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Sparano C, Corona G, Rastrelli G, Vignozzi L, Vignoli D, Maggi M. Is 'living apart together' a real advantage for patients consulting for sexual dysfunction? A cohort study. Andrology 2025. [PMID: 40099670 DOI: 10.1111/andr.70023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2024] [Revised: 01/18/2025] [Accepted: 03/06/2025] [Indexed: 03/20/2025]
Abstract
BACKGROUND Quantitative research on families has introduced a new category of relationship called living apart together, that is, when a couple in a committed relationship live in separate homes. This study aimed to confirm whether living apart together improves sexual relationships in those suffering from sexual dysfunction. METHODS This study comprised cross-sectional (N = 4852) and longitudinal (N = 1402) analyses. The former explored psychobiological, hormonal and relational correlates using the Structured Interview on Erectile Dysfunction scale. The latter assessed the occurrence of major adverse cardiovascular events in a subset of patients followed for 4.3 ± 2.59 years. RESULTS Compared to cohabiting couples, patients in living apart together relationships were younger and characterised by higher education levels, healthier lifestyles and lower comorbidity burdens (all p < 0.001). After adjusting for those confounders, the living apart together group reported better sexual functioning, more frequent sexual intercourse, and higher total testosterone levels (p < 0.001), and the relationship was often a source of conflicts within the familial context and of shorter duration (all p < 0.05). When total testosterone was included in a fully adjusted analysis of covariance, the difference in obtaining a full erection between cohabiting and living apart together relationships became non-significant (p = 0.086), suggesting a hormonal influence on erectile dysfunction. In the longitudinal analysis, Cox models adjusted for the aforementioned confounders showed that living apart together relationships are associated with a twofold greater risk of major adverse cardiovascular events than cohabiting relationships, independent of other risk factors, including total testosterone levels, waist circumference and pathological penile blood flow. DISCUSSION This study illustrates that partnership arrangements can shape sexual interest and complaints, as reported by the participants. While men involved in living apart together relationships show an ostensibly healthier phenotype, they experienced more often major adverse cardiovascular events. Therefore, co-residential relationship appears to provide more effective protection against future major adverse cardiovascular events for the male partner than a living apart together relationship.
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Affiliation(s)
- Clotilde Sparano
- Endocrinology Unit, 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Giovanni Corona
- Endocrinology Unit, Azienda AUSL, Maggiore Hospital, Bologna, Italy
| | - Giulia Rastrelli
- Andrology, Women's Endocrinology and Gender Incongruence Unit, 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Linda Vignozzi
- Andrology, Women's Endocrinology and Gender Incongruence Unit, 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
| | - Daniele Vignoli
- Department of Statistics, Computer Science, Applications, University of Florence, Florence, Italy
| | - Mario Maggi
- Endocrinology Unit, 'Mario Serio' Department of Experimental and Clinical Biomedical Sciences, University of Florence, Florence, Italy
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Konlan KD, Afaya A, Anaman-Torgbor JA, Adedia D, Todzro-Agudze M, Biney AC, Kuug A, Mumuni H, Baiden F, HyoJung S, Kim S. Risk factors of CVDs among residents of resource-limited rural settings. Preliminary findings based on a cross-sectional study, Ghana. BMC Cardiovasc Disord 2025; 25:164. [PMID: 40055593 PMCID: PMC11889812 DOI: 10.1186/s12872-025-04594-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 02/19/2025] [Indexed: 05/13/2025] Open
Abstract
BACKGROUNDS Cardiovascular disease (CVD) risk factors lead to morbidity and mortality among adults globally. In Ghana, there is a lack of coordinated efforts at all levels of healthcare service to prevent risk factors of cardiovascular disease (CVD). This study assessed cardiovascular disease risk factors among residents of resource-limited rural settings. METHODS This descriptive cross-sectional design is the first phase of a two-year community-level study aimed at implementing an intervention to reduce CVD risk in a rural community in Ghana. The study population included 379 people living in the Avenui community. We conducted a nurse-led door-to-door visit, screened for CVD risk, provided health education, and collected data using an adapted questionnaire. The data were analyzed using SPSS. Categorical data were expressed as frequencies and proportions, and the Chi-Square test of associations. A multivariable logistic regression analysis with a backward elimination method was used to examine the association of the risk factors with the risk of developing CVD. RESULTS The CVD risk among participants was categorized as 'very high' (35.4%), high (55.4%), and low or moderate (9.2%). There was a positive correlation between lifestyle (r = 0.126, p-value < 0.05), stress (r = 0.114, p-value < 0.05), blood sugar level (r = 0.102, p-value < 0.05) inflammation and pain (r = 0.109, p-value < 0.05), and high blood pressure (r = 0.268, p-value < 0.01) with history of CVD. CVD high risk was significantly associated with marital status (p-value = 0.001), employment status (p-value = 0.001), perception of personal health (p-value = 0.045), lifestyle (p-value = 0.034), knowledge of peripheral arterial disease (p-value = 0.018), and knowledge on deep vein thrombosis and pulmonary embolism (p-value = 0.002). The backward multiple logistic regression model was significant (78.912, p-value < 0.001) with a non-significant Hosmer and Lemeshow Test (2.145, p-value = 0.976) and a Cox & Snell R Square and Nagelkerke R Square of 0.393 and 0.619, respectively. The significant predictors of a 'very high' CVD risk include marital status being single (p-value = 0.001), those that exercise only two (2) times a week (p-value = 0.001) employment status being part-time worker (p-value = 0.015), poor perception of overall personal health (p-value < 0.001), and those listening to the radio (p-value = 0.024). CONCLUSION The risk factors associated with CVD were identified to be multiple and interacted variable among rural community dwellers. These factors included marital status, exercise, employment, perception of health, and listening to the radio. We recommend implementing primary prevention strategies that involve adopting a comprehensive assessment and management of the risk factors of CVD in Ghana.
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Affiliation(s)
- Kennedy Diema Konlan
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Agani Afaya
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Judith A Anaman-Torgbor
- Department of Public Health Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana.
| | - David Adedia
- Department of Basic Sciences, School of Basic and Biomedical Sciences, University of Health and Allied Sciences, Ho, Ghana
| | - Mathias Todzro-Agudze
- Department of Midwifery, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | | | - Anthony Kuug
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Hadiru Mumuni
- Department of Nursing, School of Nursing and Midwifery, University of Health and Allied Sciences, Ho, Ghana
| | - Frank Baiden
- Department of Epidemiology and Biostatistics, Fred Newton Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Sea HyoJung
- Department of Medical Law and Ethics, Graduate School, College of Medicine, Yonsei University, Seoul, 03722, Korea
- Asian Institute for Bioethics and Health Law (WHO Collaborating Centre for Health Law & Bioethics Researcher), Yonsei University Health Systems, 50-1 Yonsei-Ro, Seodaemungu-Gu, Seoul, Korea
| | - Soyoon Kim
- Asian Institute for Bioethics and Health Law (WHO Collaborating Centre for Health Law & Bioethics Researcher), Yonsei University Health Systems, 50-1 Yonsei-Ro, Seodaemungu-Gu, Seoul, Korea
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Duan Y, Yang K, Zhang T, Guo X, Yin Q, Liu H. Association between non-highdensity lipoprotein cholesterol to high-density lipoprotein cholesterol ratio and cardiovascular-kidney-metabolic syndrome: evidence from NHANES 2001-2018. Front Nutr 2025; 12:1548851. [PMID: 40093879 PMCID: PMC11906338 DOI: 10.3389/fnut.2025.1548851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2024] [Accepted: 02/18/2025] [Indexed: 03/19/2025] Open
Abstract
Objective This research is to analyze the connection between NHHR and CKD occurrence using NHANES from 2001 to 2018. It will evaluate the feasibility of NHHR as a tool for predicting CKM syndrome and offer valuable insights for personalized treatment approaches within the U.S. population. Methods Data from 16,575 individuals aged 20 to 69 years were analyzed, having excluded those who were pregnant and individuals with incomplete data. CKM syndrome was characterized by the simultaneous presence of CKD and Cardiometabolic Syndrome (CMS). For the statistical analysis, weighted logistic regression models were applied, accounting for variables such as age, gender, ethnicity, educational background, marital status, lifestyle factors, and preexisting health conditions. Differently, restricted cubic splines (RCS) were applied to investigate any possible nonlinear relationships between NHHR and CKM in the study. Results The research revealed that the occurrence of CKM syndrome was more prevalent among individuals aged 60 and older, with women representing 55.36% of those affected. Additionally, NHHR levels were notably elevated in CKM patients when compared to those without CKM (p < 0.0001). As NHHR increased, the prevalence of CKM also rose, with the highest prevalence in the highest NHHR quartile (Q4: 36.06%). A positive connection between NHHR and CKM was indicated by multivariable logistic regression, especially in the upper quartiles of NHHR (Q3 and Q4). Moreover, RCS analysis displayed a noteworthy nonlinear connection between NHHR and CKM occurrence. The subgroup analysis uncovered significant interactions influenced by BMI and Hypertension. Conclusion With the rising global prevalence of CKM syndrome, early identification of high-risk individuals using NHHR could inform targeted prevention and intervention strategies. Future research should focus on validating NHHR in diverse populations and exploring its clinical utility, as well as examining its relationship with other biomarkers of metabolic dysfunction to better understand CKM syndrome's complex pathophysiology.
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Affiliation(s)
- Yang Duan
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, China
| | - Ke Yang
- Guzhen County Traditional Chinese Medicine Hospital, Bengbu, China
| | - Tianai Zhang
- School of Integrative Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiangsheng Guo
- Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
| | - Qianran Yin
- Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou, China
- Department of Cardiology, The Fourth Affiliated Hospital of Soochow University, Suzhou, China
| | - He Liu
- Department of Cardiology, Xuzhou Central Hospital, Xuzhou, China
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Vera-Ponce VJ, Zuzunaga-Montoya FE, Vásquez-Romero LEM, Loayza-Castro JA, Orihuela Manrique EJ, Valladares-Garrido MJ, Gutierrez De Carrillo CI. Prevalence and determinants of ideal cardiovascular health by sex and region-a population-based study in Peru. Front Cardiovasc Med 2025; 11:1392579. [PMID: 39872887 PMCID: PMC11770017 DOI: 10.3389/fcvm.2024.1392579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 12/23/2024] [Indexed: 01/30/2025] Open
Abstract
Introduction Attaining what the American Heart Association terms Ideal Cardiovascular Health (ICVH) is viewed as an essential objective for preventing cardiovascular diseases (CVD). Objective To determine the prevalence of ICVH, stratified by sex and region and its associated factors in the adult population of Peru. Materials and methods Analytical cross-sectional study. Data were obtained from the Life Stage Food and Nutrition Surveillance Survey (VIANEV). ICVH can be depicted vis-a-vis the seven metrics of the AHA: blood pressure levels, total cholesterol and glucose levels, smoking status, body mass index, physical activity levels, and dietary intake through the consumption of fruits and vegetables. The variable was categorized as deficient/moderate vs. ideal for regression analysis. Results Of the 863 participants examined, findings demonstrated that 38.01% had ICVH. The prevalence is trending lower in correlation with rising age and educational attainment levels and for those inhabitants residing at higher elevations. Likewise, statistically significant variations were observable concerning the prevalence of ICVH contingent on the region of residence and marital status, in particular amongst the feminine inhabitants. Conclusions These results demonstrate that the frequency of ICVH in the grown-up inhabitants of Peru is comparatively tiny. Things linked to a lesser frequency of ICVH involve increased age, a higher level of education, living at higher altitudes, and staying married to a woman. These discoveries underscore the need to implement prevention and treatment strategies for CVD distinct for each inhabitant team.
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Affiliation(s)
- Víctor Juan Vera-Ponce
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
| | - Fiorella E. Zuzunaga-Montoya
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
| | - Luisa Erika Milagros Vásquez-Romero
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
| | - Joan A. Loayza-Castro
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
| | | | - Mario J. Valladares-Garrido
- Universidad Continental, Lima, Peru
- Oficina de Epidemiología, Hospital Regional Lambayeque, Chiclayo, Peru
- Oficina de Inteligencia Sanitaria, Red Prestacional EsSalud Lambayeque, Chiclayo, Peru
| | - Carmen Inés Gutierrez De Carrillo
- Instituto de Investigación de Enfermedades Tropicales, Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
- Facultad de Medicina (FAMED), Universidad Nacional Toribio Rodríguez de Mendoza de Amazonas (UNTRM), Amazonas, Peru
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Datta BK, Tiwari A, Jahan M, Torres N, Attari S. Spousal age difference and risk of hypertension in women: evidence from India. J Hum Hypertens 2024; 38:851-859. [PMID: 39306643 DOI: 10.1038/s41371-024-00959-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Revised: 09/13/2024] [Accepted: 09/17/2024] [Indexed: 12/08/2024]
Abstract
There has been steady progress in documenting the psychosocial risk factors of hypertension. However, most of the extant evidence is based on population from the developed countries. Using nationally representative data from India, this cross-sectional study explores whether spousal age gap is associated with risk of hypertension in married women aged 20 to 49 years. Based on the age difference with their husbands, women were grouped into four categories: husband was - i) of similar age, ii) 3-5 years older, iii) 6-9 years older, and iv) 10+ years older. Compared to women whose husbands were of similar age, the odds of having hypertension for the other categories were assessed by estimating multivariable logistic regression models. While the hypertension prevalence in our sample was 18.9%, it was 2.2%-points lower among women whose husbands were of similar age, and 3.3%-points higher among women whose husbands were 10+ years older. The adjusted odds of having hypertension for women with 10+ years of spousal age difference were 1.18 (95% CI: 1.13-1.24) times that of their counterparts who were of similar age to their husbands. These results were persistent in both younger (age 20-34) and older (age 35-49) women and robust across age at marriage, years in marriage, and various socioeconomic sub-groups including women's educational attainment, husband's educational level, household wealth, urban/rural residence, and geographic regions. The relationship also persisted after adjusting for husband's hypertension status. Our findings thus highlight spousal age difference as a biopsychosocial factor influencing the risk of hypertension in women.
