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Nedkoff L, Briffa T, Zemedikun D, Herrington S, Wright FL. Global Trends in Atherosclerotic Cardiovascular Disease. Clin Ther 2023; 45:1087-1091. [PMID: 37914585 DOI: 10.1016/j.clinthera.2023.09.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 09/10/2023] [Accepted: 09/26/2023] [Indexed: 11/03/2023]
Abstract
PURPOSE Cardiovascular disease (CVD) is the leading cause of morbidity and mortality, affecting over 523 million people globally. Atherosclerotic diseases, particularly ischemic heart disease (IHD) and stroke, are the primary mediators of CVD burden and trends, with half of CVD deaths attributed to IHD, and another quarter to ischemic stroke. The aim of this review was to provide an overview of world-wide trends in the burden of atherosclerotic CVD. METHODS A literature review of published studies reporting regional or global trends or burden of CVD was undertaken, with a specific focus on atherosclerotic-mediated CVDs. FINDINGS While long-term trends in age-standardized rates of CVD mortality and incidence indicate substantial declines in disease burden, the impact of population growth and ageing has contributed to a continued increase in the absolute number of people living with CVD. Additionally, when data are restricted to the most recent decade, there are indications that even declines in age-standardized CVD rates may have attenuated. Trends are also heterogeneous across countries and regions, with a relative increase in CVD burden in developing countries and differing trends within countries. The impact of the COVID-19 pandemic resulted in substantial short-term reductions in hospitalization rates for major atherosclerotic CVDs including acute coronary syndromes and heart failure in some countries. IMPLICATIONS Recent attenuation of declines in atherosclerotic CVDs with increasing absolute burden has significant implications for health systems and resource availability, with the impact of the COVID-19 pandemic on longer-term trends in CVD yet to be clearly established.
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Affiliation(s)
- Lee Nedkoff
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia; Victor Chang Cardiac Research Institute, Darlinghurst, New South Wales, Australia.
| | - Tom Briffa
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Dawit Zemedikun
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - Saranne Herrington
- Cardiovascular Epidemiology Research Centre, School of Population and Global Health, The University of Western Australia, Crawley, Western Australia, Australia
| | - F Lucy Wright
- Nuffield Department of Population Health, and the NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
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Davis WA, Davis TME. Temporal trends in chronic complications of diabetes by sex in community-based people with type 2 diabetes: the Fremantle Diabetes Study. Cardiovasc Diabetol 2023; 22:253. [PMID: 37716976 PMCID: PMC10505315 DOI: 10.1186/s12933-023-01980-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 09/05/2023] [Indexed: 09/18/2023] Open
Abstract
BACKGROUND Whether recent reductions in cardiovascular disease (CVD) events and mortality in type 2 diabetes apply equally to both sexes is largely unknown. The aim of this study was to characterize temporal changes in CVD events and related outcomes in community-based male and female Australian adults with type 2 diabetes or without known diabetes. METHODS Participants from the longitudinal observational Fremantle Diabetes Study Phases I (FDS1; n = 1291 recruited 1993-1996) and II (FDS2; n = 1509 recruited 2008-2011) and four age-, sex- and postcode-matched individuals without diabetes (FDS1 n = 5159; FDS2 n = 6036) were followed for first myocardial infarction, stroke, heart failure hospitalization, lower extremity amputation, CVD death and all-cause mortality. Five-year incidence rates (IRs) for males versus females in FDS1 and FDS2 were calculated, and IR ratios (IRRs) derived. RESULTS The FD1 and FDS2 participants were of mean age 64.0 and 65.4 years, respectively, and 48.7% and 51.8% were males. For type 2 diabetes, IRRs for all endpoints were 11-62% lower in FDS2 than FDS1 for both sexes. For participants without diabetes, IRRs were 8-56% lower in FDS2 versus FDS1 apart from stroke in females (non-significantly 41% higher). IRRs for males versus females across FDS phases were not significantly different for participants with type 2 diabetes or those without diabetes (P-values for male * FDS2 interaction ≥ 0.0.083 adjusted for age). For risk factors in participants with type 2 diabetes, greater improvements between FDS1 and FDS2 in smoking rates in males were offset by a greater reduction in systolic blood pressure in females. CONCLUSIONS The incidence of chronic complications in Australians with type 2 diabetes and without diabetes has fallen similarly in both sexes over recent decades, consistent with comparably improved overall CVD risk factor management.
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Affiliation(s)
- Wendy A Davis
- Medical School, University of Western Australia, Fremantle Hospital, P. O. Box 480, Fremantle, WA, 6959, Australia
| | - Timothy M E Davis
- Medical School, University of Western Australia, Fremantle Hospital, P. O. Box 480, Fremantle, WA, 6959, Australia.
