Trends In Risk Factors Research Articles

한국 청소년의 심혈관질환 위험 생리적지표 및 생활습관 인자 추이: 국민건강영양조사자료(2007-2015) 이용

한국 청소년의 심혈관질환 위험 생리적지표 및 생활습관 인자 추이: 국민건강영양조사자료(2007-2015) 이용

Trends in Costs and Risk Factors of 30-Day Readmissions for Transcatheter Aortic Valve Implantation

As transcatheter aortic valve implantation (TAVI) continues its rapid growth as a treatment approach for aortic stenosis, costs associated with TAVI, and its burden to healthcare systems will assume greater importance. Patients undergoing TAVI between January 2012 and November 2017 in the Nationwide Readmission Database were identified. Trends in cause-specific readmissions were assessed using Poisson regression. Thirty-day TAVI cost burden (cost of index TAVI hospitalization plus total 30-day readmissions cost) was adjusted to 2017 U.S. dollars and trended over year from 2012 to 2017. Overall, 47,255 TAVI were included and 30-day readmissions declined from 20% to 12% (p <0.0001). Most common causes of readmission (heart failure, infection/sepsis, gastrointestinal causes, and respiratory) declined as well, except arrhythmia/heart block which increased (1.0% to 1.4%, p <0.0001). Cost of TAVI hospitalization ($52,024 to $44,110, p <0.0001) and 30-day cost burden ($54,122 to $45,252, p <0.0001) declined. Whereas costs of an average readmission did not change ($9,734 to $10,068, p = 0.06), cost burden of readmissions (per every TAVI performed) declined ($4,061 to $1,883, p <0.0001), including reductions in each of the top 5 causes except arrhythmia/heart block ($171 to $263, p = 0.04). Index TAVI hospitalizations complicated by acute kidney injury, length of stay ≥5 days, low hospital procedural volume, and skilled nursing facility discharge were associated with increased odds of 30-day readmissions. In conclusion, the costs of index hospitalizations and 30-day cost burden for TAVI in the U.S. significantly declined from 2012 to 2017. However, readmissions due to arrhythmia/heart block and their associated costs increased. Continued strategies to prevent readmissions, especially those for conduction disturbances, are crucial in the efforts to optimize outcomes and costs with the ongoing expansion of TAVI.

Cardiovascular Risk Factors in Coronary Artery Bypass Graft Patients: Comparison Between Two Periods.

BackgroundInformation showing risk factor trends in patients undergoing coronary artery bypass graft in Saudi Arabia is scarce. Thus, we aimed to compare cardiovascular risk factors among coronary artery bypass graft patients between two periods: 2012 and 2018.MethodsThis was a cross-sectional study based on hospital records at a tertiary center in Saudi Arabia. The medical records of 72 patients in 2012 and 111 patients in 2018 were reviewed. The study included all patients who underwent coronary artery bypass grafting for the first time. The chi-square test and independent t-test were used for statistical analysis; P-values less than 0.05 were considered statistically significant.ResultsThe mean (SD) of the patient age was 61.21 (9.74) years in the first period and 58.01 (11.14) years in the second period. The number of patients who smoked was significantly higher in the second period of the study (14.3% in the first period; 27.0% in the second period; P < 0.001). The study also showed an increase in hypertension and diabetes mellitus in the second period compared to the first (70% vs 71.2% and 68.6% vs 72.1%, respectively), and a reduction in the percentage of patients with hypercholesterolemia (18.3% vs 17.1%). However, these findings were non-significant.ConclusionsThe percentage of smokers was significantly higher in the second period of this research as a consequence of cultural variation and because of the popularity of water-pipe smoking in the society. We recommend the need for increased awareness regarding smoking and the implementation of smoking-cessation programs.

