Lancet Regional Health-Americas最新文献

{"title":"Weight stigma in Latin America and the Caribbean: regional evidence and a call to action by ABESO","authors":"Luiz F. Viola,&nbsp;Cynthia M. Valerio,&nbsp;Ximena Ramos Salas,&nbsp;Shubo Saiful,&nbsp;Thaisa D.G. Trujilho,&nbsp;Rodrigo N. Lamounier,&nbsp;Alexandre Hohl,&nbsp;Bruno Halpern,&nbsp;Fábio R. Trujilho","doi":"10.1016/j.lana.2026.101409","DOIUrl":"10.1016/j.lana.2026.101409","url":null,"abstract":"<div><div>Weight stigma (WS) negatively impacts the health and well-being of people living with obesity (PwO). However, it remains understudied in Latin America and the Caribbean. This review synthesizes findings from 128 studies across the region, revealing widespread WS in society, healthcare, education, workplaces, and media. Evidence highlights explicit and implicit biases among healthcare professionals and students, frequent bullying of children and adolescents, and social exclusion of PwO. Cultural beliefs often associate obesity with personal failure, reinforcing the stigma and undermining access to care.</div><div>This review highlights the need for reforms in healthcare systems, professional education, and public communication to address WS. It also highlights the absence of legal safeguards against weight-based discrimination in most countries.</div><div>Together with the Brazilian Association for the Study of Obesity and Metabolic Syndrome (ABESO), this review issues a <em>Call to Action</em> urging the adoption of person-first, non-stigmatizing language, evidence-based care, and policies to reduce WS. Addressing WS is critical to ensuring equitable, ethical, and effective treatment for PwO in Latin America and the Caribbean.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"59 ","pages":"Article 101409"},"PeriodicalIF":9.1,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13387013/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148550413","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Targeted termination of scientific grants and minoritised researcher status in a national survey: a cross sectional analysis","authors":"Rebecca Fielding-Miller ,&nbsp;Natalie Vawter ,&nbsp;Laramie R. Smith ,&nbsp;Nicholas Metheny ,&nbsp;Abigail M. Hatcher ,&nbsp;Sarah Peitzmeier","doi":"10.1016/j.lana.2026.101478","DOIUrl":"10.1016/j.lana.2026.101478","url":null,"abstract":"<div><h3>Background</h3><div>Between January and May 2025, the National Institutes of Health terminated over 2000 grants primarily relating to health equity, particularly for Black, Indigenous, and people of color (BIPOC) and sexual and gender minority (SGM) communities. 600 grants were terminated as part of blanket, institution-wide actions that were purportedly to “combat anti-Semitism.”</div></div><div><h3>Methods</h3><div>N = 1918 investigators with grant terminations documented in the Grant Witness database were sent a unique link for an online demographic survey. We built logistic regression models to assess the odds of receiving different grant termination types, for BIPOC, SGM, female, and Jewish researchers.</div></div><div><h3>Findings</h3><div>941 investigators participated (49.1% response rate). Nearly half (48.6%) of investigators with equity-related terminations were BIPOC and 60.0% of investigators with gender-related terminations were SGM, including 16.5% who identified as transgender or non-binary. Additionally, 20.5% of investigators with institutional terminations (for purported antisemitism) were Jewish. Among investigators of terminated grants, BIPOC investigators had higher odds of receiving an equity-related termination (aOR = 2.69, 95% CI: 1.71–4.25 for BIPOC women and trans/nonbinary investigators, aOR = 1.82, 95% CI: 1.10–3.02 for BIPOC men) compared to White men. SGM investigators had 11 times higher odds of receiving a gender-related termination (aOR = 11.14, 95% CI: 6.85–18.12) than heterosexual, cisgender investigators, and White women and trans/non-binary investigators had double the odds (aOR = 2.24, 95% CI: 1.25–4.02) of a gender-related termination than cisgender White men.</div></div><div><h3>Interpretation</h3><div>Grant terminations targeting health research for BIPOC and SGM communities have disproportionately targeted the careers of BIPOC, SGM, and female researchers and researchers from disadvantaged backgrounds. Ensuring the health of all Americans will require systematic re-investment in these topics and scientists.