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Robinson K, Katzenellenbogen JM, Kleinig TJ, Kim J, Budgeon CA, Thrift AG, Nedkoff L. Large Burden of Stroke Incidence in People with Cardiac Disease: A Linked Data Cohort Study. Clin Epidemiol 2023; 15:203-211. [PMID: 36846512 PMCID: PMC9945299 DOI: 10.2147/clep.s390146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 01/28/2023] [Indexed: 02/19/2023] Open
Abstract
Purpose People with cardiac disease have 2-4 times greater risk of stroke than the general population. We measured stroke incidence in people with coronary heart disease (CHD), atrial fibrillation (AF) or valvular heart disease (VHD). Methods We used a person-linked hospitalization/mortality dataset to identify all people hospitalized with CHD, AF or VHD (1985-2017), and stratified them as pre-existing (hospitalized 1985-2012 and alive at October 31, 2012) or new (first-ever cardiac hospitalization in the five-year study period, 2012-2017). We identified first-ever strokes occurring from 2012 to 2017 in patients aged 20-94 years and calculated age-specific and age-standardized rates (ASR) for each cardiac cohort. Results Of the 175,560 people in the cohort, most had CHD (69.9%); 16.3% had multiple cardiac conditions. From 2012-17, 5871 first-ever strokes occurred. ASRs were greater in females than males in single and multiple condition cardiac groups, largely driven by rates in females aged ≥75 years, with stroke incidence in this age group being at least 20% greater in females than males in each cardiac subgroup. In females aged 20-54 years, stroke incidence was 4.9-fold greater in those with multiple versus single cardiac conditions. This differential declined with increasing age. Non-fatal stroke incidence was greater than fatal stroke in all age groups except in the 85-94 age group. Incidence rate ratios were up to 2-fold larger in new versus pre-existing cardiac disease. Conclusion Stroke incidence in people with cardiac disease is substantial, with older females, and younger patients with multiple cardiac conditions, at elevated risk. These patients should be specifically targeted for evidence-based management to minimize the burden of stroke.
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Affiliation(s)
- Keira Robinson
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia,Correspondence: Keira Robinson, School of Population and Global Health, The University of Western Australia, M431, 35 Stirling Hwy, Crawley, WA, 6009, Australia, Email
| | - Judith M Katzenellenbogen
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Timothy J Kleinig
- Department of Neurology, Royal Adelaide Hospital, Adelaide, South Australia, Australia
| | - Joosup Kim
- Department of Medicine, The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Melbourne, Victoria, Australia,Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Charley A Budgeon
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Amanda G Thrift
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia,Victor Chang Cardiac Research Institute, Sydney, New South Wales, Australia
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Weber C, Hobday M, Sun W, Kirkland L, Nedkoff L, Katzenellenbogen JM. Evolution of non-fatal burden estimates for cardiovascular disease in Australia: a comparison of national and state-wide methodology of burden of disease. AUST HEALTH REV 2022; 46:756-764. [PMID: 36395787 DOI: 10.1071/ah22149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 10/23/2022] [Indexed: 11/19/2022]
Abstract
Objective Burden of disease studies measure the impact of disease at the population level;however, methods and data sources for estimates of prevalence vary. Using a selection of cardiovascular diseases, we aimed to describe the implications of using different disease models and linked administrative data on prevalence estimation within three Australian burden of disease studies. Methods Three different methods (A = 2011 Australian Burden of Disease Study; B = 2015 Australian Burden of Disease Study; C = 2015 Western Australian Burden of Disease Study), which used linked data, were used to compare prevalence estimates of stroke, aortic aneurysm, rheumatic valvular heart disease (VHD) and non-rheumatic VHD. We applied these methods to 2015 Western Australian data, and calculated crude overall and age-specific prevalence for each condition. Results Overall, Method C produced estimates of cardiovascular prevalence that were lower than the other methods, excluding non-rheumatic VHD. Prevalence of acute and chronic stroke was up to one-third higher in Method A and B compared to Method C. Aortic aneurysms had the largest change in prevalence, with Method A producing an eight-fold higher estimate compared to Method C, but Method B was 10-20% lower. Estimates of VHD varied dramatically, with an up to six-fold change in prevalence in Method C due to substantial changes to disease models and the use of linked data. Conclusions Prevalence estimates require the best available data sources, updated disease models and constant review to inform government policy and health reform. Availability of nation-wide linked data will markedly improve future burden estimates.
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Affiliation(s)
- Courtney Weber
- School of Population and Global Health, The University of Western Australia, WA, Australia; and Centre for Clinical Research in Emergency Medicine, Harry Perkins Institute of Medical Research, Perth, WA, Australia; and Western Australian Department of Health, East Perth, WA, Australia
| | - Michelle Hobday
- Western Australian Department of Health, East Perth, WA, Australia
| | - Wendy Sun
- Western Australian Department of Health, East Perth, WA, Australia
| | - Laura Kirkland
- Western Australian Department of Health, East Perth, WA, Australia
| | - Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, WA, Australia; and Cardiology Population Health Laboratory, Victor Chang Cardiac Research Institute, Darlinghurst, NSW, Australia
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One-year readmission and mortality following ischaemic stroke by diabetes status, sex, and socioeconomic disadvantage: An analysis of 27,802 strokes from 2012 to 2017. J Neurol Sci 2022; 434:120149. [PMID: 35065425 DOI: 10.1016/j.jns.2022.120149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 01/04/2022] [Accepted: 01/06/2022] [Indexed: 11/23/2022]
Abstract
OBJECTIVE We estimated the 1-year incidence of readmission to hospital and 1-year all-cause mortality following ischaemic stroke (IS), by diabetes status, sex, and socioeconomic disadvantage. METHODS This study included all individuals aged ≥30 years who were discharged from hospital following an IS between July 2012 and June 2017 in Victoria, Australia (n = 25,421). Individuals were followed from discharge until readmission (for all-causes, cardiovascular readmission, and readmission for IS) or death, censoring at 1-year of follow-up. RESULTS The 1-year cumulative incidence of all-cause readmission following an IS was 56.1% (95% CI: 55.5-56.7); 24% of first all-cause admission were attributed to cardiovascular disease. People with diabetes were at an excess risk of all-cause, cardiovascular, and IS readmission following an IS (adjusted sub-HRs: 1.13 [95% CI: 1.09-1.17], 1.14 [1.07-1.21], and 1.17 [1.06-1.29], for people with vs. without diabetes, respectively) and 1-year mortality (adjusted HR: 1.11 [1.03-1.19]). There was no significant difference between men and women in all-cause and cardiovascular readmission risk, while women were at higher risk of IS readmission (sub-HR: 1.10 [1.01-1.21] for women vs. men) and mortality (HR: 1.12 [1.05-1.20]). There was no relationship between socioeconomic disadvantage and risk of cardiovascular or IS readmission, while 1-year mortality risk did increase with increasing socioeconomic disadvantage (HR for most vs. least disadvantaged quintile: 1.15 [1.03-1.27]; ptrend = 0.006), and all-cause readmission risk decreased (sub-HR: 0.94 [0.90-0.99]; ptrend = 0.001). CONCLUSIONS There is a high risk of readmission following IS. Decreasing the readmission rate will require more complex interventions than solely improving post-discharge cardiovascular management.
