scholarly journals Regional Prevalence of Dyslipidemia, Healthcare Utilization, and Cardiovascular Disease Risk in South Korean: A Retrospective Cohort Study

Author(s):  
Kyu-Tae Han ◽  
SeungJu Kim

Background: Health disparities between different populations have long been recognized as a problem, and they are still an unsolved public health issue. Many factors can make a difference, and disparities for cardiovascular diseases (CVDs) are especially pronounced. This study aimed to assess South Korean regional variations for dyslipidemia prevalence, differences in healthcare utilization, and CVD risk. Methods: We used data from 52,377 patients from the National Health Insurance Sampling. Outcome variables were the risk of CVD, healthcare utilization (outpatient visits), and healthcare expenditures. A generalized estimating equation model was used to identify associations between the region and CVD risk, a Poisson regression model was used for evaluating outpatient visits, and a generalized linear model (gamma and log link function) was used to evaluate healthcare expenditures. Results: A total of 12,443 (23.8%) patients were diagnosed with CVD. Dyslipidemia prevalence varied by region, and the most frequent dyslipidemia factor was high total cholesterol. CVD risk was increased in low population-density regions compared to high-density regions (odds ratio [OR]: 1.133, 95% confidence interval [CI]: 1.037–1.238). Healthcare expenditures and outpatient visits were also higher in low-density regions compared to high-density regions. Conclusions: This study provides a regional assessment of dyslipidemia prevalence, healthcare utilization, and CVD risk. To bridge differences across regions, consideration should be given not only to general socio-economic factors but also to specific regional factors that can affect these differences, and a region-based approach should be considered for reducing disparities in general health and healthcare quality.

Author(s):  
David M Kern ◽  
Stephanie DeVore ◽  
Jennifer Kim ◽  
Ying Wu ◽  
Ozgur Tunceli ◽  
...  

CV events among T2DM patients are major contributors to high healthcare utilization and cost. Healthcare utilization and costs among T2DM patients with established CVD and CVD risk factors in a large US database were explored. T2DM patients aged ≥40 years were identified from the HealthCore Integrated Research Environment from 1/1/2007 to 4/30/2011 and followed from first T2DM diagnosis (index date) until loss of eligibility or death. Established CVD [Group 1] included patients with MI, stroke, peripheral vascular disease, coronary heart disease, congestive heart failure, or revascularization in the year prior to index. CVD risk [Group 2] included patients with older age (men ≥55 y, women ≥60 y) and prior diagnosis for either dyslipidemia or hypertension. Per person year (PPY) utilization and cost following T2DM diagnosis were calculated as the total number of events/cost divided by total number of person years of follow-up. There were 177,140 Group 1 (mean age: 68 y; 57% men) and 191,441 Group 2 (mean age: 66 y; 57% men) patients who met the selection criteria. During the 12, 24, 36, and 48 months following index, a higher proportion of Group 1 vs Group 2 patients had ≥1 inpatient visit (35%, 50%, 61%, 69% vs 16%, 27%, 36%, 44% respectively) and ≥1 ED visit (6.2%, 17%, 29%, 41% vs 2.9%, 9%, 18%, 28% respectively). T2DM patients have high healthcare utilization and costs. Those with established CVD have higher PPY event rates (Figure 1) and costs (Figure 2), compared with patients with CVD risk factors. Inpatient hospitalizations and outpatient visits are key cost drivers in this T2DM population.


2021 ◽  
Vol 8 (2) ◽  
Author(s):  
Mabel Toribio ◽  
Evelynne S Fulda ◽  
Sarah M Chu ◽  
Zsofia D Drobni ◽  
Magid Awadalla ◽  
...  

Abstract Women with HIV (WWH) transitioning through menopause have heightened cardiovascular disease (CVD) risk. In the general population, hot flash burden relates to CVD risk indices. We found higher hot flash burden among women with vs without HIV. Further, among WWH, hot flash burden related to select CVD risk indices. ClinicalTrials.gov Registration NCT02874703.


2021 ◽  
pp. 1-37
Author(s):  
Laury Sellem ◽  
Bernard Srour ◽  
Kim G. Jackson ◽  
Serge Hercberg ◽  
Pilar Galan ◽  
...  

Abstract In France, dairy products contribute to dietary saturated fat intake, of which reduced consumption is often recommended for cardiovascular disease (CVD) prevention. Epidemiological evidence on the association between dairy consumption and CVD risk remains unclear, suggesting either null or inverse associations. This study aimed to investigate the associations between dairy consumption (overall and specific foods) and CVD risk in a large cohort of French adults. This prospective analysis included participants aged ≥ 18 years from the NutriNet-Santé cohort (2009–2019). Daily dietary intakes were collected using 24h-dietary records. Total dairy, milk, cheese, yogurts, fermented and reduced-fat dairy intakes were investigated. CVD cases (n=1,952) included cerebrovascular (n=878 cases) and coronary heart diseases (CHD, n=1,219 cases). Multivariable Cox models were performed to investigate associations. This analysis included n=104,805 French adults (mean age at baseline 42.8 years (SD 14.6)), mean follow-up 5.5 years (SD 3.0, i.e. 579,155 persons years). There were no significant associations between dairy intakes and total CVD or CHD risks. However, the consumption of at least 160 g/d of fermented dairy (e.g. cheese and yogurts) was associated with a reduced risk of cerebrovascular diseases compared to intakes below 57 g/d (HR=0.81 [0.66-0.98], p-trend=0.01). Despite being a major dietary source of saturated fats, dairy consumption was not associated with CVD or CHD risks in this study. However, fermented dairy was associated with a lower cerebrovascular disease risk. Robust randomized controlled trials are needed to further assess the impact of consuming different dairy foods on CVD risk and potential underlying mechanisms.


