Global Heart最新文献

{"title":"Heart Failure with Preserved Ejection Fraction in Egypt: An Expert Opinion.","authors":"Magdy Abdelhamid, Amr Zaki Salem, Hamza Kabil, Hany Ragy, Hosam Hasan-Ali, Mohamed Elnoamany, Mohamed Elsetiha, Sameh Shaheen","doi":"10.5334/gh.1411","DOIUrl":"10.5334/gh.1411","url":null,"abstract":"<p><p>Heart failure with preserved ejection fraction (HFpEF) is an ongoing challenge for healthcare systems. Major limitations that hinder adequate control of the disease, including an incomplete understanding of its pathophysiology, limited therapy options, and the absence of sufficient information on the management of comorbidities. Diagnosis and management of HFpEF in Egypt lack standardization as they are complicated with multiple comorbidities and limited by the lack of resources and data on epidemiology and patient characteristics. Diagnostic procedures for HFpEF should be implemented through guideline-specified scoring systems, due to the heterogeneity of clinical presentations and the absence of a golden standard for confirming HFpEF. In Egypt, the H₂FPEF scoring system is more commonly used for establishing HFpEF diagnosis. All HFpEF patients should be treated through multidrug regimens tailored for their state, symptoms, and comorbidities, with sodium-glucose cotransporter-2 (SGLT2) inhibitors as the mainstay of treatment together with either one or a combination of loop diuretic and aldosterone antagonists. This paper provides an integrated review of epidemiology, means of diagnosis, current and novel pharmacological therapy options for HFpEF patients in the light of the recent advances in treatment of HFpEF, discussing means of healthcare delivery and unmet needs, and proposing recommendations for clinical practice and pathways for future research.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"31"},"PeriodicalIF":3.0,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927671/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dyskalemia Prior to and After Initiation of a Fixed Dose Combination of Telmisartan and Amlodipine in Adults with Hypertension in Bangladesh.","authors":"Junichi Ishigami, Md Mahmudul Hasan, Aruna Sarker, Sharmin Nahar, Sibly Sadik Shuvo, Mir Ishraquzzaman, Mohammad Abdullah Al Mamun, Md Kalimuddin, Sheikh Mohammad Mahbubus Sobhan, Di Zhao, Kunihiro Matsushita, Lawrence J Appel, Sohel Reza Choudhury, Edgar R Miller, Fazila-Tun-Nesa Malik","doi":"10.5334/gh.1415","DOIUrl":"10.5334/gh.1415","url":null,"abstract":"<p><strong>Background: </strong>The World Health Organization recommends fixed-dose combination (FDC) pills for treating hypertension. Antihypertensive FDC pills often contain a renin-angiotensin inhibitor (RASI) or diuretic. Thus, screening and monitoring for dyskalemia (hypokalemia or hyperkalemia) before and after starting these classes of medications are recommended, a significant barrier for implementation in resource-limited settings. However, the need for blood tests may be overemphasized if the prevalence of dyskalemia in patients with hypertension is uncommon and the incidence of dyskalemia is rare after initiation of FDC.</p><p><strong>Methods: </strong>We conducted a community-based blood pressure (BP) screening program in Dhaka, Bangladesh, and determined the prevalence of dyskalemia, as defined by K < 3.0 or K > 5.5 mmol/L, in untreated adults with SBP ≥140 mmHg and/or DBP ≥90 mmHg. Among those with a baseline serum K of ≥3.0 or ≤5.0 mmol/L and creatinine clearance ≥30 ml/min, we determined the incidence of dyskalemia 2 months after initiation of a daily FDC of telmisartan 40 mg and amlodipine 5 mg. Secondary outcomes were BP change, medication adherence, and symptoms.</p><p><strong>Results: </strong>In 2022-2023, we recruited 1,073 adults with SBP ≥140 mmHg and/or DBP ≥90 mmHg. The mean age was 54 years, with 71% men and mean baseline BP 157/94 (SD 12/9.3) mmHg. The prevalence of hypokalemia and hyperkalemia was 1.6% and 0.2%, respectively. FDC was initiated in 1,017 eligible patients, and 864 completed the 2-month follow-up visit. Incident hypokalemia occurred in 1.5% of patients, but there was no case of incident hyperkalemia. The mean change in serum potassium after initiating FDC was -0.05 (0.53) mmol/L. At follow-up, 92% had BP <140/90 mmHg with a mean SBP change of -29.8 mmHg. 1% self-reported mild symptoms (e.g., leg swelling), and there was one death of undetermined cause.