Prevalence Of Coronary Heart Disease Research Articles

Wearable equipment-based telemedical management via multiparameter monitoring on cardiovascular outcomes in elderly patients with chronic coronary heart disease: an open-labelled, randomised, controlled trial

BackgroundThe prevalence of chronic coronary heart diseases (CHDs) increases with age in the elderly, which represents one of the top-ranked causes of death and disease burden.MethodsThis study aimed to investigate...

Higher remnant cholesterol increases the risk of coronary heart disease and diabetes in postmenopausal women

BackgroundPostmenopausal women represent the demographic increasingly susceptible to cardiovascular and metabolic diseases. Elevated levels of remnant cholesterol (RC) have been implicated in atherosclerosis and insulin resistance.MethodsThis study aimed to investigate the relationship between RC and the prevalence of coronary heart disease (CHD), diabetes, and CHD combined with diabetes in a nationally representative sample of US postmenopausal women using data from the National Health and Nutrition Examination Survey (NHANES) 2007-2018. Multivariate logistic regression models were employed to evaluate the association between RC and the outcomes of interest. Nonlinear associations were assessed using restricted cubic splines (RCS), and subgroup analyses, along with interaction tests, were performed.ResultsA total of 1611 participants were included in the final analysis. Higher RC levels were significantly associated with increased risks of CHD [OR=1.67, 95%CI (1.02, 2.74)], diabetes [OR=1.77, 95%CI (1.22, 2.58)], and CHD combined with diabetes [OR=2.28, 95%CI (1.17, 4.42)] (all P<0.05). Compared to the lowest RC quartile (Q1), the highest quartile (Q4) demonstrated elevated incidences of CHD [OR=1.76, 95%CI (1.04, 2.98)], diabetes [OR=1.81, 95%CI (1.30, 2.53)], and CHD combined with diabetes [OR=3.08, 95%CI (1.29, 7.37)] (all P<0.05). RCS curves indicated a nearly linear relationship between RC and the risks of CHD, diabetes, and CHD combined with diabetes.ConclusionOur study reveals a significant positive correlation between RC levels and the prevalence of CHD, diabetes, and CHD combined with diabetes among postmenopausal women. Understanding these associations could potentially inform targeted prevention and management strategies tailored to this vulnerable population.

Evaluating Performance and Agreement of Coronary Heart Disease Polygenic Risk Scores

Polygenic risk scores (PRSs) for coronary heart disease (CHD) are a growing clinical and commercial reality. Whether existing scores provide similar individual-level assessments of disease susceptibility remains incompletely characterized. To characterize the individual-level agreement of CHD PRSs that perform similarly at the population level. Cross-sectional study of participants from diverse backgrounds enrolled in the All of Us Research Program (AOU), Penn Medicine BioBank (PMBB), and University of California, Los Angeles (UCLA) ATLAS Precision Health Biobank with electronic health record and genotyping data. Polygenic risk for CHD from published PRSs and new PRSs developed separately from testing samples. PRSs that performed population-level prediction similarly were identified by comparing calibration and discrimination of models of prevalent CHD. Individual-level agreement was tested with intraclass correlation coefficient (ICC) and Light κ. A total of 48 PRSs were calculated for 171 095 AOU participants. The mean (SD) age was 56.4 (16.8) years. A total of 104 947 participants (61.3%) were female. A total of 35 590 participants (20.8%) were most genetically similar to an African reference population, 29 801 (17.4%) to an admixed American reference population, 100 493 (58.7%) to a European reference population, and the remaining to Central/South Asian, East Asian, and Middle Eastern reference populations. There were 17 589 participants (10.3%) with and 153 506 participants without (89.7%) CHD. When included in a model of prevalent CHD, 46 scores had practically equivalent Brier scores and area under the receiver operator curves (region of practical equivalence ±0.02). Twenty percent of participants had at least 1 score in both the top and bottom 5% of risk. Continuous agreement of individual predictions was poor (ICC, 0.373 [95% CI, 0.372-0.375]). Light κ, used to evaluate consistency of risk assignment, did not exceed 0.56. Analysis among 41 193 PMBB and 53 092 ATLAS participants yielded different sets of equivalent scores, which also lacked individual-level agreement. CHD PRSs that performed similarly at the population level demonstrated highly variable individual-level estimates of risk. Recognizing that CHD PRSs may generate incongruent individual-level risk estimates, effective clinical implementation will require refined statistical methods to quantify uncertainty and new strategies to communicate this uncertainty to patients and clinicians.

