Established cardiovascular disease and CVD risk factors in a primary care population of middle-aged Irish men and women

Contemporary Irish data on the prevalence of major cardiovascular disease (CVD) risk factors are sparse. The primary aims of this study were (1) to estimate the prevalence of major cardiovascular disease risk factors, including Type 2 Diabetes Mellitus, in the general population of men and women between the ages of 50 and 69 years; and (2) to estimate the proportion of individuals in this age group at high absolute risk of cardiovascular disease events on the basis of pre-existing cardiovascular disease or as defined by the Framingham equation. Participants were drawn from the practice lists of 17 general practices in Cork and Kerry using stratified random sampling. A total of 1018 people attended for screening (490 men, 48%) from 1473 who were invited, a response rate of 69.1%. Cardiovascular disease risk factors and glucose intolerance are common in the population of men and women aged between 50 and 69 years. Almost half the participants were overweight and a further quarter met current international criteria for obesity, one of the highest recorded prevalence rates for obesity in a European population sample. Forty per cent of the population reported minimal levels of physical activity and 19% were current cigarette smokers. Approximately half the sample had blood pressure readings consistent with international criteria for the diagnosis of hypertension, but only 38% of these individuals were known to be hypertensive. Eighty per cent of the population sample had a cholesterol concentration in excess of 5 mmol/l. Almost 4% of the population had Type 2 Diabetes Mellitus, of whom 30% were previously undiagnosed. A total of 137 participants (13.5%) had a history or ECG findings consistent with established cardiovascular disease. Of the remaining 881 individuals in the primary prevention population, a total of 20 high-risk individuals (19 male) had a risk of a coronary heart disease event 30% over ten years according to the Framingham risk equation, giving an overall population prevalence of 2.0% (95% CI 1.3 - 3.0). At a risk level 20% over ten years, an additional 91 individuals (8.9%) were identified. Thus a total of 24.4% of the population were at risk either through pre-existing CVD (13.5%) or an estimated 10-year risk exceeding 20% according to the Framingham risk equation (10.9%). Thus a substantial proportion of middle-aged men are at high risk of CVD. The findings emphasise the scale of the CVD epidemic in Ireland and the need for ongoing monitoring of risk factors at the population level and the need to develop preventive strategies at both the clinical and societal level.

A philosophy of performance, politics and composition

This thesis discusses socio-political issues worldwide through philosophical approaches to performance, politics and composition. My research also discuss sound decisions which I regard to be simultaneously an outlet for personal expression, as well as a practical tool to inspire a socio-political change in society. Although the latter is paramount to the methodology of the project, the sound cannot be regarded in isolation as a “political composition”. It can only become truly functional in a political sense through interaction with other art forms, within the context of a specific place and time. My portfolio for this project is of two socio-political projects which are my chief concern. The first project concerns the Israeli-Palestinian conflict. I named this project PATH. PATH aims to foster and expand peaceful thought between Jewish and Palestinian civilians in Israel-Palestine. Through performance art, PATH spreads a message of acceptance, unity and brotherhood between our peoples. Above all, PATH demands and end to intolerance, hatred and violence among all the inhabitants of the State of Israel. The second project concerns women’s rights globally. I have realised that although we have come a long way in our struggle for rights for women, great challenges remain. There is a need to unite women and men against a form of oppression that discriminates against 50% of the world’s population. I called this project, For Utopia.