scholarly journals A community-based drop-in service for NHS health checks: evaluation of uptake

2021 ◽  
Vol 3 (1) ◽  
Author(s):  
Jacob Chapman ◽  
Paula Jane Whittaker
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
Socioeconomic Deprivation ◽  
Community Based ◽  
Health Checks ◽  
Time Period ◽  
Using Data ◽  
One Year ◽  
Professional Occupation

Background: A community-based drop-in service aimed to deliver cardiovascular health checks to people living in areas of high socioeconomic deprivation. Methods: Retrospective cohort study using data collected from 1092 cardiovascular health checks performed across a one-year time period in community venues across the city of Manchester. Participants were adults aged between 40–74 years, with no pre-existing cardiovascular disease who were registered with a primary care centre within the intervention catchment area.Results: Of the total eligible population in Manchester across the study period 110194, it was found 7025(6.4%) had a cardiovascular health check, of these 1092(29%) were performed by the community-based service. Attendance was highest in younger females aged 40-45. Most patients were either in a managerial/professional occupation or unemployed. The higher risk population of cardiovascular disease (CVD were in highest attendance. Amongst the registered attendees, the checks discovered 129 new cases of hypertension, 64 new cases of type 2 diabetes, the vast majority of patients required an additional form of intervention, be that lifestyle or behaviour.  Conclusions: A community-based cardiovascular check service is a viable method of delivering CD prevention intervention in areas of high socioeconomic deprivation.

scholarly journals One-year Risks and Burdens of Incident Cardiovascular Disease in COVID-19: Cardiovascular Manifestations of Long COVID

2021 ◽  
Author(s):  
Ziyad Al-Aly ◽  
Benjamin Bowe ◽  
Yan Xie ◽  
Evan Xu
Keyword(s):  
Cardiovascular Disease ◽  
Cardiovascular Health ◽  
Acute Infection ◽  
Cerebrovascular Disorders ◽  
Cardiovascular Complications ◽  
Department Of Veterans Affairs ◽  
Increased Risk ◽  
Health And Disease ◽  
One Year ◽  
Incident Cardiovascular Disease

Abstract The cardiovascular complications of acute COVID-19 are well described; however, a comprehensive characterization of the post-acute cardiovascular manifestations of COVID-19 at one year has not been undertaken. Here we use the US Department of Veterans Affairs national healthcare databases to build a cohort of 151,195 people with COVID-19, 3,670,087 contemporary and 3,656,337 historical controls to estimate risks and 1-year burdens of a set of pre-specified incident cardiovascular outcomes. We show that beyond the first 30 days of infection, people with COVID-19 are at increased risk of incident cardiovascular disease spanning several categories including cerebrovascular disorders, dysrhythmias, ischemic and non-ischemic heart disease, pericarditis, myocarditis, heart failure, and thromboembolic disease. The risks and burdens were evident among those who were non-hospitalized during the acute phase of the infection and increased in a graded fashion according to care setting of the acute infection (non-hospitalized, hospitalized, and admitted to intensive care). Taken together, our results provide evidence that risk and 1-year burden of cardiovascular disease in survivors of acute COVID-19 are substantial. Care pathways of people who survived the acute episode of COVID-19 should include attention to cardiovascular health and disease.

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.

scholarly journals Longitudinal Measures of Trimethylamine N-oxide and Incident Atherosclerotic Cardiovascular Disease Events in Older Adults: The Cardiovascular Health Study

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1434-1434
Author(s):  
Yujin Lee ◽  
Zeneng Wang ◽  
Heidi Lai ◽  
Marcia de Oliveira Otto ◽  
Rozenn Lemaitre ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Older Adults ◽  
Renal Function ◽  
Cystatin C ◽  
Impaired Renal Function ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Atherosclerotic Cardiovascular Disease ◽  
Community Based