Temporal trends in behavioral risk and protective factors and their association with mortality rates: results from Brazil and Argentina

BackgroundDespite available information on trends in behavioral factors for Brazil and Argentina, little is known about the association of these trends with mortality. Understanding this association is important to avoid early deaths. Therefore, we aimed to evaluate temporal trends in behavioral risk and protective factors in Brazil and Argentina, and to assess their association with overall and cause-specific mortality rates.MethodsEcological study with data from two population surveys from Brazil and Argentina. Weighted prevalence of tobacco smoking, excessive alcohol consumption, fruit and vegetable consumption and physical activity for the 27 Brazilian state capitals and for the 23 Argentinean provinces were used as behavioral factors. Information on overall mortality as well as cardiovascular diseases and cancer mortality for the year 2015 was collected from national mortality banks of both countries. Estimated prevalence rates were used to describe trends in behavioral factors from 2006 to 2014 in Brazil, and from 2005 to 2013 in Argentina, while Pearson’s correlation and linear regression models were used to assess their association with overall and cause-specific mortality rates.ResultsBrazil presented improvements in behavioral risk and protective factors: sharp decrease in tobacco smoking prevalence (from 15 to 9%), increase in regular fruit and vegetable consumption (from 28 to 36%), and increase in physical activity (45 to 51%). In Argentina, results were more disappointing: small reduction in tobacco smoking (from 55 to 50%) and decrease in physical activity (from 55 to 45%). In both countries, excessive alcohol consumption remained stable, with increase only among women. The association between behavioral factors and mortality showed that in those Brazilian capitals with higher prevalence of regular consumption of fruits and vegetables, there were lower overall mortality rates. Stratification by gender revealed that significant results were only found among women.ConclusionPrevalence of regular consumption of fruits and vegetables increased in Brazilian capitals and was associated with lower overall mortality rate, suggesting a positive impact of Brazilian policies to improve dietary intake patterns on its population’s mortality. Approaches focusing on behavioral factors are especially needed in Argentina to reach similar results of those seen in Brazil.

Assessing the future medical cost burden for the European health systems under alternative exposure-to-risks scenarios.

BackgroundAgeing populations and rising prevalence of non-communicable diseases (NCDs) increasingly contribute to the growing cost burden facing European healthcare systems. Few studies have attempted to quantify the future magnitude of this burden at the European level, and none of them consider the impact of potential changes in risk factor trajectories on future health expenditures.MethodsThe new microsimulation model forecasts the impact of behavioural and metabolic risk factors on NCDs, longevity and direct healthcare costs, and shows how changes in epidemiological trends can modify those impacts. Economic burden of NCDs is modelled under three scenarios based on assumed future risk factors trends: business as usual (BAU); best case and worst case predictions (BCP and WCP).FindingsThe direct costs of NCDs in the EU 27 countries and the UK (in constant 2014 prices) will grow under all scenarios. Between 2014 and 2050, the overall healthcare spending is expected to increase by 0.8% annually under BAU. In the all the countries, 605 billion Euros can be saved by 2050 if BCP is realized compared to the BAU, while excess spending under the WCP is forecast to be around 350 billion. Interpretation: Although the savings realised under the BCP can be substantial, population ageing is a stronger driver of rising total healthcare expenditures in Europe compared to scenario-based changes in risk factor prevalence.

Trends in Retinopathy of Prematurity over 12 Years in a Colorado Cohort

ABSTRACT Purpose To determine trends in retinopathy of prematurity (ROP) in a Colorado cohort between 2006 and 2017 and compare trends in risk factors between our cohort and statewide data. Methods A retrospective cohort study was conducted by the use of records from two registry databases: 1) an academic center’s ROP registry, and 2) vital statistics birth data from the Colorado Department of Public Health and Environment (CDPHE). ROP was categorized as severe (type 1 or type 2), low grade (not type 1 or type 2), or no ROP. Other variables included in the analyses were gestational age and birth weight at delivery, and infant mortality. Trends over time were evaluated for both registry databases using generalized linear models. Results In our ROP registry cohort of 1,267 eligible infants, 134 (10.6%) developed severe ROP and 279 (22%) developed low-grade ROP. We found no overall trend in severe ROP rates (p = .23), and a decreasing trend in rates of low-grade ROP (p < .01) over the study period. Trends in gestational age, birth weight, and mortality rates remained stable during the study period in both the ROP registry and the CDPHE cohorts. Conclusion The rate of severe ROP in our ROP registry cohort did not change over time. There was evidence of a decreasing trend in low grade ROP during the 12-year study period that was not explained by a change in the primary ROP risk factors in either the ROP registry cohort or the Colorado statewide data.

