Knowledge Of Modifiable Risk Factors Research Articles

Knowledge Regarding Modifiable Risk Factors of Coronary Atherosclerosis Heart Diseases in Kathmandu Municipality

Background Progressive urbanization and adoption of the “western” lifestyle contributes to the rising burden of cardiovascular disease in the developing world Coronary Atherosclerotic Heart Disease is no longer confined by geographical area or socioeconomic boundary. The prevalence of Coronary Atherosclerotic Heart Disease is increasing in Nepal. Knowledge is an important pre-requisite for implementing both primary and secondary preventive strategies for cardiovascular diseases. This investigation attempts to quantify knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease among sample population in Kathmandu metropolitan city. Methods Community based cross-sectional descriptive study design using quantitative method of study was conducted in ward no 5 of Kathmandu out of 35 wards. Selection was done by simple random technique (lottery method). Total house hold serial number of selected ward was identified from election commission record section and data was collected using systemic random sampling. The household head aged 18 years and above was taken as representative sample (n= 196). Standard questionnaire was used to interview participants. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Results The mean age (SD) of the 196 participants was 51.26 (13.56) years. Of the participants only 22% had good level of knowledge regarding modifiable risk factors of Coronary Atherosclerotic Heart Disease. This study showed that majority of the respondent lack predefined good level of knowledge regarding modifiable risk factors of Coronary Atherosclerotic Heart Disease. 85.2%, 61.73%, 40.31%, 28.6%, 17.86% correctly identified hypertension, obesity, cholesterol, smoking and diabetes mellitus respectively as modifiable risk factor of Coronary Atherosclerotic Heart Disease. Stud y found association of good level of knowledge in male participants (p=0.006), Brahmin cast (p=0.001), living in nuclear family (p= 0.041), ex-smoker (p=0.06), doing regular exercise ( p= 0.006). Conclusion This study call for efforts such as targeted public health education to increase the level of knowledge about the modifiable risk factors of heart disease. DOI: http://dx.doi.org/10.3126/njh.v9i1.8347 Nepalese Heart Journal Vol.9(1) 2012 pp.37-42

Circulation: Clinical Summaries

<i>Circulation:</i> Clinical Summaries

High anthocyanin intake is associated with a reduced risk of myocardial infarction in young and middle-aged women.

Our current knowledge of modifiable risk factors to prevent myocardial infarction (MI) in young and middle-aged women is limited, and the impact of diet is largely unknown. Dietary flavonoids exert potential beneficial effects on endothelial function in short-term trials; however, the relationship between habitual intake and risk of MI in women is unknown. We followed up 93 600 women 25 to 42 years of age from the Nurses' Health Study (NHS) II who were healthy at baseline (1989) to examine the relationship between anthocyanins and other flavonoids and the risk of MI. Intake of flavonoid subclasses was calculated from validated food-frequency questionnaires collected every 4 years using an updated and extended US Department of Agriculture database. During 18 years of follow-up, 405 cases of MI were reported. An inverse association between higher intake of anthocyanins and risk of MI was observed (hazard ratio, 0.68; 95% confidence interval, 0.49-0.96; P=0.03, highest versus lowest quintiles) after multivariate adjustment. The addition of intermediate conditions, including history of hypertension, did not significantly attenuate the relationship (hazard ratio, 0.70; 95% confidence interval, 0.50-0.97; P=0.03). Combined intake of 2 anthocyanin-rich foods, blueberries and strawberries, tended to be associated with a decreased risk of MI (hazard ratio, 0.66; 95% confidence interval, 0.40-1.08) in a comparison of those consuming >3 servings a week and those with lower intake. Intakes of other flavonoid subclasses were not significantly associated with MI risk. A high intake of anthocyanins may reduce MI risk in predominantly young women. Intervention trials are needed to further examine the health impact of increasing intakes of commonly consumed anthocyanin-rich foods.