</p><p><strong>Conclusions: </strong>Given low prevalence and incidence of hyperkalemia and evident reduction in BP, our study suggests initiating FDC with telmisartan and amlodipine may be a practical and safe option for newly diagnosed hypertension, especially in resource-constrained settings where blood tests cannot be easily obtained.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"30"},"PeriodicalIF":3.0,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927674/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-Reported Prevalence of Chronic Non-Communicable Diseases Concerning Socioeconomic and Educational Factors: Analysis of the PURE-Ecuador Cohort.","authors":"Camilo Felix, Mavel Lopez-Flecher, Michelle Vega, Katherine Andrango, Selena Andrango, Juan Marcos Parise-Vasco, Jaime Angamarca-Iguago, Daniel Simancas-Racines, Patricio Lopez-Jaramillo, Shrikant Bangdiwala, Sumathy Rangarajan, Salim Yusuf","doi":"10.5334/gh.1416","DOIUrl":"https://doi.org/10.5334/gh.1416","url":null,"abstract":"<p><strong>Background: </strong>The changing epidemiological landscape, marked by the increasing prominence of Non-Communicable Chronic Diseases (NCDs), underscores the need for studies that identify and analyze these conditions and their associated risk factors. This secondary analysis aims to describe the association between socioeconomic and educational characteristics and the prevalence of self-reported NCDs among participants in the PURE-Ecuador cohort in urban and rural populations of the Metropolitan District of Quito (MDQ), Ecuador.</p><p><strong>Methods: </strong>This secondary analysis is part of the Prospective Urban Rural Epidemiological (PURE) study. Data were collected from February to December 2018, including 2028 participants aged 35 to 70 years from different urban and rural areas of the MDQ. Data collection utilized standardized questionnaires administered in face-to-face interviews. Pearson's chi-square tests and multivariate logistic regression were used to assess associations.</p><p><strong>Results: </strong>The self-reported prevalence of hypertension was 16.2%, rising to 32.7% in individuals over 60 years old. The prevalence of diabetes mellitus was 6.7%, coronary heart disease 1.3%, stroke 1.6%, heart failure 1.3%, COPD 0.4%, asthma 1.3%, and cancer 1.9%. Multimorbidity affected 5.9% of participants, with the highest rates in obese and older individuals (≥60 years). Adherence to medications was high for hypertension and diabetes mellitus but varied substantially between communities.</p><p><strong>Conclusions: </strong>The secondary analysis revealed significant disparities in the prevalence and management of NCDs in MDQ. The prevalence of self-reported NCDs in Quito, Ecuador, is significantly associated with age and body mass index (BMI). Older individuals, particularly those over 60 years, and obese participants demonstrated higher rates of NCDs and multimorbidity. While socioeconomic factors such as education and income showed some associations with NCD prevalence, these were less pronounced after adjusting for other variables. These findings highlight the importance of age-specific and obesity-focused interventions in addressing the burden of NCDs in this population.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"29"},"PeriodicalIF":3.0,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908430/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652114","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Burden and Predictors of Statin Use for Primary and Secondary Prevention of Cardiovascular Disease in Bangladesh: Evidence from a Nationally Representative Survey.","authors":"Shehab Uddin Al Abid, Md Mostafa Monower, Ahmad K Abrar, Jannat A Riva, Mahfuzur Rahman Bhuiyan, Mohammad Abdullah Al-Mamun, Sohel Reza Choudhury","doi":"10.5334/gh.1412","DOIUrl":"https://doi.org/10.5334/gh.1412","url":null,"abstract":"<p><strong>Background: </strong>Large-scale randomized trials have established the efficacy and safety of statin therapy in preventing cardiovascular diseases (CVDs) among individuals at increased risk (i.e., primary prevention) or those with pre-existing cardiovascular disease (i.e., secondary prevention). Consequently, recent international guidelines, including those from the WHO and ACC/AHA, have expanded the eligibility criteria for statin therapy.</p><p><strong>Objective: </strong>To assess the current burden of statin-eligible populations in Bangladesh, evaluate the current state of statin use, and identify factors associated with non-use of statins.