Vitamin D deficiency and coronary artery disease

BACKGROUND: Several factors such as hyperlipidemia, diabetes and hypertension have a determining role in cardiovascular disease. In recent years, the effect of vitamin D deficiency on cardiovascular disease has been emphasized. This study compares vitamin D deficiency in coronary heart disease patients with the control group. METHODS: In a cross-sectional study, 25-hydroxycholecalciferol level was compared in 119 individuals including 57 people with confirmed coronary heart disease and 62 healthy people. 25-hydroxyvitamin D [25(OH)D] was assessed using standard protocol. The level of 25(OH)D under 20 ng/dl was determined as cutoff point. RESULTS: The calculated odds ratio was 3.9 (95% confidence interval 2.6-5.5). Vitamin D deficiency significantly different between patients and the control group (p = 0.01). Of 37 (31%) individuals having vitamin D deficiency, 36 (97.3%) had coronary artery disease and from 57 patients with coronary artery disease 36 (63.2%) had vitamin D deficiency. CONCLUSIONS: Vitamin D deficiency is a relatively common disorder. Risk of cardiovascular disease in people with vitamin D deficiency is almost four times of those with normal levels of vitamin D. To confirm the casual relationship between vitamin D and cardiovascular disease, clinical trial studies are suggested

Gender Differences in Obesogenic Behaviour, Socioeconomic and Metabolic Factors in a Population-based Sample of Iranians: The IHHP Study

This study investigated the gender differences in association of some behavioural and socioeconomic factors with obesity indices in a population-based sample of 12,514 Iranian adults. The mean body mass index (BMI), waist circumference (WC), and the waist-to-hip ratio (WHR) were significantly higher in women than in men. Current and passive smoking had an inverse association with BMI among males whereas current smoking, transportation by a private car, and longer duration of watching television (TV) had a positive association with BMI among females. Current and passive smoking, cycling, and Global Dietary Index (GDI) had an inverse association with WC among males. Higher consumption of fruits and vegetables, current and passive smoking, duration of daily sleep, and GDI had an inverse association with WC among females. Using a private car for transportation had a significant positive association with WHR among both males and females. Living in an urban area, being married, and having a higher education level increased the odds ratio of obesity among both the genders. Non-manual work also increased this risk among males whereas watching TV and current smoking increased this risk among females. Such gender differences should be considered for culturally-appropriate interventional strategies to be implemented at the population level for tackling obesity and associated cardiometabolic risk factors

Association of an adult obesity, blood pressure adulthood socio-economic position

Background: The purpose of this study is to investigate an effect of childhood and adulthood socio-economic position on selected cardiovascular risk factors including obesity, blood pressure level and smoking behavior. Materials and Methods: This is a crosssectional study performed on 479 individuals, randomly selected by random clustered sampling from men and women aged 30-50 years, living in Esfahan. Their demographic characteristics, education, occupation and smoking behavior were questioned. Their weight, height and blood pressure were also measured, and their BMI (Body Mass Index) was calculated. The data were analyzed by SPSS 19 software. Results: In men, the odds ratio for ever smoking to never smoking at higher levels of education in comparison with the lower levels was 6.08 (2.65-14.11). For manual occupation to non-manual occupation, it was 3.55 (1.88-6.68). The odds ratio for obesity and overweight vs no overweight, for manual occupation to non-manual occupation was 3.12 (1.81-5.40) in men and for father′s occupation it was 2.03 (1.10-3.74). In women, their education with the odds ratio of 2.11 (1.17-3.82) and father′s occupation with the odds ratio of 6.63 (3.50-12.58) altered their chance of being obese or overweight. Also, in women, the mean systolic blood pressure was significantly lower at higher educational levels and in those whose fathers′ occupation were manual but lower in manual workers. Conclusion: The current socio-economic position in individuals is associated with an obesity and smoking behavior, particularly in men. Childhood socio-economic position increases the chance of an obesity and higher blood pressure, particularly in women

Comparing of goal setting strategy with group education method to increase physical activity level: A randomized trial

Background: Designing an intervention to increase physical activity is important to be based on the health care settings resources and be acceptable by the subject group. This study was designed to assess and compare the effect of the goal setting strategy with a group education method on increasing the physical activity of mothers of children aged 1 to 5. Materials and Methods: Mothers who had at least one child of 1-5 years were randomized into two groups. The effect of 1) goal-setting strategy and 2) group education method on increasing physical activity was assessed and compared 1 month and 3 months after the intervention. Also, the weight, height, body mass index (BMI), waist and hip circumference, and well-being were compared between the two groups before and after the intervention. Results: Physical activity level increased significantly after the intervention in the goal-setting group and it was significantly different between the two groups after intervention (P < 0.05). BMI, waist circumference, hip circumference, and well-being score were significantly different in the goal-setting group after the intervention. In the group education method, only the well-being score improved significantly (P < 0.05). Conclusion: Our study presented the effects of using the goal-setting strategy to boost physical activity, improving the state of well-being and decreasing BMI, waist, and hip circumference

