Prevalence Of High Cholesterol Research Articles

Case Report: The Effect of Ajwa Date Consumption on Total Cholesterol Levels in Perimenopausal Women

Based on the 2016 Riskesdas, the prevalence of high cholesterol in Indonesia among women aged 35-59 years was 52.9%, and among those aged ≥60 years, it was 58.7%. According to provincial data, the highest percentage of patients with high cholesterol levels at Posbindu and FKTP in Indonesia was in West Papua Province, reaching up to 70%. The concentration of cholesterol levels in women's blood tends to increase with age, particularly for those over 40 years old, due to hormonal factors, especially the decrease in estrogen production and function. The decline in estrogen levels leads to an increase in lipids or total cholesterol, resulting in changes in body fat composition associated with hypercholesterolemia. This case report aims to investigate the impact of consuming Ajwa dates on the total cholesterol levels of perimenopausal women. Results: Ajwa dates contain higher polyphenol concentrations with an impressive nutritional profile that enhances blood lipoproteins. Additionally, dates can increase estrogen levels due to the estradiol and estrone present in their pollen. Several experimental studies have shown a significant difference in total cholesterol levels in subjects before and after consuming Ajwa dates. Conclusion: There is a notable difference in total cholesterol levels before and after the administration of Ajwa dates.

Knowledge and perception of hypercholesterolemia among Princess Nourah Bint Abdulrahman University students

Background: Hypercholesterolemia is one of the major risk factors for cardiovascular disease, which could escalate mortality rates in Saudi Arabia. Research has shown that the prevalence of high cholesterol in Saudi Arabia is predicted to rise in the next few years. The knowledge and perception are important as this is one of the modifiable risk factors for NCDs. The aim of study is to assess the knowledge and perception regarding hypercholesterolemia among university students and to determine if there is any relation between knowledge and perception of hypercholesterolemia among university students. Methods: A cross-sectional study using a self-administrated questionnaire measuring the knowledge and perception of hypercholesterolemia was conducted among 588 medical and non-medical students at Princess Nourah Bint Abdulrahman University. Results: The result indicates that 54.93% of the participants had poor knowledge about hypercholesterolemia and 79.76% of them had a positive perception about it. Conclusions: There is a gap in knowledge and perception regarding high cholesterol. Furthermore, it was found that there is a significant association between the knowledge and perception regarding hypercholesterolemia among Princess Nourah Bint Abdulrahman University students.

Prevalence of plasma lipid abnormalities and associated risk factors among Iranian adults based on the findings from STEPs survey 2021

The study aimed to estimate the prevalence of lipid abnormalities in Iranian adults by demographic characterization, geographical distribution, and associated risk factors using national and sub-national representative samples of the STEPs 2021 survey in Iran. In this population-based household survey, a total of 18,119 individuals aged over 25 years provided blood samples for biochemical analysis. Dyslipidemia was defined by the presence of at least one of the lipid abnormalities of hypertriglyceridemia (≥ 150 mg/dL), hypercholesterolemia (≥ 200 mg/dL), high LDL-C (≥ 130 mg/dL), and low HDL-C (< 50 mg/dL in women, < 40 mg/dL in men), or self-reported use of lipid-lowering medications. Mixed dyslipidemia was characterized as the coexistence of high LDL-C with at least one of the hypertriglyceridemia and low HDL-C. The prevalence of each lipid abnormality was determined by each population strata, and the determinants of abnormal lipid levels were identified using a multiple logistic regression model. The prevalence was 39.7% for hypertriglyceridemia, 21.2% for hypercholesterolemia, 16.4% for high LDL-C, 68.4% for low HDL-C, and 81.0% for dyslipidemia. Hypercholesterolemia and low HDL-C were more prevalent in women, and hypertriglyceridemia was more prevalent in men. The prevalence of dyslipidemia was higher in women (OR = 1.8), obese (OR = 2.8) and overweight (OR = 2.3) persons, those residents in urban areas (OR = 1.1), those with inappropriate physical activity (OR = 1.2), patients with diabetes (OR = 2.7) and hypertension (OR = 1.9), and participants with a history (OR = 1.6) or familial history of CVDs (OR = 1.2). Mixed dyslipidemia prevalence was 13.6% in women and 11.4% in men (P < 0.05). The prevalence of lipid abnormalities was highly heterogeneous among provinces, and East Azarbaijan with 85.3% (81.5–89.1) and Golestan with 68.5% (64.8–72.2) had the highest and lowest prevalence of dyslipidemia, respectively. Although the prevalence of high cholesterol and LDL-C had a descending trend in the 2016–2021 period, the prevalence of dyslipidemia remained unchanged. There are modifiable risk factors associated with dyslipidemia that can be targeted by the primary healthcare system. To modify these risk factors and promote metabolic health in the country, action plans should come to action through a multi-sectoral and collaborative approach.

