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1.
Rev Lat Am Enfermagem ; 29: e3477, 2021.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-34495189

RESUMO

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.


Assuntos
Doenças Cardiovasculares , Hipertensão , Pressão Sanguínea , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Estudos Transversais , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/epidemiologia , Povos Indígenas , Masculino , Prevalência , Fatores de Risco
2.
BMJ Open ; 11(9): e049610, 2021 09 02.
Artigo em Inglês | MEDLINE | ID: mdl-34475172

RESUMO

OBJECTIVES: Management of cardiovascular disease (CVD) is an urgent challenge in low-income and middle-income countries, and interventions may require appraisal of patients' social networks to guide implementation. The purpose of this study is to determine whether egocentric social network characteristics (SNCs) of patients with chronic disease in western Kenya are associated with overall CVD risk and individual CVD risk factors. DESIGN: Cross-sectional analysis of enrollment data (2017-2018) from the Bridging Income Generation with GrouP Integrated Care trial. Non-overlapping trust-only, health advice-only and multiplex (trust and health advice) egocentric social networks were elicited for each participant, and SNCs representing social cohesion were calculated. SETTING: 24 communities across four counties in western Kenya. PARTICIPANTS: Participants (n=2890) were ≥35 years old with diabetes (fasting glucose ≥7 mmol/L) or hypertension. PRIMARY AND SECONDARY OUTCOMES: We hypothesised that SNCs would be associated with CVD risk status (QRISK3 score). Secondary outcomes were individual CVD risk factors. RESULTS: Among the 2890 participants, 2020 (70%) were women, and mean (SD) age was 60.7 (12.1) years. Forty-four per cent of participants had elevated QRISK3 score (≥10%). No relationship was observed between QRISK3 level and SNCs. In unadjusted comparisons, participants with any individuals in their trust network were more likely to report a good than a poor diet (41% vs 21%). SNCs for the trust and multiplex networks accounted for a substantial fraction of variation in measures of dietary quality and physical activity (statistically significant via likelihood ratio test, adjusted for false discovery rate). CONCLUSION: SNCs indicative of social cohesion appear to be associated with individual behavioural CVD risk factors, although not with overall CVD risk score. Understanding how SNCs of patients with chronic diseases relate to modifiable CVD risk factors could help inform network-based interventions. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov identifier: NCT02501746; https://clinicaltrials.gov/ct2/show/NCT02501746.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Hipertensão , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Diabetes Mellitus/epidemiologia , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Hipertensão/epidemiologia , Quênia/epidemiologia , Pessoa de Meia-Idade , Fatores de Risco , Rede Social
3.
J Cardiovasc Magn Reson ; 23(1): 100, 2021 09 03.
Artigo em Inglês | MEDLINE | ID: mdl-34479603

RESUMO

BACKGROUND: The prevalence of abnormal cardiovascular magnetic resonance (CMR) findings in recovered coronavirus disease 2019 (COVID-19) patients is unclear. This study aimed to investigate the prevalence of abnormal CMR findings in recovered COVID-19 patients. METHODS: A systematic literature search was performed to identify studies that report the prevalence of abnormal CMR findings in recovered COVID-19 patients. The number of patients with abnormal CMR findings and diagnosis of myocarditis on CMR (based on the Lake Louise criteria) and each abnormal CMR parameter were extracted. Subgroup analyses were performed according to patient characteristics (athletes vs. non-athletes and normal vs. undetermined cardiac enzyme levels). The pooled prevalence and 95% confidence interval (CI) of each CMR finding were calculated. Study heterogeneity was assessed, and meta-regression analysis was performed to investigate factors associated with heterogeneity. RESULTS: In total, 890 patients from 16 studies were included in the analysis. The pooled prevalence of one or more abnormal CMR findings in recovered COVID-19 patients was 46.4% (95% CI 43.2%-49.7%). The pooled prevalence of myocarditis and late gadolinium enhancement (LGE) was 14.0% (95% CI 11.6%-16.8%) and 20.5% (95% CI 17.7%-23.6%), respectively. Further, heterogeneity was observed (I2 > 50%, p < 0.1). In the subgroup analysis, the pooled prevalence of abnormal CMR findings and myocarditis was higher in non-athletes than in athletes (62.5% vs. 17.1% and 23.9% vs. 2.5%, respectively). Similarly, the pooled prevalence of abnormal CMR findings and LGE was higher in the undetermined than in the normal cardiac enzyme level subgroup (59.4% vs. 35.9% and 45.5% vs. 8.3%, respectively). Being an athlete was a significant independent factor related to heterogeneity in multivariate meta-regression analysis (p < 0.05). CONCLUSIONS: Nearly half of recovered COVID-19 patients exhibited one or more abnormal CMR findings. Athletes and patients with normal cardiac enzyme levels showed a lower prevalence of abnormal CMR findings than non-athletes and patients with undetermined cardiac enzyme levels. Trial registration The study protocol was registered in the PROSPERO database (registration number: CRD42020225234).