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Affiliation(s)
- Biplab Kumar Datta
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA.
- Department of Health Management, Economics and Policy, Augusta University, Augusta, GA, USA.
| | - Ashwini Tiwari
- Institute of Public and Preventive Health, Augusta University, Augusta, GA, USA
- Department of Community & Behavioral Health Sciences, Augusta University, Augusta, GA, USA
| | - Murshed Jahan
- Department of Economics, Finance and Healthcare Administration, Valdosta State University, Valdosta, GA, USA
| | | | - Sara Attari
- Medical College of Georgia, Augusta University, Augusta, GA, USA
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Zhang Y, Yu H, Fu J, Zhuo R, Xu J, Liu L, Dai M, Li Z. Oxidative balance score and the potential for suffering rheumatoid arthritis: a cross-sectional study. Front Immunol 2024; 15:1454594. [PMID: 39555070 PMCID: PMC11563821 DOI: 10.3389/fimmu.2024.1454594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2024] [Accepted: 10/07/2024] [Indexed: 11/19/2024] Open
Abstract
Objective Our study was conducted to explore the link between oxidative balance score (OBS) and rheumatoid arthritis (RA). Methods A total of 21,415 participants were included in our research from five cycles (2011-2012, 2013-2014, 2015-2016, 2017-2018, and 2017-2020) of the National Health and Nutrition Examination Survey (NHANES). Moreover, 20 elements related to diet as well as lifestyle were combined to calculate OBS. The relationship between OBS and RA was assessed by employing multivariable regression analysis, and further exploration was carried out through subgroup analysis, restricted cubic spline analysis, and sensitivity analysis. Multiple covariates were selected to adjust the model for more robust results. Results In our cross-sectional study, a higher OBS has a protective effect on the development of RA (OR = 0.98, 95% CI: 0.97 to 0.99). In contrast to individuals aged ≥60, the result is more prominent in the population aged 20-60 (OR = 0.97, 95% CI: 0.96 to 0.98). Marital status appears to introduce interference in the relationship between OBS and RA, and unmarried individuals exhibited different outcomes (OR = 1.02, 95% CI: 0.99 to 1.04) compared to others. The positive influence of OBS was more evident in patients with chronic kidney disease and cardiovascular disease, while it was stronger in individuals without diabetes and liver disease. Conclusion A higher OBS correlates with a reduced odd of RA. Further studies are needed to shoot more sights on improving dietary habits and lifestyles to gain proper OBS and explore whether OBS can be one of the measurements utilized to measure the risk of RA.
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Affiliation(s)
- Yimin Zhang
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Hao Yu
- Department of Urology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, China
- Department of Urology, The Second Clinical Medical College of Nanjing Medical University, Nanjing, China
| | - Jianfei Fu
- Department of Medical Records and Statistics, The First Affiliated Hospital of Ningbo University, Ningbo, China
| | - Renjie Zhuo
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Jin Xu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Liya Liu
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Manyun Dai
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
| | - Zhen Li
- School of Public Health, Health Science Center, Ningbo University, Ningbo, China
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Marshall E, Bhandari R, Haas DM, Catov J, Umer A, Silver RM, Gibbs BB. Pre-pregnancy substance use and first trimester cardiovascular health among nulliparous pregnant people: The nuMoM2b Study. Paediatr Perinat Epidemiol 2024; 38:668-676. [PMID: 39225189 PMCID: PMC11604527 DOI: 10.1111/ppe.13119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2024] [Revised: 08/08/2024] [Accepted: 08/16/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Suboptimal pre-pregnancy health, including substance use and cardiovascular risk factors, is associated with higher risks of maternal-foetal morbidity and mortality. OBJECTIVE To determine if pre-pregnancy substance use is associated with early pregnancy cardiovascular health (CVH). It is hypothesised that pre-pregnancy use of substances is associated with worse CVH in the first trimester of pregnancy. METHODS This is a secondary analysis from the 2010-2015 United States nuMoM2b cohort (n = 9895). Pre-pregnancy alcohol, tobacco, marijuana, and illicit substance use were assessed through questionnaires. Latent class analysis categorised participants based on their 3-month pre-pregnancy or ever(*) substance use: (1) Illicit substances*, marijuana*, and alcohol use (n = 1234); (2) marijuana* and alcohol use (n = 2066); (3) tobacco and alcohol use (n = 636); and (4) alcohol only use (n = 3194). The referent group reported no pre-pregnancy substance use (n = 2765). First trimester CVH score from 0 (least healthy) to 100 (most healthy) was calculated using a modified American Heart Association Life's Essential 8 framework and included body mass index (BMI), blood pressure, blood glucose, non-HDL cholesterol, diet, sleep, and physical activity. Multiple linear regression evaluated the relationship between pre-pregnancy substance use classes and CVH scores. RESULTS CVH score varied by class: No substance use (mean: 65, SD: ±1.3), illicit substances*, marijuana*, and alcohol use (68 ± 1.3), marijuana* and alcohol use (67 ± 1.3), tobacco and alcohol use (62 ± 1.4), and alcohol only use (67 ± 1.3). In adjusted models, those who used tobacco and alcohol compared to the no substance use class had a lower CVH score (-2.82); other classes had scores ranging from 1.81 to 2.44 points higher than the no substance use class. Individual CVH component scores followed similar patterns. CONCLUSIONS All groups, but most markedly those who used tobacco and alcohol prior to pregnancy, began pregnancy with only moderate CVH and may benefit from CVH promotion efforts along with substance use treatment.
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Li Z, Kang S, Kang H. Development and validation of nomograms for predicting cardiovascular disease risk in patients with prediabetes and diabetes. Sci Rep 2024; 14:20909. [PMID: 39245747 PMCID: PMC11381537 DOI: 10.1038/s41598-024-71904-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 09/02/2024] [Indexed: 09/10/2024] Open
Abstract
This study aimed to develop and validate distinct nomogram models for assessing CVD risk in individuals with prediabetes and diabetes. In a cross-sectional study design, we examined data from 2294 prediabetes and 1037 diabetics who participated in the National Health and Nutrition Examination Survey, which was conducted in the United States of America between 2007 and 2018. The dataset was randomly divided into training and validation cohorts at a ratio of 0.75-0.25. The Boruta feature selection method was used in the training cohort to identify optimal predictors for CVD diagnosis. A web-based dynamic nomogram was developed using the selected features, which were validated in the validation cohort. The Hosmer-Lemeshow test was performed to assess the nomogram's stability and performance. Receiver operating characteristics and calibration curves were used to assess the effectiveness of the nomogram. The clinical applicability of the nomogram was evaluated using decision curve analysis and clinical impact curves. In the prediabetes cohort, the CVD risk prediction nomogram included nine risk factors: age, smoking status, platelet/lymphocyte ratio, platelet count, white blood cell count, red cell distribution width, lactate dehydrogenase level, sleep disorder, and hypertension. In the diabetes cohort, the CVD risk prediction nomogram included eleven risk factors: age, material status, smoking status, systemic inflammatory response index, neutrophil-to-lymphocyte ratio, red cell distribution width, lactate dehydrogenase, high-density lipoprotein cholesterol, sleep disorder, hypertension, and physical activity. The nomogram models developed in this study have good predictive and discriminant utility for predicting CVD risk in patients with prediabetes and diabetes.
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Affiliation(s)
- Zhao Li
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Seamon Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea
| | - Hyunsik Kang
- College of Sport Science, Sungkyunkwan University, 2066 Seoburo, 16419, Jangan-gu, Suwon, Republic of Korea.
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Tan JY, Shen SH. Nomogram predicting the cardiovascular disease mortality for older patients with colorectal cancer: A real-world population-based study. World J Cardiol 2024; 16:458-468. [PMID: 39221191 PMCID: PMC11362806 DOI: 10.4330/wjc.v16.i8.458] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2024] [Revised: 07/24/2024] [Accepted: 08/06/2024] [Indexed: 08/26/2024] Open
Abstract
BACKGROUND Cardio-oncology has received increasing attention especially among older patients with colorectal cancer (CRC). Cardiovascular disease (CVD)-specific mortality is the second-most frequent cause of death. The risk factors for CVD-specific mortality among older patients with CRC are still poorly understood.
AIM To identify the prognostic factors and construct a nomogram-based model to predict the CVD-specific mortality among older patients with CRC.
METHODS The data on older patients diagnosed with CRC were retrieved from The Surveillance, Epidemiology, and End Results database from 2004 to 2015. The prognostic factors and a nomogram-based model predicting the CVD-specific mortality were assessed using least absolute shrinkage and selection operator and Cox regression.
RESULTS A total of 141251 eligible patients with CRC were enrolled, of which 41459 patients died of CRC and 12651 patients died of CVD. The age at diagnosis, sex, marital status, year of diagnosis, surgery, and chemotherapy were independent prognostic factors associated with CVD-specific mortality among older patients with CRC. We used these variables to develop a model to predict CVD-specific mortality. The calibration curves for CVD-specific mortality probabilities showed that the model was in good agreement with actual observations. The C-index value of the model in the training cohort and testing cohort for predicting CVD-specific mortality was 0.728 and 0.734, respectively.
CONCLUSION The proposed nomogram-based model for CVD-specific mortality can be used for accurate prognostic prediction among older patients with CRC. This model is a potentially useful tool for clinicians to identify high-risk patients and develop personalized treatment plans.
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Affiliation(s)
- Jia-Yu Tan
- Department of Medical Ultrasound, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan 250000, Shandong Province, China
| | - Shuo-Hao Shen
- Department of General Surgery, Qilu Hospital of Shandong University, Jinan 250000, Shandong Province, China
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Weiner CM, Khan SE, Leong C, Ranadive SM, Campbell SC, Howard JT, Heffernan KS. Association of enterolactone with blood pressure and hypertension risk in NHANES. PLoS One 2024; 19:e0302254. [PMID: 38743749 PMCID: PMC11093351 DOI: 10.1371/journal.pone.0302254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 03/30/2024] [Indexed: 05/16/2024] Open
Abstract
The gut microbiome may affect overall cardiometabolic health. Enterolactone is an enterolignan reflective of dietary lignan intake and gut microbiota composition and diversity that can be measured in the urine. The purpose of this study was to examine the association between urinary enterolactone concentration as a reflection of gut health and blood pressure/risk of hypertension in a large representative sample from the US population. This analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) collected from January 1999 through December 2010. Variables of interest included participant characteristics (including demographic, anthropometric and social/environmental factors), resting blood pressure and hypertension history, and urinary enterolactone concentration. 10,637 participants (45 years (SE = 0.3), 51.7% (SE = 0.6%) were female) were included in analyses. In multivariable models adjusted for demographic, socioeconomic and behavioral/environmental covariates, each one-unit change in log-transformed increase in enterolactone was associated with a 0.738 point (95% CI: -0.946, -0.529; p<0.001) decrease in systolic blood pressure and a 0.407 point (95% CI: -0.575, -0.239; p<0.001) decrease in diastolic blood pressure. Moreover, in fully adjusted models, each one-unit change in log-transformed enterolactone was associated with 8.2% lower odds of hypertension (OR = 0.918; 95% CI: 0.892, 0.944; p<0.001). Urinary enterolactone, an indicator of gut microbiome health, is inversely associated with blood pressure and hypertension risk in a nationally representative sample of U.S. adults.
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Affiliation(s)
- Cynthia M. Weiner
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Shannon E. Khan
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Caleb Leong
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, Texas, United States of America
| | - Sushant M. Ranadive
- Department of Kinesiology, University of Maryland, College Park, Maryland, United States of America
| | - Sara C. Campbell
- Department of Kinesiology and Health, Rutgers University, New Brunswick, New Jersey, United States of America
| | - Jeffrey T. Howard
- Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, Texas, United States of America
| | - Kevin S. Heffernan
- Department of Exercise Science, Syracuse University, Syracuse, NY, United States of America
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11
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Williams A, Little SE, Bryant AS, Smith NA. Mode of Delivery and Unplanned Cesarean: Differences in Rates and Indication by Race, Ethnicity, and Sociodemographic Characteristics. Am J Perinatol 2024; 41:834-841. [PMID: 35235955 DOI: 10.1055/a-1785-8843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
OBJECTIVE We aimed to examine the relationship of sociodemographic variables with racial/ethnic disparities in unplanned cesarean births in a large academic hospital system. Secondarily, we investigated the relationship of these variables with differences in cesarean delivery indication, cesarean delivery timing, length of second stage and operative delivery. STUDY DESIGN We conducted a retrospective cohort study of births >34 weeks between 2017 and 2019. Our primary outcome was unplanned cesarean delivery after a trial of labor. Multiple gestations, vaginal birth after cesarean, elective repeat or primary cesarean delivery, and contraindications for vaginal delivery were excluded. Associations between mode of delivery and patient characteristics were assessed using Chi-square, Fisher exact tests, or t-tests. Odds ratios were estimated by multivariate logistic regression. Goodness of fit was assessed with Hosmer Lemeshow test. RESULTS Among 18,946 deliveries, the rate of cesarean delivery was 14.8% overall and 21.3% in nulliparous patients. After adjustment for age, body mass index (BMI), and parity, women of Black and Asian races had significantly increased odds of unplanned cesarean delivery; 1.69 (95% CI: 1.45,1.96) and 1.23 (1.08, 1.40), respectively. Single Hispanic women had adjusted odds of 1.65 (1.08, 2.54). Single women had increased adjusted odds of cesarean delivery of 1.18, (1.05, 1.31). Fetal intolerance was the indication for 39% (613) of cesarean deliveries among White women as compared to 63% (231) of Black women and 49% (71) of Hispanic women (p <0.001). CONCLUSION Rates of unplanned cesarean delivery were significantly higher in Black and Asian compared to White women, even after adjustment for age, BMI, parity, and zip code income strata, and rates of unplanned cesarean delivery were higher for Hispanic women self-identifying as single. Racial and ethnic differences were seen in cesarean delivery indications and operative vaginal deliveries. Future work is urgently needed to better understand differences in provider care or patient attributes, and potential provider bias, that may contribute to these findings. KEY POINTS · Racial, ethnic, and socioeconomic differences exist in the odds of unplanned cesarean.. · Indications for unplanned cesarean delivery differed significantly among racial and ethnic groups.. · There may be unmeasured provider level factors which contribute to disparities in cesarean rates..
