1,721,199 research outputs found
Risk factors for hypertension in rheumatoid arthritis patients-A systematic review
No full textIntroduction: Rheumatoid arthritis is frequently associated with hypertension, which has been shown to increase the risk of cardiovascular disease in these patients. The aim of this systematic review was to explore demographic, behavioural or clinical factors including medication use, associated with incident hypertension in rheumatoid arthritis. Methods: MEDLINE and Scopus were searched for eligible studies that longitudinally investigated incident hypertension or changes in blood pressure (BP) in rheumatoid arthritis patients. Publications were screened by two reviewers according to predetermined inclusion and exclusion criteria. The quality of included studies was assessed via the Newcastle Ottawa Scale and Cochrane Risk of Bias Tool. Results: Fourteen studies were deemed eligible and included in this review. The proportion of female subjects ranged from 12 to 87% and the mean age ranged from 47 to 61 years. Regular exercise was associated with a decrease in systolic BP, p = 0.021. Methotrexate was associated with decreased risk of hypertension in two studies. LEF was associated with increased BP in two studies. COX-2 inhibitors were associated with systolic BP and diastolic BP variability (p = 0.009, 0.039, respectively) in one study. Prednisone was found to increase BP and risk of hypertension in three studies. The risk of hypertension in patients taking biologic disease modifying anti-rheumatic drugs (DMARDs) is unclear as some studies report increased BP while others report no difference for biologic compared to conventional DMARDs. Conclusion: Despite limited longitudinal studies exploring this topic, methotrexate and exercise were shown to protect against risk of hypertension in RA patients, while prednisone and COX-2 inhibitors may increase risk of hypertension
Where did public health go wrong? Seven lessons from the COVID-19 pandemic
No full textThe coronavirus disease 2019 (COVID-19) pandemic has been the public health moment of the century. While there is much to celebrate about the public health response, this is a good time to take stock. In this editorial, we pinpoint seven areas for a better public health response to a potential future pandemic
Does sex modify the effect of pre-pandemic body mass index on the risk of Long COVID? Evidence from the longitudinal analysis of the Survey of Health, Ageing and Retirement in Europe
No full textBackgroundResearch on Long COVID risk factors is ongoing. High body mass index (BMI) may increase Long COVID risk, yet no evidence has been established regarding sex differences in the relationship between BMI and the risk of Long COVID. Investigating the nature of this relationship was the main objective of this study.MethodsA population-based prospective study involving a sample of respondents aged 50 years and older (n = 4004) from 27 European countries that participated in the 2020 and 2021 Survey of Health, Ageing and Retirement in Europe's (SHARE) Corona Surveys and in Waves 7 and 8 of the main SHARE survey. Logistic regression models were estimated to produce unadjusted and adjusted estimates of the sex differences in the relationship between BMI and Long COVID.ResultsLinear relationship for females, with probability of Long COVID increasing with BMI (68% at BMI = 18, 93% at BMI = 45). Non-linear relationship for males, with probability of Long COVID of 27% at BMI = 18, 68% at BMI = 33, and 40% at BMI = 45. Relationships remained significant after adjusting for known Long COVID risk factors (age and COVID-19 hospitalization), presence of chronic diseases, and respondents' place of residence.ConclusionSex differences appear to play an important role in the relationship between BMI and risk of Long COVID. Overall, females were more likely to have Long COVID, regardless of their BMI. Males at the higher end of the BMI spectrum had a lower risk of Long COVID as opposed to their female counterparts. Sex-specific research is recommended for better understanding of Long COVID risk factors
Incidence of cerebral venous thrombosis and COVID-19 vaccination: possible causal effect or just chance?
