Coronary Heart Disease Risk Factors Research Articles

Association of Sustained Blood Pressure Control with Lower Risk for High-Cost Multimorbidities Among Medicare Beneficiaries in ALLHAT.

Clustering of chronic conditions is associated with high healthcare costs. Sustaining blood pressure (BP) control could be a strategy to prevent high-cost multimorbidity clusters. To determine the association between sustained systolic BP (SBP) control and incident multimorbidity cluster dyads and triads. Cohort study of Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT) linked to Medicare claims. ALLHAT included adults with hypertension and ≥1 coronary heart disease risk factor. This analysis was restricted to 5234 participants with ≥ 8 SBP measurements during a 48-month BP assessment period. SBP control was defined as <140 mm Hg at <50%, 50 to <75%, 75 to <100%, and 100% of study visits during the BP assessment period. High-cost multimorbidity clusters included dyads (stroke/chronic kidney disease [CKD], stroke/chronic obstructive pulmonary disease [COPD], stroke/heart failure [HF], stroke/asthma, COPD/CKD) and triads (stroke/CKD/asthma, stroke/CKD/COPD, stroke/CKD/depression, stroke/CKD/HF, stroke/HF/asthma) identified during follow-up. Incident dyads occurred in 1334 (26%) participants and triads occurred in 481 (9%) participants over a median follow-up of 9.2 years. Among participants with SBP control at <50%, 50 to <75%, 75 to <100%, and 100% of visits, 32%, 23%, 23%, and 19% of participants developed high-cost dyads, respectively, and 13%, 9%, 8%, and 5% of participants developed high-cost triads, respectively. Compared to those with sustained BP control at <50% of visits, adjusted HRs (95% CI) for incident dyads were 0.66 (0.57, 0.75), 0.67 (0.59, 0.77), and 0.51 (0.42, 0.62) for SBP control at 50 to <75%, 75 to <100%, and 100% of visits, respectively. The corresponding HRs (95% CI) for incident triads were 0.69 (0.55, 0.85), 0.56 (0.44, 0.71), and 0.32 (0.22, 0.47). Among Medicare beneficiaries in ALLHAT, sustained SBP was associated with a lower risk of developing high-cost multimorbidity dyads and triads.

Longitudinal associations of sleep duration and sleep quality with coronary heart disease risk among adult population: classical meta-analysis and Bayesian network meta-analysis

To examine the longitudinal associations of sleep duration and sleep quality with coronary heart disease (CHD) risk among individuals aged ≥ 20 years. A systematic review and meta-analysis of observational cohort studies were performed to evaluate the association between sleep quality and duration, and the risk of CHD. We searched three databases including PUBMED, the Cochrane Library and EMBASE, selected relevant studies and used the classical and Net-work models to establish the hazard ratio (HRs) of the results. Data extracted from 11 studies including 769,452 participants and 14,769 patients with CHD events were reviewed. In the classical meta-analysis, night sleep duration of 8 h showed an increased risk of CHD (HR = 1.13, and 1.13, respectively) compared with reference sleep (7–8 h). However, the net-work model stratified sleep quality into good and poor subgroups, and there was no change in CHD risk in each subgroup despite different sleep hours. Furthermore, individuals with poor-quality sleep were at a greater risk of CHD than those with good-quality sleep (HR = 1.4, 1.3, and 1.4 for 8 h, respectively). Moreover, individuals with reference time sleep but that of poor quality were associated with an increased risk of CHD compared with good sleepers having short/long sleep duration (HR = 1.3 and 1.2, respectively). Poor-quality sleep was associated with great morbidity and mortality of CHD, independent of sleep duration. Sleep quality rather than sleep duration might be crucial for increased CHD risk, suggesting the potential importance of poor-quality sleep as a possible CHD risk factor.

Serum Galectin-3 and Subsequent Risk of Coronary Heart Disease in Subjects With Childhood-Onset Type 1 Diabetes: A Cohort Study.

