Cardiovascular Risk Factors In Adults Research Articles

Profile of diabetes and cardiovascular risk factors in adults Anjouan Island (Comoros).

IntroductionThe aim of this study was to estimate the prevalence of Diabetes Mellitus (DM) and Impaired Fasting Glucose (IFG) in the peri-urban adult population living in the island of Anjouan, Comoros and to investigate the factors associated with diabetes mellitus.MethodsThe survey was a cross-sectional study, in which a sample of 902 individuals (540 women and 362 men) aged 25 to 64 was selected using empirical sampling “quotas” or “reasoned choice” survey method. Hypertension and obesity abdominal measurements of these subjects were collected during face-to-face interviews and following day fasting blood glucose was measured in capillary blood.ResultsParticipation rate was 83.5%. The mean age of subjects was 39.5 ± 11.63 years. The sex ratio was 0.67. Overall crude diabetes and IFG prevalence were 8.5% and 8.1%, respectively. The risk factors for diabetes type 2 onset were a family history of diabetes (P = 0.006), older age (P = 0.000), glycemic control (P = 0.010), excess waist circumference (P = 0.03) and hypertension (p = 0.000), were significantly positively associated with DM, contrary to sex (P = 0.142).ConclusionThese high figures confirm that diabetes and factors associated do not spare Anjouan population. Awareness, primary prevention, are to set up for a better control of non-communicable diseases.

College Students' Perception of Current and Projected 30-Year Cardiovascular Disease Risk Using Cluster Analysis with Internal Validation.

Cardiovascular risk factors in young adults at a national level are less than ideal specifically for hypercholesterolemia, hypertension, and diabetes. Explore college students' perception of their 30-year cardiovascular disease (CVD) risk using cluster analysis technique with internal validation. This is a descriptive and cross-sectional study. A total of 133 college students, aged 20-36 with no known history of CVD, were recruited and used to perform cluster analysis with internal validation. The mean age of the sample was 24.85 and predominately female (59.5%). The mean score for perception of cardiovascular risk factors was 21.20 ranging from 12 to 34 points on a Likert scale. The mean score for the 30-year CVD risk assessment was 5.23 ranging from 1 to 22%. Five clusters emerged from the cluster analysis. However, two of the clusters, the highest risk with moderate perception and low risk and lowest perception, were identified as areas for potential intervention as there were discrepancies between subjects' perceived risk and their actual 30-year risk. The national data and literature has indicated a lack of awareness of CVD risk among this population which our study also concurred. Identifying the discrepancies between the perceived and projected CVD risk are useful for researchers and clinicians such as nurses to take the initiative to focus on and begin to intervene in this population to reduce potential adverse events of CVD.

