Prevalence Of Modifiable Risk Factors Research Articles

Hypertension and Device-Based Therapies for Resistant Hypertension: An Up-to-Date Review.

Hypertension is the most prevalent modifiable risk factor associated with cardiovascular mortality. The World Health Organization (WHO) estimates that hypertension directly or indirectly causes the death of at least nine million people globally every year. The number of people living with hypertension (blood pressure (BP) of ≥140 mmHg systolic or ≥90 mmHg diastolic or on medication) doubled between 1990 and 2019, from 650 million to 1.3 billion. Despite a plethora of antihypertensivedrugs widely available, a sizable part of the antihypertensive population stays uncontrolled. The unmet need of controlling BP in this population may be addressed, in part, by developing new drugs and devices/procedures to treat hypertension and its comorbidities. Several device-based approaches have been introduced to lower BP, and most of these strategies aim to modulate autonomic nervous system activity. Importantly, when considering a device-based treatment, each patient's underlying pathophysiology is considered, and the procedural risks are weighed against the cardiovascular risk attributed to the elevated BP.In November 2023, the FDA approved two renal denervation (RDN) devices. This manuscript discusses current interventional devices and procedures recently approved (RDN) and others in the clinical testing stage for arterial hypertension intervention or management.As we list below, all others have shown promising results and are being evaluated on a larger clinical trial.The new device-based classes are as follows: catheter-based RDN, baroreflex amplification, arteriovenous (AV) malformation, carotid body (CB) ablation, pacemaker-based cardiac neuromodulation, electro-acupuncture, and deep brain stimulation. Baroreflex amplification uses peripheral neuromodulation, while AV malformation leverages AV anastomosis. CB ablation modulates chemoreceptors, and pacemaker-based neuromodulation adjusts atrioventricular intervals. Electro-acupuncture proves potential, and deep brain stimulation offers central nervous system intervention.

Distinct biological signature and modifiable risk factors underlie the comorbidity between major depressive disorder and cardiovascular disease

Major depressive disorder (MDD) and cardiovascular disease (CVD) are often comorbid, resulting in excess morbidity and mortality. Here we show that CVDs share most of their genetic risk factors with MDD. Multivariate genome-wide association analysis of shared genetic liability between MDD and atherosclerotic CVD revealed seven loci and distinct patterns of tissue and brain cell-type enrichments, suggesting the involvement of the thalamus. Part of the genetic overlap was explained by shared inflammatory, metabolic and psychosocial or lifestyle risk factors. Our data indicated causal effects of genetic liability to MDD on CVD risk, but not from most CVDs to MDD, and showed that the causal effects were partly explained by metabolic and psychosocial or lifestyle factors. The distinct signature of MDD–atherosclerotic CVD comorbidity suggests an immunometabolic subtype of MDD that is more strongly associated with CVD than overall MDD. In summary, we identified biological mechanisms underlying MDD–CVD comorbidity and modifiable risk factors for prevention of CVD in individuals with MDD.

Prevalence of Cardiovascular and Cancer Risk Factors Among Rheumatoid Arthritis Patients Prescribed Janus Kinase Inhibitors and Tumor Necrosis Factor Inhibitors: A Cross-Sectional Study.

The study was to determine the prevalence of baseline risk factors for cardiovascular outcomes and cancer among commercially-insured patients with rheumatoid arthritis (RA) during their first dispensed treatment for either tumor necrosis factor inhibitors (TNFi) or JAK inhibitors (JAKi). Patients with RA from August 16, 2019 to March 31, 2022 were identified in the Merative MarketScan Commercial and Medicare databases. The first date that a TNFi or JAKi was dispensed was the index date, and baseline risk factors were assessed among patients continuously eligible for 12 months before the index date. Patients who had the following were stratified into an elevated risk category: age ≥65 years, smoking, or a history of a major adverse cardiovascular event, venous thromboembolism, or cancer. The prevalence of modifiable risk factors was also reported: hypertension, hyperlipidemia, obesity, and diabetes. The crude prevalence and prevalence difference (PD) were reported. A total of 12,673 patients (TNFi [n = 7,748; 61%] and JAKi [n = 4,925; 39%]) met inclusion criteria. The prevalence of elevated risk was the same for all patients using TNFi (n = 2,051; 26%) and JAKi (n = 1,262; 26%). Compared with patients having low risk, patients with an elevated risk also had a higher prevalence of at least one primary modifiable risk factor for both patients using JAKi (79% vs 58%; PD 21%, 95% confidence interval [CI] 18%-24%) and TNFi (81% vs 60%; PD 21%, 95% CI 19%-23%). In recent years, JAKi and TNFi were used in similar proportions to treat RA among commercially-insured patients at elevated cardiovascular and cancer risk. Because uncontrolled disease, modifiable comorbidities, and treatment with JAKi are associated with these adverse events, future studies evaluating how practice patterns may be affected by the emergence of safety data will be of value.

