scholarly journals Cardiovascular Health Peaks and Meteorological Conditions: A Quantile Regression Approach

2021 ◽  
Vol 18 (24) ◽  
pp. 13277
Author(s):  
Yohann Moanahere Chiu ◽  
Fateh Chebana ◽  
Belkacem Abdous ◽  
Diane Bélanger ◽  
Pierre Gosselin
Keyword(s):  
Public Health ◽  
Quantile Regression ◽  
Cardiovascular Health ◽  
Meteorological Conditions ◽  
Significant Variable ◽  
Conditional Quantiles ◽  
Conditional Median ◽  
High Quantiles ◽  
Cardiovascular Morbidity And Mortality ◽  
Heavy Burden

Cardiovascular morbidity and mortality are influenced by meteorological conditions, such as temperature or snowfall. Relationships between cardiovascular health and meteorological conditions are usually studied based on specific meteorological events or means. However, those studies bring little to no insight into health peaks and unusual events far from the mean, such as a day with an unusually high number of hospitalizations. Health peaks represent a heavy burden for the public health system; they are, however, usually studied specifically when they occur (e.g., the European 2003 heatwave). Specific analyses are needed, using appropriate statistical tools. Quantile regression can provide such analysis by focusing not only on the conditional median, but on different conditional quantiles of the dependent variable. In particular, high quantiles of a health issue can be treated as health peaks. In this study, quantile regression is used to model the relationships between conditional quantiles of cardiovascular variables and meteorological variables in Montreal (Canada), focusing on health peaks. Results show that meteorological impacts are not constant throughout the conditional quantiles. They are stronger in health peaks compared to quantiles around the median. Results also show that temperature is the main significant variable. This study highlights the fact that classical statistical methods are not appropriate when health peaks are of interest. Quantile regression allows for more precise estimations for health peaks, which could lead to refined public health warnings.

scholarly journals Association of cardiovascular health and epigenetic age acceleration

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Tess D. Pottinger ◽  
Sadiya S. Khan ◽  
Yinan Zheng ◽  
Wei Zhang ◽  
Hilary A. Tindle ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Cardiovascular Health ◽  
Heart Association ◽  
The United States ◽  
Cross Sectional ◽  
Epigenetic Age ◽  
Younger Age ◽  
Cardiovascular Morbidity And Mortality ◽  
Epigenetic Age Acceleration ◽  
Linear Regression Modeling

Abstract Background Cardiovascular health (CVH) has been defined by the American Heart Association (AHA) as the presence of the “Life’s Simple 7” ideal lifestyle and clinical factors. CVH is known to predict longevity and freedom from cardiovascular disease, the leading cause of death for women in the United States. DNA methylation markers of aging have been aggregated into a composite epigenetic age score, which is associated with cardiovascular morbidity and mortality. However, it is unknown whether poor CVH is associated with acceleration of aging as measured by DNA methylation markers in epigenetic age. Methods and results We performed a cross-sectional analysis of racially/ethnically diverse post-menopausal women enrolled in the Women’s Health Initiative cohort recruited between 1993 and 1998. Epigenetic age acceleration (EAA) was calculated using DNA methylation data on a subset of participants and the published Horvath and Hannum methods for intrinsic and extrinsic EAA. CVH was calculated using the AHA measures of CVH contributing to a 7-point score. We examined the association between CVH score and EAA using linear regression modeling adjusting for self-reported race/ethnicity and education. Among the 2,170 participants analyzed, 50% were white and mean age was 64 (7 SD) years. Higher or more favorable CVH scores were associated with lower extrinsic EAA (~ 6 months younger age per 1 point higher CVH score, p < 0.0001), and lower intrinsic EAA (3 months younger age per 1 point higher CVH score, p < 0.028). Conclusions These cross-sectional observations suggest a possible mechanism by which ideal CVH is associated with greater longevity.