Assuntos
COVID-19/epidemiologia , Doenças Cardiovasculares/diagnóstico , Imagem Cinética por Ressonância Magnética/métodos , Miocárdio/patologia , COVID-19/diagnóstico , Doenças Cardiovasculares/epidemiologia , Comorbidade , Saúde Global , Humanos , Pandemias , Valor Preditivo dos Testes , Prevalência , SARS-CoV-2
4.
BMJ Open ; 11(9): e042668, 2021 09 06.
Artigo em Inglês | MEDLINE | ID: mdl-34489261

RESUMO

OBJECTIVES: Young adults' physical activity (PA) is a foundation of creating future healthy lifestyles. The purpose of this study was to explore differences in PA, sedentary behaviour, walkability and health beliefs among young adults with different levels of cardiometabolic risks and the influence of moderate-to-vigorous PA. DESIGN: A cross-sectional study was conducted using a structured questionnaire. PARTICIPANTS: Totally, 1149 valid responses were received for a response rate of 86.32%. According to the self-reported worst health condition, participants were categorised into healthy adults, and adults at levels 1 (overweight), 2 (obese), 3 (hypertensive, hyperlipidaemic, and/or hyperglycaemic), and 4 (with a diagnosis of cardiometabolic diseases) of cardiometabolic risks. PRIMARY OUTCOME MEASURES: PA, sedentary time, walkability and health beliefs. RESULTS: Significant differences in PA (F=3.78, p<0.01) and sedentary time (F=2.39, p<0.05) among groups with various cardiometabolic risk levels were found. Healthy adults and adults at level 1 risk had significantly higher PA than adults at risk levels 2 and 3. Young adults at risk level 3 were less likely to participate in moderate-to-vigorous PA than were healthy adults (OR=0.64 (95% CI 0.41 to 0.99), p<0.05). Individuals who perceived that there were more recreational facilities (OR=1.27 (1.05 to 1.53), p<0.05), who had higher benefits of exercise (OR=1.73 (1.30 to 2.31), p<0.001), and who had lower barriers to exercise (OR=0.42 (0.32 to 0.55), p<0.001) were more likely to participate in moderate-to-vigorous PA. CONCLUSIONS: Being aware of body weight changes could be a danger sign of a lack of PA. Developing environmental and psychological strategies to promote engaging in PA is necessary to promote the cardiometabolic health of young adults.


Assuntos
Doenças Cardiovasculares , Exercício Físico , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Humanos , Sobrepeso , Comportamento Sedentário , Adulto Jovem
6.
West Afr J Med ; 38(8): 762-769, 2021 08 30.
Artigo em Inglês | MEDLINE | ID: mdl-34503325

RESUMO

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.