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Kempel MK, Winding TN, Lynggaard V, Brantlov S, Andersen JH, Böttcher M. Traditional and novel cardiometabolic risk markers across strata of body mass index in young adults. Obes Sci Pract 2021; 7:727-737. [PMID: 34877012 PMCID: PMC8633932 DOI: 10.1002/osp4.528] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/27/2021] [Accepted: 05/09/2021] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND Cardiometabolic risk increases with increasing body mass index (BMI). The exact mechanism is poorly understood, and traditional risk assessment of young adults with obesity has shown to be ineffective. Greater knowledge about potential new effective biomarkers and the use of advanced cardiac imaging for risk assessment in young adults is, therefore, necessary. OBJECTIVE This study aims to explore traditional and novel cardiometabolic risk markers across strata of BMI in young adults. METHODS Participants (N = 264, 50% women, age 28-30 years) were invited from an ongoing cohort study, based on BMI and sex. BMI-strata were: BMI <25, 25-30, >30 kg/m2, representing normal weight (NW), overweight (OW), and obesity (OB). Participants underwent cardiac computed tomography to detect coronary artery calcification, measures of body composition, blood pressure measurements, and a comprehensive panel of circulating cardiometabolic risk markers. RESULTS No significant coronary artery calcifications were detected in this study. Minor differences in median levels of traditional risk markers were detected across BMI-strata, for example, total cholesterol (men- NW: 4.7 (4.3-5.1) and OB: 4.8 (4.2-5.6) mmol/L, p = 0.58; women- NW: 4.3 (3.9-4.8) and OB: 4.7 (4.2-5.3) mmol/L, p = 0.016), whereas substantial differences were seen in markers of inflammation and glucose metabolism, for example, high sensitive CRP (men- NW: 0.6 (0.3-1.1) and OB: 2.8 (1.5-4.0) mg/L, p < 0.001; women- NW: 0.7 (0.3-1.7) and OB: 4.0 (2.2-7.8) mg/L, p < 0.001) and insulin (men- NW: 47.0 (35.0-59.0) and OB: 113.5 (72.0-151.0) pmol/L, p < 0.001; women- NW: 44.0 (35.0-60.0) and OB: 84.5 (60.0-126.0) pmol/L, p < 0.001). CONCLUSION In young adults, obesity is associated with an early onset insulin resistance and inflammatory response prior to development of coronary artery calcification and deterioration of lipid profiles.
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Affiliation(s)
- Mia Klinkvort Kempel
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Trine Nøhr Winding
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Vibeke Lynggaard
- Cardiovascular Research UnitDepartment of CardiologyGødstrup HospitalHerningDenmark
| | - Steven Brantlov
- Department of Procurement and Clinical EngineeringCentral Denmark RegionAarhusDenmark
| | - Johan Hviid Andersen
- Department of Occupational Medicine – University Research ClinicDanish Ramazzini CentreRegional Hospital West JutlandHerningDenmark
| | - Morten Böttcher
- Cardiovascular Research UnitDepartment of CardiologyGødstrup HospitalHerningDenmark
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Krämer C, Meisinger C, Kirchberger I, Heier M, Kuch B, Thilo C, Linseisen J, Amann U. Epidemiological trends in mortality, event rates and case fatality of acute myocardial infarction from 2004 to 2015: results from the KORA MI registry. Ann Med 2021; 53:2142-2152. [PMID: 34779325 PMCID: PMC8604473 DOI: 10.1080/07853890.2021.2002926] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 11/01/2021] [Indexed: 11/23/2022] Open
Abstract
AIM This study examines epidemiological trends of acute myocardial infarction (AMI) in Germany from 2004-2015 across different age groups, using data of the population-based KORA myocardial infarction registry. METHODS Annual age-standardised, age-group- and sex-specific mortality and event rates (incident and recurrent) per 100,000 population as well as 28-day case fatality were calculated from all registered cases of AMI and coronary heart disease deaths in 25-74-year-olds from 2004-2015 and 75-84-year-olds from 2009-2015. Average annual percentage changes (AAPC) were calculated by joinpoint regression. RESULTS Mortality rates declined considerably among the elderly (75-84 years), in men by -6.0% annually, due to declines of case fatality by -3.0% and incidence rate by 3.4% and in women by -10.0%, driven by declines in incidence (-9.1%) and recurrence rate (-4.9%). Significant mortality declines also occurred in males, 65-74 years of age (AAPC -3.8%). Among the age groups 25-54 years and 55-64 years, there was no substantial decline in mortality, event rates or case fatality except for a decline of incidence rate in 55-64-year-old men (AAPC -1.8%). CONCLUSION Inhomogeneous AMI trends across age-groups indicate progress in prevention and treatment for the population >64 years, while among <55-year-olds, we found no significant trend in AMI morbidity and mortality.KEY MESSAGESAge standardised AMI mortality continued to decline from 2009 to 2015 in the study region.Declines in AMI mortality were driven by declines in event rates (both incidence and recurrence rates) and case fatality.AMI trends were inconsistent across different age groups with the strongest declines in mortality and event rates among the elderly population (75-84 years of age).
