American journal of preventive cardiology最新文献

{"title":"Optimizing cardiometabolic risk in people living with human immunodeficiency virus: A deep dive into an important risk enhancer","authors":"Elizabeth A. Kobe ,&nbsp;Aarti Thakkar ,&nbsp;Sarina Matai ,&nbsp;Esra Akkaya ,&nbsp;Neha J. Pagidipati ,&nbsp;Robert W. McGarrah ,&nbsp;Gerald S. Bloomfield ,&nbsp;Nishant P. Shah","doi":"10.1016/j.ajpc.2024.100888","DOIUrl":"10.1016/j.ajpc.2024.100888","url":null,"abstract":"<div><div>Effective antiretroviral therapy (ART) is now nearly ubiquitous. However, the survival benefits conferred with ART contribute to an aging human immunodeficiency virus (HIV) population and increased risk of chronic diseases, like atherosclerotic cardiovascular disease (ASCVD). Furthermore, HIV is a known risk enhancer of ASCVD and acknowledged as such in the current 2018 AHA/ACC Blood Cholesterol guidelines [1]. This makes cardiovascular risk factor identification and modification among people living with HIV (PLWH) of increasing importance to prevent cardiovascular events. In this review, we aim to summarize the epidemiology and pathogenesis of how HIV is linked to atherogenesis and to discuss cardiometabolic risk factor modification specific to PLWH, covering obesity, hypertension, insulin resistance, metabolic dysfunction-associated steatotic liver disease, and dyslipidemia.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100888"},"PeriodicalIF":4.3,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142571495","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":"Cardiodiabesity: Epidemiology, resource and economic impact","authors":"Duy Do,&nbsp;Tiffany Lee,&nbsp;Calie Santana,&nbsp;Angela Inneh,&nbsp;Urvashi Patel","doi":"10.1016/j.ajpc.2024.100887","DOIUrl":"10.1016/j.ajpc.2024.100887","url":null,"abstract":"<div><h3>Objective</h3><div>To assess i) the epidemiology of cardiodiabesity, ii) its association with healthcare resource utilization and cost of care, as well as iii) provide recommendations for its management.</div></div><div><h3>Methods</h3><div>A cohort study of insured adults with early-stage and/or active cardiodiabesity from January 2019 to December 2021 identified through a longitudinal, and de-identified medical and pharmacy claims database was conducted. All patients were followed for one year through December 2022. Conditions include cardiovascular disease, prediabetes, Type 2 diabetes (T2D), chronic kidney disease (CKD), overweight and/or obesity. Rates of progression from early-stage cardiodiabesity to active cardiodiabesity and/or advanced cardiodiabesity with complications; frequency of emergency department, inpatient and outpatient visits; as well as total cost of care over one year were analyzed.</div></div><div><h3>Results</h3><div>A total of 3,273,813 and 1,628,407 patients had at least one of the comorbid conditions for early-stage and active cardiodiabesity, respectively. Among those with all early-stage cardiodiabesity conditions, 27.4 % progressed to active cardiodiabesity, while 88.4 % of those with all active cardiodiabesity conditions progressed to complications within one year. Predictors of progression from early-stage to active cardiodiabesity were hypertension (OR: 2.31, 95 % CI: 2.29–2.33, <em>p</em> &lt; 0.001), hyperlipidemia (OR: 1.77, 95 % CI: 1.76–1.79, <em>p</em> &lt; 0.001), CKD stages 1 and 2 (OR: 1.74, 95 % CI: 1.69–1.79, <em>p</em> &lt; 0.001), prediabetes (OR: 1.64, 95 % CI: 1.63–1.66, <em>p</em> &lt; 0.001) and living in areas with very high social needs (OR: 1.25, 95 % CI: 1.23–1.26, <em>p</em> &lt; 0.001). Significant predictors of progression from active cardiodiabesity to complications were T2D (OR: 1.88, 95 % CI: 1.81–1.96, <em>p</em> &lt; 0.001), CVD (OR: 1.47, 95 % CI: 1.44–1.51, <em>p</em> &lt; 0.001), CKD stages 3 and 4 (OR: 1.37, 95 % CI: 1.34–1.41, <em>p</em> &lt; 0.001) and obesity (OR: 1.29, 95 % CI: 1.26–1.32, <em>p</em> &lt; 0.001). Average total cost of care increased significantly among those who progressed from one disease phase to the next (p &lt; 0.05).</div></div><div><h3>Conclusions</h3><div>Cardiodiabesity is deadly and rapidly progressive with substantial economic burden on the healthcare system. However, it is preventable. Innovative approaches to better understand the holistic impact of cardiodiabesity on total cost of care, early intervention or management to halt disease progression and promote equity, as well as decrease resource utilization are needed.