Knowledge, Skills, and Experience With Technology in Relation to Nutritional Intake and Physical Activity Among Older Adults at Risk of Falls: Semistructured Interview Study.

More than one-third of older adults (aged ≥65 y) experience falls every year. The prevalent modifiable risk factors for falling are malnutrition and physical inactivity, among others. The involvement of older adults in the prevention of falls can decrease injuries, hospitalizations, and dependency on health care professionals. In this regard, eHealth can support older adults' self-management through more physical activity and adequate food intake. eHealth must be tailored to older adults' needs and preferences so that they can reap its full benefits. Therefore, it is necessary to gain insight into the knowledge, skills, and mindset of older adults living at home who are at risk of falls regarding eHealth. This qualitative study aims to explore older adults' use of everyday digital services and technology and how they acquire knowledge about and manage their nutritional intake and physical activity in relation to their health. Semistructured interviews were conducted with 15 older adults (n=9, 60% women; n=6, 40% men; age range 71-87 y) who had all experienced falls or were at risk of falling. These individuals were recruited from a geriatric outpatient clinic. The interviews were analyzed using deductive content analysis based on a modification of the Readiness and Enablement Index for Health Technology framework. The qualitative data showed that the informants' social networks had a positive impact on their self-management, use of technology, and mindset toward nutritional intake and physical activity. Although the informants generally lived active lives, they all lacked knowledge about how their food intake influenced their physical health, including their risk of falling. Another finding was the large diversity in the use of technology among the informants, which was related to their mindset toward technology. Older adults can use technology for everyday purposes, but some need additional introduction and support to be able to use it for managing their health. They also need to learn about the importance of proper nutritional intake and physical activity in preventing falls. Older adults need a more personalized introduction to technology, nutrition, and physical activity in their contact with health professionals.

Extra-Anogenital Giant Cutaneous Squamous Cell Carcinomas.

Extra-anogenital giant cSCCs are rare but have worse outcomes compared to smaller tumors. Prompted by limited data, the authors conducted a retrospective study to gather more information about giant cSCCs to optimize clinical care. We identified seven cases of giant cSCCs from a review of cSCC cases treated in the Unit of Dermatosurgery between 2016 and 2022. Most patients were male (85.71%) with a mean age of 80.29 ± 12.22 years. UV radiation was the most common risk factor (five cases) followed by smoking (three cases) and hidradenitis suppurativa (one case). Most giant cases were located in the head area (71.4%) and the diameter of lesions ranged from 6 to 18 cm. All patients corresponded to tumor stage T3, and 42.86% of patients had lymph node metastases. Surgical excision was the treatment of choice in most cases (85.71%), while a combination of cemiplimab and RP1 was used in some cases due to the ineffectiveness of treatment or contraindications to other therapies. The authors emphasize the importance of early detection and prevention of modifiable risk factors, such as UV radiation, and a multidisciplinary approach to treatment. Other therapies, including immunotherapy, may become increasingly important.

