An exploration of modifiable health associated risk factors within a cohort of undergraduate nursing students

So-called diseases of affluence, otherwise known as 'lifestyle diseases', are attributed to modifiable risk factors that are influenced by lifestyle and personal behaviour. Leading by example is an important way for public health principles to be communicated. In the university context, students of nursing can become aware of the challenge to integrate and apply health principles in their own life so that they become responsible health leaders in the community. The aim of this study was to explore the incidence of a number of behaviour-associated health risk factors within a group of undergraduate nursing students. Ninety-four students participated in the study. Seventy-seven students (82%) reported the presence of at least one modifiable health risk factor. Forty-four percent of respondents were either overweight or obese. Further research to explore whether a health promoting curriculum encourages nursing students to internalise/apply health knowledge to their own lives is recommended. A campaign of public health might be useful within the university community to educate students about risk factors and healthy living.     

Relationship among risk factors for nephrolithiasis, cardiovascular disease, and ethnicity: focus on a law enforcement cohort.

This cross-sectional study determined the prevalence of nephrolithiasis and common cardiovascular disease (CVD) risk factors in a law enforcement officer (LEO) cohort and evaluated the relationship of nephrolithiasis with several CVD risk factors, including the possible effect of ethnicity. Self reported nephrolithiasis and CVD risk factors among currently employed male LEOs from nine states (n = 2,818) were compared to other men in the same states (n = 9,650). Of the LEOs, 6.2% (n = 174) self reported at least one kidney stone (range = 1 to 12, mean 2.3 6 2.1 stones). Twenty five percent of Native American LEOs (n = 7 of 28) self reported a history of stones. In LEOs with a history of nephrolithiasis, overweight defined as body mass index . 25 kg/m2 (odds ratio [OR] = 1.80, 95% confidence interval [CI] = 1.04, 3.11), hypercholesterolemia (OR = 1.53, 95% CI = 1.09, 2.15), and hypertension (OR = 1.46, 95% CI = 1.02, 2.11) were associated with the disease. These results suggest officers with common CVD risk factors are also at an increased risk for nephrolithiasis. Native American LEOs have a disproportionately higher prevalence of nephrolithiasis than do other ethnic groups.     

Cardiac health: relationships among hostility, spirituality, and health risk

This study examined hostility, spirituality, and indices of health risk among 100 young, primarily males of Hispanic background. Over half of the subjects were prehypertensive or hypertensive; one third had at least 2 objective risk factors for cardiac disease; and younger participants had lower spirituality scores and higher cynical distrust scores. Body mass index, spirituality, and glucose accounted for 29% of variance in systolic blood pressure; body mass index and age accounted for 39% of variance in diastolic blood pressure. The tools to assess cardiac risk (blood pressure, history, capillary blood screening, body mass index) are all "low tech" and low cost but used together are powerful in identifying risk populations.     

Assessment of cardiovascular risk in primary health care

Objective

This study aimed at investigating whether cardiovascular risk factors and their impact on total risk estimation differ between men and women.

Design

Cross-sectional cohort study.

Subjects

Finnish cardiovascular risk subjects (n = 904) without established cardiovascular disease, renal disease, or known diabetes.

Main outcome measures

Ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), oral glucose tolerance test, and total cardiovascular risk using SCORE risk charts.

Results

According to the SCORE risk charts, 27.0% (95% CI 23.1–31.2) of the women and 63.1% (95% CI 58.3–67.7) of the men (p < 0.001) were classified as high-risk subjects. Of the women classified as low-risk subjects according to SCORE, 25% had either subclinical peripheral arterial disease or renal insufficiency.

Conclusions

The SCORE system does not take into account cardiovascular risk factors typical in women, and thus underestimates their total cardiovascular risk. Measurement of ABI and eGFR in primary care might improve cardiovascular risk assessment. especially in women.Key Words: Ankle-brachial index, cardiovascular risk estimation, gender difference, glucose disorders, renal functionMore women than men die from cardiovascular disease in Europe, but the non-conventional risk factors in women may remain undiagnosed or ignored.

• In a cohort of middle-aged cardiovascular risk subjects in primary care, 27% of the women and 63% of the men (p < 0.001) were classified as high-risk subjects according to the SCORE risk charts.
• Of the women classified as low-risk subjects according to SCORE, 25% had either subclinical peripheral arterial disease or renal insufficiency.
• Measurement of ABI and eGFR in primary care might improve cardiovascular risk assessment, especially in women.

