Cardiovascular Disease Risk Prevention Research Articles

Assessing the relative importance of vitamin D deficiency in cardiovascular health.

Previous research has suggested a potential link between vitamin D (VD) deficiency and adverse cardiovascular health outcomes, although the findings have been inconsistent. This study investigates the association between VD deficiency and cardiovascular disease (CVD) within the context of established CVD risk factors. We utilized a Random Forest model to predict both CVD and VD deficiency risks, using a dataset of 1,078 observations from a rural Chinese population. Feature importance was evaluated using SHapley Additive exPlanations (SHAP) to discern the impact of various risk factors on the model's output. The results showed that the model for CVD prediction achieved a high accuracy of 87%, demonstrating robust performance across precision, recall, and F1 score metrics. Conversely, the VD deficiency prediction model exhibited suboptimal performance, with an accuracy of 52% and lower precision, recall, and F1 scores. Feature importance analysis indicated that traditional risk factors such as systolic blood pressure, diastolic blood pressure, age, body mass index, and waist-to-hip ratio significantly influenced CVD risk, collectively contributing to 70% of the model's predictive power. Although VD deficiency was associated with an increased risk of CVD, its importance in predicting CVD risk was notably low. Similarly, for VD deficiency prediction, CVD risk factors such as systolic blood pressure, glucose levels, diastolic blood pressure, and body mass index emerged as influential features. However, the overall predictive performance of the VD deficiency prediction model was weak (52%), indicating the absence of VD deficiency-related risk factors. Ablation experiments confirmed the relatively lower importance of VD deficiency in predicting CVD risk. Furthermore, the SHAP partial dependence plot revealed a nonlinear relationship between VD levels and CVD risk. In conclusion, while VD deficiency appears directly or indirectly associated with increased CVD risk, its relative importance within predictive models is considerably lower when compared to other risk factors. These findings suggest that VD deficiency may not warrant primary focus in CVD risk assessment and prevention strategies, however, further research is needed to explore the causal relationship between VD deficiency and CVD risk.

Trends and findings of lipoprotein(a) testing and associated cardiovascular disease profiles: a large single-center study from the Middle East-Gulf region.

Lipoprotein(a) [Lp(a)] is a genetically determined risk factor for atherosclerotic cardiovascular disease (CVD). Limited data are available on Lp(a) testing from the Middle-East region. Therefore, we aim to evaluate the utilization and yield of Lp(a) testing over time and characterize CVD profiles of patients with abnormal Lp(a) tasting at a single-quaternary-care center in the United Arab Emirates. Unique Lp(a) tests conducted between 07/2017 and 10-2023 were included. Overtime trends in Lp(a) test utilization and abnormal Lp(a) [defined as Lp(a) > 125 nmol/L] test findings were described. CVD rates in patients with abnormal Lp(a) were compared to those with Lp(a) ≤ 125 nmol/L using appropriate methods. In our center, 0.95% of the patients (n = 5,677) had their Lp(a) measured, with a median level of 32 [11-82] nmol/L. Lp(a) was abnormal in 15.9% of the tests. Over the years 2018-2022, there was a 109% increase in Lp(a) testing, with concomitant up-trends in findings of abnormal Lp(a) (11.8% to 16.4%, P = 0.02). Compared to patients with Lp(a) ≤ 125 nmol/I, those with abnormal Lp(a) had higher rates of any prevalent CVD (34% vs. 25.1%, P < 0.001), CAD (25.6% vs. 17.7%, P < 0.001), HF (6.5% vs. 3.8%, P < 0.001), and stroke (7.1% vs. 4.4%, P < 0.001). Almost one in six patients tested for Lp(a) had abnormally elevated Lp(a), and CVD was prevalent in one-third of the patients who tested abnormal for Lp(a). The study highlights the growing awareness of the relevance of Lp(a) for CVD risk stratification and prevention.