Abstract 4136716: Frailty and Malnutrition Predict Mortality in Older Adults with Atherosclerotic Cardiovascular Disease

Background: Frailty and malnutrition are related geriatric syndromes but it remains unknown if both provide independent prognostic information in older adults with atherosclerotic cardiovascular disease (ASCVD). Aims: We compared the prognostic value of combined frailty and malnutrition assessment with either parameter alone in predicting all-cause mortality. Methods: We analyzed 719 older adults (>70 years old) with prevalent ASCVD from visit-6 of the Atherosclerosis Risk in Communities Study. ASCVD was defined as prevalent coronary heart disease, stroke, or history of MI at visit-6. Malnutrition was assessed using the geriatric nutritional risk index (score <98), and physical frailty was determined using the Fried frailty phenotype. Participants were categorized as high-risk if both frail and malnourished, intermediate-risk if frail or malnourished, and low-risk if neither. Cox regression and model performance metrics were used to assess frailty, malnutrition, and their combination, both alone and in conjunction with a base model. Results: The mean age of the cohort was 80.5±4.5 years and 39.4% were women. A total of 67.2% had frailty, 13.4% had malnutrition and 11.1% had both. Median follow-up was 580 days with 61 mortality events. Compared to low-risk adults, intermediate-risk (2.3 [1.04-5.0], p=0.039) and high-risk (OR 3.1 [95% CI 1.1-8.5], p=0.027) adults had significantly higher adjusted risk of mortality (Figure). In contrast, frailty or malnutrition alone were not statistically significant predictors after multivariable adjustment. Addition of the combined risk to the base model led to a modest increase in the c-index compared to the malnutrition model (0.668 vs. 0.647) but not the frailty model (0.668 vs 0.667). There was no significant improvement in reclassification or integrated discrimination index, but the combined model had superior goodness-of-fit than the frailty and malnutrition models, as demonstrated by a difference >|2.0| in the Akaike information criterion (-3.4&-13.5 respectively). Conclusion: Frailty and malnutrition are highly overlapping syndromes. Incorporation of readily available nutritional risk measures to traditional frailty assessment may improve risk prediction in older adults with ASCVD.

Prevalence and predictors of coronary heart disease among individuals with and without obesity in North Dakota.

Coronary heart disease (CHD) is the most common cardiovascular disease in the United States and heart disease is the leading cause of death in North Dakota. Although obesity is a major risk factor for CHD, some studies have reported an inverse relationship between body mass index (BMI) and CHD outcomes. Understanding the epidemiology of CHD among individuals with and without obesity is essential to guide health planning. Therefore, the objectives of this study were to estimate the prevalence and identify predictors of CHD among North Dakota adults with and without obesity. Behavioral Risk Factor Surveillance System data from 2017 to 2021 were provided by the North Dakota Department of Health and Human Services. Weighted prevalence estimates and 95% confidence intervals (CIs) were computed for CHD and potential risk factors among respondents with and without obesity (BMI ≥30 kg/m2). Multivariable logistic regression was used to identify significant predictors of CHD in both groups. A total of 17,092 respondents were included in the study. Respondents with obesity had a higher prevalence of CHD (4.7%, 95% CI: 4.2-5.4) than those without obesity (3.0%, 95% CI: 2.7-3.4). Predictors of CHD among both groups included age, sex, self-reported general health, high blood pressure, high cholesterol, chronic obstructive pulmonary disease, and diabetes. Having a personal doctor (Odds Ratio [OR] = 1.91, 95% CI: 1.13-3.23) and arthritis (OR = 1.72, 95% CI: 1.34-2.22) were significant predictors of CHD among respondents without obesity, but not among those without obesity. While the prevalence of CHD was significantly higher among adults with obesity compared to those without obesity, the findings of the stratified analysis indicated that predictors of the condition tended to be similar for the two groups. This study provides useful information to guide health planning and control programs that aim to reduce the burden of CHD in North Dakota.