</p><p><strong>Methods: </strong>We analysed data from 3,140 adults aged 40 to 69 years from the nationally representative WHO-STEPS Bangladesh 2018 survey. Statin therapy eligibility for primary prevention was assessed using the WHO-2019 and the ACC/AHA-2018 guidelines separately. Individuals with a previous history of CVD were eligible for secondary prevention under both guidelines. Modified Poisson regression models identified factors associated with statin use. All analyses were conducted using appropriate survey weights.</p><p><strong>Findings: </strong>Among the participants, 443 (14.1%) reported a previous history of CVD. Of those without CVD, 11.2% (95% CI: 9.7-12.9) and 32.3% (95% CI: 30.0-34.6) were eligible for statin use for primary prevention according to the WHO-2019 and the ACC/AHA-2018 guidelines, respectively. Among adults eligible according to WHO-2019 guideline, 6.9% (95% CI: 4.1-11.5) were using statins, while among those eligible according to ACC/AHA-2018 guideline, 3.3% (95% CI: 2.1-5.1) were using statins. For secondary prevention, 23.5% (95% CI: 16.9-31.6) of adults with prior CVD were using statins. Non-use was higher among younger adults, those without regular health visits or cholesterol measurements, and those from the Mymensingh or Rajshahi divisions.</p><p><strong>Interpretation: </strong>In Bangladesh, approximately one in twenty eligible individuals uses statins for primary prevention of CVD, and one in five individuals for secondary prevention. Appropriate population health interventions are needed to scale up statin use to mitigate the burden of CVD.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"28"},"PeriodicalIF":3.0,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex Differences in Acute Coronary Syndromes: A Scoping Review Across the Care Continuum.","authors":"Anna Marzà-Florensa, Pauline Kiss, Dina Mohamed Youssef, Sara Jalali-Farahani, Fernando Lanas, Mariachiara di Cesare, José Ramón González Juanatey, Sean Taylor, Alicia Uijl, Diederick E Grobbee, Sarah Des Rosiers, Pablo Perel, Sanne A E Peters","doi":"10.5334/gh.1410","DOIUrl":"https://doi.org/10.5334/gh.1410","url":null,"abstract":"<p><strong>Introduction: </strong>Optimal diagnosis and management of acute coronary syndrome (ACS) is essential to improve clinical outcomes and prognosis. Sex disparities in ACS care have been reported in the literature, but evidence gaps remain. This review aims to map and to summarize the global evidence on sex differences in the provision of care across the ACS continuum.</p><p><strong>Methods: </strong>A systematic literature search was conducted in Pubmed, EMBASE, and the World Health Organization Global Index Medicus. The search was restricted to original research articles published between January 1, 2013, and August 30^th, 2023, and with a full-text available in English, Spanish, Dutch, or French. The search terms and key words covered five aspects of the ACS care continuum: pre-hospital care, diagnosis, treatment, in-hospital events, and discharge.</p><p><strong>Results: </strong>Of the 15,033 identified articles, 446 articles (median percentage of women per study: 29%), reporting on 1,483 outcomes, were included. Most studies were conducted in high-income regions (65%). Studies reported on pre-hospital care (8%), diagnosis (9%), treatment (45%), discharge (14%) and events (24%). For 45% of outcomes, results favored men, 5% favored women, and 50% showed mixed results or no sex difference. ACS care aspects with the largest sex differences were pre-hospital care (58% of the outcomes favored men vs 7% favored women) and diagnosis (70% favored men vs 2% favored women).</p><p><strong>Conclusion: </strong>Studies on sex differences in ACS mainly come from high-income regions. Sex differences in ACS management are widely reported and mainly unfavorable to women, especially in the early phases of pre-hospital care and diagnosis.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"26"},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Characterization of 2,500 Patients with Heart Failure and Analysis of Their Optimal Medical Therapy: Insights from the AMERICCAASS Registry.","authors":"Alex David Sotomayor-Julio, Sebastián Seni-Molina, Juliana María Gutiérrez-Posso, Juan Andrés Muñoz-Ordoñez, Valeria Azcárate-Rodríguez, Hoover O León-Giraldo, Eduardo R Perna, Víctor Rossel, Daniel Quesada-Chaves, Mario Speranza, Mark H Drazner, Walter Alarco, Alexander Romero-Guerra, Gabriel Frago, Daniela García Brasca, Álvaro Mauricio Quintero-Ossa, Javier Galeano Figueredo, Milton Lubeck Herrera, Antonella A Ferrer, Ruddy Miguel García-Safadit, Freddy Pow-Chon-Long, Felix Nunura Arrese, Kwame