Abstract 53: Health Care Utilization and Cost among Type 2 Diabetes Mellitus (T2DM) Patients with Cardiovascular Disease (CVD) or Cardiovascular Disease Risk Factors

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
David M Kern ◽  
Stephanie DeVore ◽  
Jennifer Kim ◽  
Ying Wu ◽  
Ozgur Tunceli ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Healthcare Utilization ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Care Utilization ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Group 2 ◽  
Group 1

CV events among T2DM patients are major contributors to high healthcare utilization and cost. Healthcare utilization and costs among T2DM patients with established CVD and CVD risk factors in a large US database were explored. T2DM patients aged ≥40 years were identified from the HealthCore Integrated Research Environment from 1/1/2007 to 4/30/2011 and followed from first T2DM diagnosis (index date) until loss of eligibility or death. Established CVD [Group 1] included patients with MI, stroke, peripheral vascular disease, coronary heart disease, congestive heart failure, or revascularization in the year prior to index. CVD risk [Group 2] included patients with older age (men ≥55 y, women ≥60 y) and prior diagnosis for either dyslipidemia or hypertension. Per person year (PPY) utilization and cost following T2DM diagnosis were calculated as the total number of events/cost divided by total number of person years of follow-up. There were 177,140 Group 1 (mean age: 68 y; 57% men) and 191,441 Group 2 (mean age: 66 y; 57% men) patients who met the selection criteria. During the 12, 24, 36, and 48 months following index, a higher proportion of Group 1 vs Group 2 patients had ≥1 inpatient visit (35%, 50%, 61%, 69% vs 16%, 27%, 36%, 44% respectively) and ≥1 ED visit (6.2%, 17%, 29%, 41% vs 2.9%, 9%, 18%, 28% respectively). T2DM patients have high healthcare utilization and costs. Those with established CVD have higher PPY event rates (Figure 1) and costs (Figure 2), compared with patients with CVD risk factors. Inpatient hospitalizations and outpatient visits are key cost drivers in this T2DM population.

scholarly journals Relationship between Depressive Symptoms and Cardiovascular Disease Risk Factors in African American Individuals

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
Ali A. Weinstein ◽  
Preetha Abraham ◽  
Guoqing Diao ◽  
Stacey A. Zeno ◽  
Patricia A. Deuster
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
African American ◽  
Depressive Symptoms ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Regression Analyses ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Relationship

Objective. To examine the relationship between depressive symptoms and cardiovascular disease (CVD) risk factors in a group of African American individuals.Design. A nonrandom sample of 253 (age 43.7 ± 11.6 years; 37% male) African American individuals was recruited by advertisements. Data were obtained by validated questionnaires, anthropometric, blood pressure, and blood sample measurements.Results. Regression analyses were performed to assess the relationship between depressive symptoms and CVD risk factors controlling for socioeconomic status indicators. These analyses demonstrated that those with higher levels of depressive symptoms had larger waist-to-hip ratios, higher percent body fat, higher triglycerides, and were more likely to be smokers.Conclusions. It has been well documented that higher levels of depressive symptoms are associated with higher CVD risk. However, this evidence is derived primarily from samples of predominantly Caucasian individuals. The present investigation demonstrates that depressive symptoms are related to CVD risk factors in African American individuals.

Determining the Cardiovascular Disease Risk Factor Knowledge and Related Factors Among Adults With Type 2 Diabetes Mellitus

2021 ◽  
pp. 105477382110464
Author(s):  
Emine Karaman ◽  
Aslı Kalkım ◽  
Banu Pınar Şarer Yürekli
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Type 2 Diabetes ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Related Factors

In this study was to determine knowledge of cardiovascular disease (CVD) risk factors and to explore related factors among adults with type 2 diabetes mellitus (DM) who have not been diagnosed with CVD. This descriptive study was conducted with 175 adults. Data were collected individual identification form and Cardiovascular Disease Risk Factors Knowledge Level (CARRF-KL) scale. A negative correlation was found between age and CARRF-KL score. A significant difference was found between educational status and CARRF-KL score. The individuals described their health status as good, managed their condition with diet and exercise, received information from nurses, adults with DM in their family and those with no DM complications had significantly higher scores in CARRF-KL. The knowledge of an individual with DM about CVD risk factors should be assessed, CVD risks should be identified at an early stage, and individuals at risk should be subjected to screening.

scholarly journals Dinner consumption and cardiovascular disease risk factors among a nationally representative sample of Iranian adolescents: the CASPIAN-III Study