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100887"},"PeriodicalIF":4.3,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662458","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":"Lipoprotein (a) testing patterns among subjects with a measured lipid panel: The Mayo Clinic experience","authors":"Matteo Manzato ,&nbsp;Jeffery W. Meeusen ,&nbsp;Leslie J. Donato ,&nbsp;Allan S. Jaffe ,&nbsp;Vlad C. Vasile","doi":"10.1016/j.ajpc.2024.100886","DOIUrl":"10.1016/j.ajpc.2024.100886","url":null,"abstract":"<div><h3>Objective</h3><div>Lipoprotein(a) [Lp(a)] has been associated with Atherosclerotic Cardiovascular Disease (ASCVD). Approximately 20 % of the population has elevated Lp(a). Despite its well-recognized role in ASCVD, universal screening remains controversial. The aim of our study is to investigate laboratory testing patterns for Lp(a) in subjects screened with a standard lipid panel at a large tertiary referring US institution.</div></div><div><h3>Methods</h3><div>Data were retrospectively collected at Mayo Clinic from the Mayo Data Explorer (MDE). Subjects were included if they had a lipid panel measured between May 1, 2022, and April 30, 2023. Demographic data, Lp(a) measurements, statins and aspirin prescription and ASCVD events which occurred at any time in the life of a subject were recorded along with respective dates. The cumulative number of Lp(a) laboratory test orders were also tallied from 1994 to 2023 independently of the lipid panel requests.</div></div><div><h3>Results</h3><div>Between May 1, 2022, and April 30, 2023, 257,225 subjects had a lipid panel ordered. Of these, only 386 (0.15 %) had Lp(a) tested within 1 year of the lipid panel, while 2406 (0.94 %) had Lp(a) tested at any time. Lp(a) was tested more frequently in males (67 %) and in subjects who developed Myocardial Infarction (MI) at any time (12 %). Following Lp(a) results, there was no significant change in statin or aspirin prescription associated with Lp(a) levels. Secondary prevention was the main setting for ordering Lp(a) testing, and there was no change in this trend throughout the years.</div></div><div><h3>Conclusions</h3><div>Testing rates for Lp(a) in the general population are low and the main setting remains secondary prevention. Women are less tested than men. When Lp(a) is found to be elevated, often times there is no change in patient management to mitigate the ASCVD risk.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100886"},"PeriodicalIF":4.3,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529858","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":"Neutrophil-to-High-Density Lipoprotein Ratio (NHR) and Neutrophil-to-Lymphocyte Ratio (NLR) as prognostic biomarkers for incident cardiovascular disease and all-cause mortality: A comparison study","authors":"Shih-Ming Chuang ,&nbsp;Sung-Chen Liu ,&nbsp;Ming-Nan Chien ,&nbsp;Chun-Chuan Lee ,&nbsp;Yuan-Teh Lee ,&nbsp;Kuo-Liong Chien","doi":"10.1016/j.ajpc.2024.100869","DOIUrl":"10.1016/j.ajpc.2024.100869","url":null,"abstract":"<div><div>Cardiovascular diseases (CVD) remain a leading cause of global mortality, with atherosclerosis and inflammation playing pivotal roles in their development. The neutrophil-to-lymphocyte ratio (NLR) and neutrophil-to-HDL cholesterol ratio (NHR) have emerged as potential biomarkers for assessing CVD risk. In this community-based cohort study conducted in Taiwan, involving 3278 participants, we investigated the associations between NHR, NLR, and the risks of CVD and all-cause mortality. Our findings revealed that both NHR and NLR were effective in identifying individuals at high risk for CVD. However, when assessing their joint effect, NHR alone demonstrated a stronger predictive value for CVD prognosis than NLR or the combination of both markers. Furthermore, NLR alone showed potential as a predictor of all-cause mortality when compared with NHR alone or in combination with NLR and NHR. These findings underscore the complex interplay between inflammation and lipid metabolism in the pathogenesis of CVD. While NHR shows promise as a cost-effective tool for CVD risk assessment, NLR emerges potential as a prognostic marker for mortality. Further research is warranted to explore the dynamic changes in these markers and their implications for clinical practice.