Achieving Optimal Cardiovascular Health: a Social Epidemiological Approach
AbstractPurpose of ReviewThe American Heart Association (AHA) created the cardiovascular health (CVH) index to measure and monitor population-level reduction of cardiovascular disease (CVD) risk, with a goal of 20% reduction in CVD morbidity and mortality by 2020. Few U.S. adults meet all seven ideal CVH metrics (non-smoking behavior, healthy diet and body weight, active lifestyle, good cholesterol, glucose, and blood pressure scores), with 17% of men and women only achieving five or more ideal CVH metrics. This review describes the importance of considering sociodemographic, psychosocial, and behavioral factors as key str...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Developmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk
AbstractPurpose of ReviewMany of the diseases and dysfunctions described in the paradigm of the developmental origins of health and disease have been studied in relation to prenatal nutrition or environmental toxicant exposures. Here, we selectively review the current research on four exposures —two nutritional and two environmental—that have recently emerged as prenatal risk factors for long-term health outcomes.Recent FindingsRecent studies have provided strong evidence that prenatal exposure to (1) excessive intake of sugar-sweetened beverages, (2) unhealthy dietary patterns, (3) perfluoroalkyl substances, and (4) f...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Statistical Challenges in the Analysis of Biomarkers of Environmental Chemical Exposures for Perinatal Epidemiology
AbstractPurpose of ReviewBiomarkers are widely used in perinatal epidemiology to examine the health effects of environmental chemical exposures during pregnancy. These measurements take the form of chemical concentrations measured in blood, urine, or other biospecimens. Biomarkers have the advantage of providing objective estimates of chemical exposures from multiple sources. However, they are difficult to handle at the data analysis stage. We review recent trends and developments in the statistical analysis of biomarkers with particular emphasis on exposure assessment and multivariable modeling.Recent FindingsSix statisti...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Trends in Obesity and Risk of Cardiovascular Disease
AbstractPurpose of ReviewThe obesity epidemic is a global health crisis of staggering proportion. Excess body weight is a major risk factor for the development of cardiovascular disease (CVD). We review temporal trends in obesity rates, pertinent pathophysiology to understand mechanisms of disease, and treatment strategies in the context of reducing cardiovascular risk.Recent FindingsThe prevalence of obesity is increasing in recent decades and is driven by a complex interplay of economic, environmental, and biological factors. In developed countries, changes in food intake, such as increased consumption of energy-dense an...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Understanding the Assumptions Underlying Instrumental Variable Analyses: a Brief Review of Falsification Strategies and Related Tools
AbstractPurpose of ReviewInstrumental variable (IV) methods continue to be applied to questions ranging from genetic to social epidemiology. In the epidemiologic literature, discussion of whether the assumptions underlying IV analyses hold is often limited to only certain assumptions and even then, arguments are mostly made using subject matter knowledge. To complement subject matter knowledge, there exist a variety of falsification strategies and other tools for weighing the plausibility of the assumptions underlying IV analyses.Recent FindingsThere are many tools that can refute the IV assumptions or help estimate the ma...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Branching Out: Use of Decision Trees in Epidemiology
AbstractPurpose of ReviewDecision trees are a well-established tool for statistical modeling and machine learning, but they are not widely used in the epidemiological literature. In this review, we introduce the reader to the basic concept of the decision tree and describe three distinct ways that they can be used: for explanatory modeling, outcome prediction, and subgroup identification.Recent FindingsWe discuss varieties and generalizations of decision trees that are best-suited for analyzing epidemiological data and introduce some visualizations which can help researchers interpret decision tree outputs. Throughout, we ...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Impacts of Air Pollution on Gynecologic Disease: Infertility, Menstrual Irregularity, Uterine Fibroids, and Endometriosis: a Systematic Review and Commentary
AbstractPurpose of ReviewAir pollution is widely known to affect human cardiopulmonary health, but only recently has research begun to focus on understanding the association between ambient air pollution and reproductive health and gynecologic disease incidence. In this article, we conducted a systematic literature review to examine studies conducted to evaluate the association between air pollution and the heterogeneous gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis. In this review, the authors discuss exposure assessment considerations, outcome definitions, statistical an...
Source: Current Epidemiology Reports - September 1, 2018 Category: Epidemiology Source Type: research
Cholera
AbstractPurpose of ReviewThis review describes the basic epidemiologic, clinical, and microbiologic aspects of cholera, highlights new developments within these areas, and presents strategies for applying currently available tools and knowledge more effectively.Recent FindingsFrom 1990 to 2016, the reported global burden of cholera fluctuated between 74,000 and 595,000 cases per year; however, modeling estimates suggest the real burden is between 1.3 and 4.0 million cases and 95,000 deaths yearly. In 2018, the World Health Assembly endorsed a new initiative to reduce cholera deaths by 90% and eliminate local cholera transm...
