Indicator Of Coronary Heart Disease Research Articles

Health outcomes and healthcare utilization associated with four undiagnosed chronic conditions: evidence from nationally representative survey data in Sri Lanka

BackgroundLow awareness of chronic conditions raises the risk of poorer health outcomes and may result in healthcare utilization and spending in response to symptoms of undiagnosed conditions. Little evidence exists, particularly from lower-middle-income countries, on the health and healthcare use of undiagnosed people with an indication of a condition. This study aimed to compare health (physical, mental, and health-related quality of life (HRQoL)) and healthcare (inpatient and outpatient visits and out-of-pocket (OOP) medical spending) outcomes of undiagnosed Sri Lankans with an indication of coronary heart disease (CHD), hypertension, diabetes, and depression with the outcomes of their compatriots who were diagnosed or had no indication of these conditions.MethodsThis study used a nationally representative survey of Sri Lankan adults to identify people with an indication of CHD, hypertension, diabetes, or depression, and ascertain if they were diagnosed. Outcomes were self-reported measures of physical and mental functioning (12-Item Short Form Survey (SF-12)), HRQoL (EQ-5D-5L), inpatient and outpatient visits, and OOP spending. For each condition, we estimated the mean of each outcome for respondents with (a) no indication, (b) an indication without diagnosis, and (c) a diagnosis. We adjusted the group differences in these means for socio-demographic covariates using ordinary least squares (OLS) regression for physical and mental function, Tobit regression for HRQoL, and a generalized linear model (GLM) for healthcare visits and OOP spending.ResultsAn indication of each of CHD and depression, which are typically symptomatic, was associated with a lower adjusted mean of physical (CHD -2.65, 95% CI -3.66, -1.63; depression -5.78, 95% CI -6.91, -4.64) and mental functioning (CHD -2.25, 95% CI -3.38, -1.12; depression -6.70, 95% CI -7.97, -5.43) and, for CHD, more annual outpatient visits (2.13, 95% CI 0.81, 3.44) compared with no indication of the respective condition. There were no such differences for indications of hypertension and diabetes, which are often asymptomatic.ConclusionsLiving with undiagnosed CHD and depression was associated with worse health and, for CHD, greater utilization of healthcare. Diagnosis and management of these symptomatic conditions can potentially improve health partly through substitution of effective healthcare for that which primarily responds to symptoms.

The Impact of Nurse-led Interventions on Improving Self-management and Quality of Life for Patients with Heart Failure

According to the American Heart Association, over 5 million Americans suffer from heart failure, and an additional 500,000 are diagnosed with the condition every year. It's crucial that you comprehend the nature of the illness and your possibilities for treatment because of this. We provide you the inside scoop so you can give this expanding patient population the finest treatment possible. According to National Institutions of Health, It is anticipated that the number of fatalities in India from CVD will increase from 2.26 million in 1990 to 4.77 million in 2020. According to estimates throughout the past few decades, the prevalence of coronary heart disease in India has varied between 1.6% and 7.4% in rural areas and between 1% and 13.2% in urban areas. Heart failure remains the most common cause of hospitalization for adults over 65, making it a serious public health concern in the US. Regretfully, there isn't much hope for this illness: within four years, 50% of heart failure sufferers will pass away from the condition. Heart failure claims the lives of over 287,000 individuals annually, and 40% of patients who are hospitalized for the illness either pass away or return within a year. Not to add that in 2006, the anticipated yearly cost of treating heart failure was $29.6 billion. In this paper, we will discuss through the pathophysiology, causes, and symptoms of heart failure in this post. I'll also cover key diagnostic resources, available treatments, and patient education techniques to assist your patient take care of his condition

Risk Stratification for Detection of Coronary Artery Disease and Effectiveness of Sensitization Programme on Reduction of Risk for Coronary Artery Disease among Adults in Selected Urban Areas of Vijayapur

