Modifiable Cardiovascular Disease Research Articles

The association between stair climbing and modifiable cardiovascular disease risk factors: the Suita Study.

Stair climbing is a readily available form of physical activity with potential cardiovascular benefits. This study aimed to investigate the association between stair climbing and numerous modifiable cardiovascular disease (CVD) risk factors. In this cross-sectional study, we used data from 7282 Japanese people (30-84 years) residing in Suita City, Osaka. CVD risk factors and stair climbing frequency were assessed during the Suita Study health examination. Logistic regressions were used to calculate the odds ratios (ORs) and 95% confidence intervals (95% CIs) for CVD risk factors across stair climbing frequencies. After adjustment for age, sex, lifestyle, and medical conditions, stair climbing >60% of the time, compared to <20% of the time, was inversely associated with obesity, smoking, physical inactivity, and stress: ORs (95% CIs) = 0.63 (0.53, 0.75), 0.81 (0.69, 0.96), 0.48 (0.41, 0.55), and 0.67 (0.58, 0.78), respectively (p-trends < 0.05). Stair climbing was inversely associated with obesity, smoking, physical inactivity, and stress; suggesting a potential role for cardiovascular disease prevention.

The Association of Prescribed Opioids and Incident Cardiovascular Disease

Opioid prescribing remains common despite known overdose-related harms. Less is known about links to nonoverdose morbidity. We determined the association between prescribed opioid receipt with incident cardiovascular disease (CVD) using data from the Veterans Aging Cohort Study, a national prospective cohort of Veterans with/without Human Immunodeficiency Virus (HIV) receiving Veterans Health Administration care. Selected participants had no/minimal prior exposure to prescription opioids, no opioid use disorder, and no severe illness 1 year after the study start date (baseline period). We ascertained prescription opioid exposure over 3 years after the baseline period using outpatient pharmacy fill/refill data. Incident CVD ascertainment began at the end of the prescribed opioid exposure ascertainment period until the first incident CVD event, death, or September 30, 2015. We used adjusted Cox proportional hazards regression models with matching weights using propensity scores for opioid receipt to estimate CVD risk. Among 49,077 patients, 30% received opioids; the median age was 49 years, 97% were male, 49% were Black, and 47% were currently smoking. Prevalence of hypertension, diabetes, current smoking, alcohol and cocaine use disorder, and depression was higher in patients receiving opioids versus those not but were well-balanced by matching weights. Unadjusted CVD incidence rates per 1,000-person-years were higher among those receiving opioids versus those not: 17.4 (95% confidence interval [CI], 16.5–18.3) versus 14.7 (95% CI, 14.2–15.3). In adjusted analyses, those receiving opioids versus those not had an increased hazard of incident CVD (adjusted hazard ratio 1.16 [95% CI, 1.08–1.24]). Prescribed opioids were associated with increased CVD incidence, making opioids a potential modifiable CVD risk factor. PerspectiveIn a propensity score weighted analysis of Veterans Administration data, prescribed opioids compared to no opioids were associated with an increased hazard of incident CVD. Higher opioid doses compared with lower doses were associated with increased hazard of incident CVD. Opioids are a potentially modifiable CVD risk factor.

Association between sleep duration and high blood pressure in Lithuanian adolescents