Community Social Capital and Population Health Outcomes

While the association between economic connectedness and social mobility has now been documented, the potential linkage between community-level economic connectedness and population health outcomes remains unknown. To examine the association between community social capital measures (defined as economic connectedness, social cohesion, and civic engagement) and population health outcomes (defined across prevalence of diabetes, hypertension, high cholesterol, kidney disease, and obesity). This cross-sectional study included communities defined at the zip code tabulation area (ZCTA) level in all 50 US states. Data were collected from January 2021 to December 2022. Multivariable regression analyses were used to examine the association between population health outcomes and social capital. Adjusted analyses controlled for area demographic variables and county fixed effects. Heterogeneities within the associations based on the racial and ethnic makeup of communities were also examined. In this cross-sectional study of 17 800 ZCTAs, across 50 US states, mean (SD) economic connectedness was 0.88 (0.32), indicating friendship sorting on income; the mean (SD) support ratio was 0.90 (0.10), indicating that 90% of ties were supported by a common friendship tie; and the mean (SD) volunteering rate was 0.08 (0.03), indicating that 8% of individuals within a given community were members of volunteering associations. Mean (SD) ZCTA diabetes prevalence was 10.8% (2.9); mean (SD) high blood pressure prevalence was 33.2% (6.2); mean (SD) high cholesterol prevalence was 32.7% (4.2), mean (SD) kidney disease prevalence was 3.0% (0.7), and mean (SD) obesity prevalence was 33.4% (5.6). Regression analyses found that a 1% increase in community economic connectedness was associated with significant decreases in prevalence of diabetes (-0.63%; 95% CI, -0.67% to -0.60%); hypertension (-0.31%; 95% CI, -0.33% to -0.29%); high cholesterol (-0.14%; 95% CI, -0.15% to -0.12%); kidney disease (-0.48%; 95% CI, -0.50% to -0.46%); and obesity (-0.28%; 95% CI, -0.29% to -0.27%). Second, a 1% increase in the community support ratio was associated with significant increases in prevalence of diabetes (0.21%; 95% CI, 0.16% to 0.26%); high blood pressure (0.16%; 95% CI, 0.13% to 0.19%); high cholesterol (0.16%; 95% CI, 0.13% to 0.19%); kidney disease (0.17%; 95% CI, 0.13% to 0.20%); and obesity (0.08%; 95% CI, 0.06% to 0.10%). Third, a 1% increase in the community volunteering rate was associated with significant increases in prevalence of high blood pressure (0.02%; 95% CI, 0.01% to 0.02%); high cholesterol (0.03%; 95% CI, 0.02% to 0.03%); and kidney disease (0.02%; 95% CI, 0.01% to 0.02%). Additional analyses found that the strength of these associations varied based on the majority racial and ethnic population composition of communities. In this study, higher economic connectedness was significantly associated with better population health outcomes; however, higher community support ratios and volunteering rates were both significantly associated with worse population health. Associations also differed by majority racial and ethnic composition of communities.

Screening for familial hypercholesterolaemia; extending a role for blood programs in promoting public health

