BACKGROUND

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by inflammatory arthritis and extra-articular involvement. Comorbidities are highly prevalent in patients with RA, in particular cardiovascular disease (CVD), which is responsible for over 50% of premature deaths. This study aimed to describe cardiovascular diseases and their risk factors among patients with rheumatoid arthritis in the Philippine General Hospital (PGH).

To describe cardiovascular (CV) diseases and their risk factors among patients with rheumatoid arthritis.

A retrospective descriptive cross-sectional study was done in the University of the Philippines – Philippine General Hospital (UP-PGH) inpatient and outpatient services. The study included patients 18 years old and above diagnosed with RA and fulfills the 1987 American College of Rheumatology or 2010 American College of Rheumatology-European League Against Rheumatism (ACR/EULAR) classification criteria with no overlap features with other autoimmune connective tissue diseases and with complete records of the information required for the study from January 2019-December 2022. The primary outcomes of interest were the prevalence of CV diseases and CV risk factors. Descriptive statistics were used to summarize the data.

There were 123 patients in the study, 93.4% outpatients, and 95.1% females, with a mean age and disease duration of 51.3 and 9.8 years, respectively. Disease activity was moderate in 35% and high in 9.7%, based on disease activity score (DAS 28) or clinical disease activity index (CDAI) scores. Methotrexate (54%) was the most commonly used conventional synthetic disease-modifying antirheumatic drug (csDMARD). Glucocorticoid use was observed in 51.2%. None of the patients were receiving a biologic DMARD. There were 24 (19.5%) patients with CV diseases, namely myocardial infarction, heart failure, and stroke. There were 87 (70%) patients with at least one CV risk factor and 62 (50.4%) with multiple risk factors. The risk factors identified were: dyslipidemia (43.1%), hypertension (40.7%), elevated body mass index (35.7%), and diabetes mellitus (15.4%). There were f ive deaths in the hospitalized patients (4%), one due to a myocardial infarction.

The majority (70%) in our cohort had at least one CV risk factor, 19.5% had an identified CV disease, and one died from a myocardial infarction. Dyslipidemia was the most common CV risk factor. The high proportion of patients with CV disease and CV risk factors highlights the need to add the screening and management of CV diseases and risk factors as a priority among patients with rheumatoid arthritis.

OBJECTIVE

This study aimed to evaluate the nutritional adequacy and compliance with cardiovascular disease (CVD) guidelines in therapeutic diets implemented in four hospitals in General Santos City, Philippines.

The study employed a cross-sectional study and analyzed the one-day therapeutic menus of four hospitals using the Philippine Food Composition Table and the United States Department of Agriculture nutrient database. The nutrient contents calculated in this study were compared among hospitals and benchmarked against the Philippine Dietary Reference Intakes (PDRI) and CVD-specific guidelines, the Dietary Approaches to Stop Hypertension (DASH), and Therapeutic Lifestyle Changes (TLC). The nutrient adequacy ratios (NARs) and the corresponding mean (SD) values were used to interpret the data.

Based on the PDRI, the mean (SD) NARs for proteins, simple sugars, vitamin B6, folate, and vitamin B12 were 116% (11%), 72% (16%), 139% (34%), 115% (7%), and 324% (156%), respectively, which were all interpreted as adequate. However, the mean (SD) NARs for energy, 88% (7%), and dietary fiber, 53% (33%), indicate non-compliance with the requirements for these components. As for the DASH guidelines, the hospitals failed to meet the recommendations for calcium, magnesium, and potassium, with mean (SD) NARs of 45% (14%), 49% (10%), and 51% (7%), respectively. The levels of saturated fatty acids, 195% (53%), and dietary cholesterol, 363% (177%), exceeded the limits set by the guidelines. For the TLC guidelines, the mean (SD) NARs of 70% (24%) and 40% (10%) for monounsaturated fatty acids and polyunsaturated fatty acids, respectively, were interpreted as suboptimal. Conclusive interpretations cannot be drawn for sodium, total carbohydrates, total fats due to large variations in their compositions among the hospitals.

