Concurrent increased high sensitivity C-reactive protein and chronic infections are associated with coronary artery disease: a population-based study.

BACKGROUND: An elevated serum level of C-reactive protein (CRP) is an independent predictor of coronary artery disease (CAD). Chronic infections have also been implicated in the pathogenesis of CAD. AIMS: To investigate how concomitant chronic infection and CRP related to electrocardiogram-defined CAD in a general population. SETTING AND DESIGN: A population-based cross-sectional study, which was conducted in three Iranian ports in the northern Persian Gulf. MATERIALS AND METHODS: For evaluation of CAD, we used Minnesota coding criteria of a 12-lead resting electrocardiogram in 1,754 subjects, aged 25 years and over, selected by cluster random sampling. Sera were analyzed for IgG antibodies to Chlamydia pneumoniae (C. pneumoniae), Herpes simplex virus type 1 (HSV-1), Helicobacter pylori (H. pylori) and cytomegalovirus (CMV) using ELISA. Measurement of CRP by a high-sensitivity CRP assay was done. STATISTICAL ANALYSIS: Multiple logistic regression analysis was used. RESULTS: None of the infectious agents (CMV, H. pylori, C. pneumoniae and HSV-1) showed a significant association with electrocardiogram-defined CAD after adjusting for sex and age. Elevated CRP levels did not show significant association with electrocardiogram-defined CAD independent of seropositivity to one of the four infectious agents, but concurrent elevated CRP levels (>10.0 mg/L) and anti-C. pneumoniae [OR = 1.68 (CI, 1.24-2.59; P=0.04)], H. pylori [OR = 1.98 (CI, 1.26-3.13; P=0.003)], CMV [OR = 1.66 (CI, 1.10-2.49; P=0.01)] or HSV-1 [OR=1.79 (CI, 1.18-2.72; P=0.006)] IgG antibodies were associated with prevalence of electrocardiogram-defined CAD in the general population, after adjustment for multiple risk factors, including age, sex and the components of the metabolic syndrome. CONCLUSIONS: Beyond traditional cardiovascular risk factors, concomitant chronic infection and elevated CRP are significantly correlated with electrocardiogram-defined CAD.

A school-based intervention to teach 3-4 grades children about healthy heart; the Persian Gulf healthy heart project.

BACKGROUND: Cardiovascular health promotion in children has the potential to reduce the risk of atherosclerosis in both the individual child and the population at large. It thus seems eminently reasonable to initiate healthful lifestyle training in childhood to promote improved cardiovascular health in adult life. AIMS: To test the hypothesis that a year long, classroom-based education for the third and fourth graders could change their knowledge scores about healthy heart. SETTINGS AND DESIGN: A randomized, controlled trial in elementary schools of Bushehr/Iran. METHODS AND MATERIALS: A total of 14 elementary schools, categorized by socioeconomic types and male and female setting were selected and randomized into control or intervention groups. Subjects were 1128 third and fourth graders, aged 9 to 10 years (49.1% boys and 50.9% girls). Over a course of 8 weeks, health educators and sport teachers of the elementary schools presented two hours sessions per week on heart function, nutrition, and exercise for healthy heart and living tobacco free for the intervention group. The education program was based on HeartPower! Program, an American Heart Association program. STATISTICAL ANALYSIS: Mann-Whitney U test and Wilcoxon matched-pairs signed rank test and Bonferroni correction for the two pair wise comparisons were used. RESULTS: Total heart knowledge at posttest was 25% correct higher in the intervention than in the control group (p< 0.001). Difference in means of total healthy heart knowledge scores between control and intervention group increased from 1.43 points in baseline to 4.02 points in posttest (p< 0.001). CONCLUSION: It can be concluded that the classroom-based cardiovascular health promotion had a significant effect on the heart healthy knowledge. Therefore, schools provide an excellent setting for introducing comprehensive healthy heart education and promotion of cardiovascular health to the general population.