scholarly journals Persistent pathogens linking socioeconomic position and cardiovascular disease in the US

2008 ◽  
Vol 38 (3) ◽  
pp. 775-787 ◽  
Author(s):  
A. M Simanek ◽  
J. B. Dowd ◽  
A. E Aiello
Keyword(s):  
Cardiovascular Disease ◽  
Socioeconomic Position ◽  
The Us ◽  
Persistent Pathogens

Abstract P183: 20-year Secular Trend of Cardiovascular Disease Comorbidities in the United States, 1997-2016

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Dianjianyi Sun ◽  
Tao Zhou ◽  
Xiang Li ◽  
Yoriko Heianza ◽  
Xiaoyun Shang ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Secular Trend ◽  
Adult Population ◽  
The United States ◽  
The Past ◽  
The Us ◽  
Metabolic Conditions ◽  
Respiratory Conditions ◽  
The U.S ◽  
Chronic Comorbidities

Background: Cardiovascular disease (CVD) has been the number one cause of death and disability in the US and globally for decades, and its comorbidity complicates the management of CVD. However, little is known about the secular trend of CVD comorbidities in national representative populations in the last 20 years. Methods: Prevalence of CVD and nine major chronic comorbidities was estimated using data from 1,324,214 adults aged 18 years and older in the National Health Interview Survey (NHIS) from 1997 through 2016, with age-standardized to the U.S. population in the year 2000. Results: CVD prevalence in the US adult population significantly declined in the past twenty years (from 6.6% in 1997 to 5.9% in 2016, P trend <0.01in Figure a). And such trend was shown in women and whites (P trend <0.01), but not in men and blacks (P trend >0.05). We ranked the nine major chronic comorbidities (high to low) in the CVD patients (Figure b.), including (1) hypertension, (2) respiratory conditions, (3) nervous system conditions, (4) digestive conditions, (5) diabetes, (6) cancer, (7) genitourinary conditions, (8) circulatory conditions, and (9) endocrine/nutritional/metabolic conditions. From 1997 to 2016, the prevalence of CVD comorbidities including hypertension (38.8% to 50.2%), digestive conditions (17.0% to 27.1%), diabetes (10.0% to 19.2%), cancer (9.4% to 12.8%), and genitourinary conditions (4.1% to 5.2%) continuingly increased (all P trend <0.01), while respiratory conditions declined (35.9% to 27.6%, P trend <0.01). Similar trends of CVD comorbidities were observed among subgroups stratified by gender or by race. Conclusions: CVD prevalence in the U.S. adults have declined significantly in the past two decades, but rates of CVD comorbidities including hypertension, digestive conditions, diabetes, cancer, and genitourinary conditions increased substantially.

Abstract 17309: Scope and Determinants of Nonfinancial Barriers to Healthcare Access in Individuals With Atherosclerotic Cardiovascular Disease

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Isaac Acquah ◽  
Javier Valero-Elizondo ◽  
Miguel Cainzos Achirica ◽  
Rahul Singh ◽  
Karan Shah ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Logistic Regression ◽  
Low Income ◽  
Barriers To Care ◽  
Multinomial Logistic Regression ◽  
The Elderly ◽  
Atherosclerotic Cardiovascular Disease ◽  
The Us ◽  
Barriers To Healthcare ◽  
Relative Prevalence

Introduction: Barriers to healthcare - financial and nonfinancial - may result in unmet health needs and adverse outcomes. Despite this, the nonfinancial barriers to care among adults with atherosclerotic cardiovascular disease (ASCVD) is poorly defined in the US. We aimed to explore the scope and determinants of nonfinancial barriers to care among individuals with ASCVD. Methods: We analyzed data from the 2013-17 National Health Interview Survey (NHIS). We included adults with self-reported ASCVD (heart attack, angina, and/or stroke). Nine key variables in the NHIS that represent nonfinancial barriers to healthcare were assessed as absent/present, and participants were classified as having 0-1, 2, or ≥3 barriers. Multinomial logistic regression (using 0-1 nonfinancial barriers as reference) was used to evaluate the relationship between various sociodemographic factors, and an increasing number of nonfinancial barriers. Results: Of all the 15,758 adults with ASCVD (8.1% annually in the US; representing 19.6 million), 23.4% reported having at least one nonfinancial barrier to care while 4.9% reported 3 nonfinancial barriers. In a multivariable multinomial logistic regression, after stratifying by age, individuals from low-income families had an almost 2-fold relative prevalence of 3 nonfinancial barriers ( Figure) . In the elderly, however, lack of insurance was the strongest predictor (relative prevalence ratio of 6.51 [95% confidence interval; 2.25, 18.87]) of having ≥3 barriers. Conclusion: Among adults with ASCVD, the relative prevalence of ≥3 nonfinancial barriers was low (4.9%) with low-income being the only modifiable predictor of reporting ≥3 nonfinancial barriers and lack of insurance being the strongest predictor in the elderly. Addressing financial barriers to healthcare may help alleviate these nonfinancial barriers.

