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Kassam N, Ngunga M, Varwani M, Msunza M, Jeilan M. Acute coronary syndrome patterns in the Young: risk factor profile and in-hospital outcomes in a tertiary referral hospital in Kenya. BMC Cardiovasc Disord 2024; 24:192. [PMID: 38570757 PMCID: PMC10988889 DOI: 10.1186/s12872-024-03832-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 03/07/2024] [Indexed: 04/05/2024] Open
Abstract
INTRODUCTION Acute coronary syndrome (ACS) accounts for coronary artery disease (CAD) -related morbidity and mortality. There has been growing concern about the rising incidence of ACS among young individuals globally both in developed and developing countries, including Sub-Saharan Africa. This group's phenotypic characteristics; risk factors and clinical outcomes are not well described. contextual and regional studies are necessary to understand the magnitude of ACS among young Individuals and help highlight challenges and opportunities for improved ACS outcomes in the region. The study aimed to describe the demographic and clinical characteristics of young individuals hospitalized with ACS and report on in-hospital outcomes. METHODOLOGY This single-center retrospective study was conducted at the Aga Khan University Hospital, Nairobi. Medical records of all young individuals hospitalized with ACS from 30th June 2020 to 1st May 2023 were reviewed. We defined young individuals as 50 years or below. Categorical variables were reported as frequencies and proportions, and compared with Pearson chi- square or Fisher's exact tests. Continuous variables were reported as means or medians and compared with independent t-tests or Mann-Whitney U tests. P- value < 0.05 was considered statistically significant. RESULTS Among 506 patients hospitalized with ACS, (n = 138,27.2%) were aged 50 years and below. The study population was male (n = 107, 79.9%) and African(n = 82,61.2%) predominant with a median age of 46.5 years (IQR 41.0-50.0). Hypertension (n = 101,75.4%) was noted in most study participants. More than half of the cohort were smokers (n = 69,51.5%) having a family history of premature ASCVD(n = 70,52.2%) and were on lipid-lowering therapy(n = 68,50.7%) prior to presentation. ST-segment-elevation myocardial infarction (STEMI) was the most common clinical manifestation of ACS (n = 77, 57.5%). Of the significant coronary artery disease (n = 75,56.0%), the majority of the individuals had single vessel disease (n = 60, 80%) with a predilection of left anterior deciding artery(n = 47,62.6%). The Main cause of ACS was atherosclerosis (n = 41,54.6%). The mean left ventricular ejection fraction was 46.0 (± 12.4). The in-hospital mortality was (n = 2, 1.5%). CONCLUSION This study highlights that young individuals contribute to a relatively large proportion of patients presenting with ACS at our center. The most common presentation was STEMI. The principal cause was atherosclerosis. The findings of this study highlight the importance of developing systems of care that enable the early detection of CAD. Traditional cardiovascular risk factors were prevalent and modifiable, thus targets of intervention.
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Affiliation(s)
- Nadeem Kassam
- Department of cardiology, Aga Khan University Kenya, P.O. Box 30270 - 00100, Nairobi, Kenya.
| | - Mzee Ngunga
- Department of cardiology, Aga Khan University Kenya, P.O. Box 30270 - 00100, Nairobi, Kenya
| | - Mohamed Varwani
- Department of cardiology, Aga Khan University Kenya, P.O. Box 30270 - 00100, Nairobi, Kenya
| | - Miriam Msunza
- Department of cardiology, Aga Khan University Kenya, P.O. Box 30270 - 00100, Nairobi, Kenya
| | - Mohamed Jeilan
- Department of cardiology, Aga Khan University Kenya, P.O. Box 30270 - 00100, Nairobi, Kenya
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Petersen KE, Rosthøj S, Halkjær J, Loft S, Tjønneland A, Olsen A. Parental cardiovascular disease and cardiovascular disease risk factors in the offspring: The Diet, Cancer and Health cohorts. Atherosclerosis 2024; 388:117406. [PMID: 38141480 DOI: 10.1016/j.atherosclerosis.2023.117406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 11/22/2023] [Accepted: 11/29/2023] [Indexed: 12/25/2023]
Abstract
BACKGROUND AND AIMS Cardiovascular disease (CVD) aggregates in families and offspring with parental CVD may have adverse risk factor levels long time before the potential onset of CVD. We compared risk factor levels in offspring of parents with atherosclerotic CVD (ASCVD) and parents with no ASCVD at different parental ages at onset. METHODS The study included 5751 participants (median age: 50 years) of the Diet, Cancer and Health - Next Generations study. Measurements included blood pressure, body composition and lipid fractions. Information on parental ASCVD and age at disease onset was obtained through register linkage. Parental ASCVD was defined as myocardial infarction, ischemic stroke or peripheral artery disease occurring <70 years, prematurely (mothers: <65 years fathers: <55 years), divided into age categories or using a broader classification of CVD. Linear regression models using Generalized Estimating Equations were used for analysis. Analyses were adjusted for age, sex, education, smoking, alcohol intake, physical activity and some additionally for BMI. RESULTS Offspring with parental ASCVD had a higher blood pressure, waist circumference, BMI, visceral adipose tissue, percentage of body fat and non-HDL cholesterol levels, but not other lipid levels, compared to offspring with no parental ASCVD (all p < 0.01). Overall, the same patterns were observed for parental ASCVD occurring prematurely and using a broader CVD classification. CONCLUSIONS Offspring with parental ASCVD had a higher blood pressure, higher body composition measures and higher non-HDL cholesterol levels compared to offspring with no parental ASCVD. Findings were overall consistent across different classifications of parental ASCVD.
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Affiliation(s)
| | - Susanne Rosthøj
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Jytte Halkjær
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark
| | - Steffen Loft
- Department of Public Health, Section of Environmental Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Tjønneland
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark; Department of Public Health, Section of Environmental Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anja Olsen
- Danish Cancer Institute, Danish Cancer Society, Copenhagen, Denmark; Section for Epidemiology, Department of Public Health, Aarhus University, Denmark.
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Familial aggregation of the aging process: biological age measured in young adult offspring as a predictor of parental mortality. GeroScience 2022; 45:901-913. [PMID: 36401109 PMCID: PMC9886744 DOI: 10.1007/s11357-022-00687-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 11/06/2022] [Indexed: 11/20/2022] Open
Abstract
Measures of biological age (BA) integrate information across organ systems to quantify "biological aging," i.e., inter-individual differences in aging-related health decline. While longevity and lifespan aggregate in families, reflecting transmission of genes and environments across generations, little is known about intergenerational continuity of biological aging or the extent to which this continuity may be modified by environmental factors. Using data from the Jerusalem Perinatal Study (JPS), we tested if differences in offspring BA were related to mortality in their parents. We measured BA using biomarker data collected from 1473 offspring during clinical exams in 2007-2009, at age 32 ± 1.1. Parental mortality was obtained from population registry data for the years 2004-2016. We fitted parametric survival models to investigate the associations between offspring BA and parental all-cause and cause-specific mortality. We explored potential differences in these relationships by socioeconomic position (SEP) and offspring sex. Participants' BAs widely varied (SD = 6.95). Among those measured to be biologically older, parents had increased all-cause mortality (HR = 1.10, 95% CI: 1.08, 1.13), diabetes mortality (HR = 1.19, 95% CI: 1.08, 1.30), and cancer mortality (HR = 1.07, 95% CI: 1.02, 1.13). The association with all-cause mortality was stronger for families with low compared with high SEP (Pinteraction = 0.04) and for daughters as compared to sons (Pinteraction < 0.001). Using a clinical-biomarker-based BA estimate, observable by young adulthood prior to the onset of aging-related diseases, we demonstrate intergenerational continuity of the aging process. Furthermore, variation in this familial aggregation according to household socioeconomic position (SEP) at offspring birth and between families of sons and daughters proposes that the environment alters individuals' aging trajectory set by their parents.
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Muacevic A, Adler JR, Ajibade A, Foryoung J, Roberts M, Greathouse M. Near-Fatal Acute Myocardial Infarction in a Young Patient With Occlusive Coronary Artery Disease. Cureus 2022; 14:e32012. [PMID: 36589172 PMCID: PMC9798673 DOI: 10.7759/cureus.32012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 11/30/2022] Open
Abstract
Acute myocardial infarction (AMI) due to obstructive coronary artery disease in young patients is an unusual event. Its clinical pattern somewhat differs from that of elderly patients, thus placing them at an increased risk of misdiagnosis, as this young population typically does not demonstrate the traditional risk factors associated with cardiovascular disease. We report the case of a 35-year-old man who presented with new-onset chest pain leading to cardiac arrest and was found to have 100% occlusion of the left anterior descending (LAD) coronary artery, which was successfully managed with the placement of a drug-eluting stent. We briefly reviewed the literature and noted that to reduce the risk of dramatic outcomes, it is imperative to include acute MI in the differential diagnosis of young patients presenting with chest pain, regardless of the presence or absence of any identifiable risk factor.
