Prevalence Of Individual Risk Factors Research Articles

Unveiling Cardiovascular Risk Factors in Diagnosed and Undiagnosed among Rural Population: a Prospective Observational Study

Background: Cardiovascular disease is a leading cause of morbidity and mortality worldwide. It is caused by a combination of genetic, environmental, and lifestyle factors.Several risk factors contribute to the higher prevalence of CVD in rural areas. Objective: The objective of this study was to determine prevalence of individual risk factors among undiagnosed and diagnosed patients with cardiovascular diseases. Materials and methods: A prospective observational study was carried out among the rural areas of pathanamthitta district. The sample size of the study was 500 individuals. The study period ranged from 6 months. The data was collected using a semi structured questionnaire and various instruments to evaluate risk factors including diabetes mellitus, blood pressure and BMI were used. Results: Of the total population of 500 individuals,22.4% of the total subjects were diagnosed with cardiovascular disease, and about 77.6% of the subjects were not diagnosed with cardiovascular disease. The prevalence of individual risk factors for the diagnosed population were higher than that of the undiagnosed population, although 27.5% of the undiagnosed population were found to have high risk for developing cardiovascular disease. Conclusion:The prevalence of social habits such as smoking, alcoholism and tobacco consumption is a contributing factor to cardiovascular disease. Lifestyle diseases such as hypertension, diabetes mellitus, and dyslipidemia are prevalent in causing cardiovascular disease. Among the individuals not diagnosed with cardiovascular disease, one third of the population were having high risk of developing CVD

Role of Platelet Indices for Cardiovascular Risk Assessment in Premenopausal Females with Metabolic Syndrome

Objectives: The study aimed to estimate platelet indices in premenopausal females with metabolic syndrome (MetS) and the prevalence of individual risk factors of MetS and their association with platelet indices. Materials and Methods: It was a hospital-based, cross-sectional, and observational study conducted for a period of 3 months with the 130 premenopausal females with MetS. The collected data comprised clinical profile, hematological parameters, fasting blood glucose (FBG), serum creatinine, and lipid profile and were subjected to statistical analysis with P < 0.05 as level of significance. Results: The mean age of the participants was 39.95 ± 3.44 years. Substance abuse of tobacco and alcohol was present in 9.23% and 5.37% of participants. Salt intake more than 5 g/day was confirmed by majority (86.15%). Waist circumference >80 centimeters (cm) was noted in 64.61% of participants. Body mass index in range of 25–29.9 kilograms (kg)/m2 and 30–40 kg/m2 was observed in 36.92% and 60.77%, respectively. Diabetes mellitus (DM) and hypertension (HTN) had prevalence of 86.92% and 30% of participants, respectively. FBG ≥100 mg/dL was observed in 43.84% participants. The participants with DM, HTN, and hyperlipidemia showed the highest mean platelet volume (MPV) value. Patients with glycosylated hemoglobin (HbA1C) >6.5% exhibited statistically significantly higher values of platelet distribution width, MPV, and platelet–large cell ratio. Platelet indices exhibited significant positive correlation with HbA1C, FBG, total cholesterol, triglyceride, and negative correlation with high-density lipoprotein. Conclusion: The present study highlighted the high prevalence of components associated with MetS, notably hyperglycemia, HTN, and obesity. The study also elucidated the substantial impact of DM, HTN, and hyperlipidemia on platelet indices.

Categorising Demand for Child Welfare Services Using Latent Class Analysis: A Study of the National Data-sets on Children in Need in England

Abstract In England, administrative data on children’s needs are recorded following a social work assessment. These data are typically used to understand prevalence of individual risk factors and to inform processes, such as the work of local safeguarding partners and multi-agency services. However, reporting individual factors at assessment cannot capture the complexity and heterogeneity of multiple and overlapping needs. This study aimed to identify common types of demand, via a limited number of clusters, using the factors recorded in a national data-set of over 4.2 million assessments carried out between 2014 and 2021, of which 3.6 million had at least one factor recorded. Latent class analysis was used to identify twelve distinct categories of demand for children’s social care services, which were consistent across local authorities. Conditional probabilities were used to interpret the demand represented by each category, in consultation with stakeholders. The most prevalent category was domestic abuse and violence (19.7 per cent), followed by complexities around parental mental health (18.4 per cent). Other categories included disability, child mental health, risks outside the home, complex domestic abuse and concerns about another person in the family or household. This article examines some of the operational and planning implications of categorising demand in this way.