Assuntos
Doenças Cardiovasculares , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Fatores de Risco de Doenças Cardíacas , Humanos , Masculino , Pessoa de Meia-Idade , Nigéria/epidemiologia , Prevalência , Fatores de Risco
7.
BMC Psychol ; 9(1): 130, 2021 Aug 31.
Artigo em Inglês | MEDLINE | ID: mdl-34465377

RESUMO

BACKGROUND: Symptoms of depression and anxiety are common in adults with cardiovascular diseases (CVDs) and diabetes mellitus (DM). The literature on depression and anxiety in CVDs and DM populations is extensive; however, studies examining these relationships over time, directly compared to adults without these conditions, are still lacking. This study aimed to investigate trends in depression and anxiety symptom prevalence over more than 20 years in adults with CVDs and DM compared to the general population. METHODS: We used data from the population-based Trøndelag Health Study (HUNT), Norway, including adults (≥ 20 years) from three waves; the HUNT2 (1995-97; n = 65,228), HUNT3 (2006-08; n = 50,800) and HUNT4 (2017-19; n = 56,042). Depressive and anxiety symptom prevalence was measured independently by the Hospital Anxiety and Depressions scale (HADS) in sex-stratified samples. We analyzed associations of these common psychological symptoms with CVDs and DM over time using multi-level random-effects models, accounting for repeated measurements and individual variation. RESULTS: Overall, the CVDs groups reported higher levels of depression than those free of CVDs in all waves of the study. Further, depressive and anxiety symptom prevalence in adults with and without CVDs and DM declined from HUNT2 to HUNT4, whereas women reported more anxiety than men. Positive associations of depression and anxiety symptoms with CVDs and DM in HUNT2 declined over time. However, associations of CVDs with depression symptoms remained over time in men. Moreover, in women, DM was associated with increased depression symptom risk in HUNT2 and HUNT4. CONCLUSIONS: Depression and anxiety symptoms are frequent in adults with CVDs. Further, our time trend analysis indicates that anxiety and depression are differentially related to CVDs and DM and sex. This study highlights the importance of awareness and management of psychological symptoms in CVDs and DM populations.


Assuntos
Doenças Cardiovasculares , Diabetes Mellitus , Adulto , Ansiedade/epidemiologia , Doenças Cardiovasculares/epidemiologia , Depressão/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Humanos , Masculino , Noruega/epidemiologia , Prevalência
8.
Urologiia ; (4): 132-137, 2021 Sep.
Artigo em Russo | MEDLINE | ID: mdl-34486286

RESUMO

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.


Assuntos
Doenças Cardiovasculares , Urolitíase , Oxalato de Cálcio , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Fatores de Risco , Urolitíase/epidemiologia , Urolitíase/etiologia
9.
Artigo em Russo | MEDLINE | ID: mdl-34486850

RESUMO

The article presents results of comparative analysis of morbidity and mortality of diseases of circulatory system in the Republic of Buryatia in 2003-2018. The population mortality depends on identification of risk factors for cardiovascular diseases, diseases of circulatory system and subsequent coverage of population with medical care, including dispensary monitoring. The analysis was based on data from State statistical reporting forms and official data of the Territorial Board of the Federal State Statistics Service in the Republic of Buryatia, including the form № 12 "The information on number of diseases registered in patients residing in area of medical organization servicing activity"; the form № 025-12/s "The Out-Patient Registration Card"; the form № 25-2/y "The Statistical Coupon for Final (updated) Diagnosis Registration". The study was carried out using statistical, analytical and comparative analysis methods. Currently, in the Republic of Buryatia, diseases of circular system occupying second place in the structure of total morbidity (15.7%) and primary disability of adult population (28.6%) are among leading cause of total population mortality (41.6%).