Abstract P365: Systematic Review of Self-Management Interventions for Black Women With Cardiovascular Risk Factors

Background: Cardiovascular disease (CVD) is the leading cause of death among Black women, and when compared to their non-Hispanic White counterparts, they are about 50% more likely to have uncontrolled high blood pressure (BP). The disproportionate burden of CVD in Black women highlights the need for CVD prevention programs in this population. The present systematic literature review assessed the efficacy of self-management interventions for Black women with CVD risk factors. Hypothesis: Self-management interventions that target more than one health practice, when administered to Black women with CVD risk factors, will decrease CVD risk and improve clinical outcomes. Methods: Searches were run on PubMed, Cochrane, CINAHL, and PsycINFO databases based on the following inclusion criteria: papers written from September 22, 2018; English language; US studies only; original research reports; prospective clinical trials; cardiovascular health promotion/self-management interventions that target at least two health practices (individual or group, in-person or remotely delivered, or person-person synchronous); primary prevention; comorbid conditions without a cardiovascular event; at least one patient level outcome (self-reported or biological); Black women at least 18 years of age only. Data extraction included participant demographics; intervention characteristics; self-management/health behavior domains; research design; and study outcomes. Results: Of the 1041 abstracts screened (262 duplicates removed), 87 full-text articles were screened, and 11 papers from 10 unique trials (N= 1,635) were chosen for inclusion. Intervention durations ranged from 5-weeks to 12-months, with a frequency of intervention dose ranging from daily contact to bi-weekly meetings. Of the 10 unique trials, the majority targeted physical activity (n=8), nutrition (n=5), weight loss (n=3), health knowledge (n=2), and BP control (n=2). Interventions were mostly offered in groups (n=9), and some included individual components (n=2). Nine of the eleven papers reported statistically significant improvements in CVD risk factors including weight loss (n=6), physical activity (n=2), BP control (n=2), waist circumference (n=1), and depression (n=1). Few papers (N=1) addressed mental health, and none addressed other social determinants of health. Conclusions: Evidence to date indicates that self-management interventions are not only feasible but also appear to improve CVD risk factors and clinical outcomes in Black women with CVD risk. Future research should assess best practices for the implementation of culturally informed CVD risk prevention programs in underserved populations. Further intervention development should focus on the influence that social determinants of health such as discrimination, stress, and mental health may have on self-management and CVD risk in this population.

Cardiovascular health awareness, risk perception, behavioural intention and INTERHEART risk stratification among middle-aged adults in Malaysia

Objective: To investigate the interrelationship between cardiovascular health awareness, risk perception, behavioural intention, and INTERHEART risk stratification in a middle-aged adult population in Malaysia. Methods: A cross-sectional survey with convenience sampling was conducted during November 2022 and January 2023. Participants completed validated questionnaires assessing cardiovascular health awareness, risk perception of cardiovascular diseases, behavioural intention towards adopting healthy habits, and INTERHEART risk stratification score (IHRS) based on established risk factors. A total of 602 respondents were included in the final analysis. Data were analysed with independent t-test/one-way ANOVA or Mann- Whitney/Kruskai-Wailis to test the differences, Pearson correlation or linear regression test to analyze the association of independent and dependent variables. Results: There was a significant positive correlation between medical knowledge related to cardiovascular disease (CVD) and knowledge related to CVD risk prevention, risk perception, behavioural intention and IHRS (P&lt;0.05, Pearson correlation). Notably, individuals with higher IHRS tended to have lower knowledge related to CVD and CVD risk prevention, risk perception, and behavioural intention. Males, laborers, active/former smokers, individuals with lower household income and educational levels, those involved in occupations not related to the healthcare sector, and those who did not receive the CVD health brochure or are unaware of health self-assessment tools are likely to have lower levels of knowledge, risk perception, and poorer behavioural intention regarding cardiovascular health (P&lt;0.05, one-way ANOVA). While educational level, smoking status, awareness about CVD poster, self-assessment tools were repeatedly significantly associated with knowledge related to CVD and CVD risk prevention, risk perception, behavioral intention and/or IHRS (P&lt;0.05, linear regression). Conclusions: These findings underscore the importance of promoting cardiovascular health awareness and risk perception among middle-aged adults to foster positive BI and reduce CVD risk. Tailored interventions targeting specific risk factors identified by INTERHEART may enhance risk stratification accuracy and facilitate targeted preventive strategies.

New-onset age of metabolic-associated fatty liver disease and incident cardiovascular diseases: Findings from prospective cohort