Race-related population attributable fraction of preventable risk factors of dementia: A Latino population-based study.

Risk factors for dementia have distinct frequency and impact in relation to race. Our aim was to identify differences in modifiable risk factors of dementia related to races and estimate their population attributable fraction (PAF). An epidemiological cohort was used to estimate the prevalence of 10 modifiable risk factors for dementia among five races-White, Black, Brown, Asian, and Indigenous. Sample weighting was used to estimate the prevalence and PAF of each risk factor in each race. A total of 9070 individuals were included. Overall adjusted PAF was the lowest in Indigenous (38.9%), and Asian individuals (41.2%). Race-related prevalence of individual risk factors was widely variable in our population, but hearing loss was the most important contributor to the overall PAF in all races. Public policies aiming to reduce preventable risk factors for dementia should take into consideration the race of the target populations. Preventable risk factors for dementia vary according to race.Hearing loss presented the highest prevalence among all races studied.Indigenous and Asian individuals presented the lowest population attributable fractions.Black and Brown individuals were more vulnerable to social determinants.

Clustered cardiovascular disease risk among children aged 8–13 years from lower socioeconomic schools in Gqeberha, South Africa

ObjectivesTo determine the prevalence of individual cardiovascular disease (CVD) risk factors and clustered CVD risk among children attending schools in periurban areas of Gqeberha and to investigate the independent association...

Prevalence of multiple risk factors for poor outcomes associated with COVID-19 among an elderly Australian population.

Increasing age, male sex and various chronic conditions have been identified as important risk factors for poor outcomes from COVID-19. The aim of this study was to examine the prevalence of risk factors for poor outcomes due to COVID-19 infection in an older population. The proportion of the population with one or more risk factors and the prevalence of individual risk factors and multiple risk factors were calculated among Department of Veterans' Affairs (DVA)clients aged ≥70 years. There were 103,422 DVA clients included. Of these, 79% in the community and 82% in residential aged care had at least one risk factor for poor outcomes from COVID-19. Hypertension was most prevalent, followed by chronic heart and airways disease. Over half had ≥2 risk factors, and one in five had ≥3 risk factors across multiple body systems. A substantial proportion of older Australians are at risk of poor outcomes from COVID-19 because of their multimorbid risk profile. These patients should be prioritised for proactive monitoring to avoid unintentional harm due to potential omission of care during the pandemic.

Modifiable Risk Factors in Young Adults With First Myocardial Infarction

BackgroundModifiable risk factors (RFs) play an important role in the development and prognosis of acute myocardial infarction (AMI). ObjectivesThis study sought to study the prevalence rates of modifiable RFs during a first AMI, sex/race differences, and temporal trends in U.S. young adults. MethodsThis was a retrospective cohort analysis of the U.S. National Inpatient Sample years 2005 and 2015 to identify adults 18 to 59 years of age hospitalized for a first AMI. Prevalence rates, race and sex differences, and temporal trends of hypertension, diabetes mellitus, obesity, smoking, dyslipidemia, and drug abuse were analyzed in these patients. ResultsThe authors’ study included 1,462,168 young adults with a first AMI (mean age 50 ± 7 years, 71.5% men, 58.3% white) of whom 19.2% were 18 to 44 years of age, and 80.8% were 45 to 59 years of age. In the 18- to 44-year group, smoking (56.8%), dyslipidemia (51.7%), and hypertension (49.8%) were most prevalent, and 90.3% of patients had at least 1 RF. In the 45- to 59-year group, hypertension (59.8%), dyslipidemia (57.5%), and smoking (51.9%) were most prevalent, and 92% patients had at least 1 RF. Significant sex and racial disparities were observed in the prevalence of individual RFs. Women had a higher prevalence of diabetes mellitus, hypertension, and obesity, and men had a higher prevalence of dyslipidemia, drug abuse, and smoking. The prevalence of all these RFs increased temporally except for the rate of dyslipidemia, which decreased more recently. Trends were generally consistent across sex and racial groups. ConclusionsDuring a first AMI in young adults in whom preventive measures are more likely to be effective, modifiable RFs were highly prevalent and progressively increased over time. Significant sex and racial disparities were observed for individual RFs.