Histone deacetylase inhibition by suberoylanilide hydroxamic acid during reperfusion promotes multifaceted brain and vascular protection in spontaneously hypertensive rats with transient ischaemic stroke

Hypertension is the most prevalent modifiable risk factor for stroke and is associated with worse functional outcomes. Pharmacological inhibition of histone deacetylases by suberoylanilide hydroxamic acid (SAHA) modulates gene expression and has emerged as a promising therapeutic approach to reduce ischaemic brain injury. Here, we have tested the therapeutic potential of SAHA administered during reperfusion in adult male spontaneously hypertensive (SHR) rats subjected to transient middle cerebral artery occlusion (tMCAO; 90 min occlusion/24 h reperfusion). Animals received a single dose of SAHA (50 mg/kg) or vehicle i.p. at 1, 4, or 6 h after reperfusion onset. The time-course of brain histone H3 acetylation was studied. After tMCAO, drug brain penetrance and beneficial effects on behavioural outcomes, infarct volume, oedema, angiogenesis, blood-brain barrier integrity, cerebral artery oxidative stress and remodelling, and brain and vascular inflammation were evaluated. SAHA increased brain histone H3 acetylation from 1 to 6 h after injection, reaching the ischaemic brain administered during reperfusion. Treatment given at 4 h after reperfusion onset improved neurological score, reduced infarct volume and oedema, attenuated microglial activation, prevented exacerbated MCA angiogenic sprouting and blood-brain barrier breakdown, normalised MCA oxidative stress and remodelling, and modulated brain and cerebrovascular cytokine expression. Overall, we demonstrate that SAHA administered during early reperfusion exerts robust brain and vascular protection after tMCAO in hypertensive rats. These findings are aligned with previous research in ischaemic normotensive mice and help pave the way to optimise the design of clinical trials assessing the effectiveness and safety of SAHA in ischaemic stroke.

Clinical Characteristics and Outcomes of ST-Elevation Myocardial Infarction in Young Patients: A Single-Center Experience.

Objective This study aimed to examine the clinical characteristics, risk factors, and outcomes of patients aged ≤45 years with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (pPCI). Methods From January 2018 to March 2020, this retrospective observational study took place at a tertiary cardiac center in Bahrain. We included patients aged ≤45 years who were admitted with STEMIand had primary percutaneous coronary intervention (pPCI). Results In this study, 510 patients with STEMIreceiving pPCIwere included, of whom 95 (18%) were younger than 45 years. The young age group had more smokers (57.9% vs. 40.5%, p = 0.003), newly diagnosed dyslipidemia (41.1% vs. 25.5%, p = 0.004), and a positive family history of early coronary artery disease (CAD) (14.7% vs. 4.3%, p = <0.001). Traditional cardiovascular risk factors, such as diabetes mellitus, systemic hypertension, and dyslipidemia, were significantly less common in young patients. Major adverse cardiovascular and cerebrovascular events(MACCE) were also significantly less common in young patients at the one-year follow-up (2.1 vs. 8.4%, p = 0.05). Conclusion Young patients with STEMIare more often smokers with undiagnosed dyslipidemia and have a family history of CAD. MACCE at one year is significantly lower as compared to older patients, but it is not negligible. Public health efforts are needed to reduce the prevalence of modifiable risk factors among the susceptible population.

Implementing a contextually appropriate foot-ankle exercise programme in primary care for the prevention of modifiable risk factors for ulcers in people with diabetes: protocol for a hybrid type 2 study

IntroductionDiabetes is a highly prevalent disease that negatively impacts people’s health and quality of life. It can result in diabetic peripheral neuropathy (DPN) and foot complications, which in turn lead...

Prevalence of modifiable risk factors of Hispanic adult patients admitted with gastric cancer in the US.