2019 ◽  
Vol 11 (2) ◽  
pp. 138-146
Author(s):  
Leila Azadbakht ◽  
Fahime Akbari ◽  
Mostafa Qorbani ◽  
Mohammad Esmaeil Motlagh ◽  
Gelayol Ardalan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Representative Sample ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cluster Sampling ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Nationally Representative

Introduction: This cross-sectional study aimed to assess the association between cardiovascular disease (CVD) risk factors and dinner consumption in a nationally representative sample of Iranian adolescents. Methods: The present study was conducted on 5642 adolescents aged 10-18 years old in 27 provinces in Iran. The subjects were included applying by multistage random cluster sampling. Participants who ate ≥5 dinners during a week were considered as a dinner consumer. Results: Among 5642 subjects, 1412 (25%) did not consume dinner. Dinner consumers were less likely to be overweight or obese (P < 0.001) and abdominally obese (P < 0.001) as well as to have an abnormal level of HDL-C (P = 0.02). Dinner skipper youths had a higher risk for overweight or obesity (odds ratio [OR]: 1.62; 95% CI: 1.39-1.89) and abdominal obesity (OR: 1.59; 95% CI: 1.36-1.85) which remained significant after adjusting confounding factors (P <0001). No relationship was observed between dinner consumption and the rest of the CVD risk factors, neither in crude nor in adjusted models. A higher proportion of dinner-consumer adolescents had no CVD risk factors in comparison to dinner-skipper subjects (31.1% vs. 28%). Conclusion: Eating dinner might be inversely associated with some CVD risk factors among Iranian adolescents. Further prospective studies will need to prove this theory.

scholarly journals Mixed Nut Consumption May Improve Cardiovascular Disease Risk Factors in Overweight and Obese Adults

Nutrients ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 1488 ◽  
Author(s):  
Nazanin Abbaspour ◽  
Traci Roberts ◽  
Shirin Hooshmand ◽  
Mark Kern ◽  
Mee Young Hong
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Controlled Trial ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Negative Effects ◽  
Cvd Risk ◽  
Obese Adults ◽  
Health Promoting

Emerging research indicates that nuts are a source of health-promoting compounds demonstrating cardioprotective benefits. However, most studies have assessed the effect of single nuts rather than a nut mixture. The objective of this study was, therefore, to examine the effect of mixed-nut consumption on cardiovascular disease (CVD) risk factors in overweight and obese adults. In a randomized, parallel-arm, controlled trial, 48 participants consumed isocaloric (250 kcal) amounts of pretzels or mixed-nuts. Body weight (BW) (p = 0.024), BMI (p = 0.043), and insulin levels (p = 0.032) were significantly lower in the nut group compared to the pretzel group. Mixed-nut consumption also significantly reduced glucose (p = 0.04) and insulin (p = 0.032) levels after 4 and 8 weeks compared to baseline, respectively. Lactate dehydrogenase of the nut group was significantly lower than the pretzel group (p = 0.002). No significant differences were detected between groups for triglycerides, LDL-C, and HDL-C. However, pretzel consumption increased triglycerides (p = 0.048) from 4 weeks to 8 weeks. Moreover, LDL-C increased (p = 0.038) while HDL-C transiently decreased (p = 0.044) from baseline to 4 weeks. No significant lipid changes were detected within the nut group. Our results suggest that supplementing the diet with mixed-nuts could improve CVD risk factors by improving BW and glucose regulation in comparison to a common carbohydrate-rich snack without promoting the negative effects on lipids detected with pretzels.

scholarly journals Intake of Boiled Potato in Relation to Cardiovascular Disease Risk Factors in a Large Norwegian Cohort: The HUNT Study

Nutrients ◽  
2019 ◽  
Vol 12 (1) ◽  
pp. 73
Author(s):  
Trine Moholdt ◽  
Brooke L. Devlin ◽  
Tom Ivar Lund Nilsen
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Waist Circumference ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Hunt Study ◽  
Potato Consumption

Overall potato consumption is positively associated with cardiovascular disease (CVD) risk factors, such as measures of adiposity. However, few studies have explicitly stated the preparation method of potatoes, which may impact these associations. We examined cross-sectional associations between self-reported dietary intake of boiled potatoes and levels of body mass index, waist circumference, blood pressure, and blood lipids among 43,683 participants in the HUNT Study, Norway in 2006–2008. All estimated associations were adjusted for possible imbalance in age, sex, physical activity, smoking, intake of other foods and alcohol between categories of boiled potato consumption. Overall, there were no large differences in mean levels of CVD risk factors between categories of boiled potato consumption. Compared to the reference group of individuals who consumed boiled potatoes less than once/week, those who reported eating boiled potatoes every day had slightly higher prevalence of high waist circumference (odds ratio [OR] 1.16, 95% confidence interval [CI] 1.05–1.29), high triglycerides levels (OR 1.20, 95% CI 1.07–1.34), and metabolic syndrome (OR 1.17, 95% CI 1.03–1.33). In summary, consumption of boiled potatoes showed weak and small associations with the CVD risk factors under study, but the cross-sectional design prevents us from drawing any firm conclusions.