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Affiliation(s)
- Christina Krämer
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Department of Internal Medicine I – Gastroenterology, Oncology and Endocrinology, Hospital of Friedrichshafen, Friedrichshafen, Germany
| | - Christa Meisinger
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Chair of Epidemiology, University of Augsburg at University Hospital Augsburg, Augsburg, Germany
| | - Inge Kirchberger
- Chair of Epidemiology, University of Augsburg at University Hospital Augsburg, Augsburg, Germany
| | - Margit Heier
- KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany
- Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health, Neuherberg, Germany
| | - Bernhard Kuch
- Department of Internal Medicine I – Cardiology, University Hospital of Augsburg, Augsburg, Germany
- Department of Internal Medicine – Cardiology, Hospital of Nördlingen, Nördlingen, Germany
| | - Christian Thilo
- Department of Medical Clinic I – Cardiology, Hospital of Rosenheim, Rosenheim, Germany
| | - Jakob Linseisen
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
- Institute for Medical Information Processing, Biometry, and Epidemiology, Ludwig-Maximilians-Universität München, Munich, Germany
- Chair of Epidemiology, University of Augsburg at University Hospital Augsburg, Augsburg, Germany
| | - Ute Amann
- Independent Research Group Clinical Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Germany
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Inacio MC, Lang C, Bray SCE, Visvanathan R, Whitehead C, Griffith EC, Evans K, Corlis M, Wesselingh S. Health status and healthcare trends of individuals accessing Australian aged care programmes over a decade: the Registry of Senior Australians historical cohort. Intern Med J 2021; 51:712-724. [PMID: 32359019 PMCID: PMC8251748 DOI: 10.1111/imj.14871] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 04/15/2020] [Accepted: 04/15/2020] [Indexed: 12/15/2022]
Abstract
Background Understanding the health profile, service and medicine use of Australians in the aged care sector will help inform appropriate service provision for our ageing population. Aims To examine the 2006–2015 trends in (i) comorbidities and frailty of individuals accessing aged care, and (ii) health services, medicine use and mortality after entry into long‐term care. Methods Cross‐sectional and population‐based trend analyses were conducted using the Registry of Senior Australians. Results From 2006 to 2015, 509 944 individuals accessed permanent residential care, 206 394 home care, 283 014 respite and 124 943 transition care. Over this time, the proportion of individuals accessing permanent residential care with high frailty scores (≥0.3) increased (19.7–49.7%), as did the proportion with 5–9 comorbidities (46.4–54.5%), with similar trends observed for those accessing other services. The median number of medicines dispensed in the year after entering permanent residential care increased from 9 (interquartile range (IQR) 6–12) to 10 (IQR 7–14), while remaining stable in home care (2006: 9, IQR 5–12, 2015: 9, IQR 6–13). Short‐term (within 100 days) mortality in those accessing permanent care was higher in 2006 (15.6%, 95% CI 15.2–16.0) than 2015 (14.6%, 95% CI 14.3–14.9). Longer term (101–1095 days, 2006: 44.3%, 95% CI 43.7–45.0, 2015: 46.4%, 95% CI 45.8–46.9) mortality was higher in 2015 compared to 2006. Mortality in individuals accessing home care did not change. Conclusion The health of older Australians accessing aged care programmes has declined while frailty increased, with an increasing use of medicine and worse long‐term mortality in some. Funding and care models need to adapt to this changing profile.