254 Background: More than 19% of the US population is comprised of Hispanic individuals. For decades, cancer incidence has been increasing in this population, including cancers associated with infection (gastric, hepatic, cervical) and resulting from delayed screening (colorectal, cervical and breast). Risk factors associated with gastric cancer include H. pylori, obesity, alcohol, and tobacco use. However, ethnicity has not been a commonly reported risk factor despite the fact that studies have shown increasing incidence of gastric cancer in Hispanics at a younger age. Methods: We used the 2016-2019 National Inpatient Sample (NIS) database to stratify patients with gastric cancer by age, ethnicity, and comorbidities. Results: There were 77,745 adults with gastric cancer. Of these, 578 (7.45%) were ages 18-44 (group 1), 28,370 (36.47%) 45-64 years old (group 2), and 43,590 (55.08%) were over 65 (group 3). Group 1 was comprised of 29.4% White, 34.3% Hispanic, 14.5% Black, and 21.8% Asian or Pacific Islander patients. Group 2 consisted of 46.7% White, 19.7% Hispanic, 17.4% Black, and 16.2% Asian or Pacific Islander individuals. Group 3 had the highest percentage of White patients (56.0%) and lowest percentage of Hispanic individuals (12.9%). Group 3 also consisted of 15.1% Black and 16.0% Asian or Pacific Islander patients. In Hispanics with gastric cancer, there was a predominance of H. pylori among younger patients (8.6% in group 1 vs 3.6% and 2.1% in groups 2 and 3 respectively) (p = 0.00). Incidence of smoking increased with age (19.9% in group 1, 28.1% in group 2 and 31.1% in group 3) (p = 0.00) as did incidence of diabetes (8.1% in group 1, 26.4% in group 2 and 36.0% in group 3) (p = 0.00). Alcohol use was 3.0% in group 1, 4.3% in group 2 and 2.3% in group 3 (p = 0.035). The differences between all groups for gastric ulcer, gastric polyp and obesity were not statistically significant. Conclusions: Gastric cancer accounts for approximately 1.5% of all new cancers diagnosed in the US, with a high incidence in older White populations. However, this study demonstrates that there is a large proportion of young Hispanics with gastric cancer who have higher associated instances of H. pylori. This suggests the need for further research to determine if there is utility in screening for H. pylori in asymptomatic young Hispanics to decrease the burden of gastric cancer in this population. [Table: see text]

ASSOCIATION OF VITAMIN D SERUM LEVELS AND OVARIAN CANCER : A SYSTEMATIC REVIEW

Background: Knowing the modifiable risk factors for prevention and improved prognosis is crucial, as the prognosis of ovarian cancer is poor and there are few population-level interventions for early identification and long-term therapeutic success. Research on cancer has shown a great deal of scientific interest in vitamin D since it may be one of these factors. Aims : This systematic review is to review the association of vitamin D serum levels in patients with ovarian cancer Methods: By comparing itself to the standards set by the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020, this study was able to show that it met all of the requirements. So, the experts were able to make sure that the study was as up-to-date as it was possible to be. For this search approach, publications that came out between 2014 and 2024 were taken into account. Several different online reference sources, like Pubmed and SCIENCE DIRECT, were used to do this. It was decided not to take into account review pieces, works that had already been published, or works that were only half done. Result: In the PubMed database, the results of our search brought up 329 articles, whereas the results of our search on SCIENCE DIRECT brought up 298 articles. The results of the search conducted for the last year of 2014 yielded a total 8 articles for PubMed and 12 articles for SCIENCE DIRECT. In the end, we compiled a total of 4 papers, 3 of which came from PubMed and 1 of which came from SCIENCE DIRECT. We included four research that met the criteria. Conclusion: In summary, some of the studies showed vitamin D supplementation is not necessary to increase the survival rate of ovarian cancer in the absence of a vitamin D shortage. There are limited studies about the association of vitamin D and ovarian cancer.

To Determine the Blood Group Correlation among the Cases of Dysvascular Amputation: Retrospective Study

Abstract Objective: The objective of the study was to identify the association of specific blood group among the cases of dysvascular amputation. Introduction: Literature showed the association of certain blood group with increased cardiovascular risk and other thrombotic vascular diseases in addition to increased gastric cancer risk and periodontal disease. By the way of extending the relation between blood group and atherosclerosis, this study aims to find out if there is any correlation between blood group and dysvascular amputation. Materials and Methods: Retrospective analysis of patient records with sample size of 100 is considered for this study. Sample population included was patients with lower limb amputation due to dysvascular etiology, who were admitted for prosthesis for a period of 1 year at Government Institute of Rehabilitation Medicine. Statistical analysis was performed using the standard statistical software. Results: Analysis showed that there is a correlation between non-O blood group and dysvascular amputation compared to O group. Among non-O group, population with B +ve has higher incidence of amputation as analysed from the study. Conclusion: This study reveals that there is a strong correlation between dysvascular amputation and non-O blood group. Focus on the prevention of modifiable risk factors may reduce the incidence of amputation for risk-prone blood group.