Increased risk of vascular complications in patients with type 2 diabetes and fatty liver disease

BackgroundThe prevalence of steatotic liver disease (SLD) in patients with type 2 diabetes (T2DM) exceeds 50%. This study aimed to investigate the clinical characteristics of SLD and liver fibrosis in Chinese patients with T2DM.MethodsInpatients from 2021 to 2023 were included in the study. Fatty liver index (FLI) and fibrosis-4 (FIB-4) were calculated to assess hepatic steatosis and fibrosis respectively. Statistical analysis was completed by SPSS v25 and GraphPad Prism v8.0.1.ResultsOf the 1466 participants, about one-third of the patients in T2DM-SLD group were diagnosed with liver fibrosis (LF), and the percentage of patients over 50 years old was 85.9%. Patients with SLD had higher levels of BMI, blood pressure, liver enzymes, fasting blood glucose (FBG), HbA1c, C-peptide, total cholesterol (TC) and triglyceride (TG) (P<0.05 for all). Patients with liver fibrosis had lower TC, TG, hemoglobin (Hb), erythrocyte count (RBC), leukocyte count (WBC) and platelet (PLT) levels (P<0.05 for all). Compared with simple T2DM and SLD-NLF (non-liver fibrosis) groups, for patients over 50 years old, the prevalence of coronary heart disease, stroke, tumor, and diabetic nephropathy was higher in patients with liver fibrosis. Liver fibrosis might be the risk factor of arterial stiffness, stroke, coronary heart disease and numbness based on multivariable logistic regression analysis.ConclusionHepatic steatosis and fibrosis were common in patients with T2DM. Liver fibrosis was relevant to many macrovascular and microvascular diabetic complications.

Heart failure and advanced chronic kidney disease: differences in characteristics, treatment and outcomes in patients with glomerular filtration rate greater or less than 30 ml/minute/m2

Abstract Introduction Heart failure (HF) is a serious health problem and continues to have a high mortality and incidence of decompensation, despite advances in its management. Chronic kidney disease (CKD) is very prevalent in patients with HF, hinders their treatment and worsens their prognosis, especially when it is advanced CKD (glomerular filtration rate-GFR &amp;lt;30 ml(min/m2). It is important to know the differential characteristics of these patients to improve their management. Purpose To analyze in a contemporary registry of HF patients followed in specialized HF units in Spain the differences in clinical characteristics and treatment between patients with HF and advanced CKD. Methods We analyzed data from the registry of the SEC-Excelente-IC quality accreditation program of the Spanish Society of Cardiology, with 1716 patients with HF included between 2019 and 2021 by 45 specialized HF units accredited by the SEC. Patients were included consecutively in two 1-month cutoffs (March and October) in that period. The clinical and demographic characteristics and comorbidities of the patients were compared according to GFR &amp;lt; or &amp;gt; 30ml/min/m2. Results Of the 1,716 patients, 11.1% had a GFR&amp;lt;30 and 88.9% &amp;gt;30 mL/min/m2. Figure 1 shows the main clinical characteristics and comorbidities of the 2 groups. Median LVEF was similar in both groups: 42 (30-58) vs 38% (29-54). The group with advanced CKD was older (77±9.6 vs 70.5±12.6 years; p&amp;lt;0.001), had greater HF severity (more admissions for HF in the last year, worse NYHA functional class and longer evolution time), and a higher prevalence of coronary heart disease, hypertension, diabetes mellitus, cognitive impairment, anemia, iron deficiency and hyponatremia. There were no differences in sex, BMI, serum potassium or other comorbidities (Figure 1). Figure 2 shows the treatment received in each group. Patients with GFR &amp;lt;30 received in a significantly lower proportion all drugs for HF (p&amp;lt;0.001), except diuretics and potassium binders (ACEI/ARA, sacubitril-valsartan, MRA, beta-blockers, digoxin and SLGT2 inhibitors), and less cardiac rehabilitation (5.2 vs 10.4%; p=0.029). Incidence of one-year mortality was significantly higher in patients with GFR&amp;lt;30 ml/min/m2 (37.2 vs 14.4 per 100 persons-year, p&amp;lt;0.001), as were HF hospitalizations (61.3 vs 33.0; p&amp;lt;0.001) and HF decompensations without hospitalization (24.1 vs 11; p&amp;lt;0.001). Conclusions In our contemporary cohort of real-life HF patients, the prevalence of advanced CKD was 11.1%. These patients had a higher severity of HF, despite which, the utilization of HF drugs, including SGLT2 inhibitors was much lower than in those with GFR &amp;gt;30 ml/min/m2. One-year mortality, HF hospitalization and HF decompensations were almost 3-times higher. This treatment trend needs to be modified to improve the prognosis of these patients.

Correlation of exercise blood pressure levels with concomitant cardiovascular disease.

