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- Bragason, K., et al.
(författare)
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Secondary prevention after myocardial infarction widens health disparities between Swedish and immigrant patients
- 2015
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 36:Suppl 1
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Background and introduction: Immigrants bear a disproportionate burden of poor cardiovascular health. Secondary prevention programs are essential for patients who have suffered from myocardial infarction (MI) as modification of risk factors favorably impacts their health. However, little is known about whether disparities in cardiovascular health are influenced by secondary prevention. Purpose: The purpose of this study was to determine if secondary prevention influences disparities in cardiovascular health between Swedish and immigrant MI patients. Methods: A cohort of 400 MI patients (58.6±8 years) was followed for two years, 292 Swedish and 108 immigrants (71% men). During the first year after MI patients participated in a secondary prevention program. The average number of six selected risk factors, before and two years post MI was evaluated and the mean change in risk burden from baseline calculated. The risk factors were current smoking, BMI >30 kg/m2, total cholesterol >4,5 or LDL >2,5 mmol/l (in accordance with reference values at the time of the study), HDL >1.0/1.2 (men/women) mmol/l, blood pressure >140/90 mmHg and HbA1c >45 mmol/mol (>52 mmol/mol for diabetic patients). Results: There were significant differences in risk factor exposure between Swedes and immigrants among men (p=0.045) and women (p=0.003) two years after MI. After adjustments for age, marital status and socio-economic status significance was lost among men. Swedish women reduced their exposure by 1.51 risk factors, while immigrant women only reduced theirs by 0.74 (p=0.007). No significant differences were observed for males, with Swedish men reducing their risk factors by 1.25 compared to 1.17 for immigrant men (p=0.593). Conclusion(s): The results indicate that while benefitting patients in general, secondary prevention did not benefit all groups equally. Immigrant women were less likely to reduce their risk than Swedish women, which could not be explained by age, marital status and socioeconomic status. No differences were found between immigrant and Swedish men.
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| 2. |
- Dieden, A., et al.
(författare)
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Biomarkers associated with prevalent hypertension and higher blood pressure in a population-based cohort : a proteomic approach
- 2022
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Ingår i: European Heart Journal. - : Oxford University Press. - 0195-668X .- 1522-9645. ; 43:Suppl 2, s. 2189-2189
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- BackgroundGlobally, hypertension represents an enormous health issue as it is a major, yet modifiable risk factor for developing cardiovascular disease. Recently, chitinase-3-like protein 1 (CHI3L1) was shown to be positively associated with the incidence of hypertension among prehypertensive subjects, and variants of CHI3L1 gene were associated with both CHI3L1-levels and hypertension.PurposeTo explore associations between prevalent hypertension and blood pressure, and 92 proteins with involvement in inflammation and cardiovascular disease.MethodsPlasma samples from 1713 individuals from a Swedish population-based cohort (mean age 67.3±6.0 years; 28.9% women) were analysed with a proximity extension assay panel, consisting of 92 proteins. Prior to all analyses, subjects with prevalent cardiovascular disease, defined as having a history of prevalent coronary or stroke event, were excluded (n=189). Univariate logistic regression models were carried out exploring associations between each of the 92 proteins and prevalent hypertension, defined as systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, or use of antihypertensive treatment (n=1168, 76.4%). Bonferroni-corrected significant associations between proteins and hypertension were further analysed using stepwise selection of covariates, namely age, body mass index, diabetes status, and cystatin C, in logistic regression models. Proteins with significant adjusted associations with prevalent hypertension were further analysed for associations with systolic and diastolic blood pressure individually in stepwise linear regression models. Complete data on all variables were available in 1527 subjects.ResultsSixteen proteins were significantly associated with prevalent hypertension in univariate analyses. After adjustment, three proteins remained significantly associated with prevalent hypertension (i.e., CHI3L1, low-density lipoprotein receptor (LDL receptor) and tissue plasminogen activator (tPA); Table 1). In analyses of associations with systolic blood pressure, CHI3L1 and LDL receptor showed significant associations. In analyses of associations with diastolic blood pressure, CHI3L1, LDL receptor and tPA showed significant associations (Table 1).ConclusionsHigher CHI3L1, tPA and LDL receptor levels were positively associated with prevalent hypertension after multivariable adjustment, among 1527 elderly subjects without established cardiovascular disease. Furthermore, higher CHI3L and LDL receptor levels were positively associated with mean systolic, as well as mean diastolic blood pressure in multivariable analyses.Funding AcknowledgementType of funding sources: Foundation. Main funding source(s): The Swedish Medical Research Council and The Swedish Heart and Lung Foundation
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