scholarly journals Multimorbidity patterns among COVID-19 deaths: proposal for the construction of etiological models

2020 ◽  
Vol 44 ◽  
pp. 1
Author(s):  
Julián A. Fernández-Niño ◽  
John A. Guerra-Gómez ◽  
Alvaro J. Idrovo
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Respiratory Disease ◽  
High Blood Pressure ◽  
Health Conditions ◽  
Older Individuals ◽  
Age Related ◽  
Probability Of Death ◽  
Polynomial Regressions

Objectives. To describe patterns of multimorbidity among fatal cases of COVID-19, and to propose a classification of patients based on age and multimorbidity patterns to begin the construction of etiological models. Methods. Data of Colombian confirmed deaths of COVID-19 until June 11, 2020, were included in this analysis (n=1488 deaths). Relationships between COVID-19, combinations of health conditions and age were explored using locally weighted polynomial regressions. Results. The most frequent health conditions were high blood pressure, respiratory disease, diabetes, cardiovascular disease, and kidney disease. Dyads more frequents were high blood pressure with diabetes, cardiovascular disease or respiratory disease. Some multimorbidity patterns increase probability of death among older individuals, whereas other patterns are not age-related, or decrease the probability of death among older people. Not all multimorbidity increases with age, as is commonly thought. Obesity, alone or with other diseases, was associated with a higher risk of severity among young people, while the risk of the high blood pressure/diabetes dyad tends to have an inverted U distribution in relation with age. Conclusions. Classification of individuals according to multimorbidity in the medical management of COVID-19 patients is important to determine the possible etiological models and to define patient triage for hospitalization. Moreover, identification of non-infected individuals with high-risk ages and multimorbidity patterns serves to define possible interventions of selective confinement or special management.

scholarly journals Multimorbidity patterns among COVID-19 deaths: considerations for a better medical practice

2020 ◽  
Author(s):  
Julian Alfredo Fernandez-Nino ◽  
Jhon A Guerra-Gomez ◽  
Alvaro Javier Idrovo-Velandia
Keyword(s):  
Older Adults ◽  
Health Conditions ◽  
Tropical Diseases ◽  
Older Individuals ◽  
Medical Interventions ◽  
Age Related ◽  
High Prevalence ◽  
The World ◽  
Probability Of Death ◽  
Polynomial Regressions

Medical care of individuals diagnosed with severe COVID-19 is complex, especially when patients are older adults with multimorbidity. The objective of this study was to describe patterns of multimorbidity among fatal cases of COVID-19. Data of Colombian confirmed deaths of COVID-19 until June 11, 2020, were included in this analysis (1488 deaths). Relationships between COVID-19, combinations of health conditions and age were explored using locally weighted polynomial regressions. Some multimorbidity patterns increase probability of death among older individuals, whereas other patterns are not age-related, or decreases the probability of death among older people. Consider multimorbidity in the medical management of COVID-19 patients is important to determine the more adequate medical interventions. In addition to the co-occurrence of COVID-19 with diseases of high prevalence in the world, in Colombia there are cases more complex with COVID-19 co-occur with endemic and orphan tropical diseases. In these cases, although its occurrence may be low, clinical management requires adjusting to its complex clinical condition.

scholarly journals High Blood Pressure and Cardiovascular Disease

Hypertension ◽  
2020 ◽  
Vol 75 (2) ◽  
pp. 285-292 ◽  
Author(s):  
Flávio D. Fuchs ◽  
Paul K. Whelton
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Disease ◽  
Coronary Heart Disease ◽  
Risk Factor ◽  
Heart Disease ◽  
Cohort Studies ◽  
High Blood Pressure ◽  
Population Distribution ◽  
Meta Analysis ◽  
Age Related

Fragmented investigation has masked the overall picture for causes of cardiovascular disease (CVD). Among the risk factors for CVD, high blood pressure (BP) is associated with the strongest evidence for causation and it has a high prevalence of exposure. Biologically, normal levels of BP are considerably lower than what has typically been characterized as normal in research and clinical practice. We propose that CVD is primarily caused by a right-sided shift in the population distribution of BP. Our view that BP is the predominant risk factor for CVD is based on conceptual postulates that have been tested in observational investigations and clinical trials. Large cohort studies have demonstrated that high BP is an important risk factor for heart failure, atrial fibrillation, chronic kidney disease, heart valve diseases, aortic syndromes, and dementia, in addition to coronary heart disease and stroke. In multivariate modeling, the presumed attributable risk of high BP for stroke and coronary heart disease has increased steadily with progressive use of lower values for normal BP. Meta-analysis of BP-lowering randomized controlled trials has demonstrated a benefit which is almost identical to that predicted from BP risk relationships in cohort studies. Prevention of age-related increases in BP would, in large part, reduce the vascular consequences usually attributed to aging, and together with intensive treatment of established hypertension would eliminate a large proportion of the population burden of BP-related CVD.

