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Introdução: As dislipidemias estão entre os fatores de riscos mais importantes para o desenvolvimento de doenças cardiovasculares (DCV), além de estarem relacionadas a outras patologias que predispõem às DCV. Em função da elevada prevalência e da incidência de complicações associadas à cronicidade da doença, as dislipidemias representam elevados custos ao setor da saúde e da previdência social. Diante disso, ressalta-se a importância do Sistema Único de Saúde, representado pela Atenção Primária à Saúde (APS), em prover práticas de prevenção, diagnóstico e acompanhamento dos pacientes dislipidêmicos, a fim de desonerar o sistema financeiro e promover o envelhecimento saudável. Objetivo: Descrever a prevalência de perfil lipídico alterado entre os idosos. Além disso, pretendeu-se caracterizar a amostra quanto aos aspectos sociodemográficos, de saúde e de comportamento, bem como analisar os fatores associados à distribuição do perfil lipídico alterado e às características da amostra. Métodos: Estudo transversal com dados secundários, obtidos de agosto de 2021 a julho de 2022, tendo como população pacientes idosos em acompanhamento na APS do município de Marau (RS). Todos os dados foram coletados dos prontuários eletrônicos da rede de APS e, após dupla digitação e validação dos dados, a amostra foi caracterizada por meio de estatística descritiva. Foi calculada a prevalência de perfil lipídico alterado com intervalo de confiança de 95% (IC95%) e foi verificada sua distribuição conforme as variáveis de exposição, empregando-se o teste do χ2 e admitindo-se erro tipo I de 5%. Resultados: A prevalência de dislipidemia proporcional entre os sexos foi maior no feminino (33%). A cor de pele predominante foi a branca (76,7%). Cerca de 20% dos pacientes apresentavam colesterol total, colesterol HDL-c e triglicerídeos alterados, enquanto cerca de 15% apresentavam o colesterol HDL-c anormal. Constatou-se que os pacientes dislipidêmicos apresentam mais diabetes e hipertensão em relação aos não dislipidêmicos, ocorrendo a sinergia de fatores de risco para as DCV. Conclusões: A caracterização exercida neste estudo serve de base científica para a compreensão da realidade local e, também, para o direcionamento de políticas públicas na atenção primária que atuem de forma efetiva na prevenção e no controle das dislipidemias e demais fatores de risco cardiovascular.
Introduction: Dyslipidemias are among the most important risk factors for the development of cardiovascular diseases (CVD), in addition to being related to other pathologies that predispose to CVD. Because of the high prevalence and incidence of complications associated with the chronicity of the disease, dyslipidemias represent high costs for the health and social security sector. This highlights the importance of the Unified Health System, represented by primary health care (PHC), in providing prevention, diagnosis and follow-up practices for dyslipidemic patients to relieve the financial system and promote healthy aging. Objective: The study aimed to describe the prevalence of altered lipid profile among older people. In addition, we sought to characterize the sample in terms of sociodemographic, health and behavioral aspects, as well as to analyze the factors associated with the distribution of the altered lipid profile and the characteristics of the sample. Methods: We conducted a cross-sectional study with secondary data, from August 2021 to July 2022, with older patients being followed up at the PHC in the city of Marau (RS) as the study population. All data were collected from the electronic medical records of the PHC network, and after double-typing and validation, the sample was characterized using descriptive statistics. The prevalence of altered lipid profile was determined with a 95% confidence interval (95%CI), and its distribution was verified according to the exposure variables, using the chi-square test and a type I error of 5%. Results: The prevalence of proportional dyslipidemia between sexes was higher in females (33%). The predominant skin color was white (76.7%). About 20% of the patients had altered total cholesterol, HDL-C and triglycerides, while about 15% had abnormal HDL-C. It was found that more dyslipidemic patients had diabetes and hypertension than non-dyslipidemic patients, with a synergy of risk factors for CVD. Conclusions: The characterization carried out in this study serves as a scientific basis for understanding the local reality and also for directing public policies in PHC that act effectively in the prevention and control of dyslipidemia and other cardiovascular risk factors.
Introducción: las dislipidemias se encuentran entre los factores de riesgo más importantes para el desarrollo de enfermedades cardiovasculares (ECV), además de estar relacionadas con otras patologías que predisponen a ECV. Debido a la alta prevalencia e incidencia de complicaciones asociadas a la cronicidad de la enfermedad, las dislipidemias representan altos costos para los sectores de salud y seguridad social. Frente a eso, se destaca la importancia del Sistema Único de Salud, representado por la Atención Primaria de Salud (APS), en la provisión de prácticas de prevención, diagnóstico y seguimiento de pacientes dislipidémicos, con el fin de descongestionar el sistema financiero y promover el envejecimiento saludable. Objetivo: El estudio tiene como objetivo describir la prevalencia del perfil lipídico alterado entre los ancianos. Además, se pretende caracterizar la muestra en cuanto a aspectos sociodemográficos, de salud y conductuales, así como analizar los factores asociados a la distribución del perfil lipídico alterado y las características de la muestra. Métodos: estudio transversal con datos secundarios, de agosto de 2021 a julio de 2022, con pacientes ancianos en seguimiento en la APS del municipio de Marau (RS) como población. Todos los datos fueron recolectados de la historia clínica electrónica de la red de la APS y, luego de doble digitación y validación, la muestra fue caracterizada mediante estadística descriptiva. Se calculó la prevalencia de perfil lipídico alterado con un intervalo de confianza del 95% (IC95%) y se verificó su distribución según las variables de exposición, utilizando la prueba de chi-cuadrado y admitiendo un error tipo I del 5%. Resultados: la prevalencia de dislipidemia proporcional entre sexos fue mayor en el sexo femenino (33%). El color de piel predominante fue el blanco (76,7%). Alrededor del 20% de los pacientes tenían colesterol total, colesterol HDL-C y triglicéridos alterados, mientras que alrededor del 15% tenían colesterol HDL-C anormal. Se encontró que los pacientes dislipidémicos tienen más diabetes e hipertensión que los pacientes no dislipidémicos, con una sinergia de factores de riesgo para ECV. Conclusiones: la caracterización realizada en este estudio sirve de base científica para comprender la realidad local y también para orientar políticas públicas en atención primaria que actúen de manera efectiva en la prevención y control de la dislipidemia y otros factores de riesgo cardiovascular.
Subject(s)
Primary Health Care , Dyslipidemias , Heart Disease Risk FactorsABSTRACT
Resumen El síndrome metabólico (SM) se asocia con alteraciones metabólicas e inflamatorias que imprimen un mayor riesgo de desarrollar diabetes y enfermedades cardiovasculares y tiene como base la resistencia insulínica. La alimentación, sedentarismo, educación y distribución del ingreso pueden influir en la aparición del SM. El objetivo del estudio fue conocer la prevalencia del SM y los factores de riesgo cardiovascular asociados en una población vulnerable, adulta y urbana, que acudió voluntariamente luego de una campaña de difusión, a un hospital de atención primaria en la ciudad de San Luis, Argentina. En 451 sujetos, 205 hombres y 246 mujeres (45,5±12,4 años) se analizaron datos personales, antropométricos y biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicéridos, glucosa, insulina, proteína C reactiva ultrasensible (PCRus), apolipoproteínas A y B, ácido úrico e índices subrogados de insulina. El SM se estableció empleando la definición armonizada de SM (2009). El 80% de la población no completó la educación formal. Los hombres estaban desempleados o con trabajo informal (70%). El 51,4% de la población cumplía con el criterio de SM (50,0% mujeres y 53,1% hombres). Entre los componentes del SM, la tríada más frecuente en mujeres y hombres, fue: c-HDL disminuido, circunferencia de cintura elevada e hipertrigliceridemia. El SM aumentó con la edad en los hombres. Las mujeres con SM presentaron niveles altos de PCRus. El conocimiento de la prevalencia local, tanto de la obesidad como del SM, permite valorar la magnitud del problema en cada comunidad, establecer medidas de prevención, control y compararlo con otras realidades epidemiológicas.