Abstract Background Familial hypercholesterolaemia (FH) is a genetic disorder characterized by high levels of cholesterol with evidence of coronary arterial disease at an early age. The prevalence of FH has been recently reported as 1/200 to 1/250 in the general population and although early identification and treatment is recommended (2019 ESC/EAS Guidelines for the Management of Dyslipidaemias), the disorder is largely underdiagnosed in asymptomatic individuals.1 A number of blood programs has recognised the opportunity that blood donation provides to identify ostensibly healthy individuals who might be unaware of risks to their health. These programs have included, along with mandated serological testing, such assays as non-fasting total cholesterol (TC) and haemoglobin A1C. They have also taken steps to notify individuals whose results suggest risk for cardiovascular disease or diabetes. Purpose Since our blood donation program has a long history of providing donors information about their TC, we tested whether some donors with elevated TC met the criteria for FH. Methods We reviewed unlinked total non-fasting cholesterol results from volunteers donating between 2015 and June 2019. Cholesterols were measured on a chemistry analyzer system (Beckman Coulter AU680) on residual blood after routine testing for infectious disease markers. For volunteers donating more than once, we included only their highest TC recording. TC was classified by American Heart Association (AHA) 2020 Goal Metrics as high, if ≥240 mg/dL (6.2 mmol/L) in donors ≥20 years of age and ≥200 (5.1 mmol/L) in donors &amp;lt;20 years of age. 2 We applied the United States Center for Disease Control Cooperative MEDPED diagnostic criteria for FH. Using these criteria, FH is diagnosed when TC exceeds 270 mg/dL (7.0 mmol/L) in individuals less than 20, 290 mg/dL (7.5 mmol/L) in individuals 20 to 29, 340 mg/dL (8.8 mmol/L) in individuals 30 to 39, and 360 mg/dL (9.3 mmol/L) in individuals 40 years of age and older. 3 Results There were 432,389 unique donors during the study period. The overall prevalence of high cholesterol, 11.1% and the prevalence of FH 0.24% are similar to published data for the general population. As shown in the table, the prevalence of FH was highest in blood donors 20 to 29 years of age and was lower in those over 30 years, while the prevalence of high TC was higher in older age groups. Conclusion There is a subset of blood donors, at all ages who can be identified as satisfying familial hypercholesterolaemia criteria that could benefit from additional evaluation and family screening. A sizeable proportion of blood donors have high cholesterol despite not having FH. Funding Acknowledgement Type of funding sources: None.

Prevalence and risk factors of high cholesterol and triglycerides among people with HIV in Texas

BackgroundPeople with HIV (PWH) commonly have elevated cholesterol and triglycerides levels that have been linked to medications. However, healthy behaviors including lifestyle changes can lower high cholesterol (CHOL) or high triglycerides (TG), thereby reducing individual risk for cardiovascular diseases. This study aimed to determine the prevalence and risk factors associated with high CHOL or TG among PWH in Texas.MethodsCross-sectional data of 981 PWH from the 2015–2017 Texas and Houston Medical Monitoring Projects were examined. High CHOL or TG was identified by medical chart diagnosis, CHOL or TG medication use, or most recent fasting lab ≥ 200 mg/dl (total CHOL) or ≥ 150 mg/dl (TG). High CHOL or TG associations with sociodemographic and clinical characteristics were assessed using Rao-Scott chi-square tests. Prevalence of high CHOL or TG development was calculated using multivariable logistic regression model.ResultsHigh CHOL or TG prevalence was 41% with participants being mostly male (73%), ≥ 40 years (68%), with overweight (31%) or obesity (28%), and virally suppressed (62%). Compared with PWH < 40 years of age, PWH in their 40s, 50s, and ≥ 60s were 57%, 64%, and 62% more likely to have high CHOL or TG, respectively. Participants with overweight and obesity were 41% and 30% more likely to have high CHOL or TG than those with normal weight (BMI: 18.5– < 25), respectively.ConclusionSince high CHOL and TG are modifiable CVD risk factors, increased education and lifestyle modification interventions are warranted to prevent the development of high CHOL or TG among PWH.

Abstract 001: Association Between Acculturation Level And Cardiovascular Risk Factor Prevalence Among Asian American Subgroups

Introduction: Limited disaggregated Asian subgroup data exist on the association between cardiovascular (CV) risk factors and acculturation level. Hypothesis: The association between acculturation levels and CV risk factors will differ by Asian subgroups. Methods: We used the National Health Interview Survey, a nationally representative US survey, years 2014-18. Acculturation was defined using the sum of: (a) years in the US (b) citizenship (c) English proficiency. An acculturation index was created and categorized as low, moderate, or high (scores of 0-1, 2 and ≥ 3, respectively). Self-reported risk factors included high cholesterol, obesity, tobacco use, physical activity level, diabetes and hypertension. Age-adjusted, weighted proportions were used to compare the prevalence of CV risk factors between Asian subgroups using Rao-Scott Chi Square. Results: Study sample consisted of 10,891 adults, representing 7.5 million US adults ≥ 18 years (46 % male; mean age 48.3 [SD 15.7]). The distribution by race/ethnicity was Asian Indian 15.1%, Chinese 12.9%, Filipino 10.2%, other Asian 18.2%, and NHW 43.7%. We found a positive association between prevalence of high cholesterol and acculturation level among all Asian subgroups, with increases of 50 to 90% when comparing low vs high acculturation ( Table ). Filipinos had a higher prevalence of obesity and tobacco use associated with higher acculturation level (p&lt; 0.05), but this was not observed among other Asian subgroups. In contrast, physical activity levels were higher among Asian subgroups with higher acculturation levels. No differences were seen for prevalence of hypertension or diabetes based on acculturation level. Conclusion: This study demonstrates that acculturation level was associated with higher prevalence of CV risk factors with significant variability among Asian subgroups. It highlights the need for more studies to better understand these differences based on acculturation level and can help inform targeted, culturally specific interventions.

