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Childhood adversity increases risk of cardiovascular disease

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Childhood adversity increases risk of cardiovascular disease (CVD), according to a recent study.

CVD is currently the main cause of death worldwide, with rates of CVD in young adults rising over time. Genetic factors have been associated with CVD, but investigators hypothesized that environmental and behavioral factors also impact CVD risk.

Adversity has been linked to CVD in middle-aged and older individuals, but little data has been gathered on the effects of childhood adversity on CVD in young adults. Multiple internal systems develop throughout childhood, including physiological stress response. The development of this system could be affected by frequent exposure to adversity.

Overeating, excessive alcohol consumption, and smoking are all behaviors associated with CVD, and childhood adversity has been linked with higher risk of these behaviors. However, the effects of childhood adversity on congenital aetiology are still unclear.

To examine the impact of childhood adversity on CVD in individuals aged 16 to 38 years with a focus on ischaemic heart disease (IHD) and cerebrovascular disease (CD), investigators conducted a population-based cohort study. Data was gathered from the DANish LIFE coursecohort, containing information from multiple registers nationwide.

Information on childhood adversities, morbidity, and mortality of children born from January 1, 1980, to December 31, 2001, was taken for the study. Participants were alive and residing in Denmark until their 16th birthday without a CVD or congenital heart disease diagnosis. The final study population included 1,263,013 individuals.

Cadversities were divided into 3 categories: loss or threat of loss in the family, family dynamics, and material deprivation. Family poverty and parental long-term unemployment were cases of material deprivation, while parent and sibling somatic illness and death was loss or threat of loss in the family.

Family dynamics included: parental alcohol and drug abuse, foster care placements, parental and sibling psychiatric illness, and maternal separation.

CVD as cases of IHD or CD was the primary outcome. Covariates included year of birth, paternal age at birth, parental country of origin, and parental cardiometabolic illness. Adjustments were made for the effects of being small for gestational age at birth and parental education at time of birth.

The mean follow-up period for participants was 10.8 years after their 16th birthday. During this follow-up period, 4118 participants developed CVD, 966 of which developed IHD and 3152 CD. There were 5178 deaths from a cause other than CVD, and 96,812 emigrations from the study prior to the follow-up.

Participants were more likely to face adversity if they were born to teenage mothers, with persistent deprivation risk high among this group. Material deprivation was also common in children born to parents of a non-Western origin.

Parental cardiometabolic illness in was seen in 24% of participants with material deprivation, 36% with loss or threat of loss, 39% with high adversity, and 21% with low adversity. Low parental education was seen in 8% of participants in the low adversity group and 54% of the high adversity group, and small for gestational age was seen in 11% of the low adversity group and 22% of the high adversity group.

Individuals with high adversity had an increased risk of developing CVD, with 10 to 18 extra cases per 100,000 people. Men and women in the loss or threat of loss group had 15.6 and 9.7 more CVD cases per 100,000 people respectively. Individuals early in life or having experienced material deprivation were also more likely to develop CVD, but the risk was only modestly higher than average.

As high childhood adversity led to the greatest risk of CVD, investigators recommended that efforts toward providing affected families with support could reduce the rate of long-term cardio-protective effects.

Reference

Bengtsson J, Elsenburg LK, Stig Andersen G, Lytken Larsen M, Rieckmann A, Hulvej Rod N, Childhood adversity and cardiovascular disease in early adulthood: a Danish cohort study. European Heart Journal. 2022. doi:10.1093/eurheartj/ehac607

 

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Tips for shopping for Medicare Advantage plans

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Shopping season for Medicare coverage is about to begin. With it comes the annual onslaught of TV ads and choices to consider.

People eligible for the federal government’s Medicare program will have from Oct. 15 to Dec. 7 to sign up for 2025 Medicare Advantage plans, which are privately run versions of the program. They also can add a prescription drug plan to traditional Medicare coverage.

Many people on Medicare Advantage plans will probably have to find new coverage as major insurers cut costs and pull back from markets. Industry experts also predict some price increases for Medicare prescription drug plans.

Shoppers often have dozens of options during this sign-up period. Here are some things to consider.

Don’t put off shopping for Medicare coverage

Start thinking about next year’s coverage before the annual enrollment window begins. Insurers will usually preview their offerings or let customers know about any big changes. That makes anything arriving in the mail from your insurer important to read.