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Kataria N, Panda A, Singh S, Patrikar S, Sampath S. Risk factors for cardiovascular disease in a healthy young population: Family matters. Med J Armed Forces India 2022; 78:405-412. [PMID: 36267508 PMCID: PMC9577267 DOI: 10.1016/j.mjafi.2020.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 07/07/2020] [Indexed: 10/23/2022] Open
Abstract
Background India faces an epidemic of cardiovascular disease (CVD). This study sought the effect of family history of CVD and/or its risk factors (CVD-risk) on the presence of risk factors for CVD, in a healthy young college population. Methods Blood pressure (BP), heart rate (HR), anthropometric variables, fasting blood sugar and lipid fractions were measured in two hundred healthy individuals (163 men and 37 women), aged 17-22 years. Data were analysed to elicit effect of CVD-risk on measured parameters. Results All but one subject, had family history of a CVD-risk. Men with family history of coronary heart disease had higher diastolic BP (79.24 ± 7.7 vs 75.99 ± 7.49 mmHg, p = 0.007) and triglycerides (118.66 ± 57.98 vs 85.82 ± 50.89 mg/dL, p < 0.0001) compared with those without similar family history. Men with family history of hypertension (HTN) had higher diastolic BP (78.75 ± 7.15 vs 75.84 ± 8.37 mmHg, p = 0.019) and low-density lipoprotein (86.24 ± 25.38 vs 78.21 ± 17.93 mg/dL, p = 0.019), as well as lower high-density lipoprotein (50.27 ± 8.4 vs 53.96 ± 10.38 mg/dL, p = 0.019). Women with family history of diabetes mellitus had lower high-density lipoproteins (49.89 ± 8.05 vs 59.53 ± 11.44, p = 0.006). Family history of dyslipidaemia was associated with significantly higher triglycerides (146.14 ± 46.19 vs 98.44 ± 56.19 mg/dL, p = 0.002) in men and in subjects across sex. HDL was contrarily higher, in women with family history of cerebrovascular accident/HTN and men with family history of coronary heart disease/HTN. The proportion of pre-HTN, overweight/obese, impaired fasting glucose and borderline high triglycerides was 88.3%, 36.8%, 11% and 38.7% in men and 64.9%, 37.8%, 18.9% and 48.7% in female subjects. Conclusion Young adults with a family history of CVD-risk already have an incomplete/atypical CVD risk profile.
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Affiliation(s)
| | - Arihant Panda
- Medical Cadet, Armed Forces Medical College, Pune, India
| | - Surinderpal Singh
- Additional Professor (Physiology), AIIMS, Rishikesh, Virbhadra Marg, Rishikesh, Uttarakhand, India
| | - Seema Patrikar
- Lecturer in Statistics, Department of Community Medicine, Armed Forces Medical College, Pune, India
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Kwak JH, Ha EK, Kim JH, Cha HR, Lee SW, Han MY. Association of Familial History of Diabetes, Hypertension, Dyslipidemia, Stroke, or Myocardial Infarction With Risk of Kawasaki Disease. J Am Heart Assoc 2022; 11:e023840. [PMID: 35699188 PMCID: PMC9238666 DOI: 10.1161/jaha.121.023840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
Background There are few studies on the association with Kawasaki disease in children and the family’s history of cardiovascular disease (CVD). The aim of this study was to identify the association of increased risks for Kawasaki disease in children with a family history of CVD. Methods and Results Clinical data of children born in 2008 and 2009 (n=917 707) were obtained from the National Health Insurance Service and the National Health Screening Program for Infants and Children for this study. The cohort consisted of 495 215 participants (53.8%) who completed the family history questionnaire for children 54 to 60 months old. Family history of CVD included 5 medical conditions: hypertension, dyslipidemia, myocardial infarction, stroke, and diabetes. Kawasaki disease was defined using the disease code, intravenous immunoglobulin prescription, and use of antipyretics for more than 25 days. Severe Kawasaki disease was defined as diagnosis of accompanied cardiac/coronary artery complications or intravenous immunoglobulin use ≥2 times. The incidence rate of Kawasaki disease was 124/100 000 person‐years (95% CI, 117.5–131.5) for children <2 years old, 95/100 000 person‐years (95% CI, 90.5–100.4) in children 2 to 5 years old, and 14/100 000 person‐years (95% CI, 12.6–15.6) in children >5 years old. After propensity‐score matching, 829 participants with a family history of CVD were diagnosed as having Kawasaki disease (0.68% [95% CI, 0.63–0.72]), and 690 patients with Kawasaki disease (0.56% [95% CI, 0.52–0.61]) had no family history of CVD. The family history of CVD was associated with increased risk for Kawasaki disease (risk ratio, 1.20 [95% CI, 1.08–1.32]) but not for severe Kawasaki disease (risk ratio, 1.23 [95% CI, 0.92–1.65]). Conclusions In this nationwide propensity‐score matched study, those with a family history of CVD had a significantly greater risk of Kawasaki disease compared with those who had no family history of CVD.
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Affiliation(s)
- Ji Hee Kwak
- Department of Pediatrics Kangbuk Samsung HospitalSungkyunkwan University School of Medicine Seoul Korea
| | - Eun Kyo Ha
- Department of Pediatrics Kangnam Sacred Heart HospitalHallym University College of Medicine Seoul Korea
| | - Ju Hee Kim
- Department of Pediatrics Kangdong Sacred Heart HospitalHallym University College of Medicine Seoul Korea
| | - Hye Ryung Cha
- Department of Data Science Sejong University College of Software Convergence Seoul Korea
| | - Seung Won Lee
- Department of Data Science Sejong University College of Software Convergence Seoul Korea.,Department of Precision Medicine Sungkyunkwan University School of Medicine Suwon Korea
| | - Man Yong Han
- Department of Pediatrics CHA Bundang Medical Center CHA University School of Medicine Seongnam Korea
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Ajitkumar J, Varun N. Clinical and angiographic profile of acute coronary syndrome patients (<40 years) and short-term prognosis: A cross-sectional study. JOURNAL OF THE PRACTICE OF CARDIOVASCULAR SCIENCES 2021. [DOI: 10.4103/jpcs.jpcs_58_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Parental history of coronary artery disease among adults with hypothyroidism: Case controlled study. Ann Med Surg (Lond) 2020; 60:92-101. [PMID: 33133591 PMCID: PMC7588661 DOI: 10.1016/j.amsu.2020.10.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/16/2020] [Accepted: 10/18/2020] [Indexed: 11/23/2022] Open
Abstract
Background Thyroid dysfunction has a negative impact on coronary artery diseases (CAD) through several changes in its risk factors like dyslipidemia, glucose intolerance, and components of metabolic syndrome. Parental history of premature CAD may be an important risk factor for their offspring. Objective To investigate whether overt and subclinical hypothyroidism and the risk of atherosclerosis are present in adults with parental history of CAD. Materials and methods This case control study included 135 hypothyroid patients and 100 age-sex matched controls. Data were analyzed regarding CAD risk factors, hormonal and biochemical measures including retinol Binding Protein-4, fasting serum insulin, high-sensitivity C-reactive protein, lipid profile, fasting serum glucose, and serum malondialdehyde. Results Parental history of CAD was significantly higher in overt hypothyroidism than subclinical group (P = 0.001). The level of RBP-4 in hypothyroid patients was significantly higher than euthyroid subjects (P = 0.03), and was higher in hypothyroid patients with positive parental history of CAD (p = 0.01). There were positive relationships between RBP-4 and related cardiovascular risk factors and with hypothyroidism, its sensitivity and specificity were 47.9% and 42.5% respectively. The positive predictive value was 60.8% and the negative predictive value was 30.4%. Hypothyroid patients with parental history of CAD had a risk of 3.7 times more than the euthyroid subjects. Conclusions In hypothyroidism patients, parental history of CAD is a predictor of future coronary events and the related risk factors. RBP-4 is positively correlated with waist circumference, BMI, lipid profile, High-sensitivity CRP, MDA, fasting serum glucose, fasting serum insulin, HOMA indices and TSH.
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Hamoen M, Vergouwe Y, Wijga AH, Heymans MW, Jaddoe VWV, Twisk JWR, Raat H, de Kroon MLA. Dynamic prediction of childhood high blood pressure in a population-based birth cohort: a model development study. BMJ Open 2018; 8:e023912. [PMID: 30467134 PMCID: PMC6252684 DOI: 10.1136/bmjopen-2018-023912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVES To develop a dynamic prediction model for high blood pressure at the age of 9-10 years that could be applied at any age between birth and the age of 6 years in community-based child healthcare. DESIGN, SETTING AND PARTICIPANTS Data were used from 5359 children in a population-based prospective cohort study in Rotterdam, the Netherlands. OUTCOME MEASURE High blood pressure was defined as systolic and/or diastolic blood pressure ≥95th percentile for gender, age and height. Using multivariable pooled logistic regression, the predictive value of characteristics at birth, and of longitudinal information on the body mass index (BMI) of the child until the age of 6 years, was assessed. Internal validation was performed using bootstrapping. RESULTS 227 children (4.2%) had high blood pressure at the age of 9-10 years. Final predictors were maternal hypertensive disease during pregnancy, maternal educational level, maternal prepregnancy BMI, child ethnicity, birth weight SD score (SDS) and the most recent BMI SDS. After internal validation, the area under the receiver operating characteristic curve ranged from 0.65 (prediction at age 3 years) to 0.73 (prediction at age 5-6 years). CONCLUSIONS This prediction model may help to monitor the risk of developing high blood pressure in childhood which may allow for early targeted primordial prevention of cardiovascular disease.
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Affiliation(s)
- Marleen Hamoen
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Erasmus University Medical Center, The Generation R Study Group, Rotterdam, Netherlands
| | - Yvonne Vergouwe
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Alet H Wijga
- National Institute for Public Health and the Environment, Center for Nutrition, Prevention and Health Services, Bilthoven, Netherlands
| | - Martijn W Heymans
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Vincent W V Jaddoe
- Erasmus University Medical Center, The Generation R Study Group, Rotterdam, Netherlands
| | - Jos W R Twisk
- Department of Epidemiology and Biostatistics, Amsterdam Public Health research institute, VU University Medical Center, Amsterdam, Netherlands
| | - Hein Raat
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marlou L A de Kroon
- Department of Public Health, Erasmus University Medical Center, Rotterdam, Netherlands
- Department of Health Sciences, University Medical Center Groningen, Groningen, Netherlands
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Do You Know How Young Your Heart Is? ARS MEDICA TOMITANA 2018. [DOI: 10.2478/arsm-2018-0012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
We present the case of a 25 years old patient who was submitted to our unit with a first time acute coronary syndrome. Despite his young age he had multiple cardiovascular risk factors. Although the chest pain was atypical and the electrocardiogram on presentation had unspecific changes, repeated investigations established the diagnosis of anterolateral myocardial infarction. Per primam angioplasty with stent implantation in the proximal segment of left anterior descending artery was performed, with good clinical outcome. Awareness is the key in establishing the diagnosis of myocardial infarction in young patients.