Prevalence and factors associated with self-reported diagnosis of high cholesterol in the Brazilian adult population: National Health Survey 2019.

To estimate the prevalence of self-reported high cholesterol diagnosis and to analyze the factors associated with the prevalence in the Brazilian adult population. Cross-sectional study, using data from the 2019 National Health Survey. The diagnosis of high cholesterol was self-reported. Poisson regression models yielded prevalence ratios (PR) and 95% confidence intervals (95%CI). In the 88,531 adults, the prevalence of high cholesterol was 14.6%. Positively associated: female sex (PR = 1.44; 95%CI 1.40;1.52), age ≥ 60 years (PR = 3.80; 95%CI 3.06;4.71), health insurance (PR = 1.33; 95%CI 1.24;1.42), poor or very poor self-rated health (PR = 1.75; 95%CI 1.60;1.90), hypertension (PR = 1.78; 95%CI 1.68;-1.89), diabetes (RP = 1.54; 95%CI 1.45;1.65), renal failure (PR = 1.33; 95%CI 1.15;1.53), obesity (PR = 1.27; 95%CI 1.18;1.36), former smoker (PR = 1.13; 95%CI 1.07;1.20), alcohol abuse (PR = 1.11; 95%CI 1.01;1.21), physically active during leisure time (PR = 1.22; 95%CI 1.15;1.30). High cholesterol was associated with sociodemographic characteristics, health condition and lifestyle.

Ayurvedic Approach in Management of Dyslipidemia: A Case Study

Dyslipidemia is one of the commonest presentation and major cause for various lifestyle disorders like cardiovascular diseases, pancreatitis, fatty liver, and many other diseases. The prevalence of High Cholesterol is present in 25-30% of Urban and 15-20% in rural subjects in Indian Population [1]. According to Ayurveda, Dyslipidemia is the corresponding output of Medovaha srotodushti. In Ayurveda, the line of treatment for medoroga is shodhana karma (Basti / Virechana chikitsa), Rukshana chikitsa, Udvartana, Shamana chikitsa Nidan parivarjana. Virechana therapy is considered as a purificatory procedure, which improves the functions of the digestive system by the way of intensive purgation. This therapy removes the toxins and waste from the body up to the cellular levels by excessive secretion of digestive juices, enzymes and biles. The Lipid lowering therapy in modern medicine including Statin and Fibrates is well tolerated with less side effects. But, this therapy in most of the cases is used lifelong and adds large financial burden in developing countries like India. A 64 year Female patient presented with complaints of Bharvruddhi (Overweight ), Swedadhikya (Excessive sweating), Angagaurav (Body heavyness), Ubhaya pada daha (Bilateral burning of foot), Katishoola (backache) since 1 year. Dadimashtaka Churna for rukshana, pachana purpose was given before virechana karma. Triphalaghruta was used for Abhyantar Snehapana in the form of accha snehapana. Sarvanga Snehana and Sarvanga Swedan was done with Nirgundi Oil and Nirgundi patra bashpa sweda. Triphala, Trivrutta, Kutaki Kwatha, Aragwadh, Manuka phant and Eranda Sneha was used for Virechana Yoga. On completion of the treatment the significant improvement was seen in Swedadhikya, Ubhayapadadaha,angagaurav, katishoola. The significant improvement was also observed in Lipid Profile. Thus, Virechana karma found effective in the patient of Dyslipidemia.

Prevalence and Predictors of Dyslipidemia in Children and Adolescents in Yazd Greater Area, Yazd, Iran