OBJECTIVETo study whether serum galectin-3 and other biomarkers of inflammation predict coronary heart disease (CHD) in subjects with long-standing childhood-onset type 1 diabetes.RESEARCH DESIGN AND METHODSA population-based nationwide cohort of 299 subjects with type 1 diabetes diagnosed in Norway at <15 years of age during 1973–1982 was examined in 2002–2003 at a mean age of 33 years (range 21–44), with mean diabetes duration of 24 years (range 19–30). Subjects were followed through 31 December 2017 for their first CHD event registered by a hospitalization or cause of death using nationwide registries. Stored serum samples were available for 296 subjects and analyzed for interleukin-6 (IL-6), IL-6 receptor, IL-18, hs-CRP, matrix metalloproteinase-9, tissue inhibitor of metalloproteinase-1 (TIMP-1), galectin-3, and high-sensitivity troponin T. Adjusted hazard ratios (aHRs) for CHD per SD increase in biomarker were estimated using Cox regression.RESULTSOf 295 subjects, 40 (13.6%) had a documented CHD event during a mean follow-up of 14.4 years (range 0.5–16). IL-6 (aHR 1.32 [95% CI 1.07–1.63]), galectin-3 (aHR 1.44 [95% CI 1.09–1.80]), and TIMP-1 (aHR 1.37 [95% CI 1.04–1.81]) were significant predictors of CHD after adjustment for conventional risk factors.CONCLUSIONSGalectin-3 was significantly associated with future CHD in subjects with type 1 diabetes, and if the results are replicated in larger studies, it may aid in prediction together with conventional risk factors for CHD.

Joint association between education and polygenic risk score for incident coronary heart disease events: a longitudinal population-based study of 26 203 men and women

BackgroundGenetic vulnerability to coronary heart disease (CHD) is well established, but little is known whether these effects are mediated or modified by equally well-established social determinants of CHD. We estimate...

Relationships of Alcohol Consumption with Coronary Risk Factors and Macro- and Micro-Nutrient Intake in Japanese People: The INTERLIPID Study.

Several studies have reported a J-shaped relationship between alcohol consumption and coronary heart disease (CHD) risk. However, the mechanisms of this relationship remain unclear. This study aimed to evaluate the relationships of alcohol consumption with established CHD risk factors and with macro-/micro-nutrient intake among Japanese people. Participants were 1,090 Japanese men and women aged 40-59 y enrolled in the INTERLIPID study, excluding former drinkers. Based on two 7-d alcohol records, participants were classified as non-drinkers (0 g/wk), light-drinkers (<100 g/wk), moderate-drinkers (100-299 g/wk), or heavy-drinkers (≥300 g/wk). Detailed macro-/micro-nutrient intake was evaluated using four in-depth 24-h dietary recalls and adjusted for total energy intake excluding alcohol. We analyzed the associations of CHD risk factors and nutrient intake with alcohol consumption. Serum high-density lipoprotein cholesterol and blood pressure were higher and low-density lipoprotein cholesterol was lower among those with higher alcohol consumption. J-shaped relationships with alcohol consumption were observed for the proportion of current smokers, number of cigarettes smoked, and prevalence of hypertension; these risk factors were lowest among light-drinkers. Carbohydrate and total fiber intakes were lower and protein and dietary cholesterol intakes were higher among those with higher alcohol consumption. These associations were similar for men and women. Alcohol consumption was related to nutrient intake as well as established CHD risk factors. Non-drinkers were higher on some CHD risk factors than were light-drinkers. These findings may influence the J-shaped relationship between alcohol consumption and CHD risk.

Patient Education Interventions for Health Behaviour Change in Adults Diagnosed With Coronary Heart Disease: A Systematic Review, Meta-analyses and Meta-regressions

Patient education is recommended to modify coronary heart disease risk factors. Although the importance has been established, there is a lack of knowledge of its efficacy and relative impact of duration on health behaviour outcomes. This study aimed to assess the efficacy of structured patient education on health behaviour outcomes in adults with coronary heart disease for short-term and long-term effect.

Correlation analysis of epicardial adipose tissue volume quantified by computed tomography images and coronary heart disease under optimized reconstruction algorithm.

Objectives:This paper was aimed to explore the adoption value of low-dose computed tomography (CT) imaging based on optimized ordered subset expectation maximization (OSEM) reconstruction algorithm in the correlation analysis between epicardial adipose tissue (EAT) volume and coronary heart disease (CHD).Methods:A total of 110 patients with CHD were selected for CT angiography (CTA) and coronary arteriography (CAG) examinations from October 2017 to October 2019. The predictive value of EAT for CHD was analyzed via receiver operating characteristic (ROC) curve.Results:The results showed that the iteration time and error of the improved OSEM reconstruction algorithm were better than that of MLEM algorithm under the same number of iterations. Age, smoking, hypertension, diabetes, and EAT in control group were obviously lower in contrast to those in CHD group (P<0.05). EAT in control group was (124.50±26.72) mL, and EAT in the CHD group was (159.41±38.51) mL. EAT (B=0.023, P=0.003) was an independent risk factor for CHD, which was suggested by Multiple linear regression analysis. Moreover, EAT was a risk factor for CHD, and was positively correlated with the degree and NSCV.Conclusion:The optimized OSEM algorithm was used to improve the reconstruction quality of low-dose CT images and used in quantitative measurement of epicardial fat volume. Results showed EAT was an independent risk factor for CHD, and was positively correlated with the number of coronary lesions and Gensini score. It was of great value for the prediction of CHD.