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Pillay AK, Naidoo DP. Atherosclerotic disease is the predominant aetiology of acute coronary syndrome in young adults. Cardiovasc J Afr 2017; 29:36-42. [PMID: 29293260 PMCID: PMC6002794 DOI: 10.5830/cvja-2017-035] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Accepted: 07/13/2017] [Indexed: 01/09/2023] Open
Abstract
Objectives Few studies have evaluated young adults in their third and fourth decades with coronary artery disease (CAD). This study evaluated the clinical and angiographic profile of young adults (< 35 years) with CAD. Methods A 10-year (2003–2012) retrospective chart reviewwas performed on patients less than 35 years diagnosed withCAD at Inkosi Albert Luthuli Central Hospital, Durban. Results Of the 100 patients who met the study criteria, the majority were male (90%), of Indian ethnicity (79%), and presented with acute coronary syndrome (93%). Smoking (82%), dyslipidaemia (79%) and dysglycaemia (75%) were the most prevalent risk factors. Almost half of the subjects (48%) met criteria for the metabolic syndrome. Angiographic findings revealed multi-vessel (42%), single-vessel (36%) and non-occlusive disease (20%); only two subjects had normal epicardial vessels. Disease severity was influenced by dyslipidaemia (p = 0.002) and positive family history (p = 0.002). Non-coronary aetiologies were identified in 19% of subjects. Conclusions Atherosclerotic disease associated with risk-factor clustering was highly prevalent in young adults with CAD.
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Affiliation(s)
- A K Pillay
- Department of Internal Medicine, University of KwaZulu-Natal, Durban, South Africa.
| | - D P Naidoo
- Department of Cardiology, University of KwaZulu-Natal, Durban, South Africa
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Barrett-Williams SL, Franks P, Kay C, Meyer A, Cornett K, Mosier B. Bridging Public Health and Education: Results of a School-Based Physical Activity Program to Increase Student Fitness. Public Health Rep 2017; 132:81S-87S. [PMID: 29136492 DOI: 10.1177/0033354917726328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Power Up for 30 (PU30) is a schoolwide intervention that encourages schools to provide an additional 30 minutes of physical activity during the school day, beyond physical education. The objective of this study was to evaluate the impact of PU30 on Georgia public elementary schools and their students. METHODS A total of 719 of 1320 public elementary schools in Georgia that were sent a baseline survey about school physical activity during October 2013 to September 2014 completed the survey, 160 of which were asked to complete a second survey. In the interim (March to June 2015), half (80) of these schools implemented the PU30 program. The interim surveys, which were completed during March to June 2015, assessed opportunities for student physical activity and staff member professional development focused on student physical activity. RESULTS Compared with schools that had not implemented the program, more schools using the PU30 program reported offering before- and after-school physical activity programs. Forty-four of 78 (57%) PU30 schools compared with 20 of 53 (38%) non-PU30 schools offered before-school physical activity programs. Likewise, more PU30 schools than non-PU30 schools offered after-school physical activity programs (35% vs 16%), and a greater proportion of students at PU30 schools compared with non-PU30 schools met fitness benchmarks: recess 5 days per week (91% [288 of 323] vs 80% [273 of 341]), offering ≥11 minutes per day of classroom-based physical activity (39% [53 of 136] vs 25% [47 of 189] for kindergarten through second grade; 20% [37 of 187] vs 6% [9 of 152] for grades 3 through 5), and receiving physical activity-related professional development time (42% [136 of 323] vs 14% [48 of 341]). CONCLUSIONS The surveys provided a statewide picture of the physical activity opportunities offered to students and staff members in Georgia elementary schools and demonstrated the effective use of a comprehensive, multicomponent program to offer more school-based physical activity opportunities and to improve student fitness.
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Affiliation(s)
| | | | | | | | - Kelly Cornett
- 2 Georgia Department of Public Health, Atlanta, GA, USA
| | - Brian Mosier
- 3 Department of Sport Management, Wellness, and Physical Education, College of Education, University of West Georgia, Carrollton, GA, USA
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Pourebrahim R, Fakhrzadeh H, Bandarian F, Tabatabaie O, Noori M, Djalilpour F, Zahedi F, Rahimi I, Heshmat R, Djavadi E, Ghotbi S, Larijani B. Household cardiovascular screening of high-risk families: a school-based study. ACTA ACUST UNITED AC 2016; 13:229-35. [PMID: 16575277 DOI: 10.1097/01.hjr.0000214605.53372.62] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A parental history of cardiovascular disease has a strong relationship with risk factor clusters in the offspring. This study was performed to identify major cardiovascular risk factors in middle school-aged children and their parents in both high and low-risk families. DESIGN A school-based, cross-sectional study. METHODS The middle schools of the 6th district of Tehran were divided randomly into two groups. A total of 169 high-risk children with their families were recruited from the first group and 105 low-risk children with their families were recruited from the second group of schools. Anthropometric and metabolic measurements were performed. RESULTS The means of the waist circumference and waist-to-hip ratio were significantly higher in high-risk fathers. The means of total and low-density lipoprotein (LDL) cholesterol were significantly higher in both parents and children of the high-risk group. The means of the fasting plasma glucose were significantly higher in fathers and offspring of high-risk families. More fathers in high-risk families were smokers. The prevalence of increased total cholesterol, LDL-cholesterol and hyperglycemia (> or = 100 mg/dl) were higher in high-risk parents and children. The prevalence of increased body mass index (> or = 25 kg/m for parents and 85th percentile for children) was higher in fathers and children of high-risk families. CONCLUSIONS Cardiovascular risk factors are more prevalent and clustered in high-risk families. The screening of high-risk families is essential to prevent the progression of atherosclerosis from childhood and reduce the burden of cardiovascular disease in adulthood.
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Affiliation(s)
- Rasoul Pourebrahim
- Endocrinology and Metabolism Research Center, Tehran University of Medical Sciences, Tehran, Iran
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Vulic D, Loncar S, Ostojic M, Marinkovic J, Vulic B, Wong ND. Risk factor indicators in offspring of patients with premature coronary heart disease in Banja Luka region/Republic of Srpska/Bosnia and Herzegovina. Arch Med Sci 2016; 12:736-41. [PMID: 27478453 PMCID: PMC4947620 DOI: 10.5114/aoms.2016.60958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Accepted: 02/17/2015] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Risk factor differences among offspring of patients with premature coronary heart disease (CHD) have not been widely studiem. MATERIAL AND METHODS We examined 161 persons from the region of Banja Luka, including 81 children (mean age: 25.9 years, 45.7% female) with a history of CHD and a control group of 80 persons (mean age: 24.1, 50% female). Medical history interviews and risk factor measurements were performed. RESULTS There were differences in mean body amss index (BMI) (26.1 kg/m(2) vs. 23.1 kg/m(2), p < 0.0001), waist circumference (87.7 cm vs. 83.9 cm, p = 0.002), hip circumference (99.3 cm vs. 95.84 cm, p < 0.002), systolic blood pressure (BP) (128.09 mm Hg vs. 122.7 mm Hg, p = 0.007), and diastolic BP (99.3 mm Hg vs. 95.8 mm Hg, p = 0.07). Moreover, HDL-cholesterol was significantly lower (1.1 mmol/l vs. 1.4 mmol/l, p = 0.0001), triglycerides significantly higher (2.2 mmol/l vs. 1.6 mmol/l, p = 0.001), and TC/HDL-ratio was significantly higher (5.1 vs. 4.0, p < 0.001) comparing cases and controls, respectively, adjusted for age, gender, and standard CHD risk factors total cholesterol, LDL and HDL cholesterol, smoking, systolic and diastolic BP, and BMI, those with HDL-C > 1.0 mmol/l in men and 1.2 mmol/l in women had a reduced odds (OR = 0.08, 95% CI: 0.02-0.34 of CHD as well as those with change of fat type (OR = 0.26, 95% CI: 0.11-0.60). CONCLUSIONS Children of parents with premature CHD have a significantly greater burden of CHD risk factors, with low HDL-C, in particular, being associated with an increased likelihood of being a child of a parent with premature CHD.
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Affiliation(s)
- Dusko Vulic
- Department of Internal Medicine, School of Medicine, University of Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Sasa Loncar
- Department of Cardiology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Miodrag Ostojic
- Department of Cardiology, Clinical Center Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Jelena Marinkovic
- Department of Statistics, Institute for Statitistics, Schol of Medicine, Belgrade, Serbia
| | - Branka Vulic
- Department of Internal Medicine, School of Medicine, University of Banja Luka, Republic of Srpska, Bosnia and Herzegovina
| | - Nathan D. Wong
- Heart Disease Prevention Program, Division of Cardiology, Department of Medicine, University of California, Irvine, USA
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Berentzen NE, Wijga AH, van Rossem L, Koppelman GH, van Nieuwenhuizen B, Gehring U, Spijkerman AMW, Smit HA. Family history of myocardial infarction, stroke and diabetes and cardiometabolic markers in children. Diabetologia 2016; 59:1666-74. [PMID: 27239670 DOI: 10.1007/s00125-016-3988-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 04/22/2016] [Indexed: 01/15/2023]
Abstract
AIMS/HYPOTHESIS Despite the overlap in occurrence of cardiovascular disease (CVD) and type 2 diabetes and their risk factors, family history of these diseases has not yet been investigated simultaneously in relation to cardiometabolic markers in offspring. We examined how a family history of CVD and/or diabetes relates to cardiometabolic markers in offspring, and to what extent these diseases independently contribute to cardiometabolic markers. METHODS We used data from 1,374 12-year-old children and their parents participating in a birth cohort study in the Netherlands. Family history of CVD (myocardial infarction [MI] and stroke) and diabetes were reported by the parents. Children were classified as 'no', 'moderate' or 'strong' family history, based on early/late onset of disease in parents and grandparents. Cardiometabolic markers were measured at 12 years of age: waist circumference, cholesterol, blood pressure and HbA1c. RESULTS Compared with those with no family history, children with a strong family history of MI and/or stroke and/or diabetes (29% of the study population) had 0.13 mmol/l higher total cholesterol (TC) (95% CI 0.03, 0.23) and 0.18 higher TC/HDL-cholesterol (HDLC) ratio (95% CI 0.04, 0.32). A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases. These associations remained after adjusting for BMI. Children with a moderate family history had no unfavourable cardiometabolic markers. CONCLUSIONS/INTERPRETATION One-third of the children had a strong family history of CVD and/or diabetes. These children had higher TC levels and TC/HDLC ratios than children with no family history. A strong family history of MI or diabetes was independently associated with unfavourable cardiometabolic markers specific to those diseases.
