Cardiovascular Risk Factors In Population Research Articles

Perfluoroalkyl substance mixtures and cardio-metabolic outcomes in highly exposed male workers in the Veneto Region: A mixture-based approach.

BackgroundPerfluoroalkyl substances (PFAS) have been consistently associated with cardio-metabolic traits. Occupational exposures to multiple PFAS with health outcomes have been poorly investigated. The aim of the present study was to examine these associations among former workers involved in PFAS production. MethodsWe considered 232 male ex-employees who had worked in a factory (Trissino, Veneto Region, Italy), which produced PFAS and other chemicals during 1968–2018. Out of twelve serum PFAS, only four (PFOA, PFOS, PFHxS, and PFNA) were quantifiable in at least 50% of samples. Non-fasting serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were measured. The associations between serum PFAS mixture and considered outcomes were assessed through linear regression mixed models and Weighted Quantile Sum (WQS) regression, adjusting for potential confounders. ResultsPFOA was detected at the highest level, with a median concentration (in ng/mL) of 80.8 (min-max: 0.35–13,033), followed by PFOS (median: 8.55, min-max: 0.35–343), PFHxS (median: 6.8, min-max: 0.35–597) and PFNA (median: 0.8, min-max: 0.35–5). We observed that each A quartile increase in the WQS index was positively associated with the levels of TC (β: 8.41, 95% IC: 0.78–16.0), LDL-C (β: 8.02, 95% IC: 1–15.0) and SBP (β: 3.21, 95% IC: 0.82–5.60). No association of serum PFAS concentration on HDL cholesterol and DBP emerged. WQS analyses revealed a major contribution of PFNA and PFHxS for the cholesterol levels, although PFOA reported the highest concentration. PFOA and PFOS emerged as chemicals of concern regarding the association with SBP. ConclusionsThe results showed a clear association between serum PFAS levels and markers of cardiovascular risk and support the importance of clinical surveillance of cardiovascular risk factors in population with a high exposure to PFAS, especially in the occupational setting.

Distribution and prevalence of cardiovascular risk factors in a aging population of thalassemia patients: looking at the heart of the problem

Abstract Background β-thalassemia major is a hereditary genetic disease hindered by many comorbidities due to transfusion-related iron. Since the introduction of chelation therapy life expectancy of these patients has increased from the 16 years of 1964 to 50 years today, with a marked improvement in the quality of life. Iron-related heart disease is still a leading complication but diabetes mellitus and hypogonadism may impact the cardiovascular risk in these patients, with an expected change in heart involvement with this unprecedentedly seen aging of these patients. Target This study aims to evaluate the distribution and prevalence of cardiovascular risk factors in a population of thalassemia major patients, and their relationship with observed cardiovascular events and potential modifying factors. Methods and results One-hundred fifty-nine patients older than 18 years of age with clinical and molecular diagnosis of β-thalassemia major and at least 15 years of follow-up were included in this study. Mean age was 40.9±8.4 years. Low serum lipid levels with low HDL levels were noted, with 17.6% having diabetes mellitus and 62% with hypogonadism; Splenectomy was reported in 70%. During the observed period 3.8% of patients had at least one episode of heart failure, 35.9% showed early signs of heart failure, 22% received diagnosis of diastolic dysfunction, 38% had a left ventricular ejection fraction <55% and 21.4% showed supraventricular arrhythmias. Cardiovascular risk was then assessed using two algorithms (CUORE and Pooled Cohort Risk Equation - PCRE) and was generally low but despite that patients with hypogonadism (who showed lower cardiac T2* value than those without; p<0.001) showed a statistically significant correlation with the occurrence of cardiovascular events. Discussion The β-thalassemia population has a relatively low mean age, but shows a particular metabolic profile in association with numerous comorbidities: an increased prevalence of diabetes mellitus, low HDL values and frequent hypogonadism which tends to be associated with increased iron deposition in myocardium. The cardiovascular risk estimated by specific algorithms (CUORE and PCRE) was generally low, mainly due to the young age of the cohort, but the prevalence of cardiac events was not negligible. Conclusions The chronic accumulation of iron in the heart and the specific metabolic profile, particularly observed in patients with hypogonadism, allows us to define Major Thalassemia patients as a population at high cardiovascular risk from many points of view (iron-related myopathy, atherosclerosis and arrhythmias), which requires a specific follow-up program, to prevent and to identify early signs of these serious complications. Funding Acknowledgement Type of funding sources: None.

The Prevalence of Cardiovascular Risk Factors among Polish Soldiers: The Results from the MIL-SCORE Program.