Modifiable Cardiovascular Risk Factors in Adults with Sickle Cell Disease

Introduction:Body composition, cardiorespiratory fitness (CRF) and muscular strength(MusS) are important predictors of cardiovascular (CV) mortality and morbidity. Poor CRF, body composition and MusS are each associated with higher rates of musculoskeletal injury, inflammation, heart disease, and all-cause mortality. Fortunately, these parameters in the general population, are partly influenced by lifestyle habits and can improve with modifying unhealthy behaviors such as increasing activity levels. Few studies have examined fitness parameters, in particularly MusS, in adults with sickle cell disease (SCD). As cardiopulmonary disease is a leading cause of death in SCD, we sought to better characterize fitness and body composition in adults with SCD. The objective of this study is to describe modifiable CV risk factors of fitness along with other risk factors of smoking, hypertension, and cholesterol in a population of adults with SCD.Methods:Forty-six participants (ages 21-66 yrs.; 74% female; sickle cell anemia n =29, sickle variant genotype n=17) were recruited from a comprehensive adult sickle center. Non-pregnant adults in steady-state SCD disease without an absolute contraindications to exercise were eligible to participate. CRF was measured using symptom-limited exercise testing performed on a cycle ergometer following an incremental ramp protocol. Maximal oxygen uptake (VO2 max), a key measure of CRF, was calculated during exercise testing. MusS was assessed using an isokinetic dynamometer, the Biodex system 3, the gold standard to measure MusS in rehabilitative medicine. Peak isokinetic torques of knee extension and flexion were determined at 60 degrees per second, and adjusted for body weight on the Biodex system 3. A medical history, fitness assessments, anthropometric testing, and laboratory testing were completed on all SCD participants. Sixteen SCD participants had dual energy x-ray absorptiometry imaging to assess fat, lean, and bone mass. The remaining 30 SCD patients underwent isokinetic CRF and MusS testing. Lean muscle mass and body fat of participants were compared to US national guidelines, VO2max was compared to predicted norms. As there are no well-established normative values for MusS, we compared values to a cohort of 60 adults without SCD (age 21-40 yrs.; 63% female) who underwent MusS testing as a part of a separate study. For muscle strength, multivariate regression was performed to control for the effects of age, BMI, gender, and SCD status on peak torques.Results:All SCD and control participants were able to complete testing safely without any adverse events. 34.7% of SCD participants (n=16) had a smoking history with a mean pack year history of 9 years (Table 1). 18% of participants (n=10) received medical treatment for hypertension (Table 1). 64% (n=32) of participants had reduced HDL levels and 8% (n=3) had elevated triglycerides. Median (IQR) waist-hip circumference (F=0.89(0.14), M=0.93 (0.11)) and total percent body fat (F=37.7(11.5), M=22.3(11.5)) for SCD participants were higher than national normative values and 66% were classified as obese (Table 1). SCD participants had reduced mean (SD) VO2max, 16.77 (3.29) and 19.56 (7.27) ml/min/kg for females and males respectively compared with norms. In 90% of SCD participants (n=28), percent-predicted VO2max was less than normal (i.e. < 84 percent-predicted) with 4 adults having markedly reduced VO2max with a percent-predicted value less than 50%. Hemoglobin, hydroxyurea use and SCD genotype were not predictive of VO2max. Compared to controls, mean (SD) peak torque values for knee extension (82.7 Nm (19) vs 44.33 Nm (18.85), p<0.0001) and flexion ( 38.6 Nm (9.03)vs 19.19 Nm (13.2), p<0.0001) at 60 degrees were lower in SCD participants even after adjusting for age, sex, and body mass index (BMI) (Table1).Limitations: Study limitations include a small sample size, and the lack of controls matched for race, age, BMI, and hemoglobin.Conclusion:In this pilot study we show that both CRF and MusS are decreased in adults with SCD. Additionally, this cohort had a number of CV risk factors including smoking, hypertension and reduced HDL levels. As we know these are important predictors of poor CV outcomes additional research is needed to determine whether a carefully designed exercise and diet program can improve these modifiable CV risk factors and ultimately health status in adults living with SCD. [Display omitted] DisclosuresWang:PCORI: Research Funding. Lanzkron:Pfizer: Consultancy, Research Funding; NHLBI: Research Funding; Ironwood: Research Funding; PCORI: Research Funding; GBT: Consultancy, Research Funding; Selexys: Research Funding; Prolong: Research Funding.

PO-024 Associations between the Sedentary Behavior and Cardiovascular Risk Factors in Adults of 40-49year