scholarly journals Classification of Hypertensive and Normotensive Subjects Using Bilateral Differential Biopotential Signals

2021 ◽  
Author(s):  
Arindam Sarkar ◽  
Bhaswati Goswami ◽  
Ratna Ghosh
Keyword(s):  
Blood Pressure ◽  
Random Forest ◽  
High Blood Pressure ◽  
Pivotal Role ◽  
Modern World ◽  
Hypertensive Subject ◽  
Normotensive Subjects ◽  
Electrocardiogram Ecg ◽  
Day By Day

Abstract Hypertension or high blood pressure is a severe health issue in the modern world, especially in this pandemic scenario, that can cause many heart related diseases or even death, and it is increasing day by day. For this reason, a reliable, automatic and easy to use system for hypertensive subject detection is an important focus for the researchers. Biopotential signals can play a pivotal role in this regard. Though, few strategies were proposed based on electrocardiogram (ECG) or electrodermal (EDA) signals, but those require special circuitry, as well as trained persons. In this article, a method is proposed to classify hypertensive and normotensive subjects using differential biopotential signals. Neither special circuitry, nor much expertise is required for handling this system. It was assumed that progression of rest is dependent upon blood pressure. To serve the purpose, signals were acquired from both hypertensive and normotensive subjects bilaterally for 10 continuous minutes. Result of the random forest (RF) classification establishes that from the analysis of the progression of the bilaterally acquired differential biopotential signals, hypertensive subjects can be distinguished from normotensive subjects.

333 Associations Between Insomnia and Health Correlates in Nurses

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A133-A133
Author(s):  
Samantha Nagy ◽  
Jessica Dietch ◽  
Danica Slavish ◽  
Brett Messman ◽  
Camilo Ruggero ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Sleep Apnea ◽  
High Blood Pressure ◽  
Sleep Disturbances ◽  
Sleep Problems ◽  
Health Conditions ◽  
Future Research ◽  
Evidence Based ◽  
Insufficient Sleep ◽  
Gastrointestinal Problems

Abstract Introduction Insomnia, shiftwork (i.e., circadian rhythm disruptions) and insufficient sleep are common among nurses and healthcare workers. Each of these sleep problems can contribute to physical (e.g., inflammation, musculoskeletal pain, cardiovascular disease and heart rate variability, indigestion, and menstrual cycle irregularity) and mental (e.g., depression, anxiety, suicidality) health problems as well as daytime fatigue and sleepiness among nurses and may contribute to burnout and job change. Methods Participants (N=458) were nurses recruited for a parent study, “Sleep and Vaccine Response in Nurses (SAV-RN)” (Taylor & Kelly: R01AI128359-01). Most identified as female (90.5%), White/Caucasian (77.2%), and non-Hispanic (88.6%) with an average age of 39.03 (SD = 11.07). Participants completed baseline measures online via Qualtrics survey. The Sleep Condition Indicator (SCI; Espie et al., 2014) was used to identify a probable diagnosis of insomnia (score of ≤16 = Insomnia; endorsement of each of the primary DSM-5 criteria on the measure). In addition, a checklist of current major health conditions (high blood pressure, sleep apnea, GI issues, HIV/AIDS, cancer, etc.) was also completed. A Chi square test of Independence was conducted using SPSS to determine if insomnia detected by the SCI was associated with reported health conditions. Results At baseline, 25.4% of nurses had a probable insomnia diagnosis. Insomnia was associated with a greater likelihood of diagnosed sleep apnea, cancer (all types), high blood pressure, chronic pain, gastrointestinal problems, an autoimmune disease, and/or an endocrine problem at Month 11 of the study (all ps <.05). Data cleaning is ongoing, but similar analyses will be presented examining shift work sleep disorder and insufficient sleep (i.e., average < 6hrs per night) as individual and simultaneous predictors of physical and mental health at baseline and change from baseline to Month 11 (if available). Conclusion These results help to identify associations between insomnia and health conditions in nurses and may contribute to future research that supports evidence-based intervention and prevention strategies for this population. While evidence-based interventions for sleep disturbances and insomnia exist (CBT-I), accessibility and feasibility of scaling such interventions to reach the nursing community at large remains challenging. Support (if any):

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