The MIL-SCORE (Equalization of Accessibility to Cardiology Prophylaxis and Care for Professional Soldiers) program was designed to assess the prevalence and management of cardiovascular risk factors in a population of Polish soldiers. We aimed to describe the prevalence of cardiovascular risk factors in the MIL-SCORE population with respect to age. This observational cross-sectional study enrolled 6440 soldiers (97% male) who underwent a medical history, physical examination, and laboratory tests to assess cardiovascular risk. Almost half of the recruited soldiers were past or current smokers (46%). A sedentary lifestyle was reported in almost one-third of those over 40 years of age. The prevalence of hypertension in a subgroup over 50 years of age was almost 45%. However, the percentage of unsatisfactory blood pressure control was higher among soldiers below 40 years of age. The prevalence of overweight and obese soldiers increased with age and reached 58% and 27%, respectively, in those over 50 years of age. Total cholesterol was increased in over one-half of subjects, and the prevalence of abnormal low-density lipoprotein cholesterol was even higher (60%). Triglycerides were increased in 36% of soldiers, and low high-density lipoprotein cholesterol and hyperglycemia were reported in 13% and 16% of soldiers, respectively. In the >50 years of age subgroup, high and very high cardiovascular risk scores were observed in almost one-third of soldiers. The relative risk assessed in younger subgroups was moderate or high. The results from the MIL-SCORE program suggest that Polish soldiers have multiple cardiovascular risk factors and mirror trends seen in the general population. Preventive programs aimed at early cardiovascular risk assessment and modification are strongly needed in this population.

CARDIOVASCULAR RISK FACTORS IN SOCIAL HOUSING RESIDENTS: A MULTI-SITE DESCRIPTIVE SURVEY IN OLDER ADULTS FROM ONTARIO, CANADA

Older adults living in subsidized housing are a vulnerable population with higher rates of poverty and increased risk of cardiovascular events. Larger population surveys may not adequately capture data from this population due to poor literacy and low participation rates. The purpose of this study was to determine the prevalence of cardiovascular disease risk factors in older adults residing in social housing. This was a cross-sectional study with interviewer-administered questionnaire and objective blood pressure (BP) measurement with a validated, automated device. Data was collected from residents aged 55 years and older residing in 25 subsidized social housing apartment buildings in five Ontario regions. Outcome measures were prevalence of cardiovascular risk factors in this population and association of the risk factors with measured high BP, controlled hypertension, and undiagnosed hypertension. In 1101 residents, mean age was 72.4 years, 78% were female, 87% white, and 69% had high school education or less. Self-reported risk factors included diabetes (29%), hypertension (59%), high cholesterol (44%), overweight (30%) or obese (39%), current smoker (29%), < 1 serving of fruit/vegetable daily (61%), and physical activity < 30 minutes daily (50%). Conditions that could indirectly impact cardiovascular health were limited mobility (58%), difficulty performing usual activities (41%), and pain/discomfort (70%). In a subset of 595 residents with BP measured, 304 (51%) had high BP. Any post-secondary education (OR=0.53, 95%CI 0.32-0.90), non-white ethnicity (OR=0.49, 95%CI 0.27-0.89), 75-84 years (OR=2.13, 95%CI 1.23-3.69), 85+ years (OR=2.77, 95%CI 1.26-6.12), and 1-4 medications (OR=1.90, 95%CI 1.06-3.42) were significantly associated with high BP. Non-white ethnicity (OR=0.36, 95%CI 0.17-0.78) was associated with uncontrolled hypertension. Physical activity (OR=0.41, 95%CI 0.20-0.85), 75-84 years (3.65, 95%CI 1.34-9.95), and 85+ years (OR=9.33, 95%CI 1.65-52.62) were associated with undiagnosed hypertension. There is a high prevalence of modifiable cardiovascular risk factors in this vulnerable population and the majority had either undiagnosed or unmanaged high BP. Although dietary risk factors were prevalent, they were not significantly associated with high BP, suggesting that other low-income factors may have a greater influence. Cardiometabolic sequelae are likely unless primary care interventions appropriate for this population are implemented.

Cardiovascular risk assessment in population from urban and sub urban areas of Eastern part of Odisha, India

Background: Cardiovascular disease (CVD) is a leading cause of death in the world. The aim of the study was to assess cardiovascular risk factors in population from urban and sub urban areas of eastern part of Odisha, India. Methods: We conducted an observational study; total 67 individuals (21 women, 46 men) were recruited from the population, aged 30 to 59 years, to evaluate their cardiovascular risk factors by pre-designed structured questionnaire and clinical and laboratory data were collected over a period of 6 months. Results: The prevalence of major CVD risk factors was: hypertension 28.3%, diabetes 38.8%, elevated total cholesterol/HDL ratio 38.8 %, obesity 62.6 % and current smoking 28.3%.The score of ≥4 was obtained more among the 40–49 year old age group than the 30-39 and 50-59 year old age groups (≥2) and the risk factor score of ≥3 was significantly more in the higher income group as compared with the lower income group (74% vs. 26%). A high-risk dietary pattern was found to be significantly more in the literate group as compared with the illiterate group (32.2% vs. 25%). Conclusions: This study concludes that the high prevalence of CVD and its risk factors is due to lack of awareness and special attention should be given to changing life style and dietary control among a comparatively young male population from urban and sub urban areas of eastern part of Odisha.