Abstract Background Sufficient sleep duration in children plays an essential role in physical, mental, and emotional development. High blood pressure (HBP) is growing public health problem in youth. The aim of this study was to evaluate the association between short sleep duration (SSD) and HBP in Lithuanian adolescents aged 11-18 years. Methods The cross-sectional study was conducted from 2019 to 2020 in Kaunas district, Lithuania. HBP was defined according to the 2017 AAP guidelines. Sleep duration was calculated from the time of going to bed to the time of waking up. SSD was defined as sleeping &amp;lt;8 h/day. Multivariate logistic regression was used to calculate aORs and 95% CI. Results The present analysis included 1368 subjects (723 boys and 645 girls) with a mean age of 13.96±1.76 years. Overall, the prevalence of HBP was 43.6% (51.3% for boys and 34.9% for girls). Overall, 21.7% of the subjects reported sleep duration of 7- &amp;lt; 8 h/day, and 11.3% - &amp;lt;7 h/day. In the total sample, after adjustment for sex, BMI, breakfast consumption, and parental smoking, significant associations were found between SSDs and HBP (7-&amp;lt;8 h/day: aOR=1.47; 95% CI, 1.12-1.95; P = 0.006, and &amp;lt;7 h/day: aOR=1.52; 95% CI, 1.05-2.20; P = 0.025), compared to subjects who were sleeping ≥8 h/day. In boys, after adjustment for potential confounders, SSDs were associated with higher odds of HBP (7-&amp;lt;8 h/day: aOR=1.94; 95% CI, 1.30-2.89; P = 0.001, and &amp;lt;7 h/day: aOR=2.35; 95% CI, 1.35-4.12; P = 0.003). There was no significant association between SSD and HBP among girls. Conclusions Our study showed that SSD was significantly associated with increased odds of HBP in Lithuanian adolescents, especially in boys. Public health strategies should focus more on prevention of modifiable cardiovascular disease risk factors. Key messages • Sufficient sleep duration is important for adolescents’ health and may contribute to reduce the risk of cardiovascular disease. • Future prospective studies are needed to confirm these findings.

Algorithms for Treating Dyslipidemia in Youth.

The goal of this article is to review algorithms for treating dyslipidemia in youth, discuss pitfalls, propose enhanced algorithms to address pitfalls, and consider future directions. The presence of modifiable and non-modifiable cardiovascular disease (CVD) risk factors during childhood is associated with CVD-related events in adulthood. Recent data has shown that childhood initiation of statin therapy in youth < 18years of age with familial hypercholesterolemia reduces the risk of adult CVD. However, pediatric dyslipidemia remains undertreated in part due to a lack of primary health care providers with adequate understanding of screening guidelines and pediatric lipidologists with experience in treatment and follow-up of this unique population. Management algorithms have been published by the National Heart, Lung, and Blood Institute and American Heart Association as tools to empower clinicians to manage dyslipidemia. We propose enhanced algorithms, which incorporate recently approved pharmacotherapy to address the management gaps. Future algorithms based upon clinical risk scores may enhance treatment and improve outcomes. Algorithms for dyslipidemia management which target youth < 18years of age are tools which empower clinicians to manage dyslipidemia in this unique population. Enhanced algorithms may help address pitfalls. We acknowledge the need for further risk assessment tools in pediatrics for tailored dyslipidemia management.

Prevalence and knowledge of modifiable cardiovascular diseases risk factors among vulnerable population in Central Tanzania

BackgroundCardiovascular diseases (CVDs) are the global public health problem which has been associated with increasing prevalence of modifiable CVDs risk factors. This study aimed to describe the prevalence and knowledge of modifiable CVDs risk factors among vulnerable population of Central Tanzania.MethodsA community-based cross-sectional study design was employed. A total of 749 participants were interviewed. The socio-demographic information and modifiable CVDs risk factors (behavioral and biological) were measured using a modified World Health Organization (WHO) STEPwise approach for chronic disease risk factor surveillance. Knowledge of modifiable CVDs risk factors was measured by comprehensive heart disease knowledge questionnaire. Descriptive statistics were used to describe the knowledge and prevalence of modifiable CVDs risk factors. Logistic regression analysis was used to determine the factors associated with adequate knowledge of CVDs risk factors.ResultsThe prevalence of béhavioral risk factors were; current smokers and alcohol consumers were 4.4% and 18.0% respectively, use of raw salt was 43.7%, consumption of fruit/vegetables < 5 days per week was 56.9%. The prevalence of Biological CVDs risk factors was as follows: Overall, 63.5% (33.3% overweight and 29.9% obese) were overweight or obese, 4.5% were diabetic and 43.4% were hypertensive. Only 35.4% of participants had adequate knowledge of CVDs risk factors. Being a male (AOR = 1.44, 95%CI = 1.01–2.06, p < .05), having primary education (AOR = 6.43, 95%CI = 2.39–17.36, p < .0001), being employed (AOR = 1.59, 95%CI = 1.00-2.52, p < .05), ever checked blood pressure (AOR = 0.59, 95%CI = 0.42–0.84, p < .001), family history of hypertension (AOR = 0.38, 95%CI = 0.25–0.57, p < .0001) determined adequate knowledge of CVDs risk factors.ConclusionsThis study has revealed a high prevalence of modifiable CVDs risk factors and low knowledge of CVDs risk factors. Community health promotion interventions to increase population knowledge of CVDs risk factors are recommended for the efficacious reduction of CVDs in the country.

