Predictors of Coronary Heart Disease (CHD) among Malaysian Adults: Findings from MyDiet-CHD Study

@#Introduction: This study aimed to determine the risk factors of CHD among the Malaysian adult population. Methods: Using a cross- sectional observational study design, this study involved 365 adult patients aged between 30-64 years, attending clinics from eight government hospitals and four health clinics in Terengganu, Pahang, Selangor, Putrajaya, Penang, Kedah, Johor and Sabah from February 2018 until September 2020. Sociodemographic characteristics, clinical and dietary data, physical activity and stress level were recorded using a structured questionnaire. Multiple logistic regression was used to analyse CHD risk factors. Results: The overall response rate was 99.2%. The adjusted odds ratio of CHD was greater for age (AOR; [%95 CI]) (1.043;[ 1.009,1.078]); waist circumference (1.033;[1.009, 1.057]); total fat intake (1.035;[1.021, 1.050]); full cream dairy products intake (1.004;[1.001, 1.008]); smokers vs non-smokers (4.691;[2.399, 9.176]); individual with family history of CHD vs without family history (2.705;[ 1.496, 4.891]); married vs single (0.434;[ 0.217,0.867]); and lower for HDL cholesterol (0.185;[0.052, 0.662]); Chinese vs Malays (10.619;[ 2.255, 49.995]); and third lowest income (0.197;[ 0.073, 0.532]) and forth lowest income (0.167;[ 0.056, 0.499]) vs lowest income. Conclusion: Age, race, income, smoking and marital status, family history of CHD, waist circumference, HDL cholesterol, total fat intake, full cream dairy products intake were significantly associated with CHD among this population. This finding is particularly important to the primary health carers to identify at-risk CHD individuals thus appropriate intervention could be provided.

Tea consumption is associated with a reduced risk of coronary heart disease in female but not male populations in Guangzhou, China

BACKGROUND/OBJECTIVES: The association between tea consumption and risk of coronary heart disease (CHD) remains controversial. This study aimed to determine whether tea consumption has an effect on CHD risk in Chinese adults. SUBJECTS/METHODS: In this hospital-based case-control study, 267 cases of CHD and 235 non-CHD controls were enrolled. Blood samples from all cases were examined. Cardiac function indices (left ventricular ejection fraction, left ventricular end-diastolic dimension, lactate dehydrogenase, and creatine kinase of the muscle or brain type), blood lipid index (high-density lipoprotein cholesterol), and blood coagulation function indices (fibrinogen and activated partial thromboplastin time) were recorded. Tea consumption of study participants was assessed by a specifically designed questionnaire. The baseline characteristics of the study populations were recorded, and CHD-related biomarkers were detected. Differences in baseline characteristics of the study participants were examined using t-tests for continuous variables and chi-squared tests for categorical variables. Unconditional logistic regression was used to measure the association between tea and CHD. RESULTS: There were significant differences in cardiac function indices, blood lipid index, and blood coagulation indices between CHD cases and controls (P 6 days/week was beneficial for CHD prevention (adjusted OR = 0.183, 95% CI: 0.049–0.679, P = 0.0112). When analyzed according to the duration of tea consumption, the risk of CHD was reduced in participants who had been drinking tea for 10–20 years (adjusted OR = 0.360, 95% CI: 0.137–0.946, P = 0.0382). CONCLUSIONS: Tea consumption is associated with a reduced risk of CHD in female but not male populations in Guangzhou.

High frequency of silent brain infarcts associated with cognitive deficits in an economically disadvantaged population

OBJECTIVE: Using magnetic resonance imaging, we aimed to assess the presence of silent brain vascular lesions in a sample of apparently healthy elderly individuals who were recruited from an economically disadvantaged urban region (São Paulo, Brazil). We also wished to investigate whether the findings were associated with worse cognitive performance. METHODS: A sample of 250 elderly subjects (66-75 years) without dementia or neuropsychiatric disorders were recruited from predefined census sectors of an economically disadvantaged area of Sao Paulo and received structural magnetic resonance imaging scans and cognitive testing. A high proportion of individuals had very low levels of education (4 years or less, n=185; 21 with no formal education). RESULTS: The prevalence of at least one silent vascular-related cortical or subcortical lesion was 22.8% (95% confidence interval, 17.7-28.5), and the basal ganglia was the most frequently affected site (63.14% of cases). The subgroup with brain infarcts presented significantly lower levels of education than the subgroup with no brain lesions as well as significantly worse current performance in cognitive test domains, including memory and attention (p<0.002). CONCLUSIONS: Silent brain infarcts were present at a substantially high frequency in our elderly sample from an economically disadvantaged urban region and were significantly more prevalent in subjects with lower levels of education. Covert cerebrovascular disease significantly contributes to cognitive deficits, and in the absence of magnetic resonance imaging data, this cognitive impairment may be considered simply related to ageing. Emphatic attention should be paid to potentially deleterious effects of vascular brain lesions in poorly educated elderly individuals from economically disadvantaged environments.

Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

Association between the types of obesity and the 10-year-coronary heart disease risk, in Tibet Autonomous Region and Xinjiang Uygur Autonomous Region / 中华流行病学杂志

Objective To investigate the association between types of obesity and the 10-year-coronary heart disease risk in Tibet and Xinjiang of China.Methods Using the multi-stage random sampling method,7 631 participants aged 35 or older were examined under the International Standardized Examination process but with only 5 802 were eligible for analysis,in the 2015-2016 season.Results The prevalence rates of general obesity,central obesity,visceral obesity and compound obesity were 0.53％,12.62％,10.08％ and 42.35％,respectively.Out of all the compound obesity cases,58.65％ (1 441/2 457) of them appeared as having all types of obesity in our study.Risk related to the 10-year-coronary heart disease was higher in men than in women [(3.05 ± 4.14)％ vs.(1.42-2.37) ％,P＜0.000 1.Compound obesity (30.16％) showed the highest proportion on the risk of 10-year-coronary heart disease than central obesity (28.01％),visceral obesity (18.46％) or the general obesity (19.35％).After adjustment for confounding factors,results from the multivariate analysis showed the risk in compound obesity was higher than central obesity,visceral obesity or general obesity and was associated with the highest risk on the 10-year-coronary heart disease (OR=2.889,95％CI:2.525-3.305).People with anomalous BMI and WC seemed to have had the higher risk (OR=3.168,95％CI:2.730-3.677).Conclusions Obesity was popular in the residents of Tibet and Xinjiang areas of China.Men and people with compound obesity (especially both BMI and WC were abnormal) seemed to carry greater risk on the 10-year-coronary heart disease.

Comparison of homocysteinemia and MTHFR 677CT polymorphism with Framingham Coronary Heart Risk Score / Comparación de homocisteinemia y polimorfismo 677CT MTHFR con el Escore Framingham de Riesgo Coronario

Objective: The Framingham Coronary Heart Disease Risk Score is an important clinical tool. The aim of this cross-sectional study was to compare plasma homocysteine levels and polymorphism 677CT MTHFR with this score to determine the utility of these new biomarkers in clinical practice. Methods: Plasma homocysteine levels determined by chemiluminescence and polymorphism 677CT MTHFR, detected by PCR-RFLP, were compared with Framingham coronary risk score in a cross-sectional survey on 68 men and 165 women. Results: Coronary heart disease risk augmented with an increase in the quartile of plasma homocysteine. In the 2nd, 3rd and 4th quartile of plasma homocysteine, men showed significantly (P < 0.001) higher risk than women. For the highest quartile of plasma homocysteine, OR of high-risk (10-year risk ≥ 20%) compared with the lowest quartile was 17.45 (95% CI: 5.79-52.01). Frequencies of CT and TT genotype and T allele were not over-represented in the individuals with score ≥ 10%. The higher plasma homocysteine concentrations in individuals with score ≥ 10% with respect to those with low risk (P < 0.005 and P < 0.001) were not due to the presence of T allele. The T allele (CT + TT genotypes) of the MTHFR C677T polymorphism was not significantly associated with an increased risk of coronary disease (OR = 1.09, 95% CI = 0.50-2.39, P = 0.844). Conclusions: The present study demonstrated an association between plasma homocysteine levels and the severity of coronary heart disease estimated with the Framingham coronary risk score, and this association appeared to be independent on the genotype of MTHFR. We postulate that plasma homocysteine is effective enough, considered even in isolation.

Objetivo: La puntuación del riesgo coronario de Framingham es una importante herramienta clínica. El objetivo del presente estudio transversal fue comparar los niveles plasmáticos de homocisteína plasmática y el polimorfismo 677CT de la MTHFR con esta herramienta para determinar la utilidad de estos nuevos biomarcadores en la práctica clínica. Métodos: Los niveles de homocisteína plasmática determinados por quimioluminiscencia y el polimorfismo 677CT MTHFR por PCR-RFLP fueron comparados con la puntuación del riesgo coronario de Framingham en un estudio transversal sobre 68 hombres y 165 mujeres. Resultados: El riesgo de enfermedad coronaria aumentó con el incremento en los cuartiles de homocisteína plasmática. En el segundo, tercero y cuarto cuartil de homocisteína plasmática los hombres mostraron significativamente (p < 0.001) mayor riesgo que las mujeres. Para el cuartil más alto de homocisteína plasmática, la OR de riesgo alto (riesgo a 10 años ≥ 20%) comparado con el cuartil más bajo fue 17,45 (IC 95%: 5,79-52,01; p < 0.001). Las frecuencias de los genotipos CT y TT y del alelo T no estuvieron aumentados en los individuos con una puntuación ≥ 10%. Las mayores concentraciones de homocisteína plasmática en los individuos con una puntuación ≥ 10% respecto a los de bajo riesgo (p < 0.005 y p < 0.001) no se debieron a la presencia del alelo T. El alelo T (genotipos CT + TT) del polimorfismo MTHFR C677T no estuvo significativamente asociado con mayor riesgo de enfermedad coronaria (OR = 1.09, IC 95% = 0.50-2.39, p = 0.844). Conclusiones: El presente estudio mostró una asociación entre los niveles de homocisteína plasmática y la severidad de la enfermedad coronaria estimada con el algoritmo de puntuación de riesgo coronario de Framingham y esta asociación resultó ser independiente del genotipo de MTHFR. Postulamos que la homocisteína plasmática es lo suficientemente eficaz, estudiada incluso aisladamente.