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100869"},"PeriodicalIF":4.3,"publicationDate":"2024-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529860","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":"Genetic risk score for coronary artery calcification and its predictive ability for coronary artery disease","authors":"Pashupati P. Mishra ,&nbsp;Binisha H. Mishra ,&nbsp;Leo-Pekka Lyytikäinen ,&nbsp;Sirkka Goebeler ,&nbsp;Mika Martiskainen ,&nbsp;Emma Hakamaa ,&nbsp;Marcus E. Kleber ,&nbsp;Graciela E. Delgado ,&nbsp;Winfried März ,&nbsp;Mika Kähönen ,&nbsp;Pekka J. Karhunen ,&nbsp;Terho Lehtimäki","doi":"10.1016/j.ajpc.2024.100884","DOIUrl":"10.1016/j.ajpc.2024.100884","url":null,"abstract":"<div><h3>Aim</h3><div>The modest added predictive value of the existing genetic risk scores (GRSs) for coronary artery disease (CAD) could be partly due to missing genetic components, hidden in the genetic architecture of intermediate phenotypes such as coronary artery calcification (CAC). In this study, we investigated the predictive ability of CAC GRS for CAD.</div></div><div><h3>Materials and methods</h3><div>We investigated the association of CAC GRSs with CAD and coronary calcification among the participants in the Ludwigshafen Risk and Cardiovascular Health study (LURIC) (<em>n</em> = 2742), the Tampere Vascular Study (TVS) (<em>n</em> = 133), and the Tampere Sudden Death Study (TSDS) (<em>n</em> = 660) using summary data from the largest multi-ancestry GWAS meta-analysis of CAC to date. Added predictive value of the CAC GRS over the traditional CVD risk factors as well as metaGRS, a GRS for CAD constructed with 1.7 million genetic variants, was tested with standard train–test machine learning approach using the LURIC data, which had the largest sample size.</div></div><div><h3>Results</h3><div>CAC GRS was significantly associated with CAD in LURIC (OR=1.41, 95 % CI [1.28–1.55]), TVS (OR=1.79, 95 % CI [1.05–3.21]) as well as in TSDS (OR=4.20, 95 % CI [1.74–10.52]). CAC GRS showed strong association with calcification areas in left (OR=1.78, 95 % CI [1.16–2.74]) and right (OR=1.71, 95 % CI [1.98–2.67]) coronary arteries. There was statistically significant added predictive value of the CAC GRS for CAD over the used traditional CVD risk factors (AUC 0.734 vs 0.717, p-value = 0.02). Furthermore, CAC GRS improved the prediction accuracy for CAD when combined with metaGRS.</div></div><div><h3>Conclusions</h3><div>This study showed that CAC GRS is a new risk marker for CAD in three European cohorts, with added predictive value over the traditional CVD risk factors.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100884"},"PeriodicalIF":4.3,"publicationDate":"2024-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142432751","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":"Sex, ethnicity and language differences in statin prescribing in community health center patients","authors":"Tahlia Hodes ,&nbsp;Miguel Marino ,&nbsp;Jorge Kaufmann ,&nbsp;Jennifer A Lucas ,&nbsp;Sophia Giebultowicz ,&nbsp;John Heintzman","doi":"10.1016/j.ajpc.2024.100873","DOIUrl":"10.1016/j.ajpc.2024.100873","url":null,"abstract":"<div><h3>Background</h3><div>Statins have been shown to reduce atherosclerotic cardiovascular disease (ASCVD). In the United States, statins are underutilized, and the literature suggests women and Latine individuals received even fewer prescriptions than men even when eligible. No study has shown how statins are prescribed when looking at language, ethnicity, and considering sex.</div></div><div><h3>Methods</h3><div>Data were analyzed from a multistate EHR network across the US from 2014 to 2020. We included patients aged 40+ that were non-Hispanic White, English speaking Latine, and Spanish speaking Latine and further disaggregated by sex with the aim to examine statin prescription prevalence and rates between groups. GEE logistic and negative binomial regression models were used determine the outcomes adjusted by appropriate covariates.