Research
Heart disease risk factors remain regardless of income – study
A new study reveals that many people living in extreme poverty in low- and middle-income countries have conditions that lead to heart disease, the world’s number one cause of death.
In the largest analysis of its kind exploring the relationship between poverty and cardiovascular disease (CVD) risk factors, experts discovered a high prevalence of hypertension, diabetes, smoking, obesity, and dyslipidemia in low- and middle-income countries (LMICs) regardless of income —yet most adults living in extreme poverty were not treated for these CVD-related conditions.
An international group of researchers note that their findings, published in Nature Human Behaviour, contradict the common assumption that the environment, such as food scarcity and lifestyles (more physical labour) of those living in extreme poverty in LMICs protect against CVD risk factors.
“Our study turns conventional wisdom about the relationship between poverty and cardiovascular disease (CVD) risk factors on its head. As LMICs develop economically, overweight and obesity prevalence among the poorest segments of their societies will increase – creating a rise in unhealthy weight, along with growth of diabetes, dyslipidemia, and hypertension,” said Professor Justine Davies, from the University of Birmingham.
Evidence on CVD risk factor prevalence among adults living below the World Bank’s international line for extreme poverty is sparse. To address this paucity of needed information, the researchers pooled data from 105 nationally representative household surveys across 78 countries.
Pascal Geldsetzer, Assistant Professor of Medicine at Stanford University, USA, commented: “Our detailed analyses of how CVD risk factor prevalence and treatment coverage vary around the world could help to effectively target interventions and policies to reduce CVD risk in vulnerable populations. Moreover, our study provides a crucial empirical foundation for future work in improving health outcomes for those living in the poorest sections of global society.”
The study demonstrates that CVD risk factors affect individuals across the full socio-economic spectrum, including those living in extreme poverty, within countries at all levels of economic development.
Prof. Dr. Till Baernighausen, from Heidelberg University, commented: “People living in extreme poverty experience a high prevalence of CVD risk factors and low levels of treatment for these conditions, suggesting that we need to reassess health policy in this space.
“Understanding how an assumption of low prevalence of CVD risk factors among those in extreme poverty holds true is important for setting priorities within health policy and care delivery, both for equity and effectiveness.”
Countries included in the researchers’ dataset are estimated to be home to 85 per cent of individuals living in extreme poverty worldwide, 53 per cent of the global population, and 64 per cent of the global population living in LMICs.
Sebastian Vollmer, Professor of Development Economics at the University of Göttingen, added: “Further research into mechanisms of CVD risk specifically affecting individuals living in extreme poverty is essential – uncovering the different pathways that may predispose various groups to CVD risk will be vital in reducing that risk.”
Veteran male athletes may face higher heart risk during exercise if they have existing heart scarring, new research suggests.
The study found that male endurance athletes aged over 50 were more likely to experience abnormal heart rhythms during training if scarring was present.
Nine in 10 sudden cardiac deaths during sport occur in older male athletes.
Researchers at the University of Leeds tracked 106 healthy male endurance athletes aged over 50 who had been doing more than 10 hours of running or cycling weekly for at least 15 years.
They matched training data from wearables with implantable loop recorders to align heart rhythms with activity.
Over two years, about one in four participants experienced ventricular tachycardia, a fast, abnormal rhythm arising from the heart’s lower chambers, during or just after exercising.
Three quarters of those who had these episodes had heart scarring. There were three sustained episodes during exercise, all in athletes with scarring.
Scarring may be caused by heart attacks, disease or cumulative exertion from years of high-intensity exercise.
Dr Wasim Javed, research fellow at the University of Leeds and lead author, said: “Our study shows that exercise was only associated with a risk of developing abnormal heart rhythms in those who were already high risk due to heart scarring.
“Athletes who developed abnormal heart rhythms were not exercising more or harder than athletes without abnormal heart rhythms.
“This suggests that exercise itself is not the cause, but could act as a trigger for dangerous heart rhythms in those athletes already with an underlying heart issue.”
“Exercise is safe and has immense benefits – but athletes in this group should have regular health checks to make sure they stay healthy.”
The researchers said their findings support the use of wearable technology for athletes who want to monitor their heart rate for unusual activity.
Childhood exposure to indoor air pollution may have long-term effects on brain health, with cognitive impairment appearing decades later, new research suggests.
The study analysed data from over 7,000 Chinese adults aged 45 and above using machine learning techniques.
Nearly 30 per cent of the global population, roughly 2.4bn people, still cook without clean fuels such as gas or electricity, instead using solid fuels like coal, wood and plant waste.
Researchers at the University of Helsinki found that individuals exposed as children to indoor air pollution from solid fuels performed significantly worse on cognitive tests in adulthood, particularly in episodic memory and overall mental health.
The study identified two main pathways through which childhood exposure may contribute to poorer cognitive performance: biological, including being overweight and limitations in daily activities; and socioeconomic, with exposure associated with lower education and income levels.
Men, smokers and regular alcohol users were particularly vulnerable to the detrimental effects.
Xu Zong, the study’s author, said: “Our study emphasises that early exposure to air pollution affects later cognitive health through both biological and social pathways.
“That is why public health efforts should combine clean energy initiatives with preventive strategies that support lifelong health and positive behaviours.
“Switching to cleaner fuels, such as gas or electricity, is not merely an environmental or respiratory health measure.
“It is also an investment in long-term cognitive wellbeing that could safeguard brain health for future generations.”
The longer someone has type 2 diabetes, the higher their cardiovascular disease risk, and changes in red blood cells may help explain it, new research suggests.
The study found red blood cells from patients with long-term diabetes harmed blood vessel function, while no such effect was seen in those newly diagnosed.
After seven years of follow-up, the blood cells of people initially diagnosed had developed the same harmful properties.
Zhichao Zhou, associate professor at Karolinska Institutet and lead author, said: “What really stands out in our study is that it is not only the presence of type 2 diabetes that matters, but how long you have had the disease.
“It is only after several years that red blood cells develop a harmful effect on blood vessels.”
Researchers at Karolinska Institutet in Sweden studied animals and patients with type 2 diabetes.
They identified microRNA-210, a small RNA that helps regulate gene activity, as a possible early biomarker of cardiovascular risk.
When its levels were restored in red blood cells, blood vessel function improved.
Eftychia Kontidou, doctoral student and first author, said: “If we can identify which patients are at greatest risk before vascular damage has already occurred, we can also become better at preventing complications.”
The researchers are now investigating whether the biomarker can be used in larger population studies.
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