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Affiliation(s)
- Nina E Berentzen
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Alet H Wijga
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands.
| | - Lenie van Rossem
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Gerard H Koppelman
- University of Groningen, UMCG, Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, GRIAC Research Institute, Groningen, the Netherlands
| | - Bo van Nieuwenhuizen
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences (IRAS), Division of Environmental Epidemiology, Utrecht University, Utrecht, the Netherlands
| | - Annemieke M W Spijkerman
- Center for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, PO Box 1, 3720 BA, Bilthoven, the Netherlands
| | - Henriëtte A Smit
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
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Banerjee AT, Flora PK, Stone M, Faulkner G. Differences in the Prevalence of Overweight Between 10-12-Year-old South Asian and Non-South Asian Children in Toronto, Ontario: Findings from Project BEAT. J Racial Ethn Health Disparities 2016; 2:184-91. [PMID: 26863337 DOI: 10.1007/s40615-014-0062-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Revised: 08/27/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study is to assess the prevalence of overweight among 10-12-year-old South Asian children in comparison to non-South Asian children. METHODS This cross-sectional study obtained data from 16 schools in Toronto, Ontario. The analysis included 734 children (260 South Asian and 475 non-South Asian) aged 10-12 years. Height and weight were measured, and body mass index (BMI; kg/m(2)) was calculated according to age- and sex-specific cut points established by the International Obesity Task Force (IOTF). RESULTS The prevalence of overweight was significantly higher among South Asian children when compared to non-South Asian children (36.9 vs. 23.0 %; p < 0.001). Unadjusted, South Asian children exhibited increased odds for being overweight (OR = 1.96; CI = 1.41-2.73; p < 0.001) compared to non-South Asian children and persisted after the adjustment for socio-demographic covariates but did not remain significant after the inclusion of physical activity and sedentary behaviour variables. The adjusted odds for being overweight was significantly higher among South Asian boys (but not girls) compared to their non-South Asian counterparts (OR = 2.45; CI = 1.32-4.55; p < 0.0001). CONCLUSIONS The prevalence of overweight differs by ethnic group and gender. South Asian boys have increased odds of being overweight compared to non-South Asian boys. Children of South Asian origin should receive focused attention in public health initiatives to reduce the risk of becoming overweight and the associated metabolic consequences.
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Affiliation(s)
- Ananya Tina Banerjee
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
| | - Parminder K Flora
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Michelle Stone
- School of Health and Human Performance, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Guy Faulkner
- Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Weijmans M, van der Graaf Y, de Borst GJ, Asselbergs FW, Cramer MJ, Algra A, Visseren FL. Prevalence and risk of cardiovascular risk factors and events in offspring of patients at high vascular risk and effect of location of parental vascular disease. Int J Cardiol 2015; 195:195-202. [DOI: 10.1016/j.ijcard.2015.05.059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Revised: 04/23/2015] [Accepted: 05/09/2015] [Indexed: 11/30/2022]
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18
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Parsons I, White S, Gill R, Gray HH, Rees P. Coronary artery disease in the military patient. J ROY ARMY MED CORPS 2015; 161:211-22. [PMID: 26246347 DOI: 10.1136/jramc-2015-000495] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 06/27/2015] [Indexed: 01/17/2023]
Abstract
Ischaemic heart disease is the most common cause of sudden death in the UK, and the most common cardiac cause of medical discharge from the Armed Forces. This paper reviews current evidence pertaining to the diagnosis and management of coronary artery disease from a military perspective, encompassing stable angina and acute coronary syndromes. Emphasis is placed on the limitations inherent in the management of acute coronary syndromes in the deployed environment. Occupational issues affecting patients with coronary artery disease are reviewed. Consideration is also given to the potential for coronary artery disease screening in the military, and the management of modifiable cardiovascular disease risk factors, to help decrease the prevalence of coronary artery disease in the military population.
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Affiliation(s)
- Iain Parsons
- Department of Critical Care, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - S White
- Department of Cardiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R Gill
- Department of Regional Occupational Health, Queen Elizabeth Memorial Health Centre, Tidworth, UK
| | - H H Gray
- Department of Cardiology, University Hospital Southampton NHS Foundation Trust & Civilian Consultant Advisor to the British Army, Southampton, UK
| | - P Rees
- Department of Cardiology, Barts Health NHS Trust & Academic Department of Military Medicine, London, UK
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19
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Labos C, Wang RHL, Pilote L, Bogaty P, Brophy JM, Engert JC, Thanassoulis G. Traditional risk factors and a Genetic Risk Score are associated with age of first acute coronary syndrome. Heart 2015; 100:1620-4. [PMID: 24842871 DOI: 10.1136/heartjnl-2013-305416] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE To examine the association between traditional risk factors (TRF) and a Genetic Risk Score (GRS) with age of first acute coronary syndrome (ACS). Early onset ACS may occur due to a high burden of TRFs or to genetic factors that accelerate atherosclerosis. Whether recently discovered genetic variants for ACS are more prevalent at earlier age of first ACS remains unknown. METHODS To construct a multilocus GRS, participants were genotyped for 30 single nucleotide polymorphisms (SNP) identified from prior genome-wide association studies. Linear regression models were fit to estimate the association between TRFs and GRS with age of first ACS. RESULTS We included 460 participants with a first ACS enrolled in the Recurrence and Inflammation in the Acute Coronary Syndromes (RISCA) cohort. Several TRFs were associated (all p<0.05) with earlier age of first ACS: male sex (6.9 years earlier (95% CI 4.1 to 9.7)), current cigarette smoking (8.1 years (95% CI 6.1 to 10.0)), overweight (Body Mass Index, BMI >25) and obesity (BMI>30) (5.2 years (95% CI 2.6 to 7.9)). In women, hormone replacement therapy was also associated with earlier age of first ACS (4.8 years earlier (95% CI 0.3 to 8.4)). After multivariable adjustment for TRFs, a 1 SD increment in the GRS was associated with a 1.0 (95% CI 0.1 to 2.0) year earlier age of first ACS. CONCLUSIONS Among individuals with a first ACS, a GRS composed of 30 SNPs is associated with younger age of presentation. Although genetic predisposition modestly contributes to earlier ACS, a heavy burden of TRF is associated with markedly earlier ACS.
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20
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Nielsen LA, Nielsen TRH, Holm JC. The Impact of Familial Predisposition to Obesity and Cardiovascular Disease on Childhood Obesity. Obes Facts 2015; 8:319-28. [PMID: 26465142 PMCID: PMC5644828 DOI: 10.1159/000441375] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2014] [Accepted: 08/03/2015] [Indexed: 01/24/2023] Open
Abstract
The prevalence of childhood obesity has reached alarming rates world-wide. The aetiology seems to be an interplay between genetic and environmental factors, and a surrogate measure of this complex interaction is suggested as familial predisposition. Familial predisposition to obesity and related cardiovascular disease (CVD) complications constitute the presence of obesity and/or obesity-related complications in primarily blood-related family members. The approaches of its measurement and applicability vary, and the evidence especially of its influence on obesity and obesity treatment in childhood is limited. Studies have linked a familial predisposition of obesity, CVD (hypertension, dyslipidaemia and thromboembolic events), and type 2 diabetes mellitus to BMI as well as other adiposity measures in children, suggesting degrees of familial aggregation of metabolic derangements. A pattern of predispositions arising from mothers, parents or grandparents as being most influential have been found, but further comprehensive studies are needed in order to specify the exact implications of familial predisposition. In the scope of childhood obesity this article reviews the current literature regarding familial predisposition to obesity and obesity-related complications, and how these familial predispositions may impact obesity in the offspring.