Lifestyle interventions for hypertension treatment among Iranian women in primary health-care settings: Results of a randomized controlled trial

Background: Lifestyle factors such as weight, salt intake, and physical activity have shown to be important in treating hypertension. The object of this study was to describe feasibility and to assess the effectiveness of a multicomponent lifestyle intervention on high blood pressure (BP) of Iranian women. Materials and Methods: This randomized controlled trial was conducted in four health centers by recruiting 161 women aged 35-65 years with high BP and randomizing them to a 4-week lifestyle modification (n = 80) or control group (n = 81). BP level and other health behavioral factors were assessed before and after the 4-week intervention and also after 6 months. Results: The mean systolic BP changed from 158.8 (±8.1) mmHg to 153.2 (±6.4) mmHg during 4-week and to 145.5 (±4.6)) mmHg after 6 months in the intervention group (P < 0.001). There was a significant difference between two groups of study after 4-week mean = 5.6 (confidence interval [CI] = 5.1-6.6) and 6 months follow mean (CI = 12.3-14.6).(P < 0.001) A significant correlation was detected between systolic BP (SBP) and diastolic BP (DBP) with weight, body mass index, waist circumference, salt intake, and physical activity level (P < 0.001). Stepwise regression analyses indicated that the weight, dietary salt intake, and physical activity level were significant predictors of SBP and DBP. Conclusion: The results of this study suggest that lifestyle modification program is associated with improvements in BP level in Iranian women

Association between Sleep Duration and Body Mass Index and Waist Circumference

AbstractInsufficient sleep may lead to adverse cardio-metabolic effectsby influencing body weight, blood pressure, and glucose tolerance.We aimed to assess the relation between sleep durationand indices of obesity including body mass index (BMI) andwaist circumference in a sample population in central Iran. Weselected a sub-sample of 1770 individuals from Isfahan HealthyHeart Program. The data regarding the sleep duration was collectedby using a validated questionnaire. The relation of sleepduration with BMI and waist circumference was examined byusing categorical logistic regression with adjustment for sex,BMI, and daily calorie intake. Sleep duration time less than 5hours/day compared with 7-8 hours/day increased the odds ratiofor abdominal obesity in people aged under 60 years [OR=2.49(95%CI 1.40-4.43)]. In individuals aged under 60 years, thisrelation was significant for both men, [OR=2.64 (95%CI 1.16-6.02]) and women [OR=2.38 (95% CI 1.05-5.39)]. In addition,in women, sleep time > 9 hours was negatively related to waistcircumference. Sleep duration time less than 5 hours per dayincreased odds ratio of overweight only in women [OR=1.75(95% CI 1.07-2.85)]. Sleep duration time under 5 hours in peopleaged less than 60 years was positively associated with waistcircumference. In women, sleep duration time over 9 hours wasnegatively associated with waist circumference. Only in women,sleep time under 5 hours /night increased BMI. Short sleep durationwas associated with abdominal obesity and this was independentof its relation to BMI.Iran J Med Sci 2010; 35(2): 140-144

IS THERE ANY DIFFERENCE BETWEEN DIETARY HABITS IN HYPER-TENSIVES, HYPERLIPIDEMICS, OBESE, SMOKER INDIVIDUALS AND THE NORMAL POPULATION?

Abstract &nbsp;&nbsp; BACKGROUND: Cardiovascular disease has been remained the leading cause of death worldwide. This study has been designed to comprise dietary habits of persons with cardiovascular disease (CVD) risk factors and those without them. &nbsp;&nbsp; METHOD AND MATERIALS: This cross-sectional study was performed on samples of a national community- based program for CVD prevention and control entitled Isfahan Healthy Heart Program (IHHP) including 12514 adults, aged&ge; 19 years, 6391(51.1%) females and 6123(48.9%) males. All participants were interviewed by trained personnel who used a validated qualitative 48 item food frequency questionnaire (FFQ) to determine nutritional status. Blood pressure, serum lipids including triglycerides, total cholesterol, LDL-Cholesterol and HDL-Cholesterol, weight and height were measured and smoking habit was determined by a questionnaire. The frequency of food consumption of persons with and without the risk factors was compared by student t- test. The analysis was performed by SPSS version 11.5. &nbsp;&nbsp; RESULTS: Our results show that the prevalence of dyslipidemia, hypertension, smoking and obesity are 54%, 16.8%, 15.1% and 16.8%, respectively. Hypertensive and dyslipidemic subjects have significantly more frequent consumption of healthy foods (P &lt; 0.05), in comparison to normotensive and normolipidemic whereas smokers and obese participants have a significantly higher consumption of unhealthy foods (P &lt; 0.01) in comparison to non-smokes and the non-obese subjects. &nbsp;&nbsp; CONCLUSION: Our results showed that dyslipidemic and hypertensive individuals have more attention on their dietary habits. In contrast, obese and smoker persons have less attention to a healthy diet. &nbsp; &nbsp;&nbsp; Keywords: Hypertesion, Dyslipidemia, Obesity, Smoking, Nutrition, Adult.</p