Abstract Objectives Trimethylamine N-oxide (TMAO) is a gut microbiota-dependent metabolite of dietary choline, L-carnitine and phosphatidylcholine-rich animal foods. Based on experimental studies and cohorts with prevalent disease, elevated TMAO may increase risk of atherosclerotic cardiovascular disease (ASCVD). TMAO is also renally cleared and may interact with and causally contribute to renal dysfunction and elevated cystatin-C. Yet, the associations of serial TMAO levels with incident ASCVD in a community-based prospective cohort, and the potential mediating and modifying role of renal function, are not established. Methods We investigated the associations of serial measures of plasma TMAO, assessed at baseline and 7 years post baseline, with incident ASCVD among 4144 older adults in the Cardiovascular Health Study (CHS). TMAO was measured using stable isotope dilution LC/MS/MS (lab CV <6%). Incident ASCVD (myocardial infarction, fatal coronary heart disease, stroke, sudden cardiac death, or other atherosclerotic death) was centrally adjudicated using medical records. Risk was assessed by multivariable Cox proportional hazards regression including time-varying demographics, lifestyle factors, medical history, and laboratory and dietary variables. We assessed potential mediating effects and interaction by renal function estimated by cystatin-C. Results During a median 15 years follow-up, 1757 ASCVD events occurred. After multivariable adjustment, TMAO was associated with a higher risk of ASCVD, with an extreme quintile HR (95% CI) of 1.22 (1.04, 1.44), P-trend = 0.01. This relationship appeared further mediated or confounded by estimated glomerular filtration rate (eGFR): adjusting for cystatin-C-based eGFR, the HR (95% CI) was 1.06 (0.98–1.25). Significant interaction was also observed by renal function (P-interaction < 0.001), with TMAO associated with higher risk of ASCVD among individuals with impaired renal function (eGFR ≤ 60) [1.63 (1.03–2.59)], but not normal baseline renal function (eGFR > 60) [1.15 (0.96–1.37)], even with further adjustment for continuous eGFR. Conclusions In this large community-based cohort of older US adults, higher serial measures of TMAO were associated with an elevated risk of ASCVD, in particular among those with impaired renal function. Funding Sources NIH, NHLBI.

scholarly journals Early Empowerment Strategies Boost Self-Efficacy to Improve Cardiovascular Health Behaviors

2016 ◽  
Vol 8 (9) ◽  
pp. 322 ◽  
Author(s):  
Mariam Kashani ◽  
Arn H Eliasson ◽  
Elaine M Walizer ◽  
Clarie E Fuller ◽  
Renata J Engler ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Lifestyle Intervention ◽  
Self Efficacy ◽  
Intervention Program ◽  
Cardiovascular Health ◽  
Exercise Stress ◽  
Optimal Timing ◽  
Lifestyle Intervention Program ◽  
Health Project ◽  
One Year

<p><strong>BACKGROUND:</strong> Self-efficacy, defined as confidence in the ability to carry out behavior to achieve a desired goal, is considered to be a prerequisite for behavior change. Self-efficacy correlates with cardiovascular health although optimal timing to incorporate self-efficacy strategies is not well established. We sought to study the effect of an empowerment approach implemented in the introductory phase of a multicomponent lifestyle intervention on cardiovascular health outcomes.</p><p><strong>DESIGN:</strong> Prospective intervention cohort study.</p><p><strong>METHODS:</strong> Patients in the Integrative Cardiac Health Project Registry, a prospective lifestyle change program for the prevention of cardiovascular disease were analyzed for behavioral changes by survey, at baseline and one year, in the domains of nutrition, exercise, stress management and sleep. Self-efficacy questionnaires were administered at baseline and after the empowerment intervention, at 8 weeks.</p><p><strong>RESULTS:</strong> Of 119 consecutive registry completers, 60 comprised a high self-efficacy group (scoring at or above the median of 36 points) and 59 the low self-efficacy group (scoring below median).  Self-efficacy scores increased irrespective of baseline self-efficacy but the largest gains in self-efficacy occurred in patients who ranked in the lower half for self-efficacy at baseline. This lower self-efficacy group demonstrated behavioral gains that erased differences between the high and low self-efficacy groups. <strong></strong></p><p><strong>CONCLUSIONS:</strong> A boost to self-efficacy early in a lifestyle intervention program produces significant improvements in behavioral outcomes.  Employing empowerment in an early phase may be a critical strategy to improve self-efficacy and lower risk in individuals vulnerable to cardiovascular disease.</p>

The effect of custodial penalties on juvenile reoffending

2012 ◽  
Vol 45 (1) ◽  
pp. 26-44 ◽  
Author(s):  
Andrew McGrath ◽  
Don Weatherburn
Keyword(s):  
Juvenile Offenders ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Criminal Activity ◽  
Young Offenders ◽  
Community Based ◽  
Matched Group ◽  
Time Period ◽  
Children’S Court ◽  
Using Data