2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Himani Thakkar ◽  
Vinnyfred Vincent ◽  
Sakshi Sukhla ◽  
Manraj Sra ◽  
Uma Kanga ◽  
...  

Abstract Background Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery. Methods We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages. Results A significant reduction in BMI (− 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = − 23.4%, p = 0.002; Adipo IR = − 16%, p = 0.009) and inflammation [log resistin = − 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03). Conclusion The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.


2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.


2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.


2012 ◽  
Vol 17 (9) ◽  
pp. 1163-1170 ◽  
Author(s):  
Kreton Mavromatis ◽  
Konstantinos Aznaouridis ◽  
Ibhar Al Mheid ◽  
Emir Veledar ◽  
Saurabh Dhawan ◽  
...  

Vascular injury mobilizes bone marrow–derived proangiogenic cells into the circulation, where these cells can facilitate vascular repair and new vessel formation. We sought to determine the relationship between a new biomarker of circulating bone marrow–derived proangiogenic cell activity, the presence of atherosclerotic cardiovascular disease (CVD) and its risk factors, and clinical outcomes. Circulating proangiogenic cell activity was estimated using a reproducible angiogenic colony-forming unit (CFU-A) assay in 532 clinically stable subjects aged 20 to 90 years and ranging in the CVD risk spectrum from those who are healthy without risk factors to those with active CVD. CFU-A counts increased with the burden of CVD risk factors ( p < 0.001). CFU-A counts were higher in subjects with symptomatic CVD than in those without ( p < 0.001). During follow-up of 232 subjects with CVD, CFU-A counts were higher in those with death, myocardial infarction, or stroke than in those without (110 [70–173] vs 84 [51–136], p = 0.01). Therefore, we conclude that circulating proangiogenic cell activity, as estimated by CFU-A counts, increases with CVD risk factor burden and in the presence of established CVD. Furthermore, higher circulating proangiogenic cell activity is associated with worse clinical outcome in those with CVD.


Author(s):  
K. Premanandh ◽  
R. Shankar

Background: Coronary vascular disease (CVD) risk estimation tools are a simple means of identifying those at high risk in a community and hence a potentially cost-effective strategy for CVD prevention in resource-poor countries. The WHO /ISH risk prediction charts provide approximate estimates of cardiovascular disease risk in people who do not have established coronary heart disease, stroke or other atherosclerotic disease.Methods: A total of 280 subjects between 40 to 70 years of age were included in this cross sectional study. Eligible households was selected randomly (every 5th household) for the interview using systematic random sampling. Age, gender, smoking status, systolic blood pressure, presence or absence of diabetes and total serum cholesterol were used to compute the total CVD risk using WHO/ISH CVD risk prediction chart. The chart stratify an individual into low (<10%), moderate (10% to <20%), high (20% to <30%), and very high (>30%) risk groups.Results: Moderate and high CVD risk were 12.14% and 7.5% respectively. Of total study participants, 2.5% had very high risk (>40%). High risk (binge drinking) alcohol drinkers (p=0.04) and abdominal obesity (p=0.0001) were significantly associated with higher CVD risk. Higher prevalence of behavioral risk factors was also reported in our study population.Conclusions: A large proportion of the population is at moderate and high cardiovascular risk. Risk stratification and identification of individuals with a high risk for CHD who could potentially benefit from intensive primary prevention efforts are critically important in reducing the burden of CVD in India.


2019 ◽  
Vol 11 (2) ◽  
pp. 138-146
Author(s):  
Leila Azadbakht ◽  
Fahime Akbari ◽  
Mostafa Qorbani ◽  
Mohammad Esmaeil Motlagh ◽  
Gelayol Ardalan ◽  
...  

Introduction: This cross-sectional study aimed to assess the association between cardiovascular disease (CVD) risk factors and dinner consumption in a nationally representative sample of Iranian adolescents. Methods: The present study was conducted on 5642 adolescents aged 10-18 years old in 27 provinces in Iran. The subjects were included applying by multistage random cluster sampling. Participants who ate ≥5 dinners during a week were considered as a dinner consumer. Results: Among 5642 subjects, 1412 (25%) did not consume dinner. Dinner consumers were less likely to be overweight or obese (P < 0.001) and abdominally obese (P < 0.001) as well as to have an abnormal level of HDL-C (P = 0.02). Dinner skipper youths had a higher risk for overweight or obesity (odds ratio [OR]: 1.62; 95% CI: 1.39-1.89) and abdominal obesity (OR: 1.59; 95% CI: 1.36-1.85) which remained significant after adjusting confounding factors (P <0001). No relationship was observed between dinner consumption and the rest of the CVD risk factors, neither in crude nor in adjusted models. A higher proportion of dinner-consumer adolescents had no CVD risk factors in comparison to dinner-skipper subjects (31.1% vs. 28%). Conclusion: Eating dinner might be inversely associated with some CVD risk factors among Iranian adolescents. Further prospective studies will need to prove this theory.


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