Characterisation of recent trends in cardiovascular risk factors in young and middle-aged patients with ischaemic stroke and/or transient ischaemic attack

BackgroundStrokes in the young and middle-aged are associated with a disproportionately large economic and social impact in addition to their clinical effects. Standard Modifiable Cardiovascular Risk Factors (SMuRFs; hypercholesterolaemia, hypertension, diabetes mellitus and smoking) are key drivers of cardiovascular disease including strokes, however recent temporal trends in the younger stroke population have not been well characterised. We aimed to evaluate recent trends of SMuRFs in a cohort of younger patients with ischaemic stroke. MethodsConsecutive patients aged <65 years with clinical and/or radiological diagnosis of ischaemic stroke or transient ischaemic attack in a tertiary referral centre (2013–2017) were retrospectively appraised. The demographic and clinical comorbidities of these patients were assessed including their SMuRF profile. The prevalence over time and clinical associations of patients with no SMuRFs were studied and compared to patients with SMuRFs. ResultsOf 487 patients (53.49 ± 9.13 yrs., 60% men) analysed, 23% did not have SMuRFs. The proportion of “non-SMuRF” patients increased over time (p < 0.01) and this trend was not influenced by age (p = 0.48) or gender (p = 0.68). The presence of SMuRFs was not associated with in-hospital outcomes, however patients without SMuRFs were significantly less likely to be discharged on blood pressure (p < 0.01) and lipid-lowering therapies (p = 0.03). ConclusionsThe proportion of younger stroke patients without SMuRFs is substantial and has increased over time. Our findings highlight the need for further research to better understand the mechanisms underlying stroke development in this population and whether less risk factor treatment in this population could impact longer term outcomes.

Tuberculosis in Northeastern Brasil (2001-2016): trend, clinical profile, and prevalence of risk factors and associated comorbidities.

To describe the temporal trend, clinical profile, and the prevalence of risk factors and associated comorbidities in new cases of tuberculosis in the Northeast (2001-2016). A prevalence study involving all tuberculosis cases registered in Northeast Brasil, 2001-2016. Data were obtained from the National System of Notification of Disorders. For statistical analysis, the inflection point regression model and descriptive statistics were used. 331,245 cases of tuberculosis were reported. The overall incidence rate decreased from 44.84/100,000 inhabitants (2001) to 30.92/100,000 inhabitants (2016), with a decreasing trend (AAPC: -2.3; p<0.001). The profile was characterized by men (73.53%), age 20-59 years (73.56%), pulmonary tuberculosis (86.37%), positive smear microscopy (54.78%). The main risk factors and comorbidities were: AIDS (4.64%), HIV (12.10%), Diabetes mellitus (5.46%), alcohol (11.63%), institutionalized, (4.31%) and deprived of liberty (2.30%). The cure rate was 70.66% and the abandonment rate was 9.11%. Even with a reduced incidence, tuberculosis represents a real public health problem in the Northeast region. The profile was characterized by a male population, in economically-active age, lung smear-positive pulmonary presentation, and the risk factors and comorbidities of Aids, TB/HIV co-infection, diabetes mellitus, alcohol consumption, institutionalized and deprived of freedom reflect the complexity of the challenges in facing the disease.

Thirty year trends in cardiovascular risk factors prevalence among Siberian adolescents (1989-2019)

Abstract Background Aim of the study was to assess trends of cardiovascular risk factors among Siberian adolescents during the last 30 years including period of Russian reforms (1989-2019). Methods Seven cross-sectional surveys of representative samples of school children aged 14-18 since 1989 (every 5 years) were carried out. Body mass index (BMI), systolic and diastolic blood pressure, serum total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C) and low-density lipoprotein cholesterol (LDL-C) were measured. Self-reported smoking and physical activity rates were obtained. To define overweight the sex- and age-specific IOTF cutoffs for BMI were used. Hypertension (HT) and lipid disorders were revealed according to international criteria. Results Prevalence of high TC significantly decreased from 22 to 4% (p &amp;lt; 0,01) in males and from 32 to 17% (p &amp;lt; 0,05) in females. High LDL-C showed similar trends. Prevalence of low HDL-C was stable with some fluctuations. In the period of Russian reforms (1989-1999) the prevalence of overweight significantly decreased from 12% in boys and from 14% in girls in 1989 to 4% in 1999 (p &amp;lt; 0,01). Since 2003 rapid increasing of overweight was observed. Trends of HT have shown double decreasing during the reform period and stabilization in the post-reform time. So, since 2003 discordant trends in HT and overweight were revealed. Physical activity was stably low in boys (49-55%) and girls (83-73%). Average weekly screen time doubled from 15 (2009) to 30 h/w (2019), p &amp;lt; 0,05. Cigarette smoking rates in boys dramatically decreased from 45% (1989) to 3% (2019), in girls - from 19% to 5% (p &amp;lt; 0,01). Smoking of electronic devices was registered in 2019: 6% among boys and 3% among girls. Conclusions Obtained data indicate on trends to reduction in CVD risk profile among Siberian adolescents during the period of Russian reforms. Discordant trends of HT and overweight were revealed. The study was supported by RFBR grant 19-013-00800. Key messages Long time changes in cardiovascular risk profile among Siberian adolescents were registered. Against the background of a decrease in combustible smoking among adolescents, electronic smoking began to register.