Abstract Metabolic syndrome (MS) is associated with metabolic and inflammatory alterations that increase the risk of developing diabetes and cardiovascular diseases, based on insulin resistance. Diet, sedentary lifestyle, education and income distribution can influence the appearance of MS. The objective of the study was to know the prevalence of MS and associated cardiovascular risk factors in a vulnerable, adult and urban population, that voluntarily attends after diffusion campaign, to a primary care hospital in the city of San Luis, Argentina. In 451 subjects, 205 men and 246 women (45.5±12.4 years), personal, anthropometric and biomarker data were analysed: total cholesterol HDL cholesterol (HDL-c), LDL cholesterol, triglycerides, glucose, insulin, ultrasensitive C-reactive protein (usCRP), apolipoproteins A and B, uric acid and insulin surrogate indices. The MS was established using the harmonised definition of MS (2009). Eighty percent of the population did not complete formal education. Men were unemployed or in informal work (70%). A total of 51.4% of the population had the MS criteria (50.0% women and 53.1% men). Among the components of MS, the most frequent triad in women and men, were: decreased HDL-c, elevated waist circumference and hypertriglyceridemia. The prevalence of MS increased with age in men. Women with MS presented high levels of usCRP. Knowledge of the local prevalence of both obesity and MS would allow enable the assessment of the magnitude of the problem in each community, establish prevention and control measures, and compare it with other epidemiological realities.
Resumo A síndrome metabólica (SM) está associada a alterações metabólicas e inflamatórias que aumentam o risco de desenvolvimento de diabetes e doenças cardiovasculares, considerando a resistência à insulina. A alimentação, o sedentarismo, a escolaridade e a distribuição de renda podem influenciar o aparecimento da SM. O objetivo do estudo foi conhecer a prevalência da SM e os fatores de risco cardiovascular associados em uma população vulnerável, adulta e urbana, que compareceu voluntariamente a um hospital de atenção primária na cidade de San Luis, Argentina, após uma campanha de divulgação. Em 451 indivíduos, 205 homens e 246 mulheres (45,5±12,4 anos), foram analisados dados pessoais, antropométricos e de biomarcadores: colesterol total, colesterol HDL (c-HDL), colesterol LDL, triglicerídeos, glicose, insulina, proteína C reativa ultrassensível (PCRus), apolipoproteínas A e B, ácido úrico e índices substitutos de insulina. A SM foi estabelecida utilizando a definição harmonizada de SM (2009). Oitenta por cento da população não concluiu a educação formal. Os homens estavam desempregados ou em trabalho informal (70%). 51,4% da população atendia os critérios da SM (50,0% mulheres e 53,1% homens). Dentre os componentes da SM, a tríade mais frequente em mulheres e homens: c-HDL diminuído, circunferência abdominal elevada e hipertrigliceridemia. SM aumentou com a idade nos homens. Mulheres com SM apresentaram níveis elevados de PCRus. O conhecimento da prevalência local da obesidade quanto da SM permite avaliar a magnitude do problema em cada comunidade, estabelecer medidas de prevenção e controle e compará-lo com outras realidades epidemiológicas.
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Background & Objectives: Hematological and lipid profiles play crucial roles in assessing health conditions and monitoring physiological abnormalities. Hematological and lipid profiles serve as valuable tools in this context, providing insights into various health conditions. However, due to various factors like diet, socioeconomic status, and literacy, these profiles can differ significantly across populations. Therefore, we aimed to find out the hematological as well as biochemical parameters among the patients attending Ram Janaki Hospital, Janakpurdham. Materials and Methods: This hospital based study involved 140 patients attending the medicine OPD between September 2023 and February 2024. Anthropometric measurements, blood pressure, and BMI was calculated. Venous blood samples were collected. Hematological parameters were assessed using a fully a utomated hematology analyzer, while lipid profiles were evaluated using semi analyzer Erba Chem 7 analyzer with ErbaDiagnostics kits. Data analysis was performed using SPSS version 21. Results: The study population comprised an equal distribution of males and females. Males exhibited higher values in weight, height, BMI, and blood pressure as compared to females. Hematological analysis revealed higher hemoglobin levels, red blood cell counts, and packed cell volume in males, while females showed higher total leukocyte counts. Lipid profile analysis indicated higher total cholesterol and LDL levels in males, whereas females had higher HDL, triglyceride, and VLDL levels. Conclusion: The finding highlights significant gender based differences in anthropometric, hematological, and biochemical parameters among patients in Janakpurdham. The findings emphasize the importance of considering gender differences in clinical evaluations and treatment plans. The observed variations from international norms underscore the need for population specific reference ranges.
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A systemic inflammatory disease known as rheumatoid arthritis (RA) is distinguished by excessive cardiovascular disease (CVD) morbidity and death. Traditional CV risk factors may partially contribute to CV disease in RA. Shared inflammatory mediators, post-translational modifications of peptides/proteins and subsequent immune responses, changes in the composition and function of lipoproteins, increased oxidative stress, and endothelial dysfunction are some of the mechanisms that link RA and CVD. The detailed pathogenetic pathway by which this association between RA and CVD might be explained is still not entirely known. It is crucial for controlling cardiovascular risk in people with RA. Optimizing care of traditional risk factors in addition to those inherent to RA is necessary to lessen the burden caused by CVD. The potential effect of planned Cardiac risk management in these individuals is highlighted by findings for under diagnosis and inadequate treatment of conventional CVD risk factors in RA. Present cardiovascular standards suggest RA patients to be examined for and treated for CVD risk factors without appropriate treatment goals. Utilizing potent anti-rheumatic medications that can reduce disease activity and treating the conventional CV risk factors should both be part of the therapy of CV risk in RA. There is currently insufficient scientific data to develop therapy targets for RA-related CVD risk factors. Thus, more study is required on the traditional CVD risk factor screening and management in RA patients.