Assessment of Cardiovascular Disease Risk Factors among School Children in Private Schools in Karachi, Pakistan: A Pilot Study

The prevalence of cardiovascular diseases is increasing in Pakistan due to unhealthy life style, and lack of awareness. As these diseases have their origin in the early period of life therefore, the prevention of these diseases in early stage is necessary to prevent and control them. This study aimed at identifying the children at higher risk for developing CVDs at their later ages, and providing more focused interventions for them. A cross sectional pilot study was conducted at a private school in Karachi, Pakistan. A total of 24 students (10 boys, 14 girls) were selected through a systematic random sampling. Data was collected through a structured questionnaire. Their height and weight were taken to calculate BMI. Majority of the study participants (66.7 and 62.5%) reported that CVDs were the leading cause of death among the adults in Pakistan, while 25% were not aware. Only 29.2% agreed that CVDs were preventable diseases. They had poor knowledge regarding the prevention of CVDs, 50 % reported only exercise as being a preventive measure of CVDs. The mean time spent on doing home work was 19.46 hours/week, and doing sedentary recreational activity was 15.80 hours/week for both genders. Boys were more active, and they showed less tendency of obesity/overweight as compared to girls. The findings of this study highlight a significant lack of knowledge of modifiable risk factors among the study participants. The results suggest a need of planning health promotion program through schools by focusing on children and their parents in a participatory approach.

Knowledge regarding risk factors of hypertension among entry year students of a medical university

Context:Hypertension in youth is increasing, but there is a dearth of data about the knowledge of risk factors in this age group.Aims:To assess the knowledge of risk factors of hypertension among university students and associate it with the blood pressure, physical activity, family history of cardiovascular disease (CVD), and sociodemographic variables.Materials and Methods:A cross-sectional survey among students enrolled in the first year, in the four academic programs, with the use of a validated, self-administered questionnaire on physical activity in the past 30 days and knowledge of risk factors of hypertension. A score of 6 on 11 was considered as good knowledge for modifiable risk factors. Blood pressure was also measured. The data was analyzed using PASW-17, Chi square test, and binary logistic regression analysis was done.Results:Of the 110 participants, 69.2% were < 20 years of age, 76.4% were females, and 40% were Arabs. Stress, high cholesterol, obesity, and smoking were identified as risk factors by 75.5, 73.6, 77.6, and 71.8%, respectively; 69.1% considered high salt intake and 62.7% considered high calorie diet as risk factors. Energy drink was considered as a risk factor by 64.5%, coffee consumption 35.5%, physical inactivity 47%, and oral contraceptives 13.6%. Half the group did not consider a family history of CVD as a risk factor, 60% did not consider older age as a risk factor, and 88% did not think male gender was a risk factor. Knowledge of modifiable risk factors was better than that of non-modifiable risk factors. Although nationality, course of study, raised blood pressure, and history of diabetes showed significant association with good knowledge, their net effect was not significant by the Adjusted Odd's Ratio.Conclusions:The study identified some gaps in knowledge regarding both modifiable and non-modifiable risk factors of hypertension among students. A larger study would enable health promotion activities tailored to the needs of this age group.

Assessing the prevalence of modifiable risk factors in older patients visiting an ED due to a fall using the CAREFALL Triage Instrument

