Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 2.078
Filtrar
3.
JAMA ; 326(13): 1286-1298, 2021 10 05.
Artículo en Inglés | MEDLINE | ID: mdl-34609450

RESUMEN

Importance: After decades of decline, the US cardiovascular disease mortality rate flattened after 2010, and racial and ethnic differences in cardiovascular disease mortality persisted. Objective: To examine 20-year trends in cardiovascular risk factors in the US population by race and ethnicity and by socioeconomic status. Design, Setting, and Participants: A total of 50 571 participants aged 20 years or older from the 1999-2018 National Health and Nutrition Examination Surveys, a series of cross-sectional surveys in nationally representative samples of the US population, were included. Exposures: Calendar year, race and ethnicity, education, and family income. Main Outcomes and Measures: Age- and sex-adjusted means or proportions of cardiovascular risk factors and estimated 10-year risk of atherosclerotic cardiovascular disease were calculated for each of 10 two-year cycles. Results: The mean age of participants ranged from 49.0 to 51.8 years and the proportion of women from 48.2% to 51.3% in the surveys. From 1999-2000 to 2017-2018, age- and sex-adjusted mean body mass index increased from 28.0 (95% CI, 27.5-28.5) to 29.8 (95% CI, 29.2-30.4); mean hemoglobin A1c increased from 5.4% (95% CI, 5.3%-5.5%) to 5.7% (95% CI, 5.6%-5.7%) (both P < .001 for linear trends). Mean serum total cholesterol decreased from 203.3 mg/dL (95% CI, 200.9-205.8 mg/dL) to 188.5 mg/dL (95% CI, 185.2-191.9 mg/dL); prevalence of smoking decreased from 24.8% (95% CI, 21.8%-27.7%) to 18.1% (95% CI, 15.4%-20.8%) (both P < .001 for linear trends). Mean systolic blood pressure decreased from 123.5 mm Hg (95% CI, 122.2-124.8 mm Hg) in 1999-2000 to 120.5 mm Hg (95% CI, 119.6-121.3 mm Hg) in 2009-2010, then increased to 122.8 mm Hg (95% CI, 121.7-123.8 mm Hg) in 2017-2018 (P < .001 for nonlinear trend). Age- and sex-adjusted 10-year atherosclerotic cardiovascular disease risk decreased from 7.6% (95% CI, 6.9%-8.2%) in 1999-2000 to 6.5% (95% CI, 6.1%-6.8%) in 2011-2012, then did not significantly change. Age- and sex-adjusted body mass index, systolic blood pressure, and hemoglobin A1c were consistently higher, while total cholesterol was lower in non-Hispanic Black participants compared with non-Hispanic White participants (all P < .001 for group differences). Individuals with college or higher education or high family income had consistently lower levels of cardiovascular risk factors. The mean age- and sex-adjusted 10-year risk of atherosclerotic cardiovascular disease was significantly higher in non-Hispanic Black participants compared with non-Hispanic White participants (difference, 1.4% [95% CI, 1.0%-1.7%] in 1999-2008 and 2.0% [95% CI, 1.7%-2.4%] in 2009-2018]). This difference was attenuated (-0.3% [95% CI, -0.6% to 0.1%] in 1999-2008 and 0.7% [95% CI, 0.3%-1.0%] in 2009-2018) after further adjusting for education, income, home ownership, employment, health insurance, and access to health care. Conclusions and Relevance: In this serial cross-sectional survey study that estimated US trends in cardiovascular risk factors from 1999 through 2018, differences in cardiovascular risk factors persisted between Black and White participants; the difference may have been moderated by social determinants of health.


Asunto(s)
Enfermedades Cardiovasculares/etnología , Grupos de Población Continentales/etnología , Grupos Étnicos , Factores de Riesgo de Enfermedad Cardiaca , Clase Social , Adulto , Factores de Edad , Anciano , Aterosclerosis/epidemiología , Presión Sanguínea , Índice de Masa Corporal , Enfermedades Cardiovasculares/mortalidad , Colesterol/sangre , Intervalos de Confianza , Estudios Transversales , Escolaridad , Femenino , Hemoglobina A Glucada/análisis , Humanos , Renta/tendencias , Modelos Lineales , Masculino , Persona de Mediana Edad , Encuestas Nutricionales/tendencias , Prevalencia , Factores Sexuales , Fumar/epidemiología , Fumar/tendencias , Determinantes Sociales de la Salud/etnología , Determinantes Sociales de la Salud/tendencias , Factores de Tiempo , Estados Unidos/etnología , Adulto Joven
4.
Rev Assoc Med Bras (1992) ; 67(8): 1118-1123, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34669856