Reviewing the role of dietary lipids in coronary heart disease

It has been shown that coronary heart disease (CHD) is related to high serum total cholesterol (TC) levels. In all the urban population compared with the rural population is showed a rise of serum TC. This is reflected in the trend of CHD morbidity and mortality as well. In spite of a declining trend in serum TC level, CHD morbidity and mortality are still high year after year. In general, there is still a rising trend in serum TC level and in CHD mortality in many countries. However it may be controlled and managed. This may be attributed to a better control of other CHD risk factors such as hypertension and smoking. More than a century of laboratory and human findings cholesterol levels with a propensity to develop atherosclerosis. Low-density lipoprotein (LDL) is the major atherogenic lipoprotein, and numerous clinical trials have shown the efficacy of lowering LDL-cholesterol (LDL-C) for reducing CHD 127 risk. The rising trend in serum TC level remains a cause for concern, as this will emerge as a major problem for CHD morbidity and mortality in the future.

Effects of data preprocessing on results of the epidemiological analysis of coronary heart disease and behaviour-related risk factors

Background We carried out this study to demonstrate the effects of outcome sensitivity, participant exclusions, and covariate manipulations on results of the epidemiological analysis of coronary heart disease (CHD) and its behaviour-related risk factors. Material and methods Our study population consisted of 1592 54-year-old men, who participated in the Kuopio Ischaemic Heart Disease Risk Factor (KIHD) Study. We used the Cox proportional-hazards model to predict the hazard of CHD and applied different sets of outcomes concerning outcome sensitivity and data preprocessing procedures regarding participant exclusions and covariate manipulations. Results The mean follow-up time was 23 years, and 730 men received the CHD diagnosis. Cox regressions based on data with no participant exclusions most often discovered statistically significant associations. Loose inclusion criteria for study participants with any CVD during the follow-up and strict exclusion criteria for participants with no CVD were best in discovering the associations between risk factors and CHD. Outcome sensitivity affected the associations, whereas the covariate type, continuous or categorical, did not. Conclusions This study suggests that excluding study participants who are not disease-free at baseline is probably unnecessary for epidemiological analyses. Epidemiological research reports should present results based on no data exclusions together with results based on reasoned exclusions.

Predictive Value of Small Dense Low-Density Lipoprotein in Coronary Heart Disease in the Chinese Population.

Coronary heart disease (CHD) is a global public health concern, and CHD risk assessment remains a major challenge. Therefore, in this study, the ability of small dense low-density lipoprotein (sdLDL) alone to sufficiently predict CHD risk in the Chinese population was evaluated. Patients with CHD (139) and healthy controls (58) were included in this study. Serum sdLDL was measured using the peroxidase method. Other lipid parameters were also determined. The sdLDL level in the CHD group was significantly higher than that in the control group (p < 0.001). Logistic regression analysis revealed that sdLDL was an independent risk factor for CHD. Based on the receiver operating characteristic curves, the area under the curve (AUC) of sdLDL alone for CHD was 0.722. The AUC of triglycerides (TG), high-density lipoprotein (HDL), and sdLDL combined was 0.763, which was larger than that of the independent ones or combinations of any two; however, the value was not significant. sdLDL alone can predict CHD risk efficiently similar to the combination of TG, HDL, and sdLDL. This finding suggests that sdLDL can be considered as an ideal parameter for the preliminary diagnosis of CHD in Chinese people.

Nonalcoholic Fatty Liver Disease and Cardiovascular Disease.

