Essay on Comparison of Personality Traits, Mental Health, and Mindfulness in the Elderly With Cardiovascular Disease and Normal Elderly

Introduction

Cardiovascular disease has a higher mortality rate across the globe compare with other heart diseases. It’s a well-known disease that increases with age. Several research suggests that over 18 million people die yearly due to cardiovascular. The primary coronary disease stroke is accounted for 31% of all global death. Most heart diseases are associated with unhealthy diets, tobacco use, physical inactivity, and sectary behavior. With these habits and behaviors are common across the world, the rise of cardiovascular disease is reflected (Compare et.al, 2014). The prevalence of disease increases with age because most older people’s immune deteriorates. Cardiovascular is not the only disease common among the aged population, but it includes; mental health. Therefore, there is a need for WHO and other international organizations to create enormous support to an aging population and ensure the prevention of diseases such as cardiovascular and increased useful life.

Dramatic changes are expected across the globe with an increase in the aging population. It is estimated to increase approximately to be 10% of the world population. with the projected growth in world population, then, the number of older populations will grow to approximately 19 million by 2050 from 6 million in 2020, which means that cardiovascular will increase by 22% (Compare et al., 2014). The changes significantly affect the world distribution that translates into mortality, cost, and even morbidity-related cardiovascular disease. Therefore, there is a need for more research to be conducted to improve prevention strategies and even understanding the vulnerability of an elderly population to cardiovascular.

For the case of this study, it will provide an in-depth analysis of the comparison of personality traits, mental health, and mindfulness in the elderly with cardiovascular disease and normal elderly since age has a vital role in cardiovascular deterioration, which significantly affects mental functionality, personality traits, and even mindfulness. The prevalence of cardiovascular has resulted in the aged population acquiring some personality. For the last half-century, research has been conducted on the relationship between personality traits and cardiovascular. According to a study conducted by Compare et al. (2014), two types of personality traits are associated with cardiovascular disease; type A and B. The study found that the type A trait includes; hostility, excessive, and competitive drive overrepresented in cardiovascular patients. Further, the research expanded its evaluation to cardiovascular mortality rate with regards to age. The findings negative effects with anger and hostility that are associated with such personality traits. The below image provides statistical aspect on cardiovascular mortality rate based on age.

Figure 1

(Pedersen et al. 2017)

Also, several research illustrates how the cardiovascular influence mental health. The mind-body has been studied for centuries, and some have postulated towards cardiovascular relationships. In a study conducted by Pedersen et al. (2017), there are several overlap symptoms of CVD: shortness of breath, chest difficulties, and palpitations. The primary care cardiologist and physicians focus on addressing risk factors around mental illness associated with cardiovascular disease. In addition, the social stigma that has traditionally existed for centuries on mental illness, families, and patients have hesitated to discuss the state of mental health in their community. The purpose o this research will shed light on mental health and age factors associated with cardiovascular disease. The depression in CVD patients is high in the age population than in the general population. Thus, in other words, cardiovascular and mental health show a significant relationship. This research proposal will illustrate a better understanding of the relationship between cardiovascular and mental health and personality traits compared to normal elderly individuals. The research will illustrate the in-depth relationships and comparisons between the age population with cardiovascular disease through significant literature analysis.

Descriptions

Cardiovascular disease is the common term for heart disease and blood vessels. Cardiovascular disease affects more people in the Western world than any other disease. In the United States, more than half of all people over forty-five die of heart disease. The main cause of most heart disease and sudden death is arterial stenosis: accumulation of fat in the inner wall of the coronary arteries (Correll et al., 2017). This type of seizure prevents blood from reaching the heart muscle, resulting in a sudden heart attack and death. Specialists in holistic studies have examined the risk factors for heart disease. Including age, sex, the inheritance that individuals do not have and cannot be changed, but smoke consumption, high blood pressure, tension, obesity, and low mobility are not subject to individuals and are changeable. The more people at risk, the more likely they are to develop cardiovascular disease. According to the report provided by Correll et al., 2017, Family and Community Health and Health, the Ministry of Health has grown. The most important disease during health and the most important cause of bed bugs in heart disease is vascular disease. Today, many researchers believe that cognitive factors, including personality traits, can make a person more susceptible to mental illness.