&lt;p&gt;Whether the early-onset metabolic-associated fatty liver disease (MAFLD) would promote the development of cardiovascular disease (CVD) remains unknown. To investigate the association between MAFLD and the risks of incident CVD across different new-onset age groups, we included 67,160 participants free of MAFLD and CVD at baseline (2006-2007) from the Kailuan study. During the follow-up from baseline to December 31, 2015, 24,772 new-onset MAFLD cases were identified. Each new-onset MAFLD case was matched by one control subject randomly (age �� 1 year, sex-matched). Then 24,772 case-controls were followed up for CVD events. The end of follow-up was the first occurrence of a CVD event, the loss of the follow-up date, or the end of the follow-up (December 31, 2019). Cox proportional hazard regression models with age as the time scale were used to evaluate the hazard ratios (HRs) of incident CVD. During an average follow-up of 8.27 years, 2,881 cases of CVD were identified. After multivariate adjustment, the CVD risk gradually declined with each decade of increase in the MAFLD onset age. MAFLD cases younger than 45 years had the highest CVD risk (hazard ratio, HR, 2.64 [1.87-3.72]), while the CVD risk was attenuated in the 45 to 54 years (HR, 1.41, [1.21-1.65]). However, the HRs in two groups older than 55 years were not statistically significant (HR, 1.10 [0.96-1.25] and 1.05 [0.91-1.22]). Therefore, the onset age of MAFLD is an important predictor of CVD risk. Our finding highlights the importance of intensive prevention, screening, and management of CVD risk among individuals with early-onset MAFLD (diagnosis at &lt;45 years).&lt;/p&gt;

Perceptions, Insights, and Attitudes of Selected Filipino Female Physicians on Cardiovascular Risks and Diseases

OBJECTIVE: The aim of this study was to determine the knowledge, perceptions, insights and attitudes on cardiovascular disease (CVD) prevention, personal health-related lifestyle practices, and lifestyle counseling practices of selected female physicians who are practicing or training in the PH. METHODS: This was a descriptive ambispective cross-sectional study where the survey questionnaire was adapted and modified with the authors’ permission, conducted online, and answered by 484 consenting female physicians. RESULTS: The majority had accurate responses to the CVD prevention knowledge items; 36.98% had hypertension, 32% were obese, 28.5% had dyslipidemia, and 17.2% had diabetes mellitus; 60.33% practice sleep of 6 to 8 hours, 53.51% eat vegetables and fruits daily, 55.79% prefer fish and seafood, 89.05% do not smoke, 61.2% take coffee or black tea daily, 84.51% have no regular exercise, and 30.79% of those who do exercise for only 10 to 20 minutes; 67.98% add salt or soy or fish sauce to their meals, and 72.73% do not drink enough water daily; 44.42% do not undergo annual general check-up, and 58.06% do not have a personal physician. Limitations due to COVID-19 pandemic, lack of education, and expensive screening tests are perceived to be major barriers to CVD screening. More than 90% practice health teachings on diabetes mellitus prevention, hypertension screening, cholesterol screening and management, nutrition, and weight management. Counseling on regular exercise, smoking, and alcohol abuse is practiced by 88.02%, 85.74%, and 83.88% of our respondents, respectively. CONCLUSION: Enhancement in physicians’ knowledge and behavior toward CVD risk management and prevention is an integral part in the improvement of CVD prevention. KEYWORDS: cardiovascular risks and diseases, Filipino female physicians, prevention

Awareness and Knowledge of Cardiovascular Diseases and Its Risk Factors Among Women of Reproductive Age: A Scoping Review.

Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in women. Despite the significant burden of CVD, knowledge and awareness of its risk factors among women are low.This review aimed to identify CVD awareness, knowledge, and risk factors for women of reproductive age from different countries and variables that influence health outcomes.Studies published from 2000 to 2023 were reviewed using PubMed, ScienceDirect, Elsevier, and electronic databases. A total of 50 studies were found, and 41 were excluded. The keywords used were "Knowledge of the risk factor of heart disease," "cardiac risk factors," "cardiovascular disease," "heart disease awareness," and "heart disease," combined with "women"and "reproductive age." The review revealed significant gaps in the general awareness and knowledge of CVD risk factors among women of reproductive age. Many women were unaware of the symptoms and risk factors associated with CVD, leading to delayed diagnosis and poorer outcomes. Lack of education, low socioeconomic status, and limited access to healthcare were identified as contributing factors to this knowledge gap. Young women, particularly those with poor pregnancy outcomes, demonstrated limited awareness and perception of CVD risk. The findings suggest significant gaps in general awareness, knowledge of CVD risk, risk factors among women of reproductive age from different countries, and factors that influence their health outcomes.Targeted interventions are urgently needed to improve awareness and knowledge of CVD among women of reproductive age. Efforts should focus on educating women about CVD risk factors and prevention strategies before symptoms arise. Addressing socioeconomic and educational disparities is crucial to bridging the gap in awareness. By enhancing awareness and knowledge, women can be empowered to take preventive actions and reduce their risk of developing CVD. As a result, we recommend that there are significant opportunities to educate women about CVD risk and prevention before symptoms arise. In addition, there is a need to develop effective interventions to raise awareness among women of reproductive age to close the gap in awareness and knowledge of CVD.