Hypertension is a fatal but preventable risk factor for cardiovascular disease and an important cause of death from cardiovascular disease. Exercise training has a definite clinical effect on blood pressure control. However, inappropriate exercise is ineffective and may also cause disease. The aim of this study was to evaluate the possible factors influencing blood pressure level in an exercise treadmill test and its relationship with accompanying clinical diseases. Five hundred sixty-four patients who underwent exercise treadmill test were selected and divided into the abnormal exercise blood pressure group (n = 156, age 60.46 ± 9.2 years) and normal exercise blood pressure group (n = 408, age 56.57 ± 8.8 years) according to whether the peak exercise systolic blood pressure was more than or equal to 180 mm Hg. General clinical data and associated clinical diseases were collected from both groups. The prevalence of hypertension and coronary atherosclerotic heart disease in the abnormal exercise blood pressure group was significantly higher than that in the normal exercise blood pressure group (all P < .05). At the same time, the smoking rate and glycohemoglobin level of the patients with abnormal exercise blood pressure were significantly increased (all P < .05), but there was no statistically significant difference in age, sex, body mass index, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, and other indicators between the 2 groups (all P > .05). Patients with abnormal exercise blood pressure response have a higher prevalence of hypertension and coronary heart disease. Exercise blood pressure level may be an important factor affecting patients' cardiovascular prognosis.

Usefulness of C-reactive protein-triglyceride glucose index in detecting prevalent coronary heart disease: findings from the National Health and Nutrition Examination Survey 1999-2018.

Coronary heart disease (CHD) is one of the leading causes of mortality. The current study aims to assess the association between C-reactive protein-triglyceride glucose index (CTI) and the risk of prevalent CHD and to evaluate the usefulness of CTI to refine the identification of prevalent CHD. 19,451 subjects from the National Health and Nutrition Examination Survey 1999-2010 were enrolled. CHD was ascertained according to the questionnaire. The prevalent of CHD was 6.23%. After adjusting for conventional cardiovascular risk factors, each SD increase of CTI could cast a 1.357 times risk of CHD. In quartile analysis, the top quartile had a 1.807 times risk of CHD than the bottom quartile. Smooth curving fitting displayed that the association was linear in the entire range of CTI. Subgroup analysis revealed that the association was robust among several common subpopulations but stronger in subjects aged <60. Finally, both ROC and reclassification analysis demonstrated a significant improvement in identifying CHD when introducing CTI to the Framingham risk score. CTI has a positive, linear, and robust association with prevalent CHD in the general American population, and CTI may help to improve the detection of prevalent CHD in the general population.

Population regularities of the prevalence of coronary heart disease and psychosocial risk factors in men in a medium-urbanized city of Western Siberia

Purpose of the study: to determine associations of the prevalence of coronary heart disease and some psychosocial risk factors (negative affective states) among men 25–64 years old in the open population of a mid-urban city in Western Siberia.Material and methods. A cross-sectional study with a response rate of 85.0 % was conducted on a representative sample of men 25–64 years old in the city of Tyumen (n = 1000). To determine the levels of personal anxiety, depression, hostility, vital exhaustion, and sleep quality, the standard WHO MONICA-MOPSY questionnaire was used.Results. In the open population of a mid-urban city in Western Siberia, psychosocial risk factors for CVD are significantly common in men aged 25–64 years: personal anxiety (92.4 %), depression (23.6 %), sleep disturbance (50.9 %), hostility (70.0 %), vital exhaustion (54.5 %). Frequency of detection of high gradations of psychosocial risk factors for CVD – personal anxiety (36.6 %), depression (4.6 %), sleep disorders (9.5 %), hostility (46.4 %), vital exhaustion (15.9 %) – increases with age, reaching a maximum in the sixth decade of life. In men 25–64 years old in a mid-urban city in Western Siberia with the presence of IHD, high levels of PSF are more common than in persons without IHD – personal anxiety (OR 4.07), depression (OR 21.07), sleep disorders (OR 5.05) , hostility (OR 2.71), vital exhaustion (OR 6.02); with the presence of «definite» IHD – significantly more often – personal anxiety (OR 9.51), depression (OR 39.84), sleep disturbance (OR 5.28), hostility (OR 4.65), vital exhaustion (OR 14. eleven).Conclusions. Thus, analysis of the definition of psychosocial risk factors associated with the prevalence of coronary heart disease in men 25–64 years old seems necessary to use when developing a preventive program to reduce high cardiovascular risk in the open population of a mid-urban city in Western Siberia, focused primarily on regulation of psychological parameters.