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Prevalence of Risk factors for Coronary heart disease among the workers of an industry of South India

Introduction: Industrial workers are a captive group and can be considered ideal for increasing awareness, adopting preventive strategies and thus to the control of cardiovascular diseases. However, there are limited numbers of studies which are carried out to estimate the coronary heart disease risk burden in factory settings of India. Objectives: To estimate the prevalence of coronary heart disease risk factors among the workers of a nylon yarn manufacturing factory in South India. Methods: A cross sectional study was conducted among all employees aged 20 -59 years employing a clinical examination and biochemical estimation. Body Mass Index, Blood Pressure, Fasting Blood sugar and Lipid profile were measured. Patients known to have coronary heart disease, those aged less than 20 years and those aged more than 59 years were excluded. Results: 320 workers were evaluated. Their mean age was 32 years. Among the study population, 6.25% were obese and 21.8% were current smokers. 14.7% of them were found to be hypertensives and 61.87% were pre-hypertensives. 5.9% of the workers were diabetic and 14.6% had impaired fasting glucose. 55.93% of them had an increased Total cholesterol / High Density Lipoprotein ratio. Conclusion: This study demonstrates a high prevalence of risk factors for coronary heart disease among a comparatively young population in a South Indian industrial setting.

Five-Year Risk of Acute Myocardial Infarction After Acute Ischemic Stroke in Korea.

BackgroundThe long‐term incidence of acute myocardial infarction (AMI) in patients with acute ischemic stroke (AIS) has not been well defined in large cohort studies of various race‐ethnic groups.Methods and ResultsA prospective cohort of patients with AIS who were registered in a multicenter nationwide stroke registry (CRCS‐K [Clinical Research Collaboration for Stroke in Korea] registry) was followed up for the occurrence of AMI through a linkage with the National Health Insurance Service claims database. The 5‐year cumulative incidence and annual risk were estimated according to predefined demographic subgroups, stroke subtypes, a history of coronary heart disease (CHD), and known risk factors of CHD. A total of 11 720 patients with AIS were studied. The 5‐year cumulative incidence of AMI was 2.0%. The annual risk was highest in the first year after the index event (1.1%), followed by a much lower annual risk in the second to fifth years (between 0.16% and 0.27%). Among subgroups, annual risk in the first year was highest in those with a history of CHD (4.1%) compared with those without a history of CHD (0.8%). The small‐vessel occlusion subtype had a much lower incidence (0.8%) compared with large‐vessel occlusion (2.2%) or cardioembolism (2.4%) subtypes. In the multivariable analysis, history of CHD (hazard ratio, 2.84; 95% CI, 2.01–3.93) was the strongest independent predictor of AMI after AIS.ConclusionsThe incidence of AMI after AIS in South Korea was relatively low and unexpectedly highest during the first year after stroke. CHD was the most substantial risk factor for AMI after stroke and conferred an approximate 5‐fold greater risk.

Use of Chou’s 5-steps Rule to Study the Effect of Cereal Dietary Protein on Liver and Coronary Heart Disease Prevention

Background: The liver is a vital organ in the human body involved in the metabolic processes. The liver can be damaged due to factors such as protein deficiency, viral infection, as well as consumption of alcohol, chemical contaminants, and adulterated food. High blood cholesterol, high blood pressure, diabetes, lack of exercise, poor diet, obesity and cigarette smoking are the major risk factors for stroke, heart attack and coronary heart disease (CHD). In medical science, several synthetic drugs have been discovered and used for the treatment of people suffering from liver injury and CHD, but these are not always effective and sometimes difficult to manage by medical therapies and also found to be accompanied by other side effects. Objective: The study aimed to critically review the recent research and studies of epidemiological and randomized controlled trials to find out the effective cereal protein as an alternative preventive food to reduce the risk of CHD and protect the liver from viral hepatic diseases, focusing on daily food intake, body weight, liver weight, serum enzyme activities and cholesterols. Methods: A few of the data from our experiment were used. A literature search was performed for a reliable source of published research articles, review papers, and epidemiological and randomized controlled trials on the effects of cereal protein on animals and human intervention on Google, Google scholar, Redcube, Endnote, Scopus, SpringerDirect.com, PubMed and Web of Science. Then, the data was organized, summarized and analyzed. Results: In medical science, serum enzyme activities of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH) and lipid peroxidation stress malondialdehyde (MDA) are commonly used as biochemical markers of the liver-damaging agents. Blood cholesterols (total cholesterol-TC, triglyceride-TG, low-density lipoprotein cholesterol-LDLC and highdensity lipoprotein cholesterol-HDLC) are used as the markers of heart diseases. The review shows that daily food intake and body weight data are not significantly differed among normal diet, casein (CAS) and cereals protein. The millet and wheat protein increase the liver weight, whereas the rice protein lowers the liver weight. The intake of cereal protein significantly reduces the activities of serum AST, ALT, LDH, MDA, TC, TG and LDLC, whereas it increases the HDLC. Conclusion: Experimental, review and randomized controlled trials (RCTs) data confirm that cereal protein appears to be beneficial in reducing the hepatic liver injury and CHD by maintaining body weight, liver weight, blood pressure, serum enzyme activities of AST, ALT and LDH, lipid peroxidation stress MDA and cholesterol concentrations both in plasma and liver.