</div></div><div><h3>Funding</h3><div>The authors received no external funding for this study.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"58 ","pages":"Article 101478"},"PeriodicalIF":7.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241481","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke prevention in the Americas: from knowing to doing","authors":"Mikk Jürisson ,&nbsp;Ave Voit ,&nbsp;Margus Viigimaa ,&nbsp;Jan O. Johansson","doi":"10.1016/j.lana.2026.101479","DOIUrl":"10.1016/j.lana.2026.101479","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"58 ","pages":"Article 101479"},"PeriodicalIF":7.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stroke still strikes hard: we need more primary prevention","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2026.101537","DOIUrl":"10.1016/j.lana.2026.101537","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"58 ","pages":"Article 101537"},"PeriodicalIF":7.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of stroke prevention: a review of challenges and opportunities in the Americas","authors":"Sheila O. Martins ,&nbsp;Pedro Ordunez ,&nbsp;Wyllians Vendramini Borelli ,&nbsp;Bruce Ovbiagele ,&nbsp;Victor C. Urrutia ,&nbsp;Carlos Abanto ,&nbsp;Matias J. Alet ,&nbsp;Bassel Almarie ,&nbsp;Tony Fabián Alvarez ,&nbsp;Pablo Amaya ,&nbsp;Sebastian Ameriso ,&nbsp;Antonio Arauz ,&nbsp;Miguel A. Barboza ,&nbsp;Hernán Bayona ,&nbsp;Juan Calleja ,&nbsp;Vanessa Cano-Nigenda ,&nbsp;Leonardo Augusto Carbonera ,&nbsp;Rodrigo M. Carrillo-Larco ,&nbsp;Freddy Constanzo ,&nbsp;Angel Corredor ,&nbsp;Pablo M. Lavados","doi":"10.1016/j.lana.2026.101468","DOIUrl":"10.1016/j.lana.2026.101468","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Stroke remains a leading cause of death and disability throughout the Americas, disproportionately impacting low-and middle-income countries and underserved populations. In this review, we examine the status of stroke prevention in the Americas. Prevention is essential, yet unequal access to healthcare has led to major disparities - especially among rural populations, ethnic minorities, and lower socioeconomic status. Models like the WHO HEARTS Program demonstrate that evidence-based programs can be tailored to local contexts. Telehealth and digital tools play a critical role in empowering patients, educating communities, and supporting healthcare workers. Despite growing efforts, challenges persist due to health inequities, gaps between policy and implementation, and underinvestment. Strengthening prevention will support countries in achieving the United Nations Sustainable Development Goals, targeting a one-third reduction in premature deaths from non-communicable diseases by 2030. This paper outlines effective strategies for implementing stroke prevention, emphasizing healthy lifestyles, early detection of risk factors, and system-level interventions.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;O Acidente Vascular Cerebral (AVC) permanece como uma das principais causas de morte e incapacidade em todas as Américas, impactando desproporcionalmente os países de baixa e média renda e as populações vulneráveis. Nesta revisão, examinamos o estado atual da prevenção do AVC nas Américas. A prevenção é essencial; contudo, o acesso desigual aos cuidados de saúde resultou em disparidades significativas – especialmente entre populações rurais, minorias étnicas e indivíduos de baixo nível socioeconômico. Modelos como o Programa HEARTS da OMS demonstram que programas baseados em evidências podem ser adaptados aos contextos locais. A telessaúde e as ferramentas digitais desempenham um papel fundamental na capacitação dos pacientes, na educação das comunidades e no apoio aos profissionais de saúde. Apesar dos esforços crescentes, os desafios persistem devido às iniquidades em saúde, às lacunas entre a política e a implementação, e ao subfinanciamento. O fortalecimento da prevenção apoiará os países no alcance dos Objetivos de Desenvolvimento Sustentável das Nações Unidas, visando uma redução de um terço nas mortes prematuras por doenças crônicas não transmissíveis até 2030. Este artigo apresenta estratégias eficazes para a implementação da prevenção do AVC, enfatizando estilos de vida saudáveis, a detecção precoce de fatores de risco e intervenções em nível sistêmico.