Abstract 14088: Impact of Social Determinants of Health on Blood Pressure and Cholesterol Control in a Smartphone-Based Cardiovascular Risk Self-Management Program

Background: Social determinants of health (SDOH) are environmental factors that have an impact on one's health, outcome, and quality of life. SDOH like language, income, healthcare access, race/ethnicity, and neighborhood characteristics can manifest in inequalities in cardiovascular disease (CVD) and its risk factor burden, resulting in inequitable CVD related morbidity and mortality. Limited data are available on effects of SDOH on CVD risk factor control among users of digital health technology. Aim: To study the impact of SDOH like primary language, household income, access to healthcare and urban/rural residential type on blood pressure (BP) and total cholesterol (TC) control in participants of a smartphone-based cardiovascular risk self-management program with AI-based digital coaching. Methods: Participants’ data were matched with Agency for Healthcare Research and Quality’s 2020 SDOH database by ZIP code. Changes in systolic BP (SBP), diastolic BP (DBP) and TC were evaluated from baseline to 6 months follow up. The SDOH variables- primary language, median household income, distance to healthcare facility and urban/rural residential type - were used to predict changes in BP and TC via regression models adjusted for age, gender, and baseline BP/TC. Results: In 27,553 participants (age 55 ± 0.1 y, 48.5% women), overall reduction in BP and TC were observed (p&lt;0.001). Of those with baseline stage 2 hypertension, 80.5% reduced SBP at follow up, and 82.9% of those with baseline high TC (≥240 mg/dL) reduced TC at follow up. Median household income was associated with change in SBP (β -1.6E-5, p &lt; 0.001) and DBP (β -4.8E-6, p &lt; 0.001), but not TC. This association was not clinically significant as each $62,535 increase in the median household income was associated with an additional 1 mm Hg in BP reduction. No difference in BP or TC change was found based on primary language, distance to healthcare facility, and urban/rural residential type (p &gt; 0.05). Conclusion: In a smartphone-based cardiovascular risk self-management program, the majority (&gt;80%) of high-risk participants reduce BP and TC across various SDOH factors. These results highlight the potential use of this technology to bridge health inequity gaps in prevention and control of CVD risk.

Prevalence of Sex-Specific Cardiovascular Disease Risk Factors, Medical Risk, and Engagement in Health-Promoting Behaviours in Premenopausal Females

BackgroundSeveral sex-specific risk factors (SS-RFs) increase a women’s risk for cardiovascular disease (CVD) but are often overlooked during risk assessment. The purpose of this study was to identify the prevalence of SS-RFs and assess CVD risk, knowledge, perceptions and behaviours in premenopausal Canadian women. MethodsAn online survey was distributed across Canada to premenopausal biological females (19-49 years of age). The survey gathered demographics, medical history, engagement in health-promoting behaviours, and knowledge and perceptions of CVD risk. CVD risk was calculated using medical risk and SS-RFs were tabulated from medical history. ResultsA total of 2559 participants (33 ± 8 years) completed the survey. The majority of our sample (82%) was classified as low medical risk. Of those classified as low risk, 35% had at least 1 SS-RF. Of high-risk individuals, 70% underestimated their risk, 21% of whom perceived themselves as low risk. Engagement in health behaviours was suboptimal. Knowledge of traditional CVD risk factors and prevention was relatively high; however, less than one-half were aware of SS-RFs such as early menopause (39.4%). ConclusionsConsidering both traditional and SS-RFs, 47% of premenopausal Canadian women may be at risk for developing CVD. Of those deemed low medical risk for developing CVD, more than one-third reported having at least 1 SS-RF. Canadian women have poor knowledge of the risks associated with SS-RFs, lack sufficient awareness of the need for prevention of CVD, and are not engaging in sufficient health-promoting behaviours to mitigate future CVD risk.

Knowledge of Cardiovascular Disease Risk Factors and Its Primary Prevention Practices Among the Saudi Public - A Questionnaire-Based Cross-Sectional Study.