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Affiliation(s)
- Maria C Inacio
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Catherine Lang
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sarah C E Bray
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.,Division of Health Sciences, University of South Australia, Adelaide, South Australia, Australia.,Discipline of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Renuka Visvanathan
- National Health and Medical Research Council Centre of Research Excellence in Frailty and Healthy Ageing, University of Adelaide, Adelaide, South Australia, Australia.,Adelaide Geriatrics Training and Research with Aged Care Centre, University of Adelaide, Adelaide, South Australia, Australia.,Aged and Extended Care Services, The Queen Elizabeth Hospital, Central Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia
| | - Craig Whitehead
- Division of Rehabilitation, Aged Care and Palliative Care, Southern Adelaide Local Health Network, SA Health, Adelaide, South Australia, Australia.,Rehabilitation, Aged and Extended Care, Flinders University, Adelaide, South Australia, Australia
| | - Elizabeth C Griffith
- Clinical Research, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Keith Evans
- Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Megan Corlis
- Research and Development, Helping Hand Aged Care, Adelaide, South Australia, Australia
| | - Steve Wesselingh
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
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Wan Z, Song L, Hu L, Lei X, Huang Y, Lv Y. Temporal trends in hyperuricaemia among adults in Wuhan city, China, from 2010 to 2019: a cross-sectional study. BMJ Open 2021; 11:e043917. [PMID: 33789851 PMCID: PMC8016088 DOI: 10.1136/bmjopen-2020-043917] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 02/10/2021] [Accepted: 03/15/2021] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES Hyperuricaemia is a risk factor for gout attacks, kidney damage and cardiovascular events. Evidence on the trends in hyperuricaemia burden in Wuhan city, China, was limited. The present study aimed to estimate the prevalence of and a decade trend in hyperuricaemia in Wuhan city. DESIGN Cross-sectional study. SETTING Health Management Center of Tongji Hospital. PARTICIPANTS A total of 732 527 adult participants from the general population who took a physical examination in the Health Management Center between 2010 and 2019. MAIN OUTCOME MEASURES Prevalence of and trends in hyperuricaemia. RESULTS The overall prevalence of hyperuricaemia was 25.8% (36.6% in men and 10.8% in women) in 2019. The hyperuricaemia prevalence and serum uric acid (SUA) levels were significantly higher in young men, old women and participants with obesity, hypertension, diabetes or dyslipidaemia (p<0.05). SUA levels among men and women gradually increased from 358.0 (313.0-407.0) umol/L and 250.0 (217.0-288.0) umol/L in 2010 to 388.0 (338.0-445.2) umol/L and 270.0 (233.0-314.0) umol/L in 2019, respectively, p<0.05. From 2010 through 2019, hyperuricaemia prevalence significantly increased in each age category and it increased most sharply among participants aged 20-39 years. The multivariate-adjusted prevalence among men was 26.1% (25.4% to 26.7%) in 2010, 30.9% (30.4% to 31.4%) in 2015 and 34.4% (34.1% to 34.8%) in 2019, while among women it was 5.8% (5.4% to 6.2%) in 2010, 7.2% (6.9% to 7.5%) in 2015 and 10.1% (9.9% to 10.3%) in 2019. CONCLUSIONS Hyperuricaemia was highly prevalent among adults in Wuhan city. More attention should be paid to the increasing burden of hyperuricaemia, especially for those at higher risks.
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Affiliation(s)
- Zhengce Wan
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lulu Song
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Liu Hu
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaomei Lei
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuancheng Huang
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yongman Lv
- Health Management Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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10
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Chen L, Islam RM, Wang J, Hird TR, Pavkov ME, Gregg EW, Salim A, Tabesh M, Koye DN, Harding JL, Sacre JW, Barr ELM, Magliano DJ, Shaw JE. A systematic review of trends in all-cause mortality among people with diabetes. Diabetologia 2020; 63:1718-1735. [PMID: 32632526 PMCID: PMC11000245 DOI: 10.1007/s00125-020-05199-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Accepted: 04/29/2020] [Indexed: 01/18/2023]
Abstract
AIMS/HYPOTHESIS We examined all-cause mortality trends in people with diabetes and compared them with trends among people without diabetes. METHODS MEDLINE, EMBASE and CINAHL databases were searched for observational studies published from 1980 to 2019 reporting all-cause mortality rates across ≥2 time periods in people with diabetes. Mortality trends were examined by ethnicity, age and sex within comparable calendar periods. RESULTS Of 30,295 abstracts screened, 35 studies were included, providing data on 69 separate ethnic-specific or sex-specific populations with diabetes since 1970. Overall, 43% (3/7), 53% (10/19) and 74% (32/43) of the populations studied had decreasing trends in all-cause mortality rates in people with diabetes in 1970-1989, 1990-1999 and 2000-2016, respectively. In 1990-1999 and 2000-2016, mortality rates declined in 75% (9/12) and 78% (28/36) of predominantly Europid populations, and in 14% (1/7) and 57% (4/7) of non-Europid populations, respectively. In 2000-2016, mortality rates declined in 33% (4/12), 65% (11/17), 88% (7/8) and 76% (16/21) of populations aged <40, 40-54, 55-69 and ≥70 years, respectively. Among the 33 populations with separate mortality data for those with and without diabetes, 60% (6/10) of the populations with diabetes in 1990-1999 and 58% (11/19) in 2000-2016 had an annual reduction in mortality rates that was similar to or greater than in those without diabetes. CONCLUSIONS/INTERPRETATION All-cause mortality has declined in the majority of predominantly Europid populations with diabetes since 2000, and the magnitude of annual mortality reduction matched or exceeded that observed in people without diabetes in nearly 60% of populations. Patterns of diabetes mortality remain uncertain in younger age groups and non-Europid populations. REGISTRATION PROSPERO registration ID CRD42019095974. Graphical abstract.