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RESUMEN Las dolicoarteriopatías carotídeas (DAC) son un grupo de anomalías morfológicas, con alteración de la geometría y torsión de los vasos carotídeos. Descriptas por primera vez en 1925, las DAC fueron clasificadas en tres tipos, según el grado de torsión: tortuosidad (ángulo mayor de 90°), enrollamiento o coiling (forma de S o looping), y acodamiento o kinking (ángulo menor de 90º). La fisiopatología de las DAC es controvertida, pero se han propuesto mecanismos congénitos, genéticos, enfermedades del tejido conectivo, adquiridos, relacionados con, pero no dependientes de, factores de riesgo cardiovascular, y alteraciones de la columna cervical. Las DAC han sido asociadas a diferentes eventos cardio y cerebrovasculares, secundarios a alteraciones hemodinámicas, tromboembolismo e insuficiencia e isquemia cerebrovascular. Pero la evidencia es limitada y, para algunos autores, son más una curiosidad que una condición clínica grave. Otros trabajos sustentan el valor clínico del diagnóstico y seguimiento de las DAC, y su reconocimiento no solo por internistas, cardiólogos y neurólogos, sino también por cirujanos y otorrinolaringólogos. Varios autores propusieron diversas estrategias terapéuticas, incluyendo procedimientos quirúrgicos para corregirlas. Sin embargo, las indicaciones y métodos de tratamiento son controvertidos, y son necesarios más estudios aleatorizados, multicéntricos y prospectivos para determinar cómo proceder. Hasta entonces, técnicas de imagen son la base para el diagnóstico etiológico de eventos adversos cerebrovasculares cuando se descartan todas las otras causas, y el control clínico cercano y seguimiento de los pacientes continúan siendo estrategias clave para la prevención de eventos secundarios.
ABSTRACT Carotid dolichoarteriopathies (CDA) represent a group of morphological abnormalities, with changes in the geometry and tortuosity of the carotid arteries. They were described in 1925 for the first time and were classified in three types according to the angle of torsion, in tortuosity (angle > 90°), coiling (S-shaped curve or loop) and kinking (angle < 90°). The pathophysiology of CDA is controversial and includes congenital mechanisms, genetic factors, connective tissue diseases, acquired mechanisms which can be associated with but not dependent on cardiovascular risk factors, and anomalies of the cervical spine. CDA have been associated with different cardiovascular and cerebrovascular events secondary to hemodynamic abnormalities, thromboembolism and cerebrovascular insufficiency and ischemia. However, the evidence is limited and for some authors they are more of a curiosity than a real predictor of ischemic events. Other studies support the clinical value of the diagnosis and follow-up of CDA and their understanding not only by internists, cardiologists and neurologists, but also by surgeons and otolaryngologists. Several authors proposed different therapeutic strategies to correct CDA, including surgical procedures. However, the indications and management approaches are controversial, and further randomized, multicenter, prospective studies are required to determine the most appropriate course of action. Until then, imaging techniques remain the basis for the etiologic diagnosis of cerebrovascular adverse events when all other causes have been excluded, and close clinical monitoring and follow-up of patients remain key strategies for the prevention of secondary events.
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Antecedentes: La pandemia de Covid-19 se ha convertido en uno de los desastres de salud, económicos y sociales más grandes de la historia de la humanidad. En este contexto se evidencia un aumento sustancial de trastornos emocionales diversos como, la ansiedad, la depresión, estrés y agotamiento emocional. Es preocupante el impacto que puede representar en los pacientes con factores de riesgo cardiovasculares (FRCV) durante la emergencia sanitaria. Objetivo: Analizar el impacto de la pandemia Covid 19 en los FRCV y en la salud mental en usuarios de consulta privada cardiológica. Método: Estudio observacional, analítico de corte transversal. Población objetivo 100 usuarios atendidos en consulta privada cardiológica, todos con consentimiento informado. Muestra no probabilística por conveniencia. Se realizó encuesta DASS-21 intra pandemia Covid 19 para medición de depresión, ansiedad y estrés. Medición antropométrica y exámenes de glicemia, insulinemia, hemoglobina glicosilada (HbA1c), perfil lipídico y presión arterial, para los periodos pre pandemia (PP) e intra pandemia (IP) Covid 19. Se usó software Stata para el análisis estadístico de medidas de tendencia central y el análisis bivariado con prueba de Chi2. Resultados: La muestra incluyó 100 usuarios: 51,5% de género femenino, y el promedio de edad fue 60,8 ±13,7 años. El nivel socioeconómico (NSE) fue Alto en 55,5%. El 63,6% presentaban nivel de escolaridad enseñanza superior (NEES). Al analizar ambos periodos, PP e IP, los resultados con mayor relevancia fueron: presión arterial (PA) alterada 16,6% en PP y 22,9% en IP; sobrepeso/obesidad 65,8% en PP y 70,7% en IP; HbA1c 16,6% PP y 31,9% en IP; insulinemia alterada 15,7% PP y 21% en IP; colesterol no HDL alterado 50,5% en PP y 52,7% en IP; índice HOMA alterado 44,5% en PP y 54,3% en IP. Se evidenció un importante aumento en trastornos de salud mental en IP que fueron depresión leve/moderada en 20% y depresión severa/extremadamente severa en 11%; ansiedad leve/moderada 25% y ansiedad severa/extremadamente severa 22%, estrés leve/moderado 21% y estrés severo/extremadamente severo 18%. Conclusiones: En el periodo IP hubo una alteración estadísticamente significativa en las variables clínicas como PA, HbA1c, índice HOMA, insulinemia, colesterol noHDL y sobrepeso/obesidad. En el periodo IP hubo un alto porcentaje de depresión, ansiedad y estrés, especialmente en mujeres. La pandemia por Covid 19 ha tenido impacto en los FRCV y en la salud mental en usuarios del sistema privado de salud.
Background: The Covid-19 pandemic has become one of the largest health, economic, and social disasters in human history. In this context, there has been a substantial increase in various emotional disorders such as anxiety, depression, stress, and emotional exhaustion. Given these issues, there is concern about the impact this may have on patients with cardiovascular risk factors (CVRF) during this health emergency. Objective: To analyze the impact of the COVID-19 pandemic on CVRF and mental health in subjects undergoing private cardiology consultation. Method: Observational, analytical, cross-sectional study. The target population consisted of 100 users attending a private cardiology consultation, all of them giving informed consent, with anon-probabilistic convenience sample. DASS-21 survey was conducted during the COVID-19 pandemic to evaluate depression, anxiety, and stress. Anthropometric measurements and tests for glycemia, insulinemia, glycosylated hemoglobin (HbA1c), lipid profile, and blood pressure were performed for the pre-pandemic (PP) and during-pandemic (IP) COVID-19 periods. Statistical analysis, measures of central tendency, and bivariate analysis with Chi2 test. was performed using a Stata software package. Results: The sample consisted of 100 subjects, 51.5% female, with an average age of 60.8 ± 13.7 years. Subjects had a high socio-economic Level (SEL)in 55.5% and higher education level in 63.6%. Comparing PP and IP periods, the most relevant results, re were respectivly: altered blood pressure (BP) 16.6% vs 22.9%, overweight/obesity 65.8% vs 70.7%, HbA1c 16.6% vs 31.9%, altered insulinemia 15.7% vs 21%, altered non-HDL cholesterol 52.7%, vs 50.5%, and HOMA index 44.5% vs 54.3%. A significant increase in mental health disorders in IP was evidenced, which were: mild/moderate depression 20%, and severe/extremely severe depression 11%; mild/moderate anxiety 25%, and severe/extremely severe anxiety 22%, mild/moderate stress 21%, and severe/ extremely severe stress 18%. Conclusions: In the IP phase there was a statistically significant alteration in clinical variables such as BP, HbA1c, HOMA index, insulinemia, non-HDL cholesterol, and overweight/ obesity. Also, a high percentage of depression, anxiety, and stress was observed. The COVID-19 pandemic has impacted CVR and mental health in subjects being cared for in the private health system.