Assuntos
Doenças Cardiovasculares , Sistema Cardiovascular , Adulto , Doenças Cardiovasculares/epidemiologia , Humanos , Morbidade , Pacientes Ambulatoriais , Fatores de Risco
10.
Artigo em Russo | MEDLINE | ID: mdl-34486851

RESUMO

In The Russian Federation, increasing of life expectancy and decreasing of mortality related to diseases of circulatory system are the priorities of state policy. The purpose of study was to develop approaches to the classification of cardiovascular diseases by severity degree within the framework of development of general health management model based on health care activities at the regional level. The article describes methodology of calculating indices of cardiovascular diseases severity based on statistical data of appealability for out-patient, in-patient and emergency medical care. The set of balancing coefficients reflecting input of rate of accessing for various types of medical care, as well as aggravating input of concomitant pathology, based on expert evaluation of cardiologists involved is presented. On the basis of analysis of distribution of severity index in standard region of the Russian Federation, the system of criteria was developed to classify cardiovascular diseases (according to ICD-10 sub-classes) on four degrees of severity. The approbation of the proposed method demonstrated adequacy of the results obtained to judging of experts (cardiologists). So, in standard region of the Russian Federation, in the class of diseases of circulatory system (I00-I99), 79.6% of all cases are of first degree of severity, 8.6% of cases are of second degree of severity, 3.8% of cases are of third degree, and 8% of cases are of fourth degree. The methodology is unified and can be applied to classify entire spectrum of diseases by degree of severity. Besides, the proposed methodological approaches are suitable to be applied in population health management at the municipal, regional and national levels in the Russian Federation.


Assuntos
Doenças Cardiovasculares , Sistema Cardiovascular , Serviços Médicos de Emergência , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/terapia , Humanos , Expectativa de Vida , Assistência ao Paciente
11.
Oral Health Prev Dent ; 19(1): 441-448, 2021 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-34505498

RESUMO

PURPOSE: During the past 20 years, a plethora of research reports has been published showing a statistical association between poor oral health and cardiovascular diseases. The aim of this narrative review was to focus on associations between oral infections and non-atherosclerosis-related systemic diseases. MATERIALS AND METHODS: An open literature search and evaluation of articles were conducted on Medline and Cochrane databases with the key words 'oral infection', 'periodontitis', 'pneumonia', 'osteoarthritis', 'rheumatic diseases', 'inflammatory bowel disease', 'kidney disease', 'liver diseases', 'metabolic syndrome', 'diabetes', 'cancer', 'Alzheimer's disease'. Cardiovascular diseases were excluded from the analysis. RESULTS: The scarcity of controlled studies did not allow conducting a systematic review with meta-analysis on the topics, but dental infections have been shown be associated with several general diseases also beyond the atherosclerosis paradigm. However, there is no causal evidence of the role of dental infections in this regard. Poor oral health has nevertheless often been observed to be associated with worsening of the diseases and may also affect treatments. CONCLUSIONS: Maintaining good oral health is imperative regarding many diseases, and its importance in the daily life of any patient group cannot be over emphasised.


Assuntos
Doenças Cardiovasculares , Periodontite , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Humanos , Saúde Bucal , Periodontite/complicações , Periodontite/epidemiologia
13.
Nutrients ; 13(8)2021 Aug 09.
Artigo em Inglês | MEDLINE | ID: mdl-34444889

RESUMO

Cardiometabolic risk (CMR) factors increase the likelihood of developing cardiovascular diseases (CVD). In Qatar, 24% of the total deaths are attributed to CVDs. Several nutritional disturbances have been linked to high risk of CVD. Many studies have discussed the effects of zinc (Zn) and copper (Cu) on CMR factors; however, evidence has been controversial. This investigated the association between CMR factors and the status of Zn and Cu, in addition to Zn/Cu ratio. A total of 575 Qatari men and women aged 18 years and older were obtained from Qatar Biobank. Plasma levels of Zn and Cu were determined using inductively coupled plasma mass spectrometry (ICP-MS). Anthropometric data and CMR factors were determined using standard methods. Adjusted associations between trace minerals and CMR were estimated by logistic regression. Partial correlation was performed to test the strength of the associations. Zn was not strongly correlated (p-value ˃ 0.01) or significantly associated with CMR factors and metabolic syndrome (MetS). Cu levels correlated positively with body mass index (BMI) (0.23; p ˂ 0.001), pulse rate (PR) (0.18; p ˂ 0.001), total cholesterol (0.13; p = 0.01), and high-density lipoproteins (HDL) (0.27; p ˂ 0.001); and negatively with diastolic blood pressure (DBP) (-0.13; p = 0.01). High plasma Cu significantly decreased the risk of metabolic syndrome (MetS) (0.121; p ˂ 0.001). Furthermore, Zn/Cu ratio positively correlated with waist circumference (0.13; p = 0.01), systolic blood pressure (0.13; p ˂ 0.01), and DBP (0.14; p ˂ 0.01); and negatively with BMI (-0.19; p ˂ 0.001), PR (-0.17; p ˂ 0.001), and HDL (-0.27; p ˂ 0.001). High Zn/Cu ratio increased the prevalence of low HDL (4.508; p ˂ 0.001) and MetS (5.570; p ˂ 0.01). These findings suggest that high plasma Cu levels are associated with a protective effect on DBP, HDL and MetS and that high plasma Zn/Cu ratio is associated with the risk of having low HDL and MetS.