RESUMEN

OBJECTIVE: The aim of this study was to perform dosimetric analysis of radiotherapy (RT) plans with or without elective nodal irradiation (ENI) and estimate whether the increase in mean doses (MDs) in the heart and lungs with ENI may lead to late side effects that may surpass the benefits of treatment. METHODS: The dosimetric analysis of 30 treatment plans was done with or without ENI. The planning and dose-volume histograms were analyzed, and the impact on the mortality of cardiovascular and lung cancer was estimated based on the correlation of the dosimetric data with data from population studies. RESULTS: RT with ENI increased the doses in the lungs and heterogeneity in the plans compared to breast-exclusive RT. When the increase in MDs is correlated with the increase of late side-effect risks, the most important effect of ENI is the increased risk of lung cancer, especially in patients who smoke (average increase in absolute risk=1.38%). The increase in the absolute risk of cardiovascular diseases was below 0.1% in the all the situations analyzed. CONCLUSIONS: ENI increases the heterogeneity and the doses at the lungs. When recommending ENI, the risks and benefits must be taken into account, considering the oncology factors and the plan of each patient. Special attention must be given to patients who smoke as ENI may lead to a significant increase in MD in the lung and the increased risk of radiation-induced lung cancer may surpass the benefits from this treatment.


Asunto(s)
Neoplasias de la Mama , Carcinoma de Pulmón de Células no Pequeñas , Enfermedades Cardiovasculares , Neoplasias Pulmonares , Neoplasias Primarias Secundarias , Radioterapia Conformacional , Neoplasias de la Mama/radioterapia , Enfermedades Cardiovasculares/etiología , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Neoplasias Pulmonares/etiología , Neoplasias Pulmonares/radioterapia , Ganglios Linfáticos , Planificación de la Radioterapia Asistida por Computador , Factores de Riesgo
5.
Prim Health Care Res Dev ; 22: e53, 2021 10 14.
Artículo en Inglés | MEDLINE | ID: mdl-34645536

RESUMEN

AIM: To determine the presence of cardiovascular (CV) risk (CVR) factors in university students and evaluate how these factors are affected from the knowledge, attitudes, and habits of the individuals regarding healthy lifestyle. BACKGROUND: Starting from early ages, lifestyle habits such as lack of physical activity, unhealthy eating, and inappropriate drug use increase CV and metabolic risks of individuals. METHODS: In April-May 2018, sociodemographic characteristics of 770 undergraduate students, in addition to their knowledge, attitudes, and habits regarding their nutrition and physical activity status were obtained through face-to-face questionnaires. CVR factors were determined according to blood pressure, blood glucose, total cholesterol levels, and anthropometric measurements. Collected data were compared by CVR factor presence (CV[+] or CV[-]) in students. FINDINGS: The mean age of the participants was 22.3 ± 2.6 years. 59.6% were female and 71.5% were students of non-health sciences. In total, 274 individuals (35.9%) belonged to CV(+) group (mean risk number: 1.3 ± 0.5) with higher frequency in males (42.1% versus 31.6%, P < 0.05). The most common CVR factors were smoking (20.6%), high total cholesterol (7.5%), and hypertension/high blood pressure (6.0%). 15.5% of the participants regularly used at least one drug/non-pharmaceutical product. 11.3% complied the Mediterranean diet well. 21.9% of CV(+) stated consuming fast food at lunch compared to 14.3% of CV(-) (P < 0.05). 44.6% stated exercising below the CV-protective level. CONCLUSIONS: This study showed one-third of university students was at CVR, independent of their sociodemographic characteristics. Furthermore, the students appear to perform below expectations in terms of nutrition and physical activity. Extensive additional measures are needed to encourage young individuals for healthy nutritional and physical activity habits.


Asunto(s)
Enfermedades Cardiovasculares , Adulto , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Conocimientos, Actitudes y Práctica en Salud , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Factores de Riesgo , Estudiantes , Encuestas y Cuestionarios , Adulto Joven
6.
Front Public Health ; 9: 658243, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34671586

