Mental Disorders Forecast Alzheimer’s Disease and Related Dementias in 1.7 Million New Zealanders

Neurodegenerative conditions, including Alzheimer’s disease and related dementias (ADRD), have an outsized impact on disability and loss of independence in older adults. As such, there is a growing need to identify modifiable risk factors for ADRD at the population level. We conducted a nationwide administrative-register study to investigate mental disorders as a potential preventable risk factor for later-life ADRD. Data were drawn from the New Zealand Integrated Data Infrastructure, a collection of whole-of-population administrative data sources linked at the individual level by a common spine. We identified all individuals born in New Zealand between 1928-1967 and followed them for three decades (N = 1,711,386; observation period = 1988-2018; age at baseline = 21-60 years). Diagnoses of mental disorders were ascertained from public-hospital records. Diagnoses of ADRD were ascertained from public-hospital records, mortality records, and pharmaceutical records. Individuals with a mental disorder were at elevated risk for developing Alzheimer’s disease and related dementias relative to those without a mental disorder. This prospective association was evident in both men and women, across age, and after accounting for pre-existing physical diseases. If associations are causal, ameliorating mental disorders could extend population healthspan and reduce the societal burden of neurodegenerative diseases.

A simple six-step guide to National-Scale Hypertension Control Program implementation

Hypertension is the leading single preventable risk factor for death worldwide, and most of the disease burden attributed to hypertension weighs on low-and middle-income countries. Effective large-scale public health hypertension control programs are needed to control hypertension globally. National programs can follow six important steps to launch a successful national-scale hypertension control program: establish an administrative structure and survey current resources, select a standard hypertension treatment protocol, ensure supply of medication and blood pressure devices, train health care workers to measure blood pressure and control hypertension, implement an information system for monitoring patients and the program overall, and enroll and monitor patients with phased program expansion. Resolve to Save Lives, an initiative of global public health organization Vital Strategies, and its partners organized these six key steps and materials into a structured, stepwise guide to establish best practices in hypertension program design, launch, maintenance, and scale-up.

Association between the Nutritional Quality of Household At-Home Food Purchases and Chronic Diseases and Risk Factors in the United States, 2015

Lower diet quality is a leading preventable risk factor for obesity and chronic diseases. This study assesses differences in the nutritional quality of at-home food purchases, using the Healthy Eating Index (HEI)-2015 and its components, among households with and without a member reporting type 2 diabetes (T2D), cardiovascular disease (CVD), obesity, and/or smoking. We use the 2015 IRI Consumer Network nationally representative household food purchase scanner data, combined with the IRI MedProfiler and the USDA’s Purchase-to-Plate Crosswalk datasets. For each/multiple condition(s), the difference in mean HEI score adjusted for covariates is tested for equivalence with the respective score against households without any member with the condition(s). The HEI score is higher for households without a member with reported T2D (2.4% higher), CVD (3.2%), obesity (3.3%), none of the three conditions (6.1%, vs. all three conditions), and smoking (10.5%) than for those with a member with the respective condition. Households with a member with T2D score better on the added sugar component than those with no member reporting T2D. We found that the average food purchase quality is lower than the recommended levels, especially for households with at least one member reporting a chronic condition(s).

Practical management of hypertension in adults

Hypertension is the most powerful, independent, preventable risk factor for death and disability from cardiovascular diseases. Initial clinical assessment and diagnostic testing are essential to disclose; (a) secondary causes to avoid resistant cases that needs specific therapy, (b) co-morbid conditions that limits choice of drug-therapy, and (c) target organ damage that dictates specialized approach. In this review article; an algorithm for its management is outlined that includes also specific practical approach to those with emergencies, urgencies and co-morbid conditions. Keywords: adults, coronary artery disease, heart failure, hypertension, renal failure, stroke.