Thinking beyond general greenness: The nuanced associations between a variety of greenspaces and cardiovascular diseases across urbanicity

Cardiovascular diseases (CVDs) are the leading causes of death globally. Exposure to greenspaces has been proposed to be beneficial for CVDs. However, past studies have often overlooked how varying levels of urbanicity may differently impact the relationships between greenspaces and cardiovascular health. Moreover, different types of greenspaces uniquely affect people’s behaviors and psychological wellbeing, potentially yielding distinct effects on CVDs.This study investigates the associations between population-weighted exposure to various types of greenspaces and prevalence of coronary heart disease (CHD) and stroke in the US at tract level, and whether these associations are modified by urbanicity.We identified a contrasting difference in health effects between greenspaces inside and outside park. Neighbourhoods with more forest (CHD β = −2.99, 95 % CI: −4.25, −1.73; stroke β = −1.85, 95 % CI: −2.56, −1.13) and open space (CHD β = −4.31, 95 % CI: −5.49, −3.14; stroke β = −2.33, 95 % CI: −3.00, −1.66) inside park were associated with a lower prevalence of CVDs, whereas more forest (CHD β = 7.67, 95 % CI: 5.81, 9.54; stroke β = 3.01, 95 % CI: 1.95, 4.07) and open space (CHD β = 11.52, 95 % CI: 9.99, 13.05; stroke β = 5.77, 95 % CI:4.90, 6.64) outside park were associated with a higher prevalence of CVDs. We observed a reversal pattern across urbanicity: the significant beneficial associations only held in highly urbanized tracts but attenuated or reversed in the three less urbanized tracts.These findings highlight a need to prioritize investment in parks within walking distance to urban residents and improve the accessibility and design of rural greenspaces. We propose the Landscape Compensation Effect, which may serve as a new theoretical framework to guide future research and design practices of greenspaces to promote the cardiovascular health of both urban and rural residents.

The granular landscape of health disparities: a socio-spatial examination of chronic disease prevalence within New York City's community districts

This study investigates the relationship between neighborhood Socioeconomic Position (SEP) and the prevalence of hypertension and coronary heart disease (CHD) across New York City's community districts. By using a composite SEP index derived from multiple socioeconomic indicators, the research seeks to uncover health disparities that may be obscured in broader geographic analyses. A primary objective is to identify community districts where hypertension and CHD prevalence is significantly higher than expected, even after adjusting for SEP. This focus helps pinpoint areas where targeted public health interventions may be urgently required, especially when the anticipated inverse relationship between SEP and health outcomes does not hold. A linear mixed-effects model (LMM) was used to analyze the association between SEP and these health outcomes, incorporating both fixed and random effects to account for variation across the city's 59 community districts. The analysis revealed a significant negative association between SEP and both hypertension and CHD, with higher SEP levels generally correlating with lower prevalence rates. However, some districts exhibited high random effects, indicating a higher-than-expected prevalence of these conditions, even after controlling for SEP. The authors suspect that additional factors-such as environmental exposures, healthcare accessibility, or community infrastructure-may contribute to these unexplained disparities. The findings emphasize the need for public health strategies that are sensitive to local contexts and the multifactorial nature of health inequities. Understanding the complex drivers behind these disparities can inform policies aimed at reducing health inequities in diverse urban environments.

The impact of high intensity training and sports on recipients of solid organ transplants: a narrative review.

High intensity exercise in individuals post solid organ transplant (SOT) remains a largely understudied phenomenon, with potential risks and benefits. Additionally, the optimal training protocols are still unclear. This narrative review aimed to explore the impact of high-intensity exercise training and strenuous sports on solid organ transplant recipients (SOTRs). We conducted a narrative review of intervention studies of any design that included high-intensity exercise training and cross-sectional studies of strenuous sports and activities. Additionally, we reviewed individual reports documenting post-SOT performance at highly competitive or physiological levels. We used MEDLINE to search for relevant articles followed by a manual search for additional articles. Data were extracted and results were summarized. High-intensity and strenuous exercise appears to be safe among stable SOTRs. High-intensity protocols consistently demonstrated improvements in VO2peak and a reduction in coronary artery disease prevalence, though findings related to body composition, health-related quality of life outcomes, and cardiovascular exercise variables were inconsistent. Pre-transplant athletes showcase notable achievements and physiological adaptations post-transplantation, highlighting the capacity for athletic performance among this population. However, caution is warranted in interpreting the findings from these studies due to limitations in generalizability and other methodological limitations. As evidenced by current literature, high intensity exercise emerges as a promising exercise method for safely improving various physiological parameters, and reducing the prevalence of coronary heart disease in SOTRs. It can induce similar or greater effects to moderate intensity exercise, however follow-up studies indicate low retention. Further research of higher methodological rigor is warranted in this field to advance understanding, and to guide evidence-based practice.

