors, PROCAM, and DAD equations in HIV-infected patients. A cross-sectional study was conducted in an outpatient centre in Brazil. 294 patients older than 19 years were enrolled. Estimates of 10-year cardiovascular risk were calculated. The agreement between the CVD risk equations was assessed using Cohen's kappa coefficient. The participants' mean age was 36.8 years (SD = 10.3), 76.9% were men, and 66.3% were on antiretroviral therapy. 47.8% of the participants had abdominal obesity, 23.1% were current smokers, 20.0% had hypertension, and 2.0% had diabetes. At least one lipid abnormality was detected in 72.8%, and a low HDL-C level was the most common. The majority were classified as having low risk for CV events. The percentage of patients at high risk ranged from 0.4 to 5.7. The PROCAM score placed the lowest proportion of the patients into a high-risk group, and the Framingham equation with aggravating factors placed the highest proportion of patients into the high-risk group. Data concerning the comparability of different tools are informative for estimating the risk of CVD, but accuracy of the outcome predictions should also be considered.


2021 ◽  
pp. 095646242110293
Author(s):  
Matthias C Mueller ◽  
Susanne Usadel ◽  
Winfried V Kern ◽  
Andreas Zirlik ◽  
Qian Zhou

Because people living with HIV (PLWH) have an elevated risk for cardiovascular disease (CVD), prevention of CVD should be integrated in to HIV care. In this study, we compared the agreement between three risk scores and evaluated the indication for statin therapy based on guidelines of the American Heart Association and European AIDS Clinical Society. This study is a cross-sectional, single-center study. All PLWH ≥ 30 years without CVD and statin therapy were consecutively enrolled. Agreement between CVD risk estimates was assessed using Cohen’s kappa coefficient. Of 488 PLWH, 41.2% were female with a median age of 47.8 years. D:A:D-R classified the highest proportion of patients in the categories of high/very high risk for CVD (17.8%) compared to SCORE (4.7%) and FRS (13.7%). D:A:D-R and SCORE (κ = 0.11) as well as D:A:D-R and FRS (κ = 0.33) showed poor agreement. Based on different CVD risk equations and guidelines, indication for statin therapy ranged from 34.8% to 92.0% of patients. In conclusion, a high proportion of PLWH is at high risk for CVD likely underestimated by treating physicians. Inconsistencies in the evaluation of CVD risk and primary prophylaxis should be tackled by an interdisciplinary approach.


BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e046195
Author(s):  
Mohammad Mostafa Zaman ◽  
Mohammad Moniruzzaman ◽  
Kamrun Nahar Chowdhury ◽  
Salma Zareen ◽  
AHM Enayet Hossain

ObjectiveThe aim of this study was to estimate 10-year cardiovascular disease (CVD) risk among Bangladeshi rural community residents, using the 2014 WHO/International Society of Hypertension (WHO/ISH) risk prediction charts.Study designCross-sectional population-based study done by local community healthcare workers engaging the lowest level facilities of the primary healthcare system.Setting and participantsA total of 1545 rural adults aged ≥40 years of Debhata upazila of Satkhira district of Bangladesh participated in this survey done in 2015. The community health workers collected data on age, smoking, blood pressure, blood glucose and treatment history of diabetes and hypertension.Primary outcome measuresWe estimated total 10-year CVD risk using the WHO/ISH South East Asia Region-D charts without cholesterol and categorised the risk into low (<10%), moderate (10%–19.9%), high (20%–29.9%) and very high (≥30%).ResultsThe participants’ mean age (±SD) was 53.9±11.6 years. Overall, the 10-year CVD risks (%, 95% CI) were as follows: low risk (81.6%, 95% CI 78.4% to 84.6%), moderate risk (9.9%, 95% CI 7.4% to 12.1%), high risk (5.8%, 95% CI 4.4% to 7.2%) and very high risk (2.8%, 95% CI 1.5% to 4.1%). In women, moderate to very high risks were higher (moderate 12.1%, high 6.1% and very high 3.7%) compared with men (moderate 7.5%, high 5.5% and very high 1.9%) but none of these were statistically significant. The age-standardised prevalence of very high risk increased from 2.9% (0.7%–5.2%) to 8.5% (5%–12%) when those with anti-hypertensive medication having controlled blood pressure (<140/90 mm Hg) added.ConclusionThe very high-risk estimates could be used for planning resource for CVD prevention programme at upazila level. There is a need for a national level study, covering diversities of rural areas, to contribute to national planning of CVD prevention.