In response to the aging population and rapid rise of chronic diseases, it is important to understand the knowledge about primary prevention. We aim to explore Saudi adults' knowledge of cardiovascular disease (CVD) risk factors and its primary prevention practices among the Saudi public. This is a cross-sectional community-based study, conducted among people living in Saudi Arabia to assess the knowledge of CVD risk factors using a total of 24-item questionnaires divided into two sections using the Likert scale, true /False/I do not know. The data were analyzed using the statistical software SPSS v. 26.0 (SPSS Inc., Chicago, IL, USA). In this study, the 81.8% of participants (n=296) agreed that high blood pressure was a risk factor for CVD, while more than two-thirds (68.8%; n=249) believed that diabetes was a risk factor for CVD. Furthermore, about the same proportion of respondents ((79.8%; n=289) and (78.7%; n=285)) agreed that physical inactivity and smoking were risk factors for CVD. In addition, the vast majority of them (n=324; 89.5%) believed that regular exercise aids in the prevention of CVD. In contrast, 74.9% (n=271) of individuals agreed that quitting smoking helps prevent CVD. This study indicated that 55.8% (n=202) of respondents had strong knowledge of CVD, while 44.2% (n=160) had inadequate awareness of CVD risk factors and prevention methods. In terms of the association between socio-demographic factors and overall participants' knowledge of CVD risk factors and preventative measures, we discovered that age (p=0.000), gender (p=0.011), educational status (p=0.000), and the presence of chronic disease (p=0.000) were all significantly associated with CVD knowledge score levels. Saudi adults have adequate knowledge of CVD risk factors and prevention interventions, but more effort is needed to raise continuous awareness to reduce the prevalence of CVD.

A Retrospective Five-Year Study of Cardiovascular Risk Assessment and Risk-Based Interventions Among Hypertensive Patients in Nairobi Hospital, Kenya.

Introduction Cardiovascular disease (CVD) is a leading cause of global morbidity and mortality. It is projected that the prevalence of CVD will continue to rise in developing countries, largely driven by an increase in the prevalence of potentially modifiable risk factors. Atherosclerotic cardiovascular risk assessment among individuals with risk factors for CVD but without CVD is an inexpensive and viable strategy in CVD risk stratification and prevention. Despite the known benefits of CVD risk assessment, it is not well established whether physicians/ cardiologists in Kenya comply with the guideline-recommended practice of CVD risk stratification as a prerequisite for initiation of primary CVD preventive interventions. Aims and objectives This study was designed to audit the utilization of cardiovascular risk assessment tools in risk stratification of hypertensive individuals and physician provision of risk-based primary CVD prevention interventions. Results A five-year (2017-2022) retrospective study of patients' medical records was conducted in December 2022 at the PrimeCare cardiology clinic in Nairobi Hospital, Kenya. Data were collected from 373 patients' medical records retrospectively. The data were analyzed using IBMSPSSStatistics for Windows, Version 25 (Released 2017; IBM Corp., Armonk, New York, United States). The mean age of the patients was 60 years with the majority being female (54%). The mean BMI was 30.3 kg/m2 while the mean systolic and diastolic pressurewas 140mmHg and 80mmHg, respectively. Only 2.1% of participants were current smokers. The national or alternative guideline-recommended CVD risk assessment tool was used in 0.3% and 2.4%, respectively. The 10-year CVD risk score was documented in only 1.3%. The majority of the participants (93%) had low CVD risk. Half of the patients were taking statins for primary prevention while > 60% of them had been offered therapeutic lifestyle advice. Conclusion The study revealed poor compliance with guideline-recommended CVD risk assessment tools and documentation of the CVD risk level. However, there was above-average adherence to documentation of therapeutic lifestyle measures for primary CVD prevention.

Assessing the effect of regular swimming exercise on the micro- and macrovascular physiology of older adults (ACELA II study).

Introduction: Cardiovascular disease (CVD) remains the main cause of death in the Western world. Our recent findings demonstrate potential CVD risk reduction in older adults who undertake regular swimming exercise. Nevertheless, it remains unknown whether an exercise intervention based on swimming is feasible and effective prior to a wider implementation of a CVD risk prevention strategy. Methods: This was a pragmatic, two-group, randomised controlled trial. A total of 40 older adults were randomly split into two groups (n = 20 per group). The swimming exercise group consisted of participants who engaged in swimming exercise (2-3days/week, for 8weeks). The control group did not perform any exercise. Flow-mediated dilation (%FMD) was the primary outcome. Secondary outcomes included raw cutaneous vascular conductance. Feasibility outcomes (e.g., recruitment, adherence, and attrition rates) were also assessed. Results: Statistically significant macrovascular (%FMD; swimming group: 9.8% ± 4.2%, p <0.001; control group: 4.6% ± 2.5%) and microvascular function (raw cutaneous vascular conductance; swimming group: 4.1 ± 0.9, p <0.01; control group: 3.2 ± 1.1) improvements were observed in the swimming group compared to the control group. Compliance to twice and thrice weekly in an 8-week swimming exercise was 92.6% and 88.4%, respectively, with no dropouts. Conclusion: Our 8-week, community-based, pragmatic swimming exercise intervention is a feasible and effective exercise programme that could be implemented in older adults for the prevention of age-related CVD. These findings suggest that swimming exercise could significantly reduce CVD risk in older adults, and a large research clinical trial is warranted to establish these findings.