Objective Falls in older people are a common presenting complaint. Knowledge of modifiable risk factors may lead to a more tailored approach to prevent recurrent falls and/or fractures. We investigated prevalence of 8 modifiable risk factors for recurrent falling and/or a serious consequence of the fall among older patients visiting the emergency department after a fall with the Combined Amsterdam and Rotterdam Evaluation of Falls Triage Instrument (CTI), a self-administrated questionnaire that consists of questions concerning demographics, possible cause(s) of the fall, and questions relating to (modifiable) risk factors for falling. Methods After treatment for their injuries, 1077 consecutive patients 65 years or older visiting the accident and emergency department due to a fall were evaluated by the CTI. The following were assessed: impaired vision, mobility disorder, fear of falling, mood disorder, high risk of osteoporosis, orthostatic hypotension, incontinence, and polypharmacy. Results The percentage of respondents who returned the questionnaire was 59.3%. The mean (SD) age was 78.5 (7.5) years, and 57.8% experienced a fall with serious consequences. There were 60.9% of patients with a recurrent fall versus 51% with a first fall who experienced with a serious consequence ( P = .025). Age and risk factors mobility disorder (odds ratio [OR], 1.9; 95% confidence interval [CI], 1.1-3.3), high risk of osteoporosis (OR, 2.0; 95% CI, 1.2-3.2), incontinence (OR, 1.7; 95% CI, 1.0-2.7), fear of falling (OR, 2.2; 95% CI, 1.3-3.7), and orthostatic hypotension (OR, 2.4; 95% CI, 1.4-4.2) were independently associated with a recurrent fall. Age and high risk of osteoporosis were the only risk factors predicting a serious consequence of a fall (OR, 4.6; 95% CI, 2.9-7.2). Conclusions Age and 5 modifiable risk factors assessed with the CTI were independently associated with a recurrent fall. Only high risk of osteoporosis was associated with a serious consequence.

Knowledge of modifiable risk factors of Coronary Atherosclerotic Heart Disease (CASHD) among a sample in India

BackgroundThe prevalence of Coronary Atherosclerotic Heart Disease (CASHD) is increasing in India. Several modifiable risk factors contribute directly to this disease burden. Public knowledge of such risk factors among the urban Indian population is largely unknown. This investigation attempts to quantify knowledge of modifiable risk factors of CASHD as sampled among an Indian population at a large metropolitan hospital.MethodsA hospital-based, cross sectional study was conducted at All India Institute of Medical Sciences (AIIMS), a major tertiary care hospital in New Delhi, India. Participants (n = 217) recruited from patient waiting areas in the emergency room were provided with standardized questionnaires to assess their knowledge of modifiable risk factors of CASHD. The risk factors specifically included smoking, hypertension, elevated cholesterol levels, diabetes mellitus and obesity. Identifying 3 or less risk factors was regarded as a poor knowledge level, whereas identifying 4 or more risk factors was regarded as a good knowledge level. A multiple logistic regression model was used to isolate independent demographic markers predictive of a participant's level of knowledge.Results41% of the sample surveyed had a good level of knowledge. 68%, 72%, 73% and 57% of the population identified smoking, obesity, hypertension, and high cholesterol correctly, respectively. 30% identified diabetes mellitus as a modifiable risk factor of CASHD. In multiple logistic regression analysis independent demographic predictors of a good knowledge level with a statistically significant (p < 0.05) adjusted odds ratio (aOR) were: routine exercise of moderate intensity, aOR 8.41 (compared to infrequent or no exercise), no history of smoking, aOR 8.25, and former smokers, aOR 48.28 (compared to current smokers). Although statistically insignificant, a trend towards a good knowledge level was associated with higher levels of education.ConclusionAn Indian population in a hospital setting shows a lack of knowledge pertaining to modifiable risk factors of CASHD. By isolating demographic predictors of poor knowledge, such as current smokers and persons who do not exercise regularly, educational interventions can be effectively targeted and implemented as primary and secondary prevention strategies to reduce the burden of CASHD in India.

Prospects for Life Span Extension

Life expectancy has increased dramatically in the United States and in much of the world in recent years and decades. The factors underlying this increase are incompletely understood and are undoubtedly complex. A question that drives current research is whether life expectancy can be further extended using current knowledge of modifiable risk factors. A still more challenging research focus is on the possibility that life expectancy might be further increased through knowledge gained from studies of the basic biology of aging and its genetic and environmental modifiers.

