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  • Ovid Technologies (Wolters Kluwer Health)  (19)
  • 1
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    Online Resource
    Relationship Between Daily Exposure to Biomass Fuel Smoke and Blood Pressure in High-Altitude Peru
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Hypertension Vol. 65, No. 5 ( 2015-05), p. 1134-1140
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 65, No. 5 ( 2015-05), p. 1134-1140
    Abstract: Household air pollution from biomass fuel use affects 3 billion people worldwide; however, few studies have examined the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with elevated blood pressure in high altitude Peru and if this relationship was affected by lung function. We analyzed baseline information from a population-based cohort study of adults aged ≥35 years in Puno, Peru. Daily biomass fuel use was self-reported. We used multivariable regression models to examine the relationship between daily exposure to biomass fuel smoke and blood pressure outcomes. Interactions with sex and quartiles of forced vital capacity were conducted to evaluate for effect modification. Data from 1004 individuals (mean age, 55.3 years; 51.7% women) were included. We found an association between biomass fuel use with both prehypertension (adjusted relative risk ratio, 5.0; 95% confidence interval, 2.6–9.9) and hypertension (adjusted relative risk ratio, 3.5; 95% confidence interval, 1.7–7.0). Biomass fuel users had a higher systolic blood pressure (7.0 mm Hg; 95% confidence interval, 4.4–9.6) and a higher diastolic blood pressure (5.9 mm Hg; 95% confidence interval, 4.2–7.6) when compared with nonusers. We did not find interaction effects between daily biomass fuel use and sex or percent predicted forced vital capacity for either systolic blood pressure or diastolic blood pressure. Biomass fuel use was associated with a higher likelihood of having hypertension and higher blood pressure in Peru. Reducing exposure to household air pollution from biomass fuel use represents an opportunity for cardiovascular prevention.
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.114.04840
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2094210-2
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  • 2
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    Endemic Cardiovascular Diseases of the Poorest Billion
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 133, No. 24 ( 2016-06-14), p. 2561-2575
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 133, No. 24 ( 2016-06-14), p. 2561-2575
    Abstract: The poorest billion people are distributed throughout the world, though most are concentrated in rural sub-Saharan Africa and South Asia. Cardiovascular disease (CVD) data can be sparse in low- and middle-income countries beyond urban centers. Despite this urban bias, CVD registries from the poorest countries have long revealed a predominance of nonatherosclerotic stroke, hypertensive heart disease, nonischemic and Chagas cardiomyopathies, rheumatic heart disease, and congenital heart anomalies, among others. Ischemic heart disease has been relatively uncommon. Here, we summarize what is known about the epidemiology of CVDs among the world’s poorest people and evaluate the relevance of global targets for CVD control in this population. We assessed both primary data sources, and the 2013 Global Burden of Disease Study modeled estimates in the world’s 16 poorest countries where 62% of the population are among the poorest billion. We found that ischemic heart disease accounted for only 12% of the combined CVD and congenital heart anomaly disability-adjusted life years (DALYs) in the poorest countries, compared with 51% of DALYs in high-income countries. We found that as little as 53% of the combined CVD and congenital heart anomaly burden (1629/3049 DALYs per 100 000) was attributed to behavioral or metabolic risk factors in the poorest countries (eg, in Niger, 82% of the population among the poorest billion) compared with 85% of the combined CVD and congenital heart anomaly burden (4439/5199 DALYs) in high-income countries. Further, of the combined CVD and congenital heart anomaly burden, 34% was accrued in people under age 30 years in the poorest countries, while only 3% is accrued under age 30 years in high-income countries. We conclude although the current global targets for noncommunicable disease and CVD control will help diminish premature CVD death in the poorest populations, they are not sufficient. Specifically, the current framework (1) excludes deaths of people 〈 30 years of age and deaths attributable to congenital heart anomalies, and (2) emphasizes interventions to prevent and treat conditions attributed to behavioral and metabolic risks factors. We recommend a complementary strategy for the poorest populations that targets premature death at younger ages, addresses environmental and infectious risks, and introduces broader integrated health system interventions, including cardiac surgery for congenital and rheumatic heart disease.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.116.008731
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
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  • 3
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    Abstract 17973: Biomass Fuel Use is Associated With Elevated Blood Pressure and Hypertension Status in Puno, Peru
    Ovid Technologies (Wolters Kluwer Health) ; 2014
    In:  Circulation Vol. 130, No. suppl_2 ( 2014-11-25)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 130, No. suppl_2 ( 2014-11-25)