Background: Cardiovascular diseases, especially coronary heart disease (CHD), are epidemic in India. The Registrar General of India reported that CHD led to 17% of total deaths and 26% of adult deaths in 2001-2003, which increased to 23% of total and 32% of adult deaths in 2010-2013. In India, studies have reported increasing CHD prevalence over the last 60 years, from 1% to 9%-10% in urban populations and <1% to 4%-6% in rural populations. Important risk factors for CHD in India are dyslipidemias, smoking, diabetes, hypertension, abdominal obesity, psychosocial stress, unhealthy diet, and physical inactivity. Suitable preventive strategies are required to combat this epidemic.Aim: The aim of the study is to assess and stratify the risk of coronary artery disease among adults. Materials and Methods: The research design used for this study is true experimental pre test post test control group design with follow up. Non probability Quota sampling technique will be used for this study. Sensitization programme is an intervention in which repeated administration of interventions to the participants to understand and involve in risk reduction strategies of coronary artery disease.Result: Frequency and Percentage distribution of study participants according to their risk of CAD. Majority 144(72.0%) of the study participants had low risk of CAD followed by 52(26.0%) of the study participants who had intermediate risk and remaining 4(2.0%) of the study participants had high risk. A total of 200 adults were completed the questionnaire. The sociodemographic data represented that frequency and percentage distribution of adults according to socio- demographic profile such as age, gender, religion, marital status, educational status, occupation, dietary habits, family history of heart disease, smoking habits and alcohol consumption. The BMI level of the adults depicts that majority 131(91.0%) had normal BMI, 6(4.2%) were overweight and 7(4.9%) under weight. Off high risk study subjects, majority 28(50.0%) had over weight and 14(25.0%) each of the study subjects had normal weight and obese respectively. In relation to adult stress majority 52(92.9%) were at moderate risk of illness and only 4(7.1%) were at risk illness. It was clear that coronary artery risk score were same between experimental and control group during pretest but the difference in risk scores was highly significant when compared with posttest-I, posttest-II and posttest-III. Hence the sensitization programme was effective on reduction of coronary artery disease among the adults and hence second hypothesis was proved. It was seen that there was no association between knowledge risk scores of coronary artery disease with their selected socio-demographic variables such as Age, Gender, Religion, Education, laborer, dietary habit, family History, smoking habits, alcohol consumption but it was highly associated with Marital Status. Conclusion: The study concludes that risk factor of coronary artery disease was highly associated with selected risk factors such as dietary habits, junk food consumption, family history, smoking habits, consumptions of alcohol, adult stress, BMI and physical activity.

Korelasi indeks massa tubuh terhadap rasio trigliserida dan high-density lipoprotein-cholesterol pada wanita usia subur dengan obesitas

Body mass index correlation with triglyceride and high-density lipoprotein-cholesterol ratio of reproductive age women with obesityBackground: Obesity in women of reproductive age is thought to be one of the triggers of coronary heart disease. Body mass index (BMI) correlates well with the percentage of body fat, which is a strong indicator of coronary heart disease. Accumulation of visceral adipocytes releases excess free fatty acids, resulting in increased triglyceride synthesis. Furthermore, in a state of hypertriglyceridemia, there is a decrease in HDL levels and an increase in HDL catabolism resulting in decreased HDL levels. Examination of the ratio of triglyceride levels and high-density lipoprotein cholesterol (TG/HDL-C) is a strong indicator of cardiovascular disease.Objective: The aim of his study was to investigate the correlation between BMI and TG/HDL-C ratio in women of reproductive age.Methods: Using an analytical approach with a cross-sectional design. Furthermore, height and weight were measured with Smic ZT 120. At the same time as this examination, venous blood was taken from the median cubital area to be used to check the level of triglycerides and HDL-C in the serum. TG examination with GPO-PAP and HDL-C direct method. The bivariate analysis uses the Spearman Rank correlation test, while the multivariate analysis uses the linear regression test.Results: TG levels were 106 (34-363) mg/dl, HDL-C levels were 48.19 ± 9.91 mg/dl, and the ratio between the two was 2.26 (0.52-9.58). Spearman Rank analysis obtained the value of r was 0.573, p-value 0.0001.Conclusions: There is a significant positive correlation between BMI and the ratio of TG/HDL-C levels in adult women of reproductive age with obesity.