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Affiliation(s)
- Alexandria Williams
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General, Boston, Massachusetts
| | - Sarah E Little
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Allison S Bryant
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General, Boston, Massachusetts
| | - Nicole A Smith
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts
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12
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Liu Q, Xiang H, Chen S, Ouyang J, Liu H, Zhang J, Chai Y, Gao P, Zhang X, Fan J, Zheng X, Lu H. Associations between Life's Essential 8 and abdominal aortic calcification among US Adults: a cross-sectional study. BMC Public Health 2024; 24:1090. [PMID: 38641579 PMCID: PMC11031939 DOI: 10.1186/s12889-024-18622-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/16/2024] [Indexed: 04/21/2024] Open
Abstract
BACKGROUND Cardiovascular health (CVH) and abdominal aortic calcification (AAC) are closely linked to cardiovascular disease (CVD) and related mortality. However, the relationship between CVH metrics via Life's Essential 8 (LE8) and AAC remains unexplored. METHODS The study analyzed data from the 2013-2014 National Health and Nutrition Examination Survey (NHANES) cohort, which included adults aged 40 or above. The research used the LE8 algorithm to evaluate CVH. Semi-quantitative AAC-24 scoring techniques were employed to assess AAC, categorized into no calcification, mild to moderate calcification, and severe calcification. RESULTS The primary analysis involved 2,478 participants. Following adjustments for multiple factors, the LE8 score exhibited a significant association with ACC risk (Mild-moderate ACC: 0.87, 95% CI: 0.81,0.93; Severe ACC: 0.77, 95% CI: 0.69,0.87, all P < 0.001), indicating an almost linear dose-response relationship. Compared to the low CVH group, the moderate CVH group showed lower odds ratios (OR) for mild-moderate and severe calcification (OR = 0.78, 95% CI: 0.61-0.99, P = 0.041; OR = 0.68, 95% CI: 0.46-0.99, P = 0.047, respectively). Moreover, the high CVH group demonstrated even lower ORs for mild-moderate and severe calcification (OR = 0.46, 95% CI: 0.31, 0.69, P < 0.001; OR = 0.29, 95% CI: 0.14, 0.59, P = 0.001, respectively). Interactions were found between chronic kidney disease (CKD) condition, history of CVD, marital status and CVH metrics to ACC. Participants without CKD exhibited a more pronounced negative association between the CVH metric and both mild-moderate and severe ACC. Those lacking a history of CVD, and never married/widowed/divorced/separated showed a stronger negative association between the CVH metric and severe ACC. CONCLUSIONS The novel CVH metrics demonstrated an inverse correlation with the risk of AAC. These findings suggest that embracing improved CVH levels may assist in alleviating the burden of ACC.
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Affiliation(s)
- Quanjun Liu
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Hong Xiang
- Center for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Shuhua Chen
- Department of Biochemistry, School of Life Sciences of Central, South University, Changsha, China
| | - Jie Ouyang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Huiqin Liu
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Jing Zhang
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Yanfei Chai
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Peng Gao
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Xiao Zhang
- Department of Biochemistry, School of Life Sciences of Central, South University, Changsha, China
| | - Jianing Fan
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Xinru Zheng
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China
| | - Hongwei Lu
- Health Management Center, The Third Xiangya Hospital of Central South University, Changsha, China.
- Department of Cardiology, The Third Xiangya Hospital of Central South University, No. 138, Tongzipo Road, Yuelu District, Changsha, China.
- Center for Experimental Medicine, The Third Xiangya Hospital of Central South University, Changsha, China.
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13
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Alemu YM, Bagheri N, Wangdi K, Chateau D. Nationwide Geospatial Analysis to Identify Variations in Primary Cardiovascular Risk in Ethiopia. J Prim Care Community Health 2024; 15:21501319241288312. [PMID: 39498891 PMCID: PMC11539097 DOI: 10.1177/21501319241288312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 09/11/2024] [Accepted: 09/13/2024] [Indexed: 11/07/2024] Open
Abstract
BACKGROUND Cardiovascular disease (CVD) varies across regions due to socioeconomic, cultural, lifestyle, healthcare access, and environmental factors. OBJECTIVE To find geographical variations in 10-year primary CVD risk and assess the impact of contextual factors on CVD risk. METHOD Data from 2658 Ethiopians aged 40 to 69 years with no previous CVD who participated in a nationally representative World Health Organization (WHO) STEPS survey in 2015 were included in the analysis. The mean 10-year CVD risk for 450 enumeration areas (EA) was used to identify spatial autocorrelation (using Global Moran's I) and CVD hot spots (using getas-Ord Gi*). Geographically Weighted Regression (GWR) analysis quantified the relationship between mean 10-year CVD risk and climate-related factors across areas. RESULT The spatial autocorrelation analysis identified significant spatial variation in the 10-year CVD risk at the EA level, with a global Moran's I value of 0.016. Statistically significant hot spot areas with 10-year CVD risk were identified in Addis Ababa (the capital), Benishangul Gumuz, SNNPR (Southern Nations, Nationalities, and Peoples' Region), Amhara, Afar, Oromia, and Hareri regions. In a multivariable GWR analysis, average water vapor pressure was a statistically significant explanatory variable for the geographical variations in 10-year CVD risk. CONCLUSION Hot spot areas for 10-year CVD risk were identified across numerous country regions rather than concentrated in a specific region. Alongside these hot spot areas, regions with a higher annual water vapor pressure (humidity) were identified as geographical targets for CVD prevention.
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Affiliation(s)
- Yihun Mulugeta Alemu
- The Australian National University, Canberra, ACT, Australia
- Bahir Dar University, Bahir Dar, Ethiopia
| | - Nasser Bagheri
- The Australian National University, Canberra, ACT, Australia
- University of Canberra, Canberra, ACT, Australia
| | - Kinley Wangdi
- The Australian National University, Canberra, ACT, Australia
- University of Canberra, Canberra, ACT, Australia
| | - Dan Chateau
- The Australian National University, Canberra, ACT, Australia
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Tao Z, Qu Q, Li J, Li X. Factors influencing blood pressure variability in postmenopausal women: evidence from the China Health and Nutrition Survey. Clin Exp Hypertens 2023; 45:2181356. [PMID: 36842972 DOI: 10.1080/10641963.2023.2181356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
BACKGROUND The aim is to identify the factors influencing blood pressure variability in postmenopausal women based on the China Health and Nutrition Survey (CHNS). MATERIAL AND METHODS The data on postmenopausal women between 1993 and 2015 were extracted from the CHNS. Group-based trajectory modeling was used to analyze the development track of blood pressure changes, based on which the subjects were separately divided into two groups for systolic blood pressure (SBP) and diastolic blood pressure (DBP). Univariate and multivariate analyzes were performed to analyze the factors influencing SBP and DBP. RESULTS A total of 346 women were eligible for the study. Group-based trajectory modeling showed two different trajectories of blood pressure, including the low-level, slowly developed type and the high-level, rapidly developed, stable type of SBP, as well as the low-level, slowly developed type and the high-level, slowly developed type of DBP. In multivariate analysis, age (odds ratio [OR]: 1.118, 95% confidence interval [CI]: 1.082-1.156), body mass index (BMI) (OR: 2.239, 95%CI: 1.010-4.964), antihypertensive agents (OR: 7.293, 95%CI: 2.191-24.275), hip circumference (OR: 1.069, 95%CI: 1.014-1.128) and marital status (OR: 3.103, 95%CI: 1.028-9.361) were found to be the significant factors influencing SBP; age (OR: 1.067, 95%CI: 1.039-1.096), alcohol consumption (OR: 2.741, 95%CI: 1.169-6.429), antihypertensive agents (OR: 4.577, 95%CI: 1.553-13.492), hip circumference (OR: 1.093, 95%CI: 1.049-1.138), and marital status (OR: 3.615, 95%CI: 1.228-10.644) were the predominant factors influencing DBP. CONCLUSIONS In postmenopausal women, age, BMI, antihypertensive agents, hip circumference, and marital status are associated with SBP changes, while age, alcohol consumption, antihypertensive agents, hip circumference, and marital status with DBP variability. MESH KEYWORDS postmenopausal women, blood pressure, development track, influencing factors, CHNS.
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Affiliation(s)
- Zhonge Tao
- Department of Gynecology, Tianjin First Center Hospital, Tianjin, P.R. China
| | - Quanxin Qu
- Department of Gynecology, Tianjin First Center Hospital, Tianjin, P.R. China
| | - Jing Li
- Department of Gynecology, Tianjin First Center Hospital, Tianjin, P.R. China
| | - Xiaolin Li
- Department of Gynecology, Tianjin First Center Hospital, Tianjin, P.R. China
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15
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Borghi A, De Giorgi A, Monti A, Cappadona R, Manfredini R, Corazza M. Investigating Chronotype and Sleep Quality in Psoriatic Patients: Results from an Observational, Web-Based Survey. J Pers Med 2023; 13:1604. [PMID: 38003919 PMCID: PMC10672655 DOI: 10.3390/jpm13111604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 11/07/2023] [Accepted: 11/08/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Psoriasis is an inflammatory disease for which the implications and repercussions go far beyond the skin. Psoriasis patients suffer not only due to its skin manifestations and related symptoms but also because of comorbidities and a huge emotional impact. OBJECTIVE The objective of this study was to investigate chronotype and sleep quality in a group of Italian psoriatic patients. MATERIALS AND METHODS An observational, cross-sectional, web-based study was set up by the Dermatology and Clinical Medicine Sections of the Department of Medical Sciences, University of Ferrara, Italy. The web questionnaire was sent to an email list of an Italian association of psoriatic patients with the aim of recording their main demographic, social, historical, and clinical data. The survey included two questionnaires: the Morningness-Eveningness Questionnaire (MEQ) and the Pittsburg Sleep Quality Index (PSQI). RESULTS Two hundred and forty-three psoriatic patients (mean age 52.9 ± 12.8 yrs., 32.5% males and 67.5% females) filled out the questionnaire. A good 63.8% of them were affected with psoriasis for more than 10 years, 25.9% reported having a diffuse psoriasis, and 66.7% were on treatment at the time they completed the questionnaire. With reference to chronotype, the mean MEQ score was 55.2 ± 10.7; furthermore, 44% of the patients were "morning-oriented types", M-types, or "larks", 44.5% were "intermediate-types" or I-types, and 11.5% were "evening-oriented types", E-types, or "owls". No correlations were found between chronotype and psoriasis extension. Based on the PSQI results, 72.8% of the study population was judged to have a low sleep quality. Sleep disturbance was significantly related to female sex, living alone, and the presence of comorbidities. CONCLUSIONS Sleep disturbance is very common in psoriatic patients, especially in those with comorbidities, in females, and in patients who live alone. The chronotype in psoriatic patients does not appear different when compared to the general population, nor does it seem to have any link with psoriasis severity.
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Affiliation(s)
- Alessandro Borghi
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Alfredo De Giorgi
- Clinical Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy;
| | - Alberto Monti
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Rosaria Cappadona
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Roberto Manfredini
- Clinical Medicine Unit, Department of Medicine, Azienda Ospedaliero-Universitaria S. Anna, 44124 Ferrara, Italy;
- University Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Monica Corazza
- Section of Dermatology and Infectious Diseases, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
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Tu CY, Chiu MR, Wang YW, Hsu CY, Chen YY, Chang SS. Association of Body Mass Index and Cardiometabolic Factors With Elderly Suicide: A Cohort Study of 101,518 Older Taiwanese. Am J Geriatr Psychiatry 2023; 31:965-977. [PMID: 37258341 DOI: 10.1016/j.jagp.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 04/25/2023] [Accepted: 05/02/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Older people have the highest suicide rate across age groups in most countries. The prevalence of cardiometabolic risk factors also increases with age. We investigated the association between body mass index (BMI), cardiometabolic risk factors, and suicide in a large cohort of older people in Taiwan. METHODS We conducted a cohort study using data from an elderly health examination program in Taipei City, Taiwan (2005-2010), linked to the national cause-of-death data files. We used competing risk Cox regression models to investigate the associations of BMI (kg/m2) and cardiometabolic factors with suicide after adjusting for sex, age, socioeconomic variables, chronic diseases, psychological distress, and cognitive function. RESULTS Among 101,518 individuals aged ≥ 65 years, 92 died by suicide during an average follow-up of 3.9 years. Underweight (BMI<18.5) was associated with increased suicide risk (adjusted hazard ratio [aHR]=2.33, 95% confidence interval [CI] 1.20-4.52) (reference: normal weight). Low diastolic blood pressure was associated with increased suicide risk - aHR was 0.51 (95% CI 0.29-0.91) and 0.55 (95% CI 0.31-0.99) for the third and fourth quartiles of diastolic blood pressure (reference: the lowest quartile), respectively. Older people with a higher waist circumference (aHR per 1-standard-deviation increase=0.60 [95% CI 0.37-0.98]) and a higher number of metabolic syndrome criteria (aHR per 1-criterion increase=0.65 [95% 0.46-0.92]) had lower suicide risk. Systolic blood pressure, pulse rate, fasting blood glucose, and lipid profiles were not associated with suicide risk. CONCLUSIONS Underweight, low diastolic blood pressure, and low waist circumference may be markers of increased suicide risk in older people.