scholarly journals Pleiotropic effects between cardiovascular disease risk factors and measures of cognitive and physical function in long-lived adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Julia J. Yudkovicz ◽  
Ryan L. Minster ◽  
Emma Barinas-Mitchell ◽  
Kaare Christensen ◽  
Mary Feitosa ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cognitive Function ◽  
Waist Circumference ◽  
Gait Speed ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Chair Stand

AbstractCardiovacular disease (CVD) is the leading cause of death among older adults and is often accompanied by functional decline. It is unclear what is driving this co-occurrence, but it may be behavioral, environmental and/or genetic. We used a family-based study to estimate the phenotypic and shared genetic correlation between CVD risk factors and physical and cognitive functional measures. Participants (n = 1,881) were from the Long Life Family Study, which enrolled families based on their exceptional longevity (sample mean age = 69.4 years, 44% female). Cardiovascular disease risk factors included carotid vessel measures [intima-media thickness and inter-adventitial diameter], obesity [body mass index (BMI) and waist circumference], and hypertension [systolic and diastolic blood pressures]. Function was measured in the physical [gait speed, grip strength, chair stand] and cognitive [digital symbol substitution test, retained and working memory, semantic fluency, and trail making tests] domains. We used SOLAR to estimate the genetic, environmental, and phenotypic correlation between each pair adjusting for age, age2, sex, field center, smoking, height, and weight. There were significant phenotypic correlations (range |0.05–0.22|) between CVD risk factors and physical and cognitive function (all P < 0.05). Most significant genetic correlations (range |0.21–0.62|) were between CVD risk factorsand cognitive function, although BMI and waist circumference had significant genetic correlation with gait speed and chair stand time (range |0.29–0.53|; all P < 0.05). These results suggest that CVD risk factors may share a common genetic-and thus, biologic-basis with both cognitive and physical function. This is particularly informative for research into the genetic determinants of chronic disease.

scholarly journals Changing Trends in the Prevalence and Disparities of Obesity and Other Cardiovascular Disease Risk Factors in Three Racial/Ethnic Groups of USA Adults

2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Camila X. Romero ◽  
Tomas E. Romero ◽  
Judith C. Shlay ◽  
Lorraine G. Ogden ◽  
Dana Dabelea
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Ethnic Groups ◽  
Mexican Americans ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Prevalence Of Obesity

Objectives. To examine trends in the prevalence and disparities of traditional cardiovascular disease (CVD) risk factors among the major race/ethnic groups in the USA: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), and Mexican Americans (MAs).Methods. We used cross-sectional trend analysis in women and men aged 25–84 years participating in the NHANES surveys, years 1988–1994 (n=14,341) and 1999–2004 (n=12,360).Results. The prevalence of obesity and hypertension increased significantly in NHW and NHB, both in men and women; NHB had the highest prevalence of obesity and hypertension in each time period. Diabetes prevalence showed a nonsignificant increasing trend in all groups and was higher in MA in both periods. Smoking significantly decreased in NHW men and NHB, the latter with the largest decline although the highest prevalence in each period; no changes were noted in MA, who had the lowest prevalence in both periods. Race/ethnic CVD risk factors disparities widened for obesity and hypercholesterolemia, remained unchanged for diabetes and hypertension, and narrowed for smoking.Conclusions. The increasing prevalence of obesity and hypertension underscores the need for better preventive measures, particularly in the NHB group that exhibits the worst trends. The decline in smoking rates may offset some of these unfavorable trends.

scholarly journals Cardiovascular disease risk factors induce mesenchymal features and senescence in cardiac endothelial cells

2020 ◽  
Author(s):  
Karthik Amudhala Hemanthakumar ◽  
Fang Shentong ◽  
Andrey Anisimov ◽  
Mikko I. Mäyränpää ◽  
Eero Mervaala ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Factors ◽  
Cardiovascular Disease ◽  
Endothelial Cells ◽  
Exercise Training ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Pressure Overload ◽  
Cvd Risk Factors ◽  
Cvd Risk