Efficacy of a family-based cardiovascular risk reduction intervention in individuals with a family history of premature coronary heart disease in India (PROLIFIC): an open-label, single-centre, cluster randomised controlled trial

Coronary heart disease, a leading cause of death globally, is amenable to lifestyle interventions. The family environment can affect the ability or willingness of individuals to make lifestyle changes. We aimed to investigate the efficacy of a targeted family-based intervention for reduction of total cardiovascular risk in individuals with a family history of premature coronary heart disease. We did an open-label, cluster randomised controlled trial (PROLIFIC) in the families (first-degree relatives and spouses, older than age 18 years) of individuals with coronary heart disease who had been diagnosed before age 55 years. Patients with coronary heart disease diagnosed within the past year were selected from a tertiary care speciality hospital that provides care for patients from Kerala, India. Family members of selected patients who were bedridden or terminally ill, and individuals with a history of established cardiovascular heart disease and stroke were excluded, as were families with fewer than two eligible family members. Simple randomisation with computer-generated random numbers was used to randomly assign families to intervention and usual care groups (1:1). Participants in the intervention group received a comprehensive package of interventions facilitated by non-physician health workers, consisting of: screening for cardiovascular risk factors; structured lifestyle interventions; linkage to a primary health-care facility for individuals with established chronic disease risk factors or conditions; and active follow-up for adherence. The usual care group received one-time counselling and annual screening for risk factors. We obtained data on lifestyle, clinical, and biochemical characteristics at baseline and annually during the 2-year follow-up. The primary outcome was achievement or maintenance of any three of the following: blood pressure lower than 140/90 mm Hg, fasting plasma glucose lower than 110 mg/dL, low-density lipoprotein cholesterol lower than 100 mg/dL, and abstinence from tobacco. The primary outcome was analysed in all participants available for follow-up at the relevant timepoint. This trial is registered with Clinicaltrials.gov, NCT02771873. From Jan 1, 2015, to April 30, 2017, 980 patients with coronary heart disease were assessed for eligibility and 230 were excluded primarily due to lack of evidence of coronary artery disease (n=199), or a diagnosis of coronary heart disease more than 1 year previously (n=29). Of the 750 remaining families, 368 (with 825 participants) were assigned to the intervention group and 382 (with 846 participants) were assigned to the usual care group. At the 2-year follow-up, data from 803 (97%) of 825 participants in the intervention group and 819 (97%) of 846 participants in the usual care group were available. Of the 1671 participants, 1111 (66·5%) were women, and 560 (33·5%) were men. The mean age of the study population was 40·8 years (SD 14·2). At the 2-year follow-up, the primary outcome was achieved by 514 (64%) of 803 participants in the intervention group and 379 (46%) of 819 in the usual care group. After adjustment for clustering and baseline risk factors, the odds of achieving the primary outcome at the 2-year timepoint was two times higher in the intervention group than in the usual care group (odds ratio 2·2, 95% CI 1·7-2·7; p<0·0001). The reduction of total cardiovascular risk observed after the intervention could have a substantial public health impact by preventing future cardiovascular events. The Wellcome Trust and Department of Biotechnology, Government of India, and India Alliance.

The role of the plasma glycosylated hemoglobin A1c/Apolipoprotein A-l ratio in predicting cardiovascular outcomes in acute coronary syndrome