No full textExploring Sex Differences in Risk Factors and Quality of Life Among Tuberculosis Patients in Herat, Afghanistan: A Case-Control Study
No full text: Objectives: Tuberculosis (TB) is a significant public health concern in Afghanistan, with a high burden of disease in the western province of Herat. This study explored the risk factors of TB and TB's impact on the quality of life of patients in Herat. Methods: A total of 422 TB patients and 514 controls were recruited at Herat Regional Hospital and relevant TB laboratories between October 2020 and February 2021. Data was collected through interviews using a structured questionnaire and the SF-36 questionnaire. Descriptive statistics, chi-square tests, Multivariate General Linear Model, and logistic regression analysis were used to analyze the data. Results: The results showed that male sex (p = 0.023), chronic disease (p = 0.038), lower education levels (p < 0.001), and worse health status (p < 0.001) were significantly associated with higher odds of TB infection. The study also found that TB patients had significantly lower quality of life scores in almost all components (p < 0.05). Conclusion: This study provides important insights into the specific ways in which TB affects the wellbeing of patients in Afghanistan. The findings highlight the importance of addressing the psychological and social dimensions of TB
Interplay between social media use, sleep quality, and mental health in youth: A systematic review
No full textSocial media applications are increasingly prominent among youth. This systematic review provides a comprehensive assessment of the literature on the relationship between active social media use, sleep quality, and common mental health outcomes (anxiety, depression, and psychological distress) among youth. MEDLINE, PsychINFO, EMBASE and Scopus were searched for observational studies investigating this relationship among youth (aged 16–25). Thirty-six cross-sectional studies and six prospective cohort studies met the inclusion criteria. Among cross-sectional studies, significant associations between excessive social media use with poor mental health outcomes (n = 33), poor sleep quality (n = 24), and significant associations between poor sleep quality and negative mental health (n = 16) were found. In longitudinal studies, frequent social media use was a risk factor for both poor mental health (n = 6) and poor sleep outcomes (n = 5). Some studies showed sleep quality mediating the relationship between social media use and negative mental health outcomes in youth. Overall, included evidence links excessive social media use to poor sleep quality and negative mental health in youth. Given the public health implications of sleep problems, excessive social media use warrants further investigation to clarify the directionality and strength of their associations with poor sleep quality and negative mental health outcomes
Vegan dietary pattern for the primary and secondary prevention of cardiovascular diseases
Full text linkBackground
Diet plays a major role in the aetiology of cardiovascular disease (CVD) and as a modifiable risk factor is the focus of many prevention strategies. Recently vegan diets have gained popularity and there is a need to synthesise existing clinical trial evidence for their potential in CVD prevention.
Objectives
To determine the effectiveness of following a vegan dietary pattern for the primary and secondary prevention of CVD.
Search methods
We searched the following electronic databases on 4 February 2020: the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase and Web of Science Core Collection. We also searched ClinicalTrials.gov in January 2021. We applied no language restrictions.
Selection criteria
We selected randomised controlled trials (RCTs) in healthy adults and adults at high risk of CVD (primary prevention) and those with established CVD (secondary prevention). A vegan dietary pattern excludes meat, fish, eggs, dairy and honey; the intervention could be dietary advice, provision of relevant foods, or both. The comparison group received either no intervention, minimal intervention, or another dietary intervention. Outcomes included clinical events and CVD risk factors. We included only studies with follow‐up periods of 12 weeks or more, defined as the intervention period plus post‐intervention follow‐up.
Data collection and analysis
Two review authors independently assessed studies for inclusion, extracted data and assessed risks of bias. We used GRADE to assess the certainty of the evidence. We conducted three main comparisons:
1. Vegan dietary intervention versus no intervention or minimal intervention for primary prevention;
2. Vegan dietary intervention versus another dietary intervention for primary prevention;
3. Vegan dietary intervention versus another dietary intervention for secondary prevention.
Main results
Thirteen RCTs (38 papers, 7 trial registrations) and eight ongoing trials met our inclusion criteria. Most trials contributed to primary prevention: comparisons 1 (four trials, 466 participants randomised) and comparison 2 (eight trials, 409 participants randomised). We included only one secondary prevention trial for comparison 3 (63 participants randomised).
None of the trials reported on clinical endpoints. Other primary outcomes included lipid levels and blood pressure.