Assuntos
Doenças Cardiovasculares/epidemiologia , Cobre/sangue , Síndrome Metabólica/epidemiologia , Zinco/sangue , Adolescente , Adulto , Bancos de Espécimes Biológicos , Pressão Sanguínea , Fatores de Risco Cardiometabólico , Doenças Cardiovasculares/sangue , Feminino , Humanos , Lipoproteínas HDL/sangue , Modelos Logísticos , Masculino , Síndrome Metabólica/sangue , Pessoa de Meia-Idade , Avaliação Nutricional , Estado Nutricional , Prevalência , Catar/epidemiologia , Adulto Jovem
14.
Front Public Health ; 9: 615152, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34336751

RESUMO

Human death and life span are closely related to the geographical environment and regional lifestyle. These factors considerably vary among counties and regions, leading to the geographical disparity of disease. Quantitative studies on this phenomenon are insufficient. Cerebrovascular and heart diseases are the leading causes of death. The mortality rate of cerebrovascular and heart diseases is statistically higher in northern China than in southern China; the p-value of t-test for cerebrovascular and heart diseases was 0.047 and 0.000, respectively. The population attribution fraction of 12 major risk factors for cardiovascular disease (CVD) in each province was calculated based on their exposure and relative risk. The results found that residents in northern China consume high sodium-containing food, fewer vegetables, and less sea food products, and tend to be overweight. Fine particulate matter is higher in northern China than in southern China. Cold temperatures also cause a greater number of deaths than hot temperatures. All these factors have resulted in a higher CVD mortality rate in northern China. The attributive differential for sodium, vegetable, fruit, smoking, PM2.5, omega-3, obesity, low temperature, and high temperature of heart disease between the two parts of China is 9.1, 0.7, -2.5, 0.1, 1.4, 1.3, 2.0, 4.7, and -2.1%, respectively. Furthermore, the attributive differential for the above factors of cerebrovascular disease between the two parts of China is 8.7, 0.0, -5.2, 0.1, 1.0, 0.0, 2.4, 4.7, and -2.1%. Diet high in sodium is the leading cause of the north-south differential in CVD, resulting in 0.71 less years of life expectancy in northern compared with that in southern China.


Assuntos
Doenças Cardiovasculares , Doenças Cardiovasculares/epidemiologia , China/epidemiologia , Humanos , Estilo de Vida , Material Particulado/toxicidade , Fatores de Risco
15.
Atherosclerosis ; 331: 45-53, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34344526