Comparison of routine blood alcohol tests and ICD-10-AM coding of alcohol involvement for major trauma patients

Background: Alcohol use is a key preventable risk factor for serious injury. To effectively prevent alcohol-related injuries, we rely on the accurate surveillance of alcohol involvement in injury events. This often involves the use of administrative data, such as International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, Australian Modification (ICD-10-AM) coding. Objective: To evaluate the completeness and accuracy of using administrative coding for the surveillance of alcohol involvement in major trauma injury events by comparing patient blood alcohol concentration (BAC) with ICD-10-AM coding. Method: This retrospective cohort study examined 2918 injury patients aged ≥18 years who presented to a major trauma centre in Victoria, Australia, over a 2-year period, of which 78% ( n = 2286) had BAC data available. Results: While 15% of patients had a non-zero BAC, only 4% had an ICD-10-AM code suggesting acute alcohol involvement. The agreement between blood alcohol test results and ICD-10-AM coding of acute alcohol involvement was fair ( κ = 0.33, 95% confidence interval: 0.27–0.38). Of the 341 patients with a non-zero BAC, 82 (24.0%) had ICD-10-AM codes related to acute alcohol involvement. Supplementary factors Y90 Evidence of alcohol involvement determined by blood alcohol level codes, which specifically describe patient BAC, were assigned to just 29% of eligible patients with a non-zero BAC. Conclusion: ICD-10-AM coding underestimated the proportion of alcohol-related injuries compared to patient BAC. Implications: Given the current role of administrative data in the surveillance of alcohol-related injuries, these findings may have significant implications for the implementation of cost-effective strategies for preventing alcohol-related injuries.

CATECHOL O-METHYLTRANSFERASE VAL158/MET AND HYPERTENSION: A META-ANALYSIS

Hypertension is a preventable risk factor of cardiovascular diseases. It is considered a major cause of CVD-morbidity and mortality worldwide. Some risk factors and prevention strategies related to hypertension were studied intensively, however, with growing the burden of this disorder and genetic has become the dominant field of treating diseases, still, specific genes involved in increasing blood pressure remain to be identified. This meta-analysis was conducted to assess the relationship of COMT Val158/Met variation to high systolic and diastolic blood pressure. PubMed and Web of Science (WOS) were intensively searched for the genetic association on the link of COMT Val158/Met to hypertension. The search was done up to October 15th 2020 and updated on November 22nd 2020. Two investigators were independently extracting data and evaluating the risk of bias using the Cochrane risk of bias tool. Q-genie tool was used to assess the quality of all included articles. Met-dominant model (Met/Met + Val/Met vs Val/Val) showed a significant association to systolic and diastolic blood pressure with a pooled standardized mean difference of -0.215 and 95%CI [-0.399 to -0.0300] and -0.205, 95%CI [-0.390 to -0.0197], respectively. Met allele was significantly related to high systolic and diastolic blood pressure. However, high-quality, case-control studies are lacking.

Hypogonadotropic Hypogonadism Associated With Obesity: A Case Report

One of the most significant factors with a broad impact on health is obesity. Besides cardiovascular comorbidities caused by obesity, its probable association with hypogonadotropic hypogonadism in men was discussed in this article. We described a severe obese boy, presenting with no secondary sexual characteristics and hypertension. The hypothalamus-hypophyseal-gonadal axis can be influenced by multiple mechanisms at different levels of the axis. Some of these pathophysiological mechanisms, related to our case, were explained aiming at explaining the association between obesity and accompanied reproductive disorders. Adipose tissue, as an essential influencer, insignificantly affects the metabolism of hormones secreted by other glands. Obesity, as a preventable risk factor, is valuable to be researched to decrease the burden of its induced morbidity and mortality. Thus, further studies should be conducted to exactly determine the complex network of characteristics impacting hormonal imbalances in obese individuals.