scholarly journals Association between socioeconomic position and cystatin C in the Heinz Nixdorf Recall Study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tanja Zamrik ◽  
Mirjam Frank ◽  
Carina Emmel ◽  
Lars Christian Rump ◽  
Raimund Erbel ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cystatin C ◽  
Socioeconomic Position ◽  
Social Inequalities ◽  
Men And Women ◽  
Income Quartile ◽  
Age And Sex

AbstractSocial inequalities in health and disease are well studied. Less information is available on inequalities in biomarker levels indicating subclinical stages of disease such as cystatin C, an early diagnostic marker of renal dysfunction and predictor for cardiovascular disease. We evaluated the relationship between cystatin C, socioeconomic position (SEP) and established cardiovascular risk factors in a population-based study. In 4475 men and women aged 45–75 years participating in the baseline examination of the Heinz Nixdorf Recall Study cystatin C was measured from serum samples with a nephelometric assay. SEP was assessed by education and household income. Linear regression models were used to analyse the association between SEP and cystatin C as well as the impact of cardiovascular risk factors (i.e., body mass index, blood pressure, blood glucose, diabetes mellitus, blood lipids, C-reactive protein, smoking) on this association. After adjustment for age and sex cystatin C decreased by 0.019 mg/l (95% confidence interval (CI) − 0.030 to − 0.008) per five years of education. While using a categorical education variable cystatin C presented 0.039 mg/l (95% CI 0.017–0.061) higher in men and women in the lowest educational category (≤ 10 years of education) compared to the highest category (≥ 18 years). Concerning income, cystatin C decreased by 0.014 mg/l (95% CI − 0.021 to − 0.006) per 1000 € after adjustment for age and sex. For men and women in the lowest income quartile cystatin C was 0.024 mg/l (95% CI 0.009–0.038) higher compared to the highest income quartile. After adjusting for established cardiovascular risk factors the observed associations were substantially diminished. Social inequalities seem to play a role in subclinical stages of renal dysfunction, which are also related to development of cardiovascular disease. Adjustment for traditional cardiovascular risk factors showed that these risk factors largely explain the association between SEP and cystatin C.

Abstract P551: Public Sentiment Toward Immigrants and Cardiovascular Disease Risk Among Hispanics/Latinos in the Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Danielle M Crookes ◽  
Lisa M Bates ◽  
Amelia K Boehme ◽  
Earle C Chambers ◽  
Martha Daviglus ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Alcohol Use ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Health Study ◽  
Foreign Born ◽  
The Us ◽  
Latino Immigrant ◽  
Latino Adults ◽  
Current Alcohol

