33 / 64
CARDIOVASCULAR JOURNAL OF AFRICA • Volume 31, No 6, November/December 2020
AFRICA
313
edn. Champaigne, IL: Human Kinetics, 2012.
55. Agha SY, Al Dobbagh SA. Level of physical activity among teach-
ing and support staff in the education sector in Dohuk, Iraq.
East
Mediterr
Health J 2010;
16
(12): 1278–1284.
56. Walker TJ, Heredia NI, Lee M, Laing ST, Fisher-Hoch SP, McCormick
JB, Reininger BM. The combined effect of physical activity and seden-
tary behavior on subclinical atherosclerosis: a cross-sectional study
among Mexican Americans.
BMC Public Health
2019;
19
: 161–172.
57. Ried‐Larsen M, Grøntved A, Froberg K, Ekelund U, Andersen LB.
Physical activity intensity and subclinical atherosclerosis in Danish
adolescents: The European Youth Heart Study.
Scan J Med Sci Sports
2013;
23
(3): 168–177.
58. Jain A, McClelland RL, Polak JF, Shea S, Burke GL, Bild DE,
et al
.
Cardiovascular imaging for assessing cardiovascular risk in asymp-
tomatic men versus women: the multi-ethnic study of atherosclerosis
(MESA).
Circ Cardiovasc Imaging
2011;
4
(1): 8–15.
59. Khalil A, Huffman MD, Prabhakaran D, Osmond C, Fall CH, Tandon
N,
et al
. Predictors of carotid intima–media thickness and carotid
plaque in young Indian adults: The New Delhi Birth Cohort.
Int J
Cardiol
2013;
167
(4): 1322–1328.
60. Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M,
Nicolaides AN,
et al.
Carotid plaque, intima–media thickness, cardio-
vascular risk factors, and prevalent cardiovascular disease in men and
women: the British Regional Heart Study.
Stroke
1999;
30
(4): 841–850.
61. Mayosi BM, Flisher AJ, Lalloo UG, Sitas F, Tollman SM, Bradshaw
D. The burden of non-communicable diseases in South Africa.
Lancet
2009;
374
(9693): 934–947.
62. Muluvhu TC, Monyeki MA, Strydom GL, Toriola AL. Relationship
between obesity and blood pressure among employees in the Vhembe
district municipality of Limpopo Province, South Africa.
Cardiovasc J
Afr
2019;
30
: 1–8.
63. Ong KL, Allison MA, Cheung BM, Wu BJ, Barter PJ, Rye KA. Trends
in C-reactive protein levels in US adults from 1999 to 2010.
Am J
Epidemiol
2013;
177
(12): 1430–1442.
… continued from page 303
Although statins have clear benefits in appropriate
patients, scientists and clinicians should further explore the
impact of statins on human metabolism, in particular the
interaction between lipid and carbohydrate metabolism,
said co-author Steven Clinton, a professor of medicine and
member of Ohio State’s Comprehensive Cancer Centre.
‘In addition, researchers conducting large prospective
cohort studies should be considering how statins impact
on human health overall. They should consider both risks
and benefits, not just the disease that is being treated by the
specific drug,’ Clinton said.
The study was done retrospectively, meaning that the
researchers looked back at existing records from a group of
patients to determine if there were any possible connections
between statin prescriptions and diabetes. Previous research
has suggested a connection, but this study design allowed
for a glimpse at what is happening naturally in the clinical
setting, rather than what happens in a prospective trial that
randomly assigns some people to statins and some people to
placebo, said Zigmont, who is now an assistant professor at
Southern Connecticut State University.
The study was enriched by the availability of a variety
of details on the study population, including data from
biometric screenings and a health survey that asked about
education, health behaviours and ethnicity, Zigmont said.
She also had access to medical claims data and pharmacy
claims data.
Zigmont was careful to take a wide variety of confounding
factors into account in an effort to better determine if the
statins were likely to have caused the diabetes, she said.
Those included gender, age, ethnicity, educational level,
cholesterol and triglyceride readings, body mass index,
waist circumference and the number of visits to the doctor.
Programmes that help patients improve their fitness and
diets could be considered and discussed when doctors are
prescribing statins, so that patients can be proactive about
diabetes prevention, she said.
It would also be helpful for future research to better
determine which statins and which doses might lead to the
greatest risk, Zigmont said. Her study didn’t allow for an
analysis based on different types of statins.
Limitations of the research include the fact that the
majority of statin users were white, and that the research
team had no way of knowing how closely patients adhered
to their doctors’ prescriptions. There also was no way of
determining who was at elevated risk of diabetes at the
study’s onset, Zigmont says.
Source
: Medical Brief 2019