Arterial Stiffness and Peripheral Arterial Disease as Indicators of Abdominal Aorta Diame-ters: The Atherosclerosis and Risk in Communities Study

Background: Abdominal aorta (AA) dilatation (AAD) and aneurysms result from remodeling that includes atherosclerotic and arteriosclerotic components. The latter frequently coexist across different arterial territories. Peripheral arterial disease (PAD) is an ischemic manifestation of atherosclerosis, while arterial stiffening (AS) primarily reflects arteriosclerosis. Our aim was to examine PAD and AS as potential indicators of AAD. Methods: Cross-sectional analysis of data from the 5th examination of the Atherosclerosis Risk in Communities cohort (2011-2013). 4,802 participants 70-89 years were included to examine the association between PAD and AAD, and 4,224 participants were included to examine the association between AS and AAD. The anterior-posterior (AP) diameter of the AA was quantified by b-mode ultrasound at the proximal, mid-, and distal locations. The ankle-brachial index (ABI) and pulse wave velocity (PWV) were used to evaluate PAD and AS (central and peripheral), respectively. Heart-carotid (hc) and carotid-femoral (cf) PWV were used to quantify central AS, and femoral-ankle (fa) PWV was used to measure peripheral AS. ABI and PWV measurements were performed using an automated non-invasive waveform analyzer. Results: Sixty percent of examinees were women, ~22% were black, and the mean age was 75.3±5.1 years. The mean AP diameters and confidence intervals (CIs) for proximal, mid-, and distal diameters were; 1.95±0.32cm, 1.81±0.33cm, and 1.70±0.35cm, respectively. The mean value and CI for the lowest ABI of the right and left leg was 1.10±0.14. The mean values and CIs for hcPWV, cfPWV, right faPWV, and left faPWV were 1,132.8±344.5cm/s, 1,159.5±302.7cm/s, 1,099.2±180.8cm/s, and 1,067.8±174.8cm/s, respectively. A U-shaped association between ABI and AAD was observed at all three levels of the AA. A positive, linear association between hcPWV was observed at all the levels of the aorta as the only measure of AS exhibiting a consistent and statistically significant association with AAD. Conclusions: In older adults AAD is associated with PAD and with central AS. Although statistically significant, these associations are of small magnitude and have little practical applicability as indicators of AA dilatation.Doctor of Philosoph

Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study

Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared

Seroprevalence of antibodies to SARS-CoV-2 among blood donors in the early month of the pandemic in Saudi Arabia

Background: Serologic testing provides better understanding of SARS-CoV-2 prevalence and its transmission. This study was an investigation of the prevalence of antibodies to SARS-CoV-2 among blood donors in Saudi Arabia. Objective: To estimate the seroprevalence of anti-SARS-CoV-2 antibodies among blood donors in Saudi Arabia during the early phase of the COVID-19 pandemic. Methods: Serology results and epidemiological data were analyzed for 837 adult blood donors, with no confirmed SARS-CoV-2 infection, in Saudi Arabia from 20th to 25th May 2020. Seroprevalence was determined using electrochemical immunoassay to detect anti-SARS-CoV-2 antibodies. Results: The overall seroprevalence of anti-SARS-CoV-2 antibodies was 1.4% (12/837). Non-citizens had higher seroprevalence compared with citizens (OR 13.6, p = 0.001). Secondary education was significantly associated with higher seroprevalence compared with higher education (OR 6.8, p = 0.005). The data showed that the highest seroprevalence was in Makkah (8.1%). Uisng Makkah seroprevalence as the reference, the seroprevalence in other areas was: Madinah 4.1% (OR 0.48, 95% CI 0.12-1.94), Jeddah 2.3% (OR 0.27, 95% CI 0.31-2.25), and Qassim 2.9 % (OR 0.34, 95% CI 0.04-2.89) and these were not statistically different from seroprevalence in the Makkah region. Conclusions: At the early months of the COVID-19 pandemic in Saudi Arabia, the seroprevalence of antibodies to SARS-CoV-2 among blood donors was low, but was higher among non-citizens. These findings may indicate that non-citizens and less educated individuals may be less attentive to preventive measures. Monitoring seroprevalence trends over time require repeated sampling