For comparison 1 there was moderate‐certainty evidence from four trials with 449 participants that a vegan diet probably led to a small reduction in total cholesterol (mean difference (MD) −0.24 mmol/L, 95% confidence interval (CI) −0.36 to −0.12) and low‐density lipoprotein (LDL) cholesterol (MD −0.22 mmol/L, 95% CI −0.32 to −0.11), a very small decrease in high‐density lipoprotein (HDL) levels (MD −0.08 mmol/L, 95% CI −0.11 to −0.04) and a very small increase in triglyceride levels (MD 0.11 mmol/L, 95% CI 0.01 to 0.21). The very small changes in HDL and triglyceride levels are in the opposite direction to that expected. There was a lack of evidence for an effect with the vegan dietary intervention on systolic blood pressure (MD 0.94 mmHg, 95% CI −1.18 to 3.06; 3 trials, 374 participants) and diastolic blood pressure (MD −0.27 mmHg, 95% CI −1.67 to 1.12; 3 trials, 372 participants) (low‐certainty evidence).
For comparison 2 there was a lack of evidence for an effect of the vegan dietary intervention on total cholesterol levels (MD −0.04 mmol/L, 95% CI −0.28 to 0.20; 4 trials, 163 participants; low‐certainty evidence). There was probably little or no effect of the vegan dietary intervention on LDL (MD −0.05 mmol/L, 95% CI −0.21 to 0.11; 4 trials, 244 participants) or HDL cholesterol levels (MD −0.01 mmol/L, 95% CI −0.08 to 0.05; 5 trials, 256 participants) or triglycerides (MD 0.21 mmol/L, 95% CI −0.07 to 0.49; 5 trials, 256 participants) compared to other dietary interventions (moderate‐certainty evidence). We are very uncertain about any effect of the vegan dietary intervention on systolic blood pressure (MD 0.02 mmHg, 95% CI −3.59 to 3.62) or diastolic blood pressure (MD 0.63 mmHg, 95% CI −1.54 to 2.80; 5 trials, 247 participants (very low‐certainty evidence)).
Only one trial (63 participants) contributed to comparison 3, where there was a lack of evidence for an effect of the vegan dietary intervention on lipid levels or blood pressure compared to other dietary interventions (low‐ or very low‐certainty evidence).
Four trials reported on adverse events, which were absent or minor.
Authors' conclusions
Studies were generally small with few participants contributing to each comparison group. None of the included studies report on CVD clinical events. There is currently insufficient information to draw conclusions about the effects of vegan dietary interventions on CVD risk factors. The eight ongoing studies identified will add to the evidence base, with all eight reporting on primary prevention. There is a paucity of evidence for secondary prevention
Factors associated with incident cardiovascular disease in patients with rheumatoid arthritis: A scoping review
No full textIntroduction: Rheumatoid arthritis (RA) is the most common form of autoimmune inflammatory arthritis and is associated with various comorbidities including cardiovascular disease (CVD). This scoping review summarizes the current evidence on longitudinal cohort studies assessing potential factors associated with the incidence of cardiovascular events among patients with RA.
Methods: Scopus, PubMed, Ovid MEDLINE and Cochrane databases were used to identify longitudinal cohort studies investigating the incidence of CVD among RA patients. Using predetermined inclusion and exclusion criteria, two reviewers screened and extracted the relevant studies independently to map the existing literature on this topic. The extracted data included study characteristics, demographics, comorbidities, behavioural and RA-related factors.
Results: Thirty-three research papers were included with a mean follow-up duration of 7.8 years. The sample size of the studies ranged from 182 to 4,311,022 subjects, the mean age from 46.1 to 72.3 years, and on average, 34.6% of the participants were male. The following factors were reported to be associated with a higher incidence of CVD in RA patients: older age, male sex, co-morbid hypertension, diabetes, and/or dyslipidemia, the presence of rheumatoid factor (RF) and/or acute phase reactants. Among RA treatments, glucocorticoids were shown to increase CVD incidence while DMARDs, especially methotrexate, were associated with a lower incidence of CVD.
Conclusion: This review offers a comprehensive summary of the current literature reporting on risk factors for CVD incidence among RA patients. Future research should focus on the less studied factors, including socioeconomic status, physical inactivity, alcohol consumption, sleep habits and dietary patterns as well as some RA related factors such as anti-citrullinated protein antibodies and functional impairment
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