Global trends of obesity, malnutrition and dietary risk factors

Abstract Background The burden of malnutrition across the world remains unacceptably high. Children under five years are facing multiple burdens, including stunting and wasting; conversely, overweight and obesity among adults are at record levels while global trends in chronic non-communicable diseases (NCDs) are rising globally. Methods Data from the NCD Risk Factor Collaboration (NCD-RisC) and the Global Burden of Disease (GBD) Study and insights from the Global Nutrition Report will be discussed. Results No changes in age-standardised mean BMI in girls and boys from 1975 to 2016 were registered in eastern Europe, while an increase of up to 1.00 kg/m2 per decade was reported in central Latin America (for girls) and in Polynesia and Micronesia (for boys), with lower but significant variations over time all around the world. There has been some progress in reducing malnutrition at a global level but there are significant disparities in progress at the national and subnational level. Fewer than one in five children aged 6 to 23 months eat a minimally acceptable diet while only half of children aged 6 to 23 months get the recommended minimum number of meals. Regardless of wealth, children, adolescents and adults are eating too many refined grains and sugary foods and drinks, and not enough foods that promote health such as fruits, vegetables, legumes and whole grains. A total of 11 million deaths are attributable to dietary risk factors. High intake of sodium, low intake of whole grains, and low intake of fruits are the leading dietary risk factors for deaths globally. However, important differences between regions and outcome (i.e., cardiovascular disease vs. cancer) have been registered. Conclusions Current data allow us to assess what people are eating at global level, but nutrition quality in all countries and wealth groups pose a significant threat to achieving ideal targets. Focus on healthy diets to drive better nutrition everywhere is crucial to prevent NCDs globally.

29.E. Workshop: Data analysis, advocacy activities, and actions to counteract the double burden of malnutrition

Abstract The burden of non-communicable chronic diseases (NCDs) represents a public health issue of gigantic proportion at global level. Among others, diet has been demonstrated to be a key element to maintain health and prevent NCDs. Today's world is facing the so-called “double burden of malnutrition”, characterized by the coexistence of undernutrition along with overweight, obesity or diet-related NCDs due to a substantial shift toward unhealthy diet high in sugars and ultra-processed foods and concomitant inadequate accessibility of nutritious foods. While interventions to improve diet quality and nutrition knowledge are of paramount importance in order to decrease the burden of NCDs over the next decades, the international policy framework should aim to develop evidence-based policy approaches to reduce such burden globally. In this context, the EUPHA Food and nutrition section, the EUPHA Chronic diseases section, the EUPHA Health promotion section, in collaboration with the World Health Organization (WHO), aim to propose a joint workshop to provide the latest updates from leading scientists and experts involved in global health research, with a special focus on NCDs, obesity and nutrition-related risk factors as well as ongoing interventions aimed to reduce the double burden of malnutrition. The objectives of the present workshop are the following: To quantify the global burden and temporal trends of NCDs risk factors; To assess the impact of nutrition-related risk factors on NCDs; To provide examples of advocacy activities and actions at global level to improve nutrition education and dietary behaviors; To promote translatable information at global level and drive implementation of knowledge into policy and practice. Organizing the present workshop would provide an important occasion for gathering experts in the field and sharing opinions with the audience in light of the presented results. Given the many actors involved, the workshop will provide a unique occasion to discuss about potential policy approaches in the context of the conference. Key messages There is science-based evidence demonstrating that healthy nutrition is a key factor to maintain global health and prevent chronic non-communicable diseases. Governmental and non-governmental efforts are currently working to counteract malnutrition worldwide.

