The Prevalence of Cardio-Metabolic Conditions (Diabetes, Hypertension, and Obesity) Before and During COVID-19 and Association with Health and Sociodemographic Factors

Cardiometabolic conditions, including hypertension, diabetes, and obesity are associated with adverse health outcomes, including increased rates of hospitalization and deaths in patients who are diagnosed with COVID-19. However, little to no evidence is known currently on the cardiometabolic conditions before and during the COVID-19 pandemic. This study utilizes a nationally representative sample of adults in the United States (U.S.) to estimate the prevalence of cardiometabolic conditions, focusing on diabetes, hypertension, and obesity, and determine their prevalence and absolute and relative rates before and during COVID-19 pandemic declaration. Furthermore, the study aims to determine the association between these cardiometabolic conditions and physical activity, tobacco use, anxiety/depression, and sociodemographic characteristics among U.S. adults during the COVID-19 pandemic. Data from the 2019 (N = 5359) and 2020 (N = 3830) Health Information National Trends Surveys (HINTS) on adults were utilized. Dependent variable was cardiometabolic conditions and the main explanatory variable was response before and during the COVID-19 pandemic. We conducted weighted descriptive and multivariable logistic regression controlling for confounders such as age, sex, and intensity of physical activity. While there was a slight increase in the prevalence of cardiometabolic conditions during the pandemic (56.09%) compared to before (54.96%), there was only a slight increase in the prevalence of diabetes (18.10% vs 17.28%) and obesity (34.68% vs 34.18%) and a slight decrease in the prevalence of hypertension (36.38% vs 36.36%). Results showed an increase in the prevalence of cardiometabolic conditions among former smokers (67.91% vs 63.86%), and current cigarette smokers (59.39% vs 55.43%), current e-cigarette users (37.24% vs 28.66%), individuals with mild (59.62% vs 55.43%), or moderate (61.98% vs 57.83%) anxiety/depression, sexual minority (53.50% vs 51.12%) and heterosexual (56.45% vs 54.96%) individuals during the pandemic, compared to before the pandemic. Additionally, people with mild anxiety/depression had higher odds of cardiometabolic conditions during the pandemic (AOR = 1.55, 95% CI = 1.01, 2.38), compared to before (AOR = 1.52, 95% CI =1.06, 2.19), relative to those without anxiety/depression. Similarly, former smokers had higher odds of cardiometabolic outcomes before and during the pandemic (AOR = 1.38, 95% CI = 1.01, 1.87 vs AOR = 1.57, 95% CI = 1.10, 2.25), when compared to never smokers. Odds were lower for current e-cigarette users (AOR = 0.44, 95% CI = 0.23, 0.85) compared to never e-cigarette users before the pandemic. There were no significant differences in odds of cardiometabolic conditions between sexual minorities and heterosexual individuals before and during the pandemic. In conclusion, increased risk for adverse cardiometabolic conditions was higher for individuals with cigarette use and mental health diagnoses during the COVID-19 pandemic, suggesting the critical need for smoking cessation and programs to support behavioral health

Comorbidities Predict Length of Stay Among Patients Admitted with Peripheral Artery Disease– An Analysis of The National Inpatient Sample.

The global prevalence of peripheral artery disease (PAD) is estimated to be about 120 million, making up about 25.6% of the worldwide burden of cardiovascular diseases (CVD). In the United States (U.S.), the prevalence of PAD is about 7%, representing nearly 8 million adults. There is a higher prevalence of disease in Blacks and non-Hispanic Whites, with approximately 30% of Blacks and 20% of non-Hispanic Whites developing PAD in their lifetime. The strong risk factors associated with PAD include smoking, diabetes, hypertension, age, and male sex. Our study aimed to estimate the effects of obesity, alcohol abuse, renal failure, and hypertension on patients’ length of stay (LOS) among patients admitted with a diagnosis of PAD. Using the 2012 U.S. National Inpatient Sample database, we included 336,790 patients with PAD as a separate comorbidity during their index admission. Our main outcome variable was patients’ total length of stay (LOS) during the index admission. We categorized LOS \u3c 1 into next day discharge (NDD) and LOS \u3e 1 into non-NDD. Our predictor variables were hypertension, obesity, alcohol abuse and renal failure. We ran descriptive statistics to delineate the baseline characteristics of our sample population, and bivariate analysis with t-test and chi-square analysis. Multivariable logistic regression was used to estimate odds of non-NDD given our comorbidities; obesity, hypertension, alcohol abuse, renal failure while adjusting for age, race, and sex. We reported frequencies, p-values, and odd ratios (ORs) at a 95% significance level with alpha at 0.05. Of our final sample, 54.8% were males while 45.2% were females and the mean age of patients was 71.7 + 12.8. Hypertension, obesity, alcohol abuse and renal failure were present in 75%, 12%, 3.4%, and 30.9% of patients, respectively. Majority (75%) of the patients were white, while Black and Hispanic patients made up 13.3% and 7.1%, respectively. In our adjusted model, we found that patients with hypertension had 12% lower odds of non-NDD (OR = 0.88, CI= 0.86-0.90, P\u3c0.0001) compared to those without hypertension, females had 20% increase in the odds of non-NDD compared to males (OR = 1.20, CI= 1.18-1.23, P\u3c0.0001), patients with obesity, alcohol abuse and renal failure had 39%, 43% and 45% increase in odds of non-NDD compared to those without these comorbidities. (OR = 1.39, CI= 1.34-1.44, P\u3c0.0001), (OR = 1.43, CI= 1.35-1.52, P\u3c0.0001), (OR = 1.45, CI= 1.42-1.49, P\u3c0.0001). Given the significant association between obesity, alcohol abuse, and renal failure with prolonged hospital stay in patients admitted to hospital with PAD, our study highlights the importance of adequate management of pre-existing patients\u27 comorbidities. This is expected to improve overall length of stay and total healthcare utilization and costs, among patients with PAD