Last data update: Jun 11, 2024. (Total: 46992 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Gillum RF [original query] |
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The state of US health, 1990-2010: burden of diseases, injuries, and risk factors
Murray CJ , Abraham J , Ali MK , Alvarado M , Atkinson C , Baddour LM , Bartels DH , Benjamin EJ , Bhalla K , Birbeck G , Bolliger I , Burstein R , Carnahan E , Chen H , Chou D , Chugh SS , Cohen A , Colson KE , Cooper LT , Couser W , Criqui MH , Dabhadkar KC , Dahodwala N , Danaei G , Dellavalle RP , Des Jarlais DC , Dicker D , Ding EL , Dorsey ER , Duber H , Ebel BE , Engell RE , Ezzati M , Felson DT , Finucane MM , Flaxman S , Flaxman AD , Fleming T , Forouzanfar MH , Freedman G , Freeman MK , Gabriel SE , Gakidou E , Gillum RF , Gonzalez-Medina D , Gosselin R , Grant B , Gutierrez HR , Hagan H , Havmoeller R , Hoffman H , Jacobsen KH , James SL , Jasrasaria R , Jayaraman S , Johns N , Kassebaum N , Khatibzadeh S , Knowlton LM , Lan Q , Leasher JL , Lim S , Lin JK , Lipshultz SE , London S , Lozano R , Lu Y , Macintyre MF , Mallinger L , McDermott MM , Meltzer M , Mensah GA , Michaud C , Miller TR , Mock C , Moffitt TE , Mokdad AA , Mokdad AH , Moran AE , Mozaffarian D , Murphy T , Naghavi M , Narayan KM , Nelson RG , Olives C , Omer SB , Ortblad K , Ostro B , Pelizzari PM , Phillips D , Pope CA , Raju M , Ranganathan D , Razavi H , Ritz B , Rivara FP , Roberts T , Sacco RL , Salomon JA , Sampson U , Sanman E , Sapkota A , Schwebel DC , Shahraz S , Shibuya K , Shivakoti R , Silberberg D , Singh GM , Singh D , Singh JA , Sleet DA , Steenland K , Tavakkoli M , Taylor JA , Thurston GD , Towbin JA , Vavilala MS , Vos T , Wagner GR , Weinstock MA , Weisskopf MG , Wilkinson JD , Wulf S , Zabetian A , Lopez AD . JAMA 2013 310 (6) 591-608 IMPORTANCE: Understanding the major health problems in the United States and how they are changing over time is critical for informing national health policy. OBJECTIVES: To measure the burden of diseases, injuries, and leading risk factors in the United States from 1990 to 2010 and to compare these measurements with those of the 34 countries in the Organisation for Economic Co-operation and Development (OECD) countries. DESIGN: We used the systematic analysis of descriptive epidemiology of 291 diseases and injuries, 1160 sequelae of these diseases and injuries, and 67 risk factors or clusters of risk factors from 1990 to 2010 for 187 countries developed for the Global Burden of Disease 2010 Study to describe the health status of the United States and to compare US health outcomes with those of 34 OECD countries. Years of life lost due to premature mortality (YLLs) were computed by multiplying the number of deaths at each age by a reference life expectancy at that age. Years lived with disability (YLDs) were calculated by multiplying prevalence (based on systematic reviews) by the disability weight (based on population-based surveys) for each sequela; disability in this study refers to any short- or long-term loss of health. Disability-adjusted life-years (DALYs) were estimated as the sum of YLDs and YLLs. Deaths and DALYs related to risk factors were based on systematic reviews and meta-analyses of exposure data and relative risks for risk-outcome pairs. Healthy life expectancy (HALE) was used to summarize overall population health, accounting for both length of life and levels of ill health experienced at different ages. RESULTS: US life expectancy for both sexes combined increased from 75.2 years in 1990 to 78.2 years in 2010; during the same period, HALE increased from 65.8 years to 68.1 years. The diseases and injuries with the largest number of YLLs in 2010 were ischemic heart disease, lung cancer, stroke, chronic obstructive pulmonary disease, and road injury. Age-standardized YLL rates increased for Alzheimer disease, drug use disorders, chronic kidney disease, kidney cancer, and falls. The diseases with the largest number of YLDs in 2010 were low back pain, major depressive disorder, other musculoskeletal disorders, neck pain, and anxiety disorders. As the US population has aged, YLDs have comprised a larger share of DALYs than have YLLs. The leading risk factors related to DALYs were dietary risks, tobacco smoking, high body mass index, high blood pressure, high fasting plasma glucose, physical inactivity, and alcohol use. Among 34 OECD countries between 1990 and 2010, the US rank for the age-standardized