Determinants of total end-of-life healthcare costs of Medicare beneficiaries: A quantile regression forests analysis

2021 ◽  
Author(s):  
Lihua Li ◽  
Liangyuan Hu ◽  
Jiayi Ji ◽  
Karen Mckendrick ◽  
Jaison Moreno ◽  
...  
Keyword(s):  
Quantile Regression ◽  
End Of Life ◽  
Healthcare Costs ◽  
Health Maintenance Organizations ◽  
Medicare Beneficiaries ◽  
Health Maintenance ◽  
Regional Characteristics ◽  
Hospital Referral Region ◽  
High Quantiles ◽  
Hospital Referral

Abstract Background To identify and rank the importance of key determinants of end-of-life (EOL) healthcare costs, and to understand how the key factors impact different percentiles of the distribution of healthcare costs. Methods We applied a principled, machine learning based variable selection algorithm, using Quantile Regression Forests, to identify key determinants for predicting the 10 th (low), 50 th (median) and 90 th (high) quantiles of EOL healthcare costs, including costs paid for by Medicare, Medicaid, Medicare Health Maintenance Organizations (HMO), private HMO, and patient’s out-of-pocket expenditures. Results Our sample included 7,539 Medicare beneficiaries who died between 2002 and 2017. The 10 th, 50 th and 90 th quantiles of EOL healthcare cost are $5,244, $35,466 and $87,241 respectively. Regional characteristics, specifically, the EOL-expenditure index, a measure for regional variation in Medicare spending driven by physician practice, and the number of total specialists in the hospital referral region, were the top two influential determinants for predicting the 50 th and 90 th quantiles of EOL costs, but were not determinants of the 10 th quantile. Black race and Hispanic ethnicity were associated with lower EOL healthcare costs among decedents with lower total EOL healthcare costs but were associated with higher costs among decedents with the highest total EOL healthcare costs. Conclusions Factors associated with EOL healthcare costs varied across different percentiles of the cost distribution. Regional characteristics and decedent race/ethnicity exemplified factors that did not impact EOL costs uniformly across its distribution, suggesting the need to use a “higher-resolution” analysis for examining the association between risk factors and healthcare costs.

scholarly journals Cardiac Rehabilitation: A Bibliometric Review From 2001 to 2020

2021 ◽  
Vol 8 ◽  
Author(s):  
Guozhen Yuan ◽  
Jingjing Shi ◽  
Qiulei Jia ◽  
Shuqing Shi ◽  
Xueping Zhu ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiac Rehabilitation ◽  
Developed Countries ◽  
The United States ◽  
Positive Effects ◽  
Sports Science ◽  
Subject Categories ◽  
Cardiovascular Morbidity And Mortality ◽  
Wide Range ◽  
Topic Distribution

Cardiovascular disease (CVD) is a serious threat to global public health due to its high prevalence and disability rate. Meanwhile, cardiac rehabilitation (CR) has attracted increasing attention for its positive effects on the cardiovascular system. There is overwhelming evidence that CR for patients with CVD is effective in reducing cardiovascular morbidity and mortality. To learn more about the development of CR, 5,567 papers about CR and related research were retrieved in the Web of Science Core Collection from 2001 to 2020. Then, these publications were scientometrically analyzed based on CiteSpace in terms of spatiotemporal distribution, author distribution, subject categories, topic distribution, and references. The results can be elaborated from three aspects. Firstly, the number of annual publications related to CR has increased year by year in general over the past two decades. Secondly, a co-occurrence analysis of the output countries and authors shows that a few developed countries such as the United States, Canada, and the UK are the most active in carrying out CR and where regional academic communities represented by Sherry Grace and Ross Arena were formed. Thirdly, an analysis of the subject categories and topic distribution of the papers reveals that CR is a typical interdiscipline with a wide range of disciplines involved, including clinical medicine, basic medicine, public health management, and sports science. The research topics cover the participants and implementers, components, and the objectives and requirements of CR. The current research hotspots are the three core modalities of CR, namely patient education, exercise training and mental support, as well as mobile health (mHealth) dependent on computer science. In conclusion, this work has provided some useful information for acquiring knowledge about CR, including identifying potential collaborators for researchers interested in CR, and discovering research trends and hot topics in CR, which can offer some guidance for more extensive and in-depth CR-related studies in the future.