Unique features are applied to the features that are almost always present in an individual and cause him to be distinguished from the siren. In this research, the purpose of personality traits is to have five major personality traits or five super attributes that describe the main dimensions of personality, such as; browning, acceptance, compatibility, and function (Compare et al., 2017)—the tendency of the individual to suffer. Considering the various research and theories in the field of personality traits, the question for us is what is the nature of personality traits, mental health, and awareness in healthy people and there is a difference between personality, mental health, and mental health in patients suffering from coronary heart disease and nutritional health.

Cardiovascular diseases are infectious and non-invasive; one of the most common causes is the accumulation of fat deposits called plaque in the walls of the heart’s arteries. These plaques cause hardening and hardening of the arterial wall hardening of the arteries or atherosclerosis (Correll et al., 2017). By forming these sediments in the coronary arteries, they narrow the arteries and prevent enough blood from reaching the heart muscle, in which case ischemic heart disease and infarction or heart attack occur. Cases of various heart and vascular diseases include coronary artery diseases, atherosclerosis, presidential engine, ischemic heart disease, and window diseases.

General Analysis

cardiovascular disease is one of the most common general health problems in most parts of the globe. From the fact that heart disease is the most common cause of death in the United States. More and more deaths worldwide have been dedicated to the need to investigate the cause of this disease, the process, and its treatment. Researchers also point out that the first and most common cause of death in Iran, as a developing country, is cardiovascular disease (Hardy, Hinks & Gray, 2013). The recent research in personality and its relation to health and cognitive impairments has attracted researchers’ great deal of attention. There is also ample empirical evidence that personality traits play a vital role in creating, developing, or eliminating psychological disorders.

It is part of special personality traits that lead individuals to identify themselves in different life situations, adaptive and balanced behaviors. Having the necessary awareness and knowledge about personality, preventive measures, or possible actions in personality disorders can help the individual. Therefore, it has been stated that the identification of effective factors is characteristic of personality and health. Although there is no denying the importance of the dirham, especially in the body and mind, this is still an issue. An examination of the psychological and emotional nature of the relationship between their health and the path of the disease is a secret that must be taken into account (Lewis et al., 2020). One of the characteristics that are central to this is the concept of awareness. The ongoing pain is equivalent to emotional stability and a wide spectrum of negative emotions, including anxiety, sadness, bad temper, agitation, and nervousness. Accepting experiences is a sign of the depth and complexity of the mind and the experiences of life. Bruning and adaptation attribute that is in-person; It signifies what people do together and for each other. In conclusion, disciplining the function of the task-orientation and goal-oriented social orbit requires uninterrupted oversight.

Furthermore, many emphasize the importance of awareness and memorization from philosophical, religious, and psychological perspectives. One of the specialties of awareness. There is a connection between it and much discussion about the concept of mindfulness. And one of the reasons for the increased cognitive and psychiatric research on mental health can define new dimensions of the relationship between mind and body (Hardy, Hinks & Gray, 2013). Considering the above and the relationship between the factors of personal and mental health and awareness in coronary heart disease and considering its prevalence in the country, it is necessary to do more studies in this field. And from there to the whole world. The expansion of economic, industrial, and communications has led to the mechanization of life and the development of vascular diseases due to changes in the way of life and the development of vascular heart disease (Hardy, Hinks & Gray, 2013). These changes include smoking, low mobility, and an unhealthy diet. Longevity is due to the decline in the number of diseases in the country. At the same time, the rate of expansion increases rapidly, and people are exposed to these factors for a longer period.

Current Information

Cardiovascular has been investigated in several health research. And among the various risk factors includes; personality traits and mental health. According to Leritz et al. (2011), the personality traits concerning cardiac illness are adversely related to cardiovascular incidences. Leritz mentioned that negative emotions, which include; anger, anxiety, and hostility, play a key role in the genesis of cardiovascular. However, the findings conflict with several studies discussing the role of personality in the causation of cardiovascular disease, particularly in the aged population. Personality is a unique and dynamic set of traits possessed by an individual that can typically influence their cognition or emotions, behaviors, and motivations in various circumstances.

Therefore, personalities are influenced by several factors that include; environment, situational, and heredity factors. Personality attributes are significant in humans and associated with psychological, happiness, and physical across the community, race, and religions. However, most findings are a multidimensional construct that has a wide consequential outcome. Personality traits shape the individual’s outlook in handling situations in different approaches to react with emotional or psychological distress (Jankovic et al., 2015). It has long-term effects on an individual’s behavior, hence, the role in developing disorders that behavioral patterns have a role. And because cardiovascular disease is related to certain bad behaviors, it look-like some intuitive personality traits are related to the prognosis and development of cardiovascular disease.

