Epidemiology

Jan 2nd, 2024

In the field of Epidemiology and Prevention, particularly focusing on Genetic Epidemiology, there has been significant research exploring the connections between various factors and cardiovascular diseases (CVDs). One such study is a bidirectional Mendelian randomization study that examined the causal effects of basal metabolic rate (BMR) on cardiovascular diseases (1). This genetic association study utilized data derived from European databases and did not specify a control group or the number of patients involved. The findings revealed a positive association between genetically predicted BMR and heart failure, atrial fibrillation, and flutter, suggesting a causal relationship that could be crucial for the prevention and treatment of specific CVDs.

 

In the context of Coronary Artery Disease (CAD), a longitudinal population-based study named the KERCADR study focused on the prevalence and trend of multiple CAD risk factors among an adult population aged 15 to 75 years in Kerman (2). This study, involving 5835 participants, identified a high prevalence of single and multiple CAD risk factors. The most common combinations were low physical activity plus dyslipidemia, metabolic syndrome, and dyslipidemia plus obesity. The clinical significance of these findings lies in the emphasis on the need to identify multiple CAD risk factors to reduce the burden of non-communicable diseases.

 

Concerning Ischemic Stroke and Atrial Fibrillation, a study analyzing trends in atrial fibrillation prevalence in acute ischemic stroke from 2010 to 2020 in the United States (3) employed a serial cross-sectional study design. The study focused on 5,190,148 weighted primary acute ischemic stroke (AIS) hospitalizations, finding that 25.1% had comorbid atrial fibrillation (AF). Interestingly, the age- and sex-standardized prevalence of AF in AIS hospitalizations increased initially and then plateaued, attributable to a declining prevalence in hospitalizations in women aged 60 years and above, and plateauing prevalence in men of the same age group.

 

An important study examining the relationship between pulmonary function and cardiovascular disease, specifically atherosclerosis, involved 29,593 men and women aged 50-64 years from the Swedish CArdioPulmonary BioImage study (4). The study assessed lung function, emphysema, coronary CT angiography, coronary calcium, carotid plaques, and ankle-brachial index, and found a correlation between reduced lung function and more atherosclerosis. However, this correlation was attenuated after adjusting for cardiovascular risk factors, suggesting that there might not be a causal relationship between lung function and atherosclerosis.

 

Lastly, a study investigating gender differences in cardiovascular risk examined sex variations in major adverse cardiac events (MACE) incidence among people with cardiovascular risk factors (CVRFs) (5). Although the specific study design was not detailed, this analysis involved 278,515 patients and found a higher incidence of MACE in men, with diabetes and socio-economic status being the main causal factors. The study suggests the importance of gender-targeted diabetes prevention and salary policies.

 

  1. Zhao P, Han F, Liang X, Meng L, Yu B, Liu X, et al. Causal Effects of Basal Metabolic Rate on Cardiovascular Disease: A Bidirectional Mendelian Randomization Study. J Am Heart Assoc. 2024;13(1):e031447.

  2. Zeinali-Nezhad N, Najafipour H, Shadkam M, Pourhamidi R. Prevalence and trend of multiple coronary artery disease risk factors and their 5-year incidence rate among adult population of Kerman: results from KERCADR study. BMC Public Health. 2024;24(1):25.

  3. Otite FO, Patel SD, Aneni E, Lamikanra O, Wee C, Albright KC, et al. Plateauing atrial fibrillation burden in acute ischemic stroke admissions in the United States from 2010 to 2020. Int J Stroke. 2024:17474930231222163.

  4. Engström G, Lampa E, Dekkers K, Lin YT, Ahlm K, Ahlström H, et al. Pulmonary function and atherosclerosis in the general population: causal associations and clinical implications. Eur J Epidemiol. 2024.

  5. Castel-Feced S, Malo S, Aguilar-Palacio I, Maldonado L, Rabanaque MJ, San Sebastián M. Exploring sex variations in the incidence of cardiovascular events: a counterfactual decomposition analysis. Eur J Public Health. 2024.