RESUMEN

Cardiovascular diseases (CVD) are the most common cause of death and disability worldwide. Saudi Arabia, one of the middle-income countries has a proportional CVD mortality rate of 37%. Knowledge about CVD and its modifiable risk factors is a vital pre-requisite to change the health attitudes, behaviors, and lifestyle practices of individuals. Therefore, we intended to assess the employee knowledge about risk of CVD, symptoms of heart attacks, and stroke, and to calculate their future 10-years CVD risk. An epidemiological, cross-sectional, community-facility based study was conducted. The women aged ≥40 years who are employees of Taibah University, Al-Madinah Al-Munawarah were recruited. A screening self-administrative questionnaire was distributed to the women to exclude those who are not eligible. In total, 222 women met the inclusion criteria and were invited for the next step for the determination of CVD risk factors by using WHO STEPS questionnaire: It is used for the surveillance of non-communicable disease risk factor, such as CVD. In addition, the anthropometric measurements and biochemical measurements were done. Based on the identified atherosclerotic cardiovascular disease (ASCVD) risk factors and laboratory testing results, risk calculated used the Framingham Study Cardiovascular Disease (10-year) Risk Assessment. Data were analyzed using GraphPad Prism 7 software (GraphPad Software, CA, USA). The result showed the mean age of study sample was 55.6 ± 9.0 years. There was elevated percentage of obesity and rise in abdominal circumference among the women. Hypertension (HTN) was a considerable chronic disease among the participants where more than half of the sample had it, i.e., 53%. According to the ASCVD risk estimator, the study participants were distributed into four groups: 63.1% at low risk, 20.2% at borderline risk, 13.5% at intermediate risk, and 3.2% at high risk. A comparison between these categories based on the CVD 10-year risk estimator indicated that there were significant variations between the low-risk group and the intermediate and high-risk groups (P = 0.02 and P = 0.001, respectively). The multivariate analysis detected factors related to CVD risk for women who have an intermediate or high risk of CVD, such as age, smoking, body mass index (BMI), unhealthy diet, blood pressure (BP) measurements, and family history of CVD (P < 0.05). The present study reports limited knowledge and awareness of CVD was 8.6 that is considered as low knowledge. In conclusion, the present study among the university sample in Madinah reported limited knowledge and awareness of CVD risk. These findings support the need for an educational program to enhance the awareness of risk factors and prevention of CVD.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Persona de Mediana Edad , Factores de Riesgo , Universidades
7.
Bratisl Lek Listy ; 122(11): 771-777, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34672667

RESUMEN

OBJECTIVES: The objective was to find out risk factors indicating the patients directly to selective coronarography (SCG) to avoid unnecessary non-invasive testing and in their absence to asses low cardiovascular risk and faster inclusion on the waiting list. BACKGROUND: Cardiovascular diseases (CVD) are the most frequent cause of death in dialysed patients. The aim of our retrospective analysis was to identify risk factors for coronary artery disease (CAD) before kidney transplantation (KTx). METHODS: Our retrospective analysis consisted of 55 dialysed patients (46 males, 9 females, p < 0.0001), undergoing SCG before KTx. We divided the patients according to SCG results (negative, n = 40, positive finding, n = 15). RESULTS: We confirmed a significantly lower incidence of diabetic nephropathy (p = 0.0484), ischaemic heart disease (p = 0.0174) and CAD (p = 0.0001) in patients without percutaneous coronary intervention (PCI; negative finding). Haemodynamically significant coronary stenosis correlated with the occurrence of stroke in a patient's history (p = 0.0104). We identified predictors for performing PCI (positive result): type 2 diabetes mellitus (DM) (p = 0.0472), high-density lipoprotein cholesterol ≤ 1.03 mmol/l (p = 0.0359), total calcium level ≤ 2 mmol/l (p = 0.0309), phosphate level ≥ 1.45 mmol/l (OR 0.2034; p = 0.0351). CONCLUSION: In our analysis, patients with DM and poorly managed chronic kidney disease/mineral bone disease were the riskiest subset of the patients with a positive SCG finding (Tab. 4, Fig. 2, Ref. 30). Text in PDF www.elis.sk Keywords: kidney transplantation, coronary artery disease, selective coronarography, cardiovascular risk.


Asunto(s)
Enfermedades Cardiovasculares , Diabetes Mellitus Tipo 2 , Trasplante de Riñón , Intervención Coronaria Percutánea , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Trasplante de Riñón/efectos adversos , Masculino , Estudios Retrospectivos , Factores de Riesgo
8.
Curr Cardiol Rep ; 23(11): 172, 2021 10 13.
Artículo en Inglés | MEDLINE | ID: mdl-34647161

RESUMEN

PURPOSE OF REVIEW: Current risk prediction tools do not include physical activity (PA) or cardiorespiratory fitness (CRF), despite their robust association with adverse cardiovascular disease (CVD) events and their potential as targets for preventive interventions. RECENT FINDINGS: PA and CRF are each associated with cardiovascular (CV) morbidity and mortality, independent of traditional risk factors. Improvement in CRF is associated with reduced risk of atherosclerotic cardiovascular disease (ASCVD) and heart failure (HF). Risk prediction tools have been developed for ASCVD, and more recently for HF, to refine CVD risk assessment and inform CVD prevention strategies. Attempts have been made to incorporate PA and CRF into available CVD risk prediction models. Inclusion of PA and CRF into established CVD risk assessment models improves CVD risk prediction incremental to established CVD risk prediction tools, suggesting PA and CRF are markers of CVD risk and targets for CVD prevention.