According to Jankovic et al. (2015), the study found that few personalities attribute such as openness, curiosity, optimism, and conscientiousness are related to a positive outcome in consideration with cardiovascular. Thus, these traits are referred to as cardioprotective personality attributes. Optimism is the ability of an individual to hope for a better future and experiences, which are found as protective agents against the risk of cardiovascular, especially in the elderly population. Scholars argued that positive traits help predict better life in elderly life because of better emotion and physical health.

Furthermore, conscientious personality traits encompass orderliness, self-efficacy, cautiousness, dutifulness, achievement striving, and self-discipline. A study conducted by Qin et al. (2014) found longevity of human life can be predicted based on personality traits. In research related to cardiovascular, lower conscientiousness has a high-risk factor that causes mortality due to malignancies, stroke, and cardiovascular, especially for the age between 3 to 17 years (Qin et al., 2014). The openness provides a gateway to experiences involving artistic sensitivity, active imaginations, intellectual curiosity, inner feelings, and attentiveness, which have been found to provide protective independence for the incidence of cardiovascular disease in the community or adjust to putative depression. In addition, curious personality is associated with the five factor-openness models related to longevity and independent medical risk actor and health behavior.

In the case of mental health, it is common among the elderly population. Mental and psychological distress describes the number of experiences and symptoms a particular individual’s inner life is frequently troubling, confusing, and out of the ordinary. As mentioned, cardiovascular symptoms overlap with mental illness. The most shared symptoms include; shortness of breath, chest tightness, and palpitations. Additionally, social stigma plays a role in families, mental illness, and patients may hesitate to discuss their mental illness. The objective of this proposal is to look into mental problems and their association with heart diseases.

According to a recent study conducted by Pedersen et al. (2017), depression is one mental illness with a significant role in heart disease such as cardiovascular. The most common reason for depression’s high risk is that it affects one’s lifestyle, which worsens cardiovascular. The dispersion has a high risk for unhealthy lifestyle; that includes; smoking saturates fat and diet higher. In addition, the associated psychological depression affects stress hormone cortisone. This hormone can lead to high weight gain, glucose and raise blood pressure. It cascades to affect other hormones such as adrenaline, rest in high heart bit rate, and in response patients’ exertion that may risk heart failure, infarction, and arrhythmias. Scholars agree that most inflammation from surgical procedures, poor dental hygiene, and pneumonia have a high risk of heart attack, especially among the aged population. Depression does increase inflammation that increases platelets activity which increases cardiovascular occlusion.

Furthermore, evidence shows that general anxiety weights increasing the risk of heart attack, especially the daily task anxiety. The psychological distress caused by anxiety is shown to precipitate and promote cardiovascular. In fact, according to xx, anxiety distress is progressive because it causes episodes of stress, anger, and hostility. Globally, statistics show that 20% of the elderly population has a mental illness. Mental illness and neurological disorders are among the elderly population account for 7% of total disability for this age group (Colpani et al., 2018). Thus, this study has been conducted at the right time when older adults are facing significant surges in mental illness due to pandemics and other factors. Additionally, most older adults are facing anxiety and other distress because their families have disserted them.

As mentioned, there will be significant rapid growth in the aging population between 2020 to 2050, which translates to older adults jump from 12% to 22% of the world population (Colpani et al., 2018). It is expected to increase to 2 billion from 900 million people over 60 years. Therefore, the older people will account for 17% lived with disabilities. And most older people are facing a neurological and mental diseases that are associated with depression and dementia. It affects 7% of the older population. The anxiety disease affects over 5 percent around the globe, and a high percentage comes from older people. Therefore, as mentioned before, the increase in anxiety, depression, and other mental diseases will significantly increase cardiovascular disease among the aged population. The following image show statistics on increase cases o mental health based on age.

Figure 2

(Colpani et al., 2018)

A few studies found that gravity was positively associated with emotional well-being, while ongoing rancor was negatively associated with emotional well-being. Researchers have concluded that individuals highly sensitive to low blood pressure and genetic predisposition are more likely to be emotionally drained. About 100 male and female students were found to be overweight.