Disparities in knowledge of cardiovascular risk factors and prevention methods related to cardiovascular status and functional health literacy, Poland, 2020-2021.

Numerous studies have reported a significant role for health literacy (HL) in the prevention or treatment of various diseases. However, in Poland there was no scientific research involving the status of cardiovascular disease (CVD) and HL in the assessment of health knowledge simultaneously, therefore, it became the objective of the study. We aimed to evaluate the level of CVD knowledge depending on CVD status and functional HL in Polish population. The study population consisted of 2827 participants from the WOBASZ II Survey aged 20-89 years: 2266 were CVD-free (non-CVD), 361 were hospitalized with CVD (CVDH[+]) and 200 were diagnosed with CVD, but not hospitalized (CVDH[-]). The Newest Vital Sign test (NVS) was applied to determine functional HL. Self-reported knowledge of CVD risk factors (RFs) and prevention methods (PMs) between people with different CVD status depending on HL was estimated. Multivariable ordinal and binary logistic regression analyzes were performed to find predictors of RFs and PMs knowledge. The knowledge of CVD RFs and/or PMs was strictly related to HL and CVD status. Inadequate HL decreased the satisfactory (≥5 RFs/PMs) knowledge of RFs (odds ratio [OR], 0.50; 95% confidence interval [CI], 0.40-0.62) and PMs (OR, 0.56; 95% CI, 0.45-0.71). CVDH(-) people were more likely to have a satisfactory PMs knowledge (OR, 1.49; 95% CI, 1.02-2.16), while CVDH(+) persons a satisfactory RFs knowledge (OR, 1.85; 95% CI, 1.35-2.53). HL and CVD status are the key determinants of CDV RFs/PMs knowledge. Functional HL significantly affects health knowledge; therefore, HL screening should be recommended in primary care to increase the effectiveness of primary CVD prevention.

Effects of a school-based physical activity intervention on cardiometabolic health five years after cessation.

While there have been several school-based physical activity (PA) interventions targeting improvement in cardiovascular disease (CVD) risk factors, few have assessed long-term effects. The aim of this paper was therefore to determine intervention effects on CVD risk factors five years after cessation. Two schools were assigned to intervention (n=125) or control (n=134). The intervention school offered 210 min/week more PA than the control school over two consecutive years (4th and 5th grades). Follow-up assessment was conducted five-year post intervention (10th grade) where 180-210 (73-85%) children provided valid data. Outcomes were CVD risk factors: triglyceride (TG), total-to-high-density-lipoprotein-cholesterol ratio (TC:HDL ratio), insulin resistance (HOMA), blood pressure (BP), waist circumference (WC), and cardiorespiratory fitness (VO2peak ). Variables were analyzed individually and as a composite score through linear mixed models, including random intercepts for children. Analyses revealed significant sustained five-year intervention effects for HDL (ES=.22), diastolic BP (ES=.48), VO2peak (ES=.29), and composite risk score (ES=.38). These effects were similar to the immediate results following the intervention. In contrast, while TC:HDL ratio initially decreased post intervention (ES=.27), this decrease was not maintained at five-year follow-up (ES=.09), whereas WC was initially unchanged post intervention (ES=.02), but decreased at five-year follow-up (ES=.44). The significant effects of a two-year school-based PA intervention remained for CVD risk factors five years after cessation of the intervention. As cardiometabolic health can be maintained long-term after school-based PA, this paper demonstrates the sustainability and potential of schools in the primary prevention of future CVD risk in children.