At the menu analysis level, while the therapeutic diets adhered to the recommendations for proteins, simple sugars, and the vitamins, they fell short in their provision for energy, unsaturated fats, dietary fiber, and most minerals. They also exceeded the limits for most dietary lipid parameters set by DASH and TLC. The findings of this study highlight the need for improvements in nutritional adequacy and adherence to CVD guidelines in hospital therapeutic diets. Due to the limited number of observations, future research should aim to confirm and clarify these findings.

BACKGROUND: Non-alcoholic fatty liver disease (NAFLD), now known as Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD), is linked to cardiovascular disease. This renaming emphasizes the role of metabolic problems. Coronary artery calcification (CAC) reflects early coronary artery disease, but data on the MAFLD-CAC link is limited. OBJECTIVE: To demonstrate the association between metabolic dysfunction-associated fatty liver disease (MAFLD) based on its criteria and coronary artery calcification, as measured by CT CAC score. METHODS: This single-center retrospective study involved adult Filipino patients who underwent CT CAC scoring between January 2021 and January 2023. Clinical and laboratory data were obtained via review of electronic records. RESULTS: This study involved 147 patients with an average age of 62 years, primarily females (57.14%), and mostly falling into the Obese-Class I category (31.29%). The most common comorbidities were hypertension (95.24%), dyslipidemia (62.59%), and diabetes mellitus (38.1%). In terms of CAC scores using the CT Agatston method, majority (30.61%) had low calcium buildup (Stage 2 with scores between 1-99). Approximately 26.53% had higher liver fat content with liver HU below 40, while 73.47% had lower liver fat content with HU equal to or greater than 40. Furthermore, 25.17% of patients with fatty livers and other risk factors were diagnosed with MAFLD, while 74.83% were not. The p-value indicated a significant difference in proportions, suggesting a lower proportion of MAFLD among those who had undergone CT CAC scoring. However, the Pearson Chi-Square statistic (4.051) and the p-value (0.256) indicated no statistically significant association between MAFLD and CT CAC. CONCLUSION The study found a notably lower proportion of MAFLD diagnoses in patients who underwent CT CAC scoring. Additionally, there was no statistically significant link between MAFLD and CT CAC.
Cardiovascular Diseases ; Coronary Artery Disease ; Fatty Liver, Alcoholic

INTRODUCTION

Cardiovascular diseases (CVD) are a leading global health concern. Modifiable behavioral risk factors are increasingly recognized in young adults, especially among medical students who often live independently. This study investigated the association between living alone and modifiable cardiovascular risk factors—sleep quality, sodium intake, physical activity, and body mass index (BMI)—among medical students at UERMMMCI during the 2022-2023 academic year.

Researchers conducted an analytical cross-sectional study among 220 medical students. Validated tools were used: Pittsburgh Sleep Quality Index (PSQI), Scored Sodium Questionnaire, International Physical Activity Questionnaire (IPAQ), and BMI classification. Researchers performed statistical analyses using Chi-square tests and calculated relative risks (RR) with 95% confidence intervals.

A significant positive association was found between living alone and poor sleep quality (RR 2.132 p = 0.047). No significant associations were observed between living alone and sodium intake (RR 0.96 p = 0.6868), physical activity (RR 1.18 p = 0.2239), or BMI (RR 1.03 p = 0.7367).

Among the studied cardiovascular risk factors, only poor sleep quality was significantly more prevalent among students living alone. These findings highlight the importance of interventions targeting sleep hygiene in this demographic.