Generally, the study will provide an in-depth comparison between normal and cardiovascular elderly patients. With significant existing literature in personality traits and mental illness linking its relationship with high risk with cardiovascular. One of the variables that most recent thinkers have examined is mindfulness. Research has shown that mindfulness is one of the most important elements in mental health. Mindfulness involves a conscious awareness and a lack of judgment of what is yet to happen. Aware people perceive internal and external realities freely and without distortion. They have a great deal of ability to deal with thoughts, emotions, and experiences that they enjoy and dislike. Factors of mind Awareness include observation, description, action, awareness, judgment, and non-response to internal experiences.

Pedersen et al. (2017) is a word used to describe mindfulness scientifically. In Pedersen’s view, mindfulness is a creative process, and when an individual uses three keywords becomes clear. An examination of the psychological and emotional nature of the relationship between their health and the path of the disease is a secret that must be taken into account. One of the characteristics that are central to this is the concept of awareness. Many emphasize the importance of awareness and memorization from philosophical, religious, and psychological perspectives. One of the specialties of awareness There is a connection between it and the productive discussion about the concept of mindfulness. And one of the reasons for the increased cognitive and psychiatric research in mental health can define new dimensions of the relationship between mind and body. The following will be the study objectives:

• To determine the relationship between personality traits and cardiovascular among the aged population.
• To determine the relationship between mental health and cardiovascular among the aged population.
• Compare personality traits and mental illness between normal cardiovascular elderly patients.

Methodology

The research design is important and intended to provide the necessary framework throughout the study. The research design is a framework that usually involves techniques chosen by the researchers. It allows the researchers to hone in on the research approaches favorable for the research suitable for the subject matters and up the studies to achieve its research question. The research design helps to explain the research and also its subtypes, the research problem. In addition, the methods selected by researchers aim to create a minimum bias in data and increase trust inaccuracy of the collected data to the desired outcome.

Traditionally, researchers have for a long time considered quantitative as the best approach to visual results, particularly in social sciences. However, in the late 20^th century, there has been an upsurge of interest in qualitative approaches, especially in religious and historical studies. The qualitative creates more images of reality. Today, quantitative and qualitative are the most common complementary methods in research as their presence is more or less similar to data but in different displays. The quantitative approach presents the collected data in numerical data that can produce identity and statistics patterns. While qualitative research methods present data in the form of opinions, attitudes, motivations, commonly answering questions that cannot be quantified.

Quantitative approaches focus on mathematical, statistics, and numeral analysis of data projection through surveys, questionnaires, or pols while manipulating the existing data using computational techniques. This technique is considered important in scientific research because it offers more of the needed measurable statistics that quantify the attitudes and opinions of the research participants. Typically, quantitative research presents data in the form of charts, tables, and graphs for the analysis and concussion direction from the researcher. And for this study, a qualitative approach will be used to collect the needed data.

Systematic literature Review

Like any other research, knowledge is built on prior work. It is fundamental for this research to advance the existing knowledge, and there is a need for systematic review. To push the knowledge, there must be a frontier. Thus, a systematic review of literature helps understand the depth and breadth of the current work and identify the point of contention to advance the knowledge. However, it is important to note that for this method to be effective, there is a need to select and evaluate literature that correlates directly with the topic.

Additionally, it is important to examine the quality and validity of the current work. Thus, a systematic literature review provided a better framework for selecting and synthesizing those grouped existing and related literature. As scientific inquiries, literature reviews should be valid, reliable, and repeatable.

Therefore, assigning their reliability scores is important to determine the consistency among the researchers. Checking the consistency of the results across the different researchers and observers is part of the test itself for this research. Thus, it brought the necessity of correct results and objective results. On the other hand, validity is a measure of the accuracy of reliable data. However, it is difficult to quantify the collected data for theology research, but objective questioning of the information played a significant role in providing more objective discourse to the problem. The interview question would be more objective questions designed to validate the available sources and the interviewee’s knowledge on the subject. By checking results through correspondence, theology and other measures of the same concept will be conducted throughout the text. A valid measurement is generally reliable: if a test produces accurate results, it should be reproducible.

Several steps have been developed to achieve effectiveness and determine the literature review’s reliability, readability, availability, and accuracy. The following steps are utilized throughout the study in collecting the needed and related literature:

Step one: Inclusion

Over the centuries, several journals, books, and articles have been written in different languages and with different purposes to explain cardiovascular health in the aged population. However, the research utilized only the English written or translated version of those sources. The literature review will be specific on the topic and include studies that are interrelated to the study. This is important to avoid misinterpretation or misunderstanding of the literature.