Objective Large amounts of pieces of evidence suggest sedentary behavior(SB) might have a negative impact on all-cause mortality, cardiovascular disease, and metabolic system. Our aim is to explore the associations between sedentary behavior and cardiovascular risk factors in adults of 40-49year.&#x0D; Methods Participants(N=372) were adults 40-49 years old who had a survey by using adult sit-Q-7d. The indexes of body mass index(BMI) and Waist circumference(WC) were measured as per standard protocols and blood pressure measured using an automated sphygmomanometer (Carescape V100; GE Healthcare, UK) following five minutes seated rest. HDL cholesterol (HDL-C), LDL cholesterol (LDL-C), triglycerides(TG) and fasting plasma glucose(FPG) were assessed for blood sampling of venous blood following an overnight fast (Cholestech LDX; Alere Inc, USA). We analyzed data in 2 h/day and 1 h/day as segmentation criteria of sitting time were classified as 8 groups(0&lt;2, 2-4, 4-6, 6-8, 8-10, &gt;10 h/day) and 10 groups(&lt;1, 1-2, 2-3, 3-4, 4-5, 5-6, 6-7, 7-8, 8-9，&gt;9 h/day). Statistical analyses were performed using STATA software 15.0(STATA Corp, College Station, TX). We performed multiple linear regression models adjusting for health-related confounders to assess the associations between SB of difference range and risk factors of cardiovascular disease.&#x0D; Results (1)When the sitting time as category criteria in 2 h/day, the relationship of LDL-C(β=0.651，95%CI=0.069 to 1.232, P=0.028) and HDL-C(β=0.129，95%CI=0.013 to 0.245, P=0.028) to sitting time in segment of 6-8h/day were statistically significant after adjustment for relative factor of risk; and the same in TC(β=0.932，95%CI=0.244 to 1.620, P=0.008) to sitting time in segment of 8-10h/day; (2) When the sitting time as category criteria in 1 h/day, in 3-4h/day segment, the index of BMI(β=1.550，95%CI=0.025 to 3.074, P=0.046) had a significant rise; in 7-8h/day segment, the index of LDL-C(β=0.919，95%CI=0.155 to 1.683, P=0.019) also had a significant rise; as well as, in 8-9h/day segment, the index of TC(β=1.531，95%CI=0.497 to 2.565, P=0.004) had a highly significant. (3) As has mentioned above, the threshold for each segment of sitting time for the index of LDL-C in 7-8h/day segment and the index of TC in 8-9h/day.&#x0D; Conclusions This study suggests that (1) the different category criteria of sitting time, for categories criteria in 1h/d or 2h/d, will help reduce the risk of Cardiovascular risk in some degree and determining to their dose-response relationships. (2) For the 40-49year adult of health, the sitting time threshold is less than 7 h/d, in order to decrease the detrimental effects on metabolic markers associated with cardiovascular disease and metabolic system. (3) As well as the sitting time threshold is less than 3 h/d for adding to the negative aging effect on risk of cardiovascular markers.

Lack of Relationships Between Serum Prolactin Concentrations and Classical Cardiovascular Risk Factors in Eastern Croatian Older Adults.

BackgroundRelationships between serum prolactin concentrations and various CV risk factors in older adults have rarely been assessed. The aim of this study was to examine the relationships between serum prolactin concentrations and CV risk factors in older patients with multiple CV risk factors.Material/MethodsThis case-control study included 92 patients, 50–89 years old (median, 69 years), with multiple CV risk factors. We used data from general practice electronic health records and biochemical laboratory tests. Patients were divided according to categories of CV risk factors.ResultsSerum prolactin concentrations were significantly higher in elderly people (≤65 vs. >65) and in men (70.65±58.02 vs. 150.82±114.05 mIU/L), as well as in patients with lower renal function (156.70±127.23 vs. 72.53±37.25 mIU/L, the bottom vs. top quartile of creatinine clearance), higher serum homocysteine and TSH concentrations, and in those who used NSAID and statins. Parameters indicating chronic inflammation (CRP) and renal function decline (creatinine clearance) were significantly and independently correlated with increased serum prolactin concentrations in multiple regression analysis.ConclusionsWhen assessing the relationships between prolactin and CV risk factors in older people with multiple CV risk factors, the effect of renal function decline and chronic inflammation should receive attention.

