The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

Notara, Venetia; Panagiotakos, Demosthenes B.; Kogias, Yannis; Stravopodis, Petros; Antonoulas, Antonis; Zombolos, Spyros; Mantas, Yannis; Pitsavos, Christos

doi:10.3961/jpmph.16.005

Cited by 20 publications

(11 citation statements)

References 31 publications

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“…The US National Bureau of Economic Research stated that each additional 4 years of education lowered all-cause mortality by almost 1.8% and reduced the risk of heart disease by 2.2%. 17 The present study found that the relationship between education and hypertension was a Bell-shaped pattern ( Table 3 ), showing people who attained a middle school education had a 53.5% higher risk for having hypertension (95% CI, 1.074–2.194; P =0.019) than those who attained college education. People who did not surpass primary school generally took part in more physically active jobs, which might cause them to have a lower incidence of coronary heart disease than among those whose jobs required little or no physical activity.…”

Section: Discussionsupporting

confidence: 47%

The risk factors of 9-year follow-up on hypertension in middle-aged people in Tujia-Nationality settlement of China

Liu

Schenck

et al. 2017

J Hum Hypertens

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The aim of this study was to investigate the risk factors of hypertension in middle-aged people within the Tujia-Nationality settlement in China. Demographics questionnaires and fitness tests were performed to identify the risk factors of hypertension in middle-aged people in the years 2005, 2010 and 2014 in the area of southwest Hubei of China. Of the 2428 participants, 568 were classified as hypertensive, giving an overall occurrence of hypertension at 23.4%, and the prevalence of hypertension was the highest in the year 2014 (34.9%). Furthermore, Tujia minority had a significantly higher risk for having hypertension (odds ratio=1.055 with 95% confidence interval (CI): 1.039–1.072; P=0.001) than Han people. Individuals with the lowest level of cardiorespiratory fitness (CRF) had a 2.483-fold risk for hypertension (95% CI, 1.530–4.031; P=0.001). Obesity and overweight individuals increased the risk by 3.470-fold and 2.124-fold, respectively, for having hypertension compared to normal weight people. Finally, white-collar workers had a 58.1 and 31.8% higher risk for hypertension than blue-collar workers in rural and urban areas, respectively. These results demonstrated that the prevalence of hypertension was higher between 2011 and 2014 in the area. The main risk factors for developing hypertension were found to be sex (as woman), Tujia minority, white-collar workers, overweight-obese, those with a middle school education, and those with the lowest CRF.

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Section: Discussionsupporting

confidence: 47%

The risk factors of 9-year follow-up on hypertension in middle-aged people in Tujia-Nationality settlement of China

Liu

Schenck

et al. 2017

J Hum Hypertens

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“…Association between CVD risks and As exposure could vary by age, gender, smoking status, alcohol consumption, physical activity, diabetes and obesity status, education level as well as some other socio-economic factors, all of which might be either powerful predictors of CVD risks or important factors in As toxicity [86][87][88][89][90][91][92][93][94]. However, varied adjustment for these well-identified potential confounders could be observed among different studies, leading to different magnitudes of associations estimated when combined in a meta-analysis.…”

Section: Study Characteristicsmentioning

confidence: 99%

Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis

Mondal

Polya

2020

IJERPH

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To the best of our knowledge, a dose-response meta-analysis of the relationship between cardiovascular disease (CVD) and arsenic (As) exposure at drinking water As concentrations lower than the WHO provisional guideline value (10 µg/L) has not been published yet. We conducted a systematic review and meta-analyses to estimate the pooled association between the relative risk of each CVD endpoint and low-level As concentration in drinking water both linearly and non-linearly using a random effects dose-response model. In this study, a significant positive association was found between the risks of most CVD outcomes and drinking water As concentration for both linear and non-linear models (p-value for trend < 0.05). Using the preferred linear model, we found significant increased risks of coronary heart disease (CHD) mortality and CVD mortality as well as combined fatal and non-fatal CHD, CVD, carotid atherosclerosis disease and hypertension in those exposed to drinking water with an As concentration of 10 µg/L compared to the referent (drinking water As concentration of 1 µg/L) population. Notwithstanding limitations included, the observed significant increased risks of CVD endpoints arising from As concentrations in drinking water between 1 µg/L and the 10 µg/L suggests further lowering of this guideline value should be considered.

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“…Chinese patients with better hypertension awareness prefer large hospitals with better medical quality [29,30]. Therefore, well-educated patients were more likely to use outpatient services in tertiary hospitals instead of primary healthcare institutions due to their preference for high-quality medical service and better financial status [50]. Actually, one-third of hypertensive patients visiting outpatient units in tertiary hospitals have reasonable blood pressure control and thus waste limited medical resources [29].…”

Section: Discussionmentioning

confidence: 99%

Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China

Pan

Zhong

et al. 2020

IJERPH

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This study aims to identify the characteristics and trajectories of outpatient service utilisation for hypertensive patients in tertiary hospitals. This study also attempts to investigate the determinants of the trajectories of outpatient service utilisation. A total of 9822 patients with hypertension and hypertension-related medical utilisation were recruited in Yichang, China from January 1 to December 31 in 2016. The latent trajectories of outpatient service utilisation were identified through latent class growth analysis. Differences in the demographic characteristics and medical utilisation among patients in different trajectories were tested by one-way ANOVA and chi-square analysis. The predictors of the trajectory groups of outpatient service utilisation were identified through multinomial logistic regression. Four trajectory groups were determined as stable-low (34.7%), low-fluctuating (13.4%), high-fluctuating (22.5%), and stable-high (29.4%). Significant differences were observed in all demographic characteristics (p < 0.001) and medical service utilisation variables (p < 0.001) among the four trajectories except for inpatient cost (p = 0.072). Determinants for outpatient service utilisation patterns include the place of residence, education level, outpatient visit times, inpatient service utilisation, and outpatient cost. Overall, hypertensive patients visiting outpatient units in the tertiary hospital were middle-aged, elderly, and well-educated, and they received poor follow-up services. The four identified latent trajectories have different characteristics and medical utilisation patterns. Trajectory group-based measurements are necessary for hypertension management and economic burden reduction.

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The Impact of Educational Status on 10-Year (2004-2014) Cardiovascular Disease Prognosis and All-cause Mortality Among Acute Coronary Syndrome Patients in the Greek Acute Coronary Syndrome (GREECS) Longitudinal Study

Cited by 20 publications

References 31 publications

The risk factors of 9-year follow-up on hypertension in middle-aged people in Tujia-Nationality settlement of China

The risk factors of 9-year follow-up on hypertension in middle-aged people in Tujia-Nationality settlement of China

Positive Association of Cardiovascular Disease (CVD) with Chronic Exposure to Drinking Water Arsenic (As) at Concentrations below the WHO Provisional Guideline Value: A Systematic Review and Meta-analysis

Trajectories of Outpatient Service Utilisation of Hypertensive Patients in Tertiary Hospitals in China

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