Asunto(s)
Capacidad Cardiovascular , Enfermedades Cardiovasculares , Enfermedades Cardiovasculares/prevención & control , Ejercicio Físico , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Medición de Riesgo , Factores de Riesgo , Signos Vitales
9.
J Occup Health ; 63(1): e12278, 2021 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-34599639

RESUMEN

BACKGROUND: Diabetes is a major risk factor for cardiovascular diseases (CVD). This systematic review aims to explore the work-related factors among people with diabetes in developing CVD. METHODS: Four electronic databases were searched on 1 February 2021 using a comprehensive search strategy without any time restriction. Two independent researchers screened the articles and extracted data. The risk of bias was assessed independently using the risk of bias assessment tool for non-randomized studies (RoBANS). A narrative synthesis was conducted considering the heterogeneity of the included articles. RESULTS: A total of five articles incorporating 4 409 810 participants from three geographic regions were included that highlights the research gap. As per the included studies, Occupational drivers with diabetes were at a higher risk of CVD in comparison to the nondrivers, workers with diabetes having a long working hour were at a higher risk of CVD mortality, workers with a lower occupational status were at a higher risk of 10-years stroke risk, and occupational physical activity and occupational commuting lowered the risk of CVD deaths. CONCLUSIONS: This systematic review summarized the available evidence on work-related factors influencing the risk of CVD in people with diabetes. The findings should be interpreted cautiously pondering the limited evidence and imprecision. We identified only five articles related to the topic, and there were no studies from Japan. The scarcity of studies on work-related factors on the prognosis of diabetic patients implies the need for more research in this field. We recommend further exploration of the topic designing primary studies.


Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Diabetes Mellitus/epidemiología , Factores de Riesgo de Enfermedad Cardiaca , Ocupaciones , Trabajo , Humanos
10.
Artículo en Inglés | MEDLINE | ID: mdl-34639306

RESUMEN

The current study assessed performance of the new Veterans Affairs (VA) women cardiovascular disease (CVD) risk score in predicting women veterans' 60-day CVD event risk using VA COVID-19 shared cohort data. The study data included 17,264 women veterans-9658 White, 6088 African American, and 1518 Hispanic women veterans-ever treated at US VA hospitals and clinics between 24 February and 25 November 2020. The VA women CVD risk score discriminated patients with CVD events at 60 days from those without CVD events with accuracy (area under the curve) of 78%, 50%, and 83% for White, African American, and Hispanic women veterans, respectively. The VA women CVD risk score itself showed good accuracy in predicting CVD events at 60 days for White and Hispanic women veterans, while it performed poorly for African American women veterans. The future studies are needed to identify non-traditional factors and biomarkers associated with increased CVD risk specific to African American women and incorporate them to the CVD risk assessment.


Asunto(s)
COVID-19 , Enfermedades Cardiovasculares , Veteranos , Enfermedades Cardiovasculares/epidemiología , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Incidencia , Difusión de la Información , Factores de Riesgo , SARS-CoV-2 , Estados Unidos/epidemiología , United States Department of Veterans Affairs
11.
Enferm Clin (Engl Ed) ; 31(5): 303-312, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-34565502

RESUMEN

OBJECTIVE: to assess the effect of the "Program of Training in Integral Care for Secondary Cardiovascular Prevention in Primary Care Nursing" on the level of knowledge, the degree of application of comprehensive cardiovascular care, and on the continuity of care between the cardiac rehabilitation and primary care units, in relation to post-infarction patients. METHODS: Quasi-experimental before-after study without control group. Comprised an ad-hoc survey prior to training via the Internet and a post-training survey; both the pre- and post-course surveys were anonymous. The program consisted of secondary cardiovascular prevention training, chronicity in the cardiovascular patient and adherence to the therapeutic plan, and follow-up protocol. RESULTS: Over one third of the respondents did not know the control objectives of the different cardiovascular risk factors, more marked regarding lipid control. The program significantly improved the knowledge of the objectives of blood pressure, total cholesterol and LDL cholesterol, and the self-perception of better monitoring of lipid parameters and waist circumference. In centers with a cardiac rehabilitation unit, 73% of respondents indicated that there was "no" communication with the unit before the course, reducing to 55% in the post-course survey. CONCLUSION: There are clear training needs of nurses for their involvement in these secondary prevention programs. A specific continuous training in secondary cardiovascular prevention for nurses in the field of primary care, improves and facilitates the acquisition of knowledge at this level, can improve the approach of patients with cardiovascular events during the first months of said event and communication with the reference cardiac rehabilitation units.