Adherence to the DASH-style Diet and the Presence of Cardiovascular Risk Factors in Adults from Tîrgu Mureș

Abstract Background: Adopting a healthy lifestyle, including a healthy diet, weight control, regular exercise, smoking cessation, and alcohol limitation, plays an important role in treating high blood pressure and cardiovascular and chronic diseases. Aim: This study aimed to investigate adherence to the DASH diet in relation to the occurrence of high blood pressure and chronic disease risk factors, in a group of people from Tîrgu Mureș. Material and methods: This was a cross-sectional study based on a food frequency and lifestyle questionnaire applied to a group of 2,010 people aged 15–92 years from Tîrgu Mureș. Results: Individuals over the age of 45 had higher DASH scores (Q4, Q5) compared to subjects younger than 40 years (Q1 and Q2, p &lt;0.001). An important percentage (19.3%) of subjects who preferred a meat-based diet (Q3) had significantly larger abdominal circumference (mean 92.2 ± 0.91 cm, p &lt;0.001). An association between pure alcohol intake (mean 5.6 ± 0.43 g) and an unhealthy diet (Q1) was observed, compared to the average 1.7 ± 19 g of alcohol consumed by subjects with a healthy diet (Q5), alcohol consumption decreasing with an increasing DASH score (p &lt;0.001). Conclusion: This study shows that individuals diagnosed with at least one cardiovascular risk factor had a higher adherence to the DASH diet than individuals with no cardiovascular risk factors, most likely due to the fact that diagnosed individuals had changed their eating behavior and lifestyle from the time of diagnosis, with a positive impact on treatment outcomes and quality of life.

Cardiovascular risk factors in adults with congenital heart defects — Recognised but not treated? An analysis of the German National Register for Congenital Heart Defects

BackgroundAs adult congenital heart disease (ACHD) patients are aging, a high prevalence of cardiovascular risk factors is encountered similar to the general population. Currently, data regarding the primary and secondary prevention of acquired cardiovascular disease in ACHD is lacking. MethodsThe German National Register of Congenital Heart Defects was systematically screened for ACHD patients with established cardiovascular risk factors or documented acquired cardiovascular conditions. Data were analyzed with regard to the according medical treatment. ResultsOverall, 539 patients were included (mean age 38.4 ± 17.7 years, 49.2% female). Diabetes was present in 57 pts. (10.6%), arterial hypertension in 113 pts. (21.0%), hyperlipidaemia in 81 pts. (15.0%) and obesity in 271 pts. (50.2%). 31 pts. (5.8%) were smokers. Coronary artery disease was established in 16 pts. (3.0%), peripheral vascular disease in 9 pts. (1.7%), and cerebrovascular accidents in 141 pts. (26.2%). Out of the patients with coronary artery disease only 81.3% received antithrombotic treatment. Only 18.8% were prescribed a statin. Of the pts. with peripheral arterial disease, 44.4% received an antiplatelet drug, and only 22.2% were on a statin. Patients with arterial hypertension received antihypertensive drugs in 66.4%. ConclusionsPrimary and secondary prevention of acquired cardiovascular disease in ACHD is underutilized. This highlights the importance of educating primary physicians as well as ACHD physicians about the need of primary and secondary prevention for acquired cardiovascular disease.

High birth weight was associated with increased radial artery intima thickness but not with other investigated cardiovascular risk factors in adulthood.

This study investigated whether a high birth weight was associated with increased risk factors for cardiovascular disease when Swedish adults reached 34-40. We studied 27 subjects born at Uppsala University Hospital in 1975-1979, weighing at least 4500 g, and compared them with 27 controls selected by the Swedish National Board of Welfare with birth weights within ±1 standard deviations scores and similar ages and gender. The study included body mass index (BMI), blood pressure, lipid profile, haemoglobin A1c (HbA1c), C-reactive protein (CRP) and high-frequency ultrasound measurements of intima-media thickness, intima thickness (IT) and intima:media ratio of the carotid and radial arteries. Subjects with a high birth weight did not differ from controls with regard to BMI, blood pressure, lipid profile, high-sensitivity CRP, HbA1c or carotid artery wall dimensions. However, their radial artery intima thickness was 37% greater than the control group and their intima:media ratio was 44% higher. Our findings indicate that a high birth weight was associated with increased radial artery intima thickness, but not with other investigated cardiovascular risk factors, at 34-40 years of age. The clinical implications of these findings should be investigated further, especially in subjects born with a very high birth weight.