Prevalence and Predictors of Hypertension among Company Workers in Rivers State, Nigeria

Background/ObjectiveHypertension, “the silent killer,” is an important preventable cause of premature morbidity and mortality globally. This condition has become a major non-communicable disease threatening sub-Saharan Africa, and its prevalence is rising in middle and low-income countries. This study objective was to determine the prevalence and predictors of hypertension among company workers in Rivers State, NigeriaMethodsThis analytical and cross-sectional study used a multi-stage sampling technique to recruit 296 company workers in Rivers State, Nigeria. A semi-structured questionnaire was used to obtain the respondents’ demographics, lifestyle, and healthcare characteristics. Respondents’ weight and height were measured using standard procedures. Blood pressure was determined by standard practice and criteria as defined by WHO and International Society of Hypertension. Data were analyzed using descriptive statistics, correlation, and logistic regression at p&lt; 0.05 level of significance.Results64.9% of the respondents were married and 59.5% were male. 52.0% drank alcohol, and 7.4% smoked. While 67.2% claimed they were not hypertensive, 22.6% don’t know their blood pressure status, and 58.1% were physically inactive. The prevalence of hypertension was 33.4%, and the prevalence of overweight and obesity was 43.6% and 15.2%, respectively. Predictors of hypertension in the study population were sex (male) (p&lt;0.001), age &gt;40 (p&lt;0.001), alcohol consumption (any) (p&lt;0.05), physical activity (≤rarely) (p&lt;0.001) and BMI (≥25) (p&lt;0.001) of the respondents.ConclusionThere was a high prevalence of hypertension and presence of modifiable cardiovascular disease risk factors among the population. Therefore, both secondary and primary prevention require attention, in the latter case, comprehensive population-wide and workstation interventions, including behavioral change and communication interventions that are context-specific, should be implemented.

Factors Associated With the Development of Dyslipidemia Among Pediatric Patients With Diabetes: A Single-centre–based Study

ObjectivesThe prevalence of pediatric diabetes is increasing. Dyslipidemia is an important modifiable cardiovascular disease risk factor often present in children with diabetes. In this study, we evaluated the adherence to Diabetes Canada 2018 lipid screening guidelines in a pediatric diabetes program to determine the prevalence of dyslipidemia in youth with diabetes and to identify risk factors related to dyslipidemia. MethodsThis retrospective chart review included patients at McMaster Children’s Hospital with diabetes (types 1 and 2), who were at least 12 years of age as of January 1, 2019. Extracted data included age, sex, family history of diabetes or dyslipidemia, date of diagnosis, body mass index, glycemia monitoring system used, lipid profile, glycated hemoglobin (A1C), and thyroid-stimulating hormone values at the time the lipid profile was measured. Statistical methods included descriptive statistics and logistic regression modelling. ResultsOf the 305 patients included, 61% had a lipid profile measured according to guidelines, 29% had lipid screening completed outside of the recommended window, and 10% had no lipid profile on record. Among screened patients, 45% had dyslipidemia, most commonly hypertriglyceridemia (35%). Dyslipidemia was highest amongst those with type 2 diabetes, obesity, older age, short duration of diabetes, higher A1C, and those who used capillary blood glucose for monitoring (p<0.05). ConclusionsA high proportion of patients were screened for dyslipidemia, but many outside the recommended window. Dyslipidemia is highly prevalent in this patient population and was associated with the presence of obesity, but 44% of patients without obesity also had dyslipidemia.