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Affiliation(s)
- Chao-Ying Tu
- Department of Psychiatry (C-YT), National Taiwan University Hospital Yunlin Branch, Yunlin County, Taiwan; Department of Psychiatry (C-YT), College of Medicine, National Taiwan University, Taipei City, Taiwan; Institute of Health Policy and Management (C-YT), College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Meng-Rou Chiu
- Department of Occupational Therapy (M-RC), Yonghe Cardinal Tien Hospital, New Taipei City, Taiwan; Institute of Health Behaviors and Community Sciences (M-RC, S-SC), College of Public Health, National Taiwan University, Taipei City, Taiwan
| | - Yi-Wen Wang
- Department of Psychiatry, School of Medicine (Y-WW, C-YH), College of Medicine, Taipei Medical University, Taipei City, Taiwan
| | - Chia-Yueh Hsu
- Department of Psychiatry, School of Medicine (Y-WW, C-YH), College of Medicine, Taipei Medical University, Taipei City, Taiwan; Department of Psychiatry, Wan Fang Hospital (C-YH), Taipei Medical University, Taipei City, Taiwan; Psychiatric Research Center, Wan Fang Hospital (C-YH, S-SC), Taipei Medical University, Taipei City, Taiwan
| | - Ying-Yeh Chen
- Taipei City Psychiatric Center (Y-YC), Taipei City Hospital, Taipei City, Taiwan; Institute of Public Health and Department of Public Health (Y-YC), National Yang Ming Chiao Tung University, Taipei City, Taiwan
| | - Shu-Sen Chang
- Institute of Health Behaviors and Community Sciences (M-RC, S-SC), College of Public Health, National Taiwan University, Taipei City, Taiwan; Psychiatric Research Center, Wan Fang Hospital (C-YH, S-SC), Taipei Medical University, Taipei City, Taiwan.
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Blakoe M, Petrova D, Garcia-Retamero R, Gonçalves K, Catena A, Ramírez Hernández JA, Sánchez MJ. Sex Moderates the Relationship Between Social Support and Cardiovascular Prevention Behaviors in Middle-aged and Older Adults. Ann Behav Med 2023; 57:877-887. [PMID: 37357373 DOI: 10.1093/abm/kaad030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023] Open
Abstract
BACKGROUND Most risk factors for cardiovascular disease (CVD) are modifiable, suggesting that the burden of CVD could be substantially reduced through cardiovascular screening and healthier lifestyle. People who have social support are more likely to adhere to cardiovascular prevention recommendations, but it is not clear whether the benefit of social support is equal for men and women. PURPOSE We investigated whether sex moderates the relationship between social support and adherence to cardiovascular prevention recommendations in a nationally representative sample. METHODS Participants were 17,287 adults (n = 10,264 middle-aged adults 40-64 years old and n = 7,023 older adults ≥ 65 years old) who participated in the National Health Survey of Spain in 2017. Social support was measured with the Functional Social Support Questionnaire of Duke-UNC. Adherence to cardiovascular screening recommendations was assessed based on self-reported testing of cholesterol, blood pressure, and blood sugar by a health professional in the past 12 months. Adherence to recommended health-related behaviors was assessed based on the guidelines of the European Society of Cardiology regarding diet, alcohol consumption, smoking, and physical activity. RESULTS Multiple regression models adjusted for socio-demographic and cardiovascular history and risk variables showed that social support was more strongly associated with adherence to cardiovascular prevention recommendations in men than in women. In particular, low social support levels were especially detrimental for both middle-aged men (screening: B = 0.13, 95% CI [0.06-0.20], p < .001; behaviors: B = 0.33 [0.26-0.41], p < .001) and older men (screening: B = 0.10 [0.04-0.17], p = .001; behaviors: B = 0.16 [0.08-0.25], p < .001), whereas older women had comparatively high adherence, which was unrelated to social support (screening: B = 0.02 [-0.03 to 0.08], p = .433; behaviors: B = 0.03 [-0.03 to 0.10], p = .342). CONCLUSIONS Social support is more strongly associated with cardiovascular prevention in men than in women, such that men who lack social support have the lowest adherence to cardiovascular screening and lifestyle recommendations.
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Affiliation(s)
- Mitti Blakoe
- Department of Cardiology, Rigshospitalet, The Heart Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Dafina Petrova
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Rocio Garcia-Retamero
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - Karen Gonçalves
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
| | - Andrés Catena
- Mind, Brain, and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | | | - Maria José Sánchez
- Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain
- Escuela Andaluza de Salud Pública (EASP), Granada, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
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Lin B, Zhang Z, Zhang W, Zhang C, Xue L, An B, Wang K. Associations of physical activity types and intensity with cardiovascular diseases by age and gender among 18,730 Chinese adults. Sci Rep 2023; 13:14623. [PMID: 37670128 PMCID: PMC10480160 DOI: 10.1038/s41598-023-41768-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 08/31/2023] [Indexed: 09/07/2023] Open
Abstract
The associations of physical activity (PA) intensity and types with CVD (cardiovascular diseases) in different population are inconsistent and remains not very clear. A total of 7854 males and 10,876 females over 15 years were selected by multistage random sampling methods. In males, moderate-intensity physical activity (MPA) had no effect, while vigorous-intensity physical activity (VPA) played a significant protective role (OR = 1.319 and 0.615). However, in females, both MPA and VPA had significant protective effects (OR = 0.593 and 0.537). VPA presented as a significant protective factor in stroke patients and combined CVDs for males in all age groups; however, in females, the results suggested that, for those aged over 60-74 years, MPA was a protective factor. Furthermore, for the middle-aged or younger participants, the area under the curves (AUCs) of work, housework, and leisure activity were generally higher than that of other types, while for patients aged over 60 years, the AUCs of sedentary time and sleep activity seemed much higher. VPA had a better protective effect for preventing cardiovascular events, while the young and female population could benefit from MPA as well. Regardless of the types of PA, leisure activities were strongly recommended, and young people were much more likely to benefit from exercise than older people.
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Affiliation(s)
- Beilei Lin
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Zhenxiang Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Weihong Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Chunhui Zhang
- Nursing and Health School of Zhengzhou University, Zhengzhou, China
| | - Lihong Xue
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Baoxia An
- Huaxian People Hospital of Henan Province, Anyang, China
| | - Kaijuan Wang
- Public Health School of Zhengzhou University, Zhengzhou, China.
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Hines AL, Albert MA, Blair JP, Crews DC, Cooper LA, Long DL, Carson AP. Neighborhood Factors, Individual Stressors, and Cardiovascular Health Among Black and White Adults in the US: The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study. JAMA Netw Open 2023; 6:e2336207. [PMID: 37773494 PMCID: PMC10543067 DOI: 10.1001/jamanetworkopen.2023.36207] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/23/2023] [Indexed: 10/01/2023] Open
Abstract
Importance Chronic stress has been posited to contribute to racial disparities in cardiovascular health. Investigation of whether neighborhood- and individual-level stressors mediate this disparity is needed. Objective To examine whether racial differences in ideal cardiovascular health (ICH) are attenuated by experiences with neighborhood- and individual-level stressors within a racially and geographically diverse population sample. Design, Setting, and Participants This cross-sectional study examined data from 7720 participants in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study who completed the second in-home visit (2013-2016). The REGARDS study is a population-based, longitudinal study of 30 239 non-Hispanic Black and non-Hispanic White adults aged 45 years or older at baseline (2003-2007). Data for the present study were analyzed from June to July 2021 and in March 2022. Exposures Neighborhood physical environment (eg, excessive noise, violence; scored from 7-28, with higher scores indicating more problems), neighborhood safety (scored as very safe, safe, or not safe), neighborhood social cohesion (eg, shared values; scored from 5-25, with higher scores indicating higher cohesion), perceived stress (eg, coping; scored from 0-16, with higher scores indicating greater perceived stress), and the experience of discrimination (yes or no). Main Outcomes and Measures Ideal cardiovascular health (ICH), measured as a composite of 4 health behaviors (cigarette smoking, diet, physical activity, body mass index) and 3 health factors (blood pressure, cholesterol, and glucose levels). Results The sample included 7720 participants (mean [SD] age, 71.9 [8.3] years; 4390 women [56.9%]; 2074 Black participants [26.9%]; and 5646 White participants [73.1%]). Black participants compared with White participants reported higher perceived stress (mean [SD] score, 3.2 [2.8] vs 2.8 [2.7]) and more often reported discrimination (77.0% vs 24.0%). Black participants also reported poorer neighborhood physical environment (mean [SD] score, 11.2 [3.8] vs 9.8 [2.9]) and social cohesion (mean [SD] score, 15.5 [2.0] vs 15.7 [1.9]) and more often reported their neighborhoods were unsafe (54.7% vs 24.3%). The odds of having a high total ICH score (ie, closer to ideal) were lower for Black adults compared with White adults, both overall (adjusted odds ratio [AOR], 0.53; 95% CI, 0.45-0.61) and by gender (men: AOR, 0.73 [95% CI, 0.57-0.93]; women: AOR, 0.45 [95% CI, 0.37-0.54]). In mediation analyses, the racial disparity in total ICH score was attenuated by neighborhood physical environment (5.14%), neighborhood safety (6.27%), neighborhood social cohesion (1.41%), and discrimination (11.01%). In stratified analyses, the factors that most attenuated the racial disparity in total ICH scores were neighborhood safety among men (12.32%) and discrimination among women (14.37%). Perceived stress did not attenuate the racial disparity in total ICH scores. Conclusions and Relevance In this cross-sectional study of Black and White US adults aged 45 years and older, neighborhood-level factors, including safety and physical and social environments, and individual-level factors, including discrimination, attenuated racial disparities in cardiovascular health. Interventional approaches to improve ICH that separately target neighborhood context and discrimination by gender and race are warranted.
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Affiliation(s)
- Anika L. Hines
- Department of Health Behavior and Policy, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Michelle A. Albert
- Department of Medicine, University of California, San Francisco, San Francisco
| | - Jessica P. Blair
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham
| | - Deidra C. Crews
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Lisa A. Cooper
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - D. Leann Long
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham
| | - April P. Carson
- Department of Medicine, University of Mississippi Medical Center, Jackson
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20
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Alhazmi L, El-Setouhy M, Hobani AH, Jarram RE, Zaylaee MJ, Hazazi RS, Nasib MA, Musawa AA, Hakami AY, Mahfouz MS, Oraibi O. Prevalence and Awareness of Hypertension among a Rural Jazan Population. Healthcare (Basel) 2023; 11:1676. [PMID: 37372793 DOI: 10.3390/healthcare11121676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2023] [Revised: 05/22/2023] [Accepted: 06/03/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND Hypertension (HTN) is a major global public health problem. Knowledge of the risk factors and repercussions of HTN is crucial to preventing the disease. Rural populations have lower levels of knowledge of the disease than urban populations. However, no studies have assessed the levels of awareness of HTN and their determinants in rural regions of Saudi Arabia. OBJECTIVES This study aimed to assess the awareness of HTN and its determinants among a rural population of Jazan region, Saudi Arabia. METHODOLOGY We conducted a cross-sectional analytical study among six primary healthcare centers selected randomly from the rural areas of Jazan region. We targeted all Saudi adults visiting these centers. Information was gathered using interview questionnaires completed by 607 people. SPSS was utilized to analyze the collected data. RESULTS In all population groups, the prevalence of diagnosed HTN increased with age, particularly gradually increasing in those aged younger than 40 years and then rapidly and sharply increasing in those aged 40 years and over. The women (43.3%) had a higher prevalence of HTN than the men (34.6%), which is comparable with findings in other areas in Saudi Arabia and the Middle East. Approximately 65.6% of the participants without HTN and 34.4% of the participants with HTN did not know their normal blood pressure. Approximately 61.7% of the participants without HTN and 59.0% of the participants with HTN felt that pharmaceuticals are insufficient in curing HTN, while 60.7% and 64.7% believed that HTN can be cured. CONCLUSIONS The global prevalence of HTN is increasing annually owing to rapid changes in lifestyle and dietary habits. Furthermore, because adherence to antihypertensives is poor in rural Jazan, the Ministry of Health and researchers advocate implementing a program to increase awareness and assess patient adherence to prescribed medication for the control of HTN.
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Affiliation(s)
- Luai Alhazmi
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Maged El-Setouhy
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | | | - Raed E Jarram
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohsen J Zaylaee
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Rakan S Hazazi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohammed A Nasib
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Ammar A Musawa
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Atheer Y Hakami
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Mohamed S Mahfouz
- Department of Family and Community Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
| | - Omar Oraibi
- Department of Medicine, Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia
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21
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Wang L, Yi Z. Marital status and all-cause mortality rate in older adults: a population-based prospective cohort study. BMC Geriatr 2023; 23:214. [PMID: 37016371 PMCID: PMC10074686 DOI: 10.1186/s12877-023-03880-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 03/09/2023] [Indexed: 04/06/2023] Open
Abstract
BACKGROUND Living with a partner and separation is becoming more common among older people. Mortality disparities associated with marital status are significant in increasingly diverse aging populations. The link between marital status and all-cause mortality risk in older adults remains uncertain. METHODS This prospective cohort study included data from the US National Health and Nutrition Examination Survey (NHANES). We included NHANES participants ≥ 60 years of age (data from 1999 to 2014). Data for mortality follow-up beginning from the commencement date of survey participation to the last day of December 2015. Univariate- and multivariate-adjusted Cox proportional hazard models for marital status were estimated, and the findings were presented as regression coefficients and 95% confidence intervals (CI). Kaplan-Meier curves were reported. RESULTS Compared to never married individuals, the risk of all-cause mortality was 0.77 (0.50-1.18), 0.72 (0.56-0.93), 0.56 (0.36-0.88), and 0.84 (0.67-1.07) in those people living with a partner, married, separated, and divorced, respectively, after adjusting for demographics, socioeconomics, behavior, anthropometric variables, and medical history. The risk of all-cause mortality was 1.24 (0.97-1.59) in widowed participants. CONCLUSION This population-based cohort study included a large sample size followed by long-term follow-up. The association between marriage, health, and reduced mortality in older individuals has been illustrated in this study. Being married or separated was associated with a lower risk of mortality.