</div></div><div><h3>Results</h3><div>We found compared to non-Hispanic White men, only Spanish speaking Latinos had higher odds of receiving a statin prescription, but once one statin was prescribed, non-Hispanic White women were the only group with higher rates. We found a higher percent of Spanish speaking Latine patients regardless of sex had a statin prescription. Prevalence of having a statin prescription was 59.3 % and 59.7 % for Spanish speaking Latinos and Latinas respectively compared to 55.5 % 57.0 % for non-Hispanic White men and women respectively.</div></div><div><h3>Conclusions</h3><div>Overall, we found ethnicity, language, and sex differences. Clinicians in CHCs play an important role in the process to eliminate the sex gap in preventive health. The attention to statin prescribing in Spanish speaking Latine patients indicates more conscious care is being implemented in these vulnerable populations.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100873"},"PeriodicalIF":4.3,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421452","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":"Associations of adverse childhood experiences with blood pressure among early adolescents in the United States","authors":"Abubakr A.A. Al-shoaibi ,&nbsp;Christopher M. Lee ,&nbsp;Julia H. Raney ,&nbsp;Kyle T. Ganson ,&nbsp;Alexander Testa ,&nbsp;Erin E. Dooley ,&nbsp;Holly C. Gooding ,&nbsp;Kelley Pettee Gabriel ,&nbsp;Fiona C. Baker ,&nbsp;Jason M. Nagata","doi":"10.1016/j.ajpc.2024.100883","DOIUrl":"10.1016/j.ajpc.2024.100883","url":null,"abstract":"<div><div>The associations of adverse childhood experiences (ACEs) with blood pressure in adulthood are inconclusive. Similarly, the association between ACEs and blood pressure earlier in the life course is understudied. This study aims to assess the associations of ACEs with blood pressure among early adolescents. We utilized data collected at baseline (age: 9–10 years) and Year 2 follow-up from 4077 participants in the Adolescent Brain Cognitive Development (ABCD) Study. We used adjusted multiple linear regression models to estimate the associations of ACEs (cumulative score and subtypes) at baseline with systolic blood pressure (SBP) and diastolic blood pressure (DBP) at year 2 of follow-up. Experiencing ≥4 ACEs (compared to 0) was significantly associated with higher SBP (<em>B</em> = 3.31, 95 % CI 0.03, 6.57, <em>p</em> = 0.048). Of the ACEs subtypes, household substance use (<em>B</em> = 2.28, 95 % CI 0.28, 4.28, <em>p</em> = 0.028) and divorce or separation (<em>B</em> = 2.08, 95 % CI 0.01, 4.15, <em>p</em> = 0.048) were both significantly associated with a higher SBP while household mental illness (<em>B</em> = 2.57, 95 % CI 1.32, 3.81, <em>p</em> &lt; 0.001) was significantly associated with a higher DBP. Our findings suggest that exposure to multiple ACEs is associated with higher blood pressure in adolescence.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100883"},"PeriodicalIF":4.3,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529857","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":"2022 CVS Caremark DOAC non-medical switch: Patient ramifications and physician advocacy","authors":"Kushal D. Patel ,&nbsp;Dharmesh Patel ,&nbsp;Hunt Deison ,&nbsp;Ryan Gough","doi":"10.1016/j.ajpc.2024.100870","DOIUrl":"10.1016/j.ajpc.2024.100870","url":null,"abstract":"","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100870"},"PeriodicalIF":4.3,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421451","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":"Deciphering the cardioprotective effects of statins in anthracycline-related cardiac dysfunction: A systematic review and meta-analysis","authors":"Mubashar Karamat ,&nbsp;Bilal Hussain ,&nbsp;Munis Mahboob Ahmed ,&nbsp;Mohammad Hamza ,&nbsp;Junaid Mir ,&nbsp;Ayedh Alamri ,&nbsp;Aimen Shafiq ,&nbsp;Yasar Sattar ,&nbsp;Muhammad Zia Khan ,&nbsp;Harshith Thyagaturu ,&nbsp;Karthik Gonuguntla ,&nbsp;Birjesh D Patel","doi":"10.1016/j.ajpc.2024.100874","DOIUrl":"10.1016/j.ajpc.2024.100874","url":null,"abstract":"<div><h3>Background</h3><div>Cancer induced chronic inflammation and cancer drugs effects on the vascular system can lead to rapidly progressing atherosclerotic burden. Statins drugs are known to reduce atherosclerotic plaque burden and inflammation. We studied outcomes of statins for anthracycline-related cardiac dysfunction (ARCD).