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Affiliation(s)
- Louise Aas Nielsen
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- *Louise Aas Nielsen, MS., The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, 4300 Holbæk, Denmark,
| | - Tenna Ruest Haarmark Nielsen
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
| | - Jens-Christian Holm
- The Children's Obesity Clinic, Department of Paediatrics, Copenhagen University Hospital Holbæk, Holbæk, Denmark
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Section of Metabolic Genetics, University of Copenhagen, Copenhagen, Denmark
- University of Copenhagen, Faculty of Health and Medical Sciences, Copenhagen, Denmark
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21
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Risk of progression to hypertension in nonhypertensive Japanese workers aged 20–64 years. J Hypertens 2014; 32:236-44. [DOI: 10.1097/hjh.0000000000000031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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22
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Prabhakaran D, Jeemon P. Should your family history of coronary heart disease scare you? ACTA ACUST UNITED AC 2013; 79:721-32. [PMID: 23239210 DOI: 10.1002/msj.21348] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Traditional risk factors explain most of the risk associated with coronary heart disease, and after adjustment for risk factors family history was believed to contribute very little to population-attributable risk of coronary heart disease. However, the INTERHEART study demonstrated an independent association of family history of coronary heart disease with acute myocardial infarction. To assess this relationship more comprehensively in multiple datasets in different populations, we carried out a detailed review of the available evidence. Case-control studies involving 17,202 cases and 30,088 controls yielded a pooled unadjusted odds ratio (random-effects model, overall I(2) = 64.6%, P = 0.000) of 2.03 (95% confidence interval: 1.79-2.30), whereas cohort studies that included 313,837 individuals yielded an unadjusted relative risk for future coronary heart disease (random-effects model, overall I(2) = 88.7%, P = 0.000) of 1.60 (95% confidence interval: 1.44-1.77). Although the presence of family history of coronary heart disease indicates a cumulative exposure of shared genes and environment, the risk estimates for family history did not attenuate significantly after adjustment for conventional coronary heart disease risk factors in several studies. It is probably an oversimplification to dichotomize the family history variable into a simple "yes" or "no" risk factor, as the significance of family history is influenced by several variables, such as age, sex, number of relatives, and age at onset of disease in the relatives. Moreover, a quantitative risk-assessment model for the family history variable, such as the "family risk score," has a positive linear relationship with coronary heart disease. More studies are warranted to assess the benefits and risks of intensive interventions, both targeted individually and at the family level, among individuals with a valid family history and borderline elevated risk factors.
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23
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Steffen LM, Sinaiko AR, Zhou X, Moran A, Jacobs Jr DR, Korenfeld Y, Dengel DR, Chow LS, Steinberger J. Relation of adiposity, television and screen time in offspring to their parents. BMC Pediatr 2013; 13:133. [PMID: 24004899 PMCID: PMC3766692 DOI: 10.1186/1471-2431-13-133] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2013] [Accepted: 08/24/2013] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND Few studies have examined the relations of adiposity and lifestyle factors in young offspring with their parents as children (parentschild) or at their current age (parentsadult). Therefore, we compared measures of adiposity and lifestyle in parentschild and parentsadult with their offspring. METHODS Two generations (one parent and his/her offspring) participated in this study: 234 parents from a previously established cohort and 382 offspring. Parentsadult and offspring underwent measurements for height, weight, waist circumference, % body fat, visceral fat, and lifestyle habits. Participants were classified as normal weight, overweight, obese based on age-specific BMI criteria. Mixed model linear regression analysis evaluated the associations of adiposity and lifestyle factors of parentschild and parentsadult with that of their offspring, adjusting for age, sex, race, and family membership. RESULTS The prevalence of obesity was greater among offspring mean age 12.3 years compared to their parentschild mean age 12.6 years (18.4% vs 10.1%, p<0.001) even though hours of television (TV) watching were similar between the two generations as children (p=0.80). Sixty percent of parents (as children and adults) and offspring reported more than 2 hours of TV/day. Offspring of parents who were overweight and obese as children had greater BMI (all p<0.001) than offspring of parents who were normal weight as children. For both parentadult and offspring, adiposity was greater with greater total screen time. CONCLUSIONS Identifying high-risk families is important for early intervention of overweight, especially in children.
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Affiliation(s)
- Lyn M Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Alan R Sinaiko
- Department of Pediatrics, University of Minnesota School of Medicine, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Xia Zhou
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Antoinette Moran
- Department of Pediatrics, University of Minnesota School of Medicine, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - David R Jacobs Jr
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Yoel Korenfeld
- Department of Pediatrics, University of Minnesota School of Medicine, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Donald R Dengel
- School of Kinesiology, University of Minnesota, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Lisa S Chow
- Division of Endocrinology, Diabetes and Metabolism, University of Minnesota School of Medicine, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
| | - Julia Steinberger
- Department of Pediatrics, University of Minnesota School of Medicine, 1300 South Second St Suite 300, Minneapolis, MN 55454, USA
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Guardamagna O, Abello F, Anfossi G, Pirro M. Lipoprotein(a) and family history of cardiovascular disease in children with familial dyslipidemias. J Pediatr 2011; 159:314-9. [PMID: 21392785 DOI: 10.1016/j.jpeds.2011.01.038] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2010] [Revised: 11/30/2010] [Accepted: 01/19/2011] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate in children and adolescents with familial dyslipidemias the association between lipoprotein(a) [Lp(a)] level and family history of cardiovascular disease (CVD), and whether this association is independent of the disturbed lipid profile. STUDY DESIGN Lp(a) level, lipid profile, and a 2-generation genealogic tree to detect cardiovascular events were evaluated in 231 patients with familial dyslipidemias. Lp(a) levels were stratified according to presence, age of occurrence, and number and type of cardiovascular events in the patient's kindreds. RESULTS Lp(a) and other plasma lipid fractions did not differ between patients with and those without a family history of cardiovascular events. However, the percentage of patients with elevated Lp(a) level (≥85th percentile) was higher in those with a positive family history for early cardiovascular events (P = .01). Lp(a) level was a significant independent predictor of the number of premature cardiovascular events (β = 0.17; P = .01) and of cerebrovascular events in kindreds (OR, 2.5; 95% CI, 1.05-6.03; P = .039), independent of plasma lipid fractions and other cardiovascular risk factors. CONCLUSIONS In children and adolescents with familial dyslipidemias, the overall association between Lp(a) level and family history of early CVD may be due to a threshold effect in those with the highest Lp(a) levels. However, multiple cardiovascular events and cerebrovascular events are predicted by any increase in plasma Lp(a) level, independent of other cardiovascular risk factors.
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Nadeau KJ, Maahs DM, Daniels SR, Eckel RH. Childhood obesity and cardiovascular disease: links and prevention strategies. Nat Rev Cardiol 2011; 8:513-25. [PMID: 21670745 DOI: 10.1038/nrcardio.2011.86] [Citation(s) in RCA: 130] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The prevalence and severity of pediatric obesity have dramatically increased since the late 1980s, raising concerns about a subsequent increase in cardiovascular outcomes. Strong evidence, particularly from autopsy studies, supports the concept that precursors of adult cardiovascular disease (CVD) begin in childhood, and that pediatric obesity has an important influence on overall CVD risk. Lifestyle patterns also begin early and impact CVD risk. In addition, obesity and other CVD risk factors tend to persist over time. However, whether childhood obesity causes adult CVD directly, or does so by persisting as adult obesity, or both, is less clear. Regardless, sufficient data exist to warrant early implementation of both obesity prevention and treatment in youth and adults. In this Review, we examine the evidence supporting the impact of childhood obesity on adult obesity, surrogate markers of CVD, components of the metabolic syndrome, and the development of CVD. We also evaluate how obesity treatment strategies can improve risk factors and, ultimately, adverse clinical outcomes.
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Affiliation(s)
- Kristen J Nadeau
- The Children's Hospital, Department of Pediatrics, University of Colorado School of Medicine, Building A, 13123 East 16th Avenue, Aurora, CO 80045, USA.
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26
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Affiliation(s)
- Ram Weiss
- Department of Human Metabolism and Nutrition, Hebrew University School of Medicine, Jerusalem, Israel.
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27
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Coelli AP, Nascimento LR, Mill JG, Molina MDCB. [Preterm birth as a risk factor for high blood pressure in children: a systematic review]. CAD SAUDE PUBLICA 2011; 27:207-18. [PMID: 21359457 DOI: 10.1590/s0102-311x2011000200002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2010] [Accepted: 01/14/2010] [Indexed: 11/22/2022] Open
Abstract
Epidemiological studies have suggested that arterial hypertension is a chronic disease that begins in childhood, and that prematurity (birth at less than 37 weeks' gestational age) is potentially associated with the development of hypertension in childhood and adulthood. Our objective was to identify the association between prematurity and high blood pressure in children, using a systematic literature review. Original articles related to the theme and published in English, Portuguese, or Spanish from 1998 to 2009 were selected from the MEDLINE, LILACS, and SciELO databases. We excluded articles without abstracts, review articles, and articles not related to prematurity and hypertension in childhood. Nine articles were located and analyzed: 5 case-control studies, 2 cross-sectional studies, and 2 cohort studies. The majority of the studies failed to show an association between prematurity and arterial hypertension in childhood. However, the influence of prematurity should not be ruled out, given the small number of studies on this theme and the diversity of methodological approaches in the literature.
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Affiliation(s)
- Anna Paula Coelli
- Programa de Pós-graduação em Saúde Coletiva, Universidade Federal do Espírito Santo, Vitória, Brazil
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E L, Fragakis N, Ioannidou E, Bounda A, Theodoridou S, Klonizakis P, Garipidou V. Increased levels of proinflammatory cytokines in children with family history of coronary artery disease. Clin Cardiol 2010; 33:E6-10. [PMID: 20229495 DOI: 10.1002/clc.20434] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Parental history of coronary artery disease (CAD) is considered an important risk factor for early atherosclerosis HYPOTHESIS The onset of the inflammatory process of atherosclerosis initiates early during childhood in children with positive family history (PFH) of CAD. METHODS We studied 55 healthy children (5-15 years), 30 (16 male) with PFH and 25 age and sex matched control subjects. Blood samples were taken to measure white blood count (WBC), glucose, total cholesterol, triglycerides (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), erythrocyte sedimentation rate (SDE), C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-a). We performed cultures on monocytes (from peripheral blood) measuring in the cell culture supernatants the proinflammatory cytokines IL-6 and TNF-a, by using the immunoassay ELISA method. RESULTS : Higher values of body mass index (BMI), total cholesterol, LDL, cholesterol, TG, SDE, leucocytes, and CRP were calculated in children with PFH. Significantly higher values of cytokines in monocell cultures were measured in the PFH group compared to the control group (IL-6 = 139.32 +/- 80.84 pg/ml versus 14.30 +/- 12.97 pg/ml, p < 0.001 and TNF-a = 39.91 +/- 11.80 pg/ml versus 8.65 +/- 4.35 pg/ml, p < 0.001). IL-6 values in plasma and cultures were found independently associated with PFH of premature CAD (p < 0.001, p = 0.005, respectively). A similar relation was found for TNF-a values measured in cultures (p = 0.005) and CRP values in plasma (p < 0.001). The values of IL-6 were found proportionally related to TG. CONCLUSION In individuals with PFH of CAD the inflammatory process of atheromatosis appears to begin early in childhood. Except for triglycerides, this inflammatory process appears to occur independently of several traditional cardiovascular risk factors.