Subject(s)
Humans , Male , Female , Middle Aged , Heart Disease Risk Factors , COVID-19/psychology , Cardiovascular Diseases , PandemicsABSTRACT
Introduction: Lipoprotein (a) is made up of an atherogenic LDL lipoparticle and a potentially thrombogenic apoprotein a and is therefore responsible for cardiovascular disease. The objective of this study is to evaluate serum lipoprotein (a) status and to investigate the correlation of elevated serum lipoprotein (a) levels with other cardiovascular risk factors in type 2 diabetics.Materials and Methods: This is a case-control study involving 82 patients, 37 type 2 diabetic patients and 45 non-diabetic control subjects. Sociodemographic data were collected and each patient underwent routine lipid assessment and lipoprotein (a) testing.Results: The prevalence of hyperlipoproteinemia (a) is 17.8% in control subjects and 29.7% in type 2 diabetics. HDL cholesterolemia is significantly higher in controls than in type 2 diabetics (p =0.028) while LDL cholesterol and serum lipoprotein (a) levels are higher in type 2 diabetics than in controls with a statistically significant difference (p=0.025 and p=0.026 respectively). The mean lipoprotein (a) values ??of 0.36�34 g/l in women are higher than those of male subjects which are 0.28�20 g/l (p=0.171). Mean serum lipoprotein (a) levels of 0.39�32 g/l in type 2 diabetics are significantly higher than those of controls which are 0.25�21 g/l (p= 0.026). Plasma concentrations of lipoprotein (a) vary with age and appear to be increased beyond the age of 45. There is no correlation between lipoprotein (a) and other cardiovascular risk factors.Conclusion: Hyperlipoproteinemia (a) is common in type 2 diabetics and women have the highest plasma levels. Serum lipoprotein (a) concentrations are not correlated with other cardiovascular risk factors and therefore constitute an independent risk factor.
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Background: Given the improvement in life expectancy of people living with HIV (PLWH) in sub-Saharan Africa, the risk of asymptomatic HIV-associated neurocognitive disorder (HAND) has increased. The study objectives were to investigate the prevalence of HAND and associated factors among treatment experienced adults in Ethiopia. Methods: A single-center observational cross-sectional study was conducted between December 2019 and June2020 to investigate HAND. International HIV dementia scale (IHDS) was used to screen for the disorder. Both descriptive and analytical statistics were used to analyze the data. Results: Total of 324 PLWH (63% females) who were on combination antiretroviral therapy for median of 144months (IQR: 108-168) were investigated. The mean age was 42.5 years (1SD=12.2). The prevalence of HAND was 75.3% and the difference was significantly more in those above 40 years of age (65.8% vs. 80.7%, p=0.003). Age is the only risk factor identified with multivariable logistic regression analysis. A linear decrement in the total score of cognitive performance was observed as the patient's age increase; age was responsible for 9.4% variation observed in IHDS score (r= -0.31, R2=0.094, p<0.0001). Although statistically not-significant, the trend for cardio-metabolic and behavioral risk factors (hypertension, diabetes mellitus, dyslipidemia, smoking, alcohol and khat use) was higher in the group diagnosed with HAND. Conclusion: The occurrence of neurocognitive impairment was more pronounced in individuals aged 40 years and above who were HIV positive, compared to those below 40 years. Age was found to be an independent predictor of HAND. Cardiovascular and behavioral risk factors were observed more among patients with HAND compared to no-HAND
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Humans , Male , Female , Cognitive DysfunctionABSTRACT
Introduction.Au Burkina Faso, la prévalence du syndrome coronaire aigu avec sus-décalage du segment ST (SCAST+) est en augmentation. Il est possible de prévenir la plupart des SCAST+ en s'attaquant aux facteurs de risque cardio-vasculaire. L'objectif de ce travail a été d'étudier l'impact des facteurs de risque cardio-vasculaire sur la survenue du SCAST+ au Burkina Faso.Méthodologie. Il s'agissait d'une étude observationnelle, de type cas-témoins, non appariés, un cas pour trois témoins, monocentrique, à recueil rétrospectif des donnés, allant du 1erJanvier 2010 au 31 Décembre 2016. Elle a inclus 1029 patients, soit 199 cas de SCAST+ et 830 témoins hospitalisés au sein du service de cardiologie du CHU-YO de Ouagadougou durant la période d'étude.Résultats.En analyse univariée et multivariée, les facteurs de risque cardio-vasculaire ayant impacté significativement (odds ratio ajusté [IC 95%]) la survenue du SCAST+ étaient: l'âge supérieur à 50 ans (5,96 [3,84-9,25]), le sexe masculin (3,97 [2,48-6,34]), le diabète (2,76 [1,56-4,89]), l'hypertension artérielle (2,14 [1,43-3,2]) et le tabagisme (2,09 [1,33-3,3]). Le cumul croissant des facteurs de risque cardio-vasculaire augmente significativement le risque de survenue du SCAST+ (p< 0,0005). L'odds ratio [IC 95%] de survenue d'une altération de la FEVG (FEVG< 50%) et de survenue d'un décès intrahospitalier en cas de SCAST+ était respectivement de 4,62 [2,67-7,98] et de 3,23 [1,85-5,66]. La prise en charge de l'hypertension artérielle, du diabète et du tabagisme, va permettre de réduire 72% de la fréquence de survenue du SCAST+.Conclusion.La prévention et le contrôle des facteurs de risque cardiovasculaire au Burkina Faso réduirait de plus de 72% le risque de survenu d'un syndrome coronarien aigu.