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Affiliation(s)
- Lei Chen
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Rakibul M Islam
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanna Wang
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Thomas R Hird
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Meda E Pavkov
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Edward W Gregg
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Agus Salim
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Department of Mathematics and Statistics, La Trobe University, Bundoora, VIC, Australia
| | - Maryam Tabesh
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Digsu N Koye
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Jessica L Harding
- Division of Diabetes Translation, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Julian W Sacre
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
| | - Elizabeth L M Barr
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Darwin, NT, Australia
| | - Dianna J Magliano
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
| | - Jonathan E Shaw
- Baker Heart and Diabetes Institute, 75 Commercial Road, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
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11
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Halasz G, Piepoli MF. Editor's presentation: Overweight carries a higher risk for developing heart failure in young women. Eur J Prev Cardiol 2020; 27:1123-1125. [PMID: 32646301 DOI: 10.1177/2047487320941362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Geza Halasz
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy
| | - Massimo F Piepoli
- Heart Failure Unit, G. da Saliceto Hospital, AUSL Piacenza and University of Parma, Italy.,Institute of Life Sciences, Sant'Anna School of Advanced Studies, Pisa, Italy
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12
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Gattellari M, Goumas C, Jalaludin B, Worthington JM. Population-based stroke surveillance using big data: state-wide epidemiological trends in admissions and mortality in New South Wales, Australia. Neurol Res 2020; 42:587-596. [PMID: 32449879 DOI: 10.1080/01616412.2020.1766860] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES Epidemiological trends for major causes of death and disability, such as stroke, may be monitored using administrative data to guide public health initiatives and service delivery. METHODS We calculated admissions rates for ischaemic stroke, intracerebral haemorrhage and subarachnoid haemorrhage between 1 January 2005 and December 31st, 2013 and rates of 30-day mortality and 365-day mortality in 30-day survivors to 31 December 2014 for patients aged 15 years or older from New South Wales, Australia. Annual Average Percentage Change in rates was estimated using negative binomial regression. RESULTS Of 81,703 eligible admissions, 64,047 (78.4%) were ischaemic strokes and 13,302 (16.3%) and 4,778 (5.8%) were intracerebral and subarachnoid haemorrhages, respectively. Intracerebral haemorrhage admissions significantly declined by an average of 2.2% annually (95% Confidence Interval = -3.5% to -0.9%) (p < 0.001). Thirty-day mortality rates significantly declined for ischaemic stroke (Average Percentage Change -2.9%, 95% Confidence Interval = -5.2% to -1.0%) (p = 0.004) and subarachnoid haemorrhage (Average Percentage Change = -2.6%, 95% Confidence Interval = -4.8% to -0.2%) (p = 0.04). Mortality at 365-days amongst 30-day survivors of ischaemic stroke and intracerebral haemorrhage was stable over time and increased in subarachnoid haemorrhage (Annual Percentage Change 6.2%, 95% Confidence Interval = -0.1% to 12.8%), although not significantly (p = 0.05). DISCUSSION Improved prevention may have underpinned declining intracerebral haemorrhage rates while survival gains suggest that innovations in care are being successfully translated. Mortality in patients surviving the acute period is unchanged and may be increasing for subarachnoid haemorrhage warranting investment in post-discharge care and secondary prevention.
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Affiliation(s)
- Melina Gattellari
- Ingham Institute for Applied Medical Research , Liverpool (Sydney), Australia.,Department of Neurology, Royal Prince Alfred Hospital , Camperdown (Sydney), Australia
| | - Chris Goumas
- Ingham Institute for Applied Medical Research , Liverpool (Sydney), Australia.,School of Public Health, the University of Sydney , Sydney, Australia
| | - Bin Jalaludin
- Ingham Institute for Applied Medical Research , Liverpool (Sydney), Australia.,Population Health Intelligence, Healthy People and Places Unit, South Western Sydney Local Health District , Liverpool, Sydney, Australia.,School of Public Health and Community Medicine, The University of New South Wales , Sydney, Australia
| | - John M Worthington
- Ingham Institute for Applied Medical Research , Liverpool (Sydney), Australia.,Department of Neurology, Royal Prince Alfred Hospital , Camperdown (Sydney), Australia.,School of Public Health and Community Medicine, The University of New South Wales , Sydney, Australia.,South Western Sydney Clinical School, The University of New South Wales , Liverpool, Sydney, Australia
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13
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Du R, Zheng R, Xu Y, Zhu Y, Yu X, Li M, Tang X, Hu R, Su Q, Wang T, Zhao Z, Xu M, Chen Y, Shi L, Wan Q, Chen G, Dai M, Zhang D, Gao Z, Wang G, Shen F, Luo Z, Qin Y, Chen L, Huo Y, Li Q, Ye Z, Zhang Y, Liu C, Wang Y, Wu S, Yang T, Deng H, Chen L, Zhao J, Mu Y, Li D, Qin G, Wang W, Ning G, Yan L, Bi Y, Lu J. Early-Life Famine Exposure and Risk of Cardiovascular Diseases in Later Life: Findings From the REACTION Study. J Am Heart Assoc 2020; 9:e014175. [PMID: 32233751 PMCID: PMC7428621 DOI: 10.1161/jaha.119.014175] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Background Previous studies reported that early‐life exposure to undernutrition is associated with the risk of diabetes mellitus and metabolic syndrome in adulthood, but the association with risk of cardiovascular disease (CVD) later in life remains unclear. The current study aimed to investigate whether exposure to Chinese famine in early life is associated with risk of CVD. Methods and Results We used data from REACTION (Risk Evaluation of Cancers in Chinese Diabetic Individuals: A Longitudinal Study), which recruited a total of 259 657 community‐dwelling adults aged 40 years or older from 25 centers across mainland China between 2011 and 2012. Compared with the nonexposed participants, those who had been exposed to famine in early life had a significantly increased risk of total CVD, myocardial infarction, stroke, and coronary heart disease. In the multivariable‐adjusted logistic regression model, the odds ratios (95% CI) for total CVD, myocardial infarction, stroke, and coronary heart disease in fetal famine exposure were 1.35 (1.20–1.52), 1.59 (1.08–2.35), 1.40 (1.11–1.78), and 1.44 (1.26–1.65), respectively; those odds ratios in childhood famine exposure were 1.59 (1.40–1.81), 2.20 (1.52–3.20), 1.82 (1.45–2.28), and 1.80 (1.56–2.09), respectively; and those in adolescent famine exposure were 1.52 (1.27–1.81), 2.07 (1.28–3.35), 1.92 (1.42–2.58), and 1.83 (1.50–2.24), respectively. The main finding of our study is that, compared with those who lived in the less severely affected famine area, individuals in the severely affected famine area had significantly increased risk of total CVD in all 3 exposed groups. Conclusions Early‐life exposure to undernutrition is associated with significantly increased risk of CVD in later life, especially among those who were in the severely affected famine area.