RESUMO

BACKGROUND AND AIMS: An untargeted metabolomics approach allows for a better understanding and identification of new candidate metabolites involved in the etiology of vascular disease. We aimed to investigate the associations of cardiovascular (CV) risk factors with the metabolic fingerprint and macro- and microvascular health in an untargeted metabolomic approach in predefined CV risk groups of aged individuals. METHODS: The metabolic fingerprint and the macro- and microvascular health from 155 well-characterized aged (50-80 years) individuals, based on the EXAMIN AGE study, were analysed. Nuclear magnetic resonance spectroscopy was used to analyse the metabolic fingerprint. Carotid-femoral pulse wave velocity and retinal vessel diameters were assessed to quantify macro- and microvascular health. RESULTS: The metabolic fingerprint became more heterogeneous with an increasing number of risk factors. There was strong evidence for higher levels of glutamine [estimate (95% CI): -14.54 (-17.81 to -11.27), p < 0.001], glycine [-5.84 (-7.88 to -3.79), p < 0.001], histidine [-0.73 (-0.96 to -0.50), p < 0.001], and acetate [-1.68 (-2.91 to -0.46), p = 0.007] to be associated with a lower CV risk profile. Tryptophan, however, was positively associated with higher CV risk [0.31 (0.06-0.56), p = 0.015]. The combination of a priori defined CV risk factors explained up to 45.4% of the metabolic variation. The metabolic fingerprint explained 20% of macro- and 23% of microvascular variation. CONCLUSIONS: Metabolic profiling has the potential to improve CV risk stratification by identifying new underlying metabolic pathways associated with atherosclerotic disease development, from cardiovascular risk to metabolites, to vascular end organ damage.


Assuntos
Doenças Cardiovasculares , Análise de Onda de Pulso , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Fatores de Risco de Doenças Cardíacas , Humanos , Metabolômica , Fatores de Risco
16.
Am J Clin Dermatol ; 22(5): 693-707, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34406619

RESUMO

BACKGROUND: Pivotal phase III studies demonstrated that abrocitinib, an oral, once-daily, JAK1-selective inhibitor, is effective treatment for moderate-to-severe atopic dermatitis (AD) as monotherapy and in combination with topical therapy. OBJECTIVE: The aim of this study was to evaluate the long-term safety of abrocitinib 200 mg and 100 mg in an integrated analysis of a phase IIb study, four phase III studies, and one long-term extension study. METHODS: Two cohorts were analyzed: a placebo-controlled cohort from 12- to 16-week studies and an all-abrocitinib cohort including patients who received one or more abrocitinib doses. Adverse events (AEs) of interest and laboratory data are reported. RESULTS: Total exposure in the all-abrocitinib cohort (n = 2856) was 1614 patient-years (PY); exposure was ≥ 24 weeks in 1248 patients and ≥ 48 weeks in 606 (maximum 108 weeks). In the placebo-controlled cohort (n = 1540), dose-related AEs (200 mg, 100 mg, placebo) were nausea (14.6%, 6.1%, 2.0%), headache (7.8%, 5.9%, 3.5%), and acne (4.7%, 1.6%, 0%). Platelet count was reduced transiently in a dose-dependent manner; 2/2718 patients (200-mg group) had confirmed platelet counts of < 50 × 103/mm3 at week 4. Incidence rates (IRs) were 2.33/100PY and 2.65/100 PY for serious infection, 4.34/100PY and 2.04/100PY for herpes zoster, and 11.83/100PY and 8.73/100PY for herpes simplex in the 200-mg and 100-mg groups, respectively. IRs for nonmelanoma skin cancer, other malignancies, and major adverse cardiovascular events were < 0.5/100PY for both doses. Five venous thromboembolism events occurred (IR 0.30/100PY), all in the 200-mg group. There were three deaths due to gastric carcinoma (diagnosed at day 43), sudden death, and COVID-19. CONCLUSION: Abrocitinib, with proper patient and dose selection, has a manageable tolerability and longer-term safety profile appropriate for long-term use in patients with moderate-to-severe AD. TRIAL REGISTRIES: ClinicalTrials.gov: NCT02780167, NCT03349060, NCT03575871, NCT03720470, NCT03627767, NCT03422822.