Physical Activity and Diabetes.

Physical Activity and Diabetes.

IndEcho study: cohort study investigating birth size, childhood growth and young adult cardiovascular risk factors as predictors of midlife myocardial structure and function in South Asians

IntroductionSouth Asians have high rates of cardiovascular disease (CVD) and its risk factors (hypertension, diabetes, dyslipidaemia and central obesity). Left ventricular (LV) hypertrophy and dysfunction are features of these disorders...

To Study the Relationship Between QT Interval and Cardiovascular Risk Factors in Healthy Young Adults

To Study the Relationship Between QT Interval and Cardiovascular Risk Factors in Healthy Young Adults

Reported gum disease as a cardiovascular risk factor in adults with intellectual disabilities.

Several risk factors for cardiovascular disease (CVD) have been identified among adults with intellectual disabilities (ID). Periodontitis has been reported to increase the risk of developing a CVD in the general population. Given that individuals with ID have been reported to have a higher prevalence of poor oral health than the general population, the purpose of this study was to determine whether adults with ID with informant reported gum disease present greater reported CVD than those who do not have reported gum disease and whether gum disease can be considered a risk factor for CVD. Using baseline data from the Longitudinal Health and Intellectual Disability Study from which informant survey data were collected, 128 participants with reported gum disease and 1252 subjects without reported gum disease were identified. A series of univariate logistic regressions was conducted to identify potential confounding factors for a multiple logistic regression. The series of univariate logistic regressions identified age, Down syndrome, hypercholesterolemia, hypertension, reported gum disease, daily consumption of fruits and vegetables and the addition of table salt as significant risk factors for reported CVD. When the significant factors from the univariate logistic regression were included in the multiple logistic analysis, reported gum disease remained as an independent risk factor for reported CVD after adjusting for the remaining risk factors. Compared with the adults with ID without reported gum disease, adults in the gum disease group demonstrated a significantly higher prevalence of reported CVD (19.5% vs. 9.7%; P=.001). After controlling for other risk factors, reported gum disease among adults with ID may be associated with a higher risk of CVD. However, further research that also includes clinical indices of periodontal disease and CVD for this population is needed to determine if there is a causal relationship between gum disease and CVD.

A review and mechanism analysis of cardiovascular risk factors in adults

Cardiovascular disease has become a major health problem facing human beings, and it is also the leading cause of death world wide.Now Cardiovascular disease risk factors have been found and many new complex risk factors (such as sleep, atmospheric pollution, social psychological factors, cortisol, C-reactiveprotein, homocysteine, age at menarche etc.) are put forward, which let people have a deeper understanding. In this paper, the recent advances in cardiovascular disease risk factors and influence mechanism are reviewed, so as to provide basis and support for cardiovascular disease in prevention, treatment and nursing. Key words: Cardiovascular disease; Risk factors; Effect mechanism; Review