Introduction.In Burkina Faso, the prevalence of of acute syndrome with ST-segment elevation (SCAST+) is increasing. Most SCAST+ can be prevented by addressing cardiovascular risk factors. The aim of this study was to investigate the impact of cardiovascular riskfactors on the occurrence of SCAST+ in Burkina Faso. Methodology.This was , case-control, unmatched, one-case, three-control, single-centre study with retrospective data collection from 1 January 2010 to 31 December 2016. It included 1029patients (199 SCAST+ cases and 830 controls) hospitalised in the cardiology department of the CHU-YO in Ouagadougou during the study period.Results.In univariate and multivariate analysis, the cardiovascular risk factors that had a significant impact (adjusted odds ratio [95% CI]) on the occurrence of SCAST+ were : age over 50 (5.96 [3.84-9.25]), male sex (3.97 [2.48-6.34]), diabetes (2.76 [1.56-4.89]), arterial hypertension (2.14 [1.43-3.2]) and smoking (2.09 [1.33-3.3]). Increasing accumulation of cardiovascular risk factors significantly increased the risk of SCAST+ (p<0.0005). The odds ratios [95% CI] for LVEF impairment (LVEF < 50%) and for in-hospital death in the event of SCAST+ were 4.62 [2.67-7.98] and 3.23 [1.85-5.66] respectively. Management of hypertension, diabetes and smoking reduced the incidence of SCAST+ by 72%. Conclusion.Prevention and control of cardiovascular risk factors in Burkina Faso would reduce the risk of acute coronary syndrome by more than 72%
Subject(s)
Humans , Male , Female , Diabetes Mellitus , Acute Coronary Syndrome , Tobacco Smoking , Heart Disease Risk Factors , Hypertension , PrevalenceABSTRACT
Introducción: Las enfermedades cardiovasculares constituyen la principal causa de morbimortalidad a escala mundial. Otra enfermedad con impacto significativo en los sistemas de salud pública es el VIH/sida. Los pacientes infectados con el virus de la inmunodeficiencia humana, tienen mayor riesgo de desarrollar enfermedades cardiovasculares. Posterior al tratamiento antirretroviral ha disminuido la incidencia de enfermedades oportunistas asociadas al VIH/sida, y se ha elevado la incidencia de enfermedades asociadas al envejecimiento, como la enfermedad cardiovascular. El uso de antirretrovirales inhibidores de la proteasa se asocia a hiperlipidemia y, por consiguiente, al aumento de complicaciones cardiovasculares. Objetivo: Determinar los marcadores lipídicos en pacientes con VIH/sida en tratamiento con inhibidores de la proteasa. Materiales y métodos: Se realizó un estudio observacional, analítico, transversal en los pacientes con VIH/sida de la provincia de Matanzas, durante el período comprendido entre marzo y agosto de 2020, en el Laboratorio Clínico del Hospital Universitario Clínico Quirúrgico Comandante Faustino Pérez Hernández. Resultados: Se evaluaron los marcadores lipídicos como factor de riesgo cardiovascular asociado al tratamiento antirretroviral, siendo los triglicéridos el de mayor incidencia. Conclusiones: Se identificaron los marcadores lipídicos como factores de riesgo cardiovascular, en este caso la hipertrigliceridemia.
Introduction: Cardiovascular diseases are the main risk of morbidity and mortality worldwide. Another disease with significant impact on public health systems is HIV/AIDS. Patients infected with the human immunodeficiency virus have a higher risk of developing cardiovascular diseases. After antiretroviral treatment, the incidence of opportunistic diseases associated with HIV/AIDS has decreased and the incidence of diseases associated with aging such as cardiovascular disease has increased. The use of protease inhibitor antiretroviral drugs is associated with hyperlipidemia and a consequent increase in cardiovascular complications. Objective: To determine lipid markers in patients with HIV/AIDS undergoing treatment with protease inhibitors. Materials and method: An observational, analytical, cross-sectional study was carried out in patients with HIV/AIDS from the province of Matanzas during the period from March to August 2020, in the Clinical Laboratory of the Provincial Teaching Clinical Surgical Hospital Faustino Pérez Hernandez. Results: Lipid markers were evaluated as cardiovascular risk factor associated with antiretroviral treatment, with triglycerides being the one of highest incidence. Conclusions: Lipid markers were identified as cardiovascular risk factors; in this case hypertriglyceridemia.
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Introducción: Las enfermedades cardiovasculares ateroescleróticas están en el nivel máximo de las enfermedades que afectan tanto a mujeres como a hombres adultos mayores en todo el mundo. Objetivo: Evaluar las posibles diferencias de sexo y tipo de enfermedad aterosclerótica, en pacientes mayores de 60 años, fallecidos por enfermedad cardiovascular. Métodos: Se realizó un estudio descriptivo de corte transversal en 237 adultos mayores, fallecidos por enfermedad cardiovascular, perteneciente a tres áreas de salud del municipio Santiago de Cuba, en el período de enero a diciembre de 2021 Se analizaron variables socio-demográficas y clínicas. La información fue procesada y analizada mediante estadística descriptiva. Se sistematizó la información con el paquete estadístico versión 22 y Excel. Resultados: Existieron diferencias significativas en los factores de riesgos de tabaquismo y alcoholismo con una mayor frecuencia en la población masculina, la obesidad, el sedentarismo y la diabetes mellitus fue más relevante en las mujeres, con similar comportamiento en el infarto agudo de miocardio y la enfermedad cerebrovascular. Conclusiones: La mortalidad generada por las enfermedades cardiovasculares, en la población de adultos mayores, es similar para ambos sexos la presencia de factores de riesgo evidenciaron la misma frecuencia para la mortalidad por enfermedad del corazón y cerebrovascular(AU)
Introduction: Atherosclerotic cardiovascular diseases are at the highest level of diseases that affect both older women and men worldwide. Objective: To evaluate the possible differences of sex and type of atherosclerotic disease in patients over 60 years of age who died of cardiovascular disease. Methods: A descriptive cross-sectional study was carried out in 237 older adults who died from cardiovascular disease, belonging to three health areas of Santiago de Cuba municipality, from January to December 2021. Sociodemographic and clinical variables were analyzed. The information was processed and analyzed using descriptive statistics. The information was systematized with the statistical package version 22 and Excel. Results: There were significant differences in the risk factors of smoking and alcoholism with a higher frequency in the male population, obesity, sedentary lifestyle. Diabetes mellitus was more relevant in females, with similar behavior for acute myocardial infarction and cerebrovascular disease. Conclusions: The mortality generated by cardiovascular diseases, in the population of older adults, is similar in both sexes. The presence of risk factors showed the same frequency for mortality from heart disease and cerebrovascular disease(AU)
Subject(s)
Humans , Male , Female , Aged , Cardiovascular Diseases/mortality , Risk Factors , Heart Disease Risk Factors , Aged , Epidemiology, Descriptive , Cross-Sectional StudiesABSTRACT
