scholarly journals The role of spoken language in cardiovascular health inequalities: a cross-sectional study of people with non-English language preference

BJGP Open ◽  
2017 ◽  
Vol 1 (4) ◽  
pp. bjgpopen17X101241
Author(s):  
Alex Mackay ◽  
Mark Ashworth ◽  
Patrick White
Keyword(s):  
Cardiovascular Disease ◽  
Health Inequalities ◽  
English Language ◽  
Cardiovascular Health ◽  
Cardiovascular Monitoring ◽  
Language Preference ◽  
Cross Sectional ◽  
Preference Group ◽  
Language Groups

BackgroundSocioeconomic and ethnic factors are established determinants of cardiovascular health inequalities. The role of low proficiency in the majority language as a mediator of these inequalities is uncertain.AimThis study aimed to investigate the association between non-English language preference and cardiovascular health inequalities in a community in London.Design & settingRetrospective, cross-sectional analysis of anonymised patient-level data collected from general practices in Lambeth, south London.MethodCardiovascular disease prevalence, monitoring, and risk-identification data were compared between non-English and English language groups using multiple logistic regression.ResultsOf the total number of patients registered at the 49 participating practices, 302 404 (83%) patients were aged ≥18 years. Preferred language was recorded by 69.4%: English 53.6%, Portuguese 3.2%, Spanish 2.6%, French 1.6%, Polish 1.4%, Somali 0.5%, and others 7.1%; 30.6% had no record of language preference. The non-English language preference group had a greater likelihood of coronary heart disease ([CHD], odds ratio [OR] 1.18, 95% confidence interval [CI] = 1.03 to 1.34); diabetes mellitus ([DM], OR = 1.33, 95% CI = 1.23 to 1.43); obesity (OR = 1.08, 95% CI = 1.04 to 1.13); and smoking (OR = 1.18, 95% CI = 1.14 to 1.21), but no difference in the prevalence of hypertension or stroke. Cardiovascular monitoring was not less intense in this group. Portuguese-speakers (the largest non-English language preference group) had a greater likelihood of hypertension (OR = 1.43, 95% CI = 1.30 to 1.57); DM (OR = 1.74, 95% CI = 1.50 to 2.02); stroke (OR = 1.40, 95% CI = 1.08 to 1.81); obesity (OR = 1.53, 95% CI = 1.36 to 1.73); and smoking (OR = 1.13, 95% CI = 1.02 to 1.25).ConclusionThe non-English language preference group was associated with a greater risk of some aspects of cardiovascular disease than the English language preference group, probably reflecting shared cultural and behavioural risk. Non-English language preference was not associated with lower rates of cardiovascular monitoring, providing some evidence of equitable primary care access in this group.

scholarly journals 306 - Loneliness and mortality in older adults and the role of depression

2020 ◽  
Vol 32 (S1) ◽  
pp. 64-64
Author(s):  
T.J. Holwerda ◽  
D. Rhebergen ◽  
H.C. Comijs ◽  
J.J.M. Dekker ◽  
M.L. Stek
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Mortality Risk ◽  
Meta Analysis ◽  
Clinical Perspective ◽  
Cross Sectional ◽  
Mediating Role ◽  
Underlying Mechanisms ◽  
Dexamethasone Suppression

Background:The prevalence of loneliness increases with age. The presence of loneliness in older adults has been found to be associated with health problems such as depression, decreased cognitive functioning, increases in systolic blood pressure and increased mortality. The underlying mechanisms of the higher mortality risk are largely unknown.Methods:Meta-analysis to investigate the present evidence for the associations between loneliness and mortality. Cross-sectional studies investigating the associations between loneliness and cardiovascular disease and between loneliness and cortisol in 378 depressed and 132 non-depressed older adults.Results:Loneliness appears to be associated with increased mortality, although when only studies are included that consider depression as a covariate, the association is not significant. Therefore it seems likely that depression plays a mediating role in the higher mortality risk.We did not find a significant association between loneliness and cardiovascular disease. In contrast, loneliness was significantly associated with lower cortisol output and decreased dexamethasone suppression.Discussion:The results and their implications for prevention and treatment will be discussed from a clinical perspective as well as a general health perspective. Is loneliness as potentially dangerous as depression?

scholarly journals Relationship between Determinants of Health, Equity, and Dimensions of Health Literacy in Patients with Cardiovascular Disease

2020 ◽  
Vol 17 (6) ◽  
pp. 2082 ◽  
Author(s):  
Ana Cristina Cabellos-García ◽  
Enrique Castro-Sánchez ◽  
Antonio Martínez-Sabater ◽  
Miguel Ángel Díaz-Herrera ◽  
Ana Ocaña-Ortiz ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Literacy ◽  
Social Determinants ◽  
Cardiovascular Health ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Structural Determinants ◽  
Cross Sectional ◽  
Level Of Education ◽  
Individual Level