Step two: literature identification

This step is important in identifying the possible journals, books, and articles to be used in the paper. The scientific databases such as google scholar, EBSCOhost, wen science, and university library were used as main sources of the secondary sources. These databases have a significant number and reliable peer-review books and journals. Additionally, most of them do not need any payment; they are open source. For each manuscript identified, relevance was determined based on the question of when, who wrote, and what is the main idea of the manuscript. With the advancement of technology, identifying the necessary journals and books was easy because the keywords were quoted, and the databases provided all the available. Additionally, most of the database provides customization of searches which is made easier when limiting period publication. Through the databases, five sources were identified and added to references.

Step three: Screening for inclusion

Like any scientific, abstract provides important aspects of the manuscript. The researcher reads through the abstract to identify the general concepts and ideas of the manuscript. To ensure the identified sources were reliable and accurate, the printing companies were considered important. The two discrepancies were harmonized by assessing the manuscripts to determine the quality of the article, book, or journals.

Step four: Eligibility and quality assessment

Quality and eligibility of the source are important so that the paper will build on this prior work. The selected papers will be skimmed through it to further certain the quality and eligibility of the study. Because several sources were selected before picking the five sources thus, to minimize the skimming time, all articles, journals, and books published by reliable publishers were deemed as high-quality research and, therefore, including the review. Most selected articles, journals, and books had online presentations and summaries, which were easy to understand the main idea. After careful review, the five sources were selected as best because of their publishers and finding, which concepts well with the messianic question. While conducting the quality check, it is important to note that some sources were found to have the same ideas but different findings or perspectives about the messianic question.

Step five: Iterations

It was the final and important step. The needed data were extracted for the analysis by conducting several skimming and searching for keywords forward and back to identify the connection and idea of the research. First, article methodology was reviewed to find the importance of the approach and how the author linked it to its finding. And finally, the important information or arguments were extracted and were used to back up the ideas and data collected from the email interview. The best methods used to extract the data were descriptive approaches. The descriptive review was considered significant because the paper is qualitative research. Additionally, it is easier to extract, analyze and synthesize data. Descriptive reviews do not aim to expand upon the literature but rather provide an account of the state of the literature at the time of the review.

Discussion

As mentioned, personality has significant influences on cardiovascular. The model below provides a better understanding of the relationships between personality traits and cardiovascular, especially to the elderly population. The high risk is manifested in individual lifestyle, which is responsible for stressors. Such appraisal demanding situations that threaten more individual others and have more intense physiological responses. The dangerous personality affects health indirectly through health-degrading behaviors and promoting unhealthy behaviors. Therefore, the elderly population with weaker immunity is vulnerable to unhealthy behavior such as hostility and anger. Hardy, Hinks & Gray (2013) found that it is common among the elderly population. Mental and psychological distress in terms describes the range of symptoms and experiences a particular person’s inner life is commonly held to be confusing, troubling, and out of the ordinary.

The cardiovascular symptoms overlap with mental illness. The most shared symptoms include; shortness of breath, chest tightness, and palpitations. Additionally, the social stigma plays a role in families, mental illness, and patients may hesitate to discuss their mental health. The study will provide an in-depth analysis comparison between the cardiovascular and normal elderly population by utilizing the model. In addition, the associated psychological depression affects stress hormone cortisone. This hormone can lead to high weight gain, glucose and raise blood pressure. It cascades to affect other hormones such as adrenaline, rest in high heart bit rate, and in response patients’ exertion that may risk heart failure, infarction, and arrhythmias. Scholars agree that most inflammation from surgical procedures, poor dental hygiene, and pneumonia have a high risk of heart attack, especially among the aged.

Generally, to provide a properly researched paper, a qualitative approach will create more images of reality. Today, qualitative is the most common complementary method in research. The qualitative research method will help present data in the form of opinions, attitudes, motivations, commonly answering questions, which will be easier to develop themes. The themes will provide a better comparison between cardiovascular and normal elderly patients. The bellow model will help develop a better ground for discussing the influence of personality and mental health—the severity o cardiovascular disease.

Figure 3

(Hardy, Hinks & Gray 2013)

Conclusion

Cardiovascular disease is one of the leading causes of death across the globe. It’s a well-known disease that increases with age. Several research suggests that over 18 million people die yearly due to cardiovascular. The primary coronary disease stroke is accounted for 31% of all global death. Most heart diseases are associated with unhealthy diets, tobacco use, physical inactivity, and sectary behavior. According to a study conducted by Hardy, Hinks & Gray (2013), two types of personality traits are associated with cardiovascular disease; type A and B. The study found that the type A trait includes; hostility, excessive, and competitive drive overrepresented in cardiovascular patients.