THE EFFECT OF LOW-DOSE NIACIN ADDED TO SIMVASTATIN ON LIPOPROTEIN PROFILE

&nbsp; Abstract INTRODUCTION: Different studies have demonstrated that low levels of high-density lipoprotein (HDL) cholesterol in serum are significantly related to the progression of coronary artery disease (CAD) and its related mortality. This study was performed primarily to assess the effectiveness of supplementing treatment with statins with low-dose (100 mg, bid) fast-release nicotinic acid (the only form of this drug produced in Iran) in increasing HDL; we also aimed to evaluate the effect of this regimen on other lipoproteins, and to investigate any possible side effects. methods: This double-blind placebo-controlled randomized clinical trial was conducted on patients who were treated with simvastatin (20 mg/daily) for at least four weeks and did not receive any other lipid-lowering medications. The patients were divided into two groups of 50. The case group was treated with niacin tablets (100 mg, bid) and simvastatin (20 mg/daily). The control group was treated with placebo tablets (bid) and simvastatin (20 mg/daily). All patients underwent two 6-week crossover periods and a 2-week washout period. Liver-function biomarkers (ALK-P, SGPT, SGOT), serum lipids, uric acid, CPK and fasting blood sugar (FBS) were measured before and after each course of treatment. Data were analyzed with chi-square test and paired t-test. results: Serum HDL increased from 42.44&plusmn;8.5 to 44.01&plusmn;8.39 mg/dl in the case group, with a mean increase of 2.56 mg/dl (P&lt;0.05). HDL decreased from 41.5&plusmn;9.1 to 40.9&plusmn;9.4 mg/dl in the control group (P&gt;0.05). Mean serum HDL was significantly different between the case and control groups (P&lt;0.05). The increase in mean total cholesterol and low-density lipoprotein (LDL) cholesterol in the control group, and the decrease in triglyceride (TG) in both groups were not statistically significant (P&gt;0.05). In follow-up, flushing was reported in 44.4% of case patients, resulting in discontinuation of treatment in 38.5% of patients. Flushing was reported in 5.6% of controls, resulting in discontinuation of treatment in 20% of patients. Muscle pain was reported in 24.4% of the case patients, resulting in discontinuation of treatment in 47.6% of the patients. Only 3.3% of the controls reported muscle pain, which led to discontinuation of treatment by the physician in 66.7% of the patients. CONCLUSIONS: Low-dose fast-release niacin led to significant HDL increase; hence we recommend that treatment of dyslipidemic patients with statins be supplemented with low-dose niacin, which is available in Iran.&nbsp; &nbsp; &nbsp; Keywords: Niacin, simvastatin, lipoprotein.</div

The relationship between weight and CVD risk factors in a sample population from central Iran (based on IHHP)

&nbsp;&nbsp; BACKGROUND: Atherosclerosis is one of the leading causes of mortality all around the world. Obesity is an independent risk factor for atherosclerosis and cardiovascular diseases (CVD). In this respect, we decided to examine the effect of the subgroups of weight on cardiovascular risk factors. &nbsp;&nbsp; METHODS: This cross-sectional study was done in 2006 using the data obtained by the Iranian Healthy Heart Program (IHHP) and based on classification of obesity by the World Health Organization (WHO). In this study, the samples were tested based on the Framingham risk score, Metabolic Measuring Score (MMS) and classification of obesity. Chi-square and ANOVA were used for statistical analysis. &nbsp;&nbsp; RESULTS: 12514 people with a mean age of 38 participated in this study. 6.8% of women and 14% of men had university degrees (higher than diploma). Obesity was seen in women more than men: 56.4% of women and 40% of men had a Body Mass Index of (BMI) &ge; 25 Kg/m2. 13% of the subjects had FBS &gt; 110 and13.9% of them were using hypertensive drugs. In this study, we found that all risk factors, except HDL cholesterol in men, increased with an increase in weight. This finding is also confirmed by the Framingham flowchart for men and women. &nbsp;&nbsp; CONCLUSION: One of every two Americans, of any age and sex, has a Body Mass Index of (BMI) &ge; 25 Kg/m2. Obesity associated CVD and other serious diseases. Many studies have been done in different countries to find the relationship between obesity and CVD risk factors. For example, in the U.S.A and Canada they found that emteropiotic parameters, blood presser and lipids increased by age(of both sexes). Moreover, another study done in China, which is a country in Asia like Iran, shows that BMI has an indirect effect on HDL cholesterol, LDL cholesterol and triglyceride. This data is consistent with the results of the current study. However, In China they found that this relationship in men is stronger than women, but our study reveals the opposite. &nbsp; Keywords: Body Mass Index (BMI), Overweight, Cardiovascular Risk Factors, Framingham Risk Score, Metabolic Syndrome.</p