Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

Kim, Lois; Carson, Claire; Lawlor, Debbie A.; Ebrahim, Shah

doi:10.1186/1471-2458-10-696

Cited by 5 publications

(5 citation statements)

References 25 publications

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Section: Discussionmentioning

confidence: 99%

“…A number of well established cohort studies have been published showing that established risk factors such as systolic blood pressure and smoking account for a significant proportion of geographical inequalities in cardiovascular disease within the UK. 4 5 8 12 29 However, these cohort studies do not directly address the impact of diet on geographical variation. For example, the British Regional Heart Study (a cohort of over 7000 men between 40 and 59 years of age recruited in 1978–80) found that variation in systolic blood pressure explained 27% of geographical variation in CHD incidence in Great Britain, body mass index explained 6%, and serum cholesterol levels had no affect.…”

Section: Discussionmentioning

confidence: 99%

“… 1–5 This variation is apparent for coronary heart disease (CHD), 5–8 stroke 4 9 10 and, to a lesser extent, cancer. 10 11 Previous attempts to quantify the impact of modifiable risk factors on these geographical variations have only been able to partially explain them, 5 8 and have been restricted to individual cohorts that may not represent the experience of the whole population. It would be helpful to quantify the impact of behavioural risk factors on these geographical inequalities in order to prioritise public health interventions.…”

Section: Introductionmentioning

confidence: 99%

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Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition

2011

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IntroductionIt is unclear how much of the geographical variation in coronary heart disease (CHD), stroke and cancer mortality rates within the UK is associated with diet. The aim of this study is to estimate how many deaths from CHD, stroke and cancer would be delayed or averted if Wales, Scotland and Northern Ireland adopted a diet equivalent in nutritional quality to the English diet.MethodsMortality data for CHD, stroke and 10 diet-related cancers for 2007–2009 were used to calculate the mortality gap (the difference between actual mortality and English mortality rates) for Wales, Scotland and Northern Ireland. Estimates of mean national consumption of 10 dietary factors were used as baseline and counterfactual inputs in a macrosimulation model (DIETRON). An uncertainty analysis was conducted using a Monte Carlo simulation with 5000 iterations.ResultsThe mortality gap in the modelled scenario (achieving the English diet) was reduced by 81% (95% credible intervals: 62% to 108%) for Wales, 40% (33% to 51%) for Scotland and 81% (67% to 99%) for Northern Ireland, equating to approximately 3700 deaths delayed or averted annually. For CHD only, the mortality gap was reduced by 88% (69% to 118%) for Wales, 58% (47% to 72%) for Scotland, and 88% (70% to 111%) for Northern Ireland.ConclusionImproving the average diet in Wales, Scotland and Northern Ireland to a level already achieved in England could have a substantial impact on reducing geographical variations in chronic disease mortality rates in the UK. Much of the mortality gap between Scotland and England is explained by non-dietary risk factors.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition

2011

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“…However, the pooled estimate of our subgroup analysis showed that OCs do not impact BMI as well as FBG levels. Of note, emerging evidence showed the existence of regional disparities in cardiovascular disease incidence and mortality ( 87 , 88 ). Moreover, three-quarter of the world's CVD deaths occur in low- and middle-income countries ( 89 ).…”

Section: Discussionmentioning

confidence: 99%

Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis

Fabunmi

Dludla

Nkambule

2023

Front. Cardiovasc. Med.