Asunto(s)
Enfermedades Cardiovasculares , Prestación Integrada de Atención de Salud , Enfermería de Atención Primaria , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Atención Primaria de Salud , Factores de Riesgo , Prevención Secundaria
12.
Dtsch Med Wochenschr ; 146(19): 1270-1276, 2021 Oct.
Artículo en Alemán | MEDLINE | ID: mdl-34553352

RESUMEN

The recently published guidelines "Sports cardiology and exercise in patients with cardiovascular disease" (2020) are the first of a kind by the European Society of Cardiology (ESC). The guidelines provide comprehensive training recommendations for patients with cardiovascular diseases or risk factors, covering the entire spectrum of cardiovascular diseases with case-specific recommendations for recreational and competitive sports.The ESC recognizes exercise as an essential part of both prevention and therapy of cardiovascular diseases, that - comparable to drug therapies - requires correct prescription.The initial cardiac examination is used for individual risk stratification and is indispensable for individualized training recommendations addressing training frequency, duration and intensity, as well as type of sport.Thus, the question is not whether a patient with cardiovascular disease shall be allowed to exercise, but rather how he can safely perform it. Only in exceptional cases exercise therapy is (temporarily) contraindicated.COVID-19 can lead to cardiovascular complications even in asymptomatic and mild disease courses. Before resuming intense sporting activities, different return-to-sports protocols have been introduced. The current consensus is that the extent of these examinations should be based on symptoms, severity and duration of COVID-19 and that individual return-to-training recommendations should be given.


Asunto(s)
COVID-19 , Enfermedades Cardiovasculares , Factores de Riesgo de Enfermedad Cardiaca , Deportes/fisiología , Ejercicio Físico , Humanos , Guías de Práctica Clínica como Asunto , Volver al Deporte
13.
Lakartidningen ; 1182021 09 29.
Artículo en Sueco | MEDLINE | ID: mdl-34590704

RESUMEN

Cardiovascular disease is the most important cause of death and life-years lost in Sweden today. Cardiovascular risk prediction is a cornerstone in primary prevention; the use of antihypertensive and lipid-lowering therapy is guided by absolute cardiovascular risk. The Systematic COronary Risk Evaluation (SCORE) model has been the most widely applied model in Sweden for almost two decades. Recently, an updated model called SCORE2 was published. The new risk prediction model is based on contemporary data, predicts the risk of incident cardiovascular disease in addition to cardiovascular mortality, and accounts for competing risks, thus overcoming some major limitations with SCORE. Sweden is classified as a moderate-risk country according to the new model; here we report the risk chart for moderate-risk countries translated into Swedish.


Asunto(s)
Enfermedades Cardiovasculares , Antihipertensivos/uso terapéutico , Enfermedades Cardiovasculares/tratamiento farmacológico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Prevención Primaria , Factores de Riesgo
14.
JMIR Public Health Surveill ; 7(9): e29990, 2021 09 30.
Artículo en Inglés | MEDLINE | ID: mdl-34591026

RESUMEN

BACKGROUND: The COVID-19 pandemic has required clinicians to pivot to offering services via telehealth; however, it is unclear which patients (users of care) are equipped to use digital health. This is especially pertinent for adults managing chronic diseases, such as obesity, hypertension, and diabetes, which require regular follow-up, medication management, and self-monitoring. OBJECTIVE: The aim of this study is to measure the trends and assess factors affecting health information technology (HIT) use among members of the US population with and without cardiovascular risk factors. METHODS: We used serial cross-sectional data from the National Health Interview Survey for the years 2012-2018 to assess trends in HIT use among adults, stratified by age and cardiovascular risk factor status. We developed multivariate logistic regression models adjusted for age, sex, race, insurance status, marital status, geographic region, and perceived health status to assess the likelihood of HIT use among patients with and without cardiovascular disease risk factors. RESULTS: A total of 14,304 (44.6%) and 14,644 (58.7%) participants reported using HIT in 2012 and 2018, respectively. When comparing the rates of HIT use for the years 2012 and 2018, among participants without cardiovascular risk factors, the HIT use proportion increased from 51.1% to 65.8%; among those with one risk factor, it increased from 43.9% to 59%; and among those with more than one risk factor, it increased from 41.3% to 54.7%. Increasing trends in HIT use were highest among adults aged >65 years (annual percentage change [APC] 8.3%), who had more than one cardiovascular risk factor (APC 5%) and among those who did not graduate from high school (APC 8.8%). Likelihood of HIT use was significantly higher in individuals who were younger, female, and non-Hispanic White; had higher education and income; were married; and reported very good or excellent health status. In 2018, college graduates were 7.18 (95% CI 5.86-8.79), 6.25 (95% CI 5.02-7.78), or 7.80 (95% CI 5.87-10.36) times more likely to use HIT compared to adults without high school education among people with multiple cardiovascular risk factors, one cardiovascular risk factor, or no cardiovascular risk factors, respectively. CONCLUSIONS: Over 2012-2018, HIT use increased nationally, with greater use noted among younger and higher educated US adults. Targeted strategies are needed to engage wider age, racial, education, and socioeconomic groups by lowering barriers to HIT access and use.