Prevalence of modifiable risk factors for cardiovascular disease among school-going children and adolescents in Eldoret, Kenya.

Cardiovascular disease (CVD) prevalence in Kenya is rising. Overweight, pre-hypertension and physical inactivity at younger ages is contributory. These risk factors are inadequately documented among Kenyan children and adolescents, hampering CVD prevention. this cross-sectional study randomly sampled 384 participants from Eldoret, Kenya. After ethical considerations, physical activity was assessed. Body mass index (BMI), Waist-Hip-Ratio (WHR) and Waist-Height-Ratio (WHtR) were determined, and blood pressure (BP) was measured. participants were 14.6±2.7 years, and 62.6% were female. Eight percent had BMI ≥25.0 kg/m2. Of these, 87% were in secondary schools. Using SBP, 27.9% had CVD risk (42.5% and 20% for males and females ≥13 years and 26.5% and 27% for those <13 years, respectively). For DBP, 12.8% had elevated-to-hypertensive BP (13.2% and 8.3% for males and females ≥13 years and 11.8% and 25.4% for those <13 years, respectively). Combining SBP and DBP, 8.1%, mostly males, had elevated-to-hypertensive BP. Using respective WHR cutoffs of 0.90 and 0.85, 31% (boys) and 15.6% (girls) were at CVD risk. For WHtR, 39.6% of boys were >0.463 cut-off (0.493±0.02) against 32.4% for girls >0.469 cut-off (0.517±0.05). Of these, 52.6% (boys) and 69.7% (girls) were in secondary schools. Overall, 45% of participants were sports-inactive and 77.2% did minimal physical activities. among school-going children and adolescents in Eldoret, Kenya, the prevalence of CVD risk factors was high, especially among boys and in high schools. Large proportions had elevated BP, BMI, WHR and WHtR, and, further, were sedentary, posing a high CVD risk. Lifestyle interventions to mitigate this are urgently needed.

Co-occurrence of Modifiable Risk Factors for Cardiovascular Disease amongst Diabetic Patients in Lagos State, Nigeria.

Diabetes significantly increases the likelihood of developing cardiovascular disease (CVD). This risk can be reduced by addressing modifiable risk factors. The objectives of this study were to assess the modifiable risks for CVD amongst persons with diabetes and identify the factors associated with multiple risk factors. This cross-sectional study was conducted amongst 357 diabetic patients attending a large tertiary hospital in Southwest Nigeria. Eligible patients were recruited consecutively on clinic days till the minimum sample size was reached. An interviewer-administered survey tool adapted from the World Health Organization STEPS was used to obtain information from study participants. The following risk factors were assessed: tobacco use, obesity, high blood pressure, physical activity, sedentary time and hours of sleep. Data were analysed using the STATA version 15.0 (Stata Corp.) statistical programme. The mean age of the participants was 61.7 ± 12.6 years, and they were mostly females (63.9%). Of the risk factors assessed, the most prevalent modifiable risk factors amongst the respondents were inadequate sleep - <8 h on average (91.6%), abdominal obesity (82.6%) and high blood pressure (72%). Others were inadequate physical activity (56%) and lifetime tobacco use (21%). Up to 40.3% of the diabetic persons had three or more co-existing CVD risk factors. Age, gender, work and marital status (P ≤ 0.01) were statistically associated with multiple CVD risk factors. Being male, unmarried and increasing age were predictors of multiple CVD risk factors amongst the diabetic patients. A significant proportion of the diabetic patients have multiple co-existing modifiable CVD risks. Abdominal obesity and poor sleep were the most prevalent. Older men who are unmarried were more likely to have multiple risks. Primary and secondary preventive measures to address CVD risks amongst diabetic patients are warranted and should target older unmarried men.