Source: Current Epidemiology Reports - July 27, 2018 Category: Epidemiology Source Type: research
Branching Out: Use of Decision Trees in Epidemiology
AbstractPurpose of ReviewDecision trees are a well-established tool for statistical modeling and machine learning, but they are not widely used in the epidemiological literature. In this review, we introduce the reader to the basic concept of the decision tree and describe three distinct ways that they can be used: for explanatory modeling, outcome prediction, and subgroup identification.Recent FindingsWe discuss varieties and generalizations of decision trees that are best-suited for analyzing epidemiological data and introduce some visualizations which can help researchers interpret decision tree outputs. Throughout, we ...
Source: Current Epidemiology Reports - July 23, 2018 Category: Epidemiology Source Type: research
Developmental Origins of Disease: Emerging Prenatal Risk Factors and Future Disease Risk
AbstractPurpose of ReviewMany of the diseases and dysfunctions described in the paradigm of the developmental origins of health and disease have been studied in relation to prenatal nutrition or environmental toxicant exposures. Here, we selectively review the current research on four exposures —two nutritional and two environmental—that have recently emerged as prenatal risk factors for long-term health outcomes.Recent FindingsRecent studies have provided strong evidence that prenatal exposure to (1) excessive intake of sugar-sweetened beverages, (2) unhealthy dietary patterns, (3) perfluoroalkyl substances, and (4) f...
Source: Current Epidemiology Reports - July 13, 2018 Category: Epidemiology Source Type: research
Impacts of Air Pollution on Gynecologic Disease: Infertility, Menstrual Irregularity, Uterine Fibroids, and Endometriosis: a Systematic Review and Commentary
AbstractPurpose of ReviewAir pollution is widely known to affect human cardiopulmonary health, but only recently has research begun to focus on understanding the association between ambient air pollution and reproductive health and gynecologic disease incidence. In this article, we conducted a systematic literature review to examine studies conducted to evaluate the association between air pollution and the heterogeneous gynecologic diseases of infertility, menstrual irregularity, uterine fibroids, and endometriosis. In this review, the authors discuss exposure assessment considerations, outcome definitions, statistical an...
Source: Current Epidemiology Reports - July 11, 2018 Category: Epidemiology Source Type: research
Looking to the Future: Spotlight on Emerging Biomarkers for Predicting Cardiovascular Risk
AbstractPurpose of ReviewCoronary artery disease (CAD) continues to be a major contributor to death and disability worldwide. Emerging biomarkers that are linked to CAD pathophysiology have the potential to phenotype CAD severity and identify individuals at high risk for experiencing future CAD events. This review discusses the utility of emergent biomarkers for CAD risk prediction.Recent FindingsMonocytes and neutrophils are key effectors of cardiovascular inflammation, and aspects of their biology have recently been associated with cardiovascular risk. In particular, intermediate (Mon2) monocytosis is robustly associated...
Source: Current Epidemiology Reports - July 9, 2018 Category: Epidemiology Source Type: research
Trends in Obesity and Risk of Cardiovascular Disease
AbstractPurpose of ReviewThe obesity epidemic is a global health crisis of staggering proportion. Excess body weight is a major risk factor for the development of cardiovascular disease (CVD). We review temporal trends in obesity rates, pertinent pathophysiology to understand mechanisms of disease, and treatment strategies in the context of reducing cardiovascular risk.Recent FindingsThe prevalence of obesity is increasing in recent decades and is driven by a complex interplay of economic, environmental, and biological factors. In developed countries, changes in food intake, such as increased consumption of energy-dense an...
Source: Current Epidemiology Reports - July 9, 2018 Category: Epidemiology Source Type: research
Atrial Fibrillation, Cognitive Decline, and Dementia: an Epidemiologic Review
AbstractPurpose of ReviewAtrial fibrillation (AF) and dementia are both prevalent diseases in aging societies, which exert a great economic burden worldwide. Although a handful of epidemiologic studies have indicated that AF is independently associated with faster cognitive decline and a higher risk of dementia, there is still a lack of comprehensive understanding of the observed association. In this review, we summarize evidence from major epidemiologic studies concerning AF-related cognitive decline and dementia, the potential mechanisms underlying their association, and the cognitive benefits of treatment options.Recent...
Source: Current Epidemiology Reports - July 7, 2018 Category: Epidemiology Source Type: research
The importance and implications of comparator selection in pharmacoepidemiologic research
We describe forms of confounding specific to pharmacoepidemiologic studies and discuss each comparator along with informative examples and a case study. We provide commentary on potential issues relevant to comparator selection in each study, highlighting the importance of understanding the population in whom the treatment is given and how patient characteristics are associated with the outcome.SummaryAdvanced statistical techniques may be insufficient for reducing confounding in observational studies. Evaluating the extent to which comparator selection may mitigate or induce systematic bias is a critical component of phar...
Source: Current Epidemiology Reports - July 6, 2018 Category: Epidemiology Source Type: research