Perceptions, insights, and attitudes (P.I.A.) of selected filipino female physicians on cardiovascular risks and diseases

Abstract Funding Acknowledgements Type of funding sources: None. Introduction In 2012, coronary heart disease and stroke are the leading causes of death worldwide, accounting for more than 31% of deaths from all causes. In 2020, PH statistics showed that ischemic heart diseases were the leading causes of death in the Philippines (PH), responsible for 17.3% of the total deaths. Objective To determine the knowledge, perceptions, insights and attitudes on cardiovascular disease (CVD) prevention, personal health-related lifestyle practices, and lifestyle counseling practices of selected female physicians who are practicing or training in the PH through an online survey. Methods A descriptive ambispective cross-sectional study where the survey questionnaire of Ameh, et al. (2019) was modified with the authors' permission, was conducted online and answered by consenting female physicians. 484 participants’ data were collated and analyzed. Results Majority had accurate responses for the CVD prevention knowledge items (Figures 1 and 2). Among the participants, 36.98% had hypertension, 32% were obese, 28.5% had dyslipidemia, and 17.2% had diabetes mellitus. Sleep of 6-8 hours is practiced by 60.33%, 53.51% eat vegetables and fruits daily, 55.79% prefer fish and seafood, 89.05% do not smoke, 61.2% take coffee or black tea daily, 84.51% have no regular exercise, and 30.79% of those who do only exercise for 10-20 minutes. Moreover, 67.98% add salt, soy or fish sauce to their meals, and 72.73% do not drink enough water daily. In addition, 44.42% do not undergo annual general check-up and 58.06% do not have a personal physician. Limitations due to COVID-19 pandemic, lack of education, and expensive screening tests are perceived to be major barriers to CVD screening. More than 90% of our participants practice health teachings on diabetes mellitus prevention, high blood pressure screening, cholesterol screening and management, nutrition, and weight management. Counseling on regular exercise, smoking, and alcohol abuse are being practiced by 88.02%, 85.74%, and 83.88% of our respondents, respectively. Conclusion There are female physicians who are not aware of the World Health Organization’s recommendations on the prevention of CVD, who do not do health teaching and counseling, and who practice unhealthy lifestyle. Changing physicians’ knowledge and behavior towards CVD prevention is a great challenge to improve standards of CVD prevention. Improvement and enhancement in education of both physicians and patients, together with more consultation time, financing for CVD prevention, and comprehensive, multidisciplinary preventive cardiology programs supported by government and societies in favor of prevention are some of the best ways to improve management of CVD risk factors and prevention.

Residual Atherosclerotic Cardiovascular Disease Risk: Focus on Non-High-Density Lipoprotein Cholesterol.

Cardiovascular disease (CVD) caused by atherosclerosis is the leading cause of death worldwide. The level of low-density lipoprotein cholesterol (LDL-C), considered as the initiator of atherosclerosis, is the most widely used predictor for CVD risk and LDL-C has been the primary target for lipid-lowering therapies. However, residual CVD risk remains high even with very low levels of LDL-C. This residual CVD risk may be due to remnant cholesterol, high triglyceride levels, and low high-density lipoprotein cholesterol (HDL-C). Non-high density lipoprotein cholesterol (non-HDL-C), which is calculated as total cholesterol minus HDL-C (and represents the cholesterol content of all atherogenic apolipoprotein B-containing lipoproteins), has emerged as a better risk predictor for CVD than LDL-C and an alternative target for CVD risk reduction. Major international guidelines recommend evaluating non-HDL-C as part of atherosclerotic CVD risk assessment, especially in people with high triglycerides, diabetes, obesity, or very low LDL-C. A non-HDL-C target of <130 mg/dL (3.4 mmol/L) has been recommended for patients at very high risk, which is 30 mg/dL (0.8 mmol/L) higher than the corresponding LDL-C target goal. Non-HDL-C lowering approaches include reducing LDL-C and triglyceride levels, increasing HDL-C, or targeting multiple risk factors simultaneously. However, despite the growing evidence for the role of non-HDL-C in residual CVD risk, and recommendations for its assessment in major guidelines, non-HDL-C testing is not routinely done in clinical practice. Thus, there is a need for increased awareness of the need for non-HDL-C testing for ascertaining CVD risk and concomitant prevention of CVD.