Evaluation of Cardiovascular Variables in a Calchaquí Population in the Middle and High Mountains of Tucumán

2021 ◽  
Vol 89 (1) ◽  
pp. 20-26
Author(s):  
Sebastián Galdeano ◽  
Damián Holownia ◽  
Darío Palavecino ◽  
José Daniel Abregú ◽  
María Silvina Rivas Jordan ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Cardiovascular Health ◽  
Posterior Wall ◽  
Left Ventricular ◽  
High Mountains ◽  
Urban Centers ◽  
Cross Sectional ◽  
The Third ◽  
Posterior Wall Thickness ◽  
Cardiovascular Morbidity And Mortality

Background: The Quilmes community includes 2,400 inhabitants of the middle and high mountains of Tucumán (1,800 to 4,000 meters above sea level). The purpose of the present study was to know their cardiovascular health status. Methods: A cross-sectional descriptive quantitative investigation was carried out in people belonging to the Quilmes community who voluntarily attended the planned evaluation on September 27-29, 2018. Results: Two hundred and two settlers were studied (125 women and 77 men; 48±1.4 years), 23% of them had hypertension (HTN); 14% were smokers; 4.9% had diabetes; 18% had dyslipidemia (DLP) and 25% usually consumed alcohol (1.0 ± 0.4 L/day). Also, 29% were overweight and 36% obese. High blood pressure (BP) was recorded in 48 individuals at the time of the study. Blood pressure decreased in the third compared to the first measurement, whereas heart rate increased in the third assessment (74±1 beats per minute vs. 77±1; p <0.01). Oxygen saturation (95.0±0.2%) was negatively correlated with age (Pearson r: -0.266; p <0.001). In individuals with normal BP, ultrasound E/ratio was higher (1.2±0.0) and left ventricular posterior wall thickness was lower (8.5±0.5 mm) than in those with elevated BP (0.92±0.1 and 9.0±0.3, respectively, p <0.001). Twenty-four percent of individuals had atherosclerotic plaques and 120 had DLP. Conclusions: The Quilmes population presents a prevalence of cardiovascular risk factors similar to that of urban centers, which could lead to an increase in cardiovascular morbidity and mortality in the coming years

scholarly journals Indoxyl Sulfate, a Uremic Endotheliotoxin

Toxins ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 229 ◽  
Author(s):  
Guillaume Lano ◽  
Stéphane Burtey ◽  
Marion Sallée
Keyword(s):  
Cardiovascular Health ◽  
Plasma Concentrations ◽  
Cardiovascular Complications ◽  
Indoxyl Sulfate ◽  
Uremic Toxin ◽  
Prooxidant Effect ◽  
Aryl Hydrocarbon ◽  
Cardiovascular Morbidity And Mortality ◽  
And Control

Chronic kidney disease (CKD) is associated with a high prevalence of cardiovascular diseases. During CKD, the uremic toxin indoxyl sulfate (IS)—derived from tryptophan metabolism—accumulates. IS is involved in the pathophysiology of cardiovascular complications. IS can be described as an endotheliotoxin: IS induces endothelial dysfunction implicated in cardiovascular morbidity and mortality during CKD. In this review, we describe clinical and experimental evidence for IS endothelial toxicity and focus on the various molecular pathways implicated. In patients with CKD, plasma concentrations of IS correlate with cardiovascular events and mortality, with vascular calcification and atherosclerotic markers. Moreover, IS induces a prothrombotic state and impaired neovascularization. IS reduction by AST-120 reverse these abnormalities. In vitro, IS induces endothelial aryl hydrocarbon receptor (AhR) activation and proinflammatory transcription factors as NF-κB or AP-1. IS has a prooxidant effect with reduction of nitric oxide (NO) bioavailability. Finally, IS alters endothelial cell and endothelial progenitor cell migration, regeneration and control vascular smooth muscle cells proliferation. Reducing IS endothelial toxicity appears to be necessary to improve cardiovascular health in CKD patients.

scholarly journals Fruit and Vegetable Concentrate Supplementation and Cardiovascular Health: A Systematic Review from a Public Health Perspective