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;El ataque cerebrovascular sigue siendo una de las principales causas de muerte y discapacidad en las Américas, afectando de manera desproporcionada a los países de ingresos bajos y medianos, así como a las poblaciones desatendidas. En esta revisión, examinamos el estado de la prevención del accidente cerebrovascular en las Américas. La prevención es esencial; sin embargo, el acceso desig","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"58 ","pages":"Article 101468"},"PeriodicalIF":7.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology and risk factors of stroke in the Americas: a comprehensive narrative literature review","authors":"Gisele Sampaio Silva ,&nbsp;Jose Danilo Diestro ,&nbsp;Christopher Tarzi ,&nbsp;Teruko Kishibe ,&nbsp;Antonio Bernabé-Ortiz ,&nbsp;Rodrigo M. Carrillo-Larco ,&nbsp;Bruce Ovbiagele ,&nbsp;Gustavo Saposnik ,&nbsp;Carlos Abanto ,&nbsp;Matias Alet ,&nbsp;Bassel Almarie ,&nbsp;Tony Fabián Alvarez ,&nbsp;Pablo Amaya ,&nbsp;Sebastian Ameriso ,&nbsp;Antonio Arauz ,&nbsp;Miguel A. Barboza ,&nbsp;Hernán Bayona ,&nbsp;Juan Calleja ,&nbsp;Vanessa Cano-Nigenda ,&nbsp;Leonardo Augusto Carbonera ,&nbsp;Pablo M. Lavados","doi":"10.1016/j.lana.2026.101466","DOIUrl":"10.1016/j.lana.2026.101466","url":null,"abstract":"&lt;div&gt;&lt;div&gt;Stroke remains a leading cause of death and disability across the Americas, disproportionately affecting low- and middle-income countries. According to the 2023 Global Burden of Disease (GBD) Study, the Americas recorded approximately 1.2 million incident strokes and 15.7 million prevalent cases. This narrative review synthesizes epidemiological evidence on stroke trends in the Americas, with emphasis on disparities in healthcare access. We integrated estimates from the GBD, peer-reviewed studies and national surveillance systems. Although age-standardized stroke rates declined after 1990, recent analyses demonstrate a concerning resurgence, particularly among younger adults. Stroke incidence, prevalence, and disability burden vary widely across countries. Latin America and the Caribbean show higher incidence but lower prevalence than high-income settings, reflecting limited access to acute care and higher case fatality. Socioeconomic and racial inequities drive delayed treatment and poorer functional outcomes. Over 75% of stroke burden is attributable to modifiable risk factors. Urgent system-level action is needed.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;O acidente vascular cerebral (AVC) permanece como uma das principais causas de morte e incapacidade nas Américas, afetando de forma desproporcional os países de baixa e média renda. De acordo com o estudo &lt;em&gt;Global Burden of Disease&lt;/em&gt; (GBD) 2023, as Américas registraram aproximadamente 1.2 milhão de casos incidentes de AVC e 15.7 milhões de casos prevalentes. Esta revisão narrativa sintetiza evidências epidemiológicas sobre as tendências do AVC nas Américas, com ênfase nas desigualdades no acesso à assistência em saúde. Foram integradas estimativas do GBD, estudos revisados por pares e sistemas nacionais de vigilância. Embora as taxas de AVC padronizadas por idade tenham diminuído após 1990, análises recentes demonstram uma preocupante retomada do aumento, particularmente entre adultos mais jovens. A incidência, prevalência e carga de incapacidade por AVC variam amplamente entre os países. A América Latina e o Caribe apresentam maior incidência, porém menor prevalência em comparação com países de alta renda, refletindo acesso limitado ao cuidado agudo e maior letalidade. Desigualdades socioeconômicas e raciais contribuem para atrasos no tratamento e piores desfechos funcionais. Mais de 75% da carga de AVC é atribuível a fatores de risco modificáveis, ressaltando a necessidade urgente de ações em nível de sistema de saúde.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;div&gt;El accidente cerebrovascular (ictus) sigue siendo una de las principales causas de mortalidad y discapacidad en las Américas, afectando de manera desproporcionada a los países de ingresos bajos y medianos. Según el estudio Global Burden of Disease (GBD) 2023, las Américas registraron aproximadamente 1.2 millones de casos incidentes de ictus y 15.7 millones de casos prevalentes. Esta revisión narrativa sintetiza la evidencia epidemiológica sobre las tendencias d","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"58 ","pages":"Article 