Heritability of blood pressure through latent curve trajectories in families from the Gubbio population study.

Prospective investigations on cardiovascular risk factors in populations provide a unique opportunity to dissect time-dependent quantitative complex traits, such as arterial blood pressure (BP), into their polygenic and environmental components. BP heritability analyses were carried out on 2620 patients belonging to 711 nuclear pedigrees that could be followed up throughout 25 years in the Gubbio Population Study. Each patient's BP serial measurements were summarized into individual intercepts (expected values at baseline) and slopes (time-related changes), which were predicted through latent curve models. These models considered either age in years or waves (times from the first survey) as time axis and were linked at a family level in the heritability analyses using additive polygenic-common environment-unique error models adjusted for sex, age and clinical variables. The additive genetic effect explained 32-49% of the variance of SBP values at baseline, the wave-dependent analysis with nuclear pedigrees and the sibs-household matrix accounting for higher heritability values. Heritability of DBP baseline value was lower than that of SBP in analyses by age (5-15%), but fell in the same heritability range as SBP on the analysis by waves (36-37%). The BP variation over time (slope) explained by an additive genetic effect ranged from 33 to 43% and from 24 to 25% for SBP and DBP, respectively, in the analysis by age. Shared environment also exerted a significant influence, but explained a smaller portion of the variances (4-17%) for both traits. Longitudinal data from the Gubbio population show strong to moderate genetic influences on SBP and DBP baseline values and changes over time with a smaller, though significant, effect of environment.

Prevalence of cardiovascular risk factors in an urban area of Togo : a WHO STEPS-wise approach in Lome, Togo

To determine the prevalence of hypertension and other cardiovascular risk factors in the general adult population of Lome. A cross-sectional household survey was conducted in Lome from October 2009 to January 2010, which focused on hypertension and other cardiovascular risk factors in 2 000 subjects 18 years and older. The World Health Organisation's STEPS-wise approach on non-communicable diseases was used. During the first session, blood pressure (BP) was measured on three successive occasions, one minute apart, and the mean was recorded. A second measurement session was done three weeks later in patients with BP ≥ 140/90 mmHg during the first session. Hypertension was defined as BP > 140/90 mmHg after the second session, or on antihypertensive treatment. The other risk factors were studied by clinical and blood analysis. We found 532 hypertensive patients out of a total of 2 000 subjects. The prevalence of hypertension was 26.6%. The mean age of hypertensive patients was 45 ± 10 years, ranging from 18 to 98 years. The prevalence of other cardiovascular risk factors was: stress (43%), sedentary lifestyle (41%), hypercholesterolaemia (26%), obesity (25.2%), hypertriglyceridaemia (21%), smoking (9.3%), alcohol use (11%) and diabetes (7.3%). The prevalence of hypertension and other cardiovascular risk factors in the population of Lome is high. These findings should draw the attention of authorities to define a national policy to combat hypertension and other cardiovascular risk factors.

Secular trends of blood pressure, body mass index, lipids and fasting glucose among children and adolescents in Turkey.

• Turkey is in a state of rapid transition and urbanization. There is ample evidence for an increased cardiovascular risk over the past two decades in Turkey. • Obesity, dyslipidemia and high blood pressure in children are markers of the future burden of cardiovascular disease and clustering of cardiovascular risk factors starts early in life. • The patterns of cardiovascular risk factors in populations are not static over time and the secular trends in obesity and cardiovascular risk factors among children and adolescents of developing countries have not been completely defined. • The prevalences of obesity and high blood pressure have increased several folds among Turkish children and adolescents over the past two decades. • The temporal trends in fasting glucose and lipids did not correlate with the increasing prevalence of obesity with the exception of HDL-C levels. • Finally, the prevalence of metabolic syndrome has doubled in Turkish children and adolescents over the last two decades. Our findings indicate that there may be an increase in the future morbidity and mortality from cardiovascular disease, thrombosis, stroke and diabetes mellitus throughout the developing countries. Patterns of cardiovascular risk factors and metabolic syndrome risk criteria in populations are not static over time. We analyzed the trends in lipid levels, blood pressure, fasting glucose and body mass index over the last two decades among children and adolescents. Two different cross-sectional studies were examined among students (ages 8-18) in 1989 (n = 1385) and in 2008 (n = 1746). Using the international cut-off points and percentiles, we identified children and adolescents with elevated blood pressure, triglycerides, fasting glucose (≥100 mg dL(-1) ), body mass index and low high-density lipoprotein cholesterol (HDL-C) levels. The prevalence of obesity has increased several folds over the last two decades. According to the international criteria, 4.3% of children were obese and 15.2% were overweight in 2008 vs. only 0.6% obese and 4.3% overweight in 1989 (P < 0.001). The prevalence of elevated systolic blood pressure also increased significantly among 8-12-year-old boys and girls (28.5 vs. 15.7%, P < 0.001). The temporal trends in fasting glucose and lipids did not correlate with the increasing prevalence of obesity with the exception of HDL-C levels. Low HDL-C (≤ 10th percentile) was observed in 16.3% in 1989 vs. 21.6% in 2008 (P = 0.016). HDL-C levels decreased significantly among adolescent boys. Finally, the prevalence of metabolic syndrome by modified National Cholesterol Education Program (NCEP) criteria has doubled over the last two decades (2.2 vs. 4.5%, P < 0.001). Strategies for combating the future cardiovascular mortality should focus on the prevention of obesity, high blood pressure and metabolic syndrome among children and adolescents.