     

Assessment of cardiovascular risk in primary health care

The aim of this study was to determine the frequency of audit and the proportion completed in a group of practices. Data obtained by interviewing a member of each practice and inspecting practice records were independently coded by researchers. Practices initiated an average of 3.5 (range 1-7) audits in 2 years, of which an average of 0.9 (range 0-3) were completed. Ten of 16 completed audits were externally funded or facilitated. Few audits are com pleted in general practice and practices require continuing support for audit.     

心血管疾病发病风险感知评估工具的研究进展

心血管疾病发病风险感知是个体采取健康促进行为的基础,对落实心血管疾病一级预防策略、降低心血管疾病的发病率至关重要。该文从风险感知评估工具的普适性、特异性层面,综述国内外心血管疾病发病风险感知评估工具的内容、特征及应用情况。建议进一步在风险感知概念内涵界定的基础上,开展心血管疾病发病风险感知评估工具的开发与本土化验证研究,为后续医护人员开展风险沟通和风险干预提供依据。     

Traditional and emerging risk factors for cardiovascular disease

Cardiovascular disease (CVD) is the leading cause of death in the United States and most western societies, further, approximately 50% of CVD is related to coronary heart disease (CHD). Most CVD results from an athero-thrombotic pathologic process in the body's arterial beds, and is largely preventable through risk factor reduction. Risk factors are diseases, physiologic states, biologic markers, or other identifiable factors associated with increased incidence of CVD. This article breaks down traditional, emerging,and possible risk factors for discussion.     

Assessment of cardiovascular risk factors among residents of a city in Jordan

Cardiovascular diseases are a leading cause of morbidity and mortality in many countries. The purpose of this study was to assess cardiovascular risk factors in a stratified randomly selected sample of a city near Amman, Jordan. A stratified sample of two hundred and nine randomly selected households were selected for this study. Adults from each of the households who agreed to participate in this study were asked about their cardiovascular risk factors including cigarette smoking, high blood pressure, cholesterol, diabetes, obesity, and sedentary lifestyle. The sample consisted of 84 males and 125 females ranging in age from 17 to 93 years with a mean age of 37 years. Findings identified significant cardiovascular risk factors included cigarette smoking, obesity, hypertension, stress, and diabetes. Cigarette smoking was much more common in men than women. Implications for nurses are discussed with suggestions for future research.     

Chronic kidney disease and bleeding risk in patients at high cardiovascular risk: a cohort study

Essentials

• The association between chronic kidney disease and bleeding is unknown.
• We followed 10 347 subjects at high cardiovascular risk for bleeding events.
• Chronic kidney disease was associated with a 1.5‐fold increased bleeding risk.
• Especially albuminuria rather than decreased kidney function was associated with bleeding events.

Summary

Background

There are indications that patients with chronic kidney disease have an increased bleeding risk.

Objectives

To investigate the association between chronic kidney disease and bleeding in patients at high cardiovascular risk.

Methods

We included 10 347 subjects referred to the University Medical Center Utrecht (the Netherlands) from September 1996 to February 2015 for an outpatient visit with classic risk factors for arterial disease or with symptomatic arterial disease (Second Manifestation of Arterial disease [SMART] cohort). Patients were staged according to the KDIGO guidelines, on the basis of estimated glomerular filtration rate (eGFR) and albuminuria, and were followed for the occurrence of major hemorrhagic events until March 2015. Hazard ratios (HRs) with 95% confidence intervals (CIs) for bleeding were calculated with Cox proportional hazards analyses.

Results

The incidence rate for bleeding in subjects with chronic kidney disease was 8.0 per 1000 person‐years and that for subjects without chronic kidney disease was 3.5 per 1000 person‐years. Patients with chronic kidney disease (n = 2443) had a 1.5‐fold (95% CI 1.2–1.9) increased risk of bleeding as compared with subjects without chronic kidney disease (n = 7904) after adjustment. Subjects with an eGFR of < 45 mL min^?1 1.73 m^–2 with albuminuria had a 3.5‐fold (95% CI 2.3–5.3) increased bleeding risk, whereas an eGFR of < 45 mL min^?1 1.73 m^–2 without albuminuria was not associated with an increased bleeding risk (HR 1.3, 95% CI 0.7–2.5).