2021 ◽  
Vol 37 (5) ◽  
Author(s):  
Fangyu Zhu ◽  
Yu Qin ◽  
Yuan Bi ◽  
Jian Su ◽  
Lan Cui ◽  
...  

This study aimed to investigate the association of vegetable and fruit consumption with carotid plaque (CP) and carotid intima-media thickness (CIMT), two predictors of carotid atherosclerosis, within urban and rural adults at high risk of developing cardiovascular diseases (CVDs) in regional China. A total of 11,392 adults at high CVD risk were identified from general population of 71,511 in this cross-sectional study, conducted between November of 2015 and May of 2016 in the Jiangsu Province. Among these 11,392 high risk participants, CP prevalence was 36.7%. The independent variables, vegetable and fruit intake frequency, were assessed by a food frequency questionnaire. The outcome variables, CIMT and CP, were measured by ultrasound examination. The ANCOVA analysis showed no association between CIMT values and vegetable and fruit intake frequencies. Multivariate logistic regression models were introduced to examine the association between vegetable and fruit intake and CP. After adjustment for potential confounders, the odds ratios (ORs) for participants who occasionally and daily consumed vegetable to experience any CP were 0.67 (95%CI: 0.58-0.78) and 0.70 (95%CI: 0.62-0.79), respectively, compared with those rarely consumed vegetable. While the adjusted ORs were 0.77 (95%CI: 0.64-0.92) and 0.80 (95%CI: 0.68-0.94), separately, for occasional and daily vegetable consumers to develop single CP relative to their counterparts who rarely consumed any vegetables. However, no significant association between fruit consumption and CP was observed. Among the Chinese population at high CVD risk, consumption of fresh vegetables was negatively associated with the risk of developing carotid plaque.


2015 ◽  
Vol 42 (4) ◽  
pp. 645-653 ◽  
Author(s):  
Inger Jorid Berg ◽  
Désirée van der Heijde ◽  
Hanne Dagfinrud ◽  
Ingebjørg Seljeflot ◽  
Inge Christoffer Olsen ◽  
...  

Objective.To compare the risk of cardiovascular disease (CVD) in ankylosing spondylitis (AS) and population controls, and to examine the associations between disease activity and CVD risk.Methods.A cross-sectional study was done of patients with AS grouped according to Ankylosing Spondylitis Disease Activity Score (ASDAS) into ASDAS-high and ASDAS-low. Markers of vascular pathology, impaired endothelial function [asymmetric dimethylarginine (ADMA)], and arterial stiffness [augmentation index (AIx) and pulse wave velocity (PWV)], and traditional CVD risk factors [blood pressure, lipids, body mass index (BMI), CVD risk scores] were compared between AS and controls as well as across ASDAS-high versus ASDAS-low versus controls using ANCOVA analyses.Results.Altogether, 151 patients with AS and 134 controls participated. Patients had elevated ADMA (µmol/l) and AIx (%) compared to controls: mean difference (95% CI): 0.05 (0.03, 0.07), p < 0.001 and 2.6 (0.8, 4.3), p = 0.01, respectively. AIx increased with higher ASDAS level, p(trend) < 0.04. There were no significant group differences of PWV. BMI was higher in ASDAS-high compared to ASDAS-low (p = 0.02). Total cholesterol was lower in AS compared to controls, and lower with higher ASDAS, p(trend) = 0.02. CVD risk scores were similar across groups except for Reynolds Risk Score, where the ASDAS-high group had a significantly higher score, compared to both ASDAS-low and controls.Conclusion.Elevated ADMA and AIx in AS support a higher CVD risk in AS. Elevated AIx and BMI in AS with high ASDAS indicate an association between disease activity and CVD risk. Lower total cholesterol in AS may contribute to underestimation of CVD risk.