Background: Dyslipidemia, a genetic and multifactorial disorder of lipoprotein metabolism, is defined by elevations in levels of total cholesterol, low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non–HDL-C), triglyceride, or some combination thereof, as well as lower levels of high-density lipoprotein (HDL) cholesterol. Objectives: This study aimed to investigate the prevalence and predictors of dyslipidemia in children and adolescents in the Yazd Greater Area, Yazd, Iran. Methods: This cross-sectional study was conducted as a part of the national project implemented in Yazd Greater Area, Yazd, Iran. The sampling was performed using a multi-stage cluster sampling method on three age groups of girls and boys (6-9, 10-14, and 15-18 years old). Out of the total 1,035 children and adolescents who participated in this study, only 784 participants remained in the study until the end. Data collection was performed using lifestyle questionnaires including Kiddie-SADS-Present and Lifetime Version. Results: The prevalence of high triglyceride was estimated at 1.4% and 4.2% in 6-9 and 10-18 years old children and adolescents, respectively. The prevalence of high cholesterol, LDL, and HDL was 3.2%, 3.2%, and 25.6%, respectively. The prevalence of dyslipidemia in the total population of children and adolescents in terms of demographic variables was 64.6% and 57.3% in boys and girls, respectively (P=0.038). Gender and increase in body mass index were significantly associated with dyslipidemia with OR=1.35; 95% CI: 1.01-1.81 and OR=13.781; 95% CI: 3.78- 46.43, respectively. However, after adjustment for other factors, only an increase in BMI was significantly associated with dyslipidemia (OR=16.08; 95% CI: 4.49-57.59). Conclusions: Overweight and obese adolescents had a higher concentration of serum blood triglycerides, compared to other adolescents. Weight control, lifestyle modification, and diet are three ways to reduce lipid disorders in adolescents.

Influence of Single Nucleotide Polymorphisms of ELOVL on Biomarkers of Metabolic Alterations in the Mexican Population.

The elongation of very long chain fatty acids (ELOVL) is a family of seven enzymes that have specific functions in the synthesis of fatty acids. Some have been shown to be related to insulin secretion (ELOVL2), and in the lipid profile (ELOVL6) and patients with various pathologies. The present work focused on the study of ELOVL polymorphs with clinical markers of non-communicable chronic diseases in the Mexican population. A sample of 1075 participants was obtained, who underwent clinical, biochemical, and nutritional evaluation, and a genetic evaluation of 91 genetic variants of ELOVL was considered (2–7). The results indicate a 33.16% prevalence of obesity by body mass index, 13.84% prevalence of insulin resistance by homeostatic model assessment (HOMA) index, 7.85% prevalence of high cholesterol, and 20.37% prevalence of hypercholesterolemia. The deprived alleles showed that there is no association between them and clinical disease risk markers, and the notable finding of the association studies is that the ELOVL2 variants are exclusive in men and ELVOL7 in women. There is also a strong association of ELOVL6 with various markers. The present study shows, for the first time, the association between the different ELOVLs and clinical markers of chronic non-communicable diseases.

Evaluating the Representativeness of US Centricity Electronic Medical Records With Reports From the Centers for Disease Control and Prevention: Comparative Study on Office Visits and Cardiometabolic Conditions.

BackgroundElectronic medical record (EMR)–based clinical and epidemiological research has dramatically increased over the last decade, although establishing the generalizability of such big databases for conducting epidemiological studies has been an ongoing challenge. To draw meaningful inferences from such studies, it is essential to fully understand the characteristics of the underlying population and potential biases in EMRs.ObjectiveThis study aimed to assess the generalizability and representativity of the widely used US Centricity Electronic Medical Record (CEMR), a primary and ambulatory care EMR for population health research, using data from the National Ambulatory Medical Care Surveys (NAMCS) and the National Health and Nutrition Examination Surveys (NHANES).MethodsThe number of office visits reported in the NAMCS, designed to meet the need for objective and reliable information about the provision and the use of ambulatory medical care services, was compared with similar data from the CEMR. The distribution of major cardiometabolic diseases in the NHANES, designed to assess the health and nutritional status of adults and children in the United States, was compared with similar data from the CEMR.ResultsGender and ethnicity distributions were similar between the NAMCS and the CEMR. Younger patients (aged <15 years) were underrepresented in the CEMR compared with the NAMCS. The number of office visits per 100 persons per year was similar: 277.9 (95% CI 259.3-296.5) in the NAMCS and 284.6 (95% CI 284.4-284.7) in the CEMR. However, the number of visits for males was significantly higher in the CEMR (CEMR: 270.8 and NAMCS: 239.0). West and South regions were underrepresented and overrepresented, respectively, in the CEMR. The overall prevalence of diabetes along with age and gender distribution was similar in the CEMR and the NHANES: overall prevalence, 10.1% and 9.7%; male, 11.5% and 10.8%; female, 9.1% and 8.8%; age 20 to 40 years, 2.5% and 1.8%; and age 40 to 60 years, 9.4% and 11.1%, respectively. The prevalence of obesity was similar: 42.1% and 39.6%, with similar age and female distribution (41.5% and 41.1%) but different male distribution (42.7% and 37.9%). The overall prevalence of high cholesterol along with age and female distribution was similar in the CEMR and the NHANES: overall prevalence, 12.4% and 12.4%; and female, 14.8% and 13.2%, respectively. The overall prevalence of hypertension was significantly higher in the CEMR (33.5%) than in the NHANES (95% CI: 27.0%-31.0%).ConclusionsThe distribution of major cardiometabolic diseases in the CEMR is comparable with the national survey results. The CEMR represents the general US population well in terms of office visits and major chronic conditions, whereas the potential subgroup differences in terms of age and gender distribution and prevalence may differ and, therefore, should be carefully taken care of in future studies.