Educational modules as an effort to increase knowledge of cardiovascular disease risk prevention

Background: Heart disease is no longer affecting the elderly, but more and more young people are getting heart disease. An educational approach in health promotion by using attractive media is one of the most necessary ways to invite teenagers to behave in a healthy life. The purpose of this study was to determine the effect of the education module on knowledge of risk factors for cardiovascular disease prevention. The research method used a quasi-experimental design with a control group. The research sample is students at SMK Era Pembangunan 3, West Jakarta. Sampling was done by simple random sampling and a total sample of 68 people were selected. Data were analyzed using chi square test and multiple logistic regression. The results showed that the education module given to respondents could increase students' knowledge in preventing cardiovascular disease risk factors with a p value of 0.000:OR 51.83 (95% CI 9.84-273.05). Conclusion: the education module has an effect on increasing knowledge about the prevention of cardiovascular disease risk factors. Recommendations are expected that future research will develop more instruments on risk factors for cardiovascular disease.&#x0D; &#x0D;

A Systematic Review and Meta-Analysis of Advanced Biomarkers for Predicting Incident Cardiovascular Disease among Asymptomatic Middle-Aged Adults.

Cardiovascular disease (CVD) continues as the most important cause of mortality. Better risk screening and prediction are needed to reduce the cardiovascular disease burden. The aim of the study was to assess the role of serum biomarkers in the prediction of CVD among asymptomatic middle-aged adults with no prior CVD history. A systematic review and meta-analysis were carried out using literature from PubMed and following PRISMA reporting guidelines. Twenty-five studies met our inclusion criteria and were included in the systematic review. The most commonly studied biomarker was high-sensitivity C reactive protein (hs-CRP) (10 studies), which showed that higher hs-CRP levels are associated with an increased risk of subsequent CVD events and mortality. In addition, several less-studied biomarkers (N-terminal pro-brain natriuretic peptide (NT-proBNP), fibrinogen, gamma-glutamyl transferase (GGT), and others) also showed significant associations with greater future risk of CVD. A meta-analysis was possible to perform for hs-CRP and NT-proBNP, which showed statistically significant results for the ability of hs-CRP (hazard ratio (HR) 1.19, (95% CI: 1.09-1.30), p &lt; 0.05) and NT-proBNP (HR 1.22, (1.13-1.32), p &lt; 0.05) to predict incident CVD among middle-aged adults without a prior CVD history or symptoms. Several serum biomarkers, particularly hs-CRP and NT-proBNP, have the potential to improve primary CVD risk prevention among asymptomatic middle-aged adults.

Public awareness of cardiovascular disease prevention in Korea

Background: The burden of cardiovascular disease (CVD) is significant in Korea. Ultimately, public knowledge and awareness of CVD risk factors and prevention are essential to reduce its burden. Hence, this study aimed to examine the level of public awareness of CVD risk factors and prevention in Korea in 2022. Methods: We used data from the Cardiovascular Disease Prevention Awareness Survey conducted by the Korean Society of Cardiovascular Disease Prevention in June 2022. Using a structured web-based questionnaire, 2,000 individuals aged 20 years or more were surveyed on computers or mobile devices. Information on sociodemographic characteristics, the presence of cardiometabolic disease, CVD concerns and self-assessed likelihood, and awareness of CVD prevention were analyzed. Results: Cancer (44.3%) was the most feared disease, followed by CVD (19.5%). Nevertheless, most respondents stated that they were likely to develop CVD in their lifetime (67.4%). Only 9.2% of respondents were aware of the details of recommendations to prevent CVD, and this level of knowledge was also low among respondents with cardiometabolic diseases (10.7%). Not smoking, being physically active, eating a healthy diet, and reducing alcohol consumption were deemed easy to implement. On the contrary, reducing stress, being physically active, and eating a healthy diet were considered the most difficult recommendations to practice.Conclusions: Public awareness of CVD risk factors and prevention appeared to be insufficient in Korea. Our research suggests that simple but practical recommendations should be conveyed and promoted to raise public awareness, which is currently inadequate.

The role of the dietary patterns in the cardiovascular disease risk prevention

Cardiovascular diseases (CVD) are a part of a wide group of diseases, which became main threat to the life and health of the population in highly developed countries. To prevent and treat CVD, in addition to implementation of pharmacological methods, there are a number of lifestyle components, including eating habits, that significantly influence the development of these diseases. The dietary patterns strongly correlate with the risk of cardiovascular disease. Modifications of the dietary habits allow to control many parameters such as: body weight, cholesterol/triglyceride levels or blood pressure. Alternative diets are frequently used to reduce the risk of developing a CVD. The main recommended dietary patterns includes Mediterranean diet (MD), the DASH diet (Dietary Approach to Stop Hypertension) and mild variants of vegetarianism. The more controversial nutritional styles includes the ketogenic or vegan diets. Due to various assumptions as well as the mechanisms of action of each diets, an attempt of its evaluation have been made. The aim of our study is to review and analyze the available data on the impact of various nutrition models regarding to cardiovascular diseases risk prevention.