Jean Jacques Noubiap

Metabolic syndrome (MetS), a cluster of conditions including abdominal obesity, high blood pressure, and abnormal blood sugar and lipid levels, is a growing global health concern, yet its global burden remains poorly characterized. Here we show trends in MetS prevalence from 2000 to 2023, based on a systematic review and Bayesian modelling of 3236 data points with 45,549,151 adults. Between 2000 and 2023, prevalence rose from 14.7% (13.1–16.7) to 31.0% (28.5-33.9) among women, and from 9.0% (6.9–12.1) to 25.7% (21.5–31.1) among men. In 2023, an estimated 1.54 billion adults (1.35–1.76) had MetS globally: 846 million (776–924) women and 692 million (579–837) men. Prevalence increased with age, urbanicity, and income level, ranging from 7.5% to 45.0% among women and 6.5% to 59.6% among men across regions. Among both women and men, prevalence increased in 196 countries and territories. These findings call for targeted interventions to address the rising global burden.

Background and Aims: Ventricular tachycardia and ventricular fibrillation underlie many sudden cardiac deaths, but common lifestyle factors that predict their occurrence are poorly understood. This study aimed to assess the association between methamphetamine and cocaine, the most used illicit stimulants, and ventricular arrhythmias (VA) and mortality. Methods: Healthcare databases were used to identify adults aged ≥ 18 years receiving hospital-based care in California in 2005–2019. ICD codes were used to identify diagnoses and illicit stimulant use. Cox proportional hazard models adjusting for demographics and time-updated cardiovascular risk factors were employed. The outcomes were VA combining ventricular tachycardia, ventricular fibrillation, and cardiac arrest and all-cause mortality. Results: Among 29 593 819 individuals (53.8% female, mean age 44.9 years), 690 737 (2.3%) used methamphetamine, and 290 652 (1.0%) used cocaine at some point. After adjustment for age, sex, race and ethnicity, cannabis and opioid use, and other cardiovascular risk factors, methamphetamine use and cocaine use were each associated with increased risk of incident VA [hazard ratio (HR) 1.90, 95% confidence interval (CI) 1.85–1.95, and HR 1.15, 95% CI 1.10–1.19, respectively], and mortality (HR 1.51, 95% CI 1.47–1.54 and HR 1.68, 95% CI 1.64–1.72, respectively). The risk of VA was higher in younger individuals (<65 years) and females for both methamphetamine and cocaine, whereas it was higher in Blacks and lower in Whites and Hispanics for cocaine use, and higher in Asians and lower in Blacks for methamphetamine use (P for interaction < .05 in all). Conclusions: Methamphetamine use and cocaine use were each associated with increased risk of incident VA and mortality, with differential relationships by demographic groups. Avoiding these substances may reduce risk of VA and death.

Background: Recommendations on atrial fibrillation (AF) screening by various scientific societies are inconsistent due to uncertainty about its benefit. This study aimed to summarize data from randomized controlled trials (RCTs) on the impact of AF screening on thromboembolism, major bleeding, and mortality. Methods and results: We searched PubMed/MEDLINE and Embase to identify studies providing relevant data through 5 September 2024. Risk ratios (RRs) for each reported outcome of interest were pooled through a meta-analysis with random effects models. We included six RCTs reporting data from 74 145 individuals. AF screening was associated with higher AF detection compared with no intervention [RR 2.54, 95% confidence interval (CI): 1.57–4.11, P < 0.001], and more common initiation of oral anticoagulation (RR 2.19, 1.51–3.18, P < 0.001). Incident ischaemic stroke (RR 0.93, 0.87–1.00, P = 0.048) and thromboembolism including ischaemic stroke, transient ischaemic attack, or systemic embolism (0.93, 95% CI: 0.87–0.99, P = 0.026) were less frequent in individuals who underwent AF screening vs. controls. There was no difference for major bleeding, (RR 0.99, 95% CI: 0.93–1.06, P = 0.830), haemorrhagic stroke (RR 0.94, 95% CI: 0.80–1.11, P = 0.497) and all-cause mortality (RR 0.99, 95% CI: 0.95–1.02, P = 0.411). Conclusion: AF screening might be beneficial, especially in reducing thromboembolic events.