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Affiliation(s)
- Lei Wang
- Department of Cardiology, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, 100049, Beijing, PR China
| | - Zhong Yi
- Department of Geriatric Medicine, Aerospace Center Hospital, 15 Yuquan Road, Haidian District, 100049, Beijing, PR China.
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22
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Topçu S, Ardahan M. Risk perception of cardiovascular disease among Turkish adults: a cross-sectional study. Prim Health Care Res Dev 2023; 24:e23. [PMID: 36971003 DOI: 10.1017/s1463423623000117] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023] Open
Abstract
AIM The aim of the study was to determine in adults the risk perception for cardiovascular disease (CVD) and the associated factors. BACKGROUND CVDs are the leading cause of death globally. In adults, perceptions related to the risk for CVDs have a considerable effect on decision-making processes related to one's own health. METHODS A cross-sectional study was conducted with 453 adult people from April to June 2019 in İzmir, Turkey. Data were collected with a sociodemographic characteristics questionnaire, perception of risk of heart disease scale (PRHDS), and health perception. FINDINGS The mean PRHDS score of adults was 48.88 ± 8.12. The risk perception for CVD was influenced by variables that were age, gender, education, marital status, employment status, health perception, familial cardiovascular disease history, chronic disease status, smoking status, and body mass index. Although CVDs are the most prominent cause of disease-related death in the world, risk perception for CVD was found to be low among the individuals included in this study. This finding indicates the importance of informing individuals about CVD risk factors, raising awareness, and training.
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Affiliation(s)
- Sevcan Topçu
- Nursing Faculty, Ege University, 35030, Izmir, Turkey
| | - Melek Ardahan
- Faculty of Health Sciences, Katip Çelebi University, 35620, Izmir, Turkey
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23
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Zhu C, Tran PM, Leifheit EC, Spatz ES, Dreyer RP, Nyhan K, Wang SY, Lichtman JH. Association of marital/partner status and patient-reported outcomes following myocardial infarction: a systematic review and meta-analysis. EUROPEAN HEART JOURNAL OPEN 2023; 3:oead018. [PMID: 36942107 PMCID: PMC10023828 DOI: 10.1093/ehjopen/oead018] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/07/2023] [Accepted: 02/24/2023] [Indexed: 06/18/2023]
Abstract
AIMS Little is known about the relationship between marital/partner status and patient-reported outcome measures (PROMs) following myocardial infarction (MI). We conducted a systematic review/meta-analysis and explored potential sex differences. METHODS AND RESULTS We searched five databases (Medline, Web of Science, Scopus, EMBASE, and PsycINFO) from inception to 27 July 2022. Peer-reviewed studies of MI patients that evaluated marital/partner status as an independent variable and reported its associations with defined PROMs were eligible for inclusion. Results for eligible studies were classified into four pre-specified outcome domains [health-related quality of life (HRQoL), functional status, symptoms, and personal recovery (i.e. self-efficacy, adherence, and purpose/hope)]. Study quality was appraised using Newcastle-Ottawa Scale, and data were synthesized by outcome domains. We conducted subgroup analysis by sex. We included 34 studies (n = 16 712), of which 11 were included in meta-analyses. Being married/partnered was significantly associated with higher HRQoL {six studies [n = 2734]; pooled standardized mean difference, 0.37 [95% confidence interval (CI), 0.12-0.63], I 2 = 51%} but not depression [three studies (n = 2005); pooled odds ratio, 0.72 (95% CI, 0.32-1.64); I 2 = 65%] or self-efficacy [two studies (n = 356); pooled β, 0.03 (95% CI, -0.09 to 0.14); I 2 = 0%]. The associations of marital/partner status with functional status, personal recovery outcomes, and symptoms of anxiety and fatigue were mixed. Sex differences were not evident due to mixed results from the available studies. CONCLUSIONS Married/partnered MI patients had higher HRQoL than unpartnered patients, but the associations with functional, symptom, and personal recovery outcomes and sex differences were less clear. Our findings inform better methodological approaches and standardized reporting to facilitate future research on these relationships.
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Affiliation(s)
- Cenjing Zhu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06510, USA
| | - Phoebe M Tran
- Department of Public Health, University of Tennessee, 1914 Andy Holt Ave, Knoxville, TN 37996, USA
| | - Erica C Leifheit
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06510, USA
| | - Erica S Spatz
- Center for Outcomes Research and Evaluation, Yale School of Medicine, 195 Church St., 5th Floor, New Haven, CT 06510, USA
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Rachel P Dreyer
- Department of Biostatistics, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
- Department of Emergency Medicine, Yale School of Medicine, 333 Cedar St, New Haven, CT 06510, USA
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, 333 Cedar St, New Haven, CT 06510, USA
- Department of Environmental Health Sciences, Yale School of Public Health, 60 College Street, New Haven, CT 06510, USA
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, 60 College Street, New Haven, CT 06510, USA
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24
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Barriault S, Jbilou J, Charbonneau A, Greenman PS, Grenier J, Chomienne MH. Relationship satisfaction and psychological wellbeing in men having participated in the MindTheHeart® psychoeducation intervention after an acute coronary syndrome. Health Psychol Open 2023; 10:20551029231179165. [PMID: 37273832 PMCID: PMC10233598 DOI: 10.1177/20551029231179165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
This study investigated the associations of relationship satisfaction, depression, and anxiety post-acute coronary syndrome in a sample of men having completed an early, couple-focused, and men-tailored psychoeducation intervention. A baseline sample of 50 male patients were followed over a 12-month period and completed the Couples Satisfaction Index and the Depression, Anxiety and Stress Scale. Results revealed a significant improvement in depression symptoms from T0 to T1, during which all participants completed the MindTheHeart® psychoeducation intervention. In addition, a hierarchical regression analysis showed that relationship satisfaction is an important predictor of this improvement in depression symptoms. Our preliminary findings point to the consideration of life partners in post-ACS interventions and encourage the exploration of this clinical approach in future research.
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Affiliation(s)
| | - Jalila Jbilou
- Université de Moncton, Moncton, NB, Canada
- Centre de Formation Médicale du
Nouveau-Brunswick, Moncton, NB, Canada
| | | | | | - Jean Grenier
- University of Ottawa, Ottawa, ON, Canada
- Institut du Savoir Montfort, Ottawa, ON, Canada
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25
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Dev R, Adams AM, Raparelli V, Norris CM, Pilote L. Sex and Gender Determinants of Vascular Disease in the Global Context. Can J Cardiol 2022; 38:1799-1811. [PMID: 35667597 DOI: 10.1016/j.cjca.2022.05.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/17/2022] [Accepted: 05/29/2022] [Indexed: 12/14/2022] Open
Abstract
Globally, vascular diseases are a leading cause of morbidity and mortality. Many of the most significant risk factors for vascular disease have a gendered dimension, and sex differences in vascular diseases incidence are apparent, worldwide. In this narrative review, we provide a contemporary picture of sex- and gender-related determinants of vascular disease. We illustrate key factors underlying sex-specific risk stratification, consider similarities and sex differences in vascular disease risk and outcomes with comparisons of data from the global North (ie, developed high-income countries in the Northern hemisphere and Australia) and the global South (ie, regions outside Europe and North America), and explore the relationship between country-level gendered inequities in vascular disease risk and the United Nation's gender inequality index. Review findings suggest that the rising incidence of vascular disease in women is partly explained by an increase in the prevalence of traditional risk factors linked to gender-related determinants such as shifting roles and relations related to the double burden of employment and caregiving responsibilities, lower educational attainment, lower socioeconomic status, and higher psychosocial stress. Social isolation partly explained the higher incidence of vascular disease in men. These patterns were apparent across the global North and South. Study findings emphasize the necessity of taking into account sex differences and gender-related factors in the determination of the vascular disease risk profiles and management strategies. As we move toward the era of precision medicine, future research is needed that identifies, validates, and measures gender-related determinants and risk factors in the global South.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Faculty of Applied Science, School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alayne M Adams
- Department of Family Medicine, McGill University, Montreal, Quebec, Canada
| | - Valeria Raparelli
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy; University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada; Faculty of Medicine and School of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada; Cardiovascular and Stroke Strategic Clinical Network, Alberta Health Services, Edmonton, Alberta, Canada
| | - Louise Pilote
- Divisions of General Internal Medicine and Clinical Epidemiology, Department of Medicine, McGill University, Montreal, Quebec, Canada; Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, Quebec, Canada.
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26
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Martin RC. Disparities in Heart Failure Management in Older Adults. CURRENT GERIATRICS REPORTS 2022. [DOI: 10.1007/s13670-022-00378-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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27
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Zhu C, Tran PM, Leifheit EC, Spatz ES, Dreyer RP, Nyhan K, Wang SY, Goldstein LB, Lichtman JH. The association of marital/partner status with patient-reported health outcomes following acute myocardial infarction or stroke: Protocol for a systematic review and meta-analysis. PLoS One 2022; 17:e0267771. [PMID: 36378664 PMCID: PMC9665376 DOI: 10.1371/journal.pone.0267771] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 10/06/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Marital/Partner support is associated with lower mortality and morbidity following acute myocardial infarction (AMI) and stroke. Despite an increasing focus on the effect of patient-centered factors on health outcomes, little is known about the impact of marital/partner status on patient-reported outcome measures (PROMs). OBJECTIVE To synthesize evidence of the association between marital/partner status and PROMs after AMI and stroke and to determine whether associations differ by sex. METHODS AND ANALYSIS We will search MEDLINE (via Ovid), Web of Science Core Collection (as licensed by Yale University), Scopus, EMBASE (via Ovid), and PsycINFO (via Ovid) from inception to July 15, 2022. Two authors will independently screen titles, abstracts, and then full texts as appropriate, extract data, and assess risk of bias. Conflicts will be resolved by discussion with a third reviewer. The primary outcomes will be the associations between marital/partner status and PROMs. An outcome framework was designed to classify PROMs into four domains (health-related quality of life, functional status, symptoms, and personal recovery). Meta-analysis will be conducted if appropriate. Subgroup analysis by sex and meta-regression with a covariate for the proportion of male participants will be performed to explore differences by sex. ETHICS AND DISSEMINATION This research is exempt from ethics approval because the study will be conducted using published data. We will disseminate the results of the analysis in a related peer-reviewed journal. TRIAL REGISTRATION PROSPERO registration number: CRD42022295975.
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Affiliation(s)
- Cenjing Zhu
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Phoebe M. Tran
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Erica C. Leifheit
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Erica S. Spatz
- Center for Outcomes Research and Evaluation, Yale University School of Medicine, New Haven, CT, United States of America
- Department of Internal Medicine, Section of Cardiovascular Medicine, Yale University School of Medicine, New Haven, CT, United States of America
| | - Rachel P. Dreyer
- Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, United States of America
- Department of Emergency Medicine, Yale School of Medicine, New Haven, CT, United States of America
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, CT, United States of America
- Environmental Health Sciences, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States of America
| | - Larry B. Goldstein
- Department of Neurology, University of Kentucky, Lexington, KY, United States of America
| | - Judith H. Lichtman
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, CT, United States of America
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Son M, Heo YJ, Hyun HJ, Kwak HJ. Effects of Marital Status and Income on Hypertension: The Korean Genome and Epidemiology Study (KoGES). J Prev Med Public Health 2022; 55:506-519. [PMID: 36475316 DOI: 10.3961/jpmph.22.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 09/02/2022] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES This study aimed to analyze the associations of income, marital status, and health behaviors with hypertension in male and female over 40 years of age in the Korea. METHODS The data were derived from the Korean Genome and Epidemiology Study (KoGES; 4851-302) which included 211 576 participants. To analyze the relationships of income, marital status, and health behaviors with hypertension in male and female over 40 years of age, multiple logistic regression was conducted with adjustments for these variables. RESULTS The prevalence of hypertension increased linearly as income decreased. The odds ratio for developing hypertension in people with an income of <0.5 million Korean won (KRW) compared to ≥6.0 million KRW was 1.55 (95% confidence interval [CI], 1.25 to 1.93) in the total population, 1.58 (95% CI, 1.27 to 1.98) in male, and 1.07 (95% CI, 0.35 to 3.28) in female. The combined effect of income level and marital status on hypertension was significant. According to income level and marital status, in male, low income and divorce were most associated with hypertension (1.76 times; 95% CI, 1.01 to 3.08). However, in female, the low-income, married group was most associated with hypertension (1.83 times; 95% CI, 1.71 to 1.97). CONCLUSIONS The results of this study show that it is necessary to approach male and female marital status separately according to income in health policies to address inequalities in the prevalence of hypertension.