Knowledge of modifiable risk factors of heart disease among patients with acute myocardial infarction in Karachi, Pakistan: a cross sectional study

BackgroundKnowledge is an important pre-requisite for implementing both primary as well as secondary preventive strategies for cardiovascular disease (CVD). There are no estimates of the level of knowledge of risk factor of heart disease in patients with CVD. We estimated the level of knowledge of modifiable risk factors and determined the factors associated with good level of knowledge among patients presenting with their first acute myocardial infarction (AMI) in a tertiary care hospital in Karachi, Pakistan.MethodsA hospital based cross-sectional study was conducted at the National Institute of Cardiovascular Disease, a major tertiary care hospital in Karachi Pakistan. Patients admitted with their first AMI were eligible to participate. Standard questionnaire was used to interview 720 subjects. Knowledge of four modifiable risk factors of heart disease: fatty food consumption, smoking, obesity and exercise were assessed. The participants knowing three out of four risk factors were regarded as having a good level of knowledge. A multiple logistic regression model was constructed to identify the determinants of good level of knowledge.ResultsThe mean age (SD) was 54 (11.66) years. A mere 42% of our study population had a good level of knowledge. In multiple logistic regression analysis, independent predictors of "good" level of knowledge were (odds ratio [95% confidence interval]) more than ten years of schooling were 2.5 [1.30, 4.80] (verses no schooling at all) and nuclear family system (verses extended family system) 2.54 [1.65, 3.89]. In addition, Sindhi ethnicity OR [3.03], higher level of exercise OR [2.76] and non user of tobacco OR [2.53] were also predictors of good level of knowledge.ConclusionOur findings highlight the lack of good level of knowledge of modifiable risk factors for heart disease among subjects admitted with AMI in Pakistan. There is urgent need for aggressive and targeted educational strategies in the Pakistani population.

A simple linear model for the effect of changes in metabolic risk factors on coronary heart disease

The risk of having one or more metabolic risk factors in the development of coronary heart disease (CHD) is well estimated, but it still remains to be shown which influence any given change in the number of risk factors has on the overall risk of CHD. In this prospective cardiovascular population study, 10 194 participants were examined twice with a 5-year interval for metabolic risk factors such as obesity, hypertension, hypercholesterolaemia and diabetes mellitus. During 14 years of follow-up, 1724 incident cases of CHD were identified, 973 in men and 751 in women. The effect of an increase in the number of metabolic risk factors during a 5-year interval on the relative risk of CHD could be determined to be statistically significant for both genders. But only for men, the effect of a decrease in the number of metabolic risk factors was statistically significant during the same time interval. Hence, by statistical analysis, a simple linear model could be constructed for men with two linear trend parameters, one corresponding to the number of metabolic risk factors at the first examination and one corresponding to the change in the number of metabolic risk factors from the first to the second examination. The parameters were 1.50 (1.39-1.63); P < 0.001 and 1.29 (1.18-1.41); P < 0.001, respectively. This study suggests that it is possible to fit a simple linear model for the effect of changed number of metabolic risk factors on the risk of CHD.

Risk Factors for Nosocomial Infections in Selected Neonatal Intensive Care Units in Colombia, South America

This study was designed to identify risk factors for nosocomial infections among infants admitted into eight neonatal intensive care units in Colombia. Knowledge of modifiable risk factors could be used to guide the design of interventions to prevent the problem. Data were collected prospectively from eight neonatal units. Nosocomial infection was defined as culture-proven infection diagnosed after 72 hours of hospitalization, resulting in treatment with antibiotics for >3 days. Associations were expressed as odds ratios. Logistic regression was used to adjust for potential confounders. From a total of 1504 eligible infants, 80 were treated for 127 episodes of nosocomial infection. Logistic regression analysis identified the combined exposure to postnatal steroids and H2-blockers, and use of oral gastric tubes for enteral nutrition as risk factors significantly associated with nosocomial infection. Nosocomial infections in Colombian neonatal intensive care units were associated with modifiable risk factors including use of postnatal steroids and H2-blockers.