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Affiliation(s)
- Rui Du
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Ruizhi Zheng
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Yu Xu
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Yuanyue Zhu
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Xuefeng Yu
- Tongji Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Mian Li
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Xulei Tang
- The First Hospital of Lanzhou University Lanzhou China
| | - Ruying Hu
- Zhejiang Provincial Center for Disease Control and Prevention Hangzhou China
| | - Qing Su
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine Shanghai China
| | - Tiange Wang
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Zhiyun Zhao
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Min Xu
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Yuhong Chen
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Lixin Shi
- Affiliated Hospital of Guiyang Medical College Guiyang China
| | - Qin Wan
- The Affiliated Hospital of Luzhou Medical College Luzhou China
| | - Gang Chen
- Fujian Provincial Hospital Fujian Medical University Fuzhou China
| | - Meng Dai
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Di Zhang
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | | | - Guixia Wang
- The First Hospital of Jilin University Changchun China
| | - Feixia Shen
- The First Affiliated Hospital of Wenzhou Medical University Wenzhou China
| | - Zuojie Luo
- The First Affiliated Hospital of Guangxi Medical University Nanning China
| | - Yingfen Qin
- The First Affiliated Hospital of Guangxi Medical University Nanning China
| | - Li Chen
- Qilu Hospital of Shandong University Jinan China
| | - Yanan Huo
- Jiangxi Provincial People's Hospital Affiliated to Nanchang University Nanchang China
| | - Qiang Li
- The Second Affiliated Hospital of Harbin Medical University Harbin China
| | - Zhen Ye
- Zhejiang Provincial Center for Disease Control and Prevention Hangzhou China
| | - Yinfei Zhang
- Central Hospital of Shanghai Jiading District Shanghai China
| | - Chao Liu
- Jiangsu Province Hospital on Integration of Chinese and Western Medicine Nanjing China
| | - Youmin Wang
- The First Affiliated Hospital of Anhui Medical University Hefei China
| | - Shengli Wu
- Karamay Municipal People's Hospital Xinjiang China
| | - Tao Yang
- The First Affiliated Hospital of Nanjing Medical University Nanjing China
| | - Huacong Deng
- The First Affiliated Hospital of Chongqing Medical University Chongqing China
| | - Lulu Chen
- Union Hospital Tongji Medical College Huazhong University of Science and Technology Wuhan China
| | - Jiajun Zhao
- Shandong Provincial Hospital affiliated to Shandong University Jinan China
| | - Yiming Mu
- Chinese People's Liberation Army General Hospital Beijing China
| | - Donghui Li
- Department of Gastrointestinal Medical Oncology The University of Texas MD Anderson Cancer Center Houston TX
| | - Guijun Qin
- The First Affiliated Hospital of Zhengzhou University Zhengzhou China
| | - Weiqing Wang
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Guang Ning
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Li Yan
- Sun Yat-sen Memorial Hospital Sun Yat-sen University Guangzhou China
| | - Yufang Bi
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
| | - Jieli Lu
- State Key Laboratory of Medical Genomics Key Laboratory for Endocrine and Metabolic Diseases of the Ministry of Health Department of Endocrine and Metabolic Diseases National Clinical Research Center for Metabolic Diseases, and Shanghai Clinical Center for Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic Diseases Rui-Jin Hospital Shanghai Jiao-Tong University School of Medicine Shanghai China
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14
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Salomaa V. Worrisome trends in the incidence of coronary artery disease events among young individuals. Eur J Prev Cardiol 2020; 27:1175-1177. [PMID: 31941364 DOI: 10.1177/2047487319896051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Veikko Salomaa
- Department of Public Health Solutions, THL-Finnish Institute for Health and Welfare, Finland
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15
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Hsu YH, Sung FC, Muo CH, Chuang SY, Chen CM, Hsu CY, Hsu CC. Increased risk of developing peripheral artery disease in hemodialysis patients receiving statin treatments: a population-based cohort study in Taiwan. Nephrol Dial Transplant 2019; 35:1753-1760. [PMID: 31821490 DOI: 10.1093/ndt/gfz251] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/19/2019] [Indexed: 12/24/2022] Open
Abstract
Abstract
Background
Few investigations have evaluated the influences on peripheral arterial disease (PAD) risk of statin treatment in hemodialysis (HD) subjects with hyperlipidemia (HL).
Methods
From the National Health Insurance Research Dataset, we identified 3658 HD patients with statin therapy for HL as the statin cohort, and then selected, by 1:1 propensity score matching, 3658 HD patients with HL but without statin use as the nonstatin cohort in 2000–07. The cohorts were followed through until the end of 2011. We used Cox proportional hazards regression analysis to assess the hazard ratio (HR) of PAD development.
Results
The average follow-up period was 4.18 years; the incident PAD risk was 1.35-fold greater in statin users than in nonusers (16.87 versus 12.46/1000 person-years), with an adjusted HR (aHR) of 1.34 for PAD [95% confidence interval (CI) 1.12–1.62]. The PAD risk increases were significant for patients receiving fluvastatin (aHR 1.88; 95% CI 1.12–3.14) and atorvastatin (aHR 1.60; 95% CI 1.24–2.08). The risk increased with higher annual average statin dosage (P for trend <0.0001); the risk was higher for those receiving moderate-intensity statin treatment. The sensitivity test revealed similar findings.