van der Hilst, Silvia Carolina Lazo-Majano, Elisabeth Ashley Hardin, Orlando David Fernández-Flores, Gabriela Ormaechea-Gorricho, Luis Felipe Anhuaman-Atoche, Annia María Carrero-Vásquez, Andrés Ulate Retana, Pablo Hurtado Nuñez, Emilio Samael Peralta-López, Juan Esteban Gómez-Mesa","doi":"10.5334/gh.1418","DOIUrl":"https://doi.org/10.5334/gh.1418","url":null,"abstract":"<p><strong>Introduction: </strong>Heart failure (HF) is a leading cause of hospitalization and mortality worldwide, emphasizing the critical role of optimal medical therapy (OMT) in improving patient outcomes. Despite extensive research, most scientific evidence regarding HF is gathered and studied in developed countries, leaving substantial knowledge gaps regarding HF in Latin America and the Caribbean.</p><p><strong>Objective: </strong>To characterize the sociodemographic and clinical profiles of HF patients and to assess their adherence to OMT in the Americas.</p><p><strong>Methods: </strong>The AMERICCAASS Registry is a prospective, observational, multicenter study, including patients aged 18 and older, both hospitalized and ambulatory, and diagnosed with HF. Sociodemographic and clinical data were collected from the first 2,500 patients to characterize the study population. Adherence to OMT was subsequently evaluated according to left ventricular ejection fraction (LVEF).</p><p><strong>Results: </strong>Among the 2,500 patients in the study, 36% were hospitalized and 64% were ambulatory. The median ages of the patients were 66.9 (hospitalized) and 66.3 years (ambulatory). Males made up 60.8% of hospitalized and 59.3% of ambulatory patients. The majority had HF with reduced LVEF (≤40%): 60.7% for hospitalized and 58.5% for ambulatory. The New York Heart Association (NYHA) functional class II predominated among ambulatory patients (67.9%), while NYHA functional class III predominated among hospitalized patients (46.6%). Only 21% of patients with reduced LVEF were receiving quadruple therapy, whereas 12.3% of patients with mildly reduced LVEF (41-49%) were on this treatment.</p><p><strong>Conclusion: </strong>The findings demonstrate that the sociodemographic and clinical profiles of HF patients in the Americas are broadly consistent with international reports. However, the low use of OMT observed in this population underscores gaps in adherence to current guidelines. These results highlight the need for targeted strategies to improve pharmacological treatment adherence to optimize health outcomes in this region.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"27"},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908427/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic Risk Clusters and Their Reproductive Correlates: A Latent Class Analysis of Indian Women.","authors":"Wilhemina Quarpong, Suchitra Chandrasekaran, K M Venkat Narayan, Usha Ramakrishnan, Nikhil Tandon, Shivani A Patel","doi":"10.5334/gh.1408","DOIUrl":"https://doi.org/10.5334/gh.1408","url":null,"abstract":"<p><strong>Background: </strong>Cardiometabolic conditions are rising among women in low- and middle-income countries and appearing at younger ages. The role of female reproductive characteristics in cardiometabolic risk is not well understood.</p><p><strong>Methods: </strong>We analyzed seven reproductive characteristics and seven cardiometabolic indicators obtained from 644,191 non-pregnant women aged 15-49 years in the 2019-2021 India National Family and Health Survey (NFHS-5). We conducted a latent class analysis of cardiometabolic indicators (systolic and diastolic blood pressure, random blood glucose, body mass index, waist circumference, and use of anti-hyperglycemic and antihypertensive pharmacotherapy) to identify risk clusters. Multinomial logistic regression models accounting for age and sociodemographic characteristics assessed associations between reproductive characteristics (age at menarche, age at first birth, natural or surgical menopause, parity, time since last birth, experience of pregnancy loss, current contraceptive use) and cluster membership.</p><p><strong>Results: </strong>Women had a median age of 29.4 (IQR: 21.5-38.4) years, were mostly married (71%), and resided in rural areas (68%). Five cardiometabolic clusters emerged: normal (36%), high-normal (46%), isolated-overweight (12%), hypertension-overweight (6%), and glucose dysregulation-overweight (1%). Early menarche (<13 years), early age at first birth (<20 years), and natural or surgical menopause were positively associated with two or more high-risk clusters (ORs: 1.13-1.62). Higher parity was associated with higher relative odds of isolated-overweight (ORs: 1.31-1.39), while longer time since last birth (≥ 8 years) was associated with hypertension-overweight (OR: 1.25 95% CI: 1.18-1.31) and glucose dysregulation-overweight (OR: 1.21, 95% CI: 1.07-1.37). Pregnancy loss increased the odds of all high-risk clusters (ORs: 1.21-1.42), while contraceptive use decreased the odds (ORs: 0.88-0.93).