The impact of seven major noncommunicable diseases on direct medical costs, absenteeism, and presenteeism in Gulf Cooperation Council countries

10.1080/13696998.2021.1945242Journal of Medical Economics241828-83

Saudi Arabia Mental Health Surveillance System (MHSS): mental health trends amid COVID-19 and comparison with pre-COVID-19 trends

Background: The impact of the COVID-19 pandemic on populations’ mental health has started to emerge. Objectives: To describe the mental health trends of the risk of major depressive disorder (MDD) and generalized anxiety disorder (GAD) between May and August 2020. It also compares the results with pre-COVID-19 results and identifies risk factors associated with increased likelihood of being at risk of MDD and GAD. Method: This study utilizes repeated cross-sectional design, at national-level coverage of mental health screenings via computer-assisted phone interviews conducted in four waves monthly (between May and August 2020). Arabic-speaking adults from Saudi Arabia were recruited via a random phone list. The questionnaire includes the Arabic version of the Patient Health Questionnaire (PHQ-9) and the General Anxiety Disorder-7 (GAD-7). Pre-COVID-19 comparison was done using the PHQ-2 score to allow for comparison with a previous and similar national study conducted in 2018. Results: Across the four waves, 16,513 participants completed the interviews, with an overall response rate of 81.3%. The weighted national prevalence of people at risk of MDD was 14.9% overall, and 13.8%, 13.6%, 16.8%, and 15.3% in Waves 1, 2, 3, and 4, respectively. The weighted national prevalence of people at risk of GAD was 11.4%, overall, and 10.9%, 10.7%, 12.4%, and 11.7% in Waves 1, 2, 3, and 4, respectively. The weighted national proportion of individuals who were at risk of MDD and GAD at the same time was 7.4% overall. The risk of MDD on PHQ-2 increased by 71.2%, from 12.5% in 2018 to 21.4% in 2020. Conclusions: The risks of MDD and GAD in this study are relatively high. These results can help decision makers to understand the impact of the COVID-19 pandemic on the population’s mental health and the most-impacted subgroups

Repeatability of Central and Peripheral Pulse Wave Velocity Measures: The Atherosclerosis Risk in Communities (ARIC) Study

BACKGROUND: Arterial stiffness measures are emerging tools for risk assessment and stratification for hypertension and cardiovascular disease (CVD). Carotid-femoral pulse wave velocity (cfPWV) is an established measure of central arterial stiffness. Other measures of PWV include femoral-ankle (faPWV), a measure of peripheral stiffness, and brachial-ankle PWV (baPWV), a composite measure of central and peripheral stiffness. Repeatability of central, peripheral, and composite PWV measures has not been adequately examined or compared. METHODS: Participants (n = 79; mean age 75.7 years; USA) from a repeatability study nested within the Atherosclerosis Risk in Communities (ARIC) Study visit 5 (2011–2013) underwent 2 standardized visits, 4–8 weeks apart. Trained technicians obtained 2 PWV measurements at each visit using the VP-1000 Plus system. We calculated the intraclass correlation coefficient (ICC), SE of measurement, and minimal detectable change (MDC(95); 95% confidence interval) and difference (MDD). RESULTS: The ICCs and 95% confidence intervals (95% CIs) were 0.70 (0.59, 0.81) for cfPWV, 0.84 (0.78, 0.90) for baPWV, and 0.69 (0.59, 0.79) for faPWV. The MDC(95) between repeat measures within an individual was 411.0cm/s for cfPWV, 370.6cm/s for baPWV, and 301.4cm/s for faPWV. The MDD for 2 independent samples of 100 per group was 139.3cm/s for cfPWV, 172.3cm/s for baPWV, and 100.4cm/s for faPWV. CONCLUSIONS: Repeatability was acceptable for all PWV measures in a multicenter, population-based study of older adults and supports its use in epidemiologic studies. Quantifying PWV measurement variation is critical for applications to risk assessment and stratification and eventual translation to clinical practice