Los informes de laboratorio tienen impacto en las decisiones médicas. El ayuno es un factor preanalítico "controlable" que influye en los distintos parámetros bioquímicos. El objetivo del presente trabajo es poner en discusión la realización en pediatría de análisis clínicos con la indicación de un ayuno fisiológico , analizando resultados obtenidos por diferentes autores y evaluando las diferencias clínicas encontradas según los criterios de calidad establecidos por el laboratorio de Química Clínica. La mayoría de los individuos durante el día se encuentran en estado postprandial. Los resultados del perfil lipídico en ayunas no representan las concentraciones reales promedios de los lípidos plasmáticos de un paciente. El ayuno no sería crítico en la etapa de pesquisa , pero puede ser relevante para establecer un diagnóstico certero o inicio de tratamiento. En el caso de la glucemia si se indica en el control rutinario del paciente, y no hay sospecha de alteraciones en el metabolismo de los hidratos de carbono la glucemia sin ayuno puede ser solicitada comparando la misma con valores de corte adecuado. Las diferentes guías nacionales e internacionales recomiendan que la elección de la métrica para la evaluación, control y seguimiento de pacientes con diagnóstico de diabetes se realicen según el objetivo terapéutico. En los trabajos analizados, observamos que varios parámetros bioquímicos presentaron diferencias estadísticas, aunque las diferencias clínicas no fueron relevantes y permanecieron dentro de los intervalos de referencia. El factor limitante para evaluar parámetros bioquímicos sin ayuno es la falta de valores de referencia adecuados. Hay evidencia suficiente para que tanto el perfil lipídico, la glucemia como el resto de los parámetros bioquímicos del laboratorio de química clínica, sean solicitados con la indicación de un ayuno fisiológico de 2, 4 o 6 horas, dependiendo siempre del motivo de consulta y/o la edad del paciente. Es esencial extender la evaluación a otros analitos en población pediátrica, así como evaluar nuevos puntos de corte para parámetros bioquímicos sin ayuno (AU)
Laboratory reports have an impact on medical decision-making. Fasting is a "controllable" preanalytical factor that influences the different biochemical parameters. The aim of this study is to discuss the performance of clinical analyses in pediatrics with the indication of physiological fasting, analyzing results obtained in different disciplines, and evaluating the clinical differences found according to the quality criteria established by the clinical chemistry laboratory. During the day, most patients are in a postprandial state. Fasting lipid profile results do not represent the actual average plasma lipid concentrations of a patient. Fasting would not be critical in the screening stage, but it may be relevant to establish an accurate diagnosis or initiate treatment. Regarding glycemia, if it is indicated in the routine control of the patient and there is no suspicion of alterations in carbohydrate metabolism, non-fasting glycemia can be requested, comparing it with adequate cut-off values. Different national and international guidelines recommend that the choice of metrics for the evaluation, control, and follow-up of patients with diabetes should be made according to the therapeutic objective. In the studies analyzed, we found that several biochemical parameters presented statistical differences, although the clinical differences were not relevant and remained within the reference range. The limiting factor in the evaluation of biochemical parameters without fasting is the lack of adequate reference values. There is sufficient evidence that the lipid profile, glycemia, and the remaining biochemical parameters of the clinical chemistry laboratory should be requested with the indication of a physiological fast of 2, 4, or 6 hours, always depending on the reason for consultation and/or the patient's age. It is essential to extend the evaluation to other analytes in the pediatric population, as well as to evaluate new cut-off points for biochemical parameters without fasting (AU)
Subject(s)
Humans , Child, Preschool , Child , Adolescent , Reference Values , Fasting/blood , Clinical Chemistry Tests/methods , Heart Disease Risk Factors , Pediatrics , Postprandial Period , Hyperlipidemias/diagnosisABSTRACT
El objetivo de este estudio fue establecer relaciones entre las variables de rendimiento físico e índices antropométricos según la edad de bomberos adultos chilenos, en servicio activo, provenientes de la región de Valparaíso. Participaron 68 bomberos, hombres, sanos, en servicio activo, que fueron divididos en dos grupos según edad; 30 años (n = 32; 40,6 ± 8,5 años). Se evaluaron las variables antropométricas de masa corporal (MC), estatura, perímetro de cintura (PC), índice de masa corporal (IMC] = Peso /estatura2 [m]) e índice cintura-estatura (ICE). La capacidad de salto vertical fue evaluada con los protocolos de Squat Jump, Countermovement Jump y Abalakov Jump. La resistencia en carrera fue estimada con la prueba de Course Navette y se calculó indirectamente el consumo de oxígeno (VO2). Las variables antropométricas para el grupo > 30 años fueron mayores en comparación al grupo de menor edad en MC (p = 0.027), IMC (p = 0.015), PC (p 0.05) entre ambos grupos. Existió una correlación significativa positiva entre la edad y las variables de MC (r = 0,252), IMC (r = 0,307), ICE (r = 0,431) y PC (r= 0,401). Al comparar ambos grupos de edad hubo diferencias antropométricas, pero no en la condición física. Se sugiere reforzar programas de entrenamiento para optimizar la composición corporal y capacidad física de bomberos en servicio activo para responder a las exigentes tareas que demanda este ámbito laboral.
SUMMARY: The aim of this study was 1) to compare anthropometric characteristics, jumping ability, and running endurance according to age and 2) to determine the relationship between age and physical performance parameters in Chilean adult firefighters in active service from the Valparaíso region. Sixty-eight healthy male firefighters, in active service, were divided into two groups according to age; 30 years (n = 32; 40.6 ± 8.5 years) participated. The anthropometric variables of body mass (BM), height, waist circumference (WC), body mass index (BMI = weight/height2 [m]) and waist-to-height ratio (WHR) were evaluated. Vertical jumping ability was assessed with the Squat Jump, Countermovement Jump and Abalakov Jump protocols. Running endurance was estimated with the Course Navette test and oxygen consumption (VO2) was calculated indirectly. Anthropometric variables for the > 30 years group were higher compared to the younger age group in BM (p = 0.027), BMI (p = 0.015), WC (p 0.05). There was a significant positive correlation between age and the variables of BM (r = 0.252), BMI (r = 0.307), WHR (r = 0.431) y WC (r= 0.401). When comparing both age groups, there were anthropometric differences, but not in physical condition. It is suggested to reinforce training programs to optimize the body composition and physical capacity of firefighters in active service in order to respond to the demanding tasks demanded by this work environment.
Subject(s)
Humans , Male , Adult , Anthropometry , Firefighters , Physical Functional Performance , Oxygen Consumption , Physical Endurance , Running , Body Mass Index , Age Factors , Athletic Performance , Waist Circumference , Waist-Height RatioABSTRACT
Background: Loss of estrogenic support may put postmenopausal women at higher risk of cardiovascular diseases. Aims and Objectives: This study aimed to examine premenopausal and postmenopausal woman to provide pertinent data on some of the cardiovascular risk factors and to know approximately the period which is under protection of estrogen and the period from which a woman is affected by changes in cardiovascular risk factors. Materials and Methods: This cross-sectional study was conducted in RIMS Ranchi from February 2018 to August 2019. A total of 262 apparently healthy women in the age group of 35–60 years were assessed for cardiovascular risk factors. Parameters assessed in premenopausal and postmenopausal women were heart rate, blood pressure (Systolic and Diastolic Blood Pressure), body mass index (BMI), waist circumference, hip circumference, blood sugar level, and lipid profile of the subjects. Results: Out of 262 participants, 132 were in the premenopausal group with mean age of 39.76 years and 130 were in the postmenopausal group with mean age of 50.8. Except BMI, all other cardiovascular risk parameters showed significant difference between premenopausal and postmenopausal women. Conclusion: We concluded that adverse changes in lipid profile and blood sugar along with significant increase in other cardiac risk factors in postmenopausal women as compared to premenopausal group of the study predisposed this group of women at increased risk of having cardiovascular disease in near future. Hence, preventive measures against cardiovascular disease risk should be started in premenopausal period only.