</p><p><strong>Conclusions: </strong>Five cardiometabolic risk clusters were identified in Indian women, with cluster membership linked to reproductive characteristics. The timing of fertility milestones and reproductive history appear relevant for early risk stratification among women in early to middle adulthood.</p><p><strong>Key messages: </strong>Indian women aged 15-49 years exhibited 5 distinct patterns of cardiometabolic risk clustering: normal, high-normal, isolated-overweight, hypertension-overweight, and glucose dysregulation-overweight clusters.Early age at menarche (<13 years), early age at first birth (<20 years), natural or surgical menopause, higher parity, longer time since last birth, and pregnancy losses were associated with at least one of the high-risk cardiometabolic clusters.Reproductive history and the timing of reproductive milestones may improve early disease risk stratification in Indian women.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"25"},"PeriodicalIF":3.0,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908431/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652089","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Rheumatic Heart Disease in First-Degree Relatives of Index-Cases: A Systematic Review and Meta-Analysis.","authors":"Antonio Mutarelli, Guilherme Paes Gonçalves Nogueira, Alexandre Negrao Pantaleao, Alleh Nogueira, Bruna Giavina-Bianchi, Isabella M Gonzalez Fonseca, Bruno R Nascimento, Walderez O Dutra, Robert A Levine, Maria C P Nunes","doi":"10.5334/gh.1417","DOIUrl":"https://doi.org/10.5334/gh.1417","url":null,"abstract":"<p><strong>Background: </strong>Rheumatic heart disease (RHD) is the leading cause of cardiac death in children, with over 300,000 annual fatalities. Immunological, genetic, and environmental factors contribute to an increased risk of RHD. It remains unclear whether first-degree relatives have a higher prevalence of RHD compared to the general population in the same region.</p><p><strong>Methods: </strong>We performed a systematic review and meta-analysis of echocardiographic screening studies reporting the prevalence of RHD in family members of individuals with RHD or acute rheumatic fever. PubMed, Embase, Cochrane, and Lilacs databases were searched. RHD was classified as per the 2012 World Heart Federation criteria. Random-effects models assessed definite RHD prevalence in study groups.</p><p><strong>Results: </strong>Four of the 1,160 studies were included, with 776 first-degree relatives screened. Two studies were from Africa, one from South America, and one from Oceania. In the first-degree relatives of index cases, the prevalence of RHD was 7% (95% confidence interval [CI] 3.7-13). The control group, individuals screened with no known RHD cases in their family, had a lower prevalence than first-degree relatives (risk ratio [RR] 0.44, 95% CI 0.26-0.75). There was no difference in the prevalence of RHD among siblings and parents of cases.</p><p><strong>Conclusion: </strong>There is an overall prevalence of non-relatives from the respective region, which suggests that genetic predisposition may play a role. In future studies of RHD, the systematic screening of first-degree relatives should be considered with a better control group-socioeconomic, region, age, and sex-matched.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"24"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908434/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652111","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Familial Hypercholesterolemia in Pakistan: A Pooled Analysis of 1.5 Million Individuals and Comparison with Other Countries of the Region.","authors":"Madeeha Khan, Quratul Ain, Jaka Sikonja, Hijab Batool, Muhammad Qasim Hayat, Mohammad Iqbal Khan, Urh Groselj, Fouzia Sadiq","doi":"10.5334/gh.1413","DOIUrl":"https://doi.org/10.5334/gh.1413","url":null,"abstract":"<p><strong>Background: </strong>Familial hypercholesterolemia (FH) is an inherited disorder that causes elevated LDL-C levels leading to premature cardiovascular disease but remains underdiagnosed. This study aims to determine the prevalence of FH in Pakistan using data from multiple laboratory networks and compare it with other counties of the region.