Insurance agents say many people wait until after Thanksgiving to decide coverage plans for the new year. That could be a mistake this year: The holiday falls on Nov. 28, leaving slightly more than a week to decide before the enrollment window closes.

Look beyond the premium

Many Medicare Advantage plans promote a $0 premium. That may sound attractive, but price is only one variable to consider.

Shoppers should look at whether their doctors are in the plan’s coverage network and how prescriptions would be covered. They also should know the maximum amount under the plan that they’d have to pay if a serious health issue emerges.

Plans offer many supplemental benefits, including help paying food or utility bills. Don’t let those distract from understanding the core coverage, said Danielle Roberts, co-founder of the Fort Worth, Texas, insurance agency Boomer Benefits.

“Remember that we buy health insurance for the big things, not the frills,” she said.

How to get help shopping for plans

The federal government operates a plan finder that lets people compare options. The State Health Insurance Assistance Program can be another resource. Insurance brokers or agents also guide customers through searches.

Sometimes a plan’s coverage doesn’t work as expected. If that happens, there’s another enrollment window in the first three-months of each year where some shoppers may be able to make a change.

___

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.

The Canadian Press. All rights reserved.

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The US is mailing Americans COVID tests again. Here’s how to get them

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WASHINGTON (AP) — Americans can once again order COVID-19 tests, without being charged, sent straight to their homes.

The U.S. government reopened the program on Thursday, allowing any household to order up to four at-home COVID nasal swab kits through the website, covidtests.gov. The tests will begin shipping, via the United States Postal Service, as soon as next week.

The website has been reopened on the heels of a summer COVID-19 virus wave and heading into the fall and winter respiratory virus season, with health officials urging Americans to get an updated COVID-19 booster and their yearly flu shot.

“Before you visit with your family and friends this holiday season, take a quick test and help keep them safe from COVID-19,” U.S. Health and Human Services Assistant Secretary for Preparedness and Response Dawn O’Connell said in a statement.

U.S. regulators approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, they hope, forthcoming winter ones, too. Vaccine uptake is waning, however. Most Americans have some immunity from prior infections or vaccinations, but under a quarter of U.S. adults took last fall’s COVID-19 shot.

Using the swab, people can detect current virus strains ahead of the fall and winter respiratory virus season and the holidays. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year. Insurers are no longer required to cover the cost of the tests.

Before using any existing at-home COVID-19 tests, you should check the expiration date. Many of the tests have been given an extended expiration from the date listed on the box. You can check on the Food and Drug Administration’s website to see if that’s the case for any of your remaining tests at home.

Since COVID-19 first began its spread in 2020, U.S. taxpayers have poured billions of dollars into developing and purchasing COVID-19 tests as well as vaccines. The Biden administration has given out 1.8 billion COVID-19 tests, including half distributed to households by mail. It’s unclear how many tests the government still has on hand.

The Canadian Press. All rights reserved.

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Free COVID tests are back. Here’s how to order a test to your home

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WASHINGTON (AP) — Americans can once again order free COVID-19 tests sent straight to their homes.

The U.S. government reopened the program on Thursday, allowing any household to order up to four at-home COVID nasal swab kits through the website, covidtests.gov. The tests will begin shipping, via the United States Postal Service, as soon as next week.

The website has been reopened on the heels of a summer COVID-19 virus wave and heading into the fall and winter respiratory virus season, with health officials urging Americans to get an updated COVID-19 booster and their yearly flu shot.

U.S. regulators approved an updated COVID-19 vaccine that is designed to combat the recent virus strains and, they hope, forthcoming winter ones, too. Vaccine uptake is waning, however. Most Americans have some immunity from prior infections or vaccinations, but under a quarter of U.S. adults took last fall’s COVID-19 shot.

Using the swab, people can detect current virus strains ahead of the fall and winter respiratory virus season and the holidays. Over-the-counter COVID-19 at-home tests typically cost around $11, as of last year. Insurers are no longer required to cover the cost of the tests.

Since COVID-19 first began its spread in 2020, U.S. taxpayers have poured billions of dollars into developing and purchasing COVID-19 tests as well as vaccines. The Biden administration has given out 1.8 billion COVID-19 tests, including half distributed to households by mail. It’s unclear how many tests the government still has on hand.

The Canadian Press. All rights reserved.

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