Background: Health literacy (HL) has been linked to empowerment, use of health services, and equity. Evaluating HL in people with cardiovascular health problems would facilitate the development of suitable health strategies care and reduce inequity. Aim: To investigate the relationship between different dimensions that make up HL and social determinants in patients with cardiovascular disease. Methods: Observational, descriptive, cross-sectional study in patients with cardiovascular disease, aged 50–85 years, accessing primary care services in Valencia (Spain) in 2018–2019. The Health Literacy Questionnaire was used. Results: 252 patients. Age was significantly related with the ability to participate with healthcare providers (p = 0.043), ability to find information (p = 0.022), and understanding information correctly to know what to do (p = 0.046). Level of education was significant for all HL dimensions. Patients without studies scored lower in all dimensions. The low- versus middle-class social relationship showed significant results in all dimensions. Conclusions: In patients with cardiovascular disease, level of education and social class were social determinants associated with HL scores. Whilst interventions at individual level might address some HL deficits, inequities in access to cardiovascular care and health outcomes would remain unjustly balanced unless structural determinants of HL are taken into account.

scholarly journals The Association Between Myocardial Strain and Frailty in the Cardiovascular Health Study

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 524-525
Author(s):  
Annabel Tan ◽  
Sanjiv J Shah ◽  
Jason Sanders ◽  
Bruce Psaty ◽  
Anne Newman ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Ejection Fraction ◽  
Left Atrial ◽  
Longitudinal Strain ◽  
Cardiovascular Health ◽  
Myocardial Strain ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Cross Sectional ◽  
Lv Ejection Fraction

Abstract Myocardial strain, measured by speckle tracking echocardiography (STE), is a novel measure of subclinical cardiovascular disease and may reflect myocardial aging. We aimed to explore the association between myocardial strain and frailty, a clinical syndrome of impaired resilience and lack of physiologic reserve. Frailty was defined in 4,042 participants of the Cardiovascular Health Study (CHS) as having 3 or more of the following clinical criteria: weakness, slowness, shrinking, exhaustion, and inactivity. We examined the cross-sectional and longitudinal associations of left ventricular (LV) longitudinal strain, LV early diastolic strain rate and left atrial reservoir strain with frailty in participants with no history of cardiovascular disease or heart failure at the time of echocardiography. In cross-sectional analyses, LV longitudinal strain, LV early diastolic strain, left atrial reservoir strain and LV ejection fraction (measured by conventional echocardiography) levels were lower (worse) among frail participants than among those who were not frail and pre-frail (p<0.01). This association of LV longitudinal strain and frailty was robust to adjustment by LV ejection fraction (adjusted OR: 1.34, 95% CI: 1.20, 2.09). Conversely, LV ejection fraction was not associated with frailty after adjustment for LV longitudinal strain. In longitudinal analyses, LV longitudinal strain and LV early diastolic strain were associated with incident frailty (adjusted OR: 1.49, 95% CI: 1.07, 2.08) and 1.65, 95% CI: 1.15, 2.25, respectively). In community-dwelling older adults without prevalent cardiovascular disease, worse LV longitudinal strain, reflective of subclinical myocardial dysfunction, was associated with frailty independent of LV ejection fraction and other risk factors.

scholarly journals Plasticizers and Cardiovascular Health: Role of Adipose Tissue Dysfunction

2021 ◽  
Vol 11 ◽  
Author(s):  
Mikyla A. Callaghan ◽  
Samuel Alatorre-Hinojosa ◽  
Liam T. Connors ◽  
Radha D. Singh ◽  
Jennifer A. Thompson
Keyword(s):  
Cardiovascular Disease ◽  
Adipose Tissue ◽  
Adverse Effects ◽  
Cardiovascular Health ◽  
The United States ◽  
Current Evidence ◽  
Endocrine Disrupting ◽  
And Function

Since the 1950s, the production of plastics has increased 200-fold, reaching 360 million tonnes in 2019. Plasticizers, additives that modify the flexibility and rigidity of the product, are ingested as they migrate into food and beverages. Human exposure is continuous and widespread; between 75 and 97% of urine samples contain detectable levels of bisphenols and phthalates, the most common plasticizers. Concern over the toxicity of plasticizers arose in the late 1990s, largely focused around adverse developmental and reproductive effects. More recently, many studies have demonstrated that exposure to plasticizers increases the risk for obesity, type 2 diabetes, and cardiovascular disease (CVD). In the 2000s, many governments including Canada, the United States and European countries restricted the use of certain plasticizers in products targeted towards infants and children. Resultant consumer pressure motivated manufacturers to substitute plasticizers with analogues, which have been marketed as safe. However, data on the effects of these new substitutes are limited and data available to-date suggest that many exhibit similar properties to the chemicals they replaced. The adverse effects of plasticizers have largely been attributed to their endocrine disrupting properties, which modulate hormone signaling. Adipose tissue has been well-documented to be a target of the disrupting effects of both bisphenols and phthalates. Since adipose tissue function is a key determinant of cardiovascular health, adverse effects of plasticizers on adipocyte signaling and function may underlie their link to cardiovascular disease. Herein, we discuss the current evidence linking bisphenols and phthalates to obesity and CVD and consider how documented impacts of these plasticizers on adipocyte function may contribute to the development of CVD.