Hypothalamic Gliosis is Associated With Multiple Cardiovascular Disease Risk Factors.

Hypothalamic gliosis is mechanistically linked to obesity and insulin resistance in rodent models. We tested cross-sectional associations between radiologic measures of hypothalamic gliosis in humans and clinically relevant cardiovascular disease risk factors, as well as prevalent coronary heart disease. Using brain MRI images from Framingham Heart Study participants (N=867; mean age, 55 years; 55% females), T2 signal intensities were extracted bilaterally from the region of interest in the mediobasal hypothalamus (MBH) and reference regions in the amygdala (AMY) and putamen (PUT). T2 signal ratios were created in which greater relative T2 signal intensity suggests gliosis. The primary measure compared MBH to AMY (MBH/AMY); a positive control ratio (MBH/PUT) also assessed MBH whereas a negative control (PUT/AMY) did not. Outcomes were BMI, HDL-C, LDL-C, fasting triglycerides, and the presence of hypertension (n=449), diabetes mellitus (n=66), metabolic syndrome (n=254), or coronary heart disease (n=25). Dietary risk factors for gliosis were assessed in a prospective analysis. Statistical testing was performed using linear or logistic regression. Greater MBH/AMY T2 signal ratios were associated with higher BMI (β = 21.5 [95% CI, 15.4-27.6]; P<0.001), higher fasting triglycerides (β = 1.1 [95% CI, 0.6-1.7]; P<0.001), lower HDL-C (β = -20.8 [95% CI, -40.0 to -1.6]; P=0.034), and presence of hypertension (odds ratio, 1.2 [95% CI, 1.1-1.4]; P=0.0088), and the latter two were independent of BMI. Findings for diabetes mellitus were mixed and attenuated by adjusting for BMI. Metabolic syndrome was associated with MBH/AMY T2 signal ratios (odds ratio, 1.3 [95% CI, 1.1-1.6]; P<0.001). Model results were almost uniformly confirmed by the positive control ratios, whereas negative control ratios that did not test the MBH were unrelated to any outcomes (all P≥0.05). T2 signal ratios were not associated with prevalent coronary heart disease (all P>0.05), but confidence intervals were wide. Self-reported percentages of macronutrient intake were not consistently related to future T2 signal ratios. Using a well-established study of cardiovascular disease development, we found evidence linking hypothalamic gliosis to multiple cardiovascular disease risk factors, even independent of adiposity. Our results highlight the need to consider neurologic mechanisms to understand and improve cardiometabolic health.

Prevalence of complications and co-morbidities in males and females with obesity: Real-world insights from claims data analysis.

To comprehensively examine the range of co-morbidities among males and females with a diagnosis of obesity. This cross-sectional retrospective study used US commercial and Medicare claims data from Merative MarketScan Research Databases to identify adults (age ≥ 18 years) with a diagnosis of obesity with continuous insurance coverage from 2018 to 2020. Co-morbidities were tabulated based on coded diagnoses, and prevalences were calculated in males and females across age groups. Age-adjusted odds ratios (ORs) determined differences in co-morbidities between the sexes. Of an eligible sample of 6.9 million, we identified 2 028 273 individuals with at least one obesity-related International Classification of Diseases, 10th Revision, Clinical Modificationcode. The proportions of males and females with obesity were 43.0% versus 57.0%. The most prevalent co-morbidities among males and females were hypertension (62.8% vs. 52.2%), dyslipidaemia (63.3% vs. 50.3%) and depression and/or anxiety (D/A; 29.7% vs. 48.5%). The prevalence of D/A was high in the younger age group, but steadily decreased with age in both sexes; however, hypertension and dyslipidaemia continued to increase with age. The presence of diagnosis of hypertension and dyslipidaemia was 6-8 years earlier in males than in females. Females had higher odds than males for osteoarthritis (OR 1.33), depression (OR 2.22) or osteoporosis (OR 7.10); all P < .0001. Males with obesity received a diagnosis of cardiovascular risk factors at an earlier age than females, which may have contributed to the higher prevalence of coronary heart disease. Understanding sex-specific variations in co-morbidities across ages can support early screening and diagnosis of risk clusters for optimal obesity management.