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Affiliation(s)
- Lefkou E
- Hippokrateion University Hospital of Thessaloniki, Greece.
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Abstract
BACKGROUND Family history of lifestyle-related diseases is an important risk factor and is widely used in epidemiologic studies. To justify its use the validity of the family history needs to be assessed. The aim of the present study was therefore to examine reliability, that is, consistency in repeated measurements, of the family history obtained on questionnaire. METHODS A questionnaire survey on the family history of lifestyle-related diseases was conducted for 438 high school students about students' parents, grandparents, uncles and aunts, twice with a 1 year interval. The questionnaire was filled in by their parents. Discordance between the two questionnaires in age, age at death and a positive history of lifestyle-related diseases expressed by age at onset by decade age among the family members was examined. Kappa was used as a measure of agreement. RESULTS The kappas for relatives were high, mostly >0.7 for hypertension and >0.5 for myocardial infarction, angina pectoris, stroke, diabetes mellitus and hypercholesterolemia. The discordance tended to be higher among grandparents than parents, uncles and aunts. The discordance with regard to relatives was mostly <4% for angina pectoris, myocardial infarction, stroke and diabetes mellitus; for hypertension and hypercholesterolemia the discordance was <6%. CONCLUSIONS The questionnaire provides a reliable and valid method of collecting family history on relatives of high school students. Thus, family history obtained through questionnaires can be used justifiably as a risk factor for lifestyle-related diseases among children and youths.
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Affiliation(s)
- Tomohiro Saito
- Division of Epidemiology and Department of Health Policy, National Institute for Child Health and Development, Keio University, Tokyo, Japan.
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Papazafiropoulou A, Sotiropoulos A, Skliros E, Kardara M, Kokolaki A, Apostolou O, Pappas S. Familial history of diabetes and clinical characteristics in Greek subjects with type 2 diabetes. BMC Endocr Disord 2009; 9:12. [PMID: 19397813 PMCID: PMC2680864 DOI: 10.1186/1472-6823-9-12] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2008] [Accepted: 04/27/2009] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A lot of studies have showed an excess maternal transmission of type 2 diabetes (T2D). The aim, therefore, of the present study was to estimate the prevalence of familial history of T2D in Greek patients, and to evaluate its potential effect on the patient's metabolic control and the presence of diabetic complications. METHODS A total of 1,473 T2D patients were recruited. Those with diabetic mothers, diabetic fathers, diabetic relatives other than parents and no known diabetic relatives, were considered separately. RESULTS The prevalence of diabetes in the mother, the father and relatives other than parents, was 27.7, 11.0 and 10.7%, respectively. Patients with paternal diabetes had a higher prevalence of hypertension (64.8 vs. 57.1%, P = 0.05) and lower LDL-cholesterol levels (115.12 +/- 39.76 vs. 127.13 +/- 46.53 mg/dl, P = 0.006) than patients with diabetes in the mother. Patients with familial diabetes were significantly younger (P < 0.001), with lower age at diabetes diagnosis (P < 0.001) than those without diabetic relatives. Patients with a diabetic parent had higher body mass index (BMI) (31.22 +/- 5.87 vs. 30.67 +/- 5.35 Kg/m2, P = 0.08), higher prevalence of dyslipidemia (49.8 vs. 44.6%, P = 0.06) and retinopathy (17.9 vs. 14.5%, P = 0.08) compared with patients with no diabetic relatives. No difference in the degree of metabolic control and the prevalence of chronic complications were observed. CONCLUSION The present study showed an excess maternal transmission of T2D in a sample of Greek diabetic patients. However, no different influence was found between maternal and paternal diabetes on the clinical characteristics of diabetic patients except for LDL-cholesterol levels and presence of hypertension. The presence of a family history of diabetes resulted to an early onset of the disease to the offspring.
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Affiliation(s)
- Athanasia Papazafiropoulou
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Alexios Sotiropoulos
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Eystathios Skliros
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Marina Kardara
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Anthi Kokolaki
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Ourania Apostolou
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
| | - Stavros Pappas
- 3rd Department of Internal Medicine and Center of Diabetes, General Hospital of Nikaia "Ag Panteleimon", Piraeus, Greece
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de Giorgis T, Giannini C, Scarinci A, D'Adamo E, Agostinelli S, Chiarelli F, Mohn A. Family history of premature cardiovascular disease as a sole and independent risk factor for increased carotid intima–media thickness. J Hypertens 2009; 27:822-8. [PMID: 19516181 DOI: 10.1097/hjh.0b013e328325d81b] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Nsiah-Kumi PA, Ariza AJ, Mikhail LM, Feinglass J, Binns HJ. Family history and parents' beliefs about consequences of childhood overweight and their influence on children's health behaviors. Acad Pediatr 2009; 9:53-9. [PMID: 19329092 DOI: 10.1016/j.acap.2008.11.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2008] [Revised: 10/23/2008] [Accepted: 11/02/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVES The aims of this study were to examine factors related to 1) parental perception of health risks for overweight children and 2) parents' self-efficacy for influencing their children's dietary and physical activity behaviors, especially in relation to family history (FH) of diabetes and cardiovascular disease (CVD). METHODS A consecutive sample of parents was surveyed at 7 primary care practices about FH, perceptions of childhood obesity-related health risks, health beliefs, and perceptions. Generalized estimated equation models clustering on practice were developed to examine associations with perceptions and self-efficacy. RESULTS Analyses included 386 parents of children aged 2 to 17 years. Sixty-seven percent had FH of CVD and 33% had FH of diabetes. Children were 57% white, 23% Hispanic, 12% African American, and 8% other race/ethnicity; 17% were overweight and 18% were obese. Parents whose child had FH of diabetes more often perceived higher risk of diabetes for overweight children than those with neither FH risk (adjusted odds ratio [OR] 1.4, 95% confidence interval [95% CI], 1.2-1.7), as did those with FH of CVD (adjusted OR 2.0, 95% CI, 1.6-2.5) and those with an obese child. Parents with less than college education or having African American and female children perceived risk less often. Parents had high self-efficacy for influencing their child if they had a strong belief in parental modeling and their child was aged <12 years. CONCLUSIONS Family history of diabetes and CVD and other factors are associated with parents' perceptions of health risks for overweight children. Strategies to use FH to motivate families with overweight children toward behavior change are needed.
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Affiliation(s)
- Phyllis A Nsiah-Kumi
- Department of Internal Medicine, Section of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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Alpay H, Ozdemir N, Wühl E, Topuzoğlu A. Ambulatory blood pressure monitoring in healthy children with parental hypertension. Pediatr Nephrol 2009; 24:155-61. [PMID: 18797935 DOI: 10.1007/s00467-008-0975-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2008] [Revised: 06/19/2008] [Accepted: 07/16/2008] [Indexed: 12/25/2022]
Abstract
The aim of this study was to compare ambulatory blood pressure monitoring (ABPM) parameters in offspring with at least one hypertensive parent (HP) to offspring with normotensive parents (NP) and to determine whether gender of parent or child might influence the association between parental hypertension and blood pressure (BP). Eighty-nine healthy children (mean age 11.1 +/- 3.9 years) with HP and 90 controls (mean age 10.5 +/- 3.1 years) with NP were recruited. Age, gender, and height did not differ between the two groups, whereas children of HP had higher weight, body mass index (BMI), and waist circumference compared with healthy controls. No difference was found in casual BP between the two groups. In contrast, during ABPM daytime and nighttime mean systolic and diastolic BP and mean arterial pressure (MAP) standard deviation scores (SDS) were significantly elevated in children with HP. The mean percentage of nocturnal BP decline (dipping) was not significantly different between the two groups. Children with hypertensive mothers had higher daytime systolic and MAP SDS than controls; no such difference was detected for children with hypertensive fathers. Daytime systolic and MAP SDS were significantly elevated in boys with HP compared with boys with NP but failed to be significant in girls. Multiple linear regression analysis showed that parental history of hypertension (B = 0.29) and BMI (B = 0.03) were independently correlated with increase of daytime MAP SDS. Early changes in ambulatory BP parameters were present in healthy children of HP. BP in HP offspring was influenced by the gender of the affected parent and the offspring.
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Affiliation(s)
- Harika Alpay
- Division of Pediatric Nephrology, Marmara University Medical School, Istanbul, Turkey.
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Lifecourse Social Conditions and Racial and Ethnic Patterns of Cognitive Aging. Neuropsychol Rev 2008; 18:223-54. [DOI: 10.1007/s11065-008-9064-z] [Citation(s) in RCA: 240] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2008] [Accepted: 07/30/2008] [Indexed: 11/26/2022]
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Crispim D, Canani LH, Gross JL, Tschiedel B, Souto KEP, Roisenberg I. Familial history of type 2 diabetes in patients from Southern Brazil and its influence on the clinical characteristics of this disease. ACTA ACUST UNITED AC 2007; 50:862-8. [PMID: 17160209 DOI: 10.1590/s0004-27302006000500006] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2005] [Accepted: 03/22/2006] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate the presence of maternal and paternal history of type 2 diabetes mellitus (DM) in relatives of 644 type 2 diabetic patients from Southern Brazil, and also to evaluate its influence on the clinical characteristics of this disease. PATIENTS AND METHODS Familial history of type 2 DM was investigated by a questionnaire. The maternal and paternal history was investigated over two generations. Complete data sets on familial history were obtained from 396 patients. RESULTS In general, 76.6% of the patients reported at least one first-degree affected relative. Besides, 31.6% of the patients reported a maternal history of type 2 DM and 12.6% reported a paternal history. Patients with maternal and/or paternal history presented a lower age at type 2 DM diagnosis when compared to patients without familial history. In addition, patients with only paternal history presented a higher frequency of hypertension than patients with no familial history. CONCLUSIONS This study suggests that there is a significant maternal effect in the transmission of type 2 DM in Southern Brazil, and that most of the clinical characteristics of this disease do not differ between patients with or without familial history of type 2 DM.