Background: News reports and hate crime data suggest that anti-Hispanic/Latino immigrant sentiment was expressed by some sectors of the U.S. public during the 2016 Presidential campaign and election. The purpose of this study was to examine the association between this period and cardiovascular disease (CVD) risk factors thought to be responsive to acute stress exposure among Hispanic/Latino adults in the US. Methods: Data were from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a prospective cohort study of Hispanic/Latino adults living in the US. The analytic sample was limited to non-pregnant adults, 35 to 74 years old, who participated in Visit 1 (2008-2011) and Visit 2 (2014-2017). The exposed were defined as participants who completed Visit 2 in 2016 and the unexposed were defined as participants who completed Visit 2 in 2014 or 2015. Cardiovascular disease risk factors included elevated depressive symptoms (CESD-10 score: 10+), current smoking, and at-risk levels of alcohol consumption (women: 7+ drinks/week; men: 14+ drinks/week). Current alcohol use (i.e., any current alcohol use) was also examined as a potential stress-related outcome. Predicted marginal risk ratio models were used to estimate incident Visit 2 outcomes as a function of exposure to the year 2016 among individuals who did not have those outcomes at Visit 1. Models were adjusted for age and insurance status at Visit 1. A priori interactions with nativity status, duration of residence in the US, and Hispanic/Latino background group were examined. Results: No statistically significant association between 2016 exposure and elevated depressive symptoms was observed in the main model, but additive interaction by Hispanic/Latino background group was observed ( p = 0.03) (Mexican and Central American background: RR adjusted : 1.28 (0.94, 1.76); Hispanics/Latinos of other background groups: RR adjusted : 0.85 (0.66, 1.09)). No association between 2016 exposure and incident smoking or incident at-risk alcohol consumption was observed and tests for interaction were not statistically significant. For incident current alcohol use, borderline trends in the main model suggested an association with the exposure (RR adjusted : 1.11 (0.99, 1.26)). Further, statistically significant additive interaction by nativity status was observed (Foreign-born: RR adjusted : 1.20 (1.06, 1.37); US/Puerto Rico-born: RR adjusted : 0.78 (0.55, 1.09)). Conclusions: Trends from study findings suggest an association between exposure to anti-Hispanic/Latino immigrant sentiment in 2016 and current alcohol use among foreign-born Hispanic/Latino adults. Given limitations of using time as a proxy for exposure to anti-Hispanic/Latino immigrant sentiment, future studies should explore more specific measurements of sentiment during this time and explore short and long-term effects of this sentiment.

scholarly journals Equity in statin use in New Zealand

2014 ◽  
Vol 6 (1) ◽  
pp. 17 ◽  
Author(s):  
Pauline Norris ◽  
Simon Horsburgh ◽  
Gordon Becket ◽  
Shirley Keown ◽  
Bruce Arroll ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
New Zealand ◽  
Socioeconomic Position ◽  
Risk Groups ◽  
Cross Sectional Study ◽  
Age Group ◽  
Cross Sectional ◽  
Lower Socioeconomic ◽  
Statin Prescription ◽  
Statin Use

INTRODUCTION: Preventive medications such as statins are used to reduce cardiovascular risk. There is some evidence to suggest that people of lower socioeconomic position are less likely to be prescribed statins. In New Zealand, Maori have higher rates of cardiovascular disease. AIM: This study aimed to investigate statin utilisation by socioeconomic position and ethnicity in a region of New Zealand. METHODS: This was a cross-sectional study in which data were collected on all prescriptions dispensed from all pharmacies in one city during 2005/6. Linkage with national datasets provided information on patients’ age, gender and ethnicity. Socioeconomic position was identified using the New Zealand Index of Socioeconomic Deprivation 2006. RESULTS: Statin use increased with age until around 75 years. Below age 65 years, those in the most deprived socioeconomic areas were most likely to receive statins. In the 55–64 age group, 22.3% of the most deprived population received a statin prescription (compared with 17.5% of the mid and 18.6% of the least deprived group). At ages up to 75 years, use was higher amongst Maori than non-Maori, particularly in middle age, where Maori have a higher risk of cardiovascular disease. In the 45–54 age group, 11.6% of Maori received a statin prescription, compared with 8.7% of non-Maori. DISCUSSION: Statin use approximately matched the pattern of need, in contrast to other studies which found under-treatment of people of low socioeconomic position. A PHARMAC campaign to increase statin use may have increased use in high-risk groups in New Zealand. KEYWORDS: Ethnic groups; New Zealand; prescriptions; socioeconomic status; statins

scholarly journals Burden of Cardiovascular Disease in Adult Patients with Type 1 Diabetes in the US

2020 ◽  
Vol 4 (3) ◽  
pp. 519-528 ◽  
Author(s):  
Steve Edelman ◽  
Fang Liz Zhou ◽  
Ronald Preblick ◽  
Sumit Verma ◽  
Sachin Paranjape ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Adult Patients ◽  
The Us
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