SGK1 contributes to ferroptosis in coronary heart disease through the NEDD4L/NF-κB pathway

The prevalence of coronary heart disease (CHD) has increased significantly with the aging population worldwide. It is unclear whether ferroptosis occurs during CHD. Hence, we aimed to investigate the potential mechanisms associated with ferroptosis in CHD. Bioinformatics was used to characterize differentially expressed genes (DEGs) in CHD-related datasets (GSE21610 and GSE66360). There were 76 and 689 DEGs in the GSE21610 and GSE66360, respectively, and they predominantly associated with immune and inflammatory responses. DDX3Y, EIF1AY, KDM5D, RPS4Y1, SGK1, USP9Y, and NSG1 were intersecting DEGs of GSE21610 and GSE66360. Their expression pattern in circulating endothelial cells (ECs) derived from healthy individuals and CHD patients are consistent with the results of bioinformatics analysis, especially SGK1. In vitro, SGK1 knockdown alleviated the Erastin-induced downregulation of SLC7A11, GPX4, GSH, and GSSG, as well as the upregulation of lipid peroxidation, Fe accumulation, and mitochondrial damage in mouse aortic ECs (MAECs). Notably, SGK1 may interact with NEDD4L according to the String database. Moreover, SGK1 promoted NEDD4L and p-P65 expression in MAECs. Interestingly, the effect of SGK1 knockdown on ferroptosis in MAECs was rescued by overexpression of NEDD4L or PMA (NF-κB pathway activator). In vivo, SGK1 knockdown facilitated the recovery of body weight, blood lipids, and aortic tissue structure in CHD animal models. Furthermore, SGK1 knockdown alleviated Fe accumulation in the aorta and inactivated the NEDD4L-NF-κB pathway. In conclusion, SGK1 contributes to EC ferroptosis by regulating the NEDD4L-NF-κB pathway. SGK1 could be recognized as a therapeutic target related to ferroptosis in CHD.

Adverse childhood experiences and adult disease: Examining mediating pathways in the Hispanic Community Health Study/Study of Latinos Sociocultural Ancillary Study.

Adverse childhood experiences (ACEs) have been linked to adulthood chronic diseases, but there is little research examining the mechanisms underlying this association. We tested pathways from ACEs to adult disease mediated via risk factors of depression, smoking, and body mass index. Prospective data from adults 18 to 74 years old from the Hispanic Community Health Study/Study of Latinos and Sociocultural Ancillary Study were used. Retrospectively reported ACEs and hypothesized mediators were measured at Visit 1 (2008-2011). Outcomes of disease prevalence were assessed at Visit 2, approximately 6 years later. The analytic sample includes 5,230 Hispanic/Latino participants with ACE data. Statistical mediation was examined using structural equation modeling on cardiometabolic and pulmonary disease prevalence and reported probit regression coefficients with 95% confidence intervals (CIs). We found a significant association between ACEs and the prevalence of asthma/chronic obstructive pulmonary disorder (standardized β = .07, 95% CI [0.02, 0.12]). In the mediational model, the direct association was nonsignificant (β = .02, 95% CI [-0.04, 0.07]) but was mediated by depressive symptoms (β = .03, 95% CI [0.02, 0.04]). There were no associations between ACEs and the prevalence of diabetes and self-reported coronary heart disease or cerebrovascular disease. However, a small indirect effect was identified via depressive symptoms and coronary heart disease (β = .02, 95% CI [0.01, 0.03]). In this diverse Hispanic/Latino sample, depressive symptoms were found to be a pathway linking ACEs to self-reported cardiopulmonary diseases, although the effects were of small magnitude. Future work should replicate pathways, confirm the magnitude of effects, and examine cultural moderators that may dampen expected associations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Association between body shape index and coronary heart disease in individuals over 20 years old with obese

BackgroundWhile body mass index (BMI) defines obesity as a well-established risk factor for cardiovascular disease, the paradoxical theory of BMI suggests that obesity may indeed have a favorable impact on the prognosis of cardiovascular disease. Therefore, this study aims to assess the correlation between body shape index (ABSI), which is a novel measure of obesity, and coronary heart disease (CHD) among obese individuals in the United States.MethodsThe data from the National Health and Nutrition Examination Survey (NHANES) were evaluated by us for 5046 patients. We assessed the exposure variable ABSI, which includes waist circumference (WC), height, and BMI. The outcome variable was CHD.ResultsThe cross-sectional study included a total of 5046 obese adults aged over 20 years, with an average age (standard deviation: SD) of 49.86 (16.24) years and a male proportion of 44.57%.The odds ratio (OR) values for CHD in Model 1, Model 2, 3 were found to be 2.45 (95%CI: 2.12, 2.83), 1.53 (95%CI:1.30, 1.81) and 1.31 (95%CI:1.09, 1.56) per SD increase in ABSI, respectively. In the fully adjusted model, we designated participants in the T1 group as the reference group. Our findings indicate a significant increase in the prevalence of CHD (OR:1.82, 95%CI: 1.07–3.10) only within the T3 group. Although there is an increased prevalence of CHD (OR:1.32, 95%CI: 0.77–2.29) in the T2 group, no statistically significant difference was observed.ConclusionsThe increase in ABSI is strongly associated with the rise in CHD prevalence among obese individuals in the United States.