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Affiliation(s)
- Daisy Crispim
- Departamento de Genetica, Universidade Federal do Rio Grande do Sul
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Belahsen R, Rguibi M. Population health and Mediterranean diet in southern Mediterranean countries. Public Health Nutr 2007; 9:1130-5. [PMID: 17378952 DOI: 10.1017/s1368980007668517] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND OBJECTIVES In recent decades, the prevalence of non-communicable diseases (NCDs), such as obesity, diabetes and cardiovascular disorders has increased worldwide; the objective here is to describe the situation in southern Mediterranean countries. RESULTS Data derived from surveys in the region countries showed that in 2002 more than 60% of all deaths in the southern Mediterranean region are attributed to NCDs. Cardiovascular diseases (CVD) caused from about 34.3 to 52% of all deaths, making it the major killer among NCDs. In almost all of the southern Mediterranean countries, CVD risk factors increased with age, affected more women and urban area and were significantly associated with obesity. The Mediterranean dietary pattern, generally recognised, as a healthy diet is still the model for southern Mediterranean population; however, following the rapid process of urbanisation, southern Mediterranean populations have changed their lifestyle and food habits and tend to shift from traditional food habit. Indeed, intake trends illustrate the fall in whole-grain intake with a rise in animal sources and vegetable oils. Dietary energy has been steadily increasing by approximately 1000 kcal per capita per day between 1965 and 2000, exceeding per caput energy requirements. Protein and carbohydrate contribution to the energy intake show only small deviations and fat contribution to the energy intake is low, whereas fibre intake is generally low and that of SFA is high. Also, sedentarity appears to play a critical role in the development of body fat and may be a risk indicator for features of metabolic syndrome. CONCLUSION The major goal to prevent CVD should begin by preventing obesity through physical exercise and healthy nutrition. The nutritional prevention policy required should encourage population to adhere to the Mediterranean model.
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Affiliation(s)
- Rekia Belahsen
- Training and Research Unit on Food Sciences, Laboratory of Physiology Applied to Nutrition and feeding, School of Sciences, Chouaib Doukkali University, El jadida, Morocco.
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Lipid profiles in Polish adolescents from high- and low-risk families: tracking unfavourable lipid levels over a one-year period. Acta Paediatr 2007. [DOI: 10.1111/j.1651-2227.2000.tb00406.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
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Guerrero-Romero F, Rodríguez-Morán M. Prevalence of Dyslipidemia in Non-Obese Prepubertal Children and its Association with Family History of Diabetes, High Blood Pressure, and Obesity. Arch Med Res 2006; 37:1015-21. [DOI: 10.1016/j.arcmed.2006.06.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2006] [Accepted: 06/28/2006] [Indexed: 01/21/2023]
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Rodríguez-Morán M, Guerrero-Romero F. Hyperinsulinemia in healthy children and adolescents with a positive family history for type 2 diabetes. Pediatrics 2006; 118:e1516-22. [PMID: 17015494 DOI: 10.1542/peds.2006-0845] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Our goal was to determine the relationship between family history of type 2 diabetes and fasting hyperinsulinemia in healthy children and adolescents. METHODS A total of 317 children and adolescents, 10 to 14 years of age with Tanner stage 1 or 2, were randomly selected from elementary and middle schools in Durango, northern Mexico, to participate in a cross-sectional, community-based study. Family history was ascertained by a direct, detailed medical examination that included anthropometric and laboratory measurements from both parents. We determined the prevalence of family history of type 2 diabetes, high blood pressure, obesity, hyperinsulinemia, and the adjusted odds ratio that computes the relationship between hyperinsulinemia and family history of type 2 diabetes. RESULTS Family history of type 2 diabetes, high blood pressure, and obesity was recognized in 30 (9.2%), 61 (18.7%), and 74 (22.7%) children and adolescents, respectively. Children and adolescents with positive family history showed higher systolic and diastolic blood pressure, were more obese, and exhibited significantly higher fasting insulin and triglycerides levels, as well as a higher homeostasis model analysis insulin resistance index, than children with negative family history. A total of 48 (15.1%) children and adolescents exhibited hyperinsulinemia, 35 (72.9%) with and 13 (27.1%) without family history. The odds ratio adjusted by gender, fat mass (kilograms and percent), waist circumference, BMI, and Tanner stage showed that family history of diabetes, but not high blood pressure and obesity, was independently related with hyperinsulinemia. CONCLUSIONS Among children and adolescents, family history of diabetes, but not high blood pressure and obesity, is independently associated with hyperinsulinemia.
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Affiliation(s)
- Martha Rodríguez-Morán
- Medical Research Unit in Clinical Epidemiology, Mexican Social Security Institute, Durango, Mexico
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40
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Shirakawa T, Ozono R, Kasagi F, Oshima T, Kamada N, Kambe M. Differential impact of family history on age-associated increase in the prevalence of hypertension and diabetes in male Japanese workers. Hypertens Res 2006; 29:81-7. [PMID: 16755141 DOI: 10.1291/hypres.29.81] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Family history and aging are independent risk factors for the development of hypertension as well as for the development of diabetes. However, it is unclear how the family histories influence the rate of age-associated increase in these diseases. Moreover, despite the fact that hypertension and diabetes often occur concomitantly, it is not known whether family history of hypertension increases the risk of diabetes or vice versa. To gain an insight into these questions, we investigated the cross-sectional prevalence and family history of hypertension and diabetes in 1,123 male subjects (mean age, 42.1 +/- 12 years; range, 20-60 years) who participated in annual medical check-ups. The data were analyzed by 10-year age groups (20s, 30s, 40s and 50s). The prevalence of hypertension increased with age group either in the absence (12% in the 20s and 39% in the 50s) or in the presence (21% in the 20s and 59% in the 50s) of family history of hypertension, and thus the increasing rate of prevalence with age was not affected by family history. The prevalence of diabetes in the absence of family history of diabetes was low until the 40s (< 1.2%) but it jumped in the 50s (4.3%). On the other hand, in the presence of family history, the prevalence was 4% in the 20s and progressively increased to 20% in the 50s. The impact of family history on the risk of diabetes was strong and appeared to increase with age. Family history of hypertension did not increase the risk of diabetes, and family history of diabetes did not increase the risk of hypertension. These results suggest that family history of hypertension has an additive impact on the age-associated increase in the risk of hypertension, whereas family history of diabetes has an exponential impact on aging-associated increase in the risk of diabetes.
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Dallongeville J, Grupposo MC, Cottel D, Ferrières J, Arveiler D, Bingham A, Ruidavets JB, Haas B, Ducimetière P, Amouyel P. Association between the metabolic syndrome and parental history of premature cardiovascular disease. Eur Heart J 2006; 27:722-8. [PMID: 16401673 DOI: 10.1093/eurheartj/ehi717] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
AIMS The goal of this study is to assess the association between the metabolic syndrome (MS) and parental history of cardiovascular disease (CVD). METHODS AND RESULTS Participants were recruited in a population survey of 3441 men and women, aged 35-64. MS was defined with NCEP-III guidelines. Familial history of myocardial infarction (MI), angina, and stroke was assessed with a standardized questionnaire. Parental premature CVD was defined if CVD occurred before 55/65 years in the father/mother. A total of 390 men and 281 women had MS. Positive parental CVD was associated with MS in women (43.0 vs. 36.8%, P<0.001) but not in men (36.9 vs. 31.8%, P=0.06). Similarly, parental premature CVD was associated with MS in women (19.2 vs. 11.8%, P<0.0007) but not in men (11.1 vs. 11.1%, ns). In women with MS, the age, centre, and educational level adjusted odds ratios [OR (95% CI)] of having a positive parental premature stroke was 1.84 (1.0-3.38), P=0.049. This OR was 1.76 (1.23-2.76), P=0.007 for combined parental premature MI and stroke and 1.67 (1.17-2.38), P=0.004 for combined premature MI, stroke, and angina. After further adjustment on personal coronary heart disease and CVD risk factors, the ORs of having a positive parental history of combined premature MI and stroke [1.75 (1.11-2.76), P=0.016] or MI, stroke, and angina [1.79 (1.21-2.63), P=0.003], remained statistically significant, in women with MS. CONCLUSION The MS is associated with parental premature CVD independently of classical CV risk factors, suggesting that MS is a contributor to the familial aggregation of premature CVD.
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Affiliation(s)
- Jean Dallongeville
- INSERM U508, Institut Pasteur de Lille, 1 rue du Pr Calmette, 59019 Lille Cedex, France.