Unveiling the Roadmap to Heart Health: Evaluating Modifiable Cardiovascular Disease Risk Factors in Middle-Aged Adults of Karachi

Background As a result of urbanization and lifestyle modifications, the burden of cardiovascular diseases (CVDs) is rising in developing nations. These nations' scarce resources and low literacy rates make it difficult to effectively manage CVDs. For prevention efforts, knowledge of modifiable risk factors is essential. The purpose of this study was to evaluate knowledge levels among people who had their first acute myocardial infarction and to identify variables related to a thorough comprehension of modifiable CVD risk factors. Methods In a cardiovascular disease centre in Lahore, Pakistan, a cross-sectional study was carried out. Anyone who was admitted to the hospital with an acute myocardial infarction diagnosis was eligible to participate. To assess knowledge of modifiable risk factors, such as fatty food consumption, smoking, obesity, and inactivity, a structured questionnaire was given to participants. For analysis, descriptive statistics were employed. Results 80 participants were included; 60% of them were men, and their average age was 50.2 years. Participants demonstrated good knowledge of smoking and exercise, but there were misconceptions about eating fatty foods and becoming obese. Moreover, the general Pakistani population's knowledge levels were consistent across studies. Conclusion While participants demonstrated reasonable knowledge of modifiable risk factors for CVDs, there were gaps in understanding, particularly related to fatty food consumption, obesity, and exercise. Targeted educational interventions and awareness campaigns are needed to address these gaps and promote healthier lifestyle choices. Increased knowledge can contribute to better prevention and management of CVDs. Keywords Cardiovascular Diseases, Health Education, Knowledge, Risk Factors.

Spontaneous Subgaleal Hemorrhage in a Child with Autism

Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.

Increased Adherence to a Mediterranean Diet Is Associated with Reduced Low-Grade Inflammation after a 12.7-Year Period: Results from the Moli-sani Study.

There is little knowledge on the association of changes over time in adherence to a Mediterranean diet (MD) with changes in modifiable cardiovascular disease (CVD) risk factors and of markers of low-grade inflammation. To evaluate the association between long-term changes in MD adherence and concurrent changes in established CVD risk factors and in markers of low-grade inflammation among adult Italians. A prospective cohort study was conducted. Dietary and health data were obtained both at baseline (2005-2010) and at follow-up (2017-2020). Adherence to the MD was estimated by a Mediterranean Diet Score ranging from zero to nine points, and the exposure was change in this score measured after a median 12.7-year period. This study included a subgroup of 897 men and 1,126 women aged ≥35 years at enrolment in the Moli-sani Study (n= 24,325). Changes in two composite z scores, including nine established CVD risk factors (eg, serum lipid levels and blood pressure) and four inflammatory markers (including C-reactive protein), respectively, were measured both at enrolment and after the same 12.7-year period. Multivariable-adjusted linear regression models were used. In a multivariable-adjusted analysis, an increased Mediterranean Diet Score over time was associated with decreased levels in the Inflammatory score (β= -0.372, 95% CI -0.720 to -0.025), but had little or no influence on the CVD risk score (β= -0.200, 95% CI -0.752 to 0.351), compared with individuals who had decreased their MD adherence. Among individual food groups/nutrients included in the Mediterranean Diet Score, an increased intake of monounsaturated over saturated fats over time was associated with lower CVD Risk Score, whereas increased consumption of cereals was inversely linked to the Inflammatory Score, compared with the reduced consumption group. An increased adherence to a traditional MD over time was associated with reduced low-grade inflammation. These findings suggest the potential of a traditional Mediterranean eating pattern to help reduce the long-term risk of inflammation-related chronic diseases in an ageing population.