Polygenic Risk and Coronary Artery Disease Severity.

Coronary atherosclerotic burden and adverse coronary heart disease events are related phenotypes with likely shared genetic cause. We analyzed 6021 patients with available coronary angiography, genotyping, and exome sequencing data. We tested for associations of polygenic risk scores for coronary heart disease (PRSCHD) with multiple measures of coronary artery disease (CAD) severity. We assessed the interplay between PRSCHD and pathogenic/likely pathogenic variants in 3 familial hypercholesterolemia genes. We performed mediation analyses to explore whether CAD severity mediated the association of PRSCHD with prevalent coronary heart disease and incident myocardial infarction. A 1-SD increase in PRSCHD was associated with multiple measures of CAD severity, including the log Gensini score (β, 0.31 [95% CI, 0.28-0.33]). Carrying a pathogenic/likely pathogenic familial hypercholesterolemia variant was associated with a higher log Gensini score after adjustment for PRSCHD (β, 0.21 [95% CI, 0.03-0.38]). PRSCHD was associated with incident myocardial infarction over a mean follow-up of 9.2 years (hazard ratio, 1.20 [95% CI, 1.13-1.27]; P=5×10-10), and the Gensini score mediated 90% of this association. PRSCHD was associated with multiple measures of CAD severity. The association of PRSCHD with incident myocardial infarction was almost fully mediated by CAD severity, indicating a considerable genetic overlap between the 2 phenotypes.

Characteristics of the phenotypes in prevalent and incident cases of heart failure in primary care: IBERICAN study

BackgroundThe management in primary care (PC) of the patients with Heart Failure (HF) is different from the management hospital, in a special way compared to cardiology departments.ObjectiveTo define the characteristics in both phenotypes of HF in prevalent and incident cases of HF in patients recruited in a large PC sample.MethodsWe proposed a and longitudinal analyses, in patients of the IBERICAN cohort, that recruited 8,066 patients in the Spanish primary care system, with 15,488 patients-years of follow-up. Of them, 252 patients (3.1%) had diagnoses of HF. HF was classified according to the 2014 guidelines in two groups: HF with a reduced eject fraction or HFrEF (LVEF < 50%) and HF with preserved eject fraction or HFpEF (LVEF ≥ 50%). Recommended treatment was defined as the patient receiving drug treatment with Renin-Angiotensin-System (RAS) blockers with beta-blockers and, optionally, spironolactone. The incidence of new cases of HF was calculated in the 7,814 patients without HF in the inclusion visit. Finally, we analysed which variables associated the onset new cases and get the hazard ratio (HR) with the confidence interval at 95% ([95%CI]). Clinical trials register: NCT02261441 (02/05/2017).ResultsThe HFpEF was the most frequent phenotype in prevalent cases (61.1%) and incident cases (73.9%). Patients with HFrEF had a higher prevalence of coronary heart disease (p = 0.008) and PAD (p = 0.028), and no statistically significant differences was observed in the therapeutic groups used between both groups. The incidence of HF was 12.8 cases/1000 inhabitants/year, 35.6% of them was diagnosed in PC. The renin-angiotensin system blockers were more used in PC (60%) and beta-blockers (100%) and spironolactone (60%) in hospital. The female sex showed a protective effect for incident cases (0.51 [0.28–0.92]); and AF (HR [95%CI]: 2.90 [1.51–5.54]), coronary heart disease (HR [95%CI]: 2.18 [1.19-4.00]) and hypertension (HR [95%CI]: 1.91 [1.00-3.64]) increased the risk of developing HF.ConclusionsHF phenotype more frequent and incident in PC was the HFpEF, but only one third of them are diagnosed in PC level. The female sex showed a protective effect and atrial fibrillation, ischaemic heart disease and hypertension increased the risk of develop HF.