DYSLIPIDEMIA AMONG THE ELDERLY IN SLUMS OF WEST DELHI

Objective: The objective of this study is to assess the prevalence of dyslipidemia among the elderly in slums of West Delhi.Methods: A cross-sectional study was carried out in slums of West Delhi covering a total of 234 elderly aged 60 and above. 5 ml blood was collected from 103 elderly and was analyzed for serum total cholesterol, triglyceride, high-density lipoprotein (HDL) cholesterol, and low-density lipoprotein (LDL) cholesterol by enzymatic method using fully automatic analyzer (Roche Hitachi-902). Dyslipidemia was defined using the National Cholesterol Education Program, ATP-III guidelines.Results: The overall prevalence of high cholesterol (≥200 mg/dl), high triglyceride (≥150 mg/dl), low HDL cholesterol (male - &lt;40 mg/dl; female - &lt;50 mg/dl), and high LDL cholesterol (≥130 mg/dl) was 20.39%, 45.63%, 64.08%, and 17.31%, respectively.Conclusion: Low HDL cholesterol and high triglyceride were the most form of dyslipidemia among the elderly. Awareness on dietary and lifestyle modification for management of dyslipidemia needs to be imparted.

Sarcopenic obesity and health outcomes in patients seeking weight loss treatment

To investigate the prevalence of sarcopenic obesity (SO) and its association with health outcomes in patients seeking weight loss treatment from a bariatric center. In this retrospective study, patients [≥18 years old, body mass index (BMI) ≥30kg/m2] from the Tallahassee Memorial Bariatric Center and with baseline body composition assessment by bioelectrical impedance analysis were included. Fat mass index (FMI=fat mass/height2) and fat-free mass index (FFMI=fat free mass/height2) were calculated. SO was defined by a FMI/FFMI ratio greater than the 95 percentile of sex, BMI and ethnicity specific population-representative references. Medical records were reviewed for biochemical and comorbidity measures. One hundred and forty-four patients (∼69% females, mean age 55.6 years, mean BMI 46.6kg/m2) were included. Patients' FMI/FFMI ratios ranged from 0.35 to 1.60kg/m2 across body weight spectrum, with 51% having SO. Blood pressure, fasting glucose, triglycerides, HDL or LDL were not different between patients with and without SO. However, the prevalence of high cholesterol, asthma, alcoholism and hernia were higher in patients with SO. SO was the strongest univariate predictor of high cholesterol (OR=2.08, 95% CI 1.07-4.04) and asthma (OR=2.77, 95% CI=1.12-6.83). SO was prevalent and associated with adverse health outcomes, beyond that captured by anthropometric measures in the present study.

Self-Reported High-Cholesterol Prevalence in the Brazilian Population: Analysis of the 2013 National Health Survey.

BackgroundData on the prevalence of dyslipidemia in Brazil are scarce, with surveys available only for some towns.ObjectiveTo evaluate the prevalence of the self-reported medical diagnosis of high cholesterol in the Brazilian adult population by use of the 2013 National Health Survey data.MethodsDescriptive study assessing the 2013 National Health Survey data, a household-based epidemiological survey with a nationally representative sample and self-reported information. The sample consisted of 60,202 individuals who reported a medical diagnosis of dyslipidemia. The point prevalence and 95% confidence interval (95%CI) for the medical diagnosis of high cholesterol/triglyceride by gender, age, race/ethnicity, geographic region and educational level were calculated. Adjusted odds ratio was calculated.ResultsOf the 60,202 participants, 14.3% (95%CI=13.7-14.8) never had their cholesterol or triglyceride levels tested, but a higher frequency of women, white individuals, elderly and those with higher educational level had their cholesterol levels tested within the last year. The prevalence of the medical diagnosis of high cholesterol was 12.5% (9.7% in men and 15.1% in women), and women had 60% higher probability of a diagnosis of high cholesterol than men. The frequency of the medical diagnosis of high cholesterol increased up to the age of 59 years, being higher in white individuals or those of Asian heritage, in those with higher educational level and in residents of the Southern and Southeastern regions.ConclusionThe importance of dyslipidemia awareness in the present Brazilian epidemiological context must be emphasized to guide actions to control and prevent coronary heart disease, the leading cause of death in Brazil and worldwide.