101466"},"PeriodicalIF":7.0,"publicationDate":"2026-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148241482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rapid hepatitis C test and treat with peer support at opioid treatment programs (RAPID HCV): a hybrid effectiveness-implementation type 1 randomized control trial","authors":"Oluwaseun Falade-Nwulia ,&nbsp;Jennifer C. Price ,&nbsp;Jordan J. Feld ,&nbsp;Ellen Eaton ,&nbsp;Ricardo A. Franco ,&nbsp;Brittany Barnaba ,&nbsp;Diane Brown ,&nbsp;Sarah Hussain ,&nbsp;Tarfa Verinumbe ,&nbsp;Catherine Wren ,&nbsp;Hamidreza Karimi-Sari ,&nbsp;Kyoko Hirose ,&nbsp;Chris Cavacuiti ,&nbsp;Stephen T. O'rear ,&nbsp;Camelia Capraru ,&nbsp;Karin Tobin ,&nbsp;Dhananjay Vaidya ,&nbsp;Sheree Schwartz ,&nbsp;Mark Sulkowski","doi":"10.1016/j.lana.2026.101439","DOIUrl":"10.1016/j.lana.2026.101439","url":null,"abstract":"<div><h3>Background</h3><div>People who use drugs (PWUD) face persistent barriers to hepatitis C virus (HCV) treatment, threatening HCV elimination goals. Integrating HCV testing and treatment into opioid treatment programs (OTPs) may increase access and uptake. We evaluated the effectiveness and implementation outcomes of an onsite HCV test and treat model delivered within OTPs.</div></div><div><h3>Methods</h3><div>RAPID HCV was a multicenter, open label randomized controlled trial conducted at five OTPs in the United States and Canada. PWUD with a reactive antibody test were randomized (1:1) to onsite OTP-delivered HCV test and treat with peer support (RAPID HCV) or referral to offsite specialist care. Randomization was computer generated with concealed allocation. Following randomization, participants underwent clinical eligibility assessment for glecaprevir/pibrentasvir. The primary outcome was HCV treatment initiation within 12 weeks among treatment eligible participants (modified intention-to-treat [mITT]). The trial is registered at <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> (<span><span>NCT04677153</span><svg><path></path></svg></span>).</div></div><div><h3>Findings</h3><div>Between August 2021, and November 2023, 182 participants were randomized; 58 were ineligible for treatment and two were administratively excluded, yielding 122 in the mITT population. Median age was 49 years (IQR 38–58), 73 (60%) were male, and 85 (70%) had an illicit substance detected in urine at baseline. Treatment initiation occurred in 59 of 66 (89% [95% Confidence Interval 79–95]) RAPID HCV participants compared with 12 of 56 (21% [95% CI 13–34]) referred participants (p &lt; 0.001). No serious adverse events related to study procedures or HCV treatment were observed.</div></div><div><h3>Interpretation</h3><div>Onsite HCV test and treat with peer support delivered by OTP staff significantly increased HCV treatment initiation compared with offsite referral. Integrating HCV care into OTPs is an effective strategy to advance HCV elimination among PWUD.</div></div><div><h3>Funding</h3><div><span>AbbVie</span>.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"57 ","pages":"Article 101439"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measles, mistrust, and missed protection in the Americas","authors":"The Lancet Regional Health – Americas","doi":"10.1016/j.lana.2026.101504","DOIUrl":"10.1016/j.lana.2026.101504","url":null,"abstract":"","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"57 ","pages":"Article 101504"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden of disease and life expectancy decomposition in Brazil and its federated units, 1990–2023: an analysis based on the global burden of disease study 2023","authors":"","doi":"10.1016/j.lana.2026.101441","DOIUrl":"10.1016/j.lana.2026.101441","url":null,"abstract":"<div><h3>Background</h3><div>Understanding mortality, morbidity, and life expectancy (LE) patterns in Brazil subsidies public health decisions. We analysed changes in the burden of disease from 1990 to 2023 and investigated the impact of the COVID-19 pandemic throughout Brazil and its federated units (FUs).</div></div><div><h3>Methods</h3><div>We estimated all-cause and cause-specific mortality, morbidity, risk factors, and LE from 1990 to 2023, for Brazil and its 27 FUs. To compare estimates before (1990–2019), during (2019–2021), and after (2021–2023) the COVID-19 pandemic.