Factores de Riesgo Cardiovascular en Poblaciones Jóvenes

Cardiovascular disease (CVD) involves several disorders related to the formation and development of atherosclerotic processes. Several risk factors are involved in CVD aetiology; some of them (i.e. age, hypertension, obesity, dislipidemia and diabetes) have been clearly associated, whereas others have a variable level of association. An increase in cardiovascular risk factors has been recently reported in the young population; studies of cardiovascular risk factors in this population have shown that its cardiovascular risk profile could be different from that presented by older populations. This review presents a summary of reported cardiovascular risk factors in the young population and their causes which have been released and indexed in different databases. Most factors discussed are life-habit risk factors and represent direct targets for clinical intervention. We propose that primary CVD prevention should include a more detailed knowledge of the nature of the risk factors concerning the young population and could have a positive impact on CVD prevalence during the next few years.

Trends in body mass index, blood pressure and parental smoking habits in middle socio-economic level Turkish adolescents

Patterns of cardiovascular risk factors in populations are not static over time. We examined trends in body mass index (BMI), parental smoking and blood pressure over a 15-year period in Turkish children aged 15-17 years. Two cross-sectional studies were performed in secondary schools in Turkey in 1989-1990 and 2004-2005. Study participants were 673 children in 1989-1990 and 640 adolescents in 2004-2005. Main outcome measures were weight, height, BMI, presence and amount of parental smoking, systolic and diastolic blood pressure. Age and sex matched comparisons were performed to assess temporal trends in these measures. Children in 2004-2005 had increased weight, height, BMI and decreased systolic and diastolic blood pressure in all age groups compared with children in 1989-1990. According to the international criteria, 3.4% of children were obese and 15.8% were overweight in 2005, compared to 0.7% obese and 4.2% overweight in 1990 (P<0.001). However, a decrease was noted in blood pressure; 16% were classified as hypertensive in 1989-1990 versus 8% in 2004-2005 (P<0.001). The prevalence and amount of parental smoking also decreased over the last 15 years. We observed significant changes in BMI and blood pressure in Turkish children over the last 15 years. Temporal trends in these parameters may indicate a change in the pattern of cardiovascular disease in this population.

Cardiovascular disease in HIV-positive patients

Cardiovascular disease in HIV-positive patients

Obesity in Europe – causes, costs, and consequences

Obesity (defined as a body mass index >30 kg/m2) is common in middle-aged Europeans. The prevalence is notably high in women from Mediterranean and Eastern European countries. cological comparisons show no relationship between obesity and coronary heart disease mortality in men and a weak association in women (which is stronger after adjustment for smoking). Within countries, however, increased BMI is associated with increased cardiovascular risk factors in populations across Europe. In the Netherlands the direct health care costs associated with overweight and obesity (BMI >25 kg/m2) have been calculated to be about 1 billion Dutch guilders which corresponds to about 4% of total costs of health care.

Obesity in Europe: prevalence and consequences for use of medical care.

Obesity {defined herein as a body mass index (BMI) greater than 30 kg/m2} is common in middle-aged Europeans, particularly in women from Mediterranean and Eastern European countries. Epidemiological comparison shows no relationship between obesity and coronary heart disease mortality in men, but a weak association in women, which became stronger after adjustment for smoking. Within individual countries, however, increased BMI is associated with increased cardiovascular risk factors in populations across Europe. In The Netherlands, the direct annual healthcare costs associated with overweight and obesity (BMI greater than 25 kg/m2) have been calculated to be approximately 1 billion Dutch guilders, which corresponds to about 4% of total healthcare costs.