Risk factors for osteoporosis in men aged 40 years or older: the results of the program «Osteoscreening-Russia»

Objective:to estimate the prevalence of individual risk factors (RFs) for osteoporosis (OP) and fractures, the frequency of high-risk osteoporotic fractures by the Fracture Risk Assessment Tool (FRAXR) and OP according to distal forearm X-ray densitometric findings in men aged 50 years or older in different regions of Russia.Patients and methods.Random cluster proportionally stratified samples of men aged 40 years or older were formed in the district polyclinics of 23 towns of the country with over 100,000 people in the framework of the social program «Osteoscreening-Russia» (OSR). The survey was conducted using a unified questionnaire. Screening also involved a densitometric study of distal forearm bone mineral density using a peripheral X-ray osteodensitometer (Osteometer Meditech DTX-200). The final analysis included 5057 men from 14 towns of 5 federal districts (FDs) of Russia.Results.Estimation of the prevalence of individual RFs for osteoporotic fractures in men aged 40 years or older showed that the most common RFs were insufficient dietary calcium intake (91%), smoking (30%), low-energy fractures in the history (20%), low physical activity (16%), and secondary causes of OP (11%). The men in the Ural FD (UFD), Siberian FD, and Central FD were more frequently found to have ≥3 RFs. 5% of men aged 50 years or older were at high risk for osteoporotic fractures by FRAXR, whereas the frequency of OP according to peripheral densitometric findings was 19%. The inhabitants of the North-Western FD and UFD had the greatest need for medical and preventive measures, which was identified by the FRAXR algorithm.Conclusion.The OSR survey could reveal the most common clinical RFs for OP and osteoporotic fractures in men in 5 regions of the Russian Federation, insufficient dietary calcium intake and assess the risk of osteoporotic fractures and the rate of OP according to peripheral densitometric findings.

Twenty-year trends in cardiovascular risk among men and women in the United States.

Relative to men, women have experienced slower improvement in mortality in the US in recent decades. We investigated 20-year trends in cardiovascular risk for men and women age 40 and over in the US to determine whether there was differential change in risk for men and women. Using the National Health and Nutrition Examination Survey (NHANES), we estimated total cardiovascular risk, the prevalence of individual risk factors, and potential factors contributing to change in risk. Men showed steady reductions in cardiovascular risk over the 20years; women experienced increased risk from 1990 to 2000, but decreased risk from 2000 to 2010. Sex differences in cardiovascular risk changed so that there was no significant difference by sex at any age over 50 in 2010. Large decreases in the prevalence of high risk lipids were important causes of reduction in risks for both sexes; changes in blood pressure were less important, except for women in the 2000-2010 period when they equaled the effect of changing lipids. Increasing medication usage and effectiveness drove improvements in blood pressure and total cholesterol for both sexes. In 2010 there was no difference between men and women in the use of antihypertensives or cholesterol-lowering medications. Metabolic risk, as indexed by obesity and HbA1c, increased over time and went against the trend in the summary measure. Diabetes, smoking, and hormone therapy use did not explain changes in high blood pressure or high total cholesterol for either gender. Recent decreases in cardiovascular risk may lead to future reduction in cardiovascular events and mortality among both women and men.