Conclusion

Chronic kidney disease is a risk factor for bleeding in patients with classic risk factors for arterial disease or with symptomatic arterial disease, especially in the presence of albuminuria.

     

Epidemiology and interaction of risk factors in cardiovascular disease

Many patients seen in a primary care practice have multiple risk factors for cardiovascular disease. In evaluating these patients, it is important for primary care clinicians to understand the principles of multiple risk factor assessment. Although none of the large-scale randomized primary prevention trials have convincingly proven the benefits of multiple risk factor intervention, some practical guidelines reflecting the current state of information are presented.     

Effects of incretin on cardiovascular disease and risk factors

Diabetes is an important poor prognostic factor for ischemic heart disease and other cardiovascular diseases. Various study results have previously shown that new diabetes therapeutic agents including GLP-1 agonists and DPP-4 inhibitors have been suggested to be able to not only improve the pathology of diabetes, but also improve cardiovascular risk and be useful in prognosis. This report describes the effects of incretin on the cardiovascular system and its expected efficacy in reducing cardiovascular risk.     

青岛港人群高尿酸血症患病率与心血管病危险因素的关系

目的：调查青岛港人群中血尿酸分布特点，分析其与心血管病危险因素的关联。方法：调查于2000—04／12完成。选择18-54岁青岛港职工11926名，从中整群抽样8640名进行了尿酸测定，均自愿参加调查。调查内容包括问卷、体格检查、实验室检查和特殊检查。通过问卷收集一般资料、个人疾病史、饮食和生活习惯和家族史等。测量职工的血压、身高及体质量。抽取空腹12h以上的静脉血，测定生化指标，血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、尿酸均用酶法测定，肌酐用苦味酸法测定。尿酸与心血管病的传统危险因素为血压、超重和肥胖、血糖、血脂。高尿酸血症为男性尿酸≥416μmol／L，女性尿酸≥357μmol／L。 结果：纳入青岛港职工8640名，全部进入结果分析，无脱落；①青岛港职工尿酸水平及高尿酸血症分布：男性尿酸水平明显高于女性[（320．0&;#177;66．1），（250．6&;#177;56．3）μmol／L]。男性总高尿酸血症患病率明显高于女性[7．3％，3．3％（χ^2=46．2，P〈0．01）]。②血浆尿酸与传统心血管病危险因素的相关性：除了男性年龄、血糖水平与尿酸水平无显著相关外，其他各因素均与尿酸有显著相关性（r=-0．128-0．286，P〈0．01）。③不同尿酸水平职工的心血管病危险因素水平比较：根据高尿酸血症评估标准，将全部职工按性别分别分为正常尿酸组和高尿酸血症组。除男性年龄、女性高密度脂蛋白胆固醇和心率外，两组间其他各危险因素水平比较．差异均有显著性意义（P〈0．05—0．01）。④不同尿酸水平职工的高血压、糖尿病、血脂异常等患病率比较：无论男女，高尿酸血症组的高血糖（空腹血糖受损＋糖尿病）、高血压、血脂异常和超重（包括肥胖）患病率均显著高于正常尿酸组（在20．33—249．30，P〈0．01）。（5）不同尿酸水平职工危险因素的个体聚集情况：无论男女2个及2个以上的危险因素的聚集比率在高尿酸血症组显著高于正常尿酸组[男：62．0％，29．2％；女：44．9％，13．2％（χ^27．75-164．20，P〈0．05-0．01）]。 结论：青岛港职工中高尿酸血症患病率较高，血尿酸水平与传统心血管病危险因素紧密相关，提示尿酸可以作为中国人心血管病危险因素的标志物。     