Trends in major risk factors for cardiovascular disease among adults in the Mississippi Delta region, Mississippi Behavioral Risk Factor Surveillance System, 2001-2010.

IntroductionThe prevalences of major modifiable risk factors for cardiovascular disease (CVD) are disproportionately high in the 18-county Mississippi Delta region, and many of these risk factors disproportionately affect blacks. Temporal trends in the prevalence of CVD risk factors in the Mississippi Delta have not been determined. We examined trends in CVD risk factors from 2001 to 2010 in the region.MethodsLongitudinal trends in prevalence of high blood pressure, high cholesterol, diabetes, obesity, physical inactivity, and current smoking were investigated using self-reported data from the Behavioral Risk Factor Surveillance System. Joinpoint regression models were used to examine annual percentage change (APC) in the prevalence of these risk factors.ResultsOverall, from 2001 to 2010, we observed significant increases in the prevalence of high cholesterol (APC, 4.22%), obesity (APC, 3.65%), and diabetes (APC, 3.54%). Among blacks, we found significant increases in the prevalence of high cholesterol (APC, 3.41%), obesity (APC, 3.48%), and diabetes (APC, 4.96%). Among whites, we found significant increases in high blood pressure (APC, 2.18%), high cholesterol (APC, 4.78%), obesity (APC, 4.18%), and physical inactivity (APC, 3.06%). We also observed a significant decrease in smoking among whites (APC, −1.99%).ConclusionFrom 2001 to 2010, we found a significant increase in the prevalence of high cholesterol, diabetes, and obesity in the Mississippi Delta. We also observed racial differences in those prevalences.

Lipid levels in the second year of life among HIV-infected and HIV-exposed uninfected Latin American children

Dyslipidemia is observed among older children and adults with HIV. We examined nonfasting cholesterol and triglycerides in two groups of 12-23-month-old Latin American children - HIV-infected vs. HIV-exposed but uninfected (HEU). HIV-infected and HEU children in Latin America and Jamaica were enrolled in an observational cohort. Eligibility for this analysis required having cholesterol and triglyceride results available during the second year of life. HIV-infected (n = 83) children were slightly older at the time of lipid testing than the HEU (n = 681). Forty percent of the HIV-infected children were on protease inhibitor-based antiretroviral therapy (ART); 41% were not on ART. There was no statistically significant difference in mean cholesterol concentrations (mg/dl) by HIV status; however, the HIV-infected children had higher mean triglyceride concentrations. The prevalence of high cholesterol (>200 mg/dl) and high triglycerides (>110 mg/dl) was higher among the HIV-infected vs. HEU. Among the HIV-infected children, mean cholesterol and triglyceride concentrations varied by ART. Children receiving no ART had a significantly lower mean cholesterol concentration. Those receiving protease inhibitor-containing ART had a significantly higher mean triglyceride concentration compared to the other two antiretroviral regimen groups. A greater proportion of HIV-infected children at 12-23 months have hyperlipidemia when compared to HEU children, with the highest triglyceride concentrations observed among those receiving protease inhibitor-containing ART, and the lowest cholesterol levels among those not receiving ART. Implications of these findings will require continued follow-up of HIV-infected children who initiate therapy early in life.

Recent Advances in Preventive Cardiology and Lifestyle Medicine

Multifactorial risk factor modification and control, especially interventions designed to reduce total cholesterol, systolic blood pressure, smoking prevalence, overweight/obesity, diabetes mellitus, and physical inactivity, can have a profound and favorable impact on decreasing the incidence of initial and recurrent cardiovascular events. Between 1980 and 2000, mortality rates from coronary heart disease (CHD) fell by >40%. Using a previously validated statistical model (IMPACT), researchers attempted to determine how much of this decrease could be explained by the use of medical and surgical treatments as opposed to changes in risk factors among US adults aged 25 to 84 years. Approximately half of the decline in cardiovascular deaths was attributed to reductions in major risk factors (obesity and diabetes mellitus were notable exceptions), and approximately half was attributed to evidence-based medical therapies (eg, secondary prevention medications, rehabilitation, and initial treatments for acute myocardial infarction [AMI]).1 In contrast, emergent and elective revascularization accounted for only 7% of the overall decline in deaths from CHD. Recently, similar results were reported in a Canadian study that evaluated the decrease in CHD mortality between 1994 and 2005.2 Over the past decade, mortality rates from CHD and stroke in the United States decreased by >25% (Figure 1).3 Although there were also impressive reductions in the prevalence of uncontrolled high blood pressure, elevated blood cholesterol, and, to a lesser extent, cigarette smoking, there was only limited impact on other risk factors, including increases in the prevalence of obesity and diabetes mellitus, and a small reduction in those not engaged in moderate or vigorous physical activity.3 These indicators represent major challenges to achieving future goals for cardiovascular health promotion and disease reduction. Figure 1. Mortality rates from coronary heart disease and stroke, rate of uncontrolled blood pressure, and prevalence of high cholesterol from 2004 to 2008. Reproduced …