OP.5C.07] THE LINK BETWEEN CARDIORESPIRATORY FITNESS AND CARDIAC AUTONOMIC NERVOUS SYSTEM IN OBESE YOUTH

Objective: Over the last decades the prevalence of obesity in children and adolescents has increased worldwide. This fact affects health expectancy and quality of life and then, assessment of cardiovascular risk factors has been emphasized. Among cardiovascular risk factors in adults, the relevance of cardiorespiratory fitness has been highlighted by the American Heart Association (AHA, Circulation 2016). To assess the cardiorespiratory fitness and its relationship with the cardiac autonomic neural activity, a marker of early cardiometabolic risk, in youths with abnormally increased body weight. Design and method: Sixty-four overweight and obese subjects, 9 to 17 years, of both sexes, stratified according to the international body mass index cut-off, were enrolled. Continuous electrocardiogram was recorded during 15 minutes in resting and supine conditions, and afterwards heart rate variability was analysed in the time and frequency domain as well as non-linear dynamics. In addition, cardiorespiratory fitness in effort conditions was assessed (VO2peak). Results: Among the obese youths, cardiorespiratory fitness was the lowest in severe obese despite that no significant differences were observed regarding heart rate nor heart rate variability in time and frequency domain. A positive and significant relationship, independent of the degree of obesity, pubertal stage and breathing rate under resting conditions, were observed between cardiorespiratory fitness (assessed by VO2peak) and sympatho-vagal balance, estimated by standard deviation of the NN interval (SDNN: r = 0.268, p < 0.05) and the long term variation using the Poincaré plot (PS1: r = 0.275, p < 0.05; PS2 r = 0.273, p < 0.05). Conclusions: The key finding of the present study was the presence of a link between cardiorespiratory fitness and cardiac autonomic nervous system activity, independent of the degree of obesity. This emphasises that cardiorespiratory fitness can be a relevant tool in the assessment of early cardiovascular risk in obese youths.

Childhood obesity and adult cardiovascular disease risk factors: a systematic review with meta-analysis

BackgroundOverweight and obesity is a major public health concern that includes associations with the development of cardiovascular disease (CVD) risk factors during childhood and adolescence as well as premature mortality in adults. Despite the high prevalence of childhood and adolescent obesity as well as adult CVD, individual studies as well as previous systematic reviews examining the relationship between childhood obesity and adult CVD have yielded conflicting results. The purpose of this study was to use the aggregate data meta-analytic approach to address this gap.MethodsStudies were included if they met the following criteria: (1) longitudinal and cohort studies (including case-cohort), (2) childhood exposure and adult outcomes collected on the same individual over time, (3) childhood obesity, as defined by the original study authors, (4) English-language articles, (5) studies published up to June, 2015, (6) one or more of the following CVD risk factors [systolic blood pressure (SBP), diastolic blood pressure (DBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), non-high-density lipoprotein cholesterol (non-HDL), and triglycerides (TG)], (7) outcome(s) not self-reported, and (8) exposure measurements (child’s adiposity) assessed by health professionals, trained investigators, or self-reported. Studies were retrieved by searching three electronic databases as well as citation tracking. Fisher’s r to z score was calculated for each study for each outcome. Pooled effect sizes were calculated using random-effects models while risk of bias was assessed using the STROBE instrument. In order to try and identify sources of heterogeneity, random-effects meta-regression was also performed.ResultsOf the 4840 citations reviewed, a total of 23 studies were included in the systematic review and 21 in the meta-analysis. The findings suggested that childhood obesity is significantly and positively associated with adult SBP (Zr = 0.11; 95% CI: 0.07, 0.14), DBP (Zr = 0.11; 95% CI: 0.07, 0.14), and TG (Zr =0.08; 95% CI: 0.03, 0.13), and significantly and inversely associated with adult HDL (Zr = −0.06; 95% CI: -0.10, −0.02). For those studies that adjusted for adult body mass index (BMI), associations were reversed, suggesting that adult BMI may be a potential mediator. Nine studies had more than 33% of items that placed them at an increased risk for bias.ConclusionsThe results of this study suggest that childhood obesity may be a risk factor for selected adult CVD risk factors. However, a need exists for additional, higher-quality studies that include, but are not limited to, both unadjusted and adjusted measures such as BMI before any definitive conclusions can be reached.Systematic review and meta-analysisPROSPERO 2015: CRD42015019763.