Trends in prevalence and clustering of modifiable cardiovascular disease risk factors across socioeconomic spectra in rural southwest China: a cross-sectional study

ObjectivesThis study aimed to determine the changing prevalence of clustering of cardiovascular disease (CVD) risk factors across socioeconomic spectra in rural southwest China.DesignData were collected from two waves of cross-sectional...

Stemming The Tide Of Hypertension In Women: Optimal Age For Obstetric Debut

Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.

Abstract P445: Patterns in Physical Activity Among Individuals With Cardiovascular Risk Factors in the United States: A Population-Based Contemporary Study From NHANES 2017- 2020

Background: ACC/AHA guidelines recommend at least 75 and 150 minutes per week of moderate-intensity and vigorous-intensity activity respectively for improved glycemic, blood pressure, and lipid management in patients with diabetes, hypertension, and hypercholesterolemia, and improved long-term CV outcomes. This study aimed to investigate physical activity patterns in these patients with long-standing recommendation for achieving these optimal physical activity goals. Methods: We used publicly available NHANES 2017-2020 US Population Data to identify individuals with CV risk factors and their self-reported physical activity. Individuals were diagnosed with diabetes, hypertension, or hypercholesterolemia, based on standardized questionnaire focusing on diagnosis by clinician or receipt of relevant therapies for the treatment of these conditions. Results: Of 9693 surveyed adults with mean age of 47.5 (1.0) years, 1445 (14.9%) patients reported a medical history of diabetes. Of these cohort of diabetics, only 636 patients (46.4%) reported doing a sufficient amount of physical activity in adherence to ACC/AHA guidelines. Among patients diagnosed with hypertension (2784) and hypercholesterolemia (2007), only 1410 (50.6%) and 1020 (50.8%) respectively reported performing a sufficient amount of physical activity per guidelines. Conclusions: These results point to much room for improvement to optimize modifiable cardiovascular disease risk factors such as insufficient physical activity in patients who are already at increased CV disease risk due to history of diabetes, hypertension, and hypercholesterolemia. Next steps should involve heightened focus on counseling and lifestyle modification to reduce risk of cardiovascular disease.

The effectiveness of atrial fibrillation special clinic on oral anticoagulant use for high risk atrial fibrillation patients managed in the community

BackgroundService gaps exist in oral anticoagulant (OAC) use among patients with atrial fibrillation (AF) in primary care. The purpose of this study was to explore the clinical effectiveness of a community dwelling Atrial Fibrillation Special Clinic (AFSC) run by primary care physicians by evaluating its impact on OAC use and the control of modifiable cardiovascular disease (CVD) risk factors in high risk AF patients.MethodQuasi-experimental study was conducted in AFSC run by public primary care physicians in Hong Kong. Study subjects were high risk AF patients with CHA2DS2-VASc scores ≥ 2, who had been followed up (FU) at AFSC for at least one year from 01 August, 2019 to 31 October, 2020. OAC usage and modifiable CVD risk factor control were compared before and after one year of FU at AFSC. Drug-related adverse events, emergency attendance or hospitalisation episodes, survival and mortality rates after one year FU at AFSC were also reviewed.ResultsAmong the 299 high risk AF patients included in the study, significant increase in OAC use was observed from 58.5% at baseline to 82.6% after one year FU in AFSC (P < 0.001). Concerning CVD risk factor control, the average diastolic blood pressure level was significantly reduced (P = 0.009) and the satisfactory blood pressure control rate in non-diabetic patients was markedly improved after one year FU (P = 0.049). However, the average HbA1c and LDL-c levels remained static. The annual incidence rate of ischaemic stroke/systemic embolism was 0.4%, intra-cranial haemorrhage was 0.4%, major bleeding episode was 3.2% and all-cause mortality was 4.3%, all of which were comparable to reports in the literature.ConclusionAFSC is effective in enhancing OAC use and maintaining optimal modifiable CVD risk factor control among high risk AF patients managed in primary care setting, and therefore may reduce AF-associated morbidity and mortality in the long run.