Background and aimsGlucose and lipid metabolism are major prognostic indicators of coronary heart disease. The ratio of plasma glycosylated hemoglobin A1c (HbA1c) to apolipoprotein A-l (ApoA-l) is an indirect measure of insulin resistance. The study aimed to evaluate whether the HbA1c/ApoA-1 ratio can predict the prognosis in patients with the acute coronary syndrome (ACS). Methods and resultsA total of 476 ACS patients diagnosed by coronary angiography were enrolled in this longitudinal, observational, retrospective study. Plasma HbA1c, fasting blood glucose and lipid profile were measured. Patients were stratified according to the tertiles of HbA1c/ApoA-l levels. Cox proportional hazard model was used to examine the predictive value of HbA1c/ApoA-l for study endpoints. The association between the Log HbA1c/ApoA-l ratio and major adverse cardiovascular events (MACEs) was estimated using multiple logistic regression. Baseline characteristics showed a mean age of 66 ± 8 years, and 52.5% were hypertensive, 26.8% diabetic, and 54.5% current or prior smokers. During a mean follow-up period of 22.3 ± 1.7 months, 59 deaths occurred. After adjusting for age, gender, smoking, hypertension, diabetes, and coronary artery disease severity, patients in the highest HbA1c/ApoA-l ratio tertile had a 4.36-fold increased risk of mortality compared with those in the lowest tertile. The multivariate logistic regression showed that the Log HbA1c/ApoA-l ratio was associated with MACEs (Odds ratio 2.95, p = 0.013). ConclusionAfter adjusting for traditional cardiovascular risk factors and ACS severity scores, the HbA1c/ApoA-1 ratio remained an independent predictor of all-cause mortality and MACEs in the ACS patients undergoing angiography.

Direct electrochemiluminescent immunosensing for an early indication of coronary heart disease using dual biomarkers

In this paper, a promising technology for obtaining an early indication and making a clinical diagnosis of coronary heart disease (CHD) is successfully designed. Specifically, label-free biosensors based on Au–Co nanoparticles (Au–Co NPs) were utilized to detect low-density lipoprotein (LDL) and oxidized low-density lipoprotein (ox-LDL), which are both CHD biomarkers. Conductive Au–Co NPs provided a prominent sensing platform and played the role of an efficient electrochemiluminescent (ECL) signaling amplifier. Conductive Au–Co NPs were fabricated using a simple method of water phase synthesis and were characterized using transmission electron microscope (TEM) and scanning electron microscope (SEM) images. An antibody was immobilized onto Au–Co NP-decorated indium tin oxide coated glass. After the formation of an immune complex between the antigen and antibody, using luminol as a sensing probe, it was found that the ECL signal was inhibited. Under the optimized conditions, the immunosensor exhibited sensitive detection of LDL over a wide linear range from 0.420 to 100 pg mL−1 with a detection limit of 0.256 pg mL−1. Likewise, a linear regression of the concentration of ox-LDL was obtained over the range from 0.500 pg mL−1 to 60.0 pg mL−1, with a detection limit of 0.330 pg mL−1. This research provides a new method for making a clinical diagnosis and obtaining an early indication of CHD due to the high performance sensing of these two biomarkers.

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

FRIED FOOD AND POSSIBLE HEALTH HAZARDS

Review of Burden of Risk Factors of Coronary Heart Disease in India

Review of Burden of Risk Factors of Coronary Heart Disease in India

Frequency and association of disabled homolog 2-interacting protein (DAB2IP) variant rs7025486 G>A with coronary artery disease risk in Indian population

Genome wide association study has identified rs7025486 G>A polymorphism within DAB2IP (Disabled homolog 2-interacting protein) gene with increased risk of coronary heart disease (CAD). In this study we have determined the frequency and association of rs7025486 with CAD in Indians. The study was performed on 214 patients with CAD and 125 controls. The ‘AA’ genotype was associated with an increased risk in the CAD age group <50 yrs as compared to CAD age group>50 yrs (OR 3.149; P 0.034) and controls >50 yrs (OR 3.430; P 0.080). The risk allele (A) was significantly associated with premature CAD.

A Novel Thermal Bubble Valve Integrated Nanofluidic Preconcentrator for Highly Sensitive Biomarker Detection.

In this study, we developed a new immunosensor that can achieve an ultralow detection limit and high sensitivity. This new device has an electrokinetic trapping (EKT)-based nanofluidic preconcentrator, which was integrated with oscillating bubble valves, to trap concentrated antigen and immunobeads. During the immunoassay process, oscillating bubbles rapidly grew and acted as control valves and to block the microchannel. Thereafter, the trapped preconcentrated antigen plug and antibody-coated nanobeads were preserved in the region between these two valves. Finally, the antigen concentration was quantitatively analyzed by a real-time measurement of Brownian diffusion of the immunobeads. In this work, the test sample used was C-reactive protein (CRP) which is a risk indicator of coronary heart disease and atherosclerosis.