Objective: This study aimed to evaluate the nutritional adequacy and compliance with cardiovascular disease (CVD) guidelines in therapeutic diets implemented in four hospitals in General Santos City, Philippines. Methods The study employed a cross-sectional study and analyzed the one-day therapeutic menus of four hospitals using the Philippine Food Composition Table and the United States Department of Agriculture nutrient database. The nutrient contents calculated in this study were compared among hospitals and benchmarked against the Philippine Dietary Reference Intakes (PDRI) and CVD-specific guidelines, the Dietary Approaches to Stop Hypertension (DASH), and Therapeutic Lifestyle Changes (TLC). The nutrient adequacy ratios (NARs) and the corresponding mean (SD) values were used to interpret the data.
Cardiovascular Diseases

Cardiovascular risk assessment is a basic tenet of the prevention of cardiovascular disease. Conventional risk assessment models require measurements of blood pressure, blood lipids, and other health-related information prior to assessment of risk via regression models. Compared with traditional approaches, fundus photograph-based cardiovascular risk assessment using artificial intelligence (AI) technology is novel, and has the advantages of immediacy, non-invasiveness, easy performance, and low cost. The Health Risk Assessment and Control Committee of the Chinese Preventive Medicine Association, in collaboration with the Chinese Society of Cardiology and the Society of Health Examination, invited multi-disciplinary experts to form a panel to develop the present consensus, which includes relevant theories, progress in research, and requirements for AI model development, as well as applicable scenarios, applicable subjects, assessment processes, and other issues associated with applying AI technology to assess cardiovascular risk based on fundus photographs. A consensus was reached after multiple careful discussions on the relevant research, and the needs of the health management industry in China and abroad, in order to guide the development and promotion of this new technology.
Humans ; Cardiovascular Diseases/prevention & control* ; Artificial Intelligence ; Consensus ; Risk Factors ; Heart Disease Risk Factors

INTRODUCTION: Hypertension is a major risk factor for cardiovascular diseases, with adherence to treatment often influenced by socioeconomic status. This study assessed adherence to hypertension medication among patients in Quezon City across economic classes from August to October 2023. METHODS: An analytical cross-sectional design was employed, surveying 116 hypertensive Filipinos aged 18-64 years using the Brief Medication Questionnaire-1 (BMQ-1) and socioeconomic classifications based on multiples of the poverty line. RESULTS: Findings revealed that 50.9% of respondents were adherent or probably adherent to treatment, while 49.1% exhibited low or probable low adherence. Those who are low adherent and probable low adherent are 1.399 times more likely to belong to the “Low Income and Below.”, though this association was not statistically significant. CONCLUSION Adherence to hypertension treatment among the respondents was suboptimal, particularly among the lower-income groups. While the association between socioeconomic status and adherence was not statistically significant, the findings underscore the need for interventions targeting financial barriers and improving healthcare accessibility. Addressing these challenges can enhance adherence levels and reduce the burden of hypertension and cardiovascular risks across socioeconomic strata.
Cardiovascular diseases ; hypertension ; prescription drugs ; medication adherence ; developing countries

INTRODUCTION COVID-19 (coronavirus disease 2019), which is caused by the human severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), has reached a pandemic level. As a novel disease, local epidemiologic data are important to determine high-risk age groups, as well as risk factors that contribute to mortality. This study is a retrospective cohort study of 182 COVID-19–positive patients confirmed by real-time polymerase chain reaction. Baseline demographics and data on the preexisting cardiovascular comorbidities of 182 COVID-19 patients were collected by chart review and underwent statistical analysis using STATA 14 software (StataCorp, College Station, Texas). In the study, the majority of COVID-19 patients were 61 years or older (44.5%), with a higher prevalence of individuals 61 years or older among those who died (68.4%) compared with survivors (38.2%) (P = 0.005). In terms of gender, half of the patients were male (57.7%). In terms of cardiovascular disease, the most prevalent was hypertension (48.3%), followed by diabetes (28.0%). The prevalence of coronary artery disease (CAD) was significantly higher among patients who died (15.8%) compared with survivors (2.8%) (P = 0.022). In the univariate logistic regression analysis, older age was significantly associated with increased odds for mortality (odds ratio, 1.06; 95% confidence interval, 1.03–1.09). In terms of comorbidities, having CAD was significantly associated with increased odds for mortality (odds ratio, 6.6; 95% confidence interval, 1.7–24.6). Other variables were not significantly associated with mortality. In our study, advanced age and the presence of underlying CAD have been associated with an increased risk of in-hospital mortality among COVID-19 patients.
Cardiovascular Diseases ; COVID-19 ; mortality ; Sex