Relationship between modifiable atherosclerotic cardiovascular risk factors and coronary artery bifurcation lesion

Abstract Background: Modifiable atherosclerotic cardiovascular disease risk factors are hypertension, diabetes mellitus, dyslipidemia, cigarette smoking, and obesity; the term coronary artery bifurcation is used when a coronary artery divides into two hemodynamically important branches or when the main branch has a hemodynamic significant side branch, bifurcation lesion represent 20% or more of coronary artery stenoses undergoing angiography. Objectives: To evaluate the relationship of hypertension, diabetes, dyslipidemia, cigarette smoking, and obesity to coronary bifurcation disease. Materials and Methods: In a cross-sectional study conducted in the Iraqi Center for Heart Diseases from May 2020 to May 2021, a total of 140 adult patients (70 cases with coronary bifurcation lesions and 70 control cases with non-bifurcation lesions) with angiography-documented stenotic coronary artery disease (CAD) were defined. Case demographics and modifiable CAD risk factors were addressed. Results: In the bifurcation group, the non-bifurcation lesion was mostly an associated angiographic finding (82%). The most significantly correlated atherosclerotic risk factor with bifurcation lesion compared to non-bifurcation lesion was diabetes, followed by systemic hypertension. Dyslipidemia was the most common prevalent risk factor, equally distributed in both groups. Smoking and obesity were distributed nearly equally in both groups. Conclusion: There is a significant relationship between diabetes and hypertension with coronary bifurcation lesions compared to non-bifurcation lesions.

Cardio-Oncology in Iran: Cardio-toxicity Registry

Advances in cancer treatment have resulted in a growing number of cancer survivors. However, powerful treatments such as chemotherapy, radiation treatments, and some cancer drugs are not without risks, including the potential for serious, long-term damage to the heart. Cardiology and oncology specialists often collaborate to mitigate these risks when treating cancer patients. This joining is known as cardio-oncology. The main goals of cardio-oncology are to screen for and actively manage modifiable cardiovascular risk factors and diseases in cancer patients. Cardio-oncology plays an increasingly active role at every stage of cancer therapy, including baseline risk assessment pretreatment, surveillance and prevention during treatment, response to acute complications, and assessment of survivors’ post-cardiotoxic treatments. Cancer treatment has been optimized through new treatment strategies. The first cardio-oncology clinic in Iran was instituted about 4 years ago (2017) at Shaheed Rajaei Cardiovascular Medical and Research Center in Tehran, which is the first cardio-oncology clinic in the Middle East. It provides care for cancer patients with a history of cardiovascular disease or risk for cardiotoxicity during cancer therapy. Also, all patients are enrolled in the multicenter cardio-oncology Toxicity Registry research database, and 13 other hospitals from different centers in the whole country are involved in the registry. The establishment of the cardio-oncology clinic with a focus on the patient registry is discussed in this article.

Prevalence of Hypertension, Diabetes, and Other Cardiovascular Disease Risk Factors in Two Indigenous Municipalities in Rural Guatemala: A Population-Representative Survey.

