Background: Recent guidelines recommend assessment of lifetime cardiovascular risk on the basis of traditional risk factors in adults who are not at high short-term risk. The aim of this study is to determine the implications of estimating the lifetime cardiovascular risk in individuals in a large occupational cohort in Spain.
Design: National cross-sectional study in an occupational cohort with an in-person interview including laboratory tests.
Methods: Volunteer workers who were examined between January 2011 and December 2011 were included. A total of 580,236 workers were eligible during this year and 259,834 were examined (participation rate of 44.7%). Short-term (10-year) and lifetime cardiovascular risk were estimated using the American College of Cardiology (ACC) and the American Heart Association (AHA) tool and the QRISK2 and QRISK.
Results: Sixty-eight per cent were male, mean age was 39 years, with an age range of 16 to 75 years. Total number of individuals included in this study was 258,676. The percentage of patients at high short-term risk was 6.85% (95% confidence interval (CI) 6.75%-6.95% and 20.83% (95% CI 20.60%-21.07%) with the QRISK2, and the ACC/AHA risk equations, respectively. Of the percentage of patients classified as not at high risk with the different tools 1.61% (95% CI 1.55%-1.66%) were high lifetime risk on QRISK, and 27.41% (95% CI 27.11%-27.70%) on ACC/AHA risk.
Conclusions: Application of lifetime cardiovascular risk engages greater numbers of individuals at high risk with substantial differences between the different methods available. These differences can have important clinical implications specifically in the percentage of candidates for lifestyle changes and eventually lipid lowering drugs.
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http://dx.doi.org/10.1177/2047487315579616 | DOI Listing |
J Water Health
December 2024
Department of Physics and Materials Science, Thapar Institute of Engineering and Technology, Patiala, Punjab, India E-mail:
Groundwater contamination is a major environmental concern in many regions of India, including several districts of Punjab. In this study, a comparison is carried out between the deterministic and probabilistic approaches for calculating health hazard parameters due to arsenic contamination in groundwater in India. The probabilistic calculations are carried out through Monte-Carlo simulations to quantify the hazard index (HI) and carcinogenic risk.
View Article and Find Full Text PDFJ Affect Disord
December 2024
School of Health and Wellbeing, University of Glasgow, Glasgow, UK; Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
Whether depression and poor sleep interact or have statistically independent associations with brain structure and its change over time is not known. Within a subset of UK Biobank participants with neuroimaging and subjective and/or objective sleep data (n = 28,351), we examined associations between lifetime depression and sleep disruption and their interaction with structural neuroimaging measures, both cross-sectionally and longitudinally. Sleep variables were: self-reported insomnia and difficulty getting up; actigraphy-derived short sleep (<7 h); sustained inactivity bouts during daytime (SIBD); and sleep efficiency.
View Article and Find Full Text PDFJ Nephrol
December 2024
The School of Medicine, Manchester Academic Health Sciences Centre, Manchester University, Manchester, UK.
Background: Fabry disease is a rare genetic lysosomal storage disorder, whereby the accumulation of sphingolipids consequently leads to kidney structural damage and dysfunction. We explored the epidemiology of chronic kidney disease (CKD) among patients with Fabry disease at a major UK referral centre in Greater Manchester serving over 7 million people, to inform early predictors of kidney disease and possible treatment planning.
Methods: Data were sourced from the electronic records of registered participants from November 2020 to February 2022 of adults diagnosed with Fabry disease, with at least 1 year of follow-up.
PLoS One
December 2024
Emergency Department, Queen Elizabeth University Hospital, Glasgow, United Kingdom.
Heart Failure (HF) is common, with worldwide prevalence of 1%-3% and a lifetime risk of 20% for individuals 40 years or older. Despite its considerable health economic burden, techniques for early detection of HF in the general population are sparse. In this work we tested the hypothesis that a simple Transformer neural network, trained on comprehensive collection of secondary care data across the general population, can be used to prospectively (three-year predictive window) identify patients at an increased risk of first hospitalisation due to HF (HHF).
View Article and Find Full Text PDFUps J Med Sci
December 2024
York Health Economics Consortium, University of York, York, UK.
Background: Transcatheter aortic valve implantation (TAVI) has shown similar or improved clinical outcomes compared with surgical aortic valve replacement (SAVR) in patients with symptomatic severe aortic stenosis at low risk for surgical mortality. This cost-utility analysis compared TAVI with SAPIEN 3 versus SAVR in symptomatic severe aortic stenosis patients at low risk of surgical mortality from the perspective of the Swedish healthcare system.
Methods: A published, two-stage, Markov-based cost-utility model that captured clinical outcomes from the (SWEDEHEART) registry (2018-2020) was adapted from the perspective of the Swedish healthcare system using local general population mortality, utility and costs data.
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