Asunto(s)
Factores de Riesgo de Enfermedad Cardiaca , Informática Médica/estadística & datos numéricos , Adolescente , Adulto , Anciano , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Encuestas Epidemiológicas , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos/epidemiología , Adulto Joven
15.
Rev Lat Am Enfermagem ; 29: e3477, 2021.
Artículo en Inglés, Portugués, Español | MEDLINE | ID: mdl-34495189

RESUMEN

OBJECTIVE: to identify the risk factors associated with prehypertension and arterial hypertension among Munduruku indigenous people in the Brazilian Amazon. METHOD: a cross-sectional study carried out with 459 Munduruku indigenous people selected by means of stratified random sampling. Sociodemographic variables, habits and lifestyles, anthropometric data, fasting glucose and lipid profiles were evaluated. An automatic device calibrated and validated to measure blood pressure was used. The analyses of the data collected were carried out in the R software, version 3.5.1. For continuous variables, the Kruskall-Wallis test was used; for the categorical ones, Fischer's Exact. The significance level was set at 5% and p-value≤0.05. RESULTS: the prevalence of altered blood pressure levels was 10.2% for values suggestive of hypertension and 4.1% for pre-hypertension. The risk of prehypertension among indigenous people was associated with being male (OR=1.65; 95% CI=0.65-4.21) and having a substantially increased waist circumference (OR=7.82; 95% CI=1.80-34.04). Regarding the risk for arterial hypertension, it was associated with age (OR=1.09; 95% CI=1.06-1.12), with increased waist circumference (OR=3.89; 95% CI=1.43-10, 54) and with substantially increased waist circumference (OR=5.46; 95% CI=1.78-16.75). CONCLUSION: among Munduruku indigenous people, men were more vulnerable to developing hypertension; age and increased waist circumference proved to be strong cardiovascular risk factors.


Asunto(s)
Enfermedades Cardiovasculares , Hipertensión , Presión Sanguínea , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Estudios Transversales , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Hipertensión/epidemiología , Pueblos Indígenas , Masculino , Prevalencia , Factores de Riesgo
16.
Urologiia ; (4): 132-137, 2021 09.
Artículo en Ruso | MEDLINE | ID: mdl-34486286

RESUMEN

The most common risk factors for cardiovascular disease and urolithiasis are presented in the article. Data on the prevalence of urolithiasis are discussed, as well as the pathogenetic mechanisms of stone formation in patients with metabolic syndrome, dyslipidemia, and arterial hypertension. The bi-directional relationship of cardiovascular risk factors and urolithiasis is generalized. The role of calcium, uric acid, citrate, changes in urine pH and an increase in body weight in the formation of kidney stones is shown.


Asunto(s)
Enfermedades Cardiovasculares , Urolitiasis , Oxalato de Calcio , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Factores de Riesgo , Urolitiasis/epidemiología , Urolitiasis/etiología
17.
J Laryngol Otol ; 135(11): 964-969, 2021 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-34558395

RESUMEN

BACKGROUND: Magnetic resonance imaging of the internal auditory meatus frequently detects incidental white matter hyperintensities. This study investigated the association between these and the risk of stroke and transient ischaemic attack, or myocardial infarction. METHODS: The records of patients with incidental white matter hyperintensities were reviewed, and data were collected on: age, sex, cardiovascular risk factors, and incidence of stroke and transient ischaemic attack, or myocardial infarction, five years later. The risk factors associated with vascular events were explored. RESULTS: Of 6978 patients, 309 (4.4 per cent) had incidental white matter hyperintensities. Of these, 20 (6.5 per cent) had a stroke or transient ischaemic attack within five years, and 5 (1.7 per cent) had a myocardial infarction. The number of cardiovascular risk factors was significantly associated with the incidence of stroke and transient ischaemic attack (p = 0.004), and myocardial infarction (p = 0.023). CONCLUSION: The number of cardiovascular risk factors predicts the likelihood of vascular events; appropriate risk factor management is recommended for patients with incidental white matter hyperintensities of presumed vascular origin.