Assuntos
Dermatite Atópica/tratamento farmacológico , Infecções/epidemiologia , Inibidores de Proteínas Quinases/efeitos adversos , Pirimidinas/efeitos adversos , Neoplasias Cutâneas/epidemiologia , Sulfonamidas/efeitos adversos , Acne Vulgar/induzido quimicamente , Adolescente , Adulto , Idoso , Doenças Cardiovasculares/epidemiologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Feminino , Cefaleia/induzido quimicamente , Herpes Simples/epidemiologia , Herpes Zoster/epidemiologia , Humanos , Incidência , Contagem de Linfócitos , Masculino , Pessoa de Meia-Idade , Náusea/induzido quimicamente , Contagem de Plaquetas , Inibidores de Proteínas Quinases/administração & dosagem , Pirimidinas/administração & dosagem , Fatores de Risco , Sulfonamidas/administração & dosagem , Fatores de Tempo , Tromboembolia Venosa/epidemiologia , Adulto Jovem
17.
Artigo em Inglês | MEDLINE | ID: mdl-34444092

RESUMO

Perfluorinated compounds (PFCs) are non-biodegradable synthetic chemical compounds that are widely used in manufacturing many household products. Many studies have reported the association between PFCs exposure with the risk of developing cardiovascular diseases (CVDs). However, those reports are still debatable, due to their findings. Thus, this review paper aimed to analyse the association of PFCs compound with CVDs and their risk factors in humans by systematic review and meta-analysis. Google Scholar, PubMed and ScienceDirect were searched for PFCs studies on CVDs and their risk from 2009 until present. The association of PFCs exposure with the prevalence of CVDs and their risk factors were assessed by calculating the quality criteria, odds ratios (ORs), and 95% confidence intervals (CIs). CVDs risk factors were divided into serum lipid profile (main risk factor) and other known risk factors. The meta-analysis was then used to derive a combined OR test for heterogeneity in findings between studies. Twenty-nine articles were included. Our meta-analysis indicated that PFCs exposure could be associated with CVDs (Test for overall effect: z = 2.2, p = 0.02; Test for heterogeneity: I2 = 91.6%, CI = 0.92-1.58, p < 0.0001) and their risk factors (Test for overall effect: z = 4.03, p < 0.0001; Test for heterogeneity: I2 = 85.8%, CI = 1.00-1.14, p < 0.0001). In serum lipids, total cholesterol levels are frequently reported associated with the exposure of PFCs. Among PFCs, perfluorooctanoic acid (PFOA) and perfluorooctane sulfonic acid (PFOS) exposure increased the risk of CVDs than other types of PFCs. Although the risk of PFOA and PFOS were positively associated with CVDs and their risk factors, more observational studies shall be carried out to identify the long-term effects of these contaminants in premature CVDs development in patients.


Assuntos
Ácidos Alcanossulfônicos , Doenças Cardiovasculares , Fluorcarbonetos , Caprilatos/toxicidade , Doenças Cardiovasculares/induzido quimicamente , Doenças Cardiovasculares/epidemiologia , Fluorcarbonetos/toxicidade , Humanos
18.
Artigo em Inglês | MEDLINE | ID: mdl-34444178

RESUMO

Muscle strength (MS) has been associated with cardiometabolic risk factors (CMR) in adolescents, however, the impact attributed to body size in determining muscle strength or whether body size acts as a confounder in this relationship remains controversial. We investigated the association between absolute MS and MS normalized for body size with CMR in adolescents. This was a cross-sectional study comprising 351 adolescents (44.4% male; 16.6 ± 1.0 years) from Brazil. MS was assessed by handgrip and normalized for body weight, body mass index (BMI), height, and fat mass. CMR included obesity, high blood pressure, dyslipidemia, glucose imbalance, and high inflammation marker. When normalized for body weight, BMI, and fat mass, MS was inversely associated with the presence of two or more CMR among females. Absolute MS and MS normalized for height was directly associated with the presence of two or more CMR among males. This study suggests that MS normalized for body weight, BMI, and fat mass can be superior to absolute MS and MS normalized for height in representing lower CMR among females. Absolute MS and MS normalized for height were related to higher CMR among males.