Affordability of current, and healthy, more equitable, sustainable diets by area of socioeconomic disadvantage and remoteness in Queensland: insights into food choice

Background Poor diet is the leading preventable risk factor contributing to the burden of disease globally and in Australia, and is inequitably distributed. As the price of healthy foods is a perceived barrier to improved diets, evidence on the cost and affordability of current (unhealthy) and recommended (healthy, more equitable and sustainable) diets is required to support policy action. Methods This study applied the Healthy Diets ASAP (Australian Standardised Affordability and Pricing) methods protocol to measure the cost, cost differential and affordability of current and recommended diets for a reference household in Queensland, Australia. Food prices were collected in 18 randomly selected locations stratified by area of socioeconomic disadvantage and remoteness. Diet affordability was calculated for three income categories. Results Surprisingly, recommended diets would cost 20% less than the current diet in Queensland as a whole. Households spent around 60% of their food budget on discretionary choices (that is, those not required for health that are high in saturated fat, added sugar, salt and/or alcohol). Queensland families would need to spend around 23% of their income on recommended diets. However, recommended diets would not be affordable in low socioeconomic or very remote areas, costing 30 and 35% of median household income respectively. The government supplements due to the SARS-CoV-2 pandemic would improve affordability of recommended diets by 29%. Conclusions Study findings highlight that while price is one factor affecting consumer food choice, other drivers such as taste, convenience, advertising and availability are important. Nevertheless, the study found that recommended diets would be unaffordable in very remote areas, and that low-income families are likely experiencing food stress, irrespective of where they live in Queensland. Policy actions, such as increasing to 20% the current 10% tax differential between basic healthy, and unhealthy foods in Australia, and supplementing incomes of vulnerable households, especially in remote areas, are recommended to help improve diet equity and sustainability, and health and wellbeing for all.

Supporting wellness at pantries (SWAP) nutrition stoplight system aids rural food pantry clients living with chronic disease in selecting nutritious options

Objectives Chronic disease accounts for 70% of U.S. deaths, with suboptimal nutrition an important, preventable risk factor. Food insecurity is a contributor to poor nutrition. Food pantries are a regular source of groceries for the food insecure and an ideal place for nutrition literacy programs. Supporting Wellness at Pantries (SWAP) is a stoplight nutrition ranking system based on 2015–2020 Dietary Guidelines, but has only been implemented in urban areas. Rural communities experience higher rates of poor health and food insecurity. Methods This study implements SWAP at a food pantry in a rural community with high rates of food insecurity and chronic disease. Food was sorted into “green,” “yellow,” and “red” items on color-coded shelves, with green foods the most accessible, and signage explaining the sorting was displayed. Surveys measured whether clients found SWAP helpful in choosing nutritious foods, particularly for households with chronic diseases. Results Clients reported that it was significantly (p <.0001) easier to choose items low in salt, sugar, and fat. The benefits of SWAP extended outside the pantry by increasing confidence in choosing nutritious foods while grocery shopping. Discussion SWAP can be an effective tool for improving nutrition literacy among food insecure rural residents with chronic illnesses.

Association between Hs-CRP and other Cardiovascular Risk Factors with Blood Pressure in Young Adults

INTRODUCTION: Hypertension remains the leading preventable risk factor for premature mortality and morbidity worldwide. The use of high-sensitivity C-reactive protein (hs-CRP) as the global risk prediction assessment for cardiovascular diseases (CVD) in asymptomatic individuals suggests the possibility that higher hs-CRP, or subclinical inflammation, maybe one of the causal factors contributing to an increased risk of CVD in young hypertensive patients. Most studies of hypertension and hs-CRP association were conducted regionally, whereby most of the participants were Caucasians with age beyond 40 years old. Studies of this association among young adults in Asian populations are lacking, therefore, a generalization of data might be limited to certain ages and populations only. MATERIALS AND METHOD: This comparative cross-sectional study analysed the association between hs-CRP and other cardiovascular risk factors with three different blood pressure statuses categorised into Normotensive (NT), Pre-hypertensive (PHT), and Hypertensive (HPT) groups among young adults in Kuantan, Pahang, Malaysia. RESULTS: Independently, the association was significant only in males and subjects with parental history of hypertension in the prehypertensive group. However, in the hypertensive group, the relationships were significant not only in males and individuals with parental histories of hypertension but also in obese subjects. Hs[1]CRP was not associated with blood pressure status in the present study. CONCLUSION: The hypothesis that hs[1]CRP has an independent association with blood pressure status was not demonstrated in the present study. However, the observed association between circulating hs-CRP and blood pressure status is likely to be driven by confounders namely age, gender, genetic factors, and BMI status.