Asunto(s)
Ataque Isquémico Transitorio/epidemiología , Imagen por Resonancia Magnética/métodos , Infarto del Miocardio/epidemiología , Accidente Cerebrovascular/epidemiología , Sustancia Blanca/diagnóstico por imagen , Adulto , Anciano , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Incidencia , Hallazgos Incidentales , Ataque Isquémico Transitorio/etiología , Modelos Logísticos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Valor Predictivo de las Pruebas , Medición de Riesgo , Accidente Cerebrovascular/etiología , Sustancia Blanca/patología
18.
BMJ ; 374: n2106, 2021 09 29.
Artículo en Inglés | MEDLINE | ID: mdl-34588162

RESUMEN

OBJECTIVES: To establish if the use of early computed tomography (CT) coronary angiography improves one year clinical outcomes in patients presenting to the emergency department with acute chest pain and at intermediate risk of acute coronary syndrome and subsequent clinical events. DESIGN: Randomised controlled trial. SETTING: 37 hospitals in the UK. PARTICIPANTS: Adults with suspected or a provisional diagnosis of acute coronary syndrome and one or more of previous coronary heart disease, raised levels of cardiac troponin, or abnormal electrocardiogram. INTERVENTIONS: Early CT coronary angiography and standard of care compared with standard of care only. MAIN OUTCOME MEASURES: Primary endpoint was all cause death or subsequent type 1 or 4b myocardial infarction at one year. RESULTS: Between 23 March 2015 and 27 June 2019, 1748 participants (mean age 62 years (standard deviation 13), 64% men, mean global registry of acute coronary events (GRACE) score 115 (standard deviation 35)) were randomised to receive early CT coronary angiography (n=877) or standard of care only (n=871). Median time from randomisation to CT coronary angiography was 4.2 (interquartile range 1.6-21.6) hours. The primary endpoint occurred in 51 (5.8%) participants randomised to CT coronary angiography and 53 (6.1%) participants who received standard of care only (adjusted hazard ratio 0.91 (95% confidence interval 0.62 to 1.35), P=0.65). Invasive coronary angiography was performed in 474 (54.0%) participants randomised to CT coronary angiography and 530 (60.8%) participants who received standard of care only (adjusted hazard ratio 0.81 (0.72 to 0.92), P=0.001). There were no overall differences in coronary revascularisation, use of drug treatment for acute coronary syndrome, or subsequent preventive treatments between the two groups. Early CT coronary angiography was associated with a slightly longer time in hospital (median increase 0.21 (95% confidence interval 0.05 to 0.40) days from a median hospital stay of 2.0 to 2.2 days). CONCLUSIONS: In intermediate risk patients with acute chest pain and suspected acute coronary syndrome, early CT coronary angiography did not alter overall coronary therapeutic interventions or one year clinical outcomes, but reduced rates of invasive angiography while modestly increasing length of hospital stay. These findings do not support the routine use of early CT coronary angiography in intermediate risk patients with acute chest pain and suspected acute coronary syndrome. TRIAL REGISTRATION: ISRCTN19102565, NCT02284191.


Asunto(s)
Síndrome Coronario Agudo/diagnóstico por imagen , Dolor en el Pecho/diagnóstico por imagen , Angiografía por Tomografía Computarizada/métodos , Síndrome Coronario Agudo/etiología , Síndrome Coronario Agudo/mortalidad , Enfermedad Aguda , Anciano , Dolor en el Pecho/complicaciones , Diagnóstico Precoz , Servicio de Urgencia en Hospital , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/etiología , Infarto del Miocardio/mortalidad , Evaluación de Resultado en la Atención de Salud , Modelos de Riesgos Proporcionales , Medición de Riesgo , Nivel de Atención , Factores de Tiempo
19.
West Afr J Med ; 38(8): 762-769, 2021 08 30.
Artículo en Inglés | MEDLINE | ID: mdl-34503325

RESUMEN

BACKGROUND: Cardiovascular disease is a major public health problem globally. The public service workers, who are facilitators of national development, are particularly vulnerable because the nature of their job predisposes them to unhealthy lifestyles. However, there is paucity of reference data on the profile of cardiovascular risks among public servants in Nigeria. Therefore, this study determined the pattern and predictors of cardiovascular risk among public servants in Southwest, Nigeria. METHODS: A total of 1,778 public servants were recruited from 47 Ministries, Departments and Agencies in Ondo State through multi-stage random sampling technique. The World Health Organization Stepwise instrument and Framingham Heart Study non-laboratory cardiovascular risk assessment tool were used to collect data. STATA version 14.2 was used for analysis and p-value of< 0.05 was taken as significant. RESULTS: The mean age of participants was 44.2±9.1 years. They were predominantly females (64.8%). The proportions of participants with moderate and high 10-year absolute cardiovascular risks were 18.3% and 5.6%, respectively. Significant factors associated with increased cardiovascular risk were age (p=<0.001), sex (p =<0.001), education (p =<0.001), income (p =<0.001), staff category (p =<0.001) and employment grade level (p=<0.001). The significant predictors of increased cardiovascular risk on multivariate analysis were age > 50years (AOR:1.25;CI:1.19-1.32;p=<0.001) and male sex (AOR:6.62; CI:3.76-11.65;p=<0.001). CONCLUSION: The prevalence of increased 10-year absolute cardiovascular risk among public servants in Ondo State was high. The significant predictors were age >50 years and male sex. Cardiovascular risk reduction strategies should be encouraged among public servants especially the older males.