</div></div><div><h3>Findings</h3><div>All-cause age-standardised mortality and disability-adjusted life-year (DALY) rates reduced from 1990 to 2023 (−34.5% [95% uncertainty interval −35.3 to −33.8] and −29.5% [−32.3 to −26.9]), respectively. This reduction reversed between 2019 and 2021 with an increase in all-cause age-standardised mortality (27.6% [26.7, 28.6]) and DALY (18.3% [16.3, 20.5]) rates. The magnitude of changes in these rates varied largely within Brazil. During the pandemic, most of the FUs had an increase in mortality of over 20%. In 2023, total all-cause age-standardised mortality rates returned to the level observed before the pandemic. In 2019, the main underlying causes of death were ischaemic heart disease, stroke and lower respiratory infection. In 2021, the leading cause of deaths and DALY shifted to COVID-19. In 2023, the main causes returned to the 2019 ranking. LE increased 7.01 years from 1990 to 2019, but decreased 3.4 years in the pandemic period, resulting in 7.18 years of increment from 1990 to 2023.</div></div><div><h3>Interpretation</h3><div>The pattern of LE increase and reductions in the leading causes of death from 1990 to 2019, was disrupted by the COVID-19 pandemic. The adverse effects of this health crisis on the burden of disease and LE were heterogeneous within the country. These findings reveal the strength and resilience of the public health system, but reinforces the need to focus on equity and preparedness for future health emergencies.</div></div><div><h3>Funding</h3><div>Gates Foundation and the Brazilian Ministry of Health. TED 67/2023. Health and Environment Surveillance Secretariat, Ministry of Health, Brazil.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"57 ","pages":"Article 101441"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The association between 10-year cardiovascular risk and fracture incidence in postmenopausal women: a prospective analysis from the Women's Health Initiative","authors":"Rafeka Hossain ,&nbsp;Deepika Laddu ,&nbsp;Carolyn J. Crandall ,&nbsp;Kristine E. Ensrud ,&nbsp;Jane A. Cauley ,&nbsp;Kelley Pettee Gabriel ,&nbsp;Bernhard Haring ,&nbsp;Shakia T. Hardy ,&nbsp;Meryl S. LeBoff ,&nbsp;JoAnn E. Manson ,&nbsp;Ann V. Schwartz ,&nbsp;Aladdin H. Shadyab ,&nbsp;Nelson B. Watts ,&nbsp;Nicole C. Wright","doi":"10.1016/j.lana.2026.101440","DOIUrl":"10.1016/j.lana.2026.101440","url":null,"abstract":"<div><h3>Background</h3><div>Cardiovascular disease (CVD) and fractures share pathophysiological mechanisms, yet the relationship between predicted CVD risk and fracture incidence remains unexplored. Using the PREventing cardiovascular disease eVENTs (PREVENT) score, this study aimed to determine the association between CVD risk and incident fractures in postmenopausal women.</div></div><div><h3>Methods</h3><div>This study included 21,300 participants from the Women's Health Initiative (WHI) (1993–2024). PREVENT 10-year CVD risk was categorized as low (&lt;5·0%), borderline (5·0%–7·4%), intermediate (7·5%–19·9%), or high (≥20·0%). Cox proportional hazards models estimated adjusted hazard ratios [HR (95% CI)] for incident fractures, including any clinical, major osteoporotic fracture (MOF), and hip fracture.</div></div><div><h3>Findings</h3><div>In the sample [mean (SD) age: 63·7 (7·3) years], 9224 (43·3%) experienced any clinical fracture, 4997 (23·5%) MOF, and 1717 (8·1%) hip fractures. Overall, 5370 (25·2%) had low, 4169 (19·6%) borderline, 10,661 (50·1%) intermediate, and 1100 (5·2%) high CVD risk. In fully adjusted models, compared with low-CVD risk, higher risk of MOF was observed in the intermediate- [1·14 (1·04–1·24)] and high- [1·22 (1·07–1·40)] CVD risk groups; and higher risk of hip fracture [intermediate: 1·33 (1·14–1·56); high: 1·93 (1·55–2·42)]. Associations attenuated after accounting for the competing risk of mortality, but higher CVD risk remained associated with higher fracture risk.</div></div><div><h3>Interpretation</h3><div>A higher 10-year predicted CVD risk was associated with higher MOF and hip fracture risk after adjustment for sociodemographic, lifestyle, and clinical factors. CVD risk may have implications for fracture risk assessment in postmenopausal women.</div></div><div><h3>Funding</h3><div>WHI is funded by the US National Heart, Lung, and Blood Institute. No additional funding was received for this study.</div></div>","PeriodicalId":29783,"journal":{"name":"Lancet Regional Health-Americas","volume":"57 ","pages":"Article 101440"},"PeriodicalIF":7.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147945374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}