Beyond Established and Novel Risk Factors

Dyslipidemia, hypertension, and diabetes mellitus have been appropriately highlighted as established predictors of cardiovascular disease. These risk factors have become preeminent targets for influencing cardiovascular risk; their assessment, treatment, and monitoring are major emphases of clinical care, research investigation, treatment guidelines, organization position papers, and measures of physician and hospital performance. Notably, lifestyle risk factors, including dietary habits, physical inactivity, smoking, and adiposity, strongly influence the established cardiovascular risk factors and also affect novel pathways of risk such as inflammation/oxidative stress, endothelial function, thrombosis/coagulation, and arrhythmia. Furthermore, modest alterations of these lifestyle risk factors are achievable and have substantial effects on cardiovascular risk. Thus, basic lifestyle habits should be considered fundamental risk factors for cardiovascular disease. Although efforts to combat established and novel risk factors with pharmacological treatments are important and should continue, we call for a systematic rebalancing of current research, clinical care, and policy efforts to focus more on lifestyle. The rising costs of healthcare and the epidemics of overweight and obesity highlight the inadequacies of our current strategy. Substantially more resources should be directed toward research on lifestyle risk factors, their determinants, and effective interventions to change them. The clinical evaluation and treatment of dietary, physical activity, and smoking habits must become as routine and familiar as assessment of blood pressure, cholesterol, and glucose levels. Major policy initiatives and reimbursement guidelines must also be rebalanced to emphasize lifestyle risk factors. Cardiovascular diseases are leading causes of death and disability among men and women in nearly all nations.1 Identification of persons at higher or lower risk for cardiovascular events is important to facilitate effective use of resources and interventions to reduce disease burden among individuals and in society. Each of the established risk factors for cardiovascular disease—age, gender, dyslipidemia, hypertension, diabetes mellitus, and smoking—have been appropriately highlighted …

Socioeconomic Status and Trends in Disparities in 4 Major Risk Factors for Cardiovascular Disease Among US Adults, 1971-2002

It is unknown whether the previously recognized disparities in cardiovascular disease (CVD) risk factors related to annual income and educational level have diminished, persisted, or worsened in recent decades. The objective of this study was to examine 31-year trends in CVD risk factors by annual income and educational levels among US adults. Four cross-sectional national surveys were used: National Health and Nutrition Examination Survey I (1971-1974), II (1976-1980), III (1988-1994), and 1999-2002. The main outcome measure was prevalence of high cholesterol (> or =240 mg/dL [> or =6.2 mmol/L]), high blood pressure (140/90 mm Hg), smoking, and diabetes mellitus. Between 1971 and 2002, the prevalence of all CVD risk factors, except diabetes, decreased in all income and education groups, but there has been little reduction in income- and education-related disparities in CVD risk factors and few improvements during the past 10 years. The prevalence of high blood pressure declined by about half in all income and education groups, ranging from 30.3% to 40.6% in 1971-1974 and 16.4% in 1999-2002, with the greatest reduction among those in the lowest income quartile and those with less than a high school education (18.0 and 15.9 percentage points, respectively). High cholesterol prevalence also declined in all groups and ranged from 28.8% to 32.4% in 1971-1974 and 15.3% to 22.0% in 1999-2002, with the largest decline (15.9 percentage points) among people with the highest incomes. Education- and income-related disparities in smoking widened considerably, because there were large declines in smoking prevalence among people with high incomes and education (from about 33% in 1971-1974 to about 14%-17% in 1999-2002) but only marginal reductions among those with low incomes and education (about 6-percentage point decline). Diabetes prevalence increased most among persons with low incomes and education. Despite the general success in reducing CVD risk factors in the US population, not all segments of society are benefiting equally and improvements may have slowed. Education- and income-related disparities have worsened for smoking, and increases in diabetes prevalence have occurred primarily among persons with a lower socioeconomic status. Diabetes prevention and smoking prevention and cessation programs need to specifically target persons of lower income and education.