This study uses propensity score matching to test the proposition that imprisonment deters future criminal activity among juvenile offenders. Using data from all court appearances of juveniles in the NSW Children’s Court (Australia) between 2003 and 2004 ( N = 6196), the reoffending of a group of young offenders sentenced to control (i.e. custodial) orders ( N = 376) was compared to a matched group of offenders receiving community-based sanctions. No differences were observed between the two groups. The young offenders given detention orders had a slightly lower rate of reoffending, but this difference was not significant. The results of this study indicate that, over the time period examined in this study, the imposition of a custodial sentence had no effect on the risk of reoffending.

scholarly journals Performance of Cardiovascular Disease Risk Scores in People Diagnosed With Type 2 Diabetes: External Validation Using Data From the National Scottish Diabetes Register

Diabetes Care ◽  
2018 ◽  
Vol 41 (9) ◽  
pp. 2010-2018 ◽  
Author(s):  
Stephanie H. Read ◽  
Merel van Diepen ◽  
Helen M. Colhoun ◽  
Nynke Halbesma ◽  
Robert S. Lindsay ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
External Validation ◽  
Risk Scores ◽  
Using Data ◽  
Diabetes Register

scholarly journals Fetuin-A, Type 2 Diabetes, and Risk of Cardiovascular Disease in Older Adults: The Cardiovascular Health Study

Diabetes Care ◽  
2012 ◽  
Vol 36 (5) ◽  
pp. 1222-1228 ◽  
Author(s):  
M. K. Jensen ◽  
T. M. Bartz ◽  
K. J. Mukamal ◽  
L. Djousse ◽  
J. R. Kizer ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Older Adults ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Fetuin A

scholarly journals Association of Circulating Cathepsin S and Cardiovascular Disease Among Patients With Type 2 Diabetes: A Cross-Sectional Community-Based Study

2021 ◽  
Vol 12 ◽  
Author(s):  
Yu Jing ◽  
Jie Shi ◽  
Bin Lu ◽  
Weiwei Zhang ◽  
Yehong Yang ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Critical Role ◽  
Laboratory Data ◽  
Multivariate Logistic Regression Analysis ◽  
Cathepsin S ◽  
Community Based ◽  
Cross Sectional ◽  
Coronary Syndrome

BackgroundCathepsin S, as an adipokine, was reported to play a critical role in various disease, including atherosclerosis and diabetes. The present study aims to elucidate the relationship between circulating cathepsin S and cardiovascular disease (CVD) in patients with type 2 diabetes.MethodsA total of 339 type 2 diabetes individuals were enrolled in this cross-sectional community-based study. Basic information, medical and laboratory data were collected. Serum cathepsin S levels were assessed by ELISA.ResultsCompared to the CVD (−) group, levels of serum cathepsin S were significantly higher in the CVD (+) group, with the median 23.68 ng/ml (18.54–28.02) and 26.81 ng/ml (21.19–37.69) respectively (P &lt; 0.001). Moreover, patients with acute coronary syndrome (ACS) had substantially higher levels of serum cathepsin S than those with stable angina pectoris (SAP), with the median 34.65 ng/ml (24.33–42.83) and 25.52 ng/ml (20.53–31.47) respectively (P &lt; 0.01). The spearman correlation analysis showed that circulating cathepsin S was correlated with several cardiovascular risk factors. The univariate and multivariate logistic regression analysis revealed that circulating cathepsin S was an independent risk factor for CVD (all P &lt; 0.001) after adjustment for potential confounders. Restricted cubic spline analysis showed circulating cathepsin S had a linearity association with CVD. In addition, receiver operating characteristic (ROC) curve analysis demonstrated that the area under curve (AUC) values of cathepsin S was 0.80 (95% CI: 0.75–0.84, P &lt; 0.001), with the optimal cutoff value of cathepsin 26.28 ng/ml.ConclusionCirculating cathepsin S was significantly higher in the CVD (+) group than that in the CVD (−) one among type 2 diabetes. The increased serum cathepsin S levels were associated with increased risks of CVD, even after adjusting for potential confounders. Thus, cathepsin S might be a potential diagnostic biomarker for CVD.

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