Prevalence of risk factors for breast cancer in women aged 30 years and above in Mumbai

Background: Even though there is an increasing trend of breast cancer, women still do not perceive themselves at risk. Poor awareness about the disease and its risk factors and the absence of population based screening contribute to delayed diagnosis. The objective of the study was to assess the prevalence of various risk factors for breast cancer in women aged 30 years and above. Methods: The cross-sectional study using convenience sampling of all women aged 30 years and above was conducted in Mumbai. Of the 2430 women enumerated in the study area, 1158 women participated in the study. Risk factors for breast cancer assessed included age at menarche; age at first child birth; breastfeeding; use of oral contraceptive pills, age of menopause, first degree relatives with history of breast cancer, history of current and past breast cancer; history of any previous breast related abnormalities. Results: 15.5% of the women had atleast one risk factor for breast cancer. The prevalence of individual risk factors was below 6%. Conclusions: Prevalence of the risk factors for breast cancer is not very high, but never the less, the increasing trend of breast cancer in the country makes it imperative to introduce population based screening for all women with or without risk factor.

Risk factors of the occurrence and progression of autoimmune thyroid diseases: a systematic analysis of the data over the last 10-year

The thyroid gland is the most acceptable organ for autoimmune processes due to the negative effects of exogenous and endogenous factors on the background of genetic predisposition. A multifaceted study of the risk factors of the occurrence and progression of autoimmune thyroid diseases (AITD) will prevent the rapid manifestation of this pathology in patients with problematic heredity background.The objective: to conduct a systematic analysis of available literature sources for the study of the risk factors of the occurrence and progres sion of AITD.Materials and methods. Clinical trials were found on the JAMA, Scholar, NCBI, Cochrane Library and PubMed databases for the 2007 2017 for keywords related to the risk factors and AITD without regard to their design.Results. The analyze of 83 articles in which the risk factors for the occurrence of AITD were studied. During the last 10-years, more attention was paid to the study of such factors as a genetic, microelements and vitamins, as well as associations with viral and systemic autoimmune diseases and their treatment. Frequency and prevalence of individual risk factors for AITD varies widely enough, depending on the design of the study and the number of subjects surveyed. In most cases, AITDs were associated with heredity, especially in the two following generations (>77%), vitamin D deficiency (>70% of patients), atrophic gastritis (>75% of cases), changes of the intestine microbiocynosis (>60%). Less important were factors such as iodine deficiency (14,5%), selenium (3,4%), tobacco smoking (15,4%), ionizing radiation (from 8,2% in the first generation to 45,5% in III generations), viral diseases and their treatment.Conclusions. Despite the large number of studies, the issue of the impact of risk factors of the occurrence and progression of AITD still remains poorly understood.

Prevalence of Risk Factors for Coronary Artery Disease in Southern Punjab, Pakistan

Purpose: To explore the prevalence of risk factors for coronary artery disease (CAD) in Southern Punjab, Pakistan. Methods: A cross-sectional survey was conducted for the prevalence of risk factors for CAD among 200 patients admitted at the different hospitals of Southern Punjab, Pakistan from December 2012 to April 2013. A questionnaire was used to collect data, including demographic information, family health history, dietary habits, physical activity and tobacco use. History of hypertension, diabetes mellitus (DM) or its treatment was recorded after observing their medical reports. Results: The proportion of females and males was 65.53 and 34.46 %, respectively. Of the 200 patients, the mean age of males was 52.7 years and 55.8 years for females. The most prevalent coronary artery risk factors were physical inactivity (52.5 %), hypertension (52 %), poor dietary habits (48.5 %), fatty food consumption (47.5 %), obesity (38 %) and smoking (37 %), respectively. Other less common risk factors were diabetes (30 %) and family history of CAD (20 %). Conclusion: CAD was seen in only 20 % of the subjects; the prevalence of individual risk factors ranged from 30 to 52.5 % and can be improved by encouraging the patients to adopt a healthy life style. Keywords: Risk factors, Prevalence, Coronary artery disease, Diabetes, Southern Punjab