Association of Risk Factors of Coronary Heart Diseases and Socio-demographic Characteristics of Civil Employees of Combined Military Hospital Dhaka

Introduction: Risk factors are the most ruinous and mischievous ingredient to develop coronary heart diseases (CHD). Factors contributing to develop CHD and their associates are, therefore, of prime importance. It needs endless splurge to address the issue.&#x0D; Objectives: To identify the attributing risk factors and socio-demographic characteristics of coronary heart disease among civilian employees of Combined Military Hospital (CMH) Dhaka.&#x0D; Materials and Methods: This observational study was conducted on 287 civil employees of CMH, Dhaka from September to December 2011. Data were collected by interview using questionnaire and check list which includes blood pressure measurement, anthropometric measurement and biochemical examinations.&#x0D; Results: Respondent’s age range was 23 to 59 years, educational level up to class VIII were 56.4 % and more than that were 36.6%, illiterate were 7%. Regarding income low, medium and high income group were 40.4%, 56.8% and 2.8% respectively. It was found that 68.6% had normal BP, 61.3% practices moderate exercise. Among the respondents 72.2% has got 1-5 risk factors of CHD. Risk factors (p &lt;0.001) were significantly associated with age.&#x0D; Conclusion: This study finding is suggestive of association between risk factors of CHD and socio-demographic characteristics among the study population. Care through motivation, avoidance of risk behaviour, addressing clinical conditions can resist risk factors of CHD thus coronary heart disease can be prevented.&#x0D; JAFMC Bangladesh. Vol 15, No 2 (December) 2019: 175-177

The FoxO3 Longevity Genotype Is Associated With Better Survival After Acute Myocardial Infarction in Older Patients

Background: Although numerous studies have been published on prognostic factors after a first acute myocardial infarction (AMI) among middle-aged men, little is known about the prognostic factors and genetic determinants for post-AMI elderly patients. Methods: The Kuakini Honolulu Heart Program (KHHP) is a prospective population-based study of cardiovascular disease (CVD) (defined as coronary heart disease (CHD) and stroke) among men of Japanese ancestry living in Hawaii. We identified 141 first AMI patients from participants of the KHHP exam 4 (1991-93) by ECG and/or cardiac enzymes (onset age: 73-96 years). Men who survived more than one year after AMI were followed for mortality from onset of AMI to December 2018 (all were deceased by 28 years of follow-up). All had FOXO3 genotype information available. Quantile regression was used to compare the median survival times of FOXO3-G allele carriers (longevity genotype) with FOXO3-TT homozygotes (common genotype). Results: Adjusting for age at AMI onset, baseline body mass index (BMI) and glucose levels (at exam 4), median survival times differed between FOXO3-G allele carriers and FOXO3-TT homozygotes by 2.1 years (95% CI=0.24-3.95, p=0.027). Adding other known CHD risk factors (i.e. hypertension, etc.) to the model reduced the difference to 2.03 years (95% CI=0.17-3.89, p=0.033). Furthermore, chi-square testing showed the mortality rate from CVD among FOXO3-G allele carriers was significantly lower than that among the common FOXO3-TT genotype. Conclusions: The data suggest that the FOXO3 longevity genotype reduces the risk of dying from CVD and extends survival time of elderly patients with acute myocardial infarction.

Explaining the increment in coronary heart disease mortality in Mexico between 2000 and 2012.

Mexico is still in the growing phase of the epidemic of coronary heart disease (CHD), with mortality increasing by 48% since 1980. However, no studies have analyzed the drivers of these trends. We aimed to model CHD deaths between 2000 and 2012 in Mexico and to quantify the proportion of the mortality change attributable to advances in medical treatments and to changes in population-wide cardiovascular risk factors. We performed a retrospective analysis using the previously validated IMPACT model to explain observed changes in CHD mortality in Mexican adults. The model integrates nationwide data at two-time points (2000 and 2012) to quantify the effects on CHD mortality attributable to changes in risk factors and therapeutic trends. From 2000 to 2012, CHD mortality rates increased by 33.8% in men and by 22.8% in women. The IMPACT model explained 71% of the CHD mortality increase. Most of the mortality increases could be attributed to increases in population risk factors, such as diabetes (43%), physical inactivity (28%) and total cholesterol (24%). Improvements in medical and surgical treatments together prevented or postponed 40.3% of deaths; 10% was attributable to improvements in secondary prevention treatments following MI, while 5.3% to community heart failure treatments. CHD mortality in Mexico is increasing due to adverse trends in major risk factors and suboptimal use of CHD treatments. Population-level interventions to reduce CHD risk factors are urgently needed, along with increased access and equitable distribution of therapies.