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Affiliation(s)
- Mia Son
- Department of Preventive Medicine, Kangwon National University School of Medicine, Chuncheon, Korea
| | - Yeon Jeong Heo
- Department of Nursing, Kangwon National University, Chuncheon, Korea
| | - Hye-Jin Hyun
- Department of Nursing, Kangwon National University, Chuncheon, Korea
| | - Ho Jong Kwak
- Department of Nursing, Kangwon National University, Chuncheon, Korea
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29
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Sansone A, Reisman Y, Meto S, Dolci S, Jannini EA. The Role of the "Anti-Inflammatory" Couple for the Management of Hyperuricemia With Deposition. Sex Med 2022; 10:100562. [PMID: 36087454 PMCID: PMC9537271 DOI: 10.1016/j.esxm.2022.100562] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 07/25/2022] [Accepted: 07/26/2022] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION Gout is the most prevalent inflammatory crystal arthropathy worldwide and is a chronic disease requiring strict, lifelong adherence to drug therapy and healthy lifestyles. Gout has a heavy burden on the patient's sexual health, owing to the associated inflammatory status, long-term complications, and chronic pain; however, the effects of gout also extend to the partner's sexual health. AIMS We aimed to investigate how the presence of a partner could influence the complex interaction between risk factors for sexual dysfunctions in gout in order to define novel strategies to improve sexual health and disease management. METHODS Clinical and experimental data on the role of the couple in chronic diseases, as well as on the association between gout and sexual health, were searched through Pubmed. MAIN OUTCOME MEASURES Evidence from studies describing how the presence of a couple and leveraging sexual health can improve management and clinical outcomes for chronic diseases. RESULTS Treatment adherence can improve the sexual health of gout patients and their partners; likewise, by leveraging sexual health, it would be possible to promote better health-seeking behaviors, ultimately improving gout management. CLINICAL IMPLICATIONS Promoting awareness of the sexual health relevance of gout can potentially be a pivotal strategy to improve disease management and prevent the progression of sexual dysfunctions from subclinical to overt forms. STRENGTHS AND LIMITATIONS Identifying a bidirectional association between sexual health and disease management paves the way for improved disease control and can potentially prevent the development of sexual dysfunctions in couples affected by gout. However, the relevance of the couple has not been adequately addressed in gout management, and most evidence comes from other chronic diseases. CONCLUSION Improving gout management results in better sexual health, and vice-versa promoting better sexual health can improve disease control for gout. The presence of a partner improves the behavioral well-being of gout patients, with beneficial effects on both sexual health and gout management. Sansone A, Reisman Y, Meto S, et al. The Role of the "Anti-Inflammatory" Couple for the Management of Hyperuricemia With Deposition. Sex Med 2022;10:100562.
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Affiliation(s)
- Andrea Sansone
- Chair of Endocrinology & Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Suada Meto
- A. Menarini Industrie Farmaceutiche Riunite S.R.L, Florence, Italy
| | - Susanna Dolci
- Chair of Anatomy, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Rome, Italy
| | - Emmanuele A Jannini
- Chair of Endocrinology & Medical Sexology, Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy.
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Vorobeľová L, Falbová D, Candráková Čerňanová V. Contribution of environmental factors and female reproductive history to hypertension and obesity incidence in later life. Ann Hum Biol 2022; 49:236-247. [PMID: 35867530 DOI: 10.1080/03014460.2022.2105398] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Hypertension (HT) and obesity, which are important risk factors for cardiovascular diseases, are complex traits determined by multiple biological and behavioural factors. However, the role of female reproductive history in evaluating HT and obesity is still unclear. AIM To investigate the long-term effects of reproductive factors on the probability of obesity and HT in later life after adjusting for socio-demographic and lifestyle behaviour factors. SUBJECTS AND METHODS A total of 503 women (39 - 65 years) were recruited from different localities in Slovakia. Multivariable logistic regression analyses were performed to test the associations. RESULTS Early menarche age of 11 years and under was associated with twice higher probability of obesity at midlife, independent of environmental confounders (OR = 2.27, CI = 1.35 - 3.81, p = 0.002). Breastfeeding (Bf) women had a lower likelihood of obesity in later life than non-Bf parous women, independent of environmental confounders (OR = 0.35, CI = 0.17 - 0.72, p = 0.004). Finally, age at menarche was associated with obesity-associated HT. CONCLUSION Reproductive factors are significantly associated with obesity and obesity-associated HT in later life. The age at menarche and Bf can be risk factors for early identification of women with increased likelihood of adult cardiovascular risk.
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Affiliation(s)
- Lenka Vorobeľová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
| | - Darina Falbová
- Department of Anthropology, Faculty of Natural Sciences, Comenius University, Bratislava, Slovakia
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Jiafeng L, Pengfei J, Jianwei Y, Tiantang F, Hongbo Y, Junhui S, Lu C. Shape memory properties of 3D‐printed self‐expandable poly(lactic acid) vascular stents with long‐chain branched structures. POLYM ADVAN TECHNOL 2022. [DOI: 10.1002/pat.5840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Li Jiafeng
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Jiang Pengfei
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Yang Jianwei
- China Coal Research Institute Coal Mining Branch Beijing People's Republic of China
- CCTEG Coal Mining Research Institute Beijing People's Republic of China
- State Key Laboratory of Coal Mining and Clean Utilization Beijing People's Republic of China
| | - Fan Tiantang
- College of medical Engineering & the Key Laboratory for Medical Functional Nanomaterials Jining Medical University Jining People's Republic of China
| | - Yang Hongbo
- Department of Cardiology, Zhongshan Hospital Fudan University, Shanghai Institute of Cardiovascular Diseases Shanghai China
| | - Sui Junhui
- The Key Laboratory of Biomedical Material, School of Life Science and Technology Xinxiang Medical University Xinxiang People's Republic of China
| | - Cao Lu
- Department of Orthopedic Surgery, Zhongshan Hospital Fudan University Shanghai People's Republic of China
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Factors Associated with Self-Reported Chronic Diseases of Syrian Refugees in Turkey. Ann Glob Health 2022; 88:62. [PMID: 35974984 PMCID: PMC9336782 DOI: 10.5334/aogh.3794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/03/2022] [Indexed: 11/20/2022] Open
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Newell P, Hirji S, Malarczyk A, Yazdchi F, Percy E, Harloff M, McGurk S, Shah P, Sabe A, Sobieszczyk P, Kaneko T. Marital Status and Sex-Based Differences in Outcomes After Transcatheter Aortic Valve Implantation. Am J Cardiol 2022; 173:106-111. [PMID: 35361479 DOI: 10.1016/j.amjcard.2022.02.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 02/15/2022] [Accepted: 02/18/2022] [Indexed: 11/01/2022]
Abstract
Studies have shown improved outcomes among married patients who underwent cardiovascular surgery; however, this has not been well studied in transcatheter aortic valve implantation (TAVi). We examined the impact of marital status and patient sex on outcomes after TAVi. Patients who underwent TAVi from January 2015 to June 2018 were reviewed and stratified into 3 groups: single, married, and widowed. The impact of marital status and sex on 30-day outcomes was assessed using a stepwise logistic regression analysis. Cumulative survival was estimated using Kaplan-Meier analysis and adjusted survival with multivariable Cox proportional hazards modeling. A total of 785 patients were included: 149 single, 413 married, and 223 widowed. Widowed patients were older (84 vs 79 years) with higher Society of Thoracic Surgeons risk scores (6.79% vs 5.51%, both p ≤0.001) than married patients. Neither marital status nor sex was associated with 30-day mortality or home discharge. However, 1-year survival revealed a differential survival penalty, with married females (p = 0.041) having lower survival and married males (p = 0.007) having higher survival than their single counterparts. This survival penalty persisted in the adjusted analyses (married females hazard ratio [HR] 2.24, p = 0.009; widowed males HR 2.42, p = 0.057). For patients who were readmitted in the first year, adjusted analysis showed widowed status was associated with higher 30-day readmissions (HR 1.91, p = 0.012) in both sexes. In conclusion, these findings suggest that marital status does not impact both sexes equally after TAVi; identifying at-risk patients and targeted interventions, such as adjusting discharge planning to ensure adequate home social support, may help improve outcomes.
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Smith TW. Intimate Relationships and Coronary Heart Disease: Implications for Risk, Prevention, and Patient Management. Curr Cardiol Rep 2022; 24:761-774. [PMID: 35380384 PMCID: PMC8981884 DOI: 10.1007/s11886-022-01695-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/24/2022] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW Research and clinical services addressing psychosocial aspects of coronary heart disease (CHD) typically emphasize individuals, focusing less on the context of intimate relationships such as marriage and similar partnerships. This review describes current evidence regarding the role of intimate relationships in the development, course, and management of CHD. RECENT FINDINGS Having an intimate partner is associated with reduced risk of incident CHD and a better prognosis among patients, but strain (e.g., conflict) and disruption (i.e., separation, divorce) in these relationships are associated with increased risk and poor outcomes. These associations likely reflect mechanisms involving health behavior and the physiological effects of emotion and stress. Importantly, many other well-established psychosocial risk and protective factors (e.g., low SES, job stress, depression, and optimism) are strongly related to the quality of intimate relationships, and these associations likely contribute to the effects of those other psychosocial factors. For better or worse, intimate partners can also affect the outcome of efforts to alter health behaviors (physical activity, diet, smoking, and medication adherence) central in the prevention and management CHD. Intimate partners also influence-and are influenced by-stressful aspects of acute coronary crises and longer-term patient adjustment and management. Evidence on each of these roles of intimate relationships in CHD is considerable, but direct demonstrations of the value of couple assessments and interventions are limited, although preliminary research is promising. Research needed to close this gap must also address issues of diversity, disparities, and inequity that have strong parallels in CHD and intimate relationships.
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Affiliation(s)
- Timothy W Smith
- Department of Psychology, University of Utah, Salt Lake City, UT, USA.
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Silventoinen K, Korhonen K, Martikainen P. Changing associations of coronary heart disease incidence with current partnership status and marital history over three decades. SSM Popul Health 2022; 18:101080. [PMID: 35372659 PMCID: PMC8971638 DOI: 10.1016/j.ssmph.2022.101080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 02/01/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022] Open
Abstract
Married men and women have better health than non-married, but little is known about how cohabitation and marital history are associated with coronary heart disease (CHD) incidence and how these associations have changed over time. We analyzed these associations by fitting Cox regression models to register data covering the whole Finnish population aged 35 years or older (N = 4,415,590), who experienced 530,560 first time non-fatal or fatal CHD events during the years 1990-2018. Further, we used stratified Cox regression models to analyze CHD incidence within same-sex sibling pairs (N = 377,730 pairs). Married men and women without previous divorce had the lowest CHD incidence whereas cohabitation and a history of divorce were associated with higher CHD incidence. The associations were stronger in younger (35-64 years old) than older participants (65 years or older). These associations remained after adjusting for several indicators of social position, and the lower CHD incidence among those married without previous divorce was also observed within sibling pairs with a shared family background. The differences in CHD incidence between the categories generally widened over time; the largest and most systematic widening was observed among women in the younger age category. The long standing negative effect of divorce suggests that selection may partly explain the association between partnership status and CHD incidence. Partnership status is an increasingly important factor contributing to social inequalities in health.
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Affiliation(s)
- Karri Silventoinen
- University of Helsinki, Faculty of Social Sciences, Population Research Unit, Finland
- University of Helsinki, Faculty of Medicine, Department of Public Health, Finland
| | - Kaarina Korhonen
- University of Helsinki, Faculty of Social Sciences, Population Research Unit, Finland
| | - Pekka Martikainen
- University of Helsinki, Faculty of Social Sciences, Population Research Unit, Finland
- Stockholm University, Department of Public Health Sciences, Sweden
- Max-Planck-Institute for Demographic Research, Germany
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Karboub K, Tabaa M. A Machine Learning Based Discharge Prediction of Cardiovascular Diseases Patients in Intensive Care Units. Healthcare (Basel) 2022; 10:healthcare10060966. [PMID: 35742018 PMCID: PMC9222879 DOI: 10.3390/healthcare10060966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 05/03/2022] [Accepted: 05/09/2022] [Indexed: 01/12/2023] Open
Abstract
This paper targets a major challenge of how to effectively allocate medical resources in intensive care units (ICUs). We trained multiple regression models using the Medical Information Mart for Intensive Care III (MIMIC III) database recorded in the period between 2001 and 2012. The training and validation dataset included pneumonia, sepsis, congestive heart failure, hypotension, chest pain, coronary artery disease, fever, respiratory failure, acute coronary syndrome, shortness of breath, seizure and transient ischemic attack, and aortic stenosis patients’ recorded data. Then we tested the models on the unseen data of patients diagnosed with coronary artery disease, congestive heart failure or acute coronary syndrome. We included the admission characteristics, clinical prescriptions, physiological measurements, and discharge characteristics of those patients. We assessed the models’ performance using mean residuals and running times as metrics. We ran multiple experiments to study the data partition’s impact on the learning phase. The total running time of our best-evaluated model is 123,450.9 mS. The best model gives an average accuracy of 98%, highlighting the location of discharge, initial diagnosis, location of admission, drug therapy, length of stay and internal transfers as the most influencing patterns to decide a patient’s readiness for discharge.
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Affiliation(s)
- Kaouter Karboub
- FRDISI, Hassan II University Casablanca, Casablanca 20000, Morocco
- LRI-EAS, ENSEM, Hassan II University Casablanca, Casablanca 20000, Morocco
- LGIPM, Lorraine University, 57000 Metz, France
- Correspondence: (K.K.); (M.T.); Tel.: +212-661-943-174 (M.T.)
| | - Mohamed Tabaa
- LPRI, EMSI, Casablanca 23300, Morocco
- Correspondence: (K.K.); (M.T.); Tel.: +212-661-943-174 (M.T.)
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Li C, Xu F, Han D, Zheng S, Ma W, Yang R, Wang Z, Liu Y, Lyu J. Developing and verifying a multivariate model to predict the survival probability after coronary artery bypass grafting in patients with coronary atherosclerosis based on the MIMIC-III database. Heart Lung 2022; 52:61-70. [PMID: 34875570 DOI: 10.1016/j.hrtlng.2021.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Coronary atherosclerosis is one of the main cardiovascular diseases affecting the global population. Coronary artery bypass grafting (CABG) is commonly used to improve the survival probability of patients with coronary atherosclerosis. However, the prognosis of patients after CABG remains unclear. OBJECTIVES We aimed to construct a novel nomogram comprising readily available indicators to predict the 1-, 2-, and 3-year survival rates after CABG in patients with coronary atherosclerosis. METHODS We utilized the Medical Information Mart for Intensive Care III (MIMIC-III) database for the study. The calibration plot, concordance index (C-index), net reclassification index (NRI), integrated discrimination improvement (IDI), and area under the receiver operating characteristic curve (AUROC) were used to evaluate the performance of the model, and to compare the nomogram with the Sequential Organ Failure Assessment (SOFA) score and Simplified Acute Physiology Score II (SAPS II) in order to illustrate the clinical effectiveness of the model. RESULTS The multivariate Cox regression model showed that age, marital status, body mass index, creatinine, platelet count, red cell distribution width, heart rate, intensive-care unit stay time, and Elixhauser Comorbidity Index were risk factors. The C-indexes of the nomogram exceeded 0.75, and its NRI and IDI were both higher than 0. The AUROCs were larger for the nomogram than for the SAPS II and SOFA score. CONCLUSION Our new nomogram is a personalized tool that helps clinicians choose treatment options and predict the long-term prognosis of patients.