    Abstract: Background: Household air pollution from biomass fuel use affects 3 billion people worldwide. There are few studies that examine the relationship between biomass fuel use and blood pressure. We sought to determine if daily biomass fuel use was associated with higher blood pressure and increased hypertension in Peru. Methods: We analyzed baseline information from an age- and sex-matched, population-based study in Puno, Peru. Daily biomass fuel use was self-reported. Hypertension was defined as a systolic blood pressure (SBP) ≥140 mmHg; diastolic blood pressure (DBP) ≥90 mmHg; or self-report of diagnosis and anti-hypertensive medications. We used linear and logistic multivariable regressions, adjusting for age, sex, daily cigarette use and body mass index, to examine the relationship between daily biomass fuel use with blood pressure and hypertension, respectively. Results: Data from 1004 individuals (mean age 55.3 years, 51.7% female) were included. There was evidence of an association between daily biomass fuel use and hypertension (adjusted OR = 2.1, 95%CI 1.2 to 3.5). Subjects who reported daily use of biomass fuels had 6.0 mmHg (95% CI 4.1 to 8.0) higher SBP and 4.8 mmHg (95%CI 3.5 to 6.0) higher DBP compared to those who did not use biomass fuels daily. In a secondary analysis, we used rural residence (vs. urban) as a proxy of biomass daily use and the relationship with hypertension and systolic blood pressure was similar: a higher odds of hypertension (adjusted OR = 2.1, 95%CI 1.3 to 3.6), and higher SBP (6.7mmHg, 95% CI 4.8 to 8.6) and DBP (5.5 mmHg, 95% CI 4.3 to 6.8) in rural vs. urban participants. Conclusion: Biomass fuel use is associated with increased odds of hypertension and higher blood pressure in Puno, Peru. Reducing exposure to air pollution from biomass fuel use represents a potential opportunity for cardiovascular prevention in rural communities worldwide. Longitudinal studies to evaluate the impact of reducing household air pollution are needed.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.130.suppl_2.17973
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2014
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  • 4
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    Abstract 14114: Sex Differences in the Etiology and Burden of Heart Failure Across the Sociodemographic Index: Analysis of 204 Countries and Territories, 1990-2019
    Ovid Technologies (Wolters Kluwer Health) ; 2022
    In:  Circulation Vol. 146, No. Suppl_1 ( 2022-11-08)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 146, No. Suppl_1 ( 2022-11-08)
    Abstract: Background: Heart failure (HF) is a global epidemic. Objectives: We assessed sex differences in HF across country income. Methods: Using Global Burden of Disease (GBD) data, we assessed sex differences in HF prevalence, etiology, morbidity, and temporal trends between 1990-2019 across 204 countries and territories and disaggregated results by country income (SDI or gross national income). Results: In 2019 there were 56.2 million (95% uncertainty interval [UI] 46.4-67.8 million) HF cases worldwide, with over half in females. HF morbidity was estimated at 5.1 million (95% UI 3.3-7.3 million) years lived with disability, distributed equally between the sexes. Overall, ischemic heart disease was the top cause of HF in males, and hypertensive heart disease the top cause in females. Between 1990-2019, there was an increase in total HF cases, but the age-standardized rate per 100,000 decreased by 7.1%, more so in males (9.1%) than females (5.8%). High-income regions experienced a 16.0% temporal decrease in age-standardized rates, from 877.5 to 736.8 per 100,000, while low-income regions experienced a 3.9% increase, from 612.1 to 636.0 per 100,000. Trend directionality was largely consistent in both sexes. Asia, sub-Saharan Africa, and Middle East experienced a temporal increase in age-standardized HF rates in both sexes, related to increasing ischemic heart disease. Globally, there was an increase in age-standardized HF rates due to calcific aortic valve disease and hypertensive heart disease, and a decrease due to ischemic heart disease, although regional and sex differences were noted. Conclusions: Age-standardized HF rates are increasing in the Middle East and low-SDI regions of the world, with sex differences in etiology and trends that offer targets for intervention.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.146.suppl_1.14114
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2022
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  • 5
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    Distribution of Short‐Term and Lifetime Predicted Risks of Cardiovascular Diseases in Peruvian Adults
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Journal of the American Heart Association Vol. 4, No. 8 ( 2015-08-25)
    Details
    In: Journal of the American Heart Association, Ovid Technologies (Wolters Kluwer Health), Vol. 4, No. 8 ( 2015-08-25)
    Abstract: Short‐term risk assessment tools for prediction of cardiovascular disease events are widely recommended in clinical practice and are used largely for single time‐point estimations; however, persons with low predicted short‐term risk may have higher risks across longer time horizons. Methods and Results We estimated short‐term and lifetime cardiovascular disease risk in a pooled population from 2 studies of Peruvian populations. Short‐term risk was estimated using the atherosclerotic cardiovascular disease Pooled Cohort Risk Equations. Lifetime risk was evaluated using the algorithm derived from the Framingham Heart Study cohort. Using previously published thresholds, participants were classified into 3 categories: low short‐term and low lifetime risk, low short‐term and high lifetime risk , and high short‐term predicted risk . We also compared the distribution of these risk profiles across educational level, wealth index, and place of residence. We included 2844 participants (50% men, mean age 55.9 years [ SD 10.2 years]) in the analysis. Approximately 1 of every 3 participants (34% [95% CI 33 to 36]) had a high short‐term estimated cardiovascular disease risk. Among those with a low short‐term predicted risk, more than half (54% [95% CI 52 to 56]) had a high lifetime predicted risk. Short‐term and lifetime predicted risks were higher for participants with lower versus higher wealth indexes and educational levels and for those living in urban versus rural areas ( P 〈 0.01). These results were consistent by sex. Conclusions These findings highlight potential shortcomings of using short‐term risk tools for primary prevention strategies because a substantial proportion of Peruvian adults were classified as low short‐term risk but high lifetime risk. Vulnerable adults, such as those from low socioeconomic status and those living in urban areas, may need greater attention regarding cardiovascular preventive strategies.