Assuntos
Doenças Cardiovasculares , Força da Mão , Adolescente , Índice de Massa Corporal , Fatores de Risco Cardiometabólico , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Feminino , Humanos , Masculino , Força Muscular , Fatores de Risco
19.
Artigo em Inglês | MEDLINE | ID: mdl-34444197

RESUMO

Cardiovascular disease (CVD) is the leading cause of mortality in post-renal transplant recipients (RTRs). Adequate nutrient intake is a protective factor for CVD. We examined the associations of macronutrients and micronutrients with traditional and nontraditional CVD risk factors. Conducted from September 2016 to June 2018, this cross-sectional study included 106 RTRs aged ≥18 years with a functioning allograft. Dietary intake data from 3-day dietary records were collected. Nutrient intake adequacy was defined using various instruments, including the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines. CVD risk factors were defined according to the K/DOQI guidelines. Bivariate and multivariate logistic regression models were used to analyze the associations. CVD risk was present in all patients; the lowest proportions of adequate intake were 2.8% for dietary fiber and 0.9% for calcium. Adequate nutrient intake was associated with a lower likelihood of the occurrence of traditional CVD risk factors (specifically, 1.9-31.3% for hyperlipidemia and 94.6% for diabetes mellitus). It was also associated with a lower likelihood of the occurrence of nontraditional CVD risk by 0.8% for hypophosphatemia and 34% for hyperuricemia. Adherence to dietary guidelines should be promoted among RTRs to decrease CVD risk.


Assuntos
Doenças Cardiovasculares , Transplante de Rim , Adolescente , Adulto , Doenças Cardiovasculares/epidemiologia , Estudos Transversais , Fatores de Risco de Doenças Cardíacas , Humanos , Rim , Micronutrientes , Fatores de Risco
20.
BMJ Open ; 11(8): e047849, 2021 08 18.
Artigo em Inglês | MEDLINE | ID: mdl-34408040

RESUMO

OBJECTIVES: This study is aimed at determining the association between metabolic syndrome and risk of cardiovascular disease (CVD) mortality and all-cause mortality among Malaysian adults. DESIGN: Retrospective cohort study. SETTING: The Malaysian Non-Communicable Disease Surveillance (MyNCDS-1) 2005/2006. PARTICIPANTS: A total of 2525 adults (1013 men and 1512 women), aged 24-64 years, who participated in the MyNCDS-1 2005/2006. METHODS: Participants' anthropometric indices, blood pressure, fasting lipid profile and fasting blood glucose levels were evaluated to determine the prevalence of metabolic syndrome by the Harmonized criteria. Participants' mortality status were followed up for 13 years from 2006 to 2018. Mortality data were obtained via record linkage with the Malaysian National Registration Department. The Cox proportional hazards regression model was applied to determine association between metabolic syndrome (MetS) and risk of CVD mortality and all-cause mortality with adjustment for selected sociodemographic and lifestyle behavioural factors. RESULTS: The overall point prevalence of MetS was 30.6% (95% CI: 28.0 to 33.3). Total follow-up time was 31 668 person-years with 213 deaths (111 (11.3%) in MetS subjects and 102 (6.1%) in non-MetS subjects) from all-causes, and 50 deaths (33 (2.9%) in MetS group and 17 (1.2%) in non-MetS group) from CVD. Metabolic syndrome was associated with a significantly increased hazard of CVD mortality (adjusted HR: 2.18 (95% CI: 1.03 to 4.61), p=0.041) and all-cause mortality (adjusted HR: 1.47 (95% CI: 1.00 to 2.14), p=0.048). These associations remained significant after excluding mortalities in the first 2 years. CONCLUSIONS: Our study shows that individuals with MetS have a higher hazard of death from all-causes and CVD compared with those without MetS. It is thus imperative to prescribe individuals with MetS, a lifestyle intervention along with pharmacological intervention to improve the individual components of MetS and reduce this risk.


Assuntos
Doenças Cardiovasculares , Síndrome Metabólica , Adulto , Doenças Cardiovasculares/epidemiologia , Jejum , Feminino , Humanos , Masculino , Síndrome Metabólica/epidemiologia , Modelos de Riscos Proporcionais , Estudos Retrospectivos
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