“…In our study, the mean age for men was 54.86 (sd±9.07), which transitioned them from low to higher risk categories. Our findings are similar to a study where cardiovascular risk was estimated with a pooled cohort Risk Equations among patients hospitalized in the internal medicine wards [26]. In this study, age greater or equal to 60 years was the main risk factor for high CVD risk.…”
While atherosclerotic cardiovascular disease risk is increased in patients with type 2 diabetes, the magnitude and socio-demographic determinants of this risk are not known in Uganda. We aimed to establish the magnitude of the predicted 10-year atherosclerotic cardiovascular risk and describe its socio-demographic determinants among patients with type 2 diabetes in Uganda. This was a cross-sectional study conducted in eight (8) diabetes clinics from November 2020 to February 2021. We enrolled 500 patients with type 2 diabetes aged between 40 to 79 years. Patients were interviewed on their socio-demographic characteristics. Anthropometric and laboratory measurements were performed. The predicted 10-year atherosclerotic cardiovascular risk was categorized using the Pooled Cohorts Risks Equations. Bivariate and multivariate logistic regression was conducted to establish associated socio-demographic factors. The majority of participants were females (78%), with a mean age of 55.14years (SD±8.96). Of the patients studied, 20% were at low risk (score <5%), 14.2% borderline risk (score 5-≤7.5%), 45.2% intermediate risk (score7.5-<20) and 20.6% high risk (score ≥20%). Elevated risk of score ≥7.5% was found in 65.8%. The male gender (AOR= 5.456, 95% CI 2.998-9.932, p=0.001), at least 50 years of age (AOR=7.841 95% CI 4.863-12.642, p=0.001), part-time employment (AOR=1.726, 95% CI 1.221-2.441, p=0.002) and being widowed (AOR=2.4, 95% CI 1.192-4.833, p=0.002) were significantly associated with cardiovascular disease risk. The cardiovascular disease risk among patients with type 2 diabetes is high. The male gender, age of at least 50years, part-time employment, and being widowed are socio-demographic factors that should be prioritized at primary level management of cardiovascular disease.
“…In our study, the mean age for men was 54.86 (sd±9.07), which transitioned them from low to higher risk categories. Our findings are similar to a study where cardiovascular risk was estimated with a pooled cohort Risk Equations among patients hospitalized in the internal medicine wards [26]. In this study, age greater or equal to 60 years was the main risk factor for high CVD risk.…”
While atherosclerotic cardiovascular disease risk is increased in patients with type 2 diabetes, the magnitude and socio-demographic determinants of this risk are not known in Uganda. We aimed to establish the magnitude of the predicted 10-year atherosclerotic cardiovascular risk and describe its socio-demographic determinants among patients with type 2 diabetes in Uganda. This was a cross-sectional study conducted in eight (8) diabetes clinics from November 2020 to February 2021. We enrolled 500 patients with type 2 diabetes aged between 40 to 79 years. Patients were interviewed on their socio-demographic characteristics. Anthropometric and laboratory measurements were performed. The predicted 10-year atherosclerotic cardiovascular risk was categorized using the Pooled Cohorts Risks Equations. Bivariate and multivariate logistic regression was conducted to establish associated socio-demographic factors. The majority of participants were females (78%), with a mean age of 55.14years (SD±8.96). Of the patients studied, 20% were at low risk (score <5%), 14.2% borderline risk (score 5-≤7.5%), 45.2% intermediate risk (score7.5-<20) and 20.6% high risk (score ≥20%). Elevated risk of score ≥7.5% was found in 65.8%. The male gender (AOR= 5.456, 95% CI 2.998-9.932, p=0.001), at least 50 years of age (AOR=7.841 95% CI 4.863-12.642, p=0.001), part-time employment (AOR=1.726, 95% CI 1.221-2.441, p=0.002) and being widowed (AOR=2.4, 95% CI 1.192-4.833, p=0.002) were significantly associated with cardiovascular disease risk. The cardiovascular disease risk among patients with type 2 diabetes is high. The male gender, age of at least 50years, part-time employment, and being widowed are socio-demographic factors that should be prioritized at primary level management of cardiovascular disease.