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Affiliation(s)
- Chengzhuo Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China
| | - Fengshuo Xu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China
| | - Didi Han
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China
| | - Shuai Zheng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Shaanxi University of Chinese Medicine, Shaanxi 712046, China
| | - Wen Ma
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China
| | - Rui Yang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China; Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Shaanxi 710061, China
| | - Zichen Wang
- Department of Public Health, University of California, Irvine, CA 92697, United States
| | - Yue Liu
- Xiyuan Hospital of China Academy of Chinese Medicinal Sciences, Beijing 100091, China.
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangdong 510630, China; School of Public Health, Xi'an Jiaotong University Health Science Center, Shaanxi 710061, China.
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Dev R, Raparelli V, Pilote L, Azizi Z, Kublickiene K, Kautzky-Willer A, Herrero MT, Norris CM. Cardiovascular health through a sex and gender lens in six South Asian countries: Findings from the WHO STEPS surveillance. J Glob Health 2022; 12:04020. [PMID: 35265330 PMCID: PMC8876159 DOI: 10.7189/jogh.12.04020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Background Sex and gender-based differences in cardiovascular health (CVH) has been explored in the context of high-income countries. However, these relationships have not been examined in low- and middle-income countries. The main aim of this study was to examine how sex and gender-related factors are associated with cardiovascular risk factors of people in South Asian countries. Methods We conducted a retrospective analysis of the World Health Organization’s “STEPwise approach to surveillance of risk factors for non-communicable disease” or “STEPS” from six South Asian countries, surveys conducted between 2014-2019. The main outcomes were CVH as measured by a composite measure of STEPS-HEART health index (smoking, physical activity, fruit and vegetable consumption, overweight/obesity, diabetes and hypertension), values ranging from 0 (worst) to 6 (best or ideal) and self-reported occurrence of cardiovascular disease (ie, heart attack and stroke). Multivariate linear and logistic regression models were performed. Multiple imputation with chained equations was performed. Results The final analytic sample consisted of 33 106 participants (57.5% females). The mean STEPS-HEART index score in the South Asian population was 3.43 [SD: 0.92]. Female sex (β: 0.05, 95% confidence interval (CI) = 0.01-0.08, P < 0.05) was significantly associated with better CVH compared to males. Being married (βmale = -0.30, 95% CI = -0.37, -0.23 vs βfemale = -0.23, 95% CI = -0.29, -0.17; P < 0.001) and having a household size ≥5 (βmale = -0.15, 95% CI = -0.24, -0.06 vs βfemale = -0.11, 95% CI = -0.16, -0.04; P < 0.01) were associated with poorer CVH, more so in males. Being married was also associated with high risk of CVD (ORmale = 2.54, 95% CI = 1.68-3.86, P < 0.001 vs ORfemale = 1.19, 95% CI = 0.84-1.68, P = 0.31), significant in males. Conclusions Among the South Asian population, being female may be advantageous in having an ideal CVH. However, gender-related factors such as marital status and large household size were associated with poorer CVH and greater risk of CVD, regardless of sex.
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Affiliation(s)
- Rubee Dev
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Valeria Raparelli
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- University Center for Studies on Gender Medicine, University of Ferrara, Ferrara, Italy
| | - Louise Pilote
- Research Institute of McGill University Health Centre, Division of Clinical Epidemiology McGill University, Montreal, Quebec, Canada
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Zahra Azizi
- Centre for Outcomes Research and Evaluation, McGill University Health Centre Research Institute, Montreal, QC, Canada
| | - Karolina Kublickiene
- Department of Clinical Science, Intervention & Technology (CLINTEC), Section for Renal Medicine, Karolinska Institute and Karolinska University hospital, Stockholm, Sweden
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, and Gender Institute, Iapura, Gars am Kamp, Austria
| | - Maria Trinidad Herrero
- Clinical & Experimental Neuroscience (NiCE-IMIB-IUIE), School of Medicine. University of Murcia, Murcia, Spain
| | - Colleen M Norris
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
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Castro PR, Abreu RM, Kochergin CN, Medeiros DSD, Soares DA, Louzado JA, Silva KO, Cortes ML, Mistro S, Bezerra VM, Amorim WW, Oliveira MG. Industry workers with hypertension and diabetes mellitus, the prevalence of self-reported adherence, and disease control. BRAZ J PHARM SCI 2022. [DOI: 10.1590/s2175-97902022e20153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Mo YH, Su YD, Dong X, Zhong J, Yang C, Deng WY, Yao XM, Liu BB, Wang XH. Development and Validation of a Nomogram for Predicting Sarcopenia in Community-Dwelling Older Adults. J Am Med Dir Assoc 2021; 23:715-721.e5. [PMID: 34932988 DOI: 10.1016/j.jamda.2021.11.023] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 11/16/2021] [Accepted: 11/18/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To establish and validate a nomogram that predicts the risk of sarcopenia for community-dwelling older residents. DESIGN Retrospective study. SETTING AND PARTICIPANTS A total of 1050 community-dwelling older adults. METHODS Data from a survey of community-dwelling older residents (≥60 years old) in Hunan, China, from June to September 2019 were retrospectively analyzed. The survey included general demographic information, diet, and exercise habits. Sarcopenia diagnosis was according to 2019 Asian Working Group for Sarcopenia criteria. Participants were randomly divided into the development group and validation groups. Independent risk factors were screened by multivariate logistic regression analysis. Based on the independent risk factors, a nomogram model was developed to predict the risk of sarcopenia for community-dwelling older adults. Both in the development and validation sets, the discrimination, calibration, and clinical practicability of the nomogram were verified using receiver operating characteristic curve analysis, Hosmer-Lemeshow test, and decision curve analysis, respectively. RESULTS Sarcopenia was identified in 263 (25.0%) participants. Age, body mass index, marital status, regular physical activity habit, uninterrupted sedentary time, and dietary diversity score were significant contributors to sarcopenia risk. A nomogram for predicting sarcopenia in community-dwelling older adults was developed using these factors. Receiver operating characteristic curve analysis showed that the area under the curve was 0.827 (95% CI 0.792-0.860) and 0.755 (95% CI 0.680-0.837) in the development and validation sets, respectively. The Hosmer-Lemeshow test yielded P values of .609 and .565, respectively, for the 2 sets. The nomogram demonstrated a high net benefit in the clinical decision curve in both sets. CONCLUSIONS AND IMPLICATIONS This study developed and validated a risk prediction nomogram for sarcopenia among community-dwelling older adults. Sarcopenia risk was classified as low (<11%), moderate (11%-70%), and high (>70%). This nomogram provides an accurate visual tool to medical staff, caregivers, and older adults for prediction, early intervention, and graded management of sarcopenia.
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Affiliation(s)
- Yi-Han Mo
- Cicely Saunders Institute of Palliative Care, Policy and Rehabilitation, Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, United Kingdom.
| | - Yi-Dong Su
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xin Dong
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Jing Zhong
- The Third Xiangya Hospital of Central South University, Changsha, China
| | - Chen Yang
- The Nethersole School of Nursing, Faculty of Medicine, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wen-Yu Deng
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xue-Mei Yao
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Bei-Bei Liu
- Xiangya Nursing School, The Central South University, Changsha, China
| | - Xiu-Hua Wang
- Xiangya Nursing School, The Central South University, Changsha, China.
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Pou SA, Diaz MDP, Velázquez GA, Aballay LR. Sociodemographic disparities and contextual factors in obesity: updated evidence from a National Survey of Risk Factors for Chronic Diseases. Public Health Nutr 2021; 25:1-13. [PMID: 34924081 PMCID: PMC9991557 DOI: 10.1017/s1368980021004924] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/14/2021] [Accepted: 12/16/2021] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To assess the association of sociodemographic and environmental factors with the obesity occurrence in Argentina from a sex- and age-comparative perspective and a multilevel approach. DESIGN Cross-sectional study based on secondary data from the National Survey of Chronic Diseases Risk Factors (CDRF) 2018, Argentina. Two-level logistic regression models stratified by sex and age were used. SETTING The nationwide probabilistic sample of the CDRF survey and twenty-four geographical units. PARTICIPANTS 16 410 adult people, living in Argentine towns of at least 5000 people, nested into 24 geographical units. Sex and age groups were defined as young (aged 18-44 years), middle-aged (45-64 years) and older (65 years and older) men and women. RESULTS Single men (all age groups) and divorced/widowed men (aged 45 years or older) had a lower obesity risk compared to married ones. In the middle-aged group, men with higher education showed a lower risk than men with incomplete primary education. In young women, a marked social gradient by educational level was observed. A low-income level coupled with highly urbanised contexts represents an unfavourable scenario for young and middle-aged women. Having a multi-person household was a risk factor for obesity (OR = 1·26, P = 0·038) in middle-aged women. Contextual factors linked to the availability of socially constructed recreational resources and green spaces were associated with obesity among young adults. CONCLUSIONS Socio-environmental determinants of obesity seem to operate differently according to sex and age in Argentina. This entails the need to address the obesity epidemic considering gender inequalities and the socio-environmental context at each stage of life.
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Affiliation(s)
- Sonia Alejandra Pou
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Córdoba, Argentina
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
| | - Maria Del Pilar Diaz
- Instituto de Investigaciones en Ciencias de la Salud (INICSA), Universidad Nacional de Córdoba, Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Facultad de Ciencias Médicas, Córdoba, Argentina
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
| | - Guillermo Angel Velázquez
- Instituto de Geografía, Historia y Ciencias Sociales (IGEHCS), Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Universidad Nacional del Centro de la Provincia de Buenos Aires, Tandil, Buenos Aires, Argentina
| | - Laura Rosana Aballay
- Estadística y Bioestadística, Escuela de Nutrición, Facultad de Ciencias Médicas, Universidad Nacional de Córdoba, Córdoba5016, Argentina
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Guimarães MCDLP, Coelho JC, da Silva GV, Drager LF, Gengo e Silva Butcher RDC, Butcher HK, Pierin AMG. Blood Pressure Control and Adherence to Drug Treatment in Patients with Hypertension Treated at a Specialized Outpatient Clinic: A Cross-Sectional Study. Patient Prefer Adherence 2021; 15:2749-2761. [PMID: 34916785 PMCID: PMC8670885 DOI: 10.2147/ppa.s336524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 10/21/2021] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To evaluate and identify variables associated with the control of hypertension and adherence to antihypertensive drug treatment in a group of patients with hypertension monitored in a specialized, highly complex outpatient service. METHODS A prospective, cross-sectional study was carried out in the hypertension unit of a tertiary teaching hospital. Patients diagnosed with hypertensive aged 18 years and over and accompanied for at least six months were included in the study. Patients with secondary hypertension and pregnant women were excluded. The sample consisted of 253 patients. Adherence/concordance to antihypertensive treatment was assessed using the Morisky Green Levine Scale. Blood pressure control was set for values less than 140/90 mmHg. Variables with p≤0.20 in univariate analysis were included in multiple logistic regression. The level of significance adopted was p ≤0.05. RESULTS Most of patients were white, married and women, with a mean age of 65 (13.3) years old, low income, and education levels. Blood pressure control and adherence were observed in 69.2% and 90.1% of the patients, respectively. Variables that were independently associated with blood pressure control were (OR, odds ratio; CI, 95% confidence interval): married marital status (OR 2.3; CI 1.34-4.28), use of calcium channel blockers (OR 0.4; CI 0.19-0.92) and number of prescribed antihypertensive drugs (OR 0.78; CI 0.66-0.92). Adherence was not associated with any of the variables studied. CONCLUSION There was a high frequency of patients with satisfactory adherence to antihypertensive drug treatment. Blood pressure control was less frequent and was associated with social and treatment-related factors.
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Affiliation(s)
| | - Juliana Chaves Coelho
- Graduate Program in Adult Health Nursing (PROESA), University of São Paulo Nursing School, São Paulo, SP, Brazil
| | - Giovanio Vieira da Silva
- Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, SP, Brazil
| | - Luciano Ferreira Drager
- Hypertension Unit, Renal Division, University of São Paulo Medical School, São Paulo, SP, Brazil
- Hypertension Unit, Heart Institute (InCor), University of Sao Paulo Medical School, São Paulo, SP, Brazil
| | | | - Howard K Butcher
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Angela Maria Geraldo Pierin
- Graduate Program in Adult Health Nursing (PROESA), University of São Paulo Nursing School, São Paulo, SP, Brazil
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Ganz FD, Raanan O, Shafir G, Levy D, Klempfner R, Beigel R, Iakobishvili Z. Distress among hospitalized patients with acute coronary syndrome. Nurs Crit Care 2021; 27:165-171. [PMID: 34766409 DOI: 10.1111/nicc.12730] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have demonstrated that those suffering from acute coronary syndrome (ACS) experience various physical and psychological symptoms. Few studies have investigated the multi-factorial, holistic, unpleasant experience of distress that includes physical, psychological, social, and spiritual factors among this patient population while still hospitalized. AIM To describe the level of distress among patients hospitalized with ACS and its association with demographic and clinical factors and mortality. STUDY DESIGN The study conducted a descriptive, cross-sectional survey. METHODS The Acute Coronary Syndrome Israel Study is a national, biennial registry, enrolling all patients with ACS admitted to cardiac intensive care or cardiology wards in Israel within a 2-month period. Demographic and clinical data were retrieved from an electronic database. Distress was measured by the Distress Thermometer. Nurses collected distress data directly from patients before discharge. RESULTS Nine hundred ninety participants (50.6% response rate) were surveyed. Mean age was 62.8 (SD = 12.5). Mean distress level was 4.8 (SD = 3.45) out of 10. The most frequently reported area of distress was physical, followed by emotional. Practical and family problems were less frequent. Emotional distress was found to differ based on educational level, marital status, smoking history, and previous medical history. Distress did not predict 7- or 30-day mortality. CONCLUSIONS Respondents with ACS were in moderate distress. It is recommended that those at increased risk receive increased monitoring of emotional distress while still in hospital. Further studies should investigate this holistic view of distress among the ACS population using a variety of methods and methodologies.