Correlates of axonal content in healthy adult span: Age, sex, myelin, and metabolic health

As the emerging treatments that target grey matter pathology in Alzheimer's Disease have limited effectiveness, there is a critical need to identify new neural targets for treatments. White matter's (WM) metabolic vulnerability makes it a promising candidate for new interventions. This study examined the age and sex differences in estimates of axonal content, as well the associations of with highly prevalent modifiable health risk factors such as metabolic syndrome and adiposity. We estimated intra-axonal volume fraction (ICVF) using the Neurite Orientation Dispersion and Density Imaging (NODDI) in a sample of 89 cognitively and neurologically healthy adults (20–79 years). We showed that ICVF correlated positively with age and estimates of myelin content. The ICVF was also lower in women than men, across all ages, which difference was accounted for by intracranial volume. Finally, we found no association of metabolic risk or adiposity scores with the current estimates of ICVF. In addition, the previously observed adiposity-myelin associations (Burzynska et al., 2023) were independent of ICVF. Although our findings confirm the vulnerability of axons to aging, they suggest that metabolic dysfunction may selectively affect myelin content, at least in cognitively and neurologically healthy adults with low metabolic risk, and when using the specific MRI techniques. Future studies need to revisit our findings using larger samples and different MRI approaches, and identify modifiable factors that accelerate axonal deterioration as well as mechanisms linking peripheral metabolism with the health of myelin.

The Benefit of Nutrition in Coronary Heart Disease

Coronary heart disease (CHD) is a condition of the coronary arteries that supply the heart. It is a narrowing of one or more coronary arteries. It is caused by atherosclerosis which is due to the action of fatty deposits of cholesterol. When blood flow is slowed by a blocked artery, the myocardium is no longer properly oxygenated. Coronary heart disease represents a major socio-economic challenge. In addition to genetics, the main risk factors for coronary heart disease are lack of physical activity, smoking, alcohol abuse and poor diet. The mortality rate linked to CD in the world and in Algeria is 34%. Our study involved 40 patients taken at random. It was carried out by collecting biological, clinical and anthropometric data collected during consultations. Our objective was to show the benefit of diet in the prevention of modifiable risk factors (hypertension, diabetes, dyslipidemia, obesity, sedentary lifestyle, smoking and alcohol) and compare our results with those found in the literature.

The spectrum of computed tomography calcium scoring values of individuals testing for coronary artery disease in Accra: a study from a peripheral private clinic in Southern Ghana.

Background: Coronary artery disease is a significant cause of morbidity and mortality globally. Most people with coronary artery disease are asymptomatic, making its early detection with coronary artery calcium scoring using multidetector computed tomography an important aspect of its management. Objective: Our study aimed to describe the spectrum of computed tomography findings (such as the absolute coronary artery calcium scores and coronary artery risk percentiles) and associated risk factors of 325 patients evaluated for coronary artery disease in Accra. Methods: The study was a retrospective study involving retrieving electronically stored coronary artery calcium score reports for 325 patients reported by two radiologists. Patient information, including weight, blood pressure, and a history of diabetes mellitus and hypertension, were recorded. Data were analysed using Statistical Package for the Social Sciences version 23.Results: There were 62.2% (n = 202) males and 37.8%( n = 123) females. Of the total number, 44.6%(n = 145) had a normal coronary artery calcium score of 0, while 55.4%(n = 180) had values ranging from 1 to 2,690 (mean109.0±325.4). The two most prevalent modifiable risk factors for coronary artery disease recorded for individuals with coronary artery calcium score above 0 were an abnormality of weight (overweight and obesity)and hypertension in decreasing order. A significant relationship was observed between coronary artery calcium scoring and age (p = 0.001). Conclusion: Our study showed that more than half of the participants had coronary artery calcification; abnormalities of weight followed by hypertension were the two commonest risk factors for CAD in Accra, and CAD occurred in individuals as young as 30 to 39 years old.

