Geographic Variation in Cardiovascular Health Among American Adults

Parcha, Vibhu; Kalra, Rajat; Suri, Sarabjeet Singh; Malla, Gargya; Wang, Thomas J.; Arora, Garima; Arora, Pankaj

doi:10.1016/j.mayocp.2020.12.034

Cited by 34 publications

(46 citation statements)

References 23 publications

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“…However, similar to our findings, nearly all prior studies have found a relatively high proportion of non-specific signs and symptoms prompting testing among pediatric COVID-19 patients, including lethargy, malaise, myalgia, sore throat, runny nose, sneezing, gastrointestinal symptoms, and fatigue 8,[30][31][32][33][34][35][36][37][38][39] . The relatively lower rates of typical symptoms noted in our study compared with other studies may also be due to the incomplete reporting of symptoms in the electronic health records, difficulty in eliciting symptomology in pre-verbal pediatric patients, relatively higher proportion of non-typical symptoms, geographic differences in the extent of spread of COVID-19 40 , and differences in the local screening and testing approaches. Further evaluation of the clinical presentation of COVID-19 among pediatric populations is needed to adequately target our screening and testing approaches.…”

Section: Discussioncontrasting

confidence: 80%

A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States

Parcha

Booker

Kalra

et al. 2021

Sci Rep

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114

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Children and adolescents account for ~ 13% of total COVID-19 cases in the United States. However, little is known about the nature of the illness in children. The reopening of schools underlines the importance of understanding the epidemiology of pediatric COVID-19 infections. We sought to assess the clinical characteristics and outcomes in pediatric COVID-19 patients. We conducted a retrospective cross-sectional analysis of pediatric patients diagnosed with COVID-19 from healthcare organizations in the United States. The study outcomes (hospitalization, mechanical ventilation, critical care) were assessed using logistic regression. The subgroups of sex and race were compared after propensity score matching. Among 12,306 children with lab-confirmed COVID-19, 16.5% presented with respiratory symptoms (cough, dyspnea), 13.9% had gastrointestinal symptoms (nausea, vomiting, diarrhea, abdominal pain), 8.1% had dermatological symptoms (rash), 4.8% had neurological (headache), and 18.8% had other non-specific symptoms (fever, malaise, myalgia, arthralgia and disturbances of smell or taste). In the study cohort, the hospitalization frequency was 5.3%, with 17.6% needing critical care services and 4.1% requiring mechanical ventilation. Following propensity score matching, the risk of all outcomes was similar between males and females. Following propensity score matching, the risk of hospitalization was greater in non-Hispanic Black (RR 1.97 [95% CI 1.49–2.61]) and Hispanic children (RR 1.31 [95% CI 1.03–1.78]) compared with non-Hispanic Whites. In the pediatric population infected with COVID-19, a substantial proportion were hospitalized due to the illness and developed adverse clinical outcomes.

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Section: Discussioncontrasting

confidence: 80%

A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States

Parcha

Booker

Kalra

et al. 2021

Sci Rep

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114

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“…The researchers found that the prevalence of ideal CVH (5–7 ideal metrics) in Bhutan increased from 11.6% in 2007 to 37.9% in 2019, and the mean CVH metrics increased from 2.9 in 2007 to 4.2 in 2019. A similar increase in the ideal CVH score was found in a trend study in the USA (increase from 3.89 in 2011 to 3.96 in 2017 20 , while the mean CVH metrics increased in Iran from 4.7 in 2007 to 5.0 in 2016 19 . The increase in ideal CVH metrics in this study was mainly attributed to ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal blood glucose.…”

Section: Discussionsupporting

confidence: 82%

“…In a trend study over ten years in Iran, the prevalence of 5–7 ideal CVH metrics slightly reduced from 22.7% in 2007 to 19.5% in 2016, the mean CVH metrics increased from 4.7 in 2007 to 5.0 in 2016 19 . In a trend study among adults in USA over seven years the prevalence of the ideal CVH score significantly increased from 3.89 in 2011 to 3.96 in 2017 20 , and a trend study over 20 years in France found a decrease in ideal CVH 21 .…”