Conclusions
HD patients with HL on statin medication were at increased PAD risk, which increased with cumulative statin dosage. Thorough considerations are needed before prescribing statins to HD patients.
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Affiliation(s)
- Yueh-Han Hsu
- Department of Medical Research, China Medical University Hospital, Taichung City, Taiwan, ROC
- Department of Internal Medicine, Division of Nephrology, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi City, Taiwan, ROC
- Department of Nursing, Min-Hwei Junior College of Health Care Management, Tainan City, Taiwan, ROC
| | - Fung-Chang Sung
- Department of Health Services Administration, China Medical University College of Public Health, Taichung City, Taiwan, ROC
- Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan, ROC
| | - Chih-Hsin Muo
- Management Office for Health Data, China Medical University Hospital, Taichung City, Taiwan, ROC
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung City, Taiwan, ROC
| | - Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan, ROC
| | - Chun-Ming Chen
- Department of Internal Medicine, Division of Allergy, Immunology and Rheumatology, Ditmanson Medical Foundation Chiayi Christian Hospital, Chiayi City, Taiwan, ROC
| | - Chung Y Hsu
- Graduate Institute of Clinical Medical Science, College of Medicine, China Medical University, Taichung City, Taiwan, ROC
| | - Chih-Cheng Hsu
- Department of Health Services Administration, China Medical University College of Public Health, Taichung City, Taiwan, ROC
- Institute of Population Health Sciences, National Health Research Institutes, Zhunan, Taiwan, ROC
- Department of Family Medicine, Min-Sheng General Hospital, Taoyuan, Taiwan, ROC
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16
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Mirmoghadam Z, Karami M, Mohammadi Y, Mirzaei M. The profile of health care utilization among HIV/AIDS patients in Iran from 1987 to 2016: A nationwide study. CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2019. [DOI: 10.1016/j.cegh.2018.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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17
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Nedkoff L, Goldacre R, Greenland M, Goldacre MJ, Lopez D, Hall N, Knuiman M, Hobbs M, Sanfilippo FM, Wright FL. Comparative trends in coronary heart disease subgroup hospitalisation rates in England and Australia. Heart 2019; 105:1343-1350. [PMID: 30948515 PMCID: PMC6711344 DOI: 10.1136/heartjnl-2018-314512] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 01/20/2019] [Accepted: 02/12/2019] [Indexed: 12/21/2022] Open
Abstract
Background Population-based coronary heart disease (CHD) studies have focused on myocardial infarction (MI) with limited data on trends across the spectrum of CHD. We investigated trends in hospitalisation rates for acute and chronic CHD subgroups in England and Australia from 1996 to 2013. Methods CHD hospitalisations for individuals aged 35–84 years were identified from electronic hospital data from 1996 to 2013 for England and Australia and from the Oxford Region and Western Australia. CHD subgroups identified were acute coronary syndromes (ACS) (MI and unstable angina) and chronic CHD (stable angina and ‘other CHD’). We calculated age-standardised and age-specific rates and estimated annual changes (95% CI) from age-adjusted Poisson regression. Results From 1996 to 2013, there were 4.9 million CHD hospitalisations in England and 2.6 million in Australia (67% men). From 1996 to 2003, there was between-country variation in the direction of trends in ACS and chronic CHD hospitalisation rates (p<0.001). During 2004–2013, reductions in ACS hospitalisation rates were greater than for chronic CHD hospitalisation rates in both countries, with the largest subgroup declines in unstable angina (England: men: −7.1 %/year, 95% CI −7.2 to –7.0; women: −7.5 %/year, 95% CI −7.7 to –7.3; Australia: men: −8.5 %/year, 95% CI −8.6 to –8.4; women: −8.6 %/year, 95% CI −8.8 to –8.4). Other CHD rates increased in individuals aged 75–84 years in both countries. Chronic CHD comprised half of all CHD admissions, with the majority involving angiography or percutaneous coronary intervention. Conclusions Since 2004, rates of all CHD subgroups have fallen, with greater declines in acute than chronic presentations. The slower declines and high proportion of chronic CHD admissions undergoing coronary procedures requires greater focus.
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Affiliation(s)
- Lee Nedkoff
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Raphael Goldacre
- Unit of Health-Care Epidemiology, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, England
| | - Melanie Greenland
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael J Goldacre
- Unit of Health-Care Epidemiology, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, England
| | - Derrick Lopez
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Nick Hall
- Unit of Health-Care Epidemiology, Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, England
| | - Matthew Knuiman
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Michael Hobbs
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Frank M Sanfilippo
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - F Lucy Wright
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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18
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Piepoli MF. Editorial. Eur J Prev Cardiol 2018; 25:1235-1237. [DOI: 10.1177/2047487318794533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Roever L, Tse G, Biondi-Zoccai G. Trends in cardiovascular disease in Australia and in the world. Eur J Prev Cardiol 2018; 25:1278-1279. [PMID: 29808763 DOI: 10.1177/2047487318778339] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- Leonardo Roever
- 1 Federal University of Uberlândia, Department of Clinical Research, Brazil
| | - Gary Tse
- 2 Department of Medicine and Therapeutics, Faculty of Medicine, Chinese University of Hong Kong, China.,3 Li Ka Shing Institute of Health Sciences, Faculty of Medicine, Chinese University of Hong Kong, China
| | - Giuseppe Biondi-Zoccai
- 4 Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome, Latina, Italy.,5 Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy
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