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El ayachi M, Mziwira M, Vincent S, Defoort C, Portugal H, Lairon D, Belahsen R. Lipoprotein profile and prevalence of cardiovascular risk factors in urban Moroccan women. Eur J Clin Nutr 2005; 59:1379-86. [PMID: 16118656 DOI: 10.1038/sj.ejcn.1602251] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The study aimed to characterize the lipid and apolipoprotein profile and the prevalence of cardiovascular risk factors in a population of urban adult women of Morocco. DESIGN A total of 213 women 25-55 y old were sampled from an agricultural province of Morocco: El Jadida. The following parameters of lipid and apolipoprotein profile were measured: plasma triglycerides (TG), plasma cholesterol (TC), triglyceride-rich lipoprotein triglycerides (TRL-TG), TRL-cholesterol (TRL-C), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and apolipoproteins A1, B, B48, CIII and E. Waist circumference (WC), body mass index (BMI) and blood pressure (BP) were also determined. RESULTS The women studied showed the following pattern: elevated TC, LDL-C levels and TC/HDL-C in 10, 19.4 and in 43.8%, respectively; low HDL-C levels in 45.3% (<0.9 mmol/l) or in 95% (when the cutoff <1.3 mmol/l is used), elevated TG levels in 11.8%. Elevated TRL-C (>0.6 mmol/l) and TRL-TG (>0.8 mmol/l) were observed in 13.4%. Obesity and hypertension were highly prevalent in 23.9 and 16.5%, respectively. Plasma triglyceride concentrations were closely correlated with plasma concentrations of TRL-TG (R = 0.86, P = 0.0001), apoB (R = 0.50, P = 0.0001) and apoCIII (R = 0.52, P = 0.0001) and moderately correlated with HDL-C levels (R = -0.3, P = 0.0001) and BMI (R = 0.4, P = 0.0001). The association between BMI and systolic blood pressure was statistically significant (R = 0.3, P = 0.0001). Obesity, BP, TRL-C, TRL-TG, TG, apoB and apoCIII increased with age. CONCLUSION There is a high prevalence of some risk factors for cardiovascular disease including altered lipid and lipoprotein profiles in the Moroccan urban women studied, some of these risk factors are associated with age.
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Affiliation(s)
- M El ayachi
- Laboratoire de Physiologie Appliquée à la Nutrition et à l'Alimentation, Faculté des sciences d'El jadida, Maroc
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Abstract
AIM To determine if subjects' cholesterol levels tracked relative to their peers from early childhood to adult mid-life. METHODS Longitudinal study using subjects from the Busselton Population Study. Data were available from 1967 on a triennial basis until 1983, and a re-survey held in 1994. The study included 1764 subjects aged 5-18 y at first measurement. Pearson's correlation coefficient, adjusted for age and survey year, was used to examine cholesterol tracking. The proportion of children who persisted with cholesterol measurements in the extreme high quartile was assessed over time before and after adjusting data for regression to the mean. The variability of the children's cholesterol level was examined by track width using the method of Porkka. RESULTS The correlation coefficients for tracking were from 0.35 to 0.55. Stronger correlations coincided with shorter time periods between measurements. Before adjustment for regression to the mean, 55-60% of children from the highest quartile at first measurement remained in the same quartile 27 y later. After adjustment for regression to the mean, the number of children with levels in the extreme high quartile decreased, but 80% of these persisted in that quartile. CONCLUSION Intra-individual variations in cholesterol levels have an important influence on population tracking levels and need to be considered when interpreting tracking results from early childhood to adult mid-life. However, removing the effect of regression to the mean by taking multiple measurements of cholesterol will probably improve prediction for individuals.
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Affiliation(s)
- C Adams
- School of Medicine and Pharmacology, Royal Perth Hospital, The University of Western Australia, Perth, Australia.
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Flossmann E, Schulz UGR, Rothwell PM. Potential Confounding by Intermediate Phenotypes in Studies of the Genetics of Ischaemic Stroke. Cerebrovasc Dis 2005; 19:1-10. [PMID: 15528878 DOI: 10.1159/000081905] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2004] [Accepted: 06/01/2004] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Family history (FHx) of stroke is perceived to be an important risk factor for ischaemic stroke. However, there are several intermediate phenotypes that are often involved in the aetiology of ischaemic stroke and that have a substantial genetic component themselves. We studied FHx of ischaemic heart disease (IHD), hypertension (HTN) and diabetes mellitus (DM) as risk factors for ischaemic stroke. METHODS We performed a systematic review of case-control and cohort studies reporting on FHx(IHD), FHx(HTN) or FHx(DM) as risk factors for stroke using bibliographic databases, and by hand searching reference lists and journals. Odds ratios of FHx as a risk factor for stroke were calculated within individual studies. We included unpublished data from two Oxfordshire population-based studies to assess effects on subtypes of ischaemic stroke. RESULTS We identified 54 studies that investigated the odds of stroke conferred by a positive FHx, 24 of which reported data on FHx of one or more intermediate phenotypes in addition to FHx of stroke. Most studies reported an increased frequency of FHx(IHD) and FHx(HTN) in stroke patients versus controls. The association was significant in 6 out of 14 studies for FHx(IHD) and 4 out of 11 studies for FHx(HTN). In contrast, FHx(DM) was not associated with stroke. FHx(IHD) was particularly associated with large vessel strokes (OR 1.72, CI 1.3-2.2, p = 0.00004). CONCLUSIONS FHx(IHD) and FHx(HTN) are both risk factors for stroke. It is likely that the apparent heritability of stroke is partly accounted for by heritability of HTN and large vessel atherosclerosis. Analyses of heritability of stroke and candidate gene studies should be adjusted accordingly.
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Affiliation(s)
- Enrico Flossmann
- Stroke Prevention Research Unit, University Department of Clinical Neurology, Radcliffe Infirmary, Oxford 0X2 6HE, UK
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Bueno N, Fletcher BJ, Fletcher GF, Serra S, Cruz PDMD, Kelly D, Meirelles L, Atkinson E, Tabor LA, Ramos A, Castro I. Coronary risk factors in adult children of parents with coronary heart disease: a comparison survey of southeastern Brazil and southeastern United States. PREVENTIVE CARDIOLOGY 2005; 8:149-54. [PMID: 16034217 DOI: 10.1111/j.1520-037x.2005.2248.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
A survey was performed in southeastern Brazil and in the southeastern United States to: 1) compare coronary risk factors in adult children (>18 years old) of parents with coronary heart disease enrolled in cardiac rehabilitation programs in countries with different geographic, social, and economic factors; and 2) to assess the influence of coronary heart disease of parents on alteration of lifestyle in these adult children. There were 286 biological children available for the survey (135 Brazil, 151 United States). Of those, 142 completed the survey (78 Brazil, 64 United States) for an overall compliance rate of 50% (58% Brazil, 42% United States). The following differences were noted: blood pressure > 159/90 mm Hg (23% Brazil, 15% United States [nonsignificant]); total cholesterol > 181 mg/dL (5% Brazil, 30% United States [p < 0.001]); HDL-C < 35 mg/dL (95% Brazil, 21% United States [p < 0.001]); low-fat diet (29% Brazil, 64% United States [p < 0.001]); smoke/ever (41% Brazil, 34% United States [nonsignificant]); currently smoke (72% Brazil, 18% United States [p < 0.001]); any exercise [44% Brazil, 82% United States [p < 0.001]); exercise > 90 minute/week (18% Brazil, 20% United States [nonsignificant]); improved lifestyle habits (39% Brazil, 79% United States [p < 0.001]); improved lifestyle habits related to parent's coronary heart disease (66% Brazil, 35% United States [p < 0.05]). Such differences may reflect geographic, social, and/or economic factors.
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Affiliation(s)
- Nelia Bueno
- Institute of Cardiology of Rio Grande do Sul, Porto Alegre, Brazil
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Abstract
There is growing evidence that hypertension, one of the major modifiable risk factors for cardiovascular disease (CVD), is established early in life. Given this, it is important to discover when hypertension first becomes apparent. Further, it is of particular importance to examine the ethnic differences in blood pressure (BP) in children, given the variation in rates of CVD morbidity and mortality among adults from different ethnic groups.
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Affiliation(s)
- D A Lane
- University Department of Medicine, City Hospital, Sandwell and West Birmingham Hospitals NHS Trust, Dudley Road, Birmingham, UK.
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Saito T, Furukawa T, Nanri S, Saito I. Potential errors resulting from sex and age difference in assessing family history of coronary heart disease. J Epidemiol 2004; 14:51-6. [PMID: 15162978 PMCID: PMC8660567 DOI: 10.2188/jea.14.51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2003] [Accepted: 02/27/2004] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Coronary heart disease occurs nearly exponentially with age and differently between men and women. Therefore, difference in sex and age of family members yields errors in assessing the family history as a risk factor. The influence of sex and age on the positivity of family history was assessed numerically. METHODS Through questionnaires filled in by the parents of 2316 high school students, information was obtained on the past history of coronary heart disease among students' parents, grandparents, uncles, and aunts. The sex- and age-specific proportion of a positive history was calculated from the past history among the 24,071 family members. The influence of sex and age on a positive history was estimated as odds ratios by logistic regression analysis of the past history. RESULTS The odds ratios obtained for sex and age difference were 1.61 (95% confidence interval: 1.42-1.83) and 1.07 (95% confidence interval: 1.06-1.07), respectively. This indicated that a positive history was 1.61 times higher among male members than among female members of the same age, and that a positive history increased by (1.07)y, where y was age difference by year. CONCLUSIONS Potential errors resulting from disregarding the sex and age of family members can be substantial, judging from the above numerical figures. Some measures to control for the sex and age of family members are required in assessing family history of coronary heart disease.
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Affiliation(s)
- Tomohiro Saito
- Division of Epidemiology, National Institute for Child Health and Development, Tokyo, Japan
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RASHED MOTAZAM, JACKSON ROBERTT. OVERWEIGHT ADOLESCENT GIRLS AND FAMILY HISTORY OF CHRONIC NONCOMMUNICABLE DISEASES. Ecol Food Nutr 2004. [DOI: 10.1080/03670240490274066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Berenson GS, Srinivasan S. Cholesterol as a risk factor for early atherosclerosis: the Bogalusa Heart Study. PROGRESS IN PEDIATRIC CARDIOLOGY 2003. [DOI: 10.1016/s1058-9813(03)00048-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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