2019 ◽  
Vol 8 (11) ◽  
pp. 1914
Author(s):  
Giulia Lorenzoni ◽  
Clara Minto ◽  
Maria Gabriella Vecchio ◽  
Slavica Zec ◽  
Irene Paolin ◽  
...  
Keyword(s):  
Public Health ◽  
Systematic Review ◽  
Fruits And Vegetables ◽  
Cardiovascular Health ◽  
Effective Means ◽  
Density Lipoprotein ◽  
Physiological Parameters ◽  
Noncommunicable Diseases ◽  
Public Health Perspective ◽  
Concentrate Supplementation

Fruits and vegetables (FV) are very important for the prevention of noncommunicable diseases (NCDs), but it has been demonstrated that FV consumption is below that recommended. Several companies have worked to offer FV concentrates, but it remains unclear whether they represent a potentially effective means of reducing the burden of NCDs. The present study provides a systematic review aimed at assessing the effect of FV concentrate supplementation on select parameters that are known to be risk factors for NCDs. The systematic review was done according to the PRISMA guidelines. Relevant studies were identified through the online databases PubMed, Scopus, Web of Science, and Embase. The physiological parameters of interest were total cholesterol, low-density lipoprotein, plasmatic homocysteine, systolic blood pressure, and body mass index. Data extraction was performed in duplicate. The results of the systematic review provided input for a Markov chain simulation model aimed at estimating the public health consequences of various scenarios of FV concentrate utilization on NCDs burden. The present results suggest a positive and significant role of FV concentrate supplementation on select parameters known to affect the risk of NCDs. Such an effect might be hypothesized to turn into mitigation of the burden of those NCDs modulated by the physiological parameters analyzed in the present systematic review.

Vitamin D Replacement Mitigates Menopause-Associated Dyslipidaemia and Atherogenic Indices in Ovariectomized Rats; A Biochemical Study

2019 ◽  
Vol 128 (03) ◽  
pp. 144-151 ◽  
Author(s):  
Marwa Hassan Muhammad ◽  
Noha Ibrahim Hussien ◽  
Sania K. Elwia
Keyword(s):  
Vitamin D ◽  
Cardiovascular Health ◽  
Biochemical Study ◽  
Control Diet ◽  
Cardiac Risk ◽  
Atherogenic Index ◽  
Ovariectomized Rats ◽  
Atherogenic Indices ◽  
Cardiovascular Morbidity And Mortality ◽  
The Impact

Abstract Background & Aim Dyslipidaemia is highly prevalent among postmenopausal women and its management represents a keystone in the prevention of the worldwide increase in cardiovascular morbidity and mortality. Therapy choices for menopause-associated dyslipidaemia are limited and a matter of debate. So, it becomes prudent to search for natural safe alternatives. Vitamin D (VD) has been acknowledged as an essential factor in cardiovascular health. Thus, we aimed to illustrate the impact of different VD status on dyslipidaemia and atherogenic indices. Method 5 groups of rats were conducted; SHAM group fed control diet, ovariectomized rats fed control diet (OVX), ovariectomized rats fed VD-sufficient-high fat diet (HFD) (1 000 IU/ kg diet), ovariectomized rats fed VD-deficient-HFD (25 IU/ kg diet), and ovariectomized rats fed VD-replete-HFD (10 000 IU/ kg diet) for 16 weeks. Results Dyslipidaemia with an increased atherogenic index of plasma, atherosclerosis coefficient, cardiac risk ratio, and aortic total cholesterol accumulation in addition to reduced serum 25-hydroxy-VD levels was observed in the OVX and VD-sufficient HFD versus SHAM. These findings were aggravated by VD-deficient-HFD while reversed by VD-replete-HFD. The VD-mediated abundance of aortic ATP-binding cassette transporter A1 (ABCA1) expression, reduced activity of the inflammatory Jun N-terminal kinases (JNK), and downregulation of aortic cluster of differentiation-36 (CD36) receptors expression together with increased serum total antioxidant capacity and reduced serum malondialdehyde were among the supposed mechanisms. Conclusions Our study sheds light on alarming levels of VD deficiency among ovariectomized rats. VD repletion improved the menopause-associated dyslipidaemia and atherogenic indices through hypolipidemic, antioxidant, and anti-inflammatory effects.