OBJECTIVES

Pre-impaired glucose tolerance (pre-IGT) is a prediabetes stage characterized by normoglycemia and compensatory hyperinsulinemia due to insulin resistance. Hyperinsulinemia increases cardiovascular disease (CVD) risk, especially, endothelial dysfunction (ED). However, there is paucity of studies on ED with hyperinsulinemia alone, particularly in individuals with pre-IGT. This study aimed to determine the presence of ED using brachial artery flow-mediated dilatation (FMD) among adult participants with pre-IGT and its correlation with insulin levels and other related clinical parameters.

This is a cross-sectional analytical study. We screened adult patients with risk factors for developing diabetes (first-degree relative with type 2 diabetes mellitus, obesity, history of gestational diabetes and polycystic ovary syndrome). Brachial artery FMD was performed among participants with pre-IGT and findings were correlated with CVD risk factors using Pearson’s correlation and linear regression.

Of the 23 pre-IGT patients, 5 (21.74%) had decreased FMD values with significant associations with serum insulin and HbA1c. It was further observed that for every 1-unit increase in second-hour serum insulin and in HbA1c, there was a decrease in FMD values by 0.38% and 0.50%, respectively. Serum insulin was elevated, while other biochemical parameters were normal. Moreover, participants with low FMD were older, with higher BMI and had higher HBA1c, total cholesterol and low-density lipoprotein (LDL) cholesterol.

As early as the pre-IGT stage, endothelial dysfunction using the FMD test is already present, with red flags on other CVD risk factors already developing.

INTRODUCTION

Respiratory symptoms are the most commonly observed clinical manifestations in patients with COVID-19 infection; however, some patients may present with cardiovascular complications. Patients with underlying cardiovascular diseases are associated with increased mortality risk. This study aimed to provide local data on the clinical profile and cardiovascular outcomes and to determine predictors of in-hospital mortality among COVID-19 patients admitted to a tertiary care hospital in the Philippines.

This single-center retrospective study included hospitalized patients diagnosed with COVID-19 between March 2020 and May 2022. Clinical parameters were subjected to univariate and multivariate regression analyses, with in-hospital mortality as the dependent variable.

A total of 1341 patients were admitted with a mean age of 50 years, half of whom were males. Hypertension is the most common comorbidity (728 [54.3%]), followed by diabetes mellitus (393 [29.3%]) and heart disease (136 [10.1%]). Patients admitted to the intensive care unit had significantly higher systolic blood pressure than non–intensive care unit patients (127 ± 19 vs 139 ± 26 mm Hg; P < 0.001), as well as higher plasma erythrocyte sedimentation rate, C-reactive protein, D-dimer, troponin, ferritin, and lactate dehydrogenase. The most common cardiac complications observed were heart failure (39%), acute cardiac injury (30%), and arrhythmia (30%). During hospitalization, 100 patients (7.4%) died; almost half were admitted to the critical care unit, and 84 had cardiac complications, with heart failure (21%) being the most common. Sinus tachycardia was the most common electrocardiographic abnormality (436 [32%]). Univariate analysis showed diabetes (odds ratio [OR], 2.7; P = 0.029) and hypertension (OR, 3.4; P = 0.11). Multivariate analysis revealed that age (OR, 1.095; P < 0.05) and admission duration (OR, 0.906; P < 0.05) were significantly associated with mortality.

This study highlights the clinical characteristics of patients contracted with COVID-19 who may experience several cardiac conditions. Therefore, particular attention should be given to the role of preexisting cardiovascular diseases and cardiac complications that may contribute to long-term outcomes.