The Prevalence of Metabolic Syndrome Among Soldiers of the Military Police of Bahia State, Brazil

The mortality rate of men is generally higher than that of women, irrespective of the age group. Currently, a key concern for health care professionals is the prevalence of risk factors associated with cardiovascular disease and metabolic syndrome. This study aimed at assessing the prevalence of individual risk factors for cardiovascular disease as well as the prevalence of metabolic syndrome among men serving in the Military Police Corps of the state of Bahia, Brazil. This service employs mostly men, and they are known to experience high levels of occupational stress and professional victimization. We conducted a cross-sectional study among military police soldiers (n = 452) who were candidates for a military police training course in Bahia, Brazil. All candidates who attended the selection process were evaluated according to the criteria of the National Cholesterol Education Program's Adult Panel III in order to assess the presence of medical disorders that could contribute to cardiovascular disease and metabolic syndrome. The authors identified a high prevalence of hypertension (55.76%), hypertriglyceridemia (50.85%), waist circumference of >102 cm (31.76%), low high-density lipoprotein cholesterol levels (30.46%), and impaired fasting glucose (28.15%) in our subjects. The overall prevalence of metabolic syndrome was 38.54%. The authors suggest that measures should be taken to ensure that military policemen receive continued medical care, both in their professional capacity and in their personal circumstances, and that attention be focused on intervention programs.

Women living in deprived neighbourhoods receive less perinatal care compared to women from population-matched non-deprived areas in The Netherlands

Background Pregnant women in deprived neighbourhoods experience more adverse perinatal and maternal outcomes. Higher prevalence of individual risk factors and environmental risks are at the base. Inequalities in health care provision may increase rather than reduce this disadvantage at onset. We investigated the presence of adverse perinatal health care inequalities according to neigh-bourhood deprivation. Methods A subset of care indicators was selected to judge relative undertreatment. These indicators covered different stages …

Clustering of Risk Factors for Noncommunicable Diseases in Brazilian Adolescents: Prevalence and Correlates

Few studies have investigated the prevalence and correlates of risk factors for noncommunicable diseases among Brazilian adolescents. We evaluated the clustering of risk factors and their associations with sociodemographic variables. We used a cross-sectional study carried out in 2011 comprising 1132 students aged 14-19 years from Santa Maria, Brazil. The cluster index was created as the sum of the risk factors. For the correlates analysis, a multinomial logistic regression was used. Furthermore, the observed/expected ratio was calculated. Prevalence of individual risk factors studied was as follows: 85.8% unhealthy diets, 53.5% physical inactivity, 31.3% elevated blood pressure, 23.9% overweight, 22.3% excessive drinking alcohol, and 8.6% smoking. Only 2.8% of the adolescents did not present any risk factor, while 21.7%, 40.9%, 23.1%, and 11.5% presented 1, 2, 3, and 4 or more risk factors, respectively. The most prevalent combination was between unhealthy diets and physical inactivity (observed/expected ratio =1.32; 95% CI: 1.16-1.49). Clustering of risk factors was directly associated with age and inversely associated with socioeconomic status. Clustering of risk factors for noncommunicable diseases is high in Brazilian adolescents. Preventive strategies are more likely to be successful if focusing on multiple risk factors, instead of a single one.

Cardiovascular risk in a first-episode psychosis sample: A ‘critical period’ for prevention?