Association of Height with Total Cholesterol Level in Young Adults in Assessment of Coronary Heart Disease Risk

We aimed to study the association of height with blood total cholesterol (TC) level in young adults and the potential use of the two parameters in combination as an indicator of coronary heart disease (CHD) risk in adulthood. The study involved 331 individuals (124 males, 207 females) aged 18 to 28. Other anthropometric parameters i.e. body weight and body mass index (BMI) were also incorporated to study their associations with blood TC level. Total cholesterol was measured using finger-prick blood. The prevalence of high blood TC among the study group was determined. Height was inversely associated with blood TC level (p<0.05), whereas body weight and BMI did not show significant association with blood TC level. The prevalence of high blood TC (= 5.2mmol/L) was higher in female (0.44) than male (0.26), the overall prevalence was 0.37. The current finding indicated that shorter stature was associated with high blood TC level, while other studies found significant association of shorter stature with increased risk of CHD. Therefore, data on height with blood TC level could be used as a means of assessing CHD risk among young adults. Besides, a female with shorter stature might have a higher risk of developing CHD.

Sleep disorder, an independent risk associated with arterial stiffness in menopause

As women age and go through menopause, they suffer a higher incidence of sleep disorder, cardiovascular morbidity and mortality. In addition, evidences suggested that sleep disorder was an important pathological indicator for coronary heart disease. However, the relationship between different menopausal status, sleep disorder and cardiovascular diseases was unclear. Thus, we aim to assess the association between sleep disorder with arterial stiffness in females of 40–60 years free of cardiovascular diseases through self-administered Pittsburgh Sleep Quality Index (PSQI) and brachial-ankle pulse wave velocity (baPWV). Logistic regression revealed that sleep disorder (PSQI score ≥ 8) was an independent indicator for higher risk of elevated arterial stiffness (baPWV ≥ 1465.5 cm/s, upper tertile) beyond other established cardiovascular confounders in peri-postmenopause (OR 2.83, 95% confidence interval (CI) 2.00–4.00, p < 0.001), but not in premenopause (OR 1.67, 95% CI 0.71–3.90, p = 0.223). Collectively, it clearly indicates that sleep disorder in menopausal women is of prominent value to predict arterial stiffness.

Linkages between Hypertension and Coronary Heart Disease in India: Evidence from India Human Development Survey-2 (2011-2012).

Background:Cardiovascular diseases (CVDs) are the leading causes of death globally (nearly 17.5 million deaths/year). Hypertension and coronary heart disease (CHD) are two of the most important CVDs. There is a dearth of studies at a large scale in India to ascertain the factors as well as social differentials in the prevalence of heart disease associated with hypertension. This paper attempts to bridge the gap in the relevant area.Methodology:Secondary analysis of the data obtained from India Human Development Survey (IHDS), conducted in two rounds in 2004–2005 and 2011–2012, was done (n = 147,201). Bivariate and logistic regression analyses have been used.Results:In India, the prevalence for CHD is 1.1% for 2011–2012. Findings showed that persons with hypertension are 11 times (odds ratio [OR] = 11.58, P < 0.01) more likely to be affected by CHD among adults (15 and above years) as compared to nonhypertensive adults. When the odds are adjusted for socioeconomic and demographic variables, hypertensives are found to be 5 times more likely (OR = 5.096, P < 0.01) to be having CHD as compared to nonhypertensives.Conclusions:The unadjusted odds of suffering from CHD when hypertension is a predictor are much higher than when the odds are adjusted for socioeconomic and demographic variables. Along with hypertension, age, education, and place of residence have also been found to be important determinants of CHD.