Time trends of risk and protective factors for non-communicable diseases in São Paulo City 2006-2017

Abstract Background Non-Communicable Diseases (NCD) were responsible for approximately 73% of mortality in São Paulo, Brazil in 2017, in addition to a high burden of disease, costs for the Health System and a lower quality of life. Monitoring the main risk and protection factors for NCD is essential to transform information into action and support public health promotion policies. Methods This is a time trend analysis (2006 - 2017) with data from VIGITEL - Brazilian Surveillance System of Risk and Protective Factors for NCD through Telephone Interviews with adults (≥ 18 years), carried out annually since 2006. Data from the adult population of the city of São Paulo were selected for the following risk and protection factors: obesity, regular consumption of fruits and vegetables, leisure-time physical activity, alcohol abuse and tobacco smoking. The annual percentual change (APC) were estimated by Prais Winstein regression, using Stata 14. Results In the period of 2006 to 2017, the prevalence of obesity increased from 11.3% to 18.5% (APC 4.84; CI 3.56-6.16). In relation to regular consumption of fruits and vegetables and leisure-time physical activity, the prevalence increased from 26.8% to 35.5 % (APC 2.03; IC 0,87-3,21) and 27.5% to 29.9% (APC 3,08; IC 1.12-5.08), respectively. Regarding smoking, the prevalence decreased from 18.8% to 14.2% (APC-3.83; IC-5,64- -1.98). However, alcohol abuse increased from 12.0% to 17.4% (APC 2.5; IC 1.42-3.58). Conclusions The analysis showed some advances, such as reducing smoking, increasing regular consumption of fruits and vegetables and leisure-time physical activity. On the other hand, there was a significant increase in obesity and alcohol abuse. It is worth remembering that these risk and protection factors can be modified and are related to the Social Determinants of Health that influence lifestyle, so intersectoral population strategies are necessary to face them, as well as public policies that promote healthier environments. Key messages Monitoring the main risk and protective factors for Non-Communicable Diseases is essential to implement and to support public health promotion policies and programs. This analysis showed some advances, such as reducing smoking, increasing regular consumption of fruits and vegetables. On the other hand, there was a significant increase in obesity and alcohol abuse.

Trends in cardiovascular diseases burden and vascular risk factors in Italy: The Global Burden of Disease study 1990–2017

An exhaustive and updated estimation of cardiovascular disease burden and vascular risk factors is still lacking in European countries. This study aims to fill this gap assessing the global Italian cardiovascular disease burden and its changes from 1990 to 2017 and comparing the Italian situation with European countries. All accessible data sources from the 2017 Global Burden of Disease study were used to estimate the cardiovascular disease prevalence, mortality and disability-adjusted life years and cardiovascular disease attributable risk factors burden in Italy from 1990 to 2017. Furthermore, we compared the cardiovascular disease burden within the 28 European Union countries. Since 1990, we observed a significant decrease of cardiovascular disease burden, particularly in the age-standardised prevalence (-12.7%), mortality rate (-53.8%), and disability-adjusted life years rate (-55.5%). Similar improvements were observed in the majority of European countries. However, we found an increase in all-ages prevalence of cardiovascular diseases from 5.75 m to 7.49 m Italian residents. Cardiovascular diseases still remain the first cause of death (34.8% of total mortality). More than 80% of the cardiovascular disease burden could be attributed to known modifiable risk factors such as high systolic blood pressure, dietary risks, high low density lipoprotein cholesterol, and impaired kidney function. Our study shows a decline in cardiovascular mortality and disability-adjusted life years, which reflects the success in reducing disability, premature death and early incidence of cardiovascular diseases. However, the burden of cardiovascular diseases is still high. An approach that includes the cooperation and coordination of all stakeholders of the Italian National Health System is required to further reduce this burden.

Suicide risk factors across suicidal ideators, single suicide attempters, and multiple suicide attempters