Section: Introductionmentioning

confidence: 97%

National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019

Pengpid

Peltzer

2022

Sci Rep

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The study aimed to estimate the prevalence, distribution, and correlates of ideal cardiovascular health (CVH) among individuals (20–69 years) across three cross-sectional surveys in 2007, 2014 and 2019 in Bhutan. Cross-sectional data were analysed from 9712 individuals (20–69 years, mean age = 37.6 years) who participated in the 2007, 2014 or 2019 Bhutan STEPS surveys, had complete measurement of CVH metrics, and had no history of a cardiovascular disease in 2014 and 2019. Ideal CVH measures included non-smoking, healthy diet, physical activity, body mass index (< 23 kg/m2), blood pressure < 120/ < 80 mmHg, total cholesterol < 200 mg/dL, and fasting blood glucose < 100 mg/dL). The prevalence of five to seven ideal CVH metrics increased from 11.6% in 2007 to 37.9% in 2019. Trend analyses showed that ideal physical activity, ideal total cholesterol, ideal blood pressure, and ideal fasting glucose increased from 2007 to 2019, while ideal fruit and vegetable intake, ideal smoking, and ideal body mass index decreased from 2007 to 2019. Five to seven ideal CVH metrics, 0–7 ideal CVH metrics, and 0–14 poor, intermediate, and ideal CVH metrics increased from 2007 to 2019. In the adjusted logistic regression analysis, older age decreased the odds of having 5–7 ideal CVH metrics in all three study years. Male sex increased the odds, and employment decreased the odds of 5–7 ideal CVH metrics in 2007, and urban residence increased the odds of 5–7 ideal CVH metrics in 2014 and decreased the odds in 2019. The proportion of meeting 5–7 ideal CVH metrics increased in Bhutan. Primary and secondary prevention programmes must be strengthened to improve CVH in Bhutan, considering identified associated factors.

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“…21,[49][50][51][52] We did not have access to the geographic location of the randomization site, and the geographic heterogeneity in the genetic ancestry proportion, socioeconomic, cultural, dietary, and cardiometabolic risk factors of the study population may have also contributed to the observed results. 7,8,10,21,[49][50][51][52] Due to the lack of availability of genetic data, the current investigation did not account for genetic variants that may be associated with the development of diabetes. The lack of interaction may result from inadequate power for the given sample size to detect a significant interaction.…”

Section: Discussionmentioning

confidence: 99%

Genetic European Ancestry and Incident Diabetes in Black Individuals: Insights From the SPRINT Trial

Parcha

Heindl

Kalra

et al. 2022

Circ: Genomic and Precision Medicine

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Background: Black individuals have high incident diabetes risk, despite having paradoxically lower triglyceride and higher HDL (high-density lipoprotein) cholesterol levels. The basis of this is poorly understood. We evaluated the participants of SPRINT (Systolic Blood Pressure Intervention Trial) to assess the association of estimated European genetic ancestry with the risk of incident diabetes in self-identified Black individuals. Methods: Self-identified non-Hispanic Black SPRINT participants free of diabetes at baseline were included. Black participants were stratified into tertiles (T1–T3) of European ancestry proportions estimated using 106 biallelic ancestry informative genetic markers. The multivariable-adjusted association of European ancestry proportion with indices of baseline metabolic syndrome (ie, fasting plasma glucose, triglycerides, HDL cholesterol, body mass index, and blood pressure) was assessed. Multivariable-adjusted Cox regression determined the risk of incident diabetes (fasting plasma glucose ≥126 mg/dL or self-reported diabetes treatment) across tertiles of European ancestry proportion. Results: Among 2466 Black SPRINT participants, a higher European ancestry proportion was independently associated with higher baseline triglyceride and lower HDL cholesterol levels ( P <0.001 for both). European ancestry proportion was not associated with baseline fasting plasma glucose, body mass index, and blood pressure ( P >0.05). Compared with the first tertile, those in the second (hazard ratio, 0.64 [95% CI, 0.45–0.90]) and third tertiles (hazard ratio, 0.61 [95% CI, 0.44–0.89]) of the European ancestry proportion had a lower risk of incident diabetes. A 5% point higher European ancestry was associated with a 29% lower risk of incident diabetes (hazard ratio, 0.71 [95% CI, 0.55–0.93]). There was no evidence of a differential association between the European ancestry proportion tertiles and incident diabetes between those randomized to intensive versus standard blood pressure treatment. Conclusions: The higher risk of incident diabetes in Black individuals may have genetic determinants in addition to adverse social factors. Further research may help understand the interplay between biological and social determinants of cardiometabolic health in Black individuals. Registration: URL: https://www.clinicaltrials.gov ; Unique identifier: NCT01206062.

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Geographic Variation in Cardiovascular Health Among American Adults

Cited by 34 publications

References 23 publications

A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States

A retrospective cohort study of 12,306 pediatric COVID-19 patients in the United States

National trends in ideal cardiovascular health among adults in Bhutan from three cross-sectional surveys in 2007, 2014, and 2019

Genetic European Ancestry and Incident Diabetes in Black Individuals: Insights From the SPRINT Trial

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