Asunto(s)
Enfermedades Cardiovasculares , Adulto , Enfermedades Cardiovasculares/epidemiología , Estudios Transversales , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , Masculino , Persona de Mediana Edad , Nigeria/epidemiología , Prevalencia , Factores de Riesgo
20.
Lancet Glob Health ; 9(10): e1442-e1450, 2021 10.
Artículo en Inglés | MEDLINE | ID: mdl-34534488

RESUMEN

BACKGROUND: Coronary heart disease, a leading cause of death globally, is amenable to lifestyle interventions. The family environment can affect the ability or willingness of individuals to make lifestyle changes. We aimed to investigate the efficacy of a targeted family-based intervention for reduction of total cardiovascular risk in individuals with a family history of premature coronary heart disease. METHODS: We did an open-label, cluster randomised controlled trial (PROLIFIC) in the families (first-degree relatives and spouses, older than age 18 years) of individuals with coronary heart disease who had been diagnosed before age 55 years. Patients with coronary heart disease diagnosed within the past year were selected from a tertiary care speciality hospital that provides care for patients from Kerala, India. Family members of selected patients who were bedridden or terminally ill, and individuals with a history of established cardiovascular heart disease and stroke were excluded, as were families with fewer than two eligible family members. Simple randomisation with computer-generated random numbers was used to randomly assign families to intervention and usual care groups (1:1). Participants in the intervention group received a comprehensive package of interventions facilitated by non-physician health workers, consisting of: screening for cardiovascular risk factors; structured lifestyle interventions; linkage to a primary health-care facility for individuals with established chronic disease risk factors or conditions; and active follow-up for adherence. The usual care group received one-time counselling and annual screening for risk factors. We obtained data on lifestyle, clinical, and biochemical characteristics at baseline and annually during the 2-year follow-up. The primary outcome was achievement or maintenance of any three of the following: blood pressure lower than 140/90 mm Hg, fasting plasma glucose lower than 110 mg/dL, low-density lipoprotein cholesterol lower than 100 mg/dL, and abstinence from tobacco. The primary outcome was analysed in all participants available for follow-up at the relevant timepoint. This trial is registered with Clinicaltrials.gov, NCT02771873. FINDINGS: From Jan 1, 2015, to April 30, 2017, 980 patients with coronary heart disease were assessed for eligibility and 230 were excluded primarily due to lack of evidence of coronary artery disease (n=199), or a diagnosis of coronary heart disease more than 1 year previously (n=29). Of the 750 remaining families, 368 (with 825 participants) were assigned to the intervention group and 382 (with 846 participants) were assigned to the usual care group. At the 2-year follow-up, data from 803 (97%) of 825 participants in the intervention group and 819 (97%) of 846 participants in the usual care group were available. Of the 1671 participants, 1111 (66·5%) were women, and 560 (33·5%) were men. The mean age of the study population was 40·8 years (SD 14·2). At the 2-year follow-up, the primary outcome was achieved by 514 (64%) of 803 participants in the intervention group and 379 (46%) of 819 in the usual care group. After adjustment for clustering and baseline risk factors, the odds of achieving the primary outcome at the 2-year timepoint was two times higher in the intervention group than in the usual care group (odds ratio 2·2, 95% CI 1·7-2·7; p<0·0001). INTERPRETATION: The reduction of total cardiovascular risk observed after the intervention could have a substantial public health impact by preventing future cardiovascular events. FUNDING: The Wellcome Trust and Department of Biotechnology, Government of India, and India Alliance.


Asunto(s)
Enfermedades Cardiovasculares , Enfermedad de la Arteria Coronaria , Adolescente , Adulto , Enfermedades Cardiovasculares/genética , Enfermedades Cardiovasculares/prevención & control , Femenino , Factores de Riesgo de Enfermedad Cardiaca , Humanos , India/epidemiología , Masculino , Persona de Mediana Edad , Factores de Riesgo
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...