ObjectiveStudies in first episode psychosis samples about status of cardiovascular risk factors have shown discordant results. We aimed to determine the 10-year risk of developing coronary heart disease in a sample of first episode psychosis patients referred to an early intervention clinic and compared the same with age, gender, and race matched controls from the U.S. National Health and Nutrition Examination Survey (NHANES). MethodWe conducted a cross-sectional analysis of baseline data of 56 subjects enrolled in first episode psychosis clinic from April 2006 to January 2010. This sample was compared with age, gender, and race matched 145 individuals drawn from NHANES 2005–2006 database. Sociodemographic and clinical variables were collected. Physical examination including laboratory evaluation was used to screen for common medical illnesses. The 10-year risk of developing coronary heart disease was calculated by using a tool developed by the National Cholesterol Education Program (NCEP-ATP III). ResultsThere were elevated rates of smoking (46%) and hypertension (11%) albeit statistically significant differences from the control could not be demonstrated for these measures or weight, body mass index, or total or HDL cholesterol, fasting plasma glucose, status of diabetes and impaired fasting plasma glucose, HbA1C level. The 10-year median (range) risk of developing coronary heart disease in patients and controls was 1 (0–5)% and 0 (0–9)% respectively. The difference was not statistically significant. ConclusionsFirst episode psychosis patients do not present with significantly higher cardiovascular risk than age and race-matched controls despite clinically significant prevalence of individual risk factors. This sample presents an opportunity for early intervention for the primary prevention of cardiovascular morbidity and mortality.

Treatment of acute lymphoblastic leukaemia in countries with limited resources; lessons from use of a single protocol in India over a twenty year peroid

In the 1970s, survival rates after treatment for acute lymphoblastic leukaemia (ALL) in children and young adults (less than 25 years) in India were poor, even in specialised cancer centres. The introduction of a standard treatment protocol (MCP841) and improvements in supportive care in three major cancer centres in India led to an increase in the event-free survival rate (EFS) from less than 20% to 45–60% at 4 years. Results of treatment with protocol MCP841 between 1984 and 1990 have been published and are briefly reviewed here. In addition, previously unpublished data from 1048 patients treated between 1990 and 1997 are reported. Significant differences in both patient populations and treatment outcome were noted among the centres. In one centre, a sufficiently large number of patients were treated each year to perform an analysis of patient characteristics and outcome over time. Although steady improvement in outcome was observed, differences in the patient populations in the time periods examined were also noted. Remarkably, prognostic factors common to all three centres could not be defined. Total white blood cell count (WBC) was the only statistically significant risk factor identified in multivariate analyses in two of the centres. Age is strongly associated with outcome in Western series, but was not a risk factor for EFS in any of the centres. Comparison of patient characteristics with published series from Western nations indicated that patients from all three Indian centres had more extensive disease at presentation, as measured by WBC, lymphadenopathy and organomegaly. The proportions of ALLs with precursor T-cell immunophenotypes, particularly in Chennai, were also increased, even when differences in the age distribution were taken into consideration (in <18-year olds, the range was 21.1–42.7%), and in molecular analyses performed on leukaemic cells from over 250 patients less than 21-years-old with precursor B-cell ALL, a lower frequency of TEL-AML1-positive ALL cases than reported in Western series was observed. The worse outcome of treatment in Indian patients compared with recent Western series was probably due to the higher rate of toxic deaths in the Indian patients, and possibly also due to their more extensive disease – which is, at least partly, a consequence of delay in diagnosis. Differences in the spectrum of molecular subtypes may also have played a role. The higher toxic death rates observed are likely to have arisen from a combination of more extensive disease at diagnosis, co-morbidities (e.g., intercurrent infections), differences in the level of hygiene achievable in the average home, poor access to acute care, and more limited supportive care facilities in Indian hospitals. Toxic death was not associated with WBC at presentation, and hence would tend to obscure the importance of this, and, potentially, other risk factors, as prognostic indicators. Since the prevalence of individual risk factors varies in different populations and over time, their relative importance would also be expected to vary in different centres and in different time periods. This was, in fact, observed. These findings have important implications for the treatment of ALL in countries of low socioeconomic status; it cannot be assumed that risk factors defined in Western populations are equally appropriate for patient assignment to risk-adapted therapy groups in less affluent countries. They also demonstrate that heterogeneity in patient populations and resources can result in significant differences in outcome, even when the same treatment protocol is used. This is often overlooked when comparing published patient series.