Few studies have compared the three suicidality groups—suicidal ideators (SIs), single suicide attempters (SSAs), and multiple suicide attempters (MSAs)—in relation to the suicidal process. This cross-sectional study investigated trends and differences in suicide risk factors across suicidality groups. Using the baseline data of the Korean Cohort for the Model Predicting a Suicide and Suicide-related Behavior, we analyzed trends (Jonckheere-Terpstra or Mantel-Haenszel χ2 test) and differences (analysis of covariance or logistic regression) in sociodemographic and clinical factors, psychiatric diagnoses, as well as clinical rating scores on psychopathology (suicidal ideation, depressive symptoms, anxiety symptoms, and problem drinking), trait impulsiveness, and stress across suicidality groups. Across suicidality groups comprising 193 SIs, 207 SSAs, and 376 MSAs, we observed a decreasing trend in age and increasing trends in history of early trauma, familial histories of suicide attempts and suicide, most diagnoses and psychopathologies (suicidal ideation, anxiety symptoms, and problem drinking), trait impulsiveness, and stress—with MSAs more likely to have histories of early trauma and familial suicide, almost uniformly higher proportions of diagnoses, and higher psychopathology rating scores. Overall, increasing trends in suicide risk factors were found across all suicidality groups. Notably, MSAs presented greater proportions of most psychiatric diagnoses and higher degrees of most psychopathologies, motor impulsiveness, and stress, indicating they were at more severe clinical states and were closer to suicide. Mental health professionals should ascertain the number of suicide attempts to identify MSAs, implement more thorough evaluations, and employ additional measures for reducing motor impulsiveness.

Circumstances and factors of sleep-related sudden infancy deaths in Japan.

Sudden unexpected death in infancy (SUDI) comprises both natural and unnatural causes of death. However, few epidemiological surveys have investigated SUDI in Japan. This retrospective study was conducted to investigate the latest trends of circumstances and risk factors of SUDI cases in which collapse occurred during sleep. Forensic pathology sections from eight universities participated in the selection of subjects from 2013 to 2018. Data obtained from the checklist form were analyzed based on information at postmortem. There were 259 SUDI cases consisting of 145 male infants and 114 female infants with a mean birth weight of 2888 ± 553 and 2750 ± 370 g, respectively. Deaths most frequently occurred among infants at 1 month of age (18%). According to population data as the control, the odds ratio (95% confidence interval) of mother's age ≤19 years was 11.1 (6.9-17.7) compared with ages 30-39. The odds ratio for the fourth- and later born infants was 5.2 (3.4-7.9) compared with the frequency of first-born infants. The most frequent time of day for discovery was between 7 and 8 o'clock, and the time difference from the last seen alive was a mean of 4.1 h. Co-sleeping was recorded for 61%, and the prone position was found for 40% of cases at discovery. Mother's smoking habit exhibited an odds ratio of 4.5 (2.9-5.8). This study confirmed the trends that have been observed for sudden infant death syndrome; particularly, very high odds ratios were evident for teenage mothers and later birth order in comparison with those in other developed countries. Neglect was suspected in some cases of the prolonged time to discovery of unreactive infants. To our knowledge, this is the first report of an extensive survey of SUDI during sleep in Japan.

Long-Term Trends in Ischemic Stroke Incidence and Risk Factors: Perspectives from an Asian Stroke Registry.

Long-Term Trends in Ischemic Stroke Incidence and Risk Factors: Perspectives from an Asian Stroke Registry.

Temporal trends in sexual behaviours and their impacts on HIV incidence among South African women: 2002–2016

ABSTRACT South Africa has the highest number of HIV infected individuals in the world. The primary objective of the current study was to describe temporal changes in HIV incidence rates using the data from 9,948 women who enrolled in one of the six HIV prevention trials conducted in KwaZulu-Natal, South Africa. Characteristics of the study population were presented and compared across the four study periods: 2002–2004, 2005–2008, 2009–2011 and 2012–2016. HIV infection rates increased from 6.2 to 9.3 per 100 person-year over the 15 years. These rates were as high as 14 per 100 person-year among women younger than 20 years age. Being single/not cohabiting, using injectable contraceptives, having less than two children, and diagnosed with STI(s) were associated with increased risk of HIV infection. These four factors were associated with 71%, 75%, 80% and 88% of the HIV seroconversions in four study periods. As the research continues to find ways of controlling the spread of the infections, quantifying the temporal trends in risk factors and their population-level impacts on HIV infection may have significant implications. This information may assist in developing effective counselling and education programs by targeting the sexually active single women and delivering more realistic messages.