Improvements in Cardiovascular Risk Factors in Young Adults in a Randomized Trial of Approaches to Weight Gain Prevention.

ObjectiveWeight gain occurs commonly in young adults and increases cardiovascular (CVD) risk. We previously reported that two self-regulation interventions reduced weight gain relative to control. Here we examine whether these interventions also benefit CVD risk factors.MethodsSNAP (Study of Novel Approaches to Weight Gain Prevention) was a randomized trial in 2 academic settings (N=599; 18–35 years; body mass index 21–30 kg/m2) comparing two interventions (Self-Regulation with Small Changes; Self-Regulation with Large Changes) and Control. Small Changes taught participants to make daily small changes (approximately 100 calorie) in intake and activity. Large Changes taught participants to initially lose 5–10 pounds to buffer anticipated weight gains. CVD risk factors were assessed at baseline and 2 years in 471 participants.ResultsAlthough Large Changes was associated with more beneficial changes in glucose, insulin, and HOMA-IR than Control, these differences were not significant after adjusting for multiple comparisons or 2-year weight change. Comparison of participants grouped by percent weight change baseline to 2 years showed significant differences for several CVD risk factors, with no interaction with treatment condition.ConclusionsMagnitude of weight change, rather than specific weight gain prevention interventions, was related to changes in CVD risk factors in young adults.

Effect of telehealth interventions on major cardiovascular outcomes: a meta-analysis of randomized controlled trials.

BackgroundTelehealth interventions (THI) were associated with lower levels of cardiovascular risk factors in adults, whereas the effect of THI on cardiovascular disease (CVD) still remains controversial. A meta-analysis was conducted to summarize the evidence from randomized controlled trials (RCT) which investigated potential impact of THI on the incidence of CVD in patients with or without prior CVD.MethodsPubMed, EmBase, and the Cochrane Library were searched to identify RCTs to fit our analysis through December 2016. Relative risk (RR) with its 95% confidence interval (CI) was used to measure the effect of THI using a random-effect model. Sensitivity analysis, subgroup analysis, heterogeneity tests, and tests for publication bias were also conducted.ResultsEight RCTs were included and with a total of 1635 individuals. The summarized results indicated that participants who received THI showed a significant reduction of the CVD incidence as compared with usual care (RR: 0.59; 95% CI: 0.47–0.74; P < 0.001). Furthermore, the effect of THI was greater in patients with history of CVD (RR: 0.55; 95% CI: 0.44–0.70; P < 0.001) than in patients without history of CVD (RR: 0.99; 95% CI: 0.51–1.94; P = 0.977). Sensitivity analysis suggested that the intervention effect persisted and the conclusion was not changed. Subgroup analysis indicated mean age, study quality might play an important role on the risk of CVD.ConclusionsThe findings of this study indicated THI could reduce the recurrence of CVD. Further large-scale trials are needed to verify the effect of THI on CVD in healthy individuals.

Development of a multi-component lifestyle intervention for preventing type 2 diabetes and cardiovascular risk factors in adults with intellectual disabilities.

We report on the development of the 'STOP Diabetes' education programme, a multi-component lifestyle behaviour change intervention for the prevention of type 2 diabetes and cardiovascular risk factors in adults with intellectual disabilities (ID). We combined qualitative stakeholder interviews with evidence reviews to develop the intervention, guided by the MRC Framework and informed by intervention mapping and two existing diabetes prevention programmes. We conducted two pilot cycles drawing on additional stakeholder interviews to inform and refine the intervention. The STOP Diabetes education programme employed a theoretical framework, using sound learning and behavioural principles and concrete kinaesthetic methods, to provide the grounding for innovative games and activities to promote health behaviour change in adults with ID. Qualitative data also suggested that two educators and one support person delivering a programme of one carer session followed by seven 2.5-h sessions over 7 weeks was acceptable to service users, carers and educators and appeared to benefit the participants. The STOP Diabetes education programme was successfully developed and is suitable for a definitive randomized controlled trial.