death rate changed from 18th to 27th, for the age-standardized YLL rate from 23rd to 28th, for the age-standardized YLD rate from 5th to 6th, for life expectancy at birth from 20th to 27th, and for HALE from 14th to 26th. CONCLUSIONS AND RELEVANCE: From 1990 to 2010, the United States made substantial progress in improving health. Life expectancy at birth and HALE increased, all-cause death rates at all ages decreased, and age-specific rates of years lived with disability remained stable. However, morbidity and chronic disability now account for nearly half of the US health burden, and improvements in population health in the United States have not kept pace with advances in population health in other wealthy nations. |
C-reactive protein, fibrinogen, and cardiovascular disease prediction
Kaptoge S , Di Angelantonio E , Pennells L , Wood AM , White IR , Gao P , Walker M , Thompson A , Sarwar N , Caslake M , Butterworth AS , Amouyel P , Assmann G , Bakker SJ , Barr EL , Barrett-Connor E , Benjamin EJ , Bjorkelund C , Brenner H , Brunner E , Clarke R , Cooper JA , Cremer P , Cushman M , Dagenais GR , D'Agostino RB Sr , Dankner R , Davey-Smith G , Deeg D , Dekker JM , Engstrom G , Folsom AR , Fowkes FG , Gallacher J , Gaziano JM , Giampaoli S , Gillum RF , Hofman A , Howard BV , Ingelsson E , Iso H , Jorgensen T , Kiechl S , Kitamura A , Kiyohara Y , Koenig W , Kromhout D , Kuller LH , Lawlor DA , Meade TW , Nissinen A , Nordestgaard BG , Onat A , Panagiotakos DB , Psaty BM , Rodriguez B , Rosengren A , Salomaa V , Kauhanen J , Salonen JT , Shaffer JA , Shea S , Ford I , Stehouwer CD , Strandberg TE , Tipping RW , Tosetto A , Wassertheil-Smoller S , Wennberg P , Westendorp RG , Whincup PH , Wilhelmsen L , Woodward M , Lowe GD , Wareham NJ , Khaw KT , Sattar N , Packard CJ , Gudnason V , Ridker PM , Pepys MB , Thompson SG , Danesh J . N Engl J Med 2012 367 (14) 1310-20 BACKGROUND: There is debate about the value of assessing levels of C-reactive protein (CRP) and other biomarkers of inflammation for the prediction of first cardiovascular events. METHODS: We analyzed data from 52 prospective studies that included 246,669 participants without a history of cardiovascular disease to investigate the value of adding CRP or fibrinogen levels to conventional risk factors for the prediction of cardiovascular risk. We calculated measures of discrimination and reclassification during follow-up and modeled the clinical implications of initiation of statin therapy after the assessment of CRP or fibrinogen. RESULTS: The addition of information on high-density lipoprotein cholesterol to a prognostic model for cardiovascular disease that included age, sex, smoking status, blood pressure, history of diabetes, and total cholesterol level increased the C-index, a measure of risk discrimination, by 0.0050. The further addition to this model of information on CRP or fibrinogen increased the C-index by 0.0039 and 0.0027, respectively (P<0.001), and yielded a net reclassification improvement of 1.52% and 0.83%, respectively, for the predicted 10-year risk categories of "low" (<10%), "intermediate" (10% to <20%), and "high" (≥20%) (P<0.02 for both comparisons). We estimated that among 100,000 adults 40 years of age or older, 15,025 persons would initially be classified as being at intermediate risk for a cardiovascular event if conventional risk factors alone were used to calculate risk. Assuming that statin therapy would be initiated in accordance with Adult Treatment Panel III guidelines (i.e., for persons with a predicted risk of ≥20% and for those with certain other risk factors, such as diabetes, irrespective of their 10-year predicted risk), additional targeted assessment of CRP or fibrinogen levels in the 13,199 remaining participants at intermediate risk could help prevent approximately 30 additional cardiovascular events over the course of 10 years. CONCLUSIONS: In a study of people without known cardiovascular disease, we estimated that under current treatment guidelines, assessment of the CRP or fibrinogen level in people at intermediate risk for a cardiovascular event could help prevent one additional event over a period of 10 years for every 400 to 500 people screened. (Funded by the British Heart Foundation and others.). |
Diabetes mellitus, fasting glucose, and risk of cause-specific death