Abstract 16122: Comparative Risk of Incident Coronary Heart Disease Across Multiple Chronic Inflammatory Diseases

Introduction: Inflammation plays an important role in the pathogenesis of coronary heart disease (CHD). Chronic inflammatory diseases (CIDs) may serve as models to provide insights into the relationships between immune dysfunction, inflammation, and CHD. To investigate this further, we analyzed the risk of incident CHD across different CIDs. Methods: We created a cohort of individuals with CIDs and non-CID controls (frequency-matched on demographics and CHD risk factors), free of baseline CHD, receiving regular outpatient care in a large medical system from 2000 to 2019. CIDs included psoriasis, rheumatoid arthritis (RA), systemic sclerosis (SSc), systemic lupus erythematosus (SLE), human immunodeficiency virus (HIV), and inflammatory bowel disease (IBD). CHD was defined as myocardial infarction (MI), angina, or coronary revascularization. We used adjusted hazards models to determine incident CHD risk for each CID relative to controls. We also analyzed incident CHD risk by severity of inflammation (baseline C-reactive protein) or immune dysfunction (baseline CD4 T cell level in HIV). Results: Of 18,129 individuals with CIDs and 18,988 controls, there were 1,011 incident CHD events over a median of 3.5 years. After adjusting for demographics and CHD risk factors, CHD risk was significantly elevated in SLE [hazard ratio (HR) 2.85, 95% confidence interval (CI) 2.19-3.71, p&lt;0.01], SSc (HR 2.14, 95% CI 1.54-2.99, p&lt;0.01), HIV (HR 1.38, 95% CI 1.12-1.69, p&lt;0.01), and RA (HR 1.22, 95% CI 1.00-1.49, p=0.05). Findings were similar with MI as the lone outcome. When CIDs were categorized by inflammation or immune dysfunction, there was a pattern of higher CHD risk with higher levels of inflammation/immune dysfunction across CIDs (Figure). Conclusions: Our results show that SLE, SSc, HIV, and RA were associated with significantly elevated risks of incident CHD and MI. Higher levels of inflammation or immune dysfunction were associated with heightened CHD risk within CIDs.

Sleep quality and risk of coronary heart disease - a prospective cohort study from the English longitudinal study of ageing.

Background: The association between sleep quality and risk of coronary heart disease (CHD) remains unclear in the elderly.Results: At eight-year follow up, a total of 411 (4.29%) participants developed CHD. Compared with good quality group, the multivariable hazard ratio [HR] (95% confidence interval [CI]) for CHD was 1.393 (1.005, 1.931) for intermediate quality group and 1.913 (1.206, 3.035) for poor quality group. Consistent results were observed in participants with normal sleep duration.Conclusions: Poor sleep quality may be a novel modifiable risk factor for CHD in the elderly independent of conventional cardiovascular risk factors, even when sleep duration was normal.Methods: The current study included 9570 CHD-free participants in the English Longitudinal Study of Ageing (ELSA) from wave 4 (2008 to 2009). Incident CHD included new onset angina or myocardial infarction. Sleep quality was measured by a four-item questionnaire. Score ranged from 1 (best) to 4 (poorest). Participants were divided into three groups: good quality (1 ≤ score <2), intermediate quality (2 ≤ score <3) and poor quality (3 ≤ score ≤4). Cox regression model was used to calculate HR for CHD risk according to sleep quality, adjusted for conventional CHD risk factors and sleep duration.

Sedentary lifestyle among office workers and coronary heart disease risk factors due to the COVID-19 quarantine.

The COVID-19 pandemic has affected the entire world. It is difficult to follow protocols and regulations set forth by governments, designed by the World Health Organization. The most common protocol set forth by governments is quarantining at home. Many occupations must stay home to comply with this protocol. Among these occupations, office workers are the most common group to comply and work from home. This has led to a lack of daily movement and increased sedentary lifestyle, which has made employees prone to developing coronary heart disease (CHD). Additionally, obesity is a known risk factor for this group. This commentary presents feasible protocols aimed at helping home-based office workers stay healthy and decrease the risk of developing CHD.