Duration and degree of adiposity: effect on cardiovascular risk factors at early adulthood.

The effect of adiposity dynamics throughout adolescence on adult cardiometabolic outcomes is not well known. We aimed to assess the effect of duration and degree of adiposity from adolescence to early adulthood on blood pressure and insulin resistance at 24 years. We used data from 2253 participants evaluated at 13, 17, 21 and 24 years of age in the EPITeen cohort, Porto, Portugal. The area under the curve of body mass index (BMIAUC) was computed to summarize duration and degree of BMI for the 11-year period. Outcomes were systolic blood pressure (SBP) and insulin resistance at 24 years. The homeostasis model assessment of insulin resistance (HOMA-IR) was used as an indicator of insulin resistance and the variable was log-transformed. Associations between BMIAUC and each outcome were estimated by linear regression models. The median BMIAUC was 243.1 (223.9-268.6) kg m-2 in 11 years, corresponding to 22.1 kg m-2 on average per year. In crude analyses, both BMIAUC and BMI at 24 years were positively associated with SBP (β=0.096 mm Hg, 95% confidence interval (CI) 0.077; 0.115 for BMIAUC; β=4.616 mm Hg, 95% CI 3.082; 6.151 for BMI at 24 years) and ln HOMA-IR (β=0.004, 95% CI 0.003; 0.005 for BMIAUC; β=0.047, 95% CI 0.036; 0.057 for BMI at 24 years). After adjustment for confounders and for BMI at 24 years, the magnitude of the association of BMIAUC attenuated for both outcomes, mostly for SBP, but the association remained statistically significant. Results using standardized variables confirmed that both outcomes were more strongly associated with BMI at 24 years than with BMIAUC. In addition to the effect of adult attained BMI, cumulative exposure to higher BMI throughout adolescence, taking into account duration and degree, was also relevant for adult cardiovascular risk factors, mainly for insulin resistance.

A randomized clinical trial for the effects of rice‐based Korean diet on Cardiovascular risk factors in Korean adults

BackgroundKorean dietary pattern rich in vegetables, fish, and whole grains is considered healthy diet. However, few clinical studies examined the effect of Korean diet on human health such as cardiovascular diseases.ObjectiveThis study was performed to assess the effects of rice‐based Korean diet on cardiovascular risk factors in overweight Korean adults, compared to typical American diet and diet recommended by dietary guidelines for Americans.MethodsThe study was a randomized controlled crossover feeding study conducted in twice from November 2015 to March 2016 and from October 2016 to January 2017. Total 60 subjects aged over 25 years old were randomly assigned one of six sequences for consuming the three kinds of diet. The subjects consumed each the Korean diet, diet recommended by dietary guidelines for Americans, and typical American diet for 4 weeks, and the period was separated by 2 weeks for wash‐off. Body weight was maintained at constant levels. Anthropometric data such as waist circumference and body fat percent, blood pressure, blood lipid profile, fasting blood glucose, and insulin were measured at the baseline and the end of each diet period.ResultsIn first trial conducted between November 2015 and March 2016, among 29 individuals who enrolled in the study, 25 subjects completed the study. After 4 weeks of feeding, body fat percent and total cholesterol significantly decreased in the Korean diet (p &lt;0.05). Whereas triglycerides significantly decreased on DGA diet and TA diet (p &lt;0.05). No diet had significant effect on fasting glucose and insulin. In second trial started in October 2016, 32 subjects have participated in the trial.ConclusionsThe results of this study will provide important evidence concerning the effect of rice‐based Korean diet on cardiovascular risk factors.Support or Funding InformationThis work is carried out with the support of ‘Research Program for Agricultural Science and Technology Development’, National Academy of Agricultural Science, Rural Development Administration, Republic of Korea (Project No. PJ011637022017).