The burden of breast cancer attributable to modifiable risk factors

Abstract Introduction Breast cancer (BC) is a preventable non-communicable disease and the most common cancer among women of reproductive age. Although largely associated with non-modifiable risk factors, the prevention of modifiable risk factors for BC (smoking, alcohol use, physical inactivity, and dietary risks) can help decrease society's burden. The aim of this study was to examine the BC burden among women of reproductive age attributable to these risk factors in the ten leading countries in the World Health Organization (WHO) European region, in order to describe the potential burden which can be avoided. Methods Within the EU CA 18218, we analyzed Disability-Adjusted Life-Years (DALY) rates of BC per 100,000 among women aged 15-49 years attributable to the four modifiable risk factors: smoking, alcohol use, physical inactivity and dietary risks. Estimates were taken from the Global Burden of Disease Study 2019, for ten countries with the highest DALY rates of BC in WHO European region in 2019: Monaco, Georgia, Bulgaria, Montenegro, Ukraine, North Macedonia, Armenia, Serbia, Greece and Romania. Results The highest DALY rate for BC was in Monaco (758.37) and Georgia (708.99). The highest DALY rate attributable to the four modifiable risk factors combined was in Monaco (178.89) and Bulgaria (171.68). The highest attributable DALY rate to smoking was in Bulgaria (49.04), and Monaco (44.67). The highest attributable DALY rate to alcohol use was in Ukraine (87.24) and Bulgaria (83.25). The highest attributable DALY rate to physical inactivity was in Monaco (9.88), followed by Bulgaria (3.49), as was the DALY rate attributable to dietary risks (48.51, and 35.90, respectively). Conclusions The variable burden of BC attributable to the modifiable risk factors between the examined countries calls for strengthening regional activities. The proportion of BC burden attributable to these risk factors is non-negligible, given its impact on the total burden of the disease. Key messages • A combination of four modifiable risk factors significantly contributes to the burden of breast cancer. • Regional collaboration on risk factors is needed to prevent the burden of breast cancer.

Risk factors for chronic kidney disease among adults in a tertiary hospital community in north-central, Nigeria.

Background: The prevalence of chronic kidney disease (CKD) is on the increase globally with an attendant heavy disease burden and high morbidity and mortality from end-stage renal disease (ESRD). Data on the prevalence of risk factors for chronic kidney disease from sub-Saharan Africa are scanty, more so in the northern part of Nigeria. There are several risk factors for CKD which include, obesity, hypertension, diabetes mellitus and some nephrotoxic agents. Preventive strategy through early detection and treatment has been advocated for CKD especially in our own setting where majority of patients present late and cannot afford the cost of renal replacement therapy which again is not readily available.&#x0D; Method: This study was conducted among the staff of Bingham University Teaching Hospital (BHUTH), Jos, as part of a screening exercise during the World Kidney Day (WKD) program of 2021, to determine the prevalence of modifiable risk factors for CKD. Adult subjects of 18 years and above, who consented to the study were mobilized after a sensitization talk. The parameters assessed were demographics, body mass index, blood pressures, proteinuria, fasting plasma glucose and plasma creatinine. Glomerular filtration rate (GFR) was estimated using CKD-EPI Creatinine Equation 2021. Data were analyzed using SPSS version 25. The level of statistical significance was set at a p-value of &lt; 0.05.&#x0D; Results: 150 adult volunteers participated in the study. The mean age of the participants was 43.3±11.32 years (18-71 years), with 61.3% being females and 38.7% were males. The frequency of the risk factors of CKD observed were obesity in 45 (30.0%) of the participants and diabetes mellitus found in 44 (29.3%) of the participants, Proteinuria and glycosuria were found in 49 (32.7%) and 9 (6.0%) of the participants respectively while a whopping 37 (24.7%) of the participants had haematuria. The number of participants found with estimated glomerular filtration rate (eGFR) of &lt;60ml/min/1.73m2 were 55 (36.7%). There was an independent association between older age (p = 0.010), being widowed/divorced (p = 0.041), and having diabetes (p = 0.006) with an eGFR &lt;60ml/min/1.73m2.&#x0D; Conclusion The prevalence of CKD risk factors in this study population was high. Therefore, there is the need for adequate and continuous sensitization and routine screening in our various clinics for early detection and early management by lifestyle and risk factor modification to halt or reduce the growing burden of CKD with its attendant morbidity and mortality in Nigeria.