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Introducción: En la vejez, el valor predictivo de los factores de riesgo tradicionales es inconsistente. Con el aumento de la edad, las asociaciones entre los factores de riesgo tradicionales y las enfermedades cardiovasculares cambian. Objetivo: Recopilar información sobre los factores de riesgo tradicionales de enfermedad cardiovascular y su valor predictivo en el adulto mayor. Métodos: En el policlínico Ramón López Peña de Santiago de Cuba, en el período comprendido entre enero y mayo de 2022, se realizó una revisión sobre el tema. La búsqueda se realizó a partir de las bases de datos Pubmed, Infomed y SciELO, sin restricción de fechas, en los idiomas español e inglés. Resultados: Los hallazgos más recientes sugieren que los factores de riesgo tradicionales para la enfermedad cardiovascular podrían ser predictores más débiles del riesgo futuro en los ancianos, mientras que la fuerza de otros factores aumenta con la edad. Las personas mayores constituyen un subgrupo especial en el que otros factores como la polifarmacia, la hipotensión ortostática, la depresión y la condición física han demostrado ser determinantes potencialmente importantes de su riesgo cardiovascular. Conclusiones: El valor predictivo de la presión arterial, el colesterol y la obesidad en los ancianos disminuye o incluso se invierte, mientras que otros como la polifarmacia, la fragilidad y el deterioro cognitivo parecen ser prometedores(AU)
Introduction: In old age, the predictive value of common risk factors is inconsistent. With increasing age, the associations between common risk factors and cardiovascular disease change. Objective: To collect information on the common risk factors for cardiovascular disease and their predictive value in the elderly. Methods: A review on this subject was carried out at Ramón López Peña community clinic in Santiago de Cuba, from January to May 2022. The search was carried out from Pubmed, Infomed and SciELO databases, with no date restrictions, in Spanish and English. Results: The most recent findings suggest that common risk factors for cardiovascular disease might be weaker predictors of future risk in the elderly, while the strength of other factors increases with age. Older people constitute a special subgroup in which other factors such as polypharmacy, orthostatic hypotension, depression, and physical condition have been shown to be potentially important determinants of their cardiovascular risk. Conclusions: The predictive value of blood pressure, cholesterol and obesity in the elderly decreases or even reverses, while others such as polypharmacy, frailty and cognitive impairment appear to be promising(AU)
Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Cardiovascular Diseases/epidemiology , Heart Disease Risk FactorsABSTRACT
Objective: To analyze the agreement between body mass index (BMI) and waist-to-height Ratio (WHtR) to identify preschool and school children with cardiovascular risk factors (CRFs). Methods: Three-hundred-twenty-one kids were divided into preschool (3-5 years) and school children (6-10 years). BMI was used to classify children as overweight or obese. Abdominal obesity was defined with a WHtR ≥0.50. Fasting blood lipids, glucose and insulin were measured, and the homeostasis model assessment of insulin resistance (HOMA-IR) was calculated. The presence of CRFs and multiple non-waist circumference (non-WC) metabolic syndrome factors (MetS-Factors) [high HOMA-IR, high triglycerides and low high-density lipoprotein cholesterol (HDL-C)] were analyzed. Results: One-hundred-twelve preschool and 209 school children were evaluated. WHtR ≥0.50 classified abdominal obesity in more than half of the preschool children, exceeding those classified with overweight+obesity by BMI (59.5% vs. 9.8%; p0.05). There were similar proportions of school children classified with abdominal obesity by the WHtR and overweight+obesity by the BMI (18.7% vs. 24.9%; p>0.05). There was substantial agreement between WHtR and BMI to identify school children with high total cholesterol values, low-density lipoprotein cholesterol (LDL-C), triglycerides, non-HDL-C, insulin, HOMA-IR, low HDL-C values, and the presence of multiple non-WC MetS-Factors (kappa: 0.616 to 0.857, p<0.001). Conclusion: In preschool children WHtR ≥0.5 disagree with BMI results, but in school kids, it has good agreement with the BMI to classify the children´s nutritional status and to identify those with CRFs.
Objetivo: Analizar el grado de acuerdo entre el índice de masa corporal (IMC) y la relación/cintura estatura (rCE) para identificar niños con factores de riesgo cardiovascular (FRC). Métodos: Estudio transversal analítico con 112 niños preescolares (3-5 años) y 209 escolares (6-10 años). El sobrepeso y la obesidad se clasificaron con el IMC y la obesidad abdominal con la rCE ≥0.50. Se tomaron muestras sanguíneas en ayuno para análisis de glucosa, insulina, lípidos y cálculo del índice HOMA-IR. Se analizó la presencia de FRC y de múltiples factores del síndrome metabólico (Factores-SinMet) diferentes a la cintura [HOMA-IR elevado, triglicéridos elevados y colesterol de alta densidad (HDL-C) bajo]. Resultados: rCE ≥0.50 clasificó con obesidad abdominal a más de la mitad de los niños preescolares, excediendo el número de niños clasificados con sobrepeso+obesidad por IMC (59.5% vs 9.8%; p0.05). Fueron similares las proporciones de niños escolares clasificados con obesidad abdominal por la rCE o con sobrepeso+obesidad por el IMC (18.7% vs. 24.9%; p>0.05). Hubo acuerdo sustancial entre la rCE y el IMC para identificar niños escolares con valores elevados de colesterol total, colesterol de baja densidad, triglicéridos, colesterol no-HDL, insulina, HOMA-IR, valores bajos de HDL-C y la presencia de múltiples Factores-SinMet diferentes a la cintura (kappa: 0.616 a 0.857, p<0.001). Conclusión: En niños preescolares la aplicación de rCE ≥0.5 no presenta acuerdo con el IMC, pero en escolares presenta un acuerdo sustancial con el IMC en la clasificación del estado nutricional y en la identificación de niños con FRC.
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BACKGROUND@#Sex- and age-specific impacts of cardiovascular risk factors on the development of dementia have not been well evaluated. We investigated these impacts of smoking, overweight/obesity, hypertension, and diabetes mellitus on the risk of disabling dementia.@*METHODS@#The study participants were 25,029 (10,134 men and 14,895 women) Japanese aged 40-74 years without disabling dementia at baseline (2008-2013). They were assessed on smoking status (non-current or current), overweight/obesity (body mass index ≥25 kg/m2 and ≥30 kg/m2, respectively), hypertension (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg or any antihypertensive medication use), and diabetes mellitus (a fasting serum glucose ≥126 mg/dL, non-fasting glucose ≥200 mg/dL, hemoglobin A1c ≥6.5% by the National Glycohemoglobin Standardization Program or glucose-lowering medication use) at baseline. Disabling dementia was identified as the level of care required ≥1 and cognitive disability grade ≥IIa according to the National Long-term Care Insurance Database. We used a Cox proportional regression model to estimate hazard ratios and 95% confidence intervals (95% CIs) of disabling dementia according to the cardiovascular risk factors and calculated the population attributable fractions (PAFs).@*RESULTS@#During a median follow-up of 9.1 years, 1,322 (606 men and 716 women) developed disabling dementia. Current smoking and hypertension were associated with a higher risk of disabling dementia in both sexes, whereas overweight or obesity was not associated with the risk in either sex. Diabetes mellitus was associated with a higher risk only in women (p for sex interaction = 0.04). The significant PAFs were 13% for smoking and 14% for hypertension in men and 3% for smoking, 12% for hypertension, and 5% for diabetes mellitus in women. The total PAFs of the significant risk factors were 28% in men and 20% in women. When stratified by age, hypertension in midlife (40-64 years) was associated with the increased risk in men, while diabetes mellitus in later-life (65-74 years) was so in women.@*CONCLUSIONS@#A substantial burden of disabling dementia was attributable to smoking, and hypertension in both sexes and diabetes mellitus in women, which may require the management of these cardiovascular risk factors to prevent dementia.