Further, the research expanded its evaluation to cardiovascular mortality rate with regards to age. The use of a qualitative approach will create more images of reality. Today, qualitative is the most common complementary method in research. The qualitative research method will help present data in the form of opinions, attitudes, motivations, commonly answering questions, which will be easier to develop themes. These will help to navigate in-depth associate between personality, mental health, and mindlessness with cardiovascular.

The findings negative effects with anger and hostility that are associated with such personality traits. Also, several research illustrates how the cardiovascular influence mental health. The mind-body has been studied for centuries, and some have postulated towards cardiovascular relationships. In a study conducted by Hardy, Hinks & Gray (2013), there are several overlap cardiovascular symptoms such as shortness of breath, chest tightness, and palpitations. The primary care cardiologist and physicians focus on addressing risk factors around mental illness associated with cardiovascular disease.

Cardiovascular diseases are infectious and non-invasive; one of the most common causes is the accumulation of fat deposits called plaque in the walls of the heart’s arteries. These plaques cause hardening and hardening of the arterial wall hardening of the arteries or atherosclerosis. By forming these sediments in the coronary arteries, they narrow the arteries and prevent enough blood from reaching the heart muscle, in which case ischemic heart disease and infarction or heart attack occur. In addition, the associated psychological depression affects stress hormone cortisone. This hormone can lead to high weight gain, glucose and raise blood pressure. It cascades to affect other hormones such as adrenaline, rest in high heart bit rate, and in response patients’ exertion that may risk heart failure, infarction, and arrhythmias. Scholars agree that most inflammation from surgical procedures, poor dental hygiene, and pneumonia have a high risk of heart attack, especially among the aged.

References

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Pedersen, S. S., Von Känel, R., Tully, P. J., & Denollet, J. (2017). Psychosocial perspectives in cardiovascular disease. European Journal of Preventive Cardiology, 24(3_suppl), 108-115.

Correll, C. U., Solmi, M., Veronese, N., Bortolato, B., Rosson, S., Santonastaso, P., … & Stubbs, B. (2017). Prevalence, incidence and mortality from cardiovascular disease in patients with pooled and specific severe mental illness: a large‐scale meta‐analysis of 3,211,768 patients and 113,383,368 controls. World Psychiatry, 16(2), 163-180.

Lewis, M., Chondros, P., Mihalopoulos, C., Lee, Y. Y., Gunn, J. M., Harvey, C., … & Palmer, V. J. (2020). The assertive cardiac care trial: A randomized controlled trial of a coproduced assertive cardiac care intervention to reduce absolute cardiovascular disease risk in people with severe mental illness in the primary care setting: contemporary clinical trials, 97, 106143.

Hardy, S., Hinks, P., & Gray, R. (2013). Screening for cardiovascular risk in patients with severe mental illness in primary care compared to patients with diabetes. Journal of Mental Health, 22(1), 42-50.

Leritz, E. C., McGlinchey, R. E., Kellison, I., Rudolph, J. L., & Milberg, W. P. (2011). Cardiovascular disease risk factors and cognition in the elderly. Current cardiovascular risk reports, 5(5), 407.

Jankovic, N., Geelen, A., Streppel, M. T., De Groot, L. C., Kiefte-de Jong, J. C., Orfanos, P., … & Feskens, E. J. (2015). WHO guidelines for a healthy diet and mortality from cardiovascular disease in European and American elderly: the CHANCES project. The American journal of clinical nutrition, 102(4), 745-756.

Qin, L., Yang, Z., Gu, H., Lu, S., Shi, Q., Xing, Y., … & Su, Q. (2014). Association between serum uric acid levels and cardiovascular disease in middle-aged and elderly Chinese individuals. BMC cardiovascular disorders, 14(1), 1-8.

Colpani, V., Baena, C. P., Jaspers, L., Van Dijk, G. M., Farajzadegan, Z., Dhana, K., … & Franco, O. H. (2018). Lifestyle factors, cardiovascular disease and all-cause mortality in middle-aged and older adults: a systematic review and meta-analysis. European journal of epidemiology, 33(9), 831-845.