Dietary Intake and Quality among Stroke Survivors: NHANES 1999–2018

BackgroundNutrition is an important modifiable risk factor for prevention and treatment of stroke. However, examination of nutrient intake and diet quality in stroke survivors is limited. ObjectivesThe aim of the study was to estimate usual nutrient intake and diet quality in US adults with and without a history of self-reported stroke. MethodsUsing US National Health and Nutrition Examination Survey (NHANES) 1999-2018, we analyzed demographics, health history, and dietary intake data in 1626 individuals with a history of stroke matched for age, gender, and survey cycle to respective controls (n=1621) with no history of stroke. A minimum of one 24-h dietary recall was used to assess dietary intake. Diet quality was determined using Healthy Eating Index 2015 (HEI-2015) scores. Adult food security was assessed based on responses to the US Department of Agriculture Household Food Security Survey Module. Physical and mental limitations were assessed from responses to the NHANES Physical Functioning Questionnaire. Estimates were reported as mean (standard error). ResultsIn comparison to controls, stroke survivors were more likely to be food insecure, experience poverty, and report physical and mental limitations (P < .001, all comparisons). Stroke survivors were more likely to report excessive (% > acceptable macronutrient distribution range) intake for total fat (50.9 [2.7]% vs. 40.4 [2.2]%, P < .001) and inadequate intake (% < estimated average requirement) for calcium (54.6 [1.8]% vs. 43.5 [2.4]%, P = .001) and magnesium (66 [1.8] vs. 53.6 [1.8]%, P < .001). In addition, stroke survivors reported lower HEI-2015 total scores than controls (49.8 vs. 51.9, P < .001). Finally, HEI-2015 total scores were lower in stroke survivors who were food insecure and those with a lower income-to-poverty ratio (< 185%) (P = .001). ConclusionsDietary intake in stroke survivors was nutritionally poor, with suboptimal nutrient intake and lower overall diet quality compared with age- and gender-matched controls. Furthermore, poverty and food insecurity were more prevalent in stroke survivors and associated with worse diet quality.

Improving secondary prevention knowledge in immigrants after a heart attack: adapting and evaluating a virtual patient education resource to promote behaviour change

Abstract Funding Acknowledgements Type of funding sources: None. Background Coronary heart disease (CHD) is prevalent and recurrent (40%), whereas an estimated 75% of events could be avoided by secondary prevention of modifiable risk factors and healthy lifestyle. Structured in-person secondary prevention and patient education programs are both efficient and effective strategies; however, these programs may not meet immigrants’ care or home-based learning needs, and thus alternative educational models are needed. Purpose To adapt and evaluate the simplified Chinese version of Cardiac College, a co-designed evidence-based virtual patient education resource for heart attack, in Chinese immigrants on secondary prevention knowledge and behaviour change outcomes. Methods A prospective longitudinal pre-post study was undertaken in heart attack survivors recruited from cardiac rehabilitation programs at four metropolitan tertiary hospitals from May 2021 to November 2022. Chinese Cardiac College intervention was adapted and provided education via nine booklets and 10 pre-recorded video sessions structured and delivered to patients for four weeks following hospital discharge. Validated surveys measured health literacy, disease-related knowledge, physical activity, heart-healthy diet, and self-management behaviours at baseline and one to two weeks post-intervention. Acceptability, engagement, and satisfaction were also assessed post-intervention. Results From 81 patients assessed for eligibility, 67 were recruited, and 64 (95.5%) completed the study. The sample was aged mean 67.23 ± 8.12 years, and 81.25% were males. Participants had significant improvement in disease-related knowledge in total and in each domain, with the most improvement identified in medical, followed by exercise and psychological domains (p&amp;lt;0.001) (Table 1). Healthy dietary behaviour and other self-management behaviours also significantly improved (all p&amp;lt;0.05). All participants (100%) self-reported being engaged with the materials, rating content as highly acceptable (n=20, 31.3%) and highly satisfactory (n=30, 46.9%). In addition, most participants reported that the delivered information amount was adequate (n=44, 68.8%), and 26.6% (n=17) found it overwhelming. Conclusion A virtual patient-education intervention adapted for Chinese immigrants (Chinese Cardiac College) significantly improves secondary prevention knowledge and self-care behaviour in heart attack survivors and offers a suitable model for intervention, especially where there are limited bilingual staff or resources. Further testing of randomised controlled trials and multiple populations is required.