Subject(s)
Male , Humans , Female , Adult , Middle Aged , Overweight/complications , East Asian People , Cardiovascular Diseases/epidemiology , Hypertension/etiology , Diabetes Mellitus/etiology , Obesity/etiology , Smoking/epidemiology , Risk Factors , Age Factors , Dementia/etiologyABSTRACT
ObjectiveTo observe the effect of Jiawei Shenqi Yixin prescription on cardiovascular risk factors in the patients with heart failure with preserved ejection fraction and insulin resistance. MethodFrom January 2021 to January 2022, a total of 82 patients with heart failure with preserved ejection fraction were enrolled in the ward of the First Affiliated Hospital of Heilongjiang University of Chinese Medicine. The patients were randomly assigned into two groups ( 41 cases) and received the same basic treatment. The observation group was additionally treated with Jiawei Shenqi Yixin prescription for 8 weeks. The clinical efficacy, traditional Chinese medicine (TCM) efficacy, cardiac function indexes [NT-probrain natriuretic peptide (NT-proBNP) and 6-min walking test (6MWT)], echocardiographic parameters [left atrial volume index (LAVI), left ventricular mass index (LVMI), peak early diastolic to peak late diastolic mitral flow velocity (E/A) ratio], insulin resistance-related indexes [fasting insulin (FINS), fasting plasma glucose (FPG), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), homeostatic model assessment of insulin resistance (HOMA-IR), triglyceride-glucose index (TYG), and triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio], inflammatory cytokines [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), adiponectin (ADP), and C-reactive protein (CRP)], vascular endothelial function indicators [nitric oxide (NO), endothelial nitric oxide synthase (eNOS), inducible nitric oxide synthase (iNOS), and endothelin-1 (ET-1)], and the safety of treatment were determined. In addition, Pearson correlation analysis was performed to analyze the correlations of insulin resistance, inflammatory cytokines, and vascular endothelial factors with the mitigation of heart failure. ResultIn terms of clinical efficacy, the therapy of the observation group was significantly effective in 26 patients, effective in 12 patients, ineffective in 3 patients, with the total effective rate of 92.68%, the therapy of the control group was significantly effective in 14 patients, effective in 12 patients, and ineffective in 15 patients, with the total effective rate of 63.41%. The clinical total effective rate of the observation group was higher than that of the control group (χ2=11.6, P<0.05). In terms of TCM efficacy, the therapy of the observation group was significantly effective in 26 patients, effective in 11 patients, and ineffective in 4 patients, with the total effective rate of 90.24%; the therapy of the control group was significantly effective in 9 patients, effective in 13 patients, and ineffective in 19 patients, with the total effective rate of 53.66%. The TCM total effective rate of the observation group was higher than that of the control group (χ2=8.19, P<0.05). Compared with those before treatment, the levels of NT-proBNP, LAVI, LVMI, FPG, FINS, HOMA-IR, TYG, TG/HDL-C, TNF-α, IL-6, CRP, ET-1, and iNOS in two groups declined after treatment (P<0.05), while the levels of 6MWT, E/A, ADP, NO, and eNOS elevated (P<0.05). After treatment, the observation group had lower levels of NT-proBNP, LAVI, LVMI, FPG, FINS, HOMA-IR, TYG, TG/HDL-C, TNF-α, CRP, and ET-1 (P<0.05) and higher levels of 6MWT, E/A, ADP, and NO than the control group (P<0.05). In addition, the increase in 6MWT after treatment was positively correlated with the increase in NO and the decrease in ET-1. The decrease in LVMI after treatment was positively correlated with the increase in NO and the decrease in FINS. The increase in left ventricular ejection fraction after treatment was positively correlated with the decreases in TNF-α and TYG (P<0.05). Adverse reactions were observed in neither group. ConclusionJiawei Shenqi Yixin prescription can significantly mitigate the symptoms, reduce inflammation, and improve vascular endothelial function in the patients with heart failure with preserved ejection fraction and insulin resistance, being safe without causing adverse reactions.
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Abstract Background Dietary treatment containing fiber-rich foods may contribute to lowering weight in obese women. Objective To investigate the effect of a hypoenergetic diet combined with pumpkin seed flour (PSF) consumption on diet quality, anthropometric indices, and glucose and lipid metabolism in obese women. Methods We conducted a randomized, double-blind, placebo-controlled, 90-day clinical trial with obese women, distributed into the following two groups: hypoenergetic diet + placebo (PG) and hypoenergetic diet + pumpkin seed flour (PSFG). A total of 100 participants were included in the PSFG (n = 47) and PG (n = 53). We evaluated neck circumference (NC); waist to height ratio; conicity index; fat mass (FM); lipid profile; blood concentrations of glucose and insulin; homeostatic model assessment for insulin resistance (HOMA-IR); quantitative insulin sensitivity check index (QUICKI); and blood pressure at baseline, 30, 60, and 90 days. Dietary analysis was determined by differences between diet quality indices before and after prescribing the experimental diet. Chi-squared, Student's t-tests and analysis for repeated measures were used, and values were considered significant at p < 0.05. Results The dietary pattern improved after 90 days in both groups. The PSFG presented lower NC (p < 0.001), FM (p = 0.010), triglycerides (TG) (p = 0.025), insulin (p = 0.003), and HOMA-IR (p = 0.018). The PG presented a lower diastolic blood pressure (p = 0.004) and low-density lipoprotein cholesterol (LDL-c) (p = 0.056). Conclusion A hypoenergetic diet combined with PSF consumption contributes to lowering NC, FM, HOMA-IR, TG, and insulin concentrations.
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SUMMARY OBJECTIVE: This study investigated the association of psoriasis with cardiovascular risk factors and psychological aspects among participants of the Brazilian Longitudinal Study of Adult Health. METHODS: This is a cross-sectional study from the baseline data of the Brazilian Longitudinal Study of Adult Health cohort, collected between 2008 and 2010 in six state capitals of Brazil (i.e., Belo Horizonte, Porto Alegre, Rio de Janeiro, Salvador, São Paulo, and Vitória). Participants were active and retired civil servants from college and research institutions, aged between 35 and 74 years. Exclusion criteria included the intention to quit working at the institution, pregnancy, severe cognitive impairment, and, if retired, residence outside of a study center's corresponding area. Psoriasis case identification was based on a previous medical diagnosis of psoriasis. Cardiovascular risk profile, psychological aspects, and sociodemographic variables were investigated. RESULTS: Data from 15,105 participants were analyzed (mean age of 52.3 years, 51.3% women). The prevalence of psoriasis was 1.6% (n=236). Psoriasis was associated with higher education (OR 1.94 [CI 1.07-3.52]), health insurance plan (OR 1.56 [CI 1.08-2.25]), central obesity (OR 1.63 [CI 1.10-2.40]), smoking status (former OR 1.40 [CI 1.03-1.88]; current OR 1.61 [CI 1.08-2.40]), and very bad self-perception of health (OR 7.22 [CI 2.41-21.64]), remaining significant even after multivariate adjustment. Self-reported Black participants were less likely to have psoriasis (OR 0.45 [CI 0.26-0.75]). CONCLUSION: In a sample of healthy workers, psoriasis was associated with central obesity, smoking, and a very bad self-perception of health, which may contribute to future cardiovascular disease.