Trends in cardiovascular risk factors in diabetic patients in comparison to general population in Iran: findings from National Surveys 2007\u20132016

To determine levels of change in risk factors for cardiovascular disease among people with and without a previous diagnosis of diabetes from 2007 to 2016 in Iran. Data were obtained from five rounds of the World Health Organization STEPwise approach to Surveillance (STEPS) cross-sectional surveys. Participants were 7665 and 93,733 adults with and without known diabetes, respectively, aged 25–65 years. We used logistic and linear regressions to assess the trends of risk factors. Individuals with known diabetes compared to those without the condition, experienced greater reductions in mean levels of systolic blood pressure (3.0 vs. 0.5 mmHg among women and 3.9 vs. 1.6 mmHg among men), diastolic blood pressure (6.4 vs. 5.11 mmHg in women and 3.3 vs. 1.8 mmHg in men), and non-HDL cholesterol (42.4 vs. 27.2 mg/dL among women and 30.3 vs. 21.0 mg/dL among men) throughout these years. Men with diabetes also showed a greater reduction in the prevalence of daily cigarette smoking compared to their non-diabetic counterparts (7.3% vs. 2.3%). Fasting plasma glucose decreased among subjects with diabetes but increased among those without diabetes. Significant increases were observed in proportions who met goals for blood pressure, triglycerides, non-HDL cholesterol and LDL cholesterol in both groups; however, almost half of diabetic subjects did not achieve risk factor goals in 2016. Secondary prevention in diabetic patients was more effective than primary prevention in the general population; however, the rate of diabetic patients who met the designated goals for each risk factor was still suboptimal.

Dietary patterns and risk of mild cognitive impairment among Chinese elderly: A cross-sectional study.

ObjectiveTo investigate the relationship between food patterns and mild cognitive impairment (MCI) among Chinese elderly to provide evidence for risk prevention and control of MCI among elderly population.MethodsBetween February 2017 to October 2018, a stratified multistage cluster sampling method was used to select participants from 760 communities of six districts in Xi’an, China, for 49-item food frequency questionnaire survey. A total of 2311 participants aged 60 to 88 years were included in the study with 444 (19.2%) participants of MCI among Chinese community-dwelling elderly adults. Food patterns associated with risk of dementia were assessed by using a reduced rank regression (RRR) analysis, and the multivariate linear regression was used to test trends of risk factors across scores for the food pattern.ResultsFour dietary patterns were extracted which explained 88.65% of the total variation in food intakes. Furthermore, the food pattern 1 (FP1) accounted for 60.25% of the total variation of all responsible variables and as a target dietary pattern in the study, which was related with high intake of legumes, vegetables, fruits, milk and dairy products, nuts and a low intake of noodles and cereals (p<0.05). Multivariate linear regression analysis showed that participants with a high score for FP1 had higher direction, memory and language function and FP1 can improve the ability of cognitive function (p<0.05).ConclusionThe FP1 of Chinese dietary patterns was significantly correlated with higher cognitive function which can reduce the risk of MCI among Chinese elderly.

Secular trends in cardiovascular risk factors among women aged 45\u201354\u2009years in Gothenburg, Sweden, from 1980 to 2014

BackgroundA declining trend in mean cholesterol levels and smoking has been observed in high-income western countries during the last few decades, whereas obesity rates have increased. Simultaneously, mortality from coronary heart disease has decreased. The aim of the present study was to determine whether the trends in cardiovascular risk factors have continued in successive cohorts of middle-aged women over a period of 34 years.MethodsSix population-based, cross-sectional samples of women (n = 2294) mean age: 49.8 years (range: 45–54), living in Gothenburg, Sweden, were investigated between 1980 and 2014.ResultsBody mass index (BMI) increased over time, with a mean BMI of 24.7 kg/m2 in 1980 to 25.7 kg/m2 in 2013–2014, corresponding to a weight gain of 4.5 kg, together with an increase in the proportion of obese individuals (BMI ≥ 30 kg/m2) from 10.4 to 16.6% (p = 0.0012). The proportion of smokers and women with hypertension decreased from 34.5 to 12.8% (p = 0.0006) and from 37.7 to 24.5% (p < 0.0001) respectively. Mean total serum cholesterol levels decreased from 6.23 (SD 1.09) mmol/L in 1980 to 5.43 (SD 0.98) mmol/L in 2013–2014 (p < 0.0001). Self-reported leisure time regular exercise increased from 7.8% in 1980 to 35.6% in 2013–2014 (p < 0.0001). For women born in 1963, the prevalence ratio of not having any of five major cardiovascular risk factors was 1.82 (95% confidence interval (CI) 1.38–2.41), compared with women born in 1925–1934.ConclusionThe trend towards increasing obesity, more leisure-time physical activity and less smoking remains, while the decrease in serum cholesterol appears to have abated.