Effects of Walking Exercise on Metabolic Syndrome Risk Factors and Body Composition in Obese Middle School Girls

This study was done to determine the effects of walking exercise training(WET) on metabolic syndrome risk factors and body composition in obese middle school girls. A non-equivalent pretest-posttest experimental design was used. Twenty seven subjects participated in this study from one women's middle school in Busan. The participants were purposely allocated to an experimental group (n=14) and a control group (n=13). The experimental group participated in 30-60 minutes of WET with 55 to 75% of a maximal heart rate six days a week for 12 weeks. The prevalence of individual risk factors on metabolic syndrome were improved in the experimental group after the intervention. The high waist circumference(WC), high triglyceride(TG), low high density lipoprotein cholesterol(HDL-C), high blood pressure(BP) and high fasting glucose(FG) were 21.4, 21.4, 14.3, 28.6 and 7.2%, respectively. There were significant differences in WC (F=22.24, p<.001), TG (F=5.34, p=0.30), body weight(F=21.99, p<.001), fat mass(F=19.17, p<.001), and % body fat(F=17.93, p<.001) between the experimental and control group after the intervention. However, there were no significant differences in HDL-C, FG and BP between the experimental and control group after the intervention. These results indicate that WET is effective in decreasing risk factors of the metabolic syndrome and body composition components in obese middle school girls. These findings suggest that WET can be useful as a nursing intervention in the prevention of obesity-related disorders in obese adolescents.

Hyperinsulinemia in polycystic ovary syndrome correlates with increased cardiovascular risk independent of obesity

Objective: To assess the role of insulin resistance, independent of obesity, in determining cardiovascular risk among women with the polycystic ovarian syndrome (PCOS). Design: Cross-sectional study examining the relationships between hyperinsulinemia, composite cardiovascular risk scores, and prevalence of individual risk factors among lean and obese women with PCOS and healthy controls. Setting: University-based tertiary care outpatient endocrinology clinic. Patient(s): 57 women with clinically defined PCOS and 45 unselected healthy age-matched controls. Intervention(s): Clinical and anthropomorphic measurements and laboratory determinations of insulin and lipid levels. Main Outcome Measure(s): Fasting serum insulin and a cardiovascular risk score. Results: Hyperinsulinemic women with PCOS carried more cardiovascular risk than their normoinsulinemic counterparts, who in turn had more risk than the control women ( P=.004 by analysis of covariance). In addition to the lipid changes expected with insulin resistance (high triglyceride and low HDL cholesterol levels), there was an excess of LDL cholesterol among the women with PCOS ( P=.006 by analysis of covariance). Across the range of body mass index, women with PCOS had greater insulin resistance than controls, suggesting that PCOS itself and body mass index both contribute to the observed insulin resistance. Conclusions: Our data support the hypothesis that insulin resistance in PCOS is a determinant of overall cardiovascular risk independent of obesity. The mechanism of this relationship remains uncertain and is the subject of ongoing research.

Cardiovascular risk factors in relation to educational level in 36 000 men and women in The Netherlands.

The study objective was to describe the associations between socioeconomic status and (concurrence of) cardiovascular risk factors. The Netherlands Monitoring Project on Cardiovascular Risk Factors is a screening project that was carried out from 1987-1991 in three cities. Cross-sectional data were obtained on educational level and on the prevalence of smoking, alcohol intake, physical inactivity, obesity, hypertension, hypercholesterolaemia and low HDL-cholesterol. A total of 36 000 men and women, aged 20-59 years participated. For all risk factors, except alcohol intake, a significant inverse association was found with educational level. Concurrence of risk factors was more prevalent in lower educated groups than in higher educated groups, but not more than can be expected under the condition of independence of the risk factors (no clustering). In conclusion, in the lower educated groups the prevalence of individual risk factors and of concurrence of risk factors was higher than in the higher educated groups. Concurrence of risk factors can have a synergistic effect on the risk for cardiovascular disease. Therefore socioeconomic differences in risk factors may explain a greater part of the socioeconomic differences in cardiovascular morbidity and mortality than is generally assumed.