</p><p><strong>Methods: </strong>The study analyzed lipid profile data from two large laboratory networks in Pakistan, applying Make Early Diagnosis to Prevent Early Death (MEDPED) LDL-C criteria for the general population to identify FH cases. A pooled prevalence estimate of prevalence of FH in Pakistan was calculated by combining the data of studies reporting prevalence in Pakistan. A systematic review was conducted to assess FH prevalence in South and Southeast Asian countries.</p><p><strong>Results: </strong>Analysis of 545,087 individuals (Median age 45 years, 58.2% males) identified 2,911 FH cases [0.55%, 95% confidence interval (CI): 0.53-0.57%), equivalent to a prevalence of 1:182. Pooled analysis with a previous Pakistani study, totaling 1,533,393 subjects, estimated the overall FH prevalence in Pakistan at 1:273 (95% CI: 0.21-0.64%). Prevalence decreased with age, being highest in the <20 years group (1:29), while no gender differences were observed. A systematic review of South and Southeast Asian countries revealed limited data, with FH prevalence estimates missing for majority of the countries of the region.</p><p><strong>Conclusion: </strong>This study provides an updated estimate of FH prevalence in Pakistan and highlights the scarcity of data in South and Southeast Asia.</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"23"},"PeriodicalIF":3.0,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11908433/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143652108","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Cooking with Polluting Fuels and Association with Elevated Blood Pressure Among Adults in Port au Prince, Haiti: A Cross-Sectional Analysis.","authors":"Rehana Rasul, Rodney Sufra, Marie Christine Jean Pierre, Reichling St Sauveur, Vanessa Rouzier, Joseph Inddy, Erline Hilaire, Fabiola Preval, Lily D Yan, Nour Mourra, Anju Ogyu, Daniella M Pierre, Jean William Pape, Denis Nash, Margaret L McNairy","doi":"10.5334/gh.1405","DOIUrl":"10.5334/gh.1405","url":null,"abstract":"<p><strong>Background: </strong>Cooking with polluting fuels is common in low- and middle-income countries and may impact blood pressure, yet data on this association in urban Haiti is limited. This study describes the prevalence of polluting fuel use and indoor cooking, evaluates their associations with blood pressure, and evaluates whether effects are heterogeneous by sex in urban Haiti.</p><p><strong>Methods: </strong>Using cross-sectional data from the Haiti Cardiovascular Disease Cohort study, prevalence of polluting fuel use and indoor cooking was estimated. The associations between polluting fuel use and indoor cooking with systolic blood pressure (SBP), diastolic blood pressure (DBP) and hypertension (HTN) (mean SBP ≥140 mmHg or mean DBP ≥90 mmHg) were estimated using generalized estimating equations. The interaction between polluting fuel use and sex was also evaluated.</p><p><strong>Results: </strong>Among 2,931 participants, 58.2% were female and the mean age was 42.0 (SD = 15.9) years. The majority (88.2%) primarily cooked with polluting fuels. Polluting vs clean fuel users tended to have less than a high school education (38.0% vs 22.8%), earn ≤ 1 USD/day (70.5% vs 67.4%), and have high food insecurity (85.0% vs 64.3%). Polluting vs clean fuel users had similar HTN prevalence (adjusted prevalence ratio [aPR] = 0.94, 95% CI: 0.80, 1.10). Average SBP was similar for women (0.99 mmHg, 95% CI: -1.46, 3.44) and lower for men (-4.80 mmHg, 95% CI: -8.24, -1.37) who used polluting vs clean fuels. Cooking indoors vs outdoors was associated with higher HTN prevalence (aPR = 1.12, 95% CI: 1.00, 1.25) and higher average SBP (1.67 mmHg, 95% CI: 0.15, 3.20).</p><p><strong>Conclusions: </strong>This study demonstrates that most Haitians in Port-au-Prince cook with polluting fuels and often indoors. Those with higher poverty are more exposed, with mixed results in their association with blood pressure. Longitudinal studies are needed to clarify causal relationships and inform interventions promoting clean fuel use. (ClinicalTrials.gov Identifier: NCT03892265).</p>","PeriodicalId":56018,"journal":{"name":"Global Heart","volume":"20 1","pages":"22"},"PeriodicalIF":3.0,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869832/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544632","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}