scholarly journals Probabilistic Hydrological Post-Processing at Scale: Why and How to Apply Machine-Learning Quantile Regression Algorithms

Water ◽  
2019 ◽  
Vol 11 (10) ◽  
pp. 2126 ◽  
Author(s):  
Georgia Papacharalampous ◽  
Hristos Tyralis ◽  
Andreas Langousis ◽  
Amithirigala W. Jayawardena ◽  
Bellie Sivakumar ◽  
...  
Keyword(s):  
Machine Learning ◽  
Quantile Regression ◽  
Random Forests ◽  
Large Scale ◽  
Hydrological Model ◽  
Model Errors ◽  
Post Processing ◽  
Conditional Quantiles ◽  
Daily Streamflow ◽  
Regression Algorithms

We conduct a large-scale benchmark experiment aiming to advance the use of machine-learning quantile regression algorithms for probabilistic hydrological post-processing “at scale” within operational contexts. The experiment is set up using 34-year-long daily time series of precipitation, temperature, evapotranspiration and streamflow for 511 catchments over the contiguous United States. Point hydrological predictions are obtained using the Génie Rural à 4 paramètres Journalier (GR4J) hydrological model and exploited as predictor variables within quantile regression settings. Six machine-learning quantile regression algorithms and their equal-weight combiner are applied to predict conditional quantiles of the hydrological model errors. The individual algorithms are quantile regression, generalized random forests for quantile regression, generalized random forests for quantile regression emulating quantile regression forests, gradient boosting machine, model-based boosting with linear models as base learners and quantile regression neural networks. The conditional quantiles of the hydrological model errors are transformed to conditional quantiles of daily streamflow, which are finally assessed using proper performance scores and benchmarking. The assessment concerns various levels of predictive quantiles and central prediction intervals, while it is made both independently of the flow magnitude and conditional upon this magnitude. Key aspects of the developed methodological framework are highlighted, and practical recommendations are formulated. In technical hydro-meteorological applications, the algorithms should be applied preferably in a way that maximizes the benefits and reduces the risks from their use. This can be achieved by (i) combining algorithms (e.g., by averaging their predictions) and (ii) integrating algorithms within systematic frameworks (i.e., by using the algorithms according to their identified skills), as our large-scale results point out.

scholarly journals Cardiovascular Disease Prevention and Implications of Coronavirus Disease 2019: An Evolving Case Study in the Crescent City

2020 ◽  
Vol 9 (13) ◽  
Author(s):  
Alexander C. Razavi ◽  
Tanika N. Kelly ◽  
Jiang He ◽  
Camilo Fernandez ◽  
Paul K. Whelton ◽  
...  
Keyword(s):  
Public Health ◽  
Cardiovascular Disease ◽  
Access To Health Care ◽  
Cardiovascular Health ◽  
Case Fatality ◽  
Noncommunicable Diseases ◽  
Lifestyle Behaviors ◽  
Public Health Perspective ◽  
Access To Health ◽  
The Impact

Abstract Medicine and public health have traditionally separated the prevention and treatment of communicable and noncommunicable diseases. The coronavirus disease 2019 ( COVID ‐19) pandemic has challenged this paradigm, particularly in the setting of cardiovascular disease ( CVD ). Overall, individuals with underlying CVD who acquire severe acute respiratory syndrome coronavirus 2 experience up to a 10‐fold higher case‐fatality rate compared with the general population. Although the impact of the pandemic on cardiovascular health continues to evolve, few have defined this association from a frontline, public health perspective of populations disproportionately affected by CVD and COVID ‐19. Louisiana is ranked within the bottom 5 states for cardiovascular health, and it is home to several parishes that have experienced among the highest COVID ‐19 case‐fatality rates nationally. Herein, we review CVD prevention and implications of COVID ‐19 in New Orleans, LA, a city holding a sobering yet resilient history with previous public health disasters. In particular, we discuss potential pandemic‐driven changes in access to health care, preventive pharmacotherapy, and lifestyle behaviors, all of which may adversely affect CVD prevention and management, while amplifying racial disparities. Through this process, we highlight proposed recommendations for how CVD prevention efforts can be improved in the midst of the current COVID ‐19 pandemic and future public health crises.

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