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BackgroundThe use of oral contraceptives (OCs) is associated with an increased risk of cardiovascular events such as arterial and venous thrombosis (VTE). Cardiovascular diseases (CVDs) are the leading cause of death worldwide, with low- and middle-income nations accounting for over three-quarter of CVD deaths. The aim of this systematic review is to provide a comprehensive synthesis of the available evidence on the link between OC use and CVD risk in premenopausal women and to further assess the role of geographic disparities in the reported prevalence of CVD risk in women on OCs.MethodsA comprehensive search of databases such as MEDLINE, Academic Search Complete, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Health Source: Nursing/Academic Edition was conducted, right from the inception to the present, by using the EBSCOhost search engine. The Cochrane Central Register of Clinical trials (CENTRAL) was also searched to augment relevant sources of information. OpenGrey, which is a repository of information providing open access to bibliographical references, was searched and the reference list of the selected studies was also scanned. The potential risk of bias of the included studies was assessed using the modified Downs and Black checklist. Data analysis was performed using the Review Manager (RevMan) version 5.3.ResultsWe included 25 studies that comprised 3,245 participants, of which 1,605 (49.5%) are OC users, while 1,640 (50.5%) are non-OC users. A total of 15 studies were included for meta-analysis, and the overall pooled estimates suggested a significant increase in the traditional cardiovascular risk variables [standardized mean difference (SMD) = 0.73, (0.46, 0.99) (Z = 5.41, p < 0.001)] and little to no difference in endothelial activation among OC users when compared with non-OC users [SMD = −0.11, (−0.81, 0.60) (Z = 0.30, p = 0.76)]. Europe [SMD = 0.03, (−0.21, 0.27), (Z = 0.25 p = 0.88)] had the least effect size, while North America had the highest effect size [SMD = 1.86, (−0.31, 4.04), (Z = 1.68 p = 0.09)] for CVD risk in OC users when compared with non-OC users.ConclusionThe use of OCs suggests a significant increase in the prevalence of traditional cardiovascular risk variables with little to no difference in the risk of endothelial dysfunction when compared with non-OC users, and the magnitude of CVD risks varies across different geographical regions.Registration and protocolThis systematic review was registered in the international prospective register of systematic reviews (PROSPERO) under the registration number: CRD42020216169.

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“…To further validate our PRS results, we computed the PRS in Indiana Biobank datasets [31], European Prospective Investigation into Cancer (EPIC)-Norfolk [32], and the British women's heart and health study (BWHHS) [33][34][35] using the weights learned in the UK Biobank (Methods). In the Indiana Biobank [31], we have access to Afib and observed that for all metrics M-REGLE outperforms U-REGLE among European samples.…”

Section: M-regle Improves the Prs For Cardiovascular Traitsmentioning

confidence: 99%

Utilizing multimodal AI to improve genetic analyses of cardiovascular traits

Zhou,

Cosentino,

Yun

et al. 2024

Preprint

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Electronic health record (EHR) and biobank datasets contain multiple high-dimensional clinical data (HDCD) modalities (e.g., ECG, Photoplethysmography (PPG), and MRI) for each individual. Access to multimodal HDCD provides a unique opportunity for genetic studies of complex traits because different modalities relevant to a single physiological system (e.g., circulatory system) encode complementary and overlapping information. We propose a novel multimodal deep learning method, M-REGLE, for discovering genetic associations from a joint representation of multiple complementary HDCD modalities. We showcase the effectiveness of this model by applying it to several cardiovascular modalities. M-REGLE jointly learns a lower-dimensional representation (i.e., latent factors) of multimodal HDCD using a convolutional variational autoencoder, performs genome-wide association studies (GWAS) on each latent factor, then combines the results to study the genetics of the underlying system. To validate the advantages of M-REGLE and multimodal learning, we apply it to common cardiovascular modalities (PPG and ECG), and compare its results to unimodal learning methods in which representations are learned from each data modality separately, but the downstream genetic analyses are performed on the combined unimodal representations. M-REGLE identifies 19.3% more loci on the 12-lead ECG dataset, 13.0% more loci on the ECG lead I + PPG dataset, and its genetic risk score significantly outperforms the unimodal risk score at predicting cardiac phenotypes, such as atrial fibrillation (Afib), in multiple biobanks.

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Geographical variation in cardiovascular incidence: results from the British Women's Heart and Health Study

Cited by 5 publications

References 25 publications

Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition

Differences in coronary heart disease, stroke and cancer mortality rates between England, Wales, Scotland and Northern Ireland: the role of diet and nutrition

Investigating cardiovascular risk in premenopausal women on oral contraceptives: Systematic review with meta-analysis

Utilizing multimodal AI to improve genetic analyses of cardiovascular traits

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