The impact of birth weight on cardiovascular disease risk in the Women's Health Initiative

Background and aimsCardiovascular disease (CVD) is among the leading causes of morbidity and mortality worldwide. Traditional risk factors predict 75–80% of an individual's risk of incident CVD. However, the role of early life experiences in future disease risk is gaining attention. The Barker hypothesis proposes fetal origins of adult disease, with consistent evidence demonstrating the deleterious consequences of birth weight outside the normal range. In this study, we investigate the role of birth weight in CVD risk prediction. Methods and resultsThe Women's Health Initiative (WHI) represents a large national cohort of post-menopausal women with 63,815 participants included in this analysis. Univariable proportional hazards regression analyses evaluated the association of 4 self-reported birth weight categories against 3 CVD outcome definitions, which included indicators of coronary heart disease, ischemic stroke, coronary revascularization, carotid artery disease and peripheral arterial disease. The role of birth weight was also evaluated for prediction of CVD events in the presence of traditional risk factors using 3 existing CVD risk prediction equations: one body mass index (BMI)-based and two laboratory-based models. Low birth weight (LBW) (<6 lbs.) was significantly associated with all CVD outcome definitions in univariable analyses (HR = 1.086, p = 0.009). LBW was a significant covariate in the BMI-based model (HR = 1.128, p < 0.0001) but not in the lipid-based models. ConclusionLBW (<6 lbs.) is independently associated with CVD outcomes in the WHI cohort. This finding supports the role of the prenatal and postnatal environment in contributing to the development of adult chronic disease.

Predictive Value of Lipoprotein Indices for Residual Risk of Acute Myocardial Infarction and Sudden Death in Men With Low-Density Lipoprotein Cholesterol Levels

Several epidemiologic studies have demonstrated that plasma low-density lipoprotein cholesterol (LDL-C) profile is a key risk indicator for coronary heart disease (CHD). However, almost half of all patients with CHD have normal LDL-C levels. A total of 7,931 male subjects aged ≥40 years from the general population with no cardiovascular history and no use of lipid-lowering agents were followed for incidence of acute myocardial infarction (AMI) and sudden death. Of the 4,827 participants with LDL-C levels <120 mg/dl, 55 subjects had a first AMI/sudden death during an average of 5.5 years of follow-up. After adjustment for confounding factors, multiadjusted hazard ratios (HRs) were increased by 1SD for non-high-density lipoprotein cholesterol (non-HDL-C; HR= 1.36, 95% confidence interval [CI], 1.02 to 1.81), total cholesterol (TC)/HDL-C ratio (HR= 1.40, 95% CI: 1.11 to 1.78) and LDL-C/HDL-C ratio (HR= 1.32, 95% CI: 1.02 to 1.73) but not for LDL-C (HR= 1.09, 95% CI: 0.82 to 1.44) and HDL-C (HR= 0.84, 95% CI: 0.68 to 1.04). When stratified as categorical variables on the basis of points with highest accuracy on receiver operating characteristic analysis, non-HDL-C levels >126 mg/dl (HR= 1.25, 95% CI: 1.03 to 1.51), TC/HDL-C ratio above 3.5 (HR= 1.22, 95% CI: 1.01 to 1.48) and LDL-C/HDL-C ratio >1.9 (HR= 1.25, 95% CI: 1.04 to 1.51) had increased multiadjusted HRs for AMI/sudden death. In conclusion, in men with LDL-C levels <120 mg/dl, non HDL-C, TC/HDL-C, and LDL-C/HDL-C ratios have predictive value for residual risk of AMI/sudden death.

Overuse of non-evidence based pharmacotherapies in coronary heart disease in India

Overuse of non-evidence based pharmacotherapies in coronary heart disease in India