“…Therapeutic effects of vitamin D on depression, evaluated using the Montgomery-Asberg Depression Rating Scale 2. Therapeutic effects of vitamin D on cardiovascular risk factors, evaluated using the scoring system proposed by the American College of Cardiology (ACC) and American Heart Association (AHA) [43,44] for the primary prevention of the risk of acute myocardial infarction, death by coronary heart disease, heart failure, and fatal and non-fatal stroke in a period of 10 years. The new scoring system provides specific estimates based on current age, sex, race, blood pressure, total cholesterol, HDL cholesterol, LDL cholesterol, diabetes, smoking status (current smoker, ex-smoker, or never smoked), in treatment for systemic arterial hypertension, in treatment with statins, and in treatment with aspirin.…”
AbstratofundoA depressão é uma das principais causas de incapacidade crônica em todo o mundo e um importante fator de risco cardiovascular, aumentando o risco relativo de doença arterial coronariana, bem como as taxas de morbimortalidade cardiovascular. Concomitantemente à alta prevalência de depressão, houve uma redução na exposição à luz solar com o aumento da urbanização e do uso de protetores solares, o que levou a uma redução nos níveis séricos de 25-hidroxivitamina D. Portanto, este artigo descreve uma protocolo para um ensaio clínico com o objetivo de avaliar os efeitos da suplementação de vitamina D na depressão e fatores de risco cardiovascular para contribuir com evidências sobre a influência potencial da suplementação na regulação do humor.MétodosEste estudo de protocolo foi orientado pelos itens de protocolo padrão: recomendações para ensaios intervencionistas. Um ensaio clínico randomizado, controlado por placebo, duplo-cego será realizado envolvendo 224 adultos (faixa etária de 18 a 60 anos) com depressão que estão tomando antidepressivos e não têm histórico de suplementação de vitamina D, comorbidades psiquiátricas, doença renal crônica, hipercalcemia, ou neoplasia. Os participantes serão recrutados nos ambulatórios psiquiátricos de duas universidades do nordeste do Brasil. Os participantes elegíveis que fornecerem consentimento por escrito serão designados aleatoriamente para o grupo de intervenção (n = 112; suplementação de vitamina D 50.000 UI por semana durante 6 meses) ou para o grupo controle (n = 112; placebo tomado semanalmente por 6 meses). Medidas para monitorar sintomas depressivos, exames clínicos e exames laboratoriais para avaliar fatores de risco cardiovascular e níveis séricos de vitamina D serão realizadas antes e após o período de intervenção.DiscussãoAté onde sabemos, este será o primeiro ensaio clínico com o objetivo de testar a eficácia da suplementação de vitamina D na redução do risco cardiovascular e como um adjuvante à terapia da depressão por um período prolongado (6 meses). Os resultados contribuirão para a compreensão dos efeitos terapêuticos da suplementação de vitamina D no tratamento da depressão e podem ajudar a orientar políticas públicas direcionadas à suplementação de vitamina para a redução do risco cardiovascular.Registro de testeRegistro Brasileiro de Ensaios Clínicos, RBR-6yj8sj/ Número Universal de Ensaios (UTN) U1111-1217-9237. Registrado em 23 de julho de 2018.
“…Therapeutic effects of vitamin D on cardiovascular risk factors, evaluated using the scoring system proposed by the American College of Cardiology (ACC) and American Heart Association (AHA) [37,38] for the primary prevention of the risk of acute myocardial infarction, death by coronary heart disease, heart failure, fatal and non-fatal stroke in a period of 10 years. The new scoring system provides specific estimates based on current age, sex, race, blood pressure, total cholesterol, HDL cholesterol, LDL cholesterol, diabetes, smoking status (current smoker, ex-smoker or never smoked), in treatment for systemic arterial hypertension, in treatment with statins and in treatment with aspirin.…”
Background: Depression is a major cause of chronic disability throughout the world and an important cardiovascular risk factor, increasing the relative risk of coronary artery disease as well as rates of cardiovascular morbidity and mortality. Concomitant to the greater prevalence of depression, there has been a reduction in exposure to sunlight with the increase in urbanization and the use of sun block, which has led to a reduction in serum levels of 25-hydroxyvitamin D. Therefore, this paper describes a protocol for a clinical trial aimed at evaluating the effects of vitamin D supplementation on depression and cardiovascular risk factors to contribute evidence regarding the potential influence of supplementation in situations related to mood regulation.
Methods: This protocol study was guided by the SPIRIT recommendations. A randomized, placebo-controlled, double-blind trial will be conducted with 224 adults (age range: 18 to 59 years) with depression taking antidepressants with no history of vitamin D supplementation, psychiatric comorbidities, chronic kidney disease, hypercalcemia or neoplasm in care at psychiatric outpatient clinics of two universities in northeast Brazil. Eligible participants who provided written consent will be randomly designated to either the intervention group (n = 112; vitamin D supplementation – 50,000 IU per week for six months) or control group (n = 112; placebo taken weekly for six months). Measures for monitoring depressive symptoms, clinical trials and laboratory tests for evaluating cardiovascular risk factors and serum vitamin D levels will be performed before and after the intervention period.
Discussion: To the best of our knowledge, this will be the first clinical trial with the aim of testing the effectiveness of vitamin D supplementation on the reduction in cardiovascular risk and as an adjuvant to depression therapy for a prolonged period (six months). The findings will contribute to the understanding of the therapeutic effects of vitamin D supplementation on the management of depression and can help guide public policies directed toward vitamin supplementation for the reduction of cardiovascular risk.
Trial registration: Proof: http://www.ensaiosclinicos.gov.br/rg/. Number: RBR-6yj8sj / UTN Number: U1111-1217-9237 (July 23, 2018)
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