2020 ◽  
Author(s):  
Miqdad Asaria ◽  
Rebecca Fisher

Objectives: To identify the risk of general practitioner mortality from COVID and the impact of measures to mitigate this risk on the level and socioeconomic distribution of primary care provision in the English NHS Design: Cross sectional study Setting: All GP practices providing primary care under the NHS in England Participants: 45,858 GPs and 6,771 GP practices in the English NHS Main outcome measures: Numbers of high-risk GPs, high-risk single-handed GP practices, patients associated with these high-risk single-handed practices and the regional and socioeconomic distribution of each. Mortality rates from COVID by age, sex and ethnicity were used to attribute risk to GPs and the Index of Multiple Deprivation was used to determine socioeconomic distributions of the outcomes. Results: Of 45,858 GPs in our sample 3,632 (7.9%) were classified as high risk or very high risk. Of 6,771 GP practices in our sample 639 (9.4%) were identified as single-handed practices and of these 209 (32.7%) were run by a GP at high or very high risk. These 209 single-handed practices care for 710,043 patients. GPs at the highest levels of risk from COVID, and single-handed practices run by high-risk GPs were concentrated in the most deprived neighbourhoods in the country. London had the highest proportion of both GPs and single-handed GP practices at very high risk of COVID mortality with 1,160 patients per 100,000 population registered to these practices. Conclusions: A significant proportion of GPs working in England, particularly those serving patients in the most deprived neighbourhoods, are at high risk of dying from COVID. Many of these GPs run single-handed practices. These GPs are particularly concentrated in London. There is an opportunity to provide additional support to mitigate COVID risk for GPs, GP practices and their patients. Failure to do so will likely exacerbate existing health inequalities.


2021 ◽  
Author(s):  
Kentaro Ikeue ◽  
Toru Kusakabe ◽  
Kazuya Muranaka ◽  
Hajime Yamakage ◽  
Takayuki Inoue ◽  
...  

Abstract Background: Aging individuals are prone to sarcopenic obesity (SO). SO is associated with higher risks of low physical function, metabolic diseases, cardiovascular disease (CVD), and mortality. Worldwide diagnostic criteria for SO and its cutoff values have not yet been established. In this study, from among obesity- and sarcopenia-evaluated indices, we determined a combined index most associated with the accumulation of CVD risk factors in obese patients.Methods: In this cross-sectional study, we evaluated body composition using a multifrequency bioelectrical impedance analysis device and measured handgrip strength in 188 obese patients (73 men and 115 women). We selected each index most associated with the accumulation of CVD risk factors among obesity- (body mass index, percentage body fat, or waist circumference [WC]) and sarcopenia-evaluated indices (skeletal mass index, handgrip strength, or muscle quantity [MQ]), respectively. We then classified obese patients into four groups (group C, control; group O, obesity alone; group S, sarcopenia alone; and group SO, sarcopenic obesity) using the two selected indices with each median value and compared the CVD risk score, the number of concomitant CVD risk factors, among the four groups.Results: Based on the dichotomous comparison, WC and MQ were selected as the indices most associated with CVD risk factor accumulation. The CVD risk score was significantly higher in groups S and SO as compared with group C (1.94 ± 0.80, 1.95 ± 0.91 vs. 1.41 ± 0.84, all p < 0.05). Odds ratios for CVD risk scores ≥2 were significantly higher in groups S, O, and SO compared with group C (4.78 [95% confidence interval {CI} 1.79-12.81], p = 0.002; 3.28 [95% CI 1.37-7.88], p = 0.008; 3.92 [95% CI 1.74-8.81], p = 0.001; respectively). Furthermore, odds ratios for CVD risk scores = 3 were significantly higher only in group SO compared with group C (4.29 [95% CI 1.49-12.33], p = 0.007).Conclusion: In obese patients, WC and MQ were most associated with the accumulation of CVD risk factors, respectively. Furthermore, classification using the combined index of WC and MQ reflects the accumulation of CVD risk factors in obese patients, regardless sex and age.


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