</div></div><div><h3>Methods</h3><div>We conducted an online systematic search on PubMed and Embase to identify studies assessing statins' role in alleviating ARCD. We selected 9 studies that had patients with ARCD and use of statins. We primarily focused on outcomes including incidence of heart failure (HF), mean changes in left ventricular ejection fraction (LVEF), end-diastolic volume (LVEDV), and end-systolic volume (LVESV) from baseline. Odds ratios (OR) were calculated using a random effect model in <em>R-statistics.</em></div></div><div><h3>Results</h3><div>Among 9 studies with a total of 2784 patients we noticed a significant reduction in the incidence of HF among patients administered statins, with an OR of 0.52 (95 % CI 0.37-0.74, p &lt; 0.0003), indicating a substantial protective effect. However, the mean changes in EF, LVEDV, and LVESV from baseline, represented by <em>Hedges's g</em> of 1.09 (95 % CI -0.40 to 2.57, p = 0.15), 0.91 (95 % CI -1.69 to 3.51, p = 0.47), and 1.32 (95 % CI -2.30 to 4.94, p = 0.49) respectively, were not statistically significant. (Figure 1).</div></div><div><h3>Conclusion</h3><div>Our meta-analysis confirms statins' effectiveness in reducing risk of ARCD. However, their influence on EF, LVEDV, and LVESV remains uncertain, warranting further study.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100874"},"PeriodicalIF":4.3,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142529859","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":"Vegetarian dietary patterns and cardiovascular risk factors and disease prevention: An umbrella review of systematic reviews","authors":"Matthew J. Landry ,&nbsp;Katelyn E. Senkus ,&nbsp;A Reed Mangels ,&nbsp;Nanci S. Guest ,&nbsp;Roman Pawlak ,&nbsp;Sudha Raj ,&nbsp;Deepa Handu ,&nbsp;Mary Rozga","doi":"10.1016/j.ajpc.2024.100868","DOIUrl":"10.1016/j.ajpc.2024.100868","url":null,"abstract":"<div><h3>Background</h3><div>Diet significantly influences the risk of developing cardiovascular disease (CVD), the leading cause of death in the United States. As vegetarian dietary patterns are increasingly being included within clinical practice guidelines, there is a need to review the most recent evidence regarding if and how these dietary patterns mitigate CVD risk.</div></div><div><h3>Objective</h3><div>This umbrella review of systematic reviews compared the relationships between vegetarian, vegan and non-vegetarian dietary patterns and CVD health outcomes and risk factors among presumably healthy adults (≥18 years) in the general population.</div></div><div><h3>Methods</h3><div>MEDLINE, CINAHL, Cochrane Databases of Systematic Reviews, Food Science Source and SportsDiscus databases were searched for systematic reviews (SRs) published from 2018 until March 2024. Eligible SRs and meta-analyses examined relationships between vegetarian or vegan diets and CVD risk factors and disease outcomes compared to non-vegetarian diets. SRs were screened in duplicate, and SR quality was assessed with AMSTAR2. The overall certainty of evidence (COE) was evaluated using the Grading of Recommendation, Assessment, Development, and Evaluation (GRADE) method.</div></div><div><h3>Results</h3><div>There were 758 articles identified in the databases’ search and 21 SRs met inclusion criteria. SRs targeting the general population had primarily observational evidence. Vegetarian, including vegan, dietary patterns were associated with reduced risk for CVD incidence [Relative Risk: 0.85 (0.79, 0.92)] and CVD mortality [Hazard Ratio: 0.92 (0.85, 0.99)] compared to non-vegetarian diets. Vegan dietary patterns were associated with reductions in CVD risk factors including blood pressure [systolic mean difference (95 % CI): -2.56 mmHg (-4.66, -0.445)], low-density lipoprotein cholesterol [-0.49 mmol/l (-0.62, -0.36)], and body mass index [-1.72 kg/m² (-2.30, -1.16)] compared to non-vegetarian dietary patterns, as well as c-reactive protein concentrations in a novel meta-analysis [-0.55 mg/l (-1.07, -0.03)].</div></div><div><h3>Conclusion</h3><div>Practitioners can consider recommending vegetarian dietary patterns to reduce cardiometabolic risk factors and risk of CVD incidence and mortality.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"20 ","pages":"Article 100868"},"PeriodicalIF":4.3,"publicationDate":"2024-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421450","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}