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Affiliation(s)
- Freda DeKeyser Ganz
- Faculty of Life and Health Sciences, Jerusalem College of Technology, Jerusalem, Israel.,Hadassah-Hebrew University School of Nursing, Jerusalem, Israel
| | - Ofra Raanan
- Sheba Medical Center School of Nursing, Tel Hashomer, Israel
| | - Gennady Shafir
- Cardiac Intensive Care Unit, Haemek Medical Center, Afula, Israel
| | - Dassy Levy
- Division of Cardiology, Rambam Medical Center, Haifa, Israel
| | - Robert Klempfner
- Department of Cardiology, Sheba Medical Center, Cardiac Rehabilitation Institute, Tel Hashomer, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Roy Beigel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Cardiology, Sheba Medical Center, Tel Hashomer, Israel
| | - Zaza Iakobishvili
- Department of Community Cardiology, Clalit Health Services, Tel Aviv, Israel.,Department of Cardiology, Samson Assuta Ashdod University Hospital, Ashdod, Israel
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Karand JC, Reis K, Stephano PF, Gargurevich N, Zhou J, Desderius B, Fadhil S, Ladha Y, Rosengard R, Kowal DR, Peck RN. Sex-dependent correlates of arterial stiffness in Tanzanian adults. Trop Med Int Health 2021; 26:1494-1502. [PMID: 34478605 DOI: 10.1111/tmi.13676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Arterial stiffness is a known indicator for cardiovascular disease. However, the factors that lead to arterial stiffening have primarily been studied in participants from high-income countries. Here, we examine clinical and lifestyle metrics in relation to arterial stiffness in Tanzanian adults. METHODS We performed pulse wave velocity (PWV), the gold standard measure of arterial stiffness, on 808 Tanzanian adults (ages 18-65) enrolled in a longitudinal cohort studying trends in blood pressure. RESULTS As expected, PWV was strongly associated with age, blood pressure and sex. We controlled for these factors in our statistical analysis. Lifestyle metrics were compared across multiple PWV quantiles. We found that determinants of PWV varied by sex: in female participants, PWV was associated with common obesity metrics and menopause, while in male participants, PWV was associated with HIV status and duration of anti-retroviral therapy (ART). Further clinical and lifestyle factors such as marriage status and type of occupation were also significantly associated with PWV and moderated by sex. CONCLUSION Together, our data demonstrate the importance of studying sex-specific causal pathways for arterial stiffness and of including under-represented populations in these studies.
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Affiliation(s)
- Julie C Karand
- Fulbright U.S. Scholar Program, Washington, DC, USA.,University of Delaware, Newark, DE, USA
| | - Karl Reis
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
| | | | | | | | | | | | - Yumna Ladha
- Weill Bugando School of Medicine, Mwanza, Tanzania
| | - Rachel Rosengard
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA
| | | | - Robert N Peck
- Center for Global Health, Weill Cornell Medicine, New York, NY, USA.,Weill Bugando School of Medicine, Mwanza, Tanzania
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Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States. World J Cardiol 2021. [DOI: 10.4330/wjc.v13.i8.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
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Appiah D, Farias R, Helo D, Appiah L, Olokede OA, Nwabuo CC, Nair N. Association of marital status with takotsubo syndrome (broken heart syndrome) among adults in the United States. World J Cardiol 2021; 13:340-347. [PMID: 34589169 PMCID: PMC8436683 DOI: 10.4330/wjc.v13.i8.340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 03/28/2021] [Accepted: 07/27/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The pathophysiology of takotsubo syndrome (TTS) is not well understood, however, it is often precipitated by psychological or physical stress. Marital status is related to emotional stress, but its associations with TTS are limited.
AIM To explored the potential association between marital status and TTS.
METHODS We conducted a case-control study using data on patients aged ≥ 40 years with marital status data in the National Hospital Discharge Survey (2006-2010). The International Classification of Diseases Ninth Revision codes were used to identify cases with TTS and other comorbid conditions. Each case was matched to 5 controls by age, sex, year of TTS diagnosis and bed size of hospital. Two sets of controls were selected: Acute myocardial infarction (AMI) controls and non-cardiovascular disease (CVD) controls. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the association of marital status with TTS.
RESULTS The 59 patients with TTS who had information on marital status were matched to 295 controls with AMI and 295 non-CVD controls, resulting in a sample of 649 patients. The average age of cases was 69.7 ± 11 years with 90% being women and 88% reporting White race. In multivariable-adjusted models, compared to singles, patients who were married had lower odds of TTS (OR = 0.86, 95%CI: 0.79–0.93) while those who were widowed (OR = 1.14, 95%CI: 1.05–1.23) or divorced/separated (OR = 1.32, 95%CI: 1.21–1.45) had elevated odds for TTS when compared to non-CVD controls. Similar results were observed when cases were compared to controls with AMI.
CONCLUSION In this study, being married was associated with lower odds for TTS while being divorced/separated or widowed was related to elevated odds for TTS. These novel findings that underscore the potential importance of social factors like marital status in the development of TTS need confirmation in larger studies.
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Affiliation(s)
- Duke Appiah
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Rachel Farias
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Dena Helo
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Linda Appiah
- College of Education, Texas Tech University, Lubbock, TX 79409, United States
| | - Olugbenga A Olokede
- Department of Public Health, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Chike C Nwabuo
- Division of Cardiology, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Nandini Nair
- School of Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
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Cartwright K. Social determinants of the Latinx diabetes health disparity: A Oaxaca-Blinder decomposition analysis. SSM Popul Health 2021; 15:100869. [PMID: 34401459 PMCID: PMC8350406 DOI: 10.1016/j.ssmph.2021.100869] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Revised: 07/07/2021] [Accepted: 07/08/2021] [Indexed: 11/15/2022] Open
Abstract
Latinx people living in the U.S. report a disproportionately high prevalence of diabetes. This project builds on the existing social determinants of diabetes literature by examining factors associated with a greater likelihood of diabetes and investigates factors correlated with the Latinx/non-Latinx disparity. This project studies the adult sample (18 and older) from the 2010–2018 IPUMS Health: National Health Interview Survey (NHIS) data. Logistic regression analyses are used to examine the patterns between reporting Latinx identity and reporting diabetes with additional subgroup analyses of the Latinx and non-Latinx groups. Then, Oaxaca-Blinder decomposition is used to examine the patterns explaining the difference in self-reported diabetes between the Latinx and non-Latinx population for the whole sample and by age group. The logistic regression analyses show that after adjusting for age and other key social determinants of health, Latinx individuals are approximately 64.5% (OR 1.645, [95% CI, 1.536–1.760]) more likely to report being diagnosed with diabetes than non-Latinx individuals. Individual characteristics of age, race, and smoking behaviors are identified as suppressors of the gap, and conversely, characteristics of income, education, and BMI all contribute to the Latinx diabetes disparity gap. The Oaxaca-Blinder decomposition results show that the measured social determinants of health characteristics explain a meaningful amount of the Latinx diabetes gap. Importantly, differences in education and income (which are more immediately actionable policy areas) make larger contributions to the gap than BMI or other health behaviors.
The Latinx diabetes disparity should always presented after adjusting for age. In the age-adjusted model, Latinx adults are 64.5% more likely to report diabetes. Oaxaca-Blinder decomposition analysis shows how factors such as income, education, and BMI drive the diabetes disparity. Income and education are identified as modifiable factors to be prioritized in policy interventions aimed at reducing the diabetes disparity.
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Effects of divorce and widowhood on subsequent health behaviours and outcomes in a sample of middle-aged and older Australian adults. Sci Rep 2021; 11:15237. [PMID: 34341364 PMCID: PMC8328969 DOI: 10.1038/s41598-021-93210-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 06/14/2021] [Indexed: 11/08/2022] Open
Abstract
Marital disruption is a common life event with potential health implications. We examined the prospective association of divorce/widowhood with subsequent lifestyles, psychological, and overall health outcomes within short and longer terms using three waves of data from the 45 and Up Study in Australia (T1, 2006–09; T2, 2010; T3, 2012–16). Marital status and health-related outcomes were self-reported using validated questionnaires. Nine outcomes were examined including lifestyles (smoking, drinking, diet and physical activity), psychological outcomes (distress, anxiety and depression) and overall health/quality of life. Logistic regression was adjusted for sociodemographic characteristics and baseline health outcomes. Of the 33,184 participants who were married at T1 (mean age 59.5 ± 9.3 years), after 3.4 years, 2.9% became divorced and 2.4% widowed at T2. Recent divorce was positively associated with smoking, poor quality of life, high psychological distress, anxiety and depression at T2. Similar but weaker associations were observed for widowhood. However, these associations were much attenuated at T3 (5 years from T2). Marital disruption in midlife or at an older age can be detrimental to health, particularly psychological health in the short term. Public awareness of the health consequences of spousal loss should be raised. Resources, including professional support, should be allocated to help individuals navigate these difficult life transitions.
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Li K, Ma X, Yuan L, Ma J. Age differences in the association between marital status and hypertension: a population-based study. J Hum Hypertens 2021; 36:670-680. [PMID: 34088991 DOI: 10.1038/s41371-021-00558-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 05/11/2021] [Accepted: 05/24/2021] [Indexed: 11/09/2022]
Abstract
The findings on the relationship between marital status and hypertension are inconsistent. We aimed to explore age differences in their associations. We used Hainan Hypertension Survey data, including 13,088 individuals aged more than 25 years, as part of the China Hypertension Survey study, a population-based nationwide study. The marital status was classified as following three groups: the unmarried, the married, and those who formerly lived with his/her spouse. We examined the association between marital status and blood pressure levels and the odds of hypertension across different ages and sex. The participants' mean age was 49.9 ± 17 years, 49% were male, and 23% experienced hypertension. The multivariable logistic regression model showed among younger (<40 years) and older (≥60 years) participants, the married subjects appeared to have higher odds of hypertension compared with the unmarried counterparts, particular for men (Pheterogeneity = 0.039), after adjustment for age, sex, smoking, drinking, education background, employment situation, and body mass index. Compared with the unmarried and the married people, younger persons who previously had partners had a higher OR of hypertension than the older counterparts, and the ORs tended to decline with age (All Ptrend ≤ 0.005). The associations between marital status and blood pressure levels from multivariable linear regression models seemed consistent with the relationships mentioned above from logistic regression models. Our study indicates a marital status change is associated with a higher odds of hypertension, and it appears to be more obvious in young people.
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Affiliation(s)
- Kuibao Li
- Heart Center and Beijing key Laboratory of Hypertension, Beijing Chaoyang Hospital Affiliated to Capital Medical University, Beijing, China.
| | - Xiangjie Ma
- Department of Cardiology, Hainan Provincial People's Hospital, Haikou, Hainan, China
| | - Liangyan Yuan
- Medical Care Center of Hainan Provincial People's Hospital, Haikou, Hainan, China
| | - Jianlin Ma
- Department of Cardiology, Hainan Provincial People's Hospital, Haikou, Hainan, China
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Contemporary analysis of the effect of marital status on survival in upper tract urothelial carcinoma patients treated with radical nephroureterectomy: A population-based study. Urol Oncol 2021; 39:789.e9-789.e17. [PMID: 34092481 DOI: 10.1016/j.urolonc.2021.04.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/24/2021] [Accepted: 04/26/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Unmarried status is an established risk factor for worse cancer control outcomes in various malignancies. Moreover, several investigators observed worse outcomes in unmarried males, but not in females. This concept has not been tested in upper tract urothelial carcinoma and represents the topic of the study. METHODS Within Surveillance, Epidemiology and End Results database (2004-2016), we identified 8833 non-metastatic upper tract urothelial carcinoma patients treated with radical nephroureterectomy (5208 males vs. 3625 females). Kaplan Meier plots and multivariable Cox regression models predicting overall mortality, other-cause mortality and cancer-specific mortality were used. RESULTS Overall, 1323 males (25.4%) and 1986 females (54.8%) were unmarried. Except for lower rates of chemotherapy in unmarried males (15.6 vs. 19.6%, P = 0.001) and unmarried females (13.8 vs. 23.6%, P < 0.001), no clinically meaningful differences were recorded between males and females. In multivariable Cox regression models, unmarried status was an independent predictor of higher overall mortality in both males (Hazard ratio [HR]: 1.33, 95% confidence interval [CI]: 1.19-1.48, P < 0.001) and females (HR: 1.13, 95%CI: 1.00-1.27, P = 0.04), as well as of higher other-cause mortality in both males (HR: 1.53, 95%CI: 1.26-1.84,P < 0.001) and females (HR: 1.43, 95%CI: 1.15-1.78,P < 0.01). However, higher cancer-specific mortality was only recorded in unmarried males (HR: 1.24, 95%CI: 1.08-1.42, P < 0.01), but not in females (HR: 1.02, 95%CI: 0.89-1.17, P = 0.7). CONCLUSION Unmarried status is a marker of worse survival in both males and females and should be flagged as an important risk factor at diagnosis, in both sexes. In consequence, unmarried patients represent candidate for interventions aimed at decreasing the survival gap relative to married counterparts.
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