Cardiovascular Disease

2018 ◽  
Author(s):  
Mara Caroline ◽  
Ryan Bradley ◽  
Mimi Guarneri
Keyword(s):  
Cardiovascular Disease ◽  
Elderly Population ◽  
Cardiovascular Health ◽  
The Elderly ◽  
Nutrient Deficiencies ◽  
Comorbid Conditions ◽  
Increased Risk ◽  
Increased Susceptibility

The older population is challenging to treat for numerous reasons, including comorbid conditions and increased susceptibility to adverse drug reactions, limiting medical therapy. They are at increased risk for loneliness and depression, which strongly impacts their cardiovascular outcomes, and they also have different values, usually prioritizing quality of life over mortality objectives. Finally, the elderly are underrepresented in cardiovascular clinical trials, thus limiting the applicability of guideline recommendations. This chapter emphasizes the importance of a comprehensive assessment of individual circumstances when assessing cardiovascular health in the elderly population. The chapter focuses on the role of nutrition, resiliency, and exercise for the prevention and treatment of cardiovascular disease. Nutrient deficiencies commonly seen with cardiovascular drugs are also discussed, as well as specific integrative strategies for optimizing dyslipidemia, atrial fibrillation, and heart failure in this population.

Abstract 16562: Association of County-Level Social Vulnerability Index and Cardiovascular Disease in the United States, 1999-2018

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Quentin R Youmans ◽  
Megan E McCabe ◽  
Clyde W Yancy ◽  
Lucia Petito ◽  
Kiarri N Kershaw ◽  
...  
Keyword(s):  
United States ◽  
Cardiovascular Disease ◽  
Social Vulnerability ◽  
Cardiovascular Health ◽  
Vulnerability Index ◽  
The United States ◽  
County Level ◽  
Social Vulnerability Index ◽  
Cross Sectional ◽  
Cvd Mortality

Introduction: Social determinants of health are multi-dimensional and span various interrelated domains. In order to inform community-engaged clinical and policy efforts, we sought to examine the association between a national social vulnerability index (SVI) and age-adjusted mortality rate (AAMR) of CVD. Hypothesis: Higher county-level SVI or greater vulnerability will be associated with higher AAMR of CVD between 1999-2018 in the United States. Methods: In this serial, cross-sectional analysis, we queried CDC WONDER for age-adjusted mortality rates (AAMRs) per 100,000 population for cardiovascular disease (I00-78) at the county-level between 1999-2018. We quantified the association of county-level SVI and CVD AAMR using Spearman correlation coefficients and examined trends in CVD AAMR stratified by median SVI at the county-level. Finally, we performed geospatial county-level analysis stratified by combined median SVI and CVD AAMR (high/high, high/low, low/high, and low/low). Results: We included data from 2766 counties (representing 95% of counties in the US) with median SVI 0.53 (IQR 0.28, 0.76). Overall SVI and the household and socioeconomic subcomponents were strongly correlated with 2018 CVD AAMR (0.47, 0.50, and 0.56, respectively with p<0.001 for all). CVD mortality declined between 1999-2011 and was stagnant between 2011-2018 with similar patterns in high and low SVI counties (FIGURE). Counties with high SVI and CVD AAMR were clustered in the South and Midwest (n=977, 35%). Conclusion: County-level social vulnerability is associated with higher CVD mortality. High SVI and CVD AAMR coexist in more than 1 in 3 US counties and have persisted over the past 2 decades. Identifying counties that are disproportionately vulnerable may inform targeted and community-based strategies to equitably improve cardiovascular health across the country.

scholarly journals Time Spent Sitting as an Independent Risk Factor for Cardiovascular Disease

2017 ◽  
Vol 14 (2) ◽  
pp. 204-215
Author(s):  
Beate Henschel ◽  
Anna M. Gorczyca ◽  
Andrea K. Chomistek
Keyword(s):  
Cardiovascular Disease ◽  
Sedentary Behavior ◽  
Cardiovascular Health ◽  
Scientific Evidence ◽  
Sitting Time ◽  
Recreational Physical Activity ◽  
Tv Viewing ◽  
Cvd Risk ◽  
Metabolic System ◽  
Cross Sectional

Sedentary behavior is highly prevalent despite growing evidence of adverse effects on the cardiovascular and metabolic system that are independent of the level of recreational physical activity (PA). We present results for the association between sitting time and cardiovascular disease (CVD) from selected cohort and cross-sectional studies published in or after the year 2010 according to the domains where sitting time is accumulated during the day. These include TV viewing, occupational sitting, and sitting during transportation as well as overall sitting. The outcomes considered in this review are total CVD, coronary heart disease, and stroke as well as CVD risk factors—namely, hypertension, hypercholesterolemia, and type 2 diabetes and their associated biomarkers. Finally, several current issues with regard to studying the effects of sitting time on CVD are discussed, including how sedentary behavior is assessed, isotemporal substitution modeling, examination of joint associations for sitting and PA, and benefits of breaks in sitting time. Overall, the scientific evidence supports public health recommendations that encourage adults to limit their sedentary time in order to improve their cardiovascular health.

Sign in / Sign up

Export Citation Format

Share Document