Alcoholic fatty liver disease elevates estimated coronary heart disease risk to levels comparable with those of nonalcoholic fatty liver disease in the Korean population: a cross-sectional study

BACKGROUND/AIMS: A close relationship has been established between nonalcoholic fatty liver disease (NAFLD) and an elevated risk of coronary heart disease (CHD), but little is known about the association between alcoholic fatty liver disease (AFLD) and CHD risk. The aim of this study was to determine whether AFLD is associated with elevated CHD risk. METHODS: We retrospectively enrolled 10,710 subjects out of 11,469 individuals who visited the Konkuk University Health Care Center for a routine health checkup in 2010. AFLD was diagnosed made when the usual amount of alcohol consumption exceeded 210 g/week in males and 140 g/week in females for the previous 2 years and when hepatic steatosis was detected by liver ultrasonography. The 10-year risk for CHD was estimated using the Framingham Risk Score. RESULTS: Hepatic steatosis was diagnosed in 4,142 of the 10,710 individuals (38.7%); the remainder (i.e., n=6,568) became the control group. The 4,142 individuals with hepatic steatosis were divided into two groups: NAFLD (n=2,953) and AFLD (n=1,189). The risk of CHD was higher in AFLD (6.72+/-0.12) than in the control group (5.50+/-0.04, P<0.001), and comparable to that in NAFLD (7.32+/-0.07, P=0.02). CONCLUSIONS: Individuals with AFLD have an elevated 10-year risk of CHD that is comparable to those with NAFLD. Therefore, AFLD should be considered a significant risk for future CHD, and preventive measures should be considered earlier.

Riesgo coronario según ecuación de Framingham en adultos con síndrome metabólico de la ciudad de Soledad, Atlántico. 2010 / Coronary risk according to Framinghan equation in adults with metabolic syndrome in the city of Soledad, Atlantico, 2010

Objetivo: determinar el riesgo coronario en adultos con síndrome metabólico de la ciudad de Soledad, Atlántico, en 2010. Métodos: estudio descriptivo transversal, en el que se estudiaron 99 adultos del municipio de Soledad, a quienes se aplicó una encuesta de factores de riesgo cardiovascular, y adicionalmente se tomaron mediciones de peso, talla, perímetro de cintura y presión arterial, así como pruebas bioquímicas de glicemia, colesterol total, colesterol HDL y triglicéridos, para determinar la prevalencia de síndrome metabólico. Adicionalmente, se aplicó el puntaje de Framingham para evaluar riesgo coronario. Resultados y conclusiones: 49,5 porciento de los sujetos tenían síndrome metabólico según la International Diabetes Foundation (IDF), 41,4 prciento de acuerdo con la American Heart Asociation (AHA) y 20,2 porciento con base en el Adult Treatment Panel III (ATP III). La prevalencia de síndrome metabólico fue mayor en mujeres (p>0,05); por edad se encontraron diferencias estadísticamente significativas (p<0,05). El promedio de porcentaje de riesgo cardiovascular según Framingham fue de 3 porciento (DE ±: 4,72 porciento), mayor en los hombres: 5,67 (DE ±: 5,24) frente a 1,01 (DE±: 3,04) en mujeres. En los hombres con síndrome metabólico el riesgo cardiovascular fue mayor.

Objective: to determine coronary risk in adults with coronary syndrome in the city of Soledad, Atlantico. 2010. Methods: cross sectional study. A survey of cardiovascular risks was applied to 99 adults in the city of Soledad. Additionally, measures of weight, height, waist circumference and blood pressure were taken, as well as biochemical tests for blood glucose, total cholesterol, HDL cholesterol and triglycerides, in order to determine the metabolic syndrome prevalence. In addition, we applied the Framinghan score to evaluate coronary risk. Results and Conclusions: 49.5 percent subjects had metabolic syndrome according to the International Diabetes Foundation, 41.4 percent according to the American Heart Association, and 20.2 percent according to the American Treatment Pannel III. The prevalence of metabolic syndrome was higher in women (p >0,05); age differences were statistically significant (p <0,05). The average percentage of Framinghan cardiovascular risk was 3 percent (SD ±: 4.72 percent), higher in men: 5.67 (SD ±: 5.24) versus 1.01 (SD ±: 3, 04) in women. In men with metabolic syndrome, the cardiovascular risk was higher.