PHASE IV CARDIAC REHABILITATION PATIENT KNOWLEDGE AND AWARENESS OF MODIFIABLE RISK FACTORS

PURPOSE The purpose of this study was to determine if phase IV cardiac rehabilitation patients are aware of the risk factors for cardiovascular disease (CVD) and if they know their personal and recommended values for specific risk factors. These risk factors include hypertension, hypercholesterolemia, obesity, diabetes, smoking, sedentary lifestyle, and stress. METHODS There were 24 men and 5 women from the Immanuel St. Joseph - Mayo Health System that volunteered to participate in the study. The participants were between the ages of 53 and 82 and reported a mean of 70 +/− 8.4 years. Subjects completed a questionnaire asking what the risk factors for CVD are and if they knew their personal and recommended values for specific risk factors. Data was analyzed for means and percentages for demographics and each variable. RESULTS The most frequently mentioned risk factor was sedentary lifestyle, followed by diet and obesity. Of the subjects, 72.4% could correctly identify three or more risk factors. Awareness of average fasting blood sugar, target heart rate and blood pressure was high, while awareness of total cholesterol, LDH, HDL, and triglyceride levels were low. Knowledge of recommended days per week for exercise and blood pressure were higher than knowledge of recommended minutes per session for exercise, target heart rate, cholesterol levels and average blood sugar levels. CONCLUSION The results from this investigation suggest that as the subjects education level and/or length of time in the program increased, their awareness and knowledge of modifiable risk factors also favorably increased.

Risk factors for bloodstream infections at a cancer center.

A hospital-based matched case-control study was conducted in order to identify risk factors for the development of bloodstream infections in adult hospitalized patients. Between January 1993 and December 1994, 264 episodes of bloodstream infection were evaluated. Significant variables identified by univariate analysis were included in a multivariate model that showed that central venous catheter [odds ratio (OR), 6.71], poor performance status (OR, 3.40), weight loss (OR, 2.47), hematologic diseases (OR, 2.24), and previous antimicrobial therapy (OR, 2.12) independently influenced the outcome. The knowledge of modifiable risk factors is useful in the development of strategies that may contribute to the prevention of bloodstream infections.

Risk factors for subarachnoid hemorrhage.

Background and Purpose Knowledge of modifiable risk factors for subarachnoid hemorrhage (SAH) is important in terms of prevention. We therefore conducted a systematic review of studies on risk factors for SAH, with emphasis on sufficiently precise criteria for the diagnosis of SAH. Methods To identify studies we performed a Medline search from 1966 to 1994 and searched the reference lists of all relevant publications. Studies were included only if they fulfilled predefined methodological criteria. Case-control studies were included if the diagnosis of SAH was proved by CT, angiography, or autopsy in at least 70% of patients. Longitudinal studies were included if the criteria for SAH were based on a review of the medical records. Results Nine longitudinal studies and 11 case-control studies were included. Significant risk factors were as follows: (1) smoking (relative risk [RR] for longitudinal studies, 1.9; 95% confidence interval [CI], 1.5 to 2.3; odds ratio [OR] for case-control studies, 3.5; 95% CI, 2....

Knowledge about modifiable risk factors for non-communicable diseases adults living with HIV in Rwanda.

Non-communicable diseases (NCD) are of international public health concern. Of more concern are people living with HIV (PLHIV), who have the increased risk of developing NCDs, such as hypertension, stroke and diabetes. Research has revealed that there is a relationship between knowledge of NCD risk factors and risk perceptions in the general population. Therefore, an assessment of PLHIV's NCD risk factors knowledge is quite critical, to design effective NCD prevention programmes. To assess the level of knowledge of modifiable risk factors for NCDs and its associated factors among adults living with HIV in Rwanda. A cross-sectional quantitative design was used to collect the data. The study targeted PLHIV who visited the out-patients' public health centres in three purposively selected provinces of Rwanda. The knowledge assessment questionnaire relating to risk factors for chronic diseases of lifestyle was used to collect the data. Data were analysed using SPSS version 23. Of the 794 respondents, 64.6% were women, and the mean age was 37.9 (±10.8) years. The results revealed that the majority of the respondents (65.0%) had low levels of knowledge about NCD risk factors, while some (35.6%) were of the opinion that they had a low risk of contracting NCDs. Good knowledge was significantly associated with high educational status, a low CD4+ cell count (< 350 cells/mm3) and normotension. The current study findings highlight the need for comprehensive health education, to raise awareness of non-communicable diseases' risk factors for adults living with HIV in Rwanda.