AbstractAging, obesity, hypertension and physical inactivity are major risk factors for endothelial dysfunction and cardiovascular disease (CVD). We applied fluorescence-activated cell sorting (FACS), RNA sequencing and bioinformatic methods to investigate the common effects of CVD risk factors on cardiac endothelial cells (ECs). Aging, obesity and pressure overload all upregulated pathways related to TGF-β signaling and mesenchymal gene expression, inflammation, vascular permeability, oxidative stress, collagen synthesis and cellular senescence, whereas exercise training downregulated most of the same pathways. We identified collagen chaperone SerpinH1/HSP47 to be significantly increased by aging and obesity and repressed by exercise training. Mechanistic studies demonstrated that SERPINH1/HSP47 in human ECs changed cell morphology and increased mesenchymal gene expression, while its silencing inhibited collagen deposition. Our data demonstrate that CVD risk factors significantly remodel the transcriptomic landscape of cardiac ECs to acquire senescence and mesenchymal features. SERPINH1/HSP47 was identified as a potential therapeutic target in ECs.

scholarly journals Sex-Related Differences in Cardiovascular Disease Risk Profile in Children and Adolescents with Type 1 Diabetes

2021 ◽  
Vol 22 (19) ◽  
pp. 10192
Author(s):  
Darja Smigoc Schweiger ◽  
Tadej Battelino ◽  
Urh Groselj
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Type 1 Diabetes ◽  
Children And Adolescents ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Risk Profile ◽  
Cvd Risk Factors ◽  
Cvd Risk

Cardiovascular disease (CVD) is the primary cause of higher and earlier morbidity and mortality in people with type 1 diabetes (T1D) compared to people without diabetes. In addition, women with T1D are at an even higher relative risk for CVD than men. However, the underlying pathophysiology is not well understood. Atherosclerotic changes are known to progress early in life among people with T1D, yet it is less clear when excess CVD risk begins in females with T1D. This review explores the prevalence of classical CVD risk factors (such as glycemic control, hypertension, dyslipidemia, obesity, albuminuria, smoking, diet, physical inactivity), as well as of novel biomarkers (such as chronic inflammation), in children and adolescents with T1D with particular regard to sex-related differences in risk profile. We also summarize gaps where further research and clearer clinical guidance are needed to better address this issue. Considering that girls with T1D might have a more adverse CVD risk profile than boys, the early identification of and sex-specific intervention in T1D would have the potential to reduce later CVD morbidity and excess mortality in females with T1D. To conclude, based on an extensive review of the existing literature, we found a clear difference between boys and girls with T1D in the presence of individual CVD risk factors as well as in overall CVD risk profiles; the girls were on the whole more impacted.

scholarly journals Association of cardiovascular disease risk factors with coronary artery calcium volume versus density

Heart ◽  
2017 ◽  
Vol 104 (2) ◽  
pp. 135-143 ◽  
Author(s):  
Isac C Thomas ◽  
Brandon Shiau ◽  
Julie O Denenberg ◽  
Robyn L McClelland ◽  
Philip Greenland ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Coronary Artery ◽  
Coronary Artery Calcium ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Density Score ◽  
Volume Score

ObjectivesRecently, the density score of coronary artery calcium (CAC) has been shown to be associated with a lower risk of cardiovascular disease (CVD) events at any level of CAC volume. Whether risk factors for CAC volume and CAC density are similar or distinct is unknown. We sought to evaluate the associations of CVD risk factors with CAC volume and CAC density scores.MethodsBaseline measurements from 6814 participants free of clinical CVD were collected for the Multi-Ethnic Study of Atherosclerosis. Participants with detectable CAC (n=3398) were evaluated for this study. Multivariable linear regression models were used to evaluate independent associations of CVD risk factors with CAC volume and CAC density scores.ResultsWhereas most CVD risk factors were associated with higher CAC volume scores, many risk factors were associated with lower CAC density scores. For example, diabetes was associated with a higher natural logarithm (ln) transformed CAC volume score (standardised β=0.44 (95% CI 0.31 to 0.58) ln-units) but a lower CAC density score (β=−0.07 (−0.12 to −0.02) density units). Chinese, African-American and Hispanic race/ethnicity were each associated with lower ln CAC volume scores (β=−0.62 (−0.83to −0.41), −0.52 (−0.64 to −0.39) and −0.40 (−0.55 to −0.26) ln-units, respectively) and higher CAC density scores (β= 0.41 (0.34 to 0.47), 0.18 (0.12 to 0.23) and 0.21 (0.15 to 0.26) density units, respectively) relative to non-Hispanic White.ConclusionsIn a cohort free of clinical CVD, CVD risk factors are differentially associated with CAC volume and density scores, with many CVD risk factors inversely associated with the CAC density score after controlling for the CAC volume score. These findings suggest complex associations between CVD risk factors and these components of CAC.

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