    Type of Medium: Online Resource
    ISSN: 2047-9980
    URL: Article
    DOI: 10.1161/JAHA.115.002112
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 2653953-6
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  • 6
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    Agreement Between Cardiovascular Disease Risk Scores in Resource-Limited Settings : Evidence from 5 Peruvian Sites
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine Vol. 14, No. 2 ( 2015-06), p. 74-80
    Details
    In: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 14, No. 2 ( 2015-06), p. 74-80
    Type of Medium: Online Resource
    ISSN: 1535-282X
    URL: Article
    DOI: 10.1097/HPC.0000000000000045
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 7
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    Sex Differences in Health Care-seeking Behavior for Acute Coronary Syndrome in a Low Income Country, Peru
    Ovid Technologies (Wolters Kluwer Health) ; 2011
    In:  Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine Vol. 10, No. 2 ( 2011-06), p. 99-103
    Details
    In: Critical Pathways in Cardiology: A Journal of Evidence-Based Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 10, No. 2 ( 2011-06), p. 99-103
    Type of Medium: Online Resource
    ISSN: 1535-282X
    URL: Article
    DOI: 10.1097/HPC.0b013e318223e375
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2011
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  • 8
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    A17044 Community health workers for non-communicable disease interventions in the digital age
    Ovid Technologies (Wolters Kluwer Health) ; 2018
    In:  Journal of Hypertension Vol. 36 ( 2018-10), p. e339-
    Details
    In: Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 36 ( 2018-10), p. e339-
    Type of Medium: Online Resource
    ISSN: 0263-6352
    URL: Article
    DOI: 10.1097/01.hjh.0000549386.67982.d6
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2018
    detail.hit.zdb_id: 2017684-3
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  • 9
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    Abstract P371: Prevalence of Cardiometabolically Healthy and Cardiometabolically Unhealthy Peruvians by Body Mass Index Categories: The CRONICAS Cohort Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 131, No. suppl_1 ( 2015-03-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 131, No. suppl_1 ( 2015-03-10)
    Abstract: Background: Obesity is associated with a number of cardiometabolic risk factors. However, despite increased adiposity, some obese individuals display normal metabolic features. Conversely, individuals with normal weight can display metabolically unhealthy features. These profiles have not been researched in Latin American populations. We aimed to characterize cardiometabolic status by body mass index (BMI) status with emphasis on unhealthy cardiometabolic profile among normal weight individuals, and healthy cardiometabolic profile among overweight and obese. Methods: The CRONICAS Cohort is a an age- and sex-matched population-based study across four different geographical settings: Lima (Peru’s capital, urban), Tumbes (lowland, semirural), Puno rural and Puno urban (both high altitude). Individuals were classified into two groups: cardiometabolically healthy with (0-1 abnormality) or cardiometabolically unhealthy (≥2 abnormalities). The conditions for cardiometabolic assessment included components of the metabolic syndrome, high-sensitivity C-reactive protein, and insulin resistance. Results: A total of 3088 individuals, mean age 55.6 (SD±12.6) years, 51.3% females, had all measurements for this analysis. Of these, 889 subjects (28.8%), 1359 (44.1%) and 838 (27.1%) had normal weight, overweight and obese, respectively. Among normal weight individuals, 43.1% were cardiometabolically unhealthy (figure), and age ≥65 years, female, and highest wealth index groups were more likely to have this pattern. In contrast, only 16.0% of overweight and 3.6% of obese individuals were cardiometabolically healthy. In the combined overweight/obese group, compared to Lima, rural and urban sites in Puno were more likely of having the cardiometabolically healthier profile. Conclusions: Our results indicate a high prevalence of cardiometabolic abnormalities in Peru, specifically among normal weight individuals. Prevention programs to address cardiovascular risk need to include people of normal weight.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.131.suppl_1.p371
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
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  • 10
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    Gaps in Hypertension Guidelines in Low- and Middle-Income Versus High-Income Countries : A Systematic Review
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Hypertension Vol. 68, No. 6 ( 2016-12), p. 1328-1337
    Details
    In: Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 68, No. 6 ( 2016-12), p. 1328-1337
    Type of Medium: Online Resource
    ISSN: 0194-911X , 1524-4563
    URL: Article
    DOI: 10.1161/HYPERTENSIONAHA.116.08290
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 2094210-2
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