Nearly 50% of Guatemalans are Indigenous Maya, yet few studies have examined the prevalence of modifiable cardiovascular disease (CVD) risk factors in Indigenous Maya populations. Therefore, we sought to estimate the prevalence of modifiable CVD risk factors in two Indigenous Maya areas in Guatemala. We conducted, between June 2018 and October 2019, a population-representative survey of adults aged 18 years and older in two rural Indigenous Maya municipalities in Guatemala. Our primary outcomes were five modifiable CVD risk factors: diabetes, hypertension, obesity, smoking, and alcohol use. We estimated the crude and age-standardized prevalence of each outcome. We also constructed multivariable logistic regression models to assess prevalence over covariates including age, sex, education level, ethnicity, and poverty. Sampling weights adjusted for nonresponse, and appropriate survey commands were used in all analyses. The crude prevalence of diabetes was 12.5% (95% confidence Interval [CI] 9.6% to 16.1%), hypertension 20.3% (95% CI 17.1% to 23.9%), obesity 23.7% (95% CI 19.4% to 28.6%), smoking 10.7% (95% CI 7.8% to 14.5%), and high alcohol use 0.9% (95% CI 0.5% to 1.6%). Age-standardized prevalence of each outcome was similar to the crude prevalence. The prevalence of multiple CVD risk factors increased between the age groups 18-29 years and 50-59 years before decreasing among older age groups. Men had twenty-fold higher smoking prevalence than women (20.5% vs. 1.2%, respectively) and women had nearly double the age-adjusted prevalence of obesity as men (30.1% vs. 17.0%, respectively). There is a substantial prevalence of modifiable CVD risk factors in rural, Indigenous populations in Guatemala, in particular hypertension, diabetes, obesity (among women), and smoking (among men). These findings can help catalyze policy and clinical investments to improve the prevention, management, and control of CVD risk factors in these historically marginalized communities.

The challenge of lipid-modifying therapies in the achievement of optimal LDL-C levels in high and very high CV risk patients: Still an open question

Background and Aims : Hypercholesterolemia is one of the main modifiable atherosclerotic cardiovascular (CV) disease’s risk factors. The aim was to evaluate the efficacy of the currently available lipid lowering therapy (LLT) and the achievement of treatment targets (TT) in a cohort of high and very-high CV risk patients treated with maximum tolerated LLT.

Knowledge of modifiable cardiovascular diseases risk factors and its primary prevention practices among diabetic patients at Jimma University Medical Centre: A cross-sectional study.

Cardiovascular diseases (CVDs) are the most common cause of mortality and morbidity globally. This is due to the increasing prevalence of modifiable CVDs risk factors. Hence, the study was aimed to identify knowledge and unhealthy behaviors that contribute to CVD among diabetes mellitus patients. An institutional-based cross-sectional study design was employed among diabetes mellitus patients. A close-ended questionnaire developed from up-to-date similar literature was pretested and face-to-face interview techniques were used to collect data. Checked data were entered into the Epidata 4.1 versions. Then, descriptive and bivariate logistic regression was done using SPSS 25 versions. Of the study participants included in the study, 318, more than half of them, 167(52.5%), were aged ≥45 years and 187(58.8%) of them were females. Among the study participants, more than half, 198(62.3%), had good Knowledge of modifiable CVDs risk factors. Most of the study participants identified consuming foods rich in fats instead of vegetables and fruits 198(62.3%), followed by physical inactivity 196(61.6%) as a risk factor for CVD. Regarding CVDs prevention practice, 175(55.0%) of the patients had a good practice. More than three-fourths, 267(84.0%), practice avoiding foods rich in fats and, sugar, and cigarette smoking 250(78.6%). Predictors like educational status, college and above (AOR 2.68; 95% CI 1.14-6.27), and urban residence area (AOR 1.94; 95% CI 1.09-3.15) were associated with knowledge of CVDs risk factors. While sex, marital status monthly income, and age of the participants had no association with knowledge and prevention practice of modifiable CVDs risk factors. The study participants' knowledge and prevention practice of modifiable cardiovascular disease risk factors was satisfactory, even though continuous awareness creation is required to lower CVD mortality and morbidity burdens. Educational status and residence are of the study participants affect the knowledge and prevention practice modifiable of cardiovascular disease risk factors.

Tailoring lipid management interventions to reduce inequalities in cardiovascular disease risk management in primary care for deprived communities in Northern England: a mixed-methods intervention development protocol

IntroductionHyperlipidaemia contributes a significant proportion of modifiable cardiovascular disease (CVD) risk, which is a condition that disproportionally affects disadvantaged socioeconomic communities, with death rates in the most deprived areas being...