青岛港人群高尿酸血症患病率与心血管病危险因素的关系

目的:调查青岛港人群中血尿酸分布特点,分析其与心血管病危险因素的关联。方法:调查于2000-04/12完成。选择18～54岁青岛港职工11926名,从中整群抽样8640名进行了尿酸测定,均自愿参加调查。调查内容包括问卷、体格检查、实验室检查和特殊检查。通过问卷收集一般资料、个人疾病史、饮食和生活习惯和家族史等。测量职工的血压、身高及体质量。抽取空腹12h以上的静脉血,测定生化指标,血糖、总胆固醇、三酰甘油、高密度脂蛋白胆固醇、尿酸均用酶法测定,肌酐用苦味酸法测定。尿酸与心血管病的传统危险因素为血压、超重和肥胖、血糖、血脂。高尿酸血症为男性尿酸≥416μmol/L,女性尿酸≥357μmol/L。结果:纳入青岛港职工8640名,全部进入结果分析,无脱落。①青岛港职工尿酸水平及高尿酸血症分布:男性尿酸水平明显高于女性[(320.0±66.1),(250.6±56.3)μmol/L]。男性总高尿酸血症患病率明显高于女性[7.3%,3.3%(χ2=46.2,P<0.01)]。②血浆尿酸与传统心血管病危险因素的相关性:除了男性年龄、血糖水平与尿酸水平无显著相关外,其他各因素均与尿酸有显著相关性(r=-0.128～0.286,P<0.01)。③不同尿酸水平职工的心血管病危险因素水平比较:根据高尿酸血症评估标准,将全部职工按性别分别分为正常尿酸组和高尿酸血症组。除男性年龄、女性高密度脂蛋白胆固醇和心率外,两组间其他各危险因素水平比较,差异均有显著性意义(P<0.05～0.01)。④不同尿酸水平职工的高血压、糖尿病、血脂异常等患病率比较:无论男女,高尿酸血症组的高血糖(空腹血糖受损+糖尿病)、高血压、血脂异常和超重(包括肥胖)患病率均显著高于正常尿酸组(χ2=20.33～249.30,P<0.01)。⑤不同尿酸水平职工危险因素的个体聚集情况:无论男女2个及2个以上的危险因素的聚集比率在高尿酸血症组显著高于正常尿酸组[男:62.0%,29.2%;女:44.9%,13.2%(χ2=7.75～164.20,P<0.05～0.01)]。结论:青岛港职工中高尿酸血症患病率较高,血尿酸水平与传统心血管病危险因素紧密相关,提示尿酸可以作为中国人心血管病危险因素的标志物。     

Asthma in Head Start children: prevalence,risk factors,and health care utilization

PURPOSES: 1. To identify the prevalence and severity of asthma in a Massachusetts Head Start program; 2. To identify associated risk factors for children with asthma; 3. To assess factors associated with health care utilization for asthma management. METHOD: Parents of 316 Head Start children were interviewed using a close-ended survey questionnaire. Survey A was used for demographics and general health screening. Survey B documented more specific asthma information. FINDINGS: There was a 35% prevalence rate of asthma in this preschool Head Start population. Most children had mild to moderate degrees of severity. Atopy, environmental triggers, and tobacco smoke exposure were common risk factors. Seventy-four percent of these children with asthma had used the emergency department at least once in their lifetime for asthma management. Forty-one percent had been hospitalized at least one time for asthma. CONCLUSIONS: These findings are consistent with previous studies that support the need for asthma outreach and interventions in at-risk Head Start preschool populations.     

Classical and "non-classical" cardiovascular risk factors in Tunisian patients with end stage renal disease: prevalence and association with cardiovascular events

This study was aimed to determine the prevalence of several classical and non-classical cardiovascular risk factors, and to test their association with cardiovascular events in Tunisian patients with end-stage renal disease. A total of 35 chronic renal failure, 50 hemodialysed and 30 renal transplant recipient patients and 31 healthy subjects were included. Hypertension, elevated plasma concentrations of total homocysteine, fibrinogen, C-reactive protein, and lipoprotein(a) were highly prevalent in patients, whereas, smoking, hypertriglyceridemia, hypercholesterolemia, hypoHDLemia, and hypoalbuminemia were less common. In univariate analysis, cardiovascular events were associated with age, hypertension, and the top quartile of the total homocysteine and C-reactive protein values. When controlling for several potential confounding factors, cardiovascular events remained associated with age, hypertension (OR, 7.07; 95% CI, 1.76-28.34; P=0.01), and the top quartile of total homocysteine (OR, 10.41; 95% CI, 2.61-41.55; P=0.001) and C-reactive protein (OR, 3.99; 95% CI, 1.06-14.99; P=0.04).