Seshasai SR , Kaptoge S , Thompson A , Di Angelantonio E , Gao P , Sarwar N , Whincup PH , Mukamal KJ , Gillum RF , Holme I , Njolstad I , Fletcher A , Nilsson P , Lewington S , Collins R , Gudnason V , Thompson SG , Sattar N , Selvin E , Hu FB , Danesh J . N Engl J Med 2011 364 (9) 829-41 BACKGROUND: The extent to which diabetes mellitus or hyperglycemia is related to risk of death from cancer or other nonvascular conditions is uncertain. METHODS: We calculated hazard ratios for cause-specific death, according to baseline diabetes status or fasting glucose level, from individual-participant data on 123,205 deaths among 820,900 people in 97 prospective studies. RESULTS: After adjustment for age, sex, smoking status, and body-mass index, hazard ratios among persons with diabetes as compared with persons without diabetes were as follows: 1.80 (95% confidence interval [CI], 1.71 to 1.90) for death from any cause, 1.25 (95% CI, 1.19 to 1.31) for death from cancer, 2.32 (95% CI, 2.11 to 2.56) for death from vascular causes, and 1.73 (95% CI, 1.62 to 1.85) for death from other causes. Diabetes (vs. no diabetes) was moderately associated with death from cancers of the liver, pancreas, ovary, colorectum, lung, bladder, and breast. Aside from cancer and vascular disease, diabetes (vs. no diabetes) was also associated with death from renal disease, liver disease, pneumonia and other infectious diseases, mental disorders, nonhepatic digestive diseases, external causes, intentional self-harm, nervous-system disorders, and chronic obstructive pulmonary disease. Hazard ratios were appreciably reduced after further adjustment for glycemia measures, but not after adjustment for systolic blood pressure, lipid levels, inflammation or renal markers. Fasting glucose levels exceeding 100 mg per deciliter (5.6 mmol per liter), but not levels of 70 to 100 mg per deciliter (3.9 to 5.6 mmol per liter), were associated with death. A 50-year-old with diabetes died, on average, 6 years earlier than a counterpart without diabetes, with about 40% of the difference in survival attributable to excess nonvascular deaths. CONCLUSIONS: In addition to vascular disease, diabetes is associated with substantial premature death from several cancers, infectious diseases, external causes, intentional self-harm, and degenerative disorders, independent of several major risk factors. (Funded by the British Heart Foundation and others.). |
Association of hypertension treatment and control with all-cause and cardiovascular disease mortality among US adults with hypertension
Gu Q , Dillon CF , Burt VL , Gillum RF . Am J Hypertens 2009 23 (1) 38-45 BACKGROUND: Clinical trials have provided convincing evidence that blood pressure (BP) lowering treatment reduces the risk of cardiovascular disease (CVD) and total mortality. OBJECTIVE: to examine the association of hypertension treatment, control, and BP indexes with all-cause and cardiovascular mortality among US adults with hypertension. METHODS: Persons aged ≥18 years from the Third National Health and Nutrition Examination Survey (NHANES III) were identified as hypertensives based on a BP ≥140/90 mm Hg or current treatment for hypertension. Vital status in 2006 was ascertained by passive follow-up using the National Death Index. Cox regression models were used to assess correlates of survival. RESULTS: At baseline, 52% of hypertensive adults reported currently taking prescription medicine for high BP and 38% of treated persons had BP controlled. Compared to treated controlled hypertensives, treated uncontrolled hypertensives had a 1.57-fold (95% confidence interval (CI) 1.28-1.91) and 1.74-fold (95% CI 1.36-2.22) risk of all-cause and cardiovascular mortality; untreated hypertensives had a 1.34-fold (95% CI 1.12-1.62) and 1.37-fold (95% CI 1.04-1.81) risk of all-cause and cardiovascular mortality, respectively. The association persisted after further excluding persons with pre-existing hypertension comorbidities. Mortality risk was linearly increased with systolic BP (SBP), pulse pressure (PP), and mean arterial pressure (MBP), whereas diastolic BP (DBP) was not a significant predictor of cardiovascular mortality overall. No significant associations were observed between drug classes and mortality risk. CONCLUSIONS: This study indicates that uncontrolled and untreated hypertension was associated with increased risk of total and cardiovascular mortality among the general hypertensive population.American Journal of Hypertension 2009; doi:10.1038/ajh.2009.191. |
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