Erythrocyte sedimentation rate as a marker for coronary heart disease

BackgroundPatients with angina pectoris or myocardial infarction frequently present without evidence of cardiac-specific heart enzymes by laboratory analysis or specific pathologic electro-cardiogram findings. The current study analyzed the efficacy of the erythrocyte sedimentation rate as an additional potential indicator for coronary heart disease, the aim being to enable quicker identification of patients with angina pectoris or myocardial infarction so that they can be more rapidly treated.MethodsPatients with angina pectoris or myocardial infarction who had undergone a heart catheter examination were included in the study. The diagnosis of acute coronary heart disease was made by the physician who performed coronary angiography. Patients without coronary heart disease were used as a control group. The erythrocyte sedimentation rate was measured in all patients. Patients with angina pectoris or myocardial infarction and an inflammatory or tumor disease were excluded.ResultsThe erythrocyte sedimentation rate was prolonged in 79 (58.09%) of 136 patients; 69 (50.74%) patients (95% confidence interval ±8.4%, 42.34%–59.14%) had coronary heart disease and a prolonged erythrocyte sedimentation rate. The erythrocyte sedimentation rate was prolonged in ten (7.35%) patients (95% confidence interval ±4.39%, 2.96%–11.74%) without coronary heart disease by coronary angiography. The specificity of the erythrocyte sedimentation rate for coronary heart disease was 70.59% and the sensitivity was 67.65%.ConclusionErythrocyte sedimentation rate may be a useful additional diagnostic criterion for coronary heart disease.

Age-Related Macular Degeneration and Incident Cardiovascular Disease: The Multi-Ethnic Study of Atherosclerosis

To determine whether age-related macular degeneration (AMD) is a risk indicator for coronary heart disease (CHD) and cardiovascular disease (CVD) events independent of other known risk factors in a multi-ethnic cohort. Population-based prospective cohort study. A diverse population sample of 6233 men and women aged 45 to 84 years without known CVD from the Multi-Ethnic Study of Atherosclerosis (MESA). Participants in the MESA had retinal photographs taken between 2002 and 2003. Photographs were evaluated for AMD. Incident CHD and CVD events were ascertained during clinical follow-up visits for up to 8 years after the retinal images were taken. Incident CHD and CVD events. Of the 6814 persons at risk of CHD, there were 893 participants with early AMD (13.1%) and 27 patients (0.5%) at baseline. Over a mean follow-up period of 5.4 years, there was no statistically significant difference in incident CHD or CVD between the AMD and non-AMD groups (5.0% vs. 3.9%, P = 0.13 for CHD and 6.6% vs. 5.5%, P = 0.19 for CVD). In Cox regression models adjusting for CVD risk factors, there was no significant relationship between presence of any AMD and any CHD/CVD events (hazard ratio 0.99; 95% confidence interval, 0.74-1.33; P = 0.97). No significant association was found between subgroups of early AMD or late AMD and incident CHD/CVD events. In persons without a history of CVD, AMD was not associated with an increased risk of CHD or CVD.

Nutrition transition in India: Secular trends in dietary intake and their relationship to diet-related non-communicable diseases

India is facing an "epidemic" of diet-related non-communicable diseases (DR-NCDs), along with widely prevalent undernutrition resulting in substantial socioeconomic burden. The aim of this paper is to review secular trends in food groups and nutrient intake, and implications for DR-NCDs in India so as to understand optimal choices for healthy diets for the prevention of DR-NCDs. The literature search was carried out in PubMed (National Library of Medicine, Bethesda, MD, USA) and Google Scholar search engines up to April 2011. A manual search for all other references, national and medical databases was also carried out. Nutrition transition over the past 30 years (1973-2004), has resulted in a 7% decrease in energy derived from carbohydrates and a 6% increase in energy derived from fats. A decreasing intake of coarse cereals, pulses, fruits and vegetables, an increasing intake of meat products and salt, coupled with declining levels of physical activity due to rapid urbanization have resulted in escalating levels of obesity, atherogenic dyslipidemia, subclinical inflammation, metabolic syndrome, type 2 diabetes mellitus, and coronary heart disease in Indians. Studies also suggest that adverse perinatal events due to maternal nutritional deprivation may cause low-birth weight infants, which, coupled with early childhood "catch-up growth", leads to obesity in early childhood, thus predisposing to NCDs later in life. In view of rapidly increasingly imbalanced diets, a multisectoral preventive approach is needed to provide balanced diets to pregnant women, children and adults, and to maintain a normal body weight from childhood onwards, to prevent the escalation of DR-NCDs in India.